Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
Carondelet Heart & Vascular Institute
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
2202 North Forbes Blvd
 
Room/suite
City or town, state or country, and ZIP + 4
Tucson, AZ85745
D Employer identification number

56-1943271
E Telephone number

G Gross receipts $ 55,931,872
F Name and address of principal officer:
Deb S Mohesky
2202 North Forbes Blvd
Tucson,AZ85745
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.carondelet.org
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:
 
L Year of formation: 2010
M State of legal domicile: AZ
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: To provide for the community's healthcare needs.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 12
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 370
6 Total number of volunteers (estimate if necessary) .... 6 20
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) .........   17,352
9 Program service revenue (Part VIII, line 2g) .........   55,510,860
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....   108,557
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)   278,286
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................   55,915,055
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...   19,043
14 Benefits paid to or for members (Part IX, column (A), line 4) ....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)   20,507,449
16a Professional fundraising fees (Part IX, column (A), line 11e)....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....   39,160,725
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)   59,687,217
19 Revenue less expenses. Subtract line 18 from line 12......   -3,772,162
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............   38,367,072
21 Total liabilities (Part X, line 26)............   53,688,277
22 Net assets or fund balances. Subtract line 21 from line 20 .....   -15,321,205
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: Provide for the healthcare needs of the community; to embrace the whole person in mind, body and spirit; and to serve all people with dignity.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 44,365,575 including grants of $ 19,043 ) (Revenue $ 55,613,910 )
During calendar year 2010, Carondelet Heart & Vascular Institute provided $2,958,835, or 5.2 percent of net revenue, in community benefit to the residents of Southern Arizona. Carondelet Heart & Vascular Institute provides community education and outreach as well as community spiritual care and outreach services for the poor and vulnerable. As a Catholic, faith-based healing ministry, Carondelet Heart & Vascular Institute is deeply committed to transforming health care through active collaboration with community organizations and non-profit organizations to identify and address community needs to improve health and well-being, for life. See Schedule O for Community Benefit Report.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 44,365,575
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
No
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II...........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III...............
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
95
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
370
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
 
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
 
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
13
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
AZ
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
Deb Mohesky
2202 N Forbes Blvd
Tucson,AZ85745
(520) 872-7700
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Stephen Quinlan
Chairman
 .50 X   X       0 0 0
(2) Sr Annette Bower
Vice-Chair
 .50 X   X       0 0 0
(3) Elizabeth Kaminski
Treasurer
 .50 X   X       0 0 0
(4) Christopher Linscott
Secretary
 .50 X   X       0 0 0
(5) John Boulet
Director
 .50 X           0 0 0
(6) Wade Harman
Director
 .50 X           0 0 0
(7) John Lauer
Director
 .50 X           0 0 0
(8) Sr Judy Murphy
Director
 .50 X           0 0 0
(9) Fran Roberts
Director
 .50 X           0 0 0
(10) Carolyn Smeltzer
Director
 .50 X           0 0 0
(11) William Stout
Director
 .50 X           0 0 0
(12) Ronald Wagner
Director
 .50 X           0 0 0
(13) Ruth Brinkley
CEO - CHN
 40.00 X   X       0 1,329,431 41,330
(14) Sue Gold
CNO & COO - CHVI
 40.00     X       142,633 0 22,241
(15) Odette Bolano
COO - CHN
 40.00     X       0 455,122 29,147
(16) Andrew Guarni
CFO - CHN (end 1/11)
 40.00     X       0 189,861 3,488
(17) Deb Mohesky
CFO - CHN (start 1/11)
 40.00     X       0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Michael Hecht
CMO - CHVI
 40.00       X     162,500 0 0
(19) Daisy Jenkins
Sr. VP Human Resources
 40.00       X     0 291,966 37,054
(20) Neil Carolan
VP Physician Development Officer
 40.00       X     0 218,131 28,989
(21) Irma Ramirez
VP Community & Government Relations
 40.00       X     0 217,287 28,206
(22) Anthony Fonze
VP - CIO
 40.00       X     0 274,481 28,915
(23) Patricia Martinez
VP Chief Quality Officer
 40.00       X     0 266,859 13,862
(24) Donna Zazworsky
VP Comm Hlth & Cont Svcs
 40.00       X     0 166,540 28,845
(25) Judy Tatman
VP Clinical Excellence
 40.00       X     0 320,193 32,306
(26) Jude Magers
VP Mission Integration
 40.00       X     0 187,271 31,825
(27) Tracy Prigmore
VP Strategic Planning
 40.00       X     0 312,174 18,433
(28) Linda Werbylo
VP Operations and Integrity
 40.00       X     0 242,229 35,366
(29) Lisa Pope
Operations Executive
 40.00         X   191,632 0 34,480
(30) Jill Bennett
Clinical Lead
 40.00         X   146,084 0 6,949
(31) Michelle Clark
Clinical Nurse Lead
 40.00         X   137,720 0 19,864
(32) Yvonne Gomez
Clinical Lead
 40.00         X   122,799 0 29,269
(33) Kay de Vilbis King
Pharmacist
 40.00         X   113,172 0 21,061
(34) Wesley Colvin
Former COO - CHN
 0.00           X 0 415,301 4,754
(35) Thomas Murphy
Former CLO - CHN
 0.00           X 0 139,955 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 1,016,540 5,026,801 496,384
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet23
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Morrison's Mgmt Specialists Inc
5801 Peachtree Dunwoody Rd
Atlanta,GA30342 		Nutritional Services 1,117,050
TriMedx LLC
P O Box 636129
Cincinnati,OH452636129 		Equipment Maintenance 1,101,001
Crothall Healthcare Inc
13028 Collections Center Dr
Chicago,IL60693 		Housekeeping Services 753,865
Palo Verde Perfusion Svcs
2251 N Indian Ruins Rd Suite C
Tucson,AZ85715 		Medical Services 411,785
TRG Healthcare Solutions
650 S Cherry St Suite 530
Denver,CO80246 		Consulting 229,223
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet11
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 2,552
e Government grants (contributions)1e 14,800
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 17,352
Program Service Revenue Business Code
2a Net Patient Svcs 621,990 55,510,860 55,510,860    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 55,510,860
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 125,374     125,374
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses   16,817
c Gain or (loss)   -16,817
d Net gain or (loss)..........MediumBullet -16,817     -16,817
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a Cafeteria Revenue 722,210 211,469     211,469
b Misc Revenue 900,099 66,817 66,817    
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 278,286
12 Total revenue. See Instructions....MediumBullet 55,915,055 55,577,677 0 320,026
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 19,043 19,043
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 327,374 327,374    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 17,899,716 14,542,032 3,357,684  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 506,126 397,714 108,412  
9 Other employee benefits ....... 413,497 324,926 88,571  
10 Payroll taxes ........... 1,360,736 1,069,266 291,470  
11 Fees for services (non-employees):        
a Management ...... 7,547   7,547  
b Legal ......... 2,351   2,351  
c Accounting ...........        
d Lobbying ........... 3,567   3,567  
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 6,148,202 3,202,665 2,945,537  
12 Advertising and promotion .... 18,182 34 18,148  
13 Office expenses ....... 1,110,858 1,039,138 71,720  
14 Information technology ...... 27,735 20,518 7,217  
15 Royalties ..        
16 Occupancy ........... 586,616 460,963 125,653  
17 Travel ............ 38,064 7,463 30,601  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 1,179,488 926,842 252,646  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 2,456,439 1,930,270 526,169  
23 Insurance .............. 283,369 257,418 25,951  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a Supplies 17,690,088 17,400,482 289,606 0
b Shared Svcs Allocation 6,351,081 0 6,351,081 0
c Bad Debt 2,354,255 2,354,255 0 0
d Food Service Expenses 439,748 50,440 389,308 0
e National Office Fees 140,012 0 140,012 0
f All other expenses 323,123 34,732 288,391  
25 Total functional expenses. Add lines 1 through 24f 59,687,217 44,365,575 15,321,642 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1 1,931,929
2 Savings and temporary cash investments .......   2  
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net .........   4 7,922,543
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use ..............   8 1,690,156
9 Prepaid expenses and deferred charges ............   9 91,981
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 53,610,545
b Less: accumulated depreciation. ..... 10b 27,349,044 0 10c 26,261,501
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ...........   15 468,962
16 Total assets. Add lines 1 through 15 (must equal line 34)... 0 16 38,367,072
Liabilities 17 Accounts payable and accrued expenses .   17 2,588,342
18 Grants payable ..........   18  
19 Deferred revenue ..........   19 343,376
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 0 25 50,756,559
26 Total liabilities. Add lines 17 through 25..... 0 26 53,688,277
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .....   27 -15,407,817
28 Temporarily restricted net assets .....   28 86,612
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 0 33 -15,321,205
34 Total liabilities and net assets/fund balances ..... 0 34 38,367,072
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
55,915,055
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
59,687,217
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
-3,772,162
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
0
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-11,549,043
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
-15,321,205
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Carondelet Heart & Vascular Institute
 
