Our Lady of Bellefonte Hospital Inc: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- Our Lady of Bellefonte Hospital Inc (EIN 61-1356023)
- Tax period
- 2009-09-01 to 2010-08-31
- Filed
- 2011-07-14
- IRS object ID
- 201141959349301119
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-07-14T17:59:18-05:00 | Timestamp |
| Tax Period End Date | 2010-08-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1750 TYSONS BLVD | AddressLine1 |
| City | MCLEAN | City |
| State | VA | State |
| ZIP Code | 221024219 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-09-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 611356023 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Our Lady of Bellefonte Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | OURL | NameControl |
| Phone | 6068333333 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | St Christopher Drive | AddressLine1 |
| City | Ashland | City |
| State | KY | State |
| ZIP Code | 41101 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Joe Buchheit | Name |
| Title | Chief Executive Officer | Title |
| Phone | 6068333600 | Phone |
| Date Signed | 2011-07-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Emily Hayes Smith | Name |
| Phone | 7032511000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Kevin Halter | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | St Christopher Drive | AddressLine1 |
| City | Ashland | City |
| State | KY | State |
| ZIP Code | 41101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 153782023 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c | X | Organization501c |
| Web Site | www.olbh.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1999 | YearFormation |
| State Legal Domicile | KY | StateLegalDomicile |
| Activity Or Mission Description | Acute Care Hospital | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 27 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 18 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1332 | TotalNbrEmployees |
| Total Nbr Volunteers | 150 | TotalNbrVolunteers |
| Total Gross UBI | 1768578 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 156175731 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 148921164 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -467017 | InvestmentIncomePriorYear |
| Investment Income Current Year | 325050 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4360653 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4297822 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 160069367 | TotalRevenuePriorYear |
| Total Revenue Current Year | 153544036 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 59491023 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 56546781 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 97351220 | OtherExpensePriorYear |
| Other Expenses Current Year | 89177766 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 156842243 | TotalExpensesPriorYear |
| Total Expenses Current Year | 145724547 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3227124 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 7819489 | RevenuesLessExpensesCY |
| Total Assets BOY | 91747643 | TotalAssetsBOY |
| Total Assets EOY | 91664809 | TotalAssetsEOY |
| Total Liabilities BOY | 58976908 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 55485081 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 32770735 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 36179728 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 133838757 | Expense |
| Revenue | 148921164 | Revenue |
| Description | To bring compassion to healthcare and to be good helpto those in need by providing healthcare services. Please see community benefit disclosures in Sch H. | Description |
| Total Program Service Expense | 133838757 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 144 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1332 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 27 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 18 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pam Hall | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6068333601 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | OLBH St Christopher Drive | AddressLine1 |
| City | Ashland | City |
| State | KY | State |
| ZIP Code | 41101 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (38 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| Gregory Bausch | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| Danny Bentley | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| Mary Carolyn Carter | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| William Dickens | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| Larry Fields | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| Mary Catherine Flath | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| John Gross III | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| Sr Karen Hartman | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| Skip Hubbard | |||||||||
| Board Member | 50.00 | X | 0 | 694737 | 99499 | ||||
| Daniel Huffman | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| Sr Rose Marie Jasinski | |||||||||
| President (Sept-Dec) | 4.00 | X | 0 | 0 | 0 | ||||
| Connie Johnson | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| David Jones | |||||||||
| Board Member | 50.00 | X | 0 | 898058 | 91577 | ||||
| Larry Jones | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| Elizabeth Keith | |||||||||
