Bon Secours - St Francis Medical Center Inc: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
Bon Secours - St Francis Medical Center Inc (EIN 31-1716973)
Tax period
2010-09-01 to 2011-08-31
Filed
2012-07-12
IRS object ID
201231949349300133
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)
Timestamp2012-07-12T12:53:42-05:00Timestamp
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)
EIN311716973EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Bon Secours - St Francis Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBONSNameControl
Phone8046275400Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line18580 Magellan Parkway Building IVAddressLine1
CityRichmondCity
StateVAState
ZIP Code23227ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePeter F GallagherName
TitleTreasurer CFO-BSVTitle
Phone8045947400Phone
Date Signed2012-07-12DateSigned
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 PersonMark GordonNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line18580 Magellan Parkway Building IVAddressLine1
CityRichmondCity
StateVAState
ZIP Code23227ZIPCode
FieldValueIRS element (for citing)
Gross Receipts220105760GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.bonsecours.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1999YearFormation
State Legal DomicileVAStateLegalDomicile
Activity Or Mission DescriptionAcute Care HospitalActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees1140TotalNbrEmployees
Total Nbr Volunteers265TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year265237ContributionsGrantsPriorYear
Contributions Grants Current Year2012916ContributionsGrantsCurrentYear
Program Service Revenue Prior Year195538266ProgramServiceRevenuePriorYear
Program Service Revenue CY215300734ProgramServiceRevenueCY
Investment Income Prior Year20749InvestmentIncomePriorYear
Investment Income Current Year25743InvestmentIncomeCurrentYear
Other Revenue Prior Year1016769OtherRevenuePriorYear
Other Revenue Current Year2168627OtherRevenueCurrentYear
Total Revenue Prior Year196841021TotalRevenuePriorYear
Total Revenue Current Year219508020TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year102000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY72000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year60545554SalariesEtcPriorYear
Salaries Etc Current Year67514944SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year123179643OtherExpensePriorYear
Other Expenses Current Year139228429OtherExpensesCurrentYear
Total Expenses Prior Year183827197TotalExpensesPriorYear
Total Expenses Current Year206815373TotalExpensesCurrentYear
Revenues Less Expenses Prior Year13013824RevenuesLessExpensesPriorYear
Revenues Less Expenses CY12692647RevenuesLessExpensesCY
Total Assets BOY141494600TotalAssetsBOY
Total Assets EOY144937947TotalAssetsEOY
Total Liabilities BOY141157825TotalLiabilitiesBOY
Total Liabilities EOY135497325TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY336775NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY9440622NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe mission is to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense185414124Expense
Grants72000Grants
Revenue214127793Revenue
DescriptionPatient Service in order to bring compassion to healthcare and to be good help to those in need by providing healthcare services. Please refer to the Community Benefit information on Schedule H.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2516441Expense
Revenue2153893Revenue
DescriptionBon Secours St. Francis Family Medicine Residency Program: The Virginia Commonwealth University (VCU) affiliated Bon Secours St. Francis Family Medicine Residency Program opened its doors in August 2005 and is fully accredited by the Accreditation Council for Graduate Medical Education.Bon Secours has built a program that creates family physicians and serves western Chesterfield county and surrounding areas in suburban Richmond, Virginia. The faculty includes a mixture of rural and suburban-based academicians and clinicians. Subspecialty preceptors are drawn from a premier network of Bon Secours affiliated physicians. The residency program is housed in a building designed specifically for the needs of resident education and efficient clinical care. In addition to rotating through Bon Secours St. Francis Medical Center, residents use many of the award-winning systems through our practice, the four hospitals of Bon Secours Richmond Health System, and our community outreach including Care-A-Van, our free mobile health clinic.Description
FieldValueIRS element (for citing)
Total Program Service Expense187930565TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
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
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
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 With109685NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1140NumberOfEmployees
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 Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
