Bon Secours - Maryview Nursing Care Center: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
Bon Secours - Maryview Nursing Care Center (EIN 52-1578169)
Tax period
2010-09-01 to 2011-08-31
Filed
2012-07-20
IRS object ID
201222029349300102
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)
Timestamp2012-07-20T08:36:09-05:00Timestamp
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)
EIN521578169EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Bon Secours - Maryview Nursing Care CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBONSNameControl
Phone7578895000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line17007 Harbour View Blvd No 108AddressLine1
CitySuffolkCity
StateVAState
ZIP Code23435ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMichael K KernerName
TitleCEO - BSHRTitle
Phone7576865000Phone
Date Signed2012-07-20DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLaura L CatlettName
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 PersonMichael K KernerNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line17007 Harbour View Blvd No 108AddressLine1
CitySuffolkCity
StateVAState
ZIP Code23435ZIPCode
FieldValueIRS element (for citing)
Gross Receipts9972629GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.bonsecourshamptonroads.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1988YearFormation
State Legal DomicileVAStateLegalDomicile
Activity Or Mission DescriptionSkilled Nursing CenterActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees163TotalNbrEmployees
Total Nbr Volunteers39TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year9796655ProgramServiceRevenuePriorYear
Program Service Revenue CY9919187ProgramServiceRevenueCY
Investment Income Prior Year33219InvestmentIncomePriorYear
Investment Income Current Year23132InvestmentIncomeCurrentYear
Other Revenue Prior Year37589OtherRevenuePriorYear
Other Revenue Current Year30310OtherRevenueCurrentYear
Total Revenue Prior Year9867463TotalRevenuePriorYear
Total Revenue Current Year9972629TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4797427SalariesEtcPriorYear
Salaries Etc Current Year5005918SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3586551OtherExpensePriorYear
Other Expenses Current Year3724988OtherExpensesCurrentYear
Total Expenses Prior Year8383978TotalExpensesPriorYear
Total Expenses Current Year8730906TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1483485RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1241723RevenuesLessExpensesCY
Total Assets BOY16416661TotalAssetsBOY
Total Assets EOY17646817TotalAssetsEOY
Total Liabilities BOY5218553TotalLiabilitiesBOY
Total Liabilities EOY5206986TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY11198108NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY12439831NetAssetsOrFundBalancesEOY
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
Expense6541107Expense
Revenue7374869Revenue
DescriptionSkilled Nursing Care provided to patients to include assessment of cognitive and physical status, personal hygiene care, nutrition and maintenance of a clean and comfortable environment.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense367370Expense
Revenue671457Revenue
DescriptionMedication & Diagnostic Treatments to include the administration of medication, ongoing assessment of potential interactions and negative side effects, wound care and facilitation of diagnostic testing as needed.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense992022Expense
Revenue1872861Revenue
DescriptionRehabilitation Therapies to include physical therapy, respiratory therapy and occupational therapy so as to maintain each patient's optimal quality of life.Description
FieldValueIRS element (for citing)
Total Program Service Expense7900499TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
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
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109619NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees163NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1James PirtleBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7572152709TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17007 Harbour View Blvd Suite 108AddressLine1
CitySuffolkCity
StateVAState
ZIP Code23435ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeFormerFormer
Michael D Blount
Board Member4.00X000
J Robert Bray
Board Member4.00X000
Bruce Britton MD
Board Member (Jan-Aug)4.00X000
Arthur L Collins
Board Member4.00X000
William H Kline
Board Member4.00X000
Michael S LaRock
Board Member4.00X000
Margaret U Moser
Board Member (Sept-Dec)4.00X000
Mary Jane Nero
Board Member4.00X000
Carol Ormond
Board Member4.00X000
P Ward Robinett Jr
Board Member (Jan-Aug)4.00X000
R B Seal MD
Board Member4.00X000
Robert Squatrito MD
Board Member (Jan-Aug)4.00X013200
Deborah K Stearns
Board Member4.00X000
Sr Rita Thomas
Board Member4.00X000
Sr Elaine Davia
Board Member4.00X000
Timothy J Davis
Board Member50.00X0743518132790
Linwood E Howard
Chairman6.00X000X
Sr Patricia Heath
President50.00X000X
Michael K Kerner
Sec/Treas (CEO-BSHR)50.00X0606241145769X
Gregory Simia
CFO BSHR (Sept-May)50.00043857355734X
Ernie Padden
Int. CFO BSHR (June-Aug)50.00000X
Patricia Robertson
CEO-MIH & Extended Care50.00037682428833X
Diana L Jarrett
Exec Dir, Extended Care50.00016255313852X
Richard Hanson
Former CEO BSHR0.0001000228651X
Joseph Buchheit
Former CFO BSHR50.00029288441939X
Eileen Malo
Former EVP Cont. Care50.0002223417777X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2944276TotalReportableCompFrmRltdOrgs
Total Other Compensation435345TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Rehabcare Group Inc
PO Box 502096St LouisMO631502096Rehabilitation Services973171
ShiftWise Corporate
1800 SW 1st AvenuePortlandOR97201Contract Nursing Services114976
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient Service Rev.Description
Business Code621110BusinessCode
Total Revenue Column9919187TotalRevenueColumn
Related Or Exempt Function Income9919187RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue9919187TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column21630TotalRevenueColumn
Exclusion$21,630ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column1502TotalRevenueColumn
Exclusion$1,502ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
Resident Laundry Ser.81230012233$12,233
Beauty & Barber Shop81290011165$11,165
Cafe and Vending7223206709$6,709