| Board Member | 50.00 | X | 0 | 0 | 32292 | ||||
| Phillip Leslie | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| Angela Lewis | |||||||||
| Board Member | 4.00 | X | 15449 | 0 | 0 | ||||
| George Moore | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| Sam Ross | |||||||||
| Board Member | 50.00 | X | 0 | 623476 | 85946 | ||||
| Valinda Rutledge | |||||||||
| Board Member | 50.00 | X | 0 | 798608 | 92051 | ||||
| Ramona Salyer | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| EW Unnikrishnan MD | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| William Willan | |||||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||||
| Kevin Halter | |||||||||
| CEO | 50.00 | X | 0 | 385942 | 62878 | X | |||
| Joe Buccheit | |||||||||
| CFO/ Treasurer | 50.00 | X | 354134 | 0 | 47427 | X | |||
| John Wallenhorst | |||||||||
| President (Jan-Aug) | 50.00 | X | 0 | 269069 | 42368 | X | |||
| Frank Warnock | |||||||||
| Chairman | 6.00 | X | 0 | 0 | 0 | X | |||
| Jennifer Moore | |||||||||
| VP Pat Care/Chief Nurse Officer | 50.00 | 212496 | 0 | 19590 | X | ||||
| Emilio A Punzal MD | |||||||||
| Physician | 50.00 | 421826 | 0 | 27736 | X | ||||
| Jose Marie Makalinao MD | |||||||||
| Physician | 50.00 | 274623 | 0 | 9333 | X | ||||
| Peter O Lyn MD | |||||||||
| Physician | 50.00 | 229283 | 0 | 26306 | X | ||||
| Myra L Carroll | |||||||||
| Critical Care RN | 50.00 | 156175 | 0 | 13501 | X | ||||
| Thomas G Lyons | |||||||||
| Director of Pharmacy | 50.00 | 147382 | 0 | 3513 | X | ||||
| Mark Gordon | |||||||||
| Former CEO | 0.00 | 0 | 681718 | 59405 | X | ||||
| Charles Rhodes MD | |||||||||
| Former Board Member | 0.00 | 0 | 0 | 0 | X | ||||
| Mark Neff | |||||||||
| Former Board Member | 0.00 | 0 | 0 | 0 | X | ||||
| Thomas Wolf | |||||||||
| Former Board Member | 0.00 | 0 | 0 | 0 | X | ||||
| Angela Foltz | |||||||||
| Board Member | 0.00 | 0 | 0 | 0 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1811368 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4351608 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 713422 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Morrison Management Specialists Inc | |||||
| PO Box 102289 | Atlanta | GA | 303682289 | Cafeteria/Food Services | 3335763 |
| Ashland Anesthesia PSC | |||||
| PO Box 1377 | Ashland | KY | 411051377 | Anesthesia | 2695660 |
| Aramark Healthcare Facility Services In | |||||
| 24863 Network Place | Chicago | IL | 606731248 | Healthcare Cleaning | 1820011 |
| Aramark CTS Inc | |||||
| 12483 Collections Center Dr | Chicago | IL | 60693 | Equipment maintenance | 1385429 |
| Ashland GI Svcs LLC | |||||
| 6339 E Speedway Suite 201 | Tucson | AZ | 85710 | Gastrointestinal Services | 961920 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 91 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient Service Rev. | Description |
| Business Code | 622110 | BusinessCode |
| Total Revenue Column | 148921164 | TotalRevenueColumn |
| Related Or Exempt Function Income | 148921164 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 148921164 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 517732 | TotalRevenueColumn |
| Exclusion | $517,732 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1125 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1125 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1125 | TotalRevenueColumn |
| Unrelated Business Revenue | 1125 | UnrelatedBusinessRevenue |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 45305 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 237987 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -192682 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -192682 | TotalRevenueColumn |
| Exclusion | -$192,682 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|
| Retail Pharmacy Rev. | 446110 | 2430186 | 607547 | $1,822,639 |
| Non-patient Lab Svcs. | 531120 | 1159906 | 1159906 | |
| JV - Infusion Sols. | 621610 | -14177 | -$14,177 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 720782 | TotalRevenueColumn |
| Exclusion | $720,782 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4296697 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 153544036 | TotalRevenueColumn |
| Related Or Exempt Function Income | 148921164 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1768578 | UnrelatedBusinessRevenue |
| Exclusion | $2,854,294 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1305666 | Total |
| Program Services | 949207 | ProgramServices |
| Management And General | 356459 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40276946 | Total |
| Program Services | 36265654 | ProgramServices |
| Management And General | 4011292 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4140360 | Total |
| Program Services | 3726324 | ProgramServices |
| Management And General | 414036 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7856762 | Total |
| Program Services | 7071086 | ProgramServices |
| Management And General | 785676 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2967047 | Total |
| Program Services | 2670342 | ProgramServices |
| Management And General | 296705 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 419151 | Total |
| Management And General | 419151 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 86758 | Total |
| Management And General | 86758 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14411 | Total |
| Management And General | 14411 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5603377 | Total |