Employer identification number

56-1943271
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
Carondelet Heart & Vascular Institute
 
Employer identification number

56-1943271
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
Carondelet Heart & Vascular Institute
  		Employer identification number

56-1943271
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
Carondelet Heart & Vascular Institute
  		Employer identification number

56-1943271
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
Carondelet Heart & Vascular Institute
  		Employer identification number

56-1943271
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Carondelet Heart & Vascular Institute
 
Employer identification number

56-1943271
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
3,567
j
Total. lines 1c through 1i ...................................
3,567
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Explanation of Other Lobbying Activities: Part II-B, Line 1i: Other activities represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Carondelet Heart & Vascular Institute
 
Employer identification number

56-1943271
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   3,230,000 3,230,000
b Buildings ................   28,738,340 8,445,487 20,292,853
c Leasehold improvements ............   401,774 10,325 391,449
d Equipment ................   21,240,431 18,893,232 2,347,199
e Other .................        
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 26,261,501
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
Medicare Settlements 1,015,607
Intercompany to Ascension Health 36,300,296
Note Payable to Carondelet Health Network 3,853,075
Capital Leases 310,927
General Professional Liability IBNR 114,482
Retirement Plan Employer Match 298,770
Miscellaneous 4,306
Intercompany to Carondelet Health Network 8,859,096

Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 50,756,559
2. Fin 48 (ASC 740) Footnote. In Part XIV, 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 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Carondelet Heart & Vascular Institute
 
