2011-07-13T19:08:19-05:00 2010-08-31 Deloitte Tax LLP 1750 Tysons Blvd McLean VA 221024219 990 2009-09-01 521301088 Bon Secours Health System Inc BONS 4104425511 1505 Marriottsville Road Marriottsville MD 21104 KATHERINE ARBUCKLE 4104423374 2011-07-13 1 7032511000 2009 2016-02-24 21:20:13Z Katherine Arbuckle 1505 Marriottsville Road Marriottsville MD 21104 160282232 0 0928 X www.bshsi.com X 1983 MD Provide admin/mgmt services to hospitals, nursing homes, & other related healthcare organizations. 17 16 664 16 -629256 -629256 45329 29169 96256611 111888740 -36420485 2612574 14684324 19984085 74565779 134514568 1117850 1731283 0 85057546 89522648 0 0 70790274 67960520 156965670 159214451 -82399891 -24699883 1095616615 1090187018 1160036366 1229813072 -64419751 -139626054 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. 0 0 143466134 1731283 124386778 The Bon Secours Health System provides a wide range of corporate support services to the facilities it owns or has affiliations. The system's mission services ensure that all Bon Secours facilities support the ministry of the Sisters of Bon Secours and the Catholic Church, and are driven by the system's mission and values. The system's financial, operational and business development services provide essential centralized support to improve operations, financial performance, and the delivery of patient care. With expertise in all areas of acute, long-term care and assisted living facility and home care management and operations, the corporate staff also serves as an invaluable corporate consulting resource. Mission Services:-Direction, support and consultation for the local and corporate staffand boards of directors-Policy development in areas such as sponsorship, businessrelationships, moral investments, bioethics, organizational ethics,social justice and community commitment services-Education to promote the Bon Secours mission, philosophy and values tokey staff-Coordination of teams charged with addressing health care issues andethical concernsFinancial & Treasury Services:-Negotiation of access to capital-Oversight, coordination and control of external audits-Coordination of and assistance in maximizing third-party reimbursementand filing related appeals-Monitoring of federal health care policy-Monitoring of System's master pension trust encompassing the pooledinvestment of all defined benefit pension plan assets of System members, including the selection of master pension trust investment advisor and managers and evaluation of their performance-Management of System members' trustee-held funds and System-wideinvestment program encompassing the vast majority of System members'investments, including funded depreciation accounts and centralized cash management program, in accordance with uniform System investmentguidelines-Management of centralized cash management program-Maintenance of System-wide common financial data base providing statusof key financial indicators and operating statistics-Long range capital and financial planning and annual operating andcapital budgeting support-Preparation of monthly and year-end consolidating System-widefinancial statements, including budget variation reporting andstatistical analysis-Development, implementation and monitoring of standardized accountingpolicies and educates senior leaders on financial literacy andcontemporary financial practices-Development of external financial disclosures to investors and thepublic at large-Primary contact with rating agencies, bond insurers and for investorsquestions Oversight of System consulting in the areas of tax returns,cost reporting, A-133 filings, CDM compliance and third party appeals-Organization of meetings of Chief Financial Officers to bettercoordinate implementation of System-wide goals, strategies, tactics andobjectives and to monitor facility operations and corporate complianceOperational Services:-Actuarial, accounting and investment functions for self insurancefunding of System members' general and professional liability andworkers compensation claims and for a System-wide self-funded plan for employee health benefits-Coordination of functions for a System-wide standard hospitalinformation system and other systems for use throughout the System andsupport functions for implementing and maintaining the informationsystem-Standardized purchasing function, material management, Lawson ERPsystem, and other standard IS-Knowledge Transfer of best practices and successes on revenueenhancement and cost reduction initiatives.Strategic Planning, Marketing, and Business Development Services:-Coordination of System strategic planning including coordination ofdevelopment of the System's vision, goals, and 3-year strategic planand annual planning processes.