Mary Immaculate Nursing Center Inc: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
Mary Immaculate Nursing Center Inc (EIN 54-1516476)
Tax period
2009-09-01 to 2010-08-31
Filed
2011-07-12
IRS object ID
201101939349301000
Schema version
2009v1.7
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)
Timestamp2011-07-12T20:08:10-05:00Timestamp
Tax Period End Date2010-08-31TaxPeriodEndDate

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 Date2009-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN541516476EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mary Immaculate Nursing CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMARYNameControl
Phone7578895000Phone

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameGreg SimiaName
TitleEVPTitle
Phone7578866500Phone
Date Signed2011-07-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameEmily Hayes SmithName
Phone7032511000Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeXAddressChange

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1St Francis Nursing CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonDiana JarrettNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14 Ridgewood ParkwayAddressLine1
CityNewport NewsCity
StateVAState
ZIP Code236020000ZIPCode
FieldValueIRS element (for citing)
Gross Receipts7236234GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501cXOrganization501c
Web Sitewww.bonsecourshamptonroads.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1989YearFormation
State Legal DomicileVAStateLegalDomicile
Activity Or Mission DescriptionSkilled Nursing FacilityActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees120TotalNbrEmployees
Total Nbr Volunteers35TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year7759071ProgramServiceRevenuePriorYear
Program Service Revenue CY7180653ProgramServiceRevenueCY
Investment Income Prior Year116804InvestmentIncomePriorYear
Investment Income Current Year16693InvestmentIncomeCurrentYear
Other Revenue Prior Year43510OtherRevenuePriorYear
Other Revenue Current Year38888OtherRevenueCurrentYear
Total Revenue Prior Year7919385TotalRevenuePriorYear
Total Revenue Current Year7236234TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3706759SalariesEtcPriorYear
Salaries Etc Current Year3562816SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3496679OtherExpensePriorYear
Other Expenses Current Year3415959OtherExpensesCurrentYear
Total Expenses Prior Year7203438TotalExpensesPriorYear
Total Expenses Current Year6978775TotalExpensesCurrentYear
Revenues Less Expenses Prior Year715947RevenuesLessExpensesPriorYear
Revenues Less Expenses CY257459RevenuesLessExpensesCY
Total Assets BOY8807849TotalAssetsBOY
Total Assets EOY9214491TotalAssetsEOY
Total Liabilities BOY3979443TotalLiabilitiesBOY
Total Liabilities EOY4151891TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4828406NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5062600NetAssetsOrFundBalancesEOY
Mission DescriptionThe mission is to bring compassion to skilled nursing care and to be good help to those in need, especially those who are elderly, poor and dying.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense5681416Expense
Revenue5112326Revenue
DescriptionSkilled Nursing Care provided to patients to include assessment of cognitive and physical status, personal hygeine care, nutrition and maintenance of a clean and comfortable environment.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense31261Expense
Revenue531002Revenue
DescriptionMedication & Diagnostic Treatments to include the administration of medication, ongoing assessment of potential interactions and negative side effects, wound care and facillitation of diagnostic testing as needed.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense599849Expense
Revenue1537325Revenue
DescriptionRehabilitation Therapies to include physical therapy, respiratory therapy and occupational therapy so as to maintain each patient's optimal quality of life.Description
FieldValueIRS element (for citing)
Total Program Service Expense6312526TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109610NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees120NumberOfEmployees
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
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