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 Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledVAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Melinda S HancockBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8046275400TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line18580 Magellan Parkway Building IVAddressLine1
CityRichmondCity
StateVAState
ZIP Code23227ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Jean Ann Bolling
Board Member4.00X000
John Bowman MD
Board Member4.00X000
Robert J Cohen MD
President4.00X000
Alexander J Corbett PhD
Board Member4.00X000
Toni Ardabell
Board Member50.00X047359435077
Richard Jackson MD
Board Member4.00X000
Kenneth J Jones
Board Member4.00X000
Sr Anne Marie Mack CBS
Board Member50.00X000
Joanne Nattrass
Board Member4.00X000
Michael Robinson
Board Member50.00X052089878018
Nancy Thomas
Board Member4.00X000
Jane Watkins
Board Member4.00X000
Michael Williams
Board Member4.00X000
Pete B Cleal
Chairman (Sept-Dec)6.00X000X
Thomas Winfree
Chairman (Feb-Aug)6.00X000X
Sr Victoria Segura MD CBS
President50.00X000X
Mark Gordon
CEO-SFMC50.00X045964457923X
Allen Goolsby
Secretary6.00000X
Peter J Bernard
CEO-BSV50.000965548188973X
Peter F Gallagher
Treasurer (CFO-BSV)50.00047634058283X
Kevin Sheppard
COO-SFMC50.00207989028107X
Shelly A Buck-Turner
VP CNE-SFMC50.00171622027836X
James Pellicane
Physician50.00497218029652X
Polly Stephans
Physician50.00370279029192X
Chi-Kin Ng
Physician50.00285229016804X
Stacey L Epps
Physician50.00277820022306X
John P Sherrod
Physician50.00261293021765X
Michael Kerner
Former Board Member50.000606241145769X
Thomas Morris PhD
Former Board Member50.00035156640989X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2071450TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3853831TotalReportableCompFrmRltdOrgs
Total Other Compensation780694TotalOtherCompensation
Number Individuals GT100 K43NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Aramark CTS Inc
12483 Collections Center DriveChicagoIL60693Clinical Services1512259
Sheltering Arms Hospital
8254 Atlee RoadMechanicsvilleVA23116Physical Therapy1390428
Prof Emergency Care Inc
38935 Ann Harbor RoadLivoniaMI48150Emergency Room Physicians1369013
OB Hospitalists
1754 Woodruff RoadGreenvilleSC29607Obstetric Hospitalists1228616
Commonwealth Anesthesia Assoc
PO Box 35808RichmondVA23235Anesthesia Physicians1018757
FieldValueIRS element (for citing)
Number Of Contractors GT100 K104NumberOfContractorsGT100K
Related Organizations251994RelatedOrganizations
Government Grants1760922GovernmentGrants
Total Contributions2012916TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net Patient Serv. Rev.622110213146841213146841
Fmly Prac Res Prg Tuit62211021538932153893
FieldValueIRS element (for citing)
Total Program Service Revenue215300734TotalProgramServiceRevenue

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real462755Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real492209Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-29454Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-29454TotalRevenueColumn
Exclusion-$29,454ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other131274Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other105531Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other25743Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column25743TotalRevenueColumn
Exclusion$25,743ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Cafe/Vending/Gift Shop7222121028739$1,028,739
Sheltering Arms Rev.900099980952980952
Purchase Discounts90009940486$40,486

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column147904TotalRevenueColumn
Exclusion$147,904ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2198081TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column219508020TotalRevenueColumn
Related Or Exempt Function Income216281686RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,213,418ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total72000Total
Program Services72000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total381194Total
Program Services343075ProgramServices
Management And General38119ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total53784348Total
Program Services48405913ProgramServices
Management And General5378435ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1531190Total
Program Services1378071ProgramServices
Management And General153119ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7989616Total
Program Services7190654ProgramServices
Management And General798962ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3828596Total
Program Services3445736ProgramServices
Management And General382860ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total354339Total
Program Services318905ProgramServices
Management And General35434ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total12272Total
Program Services11045ProgramServices
Management And General1227ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total30817506Total
Program Services27735755ProgramServices
Management And General3081751ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total118277Total
Program Services106449ProgramServices
Management And General11828ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total689702Total
Program Services620732ProgramServices