-Market assessment and strategy development for improved local marketpositioning-Strategic planning support for acute, long-term and home careoperations-New product/service research and development-Emerging technology research & assessment; knowledge transfer oftechnology and implications for system-Coordination and consultative assistance in service line planning &profitability analyses-Implementation of strategic growth initiatives in new and existingcommunities-Coordination of Planning & Business Development leaders, Customer Satisfaction, and Marketing & Communications leaders networksOther Corporate Services:-Corporate Communications and Public Relations-Internal auditing-Corporate Responsibility-Risk management-Governance-Coordination and control of System-wide benefit testing-Administration of System-wide health benefit plans-Placement and renewal of various System-wide welfare benefit plans-Coordination and management of legal services provided to Systemmembers-Regulatory compliance and insurance functions-System-wide employee, patient, resident and physician satisfactionprogram 143466134 1 0 0 0 0 0 0 0 0 1 0 1 0 0 1 1 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 366 0 1 664 1 1 1 1 CJ 0 0 0 0 0 0 0 17 16 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 1 0 X Laura Ellison 4433672212 8990M Old Annapolis Road Columbia MD 21045 Chris Allen 4.00 X 0 0 0 Richard Blair 6.00 X 0 0 0 Michael Carey 6.00 X 0 0 0 Sister Elaine Davia 4.00 X 0 0 0 Marcia Dush 4.00 X 0 0 0 Roger Huang 4.00 X 0 0 0 David Jimenez 4.00 X 0 0 0 Laurie Lafontaine 6.00 X 0 0 0 Lucretia McClenney 6.00 X 0 0 0 Susan Sandlund 4.00 X 0 0 0 Richard Serafini 4.00 X 0 0 0 Rev Myles Sheehan 4.00 X 0 0 0 Sister Mary Shimo 4.00 X 0 0 0 Sister Alice Talone 4.00 X 0 0 0 Sister Patricia Eck 50.00 X X 0 0 0 Donald Seitz 12.00 X X 0 0 0 Richard Statuto 50.00 X X 1968409 0 207835 Martha Riva 50.00 X 566339 0 91597 Katherine Arbuckle 50.00 X 872989 0 95882 Timothy Davis 50.00 X 1223989 0 129362 Lawrence Hubbard 50.00 X 694737 0 99499 Peter Bernard 50.00 X 1248815 0 174770 Michael Kerner 50.00 X 940681 0 126469 Matthew Toddy 50.00 X 935738 0 118299 Marlon Priest 50.00 X 899200 0 114758 David Jones 50.00 X 898058 0 91577 Sister Barbara Conroy 4.00 X 0 0 0 Donald Strange 0.00 X 787027 0 1385 Kevin Quinn 4.00 X 0 0 0 Michael Cottrell 50.00 X 48645 0 0 Edward Boyer 0.00 X 938417 0 17317 Dominick Stanzione 0.00 X 567664 0 27073 12542063 0 1295823 205 1 1 0 EPIC 1979 Milky Way Verona WI 53593 Software Services 5947256 JDA E Health Sys Inc 1717 Park Street Ste 250 Naperville IL 60563 Business Office Claims Mgmt 4490145 Premier Inc 5882 Collection Center Drive Chicago IL 60693 Productivity & Clinical Advisory 3373071 Towers Watson PO Box 8500 S-6110 Philadelphia PA 19178 Actuarial 3023563 KPMG LLP 111 South Calvert Street Baltimore MD 21202 Audit 2858483 136 29169 29169 Corp Mgmt & IS Fees 900099 111888740 111888740 111888740 23727612 23727612 1231197 1231197 182604 182604 182604 182604 3421429 25767664 -25767664 3421429 -22346235 -22346235 Roper Joint Venture 900099 6611789 6611789 Inv in PTRPs 900099 5256993 5886249 -629256 Rebate 900099 4711551 4711551 3221148 3221148 19801481 134514568 124386778 -629256 10727877 1456283 1456283 275000 275000 5360667 4824600 536067 63743130 57368817 6374313 6208072 5587265 620807 10539633 9485670 1053963 3671146 3304031 367115 518992 467093 51899 533996 480596 53400 8368011 7531210 836801 532030 478827 53203 897913 808122 89791 21414404 19272964 2141440 6564637 5908173 656464 3041423 2737281 304142 1144610 1030149 114461 21139347 19025412 2113935 150003 135003 15000 Recruitment/Relocation 1097789 988010 109779 0 Townley Non-Ops Expense 476964 429268 47696 0 Dues & Subscriptions 225815 203233 22582 0 0 0 0 0 0 0 0 0 1854586 1669127 185459 159214451 143466134 15748317 0 13268620 629912 1697300 14419113 15254290 222215412 51983505 152244156 170231907 235980798 246370855 66185513 35221376 612888503 621411290 1095616615 1090187018 48670012 50819875 856134592 842482623 10185693 7854080 245046069 328656494 1160036366 1229813072 X -64419751 -146886054 7260000 -64419751 -139626054 1095616615 1090187018 X 0 1 1 X 1 1 X X X 0 0 0 The Sisters of Bon Secours in the United States Inc 520715237 1 1 1 0 6343865 See Part IV 521301088 9 1 1 1 0 2 6343865 Schedule A, Part IV, Supplemental Information: Part I, Line 11 H (i) - Supported Organizations: Bon Secours Health System, Inc. is formed exclusively for the benefit of, to perform the functions of, and to carry out the purposes of the The Sisters of Bon Secours in the United States, Inc. and all other publicly supported organizations (within the meaning of section 509(a)(1) or 509(a)(2) of the Internal Revenue Code of 1986) in, or operating for the benefit of, the Bon Secours Health System, Inc. Additionally, Bon Secours Health System, Inc. is formed: (1) To participate in the charitable health care system sponsored by Bon Secours Ministries throughout the United States, and globally, through which the health care mission of The Sisters of Bon Secours in the United States, Incorporated (the "Congregation"), the founding participating entity of Bon Secours Ministries, is furthered; (2) To fulfill and to participate in, the charitable health care mission sponsored by Bon Secours Ministries throughout the United States, and globally, as it carries out its health care mission in accordance with the philosophy, mission and policies of Bon Secours Ministries and the directives and teachings of the Roman Catholic Church; (3) To participate in the activities and implement the operational policies and procedures pertaining to health care facilities and other enterprises sponsored by Bon Secours Ministries, or associated or affiliated with, BSHSI, a Maryland nonstock, nonprofit corporation; (4) To benefit the Congregation and all other publicly supported organizations (within the meaning of Section 509(a)(I) or 509(a)(2) of the Code) in, or operating for the benefit of, the Bon Secours Health System in the United States by carrying out the health care mission of the