SAINT JOHN HOSPITAL INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SAINT JOHN HOSPITAL INC (EIN 48-0543768)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-16
- IRS object ID
- 201223219349300037
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-16T12:23:42-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRUCE E BERNSTIEN & ASSOC PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10440 N CENTRAL EXPRESSWAY STE 1040 | AddressLine1 |
| City | DALLAS | City |
| State | TX | State |
| ZIP Code | 75231 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480543768 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAINT JOHN HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % DAVID DULNY | InCareOfName |
| Name Control | SAIN | NameControl |
| Phone | 9136806000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3500 South Fourth Street | AddressLine1 |
| City | Leavenworth | City |
| State | KS | State |
| ZIP Code | 66048 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RANDALL NYP | Name |
| Title | ceo | Title |
| Date Signed | 2012-11-14 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRUCE E BERNSTIEN | Name |
| Phone | 2147060840 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | dan sheehan | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8929 PARALLEL PARKWAY | AddressLine1 |
| City | KANSAS CITY | City |
| State | KS | State |
| ZIP Code | 66112 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 34260259 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.providence-health.org/sjh | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1974 | YearFormation |
| State Legal Domicile | KS | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 421 | TotalNbrEmployees |
| Total Nbr Volunteers | 25 | TotalNbrVolunteers |
| Total Gross UBI | 1089 | TotalGrossUBI |
| Contributions Grants Prior Year | 9648 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 18088 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 34852121 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 34138182 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 23320 | InvestmentIncomePriorYear |
| Investment Income Current Year | 66039 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 31632 | OtherRevenuePriorYear |
| Other Revenue Current Year | 37950 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 34916721 | TotalRevenuePriorYear |
| Total Revenue Current Year | 34260259 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 14000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 13500 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 18643171 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 17950092 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 19947890 | OtherExpensePriorYear |
| Other Expenses Current Year | 18806249 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 38605061 | TotalExpensesPriorYear |
| Total Expenses Current Year | 36769841 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3688340 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -2509582 | RevenuesLessExpensesCY |
| Total Assets BOY | 19571211 | TotalAssetsBOY |
| Total Assets EOY | 17502627 | TotalAssetsEOY |
| Total Liabilities BOY | 4708432 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4637644 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 14862779 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 12864983 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 25978164 | Expense |
| Revenue | 34138182 | Revenue |
| Description | IT IS THE PHILOSOPHY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AND AFFILIATED HOSPITALS TO TREAT PATIENTS IN A NON-DISCRIMINATORY MANNER, MINIMIZE HUMAN SUFFERING AS MUCH AS POSSIBLE; CREATE A PREFERENTIAL OPTION FOR THE POOR; AND PROVIDE ASSISTANCE TO THOSE PATIENTs WHO HAVE LIMITED FINANCIAL RESOURCES. THE HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMs AND AS SUCH PROVIDE CARE AT REIMBURSEMENT LEVELS LOWER THAN CHARGES. THE DIFFERENCE BETWEEN REIMBURSEMENT FROM THESE PROGRAMS AND CHARGES AT ESTABLISHED RATES Are INCLUDED IN THE HOSPITAL's MISSION In SERVICE TO the COMMUNITY WHICH IT OPERATES. TO THAT END, THE HOSPITAL HAS INSTITUTED AND PARTICIPATES IN THE FOLLOWING COMMUNITY BENEFIT ACTIVITIES; PROVIDES LABORATORY, RADIOLOGICAL, AND PHARMACEUTICAL SERVICE AT DUCHESNE CLINIC. DUCHESNE CLINIC IS A CLINIC FOR THE CARE OF THE MEDICALLY INDIGENT. COMMUNITY HEALTH SERVICES are PROVIDED AT MINIMAL OR NO CHARGE: CHOLESTERAL SCREENING, BLOOD SUGAR SCREENING, SIBLING PREPARATION, LAMAZE CHILDBIRTH CLASSES, CANcER SUPPORT, GROUP STROKE SUPPORT GROUp, BREAST FEEDING SUPPORT, HEARING SCREENING, CESAREAN BIRTH CLASSES, FREEDOM FROM SMOKING, COLORECTAL SCREENING, NUTRITIONAL COUNSELING; HOSPITAL CARE: INPATIENT DAYS OF CARE, INPATIENT ADMISSIONS, NEWBORN DELIVERIES, OUTPATIENT REGISTRATIONS, EMERGENCY ROOM VISITS, CLINIC VISITS. | Description |
| Total Program Service Expense | 25978164 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | true | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 55 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 421 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DAVID DULNY | NamePerson |
| Telephone Number | 9135964835 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8929 PARALLEL PARKWAY | AddressLine1 |
| City | Kansas City | City |
| State | KS | State |
| ZIP Code | 66112 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| BRENDA CALVIN | |||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||||
| DANIEL CRABTREE | |||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||||
| DR L DUGAN MD | |||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||||
| DORIS F GIVENS PHD | |||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||||
| MARY LOU JARAMILLO | |||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||||
| RANDALL NYP | |||||||||
| CHIEF EXECUTIVE OFFICER | 1.0 | X | 0 | 113865 | 164 | X | |||
| DR MICHAEL PARRA MD | |||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||||
| WILLIAM PETRIE | |||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||||