Management And General68970ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5209186Total
Program Services4688268ProgramServices
Management And General520918ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total217408Total
Program Services195667ProgramServices
Management And General21741ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3655736Total
Program Services3655736ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6554313Total
Program Services5898882ProgramServices
Management And General655431ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1146762Total
Program Services1032086ProgramServices
Management And General114676ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Supplies40550421364953794055042
Purchased Services26925511242329602692551
Bad Debt1423955914239559
Equip. Rent and Maint.42346293811166423463
Education and Training27623192486087276232

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1740489Total
Program Services1566440ProgramServices
Management And General174049ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total206815373Total
Program Services187930565ProgramServices
Management And General18884808ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY65708BOY
EOY61091EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY4032EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY23766339BOY
EOY21868977EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3528746BOY
EOY3634673EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY924517BOY
EOY881629EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis168876678LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec58731340LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY108124281BOY
EOY110145338EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY5085009BOY
EOY8342207EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY141494600BOY
EOY144937947EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9606589BOY
EOY12773258EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY61770BOY
EOY3765443EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY131489466BOY
EOY118958624EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY141157825BOY
EOY135497325EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY336775BOY
EOY9436139EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY4483EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY336775BOY
EOY9440622EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY141494600BOY
EOY144937947EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses12692647ReconcilationRevenueExpenses
Reconcilation Other Changes-3588800ReconcilationOtherChanges
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)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$12,272OtherActivitiesAmount
Total Lobbying Expenditures IIB12272TotalLobbyingExpendituresIIB
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
ExplanationBon Secours - St. Francis Medical Center paid dues to the American Hospital Association (AHA), the Virginia Hospital Healthcare Association (VHHA) and the Catholic Hospital Association (CHA), a portion of which is used for lobbying activities. The portion of dues allocated to lobbying activities for each of these organizations is as follows: AHA ($5,218 or 24.2%), VHHA ($4,296 or 9.70%), CHA ($2,758 or 4.68%) for a total of $12,272.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis21097936OtherCostOrOtherBasis
Book Value21097936BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis73660728OtherCostOrOtherBasis
Depreciation12922337Depreciation
Book Value60738391BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5314874OtherCostOrOtherBasis
Depreciation2151776Depreciation
Book Value3163098BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis55847390OtherCostOrOtherBasis
Depreciation39886392Depreciation
Book Value15960998BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12955750OtherCostOrOtherBasis
Depreciation3770835Depreciation
Book Value9184915BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings110145338TotalOfBookValueLandBuildings

Other Assets OtherAssets (8 entries)

DescriptionDescriptionBook ValueBookValue
Misc A/R1920697
Accrued Revenue1857569
Cost Report Settlements Receivable1396389
Financing Costs1323609
Due From Affiliates150428
Physician Loan Receivable906280
Other21198
Due From BSHSI766037
FieldValueIRS element (for citing)
Total Book Value Other Assets8342207TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Due to Affiliates$80,000,000
Medicare Settlement 2011$2,219,300
Miscellaneous$198,161
Due to BSHSI$36,541,163
FieldValueIRS element (for citing)
Total Of Amounts118958624TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDescription of Uncertain Tax Positions Under FIN 48:Identifier
Return ReferencePart X:ReturnReference
ExplanationSchedule 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.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense7771942TotalCommunityBenefitExpense
Net Community Benefit Expense7771942NetCommunityBenefitExpense
Percent Of Total Expense0.04100PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense14068604TotalCommunityBenefitExpense
Direct Offsetting Revenue10203194DirectOffsettingRevenue
Net Community Benefit Expense3865410NetCommunityBenefitExpense