Congregation in accordance with the philosophy, mission and policies of the Congregation, and in accordance with, and subject to, the directives and teachings of the Roman Catholic Church or in concert with one or more other publicly supported organizations which provide health care services in a manner that is consistent with the teachings of the Roman Catholic Church; (5) To perform all activities permitted corporations under the laws of the State of Maryland, to the extent such activities are permitted by organizations which are exempt from Federal income tax under Section 501(c)(3) of the Code and contributions to which are deductible under Sections 170(c)(2), 2055(a)(2) and 2522(a)(2) of the Code and to the extent such activities are not inconsistent with the Corporation's non-private foundation status under Section 509(a) of the Code, including the making of distributions for charitable, religious, educational, and scientific purposes to organizations which are exempt from Federal income tax under Section 501(c)(3) of the Code and contributions to which are deductible under Sections 170i(c)(2), 2055(a)(2) and 2522(a)(2) of the Code (a "Charity"). 6446081 6446081 7244972 2639209 4605763 1024366 1016969 7397 1914051 856265 1057786 205585942 47471062 158114880 170231907 Other Assets (Misc and Exec Assets - Cap accum, Insurance policies) 11669917 Due from Affiliates 498490253 Investment in Joint Ventures 111251120 621411290 Other Liabilities 12531800 Worker's Comp Liability 29521115 Health Plan Liability 17794032 Pension Liability 126137578 Swaps 135435120 Discontinued Operations Liability 7236849 328656494 Part X: Description of Uncertain Tax Positions Under FIN 48: Schedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48. 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 change. 1 Central America & the Caribbean 1 Program services Off Shore Captive Management 28553735 Europe (including Iceland & Greenland) Grant making Maintenance of Mother House Exterior 250000 Sub Saharan Africa Grant making Support of Boys Shelter in Louis Trichard 25000 0 1 28828735 Europe (including Iceland & Greenland) Maintenance of Mother House Exterior 250000 Electronic Fund/Wire Book Sub Saharan Africa Boys Shelter in Louis Trichard 25000 Electronic Fund/Wire Book 2 0 Procedure for Monitoring Grants Outside the U.S.: Schedule F, Part I, Line 2: Grantees submit progress reports on the anniversary date on which the grant was received. Includes status of goals and objectives and progress towards acheivement of desired outcomes. An accurate accounting of revenues and expenses must be submitted. 1 BS HR HS - East Ocean View Neighborhood 150 Kingsley Lane Norfolk VA 23505 541820093 501(c)(3) 100000 East Ocean View Neighborhood Project Bon Secours of MD FoundationOpen Space Management 26 North Fulton Avenue Baltimore MD 21223 531732800 501(c)(3) 50000 Open Space Management Support Bon Secours of MD FoundationYouth Employment & Entrepreneurship 26 North Fulton Avenue Baltimore MD 21223 531732800 501(c)(3) 50000 Youth Employment and Entrepreneurship Program Bon Secours Richmond HS - Charrette for East End 5875 Bremo Road Richmond VA 23226 541201346 501(c)(3) 100000 Charrette for East End Program Bon Secours St Petersburg - Holistic Expressive Arts for Life 10300 4th Street North St Petersburg FL 33716 650051820 501(c)(3) 25000 Holistic Expressive Arts for Life Program Bon Secours St Petersburg - Pinellas Community Voice Mail 10300 4th Street North St Petersburg FL 33716 650051820 501(c)(3) 20000 Pinellas Community Voice Mail Program Bon Secours St Petersburg - Free Clinic 10300 4th Street North St Petersburg FL 33716 650051820 501(c)(3) 50000 Free Clinic Support BS NY HS - TeleHealth Medicines 2975 Independence Avenue Riverdale NY 10463 131740397 501(c)(3) 25000 TeleHealth Medicines Program BS OLBH Foundation - Healthy Community Svc Van Ministry 1000 Ashland Drive Ashland KY 41101 611381952 501(c)(3) 43500 Healthy Community Services Van Ministry Program BS St Francis HS - Sterling Trail Project One St Francis Drive Greenville SC 29601 582504530 501(c)(3) 100000 Sterling Trail Project BS Charity Health System - Community Gardens 255 Lafayette Avenue Suffern NY 10901 131740104 501(c)(3) 68500 Community Garden Project Bon Secours Richmond HS - Community Gardens 5875 Bremo Road Richmond VA 23226 541201346 501(c)(3) 20000 Community Garden Project Bon Secours MD Foundation - Women's Resource Center 26 North Fulton Avenue Baltimore MD 21223 531732800 501(c)(3) 50000 Women's Resource Center Support ARHS - Nehemiah Project 620 Howard Avenue Altoona PA 16602 231352155 501(c)(3) 50000 Nehemiah Project BS St Francis HS - Mobile Dental Unit One St Francis Drive Greenville SC 29601 582504530 501(c)(3) 55000 Mobile Dental Unit Program BS HR HS - Life Coaches 150 Kingsley Lane Norfolk VA 23505 541820093 501(c)(3) 45000 Life Coaches Program Roper - St Francis Health System 125 Doughty Street Ste 790 Charleston SC 29403 571068509 501(c)(3) 43000 HIV Specialty Care Clinic & Wellness Center Bon Secours St Petersburg - DayStar Life Center 10300 4th Street North St Petersburg FL 33716 650051820 501(c)(3) 30000 DayStar Life Ctr Identification Assistance Program Mercy Housing 1999 Broadway Ste 1000 Denver CO 80202 470646706 501(c)(3) 125000 Strategic Healthcare Partnership Pledge Catholic Medical Mission Board 10 West 17th Street New York NY 100115765 135602319 501(c)(3) 116250 