Form990
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 09-01-2018 , and ending 08-31-2019
BCheck if applicable:
CName of organization
Bon Secours - St Mary's Hospital of Richmond Inc
 
 
Doing business as
St Mary's Hospital
 
Number and street (or P.O. box if mail is not delivered to street address)
8580 Magellan Parkway Building IV
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Richmond, VA23227
D Employer identification number

54-0793767
E Telephone number

G Gross receipts $ 750,135,881
F Name and address of principal officer:
FRANCINE BARR
5801 BREMO ROAD
RICHMOND,VA23226
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.bonsecours.com
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1961
M State of legal domicile: VA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: ACUTE CARE HOSPITAL
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 19
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 18
5 Total number of individuals employed in calendar year 2018 (Part V, line 2a) ...... 5 5,608
6 Total number of volunteers (estimate if necessary) ............. 6 715
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 29,126
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) ......... 2,769,855 2,616,541
9 Program service revenue (Part VIII, line 2g) ......... 741,475,338 706,090,737
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 24,307,257 34,407,123
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 6,990,375 6,771,893
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 775,542,825 749,886,294
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 7,157,695 7,535,102
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) 327,492,900 286,471,560
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–24e).... 382,519,245 387,891,175
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 717,169,840 681,897,837
19 Revenue less expenses. Subtract line 18 from line 12....... 58,372,985 67,988,457
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,103,110,014 1,101,513,527
21 Total liabilities (Part X, line 26)............. 319,430,117 308,558,731
22 Net assets or fund balances. Subtract line 21 from line 20..... 783,679,897 792,954,796
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 Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2018)
Form 990 (2018)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: THE MISSION IS TO BRING COMPASSION TO HEALTH CARE AND TO BE GOOD HELP TO THOSE IN NEED, ESPECIALLY THOSE WHO ARE POOR AND DYING. AS A SYSTEM OF CAREGIVERS, WE COMMIT OURSELVES TO HELP BRING PEOPLE AND COMMUNITIES TO HEALTH AND WHOLENESS.
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 organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations 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 $ 545,045,405 including grants of $ 7,535,102 ) (Revenue $ 709,358,590 )
St. Mary's Hospital provides medical care to patients without regard to their ability to pay. As the major community not for profit hospital in Richmond, St. Mary's is the access for under-insured and financially disadvantaged who will not be treated at the for profit hospitals. In addition, St. Mary's provides support for community services, shared services to related organizations to assist with furthering its mission of providing help to those in need, and an accredited 18-month radiography program through the Bon Secours St. Mary's Hospital School of Medical Imaging designed to prepare individuals to enter the workforce as Diagnostic Radiologic Technologists.
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 expensesMediumBullet545,045,405
Form 990 (2018)
Form 990 (2018)
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 (see instructions)? 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 I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? 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 for which 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 I..................
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 II...
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.............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; 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 IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V......
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, line 10?
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.......
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.......
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............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick 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 XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII .................
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 and XII 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, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
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(see instructions) ....
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
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government 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 or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
Form 990 (2018)
Form 990 (2018)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
23
Did the organization answer "Yes" to Part VII, Section A, line 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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
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), 501(c)(4), and 501(c)(29) 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
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? 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 employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? 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.....................Click to see attachment
28b
Yes
 
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 direct or indirect 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
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, 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 ...
35b
 
 
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.............
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 VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
215
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
 
Form 990 (2018)
Form 990 (2018)
Page 5
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
5,608
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
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
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, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
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 as charitable contributions? ...
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
Yes
 
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
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
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.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring 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. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the 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 amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see instructions and file Form 4720, Schedule N .....
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
If "Yes," complete Form 4720, Schedule O ................
16
 
No
Form 990 (2018)
Form 990 (2018)
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 or note to any line 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
19
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
18
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
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
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
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete 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 this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did 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
 
No
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, 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
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
VA
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletTRAVIS CRUM1701 MERCY HEALTH PLACE   CINCINNATI,OH45237 (513) 952-5000
Form 990 (2018)
Form 990 (2018)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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. 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 organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Toni Ardabell
 
CEO-BSV (End 07/19)
 20.0
.................
30.0 		X   X       0 1,835,830 16,500
(2) Brian White
 
Interim CEO - Richmond (Beg 07/19)
 20.0
.................
30.0 		X   X       0 0 0
(3) Sr Anne Marie MACK CBS
 
President
 3.5
.................
46.5 		X   X       0 0 0
(4) NANCY THOMAS
 
Chairman (End 12/18)
 2.0
.................
0.0 		X   X       0 0 0
(5) Jane Watkins
 
Chairman (Beg 01/19)
 2.0
.................
0.0 		X   X       0 0 0
(6) Janice Burnett
 
Board Member (End 03/19)
 2.0
.................
48.0 		X           0 2,119,569 148,793
(7) Sr VICTORIA SEGURA MD CBS
 
Board Member
 2.0
.................
48.0 		X           0 0 0
(8) Linda Rigsby
 
Board Member
 2.0
.................
0.5 		X           0 0 0
(9) JEFFREY BROWN MD
 
Board Member
 2.0
.................
0.0 		X           0 0 0
(10) STUART BUNTING
 
Board Member
 2.0
.................
0.0 		X           0 0 0
(11) Chandrashekar Challa
 
Board Member
 2.0
.................
0.0 		X           0 0 0
(12) Elizabeth CROWTHER
 
Board Member
 2.0
.................
0.0 		X           0 0 0
(13) John Daniel III MD
 
Board Member
 2.0
.................
0.0 		X           0 0 0
(14) CHRIS HAIRSTON-WHITE
 
Board Member
 2.0
.................
0.0 		X           0 0 0
(15) ROSALYN HOBSON HARGRAVES MD
 
Board Member (Beg 08/19)
 2.0
.................
0.0 		X           0 0 0
(16) Matthew Illian
 
Board Member (Beg 08/19)
 2.0
.................
0.0 		X           0 0 0
(17) Morris Henderson DMIN
 
Board Member (End 12/18)
 2.0
.................
0.0 		X           0 0 0
Form 990 (2018)
Form 990 (2018)
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 (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Birdie Jamison
 
Board Member
 2.0
.......................0.0 		X           0 0 0
(19) Joyce Lanier
 
Board Member
 2.0
.......................0.0 		X           0 0 0
(20) Pamela Royal MD
 
Board Member
 2.0
.......................0.0 		X           0 0 0
(21) Joseph SCHILLing
 
Board Member (End 12/18)
 2.0
.......................0.0 		X           0 0 0
(22) SHANNON Sinclair
 
Board Member
 2.0
.......................0.0 		X           0 0 0
(23) Deborah Ulmer PHD RN
 
Board Member
 2.0
.......................0.0 		X           0 0 0
(24) BK FULTON
 
Board Member
 2.0
.......................0.0 		X           0 0 0
(25) Stephan Quiriconi
 
Treasurer, CFO - Richmond Market
 10.0
.......................40.0 		    X       657,986 0 25,196
(26) Rhodes Ritenour
 
Secretary (Beg 01/19)
 48.0
.......................2.0 		    X       264,239 0 42,470
(27) FRANCINE BARR
 
CEO-SMH
 50.0
.......................0.0 		    X       643,607 0 41,034
(28) ALLEN GOOLSBY III
 
Secretary (End 01/19)
 2.0
.......................0.0 		    X       0 0 0
(29) James McNamara
 
VP Orthopedics (End 09/18)
 10.0
.......................40.0 		      X     0 325,111 21,923
(30) Jim Godwin
 
SVP HR - Richmond (End 11/18)
 16.0
.......................34.0 		      X     361,676 0 43,292
(31) Paul Junod
 
VP HR - Richmond (Beg 11/18)
 8.0
.......................42.0 		      X     0 178,647 38,572
(32) Kevin Sheppard
 
VP - Integration
 40.0
.......................10.0 		      X     357,132 0 32,736
(33) Eleanor LEAgue
 
VP CNE
 50.0
.......................0.0 		      X     364,851 0 38,384
(34) Leigh Sewell
 
VP Service Line Strategy (End 09/18); CEO - MRMC & RCH (Beg 09/18)
 14.0
.......................36.0 		      X     381,449 0 52,643
(35) Matthew Ngo MD
 
Cardiologist
 50.0
.......................0.0 		        X   1,052,914 0 39,429
(36) Mark Bladergroen MD
 
Cardiologist
 50.0
.......................0.0 		        X   979,351 0 23,332
(37) STEVEN FISER MD
 
Cardiac Surgeon
 50.0
.......................0.0 		        X   2,078,399 0 14,954
(38) SUSAN SCHAFFER WHITEMAN MD
 
Physician
 50.0
.......................0.0 		        X   802,230 0 36,537
(39) SHAKIL KHAN MD
 
Cardiologist
 50.0
.......................0.0 		        X   775,463 0 32,307
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 8,719,297 4,459,157 648,102
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet389
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
 
No
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. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
WM JORDAN CO INC

PO BOX 1337
NEWPORT NEWS,VA236010337 		CONSTRUCTION 9,892,985
SOUND PHYSICIANS - RICHMOND VA

PO BOX 742936
LOS ANGELES,CA900742936 		PHYSICIAN ADVISORY 9,153,317
TRIMEDX INC

12483 COLLECTIONS CTR DR
CHICAGO,IL60693 		ASSET MANAGEMENT 7,356,809
MORRISON MGT SPECIALISTS

PO BOX 102289
ATLANTA,GA303682289 		DIETARY MANAGEMENT 6,369,651
US BANK CORPORATE TRUST (SHIFTWISE)

PO BOX 70870
ST PAUL,MN551709705 		Contract Nursing 5,378,592
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet233
Form 990 (2018)
Form 990 (2018)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 2,580,011
e Government grants (contributions)1e 36,504
f All other contributions, gifts, grants, and similar amounts not included above1f 26
g Noncash contributions included in lines 1a - 1f:$  
h Total. Add lines 1a-1f.......MediumBullet 2,616,541
Program Service RevenueAmt Business Code
2a PATIENT SERVICE REV. 621300 628,920,602 628,891,476 29,126  
b SHARED SERVICES 561499 76,064,372 76,064,372    
c OTHER REV - MISC JV IN 621999 911,192 911,192    
d SCH. OF IMAG. TUITION 611310 194,571 194,571    
e
f All other program service revenue. 0 0 0 0
g Total. Add lines 2a–2f ....MediumBullet 706,090,737
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 7,617,178     7,617,178
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   848,149
b Less: rental expenses   249,587
c Rental income or (loss) 0 598,562
d Net rental income or (loss)......MediumBullet 598,562     598,562
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 37,900 26,752,045
b Less: cost or other basis and sales expenses    
c Gain or (loss) 37,900 26,752,045
d Net gain or (loss).....MediumBullet 26,789,945     26,789,945
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        
Business Code Miscellaneous Revenue
11a CHILD CARE 900099 2,788,223 2,788,223    
b CARE COORDINATION 900099 1,114,244     1,114,244
c Clinical Drug Trials 900099 508,756 508,756    
d All other revenue .... 1,762,108 0 0 1,762,108
e Total. Add lines 11a–11d ...... MediumBullet 6,173,331
12 Total revenue. See Instructions......MediumBullet 749,886,294 709,358,590 29,126 37,882,037
Form 990 (2018)
Form 990 (2018)
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).Check if Schedule O contains a response or note to any line in this Part IX..............
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 domestic organizations and domestic governments. See Part IV, line 21 7,513,020 7,513,020
2 Grants and other assistance to domestic individuals. See Part IV, line 22 22,082 22,082
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 3,306,696 2,976,026 330,670  
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 220,657,061 198,591,355 22,065,706  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 13,655,027 12,289,524 1,365,503  
9 Other employee benefits ....... 31,298,959 28,169,063 3,129,896  
10 Payroll taxes ........... 17,553,817 15,798,435 1,755,382  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 400,365   400,365  
c Accounting ........... 37,130   37,130  
d Lobbying ........... 45,296 40,766 4,530  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 164,115,939 64,750,582 99,365,357 0
12 Advertising and promotion .... 1,453,083 1,307,775 145,308  
13 Office expenses ....... 5,801,866 5,221,679 580,187  
14 Information technology ...... 3,411,362 3,070,226 341,136  
15 Royalties ..        
16 Occupancy ........... 19,287,173 17,358,456 1,928,717  
17 Travel ............ 1,026,912 924,221 102,691  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 144,782 130,304 14,478  
20 Interest ........... 1,875,048 1,875,048    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 18,956,299 17,060,669 1,895,630  
23 Insurance ... 3,481,280 3,133,152 348,128  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 96,852,077 96,852,077    
b BAD DEBT EXPENSE 23,407,775 23,407,775    
c PHARMACY SUPPLIES 17,178,602 17,178,602    
d FEDERAL INCOME TAX EXPENSE 76,013 68,412 7,601  
e All other expenses 30,340,173 27,306,156 3,034,017 0
25 Total functional expenses. Add lines 1 through 24e 681,897,837 545,045,405 136,852,432 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2018)
Form 990 (2018)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 3,031 1 3,029
2 Savings and temporary cash investments ......... 391,252,330 2 380,011,204
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 72,556,506 4 78,389,558
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
  6 0
7 Notes and loans receivable, net ....   7  
8 Inventories for sale or use ........ 10,197,416 8 11,519,795
9 Prepaid expenses and deferred charges ...... 4,328,074 9 2,824,338
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 472,074,617
b Less: accumulated depreciation 10b 341,978,505 154,240,004 10c 130,096,112
11 Investments—publicly traded securities . 447,432,564 11 450,743,221
12 Investments—other securities. See Part IV, line 11 ..... 0 12  
13 Investments—program-related. See Part IV, line 11 .. 378,387 13 364,383
14 Intangible assets ...............   14 317,855
15 Other assets. See Part IV, line 11 ........... 22,721,702 15 47,244,032
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,103,110,014 16 1,101,513,527
Liabilities 17 Accounts payable and accrued expenses ..... 101,881,891 17 87,169,566
18 Grants payable ...   18  
19 Deferred revenue ......... 10,230,334 19 9,995,220
20 Tax-exempt bond liabilities ......... 30,296,254 20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..   22 0
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 (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 177,021,638 25 211,393,945
26 Total liabilities. Add lines 17 through 25.. 319,430,117 26 308,558,731
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets 783,679,897 27 792,954,796
28 Temporarily restricted net assets ...........   28  
29 Permanently restricted net assets   29  
Organizations that do not follow SFAS 117 (ASC 958), 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 ........... 783,679,897 33 792,954,796
34 Total liabilities and net assets/fund balances ........ 1,103,110,014 34 1,101,513,527
Form 990 (2018)
Form 990 (2018)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
749,886,294
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
681,897,837
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
67,988,457
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
783,679,897
5
Net unrealized gains (losses) on investments ...............
5
-25,634,418
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
100,000
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-33,179,140
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
792,954,796
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
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
Yes
 