| ROY L ROBINSON | |||||||||
| CHAIRMAN | 1.0 | X | 0 | 0 | 0 | X | |||
| SABATO SISSILLO MD FCCP | |||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||||
| DIANE MARIE STEELE SCL | |||||||||
| TREASURER | 1.0 | X | 0 | 0 | 0 | X | |||
| RICKY D TURNER | |||||||||
| VICE CHAIRMAN | 1.0 | X | 0 | 0 | 0 | X | |||
| JOE JEANS | |||||||||
| REGION VICE PRESIDENT FINANCE | 10.0 | 0 | 179894 | 43730 | X | ||||
| DANIEL SHEEHAN | |||||||||
| CHIEF ADMIN OFFICER | 40.0 | 0 | 145712 | 32505 | X | ||||
| MICHAEL A DORSEY | |||||||||
| former CEO | 9.5 | 0 | 352700 | 30440 | X | ||||
| JUANITA ROY | |||||||||
| EXECUTIVE VP & COO | 10.0 | 0 | 292006 | 35184 | X | ||||
| DR MARC LUCKETT | |||||||||
| PHYSICIAN | 40.0 | 331039 | 0 | 0 | X | ||||
| CAROLYN BOWMER | |||||||||
| Vice President- Human Resource | 10.0 | 0 | 171245 | 17211 | X | ||||
| JAN YERGAN | |||||||||
| VICE PRESIDENT STRATEGY & BUS | 10.0 | 0 | 296171 | 17641 | X | ||||
| BARRY SOLOMON | |||||||||
| CHIEF MEDICAL OFFICER | 40.0 | 0 | 286335 | 54345 | X | ||||
| GEORGE NOONAN | |||||||||
| VP MISSION INTEGRATION | 40.0 | 0 | 184328 | 27599 | X | ||||
| JAMES PAQUETTE | |||||||||
| FORMER CEO | 0.0 | 0 | 738527 | 123111 | X | ||||
| BAIN FARRIS | |||||||||
| INTERIM CHIEF ADMIN OFFICER | 0 | 553036 | 99532 | X | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 331039 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3313819 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 481462 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| anesthesiology chartered | |||||
| 5600 W 95TH STREET SUITE 123 | OVERLAND PARK | KS | 66207 | ANESTHESIOLOGY SVCS | 1755712 |
| sisters of charity of leavenworth | |||||
| 9801 renner blvd ste 100 | LENEXA | KS | 66219 | mgmt & it support | 1444920 |
| covenant group pa | |||||
| 14400 COLLEGE BLVD STE 100 | OVERLAND PARK | KS | 66215 | er physician svcs | 536659 |
| horizon health | |||||
| 2941 south lake vista dr | LEWISVILLE | TX | 75067 | mgmt of gerio psych | 415305 |
| midwest vascular access | |||||
| 125325 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| Related Organizations | 18088 | RelatedOrganizations |
| Total Contributions | 18088 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| PATIENT CARE REVENUE | 621500 | 33734851 | 33733762 | 1089 | |
| CAFETERIA/VEND | 722210 | 46732 | $46,732 | ||
| MOB RENTAL INCOME | 531120 | 251823 | $251,823 | ||
| OTHER | 900099 | 104776 | $104,776 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 34138182 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 46754 | TotalRevenueColumn |
| Exclusion | $46,754 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 19285 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 19285 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 19285 | TotalRevenueColumn |
| Exclusion | $19,285 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MEDICAL STAFF | Description |
| Business Code | 541900 | BusinessCode |
| Total Revenue Column | 37950 | TotalRevenueColumn |
| Related Or Exempt Function Income | 37950 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 37950 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 34260259 | TotalRevenueColumn |
| Related Or Exempt Function Income | 33771712 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1089 | UnrelatedBusinessRevenue |
| Exclusion | $469,370 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13500 | Total |
| Program Services | 13500 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14911856 | Total |
| Program Services | 13839198 | ProgramServices |
| Management And General | 1072658 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 551943 | Total |
| Management And General | 551943 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1525554 | Total |
| Program Services | 1480319 | ProgramServices |
| Management And General | 45235 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 960739 | Total |
| Program Services | 937540 | ProgramServices |
| Management And General | 23199 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1560470 | Total |
| Program Services | 25476 | ProgramServices |
| Management And General | 1534994 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -3268 | Total |
| Management And General | -3268 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5533808 | Total |
| Program Services | 4922067 | ProgramServices |
| Management And General | 611741 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 203623 | Total |
| Management And General | 203623 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 116294 | Total |
| Program Services | 114234 | ProgramServices |
| Management And General | 2060 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 245205 | Total |
| Program Services | 213093 | ProgramServices |
| Management And General | 32112 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 223614 | Total |
| Program Services | 222673 | ProgramServices |
| Management And General | 941 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21277 | Total |
| Program Services | 7010 | ProgramServices |
| Management And General | 14267 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3737 | Total |
| Program Services | 3294 | ProgramServices |
| Management And General | 443 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72877 | Total |
| Management And General | 72877 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2065983 | Total |
| Management And General | 2065983 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 232123 | Total |
| Program Services | 22295 | ProgramServices |
| Management And General | 209828 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBTS | 3244257 | 3244257 | |
| PHARMACEUTICALS | 980099 | 933208 | 46891 |
| UTILITIES | 515361 | 515361 | |
| NON-MEDICAL SUPPLIES | 186375 | 186375 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3604414 | Total |
| Management And General | 3604414 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36769841 | Total |
| Program Services | 25978164 | ProgramServices |