| Program Services | 5603377 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1172288 | Total |
| Program Services | 1055059 | ProgramServices |
| Management And General | 117229 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14485515 | Total |
| Program Services | 13121575 | ProgramServices |
| Management And General | 1363940 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 383459 | Total |
| Program Services | 260502 | ProgramServices |
| Management And General | 122957 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4870131 | Total |
| Program Services | 3652598 | ProgramServices |
| Management And General | 1217533 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8653966 | Total |
| Program Services | 7788569 | ProgramServices |
| Management And General | 865397 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Medical Supplies | 19107614 | 19107614 | 0 | 0 |
| Purchased Services | 12871366 | 11595969 | 1275397 | 0 |
| Bad Debt | 12694325 | 12694325 | 0 | 0 |
| Corporate Dues | 3426912 | 3426912 | 0 | 0 |
| 0 | 0 | 0 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5388493 | Total |
| Program Services | 4849644 | ProgramServices |
| Management And General | 538849 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 145724547 | Total |
| Program Services | 133838757 | ProgramServices |
| Management And General | 11885790 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1008131 | BOY |
| EOY | 4894049 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14444063 | BOY |
| EOY | 14879379 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 822688 | BOY |
| EOY | 802885 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3537039 | BOY |
| EOY | 3535658 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 159245 | BOY |
| EOY | 966986 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 115255138 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 57506652 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62652544 | BOY |
| EOY | 57748486 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 463418 | BOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5796335 | BOY |
| EOY | 6686874 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2864180 | BOY |
| EOY | 2150492 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91747643 | BOY |
| EOY | 91664809 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46862143 | BOY |
| EOY | 12878637 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 4114833 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12114765 | BOY |
| EOY | 38491611 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58976908 | BOY |
| EOY | 55485081 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32770735 | BOY |
| EOY | 36179728 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32770735 | BOY |
| EOY | 36179728 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91747643 | BOY |
| EOY | 91664809 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $14,411 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 14411 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i: | Identifier |
| Return Reference | Explanation of Other Lobbying Activities: | ReturnReference |
| Explanation | Our Lady of Bellefonte Hospital paid dues to the Kentucky Hospital Association, Catholic Health Association, and American Hospital Association 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: 15.6% ($8,069) to the KHA, 4.68% (1,367) CHA, 23.76% (4,975) AHA. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4583456 | OtherCostOrOtherBasis |
| Book Value | 4583456 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 57030296 | OtherCostOrOtherBasis |
| Depreciation | 20423501 | Depreciation |
| Book Value | 36606795 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2528936 | OtherCostOrOtherBasis |
| Depreciation | 1046046 | Depreciation |
| Book Value | 1482890 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 48073825 | OtherCostOrOtherBasis |
| Depreciation | 34352333 | Depreciation |
| Book Value | 13721492 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3038625 | OtherCostOrOtherBasis |
| Depreciation | 1684772 | Depreciation |
| Book Value | 1353853 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 57748486 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Mellon Investments | Description |
| Book Value | 6686874 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 6686874 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Pension Liability | $35,441,002 |
| Mcare/Mcaid Liability | $2,248,855 |
| Other Miscellaneous | $650,843 |
| Payroll and State Liabilities | $150,911 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 38491611 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| ExplanationExplanation |
|---|
| Part X: 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. |
| 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: 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. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2903 | PersonsServed |
| Total Community Benefit Expense | 3809518 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 953115 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2856403 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02150 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 25754 | PersonsServed |
| Total Community Benefit Expense | 20739543 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15198912 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5540631 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04160 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 28657 | PersonsServed |