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
Yes
 
Form 990 (2018)
Form 990 (2018)
Additional Data


Software ID: 18007697
Software Version: 2018v3.1
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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
Bon Secours - St Mary's Hospital of Richmond Inc
 
Employer identification number

54-0793767
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 12, check only one box.)
1
2
3
4
5
6
7
8
9

10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
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) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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 VI.) ..            
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) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2018 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2018 		(iii)
Distributable
Amount for 2018
1 Distributable amount for 2018 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2018:
a From 2013.......  
b From 2014.......  
c From 2015.......  
d From 2016.......  
e From 2017.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2018 distributable amount  
i Carryover from 2013 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2018 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2018 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2018, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.		  
6 Remaining underdistributions for 2018. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.		  
7 Excess distributions carryover to 2019. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a Excess from 2014......  
b Excess from 2015.....  
c Excess from 2016.....  
d Excess from 2017.....  
e Excess from 2018.....  
Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1
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.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Name of the organization
Bon Secours - St Mary's Hospital of Richmond Inc
 
Employer identification number

54-0793767
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 isn't covered by the General Rule and/or the Special Rules doesn't 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 on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't 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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
Name of organization
Bon Secours - St Mary's Hospital of Richmond Inc
  		Employer identification number
54-0793767
Part I
Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 3
Name of organization
Bon Secours - St Mary's Hospital of Richmond Inc
  		Employer identification number

54-0793767
Part II
Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 4
Name of organization
Bon Secours - St Mary's Hospital of Richmond Inc
  		Employer identification number

54-0793767
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(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) (2018)

Additional Data


Software ID: 18007697
Software Version: 2018v3.1
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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Bon Secours - St Mary's Hospital of Richmond Inc
 
Employer identification number

54-0793767
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 in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

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 function 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-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2018

Schedule C (Form 990 or 990-EZ) 2018
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2018


Schedule C (Form 990 or 990-EZ) 2018
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)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(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)? ........
Yes
 
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? ...................................................................................................................
Yes
 
45,296
j
Total. Add lines 1c through 1i ....................................................................................................
45,296
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 carry over 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) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible 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
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY The filing organization maintains memberships to various professional healthcare associations. Portions of their membership dues are used for lobbying activities. The lobbying portion of such dues is included on line 1i.
Schedule C (Form 990 or 990EZ) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
Bon Secours - St Mary's Hospital of Richmond Inc
 
Employer identification number

54-0793767
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of 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 can 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" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 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 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, 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 section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, 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" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), 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)
Revenue included on 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 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, 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 XIII.
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" on 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 XIII 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, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds. Complete if the organization answered "Yes" on 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 Net investment earnings, gains, and 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 current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
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" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   5,497,311 5,497,311
b Buildings ....   167,745,846 97,321,817 70,424,029
c Leasehold improvements   23,614,757 19,077,847 4,536,910
d Equipment ....   261,338,984 222,423,208 38,915,776
e Other .....   13,877,719 3,155,633 10,722,086
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 130,096,112
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. 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........    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
LT PENSION LIABILITY 125,304,409
DUE TO AFFILIATES 37,688,901
OTHER LIABILITIES (MOB REYNOLDS LEASE FROM 2008) 24,865,650
HPL/GL LIABILITY 16,069,154
PATIENT CREDIT BALANCES 3,232,105
DEFERRED RENT 0
MEDICARE/MEDICAID SETTLEMENT 3,855,293
FIN47 LT ASBESTOS LIAB 336,464
OTHER MISC LIABILITIES 41,969
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 211,393,945
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 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 XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 XIII.) ............ 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 XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under ASC 740. ASC 740 addresses the accounting for uncertainty in income taxes recognized in an entity's financial statements and prescribes a threshold of more-likely-than-not for recognition and derecognition of tax positions taken or expected to be taken in a tax return. The adoption of ASC 740 by Bon Secours Mercy Health, Inc. on September 1, 2007 did not have a material impact on BSMH's consolidated financial statements. As the organization does not conduct a separate audit of its financial statements, below is the related statement from the Bon Secours Mercy Health, Inc. consolidated audited financial statements: The Company and most of its subsidiaries (including certain joint venture entities) are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The Company accounts for uncertain tax positions in accordance with ASC Topic 740, Income Taxes. Their related income is exempt from federal income tax under Section 501(A). The Company accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The Company has determined that no significant unrecognized tax benefits or liabilities exist as of December 31, 2018. Accounting for uncertainty in income taxes, ASC Topic 740-10 prescribes a comprehensive model for how an organization should measure, recognize, present and disclose in its financial statements uncertain tax positions that an organization has taken or expects to take on a tax return. The Company is subject to routine audits by taxing jurisdictions; with currently the IRS audit of Mercy for 2016 tax period in progress. The Company believes it is no longer subject to income tax examinations for years prior to 2013. As of December 31, 2018, the Company has no uncertain tax positions. The Company's taxable subsidiaries had $169,666 of gross net operating loss carryforwards as of December 31, 2018, which expire in varying periods through 2037 and are available to offset future taxable income. The Company accounts for income taxes under the asset and liability method. Under this method, deferred tax assets and liabilities are recognized for the estimated future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to be in effect during the year in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. Interest and penalties related to income taxes are accounted for as income tax expense. The Company's deferred tax assets are fully reserved at December 31, 2018 as the Company considers it more likely than not that these amounts will not be recognized. On December 22, 2017, the President signed into law H.R. 1, originally known as the Tax Cuts and Jobs Act. The Act significantly revises the U.S. corporate income tax by, lowering the statutory corporate tax rate from 35% to 21% and eliminating certain deductions. The new law also includes several provisions that result in substantial changes to the tax treatment of tax-exempt organizations and their donors. The Company has reviewed these provisions and the potential impact and concluded the enactment of H.R. 1 will not have a material effect on the operations of the organization.
Schedule D (Form 990) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
Bon Secours - St Mary's Hospital of Richmond Inc
 
Employer identification number

54-0793767
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance 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 discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
 
No
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance 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 Financial Assistance at cost
(from Worksheet 1) . . . 		    11,390,177   11,390,177 1.73 %
b Medicaid (from Worksheet 3, column a) . . . . .     52,967,360 32,428,716 20,538,644 3.12 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     0   0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 64,357,537 32,428,716 31,928,821 4.85 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     3,402,833   3,402,833 0.52 %
f Health professions education (from Worksheet 5) . . .     1,094,253 1,094,253 0 0 %
g Subsidized health services (from Worksheet 6) . . . .     0   0 0 %
h Research (from Worksheet 7) .     0   0 0 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     979,720   979,720 0.15 %
j Total. Other Benefits . . 0 0 5,476,806 1,094,253 4,382,553 0.67 %
k Total. Add lines 7d and 7j . 0 0 69,834,343 33,522,969 36,311,374 5.51 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(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     79,499   79,499 0.01 %
2 Economic development     281,427   281,427 0.04 %
3 Community support     524,695   524,695 0.08 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		     79,499   79,499 0.01 %
6 Coalition building         0 0 %
7 Community health improvement advocacy     42,234   42,234 0.01 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 0 0 1,007,354 0 1,007,354 0.15 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
23,407,775
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
127,302,312
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
133,239,552
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-5,937,240
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
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(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) 2018
Schedule H (Form 990) 2018
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 ST MARY'S HOSPITAL OF RICHMOND INC
5801 BREMO ROAD
RICHMOND,VA23226
www.bonsecours.com
H1833 		X X   X   X X      
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
ST MARY'S HOSPITAL OF RICHMOND INC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.bonsecours.com/about-us/community-commitment/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
ST MARY'S HOSPITAL OF RICHMOND INC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
http://www.fa.bonsecours.com/
b
http://www.fa.bonsecours.com/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 6
Part VFacility Information (continued)

