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.
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OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
Bon Secours - Richmond Health System
Inc
Employer identification number

52-1988421
Return Reference Explanation
Form 990, Part VI, Section A, line 6 Bon Secours Mercy Health, Inc. is the sole member of Bon Secours Richmond, LLC a single member limited liability company. Bon Secours Richmond, LLC 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.
Form 990, Part VI, Section A, line 7a The governing body of Bon Secours-Richmond Health System is appointed by the Class B Member, Bon Secours Richmond, LLC, subject to the approval of Bon Secours Mercy Health, Inc.
Form 990, Part VI, Section A, line 7b Certain authorities of Bon Secours-Richmond Health System are reserved to its member or to Bon Secours Mercy Health, Inc.
Form 990, Part VI, Section B, line 11b The Form 990 is prepared by BSMH's tax department and reviewed by management. Upon review, the Form 990 is then forwarded to the local system's independent Audit and Compliance Committee for review and approval. Once the Form 990 is reviewed by all applicable parties a copy of the final version is provided to all members of the governing body prior to filing.
Form 990, Part VI, Section B, line 12c 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, Section B, line 15b 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 the BSMH. The compensation committee consists of a group of independent board members and engages independent external compensation consultant to ensure they receive appropriate analysis of market and follow the practices necessary to obtain full compliance with the IRS' 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 in human resources.
Form 990, Part VI, Section C, line 19 The filing organization makes all documents available to the general public upon request.
Form 990, Part VII - Additional Disclosure: Board Member positions are generally voluntary in nature. Compensated employees of the filing organization and other related organizations who also hold board positions are compensated only in relation to their employment and do not receive additional compensation for their board responsibilities. Sr. Anne Marie Mack, Sr. Rose Marie Jasinski, and Sr. Victoria Segura do not receive payroll distributions as they have taken a vow of poverty.
Form 990, Part IX, line 11g Purchased Services - Intercompany: Program service expenses 7,020. Management and general expenses 780. Fundraising expenses 0. Total expenses 7,800. Physician Fees: Program service expenses 47,365. Management and general expenses 0. Fundraising expenses 0. Total expenses 47,365. Billing and Collections: Program service expenses 212,399. Management and general expenses 23,600. Fundraising expenses 0. Total expenses 235,999. Other Purchased Services: Program service expenses 1,126,732. Management and general expenses 125,192. Fundraising expenses 0. Total expenses 1,251,924. Maintenance and Service Agreements: Program service expenses 275,785. Management and general expenses 30,643. Fundraising expenses 0. Total expenses 306,428. Consulting: Program service expenses 1,363,638. Management and general expenses 151,515. Fundraising expenses 0. Total expenses 1,515,153. Contracted Nursing and Ancillary Tech Staff: Program service expenses 276,319. Management and general expenses 0. Fundraising expenses 0. Total expenses 276,319. Security: Program service expenses 1,020. Management and general expenses 114. Fundraising expenses 0. Total expenses 1,134. BSMH Corporate Dues: Program service expenses 1,323,056. Management and general expenses 147,006. Fundraising expenses 0. Total expenses 1,470,062.
Form 990, Part XI, line 9: Capitalization of Rappahannock General Hospital Foundation, Inc. debt -1,133,333.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2017


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