Percent Of Total Expense0.02040PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense21840546TotalCommunityBenefitExpense
Direct Offsetting Revenue10203194DirectOffsettingRevenue
Net Community Benefit Expense11637352NetCommunityBenefitExpense
Percent Of Total Expense0.06140PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served7PersonsServed
Total Community Benefit Expense264849TotalCommunityBenefitExpense
Net Community Benefit Expense254849NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense3293176TotalCommunityBenefitExpense
Direct Offsetting Revenue838047DirectOffsettingRevenue
Net Community Benefit Expense2455129NetCommunityBenefitExpense
Percent Of Total Expense0.01300PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense51058TotalCommunityBenefitExpense
Net Community Benefit Expense51058NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served7PersonsServed
Total Community Benefit Expense3609083TotalCommunityBenefitExpense
Direct Offsetting Revenue838047DirectOffsettingRevenue
Net Community Benefit Expense2761036NetCommunityBenefitExpense
Percent Of Total Expense0.01470PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served7PersonsServed
Total Community Benefit Expense25449629TotalCommunityBenefitExpense
Direct Offsetting Revenue11041241DirectOffsettingRevenue
Net Community Benefit Expense14398388NetCommunityBenefitExpense
Percent Of Total Expense0.07610PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$3,350,995BadDebtExpenseAmount
Amount Reimbursed By Medicare42230966AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare55672667CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-13441701MedicareSurplusOrShortfall
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1St Francis Medical CenterBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line113710 St Francis BlvdAddressLine1
CityMidlothianCity
StateVAState
ZIP Code23114ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities7NumberOfOtherFacilities

Other Facilities OtherFacilities (7 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
St Francis Family Medical Practice
13540 Hull Street RoadMidlothianVA23112Physician Practice
Virginia Breast Center
14051 St Francis Blvd Suite 2210MidlothianVA23114Physician Practice
Neurology Clinic Bon Secours Med Group
11601 Ironbridge Road Suite 207ChesterVA23831Physician Practice
St Francis Medical Women's Center
13700 St Francis Blvd Suite 502MidlothianVA23114Physician Practice
Diabetes Treatment Center
2372 Colony CrossingMidlothianVA23114Physician Practice
Charter Colony Family Practice
13700 St Francis Blvd Suite 302MidlothianVA23114Physician Practice
St Joseph Outreach Center
8000 Brook RoadRichmondVA23227Physician Practice

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 6a: Annually, Bon Secours Richmond Health System (BSRHS) publishes a report for the community, explaining the various community benefit services and programs that exist. This report also includes the annual financial commitment of the local system to the community, detailing monetary contributions for government sponsored healthcare shortfall, community benefit programs and charity care at cost. This report is available to the public each year on or around January 24, commemorating Foundation Day of the Sisters of Bon Secours.
Part I, Line 7: Part I, line 7a: Charity Care at cost is computed by applying a cost-to-charge ratio to the aggregate charity adjustments recorded in the general ledger. Part I, line 7b: Unreimbursed Medicaid is computed by determining the cost of Medicaid services supplied less payments received for these services. To determine the cost of Medicaid services provided, a cost-to-charge ratio is applied to traditional and managed Medicaid gross charges recorded in the general ledger. Payments include payments for individual claims, payments from the Medicaid program paid outside the claim process (such as medical education payments) and expected or actual cost report settlements.Part I, line 7c: Unreimbursed costs from other means-tested government programs are computed by applying a cost-to-charge ratio to the total charges to patients covered under these programs. The charges are identified by the financial class assigned to the patient. For Part I, Line 7 a-c computations: The cost-to-charge ratio is derived using the suggested computation in Worksheet 2, Ratio of Patient Care Cost-to-Charges. Operating expenses and Gross patient charges are taken from the general ledger. Expenses for nonpatient care activities recorded in operating expenses are approximated as directly equaling other operating revenue, assuming these activities do not provide profit. Part I, line 7e: Community health improvement services and community benefit operations are accumulated throughout the year and reported at actual cost in a software program that specifically addresses this purpose.Part I, line 7f: Health professions education cost is determined as the direct and indirect cost of qualifying education activities as traditionally reported in columns 21-24 on Worksheet B of the Medicare cost report as a Medical Education program, nursing school or other allied health program.