Billing and Collections
ST MARY'S HOSPITAL OF RICHMOND INC
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
ST MARY'S HOSPITAL OF RICHMOND INC
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - ST. MARY'S HOSPITAL OF RICHMOND, INC. In order to obtain input from the community, three initiatives were advanced: a Community Health Needs Assessment Steering Committee was convened, a community engagement survey was conducted, and several community conversations were held. The purpose of the CHNA Steering Committee is to support the CHNA process by engaging community members and providing feedback on the findings. All organizations involved with the CHNA Steering Committee have special knowledge of public health and underserved populations in the service area. Organizations involved in the Steering Committee are identified as having either a) conducted a previous Community Health Needs Assessment/Community Health Assessment due to IRS or accreditation requirements or b) already engaged in regional population health assessment. From January 2018 to April 2019 Steering Committee members served as key informants representing medically underserved, low- income or minority populations. The committee met bi-monthly to identify regional indicators and to inform the community engagement strategy for the creation of this document. Additionally, a survey to assess community health needs was conducted as part of the CHNA process during a six-week period between January and February 2019. One thousand one hundred (1100) individuals responded listing their top five health concerns. Seven Community Conversations occurred in March of 2019 as part of the CHNA process in which 60 individuals participated from all of the core jurisdictions. The purpose of the conversation was to elicit feedback from community members about publically available health data describing health conditions in the service areas and to review the survey results to further explore the findings. The top 10 health issues as identified from the survey results were presented to the attendees and they were asked to 1) rank the health issues according to which issues impacted them and the people close to them the most and 2) from a community perspective, rank the issues that should be addressed to improve the overall health of the region. Additional detail can be found on the Bon Secours website at https://bonsecours.com/about-us/community-commitment/community-health-needs-assessment.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - ST. MARY'S HOSPITAL OF RICHMOND, INC. Memorial Regional Medical Center St. Francis Medical Center Richmond Community Hospital Rappahannock General Hospital
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - St. Mary's Hospital of Richmond, Inc. The Implementation Plan focuses on 4 broad areas including Access to Care for the Uninsured with Chronic Disease, Mental Health, Transportation, and Education. Goals and objectives were created for each area and were based on Healthy People 2020 objectives, Virginia's Plan for Well-Being 2016-2020 goals, and other evidence-based sources. Access to Care for the Uninsured with Chronic Disease Goal: Improve access to high quality health care services by providing support through community partners working with uninsured populations and by providing services to the uninsured through the Care-A-Van, St. Joseph's Outreach Clinic and Community Nutrition programs. *The overarching goal for Access to Care for the Uninsured with Chronic Disease is to improve access to high quality health care services. This has been achieved in part by supporting the many community partners who work with the uninsured population to include: health safety net partners, partners addressing the social determinants of health, and the two other hospital systems in the region. *Bon Secours Mercy Health provides over $1.2 million in direct health services to nearly 30,000 uninsured patients through the Care-A-Van mobile health program, the Community Nutrition Outreach program, and the Every Woman's Life Program. *Bon Secours Mercy Health also provides labs at no cost to over 12,000 patients annually who are cared for through nine safety net clinic partnerships. *Additional partnerships to achieve this objective include ten non-profit organization working to increase coordination and access to care for the most vulnerable in our communities. We partner to provide nearly $900,000 in direct partnerships and investments. Mental Health Goal: Improve mental health status by ensuring access to appropriate, quality mental health services. Increase the proportion of people who receive appropriate treatment for mental health disorders. *The goal in addressing Mental Health is to improve mental health status by ensuring access to appropriate, quality mental health services. We aim to achieve this by increasing the proportion of people who receive appropriate treatment for mental health disorders. *Bon Secours Mercy Health has a robust Forensic Nursing program serving 42 cities, counties and towns across Virginia. The Forensic Nursing team has provided care and coordinated case management services to over 2,500 patients of all ages who report or are suspected of being victims of sexual, physical, elder abuse, human trafficking and strangulation. Additionally, the Forensic team is focused on human trafficking advocacy providing education to over 5,000 residents. *Increasing the use of depression screenings and integrating behavioral health with primary care are two strategies that have been implemented to impact this goal. Partners in this work include Safe Harbor, Caritas, Substance Abuse and Addition Recovery Alliance (SAARA), Young Women's Christian Association (YWCA), ChildSavers, Stop Child Abuse Now (SCAN), Substance Abuse Free Environment (SAFE), and Challenge Discovery Projects. *Additionally, Henrico Area Mental Health and Development Services, Chesterfield Department of Mental Health Support Services, the City of Richmond Department of Health, and the two other health systems in the region are influential partners impacting Mental Health. Transportation Goal: Increase safe, healthy, and reliable transportation options for residents in the Richmond service area. Promote active transportation through advocacy for and provision of place making in the neighborhoods we serve. Advocate for the expansion of public transportation options to increase access for those in underserved areas and improve ridership through a community-based design. *Transportation is being addressed by increasing safe, healthy, and reliable transportation options for residents in the Richmond service area. *Bon Secours Mercy Health promotes active transportation through a direct advocacy partnership with a local non-profit, SportsBackers, that supports place making in the neighborhoods we serve. *We are an advocate for the expansion of public transportation options to increase access for those in underserved areas and improve ridership through a community-based design. Bon Secours Mercy Health also invests $215,500 annually to subsidize the public transit system, ensuring that all residents have access to jobs, healthcare, housing, and education. *Another place making activity includes the Sarah Garland Jones Center for Health Communities that provides a community room for over 270 non-profits. The Center also has a commercial kitchen that provides healthy cooking classes and diabetes prevention and management education to students throughout the public school system and non-profit networks. *Bon Secours Mercy Health also provides a variety of transportation options (bus, taxi, and rideshare) for individuals who experience transportation as a barrier to healthcare.
Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - St. Mary's Hospital of Richmond, Inc. Education Goal: Promote student success in schools to improve health and quality of life for the Richmond community and future generation. Increase the percentage of 3rd graders who pass the Standards of Learning (SOL) reading test to align with the Health People 2020 goal of 80%. Increase the proportion of students who graduate with a regular diploma 4 years after starting 9th grade. *The goal for Education is to promote student success in schools to improve health and quality of life for the Richmond community and future generations. *Our efforts have focused on kindergarten readiness, 3rd grade SOL reading test scores, and high school graduation rates. *The Care-A-Van provides school physicals and over 5,700 no cost vaccination to children across the region ensuring nearly 3,500 children have an opportunity to start school on time. The team also works to enrolls eligible children in FAMIS Medicaid to expand access to additional health options. *Partners to support this work include, Cristo Rey High School, Richmond Public Schools, Chesterfield Public Schools, Henrico Public Schools, Hanover Public Schools, Friends Association, NextUp, Smart Beginnings, Richmond Hill, Swim RVA, VA Home for Boys and Girls, Children's Home Society, Reach Out and Read, Sacred Heart Center, YMCA, YWCA, Peter Paul Development Center, Tricycle, Church Hill Activities and Tutoring, Higher Achievement, Salvation Army Boys and Girls Club, Reynolds Community College, John Tyler Community College and many others providing direct education, workforce readiness training, and trauma-informed services. Our Community Benefit Investment in this sector is over $2 million annually. Community Health Needs Being Addressed By Other Community Partners: Access to care for Medicaid and Medicare beneficiaries, adult and childhood obesity, jobs with fair wages, families living in poverty and seniors were identified as high needs in the community. The CHNA Advisory Board also identified these needs as having high feasibility meaning there was sufficient community support to make an impact. During the Community Conversations, older adults with Medicare shared they had challenges finding community physicians who accepted Medicare patients. This need is addressed by Bon Secours Richmond Health System's Medical Group and partner health system, VCU Health. These two entities readily accept Medicaid and Medicare patients. Adult and childhood obesity are being addressed in the community by multiple organizations including Active RVA, City of Richmond's Corner Store initiative, Faces of Hope, Fit 4 Kids, the Seventh District Health and Wellness Initiative, Shalom Farms, Sports Backers/Richmond Strikers, Tricycle Gardens, Virginia Recreation and Parks and the YMCA. Jobs with Fair Wages is being addressed by the City of Richmond Community Wealth Building, Goodwill, Richmond Technical Center, Chesterfield Career and Technical Center, The Hanover Center for Trades and Technology, Henrico County Public Schools Career and Technical Education, United Way of Greater Richmond & Petersburg and the Virginia Interfaith Center. A family living in poverty is a multi-factorial issue which may be impacted through enhanced education and transportation, both areas of focus for the FY2016 CHNA. Organizations presently engaged in breaking the cycle of poverty include Area Congregations Together in Service, Better Housing Coalition, Capital Region Collaboration, City of Richmond Community Wealth Building, Commonwealth Catholic Charities, Local Initiative Support Corporation (LISC), Peter Paul Development Center, Richmond Hill, Richmond Redevelopment and Housing Authority, Salvation Army Boys and Girls Club. The needs of the older adult population in the greater metro Richmond area or seniors are being addressed by Circle Center Adult Day Services, Old Dominion Partnership, Peter Paul Development Center, Rebuilding Together Richmond, Senior Connections, and others.
Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - St. Mary's Hospital of Richmond, Inc. Information regarding the FAP is available on our websites, brochures are available at time of registration. We have on-site Financial Counselors who assist patients. We also have eligibility vendors who work with the patients and our statements indicate we have an FAP. We also provided local clinics in each market brochures regarding our FA program.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?39
Name and address Type of Facility (describe)
1 Cardiovascular Associates of VA
7001 Forest Avenue Suite 200
Richmond,VA232301727 		Physician Practice
2 Women's Imaging Center
5875 Bremo Road MOB South Suite 105
Richmond,VA23226 		Imaging
3 Cardiac Surgery Specialists
5875 Bremo Road MOB South Suite G-5
Richmond,VA231226234 		Physician Practice
4 Patterson Avenue Family Practice
9600 Patterson Avenue
Richmond,VA23229 		Physician Practice
5 Sleep Lab (located at St Mary's)
5875 Bremo Rd Suite 709
Richmond,VA23226 		Sleep Lab
6 PTOTSPLymphedema
5875 Bremo Road MOB South Suite 611
Richmond,VA23226 		Physicial Therapy, Outpatient Care, Etc.
7 West End Internal Medicine
7001 Forest Avenue Suite 2500
Richmond,VA23230 		Physician Practice
8 Surgical Dermatology Center
5207 Hickory Park Drive Suite A
Glen Allen,VA230592624 		Physician Practice
9 Bon Sec Sports Med and Fam Pra
2401 W Leigh Street
Richmond,VA23226 		Physician Practice
10 Senior Care Services
7001 Forest Avenue Suite 100
Richmond,VA23230 		Physician Practice
11 Perinatal Center
5855 Bremo Road MOB North Suite 306
Richmond,VA232261926 		Physician Practice
12 Sports Medicine
9600 Patterson Avenue
Richmond,VA232296053 		Sports Medicine Rehab
13 OP Wound Care
6900 Forest Avenue Suite 115
Richmond,VA23230 		OP Wound Care
14 Neurology Clinic at St Mary's
5801 Bremo Road
Richmond,VA23226 		Physician Practice
15 Sleep Center - Chesterfield
13520 Hull St
Midlothian,VA23112 		Sleep Lab
16 Richmond OBGYN at SMH
7001 Forest Avenue Suite 103
Richmond,VA23230 		Physician Practice
17 Monument Internal Medicine
5855 Bremo Road MOB North Suite 102
Richmond,VA23226 		Physician Practice
18 Redskins Sports Performance
2401 W Leigh Street
Richmond,VA23226 		Sports Medicine Rehab
19 Associated Internists
5855 Bremo Road MOB North Suite 207
Richmond,VA232261930 		Physician Practice
20 Pediatric Gastroenterology
5875 Bremo Road MOB South Suite 303
Richmond,VA23175 		Physician Practice
21 Commonwealth Internal Medicine
9220 Forest Avenue Suite 1-A
Richmond,VA23235 		Physician Practice
22 Pediatric Endo & Diabetes Assoc
5875 Bremo Road MOB South Suite 207
Richmond,VA232261926 		Physician Practice
23 Arthritis & Osteoporosis Center
9600 Patterson Avenue
Richmond,VA232296053 		Physician Practice
24 Glen Allen Internal Medicine
5207 Hickory Park Drive Suite A
Glen Allen,VA23059 		Physician Practice
25 Advan Heart Fail Cntr-LVAD program
7001 Forest Avenue Suite 103
Richmond,VA23230 		Cardiac Rehabilitation
26 Cardiac Rehab
7001 Forest Avenue Suite 101
Richmond,VA23230 		Cardiac Rehabilitation
27 Pediatric Lung Care
5875 Bremo Road MOB South Suite 104
Richmond,VA232261930 		Physician Practice
28 Pediatric Dental
6900 Forest Avenue Suite 110
Richmond,VA23141 		Physician Practice
29 Palliative Care Clinic
2366 Colony Crossing
Midlothian,VA231124280 		Physician Practice
30 BS Canal Crossing Internal Med
5801 Bremo Road
Richmond,VA23226 		Physician Practice
31 Parham Road Internal Medicine
2600 E Parham Road
Richmond,VA23228 		Physician Practice
32 Thoracic Surgery at St Mary's
5875 Bremo Road MOB South Suite 110
Richmond,VA23226 		Physician Practice
33 Neurointerventional Surg Serv
5875 Bremo Road MOB South Suite 208
Richmond,VA232261926 		Physician Practice
34 BS Infectious Disease Specialists
5855 Bremo Road MOB North Suite 102
Richmond,VA23225 		Physician Practice
35 Pediatric Neurology Clinic
5875 Bremo Road MOB South Suite 207
Richmond,VA232261926 		Physician Practice
36 Good Health Clinic
5875 Bremo Road MOB South Suite 204
Richmond,VA232261926 		Physician Practice
37 Diabetes Treatment Center
5875 Bremo Road MOB South Suite 712
Richmond,VA23226 		Diabetes Treatment
38 BS Dev & Special Needs Peds
5875 Bremo Road MOB South Suite 104
Richmond,VA232261934 		Physician Practice
39 Home Based PC and SS
5855 Bremo Road MOB North Suite 403
Richmond,VA23226 		Physician Practice
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 14 SCHEDULE H, PART V, LINE 14 Charges for patients who are eligible for financial assistance shall be limited to no more than amounts generally billed ("AGB") for such services. These charges are based on the average allowed amounts from Medicare and commercial payers for emergency and other medically necessary care. The allowed amounts include both the amount the insurer will pay and the amount, if any, the individual is personally responsible for paying. The AGB is calculated using a look back method.
Schedule H, Part V, Section B Line 16g Bon Secours Mercy Health hospitals implemented new policies and procedures to meet the notification requirements outlined under the final IRC Section 501(r) regulations. Training materials were revised, new scripting was developed, and training sessions were held for applicable Revenue Cycle employees which required competency sign-off for those who completed the training. Procedures initially implemented included offering a copy of the plain language summary (PLS) to patients as part of the intake process. Individuals were notified about the Financial Assistance Policy (FAP) by receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or other measures reasonably calculated to attract patients' attention. As a result of an annual internal review, it was determined that the PLS of Bon Secours Mercy Health's Healthcare FAP was not being offered to all patients at intake during 2018. Immediately upon recognition of the minor oversight, Bon Secours Mercy Health began taking steps to offer a copy of the PLS to all patients who visit the hospital facilities by adding scripting to notify patients of the availability of financial assistance and offering a copy of the PLS to the patient intake process. In addition, Bon Secours Mercy Health added new language to the Consent for Treatment, Payment, and Health Care Operations (Consent) form required to be signed by all patients, including a copy of the PLS attached as an addendum to the Consent to certify that the patient is aware of Bon Secours Mercy Health's FAP and a copy of the PLS was offered. Additional training has also been provided to all applicable staff. Bon Secours Mercy Health widely publicized its FAP, the FAP Application, and the PLS on the organization's website, includes a conspicuous written notice about the FAP on patients' billing statements, posts conspicuous public displays in the Emergency Department and Registration areas of the hospitals, and notifies members of the community about availability of the FAP. Bon Secours Mercy Health will continue to perform an internal audit on a regular and continuous basis at least once per year to ensure compliance. We do not believe the minor oversight to be considered "willful or egregious" and Bon Secours Mercy Health has performed internal research to identify how the minor oversight occurred and taken additional steps to ensure compliance going forward.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 23407775