Employer identification number

56-1943271
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    184,284   184,284 0.320 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    7,251,156 4,641,358 2,609,798 4.550 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs ..... 		    7,435,440 4,641,358 2,794,082 4.870 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    115,632   115,632 0.200 %
f Health professions education
(from Worksheet 5) .. 		    61,773   61,773 0.110 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		           
jTotal Other Benefits ...     177,405   177,405 0.310 %
kTotal. Add lines 7d and 7j. ..     7,612,845 4,641,358 2,971,487 5.180 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense (at cost).....
2
2,354,255
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
371,790
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
37,691,870
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
36,197,308
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
1,494,562
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 Carondelet Heart & Vascular Institute
4888 N Stone Ave
Tucson,AZ85704 		X X         X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:NA
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?  
Name and address Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    Part I, Line 6a: The organization prepares and files an annual Community Benefit Report. This report is prepared on a consolidated basis and includes data for Carondelet Health Network, Holy Cross Hospital, Inc., Carondelet Foundation, and Carondelet Heart & Vascular Institute.
    Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a costing accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table.
    Part I, L7 Col(f): The amount of bad debt expense reported on Form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentages in Part I, Line 7, column (f) is $2,354,255.
    Part III, Line 4: The organization is a part of the Carondelet Health Network consolidated audit. The footnote that references bad debt expense in the 2011 consolidated audit is as follows.The provision for bad debts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based on historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modification to the provision for bad debts to establish an appropriate allowance for uncollectible accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the organization follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restriction on collection efforts as determined by the organization. Accounts receivable are written off after collection efforts have been followed in accordance with the organization's policies.
    Part III, Line 8: Carondelet Heart & Vascular Institute follows the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit.
    Part III, Line 9b: The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. Patients who are cooperating in good faith to resolve their hospital bills will not receive from Carondelet Heart & Vascular Institute liens on primary residences or wage garnishments and unpaid bills will not be sent outside to collection agencies.
    Part VI, Line 2: Carondelet Heart & Vascular Institute follows the Catholic Healthcare Association Guidelines which state that a Community Needs Assessment ("CNA") should be completed every three years. As CHVI is a new 501(c)(3) entity, this assessment has not yet been performed.The community needs assessment plan will be completed by 12/31/2011. The needs assessment will include a five county region (Pima, Santa Cruz, Pinal, Cochise, and Graham, for Mt. Graham Hospital, and a U.S. Mexico border health perspective due to our proximity to the U.S. Mexico border.) Additional perspectives will include community health data assessment to address the needs of our telemedicine patients, snowbirds (who travel from out of state and country to Tucson), and specialty services which are offered by Carondelet Neurological Institute and Carondelet Heart and Vascular Institute. In gathering this data, we intend to partner with local universities; public health, social service, interfaith community partners; business community and employers; and Southern Arizona hospital partners to ensure a comprehensive needs assessment is conducted.
    Part VI, Line 3: Upon admission, patients are encouraged to apply for the state Medicaid program if they are uninsured as well as other public benefits such as TANF or SNAP if the patient has a need. If patients prove they meet at least one (1) of eight (8) criteria outlined in the charity care policy, they will be eligible for charity care. The patient will be placed in preemptive charity care status and after all bills are finalized a request for the total amount to be billed and written-off as charity care will be made on the patients behalf by their financial counselor. Trained financial counselors will work with patients if it is not easily determined that a patient qualifies for charity care or to what level of financial assistance a patient may qualify for. The Preemptive Charity Care Policy is posted in the Emergency Department, Admitting, hospital lobbies, other public areas as well as summarized on the Carondelet Health Network website and is to be included in a patient's financial statements when sent.
    Part VI, Line 4: Carondelet Heart & Vascular Institute is the only free-standing cardiovascular hospital serving the Southern Arizona region. The Southern Arizona population is 1.21 million individuals based on 2010 census data. This represents growth of 2.05% from 2000. The average household size is 2.53. The median age is 37.4, which is at the national average. 51.7% of the population earns less than $50,000 with the median household income at $48,208 and the per capita income at $24,171. 27.2% of the population is over the age of 55. The demographics of the area with regard to ethnicity are as follows: 36% of Hispanic Origin, 3.8% two or more races, 15.6% some other race alone, 0.2% Pacific Islander alone, 2.2% Asian American, 2.8% American Indian alone, 3.5% Black and 36% White alone.
    Part VI, Line 6: Carondelet Heart & Vascular Institute, as a new 501(c)(3) entity, has recently broadened its services to benefit the community. Activities include chronic disease education and outreach to patients, families, and the general community, spiritual care services, nurse shadowing programs, transportation programs for patients and families meeting the financial assistance guidelines, and social service enrollment.
    Part VI, Line 7: Carondelet Health Network ("CHN") is a member of Ascension Health. Ascension Health is a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 20 states within the United States and the District of Columbia. Ascension Health is sponsored by the Northeast, Southeast, East Central, and West Central Provinces of the Daughters of Charity of St. Vincent de Paul, the Congregation of St. Joseph, and the Congregation of the Sisters of St. Joseph of Carondelet.Carondelet Heart & Vascular Institute is part of CHN. CHN is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health are related to providing health care services. Mission: Ascension Health directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with Ascension Health's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. Ascension Health uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs: 1. Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured. 2. Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons. 3. Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome. 4. Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research. Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to the patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of person who are poor and community benefit programs. The cost of providing care of person who are poor and community benefit programs is established using internal cost data.
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Carondelet Heart & Vascular Institute
 
Employer identification number
56-1943271
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) Tucson Nurses Week FoundationPO Box 65085
Tucson,AZ857285085 		86-0771880 501(c)(3) 7,000       Event Sponsorship
(2) American Heart Association710 Second Ave 900
Seattle,WA98104 		31-5613797 501(c)(3) 7,500       Event Sponsorship




















2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
2
3
Enter total number of other organizations ................................ . Bullet Image
0
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The organization provides charitable contributions to organizations in the community. Our related foundation, Carondelet Foundation (EIN: 86-0749574), organizes and monitors all contributions and ensures that the receiving organization are qualified 501(c)(3) entities.
Schedule I (Form 990) 2010


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Carondelet Heart & Vascular Institute
 