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 Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1James PirtleBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7578895717TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1150 Kingsley laneAddressLine1
CityNorfolkCity
StateVAState
ZIP Code23505ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
John H Garrett
Board Member4.00X000
Steven B Hopson
Board Member4.00X000
Matthew James
Board Member4.00X000
Sr M Margaret Jackson
Board Member4.00X000
Robert M Yacobi
Board Member4.00X000
Susan B Anthony
Board Member4.00X000
Sr Lynn Rachelle Pascoe
Board Member4.00X000
Timothy J Davis
Board Member50.00X01223989129362
Sr Patricia Heath
Board Member50.00X000
Sr Anne M Lutz
Board Member50.00X000
Sr Elaine Davia
Board Member4.00X000
Paul W Garman
Chairman 20096.00X000X
Jon A Nystrom
Chairman 20106.00X000X
Sr David Ann Niski
President6.00X000X
Kasia Grzelkowski
Secretary6.00X000X
Patricia Robertson
Executive Vice President50.00X044162042145X
Gregory Simia
Treasurer50.00040407551557X
Michael Kerner
CEO - Hampton Roads50.000940681126469X
Timothy Short
Administrator50.00156557030423X
Leanne Bailey
Administrator50.00000X
Joyce Williams
Assistant Administrator50.00107749011749X
Richard Hanson
Former CEO50.000772746108243X
Joseph Buccheit
Former CFO50.00035413444775X
Eileen Malo
Former EVP Continuing Care50.00017600925752X
FieldValueIRS element (for citing)
Total Reportable Comp From Org264306TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4313254TotalReportableCompFrmRltdOrgs
Total Other Compensation570475TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Rehabcare Group IncBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 502096AddressLine1
CitySt LouisCity
StateMOState
ZIP Code631502096ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesRehabilitative TherapiesDescriptionOfServices
Compensation726977Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient Service Rev.Description
Business Code623110BusinessCode
Total Revenue Column7180653TotalRevenueColumn
Related Or Exempt Function Income7180653RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue7180653TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column16693TotalRevenueColumn
Exclusion$16,693ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
Other90009923170$23,170
Beauty & Barber Shop90009915718$15,718
FieldValueIRS element (for citing)
Total Other Revenue38888TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column7236234TotalRevenueColumn
Related Or Exempt Function Income7180653RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$55,581ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total178652Total
Program Services160787ProgramServices
Management And General17865ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2641223Total
Program Services2377101ProgramServices
Management And General264122ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total55169Total
Program Services49652ProgramServices
Management And General5517ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total487228Total
Program Services438505ProgramServices
Management And General48723ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total200544Total
Program Services180490ProgramServices
Management And General20054ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total11433Total
Program Services10290ProgramServices
Management And General1143ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total18520Total
Program Services16668ProgramServices
Management And General1852ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total21489Total
Program Services19340ProgramServices
Management And General2149ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total142706Total
Program Services128435ProgramServices
Management And General14271ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total4544Total
Program Services4089ProgramServices
Management And General455ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total218341Total
Program Services218341ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total245367Total
Program Services220830ProgramServices
Management And General24537ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total70543Total
Program Services63489ProgramServices
Management And General7054ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Purchased Services139816612583501398160
Total Supplies858948773053858950
Repairs192130172917192130
Bad Debt979509795000
Equipment Rental249122242024920

