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

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
ST VINCENT MERCY MEDICAL CENTER
 
Doing Business As
MERCY ST VINCENT MEDICAL CENTER
 
Number and street (or P.O. box if mail is not delivered to street address)
2213 Cherry Street
 
Room/suite
City or town, state or country, and ZIP + 4
Toledo, OH43608
D Employer identification number

34-4428250
E Telephone number

G Gross receipts $ 483,718,747
F Name and address of principal officer:
IMRAN ANDRABI MD CEO
2213 CHERRY STREET
TOLEDO,OH43608
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MERCYWEB.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:
 
L Year of formation: 1855
M State of legal domicile: OH
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE PRIMARY EXEMPT PURPOSE OF ST. VINCENT MERCY MEDICAL CENTER IS TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. ST. VINCENT MERCY MEDICAL CENTER ACCOMPLISHES THIS PURPOSE BY DEMONSTRATING BEHAVIORS REFLECTING OUR CORE VALUES OF COMPASSION, EXCELLENCE, HUMAN DIGNITY, JUSTICE, SACREDNESS OF LIFE, AND SERVICE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 20
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 17
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 4,394
6 Total number of volunteers (estimate if necessary) .... 6 453
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 968,678
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b -421,062
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 206,532 406,029
9 Program service revenue (Part VIII, line 2g) ......... 461,035,827 467,609,430
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 4,419,305 7,921,186
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 4,297,559 3,930,505
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 469,959,223 479,867,150
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 193,634,377 194,309,767
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 256,920,578 253,009,493
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 450,554,955 447,319,260
19 Revenue less expenses. Subtract line 18 from line 12...... 19,404,268 32,547,890
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 474,195,148 486,070,033
21 Total liabilities (Part X, line 26)............ 165,524,863 142,493,337
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 308,670,285 343,576,696
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: ST. VINCENT MERCY MEDICAL CENTER HAS BEEN INCORPORATED AS A ROMAN CATHOLIC HEALTH ORGANIZATION FOR THE PURPOSES SET FORTH IN ITS ARTICLES OF INCORPORATION. IN FURTHERANCE OF THESE PURPOSES IT IS CONTEMPLATED THAT THE CORPORATION WILL PROVIDE ASSISTANCE, SUPPORT AND DIRECTION TO ALL OF THE HEALTH CARE INSTITUTIONS AND ACTIVITIES OPERATED AND MAINTAINED BY SUBSIDIAIRIES. THE MISSION OF THE CORPORATION IN PERFORMING THESE ACTIVITIES SHALL BE TO PROVIDE A MEANS BY WHICH THE SPONSORS MANIFEST THE HEALING MINISTRY OF JESUS. THROUGH GOVERNANCE, MANAGEMENT, DEVELOPMENT OF LEADERSHIP AND USE OF RESOURCES THE CORPORATION INTENDS TO GIVE SUBSTANCE AND DIRECTION TO A DYNAMIC CATHOLIC HEALTH MININSTRY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 368,477,484 including grants of $   ) (Revenue $ 434,673,681 )
THE PRIMARY EXEMPT PURPOSE OF ST. VINCENT MERCY MEDICAL CENTER IS TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. ST. VINCENT MERCY MEDICAL CENTER ACCOMPLISHES THIS PURPOSE BY DEMONSTRATING BEHAVIORS REFLECTING OUR CORE VALUES OF COMPASSION, EXCELLENCE, HUMAN DIGNITY, JUSTICE, SACREDNESS OF LIFE AND SERVICE. NET CHARITY CARE PROVIDED WAS $10,167,688 SERVING 9,688 INDIVIDUALS.
4b (Code:   ) (Expenses $ 10,603,689 including grants of $   ) (Revenue $ 21,765,815 )
EDUCATION AND TRAINING PROVIDED TO ALLOPATHIC PHYSICIANS, OSTEOPATHIC PHYSICIANS, NURSING STUDENTS, PROFESSIONAL AND TECHNICAL STUDENTS SERVING 10,465 INDIVIDUALS.
4c (Code:   ) (Expenses $ 9,176,869 including grants of $   ) (Revenue $ 11,169,934 )
PRIMARY CARE AND SPECIALTY CLINICS FOR THE UNINSURED, MEDICAID, AND UNDERINSURED. THE CLINICS ARE LOCATED IN THE NEIGHBORHOODS NEAR THE HOSPITAL. 84,937 INDIVIDUALS WERE SERVED DURING 2010.
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 388,258,042
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part 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; 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 term, permanent,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, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.
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 X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
No
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II...........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III...............
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2...........
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 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
0
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
 
 
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
4,394
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,” 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 or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
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 and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
20
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
17
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
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
MINDY WARD
2200 Jefferson Avenue
TOLEDO,OH43604
(419) 251-8936
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) ANTHONY J ARMSTRONG MD
TRUSTEE
 1 X           328,585 0 30,479
(2) JUDGE VERNELIS K ARMSTRONG
TRUSTEE
 1 X           0 0 0
(3) WILLIAM F BUCKLEY
TRUSTEE
 1 X           0 0 0
(4) SR MILDRED ELY HM
TRUSTEE
 1 X           0 0 0
(5) KAREN L FRAKER
SECRETARY
 5 X   X       0 0 0
(6) CHARLES E GALLAGHER
VICE CHAIRMAN
 5 X   X       0 0 0
(7) ROOSEVELT GANT
TRUSTEE
 1 X           0 0 0
(8) TIMOTHY M GLADIEUX
TRUSTEE
 1 X           0 0 0
(9) JOHN H HARRIS
TRUSTEE
 1 X           0 0 0
(10) DENISE M HASBROOK
TRUSTEE
 1 X           0 0 0
(11) WILLARD P HEDDLES
TRUSTEE
 1 X           0 0 0
(12) PAMELA HOWELL-BEACH
TRUSTEE
 1 X           0 0 0
(13) DENNIS G JOHNSON
CHAIRMAN
 5 X   X       0 0 0
(14) CHERREFE A KADRI ESQ
TRUSTEE
 1 X           0 0 0
(15) MICHAEL P KILLIAN
TRUSTEE
 1 X           0 0 0
(16) GEOFFREY G MEYERS
TREASURER
 5 X   X       0 0 0
(17) CATHLEEN NELSON
SERVICE LINE ADMINISTRATOR
 30       X     248,374 0 37,143
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) RANDALL HERMANN
SERVICE LINE ADMINISTRATOR
 55       X     209,601 0 39,304
(19) STEVEN L MICKUS
SVP, DIVISIONAL CEO, CHP COO
 5 X   X       0 1,473,700 289,519
(20) ANDREA PRICE
COO, MERCY HEALTH PARTNERS
 1       X     0 513,285 67,883
(21) SAMANTHA PLATZKE
SVP & DIVISIONAL CFO
 5     X       0 488,468 72,045
(22) TODD WARNER
CFO, NORTHERN REGION
 5     X       0 245,889 47,441
(23) H TERRENCE SMITH
SVP, GENERAL COUNSEL & PRES. MPE
 1       X     0 423,376 73,365
(24) GARY GEORGE
SVP HUMAN RESOURCES
 1       X     0 328,401 49,863
(25) DENNIS SHERRY
SVP OFFICE OF STRATEGY MGMT
 1       X     0 312,485 56,828
(26) CAROL WHITTAKER
REGIONAL CNO, MHP
 1       X     0 382,640 96,689
(27) JOSEPH GLASS
REG VP REV CYCLE & MANAGED CARE
 1       X     0 254,767 44,663
(28) BARBARA DIANDA-MARTIN
CNO, SVMMC
 1       X     0 236,865 49,894
(29) IMRAN ANDRABI MD
PRESIDENT & CEO SVMMC
 1       X     0 512,238 68,627
(30) JOHN SCHAEUFELE MD
PRESIDENT & CEO, MSVCH
 1       X     0 295,938 51,973
(31) ERICH R PONTASCH MD
TRUSTEE
 1 X           0 22,917 0
(32) SUDHAKAR PANGULUR MD
TRUSTEE
 1 X           0 118,167 0
(33) DAVID AROSE
INTERIM CIO
 1       X     0 250,369 29,949
(34) SCOTT SHOOK
SVP STRATEGIC INITIATIVES
 1       X     0 772,534 227,338
(35) S MARK ELLIS
VP OPERATIONS & TRANSFORMATION
 1       X     0 262,089 51,667
(36) WILLIAM SUTTON
VP OPERATIONS
 1       X     0 280,555 68,857
(37) SRIRAM PERNI MD
PHYSICIAN
 55         X   747,190 0 35,043
(38) CLAUDEL JEAN-PIERRE MD
PHYSICIAN
 55         X   639,051 0 38,173
(39) MALINI NARAYANAN MD
PHYSICIAN
 55         X   549,642 0 24,415
(40) DAVID FRANZBLAU MD
FORMER KEY EMPLOYEE
 0           X 0 473,739 75,769
(41) VIJAY M ADAPPA MD
TRUSTEE
 1 X           0 0 0
(42) CAROL BINTZ
TRUSTEE
 1 X           0 0 0
(43) RALPH A THAN
TRUSTEE
 1 X           0 0 0
(44) JULIE GEORGOFF
SERVICE LINE ADMINISTRATOR
 55       X     160,516 0 26,235
(45) BARRY HUDGIN
VP & GENERAL COUNSEL
 1       X     0 224,417 36,550
(46) FAYYAZ HASHMI MD
PHYSICIAN
 55         X   794,476 0 44,373
(47) JIM BURDINE MD
PHYSICIAN
 55         X   619,815 0 41,922
(48) RICHARD GRAY
FORMER KEY EMPLOYEE
 0           X 109,954 0 14,378
(49) SCOTT WILLIAMS
FORMER KEY EMPLOYEE
 0           X 0 233,600 37,052
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 4,407,204 8,106,439 1,827,437
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet142
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet0
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 406,029
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 406,029
Program Service Revenue Business Code
2a NET PATIENT SERVICE REVENUE 621,990 466,683,561 466,683,561    
b INCOME FROM JV'S 900,099 925,869 872,008 53,861  
c
d
e
f All other program service revenue . 0 0 0 0
g Total. Add lines 2a–2f........MediumBullet 467,609,430
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 11,772,783     11,772,783
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross Rents 478,900  
b Less: rental expenses    
c Rental income or (loss) 478,900 0
d Net rental income or (loss).......MediumBullet 478,900     478,900
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses   3,851,597
c Gain or (loss) 0 -3,851,597
d Net gain or (loss)..........MediumBullet -3,851,597     -3,851,597
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 0    
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 0      
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 0      
Miscellaneous Revenue Business Code
11a FOOD SERVICE 722,210 1,940,993     1,940,993
b PHARMACY 446,110 894,759   894,759  
c CENTER FOR HEALTH PROMOTION 713,940 20,058   20,058  
d All other revenue .... 595,795 0 0 595,795
e Total. Add lines 11a–11d ......MediumBullet 3,451,605
12 Total revenue. See Instructions....MediumBullet 479,867,150 467,555,569 968,678 10,936,874
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 0  
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 721,173 626,844 94,329  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 152,536,546 132,585,628 19,950,918  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 7,322,824 6,370,291 952,533  
9 Other employee benefits ....... 24,090,781 20,957,117 3,133,664  
10 Payroll taxes ........... 9,638,443 8,384,700 1,253,743  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 0      
c Accounting ........... 0      
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 0      
g Other .......... 93,449,847 81,569,211 11,880,636  
12 Advertising and promotion .... 95,896 80,738 15,158  
13 Office expenses ....... 93,383,714 84,692,617 8,691,097  
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 5,415,231 256,615 5,158,616  
17 Travel ............ 559,394 485,614 73,780  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 16,624 16,624    
20 Interest ........... 5,964,587 4,771,670 1,192,917  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 24,015,007 19,212,006 4,803,001  
23 Insurance .............. 4,101,593 3,280,509 821,084  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a BAD DEBT 19,279,071 19,279,071    
b MEMBERSHIP DUES 874,259 269,940 604,319  
c TUITION 502,952 502,952    
d MEDICAID ASSESSMENT 4,795,267 4,795,267    
e SUBSCRIPTIONS 311,187 64,482 246,705  
f All other expenses 244,864 56,146 188,718 0
25 Total functional expenses. Add lines 1 through 24f 447,319,260 388,258,042 59,061,218 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		0      
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 15,425,742 1 9,923,061
2 Savings and temporary cash investments ....... 4,774,329 2 4,123,580
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 84,255,534 4 88,873,509
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 8,477,099 8 9,064,657
9 Prepaid expenses and deferred charges ............ 3,677,953 9 4,512,331
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 525,349,775
b Less: accumulated depreciation. ..... 10b 350,014,609 198,564,016 10c 175,335,166
11 Investments—publicly traded securities .......... 136,504,348 11 172,127,586
12 Investments—other securities. See Part IV, line 11 ......   12 0
13 Investments—program-related. See Part IV, line 11 ..   13 0
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 22,516,127 15 22,110,143
16 Total assets. Add lines 1 through 15 (must equal line 34)... 474,195,148 16 486,070,033
Liabilities 17 Accounts payable and accrued expenses . 33,870,817 17 15,707,615
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 131,654,046 25 126,785,722
26 Total liabilities. Add lines 17 through 25..... 165,524,863 26 142,493,337
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 308,670,285 27 343,576,696
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 308,670,285 33 343,576,696
34 Total liabilities and net assets/fund balances ..... 474,195,148 34 486,070,033
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
479,867,150
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
447,319,260
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
32,547,890
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
308,670,285
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
2,358,521
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
343,576,696
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
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 (2010)
Additional Data