Employer identification number

56-1943271
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) Ruth Brinkley (i)
(ii)		 0
673,820 		0
631,788 		0
23,823 		0
22,000 		0
19,330 		0
1,370,761 		0
0
(2) Sue Gold (i)
(ii)		 123,826
0 		14,321
0 		4,486
0 		16,250
0 		5,991
0 		164,874
0 		0
0
(3) Odette Bolano (i)
(ii)		 0
368,458 		0
80,500 		0
6,164 		0
22,000 		0
7,147 		0
484,269 		0
0
(4) Andrew Guarni (i)
(ii)		 0
42,770 		0
128,700 		0
18,391 		0
1,905 		0
1,583 		0
193,349 		0
0
(5) Michael Hecht (i)
(ii)		 162,500
0 		0
0 		0
0 		0
0 		0
0 		162,500
0 		0
0
(6) Daisy Jenkins (i)
(ii)		 0
245,450 		0
40,000 		0
6,516 		0
22,000 		0
15,054 		0
329,020 		0
0
(7) Neil Carolan (i)
(ii)		 0
178,092 		0
38,759 		0
1,280 		0
13,000 		0
15,989 		0
247,120 		0
0
(8) Irma Ramirez (i)
(ii)		 0
185,113 		0
31,466 		0
708 		0
22,000 		0
6,206 		0
245,493 		0
0
(9) Anthony Fonze (i)
(ii)		 0
220,068 		0
53,520 		0
893 		0
12,250 		0
16,665 		0
303,396 		0
0
(10) Patricia Martinez (i)
(ii)		 0
196,307 		0
61,848 		0
8,704 		0
2,540 		0
11,322 		0
280,721 		0
0
(11) Donna Zazworsky (i)
(ii)		 0
163,090 		0
2,934 		0
516 		0
22,000 		0
6,845 		0
195,385 		0
0
(12) Judy Tatman (i)
(ii)		 0
239,234 		0
39,693 		0
41,266 		0
19,708 		0
12,598 		0
352,499 		0
0
(13) Jude Magers (i)
(ii)		 0
160,737 		0
22,776 		0
3,758 		0
22,000 		0
9,825 		0
219,096 		0
0
(14) Tracy Prigmore (i)
(ii)		 0
160,492 		0
76,059 		0
75,623 		0
13,314 		0
5,119 		0
330,607 		0
0
(15) Linda Werbylo (i)
(ii)		 0
234,264 		0
0 		0
7,965 		0
16,897 		0
18,469 		0
277,595 		0
0
(16) Lisa Pope (i)
(ii)		 175,387
0 		1,689
0 		14,556
0 		19,000
0 		15,480
0 		226,112
0 		0
0
(17) Jill Bennett (i)
(ii)		 140,014
0 		0
0 		6,070
0 		5,722
0 		1,227
0 		153,033
0 		0
0
(18) Michelle Clark (i)
(ii)		 137,453
0 		0
0 		267
0 		13,894
0 		5,970
0 		157,584
0 		0
0
(19) Yvonne Gomez (i)
(ii)		 116,114
0 		0
0 		6,685
0 		15,925
0 		13,344
0 		152,068
0 		0
0
(20) Wesley Colvin (i)
(ii)		 0
0 		0
0 		0
415,301 		0
3,473 		0
1,281 		0
420,055 		0
0
(21) Thomas Murphy (i)
(ii)		 0
0 		0
0 		0
139,955 		0
0 		0
0 		0
139,955 		0
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  Part I, Lines 4a-b The following individuals received severance payments from Carondelet Health Network: Wesley Colvin - $415,301 Thomas Murphy - $139,955 Part I, Line 4b: Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provisions, there is no guarantee that these executives will ever receive any benefits under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. Carondelet Health Network made contributions to and/or payments from the supplemental nonqualified retirement plan in the amounts as noted: Irma Ramirez - $10,144 Linda Werbylo - $20,459 Odette Bolano - $34,661 Neil Carolan - $15,863 Sue Gold - $10,682 Jude Magers - $14,144
Supplemental Information Part III Part I, Line 3: Carondelet Health Network, a related organization of Carondelet Heart & Vascular Institute., uses the following to establish the compensation of the organization's CEO: - Compensation Committee - Independent Compensation Consultant - Written Employment Contract - Compensation Survey or Study, and - Approval by the Board or Compensation Committee
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Carondelet Heart & Vascular Institute
 