| Total Community Benefit Expense | 24549061 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 16152027 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8397034 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06310 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 30 | NumberOfActivitiesOrPrograms |
| Persons Served | 56195 | PersonsServed |
| Total Community Benefit Expense | 542164 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 60346 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 481818 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00360 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 215 | PersonsServed |
| Total Community Benefit Expense | 1162828 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 163801 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 999027 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00750 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 924162 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 924162 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00690 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 10 | NumberOfActivitiesOrPrograms |
| Persons Served | 2137 | PersonsServed |
| Total Community Benefit Expense | 43529 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 43529 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 45 | NumberOfActivitiesOrPrograms |
| Persons Served | 58547 | PersonsServed |
| Total Community Benefit Expense | 2672683 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 224147 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2448536 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01830 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 45 | NumberOfActivitiesOrPrograms |
| Persons Served | 87204 | PersonsServed |
| Total Community Benefit Expense | 27221744 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 16376174 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10845570 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08140 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 1102 | PersonsServed |
| Total Community Building Expense | 6388 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6388 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 271 | PersonsServed |
| Total Community Building Expense | 172707 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 172707 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 775 | PersonsServed |
| Total Community Building Expense | 4917 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4917 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 9 | NumberOfActivitiesOrPrograms |
| Persons Served | 1602 | PersonsServed |
| Total Community Building Expense | 160350 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 160350 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 21878 | PersonsServed |
| Total Community Building Expense | 41002 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 41002 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 140 | PersonsServed |
| Total Community Building Expense | 799 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 799 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 890 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 890 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 20 | NumberOfActivitiesOrPrograms |
| Persons Served | 25768 | PersonsServed |
| Total Community Building Expense | 387053 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 387053 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00280 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $3,535,840 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 41496975 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 41825111 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -328136 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (8 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | Er OtherErOther | OtherOther |
|---|---|---|---|---|---|---|---|---|
| Our Lady of Bellefonte Hospital Inc | ||||||||
| St Christopher Dr | Ashland | KY | 41101 | X | X | X | ||
| Bellefonte Home Health Care Agency | ||||||||
| 1819 Ashland Road | Greenup | KY | 41144 | X | ||||
| OLBH Pediatric Rehabilitation Clinic | ||||||||
| 1629 Ashland Road Unit 2 | Greenup | KY | 41144 | X | ||||
| Sleep Lab | ||||||||
| 118 St Christopher Dr | Ashland | KY | 41101 | X | ||||
| Bellefonte Behavioral Health | ||||||||
| St Christopher Dr | Ashland | KY | 41101 | X | ||||
| Bellefonte Center | ||||||||
| 1000 Ashland Drive | Ashland | KY | 41101 | X | Women's and Administrative Services | |||
| Renaissance Sleep Lab | ||||||||
| 2920 Winchester Avenue | Ashland | KY | 41101 | Sleep Lab | ||||
| Ironton MRI | ||||||||
| 1015 East Ring Road | Ironton | OH | 45638 | Diagnostic MRIs | ||||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Annual Community Benefit Expln | Part I, Line 6a: Bon Secours Kentucky Health System annually develops a report to 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 published each year and posted on the web at http://www.olbhfoundation.com. | AnnualCommunityBenefitExpln |
| Costing Method Used | 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 non patient 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. | CostingMethodUsed |