Software ID: 10000128
Software Version: v2010.1.0
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

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

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

34-4428250
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

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

Additional Data


Software ID: 10000128
Software Version: v2010.1.0
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
ST VINCENT MERCY MEDICAL CENTER
 
Employer identification number

34-4428250
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
ST VINCENT MERCY MEDICAL CENTER
  		Employer identification number

34-4428250
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
ST VINCENT MERCY MEDICAL CENTER
  		Employer identification number

34-4428250
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
ST VINCENT MERCY MEDICAL CENTER
  		Employer identification number

34-4428250
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID: 10000128
Software Version: v2010.1.0
SCHEDULE C
(Form 990 or 990-EZ)

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

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

34-4428250
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

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

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

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

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










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

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

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


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
Yes
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
Yes
 
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
5,475
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
 
No
 
j
Total. lines 1c through 1i ...................................
5,475
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
0
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
LOBBYNG ACTIVITIES SCHEDULE C, PART II-B, LINE 1F LOBBYING ACTIVITIES PERFORMED INCLUDE BOTH THE USE OF VOLUNTEERS ENCOURAGED TO WRITE LETTERS TO PUBLIC OFFICIALS ON ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE TO PROVIDE HEALTH SERVICES TO THE COMMUNITIES SERVED, AND THE USE OF PAID STAFF MEMBERS AND MANAGEMENT PERSONNEL. PAID MANAGEMENT PERSONNEL REGULARLY ISSUE MAILINGS TO LEGISLATORS ATTEMPTING TO INFLUENCE LEGISLATIVE MATTERS AND REFERENDUM, AND ORGANIZE AND HOST MEETINGS AMONG HOSPITAL EXECUTIVES AND THEIR LEGISLATORS REGARDING ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE PROVIDING HEALTHCARE SERVICES TO ITS PATIENTS AND TO CONTINUE IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. PAID STAFF MEMBERS HAVE, ON LIMITED OCCASIONS, WRITTEN TO LEGISLATORS ON SUCH ISSUES. THE PRIMARY PURPOSE FOR LOBBYING ACTIVITIES IS TO ENHANCE THE ORGANIZATION'S PUBLIC POSITION ON LEGISLATIVE AND REGULATORY ISSUES THAT IMPACT PATIENT CARE THROUGHOUT OUR SYSTEM. THE ORGANIZATION FOCUSES ON PUBLIC POLICY ISSUES THAT EXTEND OUR HEALING MINISTRY TO THOSE WHO ARE POOR AND UNDERSERVED IN THE COMMUNITIES WE SERVE. TO CARRY OUT THESE EFFORTS, THE ORGANIZATION PARTNERS WITH EXPERT CONSULTANTS AND PROFESSIONAL TRADE ASSOCIATIONS TO BUILD AWARENESS AND EXECUTE SPECIFIC STRATEGIES THAT WILL YIELD A FAVORABLE OUTCOME FOR PATIENT CARE IN THE ORGANIZATION'S FACILITIES WHERE THEY ARE TREATED.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID: 10000128
Software Version: v2010.1.0

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

34-4428250
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

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

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   7,448,787 7,448,787
b Buildings ................   327,330,021 189,361,221 137,968,800
c Leasehold improvements ............   1,375,087 1,375,087 0
d Equipment ................   178,247,233 151,911,114 26,336,119
e Other .................   10,948,647 7,367,187 3,581,460
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 175,335,166
Schedule D (Form 990) 2010

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








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








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








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes 0
RESTRUCTURING COSTS 973,673
ACCRUED RETIREMENT BENEFITS 6,033,664
ACCRUED PENSION 10,365,884
NOTE PAYABLE TO AFFILIATE 103,157,787
OTHER 6,254,714




Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 126,785,722
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 479,867,150
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 447,319,260
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 32,547,890
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 0
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 0
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 32,547,890
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d 0
e Add lines 2a through 2d ..................... 2e 0
3 Subtract line 2e from line 1..................... 3 0
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b 0
c Add lines 4a and 4b....................... 4c 0
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 0
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d 0
e Add lines 2a through 2d...................... 2e 0
3 Subtract line 2e from line 1..................... 3 0
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b 0
c Add lines 4a and 4b....................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 0
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 CATHOLIC HEALTH PARTNERS AND AFFILIATED ENTITIES COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AT DECEMBER 31, 2010 AND 2009, AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT DECEMBER 31, 2010 OR 2009.
Schedule D (Form 990) 2010

Additional Data


Software ID: 10000128
Software Version: v2010.1.0




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

34-4428250
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		  9,688 20,858,557 10,690,869 10,167,688 2.380 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		  25,467 100,524,664 97,086,006 3,438,658 0.800 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....     0 0 0 0 %
dTotal Charity Care and
Means-Tested Government Programs ..... 		0 35,155 121,383,221 107,776,875 13,606,346 3.180 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		  76,578 3,382,507 315,924 3,066,583 0.720 %
f Health professions education
(from Worksheet 5) .. 		  10,465 32,369,504 21,765,815 10,603,689 2.480 %
g Subsidized health services
(from Worksheet 6) .. 		  85,166 22,234,267 11,169,934 11,064,333 2.580 %
h Research (from Worksheet 7)     2,561   2,561 0 %
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		  1,789 1,242,127 9,892 1,232,235 0.290 %
jTotal Other Benefits ... 0 173,998 59,230,966 33,261,565 25,969,401 6.070 %
kTotal. Add lines 7d and 7j. .. 0 209,153 180,614,187 141,038,440 39,575,747 9.250 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing         0 0 %
2 Economic development   664 70,296   70,296 0.020 %
3 Community support   23,786 466,550   466,550 0.100 %
4 Environmental improvements         0 0 %
5 Leadership development and training for community members         0 0 %
6 Coalition building   122 65,442   65,442 0.010 %
7 Community health improvement advocacy   3,400 25,879   25,879 0.010 %
8 Workforce development   6 358   358 0 %
9 Other         0 0 %
10 Total 0 27,978 628,525 0 628,525 0.140 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense (at cost).....
2
4,618,163
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
756,669
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
105,002,491
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
107,907,478
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-2,904,987
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1CARDIOVASCULAR PHYSICIANS-MHP LLC
  		OUTPATIENT CARDIAC CATHERIZATION LAB 49 % 0 % 51 %
2MOBILE CARDIAC IMAGING
  		OWNS AND OPERATES A MOBILE NUCLEAR MEDICINE BUSINESS 50 % 0 % 50 %
3MERCY HOSPITAL OF DEFIANCE LLC
  		HOSPITAL 50 % 0 % 50 %
4TOLEDO COMMUNITY LITHOTRIPTER
  		PROVIDES EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY SERVICES 18.6 % 0 % 20 %
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?3
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 ST VINCENT MERCY CHILDREN'S HOSPITAL
2222 CHERRY STREET
TOLEDO,OH43608 		    X            
2 ST VINCENT MEDICAL CENTER
2213 CHERRY STREET
TOLEDO,OH43608 		X X   X     X    
3 MERCY HOSPITAL OF DEFIANCE LLC
1404 E SECOND ST
DEFIANCE,OH43512 		X X              
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