| Management And General | 10791677 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -389413 | BOY |
| EOY | 908400 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5738568 | BOY |
| EOY | 4273366 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 799051 | BOY |
| EOY | 776856 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 207488 | BOY |
| EOY | 202309 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 37391321 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 27363318 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10455954 | BOY |
| EOY | 10028003 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2697282 | BOY |
| EOY | 1247321 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62281 | BOY |
| EOY | 66372 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19571211 | BOY |
| EOY | 17502627 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2683233 | BOY |
| EOY | 2991015 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1605816 | BOY |
| EOY | 1473299 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 419383 | BOY |
| EOY | 173330 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4708432 | BOY |
| EOY | 4637644 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14862779 | BOY |
| EOY | 12864983 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14862779 | BOY |
| EOY | 12864983 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19571211 | BOY |
| EOY | 17502627 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -2509582 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 511786 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 926607 | BeginningOfYearBalance |
| Contributions | 7655 | Contributions |
| Investment Earnings Or Losses | 17123 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 3000 | GrantsOrScholarships |
| End Of Year Balance | 948385 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 871512 | BeginningOfYearBalance |
| Contributions | 3900 | Contributions |
| Investment Earnings Or Losses | 88300 | InvestmentEarningsOrLosses |
| Other Expenditures | 37105 | OtherExpenditures |
| End Of Year Balance | 926607 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 736128 | BeginningOfYearBalance |
| Contributions | 1250 | Contributions |
| Investment Earnings Or Losses | 138884 | InvestmentEarningsOrLosses |
| Other Expenditures | 4750 | OtherExpenditures |
| End Of Year Balance | 871512 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 953198 | BeginningOfYearBalance |
| Contributions | 1850 | Contributions |
| Investment Earnings Or Losses | -209520 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 9400 | GrantsOrScholarships |
| End Of Year Balance | 736128 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.78950 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.21050 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | true | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | true | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 110861 | OtherCostOrOtherBasis |
| Book Value | 110861 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 19162256 | OtherCostOrOtherBasis |
| Depreciation | 12557103 | Depreciation |
| Book Value | 6605153 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17907253 | OtherCostOrOtherBasis |
| Depreciation | 14449001 | Depreciation |
| Book Value | 3458252 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 210951 | OtherCostOrOtherBasis |
| Depreciation | 357214 | Depreciation |
| Book Value | -146263 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 10028003 | TotalOfBookValueLandBuildings |
| Financial Derivatives | FinancialDerivatives | |
| Closely Held Equity Interests | CloselyHeldEquityInterests |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INVESTMENTS | Description |
| Book Value | 1247321 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 1247321 | TotalOfBookValueSecurities |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | EST 3RD PARTY SETTLEMENT | Description |
| Amount | $173,330 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 173330 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE D, PART V, LINE 4 | Identifier |
| Return Reference | ENDOWMENT FUNDS | ReturnReference |
| Explanation | Retained endowment funds are intended to support indigent care, provide nursing scholarships, and to be used for the general support of the hospital at the discretion of the board. Endowment funds are held by Providence/Saint John Foundation. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To Most Hospitals | X | PolicyAppliedToMostHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3715 | PersonsServed |
| Total Community Benefit Expense | 1273936 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1273936 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03800 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3864 | PersonsServed |
| Total Community Benefit Expense | 4076251 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4050802 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 25449 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7579 | PersonsServed |
| Total Community Benefit Expense | 5350187 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4050802 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1299385 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03810 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 152 | PersonsServed |
| Total Community Benefit Expense | 12046 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12046 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 500 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 500 | NetCommunityBenefitExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 152 | PersonsServed |
| Total Community Benefit Expense | 12546 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12546 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 7731 | PersonsServed |