Employer identification number

56-1943271
Identifier Return Reference Explanation
Form 990, Part VI, Section A, line 6   Carondelet Heart & Vascular Institute has a single corporate member, Carondelet Health Network.
Form 990, Part VI, Section A, line 7a   Carondelet Heart & Vascular Institute has a single corporate member, Carondelet Health Network, who has the ability to elect members to the governing body of Carondelet Heart & Vascular Institute.
Form 990, Part VI, Section A, line 7b   All decisions that have a material impact to Carondelet Heart & Vascular Institute financial information or corporation as a whole are subject to approval by its sole corporate members, Carondelet Health Network.
Form 990, Part VI, Section B, line 11   Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members questions.
  Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.
  Form 990, Part VI, Section B, line 15 In determining compensation of the organization's CEO, the process, performed by a related organization, Carondelet Health Network, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The audit committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to other healthcare organizations in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The Individual was not present when her compensation was decided. In determining compensation of other officers or key employees of the organization, the process, performed by a related organization, Carondelet Health Network, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The audit committee reviewed and approved the compensation. In the review of the compensation, the other officers or key employees of the organization were compared to other healthcare organizations' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes.
  Form 990, Part VI, Section C, line 19 The organization will provide any documents open to public inspection upon request.
Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Beginning Net Assets -11,549,043. Total to Form 990, Part XI, Line 5: -11,549,043.
Other Adjustments to net assets or fund balances: Form 990, Part XI, Line 5: Other changes in net assets represent beginning balance of CHVI net assets, as this is the first year of filing of Form 990.
Community Benefit Report: Form 990, Part II, Line 4a: Carondelet Health Network June 30, 2010 A LETTER FROM THE CHAIR OF THE BOARD AND THE PRESIDENT AND CEO It is with great pride that we introduce the 2010 Carondelet Health Network Report to the Community. This annual publication details the 2010 fiscal year that ended June 30, 2010. It is a summary of Carondelet's efforts - alone and with key partners in Southern Arizona - dedicated to bringing access to healthcare and wellness to all, with a special focus on the poor and vulnerable. During a year in which economic strain caused federal and state service reductions, funding freezes and complete program eliminations, we were continually reminded of the vital role our health ministry plays in Southern Arizona. In 2010, Carondelet provided $49,906,676 (8.3 percent of our total revenue) to serve those in need through assistance within our hospitals and health network and throughout our communities. We are particularly proud of our continuing tradition of service to those in need as we celebrate Carondelet Health Network's 130th anniversary. The Sisters of St. Joseph of Carondelet first opened the doors of St. Mary's Hospital in 1880. Ten years earlier, those Sisters had answered a call: spiritual help was needed in Tucson. They endured a 36-day trek from Carondelet, Missouri, enduring scorching temperatures, sand storms, and a raft ride across the Colorado River. Today, that trek continues as we answer another urgent call: the need for health care for the local homeless population. Thanks to a generous donation, a new collaborative called the Southern Arizona Health Village for the Homeless was launching. Its flagship "Van of Hope" will directly provide medical care to a population that can number over 4,000 in the Tucson community. We hope you will read with interest about the volunteers, dedicated associates and community partners who innovate and provide programs that expand access to health care, focus on preventive care and wellness and improve the quality of life for thousands across the region. On behalf of our Board of Directors, leadership, medical staff, associates and volunteers, we offer our most sincere thanks for your support that makes these efforts possible. We are proud of the vital services and care that Carondelet Health Network provides and we are deeply grateful to the many partners and generous supporters who make it possible for us to continue the legacy of the Seven Sisters. Sincerely, RUTH W. BRINKLEY, RN, FACHE President and CEO, Carondelet Health Network West Ministry Market Leader, Ascension Health STEPHEN E. QUINLAN Chair, Carondelet Health Network Board Chair of the Board, Long Realty Companies Co-CEO, Miramonte Homes KEY STATISTICS - Acute care beds 965 - Associates 4,841 - Active medical staff 626 - Credentialed Allied Health Professionals 214 - Volunteers 377 UTILIZATION - Births 3,716 - Inpatient surgeries 10,965 - Outpatient surgeries 16,100 - Patient days 212,239 - Emergency room visits 14,140 CARONDELET HEALTH NETWORK HOSPITALS AND FACILITIES HOSPITALS - Carondelet St. Joseph's Hospital - Carondelet St. Mary's Hospital - Carondelet Heart & Vascular Institute - Carondelet Holy Cross Hospital, Nogales IMAGING CENTERS - Central Imaging Center - St. Mary's Imaging Center - Medical Mall at Green Valley - Medical Mall at Rita Ranch - Green Valley Imaging Center - Carondelet Imaging Center - St. Joseph's Medical Plaza II Imaging Center SURGERY CENTER - Foothills Surgery Center HOSPICE & PALLIATIVE CARE - Inpatient and Outpatient Care CARONDELET SPECIALIST GROUP (5 locations) - Tucson Vascular Specialists - Vein Solutions - Arizona Cardiothoracic Surgery Specialists - Southwest Heart CARONDELET MEDICAL GROUP (18 locations, including Carondelet Silverbell and Carondelet Medical Group - Sahuarita walk-in clinics) CARONDELET FOUNDATION CHN COMMUNITY BENEFIT FY10 COMMUNITY BENEFIT FOR FY 2010 IS $49,906,676 OR 8.3 PERCENT OF NET REVENUE - Traditional Charity Care $ 2,264,998 ( 4.5%) - Unpaid Costs to Public Programs $29,187,364 (58.5%) - Community Services $ 6,053,250 (12.1%) - Financial Contributions & In-Kind Donations $ 274,237 ( .5%) - Subsidized Health Services $11,668,177 (23.4%) - Community-Building and Leadership Activities $ 81,038 ( .2%) - Community Benefit Operations $ 377,612 ( .8%) TOTAL $49,906,676 (100.0%) COMMUNITY PARTNERS Carondelet works with the following local, regional and national organizations to bring access to healthcare and wellness to those living in Southern Arizona. - Alzheimer's Association, Desert Southwest Chapter - American Diabetes Association in Tucson - American Heart Association - American Parkinson Disease Association, Arizona Chapter - American Red Cross, Southern Arizona Chapter - Arizona Chamber of Commerce - Arizona Children's Association - Arizona Covering Kids Coalition - Arizona Department of Health Services - Arizona Healthcare Cost Containment System - Arizona Health-e Connection - Arizona Hospital and Healthcare Association - Arizona Nurses Association - Arizona Postpartum Wellness Coalition - Arizona State University - Arthritis Foundation, Greater Southwest Chapter - Benson Hospital - Big Brothers Big Sisters of Tucson - Big Chuy Cancer Foundation - Boys & Girls Club of Tucson - Casa de Esperanza - Casa de los Ninos - Catholic Community Services of Southern Arizona - Catholic Foundation for the Diocese of Tucson - Catholic Health Association - Catholic Healthcare West - Child and Family Resources - Children's Action Alliance - City of Tucson - City of Tucson Mayor's Office - Coalition for African American Health & Wellness - Community Food Bank of Tucson - Copper Queen Community Hospital, Bisbee - Dependable Home Health - Desert Senita Community Health Center, Ajo - El Rio Community Health Center - Grand Canyon University - Greater Tucson Leadership Organization - Green Valley/Sahuarita Chamber of Commerce - Habitat for Humanity - Hospital Council of Southern Arizona - Hospital General Nogales, Sonora - Indian Health Service Hospital, Sells - Jewish Federation of Southern Arizona - Junior Achievement of Arizona - La Frontera Health Center - Marana Health Center - March of Dimes, Arizona Chapter - Mariposa Community Health Center - Mt. Graham Regional Medical Center, Safford - Muscular Dystrophy Association - National Alliance on Mental Illness - National Multiple Sclerosis Society, Southern Arizona Region - Nogales, Arizona Lions Club - Nogales Chamber of Commerce - Nogales, Sonora Lions Club - Northern Cochise Community Hospital, Willcox - Pima Community Access Program - Pima Community College - Pima Council on Aging - Pima County Health Department - Primavera Foundation - Rebuilding Together - Rio Salado College - Rotary Club of Tucson - Science Foundation of Southern Arizona - St. Andrew's Children's Clinic - St. Elizabeth's Health Center - Southern Arizona Health Information Exchange - Southern Arizona Leadership Council - Southern Arizona Medical Center, Douglas - Tu Nidito Child and Family Services - Tucson Black Chamber of Commerce - Tucson Hispanic Chamber of Commerce - Tucson Metropolitan Chamber of Commerce - Tucson Postpartum Depression Coalition - Tucson Regional Economic Opportunities - Tucson Urban League - United Community Health Center - United Way of Santa Cruz County - United Way of Tucson and Southern Arizona - University of Arizona - Wellness Council of Southern Arizona - YMCA of Tucson - YWCA of Tucson