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

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

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

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

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?32
Name and address Type of Facility (Describe)
1 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
2 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
3 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
4 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
5 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
6 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
7 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
8 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
9 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
10 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
11 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
12 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
13 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
14 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
15 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
16 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
17 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
18 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
19 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
20 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
21 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
22 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
23 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
24 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
25 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
26 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
27 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
28 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
29 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
30 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
31 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
32 MERCY PHYSICAL THERAPY
4546 N SUMMIT ST
TOLEDO,OH43611 		PHYSICAL THERAPY CENTER
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
Community benefit report prepared by related organization Schedule H, Part I, Line 6a MERCY HEALTH PARTNERS
Subsidized Health Services Schedule H, Part I, Line 7g $20,574,258 OF COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WAS INCLUDED AS SUBSIDIZED HEALTH SERVICES
Bad Debt Expense excluded from financial assistance calculation Schedule H, Part I, Line 7, column(f) 19,279,071
Costing Methodology used to calculate financial assistance Schedule H, Part I, Line 7 COST OF CHARITY CARE WAS CALCULATED WITH A COST TO CHARGE RATIO USING WORKSHEET 2. THE COST RELATED TO MEDICAID PATIENTS WAS ALSO DETERMINED USING THE COST TO CHARGE RATIO USING WORKSHEET 2 AND INCLUDED BOTH INPATIENTS AND OUTPATIENTS FOR TRADITIONAL MEDICAID AND MEDICAID MANAGED CARE PLANS. FOR SUBSIDIZED SERVICES THE HOSPITAL'S COST ACCOUNTING SYSTEM IS USED TO DETERMINE COST RELATED TO THE SPECIFIC SERVICE FOR COMMERCIAL PATIENTS ONLY. COSTS FOR OTHER PROGRAMS REFLECT THE DIRECT AND INDIRECT COSTS OF PROVIDING THOSE PROGRAMS.
Bad debt expense - financial statement footnote Schedule H, Part III, Line 4 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. BAD DEBT IS CLASSIFIED AS AN OPERATING EXPENSE. THIS TREATMENT IS CONSISTENT WITH THE HFMA PRINCIPLES AND PRACTICES BOARD STATEMENT NO. 15 AND WITH THE AICPA AUDIT AND ACCOUNTING GUIDE FOR HEALTH CARE ORGANIZATIONS. AN AGGREGATE COST TO CHARGE RATIO WAS USED TO PROVIDE BAD DEBT AT COST FOR PART III, LINE 2. REMAINING BALANCES FOR PATIENTS THAT WE KNOW ARE ELIGIBLE FOR CHARITY CARE ARE WRITTEN OFF TO CHARITY CARE. PATIENTS WHO MIGHT BE ELIGIBLE FOR CHARITY CARE BUT ARE UNKNOWN TO US ARE WRITTEN OFF TO BAD DEBT AND THEREFORE NOT INCLUDED IN CHARITY CARE. THE ESTIMATED AMOUNT OF THE HOSPITAL'S BAD DEBT EXPENSE (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S CHARITY CARE POLICY REPORTED ON PART III, LINE 3 WAS DETERMINED AS FOLLOWS: REVIEWED DOLLAR AMOUNTS FOR TOTAL REFERRED FOR ASSISTANCE, APPROVED FOR ASSISTANCE AND APPLICATIONS DENIED BECAUSE OF INCOMPLETE INFORMATION; DEVELOPED THE PERCENTAGE OF APPROVED APPLICATIONS TO COMPLETED APPLICATIONS AND THEN APPLIED PERCENTAGE TO THOSE APPLICATIONS THAT WERE INCOMPLETE. THIS PROVIDED AN ESTIMATED AMOUNT OF THOSE APPLICATIONS THAT WERE INCOMPLETE THAT WOULD HAVE QUALIFIED FOR ASSISTANCE IF THE APPLICATION HAS BEEN COMPLETED. THE DOLLAR AMOUNT OF CHARITY CARE ACTUALLY WRITTEN OFF REPRESENTS THOSE THAT WERE APPROVED. TO CALCULATE THE FULL ESTIMATED AMOUNT OF CHARITY CARE, A CALCULATION WAS DONE TO DETERMINE WHAT 100% OF CHARITY WOULD BE FOR THE TOTAL OF THE APPROVED APPLICATIONS AND THE ESTIMATED AMOUNT FOR THOSE APPLICATIONS THAT WERE INCOMPLETE BUT WOULD HAVE BEEN APPROVED IF COMPLETED. THE DIFFERENCE BETWEEN THIS ESTIMATED TOTAL AMOUNT AND THE ACTUAL WRITE-OFF AMOUNT FOR CHARITY CARE WAS THEN APPLIED TO THE RATIO COST-OF-CHARGES USED FOR CHARITY CARE AT COST.
Community benefit & methodology for determining medicare costs Schedule H, Part III, Line 8 MEDICARE SHORTFALL IS NOT TREATED AS A COMMUNITY BENEFIT. THE AMOUNTS ON PART III, LINE 6 WERE GENERATED BY THE MEDICARE COST REPORT WHICH UTILIZES A DEPARTMENT COST TO CHARGE METHODOLOGY.
Collection practices for patients eligible for financial assistance Schedule H, Part III, Line 9b PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE NOT SENT TO A COLLECTION AGENCY. THE ORGANIZATION REPEATEDLY OFFERS PATIENTS ACCESS TO FINANCIAL HELP DURING THEIR HOSPITAL STAY AND AFTER, AS WELL AS WITH EACH BILLING NOTICE. BILLS ARE SENT TO A COLLECTION AGENCY AS A LAST RESORT AND ONLY: WHEN PATIENTS HAVE THE ABILITY TO PAY SOME PORTION OF THEIR HEALTHCARE EXPENSES BUT REFUSE TO DO SO; WHEN PATIENTS REFUSE TO WORK WITH THE ORGANIZATION TO DETERMINE IF THEY QUALIFY FOR FREE OR DISCOUNTED CARE VIA FEDERAL, STATE, LOCAL OR HOSPITAL ASSISTANCE PROGRAMS; WHEN THE ORGANIZATION IS UNABLE TO LOCATE THE PATIENT OR PERSON RESPONSIBLE FOR THE BILL.
Needs assessment. Schedule H, Part VI, Line 2 MERCY ST. VINCENT MEDICAL CENTER ASSESSES AND CONTINUALLY RESPONDS TO CHANGING COMMUNITY NEEDS THROUGH THE SERVICES OFFERED. MERCY ST. VINCENT MEDICAL CENTER JOINS AN EXISTING COMMUNITY BASED NEEDS ASSESSMENT EVERY THREE YEARS AND UPDATES ARE PROVIDED BETWEEN ASSESSMENTS. MERCY ST. VINCENT MEDICAL CENTER INCORPORATES PLANNING FOR COMMUNITY BENEFITS AS PART OF ITS ANNUAL BUSINESS AND STRATEGIC PLANNING PROCESSES. MERCY ST. VINCENT RECOGNIZES 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. MERCY ST. VINCENT HAS A DEDICATED STAFF TO ASSIST IN THE COMMUNITY BENEFIT EFFORT. MERCY ST. VINCENT'S COMMUNITY BENEFITS COMMITTEE MEETS QUARTERLY TO PROVIDE OVERSIGHT TO THE ORGANIZATION'S COMMUNITY BENEFITS PROGRAM. MERCY ST. VINCENT MEDICAL CENTER WORKS CLOSELY WITH HEALTH AND HUMAN SERVICE ORGANIZATIONS IN THE AREA, PARTNERING WITH SOME TO PROVIDE SERVICES AND TO AVOID DUPLICATION.
Patient education of eligibility for assistance. Schedule H, Part VI, Line 3 MERCY ST VINCENT MEDICAL CENTER POSTS ITS CHARITY CARE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSIONS AREAS, EMERGENCY DEPARTMENTS AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. THE HOSPITAL PROVIDES A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO PATIENTS AS PART OF THE INTAKE PROCESS AND WITH DISCHARGE MATERIALS. ADDITIONALLY, A COPY OF THE POLICY OR A SUMMARY ALONG WITH FINANCIAL ASSISTANCE CONTACT INFORMATION IS INCLUDED IN PATIENT BILLS. THE HOSPITAL DISCUSSES WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSISTS THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. THE HOSPITAL ELIGIBILITY LINK PROGRAM (HELP) IS A FREE REFERRAL SERVICE PROVIDED BY THE HOSPITAL. THE PURPOSE OF HELP IS TO ASSIST PATIENTS IN OBTAINING MEDICAL BENEFITS THROUGH FEDERAL, STATE, AND HOSPITAL PROGRAMS. HELP REPRESENTATIVES WILL PROVIDE THE FOLLOWING SERVICES AT NO COST TO THE PATIENT: * EXPLORE ELIGIBILITY UNDER PUBLIC ASSISTANCE PROGRAMS * FILE APPLICATIONS ON PATIENT'S BEHALF * SCHEDULE AND ATTEND APPOINTMENTS * PROVIDE TRANSPORTATION WHEN NECESSARY * PROVIDE MEDICAL DOCUMENTATION TO SOCIAL SECURITY ADMINISTRATION FOR DISABILITY CLAIMS. THROUGH HELP, PATIENTS AND THEIR COUNSELORS LOOK AT WHAT OPTIONS ARE AVAILABLE. THE HOSPITAL UNDERSTANDS THAT NOT EVERYONE CAN PAY FOR HEALTHCARE SERVICES. HELP IS HERE TO OFFER OPTIONS AND ASSISTANCE FOR THOSE WHO ARE UNINSURED OR UNDERINSURED. HELP IS AN EXTENSION OF THE HOSPITAL'S MISSION TO IMPROVE THE HEALTH OF OUR COMMUNITY WITH EMPHASIS ON THE POOR AND UNDERSERVED. MEETING THE NEEDS OF THOSE WITH LIMITED RESOURCES HAS BEEN THE HEART OF OUR MISSION. IN 2010, HELP MANAGED 28,761 PATIENT REFERRALS. MERCY ST VINCENT MEDICAL CENTER IS PROUD TO MAKE OUR FINANCIAL ASSISTANCE INFORMATION AVAILABLE TO THE PUBLIC THROUGH OUR WEBSITE, WHICH CAN BE FOUND AT MERCYWEB.ORG.
Community information. Schedule H, Part VI, Line 4 MERCY ST VINCENT MEDICAL CENTER SERVES A 20 COUNTY GEOGRAPHIC AREA FEATURING THE FOLLOWING COUNTIES: ALLEN, DEFIANCE, ERIE, FULTON, HANCOCK, HENRY, HURON, LUCAS, OTTAWA, PAULDING, PUTNAM, SANDUSKY, SENECA, VAN WERT, WILLIAMS, WOOD, AND WYANDOT IN OHIO, AND HILLSDALE, LENAWEE, AND MONROE COUNTIES IN MICHIGAN. THE POPULATION OF MERCY ST VINCENT MEDICAL CENTER'S PRIMARY SERVICE AREA IS APPROXIMATELY 750,000 AND IS OLDER, POORER AND HAS WORSE HEALTH STATISTICS THAN STATE AND NATIONAL AVERAGES. OUR COMMUNITY IS CHANGING AND WE ALSO SERVE A GROWING UNINSURED AND UNDERINSURED POPULATION. THERE ARE 8 HOSPITALS IN THE COMMUNITY OF WHICH SEVEN ARE NOT-FOR-PROFIT HOSPITALS. NONE HAVE BEEN FEDERALLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA OR POPULATION. THE DEMOGRAPHIC AREA SERVED BY MERCY ST VINCENT MEDICAL CENTER SERVES THE FOLLOWING ETHNIC AND CULTURAL GROUPS: CAUCASIAN (70.6%), BLACK (17.7%), HISPANIC (5.1%), ASIAN (1.3%), AMERICAN-INDIAN (0.1%), SOME OTHER RACE (2.8%), TWO OR MORE RACES (2.4%). 12% OF RESIDENTS ARE IN HOUSEHOLDS BELOW THE FEDERAL POVERTY GUIDELINES. 20% OF FAMILIES ARE ON MEDICAID OR OTHER ASSISTANCE. IN THE COMMUNITY SERVED BY MERCY ST VINCENT MEDICAL CENTER HEART DISEASE, STROKE, AND CANCER ARE THE MAJOR HEALTH PROBLEMS AND/OR LEADING CAUSES OF DEATH. EACH OF THESE ARE PREVENTABLE THROUGH PROPER CARE AND MAINTAINING CONTROL OF THE ILLNESS/DISEASE AS WELL AS LEADING HEALTHIER LIVES. THE SMOKING RATE IS 23% OF THE ADULT POPULATION. MERCY ST VINCENT MEDICAL CENTER WORKS CLOSELY WITH LOCAL COMMUNITY AGENCIES AND HEALTH DEPARTMENTS TO ADDRESS THESE PROBLEMS AND MINIMIZE THE EFFECTS ON THOSE WHO SUFFER. IN 2010, MERCY ST VINCENT MEDICAL CENTER HAD 20,444 ADMISSIONS, 199,423 OUTPATIENT VISITS, AND 62,867 EMERGENCY ROOM VISITS.
Promotion of community health Schedule H, Part VI, Line 5 MERCY ST VINCENT MEDICAL CENTER OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO PROVIDING EMERGENCY SERVICES, THE HOSPITAL ALSO PROVIDES MINOR EMERGENCY AND URGENT CARE SERVICES TO ALL REGARDLESS OF ABILITY TO PAY. THE HOSPITAL OPERATES PSYCHIATRIC, SKILLED NURSING, NEONATAL ICU, RENAL DIALYSIS, NEWBORN NURSERY, WOUND CARE, AND DIABETES MANAGEMENT DEPARTMENTS . MERCY ST VINCENT MEDICAL CENTER HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA (WITH CERTAIN LIMITED EXCEPTIONS INVOLVING TRADITIONALLY EXCLUSIVE HOSPITAL-BASED SERVICES). THE MAJORITY OF THE GOVERNING BODY CONSISTS OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY SERVED BY THE HOSPITAL. MERCY ST VINCENT MEDICAL CENTER'S EMERGENCY DEPARTMENT TREATS 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. MERCY ST VINCENT MEDICAL CENTER PARTICIPATES IN MEDICARE, MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS.
Affiliated health care system Schedule H, Part VI, Line 6 MERCY ST. VINCENT MEDICAL CENTER IS A MEMBER OF MERCY HEALTH SYSTEM -NORTHERN REGION AND AFFILIATED WITH MERCY ST. CHARLES HOSPITAL, MERCY ST. ANNE HOSPITAL, MERCY HOSPITAL OF TIFFIN OHIO AND MERCY WILLARD HOSPITAL. ALL ARE OHIO NON-PROFIT CORPORATIONS. THE HOSPITAL IS SPONSORED BY THE SISTERS OF MERCY AND SISTERS OF CHARITY OF MONTREAL (GREY NUNS) AND HAS BEEN AN INTEGRAL PART OF THE COMMUNITY SINCE 1855. THE HOSPITAL IS AN ACUTE CARE HOSPITAL WITH APPROXIMATELY 568 LICENSED BEDS. MERCY HEALTH SYSTEM -NORTHERN REGION COMMUNITY BENEFIT FOR 2010 PER THE AUDIT FOOTNOTE IS AS FOLLOWS: TOTAL 2010 COMMUNITY BENEFIT: $74.5 MILLION BENEFITS TO THE BROADER COMMUNITY: $20.5 MILLION UNREIMBURSED CARE FOR THOSE WHO ARE POOR AND QUALIFY FOR MEDICAID: $15.5 MILLION COST OF CARE FOR THOSE WHO COULD NOT AFFORD TO PAY: $21.9 MILLION SUPPORT FOR OTHER PROGRAMS FOR THOSE WHO ARE POOR: $16.6 MILLION COMMUNITY BENEFIT AS PERCENT OF TOTAL EXPENSE: 9.1 PERCENT MERCY ST VINCENT MEDICAL CENTER IS A MEMBER OF CATHOLIC HEALTH PARTNERS (CHP). CHP IS THE CONTINUATION OF THE HEALTH MINISTRY STARTED MORE THAN 150 YEARS AGO BY OUR CO-SPONSORING CONGREGATIONS: THE SISTERS OF MERCY, REGIONAL COMMUNITY OF CINCINNATI (OH); THE MID-ATLANTIC COMMUNITY, MERION STATION, PA; THE SISTERS OF HUMILITY OF MARY; THE FRANCISCAN SISTERS OF THE POOR; AND COVENANT HEALTH SYSTEMS. OUR SYSTEM OF REGIONAL HEALTH CARE PROVIDERS SERVES LOCAL HEALTH NEEDS IN COMMUNITIES IN OHIO, KENTUCKY, PENNSYLVANIA AND TENNESSEE. CHP IS FOCUSED ON IMPROVING THE HEALTH OF COMMUNITIES WE SERVE BY PROVIDING INTEGRATED HEALTH SERVICES THROUGH FACILITIES THAT INCLUDE ACUTE CARE HOSPITALS, LONG-TERM CARE RESIDENCES, HOUSING SITES FOR THE ELDERLY, HOME HEALTH AGENCIES, HOSPICE PROGRAMS, OUTREACH SERVICES AND WELLNESS CENTERS. OUR HOSPITALS INCLUDE FOUR CRITICAL ACCESS FACILITIES OFFERING ESSENTIAL HEALTH SERVICES THAT WOULD OTHERWISE NOT EXIST IN THOSE COMMUNITIES. WE CARE FOR EVERYONE WHO COMES TO US, REGARDLESS OF THEIR ABILITY TO PAY. AS WE HAVE DONE FOR DECADES, WE PROVIDE EXTENSIVE SERVICES TO THE BROADER COMMUNITY, WITH EMPHASIS ON SERVICES FOR PERSONS WHO ARE POOR AND UNDER-SERVED. CHP'S HOME OFFICE PROVIDES SERVICES AND SUPPORT TO THE ENTIRE SYSTEM, INCLUDING BUT NOT LIMITED TO: PROVIDING GOVERNANCE, MANAGEMENT OVERSIGHT, STRATEGIC LEADERSHIP, FOCUSING RESOURCES TO ASSURE THE HEALING MISSION, PROVIDING ACCESS TO LOWER COST DEBT FINANCING TO SUPPORT OPERATIONS, IMPROVING CLINICAL OUTCOMES AND REDUCING OPERATING COSTS. SYSTEM-WIDE COMMUNITY BENEFIT FOR 2010 PER THE AUDIT FOOTNOTE IS AS FOLLOWS: TOTAL 2010 COMMUNITY BENEFIT: $365.1 MILLION BENEFITS TO THE BROADER COMMUNITY $77.1 MILLION UNREIMBURSED CARE FOR THOSE WHO ARE POOR AND QUALIFY FOR MEDICAID $131.7 MILLION COST OF CARE FOR THOSE WHO COULD NOT AFFORD TO PAY $123.2 MILLION SUPPORT FOR OTHER PROGRAMS FOR THOSE WHO ARE POOR $33.1 MILLION COMMUNITY BENEFIT AS PERCENT OF TOTAL EXPENSE: 8.5 PERCENT
Schedule H (Form 990) 2010
Additional Data