| Total Community Benefit Expense | 5362733 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4050802 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1311931 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03850 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,150,470 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 10349534 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 12499524 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -2149990 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAINT JOHN HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3500 SOUTH FOURTH STREET | AddressLine1 |
| City | LEAVENWORTH | City |
| State | KS | State |
| ZIP Code | 66048 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAINT JOHN HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 200. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Notified All Patients | X | NotifiedAllPatients |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | true | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 5 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (5 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| SAINT JOHN MEDICAL OFFICE BUILDING | ||||
| 3550 SOUTH FOURTH STREET | LEAVENWORTH | KS | 66048 | MEDICAL OFFICE BUILDING |
| associate in family healthcare | ||||
| 712 first terrace | LANSING | KS | 66043 | PRIMARY CARE PRACTICE/stat lab |
| st john obgyn | ||||
| 3550 south 4th st | leavenworth | KS | 66048 | primary care practice |
| primary care practice | ||||
| 1004 progress dr ste 200 | lansing | KS | 66043 | primary care practice |
| st john rock creek imaging center | ||||
| 712 1st terrace b | lansing | KS | 66043 | outpatient imaging center |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| determining eligibility | form 990, sch h, part i, line 3c: | PART I, LINE 7, METHODOLOGY FOR COMPUTING THE COST OF CHARITY AND UNREIMBURSED MEDICAID COST WAS BASED ON THE CATHOLIC HOSPITAL ASSOCIATION GUIDE FOR PLANNING AND REPORTING OF COMMUNITY BENEFITS, APPENDIX D, WORKSHEET 2. THIS METHODOLOGY COMPUTES A COST TO CHARGE RATIO USING TOTAL OPERATING EXPENSES INCLUDING BAD DEBT EXPENSE AND EXCLUDING MEDICAID PROVIDER TAXES. THIS AMOUNT IS REDUCED BY OTHER OPERATING REVENUE TO ARRIVE AT NET EXPENSE. NET EXPENSE AS A PERCENTAGE OF GROSS PATIENT REVENUE IS THE PERCENTAGE USED TO COMPUTE THE COST OF CHARITY AND UNREIMBURSED MEDICAID COST. OTHER BENEFITS (INCLUDING COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS ARE CALCULATED BASED ON THE ACTUAL COST TO DELIVER THESE SERVICES. FOR DONATIONS OTHER THAN MONETARY (IE STAFF TIME AND IN-KIND DONATIONS), THE COSTS ARE DETERMINED BASED ON FAIR MARKET VALUE OF THE DONATION. THIS INFORMATION IS TRACKED ON CBISA, A SOFTWARE DATABASE EXCLUSIVELY USED TO TRACK COMMUNITY BENEFIT REPORTING. NET COMMUNITY BENEFIT EXPENSE IS CALCULATED AS A PERCENTAGE OF TOTAL EXPENSES EXCLUDING BAD DEBT OF $3,448,832. |
| community building activities | form 990, sch h, part ii: | OUR COMMUNITY BUILDING EXPENSES ARE THOSE IDENTIFIED IN OUR COMMUNITY HEALTH ASSESSMENT AS CONTRIBUTING TO THE HEALTH OF THE COMMUNITY, BUT NOT DIRECTLY PROVIDING HEALTH SERVICES. |
| bad debt, medicare & collection practices | form 990, sch h, part iii, section a, line 4: | THE COSTING METHODOLOGY USED TO CALCULATE THE COST OF GROSS BAD DEBT EXPENSE WAS BASED ON THE COSTING METHODOLOGY IN THE INSTRUCTIONS TO SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES. LINE 11 OF WORKSHEET 2 (RATIO OF PATIENT CARE COST TO CHARGES) WAS MULTIPLIED AGAINST THE GROSS BAD DEBT EXPENSE TO ARRIVE AT THE COST OF BAD DEBT EXPENSE. BAD DEBT EXPENSE REPRESENTS THE UNPAID PORTION OF THE GROSS CHARGES (AT ESTABLISHED RATES) LESS PAYMENTS FROM 3RD PARTY PAYORS AND THE PATIENT AND ANY CONTRACTUAL ADJUSTMENTS. THE HOSPITAL DOES NOT PROVIDE ANY PROMPT PAY DISCOUNTS FOR PAYING THE PATIENT PORTION OF THE BALANCE OF THEIR ACCOUNT WITHIN A SPECIFIED TIMEFRAME. SOME ACCOUNTS WRITTEN OFF TO BAD DEBTS WHICH ARE SENT TO THE HOSPITAL'S COLLECTION AGENCIES ARE SUBSEQUENTLY RECLASSIFIED TO CHARITY. ACCOUNTS THAT ARE CLOSED BY THE COLLECTION AGENCY BASED ON THE AGENCY'S ASSESSMENT OF THE PATIENT AND\OR GUARANTOR'S FINANCIAL POSITION (I.E. UNEMPLOYED, NO ASSETS, ETC.) ARE RECLASSIFIED TO CHARITY EXPENSE ONCE THAT DETERMINATION IS MADE. ACCOUNTS WRITTEN OFF TO BAD DEBT EXPENSE IN CY 2011 AND SUBSEQUENTLY RECLASSIFIED TO CHARITY IN CY 2012 WERE NOT QUANTIFIED AT DECEMBER 31, 2011. THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. WITHIN THE FINANCIAL STATEMENTS OF SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, BAD DEBT EXPENSE IS INCLUDED WITHIN OPERATING EXPENSES, AT THE VALUE OF UNCOLLECTED AND ESTIMATED UNCOLLECTIBLE CHARGES AFTER CONTRACTUAL ALLOWANCES AND SELF-PAY DISCOUNTS ARE APPLIED. |
| bad debt, medicare & collection practices | form 990, sch h, part iii, section b, line 8: | THE MEDICARE ALLOWABLE COSTS WERE ARRIVED AT FROM VARIOUS WORKSHEETS C, D AND E OF THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED DECEMBER 31, 2011. THE MEDICARE SHORTFALL INDICATED IN PART III, LINE 7 WAS NOT INCLUDED IN PART I, LINE 7, COMMUNITY BENEFIT. |
| bad debt, medicare & collection practices | form 990, sch h, part iii, section c, 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. SAINT JOHN HOSPITAL 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. Measures to publize the policy form 990, sch h, part V, line 13g: The brochures which include policy will be provided to the patients How the hospital charged for emergency or other medically care form 990, sch h, part V, line 19: All patients are charged a standard rate at the time of service. The charge for FAP-eligible patients form 990, sch h, part V, line 21: All patients are charged a standard rate at the time of service. Gross charges are the charges for everyone. |