Integrated Management of Neonatal and Childhood Illnesses project Basilica of the Assumption Historic Trust Inc 408 N Charles Street Baltimore MD 21201 521065433 501(c)(3) 20000 Pope John Paul II Prayer Garden National Multiple Sclerosis Society 2112 W Laburnum Avenue Richmond VA 23227 043739083 501(c)(3) 25000 Dinner of Champions Sponsorship Catholic Relief Service 209 W Fayette Street Baltimore MD 21201 135563422 501(c)(3) 50000 Haiti Relief Fund Health Wagon 119 Number Ten Street Clinchco VA 24226 501(c)(3) 25000 Lung/Pulmonary Clinic Catholic Relief Service 209 W Fayette Street Baltimore MD 21201 135563422 501(c)(3) 25000 Chilie Relief Fund Sisters of Bon Secour Volunteer Ministry 1525 Marriottsville Road Marriottsville MD 211041399 501(c)(3) 98783 Volunteer Ministry Sisters Academy of Baltimore 139 First Ave Baltimore MD 21227 341975939 501(c)(3) 30000 Class of 2013 Sponsor Leadership Conference of Women Religious of the USA Inc 8808 Cameron Street Silver Spring MD 20910 436033728 501(c)(3) 10000 Documentary Project for Catholic Sisters in America Exhibit Roper St Francis Foundation 69-B Barre Street Charleston SC 29401 571068509 501(c)(3) 5000 Golf/Hat Sponsorship 29 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Grantees submit progress reports on the anniversary date on which the grant was received. The evaluation report includes : 1) progress toward the deployment of the stated goals and objectives, 2) progress towards the achievement of desired outcome as demonstrated by Project Work Plan, 3) an accurate accounting of the revenue and expenses and the amount of the mission fund award expensed, and 4) a summary past, current and future funding sources and efforts to secure sustaining sources of funding. Other Information: Part IV: Description of the Bon Secours Health System Mission Fund: Bon Secours Health System, Inc performs its philanthropic work through its mission department. This initiative, called the Bon Secours Health System Mission Fund ("Mission Fund"), was developed to promote the Catholic Health Ministry and the BSHSI Mission. This purpose is realized through the funding of initiatives that improve the health and well being of communities, particularly for disenfranchised and marginalized people, served by BSHSI Local Systems ("Local Systems"), Cosponsors and the Congregation of the Sisters of Bon Secours. The scope of its purpose and use of funds would be to: -promote healthy community coalition initiatives in conjunction with local system efforts, -develop local system and community excellence for a specific health condition and preventive need, and -improve access for uninsured populations and reduce health disparities among populations in the community. The Strategic Quality Plan of the health system calls for focused efforts to Build Healthier Communities. The health system understands "health" to include social and communal dimensions and has adopted the following articulation of a healthy community. The conditions of communities and individuals served by BSHSI reflect the interaction of significant factors and complex behaviors at the individual, communal, and societal level. It is not likely that interventions by any one organization will result in substantial improvement or benefit to the community. Rather, increased participation by stakeholders and greater cooperation among entities with appropriate skills and resources is necessary for systemic change and improved outcomes. Mission Fund grants place emphasis on increased collaboration among community based members (Healthy Community Initiative), public health officials and other providers of services. The Mission Fund anticipates that most endeavors that seek to bring meaningful improvement require time and commitment. Consequently, local system grant recipients may expect continuity of support (several years) to establish and track outcomes. At the same time, grant applicants need to cultivate and achieve a wide array of financial resources necessary to sustain promising projects and service programs. X X X X X 1 1 0 0 0 0 0 0 0 Richard Statuto 1023309 0 941402 0 3698 0 177950 0 29885 0 2176244 0 0 0 Martha Riva 309210 0 243796 0 13333 0 64931 0 26666 0 657936 0 0 0 Katherine Arbuckle 480159 0 369662 0 23168 0 74349 0 21533 0 968871 0 0 0 Timothy Davis 536658 0 665880 0 21451 0 110185 0 19177 0 1353351 0 0 0 Lawrence Hubbard 359458 0 283459 0 51820 0 79795 0 19704 0 794236 0 0 0 Peter Bernard 696077 0 547034 0 5704 0 146706 0 28064 0 1423585 0 0 0 Michael Kerner 467646 0 290947 0 182088 0 99435 0 27034 0 1067150 0 0 0 Matthew Toddy 483818 0 386743 0 65177 0 92056 0 26243 0 1054037 0 0 0 Marlon Priest 477377 0 393099 0 28724 0 83697 0 31061 0 1013958 0 0 0 David Jones 393968 0 305114 0 198976 0 68174 0 23403 0 989635 0 0 0 Donald Strange 103594 0 0 0 683433 0 0 0 1385 0 788412 0 0 0 Edward Boyer 437219 0 416683 0 84515 0 8188 0 9129 0 955734 0 0 0 Dominick Stanzione 60543 0 0 0 507121 0 0 0 27073 0 594737 0 0 0 Part I, Lines 4a-b: David Jones, Donald Strange and Dominick Stanzione received severance payments of $37,038, $682,000 and $503,654 respectively. BSHSI participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and available only to officers and key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits are made into this plan South Carolina Jobs-Economic Development Authority 576000286 837031QH9 2008-01-15 69925000 Construct and equip