| Percent Of Total Expense Expln | Part I, Line 7f: Current year bad debt expense not included in the calculation for line 7, Column (f) is $12,694,325. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | 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. | BadDebtFootnote |
| Shortfall As Community Benefit | 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 non reimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and non reimburseable 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 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 publically insured patients where reimbursement is less than cost of providing the service. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | 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 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 approval. 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. | DebtCollectionPolicy |
| Needs Assessment | Part VI, Line 2: Bon Secours Kentucky, Our Lady of Bellefonte Hospital (OLBH) uses multiple approaches to assess the health needs of the communities it serves. We have a community based Board of Directors that provides the hospital with guidance and input on services needed in the local community through contacts with local business and government leaders. Community health screening data is gathered through the year and analyzed for use in planning. OLBH currently partners with the Greenup County Health Department in its MAPP (Mobilize for Action through Planning & Partnerships) project which is a state mandated program that will result in a comprehensive community health plan for each county in Kentucky. OLBH also supports the Northeast Kentucky Care Center (NEKCC), a free health care clinic serving uninsured adult residents of Boyd and Greenup Counties. The clinic provides an option other than the emergency department for our uninsured adult population that needs primary care services. OLBH has provided financial support, volunteer personnel, and supplies for the clinic.The most recent comprehensive community needs assessment for our tri-state area was a collaborative effort by the Lewis College of Business at Marshall University in Huntington, WV, and the River Cities Community Health Coalition. Conducted in 2002, a survey questionnaire of 88 questions was jointly developed and then administered by telephone to a random sample of households in the 12-county, tri-state area that comprises the River Cities (Ashland, KY; Huntington, WV; and Portsmouth, OH). Significant findings include:- Nearly 30% of respondents did not participate in any kind of physical activity.- Nearly 50% of respondents were trying to lose weight.- It had been more than one year since 20% of respondents had had their blood pressure checked.- Slightly over 25% of the survey respondents smoked cigarettes and over 80% of these respondents said they would like to quit smoking if they could.- 33% of male respondents had not had prostate or testicular cancer screening.- 36% of female respondents over the age of 40 had never had a mammogram.- 52% of respondents had not had a tetanus shot in the past 10 years.- Nearly 24% of respondents said they had never had their cholesterol checked by a health professional.- Almost 43% of the overall survey respondents said they had needed medical care but did not seek it because of a lack of money, lack of insurance or lack of transportation.OLBH has been instrumental in developing programs to meet these needs that include a van ministry that provides free non-emergency medical transportation for outpatient services at our campus and primary care centers; developing the Greenup County Interagency Council; a county drug task force, Greenup Residents Ending Addiction Together (GREAT); church partnerships with 52 churches to develop health ministry and/or faith community nursing programs; and our support of the previously mentioned Northeast Kentucky Care Center and Greenup County Health Department MAPP project.Community need assessments are updated using a variety of informational sources including Kentucky Health Information for state-based performance data, Kentucky Hospital Association info site 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 Our Lady of Bellefonte Hospital.Our primary service area consists of Boyd, Greenup, and Carter Counties in Kentucky and Lawrence County in Ohio. Our secondary service area consists of Lewis County, Kentucky and Scioto County, Ohio. We continually update our information for our market share and physician planning to offer services in underserved areas of our region utilizing hospital databases, 3rd party databases, and US Census Bureau data. We have also developed regional alignment plans using this data and tying it to our underserved areas to plan for future growth in the communities we serve by providing more access points to our patients in our service areas. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: Patient financial assistance policy is communicated to patients verbally upon registration and there are visible postings of the policy in common areas throughout the hospital OLBH is committed to ensuring access to health care services for all. As a health care provider, OLBH treats all patients, whether insured, underinsured or uninsured, with dignity, respect and compassion throughout admission, delivery of services, discharge and billing and collection processes. OLBH addresses the needs of the uninsured by providing free or reduced fees on hospital services. OLBH 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 communitys relative cost of living ("Adjusted FPG"). A sliding scale assistance policy is afforded patients that exceed the income guidelines for 100% assistance. Sliding scale assistance is provided to patients over 200% of the Adjusted FPG and progressively declines in proportion to the patients 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"). | PatientEducationAssistance |