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Cost of financial assistance at cost was calculated with a cost to charge ratio using worksheet 2. The cost related to Medicaid patients was determined using Bon Secours Mercy Health's cost accounting system and included both inpatients and outpatients for traditional Medicaid and Medicaid managed care plans. For subsidized services Bon Secours Mercy Health's cost accounting system used to determine cost related to the specific service excluding traditional Medicaid and Medicaid managed care patients. Costs for charity and bad debt accounts are deducted using a ration of cost to charge specific to that subsidized service. Costs for other programs reflect the direct and indirect costs of providing those programs.
Schedule H, Part II Community Building Activities Bon Secours Mercy Health addresses various community concerns including health improvement, poverty, workforce development, and access to health care. Bon Secours Mercy Health hospitals conduct community health education and support groups, health fairs and screenings for the communities served. Bon Secours Mercy Health hospitals work with state and local leadership to address community needs and provide healthcare services to the poor and underserved. Bon Secours Mercy Health hospitals provide programs to improve the physical surroundings and housing in the communities served. Inadequate housing has a negative impact on the health of residents in the area by leading to violence in the neighborhoods. A robust economy positively impacts residents covered by health insurance and improves the capacity of the community to support health services. Social support services such as HELP (Hospital Eligibility Link Program) are also important to support the ability of residents to gain and retain employment and therefore access to health insurance and improved access to health services.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. NET PATIENT ACCOUNTS ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED UPON BON SECOURS MERCY HEALTH'S HISTORICAL COLLECTION EXPERIENCE ADJUSTED FOR CURRENT ENVIRONMENTAL RISKS AND TRENDS FOR EACH MAJOR PAYOR SOURCE. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS IN THE PERIOD OF SERVICE BASED ON PAST COLLECTION EXPERIENCE. BON SECOURS MERCY HEALTH'S CONCENTRATION OF CREDIT RISK RELATED TO NET PATIENT ACCOUNTS IS LIMITED DUE TO THE DIVERSITY OF PATIENTS AND PAYORS. NET PATIENT ACCOUNTS CONSIST OF AMOUNTS DUE FROM GOVERNMENTAL PROGRAMS (PRIMARILY MEDICARE AND MEDICAID), PRIVATE INSURANCE COMPANIES, MANAGED CARE PROGRAMS AND PATIENTS THEMSELVES. NET PATIENT SERVICE REVENUE FOR SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE IS RECOGNIZED BASED ON CONTRACTUAL RATES FOR SERVICES RENDERED. BON SECOURS MERCY HEALTH RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME SERVICES ARE RENDERED EVEN THOUGH IT DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). AMOUNTS RECOGNIZED ARE SUBJECT TO ADJUSTMENT UPON REVIEW BY THIRD-PARTY PAYORS. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, BON SECOURS MERCY HEALTH RECOGNIZES REVENUE WHEN SERVICES ARE PROVIDED. BASED ON HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF BON SECOURS MERCY HEALTH'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR SERVICES PROVIDED. THUS, BON SECOURS MERCY HEALTH RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. ANY DISCOUNTS APPLIED TO SELF-PAY PATIENTS WOULD BE DEEMED EITHER CHARITY OR A CONTRACTUAL ADJUSTMENT. BAD DEBT WOULD BE BASED ON THE BALANCE AFTER THE CHARITY OR CONTRACTUAL ADJUSTMENT THAT IS DEEMED UNCOLLECTABLE FOLLOWING A REASONABLE COLLECTION EFFORT.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY DOES NOT PERMIT THE COST OF PATIENTS WHO ARE UNCOOPERATIVE OR UNABLE TO BE LOCATED TO BE RECLASSIFIED FROM FINANCIAL ASSISTANCE TO BAD DEBT. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES AN APPLICATION AND SUPPORTING DOCUMENTATION. THEREFORE, ZERO DOLLARS ARE BEING REPORTED ON PART III, LINE 3 AS AMOUNTS INCLUDED IN BAD DEBT THAT COULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY. THE HOSPITAL FOLLOWS THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES POLICY DOCUMENT, COMMUNITY BENEFIT PROGRAM, A REVISED RESOURCE FOR SOCIAL ACCOUNTABILITY ("CHA GUIDELINES") FOR DETERMINING COMMUNITY BENEFIT. THE CHA GUIDELINES RECOMMEND THAT HOSPITALS NOT INCLUDE BAD DEBT EXPENSE AS COMMUNITY BENEFIT.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote BON SECOURS MERCY HEALTH'S AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. BON SECOURS MERCY HEALTH ELECTED TO EARLY ADOPT ASU 2011-07. ACCORDINGLY, BAD DEBT EXPENSE IS REFLECTED AS A DEDUCTION FROM REVENUE RATHER THAN AS AN OPERATING EXPENSE. NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, B. SIGNIFICANT ACCOUNTING POLICIES, NET PATIENT ACCOUNTS AND NET PATIENT SERVICE REVENUE (PAGE 10) STATES NET PATIENT ACCOUNTS ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED UPON THE HISTORICAL COLLECTION EXPERIENCE OF EACH REGIONAL AFFILIATE ADJUSTED FOR CURRENT ENVIRONMENTAL RISKS AND TRENDS FOR EACH MAJOR PAYOR SOURCE. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS IN THE PERIOD OF SERVICE BASED UPON PAST COLLECTION EXPERIENCE.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Medicare allowable costs reflected in Part III come directly from the facility's Medicare cost report. The cost report segregates the total facility actual expenses into costs for support departments, clinical departments (routine and ancillary) and nonreimburseable departments. The cost report uses appropriate statistical bases to "step down" support costs to allowable clinical and nonreimburseable departments. The charges for clinical departments are matched to the total cost for these departments for a cost-to-charge ratio. Medicare-specific allowable costs for in- and outpatient ancillary departments are computed by applying the department-specific cost-to-charge ratio to the Medicare program charges by department. For routine departments, a per diem total cost is computed and applied to Medicare program days for the Medicare routine program cost.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance The hospital has a written policy that describes collection practices applying to patients who qualify for financial assistance. If full assistance is approved, no collection efforts are pursued on that patient's account(s). If partial assistance is approved, the patient is responsible for the adjusted account balance and collection efforts will follow the established practices for all patients where a self-pay balance exists. Collection efforts are not pursued on any pending FAP account. Specific criteria exists for how much financial assistance, partial or total, will be provided to the patient based on the assessed need. Criteria is based on Federal Poverty Guidelines and is reviewed and updated annually. Once a patient has been deemed eligible for the Patient Financial Assistance Program (FAP), the patient is notified by letter within 60 days after receipt of the application and supporting documentation. The patient retains eligibility for a period of eight months from the date of the application. This eligibility is identified by hospital admissions, billing and collection staff by the assignment of a specific financial class with accompanying eligibility dates. At the end of the eight months, the patient is responsible for reapplying for FAP eligibility.
Schedule H, Part V, Section B, Line 16a FAP website - ST. MARY'S HOSPITAL OF RICHMOND, INC: Line 16a URL: http://www.fa.bonsecours.com/;
Schedule H, Part V, Section B, Line 16b FAP Application website - ST. MARY'S HOSPITAL OF RICHMOND, INC: Line 16b URL: http://www.fa.bonsecours.com/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ST. MARY'S HOSPITAL OF RICHMOND, INC: Line 16c URL: http://www.fa.bonsecours.com/;
Schedule H, Part VI, Line 2 Needs assessment BON SECOURS HOSPITALS ASSESS AND CONTINUALLY RESPOND TO CHANGING COMMUNITY NEEDS THROUGH THE SERVICES OFFERED. BON SECOURS HOSPITALS JOIN AN EXISTING COMMUNITY-BASED NEEDS ASSESSMENT EVERY THREE YEARS AND UPDATES ARE PROVIDED BETWEEN ASSESSMENTS. BON SECOURS HOSPITALS INCORPORATE PLANNING FOR COMMUNITY BENEFITS AS PART OF ITS ANNUAL BUSINESS AND STRATEGIC PLANNING PROCESSES. BON SECOURS HOSPITALS RECOGNIZE THE HEALTH OF THE COMMUNITY IS INFLUENCED BY SOCIAL, ECONOMIC, AND ENVIRONMENTAL FACTORS, NOT JUST BY DISEASE AND ILLNESS. OUR COMMUNITY BENEFIT INCLUDES BOTH QUALITATIVE AND QUANTITATIVE DATA; DEMOGRAPHICS INCLUDING RACE, AGE, AND ETHNICITY; SOCIOECONOMIC DATA INCLUDING INCOME, EDUCATION, AND HEALTH INSURANCE RATES; PRIMARY CARE AND CHRONIC DISEASE NEEDS OF UNINSURED PERSONS; AND DATA ON HEALTH DISPARITIES IN HEALTH OUTCOMES AMONG MINORITY GROUPS. BON SECOURS HAS A DEDICATED STAFF TO ASSIST IN THE COMMUNITY BENEFIT EFFORT. BON SECOURS'S COMMUNITY BENEFITS COMMITTEES MEET TO PROVIDE OVERSIGHT TO THE ORGANIZATION'S COMMUNITY BENEFITS PROGRAM. BON SECOURS HOSPITALS WORK CLOSELY WITH HEALTH AND HUMAN SERVICE ORGANIZATIONS IN THE AREA, PARTNERING WITH SOME TO PROVIDE SERVICES TO AVOID DUPLICATION.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance The Patient Financial Assistance program is communicated to patients verbally upon scheduling, registration, visible postings of the program are in common areas throughout the hospital, along with brochures and the program is detailed on our Bon Secours website. In addition, patient billing statements and letters inform patients regarding our financial assistance program. Bon Secours proactively screens patients to identify individuals and their families who may qualify for federal, state or local health insurance programs or the Bon Secours Patient Financial Assistance Program ("FAP") and assist the potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Bon Secours is also dedicated to meeting the needs of non-English speaking patients by having on-site Spanish translators, and other language translation services. In addition, Bon Secours employs a telephone language service which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including the financial assistance process. Based on market need, our financial assistance policy and application are translated into multiple languages and placed on our Bon Secours website for patients to access
Schedule H, Part VI, Line 4 Community information St Mary's Hospital opened in 1966 with a unique vision for the time, allowing patients of all colors and religions to receive treatment there. Fifty years later, St. Mary's has grown into an acute care facility licensed for 391 beds. St. Mary's has over 3,000 full and part-time employees and more than 1,000 associated physicians. The St. Mary's Hospital serves residents primarily from the counties of Chesterfield, Goochland, Hanover, Henrico, and Richmond City. While its core is based in the Richmond metropolitan area, its services reach into the surrounding rural counties. Bon Secours Richmond Health System serves the larger Richmond, Virginia metropolitan area and includes four hospital facilities whose service areas largely overlap. While the hospitals serve patients from many cities and counties, the majority of patients fall within the counties of Chesterfield, Henrico, Hanover and the City of Richmond totaling over 1 million residents. For the purpose of this CHNA, we refer to these as the "Richmond Core Service Area." The Richmond Core Service Area is primarily Caucasian and African American. When the demographics of the City of Richmond are viewed alone, we find a much lower percentage of Caucasians and a much higher percentage of African Americans than the community overall. The population age distribution for the Richmond Core Service Area is similar to Virginia overall with the exception of the City of Richmond, which has a higher percentage of 19-64 year olds (69%) and lower percentages of children (18%) and older adults (13%). Median household incomes in the United States are less than those found in Virginia overall. The Richmond Core Service Area counties of Henrico, Hanover and Chesterfield all have higher median household incomes than the U.S. overall. In contrast, the City of Richmond has a much lower median household income as compared to the U.S. and Virginia overall. Compared to Virginia, the percentage of uninsured adults is highest in the City of Richmond and lowest in Hanover County. The percentages of uninsured children show a much lower degree of variance.
Schedule H, Part VI, Line 5 Promotion of community health BON SECOURS HOSPITALS OPERATE EMERGENCY ROOMS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO PROVIDING EMERGENCY SERVICES, BON SECOURS HOSPITALS ALSO PROVIDE MINOR EMERGENCY AND URGENT CARE SERVICES TO ALL REGARDLESS OF ABILITY TO PAY. BON SECOURS HOSPITALS OPERATE TRAUMA SERVICES, AIR AMBULANCE SERVICES, DISEASE MANAGEMENT, WOUND CARE, SPECIALTY CLINICS, DEVELOPMENTAL THERAPY, HOSPICE, HOME CARE, CRISIS INTERVENTION, BEHAVIORAL SERVICES AND SUBSTANCE ABUSE SERVICES. BON SECOURS HOSPITALS HAVE OPEN MEDICAL STAFFS WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. THE MAJORITY OF THE GOVERNING BODY CONSISTS OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITIES SERVED BY BON SECOURS HOSPITALS. THE BON SECOURS MERCY HEALTH BOARD AND ITS MARKET GOVERNING BOARDS ARE COMPOSED OF MEMBERS OF THE COMMUNITIES SERVED WHO DIRECT AND GUIDE MANAGEMENT IN CARRYING OUT THE MISSION OF BON SECOURS MERCY HEALTH. BOARD MEMBERS ARE SELECTED ON THE BASIS OF THEIR EXPERTISE AND EXPERIENCE IN A VARIETY OF AREAS BENEFICIAL TO BON SECOURS MERCY HEALTH AND ITS AFFILIATED HOSPITALS IN FULFILLING ITS MISSION OF PROVIDING HEALTHCARE SERVICES TO THE POOR AND UNDER SERVED. BON SECOURS HOSPITALS ENGAGE IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS. BON SECOURS HOSPITALS PROVIDE RESIDENCY PROGRAMS AND OTHER TRAINING PROGRAMS. BON SECOURS HOSPITALS PARTICIPATE IN MEDICAID, MEDICARE, CHAMPUS, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. BON SECOURS HOSPITAL'S EMERGENCY DEPARTMENTS TREAT AN INCREASING NUMBER OF PATIENTS WHO USE THE FACILITY FOR PRIMARY CARE NEEDS. PATIENT DEMOGRAPHICS REFLECT THE CHANGING COMMUNITY. AS IN OTHER COMMUNITIES, SOME AREA PHYSICIANS PLACE LIMITS ON THEIR ACCEPTANCE OF MEDICAID PATIENTS. IN ADDITION, SOME PRIMARY CARE PHYSICIANS REFER PATIENTS WITH AFTER-HOURS NEEDS DIRECTLY TO AREA EMERGENCY ROOMS. COMMUNITY GROUPS AND INDIVIDUALS ARE VERY SUPPORTIVE OF BON SECOURS MERCY HEALTH. BON SECOURS MERCY HEALTH FORGES COLLABORATIVE RELATIONSHIPS WITH THE FEDERALLY QUALIFIED HEALTH CENTERS IN ITS COMMUNITIES.
Schedule H, Part VI, Line 6 Affiliated health care system Bon Secours Mercy Health, Inc., a Maryland nonprofit, nonstock membership corporation (BSMH), and all of the other entities that are controlled directly or indirectly by BSMH are described collectively as the System. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of New York, Pennsylvania, Maryland, Virginia, Kentucky, Ohio, South Carolina, and Florida, each referred to as a local system. The Ministry of BSMH aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. As a member of the Catholic health ministry and a member of BSMH, this organization and its related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." This organization and related organizations share the BSMH Vision. BSMH's vision to partner with communities to create a more humane world, build social justice for all and provide exceptional value for those served is implemented through its Strategic Quality Plan which provides focus in four goal areas for the current three year period (2016-2018). - Co-Create Healthy Communities: We recognize that the factors which drive health outcomes extend well beyond the scope of traditional health care services. Thus, we commit to improve the health of communities through partnership and collaboration with a broad range of constituencies including committed community residents - Be Person Centric: We recognize that those whom we serve are increasingly engaged in their own care and are seeking convenience, affordability and reliability. Thus, we commit to anticipate and respond to the changing expectations of health care consumers, and to ensure that we engage each person in an individualized plan for health with a focus on prevention and wellness. - Serve Those Who Are Vulnerable: We recognize, by our Catholic identity, that the struggle for a more humane world is not an option, but an integral part of spreading the gospel. Thus, we commit to serve those who are vulnerable in many ways, addressing health disparities, sustaining global ministries, healing the environment and working to end violence and oppression. - Strengthen Our Culture and Capabilities: We recognize that the health care delivery system is undergoing rapid change with increasing complexity. Thus, we commit to liberate the potential of our people by strengthening individual and collective capabilities with respect to ministry leadership, knowledge, analytics, innovation and finances. Please see Schedule R for listings of the related organizations. Each of the reported entities play a role in achieving the vision of BSMH and the SQP (Strategic Quality Plan).
Schedule H (Form 990) 2018
Additional Data