| NEEDS ASSESSMENT | form 990, sch h, part vi, line 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. SAINT JOHN HAS REGULARLY PARTICIPATED IN NEEDS ASSESSMENT SURVEYS TO IDENTIFY THE ONGOING AND CHANGING NEEDS OF THE COMMUNITY. THE MOST RECENT SURVEY WAS CONDUCTED IN 2009, AND ONE IS SCHEDULED TO BE COMPLETED IN 2013. THIS ASSESSMENT STUDIES A DEFINED COMMUNITY SERVED BY SAINT JOHN, 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 HEATLH STATISTICS. EVERY YEAR AS A COMPONENT OF THE ANNUAL STRATEGIC PLANNING PROCESS, SAINT JOHN PARTNERS WITH COMMUNITY ORGANIZATIONS INCLUDING THE AMERICAN CANCER SOCIETY, THE AMERICAN HEART ASSOCIATION, THE LEAVENWORTH ECONOMIC DEVELOPMENT COUNCIL AND THE UNITED WAY TO REVIEW STATISTICS REGARDING THE POPULATION AND HEALTH-RELATED TRENDS. THE MOST RECENT SURVEY WAS CONDUCTED IN 2010 AND WILL BE UPDATED AS A PART OF THE 2012 PLANNING PROCESS. IN ADDITION, SAINT JOHN CONDUCTED A PHYSICIAN NEEDS ASSESSMENT OF LEAVENWORTH COUNTY UTILIZING QUANTITATIVE RESEARCH METHODS TO DETERMINE GAPS IN PHYSICIAN SPECIALTY COVERAGE IN THE MARKET. 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. |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | SCHEDULE H, PART VI, LINE 3: | SAINT JOHN HOSPITAL TREATS PATIENTS WITH RESPECT AND DIGNITY REGARDLESS OF THEIR ABILITY TO PAY. SAINT JOHN HOSPITAL 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, 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 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. WE HAVE A PARTNERSHIP WITH THE MIDLAND GROUP TO PROVIDE EXTENDED PAYMENT PLANS. THIS HELPS PATIENTS MEET THEIR FINANCIAL OBLIGATIONS IN A REASONABLE AND DIGNIFIED MANNER BASED ON THEIR ABILITY TO PAY, AND ALLOWS THEM TO CONTINUE TO ENSURE THE ONGOING WELFARE OF THEIR FAMILIES. THIS IS DONE IN ACCORDANCE WITH OUR CORE VALUE OF RESPECT. |
| COMMUNITY INFORMATION | SCHEDULE H, PART VI, LINE 4: | SAINT JOHN IS PART OF A NATIONAL SYSTEM OF FAITH-BASED HOSPITALS SPONSORED BY THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM LOCATED IN denver, colorado. THE HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH OF THE RESIDENTS IN ITS SERVICE AREAS INCLUDING LEAVENWORTH AND WYANDOTTE COUNTIES IN KANSAS. BASED ON RESEARCH FROM CLARITAS, INC., SAINT JOHN'S PRIMARY SERVICE AND SECONDARY SERVICE AREAS ARE EXPECTED TO INCREASE RAPIDLY OVER THE NEXT FIVE YEARS, INCREASING THE NEED FOR SERVICES THESE INDIVIDUALS HISTORICALLY NEED, SUCH AS CARDIOLOGY, NEUROLOGY, ONCOLOGY, ORTHOPAEDIC AND PULMONARY CARE. IN THE HOSPITAL'S PRIMARY SERVICE AREA, 78.1 PERCENT OF THE ETHNIC POPULATION IS WHITE; 12.5 PERCENT IS AFRICAN-AMERICAN; AND 4.2 PERCENT IS HISPANIC. THE HOSPITAL'S SECONDARY SERVICE AREA IS 92.5 PERCENT WHITE. ADDITIONALLY, IN LEAVENWORTH COUNTY, 10.6 PERCENT OF THE POPULATION IS UNINSURED, WITH 42 PERCENT OF THE UNINSURED FALLING UNDER 200 PERCENT OF THE FEDERAL POVERTY LINE. |
| PROMOTION OF COMMUNITY HEALTH | SCHEDULE H, PART VI, LINE 5: | WE ARE AN IMPORTANT PART OF OUR COMMUNITY AND SERVE IN MANY WAYS FROM DELIVERING CORE HEALTH CARE TO PREVENTIVE CARE TO SUPPORT OF OTHER CIVIC GROUPS. IN 2011, WE PROVIDED COMMUNITY BENEFIT TOTALING $1,311,931, INCLUDING TRADITIONAL CHARITY CARE AND THE UNPAID COST OF MEDICAID. 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 SAINT JOHN 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 EXTEND OUR CARE BEYOND OUR HOSPITAL'S WALLS IN ORDER TO IMPROVE THE HEALTH OF OUR COMMUNITY. OUR COMMUNITY ACTIVITIES DEMONSTRATE THIS COMMITMENT. DURING THIS YEAR, OUR COMMUNITY ACTIVITIES INCLUDED: -ATHLETIC TRAINERS-TEAM WORKS IS A SAINT JOHN-SPONSORED PROGRAM THAT WORKS WITH THE LEAVENWORTH AND LANSING AREA HIGH SCHOOLS TO PROVIDE CERTIFIED ATHLETIC TRAINERS TO THE SCHOOLS AT LITTLE COST. TEAM WORKS PROVIDES GAME EVENT COVERAGE, INJURY PREVENTION COUNSELING, EFFICIENT RUNNING ASSESSMENT PROGRAMS, PRE-GAME WORKOUTS, WELLNESS PROGRAMS, MANAGEMENT AND TREATMENT OF INJURIES ON THE FIELD, ATHLETIC TRAINING PROGRAMS, A COMPREHENSIVE REHABILITATION/RECONDITIONING PROGRAM FOR INJURIES, HEALTH INFORMATION AND COUNSELING, SPORTS PERFORMANCE/CONDITIONING AND INJURY TRACKING CAPABILITIES. THE PROGRAM'S GOALS INCLUDE EARLY DIAGNOSIS OF CONCUSSIONS ON THE FIELD TO PREVENT LONG-TERM AFFECTS, OR EVEN DEATH; AND TO PREVENT OR REHABILITATE INJURIES EARLY ON IN THESE STUDENTS SO THAT THESE INJURIES DO NOT BECOME LIFETIME HEALTH ISSUES. -CANCER SUPPORT GROUP-SAINT JOHN SPONSORS A CANCER SUPPORT GROUP THAT MEETS ON A REGULAR BASIS TO ASSIST PATIENTS AS THEY ARE UNDERGOING CANCER TREATMENT AND RECOVERY. ISSUES COVERED INCLUDE NUTRITION, CANCER-RELATED FATIGUE AND DISEASE RECURRENCE. -CHILDBIRTH PREPARATION COURSES-TO PROVIDE THE COMMUNITY'S NEWEST RESIDENTS WITH THE BEST STARTS POSSIBLE IN LIFE, SAINT JOHN OFFERS A WIDE RANGE OF CHILDBIRTH PREPARATION COURSES, INCLUDING BREASTFEEDING, PREPARED CHILDBIRTH, AND SIBLING PREPARATION. THE GOAL IS TO PROMOTE A HEALTHY FAMILY ENVIRONMENT, REDUCE THE RISK OF LOW-BIRTH WEIGHT BABIES AND IMPROVE THE SUCCESS OF BREASTFEEDING FOR NEW MOTHERS AND THEIR INFANTS. THESE INITIATIVES HAVE BEEN PROVEN TO LOWER HEALTH-RELATED COSTS ASSOCIATED WITH CHILDBIRTH, AND RELATED COMPLICATIONS. -DIABETES EDUCATION COURSES-SAINT JOHN OFFERS COURSES TO REDUCE COMPLICATIONS AND COSTS ASSOCIATED WITH DIABETES, INCLUDING A DIABETES DINING CLUB, DIABETES OUTPATIENT CLASSES AND DIABETES SUPPORT GROUP. THESE OFFERINGS ASSIST PATIENTS WITH SUCCESSFULLY MANAGING THEIR DISEASE, IMPROVING LONG-TERM HEALTH FOR THESE PATIENTS AND THE COMMUNITY. -HEART HEALTH EDUCATION-BY ENCOURAGING COMMUNITY PARTICIPATION IN ACTIVITIES SUCH AS BLOOD PRESSURE SCREENINGS, HEART HEALTH FAIRS, AND WALKS, SAINT JOHN ASSISTS INDIVIDUALS IN MAKING HEALTHIER LIFESTYLE CHOICES (EXERCISE AND SMOKING CESSATION) THAT CAN IMPROVE THEIR INDIVIDUAL HEALTH, AS WELL AS THE COMMUNITY'S HEALTH IN GENERAL. THE HOSPITAL ALSO HAS PARTNERED WITH THE AMERICAN HEART ASSOCIATION TO IMPLEMENT THE SEARCH YOUR HEART PROGRAM IN THE LEAVENWORTH COMMUNITY. SEARCH YOUR HEART IS AN EFFORT TO EDUCATE AREA CONGREGATIONS ON ISSUES RELATED TO HEART DISEASE AND STROKE. THE HOSPITAL ALSO SPONSORS HEALTH SCREENINGS, COOKING DEMONSTRATIONS AND OTHER AWARENESS ACTIVITIES FOR PARTICIPATING CHURCHES. -OTHER COMMUNITY EVENTS SAINT JOHN PARTICIPATED IN DURING 2011 INCLUDE: " BREASTFEEDING CLASSES " CANCER SUPPORT GROUP " CITY OF LEAVENWORTH HEALTH FAIR " CHILDBIRTH PREPARATION CLASSES " COVER THE UNINSURED WEEK " DIABETES DINING CLUB " DIABETES OUTPATIENT CLASSES " DIABETES SUPPORT GROUP " FT. LEAVENWORTH PAIR DAY " HALLMARK EMPLOYEE HEALTH FAIR " LEAVENWORTH COUNTY EMPLOYEES SAFETY DAY " LEAVENWORTH COUNTY HEALTH FAIR " LEAVENWORTH FIRST CITY FESTIVAL " LEAVENWORTH HEART WALK " NATIONAL HEALTH CARE DECISIONS DAY " RELAY FOR LIFE " SIBLING PREPARATION CLASSES " UNIVERSITY OF SAINT MARY HEALTH FAIR 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: " CATHOLIC CHARITIES FOOD SUPPLIES DRIVE " CHRISTMAS IN OCTOBER " COMMUNITY BLOOD CENTER BLOOD DRIVE " CRISTO REY SCHOOL SUPPLIES DRIVE " HAITI RELIEF EFFORTS " HARVESTERS FOOD DRIVE " LENTEN FOOD FOR THOUGHT " UNITED WAY CAMPAIGN WE ARE GOOD CITIZENS AND PARTNER WITH OTHER ORGANIZATIONS AND AGENCIES TO SUPPORT A THRIVING COMMUNITY: " ALLIANCE AGAINST FAMILY VIOLENCE " AMERICAN CANCER SOCIETY " AMERICAN HEART ASSOCIATION " CARITAS CLINICS, INC. " FRIENDS OF LEAVENWORTH HIGH SCHOOL " GREATER KANSAS CITY MEDICAL SOCIETY " IMMACULATA HIGH SCHOOL " KANSAS CITY WIZARDS " LANSING BASKETBALL COMMITTEE " LANSING EDUCATIONAL FOUNDATION " LANSING HIGH SCHOOL OPERATION GRADUATION " LEAVENWORTH COUNTY CHILD ABUSE PREVENTION COUNCIL " LEAVENWORTH HIGH SCHOOL PIONEER FOOTBALL " LEAVENWORTH PARK AND COMMUNITY ACTIVITIES DEPARTMENT " LEAVENWORTH REGIONAL CATHOLIC SCHOOLS " LEAVENWORTH YAC " LEAVENWORTH-LANSING AREA CHAMBER OF COMMERCE " LEGENDS OF KANSAS CITY " MAKE-A-WISH FOUNDATION " METROPOLITAN MEDICAL SOCIETY " MOUNT SCHOLASTICA BENEDICTINE SISTERS " OLDER AMERICAN MONTH CELEBRATIONS " SAINT FRANCIS DE SALES " SAINT VINCENT CLINIC " T-BONES BASEBALL CLUB " UNIVERSITY OF SAINT MARY " USD 453 LEAVENWORTH SCHOOL DISTRICT " USD 469 LANSING SCHOOL DISTRICT " WOMEN'S FOUNDATION OF GREATER KANSAS CITY WE PROVIDE FOCUSED SUPPORT FOR CARITAS CLINICS, INC., (DUSCHENE AND SAINT VINCENT CLINICS) THE COMMUNITY'S HEALTH CLINICS FOR THE UNINSURED. WE WORK CLOSELY TOGETHER TO PROVIDE INTEGRATED CARE FOR THOSE WHO COME TO EITHER THE HOSPITAL OR THE CLINICS FOR THEIR HEALTH NEEDS. CARITAS CLINICS PROVIDE QUALITY PRIMARY HEALTH CARE SERVICES FOR UNINSURED, LOW-INCOME PATIENTS REGARDLESS OF ABILITY TO PAY. THE CLINICS ARE COMMITTED TO PROVIDING ACCESS TO COMPASSIONATE AND TRUSTWORTHY CARE FOR THE UNINSURED POOR. SERVICES THE CLINICS PROVIDE INCLUDE PRIMARY CARE, ONGOING MANAGEMENT OF CHRONIC DISEASES AND MEDICATION ASSISTANCE. IN ADDITION TO FINANCIAL SUPPORT, SAINT JOHN ASSISTS THE CLINICS IN MANY OTHER WAYS INCLUDING STRATEGY AND OPERATIONS GUIDANCE, DONATING SUPPLIES AND PROVIDING IT AND FINANCIAL SYSTEMS MANAGEMENT. COMMUNITY BENEFITS PROVIDED IN 2011 THROUGHOUT SCLHS TOTALED $220.5 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." WE ARE COMMITTED TO LIVING AND DEMONSTRATING OUR CORE VALUES OF EXCELLENCE, RESPECT, RESPONSE TO NEED, STEWARDSHIP AND WHOLENESS. SCLHS SUPPORTS ITS HOSPITALS BY PROVIDING GUIDANCE, OVERSIGHT, AND RESOURCES TO HELP THEM ACCOMPLISH INITIATIVES THAT IMPROVE HEALTH IN ALL OUR COMMUNITIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. OTHER WAYS SCLHS BENEFITS ITS HOSPITALS INCLUDE QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE IT IMPLEMENTATION AND INFRASTRUCTURE; STRATEGIC AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND PURCHASING; BENEFITS ADMINISTRATION (INCLUDING A WELLNESS PROGRAM FREE TO EMPLOYEES THAT PROMOTES THEIR HEALTH AND WELL-BEING); RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE. BY SHARING THE WORK ACROSS OUR SYSTEM WE ARE ABLE TO LIGHTEN THE BURDEN FOR ALL IN ORDER TO FULFILL OUR MISSION OF IMPROVING HEALTH IN OUR COMMUNITIES. SCLHS IMPROVES OVERALL HEALTH IN OUR COMMUNITIES BY PROVIDING INFRASTRUCTURE TO SUPPORT AND SUSTAIN FOUR CLINICS FOR THE UNINSURED IN KANSAS AND COLORADO. THE SCLHS CLINICS FOR THE UNINSURED ARE OFTEN THE ONLY SAFETY NET CLINIC IN THEIR COMMUNITY AND PROVIDE VALUABLE SERVICES FOR THOSE WHO ARE MOST VULNERABLE. EACH HOSPITAL IS SUPPORTED BY A FOUNDATION TO ACCESS AND OPTIMIZE LOCAL PHILANTHROPIC ORGANIZATIONS AND INDIVIDUALS. THESE FOUNDATIONS RAISE FUNDS THROUGH OUTREACH, SPECIAL EVENTS, AND BUILDING DONOR RELATIONS THROUGHOUT THEIR COMMUNITY TO SUPPORT THE NEEDS OF THE HOSPITAL. |
| AFFILIATED HEALTH CARE SYSTEM | SCHEDULE H, PART VI, LINE 6: | SAINT JOHN HOSPITAL IS A CONTROLLED ENTITY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). SCLHS AND ITS AFFILIATED ENTITIES HAVE A COMMON CALLING AND MISSION "TO REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE." SAINT JOHN HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY BY DELIVERING DIRECT HIGH QUALITY HEALTHCARE SERVICES THAT ARE RESPONSIVE TO THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES. SCLHS SUPPORTS THE EFFORTS OF THE HOSPITAL THROUGH STRATEGIC DIRECTION AND OPERATING OVERSIGHT. SCLHS SUPPLIES OVERHEAD SUPPORT SERVICES TO SAINT JOHN HOSPITAL, INCLUDING INFORMATION TECHNOLOGY SERVICES, CENTRAL CASH MANAGEMENT AND INVESTMENT, INTERNAL AUDIT, SUPPLY CHAIN MANAGEMENT, BENEFITS ADMINISTRATION, RISK MANAGEMENT AND INSURANCE AND QUALITY IMPROVEMENT LEADERSHIP. |
| STATE FILING OF COMMUNITY BENEFIT REPORT | SCHEDULE H, PART VI, LINE 7: | THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM FILES A COMMUNITY BENEFIT REPORT IN THREE STATES: CALIFORNIA, KANSAS AND MONTANA. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENCESAINT JOHN FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8929 PARALLEL PARKWAY | AddressLine1 |
| City | KANSAS CITY | City |
| State | KS | State |
| ZIP Code | 66112 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 480925688 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 13500 | AmountOfCashGrant |
| Purpose Of Grant | OFFSET OPERATING COSTS AND GENERAL SUPPORT OF FOUNDATION'S MISSION | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR MARC LUCKETT | |||||||||||||
| 331039 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 331039 | 0 | 0 | 0 |
| CAROLYN BOWMER | |||||||||||||
| 0 | 88086 | 0 | 0 | 0 | 83159 | 0 | 12856 | 0 | 4355 | 0 | 188456 | 0 | 0 |
| JAN YERGAN | |||||||||||||
| 0 | 190248 | 0 | 0 | 0 | 105923 | 0 | 11819 | 0 | 5822 | 0 | 313812 | 0 | 80928 |
| JAMES PAQUETTE | |||||||||||||