Software ID: 10000128
Software Version: v2010.1.0
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ST VINCENT MERCY MEDICAL CENTER
 
Employer identification number

34-4428250
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

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

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) ANTHONY J ARMSTRONG MD (i)
(ii)		 293,852
0 		33,201
0 		1,532
0 		17,150
0 		13,329
0 		359,064
0 		0
0
(2) CATHLEEN NELSON (i)
(ii)		 212,805
0 		25,732
0 		9,837
0 		19,600
0 		17,543
0 		285,517
0 		0
0
(3) RANDALL HERMANN (i)
(ii)		 180,770
0 		23,260
0 		5,571
0 		23,652
0 		15,652
0 		248,905
0 		0
0
(4) STEVEN L MICKUS (i)
(ii)		 0
846,286 		0
253,802 		0
373,612 		0
267,760 		0
21,759 		0
1,763,219 		0
0
(5) ANDREA PRICE (i)
(ii)		 0
469,225 		0
33,480 		0
10,580 		0
48,514 		0
19,369 		0
581,168 		0
0
(6) SAMANTHA PLATZKE (i)
(ii)		 0
396,451 		0
82,269 		0
9,748 		0
52,686 		0
19,359 		0
560,513 		0
0
(7) TODD WARNER (i)
(ii)		 0
189,750 		0
48,226 		0
7,913 		0
30,492 		0
16,949 		0
293,330 		0
0
(8) H TERRENCE SMITH (i)
(ii)		 0
316,656 		0
81,578 		0
25,142 		0
49,647 		0
23,718 		0
496,741 		0
0
(9) GARY GEORGE (i)
(ii)		 0
252,047 		0
64,778 		0
11,576 		0
41,010 		0
8,853 		0
378,264 		0
0
(10) DENNIS SHERRY (i)
(ii)		 0
239,067 		0
61,980 		0
11,438 		0
39,272 		0
17,556 		0
369,313 		0
0
(11) CAROL WHITTAKER (i)
(ii)		 0
302,210 		0
68,394 		0
12,036 		0
82,756 		0
13,933 		0
479,329 		0
0
(12) JOSEPH GLASS (i)
(ii)		 0
197,649 		0
49,501 		0
7,617 		0
27,637 		0
17,026 		0
299,430 		0
0
(13) BARBARA DIANDA-MARTIN (i)
(ii)		 0
183,926 		0
45,951 		0
6,988 		0
33,055 		0
16,839 		0
286,759 		0
0
(14) IMRAN ANDRABI MD (i)
(ii)		 0
401,010 		0
102,000 		0
9,228 		0
49,258 		0
19,369 		0
580,865 		0
0
(15) JOHN SCHAEUFELE MD (i)
(ii)		 0
228,351 		0
56,265 		0
11,322 		0
38,720 		0
13,253 		0
347,911 		0
0
(16) DAVID AROSE (i)
(ii)		 0
216,222 		0
33,001 		0
1,146 		0
17,150 		0
12,799 		0
280,318 		0
0
(17) SCOTT SHOOK (i)
(ii)		 0
223,987 		0
75,700 		0
472,847 		0
213,189 		0
14,149 		0
999,872 		0
442,897
(18) S MARK ELLIS (i)
(ii)		 0
202,571 		0
51,000 		0
8,518 		0
34,573 		0
17,094 		0
313,756 		0
0
(19) WILLIAM SUTTON (i)
(ii)		 0
205,806 		0
51,022 		0
23,727 		0
56,188 		0
12,669 		0
349,412 		0
0
(20) SRIRAM PERNI MD (i)
(ii)		 696,294
0 		50,000
0 		896
0 		17,150
0 		17,893
0 		782,233
0 		0
0
(21) CLAUDEL JEAN-PIERRE MD (i)
(ii)		 638,511
0 		0
0 		540
0 		12,250
0 		25,923
0 		677,224
0 		0
0
(22) MALINI NARAYANAN MD (i)
(ii)		 548,732
0 		0
0 		910
0 		19,600
0 		4,815
0 		574,057
0 		0
0
(23) DAVID FRANZBLAU MD (i)
(ii)		 0
379,934 		0
78,753 		0
15,052 		0
60,781 		0
14,988 		0
549,508 		0
0
(24) JULIE GEORGOFF (i)
(ii)		 144,902
0 		12,001
0 		3,613
0 		9,926
0 		16,309
0 		186,751
0 		0
0
(25) BARRY HUDGIN (i)
(ii)		 0
171,964 		0
44,200 		0
8,253 		0
28,954 		0
7,596 		0
260,967 		0
0
(26) FAYYAZ HASHMI MD (i)
(ii)		 637,669
0 		154,115
0 		2,692
0 		26,950
0 		17,423
0 		838,849
0 		0
0
(27) JIM BURDINE MD (i)
(ii)		 453,977
0 		164,226
0 		1,612
0 		24,500
0 		17,422
0 		661,737
0 		0
0
(28) RICHARD GRAY (i)
(ii)		 29,170
0 		22,110
0 		58,674
0 		7,719
0 		6,659
0 		124,332
0 		0
0
(29) SCOTT WILLIAMS (i)
(ii)		 0
187,577 		0
38,137 		0
7,886 		0
29,027 		0
8,025 		0
270,652 		0
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
Severance or change-of-control payment Schedule J, Part I, Line 4a 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 YEAR TO LISTED INDIVIDUALS WERE AS FOLLOWS: RICHARD GRAY $40,819.
Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b THE MERCY HEALTH PARTNERS (MHP) - NORTHERN REGION NONQUALIFIED SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN IS FOR CERTAIN HIGHLY COMPENSATED INDIVIDUALS AS DETERMINED BY THE BOARD OF TRUSTEES' EXECUTIVE EVALUATION AND COMPENSATION COMMITTEE TO PROVIDE A BENEFIT TO REPLACE THE BENEFIT THESE PARTICIPANTS WOULD HAVE RECEIVED UNDER THE FORMULA OF THE APPLICABLE QUALIFIED PLAN PRIOR TO ITS AMENDMENT TO COMPLY WITH THE OMNIBUS BUDGET RECONCILIATION ACT OF 1993, AND PROVIDING A DEFERRED COMPENSATION PLAN OF 5% OF ANNUAL BASE SALARY TO RETAIN EXECUTIVES. PARTICIPANTS VEST IN THIS PLAN AND RECEIVE A BENEFIT UNDER THIS PLAN ONCE THEY HAVE SATISFIED BOTH OF THESE TWO CONDITIONS: (1) MEET THE VESTING REQUIREMENTS OF THE APPLICABLE QUALIFIED PLAN, AND (2) COMPLETE A 24-MONTH POST-EMPLOYMENT NON-COMPETE REQUIREMENT. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO SERP PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: SAMANTHA PLATZKE $0; H. TERRENCE SMITH $0; GARY GEORGE $0; DENNIS SHERRY $0; CAROL WHITTAKER $0; IMRAN ANDRABI $0; SCOTT SHOOK $458,416; WILLIAM SUTTON $10,460; JOHN SCHAEUFELE, M.D. $0; DAVID FRANZBLAU $0.
Non-fixed payments Schedule J, Part I, Line 7 THE ORGANIZATION PROVIDES ANNUAL INCENTIVE COMPENSATION FOR LISTED INDIVIDUALS. THE ORGANIZATION'S BOARD OF TRUSTEES ESTABLISHES OBJECTIVE THRESHOLDS FOR QUALITY, COMMUNITY BENEFIT, AND FINANCIAL PERFORMANCE WHICH MUST BE ACHIEVED FOR INCENTIVES TO BE AWARDED. THE BOARD ALSO ESTABLISHES THRESHOLD, TARGET AND MAXIMUM LEVELS FOR INCENTIVE AWARDS. WITHIN THESE ESTABLISHED PARAMETERS, THE CEO RECOMMENDS INCENTIVE AWARDS FOR LISTED INDIVIDUALS TO THE BOARD'S EXECUTIVE EVALUATION AND COMPENSATION COMMITTEE. THE BOARD COMMITTEE REVIEWS AND APPROVES OR MODIFIES THE CEO'S RECOMMENDATIONS.
THE CHP SERP PLAN SCHEDULE J, PART I, LINE 4B THE CATHOLIC HEALTH PARTNERS (CHP) SERP PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATE. IT PROVIDES ANNUAL CREDITS OF A SPECIFIED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST 50%, 75%, AND 100% IN THEIR ACCOUNTS AFTER 5, 6, AND 7 YEARS OF SERVICE, RESPECTIVELY, VESTING OCCURS EARLIER FOR DEATH OR TOTAL DISABILITY OR REACHING AGE 60 WHILE EMPLOYED, OR INVOLUNTARY TERMINATION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHANGE IN CONTROL OF THE ORGANIZATION OR DUE TO POSITION ELIMINATION, PAYMENTS DURING EMPLOYMENT ARE MADE FOR REQUIRED TAX WITHHOLDINGS. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS AFTER TERMINATION OF EMPLOYMENT. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO SERP PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: STEVEN L. MICKUS $362,400.
THE CHP RETENTION PLAN SCHEDULE J, PART I, LINE 4B THE CATHOLIC HEALTH PARTNERS (CHP) RETENTION PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES EMPLOYMENT CONTINUATION INCENTIVES TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATE. IT PROVIDES ANNUAL CREDITS OF A SPECIFIED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST AND CEASE TO RECEIVE CREDITS AFTER 5 YEARS OF PLAN PARTICIPATION PROVIDED THEY REMAIN EMPLOYED. VESTING AND CESSATION OF CREDITS OCCUR EARLIER FOR DEATH OR TOTAL DISABILITY WHILE EMPLOYED, INVOLUNTARY TERMINATION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHANGE IN CONTROL OF THE ORGANIZATION, OR, FOR CERTAIN PARTICIPANTS, UPON BEING OFFERED A SPECIFIED PROMOTION. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS UPON VESTING. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO RETENTION PLAN PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: STEVEN L. MICKUS $0.
Schedule J (Form 990) 2010