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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," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
Bon Secours - St Mary's Hospital of Richmond Inc
 
Employer identification number
54-0793767
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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC 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
noncash assistance		 (h) Purpose of grant
or assistance
(1) Bon Secours Richmond Healthcare Foundation
7229 Forest Avenue Suite 200
Richmond,VA23226 		54-1201346 501(C)(3) 2,600,801       MISSION SUPPORT
(2) Richmond Symphony
612 East Grace St
Richmond,VA23219 		54-6024033 501(C)(3) 100,000       MISSION SUPPORT
(3) YMCA of Greater Richmond
2 West Franklin Street
Richmond,VA23220 		54-0505986 501(C)(3) 185,000       Youth Development
(4) CrossOver Healthcare Ministry
8600 Quioccasin Road
Richmond,VA23229 		54-1371067 501(C)(3) 150,000       Operations
(5) Virginia Supportive Housing
PO Box 8585
Richmond,VA23226 		54-1444564 501(C)(3) 50,000       End Homelessness
(6) Greater Richmond SCAN
103 East Grace Street
Richmond,VA23219 		54-1584969 501(C)(3) 75,000       Greater Richmond TICN
(7) Tricycle Gardens
2314 Jefferson Avenue
Richmond,VA23223 		75-3253795 501(C)(3) 200,000       Urban Agriculturists
(8) Higher Achievement
4009 Fitzhugh Avenue
Richmond,VA23230 		52-1383374 501(C)(3) 65,000       MISSION SUPPORT
(9) Area Congregations Together in Service
1 N 5th Street
Richmond,VA23219 		45-3020788 501(C)(3) 120,000       Housing Stability
(10) Cristo Rey Richmond
7800 Carousel Lane
Richmond,VA23294 		81-2742073 501(C)(3) 700,000       MISSION SUPPORT
(11) Maggie Walker Community Land Trust
203 N Robinson Street
Richmond,VA23220 		47-5629011 501(C)(3) 250,000       Affordable Homeownership
(12) NextUp RVA
7501 Boulders View Dr
Richmond,VA23225 		46-3607727 501(C)(3) 175,000       The Path to Success: Richmond's Out-of-School Time Network
(13) City of Richmond
900 E Broad St
Richmond,VA23219 		54-6001556 Government 80,000       MISSION SUPPORT
(14) Virginia Health Care Foundation
707 EAST MAIN ST
RICHMOND,VA23219 		54-1639924 501(C)(3) 10,000       MISSION SUPPORT
(15) Greater Richmond Transit Co
301 East Belt Boulevard
RICHMOND,VA23224 		54-1257540 Government 212,500       MISSION SUPPORT
(16) Access Now Inc
2821 Emerywood Parkway
Richmond,VA23294 		26-1695468 501(C)(3) 75,000       Prescriptions
(17) Caritas
PO BOX 25790
RICHMOND,VA23260 		54-1441917 501(C)(3) 50,000       MISSION SUPPORT
(18) Center for Healthy Hearts
1200 West Cary Street
Richmond,VA23220 		52-1303481 501(C)(3) 25,000       Diabetes Program
(19) Challenge Discovery project
1503 SANTA ROSA RD
Richmond,VA23229 		51-0250681 501(C)(3) 30,000       MISSION SUPPORT
(20) ChildSavers
200 North 22nd Street
Richmond,VA23223 		54-0505927 501(C)(3) 100,000       Richmond Public Schools Resiliency Partnership
(21) Family Lifeline
2325 WEST BROAD ST
RICHMOND,VA23220 		54-0737133 501(C)(3) 50,000       MISSION SUPPORT
(22) Free Clinic of Powhatan
3908 Old Buckingham Road
Powhatan,VA23139 		26-1275136 501(C)(3) 62,960       MISSION SUPPORT
(23) FRIENDS Association for Children
Saint John Street
Richmond,VA23220 		54-0505899 501(C)(3) 85,000       Early Childhood Education
(24) Goochland CARES
2999 RIVER ROAD WEST
GOOCHLAND,VA23063 		54-1967650 501(C)(3) 50,000       MISSION SUPPORT
(25) Greater Richmond Chamber Foundation
PO BOX 1598
RICHMOND,VA23218 		51-0252958 501(C)(3) 75,000       MISSION SUPPORT
(26) Health Brigade (formerly Fan Free Clinic)
1010 North Thompson Street
Richmond,VA23230 		54-0927792 501(C)(3) 80,000       Operations
(27) Housing Families First
3900 Nine Mile Road
Henrico,VA23223 		54-1995917 501(C)(3) 50,000       Building Neighbors: A Solution that Works
(28) Neighborhood Resource Center
1519 WILLIAMSBURG RD
Richmond,VA23231 		33-1024355 501(C)(3) 60,000       MISSION SUPPORT
(29) Peter Paul Development Center
1708 N 22ND ST
Richmond,VA23223 		54-1137164 501(C)(3) 75,000       Community Engagement for Youth and Family Success
(30) Richmond Academy of Medicine
2821 emerywood pkwy
Richmond,VA23294 		54-0356395 501(C)(6) 35,000       MISSION SUPPORT
(31) Richmond Hill Inc
2209 E Grace St
Richmond,VA23223 		54-1360535 501(C)(3) 25,000       Armstrong Leadership Program
(32) Richmond Metropolitan Habitat for Humanity (RMHFH)
2281 Dabney Road
Richmond,VA23230 		54-1385198 501(C)(3) 200,000       Revitalizing Randolph into a Thriving, Mixed-Income Neighborhood
(33) Rx Partnership
2924 Emerywood Parkway
Richmond,VA23294 		57-1186937 501(C)(3) 20,000       Prescriptions
(34) Sacred Heart Center
1400 Perry Street
Richmond,VA23224 		54-1590419 501(C)(3) 100,000       Sustaining the Impact of the Sacred Heart Center (SHC)
(35) Safe Harbor
PO Box 17996
Richmond,VA23226 		54-1950038 501(C)(3) 80,000       Counseling Services for Immigrant and Human Trafficking Survivors and Motivational Interviewing Training for Staff
(36) Senior Connections
24 EAST CARY ST
Richmond,VA23219 		54-0950714 501(C)(3) 75,000       MISSION SUPPORT
(37) Virginia LISC
413 Stuart Circle
Richmond,VA23220 		13-3030229 501(C)(3) 75,000       Supporting East End Entrepreneur Development (SEED) Program
(38) Salvation Army
615 SLATERS LANE 3RD FL
ALEXANDRIA,VA22314 		13-2923701 501(C)(3) 671,000       MISSION SUPPORT
(39) Substance Abuse Free ENVIRONMENT INC
PO BOX 40
CHESTERFIELD,VA23832 		54-1936878 501(C)(3) 52,730       MISSION SUPPORT
(40) United Methodist Urban Ministries of Richmond
1010 W Laburnum Ave
Richmond,VA23227 		23-7136747 501(C)(3) 58,000       MISSION SUPPORT
(41) Virginia Interfaith Center
1716 E FRANKLIN ST
Richmond,VA23223 		54-1362857 501(C)(3) 30,000       MISSION SUPPORT
(42) SAARA of Virginia
2000 MECKLENBURG ST
Richmond,VA23223 		54-2056367 501(C)(3) 20,000       MISSION SUPPORT
(43) greater richmond aquatics partnership (SwimRVA)
5050 ridgedale parkway
Richmond,VA23234 		27-4185518 501(C)(3) 35,000       MISSION SUPPORT
(44) Richmond Opportunities Inc
1810 CREIGHTON RD
Richmond,VA23223 		54-1587555 501(C)(3) 35,000       MISSION SUPPORT
(45) Daily Planet HEALTH SERVICES
517 W GRACE ST
Richmond,VA23220 		54-0900368 501(C)(3) 81,667       MISSION SUPPORT
(46) Voices for Virginias Children
1606 SANTA ROSA RD
Richmond,VA23229 		54-1726265 501(C)(3) 37,500       MISSION SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
46
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2018

Schedule I (Form 990) 2018
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1) INDIGENT CAB FARE 883 22,082      
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Schedule I, Part III, Column (b) Estimated Number Of Recipients INDIGENT CAB FARE : Cab fare is estimated at $25 per individual.
Schedule I, Part III SCHEDULE I, PART III Cab fares are estimated at $25/round-trip
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Per Bon Secours Mercy Health's system-wide financial and accounting policies, contributions are generally made as reimbursements for funds spent. In such cases, the donee/grantee organization must provide documentation to the filing organization before funds are approved for disbursement. In other cases, grantees submit progress reports on the anniversary date on which the grant was received. The evaluation report includes: 1) progress toward the deployment of the stated goals and objectives, 2) progress towards the achievement of desired outcome as demonstrated by Project Work Plan, 3) an accurate accounting of the revenue and expenses and the amount of the mission fund award expensed, and 4) a summary past, current and future funding sources and efforts to secure sustaining sources of funding. Description of the Bon Secours Mercy Health Mission Fund: Bon Secours Mercy Health performs its philanthropic work through its mission department. This initiative, called the Bon Secours Health System Mission Fund ("Mission Fund"), was developed to promote the Catholic Health Ministry and the Bon Secours Mercy Health, Inc. Mission. This purpose is realized through the funding of initiatives that improve the health and well-being of communities, particularly for disenfranchised and marginalized people, served by Bon Secours Mercy Health Local Systems ("Local Systems"), Cosponsors and the Congregation of the Sisters of Bon Secours. The scope of its purpose and use of funds would be to: -promote healthy community coalition initiatives in conjunction with local system efforts, -develop local system and community excellence for a specific health condition and preventive need, and -improve access for uninsured populations and reduce health disparities among populations in the community. The Strategic Quality Plan of the health system calls for focused efforts to Build Healthier Communities. The health system understands "health" to include social and communal dimensions and has adopted the following articulation of a healthy community. The conditions of communities and individuals served by Bon Secours Mercy Health reflect the interaction of significant factors and complex behaviors at the individual, communal, and societal level. It is not likely that interventions by any one organization will result in substantial improvement or benefit to the community. Rather, increased participation by stakeholders and greater cooperation among entities with appropriate skills and resources is necessary for systemic change and improved outcomes. Mission Fund grants place emphasis on increased collaboration among community based members (Healthy Community Initiative), public health officials and other providers of services. The Mission Fund anticipates that most endeavors that seek to bring meaningful improvement require time and commitment. Consequently, local system grant recipients may expect continuity of support (several years) to establish and track outcomes. At the same time, grant applicants need to cultivate and achieve a wide array of financial resources necessary to sustain promising projects and service programs.
Schedule I (Form 990) 2018



Additional Data


Software ID: 18007697
Software Version: 2018v3.1


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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
Bon Secours - St Mary's Hospital of Richmond Inc
 
Employer identification number

54-0793767
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 on 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 or provision of all of 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
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on 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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on 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," on line 5a or 5b, describe in Part III.
6
For persons listed on 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," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (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 in column (B) reported as deferred on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1Toni Ardabell
 
CEO-BSV (End 07/19) 		(i)

(ii)		 0
-------------
699,411 		0
-------------
215,374 		0
-------------
921,045 		0
-------------
16,500 		0
-------------
0 		0
-------------
1,852,330 		0
-------------
0
2Janice Burnett
 
Board Member (End 03/19) 		(i)

(ii)		 0
-------------
699,015 		0
-------------
215,867 		0
-------------
1,204,687 		0
-------------
146,360 		0
-------------
2,433 		0
-------------
2,268,362 		0
-------------
90,877
3Stephan Quiriconi
 
Treasurer, CFO - Richmond Market 		(i)

(ii)		 422,940
-------------
0 		102,164
-------------
0 		132,882
-------------
0 		6,617
-------------
0 		18,579
-------------
0 		683,182
-------------
0 		0
-------------
0
4Rhodes Ritenour
 
Secretary (Beg 01/19) 		(i)

(ii)		 221,002
-------------
0 		43,026
-------------
0 		211
-------------
0 		13,020
-------------
0 		29,450
-------------
0 		306,709
-------------
0 		0
-------------
0
5FRANCINE BARR
 
CEO-SMH 		(i)

(ii)		 343,288
-------------
0 		92,180
-------------
0 		208,139
-------------
0 		16,500
-------------
0 		24,534
-------------
0 		684,641
-------------
0 		0
-------------
0
6James McNamara
 