| 0 | 418351 | 0 | 0 | 0 | 320176 | 0 | 107885 | 0 | 15226 | 0 | 861638 | 0 | 0 |
| JOE JEANS | |||||||||||||
| 0 | 177565 | 0 | 0 | 0 | 2329 | 0 | 32656 | 0 | 11074 | 0 | 223624 | 0 | 0 |
| JUANITA ROY | |||||||||||||
| 0 | 255416 | 0 | 0 | 0 | 36590 | 0 | 19600 | 0 | 15584 | 0 | 327190 | 0 | 0 |
| DANIEL SHEEHAN | |||||||||||||
| 0 | 143663 | 0 | 0 | 0 | 2049 | 0 | 26489 | 0 | 6016 | 0 | 178217 | 0 | 0 |
| BARRY SOLOMON | |||||||||||||
| 0 | 282421 | 0 | 0 | 0 | 3914 | 0 | 48113 | 0 | 6232 | 0 | 340680 | 0 | 0 |
| GEORGE NOONAN | |||||||||||||
| 0 | 161076 | 0 | 0 | 0 | 23252 | 0 | 13608 | 0 | 13991 | 0 | 211927 | 0 | 0 |
| MICHAEL A DORSEY | |||||||||||||
| 0 | 298162 | 0 | 0 | 0 | 54538 | 0 | 19000 | 0 | 11440 | 0 | 383140 | 0 | 0 |
| BAIN FARRIS | |||||||||||||
| 0 | 428580 | 0 | 105122 | 0 | 19334 | 0 | 88843 | 0 | 10689 | 0 | 652568 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PROCESS FOR DETERMINING COMPENSATION | form 990, sch j, part i, line 3: | 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. |
| SEVERANCE PAYMENTS | form 990, sch j, part i, line 4A: | THE AMOUNTS PAID FOR SEVERANCE IN 2011 WERE: CAROLYN S. BOWMER $76,100 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN form 990, sch 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: JUANITA D. ROY $10,720 GEORGE M. NOONAN $5,891 JANIS L. YERGAN $41,156 JAMES T. PAQUETTE $105,270 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: MICHAEL A. DORSEY $25,268 CAROLYN S. BOWMER $5,477 |
| SCHEDULE J, PART II | THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) CONSISTS OF ELEVEN HOSPITALS AND THREE CLINICS (AFFILIATES) IN FOUR STATES INCLUDING SAINT JOHN HOSPITAL (SAINT JOHN) IN LEAVENWORTH, KANSAS. SCLHS AND ITS AFFILIATES ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. BAIN J. FARRIS IS PRESIDENT & CHIEF EXECUTIVE OFFICER OF EXEMPLA SAINT JOSEPH HOSPITAL (ESJH) IN DENVER, COLORADO WHICH IS AN SCLHS AFFILIATE. AS A FORMER OFFICER OF SAINT JOHN'S, THIS DISCLOSURE IS REQUIRED FOR 990 REPORTING PURPOSES ONLY. THE COMPENSATION REFLECTED IS THAT OF MR. FARRIS' POSITION AS AN ESJH EXECUTIVE AND IS NOT RELATED TO SAINT JOHN'S. JAMES T. PAQUETTE IS A SYSTEM PROJECT LEADER OF SCLHS IN DENVER, COLORADO. AS A FORMER OFFICER OF SAINT JOHN'S, THIS DISCLOSURE IS REQUIRED FOR 990 REPORTING PURPOSES ONLY. THE COMPENSATION REFLECTED IS THAT OF MR. PAQUETTE'S POSITION AS AN SCLHS SYSTEM PROJECT LEADER AND IS NOT RELATED TO SAINT JOHN'S. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON SCLHS OR AFFILIATE BOARDS IS COMPENSATED FOR THAT SERVICE. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| delegate control over management duties | FORM 990, PART VI, SECTION A, LINE 3: | ALTHOUGH THESE SERVICES MAY NOT ALL RISE TO THE LEVEL OF MANAGEMENT CONTROL AS DEFINED IN THE 990 INSTRUCTION, 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 FORM 990, PART VI, SECTION A, LINE 6, 7A & 7B: MEMBERS OF THE ORGANIZATION PROVIDENCE MEDICAL CENTER, INC. IS THE SOLE MEMBER OF SAINT JOHN HOSPITAL, INC. |
| form 990 review process | FORM 990, PART VI, SECTION B, LINE 11B: | COPIES OF THE 990 WERE DISTRIBUTED TO ALL BOARD MEMBERS FOR THEIR REVIEW PRIOR TO FILING THE RETURN. THE FORM 990 IS ALSO REVIEWED BY FINANCE PERSONNEL AT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM AND AN INDEPENDENT ACCOUNTING FIRM. |
| conflict of interest policy | FORM 990, PART VI, SECTION B, LINE 12C: | CONFLICT OF INTEREST FORMS ARE SENT OUT ANNUALLY TO ALL BOARD MEMBERS AND KEY EMPLOYEES. THESE STATEMENTS ARE CAREFULLY REVIEWED AND A REPORT PROVIDED TO THE CEO AND COO REGARDING EMPLOYEES AND OFFICERS, AND TO THE CHAIR OF THE BOARD AND CHAIR OF THE GOVERNANCE COMMITTEE REGARDING BOARD MEMBERS. IF A CONFLICT OF INTEREST ARISES, THE CEO DETERMINES ANY ACTION TO BE TAKEN AT THAT TIME. |
| PUBLIC AVAILABILITY OF FINANCIALS, GOVERNING DOCUMENTS, AND COI POLICIES | form 990, part vi, section c, line 19: | SCLHS' GOVERNANCE MANUAL FOR BOARD MEMBERS AND ITS AFFILIATE BOARD MEMBERS IS AVAILABLE TO THE PUBLIC ON THE WEBSITE, WWW.GREATBOARDS.ORG. THE MANUAL SETS FORTH THE STANDARDS AND EXPECTATIONS OF EACH BOARD MEMBER INCLUDING THE FIDUCIARY DUTY OF LOYALTY WHICH REQUIRES THAT EACH MEMBER ABIDE BY SCLHS' CONFLICT OF INTEREST POLICY, DISCLOSE ANY ISSUES WHICH MAY PRESENT A CONFLICT, COMPLETE THE ANNUAL DISCLOSURE STATEMENT, REVIEW POLICIES AND PROCEDURES PERTAINING TO CONFLICTS OF INTEREST, AND PROVIDE OVERSIGHT OF SCLHS' RESPONSIBILITY PROGRAM. SAINT JOHN HOSPITAL'S UNAUDITED FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. SAINT JOHN HOSPITAL IS A MEMBER OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM. THE AUDITED FINANCIAL STATEMENTS FOR THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM ARE AVAILABLE TO THE PUBLIC AT THEIR WEBSITE. |
| other changes in net assets or fund balances | FORM 990, PART XI, LINE 5: | EQUITY TRANSFERS $ 568,750 CONTRIBUTIONS TO LONG LIVED ASSETS $ 9,245 MEDICAL STAFF EQUITY ADJUSTMENT $ 221 Net unREALIZED GAINS & LOSSES $(66,457) Rounding $ 27 |
| STATEMENT OF CONTROLLED FOREIGN CORPORATION | SAINT JOHN HOSPITAL, INC. PARTICIPATION CORPORATION EIN: 48-0543768 FOR THE TAX YEAR ENDED DECEMBER 31, 2011 THIS STATEMENT IS BEING FILED PURSUANT TO TREAS. REG. 1.6038-2(J)(3). SAINT JOHN HOSPITAL, 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 | |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RANDALL NYP TITLE:CHIEF EXECUTIVE OFFICER HOURS:39 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JOE JEANS TITLE:REGION VICE PRESIDENT FINANCE HOURS:30 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MICHAEL A DORSEY TITLE:former CEO HOURS:31 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JUANITA ROY TITLE:EXECUTIVE VP & COO HOURS:30 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:CAROLYN BOWMER TITLE:Vice President- Human Resource HOURS:30 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JAN YERGAN TITLE:VICE PRESIDENT STRATEGY & BUS HOURS:30 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (27 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| SISTERS OF CHARITY LEAVENWORTH HLTH SYST | ||||||||||