facility 0 0 Economic Development Authority of Henrico County Virginia 541197472 42605PBH7 2008-01-15 80695000 Construct, renovate and equp facility 0 0 Economic Development Authority of the County of Chesterfield 521279622 16639EAB0 2008-01-15 92660000 Refund Econ. Dev. Auth. Of Co of Chesterfield 11/12/03 and renovate and equ 0 0 South Carolina Jobs-Economic Development Authority 570960018 8370131RA 2008-10-17 30365000 Refund SC Jobs-Econ. Dev. Auth. Bonds on 12/30/02 0 0 Economic Development Authority of Henrico County Virginia 541197472 42605PBK0 2008-10-17 53890000 Refund Econ. Dev. Auth. Of Henrico County, Virginia on 12/30/02 0 0 69925000 729108 67501374 2008 0 0 1 1 80695000 877767 78237655 2008 0 0 1 1 92660000 1413340 6716534 2008 1 0 1 1 30365000 255675 2009 1 0 1 1 53890000 449479 2009 1 0 1 1 0 1 1 1 1 0.00440 0.00000 0.00440 1 0 0 1 0 1 0.00010 0.00070 0.00080 1 0 0 1 0 1 0.00000 0.00000 0.00000 1 0 1 1 1 1 0.00000 0.00000 0.00000 1 0 0 1 0 1 0.00000 0.00000 0.00000 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 Economic Development Authority of Hanover County 541228097 41077RAC6 2008-10-17 124715000 2008D-1 Refund bonds issued by the Econ. Dev. Auth. Of Hanover Co. on 12/30/ 0 0 Economic Development Authority of the City of Norfolk 521375010 65588QAE5 2008-10-17 84610000 2008D-1 Refund bonds issued by the Econ. Dev. Auth. of the City of Norfolk o 0 0 124715000 1131056 2009 1 0 1 1 84610000 812157 2009 1 0 1 1 0 0 1 0 1 0.00000 0.00000 0.00000 1 0 0 1 0 1 0.00000 0.00000 0.00000 1 0 1 0 0 0 0 0 1 0 0 0 0 Form 990, Part VI, Section A, line 4 Effective 12/21/2009 (bylaws effective 1/1/2010), the amended Articles of Incorporation reflect the current operational realities and governance best practices, and reflect the transfer of sponsorship of the Bon Secours Health System from the Sisters of Bon Secours to Bon Secours Ministries. Form 990, Part VI, Section A, line 6 Bon Secours, Inc. is the sole member of Bon Secours Health System, Inc. Form 990, Part VI, Section A, line 7a The governing body of Bon Secours Health System, Inc. is appointed by its member Bon Secours, Inc. Form 990, Part VI, Section A, line 7b Certain authorities of Bon Secours Health System, Inc. are reserved to its Member, Bon Secours, Inc. Form 990, Part VI, Section B, line 11 The process the organization uses to review the Form 990 consists of a review by BSHSI's audit and compliance board committee and providing the form to the BSHSI board of directors to allow for a thorough review by both before the filing date of July 15, 2011. BSHSI's audit and compliance and governance board committee and BSHSIs 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 15, 2011. Form 990, Part VI, Section B, line 12c BSHSI 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 BSHSI. 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, and the 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 15 The 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 BSHSI. The compensation committee consists of a group of independent board members and engages independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS's rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy, reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSHSI board of directors and compensation committee minutes. Form 990, Part VI, Section b , Line 15b - Compensation Process Other Officers/ Key Employees: Compensation for other employees includes a review and approval by independent person, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of BSHSI 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 19 BSHSI provides any documents open to public inspection upon request. Form 990, Part VII: As the parent organization of nine local systems, Bon Secours Health System, Inc.'s officers, directors, key employees and highly compensated employees have duties and responsibilities which encompass the activities of many of the related organizations within those local systems. Part VII, Section B: Five Highest Paid Independent Contractors Providing Services Paid over 100K. Independent contractors and vendors paid/invoiced to Bon Secours Health System, Inc. are generally for services covering a majority of the related organizations, if not all. Form 990, Part VII, Section B: Five Highest Paid Independent Contractors Providing Services: Independent contractors and vendors paid/invoiced to Bon Secours Health System, Inc. are generally for services covering a majority of the related organizations, if not all. Form 990, Part VII: As the parent organization of nine local systems, Bon Secours Health System, Inc.'s officers, directors, key employees and highly compensated employees have duties and responsibilitites which encompass the activities of many of the related organizations within those local systems. Form 990, Part XI, Line 3: Bon Secours Health System, Inc. undergoes an annual single audit under OMB Circular A-133 on a consolidated basis with all entities of Bon Secours Health System, Inc. Bon Secours Associates Services LLC 1505 Marriottsville Road Marriottsville MD 211041301 522321591 Healthcare MD 267000 1708000 N/A Townley IV Farm LLC 1402 Stapleton Road Gladstone VA 245533138 541833386 Farm VA 21447 7363722 N/A Bon Secours St Petersburg Home Care Services Inc 10300 Fourth Street North St Petersburg FL 33716 134334363 Home Care Services FL 501(c)3 Line 9 Maria Manor Nursing Care Center Bon Secours