VP Orthopedics (End 09/18) 		(i)

(ii)		 0
-------------
181,608 		0
-------------
39,780 		0
-------------
103,723 		0
-------------
11,604 		0
-------------
10,319 		0
-------------
347,034 		0
-------------
0
7Jim Godwin
 
SVP HR - Richmond (End 11/18) 		(i)

(ii)		 264,392
-------------
0 		62,670
-------------
0 		34,614
-------------
0 		22,511
-------------
0 		20,781
-------------
0 		404,968
-------------
0 		0
-------------
0
8Paul Junod
 
VP HR - Richmond (Beg 11/18) 		(i)

(ii)		 0
-------------
147,913 		0
-------------
17,142 		0
-------------
13,592 		0
-------------
9,868 		0
-------------
28,704 		0
-------------
217,219 		0
-------------
0
9Kevin Sheppard
 
VP - Integration 		(i)

(ii)		 317,467
-------------
0 		39,081
-------------
0 		584
-------------
0 		5,069
-------------
0 		27,667
-------------
0 		389,868
-------------
0 		0
-------------
0
10Eleanor LEAgue
 
VP CNE 		(i)

(ii)		 324,512
-------------
0 		38,607
-------------
0 		1,732
-------------
0 		15,103
-------------
0 		23,281
-------------
0 		403,235
-------------
0 		0
-------------
0
11Leigh Sewell
 
VP Service Line Strategy (End 09/18); CEO - MRMC & RCH (Beg 09/18) 		(i)

(ii)		 257,457
-------------
0 		66,711
-------------
0 		57,281
-------------
0 		15,065
-------------
0 		37,578
-------------
0 		434,092
-------------
0 		0
-------------
0
12Matthew Ngo MD
 
Cardiologist 		(i)

(ii)		 698,001
-------------
0 		354,063
-------------
0 		850
-------------
0 		3,808
-------------
0 		35,621
-------------
0 		1,092,343
-------------
0 		0
-------------
0
13Mark Bladergroen MD
 
Cardiologist 		(i)

(ii)		 658,436
-------------
0 		302,422
-------------
0 		18,493
-------------
0 		4,176
-------------
0 		19,156
-------------
0 		1,002,683
-------------
0 		0
-------------
0
14STEVEN FISER MD
 
Cardiac Surgeon 		(i)

(ii)		 1,090,869
-------------
0 		986,606
-------------
0 		924
-------------
0 		3,929
-------------
0 		11,025
-------------
0 		2,093,353
-------------
0 		0
-------------
0
15SUSAN SCHAFFER WHITEMAN MD
 
Physician 		(i)

(ii)		 540,365
-------------
0 		259,438
-------------
0 		2,427
-------------
0 		3,915
-------------
0 		32,622
-------------
0 		838,767
-------------
0 		0
-------------
0
16SHAKIL KHAN MD
 
Cardiologist 		(i)

(ii)		 518,202
-------------
0 		256,901
-------------
0 		360
-------------
0 		3,791
-------------
0 		28,516
-------------
0 		807,770
-------------
0 		0
-------------
0
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Bon Secours Mercy Health, Inc., a related organization of the filing organization, uses the following to establish the compensation of the organization's CEO/Executive Director: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee
Schedule J, Part I, Line 4a Severance or change-of-control payment Severance Benefits consisting of continuation of base salary and insurance benefits were provided to listed individuals for specified periods. The listed individuals executed releases and waivers of claims in exchange for the severance benefits. Salary continuation amounts provided during the reporting year to listed individuals were as follows: James McNamara, $78,540.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan The filing organization participates in a BSMH sponsored executive retirement program that allows for deposits into additional retirement plans and is available only to officers and key employees. The 457F plan is a non-qualified plan and is subject to a minimum three-year service requirement before vesting on deposits made into this plan. Individuals that received a distribution or participated in the plan include: Janice Burnett, $108,897; Stephan Quiriconi, $0; James Godwin, $12,540; Francine Barr, $572.
Schedule J, Part I, Line 7 Non-fixed payments The organization provides annual incentive compensation for listed individuals. The organization's Board of Trustees establishes objective thresholds which must be achieved for incentives to be awarded. The Board also establishes threshold, target and maximum levels for incentive awards. Within the established parameters, the Board determines the CEO's incentive award and incentive awards for other listed individuals are determined by the listed individual's supervisor and disclosed to the Board. The Board may authorize modified incentive awards when appropriate in its judgment.
Schedule J (Form 990) 2018
Additional Data


Software ID: 18007697
Software Version: 2018v3.1
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
Bon Secours - St Mary's Hospital of Richmond Inc
 
Employer identification number

54-0793767
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2018
Schedule L (Form 990 or 990-EZ) 2018
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) MARTHA E MERCHENT
  		FAMILY MEMBER OF OFFICER STEPHAN QUIRICONI 62,056 EMPLOYMENT   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1




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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
Bon Secours - St Mary's Hospital of Richmond Inc
 
Employer identification number

54-0793767
Return Reference Explanation
Form 990, Part VI, Line 6 Classes of members or stockholders Bon Secours Mercy Health, Inc. is the sole member of Bon Secours Richmond LLC which was formerly Bon Secours Richmond Health Corp, a nonprofit tax exempt organization prior to conversion. Bon Secours Richmond LLC holds the majority interest in Bon Secours - Richmond Health System, which in turn is the sole member of St. Mary's Hospital of Richmond, Inc.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The governing body of St. Mary's Hospital of Richmond, Inc. is appointed by its member Bon Secours - Richmond Health System and subject to approval by Bon Secours Mercy Health, Inc.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders CERTAIN MATTERS REQUIRE APPROVAL OF THE BSMH CORPORATE MEMBER, BSMH GOVERNING BODY, OR BSMH CEO. THE REGULATIONS OF THE ORGANIZATION DESCRIBE THE LEVEL OF APPROVAL REQUIRED FOR VARIOUS DECISIONS.
Form 990, Part VI, Line 11b Review of form 990 by governing body THE FORM 990 IS PREPARED BY BSMH'S TAX DEPARTMENT AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. A COPY OF THE FORM 990 IS THEN REVIEWED BY MANAGEMENT. Upon review, a copy of the final version of the Form 990 is provided to all members of the governing body prior to filing.
Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1) disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSMH CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members).
Form 990, Part VI, Line 15b Process to establish compensation of other employees The compensation committee of the board of Bon Secours Mercy Health, Inc. (BSMH) engages in a comprehensive process for the oversight and management of remuneration for executive employees and disqualified parties of BSMH. The compensation committee consists of a group of independent board members and engages an independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' rebuttable presumption of reasonableness. The committee establishes and maintains a compensation philosophy; reviews pay practices against local, regional and national healthcare organizations and approves all remunerative decisions for this group of individuals. The committee reviews and receives assurances that all levels of pay within the organization are reasonable based on performance and validates incentives are met. These decisions are documented in the BSMH board of directors' and compensation committee minutes. Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSMH compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the other officers or key employees of the organization were compared to other hospitals' employees in the area that hold the same title. During the review and approval of the compensation, documentation of the decision was recorded by human resources.
Form 990, Part VI, Line 19 Required documents available to the public The conflict of interest policy and financial statements are posted on the BSMH website.
Form 990, Part VII, Section A ADDITIONAL DISCLOSURE The governing bodies of the following entities are comprised of the same board members and board officers (Chairman, President, Secretary and Treasurer): - Bon Secours St. Mary's Hospital - Bon Secours St. Francis Medical Center - Bon Secours Memorial Regional Medical Center - Richmond Community Hospital - Chesapeake Hospital Corporation - Chesapeake Medical Group The entities listed above and the parent organization to these entities, Bon Secours Richmond Health System, Inc. (RHS), established a mirror board. The action aligned the board members and board officers of RHS and the listed entities. Hours reported on Form 990, Part VII represents total hours worked per week. These hours may include time spent as an employee of the organization and any hours spent serving as a volunteer board member. Any compensation paid to these individuals is payment for their employment with the filing organization or related organization. Volunteers are not paid for their time. Sr. Anne Marie Mack and Sr. Victoria Segura do not receive payroll distributions as they have taken vows of poverty.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue OTHER REV - Total Revenue: 1762108, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 1762108;
Form 990, Part IX, Line 11g Other Fees PURCHASED SERVICES - INTERCOMPANY - Total Expense: 3378036, Program Service Expense: 3040232, Management and General Expenses: 337804, Fundraising Expenses: ; PHYSICIAN FEES - Total Expense: 19992686, Program Service Expense: 19992686, Management and General Expenses: , Fundraising Expenses: ; BILLING AND COLLECTIONS - Total Expense: 3614833, Program Service Expense: 3253350, Management and General Expenses: 361483, Fundraising Expenses: ; SECURITY SERVICES - Total Expense: 9347, Program Service Expense: 8412, Management and General Expenses: 935, Fundraising Expenses: ; OTHER PURCHASED SERVICES - Total Expense: 28537086, Program Service Expense: 25683378, Management and General Expenses: 2853708, Fundraising Expenses: ; MAINTENANCE AND SERVICE AGREEMENTS - Total Expense: 5258340, Program Service Expense: 4732506, Management and General Expenses: 525834, Fundraising Expenses: ; CONSULTING - Total Expense: 2584308, Program Service Expense: 2325877, Management and General Expenses: 258431, Fundraising Expenses: ; CONTRACTED NURSING AND ANCILLARY TECH STAFF - Total Expense: 4910485, Program Service Expense: 4910485, Management and General Expenses: , Fundraising Expenses: ; DUES - PHYSICIANS - Total Expense: 803656, Program Service Expense: 803656, Management and General Expenses: , Fundraising Expenses: ; DUES - MGT - NON OPS - Total Expense: 95027162, Program Service Expense: , Management and General Expenses: 95027162, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances TRANSFERS TO AFFILIATES - 52920; MINIMUM PENSION LIABILITY - -32186472; BSMH Principle and SWAPS Allocation - -1519789; Other Net Asset Transfers - 474201;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2018


Additional Data


Software ID: 18007697
Software Version: 2018v3.1
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
Bon Secours - St Mary's Hospital of Richmond Inc
 
Employer identification number

54-0793767
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) 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
(1) Richmond CIN LLC
5875 Bremo Road
Ste 710
Richmond,VA23226
81-4161677 		Care Coordination VA 42,242 0 Bon Secours - St Mary's Hospital of Richmond Inc
 
(2) Community ASC LLC
8580 Magellan Parkway
Richmond,VA23227
 Inactive VA 0 0 Bon Secours - St Mary's Hospital of Richmond Inc
 








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 entity?
Yes No
(1)MERCY HEALTH
1701 Mercy Health Place

CINCINNATI,OH45237
31-1161086 		HEALTHCARE SYSTEM PARENT OH 501(c)(3) 3 Bon Secours Mercy Health Inc
 
 
No
(2)MERCY HEALTH FOUNDATION
1701 Mercy Health Place

CINCINNATI,OH45237
20-1072726 		FUNDRAISING OH 501(c)(3) 7 MERCY HEALTH
 
 
No
(3)MERCY HEALTH RETIREMENT TRUST
1701 Mercy Health Place

CINCINNATI,OH45237
31-6046304 		RETIREMENT TRUST OH 501(c)(3) 7 MERCY HEALTH
 
 
No
(4)COMMUNITY HEALTH PARTNERS PHYSICIANS OFFICE BUILDINGS
3700 KOLBE ROAD

LORAIN,OH44053
34-1268828 		MEDICAL OFFICE RENTAL OH 501(c)(3) 10 MERCY HEALTH - REGIONAL MEDICAL CENTER LLC
 
 
No
(5)ALLEN MEDICAL CENTER MEDICAL OFFICE BUILDING
200 WEST LORAIN ST

OBERLIN,OH44074
36-4504991 		MEDICAL OFFICE RENTAL OH 501(c)(3) 10 MERCY HEALTH - ALLEN HOSPITAL LLC
 
 
No
(6)MERCY FRANCISCAN SENIOR HEALTH AND HOUSING SERVICES INC
7010 ROWAN HILLS DR

CINCINNATI,OH45227
31-1308729 		RETIREMENT HOME OH 501(c)(3) 10 MERCY HEALTH CINCINNATI LLC
 
 
No
(7)MERCY FRANCISCAN SOCIAL MINISTRIES INC
1800 LOGAN STREET

CINCINNATI,OH45210
31-1222942 		LOW INCOME HOUSING OH 501(c)(3) 7 MERCY HEALTH CINCINNATI LLC
 
 
No
(8)COMMUNITY MERCY HEALTH SYSTEM
100 Medical Center Drive

SPRINGFIELD,OH45504
30-0272454 		MARKET PARENT OH 501(c)(3) Type III-FI MERCY HEALTH
 
 
No
(9)COMMUNITY MERCY HEALTH PARTNERS
100 Medical Center Drive

SPRINGFIELD,OH45504
31-0785684 		HOSPITAL OH 501(c)(3) 3 COMMUNITY MERCY HEALTH SYSTEM
 
 
No
(10)C H HEALTH SERVICES COMPANY
100 Medical Center Drive

SPRINGFIELD,OH45504
31-1181984 		HOSPITAL OH 501(c)(3) 3 COMMUNITY MERCY HEALTH SYSTEM
 
 
No
(11)THE WALLACE S MURRAY AND FRANCES RABBITTS MURRAY MEMORIAL TRUST
100 Medical Center Drive