| 9801 RENNER BLVD STE 100 | LENEXA | KS | 66219 | 237379161 | SUPPORT MMBRS | KS | 501(c)(3) | 11B-TYPE II | NA | false |
| CARITAS CLINICS INC | ||||||||||
| 818 NORTH 7TH STREET | LEAVENWORTH | KS | 66048 | 481009910 | CLINIC SVCS | KS | 501(c)(3) | 3 | SCLHS | true |
| MARIAN CLINIC INC | ||||||||||
| 1001 SW GARFIELD | TOPEKA | KS | 66604 | 481046905 | CLINIC SVCS | KS | 501(c)(3) | 3 | SCLHS | true |
| MARILLAC CLINIC INC | ||||||||||
| 2333 N 6TH STREET | GRAND JUNCTION | CO | 81501 | 841085822 | CLINIC SVCS | CO | 501(c)(3) | 3 | SCLHS | true |
| PROVIDENCE MEDICAL CENTER | ||||||||||
| 8929 PARALLEL PARKWAY | KANSAS CITY | KS | 66112 | 480784446 | HEALTHCARE | KS | 501(c)(3) | 3 | SCLHS | true |
| BETHANY COMMUNITY PLAZA INC | ||||||||||
| 15 NORTH 12TH STREET | KANSAS CITY | KS | 66102 | 481207407 | HEALTHCARE | KS | 501(c)(3) | 3 | PMC | true |
| PROVIDENCEST JOHN FOUNDATION INC | ||||||||||
| 8929 PARALLEL PARKWAY | KANSAS CITY | KS | 66112 | 480925688 | SUPPORT 501C3 | KS | 501(c)(3) | 7 | PMC | true |
| ST FRANCIS HEALTH CENTER INC | ||||||||||
| 1700 SW 7TH STREET | TOPEKA | KS | 66606 | 480547719 | HEALTHCARE | KS | 501(c)(3) | 3 | SCLHS | true |
| ST FRANCIS HEALTH CENTER FOUNDATION | ||||||||||
| 1700 SW 7TH STREET | TOPEKA | KS | 66606 | 481092520 | SUPPORT 501C3 | KS | 501(c)(3) | 11A-TYPE I | SFHC | true |
| ST MARYS HOSPITAL & MEDICAL CENTER INC | ||||||||||
| 2635 N 7TH STREET | GRAND JUNCTION | CO | 81502 | 840425720 | HEALTHCARE | CO | 501(c)(3) | 3 | SCLHS | true |
| ST MARYS HOSPITAL FOUNDATION | ||||||||||
| 2635 N 7TH STREET | GRAND JUNCTION | CO | 81502 | 237001007 | SUPPORT 501C3 | CO | 501(c)(3) | 11A-TYPE I | SMHMC | true |
| SAINT JOSEPH HOSPITAL FOUNDATION | ||||||||||
| 1835 FRANKLIN STREET | DENVER | CO | 80218 | 840735096 | SUPPORT 501C3 | CO | 501(c)(3) | 11A-TYPE I | SJH | true |
| HOLY ROSARY HEALTHCARE | ||||||||||
| 2600 WILSON | MILES CITY | MT | 59301 | 810231792 | HEALTHCARE | MT | 501(c)(3) | 3 | SCLHS | true |
| HOLY ROSARY HEALTHCARE FOUNDATION INC | ||||||||||
| 2600 WILSON | MILES CITY | MT | 59301 | 202270238 | SUPPORT 501C3 | MT | 501(c)(3) | 11A-TYPE I | HRHC | true |
| ST VINCENT HEALTHCARE | ||||||||||
| 1233 NORTH 30TH | BILLINGS | MT | 59101 | 810232124 | HEALTHCARE | MT | 501(c)(3) | 3 | SCLHS | true |
| ST VINCENT HEALTHCARE FOUNDATION | ||||||||||
| PO BOX 35200 | BILLINGS | MT | 59107 | 810468034 | SUPPORT 501C3 | MT | 501(c)(3) | 7 | SVHC | true |
| NORTHWEST RESEARCH & EDUCATION INSTITUTE | ||||||||||
| 315 NORTH 25TH STREET | BILLINGS | MT | 59101 | 201343024 | COMM HLTH RES | MT | 501(c)(3) | 9 | SVHC | true |
| ST JAMES HEALTHCARE | ||||||||||
| 400 SOUTH CLARK STREET | BUTTE | MT | 59701 | 810231785 | HEALTHCARE | MT | 501(c)(3) | 3 | SCLHS | true |
| ST JAMES HEALTHCARE FOUNDATION | ||||||||||
| 400 SOUTH CLARK STREET | BUTTE | MT | 59701 | 651202190 | SUPPORT 501C3 | MT | 501(c)(3) | 11A-TYPE I | SJHC | true |
| SAINT JOHNS HEALTH CENTER | ||||||||||
| 1328 22ND STREET | SANTA MONICA | CA | 90404 | 951684082 | HEALTHCARE | CA | 501(c)(3) | 3 | SCLHS | true |
| JOHN WAYNE CANCER INSTITUTE | ||||||||||
| 2000 SANTA MONICA BLVD | SANTA MONICA | CA | 90404 | 954291515 | CANCER R&D | CA | 501(c)(3) | 4 | SJHHC | true |
| SAINT JOHNS HOSPITAL & HLTH CENTER FNDTN | ||||||||||
| 1328 22ND STREET | SANTA MONICA | CA | 90404 | 956100079 | SUPPORT 501C3 | CA | 501(c)(3) | 11A-TYPE I | SJHHC | true |
| EXEMPLA INC FKA LUTHERAN HOSPITAL | ||||||||||
| 2420 W 26TH AVE SUITE 100D | DENVER | CO | 80211 | 841103606 | HEALTHCARE | CO | 501(c)(3) | 3 | SCLHS | true |
| EXEMPLA LUTHERAN MEDICAL CENTER FNDTN | ||||||||||
| 2480 W 26TH AVESUITE 360B | DENVER | CO | 80211 | 208846152 | SUPPORT 501C3 | CO | 501(c)(3) | 7 | EXEMPLA INC | true |
| EXEMPLA GOOD SAMARITAN MEDICAL CTR FNDTN | ||||||||||
| 200 EXEMPLA CIRCLE | LAFAYETTE | CO | 80026 | 841649162 | SUPPORT 501C3 | CO | 501(c)(3) | 7 | EXEMPLA INC | true |
| LUTH MED CNTR PRO&GEN LIAB SELF-INS TRST | ||||||||||
| 2480 W 26TH AVESUITE 360B | DENVER | CO | 80211 | 742571584 | INSURANCE | CO | 501(c)(3) | 11A-TYPE I | EXEMPLA INC | true |
| SAINT JOSEPH HOSPITAL | ||||||||||
| 1835 FRANKLIN STREET | DENVER | CO | 80218 | 840417134 | HEALTHCARE | CO | 501(c)(3) | 3 | SCLHS | true |
Form990 Schedule R Part III Form990ScheduleRPartIII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|
| PAVILION IMAGING LLC | |||||||||
| 750 WELLINGTON | GRAND JUNCTION | CO | 81501 | 030516198 | RADIOLOGY | CO | NA | false | false |
| GRAND VALLEY SURGICAL CENTER LLC | |||||||||
| 710 WELLINGTON | GRAND JUNCTION | CO | 81501 | 841505075 | OP SURGERY | CO | NA | false | false |
| SAN JUAN CANCER CENTER LLC | |||||||||
| 600 SOUTH 5TH STREET | MONTROSE | CO | 81401 | 202856331 | OP CANCER | CO | NA | false | false |
| BILLINGS MRI CENTER LLC | |||||||||
| 1041 NORTH 29TH STREET | BILLINGS | MT | 59101 | 810450943 | MRI-PET SCAN | MT | NA | false | false |
| LUTHERAN CAMPUS ASC LLC | |||||||||
| 3455 LUTHRN PKW SUITE 150 | WHEATRIDGE | CO | 800336028 | 020749532 | OP SURGERY | CO | NA | false | false |
| COLORADO SURGICAL VENTURES LLC | |||||||||
| 30 S WACKER DR SUITE 2302 | CHICAGO | IL | 60605 | 208038915 | OP SURGERY | CO | NA | false | false |
| COLORADO SURGICAL HOSPITAL LLC | |||||||||
| 30 S WACKER DR SUITE 2302 | CHICAGO | IL | 60605 | 208038977 | OP SURGERY | CO | NA | false | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Type Of EntityTypeOfEntity | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARITAS INC AND SUBSIDIARIES | |||||||||||||
| 9801 RENNER BOULEVARD SUITE 100 | LENEXA | KS | 66219 | 480941069 | OTHER MEDICAL | KS | C CORP | ||||||
| LEAVEN INSURANCE COMPANY LTD | |||||||||||||
| 980370522 | INSURANCE | 23 LIME TREE BAY AVE PO BOX 1051 | GEORGETOWN | GRAND CAYMAN | CJ | KY1-1102 | CJ | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| PROVIDENCESAINT JOHN HOSPITAL | ||
| c | 9246 | COST |
| PROVIDENCESAINT JOHN HOSPITAL | ||
| P | 8842 | COST |
| PROVIDENCE MEDICAL CENTER | ||
| N | 1263398 | COST |
| PROVIDENCE MEDICAL CENTER | ||
| L | 2032142 | COST |