| Community Information | Part VI, Line 4: BSKHS serves a region of approximately to 400,000 people in northeastern Kentucky, southern Ohio, and western West Virginia. The service areas includes six counties in northeastern Kentucky (Greenup, Boyd, Lawrence, Carter and Elliott which comprise the FIVCO Area Development District as well as Lewis County); two counties in southern Ohio (Lawrence and Scioto counties); and Wayne and Cabell counties in western West Virginia. Due to our growing aging population, services for our community residents aged 55 and older are needed, particularly women's health, orthopedics, diabetes, cardiopulmonary services and wound care. Major trends in the service area indicate a stable population that is aging. The 55 and older population is expected to increase by 14% over the next five years. The younger population tends to leave the area to find jobs. The high poverty and high unemployment rate in the area result in a low socioeconomic status. It is a very industrialized region which creates carcinogens and unhealthy life styles especially in eastern Kentucky which has some of the highest incidences in the country of smoking, diabetes, obesity and carcinogens. These demographic characteristics create a high demand for chronic disease health care including diabetes, cancer and heart disease among others. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: BSKHS commitment to social and economic justice is integrated into the fabric of the organization through its Strategic Quality Plan and its common vision of a healthy community. Our vision of a healthy community is embodied in the following statements. A healthy community is a good place to live for all residents. The rich diversity of cultures and capacities of the community are celebrated and mobilized, with a particular concern for the poor, marginalized and dying, to create physical and social environments that promote families, nurture youth and support senior citizens. Individuals have the opportunity to fully participate in defining holistic well being and assuming responsibility for the development of their innate potential. Healthy Community Services provided education and support to nurse volunteers in 61 area churches through its health ministry/faith community nursing ministry. BSKHS assists these faith communities in developing health and wellness programs that blend with existing ministries to meet the unique needs of each congregation. In all programs, the relationship between physical and spiritual health is emphasized. Through the programs and screenings, health problems such as glaucoma, diabetes, peripheral vascular disease, heart disease and hypertension, result in participants seeking early intervention and treatment. In August 2010, we became an educational partner with the International Parish Nurse Resource Center and we now have trained faculty and the rights to their basic parish nurse preparation curriculum. We are now well-positioned to transition from a lay health-ministry approach to a true parish nurse model in FY2011. HCS Van Ministry provided free non-emergency transportation to outpatient services to 203 individuals which represents 1,704 round trips and nearly 40,000 miles traveled to outpatient destinations such as rehabilitative therapies (i.e., PT, OT, ST, cardiac and pulmonary rehab); chemotherapy and radiation treatment at the Ashland-Bellefonte Cancer Center; and visits to physician offices on the OLBH campus and OLBH Primary Care Centers. With little or no public transportation available in the areas we serve, this been a tremendous help in providing access to these services that are so desperately needed by the people we serve.Senior Services: Our Senior Services program had to discontinue the newest Meals on Wheels program that served an outlying area of Boyd County due to a lack of volunteers. We have, however, successfully maintained eight programs that serve ten communities in our service area. Each month 212 volunteers deliver over 4,500 meals to 212 elderly and/or disabled individuals who reside in these communities. Additionally, 27 volunteers provide support services such as friendly visits and assistance with laundry to 12 care receivers. This represents approximately 2,000 volunteer hours of service each month which has a dollar value of $48,600 annually. As our senior services coordinator has transitioned into the role of grant writer, we have found community partners such as the FIVCO Area Council on Aging to assume responsibility for the Alzheimers education and support groups we were providing. BSKHS provides Women's Services mobile clinic that offers osteoporosis and mammography screening. Additionally, Healthy Community Services provides bone density screening monthly at the Greenup County Health Department. In FY 2010, we served 73 women at the health department identifying 24 in the pre-osteoporosis or osteoporosis range.Children and Youth Services: Healthy Community Services participated in our 12th Annual Bicycle Safety Camp in FY 2010 and assisted a local congregation in providing a camp for children in Ironton, OH. These two camps served a total of 112 children. We also provided educational programs at both end-of- school activities and back-to-school events such as Ready fest in both Greenup and Boyd Counties.Primary Care Clinic Subsidy: Bellefonte Physician Services, Inc. (BPS), in conjunction with Our Lady of Bellefonte Hospital, employs 49 providers in order to offer quality healthcare to the residents of Eastern Kentucky, more specifically Boyd, Greenup, and Carter Counties. BPS providers offer healthcare services to patients who are either uninsured or are covered by Medicaid, which equals approximately 12% and 23% of our overall patient population, respectively. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: BSKHS is working to engage and empower the members of the Argillite community located in Greenup County to support them in improving their quality of life and holistic health. Argillite is a rural community with approximately 1,000 residents. Single-family homes and trailers prevail. 47% of the households make less than $25,000 per year with 17% of that number making less than $15,000 annually. 43% of residents have no high school diploma; 16% of that number have less than a 9th grade education. Argillite Elementary has 71% of students receiving free and reduced lunch. The Director of Healthy Community Initiatives is coordinating efforts to unite the community and aid in health and social issues. The Director is assessing the needs and assets of the community through resident interviews, community forums, community survey and focus groups. With this data, the community members will choose the priority improvement initiatives that residents and supporting organizations want to begin to address. One of the first initiatives was a summer feeding and reading program for children in collaboration with the Greenup County School's Family Resource and Youth Service Center. Other community projects include distribution of free dictionaries and books to students and Thanksgiving food baskets to needy families; a Back pack program to assist low income students with school supplies and clothes and funding for a weekend snack sack program that provides students most at risk of going hungry with food during the weekend. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: Bon Secours Health System, Inc., a Maryland nonprofit, non stock membership corporation (BSHSI), and all of the other entities that are controlled directly or indirectly by Bon Secours, Inc., a Maryland nonprofit, non stock 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. Activities directly associated with this purpose are considered operating activities. Operating activities also include other incidental services that are closely related to healthcare. BSKHS hospital, Our Lady of Bellefonte Hospital, operates an emergency room that is open 24 hours 7 days a week to all persons regardless of ability to pay. Three years ago, the hospital implemented the 30-minute guarantee that patients will be evaluated within 30 minutes of their arrival. This access to care guarantee continues to be the benchmark of performance. Our Lady of Bellefonte Hospital has an open medical staff with privileges available to all qualified physicians in the area. BSKHS has a governing body in which independent persons representative of the community comprise a majority. The governing body of BSKHS consists of 18 members - 16 of which represent the local community. Their expertise includes health care and health care administration, pharmacy, education, business, finance, insurance/real estate and the law. Educational preparation ranges from high school with some college to doctoral degrees in medicine, pharmacy, and law. BSKHS engages in medical and scientific research programs such as a lung cancer study with such prestigious institutions as the University of Kentucky and the Cleveland Clinic. BSKHS engages in the training and education of health care professionals. As a teaching hospital, BSKHS is affiliated with several medical schools (Marshall University and the West Virginia and Pikeville Schools of Osteopathic Medicine) as well as local schools of nursing. BSKHS also offers a Family Practice Residency program. OLBH is the only teaching hospital in the southern Ohio and far northeastern Kentucky area. BSKHS participates in Medicaid, Medicare, CHAMPUS, Tricare, and other government-sponsored health care programs. | AffiliatedHealthCareSystem |
| Reports Filed With States | KY | ReportsFiledWithStates |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Skip Hubbard | |||||||||||||
| 0 | 359458 | 0 | 283459 | 0 | 51820 | 0 | 79795 | 0 | 19704 | 0 | 794236 | 0 | 0 |
| David Jones | |||||||||||||
| 0 | 393968 | 0 | 305114 | 0 | 198976 | 0 | 68174 | 0 | 23403 | 0 | 989635 | 0 | 0 |
| Sam Ross | |||||||||||||
| 0 | 392569 | 0 | 226397 | 0 | 4510 | 0 | 63612 | 0 | 22334 | 0 | 709422 | 0 | 0 |
| Valinda Rutledge | |||||||||||||
| 0 | 428528 | 0 | 356742 | 0 | 13338 | 0 | 72325 | 0 | 19726 | 0 | 890659 | 0 | 0 |
| Kevin Halter | |||||||||||||
| 0 | 288386 | 0 | 83943 | 0 | 13613 | 0 | 40233 | 0 | 22645 | 0 | 448820 | 0 | 0 |
| Joe Buccheit | |||||||||||||
| 224034 | 0 | 47590 | 0 | 82510 | 0 | 31452 | 0 | 15975 | 0 | 401561 | 0 | 0 | 0 |
| John Wallenhorst | |||||||||||||
| 0 | 196349 | 0 | 59243 | 0 | 13477 | 0 | 33533 | 0 | 8835 | 0 | 311437 | 0 | 0 |
| Jennifer Moore | |||||||||||||
| 175112 | 0 | 35886 | 0 | 1498 | 0 | 11473 | 0 | 8117 | 0 | 232086 | 0 | 0 | 0 |
| Emilio A Punzal MD | |||||||||||||
| 158811 | 0 | 262498 | 0 | 517 | 0 | 3984 | 0 | 23752 | 0 | 449562 | 0 | 0 | 0 |