Maria Manor Nursing Care Center 10300 Fourth Street North St Petersburg FL 33716 134334363 Nursing Home FL 501(c)3 Line 9 N/A Our Lady of Bellefonte Hospital Inc 1000 St Christopher Dr Ashland KY 41101 611356023 Acute Care Hospital KY 501(c)3 Line 3 Bon Secours Kentucky Health System Bon Secours Kentucky Health System Inc St Christopher Dr Ashland KY 41101 611356024 Local System Parent Org. KY 501(c)3 Line 11b, Type 2 N/A Our Lady of Bellefonte Hospital Foundation St Christopher Dr Ashland KY 41101 611381952 Grant Making Foundation KY 501(c)3 Line 9 Bon Secours Kentucky Health System Bellefonte Physician Services Inc St Christopher Dr Ashland KY 41101 352320780 Physician Practices KY 501(c)3 Line 3 Bon Secours Kentucky Health System Bon Secours Baltimore Hospital 2000 West Baltimore Street Baltimore MD 21223 521909599 Health Care MD 501(c)3 Line 3 Bon Secours Baltimore Health System Washington Village Community Medical Center Inc 2600 Liberty Heights Avenue Baltimore MD 21223 521138191 Health Care MD 501(c)3 Line 9 Community Health Services Bon Secours Inc 1505 Marriottsville Road Marriottsville MD 21104 521301091 Supporting Org. to Bon Secours Health System, Inc. MD 501(c)3 Line 11a, Type 1 N/A Liberty Medical Center Inc 2600 Liberty Heights Avenue Baltimore MD 21215 521466304 Health Care MD 501(c)3 Line 3 Bon Secours Baltimore Health System Urban Medical Institute Inc 2600 Liberty Heights Avenue Baltimore MD 21215 521905869 Health Care MD 501(c)3 Line 3 Liberty Medical Center Bon Secours Baltimore Development 26 North Fulton Avenue Baltimore MD 21223 760785344 Community Housing MD 501(c)3 Line 7 Unity Properties Inc Bon Secours Community Health Services Inc 2600 Liberty Heights Avenue Baltimore MD 21215 521909599 Health Care MD 501(c)3 Line 9 Bon Secours Baltimore Health System The Bon Secours of Maryland Foundation Inc 26 North Fulton Avenue Baltimore MD 21223 521732800 Grant Making Foundation MD 501(c)3 Line 11b, Type 3 Bon Secours Baltimore Health System Unity Properties Inc 26 North Fulton Avenue Baltimore MD 21223 521857768 Low Income Housing MD 501(c)3 Line 7 Bon Secours of Maryland Foundation Bon Secours Housing 26 North Fulton Avenue Baltimore MD 21223 521442707 Low Income Housing MD 501(c)3 Line 9 Bon Secours of Maryland Foundation Bon Secours Housing II 26 North Fulton Avenue Baltimore MD 21223 521543174 Low Income Housing MD 501(c)3 Line 9 Bon Secours of Maryland Foundation Bon Secours Baltimore Health System 2000 West Baltimore Street Baltimore MD 21223 Local System Parent Org. MD 501(c)3 Line 11b, Type 2 N/A St Francis Center at the Knolls Inc 20 Grand Street Warwick NY 10990 061370576 Long term Care NY 501(c)3 Line 3 Bon Secours Charity Health System Villa Francis at the Knolls (dba Schervier Pavilion) 20 Grand Street Warwick NY 10990 061381994 Skilled Nursing NY 501(c)3 Line 3 Bon Secours Charity Health System Good Samaritan Hospital 255 Lafayette Avenue Suffern NY 10901 131740104 Acute Care Hospital NY 501(c)3 Line 3 Bon Secours Charity Health System Frances Schervier Home and Hospital 2975 Independence Avenue Bronx NY 10463 131740397 Long term nursing care NY 501(c)3 Line 3 Bon Secours NY Health System Schervier Housing Development Fund Corporation 2975 Independence Avenue Bronx NY 10463 133098867 Housing NY 501(c)3 Line 9 N/A Good Samaritan Foundation for Better Health Inc 255 Lafayette Avenue Suffern NY 10901 133400353 Grant Making Foundation NY 501(c)3 Line 7 Bon Secours Charity Health System St Anthony Community Hospital 15-19 Maple Ave Warwick NY 10990 141340100 Hospital NY 501(c)3 Line 3 Bon Secours Charity Health System Bon Secours Community Hospital 160 E Main Street Port Jervis NY 12771 141347717 Health Care NY 501(c)3 Line 3 Bon Secours Charity Health System The Bon Secours Warwick Health Foundation 20 Grand Street Warwick NY 10990 141972807 Grant Making Foundation NY 501(c)3 Line 7 Bon Secours Charity Health System Bon Secours Charity Health System Inc 255 Lafayette Avenue Suffern NY 10901 912135195 Local System Parent Org. NY 501(c)3 Line 11b, Type 2 N/A Bon Secours Community Hospital Foundation 160 E Main Street Port Jervis NY 12771 810667395 Grant Making Foundation NY 501(c)3 Line 7 Bon Secours Charity Health System St Francis Foundation One St Francis Drive Greenville SC 29601 260012031 Grant Making Foundation SC 501(c)3 Line 7 St Francis Health System St Francis Hospital Inc One St Francis Drive Greenville SC 29601 582504530 Health Care SC 501(c)3 Line 3 St Francis Health System Bon Secours St Francis Health System Inc 1 St Francis Drive Greenville SC 29601 582504528 Local System Parent Org. SC 501(c)3 Line 7 N/A St Francis Physician Services Inc One St Francis Drive Greenville SC 29601 134290167 Physician Services SC 501(c)3 Line 11b, Type 1 St Francis Health System Mary Immaculate Foundation 150 Kingsley Lane Norfolk VA 23505 311644734 Fundraising VA 501(c)3 Line 11b, Type 3- FI Mary Immaculate Hospital Bon Secours Hampton Roads Health System 5818 Harbourview Blvd Portsmouth VA 23435 521538513 Local System Parent Org. VA 501(c)3 Line 11b, Type 2 N/A Bon Secours - Maryview Nursing Care Center 4775 Bridge Road Suffolk VA 23435 521578169 Nursing Care Center VA 501(c)3 Line 9 Maryview Hospital Bon Secours Maryview Foundation 150 Kingsley Lane Norfolk VA 23505 521694731 Fundraising VA 501(c)3 Line 11b, Type 3-FI Bon Secours Hampton Roads Health System Maryview Hospital 3636 High Street Portsmouth VA 23707 