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total110910Total
Program Services99819ProgramServices
Management And General11091ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6978775Total
Program Services6312526ProgramServices
Management And General666249ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY6161665BOY
EOY6668593EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY693062BOY
EOY782992EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2243BOY
EOY2243EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4227526LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2513915LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1909093BOY
EOY1713611EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY41786BOY
EOY47052EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8807849BOY
EOY9214491EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY446035BOY
EOY573318EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3533408BOY
EOY3578573EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3979443BOY
EOY4151891EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4809360BOY
EOY5043554EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY19046BOY
EOY19046EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4828406BOY
EOY5062600EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8807849BOY
EOY9214491EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6501987CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6285696CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7449594CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7759071CurrentTaxYearMinus1Year
Current Tax Year7810653CurrentTaxYear
Total35807001Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6501987CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6285696CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7449594CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7759071CurrentTaxYearMinus1Year
Current Tax Year7810653CurrentTaxYear
Total35807001Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50935807001PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years226423CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years318807CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years137669CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year116804CurrentTaxYearMinus1Year
Current Tax Year16693CurrentTaxYear
Total816396Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years226423CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years318807CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years137669CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year116804CurrentTaxYearMinus1Year
Current Tax Year16693CurrentTaxYear
Total816396Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6728410CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6604503CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7587263CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7875875CurrentTaxYearMinus1Year
Current Tax Year7827346CurrentTaxYear
Total36623397Total
FieldValueIRS element (for citing)
Public Support Percentage5090.97770PublicSupportPercentage509
Prior Year Support Percentage0.97500PriorYearSupportPercentage
Investment Income Percentage0.02230InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.02500PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3166066OtherCostOrOtherBasis
Depreciation1915872Depreciation
Book Value1250194BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1007781OtherCostOrOtherBasis
Depreciation597325Depreciation
Book Value410456BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis53679OtherCostOrOtherBasis
Depreciation718Depreciation
Book Value52961BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1713611TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
I/C LT Liab - MCA Transition Company$3,498,335
Other Current Liabilities$80,238
FieldValueIRS element (for citing)
Total Of Amounts3578573TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart X:Identifier
Return ReferenceDescription of Uncertain Tax Positions Under FIN 48: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. As the organization does not conduct a separate audit of its financial statement, 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 $98,300 and $117,200 of net operating loss carryforwards as of August 31, 2010 and 2009, respectively, which expire in varying periods through 2030 and are available to offset future taxable income. The System's deferred tax assets are fully reserved at August 31, 2010 and 2009. Any changes to the valuation allowance on the deferred tax asset are reflected in the year of the change.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Timothy J Davis
0536658066588002145101101850191770135335100
Patricia Robertson
0277752014179002207803226609879048376500
Gregory Simia
0289470069599045006024464027093045563200
Michael Kerner
0467646029094701820880994350270340106715000
Timothy Short
12230602956304688038320265910186980000
Richard Hanson
04079900335679029077080844027399088098900
Joseph Buccheit
0224034047590082510028800015975039890900
Eileen Malo
017600900000249100842020176100