Additional Data


Software ID: 10000128
Software Version: v2010.1.0
SCHEDULE O
(Form 990 or 990-EZ)

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

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
ST VINCENT MERCY MEDICAL CENTER
 
Employer identification number

34-4428250
Identifier Return Reference Explanation
Family/business relationships amongst interested persons Form 990, Part VI, Section A, Line 2 JUDGE VERNELIS ARMSTRONG AND ANTHONY ARMSTRONG, MD - FAMILY RELATIONSHIP
Classes of members or stockholders Form 990, Part VI, Section A, Line 6 MERCY HEALTH SYSTEM - NORTHERN REGION IS THE SOLE MEMBER OF ST. VINCENT MERCY MEDICAL CENTER.
Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a CATHOLIC HEALTH PARTNERS (CHP) APPROVES MEMBERS THAT ARE APPOINTED TO THE BOARD OF TRUSTEES. ALL OF THE BOARD OF TRUSTEES HAVE FULL VOTING RIGHTS.
Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b CERTAIN MATTERS REQUIRE APPROVAL OF THE CHP CORPORATE MEMBER, CHP GOVERNING BODY, OR CHP CEO. THE REGULATIONS OF THE ORGANIZATION DESCRIBE THE LEVEL OF APPROVAL REQUIRED FOR VARIOUS DECISIONS.
Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b THE FORM 990 IS PREPARED BY CHP'S TAX DEPARTMENT AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. UPON REVIEW, THE FORM 990 IS THEN FORWARDED TO THE AUDIT & CORPORATE RESPONSIBILITY COMMITTEE FOR APPROVAL. ADDITIONALLY, THE COMPENSATION COMMITTEE REVIEWS ALL COMPENSATION RELATED SCHEDULES AND DISCLOSURES. BOTH THE AUDIT & CORPORATE RESPONSIBILITY COMMITTEE AND THE COMPENSATION COMMITTEE ARE INDEPENDENT OF THE FILING ORGANIZATION. 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.
Conflict of interest policy Form 990, Part VI, Section B, Line 12c FOR BOARD AND/OR SUBCOMMITTEE MEETINGS - ALL BOARD/SUBCOMMITTEE MEMBERS MUST FILE A CONFLICT OF INTEREST FORM. THE COMMITTEE CHAIR OR BOARD CHAIR IS NOTIFIED OF ANY CONFLICTS FOR ANY OF THE COMMITTEE MEMBERS OR BOARD OF TRUSTEE MEMBERS. AT THE BEGINNING OF ALL BOARD MEETINGS OR COMMITTEE MEETINGS, MEMBERS ARE REMINDED THAT THEY ARE TO NOTIFY THE CHAIR OF ANY CONFLICTS AND RECUSE THEMSELVES AS NECESSARY FROM THE DISCUSSION AND/OR VOTE. FOR KEY EMPLOYEES - THEIR MANAGER IS NOTIFIED OF ANY CONFLICTS REPORTED ON THE COI FORM. IF A CONFLICT EXISTS, WE REQUIRE THE EMPLOYEE TO RECUSE THEMSELVES FROM THE ISSUE.
Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a THE ORGANIZATION'S FORMAL PROCESS FOR DETERMINING TOTAL COMPENSATION FOR THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES IS INTENDED TO PROVIDE REASONABLE COMPENSATION FOR ACCOMPLISHING THE ORGANIZATION'S MISSION, TO RECOGNIZE PERFORMANCE, AND TO OPERATE IN KEEPING WITH THE ORGANIZATION'S OBLIGATIONS AS A TAX-EXEMPT CHARITABLE ORGANIZATION. THE EXECUTIVE EVALUATION & COMPENSATION COMMITTEE OF THE ORGANIZATION'S BOARD OF TRUSTEES CONDUCTS AN ANNUAL REVIEW OF THE COMPENSATION OF THE CEO AND OTHER OFFICERS AND CERTAIN KEY EMPLOYEES. IN DOING SO, THE COMMITTEE RETAINS A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT A COMPETITIVE MARKET ANALYSIS OF THE MARKET RANGES OF BASE, INCENTIVE, AND TOTAL CASH COMPENSATION, BENEFITS, AND TO PROVIDE ADVICE CONCERNING THE REASONABLENESS OF THE COMPENSATION OF THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES. THE COMMITTEE UTILIZES THAT ANALYSIS AND OTHER APPROPRIATE INFORMATION IN CONNECTION WITH ITS ANNUAL REVIEW AND APPROVAL OF ADJUSTMENTS TO THE CEO'S COMPENSATION AND THE COMPENSATION FOR OTHER OFFICERS AND CERTAIN KEY EMPLOYEES. INFORMATION WHICH THE COMMITTEE MAY CONSIDER CAN INCLUDE BUT IS NOT LIMITED TO THE PERFORMANCE OF AN INDIVIDUAL, THE PERFORMANCE OF THE ORGANIZATION, AN INDIVIDUAL'S LENGTH OF SERVICE, CREDENTIALS AND EXPERIENCE, THE ELEMENTS OF TOTAL COMPENSATION AND SALARY HISTORY, THE ORGANIZATION'S COMPENSATION TARGETS, AND COMPARABILITY DATA, INCLUDING THE DATA PREPARED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE COMMITTEE. THE COMMITTEE ASSURES THERE IS A FORMAL PERFORMANCE APPRAISAL PROCESS IN THE CEO'S COMPENSATION REVIEW. IT UTILIZES A MULTI-PERSPECTIVE APPROACH AND PERFORMANCE MEASURES WHICH ARE LINKED TO THE ORGANIZATION'S ACHIEVEMENT OF ANNUAL SYSTEM AND FACILITY OBJECTIVES, AND PERSONAL OBJECTIVES. THE CEO IS NOT PRESENT WHEN THE COMMITTEE DISCUSSES AND ESTABLISHES HIS COMPENSATION. IN ADDITION, THE COMMITTEE DETERMINES IF THE THRESHOLD REQUIREMENTS FOR INCENTIVE AWARDS ARE MET, CONSISTING OF THE ORGANIZATION'S PERFORMANCE RESULTS FOR COMMUNITY BENEFIT, QUALITY, AND FINANCIAL PERFORMANCE. THE COMMITTEE APPROVES THE CEO'S INCENTIVE AWARD AND THE INCENTIVE AWARD LEVELS FOR WHICH OTHER LISTED INDIVIDUALS MAY BE ELIGIBLE AND SHARES THIS INFORMATION WITH THE FULL BOARD OF TRUSTEES. THE COMMITTEE'S REPORT, INCLUDING DECISIONS CONCERNING SALARY RANGE ADJUSTMENTS AND INCENTIVE AWARDS AND THE BASIS FOR THE COMMITTEE'S DECISIONS, GOES TO THE FULL BOARD FOR REVIEW IN EXECUTIVE SESSION WHICH DOES NOT INCLUDE THE CEO OR OTHER OFFICERS OR KEY EMPLOYEES. THE FULL BOARD REVIEWS THE COMMITTEE'S DETERMINATION THAT THE COMPENSATION IS REASONABLE, AND IS IN THE ORGANIZATION'S BEST INTEREST AND FOR ITS BENEFIT. FOR OTHER OFFICERS, ADJUSTMENTS AND INCENTIVE AWARDS ARE APPROVED BY THE COMMITTEE. FOR KEY EMPLOYEES, THE ORGANIZATION'S CEO APPROVES ADJUSTMENTS AND INCENTIVE AWARDS WITHIN SUCH BOARD-APPROVED PARAMETERS. ADJUSTMENTS AND AWARDS FOR OTHER LISTED INDIVIDUALS ARE APPROVED BY THE SUPERVISING EXECUTIVE WITHIN SUCH PARAMETERS, WITH REGIONAL BOARD APPROVAL WHEN APPROPRIATE. INCENTIVE AWARDS ARE SUBJECT TO REPAYMENT IF THE ORGANIZATION MUST RESTATE FINANCIAL REPORTS DUE TO MATERIAL NONCOMPLIANCE WITH THE ORGANIZATION'S CODE OF RESPONSIBILITY AND STANDARDS OF RESPONSIBLE CONDUCT.
Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b PLEASE REER TO LINE 15A RESPONSE WHICH DESCRIBES THE PROCESS USED FOR BOTH THE TOP MANAGEMENT OFFICIAL AND FOR THE OTHER OFFICERS AND KEY EMPLOYEES.
Public Disclosure Form 990, Part VI, Section C, Line 19 THE SYSTEM-WIDE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE POSTED ON THE CATHOLIC HEALTH PARTNERS WEBSITE.
AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS BY LISTED PERSONS FORM 990 PART VII SECTION A COLUMN (B) JUDGE VERNELIS K. ARMSTRONG 3 ANTHONY J. ARMSTRONG, M.D. 5 VIJAY M. ADAPPA, M.D. 3 CAROL BINTZ 3 WILLIAM F. BUCKLEY 3 SR MILDRED ELY, HM 3 KAREN L FRAKER 15 CHARLES E.. GALLAGHER 15 ROOSEVELT GANT 3 TIMOTHY M. GLADIEUX 3 JOHN H. HARRIS III, M.D. 5 DENISE M. HASBROOK 3 WILLARD P. HEDDLES 4 PAMELA HOWELL-BEACH 3 DENNIS G. JOHNSON 15 CHERREFE A. KADRI, ESQ. 3 MICHAEL P. KILLIAN 3 GEOFFREY G. MEYERS 15 SUDHAKAR PANGULUR, M.D. 3 ERICH R. PONTASCH, M.D. 3 RALPH A THAN 5 ANDREA PRICE 55 SAMANTHA PLATZKE 55 TODD WARNER 55 H. TERRENCE SMITH 55 GARY GEORGE 55 DAVID AROSE 55 WILLIAM SUTTON 55 DENNIS SHERRY 55 JOSEPH GLASS 55 SCOTT SHOOK 55 BARRY HUDGIN 55 CAROL WHITTAKER 55 STEVEN L. MICKUS 55 CATHLEEN NELSON 25 RANDALL HERMANN 2 JOHN SCHAEUFELE, M.D. 1 S. MARK ELLIS 1 JULIE GEORGOFF 2 SCOTT WILLIAMS 55 RICHARD GRAY 2 IMRAN ANDRABI, M.D. 55 DALE THORNTON 55 DAVID FRANZBLAU, M.D. 55
Other changes in net assets or fund balances Form 990, Part XI, Line 5 NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - 4920501; EQUITY TRANSFER TO MERCY COLLEGE FOUNDATION - -375000; PENSION ADJUSTMENT - -111332; FAS106 ADJUSTMENT - -698097; PENSION CHANGE-MERCER ADJUSTMENT - -1239739; CHANGE IN OBLIGATION FROM MERCY COLLEGE - 242668; FOUNDATION CONTRIBUTIONS RECOGNIZED 2011 BY BOOKS - -380480;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID: 10000128
Software Version: v2010.1.0
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ST VINCENT MERCY MEDICAL CENTER
 