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column203TotalRevenueColumn
Exclusion$203ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue30310TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column9972629TotalRevenueColumn
Related Or Exempt Function Income9919187RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$53,442ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3851984Total
Program Services3466786ProgramServices
Management And General385198ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total82778Total
Program Services74500ProgramServices
Management And General8278ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total794138Total
Program Services714724ProgramServices
Management And General79414ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total277018Total
Program Services249316ProgramServices
Management And General27702ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2188Total
Program Services1969ProgramServices
Management And General219ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total821Total
Program Services739ProgramServices
Management And General82ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1266868Total
Program Services1140181ProgramServices
Management And General126687ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total292Total
Program Services263ProgramServices
Management And General29ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total57211Total
Program Services51490ProgramServices
Management And General5721ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total9677Total
Program Services8709ProgramServices
Management And General968ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total229272Total
Program Services206345ProgramServices
Management And General22927ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total10659Total
Program Services9593ProgramServices
Management And General1066ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total227212Total
Program Services227212ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total232281Total
Program Services209053ProgramServices
Management And General23228ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total44081Total
Program Services39673ProgramServices
Management And General4408ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Expenses98000888200798001
Bad Debt199629199629
Purchased Services18275016447518275
Repairs & Equip Rental12051710846512052
BSHSI allocation75220676987522

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total86302Total
Program Services77672ProgramServices
Management And General8630ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total8730906Total
Program Services7900499ProgramServices
Management And General830407ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY12989095BOY
EOY78277EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY14889529EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY933878BOY
EOY847470EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY5434BOY
EOY65281EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis7369817LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5726413LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1877293BOY
EOY1643404EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY31778BOY
EOY11632EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY488179BOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY91004BOY
EOY111224EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY16416661BOY
EOY17646817EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY708320BOY
EOY1298581EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY3900000BOY
EOY3900000EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
EOY5700EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY610233BOY
EOY2705EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5218553BOY
EOY5206986EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY11198108BOY
EOY12439831EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY11198108BOY
EOY12439831EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16416661BOY
EOY17646817EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses1241723ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
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