SPRINGFIELD,OH45504
34-6827136 		INDIGENT MEDICAL CARE OH 501(c)(3) Type I NA
 
 
No
(12)MERCY PROPERTY HOLDINGS
2200 JEFFERSON AVENUE

TOLEDO,OH43604
30-0699825 		TITLE HOLDING COMPANY OH 501(c)(2)   MERCY HEALTH NORTH LLC
 
 
No
(13)MERCY COLLEGE OF OHIO
2221 MADISON AVENUE

TOLEDO,OH43604
34-1726619 		MEDICAL COLLEGE OH 501(c)(3) 2 MERCY HEALTH NORTH LLC
 
 
No
(14)MERCY COLLEGE OF NORTHWEST OHIO FOUNDATION INC
2221 MADISON AVENUE

TOLEDO,OH43604
14-1963204 		FOUNDATION OH 501(c)(3) 7 MERCY COLLEGE OF OHIO
 
 
No
(15)LIFESTAR AMBULANCE INC
2200 JEFFERSON AVENUE

TOLEDO,OH43604
34-1354653 		MEDICAL TRANSPORTATION OH 501(c)(3) 10 MERCY HEALTH NORTH LLC
 
 
No
(16)SIMON OUTREACH SERVICES
2600 NAVARRE AVENUE

OREGON,OH43616
34-1383325 		MEDICAL OFFICE RENTAL OH 501(c)(3) 10 MERCY HEALTH - ST CHARLES HOSPITAL LLC
 
 
No
(17)NEW VISION MEDICAL LABORATORIES INC
750 W HIGH ST STE 400

LIMA,OH45801
34-1937267 		MEDICAL LAB SERVICES OH 501(c)(3) 3 ST RITA'S MEDICAL CENTER LLC
 
 
No
(18)THE ASSUMPTION VILLAGE
9800 N MARKET STREET

NORTH LIMA,OH44452
34-1013695 		NURSING HOME OH 501(c)(3) 10 MERCY HEALTH YOUNGSTOWN LLC
 
 
No
(19)HOSPICE OF THE VALLEY
5190 MARKET STREET

YOUNGSTOWN,OH44512
34-1288745 		HOSPICE SERVICES OH 501(c)(3) 10 MERCY HEALTH YOUNGSTOWN LLC
 
 
No
(20)HUMILITY HOUSE
755 OHLTOWN ROAD

AUSTINTOWN,OH44515
34-1894783 		NURSING HOME OH 501(c)(3) 10 MERCY HEALTH YOUNGSTOWN LLC
 
 
No
(21)ST JOSEPH HEALTH CENTER AUXILIARY
677 EASTLAND SE

WARREN,OH44484
34-6556121 		FUNDRAISING OH 501(c)(3) 10 MERCY HEALTH YOUNGSTOWN LLC
 
 
No
(22)LOURDES HOSPITAL AUXILIARY GIFT SHOP
1530 LONE OAK ROAD

PADUCAH,KY42003
61-0927805 		FUNDRAISING KY 501(c)(3) 10 MERCY HEALTH FOUNDATION
 
 
No
(23)HEALTHSPAN PARTNERS
1701 Mercy Health Place

CINCINNATI,OH45237
46-3055925 		MARKET PARENT OH 501(c)(3) Type II MERCY HEALTH
 
 
No
(24)HEALTHSPAN INTEGRATED CARE
1701 Mercy Health Place

CIncinnati,OH45237
34-0922268 		HMO OH 501(c)(3) 10 HEALTHSPAN PARTNERS
 
 
No
(25)Bon Secours Mercy Health Inc
1701 Mercy Health Place

CINCINNATI,OH45237
52-1301088 		HEALTHCARE SYSTEM PARENT MD 501(c)(3)   NA
 
 
No
(26)Bon Secours New York Health System Inc
2975 Independence Avenue

Bronx,NY10463
91-2135196 		Local System Parent Org. NY 501(c)(3) Type I Bon Secours Mercy Health Inc
 
 
No
(27)Bon Secours Kentucky Health System Inc
St Christopher Dr

Ashland,KY41101
61-1356024 		Local System Parent Org. KY 501(c)(3) Type III-FI Bon Secours Mercy Health Inc
 
 
No
(28)Bon Secours Baltimore Health Corporation (dba Bon Secours Baltimore Health
S2000 West Baltimore Street

Baltimore,MD21223
80-0728893 		Local System Parent Org. MD 501(c)(3) Type III-FI Bon Secours Mercy Health Inc
 
 
No
(29)Bon Secours St Francis Health System Inc
1 St Francis Drive

Greenville,SC29601
58-2504528 		Local System Parent Org. SC 501(c)(3) Type III-FI Bon Secours Mercy Health Inc
 
 
No
(30)Bon Secours Hampton Roads Health System
7007 Harbour View Blvd

Portsmouth,VA23435
52-1538513 		Local System Parent Org. VA 501(c)(3) Type III-FI Bon Secours Mercy Health Inc
 
 
No
(31)Bon Secours Richmond Health System
8580 Magellan Parkway

Richmond,VA23227
52-1988421 		Local System Parent Org. VA 501(c)(3) Type III-FI Bon Secours Mercy Health Inc
 
 
No
(32)Bon Secours Baltimore Health System Foundation Inc
26 North Fulton Avenue

Baltimore,MD21223
38-3843816 		Grant Making Foundation MD 501(c)(3) Type III-FI Bon Secours Baltimore Health Corporation (dba Bon Secours Baltimore Health
S
 
No
(33)The Bon Secours of Maryland Foundation Inc (dba Bon Secours Community Work
26 North Fulton Avenue

Baltimore,MD21223
52-1732800 		Grant Making Foundation MD 501(c)(3) Type III-FI Bon Secours Baltimore Health Corporation (dba Bon Secours Baltimore Health
S
 
No
(34)Mary Immaculate Foundation
7007 Harbour View Blvd

Suffolk,VA23435
31-1644734 		Fundraising VA 501(c)(3) Type III-FI Mary Immaculate Hospital
 
 
No
(35)Bon Secours DePaul Health Foundation
7007 Harbour View Blvd

Suffolk,VA23435
54-1843876 		Fundraising VA 501(c)(3) 7 Bon Secours DePaul Medical Center
 
 
No
(36)Bon Secours Maryview Foundation
7007 Harbour View Blvd

Suffolk,VA23435
52-1694731 		Fundraising VA 501(c)(3) 7 Bon Secours Hampton Roads Health System
 
 
No
(37)Our Lady of Bellefonte Hospital Inc
1000 St Christopher Dr

Ashland,KY41101
61-1356023 		Health Care KY 501(c)(3) 3 Bon Secours Kentucky Health System
 
 
No
(38)Bon Secours Hospital Baltimore Inc
2000 West Baltimore Street

Baltimore,MD21223
52-0591555 		Health Care MD 501(c)(3) 3 Bon Secours Baltimore Health Corporation (dba Bon Secours Baltimore Health
S
 
No
(39)St Francis Hospital Inc
One St Francis Drive

Greenville,SC29601
58-2504530 		Health Care SC 501(c)(3) 3 Bon Secours St Francis Health System Inc
 
 
No
(40)Mary Immaculate Hospital Inc
7007 Harbour View Blvd

Suffolk,VA23435
54-0548200 		Health Care VA 501(c)(3) 3 Bon Secours Mercy Health Inc
 
 
No
(41)Bon Secours - DePaul Medical Center Inc
7007 Harbour View Blvd

Suffolk,VA23435
54-1820093 		Health Care VA 501(c)(3) 3 Bon Secours Hampton Roads Health System
 
 
No
(42)Maryview Hospital
7007 Harbour View Blvd

Portsmouth,VA23707
54-0506463 		Health Care VA 501(c)(3) 3 Bon Secours Hampton Roads Health System
 
 
No
(43)Bon Secours - Memorial Regional Medical Center Inc
8580 Magellan Parkway

Richmond,VA23227
54-1744931 		Health Care VA 501(c)(3) 3 Bon Secours Richmond Health System
 
 
No
(44)Bon Secours - St Mary's Hospital of Richmond Inc
8580 Magellan Parkway

Richmond,VA23227
54-0793767 		Health Care VA 501(c)(3) 3 Bon Secours Richmond Health System
 
 
No
(45)Bon Secours - Richmond Community Hospital
8580 Magellan Parkway

Richmond,VA23227
54-0647482 		Health Care VA 501(c)(3) 3 Bon Secours Richmond Health System
 
 
No
(46)Bon Secours - St Francis Medical Center Inc
8580 Magellan Parkway

Richmond,VA23227
31-1716973 		Health Care VA 501(c)(3) 3 Bon Secours Richmond Health System
 
 
No
(47)Bon Secours Kentucky Health System Foundation Inc
St Christopher Dr

Ashland,KY41101
61-1381952 		Grant Making Foundation KY 501(c)(3) 7 Bon Secours Kentucky Health System
 
 
No
(48)Bon Secours Baltimore Development Inc
26 North Fulton Avenue

Baltimore,MD21223
76-0785344 		Community Housing MD 501(c)(3) 7 Unity Properties Inc
 
 
No
(49)Unity Properties Inc
26 North Fulton Avenue

Baltimore,MD21223
52-1857768 		Low Income Housing MD 501(c)(3) 7 Bon Secours of Maryland Foundation
 
 
No
(50)Bon Secours - St Francis Health System Foundation Inc
One St Francis Drive

Greenville,SC29601
26-0012031 		Grant Making Foundation SC 501(c)(3) 7 St Francis Hospital Inc
 
 
No
(51)Bon Secours Richmond Health Care Foundation
8580 Magellan Parkway

Richmond,VA23227
54-1201346 		Grant Making Foundation VA 501(c)(3) 7 Bon Secours Richmond LLC
 
 
No
(52)Bon Secours St Petersburg Home Care Services Inc
10300 Fourth Street North

St Petersburg,FL33716
13-4334363 		Home Care Services FL 501(c)(3) 10 Maria Manor Nursing Care Center
 
 
No
(53)Bon Secours - Maria Manor Nursing Care Center Inc
10300 Fourth Street North

St Petersburg,FL33716
65-0061820 		Nursing Home FL 501(c)(3) 10 Bon Secours Mercy Health Inc
 
 
No
(54)Bellefonte Physician Services Inc
St Christopher Dr

Ashland,KY41101
35-2320780 		Physician Practices KY 501(c)(3) 10 Bon Secours Kentucky Health System
 
 
No
(55)Bon Secours Housing Inc
26 North Fulton Avenue

Baltimore,MD21223
52-1442707 		Low Income Housing MD 501(c)(3) 10 Bon Secours of Maryland Foundation
 
 
No
(56)Bon Secours Housing II Inc
26 North Fulton Avenue

Baltimore,MD21223
52-1543174 		Low Income Housing MD 501(c)(3) 10 Bon Secours of Maryland Foundation
 
 
No
(57)Schervier Housing Development Fund Corporation
2975 Independence Avenue

Bronx,NY10463
13-3098867 		Housing NY 501(c)(3) 10 Bon Secours NY Health System
 
 
No
(58)St Francis Physician Services Inc
One St Francis Drive

Greenville,SC29601
13-4290167 		Physician Services SC 501(c)(3) 10 St Francis Health System Inc
 
 
No
(59)Mary Immaculate Nursing Center Inc
7007 Harbour View Blvd

Suffolk,VA23435
54-1516476 		Nursing Care Center VA 501(c)(3) 10 Mary Immaculate Hospital
 
 
No
(60)Bon Secours - Maryview Nursing Care Center
7007 Harbour View Blvd

Suffolk,VA23435
52-1578169 		Nursing Care Center VA 501(c)(3) 10 Bon Secours Hampton Roads Health System
 
 
No
(61)Bayley Properties
7007 Harbour View Blvd

Suffolk,VA23435
54-1424748 		Title Holding Company VA 501(c)(2)   Bon Secours DePaul Medical Center
 
 
No
(62)Laburnum Properties
8580 Magellan Parkway

Richmond,VA23227
52-1260700 		Title Holding Company VA 501(c)(2)   Bon Secours Richmond Health System
 
 
No
(63)Bon Secours Health System Foundation Inc
8990 Old Annapolis Road

Columbia,MD21045
47-4765376 		Fundraising MD 501(c)(3) 7 Bon Secours Mercy Health Inc
 
 
No
(64)IVNA Health Services
5008 Monument Avenue

Richmond,VA23230
54-1479847 		Home Care Services VA 501(c)(3) 10 Bon Secours Home Care LLC
 
 
No
(65)Rappahannock General Hospital Foundation
101 Harris Road

Kilmarnock,VA22482
54-1210450 		Supporting Organization VA 501(c)(3) 7 Bon Secours Richmond Health System
 
 
No
(66)Chesapeake Medical Group
101 Harris Road

Kilmarnock,VA22482
54-1857174 		Healthcare Services VA 501(c)(3) 10 Bon Secours Richmond Health System
 
 
No
(67)Chesapeake Hospital Corporation
101 Harris Road

Kilmarnock,VA22482
23-7424835 		Health Care VA 501(c)(3) 3 Bon Secours Richmond Health System
 
 
No
(68)Bon Secours New Jersey Health System Inc
1505 Marriottsville Road

Marriottsville,MD27104
22-2754781 		Local System Parent Org. NJ 501(c)(3) Type III-FI Bon Secours Mercy Health Inc
 
 
No
(69)St Mary Hospital Inc
308 Willow

Hoboken,NJ07030
22-1487324 		Health Care NJ 501(c)(3) 3 Bon Secours New Jersey Health System Inc
 
 
No
(70)Mercy Health Services
1505 Marriottsville Road

Marriottsville,MD27104
25-1585441 		Local System Parent Org. PA 501(c)(3) Type III-FI Bon Secours Mercy Health Inc
 