Employer identification number

34-4428250
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

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


 		(f)
Direct controlling
entity

















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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

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

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) CATHOLIC HEALTH PARTNERS

615 ELSINORE PLACE

CINCINNATI,OH45202
31-1161086 		HEALTHCARE SYSTEM PARENT OH 501(C)(3) 11 - Type III - FI NA
 
 
 
(2) CATHOLIC HEALTHCARE PARTNERS FOUNDATION

615 ELSINORE PLACE

CINCINNATI,OH45202
20-1072726 		FUNDRAISING OH 501(C)(3) 7 CATHOLIC HEALTH PARTNERS
 
 
 
(3) CATHOLIC HEALTHCARE PARTNERS HOUSING DEVELOPMENT

615 ELSINORE PLACE

CINCINNATI,OH45202
20-8943658 		HUD PARENT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(4) CATHOLIC HEALTHCARE PARTNERS RETIREMENT TRUST

615 ELSINORE PLACE

CINCINNATI,OH45202
31-6046304 		RETIREMENT TRUST OH 501(C)(3) 8 CATHOLIC HEALTH PARTNERS
 
 
 
(5) SISTERS OF MERCY WORKERS COMPENSATION SELF-INSURANCE TRUST

615 ELSINORE PLACE

CINCINNATI,OH45202
31-0990309 		TRUST ADMINISTRATION OH 501(C)(3) 11 - Type I CATHOLIC HEALTH PARTNERS
 
 
 
(6) COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM

3700 KOLBE ROAD

LORAIN,OH44053
27-0071694 		REGIONAL PARENT OH 501(C)(3) 11 - Type II CATHOLIC HEALTH PARTNERS
 
 
 
(7) COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER

3700 KOLBE ROAD

LORAIN,OH44053
34-0714704 		HOSPITAL OH 501(C)(3) 3 COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM
 
 
 
(8) ALLEN MEDICAL CENTER

200 WEST LORAIN ST

OBERLIN,OH44074
34-0864230 		HOSPITAL OH 501(C)(3) 3 COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM
 
 
 
(9) COMMUNITY HEALTH PARTNERS REGIONAL FOUNDATION

3700 KOLBE ROAD

LORAIN,OH44053
34-1504558 		FOUNDATION OH 501(C)(3) 11 - Type III - FI COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER
 
 
 
(10) COMMUNITY HEALTH PARTNERS PHYSICIANS OFFICE BUILDINGS

3700 KOLBE ROAD

LORAIN,OH44053
34-1268828 		MEDICAL OFFICE RENTAL OH 501(C)(3) 9 COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER
 
 
 
(11) ALLEN MEDICAL CENTER FOUNDATION

200 WEST LORAIN ST

OBERLIN,OH44074
34-1675592 		FOUNDATION OH 501(C)(3) 11 - Type I ALLEN MEDICAL CENTER
 
 
 
(12) ALLEN MEDICAL CENTER MEDICAL OFFICE BUILDING

200 WEST LORAIN ST

OBERLIN,OH44074
36-4504991 		MEDICAL OFFICE RENTAL OH 501(C)(3) 11 - Type II ALLEN MEDICAL CENTER
 
 
 
(13) MERCY HEALTH PARTNERS OF SOUTHWEST OHIO

4600 MCAULEY PLACE

CINCINNATI,OH45242
31-1063783 		REGIONAL PARENT OH 501(C)(3) 11 - Type III - FI CATHOLIC HEALTH PARTNERS
 
 
 
(14) MERCY HEALTH PARTNERS OF SOUTHWEST OHIO FOUNDATION

4600 MCAULEY PLACE

CINCINNATI,OH45242
31-1217563 		FOUNDATION OH 501(C)(3) 7 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO
 
 
 
(15) MERCY HOSPITALS WEST

2446 KIPLING AVENUE

CINCINNATI,OH45239
31-1091597 		HOSPITAL OH 501(C)(3) 3 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO
 
 
 
(16) MERCY HOSPITAL ANDERSON

7500 STATE ROAD

CINCINNATI,OH45255
31-0537085 		HOSPITAL OH 501(C)(3) 3 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO
 
 
 
(17) THE SISTERS OF MERCY OF HAMILTON OHIO

3000 MACK ROAD

FAIRFIELD,OH45014
31-0538532 		HOSPITAL OH 501(C)(3) 3 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO
 
 
 
(18) THE SISTERS OF MERCY OF CLERMONT COUNTY OHIO

3000 HOSPITAL DRIVE

BATAVIA,OH45103
31-0830955 		HOSPITAL OH 501(C)(3) 3 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO
 
 
 
(19) CLERMONT MERCY FOUNDATION

3000 HOSPITAL DRIVE

BATAVIA,OH45103
31-1514749 		FOUNDATION OH 501(C)(3) 11 - Type III - FI THE SISTERS OF MERCY OF CLERMONT COUNTY OHIO
 
 
 
(20) MERCY FRANCISCAN SENIOR HEALTH AND HOUSING SERVICES INC

7010 ROWAN HILLS DR

CINCINNATI,OH45227
31-1308729 		RETIREMENT HOME OH 501(C)(3) 9 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO
 
 
 
(21) MERCY SACRED HEART INC

2120 PAYNE STREET

LOUISVILLE,KY40206
61-1318326 		RETIREMENT HOME KY 501(C)(3) 9 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO
 
 
 
(22) MERCY LONG TERM CARE INITIATIVE

4915 CHARLESTOWN RD

NEW ALBANY,IN47150
31-1332491 		RETIREMENT HOME IN 501(C)(3) 9 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO
 
 
 
(23) PROVIDENCE RETIREMENT HOME AUXILIARY

4915 CHARLESTOWN RD

NEW ALBANY,IN47150
20-4664839 		SUPPORTING ORG IN 501(C)(3) 11 - Type II MERCY LONG TERM CARE INITIATIVE
 
 
 
(24) MERCY FRANCISCAN SOCIAL MINISTRIES INC

1800 LOGAN STREET

CINCINNATI,OH45210
31-1222942 		LOW INCOME HOUSING OH 501(C)(3) 7 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO
 
 
 
(25) MERCY FRANCISCAN AT ST RAPHAEL INC

610 HIGH STREET

HAMILTON,OH45011
20-2934871 		SERVICES TO THE POOR OH 501(C)(3) 7 MERCY HEALTH PARTNERS OF SOUTHWEST OHIO
 
 
 
(26) COMMUNITY MERCY HEALTH SYSTEM

ONE S LIMESTONE ST

SPRINGFIELD,OH45502
30-0272454 		REGIONAL PARENT OH 501(C)(3) 11 - Type III - FI CATHOLIC HEALTH PARTNERS
 
 
 
(27) COMMUNITY MERCY HEALTH PARTNERS

ONE S LIMESTONE ST

SPRINGFIELD,OH45502
31-0785684 		HOSPITAL OH 501(C)(3) 3 COMMUNITY MERCY HEALTH SYSTEM
 
 
 
(28) THE COMMUNITY MERCY FOUNDATION

1343 N FOUNTAIN BLVD

SPRINGFIELD,OH45504
31-1443778 		FOUNDATION OH 501(C)(3) 7 COMMUNITY MERCY HEALTH SYSTEM
 
 
 
(29) COMMUNITY HOSPITAL HEALTH SERVICES COMPANY

ONE S LIMESTONE ST

SPRINGFIELD,OH45502
31-1181984 		HOSPITAL OH 501(C)(3) 3 COMMUNITY MERCY HEALTH SYSTEM
 
 
 
(30) CLARKE & CHAMPAIGN COUNTIES HEALTH INFORMATION EXCHANGE

1150 E HOME ROAD

SPRINGFIELD,OH45503
26-0698515 		MEDICAL INFORMATION EXCHANGE OH 501(C)(3) 9 COMMUNITY MERCY HEALTH SYSTEM
 
 
 
(31) THE WALLACE S MURRAY AND FRANCES RABBITTS MURRAY MEMORIAL TRUST

ONE S LIMESTONE ST

SPRINGFIELD,OH45502
34-6827136 		INDIGENT MEDICAL CARE OH 501(C)(3) 11 - Type I NA
 
 
 
(32) MERCY HEALTH SYSTEM - NORTHERN REGION

2200 JEFFERSON AVENUE

TOLEDO,OH43604
34-1344482 		REGIONAL PARENT OH 501(C)(3) 11 - Type III - FI CATHOLIC HEALTH PARTNERS
 
 
 
(33) ST CHARLES MERCY HOSPITAL OF OREGON OHIO

2600 NAVARRE AVENUE

OREGON,OH43616
34-4445373 		HOSPITAL OH 501(C)(3) 3 MERCY HEALTH SYSTEM - NORTHERN REGION
 
 
 
(34) ST CHARLES MERCY HEALTH FOUNDATION

2600 NAVARRE AVENUE

OREGON,OH43616
34-1414900 		FOUNDATION OH 501(C)(3) 11 - Type III - FI ST CHARLES MERCY HOSPITAL OF OREGON OHIO
 
 
 
(35) RIVERSIDE MERCY HOSPITAL

3404 W SYLVANIA AVE

TOLEDO,OH43623
31-1556401 		HOSPITAL OH 501(C)(3) 3 MERCY HEALTH SYSTEM - NORTHERN REGION
 
 
 
(36) MERCY HOME CARE INC

2200 JEFFERSON AVENUE

TOLEDO,OH43604
34-1587572 		HOME HEALTHCARE OH 501(C)(3) 9 MERCY HEALTH SYSTEM - NORTHERN REGION
 
 
 
(37) MERCY COLLEGE OF NORTHWEST OHIO

2221 MADISON AVENUE

TOLEDO,OH43604
34-1726619 		MEDICAL COLLEGE OH 501(C)(3) 2 MERCY HEALTH SYSTEM - NORTHERN REGION
 
 
 
(38) MERCY COLLEGE OF NORTHWEST OHIO FOUNDATION INC

2221 MADISON AVENUE

TOLEDO,OH43604
14-1963204 		FOUNDATION OH 501(C)(3) 11 - Type I MERCY COLLEGE OF NORTHWEST OHIO
 
 
 
(39) MERCY HOSPITAL OF TIFFIN OHIO

45 ST LAWRENCE DRIVE

TIFFIN,OH44883
34-4431174 		HOSPITAL OH 501(C)(3) 3 MERCY HEALTH SYSTEM - NORTHERN REGION
 
 
 
(40) MERCY TIFFIN HEALTH FOUNDATION

45 ST LAWRENCE DRIVE

TIFFIN,OH44883
34-1499894 		FOUNDATION OH 501(C)(3) 11 - Type III - FI MERCY HOSPITAL OF TIFFIN OHIO
 
 
 