540506463 Health Care VA 501(c)3 Line 3 Bon Secours Hampton Roads Health System Mary Immaculate Hospital Inc 2 Bernadine Drive Newport News VA 23602 540548200 Health Care VA 501(c)3 Line 3 Bon Secours Hampton Roads Health System Bon Secours Richmond Health Care Foundation 8580 Magellan Parkway Richmond VA 23227 541201346 Grant Making Foundation VA 501(c)3 Line 7 Bon Secours Richmond Health Corp Bayley Properties 150 Kingsley Lane Norfolk VA 23505 541424748 Rental VA 501(c)2 N/A Bon Secours DePaul Medical Center Mary Immaculate Nursing Center Inc 4 Ridgewood Parkway Newport News VA 23602 541516476 Nursing Care Center VA 501(c)3 Line 9 Mary Immaculate Hospital Bon Secours Richmond Health Corporation 8580 Magellan Parkway Richmond VA 23227 541356155 Supporting Org. to Bon Secours Richmond Health System VA 501(c)3 Line 11, Type 2 Bon Secours Richmond Health System Bon Secours Stuart Circle Hospital 8580 Magellan Parkway Richmond VA 23227 541740128 Health Care VA 501(c)3 Line 3 Bon Secours Richmond Health System Bon Secours Memorial Regional Medical Center Inc 8580 Magellan Parkway Richmond VA 23227 541744931 Health Care VA 501(c)3 Line 3 Bon Secours Richmond Health System Bon Secours DePaul Medical Center Inc 150 Kingsley Lane Norfolk VA 23505 541820093 Health Care VA 501(c)3 Line 3 Bon Secours Hampton Roads Health System Bon Secours DePaul Health Foundation 150 Kingsley Lane Norfolk VA 23505 541843876 Fundraising VA 501(c)3 Line 11b, Type 3- FI Bon Secours Hampton Roads Health System Mary Immaculate Hospital Auxiliary 2 Bernadine Drive Newport News VA 23602 546040266 Auxiliary VA 501(c)3 Line 11b, Type 3- FI N/A Bon Secours Richmond Health System 8580 Magellan Parkway Richmond VA 23227 521988421 Supporting Org. to Bon Secours Richmond Health System VA 501(c)3 Line 11, Type 2 N/A Bon Secours St Mary's Hospital 8580 Magellan Parkway Richmond VA 23227 540793767 Health Care VA 501(c)3 Line 3 Bon Secours Richmond Health System Bon Secours Richmond Community Hospital 8580 Magellan Parkway Richmond VA 23227 540647482 Health Care VA 501(c)3 Line 3 Bon Secours Richmond Health System Bon Secours St Francis Medical Center 8580 Magellan Parkway Richmond VA 23227 311716973 Health Care VA 501(c)3 Line 3 Bon Secours Richmond Health System Laburnum Properties 8580 Magellan Parkway Richmond VA 23227 521260700 Title Holding Company VA 501(c)2 N/A Bon Secours Richmond Health System St Mary's Hospital Auxiliary 5801 Bremo Road Richmond VA 23226 540742852 Suppoting Org. to St. Mary's Hospital VA 501(c)3 Line 11, Type 1 St Mary's Hospital St Mary's Hospital Building Corporation 8580 Magellan Parkway Richmond VA 23227 521228667 Rental - Medical Office Building VA 501(c)3 Line 11 St Mary's Hospital Bon Secours Place at St Petersburg LLP 10300 Fourth Street North St Petersburg FL 33716 593589729 Assisted Living/Senior Care FL Bon Secours Florida Integrated Services Related 0 0 Bon Secours Apartments LP 1800 West Baltimore St Baltimore MD 21223 521952505 Low Income Housing MD Unity Housing Inc Related 0 0 Bon Secours Apartments II LP 1800 West Baltimore St Baltimore MD 21223 522063512 Low Income Housing MD Unity Housing Inc Related 0 0 Liberty Senior Housing LP 1800 West Baltimore St Baltimore MD 21223 522134447 Low Income Housing MD Unity Housing Inc Related 0 0 Bon Secours Apartments III LP 1800 West Baltimore St Baltimore MD 21223 522134444 Low Income Housing MD Unity Housing Inc Related 0 0 Bon Secours Smallwood Summit 26 North Fulton Ave Baltimore MD 21223 522280175 Low Income Housing MD Unity Housing Inc Related 0 0 Bon Secours Chesapeake Apartments LP 26 North Fulton Ave Baltimore MD 21223 200107034 Low Income Housing MD Chesapeake Housing LLC Related 0 0 Bon Secours Shiloh LP 26 North Fulton Ave Baltimore MD 21223 203965243 Low Income Housing MD Bon Secours Baltimore Development Inc Related 0 0 Bon Secours Wayland LP 26 North Fulton Ave Baltimore MD 21223 270468688 Low Income Housing MD Unity Properties Inc Related 0 0 Shannon HealthMOB Limited Partnership No 1 3 Richland Medical Park Ste 120 Columbia SC 29203 571127282 Medical Office Building SC St Francis Health System Related 0 0 BSB HealthMOB Limited Partnership No 2 3 Richland Medical Park Ste 120 Columbia SC 29203 412054344 Medical Office Building SC St Francis Health System Related 0 0 Upstate Surgery Center LLC One St Francis Drive Greenville SC 29601 562186977 Ambulatory Surgery Center SC St Francis Hospital Related 0 0 Province Place of DePaul LLC 6403 Granby Street Norfolk VA 23505 541950880 Assisted Living Facilities VA Bon Secours Hampton Road Health System Related 0 0 Western Tidewater Diagnostic Imaging LLC 150 Bousch St Norfolk VA 23505 383655545 Healthcare VA Maryview Hospital Related 0 0 Province Place of Maryview LLC One Bon Secours Way Portsmouth VA 23703 541842697 Assisted Living VA Bon Secours Hampton Road Health System Related 0 0 Broad64 Imaging LLC 8580 Magellan Parkway Richmond VA 23227 205886018 Imaging Services VA Bon Secours Virginia Health Source Inc Related 0 0 Richmond Radiation Oncology Center I LLC 8580 Magellan Parkway Richmond VA 23227 208444551 Radiation Oncology Services VA Richmond Radiation Oncology Center Inc Related 0 0 CCHC Ironbridge Realty LLC 8580 Magellan Parkway Richmond VA 23227 300181909 Rental - Land VA Chesterfield Community Healthcare Center Inc Related 0 0 RI LP 8580 Magellan Parkway Richmond VA 23227 541708835 Imaging Services VA Bon Secours Virginia