Part I, L7 Col(f): The bad debt expense included in Part IX: line 25 and excluded from the "percent of total expense" calculation is: $14,239,559
Part II: In partnership with Bon Secours Richmond Health System, St. Francis Medical Center (SFMC) uses multiple approaches to assess the health needs of the communities it serves. In October 2009, the Central Virginia Health Planning Agency released an Immigrant Needs Assessment commissioned by Bon Secours Richmond Health System in collaboration with St. Francis Medical Center. This work documented the growth of the immigrant population in the metropolitan Richmond area and made multiple recommendations including the need for interpretation and translation services, health resource information in other languages, preventive services, health screenings including vision and dental, affordable health insurance for immigrants and their families and access to behavioral health services. Bon Secours Richmond has initiated many of the recommendations.Community need assessments are updated using a variety of informational sources including Virginia Health Information for state-based performance data, Health Group West and Hammes Company for market and geographic data. Thomson-Reuters Market Expert is used to retrieve demographic information and trends for the primary and secondary service areas pertaining to St. Francis Medical Center. National Research Corporation (NRC) is also utilized.
Part III, Line 4: Part III, line 2: Bad Debt Expense at cost is computed by applying the cost-to-charge ratio computed on Worksheet 2 to the aggregate bad debt expense for patient accounts recorded in the general ledger. Bad debt expense on the general ledger includes: 1) actual write offs of discounted gross charges where it is determined an uninsured patient can pay and does not pay; and 2) the estimated write offs for uninsured patient accounts with outstanding balances after discount. Estimates are based on historical collection rates.When an uninsured patient is billed for patient care services, the charges are automatically discounted and the patient is requested to only pay the amount after discount. The discount is recorded as an adjustment to gross revenue and is not recorded in bad debt expense. If the balance after discount is not paid or not paid in full, the unpaid amount will be written off to bad debt expense. When a patient remits a payment on an account that has already been written off to bad debt expense, the payment is recorded as a recovery of bad debt, which reduces bad debt expense.Part III, line 3: The organization does not report an estimate for the portion of bad debt expense that may have been likely to qualify for financial assistance under the hospital's charity care policy. The organization takes the position that ample opportunity and assistance is provided to the patient to qualify under the financial assistance policy. If sufficient information is not provided, the organization must assume the patient does not qualify.
Part III, Line 8: Part III, Line 6: Medicare allowable costs reflected in Part III come directly from the facility's Medicare cost report. The cost report segregates the total facility actual expenses into costs for support departments, clinical departments (routine and ancillary) and nonreimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and nonreimburseable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.Part III, Line 8: The organization feels the total shortfall of Medicare reimbursement compared to computed Medicare allowable costs should be treated as community benefit. The hospital improves access to patient care by providing services regardless of a patient's ability to pay or the hospital's ability to receive full cost reimbursement for services. The hospital also relieves the government of a financial burden when it provides care to publicly insured patients where reimbursement is less than cost of providing the service.
Part III, Line 9b: The hospital has a written policy that describes collection practices applying to patients that qualify for charity care or financial assistance. If full assistance is approved, no collection efforts are pursued on that patient's account(s). If partial assistance is provided, the patient is responsible for the adjusted account balance and collection efforts will follow the established practices for all patients where a self-pay balance exists. Collection efforts are not pursued on any pending FAP account.Specific criteria exist for how much financial assistance, partial or total, will be provided to the patient based on the assessed need. Criteria is based on Federal Poverty Guidelines and is reviewed and updated annually. Once a patient has been deemed eligible for the Patient Financial Assistance Program (FAP), the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of twelve months from the date of the application. This eligibility is signaled to hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of those twelve months, the patient is responsible for reapplying for FAP eligibility.