(41) THE SISTERS OF MERCY OF WILLARD OHIO

110 EAST HOWARD ST

WILLARD,OH44890
34-1577110 		HOSPITAL OH 501(C)(3) 3 MERCY HEALTH SYSTEM - NORTHERN REGION
 
 
 
(42) MERCY HOSPITAL OF WILLARD FOUNDATION

110 EAST HOWARD ST

WILLARD,OH44890
11-3742347 		FOUNDATION OH 501(C)(3) 11 - Type III - FI THE SISTERS OF MERCY OF WILLARD OHIO
 
 
 
(43) ST VINCENT MERCY MEDICAL CENTER FOUNDATION

2213 CHERRY STREET

TOLEDO,OH43608
23-7393213 		FOUNDATION OH 501(C)(3) 11 - Type III - FI ST VINCENT MERCY MEDICAL CENTER
 
 
 
(44) LIFESTAR AMBULANCE INC

2200 JEFFERSON AVENUE

TOLEDO,OH43604
34-1354653 		MEDICAL TRANSPORTATION OH 501(C)(3) 11 - Type II MERCY HEALTH SYSTEM - NORTHERN REGION
 
 
 
(45) RSM MEDICAL FOUNDATION

2200 JEFFERSON AVENUE

TOLEDO,OH43624
34-1693671 		HOSPITAL OH 501(C)(3) 3 MERCY HEALTH SYSTEM - NORTHERN REGION
 
 
 
(46) ST MARGUERITE D'YOUVILLE FOUNDATION II

2213 CHERRY STREET

TOLEDO,OH43608
13-4350655 		FOUNDATION OH 501(C)(3) 11 - Type II CATHOLIC HEALTH PARTNERS
 
 
 
(47) SIMON OUTREACH SERVICES

2600 NAVARRE AVENUE

OREGON,OH43616
34-1383325 		MEDICAL OFFICE RENTAL OH 501(C)(3) 11 - Type II ST CHARLES MERCY HOSPITAL OF OREGON OHIO
 
 
 
(48) FARLEY HEALTHCARE CORPORATION

2200 JEFFERSON AVENUE

TOLEDO,OH43604
34-1363204 		HEALTH SERVICES OH 501(C)(3) 9 MERCY HEALTH SYSTEM - NORTHERN REGION
 
 
 
(49) ST RITA'S MEDICAL CENTER

730 W MARKET STREET

LIMA,OH45801
34-1105619 		HOSPITAL OH 501(C)(3) 3 CATHOLIC HEALTH PARTNERS
 
 
 
(50) SRHC FOUNDATION

730 W MARKET STREET

LIMA,OH45801
34-1368429 		FOUNDATION OH 501(C)(3) 11 - Type III - FI ST RITA'S MEDICAL CENTER
 
 
 
(51) NEW VISION MEDICAL LABORATORIES INC

750 W HIGH ST STE 400

LIMA,OH45801
34-1937267 		MEDICAL LAB SERVICES OH 501(C)(3) 11 - Type III - FI ST RITA'S MEDICAL CENTER
 
 
 
(52) HUMILITY OF MARY HEALTH PARTNERS

1044 BELMONT AVENUE

YOUNGSTOWN,OH44501
34-0505560 		HOSPITAL OH 501(C)(3) 3 CATHOLIC HEALTH PARTNERS
 
 
 
(53) THE ASSUMPTION VILLAGE

9800 N MARKET STREET

NORTH LIMA,OH44452
34-1013695 		NURSING HOME OH 501(C)(3) 9 HUMILITY OF MARY HEALTH PARTNERS
 
 
 
(54) HOSPICE OF THE VALLEY

5190 MARKET STREET

YOUNGSTOWN,OH44512
34-1288745 		HOSPICE SERVICES OH 501(C)(3) 9 HUMILITY OF MARY HEALTH PARTNERS
 
 
 
(55) HUMILITY OF MARY DEVELOPMENT FOUNDATION

1044 BELMONT AVENUE

YOUNGSTOWN,OH44501
34-1826978 		FOUNDATION OH 501(C)(3) 11 - Type III - FI HUMILITY OF MARY HEALTH PARTNERS
 
 
 
(56) HUMILITY OF MARY INFORMATION SYSTEMS

250 FEDERAL PLAZA EAST

YOUNGSTOWN,OH44501
34-1452943 		INFORMATION SERVICES OH 501(C)(3) 11 - Type II HUMILITY OF MARY HEALTH PARTNERS
 
 
 
(57) HUMILITY HOUSE

755 OHLTOWN ROAD

AUSTINTOWN,OH44515
34-1894783 		NURSING HOME OH 501(C)(3) 9 HUMILITY OF MARY HEALTH PARTNERS
 
 
 
(58) LAUREL LAKE RETIREMENT COMMUNITY INC

200 LAUREL LAKE DRIVE

HUDSON,OH44236
34-1481142 		NURSING HOME OH 501(C)(3) 9 HUMILITY OF MARY HEALTH PARTNERS
 
 
 
(59) LAUREL LAKE RETIREMENT COMMUNITY FOUNDATION INC

200 LAUREL LAKE DRIVE

HUDSON,OH44236
34-1779303 		FOUNDATION OH 501(C)(3) 7 LAUREL LAKE RETIREMENT COMMUNITY INC
 
 
 
(60) ST JOSEPH HEALTH CENTER AUXILIARY

677 EASTLAND SE

WARREN,OH44484
34-6556121 		FUNDRAISING OH 501(C)(3) 9 HUMILITY OF MARY HEALTH PARTNERS
 
 
 
(61) MERCY HEALTH PARTNERS - LOURDES INC

1530 LONE OAK ROAD

PADUCAH,KY42003
61-0600313 		HOSPITAL KY 501(C)(3) 3 CATHOLIC HEALTH PARTNERS
 
 
 
(62) LOURDES FOUNDATION INC

1530 LONE OAK ROAD

PADUCAH,KY42003
61-1258960 		FOUNDATION KY 501(C)(3) 7 MERCY HEALTH PARTNERS - LOURDES INC
 
 
 
(63) LOURDES HOSPITAL AUXILIARY GIFT SHOP

1530 LONE OAK ROAD

PADUCAH,KY42003
61-0927805 		FUNDRAISING KY 501(C)(3) 11 - Type III - FI LOURDES FOUNDATION INC
 
 
 
(64) MARCUM AND WALLACE MEMORIAL HOSPITAL INC

60 MERCY COURT

IRVINE,KY40336
61-0927491 		HOSPITAL KY 501(C)(3) 3 MERCY HEALTH PARTNERS - LOURDES INC
 
 
 
(65) MARCUM AND WALLACE HOSPITAL FOUNDATION INC

60 MERCY COURT

IRVINE,KY40336
32-0026557 		FOUNDATION KY 501(C)(3) 11 - Type III - FI MARCUM AND WALLACE MEMORIAL HOSPITAL INC
 
 
 
(66) MERCY HEALTH PARTNERS INC

900 EAST OAK HILL AVE

KNOXVILLE,TN37917
73-1627534 		REGIONAL PARENT TN 501(C)(3) 11 - Type I CATHOLIC HEALTH PARTNERS
 
 
 
(67) MERCY HEALTH SYSTEM INC

900 EAST OAK HILL AVE

KNOXVILLE,TN37917
62-0480068 		HOSPITAL TN 501(C)(3) 3 MERCY HEALTH PARTNERS INC
 
 
 
(68) ST MARY'S MEDICAL CENTER OF CAMPBELL COUNTY INC

923 EAST CENTRAL AVE

LAFOLLETTE,TN37766
62-1817376 		HOSPITAL TN 501(C)(3) 3 MERCY HEALTH PARTNERS INC
 
 
 
(69) MERCY HEALTH PARTNERS FOUNDATION INC

900 EAST OAK HILL AVE

KNOXVILLE,TN37917
62-1247676 		FOUNDATION TN 501(C)(3) 7 MERCY HEALTH PARTNERS INC
 
 
 
(70) JEFFERSON MEMORIAL HOSPITAL INC

110 HOSPITAL DRIVE

JEFFERSON CITY,TN37760
62-1660663 		HOSPITAL TN 501(C)(3) 3 MERCY HEALTH PARTNERS INC
 
 
 
(71) JEFFERSON MEMORIAL FOUNDATION INC

110 HOSPITAL DRIVE

JEFFERSON CITY,TN37760
62-1660666 		FOUNDATION TN 501(C)(3) 11 - Type III - FI JEFFERSON MEMORIAL HOSPITAL INC
 
 
 
(72) ST MARY'S MEDICAL CENTER OF SCOTT COUNTY INC

18797 ALBERTA STREET

ONEIDA,TN37841
26-1535503 		HOSPITAL TN 501(C)(3) 3 MERCY HEALTH PARTNERS INC
 
 
 
(73) THE BAPTIST HEALTH SYSTEM FOUNDATION INC

101 BLOUNT AVE BOX 1788

KNOXVILLE,TN37920
58-1565290 		FOUNDATION TN 501(C)(3) 7 MERCY HEALTH PARTNERS INC
 
 
 
(74) BAPTIST HOSPITAL OF EAST TENNESSEE INC

137 BLOUNT AVE

KNOXVILLE,TN37920
62-0506166 		HOSPITAL TN 501(C)(3) 3 MERCY HEALTH PARTNERS INC
 
 
 
(75) BAPTIST HOSPITAL WEST INC

10820 PARKSIDE DRIVE

KNOXVILLE,TN37934
62-1870324 		HOSPITAL TN 501(C)(3) 3 MERCY HEALTH PARTNERS INC
 
 
 
(76) BAPTIST HOSPITAL OF COCKE COUNTY INC

435 SECOND STREET

NEWPORT,TN37821
62-1133149 		HOSPITAL TN 501(C)(3) 3 MERCY HEALTH PARTNERS INC
 
 
 
(77) MERCY HEALTH AND REHABILITATION CENTER INC

3916 BOYDS BRIDGE PIKE

KNOXVILLE,TN37917
62-1592992 		REHAB CENTER TN 501(C)(3) 9 MERCY HEALTH PARTNERS INC
 
 
 
(78) MERCY HEALTH PARTNERS - NORTHEAST REGION INC

746 JEFFERSON AVENUE

SCRANTON,PA18510
23-2813196 		REGIONAL PARENT PA 501(C)(3) 11 - Type III - FI CATHOLIC HEALTH PARTNERS
 
 
 
(79) MERCY HEALTHCARE FOUNDATION

746 JEFFERSON AVENUE

SCRANTON,PA18510
23-2972928 		FOUNDATION PA 501(C)(3) 11 - Type III - FI MERCY HEALTH PARTNERS - NORTHEAST REGION INC
 
 
 
(80) MERCY HOSPITAL SCRANTON PA

746 JEFFERSON AVENUE

SCRANTON,PA18510
24-0795456 		HOSPITAL PA 501(C)(3) 3 MERCY HEALTH PARTNERS - NORTHEAST REGION INC
 
 
 
(81) MERCY COMMUNITY CARE CORPORATION

746 JEFFERSON AVENUE

SCRANTON,PA18510
23-2310566 		MEDICAL CARE PA 501(C)(3) 9 MERCY HEALTH PARTNERS - NORTHEAST REGION INC
 
 
 
(82) MERCY MED-CARE INC

746 JEFFERSON AVENUE

SCRANTON,PA18510
23-2261991 		HOSPITAL PA 501(C)(3) 3 MERCY HEALTH PARTNERS - NORTHEAST REGION INC
 
 
 
(83) MERCY HOSPITAL NANTICOKE

128 W WASHINGTON ST

NANTICOKE,PA18634
23-2604818 		HOSPITAL PA 501(C)(3) 3 MERCY HEALTH PARTNERS - NORTHEAST REGION INC
 
 
 
(84) MERCY HOSPITAL OF WILKES-BARRE

746 JEFFERSON AVENUE

SCRANTON,PA18510
24-0795625 		HOSPITAL PA 501(C)(3) 3 MERCY HEALTH PARTNERS - NORTHEAST REGION INC
 
 
 