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Lines 4a-b:ReturnReference
ExplanationEileen Malo received severance payments of $176,821. Part I, Line 4b: Mary Immaculate Nursing Center participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirements plans and available only to officers and key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits are made into this plan. Part I, Line 3: Bon Secours Health System, Inc., a related organization of Mary Immaculate Nursing 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 committeeExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part I, Item CDoing Business AsSt Francis Nursing Center
Form 990, Part VI, Section A, line 6Bon Secours Health System, Inc. and the General Minister and General Council of the Bernardine Sisters of the Third Order of St. Francis are the members of Mary Immaculate Hospital Inc., which in turn is the sole member of Mary Immaculate Nursing Center.
Form 990, Part VI, Section A, line 7aThe governing body of Mary Immaculate Nursing Center is appointed by its member, Mary Immaculate Hospital, Inc., and subject to approval by Bon Secours Health System, Inc.
Form 990, Part VI, Section A, line 7bCertain authorities of Mary Immaculate Nursing 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 Mary Immaculate Nursing Center's audit and compliance board committee and providing the form to the Mary Immaculate Nursing Center's board of directors to allow for a thorough review by both before the filing date of July 15, 2011. Mary Immaculate Nursing Center's audit and compliance board committee and Mary Immaculate Nursing Center's board of directors will review the Form 990 and ask any additional questions regarding the Form 990 before the return is filed July 15, 2011.
Form 990, Part VI, Section B, line 12cMary Immaculate Nursing Center 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 Mary Immaculate Nursing Center. 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 participates 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). Part VI, Section B, Line 14: Document Retention and Destruction Policy While Bon Secours Health System, Inc. does not have a written organization-wide document retention and destruction policy, individual department policies and practices are in place to ensure that each department of the organization maintains their documentation in compliance with state and federal requirements. In addition, any areas responsible for medical records have department policies in compliance with Medicare and HIPAA requirements. An organization-wide policy is currently in place for fiscal year ending August 31, 2011.
Form 990, Part VI, Section B, line 15The compensation committee of the board of Bon Secours Health System, Inc. engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of Mary Immaculate Nursing Center as well as other officers, key employees and highest paid employees. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure the reasonableness of compensation paid to executives and disqualified parties. The committee maintains a Board-approved 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 reported to the BSHSI Board of Directors and documented in the BSHSI 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 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 other key employees or highest paid employees were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in human resources.
Form 990, Part VI, Section C, line 19Mary Immaculate Nursing Center provides any documents open to public inspection upon request.
Form 990, Part VII:Hours worked are not tracked on an entity by entity basis. All officer's and director's 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. Timothy J. Davis' compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as Executive Vice President and Chief Administrative Officer of Bon Secours Health System, Inc. Michael Kerner's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the Chief Executive Officer of Bon Secours Hampton Roads Health System. Greg Simia's compensation is paid by Maryview Hospital, a related organization. The compensation he receives is for his role as the Chief Financial Officer of Bon Secours Hampton Roads Health System. Patricia Robertson's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation she receives is for her role as the Executive Vice President of Mary Immaculate Hospital. Sr. Pat Heath and Sr. Anne Lutz do not receive payroll distributions as they have taken vows of poverty.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
Mary Immculate Hospital Inc
7007 Harbour View Blvd Ste 108SuffolkVA23435540548200HealthcareVA501(c)(3)Line 3: 170(b)(1)(A)N/A
Bon Secours Hampton Roads Health System Inc
5818 Harbourview BlvdSuffolkVA23435521538513Local System Parent Org.VA501(c)(3)Line 11, Type II: 50N/A
Bon Secours Maryview Nursing Care Center
7007 Harbour View Blvd Ste 108SuffolkVA23435521578169Nursing Care CenterVA501(c)(3)Line 9: 509(a)(2)N/A
Maryview Hospital
7007 Harbour View Blvd Ste 108SuffolkVA23435540506463HealthcareVA501(c)(3)Line 3: 170(b)(1)(A)N/A
Bayley Properties
150 Kingsley LaneNorfolkVA23505541424748RentalVA501(c)(2)N/AN/A
Bon Secours Health System Inc
1505 Marriottsville RoadMarriottsvileMD21104521301088Parent Org. Management ServicesMD501(c)(3)Line 11, Type II: 50N/A
Bon Secours DePaul Health Foundation
7007 Harbour View Blvd Ste 108SuffolkVA23435541843876FundraisingVA501(c)(3)Line 11, Type III-FIN/A
Bon Secours DePaul Medical Center
7007 Harbour View Blvd Ste 108SuffolkVA23435541820093HealthcareVA501(c)(3)Line 3: 170(b)(1)(A)N/A
Bon Secours Maryview Foundation
7007 Harbour View Blvd Ste 108SuffolkVA23435521694731FundraisingVA501(c)(3)Line 11, Type III-FIN/A
Mary Immaculate Foundation
150 Kingsley LaneNorfolkVA23505311644734FundraisingVA501(c)(3)Line 11, Type III-FIN/A

Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
Province Place of Maryview LLC
7007 Harbourview Blvd Ste 108SuffolkVA23435541842697Assisted LivingVAN/ARelated00
Province Place of DePaul LLC
7007 Harbourview Blvd Ste 108SuffolkVA23435541950880Assisted LivingVAN/ARelated00
Western Tidewater Diagnostic Imaging LLC
c/o Roberts Dean PLC 150 Bousch StNorfolkVA23510383655545HealthcareVAN/ARelated00

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntity
Professional Health Care Mgmt Inc
7007 Harbourview Blvd Ste 108SuffolkVA23435541241031AdministrativeVAN/AC
Tidewater Diversified Inc
7007 Harbourview Blvd Ste 108SuffolkVA23435541431826PharmacyVAN/AC
OSF Inc
7007 Harbourview Blvd Ste 108SuffolkVA23435541369919RentalVAN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1NoneBusinessNameLine1

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