    COMMUNITY OUTREACH: DIABETES EDUCATION DIABETES & OBESITY PROGRAMS PUT KIDS ON A HEALTHY PATH NOGALES HIGH SCHOOL & HA:SAN PREPATORY AND LEADERSHIP SCHOOL Across Southern Arizona and the nation, Hispanics and Native Americans are at the highest risk of developing Type 2 Diabetes. That's why Carondelet Health Network, Ha:san Preparatory and Leadership School and Nogales High School partner to bring valuable education to students of the Tohono O'odham Nation and Nogales Unified School District. Each month, Ha:san freshmen travel from the Tohono O'odham Nation, in buses provided by Ha:san High School, to Carondelet St. Mary's Hospital to learn about diabetes prevention, healthy eating and exercise. In real time, via live television interface, Nogales High School students participate in the same class remotely from Carondelet Holy Cross Hospital. SAN MIGUEL HIGH SCHOOL & SANTA CRUZ ELEMENTARY SCHOOL Thanks to a generous donation from Dr. C. Harold and Nancy Willingham, more than 325 Tucson students at two parochial schools were able to participate in a new Carondelet program aimed toward preventing childhood diabetes and obesity. The Willinghams have been generous donors to Carondelet Foundation since 1969. Nancy Willingham explains, "The Carondelet Diabetes Care Center made such a difference in my life. That's why we are so supportive of their work." More than 200 students, K-8, participated at Santa Cruz Elementary. Evelyn Jacobs, RN, explains, "We saw the elementary students during their lunch breaks and gave 10-minute talks throughout the school year. The children became excited to talk about the healthy foods they were eating." At San Miguel High School, one-hundred twenty-five 9th graders participated. Jacobs and Gwen Gallegos, FNP, MSN, CDE conducted five sessions for each of six different science classes during the course of the project. Fifteen-year-old Natasha Avila took what she learned home with her. Relatives on both sides of her family have diabetes and she didn't know very much about the disease. After participating in the diabetes program she said, "I learned about the importance of a good diet and exercise, and I read food labels a lot now." She has incorporated more fruits and vegetables into her diet and works out at her gym more frequently. She and her parents also do a lot of walking together. SAN XAVIER CATHOLIC SCHOOL A special "Stop Diabetes Day" was held at San Xavier Catholic School, where three interactive presentations were tailored to students in first through eighth grades. Carondelet Health Network also offers a wide range of care for those with diabetes, including individual consultations, educational classes for adults, self-management programs, insulin pump training and support groups. For more information, visit carondelet.org/diabetes. COMMUNITIES PUTTING PREVENTION TO WORK In March 2010, the federal Centers for Disease Control and Prevention (CDC) awarded grants to address the obesity epidemic in communities around the country. The Pima County Health Department received a grant for nearly $16 million dollars. The Communities Putting Prevention to Work Grant provides Pima County with funding designed to institute population-based policy, systems and environmental changes in both communities and schools to prevent or decrease the spread of obesity and related chronic diseases through increased physical activity and improved nutrition. One of Carondelet's focus areas will be faith-based and health & human service organizations. Our goal is for 100 faith-based and 100 health & human service organizations to adopt and implement wellness guidelines to improve opportunities for physical activity and access to healthy food. Through a Wellness Coach, Carondelet will provide technical assistance and social support for organizations to establish wellness committees that encourage and support physical activity and access to healthy foods. Other organizations working with Carondelet in this mission are El Rio Health Center, St. Elizabeth's Health Center, United Community Health Center, MHC Healthcare and Desert Senita Community Health Center. REACHING OUT TO THOSE IN NEED HOPE FOR THE HOMELESS Every community faces the challenge of providing healthcare services to homeless individuals. The need for housing, food, job training and other basic necessities crosses medical, behavioral and social services lines. Tucson's homeless population includes about 4,000 people - single men and women, teenagers and families with small children. Expectedly, this population has grown as the economy has declined. The Southern Arizona Health Village for the Homeless collaborative was formed to develop an integrated system of care for the homeless in Southern Arizona. With Carondelet serving as facilitator, key partners have come together to work collaboratively with a common goal: to end homelessness. This collaboration is made up of Carondelet, El Rio Community Health Center, the Primavera Foundation, the Salvation Army, Dependable Health Services, Interfaith Coalition for the Homeless, Pima Community Access program, Pima County Health Department, St. Elizabeth's Health Center and the Veterans Administration. The program's flagship effort is a 38-foot air-conditioned RV, known as the "Van of Hope." The van is equipped to provide telehealth and mobile medical services at sites including soup kitchens, churches and shelters. Tele health services include tele-dermatology, tele-wound care, behavioral health and other consultations can be offered. Carondelet and two other primary partners, El Rio Community Health Center and Primavera Foundation, work together to staff the van and connect clients to community services. The goals of the Health Village are to: - Avoid preventable conditions from becoming acute due to lack of primary care. - Establish designated community-wide acute and extended care beds for homeless patients. - Provide case management and social service outreach to homeless children through school systems. - Offer behavioral health screenings and referral to Carondelet's behavioral health program. - Conduct specialized health ministry training to churches and faith-based communities that already help the homeless with social services. This program has been made possible by a grant from an anonymous donor. In coordination with local organizations, Carondelet Health Network worked with the Carondelet Foundation to secure a financial commitment of $2 million dollars from this generous soul. The funds are payable at $400,000 a year for five years. This provides the startup funding for the staff and the services offered by the Van of Hope, with the eventual goal of creating a sustainable model of care. MOBILE MEALS DELIVER BETTER HEALTH For someone with a medical problem, staying healthy often depends on the right diet. Those with diabetes, for example, must be careful with their food to avoid serious medical problems. Thankfully, Mobile Meals of Tucson comes to the rescue for many such residents of Tucson with health issues that are unable to shop and prepare their own meals. Supported in part by Carondelet Health Network, Mobile Meals volunteers deliver two diet-specific meals five days a week to hundreds of people throughout much of the city. Morrison's Healthcare, Carondelet's foodservice provider, prepares 34,000 nutritious meals a year at Carondelet St. Mary's and St. Joseph's hospitals. Mobile Meals clients get two of these meals a day delivered to their homes for a nominal fee or free if they can't afford it. Carondelet Health Network absorbs the difference in cost, which exceeds $150,000 each year. Carondelet has been aiding this community program since it began 40 years ago. It helps keep vulnerable residents healthy and prevents problems from occurring that could otherwise result in illness and hospitalization. Priscilla Altuna, Executive Director of Mobile Meals of Tucson, explains, "About 300 volunteer drivers pick up food at St. Joseph's and St. Mary's Hospitals and deliver meals every week. Many clients are frail, diabetic and on special diets. Without this program they would not be eating the proper foods. We deliver one hot and one cold meal each day, Monday through Friday, every day but Christmas and Thanksgiving."