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7671247CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8298190CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10032865CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9796655CurrentTaxYearMinus1Year
Current Tax Year9919187CurrentTaxYear
Total45718144Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7671247CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8298190CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10032865CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9796655CurrentTaxYearMinus1Year
Current Tax Year9919187CurrentTaxYear
Total45718144Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50945718144PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years508222CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years298047CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years212923CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year33219CurrentTaxYearMinus1Year
Current Tax Year23132CurrentTaxYear
Total1075543Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years508222CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years298047CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years212923CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year33219CurrentTaxYearMinus1Year
Current Tax Year23132CurrentTaxYear
Total1075543Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year30310CurrentTaxYear
Total30310Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8179469CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8596237CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10245788CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9829874CurrentTaxYearMinus1Year
Current Tax Year9972629CurrentTaxYear
Total46823997Total
FieldValueIRS element (for citing)
Public Support Percentage5090.97640PublicSupportPercentage509
Prior Year Support Percentage0.96840PriorYearSupportPercentage
Investment Income Percentage0.02300InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.03160PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

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$821OtherActivitiesAmount
Total Lobbying Expenditures IIB821TotalLobbyingExpendituresIIB
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
ExplanationMaryview Nursing Care Center paid dues to the Virginia Health Care Association, a portion of which is used for lobbying activities. The portion of the dues allocated to lobbying activities is $821 or 11.71%.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2087243OtherCostOrOtherBasis
Depreciation1033692Depreciation
Book Value1053551BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4418769OtherCostOrOtherBasis
Depreciation3810294Depreciation
Book Value608475BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis863805OtherCostOrOtherBasis
Depreciation882427Depreciation
Book Value-18622BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1643404TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Bond Fund 1992 - Debt Service$460
ST Payable - Maryview$2,194
ST Payable - MRMC$51
FieldValueIRS element (for citing)
Total Of Amounts2705TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part IV, Line 2b:The filing organization holds, safeguards, manages and accounts for the personal funds of residents who have authorized the facility in writing to manage any personal funds. Any resident may deposit money into a personal Resident Fund Account. Deposits may not exceed $2,000 for residents receiving Medicaid. Withdrawal requests greater than $50 must be made prior to 4PM to allow time to obtain funds from the banking institution if necessary. 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 J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
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 (8 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
Timothy J Davis
05681010168422069950111800020990087630800
Michael K Kerner
04634670138768040060116245029524075201000
Gregory Simia
0303064069986065523025631030103049430700
Patricia Robertson
0282666067407026751017150011683040565700
Diana L Jarrett
013736502493202560136380214017640500
Richard Hanson
09158006800776206444022070108673069611
Joseph Buchheit
0229525041221022138019617022322033482300
Eileen Malo
04676903941401361580384203935023011800

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Lines 4a-bPart I, Line 4a: Bon Secours Health System, Inc. has system wide severance policies for various levels of executive management. Executive positions throughout the system may include, but are not limited to, CEO/President, CFO, COO, EVP, SVP, VP and Directors. Severance periods vary based on length of service, subsequent employment and violations of the severance policy. Generally, severance periods can be up to 24 months. Benefits may include, but are not limited to, base salary, certain health benefits and payment of unused vacation. The following individual(s) received severance payments during the applicable calendar year: Eileen Malo, $136,016. Part I, Line 4b: Maryview Nursing Care Center participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and 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 deposits are made into this plan. The following individuals received payments in 2011: Richard Hanson - $71,180.
Part IIIPart I, Line 3: Bon Secours Health System, Inc., a related organization of Bon Secours Maryview Nursing Care Center, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation committee Independent compensation consultant Written employment contracts Compensation survey or study Approval by the board/compensation committeeSupplemental Information