| Jose Marie Makalinao MD | |||||||||||||
| 160392 | 0 | 114097 | 0 | 134 | 0 | 0 | 0 | 9333 | 0 | 283956 | 0 | 0 | 0 |
| Peter O Lyn MD | |||||||||||||
| 124543 | 0 | 104336 | 0 | 404 | 0 | 0 | 0 | 26306 | 0 | 255589 | 0 | 0 | 0 |
| Myra L Carroll | |||||||||||||
| 153849 | 0 | 2259 | 0 | 67 | 0 | 4176 | 0 | 9325 | 0 | 169676 | 0 | 0 | 0 |
| Thomas G Lyons | |||||||||||||
| 134427 | 0 | 11240 | 0 | 1715 | 0 | 2268 | 0 | 1245 | 0 | 150895 | 0 | 0 | 0 |
| Mark Gordon | |||||||||||||
| 0 | 335043 | 0 | 235710 | 0 | 110965 | 0 | 33893 | 0 | 25512 | 0 | 741123 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part I, Line 4b: | Our Lady of Bellefonte Hospital, Inc., participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and is 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 III | Part I, Line 3: Bon Secours Health System, Inc., a related organization of Our Lady of Bellefonte Hospital, Inc., uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent compensation consultant Written employment contracts Compensation survey or study Approval by the board/compensation committee | Supplemental Information |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 2 | Board members Philip B. Leslie and Frank Warnock have a business relationship. |
| Form 990, Part VI, Section A, line 6 | Bon Secours Health System, Inc. is the sole member of Bon Secours Kentucky Health System, which in turn is the sole member of Our Lady of Bellefonte Hospital, Inc. |
| Form 990, Part VI, Section A, line 7a | The governing body of Our Lady of Bellefonte Hospital, Inc. is appointed by its Member, Bon Secours Kentucky Health System, Inc. and subject to approval by Bon Secours Health System, Inc. |
| Form 990, Part VI, Section A, line 7b | Certain authorities of Our Lady of Bellefonte Hospital, Inc. are reserved to its member or to Bon Secours Health System, Inc. |
| Form 990, Part VI, Section B, line 11 | The process the organization uses to review the Form 990 consists of a review by Bon Secours Kentucky Health System's audit and compliance board committee and providing the form to the Our Lady of Bellefonte Hospital, Inc.'s board of directors to allow for a thorough review by both before the filing date of July 15, 2011. Bon Secours Kentucky Health System's audit and compliance board committee and Our Lady of Bellefonte Hospital, Inc.'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 12c | Our Lady of Bellefonte Hospital, Inc. 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 Our Lady of Bellefonte Hospital, Inc. 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). |
| 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 Our Lady of Bellefonte Hospital, Inc., 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 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 other officers or key employees of BS-KY 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 | Our Lady of Bellefonte Hospital, Inc. provides any documents open to public inspection upon request. |
| Form 990, Part VI, Section B, Line 14: | 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 HIPPA requirements. An organization-wide policy is currently in place for fiscal year ending August 31, 2011. |
| Form 990, Part VII | 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. Kevin Halter'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 Our Lady of Bellefonte Hospital, Inc. John Wallenhorst's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the VP of Mission & Ethics at Bon Secours Health System, Inc. Samuel L. Ross, M.D.'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 Baltimore Health System, Inc. David Jones' compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the SVP of Human Resources for Bon Secours Health System, Inc. Skip Hubbard's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation he receives is for his role as the Chief Information Officer of Bon Secours Health System, Inc. Valinda Rutledge's compensation is paid by Bon Secours Health System, Inc., a related organization. The compensation she receives is for her role as the CEO of Bon Secours St. Francis Health System, Inc. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| Bon Secours Health System Inc | |||||||||
| 1505 Marriottsville Rd | Marriottsville | MD | 21104 | 521301088 | Parent Org. Management Services | MD | 501(c)(3) | Line 11, Type II: 50 | N/A |
| Bellefonte Physician Services Inc | |||||||||
| St Christopher Dr | Ashland | KY | 41101 | 352320780 | Physician Practices | KY | 501(c)(3) | Line 3: 170(b)(1)(A) | N/A |
| Our Lady of Bellefonte Hospital Foundation | |||||||||
| St Christopher Dr | Ashland | KY | 41101 | 611381952 | Grant Making Foundation | KY | 501(c)(3) | Line 9: 509(a)(2) | N/A |
| Bon Secours Kentucky Health System | |||||||||
| St Christopher Dr | Ashland | KY | 41101 | 611356024 | Local System Parent Org. | KY | 501(c)(3) | Line 11, Type II: 50 | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tri State Quality Health Network | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 St Christopher Dr | AddressLine1 |
| City | Ashland | City |
| State | KY | State |
| ZIP Code | 41101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 611263174 | EIN |
| Primary Activity | Physician Hospital Organization | PrimaryActivity |
| Legal Domicile State | KY | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Percentage Ownership | 0.50000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | None | BusinessNameLine1 |