(85) MERCY HEALTH CARE CENTER

746 JEFFERSON AVENUE

SCRANTON,PA18510
23-2322809 		HOSPITAL PA 501(C)(3) 3 MERCY HEALTH PARTNERS - NORTHEAST REGION INC
 
 
 
(86) MERCY TYLER HEALTH SYSTEMS

880 SR 6W

TUNKHANNOCK,PA18657
23-2772476 		SUPPORTING ORG PA 501(C)(3) 11 - Type II MERCY HEALTH PARTNERS - NORTHEAST REGION INC
 
 
 
(87) MERCY TYLER HOSPITAL

880 SR 6W

TUNKHANNOCK,PA18657
24-0779665 		HOSPITAL PA 501(C)(3) 3 MERCY TYLER HEALTH SYSTEMS
 
 
 
(88) MERCY TYLER HOME HEALTH SERVICES

880 SR 6W

TUNKHANNOCK,PA18657
23-2723529 		IN-HOME MEDICAL CARE PA 501(C)(3) 9 MERCY TYLER HEALTH SYSTEMS
 
 
 
(89) SIENA SPRINGS

615 ELSINORE PLACE

CINCINNATI,OH45202
31-1052772 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(90) SIENA SPRINGS II

615 ELSINORE PLACE

CINCINNATI,OH45202
31-1591780 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(91) CHARLES MEADOW CORPORATION

615 ELSINORE PLACE

CINCINNATI,OH45202
34-1552671 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(92) CHARLES CREST CORPORATION

615 ELSINORE PLACE

CINCINNATI,OH45202
34-1399869 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(93) CHARLES CREST II CORPORATION

615 ELSINORE PLACE

CINCINNATI,OH45202
34-1714407 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(94) ST THERESA VILLAGE INC

615 ELSINORE PLACE

CINCINNATI,OH45202
31-1411529 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(95) SACRED HEART VILLAGE INC

615 ELSINORE PLACE

CINCINNATI,OH45202
31-1411531 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(96) SACRED HEART VILLAGE II INC

615 ELSINORE PLACE

CINCINNATI,OH45202
61-1339396 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(97) SACRED HEART VILLAGE III INC

615 ELSINORE PLACE

CINCINNATI,OH45202
61-1367719 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(98) MCAULEY MANOR INC

615 ELSINORE PLACE

CINCINNATI,OH45202
31-1548500 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(99) DUBLIN MANOR INC

615 ELSINORE PLACE

CINCINNATI,OH45202
02-0655254 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(100) MERCY MANOR INC

615 ELSINORE PLACE

CINCINNATI,OH45202
61-1344092 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(101) ST MARY'S VILLA INC

615 ELSINORE PLACE

CINCINNATI,OH45202
31-1548512 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(102) RIVERVIEW ST MARY'S INC

615 ELSINORE PLACE

CINCINNATI,OH45202
62-1782683 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
(103) ST MARY'S VILLA AT RIVERVIEW II INC

615 ELSINORE PLACE

CINCINNATI,OH45202
31-1723287 		HUD HOUSING PROJECT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS
 
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No
(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) MERCY HOSPITAL OF DEFIANCE LLC

1404 E SECOND ST
DEFIANCE,OH43512
02-0701635 		HOSPITAL OH ST VINCENT MERCY MEDICAL CENTER
  		N/A 431,811 10,007,261   No 0 Yes   50 %
(4) WEST CENTRAL OHIO REGIONAL HEALTHCARE ALLIANCE

FORT AMANDA ROAD
LIMA,OH45804
34-1817078 		REG HOSPITALS OH NA
  		N/A                
(5) WEST CENTRAL OHIO SURGERY & ENDO CENTER

770 W HIGH ST SUITE 100
LIMA,OH45801
34-1868154 		AMBULATORY SURGERY CENTER OH NA
  		N/A                
(6) NEW VISION MEDICAL LAB LLC

750 W HIGH STREET
LIMA,OH45801
34-1913433 		LAB SERVICES OH NA
  		N/A                
(7) WEST CENTRAL OHIO GROUP LTD

801 MEDICAL DRIVE
LIMA,OH45804
34-1848147 		ORTHOPEDIC HOSPITAL OH NA
  		N/A                
(8) KIDNEY SERVICES OF WEST CENTRAL OHIO

750 W HIGH STREET SUITE 100
LIMA,OH45801
06-1644264 		DIALYSIS CENTER OH NA
  		N/A                
(9) ST ELIZABETH CARDIAC CATH LAB LLC

1044 BELMONT AVE
YOUNGSTOWN,OH44501
30-0023795 		CARDIAC CATH LAB OH NA
  		N/A                
(10) ST ELIZABETH SOUTHWOODS IMAGING

250 DEBARTOLO PLACE BLDG B
YOUNGSTOWN,OH44512
26-1626482 		DIAGNOSTIC IMAGING OH NA
  		N/A                
(11) UROLOGIC ONCOLOGY OF MAHONING VALLEY LLC

1044 BELMONT AVE
YOUNGSTOWN,OH44501
26-2989686 		RADIATION THERAPY OH NA
  		N/A                
(12) HMHPUSP SURGERY CENTERS LLC

15305 DALLAS PKWY STE 1600
ADDISON,TX75001
27-1953122 		SURGERY CENTER TX NA
  		N/A                
(13) OSC-HMHP LLC

6505 MARKET ST BLDG B STE 101
BOARDMAN,OH44512
01-0724836 		ORTHOPEDIC SURGERY CENTER OH NA
  		N/A                
(14) MERCY HEALTHPLEX ANDERSON LLC

7495 STATE ROAD
CINCINNATI,OH45255
31-1589865 		FITNESS FACILITY OH NA
  		N/A                
(15) MERCY HEALTHPLEX FAIRFIELD LLC

3050 MACK ROAD
FAIRFIELD,OH45014
31-1589867 		FITNESS FACILITY OH NA
  		N/A                
(16) LOURDES AMBULATORY SURGERY CENTER

225 MEDICAL CENTER DRIVE
PADUCAH,KY42003
61-1258960 		SURGERY CENTER KY NA
  		N/A                
(17) TOMOGRAPHY ASSOCIATES LLC

2000 CHAPMAN HWY
KNOXVILLE,TN37920
74-2034927 		EQUIPMENT LEASING TN NA
  		N/A                
(18) EAST TENNESSEE DIAGNOSTIC CENTER LLC

1450 DOWELL SPRINGS BLVD SUITE 250
KNOXVILLE,TN37909
20-4773300 		DIAGNOSTIC SERVICES TN NA
  		N/A                
(19) LACKAWANNA SURGERY CENTER LLC

415 ADAMS AVENUE
SCRANTON,PA18503
20-5360014 		AMBULATORY SURGERY CENTER PA 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
(1) CHP INSURANCE LTD
615 ELSINORE PLACE
CINCINNATI,OH45202
98-0621978 		INSURANCE CJ NA
  		C CORPORATION      
(2) HEALTHSPAN INC
225 PICTORIA DRIVE STE 320
CINCINNATI,OH45246
31-1431434 		PPO OH NA
  		C CORPORATION      
(3) MHSWO HEALTH VENTURES INC
1 S LIMESTONE ST
SPRINGFIELD,OH45502
31-1072139 		PHYSICIAN PRACTICES OH NA
  		C CORPORATION      
(4) NORTHPARKE MEDICAL COMMONS CONDO ASSN
333 N LIMESTONE ST
SPRINGFIELD,OH45503
31-1391230 		REAL PROPERTY MGMNT OH NA
  		C CORPORATION      
(5) MERCY HEALTH AFFILIATES INC
2200 JEFFERSON AVENUE
TOLEDO,OH43604
34-1372633 		PHYSICIAN SERVICES OH NA
  		C CORPORATION      
(6) PHYSICIAN'S HEALTH COLLABORATIVE
2200 JEFFERSON AVENUE
TOLEDO,OH43604
20-3986844 		MEDICAL & HOSPITAL SERVICES OH NA
  		C CORPORATION      
(7) NORTHSIDE CORPORATION
2200 JEFFERSON AVENUE
TOLEDO,OH43604
34-1318438 		RESIDENT RENTALS OH NA
  		C CORPORATION      
(8) MERCY WORK SOLUTIONS
2200 JEFFERSON AVENUE
TOLEDO,OH43604
30-0066340 		WORKERS COMPENSATION OH NA
  		C CORPORATION      
(9) GENESIS HEALTH PLAN OF OHIO INC
2200 JEFFERSON AVENUE
TOLEDO,OH43604
34-1819975 		HMO OH NA
  		C CORPORATION      
(10) MERCY HEALTH SYSTEM PHO
2200 JEFFERSON AVENUE
TOLEDO,OH43604
34-1778321 		MEDICAL SERVICES OH NA
  		C CORPORATION      
(11) PHYSICIAN MANAGED CARE INC
2200 JEFFERSON AVENUE
TOLEDO,OH43604
34-1565320 		HEALTH SERVICES OH NA
  		C CORPORATION      
(12) MCAULEY MANAGEMENT SERVICES INC
730 W MARKET STREET
LIMA,OH45801
34-1379037 		PROPERTY RENTAL OH NA
  		C CORPORATION      
(13) LIMA MEDICAL SUPPLIES INC
730 W MARKET STREET
LIMA,OH45801
34-0944477 		MEDICAL EQUIPMENT OH NA
  		C CORPORATION      
(14) COMMUNITY HEALTH PARTNERS ENTERPRISES INC
3700 KOLBE ROAD
LORAIN,OH44053
34-1455525 		HOLDING COMPANY OH NA
  		C CORPORATION      
(15) COMMUNITY HEALTH PARTNERS PHYSICIANS INC
3700 KOLBE ROAD
LORAIN,OH44053
34-1803352 		PHYSICIAN PRACTICES OH NA
  		C CORPORATION      
(16) AMC PHYSICIANS INC
200 W LORAIN STREET
OBERLIN,OH44074
37-1439554 		PHYSICIAN SERVICES OH NA
  		C CORPORATION      
(17) MERCY HEALTH VENTURES INC
4600 MCAULEY PLACE
CINCINNATI,OH45242
31-1185477 		DIVERSIFIED ACTIVITIES OH NA
  		C CORPORATION      
(18) FRANCISCAN HOMES I INC
1300 MAIN STREET
CINCINNATI,OH45210
31-1313185 		LOW-INCOME HOUSING OH NA
  		C CORPORATION      
(19) FRANCISCAN HOMES II INC
1300 MAIN STREET
CINCINNATI,OH45210
31-1336890 		LOW-INCOME HOUSING OH NA
  		C CORPORATION      
(20) FRANCISCAN HOMES III INC
1300 MAIN STREET
CINCINNATI,OH45210
31-1394510 		LOW-INCOME HOUSING OH NA
  		C CORPORATION      
(21) FRANCISCAN HOMES IV INC
1300 MAIN STREET
CINCINNATI,OH45210
31-1483370 		LOW-INCOME HOUSING OH NA
  		C CORPORATION      
(22) MERCY FRANCISCAN AT WINTON WOODS I INC
10290 MILL ROAD
CINCINNATI,OH45231
31-1658668 		LOW-INCOME HOUSING OH NA
  		C CORPORATION      
(23) MERCY HEALTH MANAGEMENT INC
1530 LONE OAK ROAD
PADUCAH,KY42003
61-1086762 		MEDICAL OFFICES KY NA
  		C CORPORATION      
(24) HEALTH DYNAMICS INC
900 E OAK HILL AVENUE
KNOXVILLE,TN37917
62-1247729 		MEDICAL EQUIPMENT SALES TN NA
  		C CORPORATION      
(25) HEALTH VENTURES INC & SUBSIDIARIES
P O BOX 1788
KNOXVILLE,TN37901
62-1175587 		MEDICAL SERVICES TN NA
  		C CORPORATION      
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























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


Software ID: 10000128
Software Version: v2010.1.0