 
No
(71)Pennsylvania Health Choice Plan
1505 Marriottsville Road

Marriottsville,MD27104
 Health Care PA 501(c)(3) 10 Mercy Health Services
 
 
No
(72)Liberty Medical Center
1505 Marriottsville Road

Marriottsville,MD27104
52-1466304 		Health Care MD 501(c)(3) 3 Bon Secours Baltimore Health Corporation (dba Bon Secours Baltimore Health
S
 
No
(73)Bon Secours - Stuart Circle Hospital Inc
8580 Magellan Parkway

Richmond,VA23227
54-1740128 		Health Care VA 501(c)(3) 3 Bon Secours Richmond Health System
 
 
No
(74)Bon Secours Ireland DAC
 
 
Local System Parent Org. EI 501(c)(3) Type III-FI Bon Secours Mercy Health Inc
 
 
No
(75)Bon Secours Health System CLG
 
 
Hospital EI 501(c)(3) 3 Bon Secours Ireland DAC
 
 
No
(76)Our Money Place Inc
26 North Fulton Avenue

Baltimore,MD21223
56-2306119 		Financial services education MD 501(c)(3) 10 Bon Secours of Maryland Foundation
 
 
No
(77)Frances Schervier Home and Hospital
2975 Independence Avenue

Bronx,NY10463
13-1740397 		Long term nursing care NY 501(c)(3) 10 Bon Secours NY Health System
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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
(1) NWO Integrated Laboratories Mercy LLC

2200 Jefferson Avenue
Toledo,OH43624
34-1898285 		Laboratory services OH NA
  		N/A                
(2) Tiffin Ambulatory Surgical Associates

45 St Lawrence Drive
Tiffin,OH44833
37-1567866 		Ambulatory Surgery Center OH NA
  		N/A                
(3) New Vision Medical Lab LLC

750 W High Street
Lima,OH45801
34-1913433 		Lab Services OH NA
  		N/A                
(4) West Central Ohio Group Ltd

801 Medical Drive
Lima,OH45804
34-1848147 		Orthopedic Hospital OH NA
  		N/A                
(5) West Central Ohio Regional Healthcare Alliance Ltd

2615 Fort Amanda Road
Lima,OH45805
34-1817078 		Healthcare quality OH NA
  		N/A                
(6) Urologic Oncology of Mahoning Valley LLC

1044 Belmont Ave
Youngstown,OH44501
26-2989686 		Radiation Therapy OH NA
  		N/A                
(7) Lourdes Ambulatory Surgery Center

225 Medical Center Drive
Paducah,KY42003
20-5588350 		Surgery Center KY NA
  		N/A                
(8) Marshall County MRI LLC

615 Old Symsonia Road
Benton,KY42025
61-0601267 		MRI facility KY NA
  		N/A                
(9) PREMIUM SURGERY CENTER LLC

5217 Maryland Way
SUITE 200
Brentwood,TN37027
20-0400753 		Surgery Center TN NA
  		N/A                
(10) MERCY HEALTH INNOVATIONS LLC

1701 MERCY HEALTH PLACE
CINCINNATI,OH45237
82-0639499 		BUSINESS DEVELOPMENT OH NA
  		N/A                
(11) MERCY FRANCISCAN AT WINTON WOODS I LP

10290 Mill Road
Cincinnati,OH45231
31-1624311 		Rental Real Estate OH NA
  		N/A                
(12) Bon Secours Place at St Petersburg LLP

10300 Fourth Street North
St Petersburg,FL33716
59-3589729 		Assisted Living/Senior Care FL NA
  		N/A                
(13) Bon Secours Apartments LP

1800 West Baltimore St
Baltimore,MD21223
52-1952505 		Low Income Housing MD NA
  		N/A                
(14) Bon Secours Apartments II LP

1800 West Baltimore St
Baltimore,MD21223
52-2063512 		Low Income Housing MD NA
  		N/A                
(15) Liberty Senior Housing LP

1800 West Baltimore St
Baltimore,MD21223
52-2134447 		Low Income Housing MD NA
  		N/A                
(16) Bon Secours Apartments III LP

1800 West Baltimore St
Baltimore,MD21223
52-2134444 		Low Income Housing MD NA
  		N/A                
(17) Bon Secours Smallwood Summit LP

26 North Fulton Ave
Baltimore,MD21223
52-2280175 		Low Income Housing MD NA
  		N/A                
(18) Bon Secours Chesapeake Apartments LP

26 North Fulton Ave
Baltimore,MD21223
20-0107034 		Low Income Housing MD NA
  		N/A                
(19) Bon Secours Shiloh LP

26 North Fulton Ave
Baltimore,MD21223
20-3965243 		Low Income Housing MD NA
  		N/A                
(20) Bon Secours New Shiloh II Limited Partnership

26 North Fulton Ave
Baltimore,MD21223
82-0655142 		Low Income Housing MD NA
  		N/A                
(21) Bon Secours Wayland LP

26 North Fulton Ave
Baltimore,MD21223
27-0468688 		Low Income Housing MD NA
  		N/A                
(22) Bon Secours Gibbons Apartments LP

26 North Fulton Ave
Baltimore,MD21223
47-2322323 		Low Income Housing MD NA
  		N/A                
(23) Upstate Surgery Center LLC

One St Francis Drive
Greenville,SC29601
56-2186977 		Ambulatory Surgery Center SC NA
  		N/A                
(24) Broad64 Imaging LLC

8580 Magellan Parkway
Richmond,VA23227
20-5886018 		Imaging Services VA NA
  		N/A                
(25) Richmond Radiation Oncology Center I LLC

8580 Magellan Parkway
Richmond,VA23227
20-8444551 		Radiation Oncology Services VA NA
  		N/A                
(26) RI LP

8580 Magellan Parkway
Richmond,VA23227
54-1708835 		Imaging Services VA NA
  		N/A                
(27) Bon Secours Benet House LP

26 North Fulton Ave
Baltimore,MD21223
36-4765400 		Low Income Housing MD NA
  		N/A                
(28) Bon Secours Benet House LLC

26 North Fulton Ave
Baltimore,MD21223
46-3055312 		Low Income Housing MD NA
  		N/A                
(29) Southeastern Health PartnersLLC

One St Francis Drive
Greenville,SC29601
81-3264385 		Coordinated Care SC NA
  		N/A                
(30) Harbour View MOB 2 LLC

5818 Harbour View Blvd Suite A1
Suffolk,VA23435
82-2484997 		Real Estate VA NA
  		N/A                
(31) Bon Secours Diagnostic Imaging LLC

10 S Academy Street Suite 300
Greenville,SC29601
 Outpatient Imaging Centers SC NA
  		N/A                
(32) Memorial Ambulatory Surgery Center LLC

8580 Magellan Parkway
Richmond,VA23227
59-3813233 		Ambulatory Surgery Center VA NA
  		N/A                
(33) Community Mercy Home Care Services of Springfield LLC

1700 Edison Drive
Milford,OH45150
31-1746556 		Home Care OH NA
  		N/A                
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
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) MERCY HEALTH INSURANCE COMPANY (SPC) LTD

 
 
98-0621978 		SELF-INSURANCE CJ NA
  		C Corporation         No
(2) NORTHPARKE MEDICAL COMMONS CONDO ASSN

333 N LIMESTONE ST
SPRINGFIELD,OH45503
31-1391230 		REAL PROPERTY MGMNT OH NA
  		C Corporation         No
(3) NORTHSIDE CORPORATION

2200 JEFFERSON AVENUE
TOLEDO,OH43604
34-1318438 		RESIDENT RENTALS OH NA
  		C Corporation         No
(4) MERCY HEALTH SYSTEM PHO INC

2200 JEFFERSON AVENUE
TOLEDO,OH43604
34-1778321 		MEDICAL SERVICES OH NA
  		C Corporation         No
(5) MCAULEY MANAGEMENT SERVICES INC

730 W MARKET STREET
LIMA,OH45801
34-1379037 		PROPERTY RENTAL OH NA
  		C Corporation         No
(6) LIMA MEDICAL SUPPLIES INC

730 W MARKET STREET
LIMA,OH45801
34-0944477 		MEDICAL EQUIPMENT OH NA
  		C Corporation         No
(7) COMMUNITY HEALTH PARTNERS ENTERPRISES INC

3700 KOLBE ROAD
LORAIN,OH44053
34-1455525 		HOLDING COMPANY OH NA
  		C Corporation         No
(8) MERCY HEALTH VENTURES INC

1701 Mercy Health Place
CINCINNATI,OH45237
31-1185477 		DIVERSIFIED ACTIVITIES OH NA
  		C Corporation         No
(9) MERCY FRANCISCAN AT WINTON WOODS I INC

10290 MILL ROAD
CINCINNATI,OH45231
31-1658668 		LOW-INCOME HOUSING OH NA
  		C Corporation         No
(10) RALPH EWE TRUST

270 PARK AVENUE
NEW YORK,NY10017
34-6866422 		BENEFICIAL TRUST NY NA
  		Trust         No
(11) ELIZABETH HINES CATES TRUST

PNC 1900 E 9TH ST
CLEVELAND,OH44114
34-6515678 		BENEFICIAL TRUST OH NA
  		Trust         No
(12) WILLIS PARK TRUST

PNC 1900 E 9TH ST
CLEVELAND,OH44114
34-6519904 		BENEFICIAL TRUST OH NA
  		Trust         No
(13) ERMA GIBSON BALDWIN TRUST

PNC 1900 E 9TH ST
CLEVELAND,OH44114
34-6515566 		BENEFICIAL TRUST OH NA
  		Trust         No
(14) HEALTHSPAN INC

225 PICTORIA DR
CINCINNATI,OH45246
31-1431434 		INSURANCE OH NA
  		C Corporation         No
(15) HEALTHSPAN SOLUTIONS INC

1701 Mercy Health Place
CINCINNATI,OH45237
30-0810766 		CONSULTING OH NA
  		C Corporation         No
(16) HEALTHCARE SERVICES AND SUPPORT

1701 Mercy Health Place
CINCINNATI,OH45237
81-2388652 		HEALTHCARE SERVICES OH NA
  		C Corporation         No
(17) Bon Secours Assurance Company Ltd

 
 
98-0152147 		SELF-INSURANCE CJ NA
  		C Corporation         No
(18) Bon Secours-Florida Integrated Services Inc

10300 Fourth Street North
St Petersburg,FL33716
65-0779777 		Holding Company/Assisted Living FL NA
  		C Corporation         No
(19) Unity Housing Inc

26 North Fulton Avenue
Baltimore,MD21223
52-1952507 		Low Income Housing MD NA
  		C Corporation         No
(20) Bon Secours Wayland LLC

26 North Fulton Avenue
Baltimore,MD21223
27-0468561 		Low Income Housing MD NA
  		C Corporation         No
(21) Professional Health Care Management Services Inc

150 Kingsley Lane
Norfolk,VA23505
54-1241031 		Administrative VA NA
  		C Corporation         No
(22) OSF Inc

2 Bernadine Drive
Newport News,VA23602
54-1369919 		Rental VA NA
  		C Corporation         No
(23) Bon Secours Tidewater Diversified Inc

160 Kingsley Lane
Norfolk,VA23505
54-1431826 		Pharmacy VA NA
  		C Corporation         No
(24) Chesterfield Community Healthcare Center Inc

8580 Magellan Parkway
Richmond,VA23227
54-1812738 		Ambulatory Healthcare Services VA NA
  		C Corporation         No
(25) Ironbridge Assisted Living Retirement Community LC

5801 Bremo Road
Richmond,VA23226
54-1807857 		Ambulatory Healthcare Services VA NA
  		C Corporation         No
(26) Bon Secours-Virginia Healthsource Inc

8580 Magellan Parkway
Richmond,VA23227
54-1417686 		Ambulatory Healthcare Services VA NA
  		C Corporation         No
(27) RHS Management Corp

8580 Magellan Parkway
Richmond,VA23227
54-1313425 		Independent Living Facility VA NA
  		C Corporation         No
(28) Bon Secours New York Housing Development Fund Corporation

2975 Independence Avenue
Bronx,NY10463
47-2224316 		Low Income Housing NY NA
  		C Corporation         No
(29) Richmond MRI Inc

8580 Magellan Parkway
Richmond,VA23227
54-1568452 		Medical Services VA NA
  		C Corporation         No
(30) Good Help Connections LLC

8990 Old Annapolis Road
Columbia,MD21045
47-2345223 		IT Consulting MD NA
  		C Corporation         No
(31) Bon Secours New Shiloh II LLC

26 North Fulton Avenue
Baltimore,MD21223
82-0631206 		Low Income Housing MD NA
  		C Corporation         No
(32) Maryview Building Corporation

3636 High Street
Portsmouth,VA23707
54-1306612 		Administrative VA NA
  		C Corporation         No
(33) Richmond Radiation Oncology Center Inc

8580 Magellan Parkway
Richmond,VA23227
54-1570244 		Ambulatory Healthcare Services VA NA
  		C Corporation         No
(34) Optimum Health Network Inc

One St Francis Drive
Greenville,SC29601
57-0973524 		Healthcare Services SC NA
  		C Corporation         No
(35) Barringtons Hospital Limited

 
 
Healthcare Services EI NA
  		C Corporation         No
(36) BMC Properties Limited

 
 
REAL PROPERTY MGMNT EI NA
  		C Corporation         No
(37) Post Office Plaza Owners Association Inc

1807 N Boulevard
Anderson,SC29621
 REAL PROPERTY MGMNT SC NA
  		C Corporation         No
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
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, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved





Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(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 Yes No






























Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2018

Additional Data


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