Part VI, Line 2: In partnership with Bon Secours Richmond Health System, St.Francis Medical Center (SFMC) uses multiple approaches to assess the health needs of the communities it serves. In October 2009, the Central Virginia Health Planning Agency released an Immigrant Needs Assessment commissioned by Bon Secours Richmond Health System in collaboration with Saint Francis Medical Center. This work documented the growth of the immigrant population in the metropolitan Richmond area and made multiple recommendations including the need for interpretation and translation services, health resource information in other languages, preventive services, health screenings including vision and dental, affordable health insurance for immigrants and their families and access to behavioral health services. Bon Secours Richmond has initiated many of the recommendations.Community need assessments are updated using a variety of informational sources including Virginia Health Information for state-based performance data, Health Group West and Hammes Company for market and geographic data. Thomson-Reuter's Market Expert is used to retrieve demographic information and trends for the primary and secondary service areas pertaining to Saint Francis Medical Center. National Research Corporation (NRC) is also utilized.
Part VI, Line 3: Patient financial assistance policy is communicated to patients verbally upon scheduling, registration, visible postings of the policy in common areas throughout the hospital, brochures and on Bon Secours website. In addition, patient statements request that patients apply for financial assistance, if needed, once any patient financial obligation is determined.Bon Secours is committed to ensuring access to health care services for all. As a health care provider, Bon Secours treats all patients, whether insured, underinsured or uninsured, with dignity, respect and compassion throughout admission, delivery of services, discharge and billing and collection processes. Bon Secours addresses the needs of the uninsured by providing free or reduced fees on hospital services, community outreach efforts to assist with enrollment in Medicaid and other medical coverage programs, including free community-based preventive and primary care services. Bon Secours proactively screens to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours Patient Financial Assistance Program ("FAP") and assist the potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Patients are responsible for providing the information necessary to complete the documentation. The FAP aids uninsured and underinsured patients who do not qualify for government-sponsored health insurance and who communicate their inability to pay for their medical care. The FAP provides 100% financial assistance to uninsured patients with annual family incomes at or below 200% of the Federal Poverty Guidelines ("FPG"), as adjusted by the Medicare geographic wage index for each community served to reflect that community's relative cost of living ("Adjusted FPG"). Adjustments to these guidelines are made in certain States, where applicable. A sliding scale assistance policy is afforded patients that exceed the income guidelines for 100% assistance. Sliding scale assistance is provided to patients and progressively declines in proportion to the patient's higher income level. Additionally, all uninsured (i.e. self pay) patients are given a reduction to the amount of the full charges for medically necessary services through a community service adjustment ("CSA"). The CSA is market adjusted and based on the payment discount received by other health care payers doing business in the community. For these patients, the FAP also sets a maximum annual family payment liability to ensure that no family suffers a catastrophic financial burden to receive necessary health care services. Based on research conducted by the Tax Foundation, a non partisan tax research group based in Washington DC, the maximum annual family liability is based on a sliding scale determined by the family income and size. The standard sliding scale is adjusted by the Medicare geographic wage index of each community served to reflect that community's relative cost of living. All patients are also eligible for a Prompt Pay Discount. In addition, a variety of other potential payment options are available. Bon Secours is dedicated to meeting the needs of non-English speaking patients by having on-site Spanish translators, and other language translation services. In addition, Bon Secours employs a telephone language service which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including the financial process.
Part VI, Line 4: SFMC serves the greater Richmond, Virginia area. Projections indicate that the population will grow by 5.0% from 1,242,918 in 2010 to 1,304,689 in 2015, with 9.2% of the service area having a household income of less than $15,000 per year, compared to the national average of 12.1%. Similarly, 17.3% of the service area's populace maintains a household income less than $25,000 per year, compared to the national average of 22.3%. Demographic data shows that 61.6% of the population is white and 29.4% is black, compared to the national averages of 64.7% and 12.1% respectively. Demographics of the service area indicate that the age cohort of 64 to 75 will increase by 29.5% between 2010 and 2015. SFMC is a disproportionate share hospital (DSH). In fiscal year 2011, it served 8,926 inpatients and provided outpatient services for 46,222 visits. Additionally, SFMC provided 39,428 emergency room visits. The Emergency Department is open 24 hours a day and available to all persons regardless of ability to pay. SFMC participates in Medicare, Medicaid, CHAMPUS, Tricare and other government sponsored health care programs such as the State/Local Hospitalization program and the SCHIP/FAMIS program for children.