    - Anna Garcia, a local realtor, has been a volunteer driver for about 10 years. She delivers meals to her St. Mary's-area clients every Wednesday. - Client Juliana Era echoes that sentiment. "Whenever I'm sick, I get the meals delivered. I have diabetes and need a special diet that I can't make myself. Anna is so helpful." - Volunteer Bill Webber, MD, and his wife Elaine have been delivering meals from St. Joseph's Hospital each Thursday for a year now. After he retired in 1994 as chief of plastic surgery at Carondelet St. Mary's Hospital in St. Louis, he found that he missed the aspect of helping people that he used to enjoy in his career. "It's fun getting to know folks. They're very appreciative," Dr. Webber says. "These meals are so good for people with health conditions. Specialized hospital-prepared meals for diabetics can be a lifesaver." - Client Patricia Sanchez has had Mobile Meals delivered for about a year. With diabetes and crippling arthritis in both knees and hips, she is grateful for the service. "This program is so commendable," she says. "The meals are very helpful and quite substantial. I'm very glad I can receive them." CENTRO DE SALUD AT NOGALES SENIOR CENTER Carondelet Health Network has a long history with the Nogales Senior Center. Carondelet nurses have been screening seniors for diabetes and delivering education there for many years. Since 1984, Maria Astorga, LPN, has been visiting the Center; Gwen Gallegos, FNP, MSN, CDE, has been going since 1994. They have become like family to many patients in Nogales, who look forward to the clinics every 2nd and 4th Thursdays of each month. "Your Health Hotline" Outreach Effort A Huge Success This year, Carondelet Health Network teamed up with community organizations in Pima and Santa Cruz counties to create two major outreach campaigns. Carondelet aided with the promotion and execution of the phone-a-thons by working with media outlets for advertising and facility space at Clear Channel to handle all the phone calls from the community as well as snacks for the volunteers. In the fall of 2009, Phone-a-Thon efforts were focused on families in need who might have been unaware of the State Children's Health Insurance Program, KidsCare. Unfortunately, the state budget crisis later eliminated the ability for families to enroll in KidsCare. Therefore, in 2010 the spring and fall Phone-a-Thons focused on providing information about health and social services to anyone in need. The spring event resulted in nearly three times as many calls as in previous years, clearly showing the need that exists for healthcare and other public services in our community. Penelope Jacks, Southern Arizona Director of the Children's Action Alliance says, "We received 2,903 phone calls in 13 hours during the spring event showing the intense level of need for medical services for young children to seniors. It is vital that community organizations work together to guarantee that people know about the services available to them." The fall event received 1707 phone calls from the community looking for a variety of services ranging from low-cost and no-cost medical services, credit and debt repayment services, utility and rental assistance, food stamps, food boxes, and adult education classes. NEW LIFE PRIMEROS PASOS DELIVERS...AGAIN! Moms-to-be can take an important "First Step" in caring for the health of their babies at Carondelet Health Network's Primeros Pasos prenatal and postnatal clinic. Expectant mothers in Tucson, including those who lack insurance or face economic difficulties, are able to receive essential prenatal care and education plus follow-up care. Diane Ramos had nothing but enthusiastic praise for Primeros Pasos and the Carondelet St. Joseph's Hospital Women's Center. She said, "My whole experience, from beginning to end, was phenomenal! The people, the doctors, and the atmosphere - it's great there. You're always greeted with smiles, and it's so convenient. Just one stop for everything I needed." The Primeros Pasos staff took excellent care of the Ramos family. They helped Ramos with paperwork to get insurance coverage quickly and worked with AHCCCS to resolve processing problems. Ramos calls the birth of her healthy daughter, Emily Rose, "a beautiful experience. Dr. Laudonio [Frank Laudonio, MD, her obstetrician] was really great. He talked us through everything and made both my husband and me comfortable." CARONDELET POST PARTUM DEPRESSION PROGRAM WINS STATE GRANT Carondelet Health Network's Postpartum Depression Program, part of Carondelet Women's Care, received a $35,000 grant to provide education, screening and support for pregnant and postpartum women, as well as to identify and treat mood disorders. This grant is part of our state's child abuse prevention efforts. "Mood disorders around childbirth impact several generations," says Carole Sheehan, MA, RNC, coordinator of St. Joseph's Postpartum Depression Program. Robin Shepherd, Director of Carondelet Women's Care program, adds, "This grant helps us assist families and their physicians as they navigate through postpartum depression. We help families heal, bond and thrive...and that makes our entire community stronger and healthier." REACHING OUT THROUGH EDUCATION HUNDREDS BENEFIT FROM CAREGIVERS' CONFERENCE More than 200 were in attendance for a March conference for caregivers. This event was co-hosted by Carondelet Health Network and the Catholic Diocese of Tucson. "The Resilient Caregiver: Embracing the Spiritual Journey," offered education and inspiration for those who care for spouses, parents, siblings, children and friends - loved ones who can no longer care for themselves. Care giving is a very stressful experience that can also be incredibly rewarding. According to Bishop Gerald Kicanas, "Very often, it is the support of the community that makes all the difference. This conference provided support to caregivers and informed them of support resources in our community." Experts from the University of Arizona and Carondelet Health Network shared advice and personal stories of their experiences as caregivers. Attendees learned that they are not alone on their difficult but fulfilling journey. They also collected resource information from local agencies to assist with their loved ones' long-term care needs. CARONDELET DIABETES EDUCATION INSTITUTE The Carondelet Diabetes Education Institute (CDEI) provides professional education to healthcare providers in Tucson and rural communities. Through video conferencing technology, Carondelet's experts provide core and advanced training in diabetes, cardiology and neurology to local and rural nurses, physicians, community health outreach workers/promotoras, and medical assistants. This ensures that patients will be able to receive the high-quality care they need, closer to home. As a result, more than 1000 healthcare professionals and community health workers have graduated from CDEI classes since the program began five years ago. Three hundred twenty-two of these graduates came from rural sites in Arizona,Texas and New Mexico. Each year brings increased participation for these high-quality educational opportunities. PUTTING PROFESSIONALS WHERE THEY ARE NEEDED TELECARDIOLOGY Telehealth services has played a vital role in bridging a healthcare delivery gap for rural Arizona, and continues to make great strides as other specialty areas are added. Donna Zazworsky, Vice President of Carondelet Community Health and Continuum Care, notes, "Carondelet's Telehealth services has met a need for rural hospitals to better serve their community." Now, with the help of Southwest Heart Cardiologists, patients in rural communities can be seen either in their Rural Hospital Emergency Room or at the bedside via telemedicine for evaluation and care. In some cases, these patients can stay in their community hospital rather than be transported to a hospital in Tucson or Phoenix." Recognizing the advantages of Telehealth, several rural hospitals are now using the technology and have formed the Southeastern Arizona Telemedicine Alliance (SATA). The group includes Copper Queen Community Hospital in Bisbee; Northern Cochise Community Hospital in Willcox; Benson Community Hospital, Mount Graham Regional Medical Center in Safford; Southeast Arizona Medical Center in Douglas and Carondelet Holy Cross Hospital in Nogales.
    RNs SAVE THE GAME The annual tradition of Carondelet nurses providing first aid during baseball spring training continued in 2010. Organizer Evelyn Chapman, RN has coordinated this effort the entire 18 years the Colorado Rockies have been in Tucson. In 2010 she and 15 other nurses volunteered a total of 330 hours for games at Hi Corbett Field. Evelyn was recognized at the final game of spring training for her years of service. Congratulations to Evelyn and the volunteer RN staff for an appreciated service and job well done. SERVING OUR COMMUNITY CARONDELET HEALTH NETWORK AND ITS ASSOCIATES SUPPORT THESE AND MANY OTHER COMMUNITY EVENTS THROUGHOUT THE YEAR: - Annual walk and fundraising events for the American Heart Association, American Diabetes Association and other organizations - Blood drives - several each year at Carondelet facilities - Food and clothing drives - Homeless Connect events - People of Color Festival STROKE CHECK HELPED 776 This year's Stroke Check event was another rousing success, with a total of 776 participants in Tucson being screened at hospitals all over town. At Carondelet St. Joseph's Hospital, 152 people received services, while 155 were seen at Carondelet St. Mary's Hospital. More than 100 volunteers turned out to help improve our community's health. SECURING OUR HEALTHCARE FUTURE CHARITABLE GIVING Many of the Carondelet programs highlighted in this Community Benefit Report have been made possible through the generosity of our community and the partnerships forged through the Carondelet Foundation. Some examples of the programs supported by charitable giving include the following: - The Carondelet Diabetes Care Center has been able to implement a network-wide Diabetes Chronic Care Model. - Carondelet, in conjunction with community partners, established the Southern Arizona Health Village for the Homeless. The "Van of Hope" is a 38 foot RV equipped to provide medical and telehealth services for the homeless of Tucson by going to shelters, churches and soup kitchens. "Carondelet's mission is to provide for the healthcare needs of our community; to embrace the whole person in mind, body, and spirit; and to serve all people with dignity. The work of the Foundation provides resources, so that Carondelet Health Network is able to fulfill its mission. We will continue our efforts, so this and future generations can live a more robust and healthy lifestyle" T.K. Warfield, Jr., DVM Chair, Carondelet Foundation Board of Trustees
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Carondelet Heart & Vascular Institute
 