Health Source Inc Related 0 0 St Mary's Medical Building Assoc LP 8580 Magellan Parkway Richmond VA 23227 541204289 Medical Office Building VA Bon Secours Richmond Health System Related 0 0 Mental Healthsource LLC 8580 Magellan Parkway Richmond VA 23227 541785409 Behavorial Health Services VA Bon Secours Virginia Health Source Inc Related 0 0 St Mary's MRI LP 8580 Magellan Parkway Richmond VA 23227 541568022 Imaging Services VA Bon Secours Virginia Health Source Inc Related 0 0 Chesterfield Community Healthcare Center MOB 1 LLC 435 Southlake Blvd Richmond VA 23236 541745670 Rental - Medical Office Building VA Bon Secours Virginia Health Source Inc Related 0 0 Franciscan Health System Insurance Company LTD PO Box 69 CJ KY1-1102 980522620 Offshore Captive Management CJ N/A C 2 1801676 1.00000 Bon Secours Assurance Company Ltd PO Box 69 CJ KY1-1102 980152147 Offshore Captive Management CJ N/A C 28553733 70774337 1.00000 Bon Secours-Florida Integrated Health Services Inc 10300 Fourth Street North St Petersburg FL 33716 650779777 Holding Company/Assisted Living FL Bon Secours Maria Manor Nursing Care C 202967 1498880 0.80000 Unity Housing Inc 26 North Fulton Avenue Baltimore MD 21223 521952507 Low Income Housing MD Unity Properties Inc C -108 350100 1.00000 Bon Secours Wayland LLC 26 North Fulton Avenue Baltimore MD 21223 270468561 Low Income Housing MD Unity Properties Inc C 1.00000 HealthCare Enterprises Inc & Subs One St Francis Drive Greenville SC 29601 571012852 Holding Company SC St Francis Hospital C 1.00000 Professional Health Care Management Inc 150 Kingsley Lane Norfolk VA 23505 541241031 Administrative VA Bon Secours Hampton Roads Health System inc C 1.00000 OSF Inc 2 Bernadine Drive Newport News VA 23602 541369919 Rental VA Mary Immaculate Hospital C 48569 862233 0.60000 Tidewater Diversified Inc 160 Kingsley Lane Norfolk VA 23505 541431826 Pharmacy VA DePaul Medical Center C 540523 2517773 1.00000 Chesterfield Community Healthcare Center Inc 8580 Magellan Parkway Richmond VA 23227 541812738 Ambulatory Healthcare Services VA Bon Secours Richmond Health System C 65492 301841 0.83000 Bon Secours-Virginia Healthsource Inc & Subs 8580 Magellan Parkway Richmond VA 23227 541417686 Ambulatory Healthcare Services VA Bon Secours Richmond Health System C 40861817 24555006 0.83000 Richmond MRI Inc 8580 Magellan Parkway Richmond VA 23227 541568452 Imaging Services VA Bon Secours Virginia Healthsource Inc C 471991 467633 0.42000 Chesterfield Community Taxable Sub Inc 8580 Magellan Parkway Richmond VA 23227 541818555 Ambulatory Healthcare Services VA Chesterfield Community Healthcare C 0.83000 RHS Management Corp 8580 Magellan Parkway Richmond VA 23227 541313425 Independent Living Facility VA Bon Secours Richmond Health System C 519797 149582 0.83000 Richmond Radiation Oncology Center Inc 8580 Magellan Parkway Richmond VA 23227 541570244 Oncology Services VA Bon Secours Virginia Healthsource Inc C 9382249 7153543 0.83000 Central Virginia Health Network Inc 2201 West Broad Street Richmond VA 23220 541806281 Healthcare Support Services VA Bon Secours Richmond Health System C 0.47000 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 1 0 0 Bon Secours DePaul Medical Center D 4048366 Bon Secours Charity D 11646332 Bon Secours of MD Foundation D 900650 Bon Secours Richmond D 4980112 St Francis Hospital D 30727072 Our Lady of Bellefonte Hospital E 4605470 Bon Secours Community Hospital K 2235985 Bon Secours Hospital Baltimore K 3078201 Bon Secours Maria Manor Nursing Center K 220253 Richmond Shared Services K 20566470 Good Samaritan Hospital of Suffern K 6746004 Our Lady of Bellefonte Hospital K 3433311 Schervier Housing Development K 113038 Schervier Long Term K 506044 Hampton Roads Shared Services K 12730233 St Anthony Community Hospital K 1396477 St Francis Hospital K 13077285 Bon Secours Community Shared Services P 163815 Bon Secours Community Health Services P 8169 Bon Secours Community Hospital P 3449704 Bon Secours DePaul Medical Center P 8044603 Bon Secours Hospital Baltimore P 10543909 Bon Secours Maria Manor Nursing Center P 2730676 Bon Secours Maryview Nursing Care Center P 638355 Bon Secours Memorial Regional Medical Center P 21235158 Bon Secours of MD Foundation P 162950 Bon Secours Place at St Petersburg P 108439 Bon Secours Richmond Community Hospital P 3696096 Bon Secours St Francis Medical Center P 12375235 Bon Secours St Mary's Hospital P 31584122 Bon Secours St Petersburg Home Care Services P 35134 Broad64 Imaging P 169355 Chesterfield Community Health Ctr P 1512 Good Samaritan Hospital of Suffern P 34377027 GSH Medical Care PC P 255624 Hampton Roads Shared Services P 1900741 Healthsource P 3835285 Iron Bridge Alf P 167323 Mary Immaculate Hospital P 7635284 Mary Immaculate Nursing Center P 709320 Maryview Hospital P 13062525 Mt Alverno ALF P 347200 Optimum Health Network P 33797 Our Lady of Bellefonte Hospital P 16102413 Province Place of DePaul P 563526 Province Place of Maryview P 419425 Richmond Health Care Foundation P 6264 Richmond Shared Services P 10230738 RHS Ent P 79336 RI LP P 254602 Richmond Radiation Oncology Center P 216360 Schervier Housing Development P 1172381 Schervier Pavillion P 610736 St Anthony Community Hospital P 2613286 St Francis Hospital P 38426539 St Francis Physician Services P 3950618 St Mary's MRI Center P 176666 Tidewater Diversified P 19675 Unity Properties P 20257 Urban Medical Institute P 12118