Part VI, Line 6: SFMC has an open medical staff with privileges available to all qualified physicians in the area. SFMC, through the BSRHS is governed by a board of directors whose composition is representative of the community. SFMC also engages in medical research. Inpatient and outpatient research-related activities are conducted by SFMC with oversight from the BSRHS Institutional Review Board.
Part VI, Line 7: Bon Secours Health System, Inc., a Maryland nonprofit, nonstock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc, a Maryland nonprofit, nonstock membership corporation (BSI) are described collectively as the System. BSI, which is the sole corporate member of BSHSI, has no healthcare operations. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSHSI aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. BSHSI's vision to bring about the holistic health of the communities it serves is implemented through its Strategic Quality Plan which provides focus in four goal areas for the current three year period (2010-2012). One of those goals is to partner with communities to co-create a more humane world, improve health and model social justice. To accomplish this, two key strategies are to: - Engage communities to identify needs and assets and building partnerships to improve health and quality of life of a specific population.- Demonstrate sustainable stewardship for healing the earth as a way to improve health and life quality.As a member of the Catholic health ministry and a member of Bon Secours Health System, Inc. (BSHSI), Bon Secours Richmond Health System (BSRHS) is called to continue the healing ministry of Jesus. BSRHS exists to benefit the people living in the communities it serves. Through all of the services offered to the community, the 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 as part of the healing ministry of Jesus Christ and the Catholic Church." BSRHS shares the BSHSI Vision. "Inspired by the healing ministry of Jesus Christ and the charism of Bon Secours, Bon Secours Health System will be recognized for its leadership in justice, transforming the communities in which we serve and work into places of health and hope, and being a prophetic voice for systemic US health reform and a more humane world." Please see Schedule R for listings of the related organizations within BSRHS.
VAReports Filed With StatesPart VI, Line 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1Bon Secours Richmond Healthcare FoundationBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line18580 Magellan Parkway Building IVAddressLine1
CityRichmondCity
StateVAState
ZIP Code23227ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient541201346EINOfRecipient
IRC Section501(c)(3)IRCSection
Amount Of Cash Grant70000AmountOfCashGrant
Purpose Of GrantGeneral SupportPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (14 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
Toni Ardabell
035580508418303360603237502702050867100
Michael Robinson
0395596094735030567058409019609059891600
Mark Gordon
03345410101237023866030227027696051756700
Peter J Bernard
073398302229540861101582750306980115452100
Peter F Gallagher
038713408623602970027746030537053462300
Kevin Sheppard
1763300314140245032280248790236096000
Shelly A Buck-Turner
1465180249730131013110265250199458000
James Pellicane
496843000375026880269640526870000
Polly Stephans
369904000375026640265280399471000
Chi-Kin Ng
2834610001768000168040302033000
Stacey L Epps
277545000275000223060300126000
John P Sherrod
105242015445201599035880181770283058000
Michael Kerner
04634670138768040060116245029524075201000
Thomas Morris PhD
0258451070978022137028541012448039255500

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

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

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 6Bon Secours Health System, Inc. is the sole member of Bon Secours - Richmond Health Corp, which in turn holds the majority interest in Bon Secours- Richmond Health System, which in turn is the sole member of Bon Secours - St. Francis Medical Center.
Form 990, Part VI, Section A, line 7aThe governing body of Bon Secours - St. Francis Medical Center is appointed by its member Bon Secours - Richmond Health System and subject to approval by Bon Secours Health System, Inc.
Form 990, Part VI, Section A, line 7bCertain authorities of Bon Secours - St. Francis Medical 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 - St. Francis Medical 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. Peter J. Bernard's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the CEO of Bon Secours Virginia Health System which includes direct management, monitoring and oversight of Bon Secours Richmond Health System, Bon Secours Hampton Roads Health System and their related organizations. Peter F. Gallagher's compensation is paid by Memorial Regional Medical Center, a related organization. The compensation he receives is for his role as the CFO of Bon Secours Virginia Health System which includes direct financial management, monitoring and oversight of Bon Secours Richmond Health System, Bon Secours Hampton Roads Health System and their related organizations. Toni Ardabell's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation she receives is for her role as the Chief Executive Officer of St. Mary's Hospital of Richmond, Inc., a related organization. Mark Gordon'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 St. Francis Medical Center, a related organization. Michael Robinson'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 Memorial Regional Medical Center and Richmond Community Hospital. Sr. Anne Marie Mack and Sr. Victoria Segura do not receive payroll distributions as they have taken vows of poverty.Form 990, Part VII:
Changes in Net Assets or Fund Balances:Transfers to Affiliates -3,377,565. Assets Released from restrictions for operations -11,352. Temp restricted Fed grants recognized as rev for tax purposes 15,835. Contribution reported for tax purposes -215,718. Total to Form 990, Part XI, Line 5: -3,588,800.Form 990, Part XI, line 5:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (9 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 Marriotsville RoadMarriotsvilleMD21104521301088Parent Org. Management ServicesMD501(c)(3)11bBon Secours Inc0
Bon Secours Richmond Health Corporation
8580 Magellan ParkwayRichmondVA23227541356155Management ServicesVA501(c)(3)11bBon Secours Health System Inc0
Bon Secours Richmond Health System
8580 Magellan ParkwayRichmondVA23227521988421Local System Parent Org.VA501(c)(3)11bBon Secours Richmond Health Corporation0
Bon Secours Memorial Regional Medical Center
8580 Magellan ParkwayRichmondVA23227541744931Health CareVA501(c)(3)3Bon Secours Richmond Health System0
Bon Secours St Mary's Hospital Inc
8580 Magellan ParkwayRichmondVA23227540793767Health CareVA501(c)(3)3Bon Secours Richmond Health System0
Bon Secours Richmond Community Hospital Inc
8580 Magellan ParkwayRichmondVA23227540647482Health CareVA501(c)(3)3Bon Secours Richmond Health System0
Laburnum Properties
8580 Magellan ParkwayRichmondVA23227521260700Title Holding CompanyVA501(c)(2)Bon Secours Richmond Health System0
Bon Secours Stuart Circle Hospital
8580 Magellan ParkwayRichmondVA23227541740128Health CareVA501(c)(3)3Bon Secours Richmond Health System0
Bon Secours Richmond Healthcare Foundation
8580 Magellan ParkwayRichmondVA23227541201346Grant Making FoundationVA501(c)(3)7Bon Secours Richmond Health Corporation0

Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
St Mary's MRI LP
8580 Magellan ParkwayRichmondVA23227541568022Imaging ServicesVABon Secours Virginia Healthsource IncRelated000.00000
RI LP
8580 Magellan ParkwayRichmondVA23227541708835Imaging ServicesVABon Secours Virginia Healthsource IncRelated000.00000
Broad64 Imaging LLC
8580 Magellan ParkwayRichmondVA23227205886018Imaging ServicesVABon Secours Virginia Healthsource IncRelated000.00000
Richmond Radiation Oncology Center I LLC
8580 Magellan ParkwayRichmondVA23227208444551Radiation Oncology ServicesVARichmond Radiation Oncology Center IncRelated000.00000
Chesterfield Community Healthcare Center MOB I LLC
435 Southlake BlvdRichmondVA23236541745670Rental- Medical Office BuildingVABon Secours Virginia Healthsource IncRelated000.00000

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
Chesterfield Community Healthcare Center Inc
8580 Magellan ParkwayRichmondVA23227541812738Ambulatory Healthcare ServicesVABon Secours Richmond Health SystemC
RHS Management Corporation
8580 Magellan ParkwayRichmondVA23227541313425Independent Living FacilityVABon Secours Richmond Health SystemC
Bon Secours -Virginia HealthSource Inc
8580 Magellan ParkwayRichmondVA23227541417686Ambulatory Healthcare ServicesVABon Secours Richmond Health SystemC
Richmond MRI Inc
8580 Magellan ParkwayRichmondVA23227541568452Imaging ServicesVABon Secours Virginia Healthsource IncC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
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 Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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