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 6Bon Secours Health System, Inc. is the sole member of Bon Secours Hampton Roads Health System, Inc., which in turn is the sole member of Bon Secours - Maryview Nursing Care Center.
Form 990, Part VI, Section A, line 7aThe governing body of Bon Secours - Maryview Nursing Care Center is appointed by its Member, Bon Secours Hampton Roads Health System, Inc. and subject to approval by Bon Secours Health System, Inc.
Form 990, Part VI, Section A, line 7bCertain authorities of Bon Secours - Maryview Nursing Care Center are reserved to its member or to Bon Secours Health System, Inc.
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' 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-Maryview 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. Michael K. Kerner's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the Chief Executive Officer of Bon Secours Hampton Roads Health System which includes direct management, monitoring and oversight of Bon Secours Hampton Roads Health System and its related organizations. Greg Simia's compensation is paid by Maryview Hospital, a related organization. The compensation he receives is for his role as the Chief Financial Officer of Bon Secours Hampton Roads Health System and all related organizations. Patricia Robertson's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation she receives is for her role as the Executive Vice President of Mary Immaculate Hospital and both nursing care facilities in the Hampton Roads Health System. Diana L. Jarret's compensation is paid by Maryview Hospital, a related organization. The compensation she receives is for her role as the Executive Director, Extended Care. This position includes responsibilities over both nursing care facilities in the Hampton Roads Health System. Timothy J. Davis's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as Executive Vice President and Chief Administrative Officer of Bon Secours Health System, Inc. Sr. Patricia Heath does not receive payroll distributions as she has taken a vow of poverty.Form 990, Part VII:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (10 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 RoadMarriottsvileMD21104521301088Parent Org. Management ServicesMD501(c)(3)11bBon Secours Inc0
Bon Secours Hampton Roads Health System Inc
5818 Harborview Blvd Ste APortsmouthVA23435521538513Local System Parent Org.VA501(c)(3)11bBon Secours Health System Inc0
Mary Immaculate Nursing Center
7007 Harbour View BlvdNewport NewsVA23602541516476Nursing Care CenterVA501(c)(3)9Mary Immaculate Hospital0
Mary Immaculate Foundation
2 Bernadine DriveNewport NewsVA23602311644734FundraisingVA501(c)(3)11cMary Immaculate Hospital0
Mary Immaculate Hospital
4 Ridgewood ParkwayNewport NewsVA23602540548200HealthcareVA501(c)(3)3Bon Secours Hampton Roads Health System0
Bon Scours Maryview Foundation
3520 High Street Ste 100PortsmouthVA23707521694731FundraisingVA501(c)(3)11cBon Secours Hampton Roads Health System0
Maryview Hospital
3636 High StreetPortsmouthVA23707540506463HealthcareVA501(c)(3)3Bon Secours Hampton Roads Health System0
Bon Secours DePaul Medical Center
150 Kingsley LaneNorfolkVA23505541820093HealthcareVA501(c)(3)3Bon Secours Hampton Roads Health System0
Bon Secours DePaul Health Foundation
150 Kingsley LaneNorfolkVA23505541843876FundraisingVA501(c)(3)11cBon Secours Hampton Roads Health System0
Bayley Properties
150 Kingsley LaneNorfolkVA23505541424748RentalVA501(c)(2)N/ABon Secours DePaul Medical Center0

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
Province Place of Maryview LLC
7007 Harbourview Blvd Ste 108SuffolkVA23435541842697Assisted LivingVAProfessional Health Care MgmtRelated00
Province Place of DePaul LLC
7007 Harbourview Blvd Ste 108SuffolkVA23435541950880Assisted LivingVAProfessional Health Care MgmtRelated00

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
Professional Health Care Mgmt Inc
150 Kingsley LaneNorfolkVA23505541241031AdministrativeVABon Secours Hampton Roads Health System IncC
Tidewater Diversified Inc
160 Kingsley LaneNorfolkVA23505541431826PharmacyVABon Secours DePaul Medical Center IncC
OSF Inc
2 Bernadine DriveNewport NewsVA23602541369919RentalVAMary Immaculate Hospital IncC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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 Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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