Employer identification number

56-1943271
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) Ascension Health Inc

PO Box 45998

St Louis,MO63134
31-1662309 		National Health System MO 501(c)(3) Schedule A, Line 11a N/A
 
No
(2) Carondelet Health Network

2202 N Forbes Rd

Tucson,AZ85745
86-0455920 		Hospital AZ 501(c)(3) Schedule A, Line 3 Ascension Health
 
 
No
(3) Southwest Catholic Health Network

4350 E Cotton Center Blvd Bldg D

Phoenix,AZ85040
86-0527381 		Insurance AZ 501(c)(3) Schedule A, Line 11a Carondelet Hlth Ntwrk & Catholic Hlthcr W
 
Yes
 
(4) Holy Cross Hospital Inc

1171 W Target Range Rd

Nogales,AZ85621
86-0575938 		Hospital AZ 501(c)(3) Schedule A, Line 3 Carondelet Health Network
 
Yes
 
(5) Carondelet Foundation Inc

120 N Tucson Blvd

Tuscon,AZ85716
86-0749574 		Foundation AZ 501(c)(3) Schedule A, Line 11a Carondelet Health Network
 
Yes
 
(6) Chalon Living Inc

8553 E San Alberto Dr

Scottsdale,AZ85258
86-0805615 		Elderly/Disabled Housing AZ 501(c)(3) Schedule A, Line 11a Holy Cross Hospital Inc
 
Yes
 


For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) Carondelet Specialist Group Inc
2202 N Forbes Blvd
Tucson,AZ85745
28-1558773 		Physician Practice AZ N/A
 C      
(2) Carondelet Medical Group PC
2202 N Forbes Blvd
Tucson,AZ85745
86-0836126 		Medical Group AZ N/A
 C      










Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) Carondelet Health Network

 Q 359,838 Payments of Intercompany Loan
(2) Carondelet Health Network

 P 23,100,000 Transfer of Cash - CHVI Expenses
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID:  
Software Version: