Attach to Form 990 or Form 990-EZ.
See separate instructions.| (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? |
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|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
| 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. | ||||||
| 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). | ||||||






| 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.") . | 0 | 0 | 0 | 0 | 0 | 0 |
| 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...... | 0 | 0 | 0 | 0 | 0 | 0 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | 0 | 0 | 0 | 0 | 0 |
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 6 | Total. Add lines 1 through 5. | 0 | 0 | 0 | 0 | 0 | 0 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | 0 | 0 | 0 | 0 | 0 |
| 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. | 0 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 7a and 7b.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 8 | Public Support (Subtract line 7c from line 6.) | 0 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 0 | 0 | 0 | 0 | 0 | 0 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 0 | 0 | 0 | 0 | 6,148 | 6,148 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 10a and 10b. | 0 | 0 | 0 | 0 | 6,148 | 6,148 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | 0 | 0 | 0 | 0 | 0 |
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | 0 | 0 | 0 | 0 | 0 | 0 |
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 0 | 0 | 0 | 0 | 6,148 | 6,148 |




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 10000077 |
| Software Version: | v1.00 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| F990_P06_S0A_L06 | Form 990, Part VI, Section A, Line 6 | The filing organization has three members. Those members are Mercy Memorial Hospital Corporation, Emma L. Bixby Medical Center and the Barbara Ann Karmanos Center Hospital, who each share 33 1/3% ownership of the filing organization. |
| F990_P06_S0A_L07a | Form 990, Part VI, Section A, Line 7a | Each member appoints it's own person to the filing organizations Board of Directors. |
| F990_P06_S0A_L07b | Form 990, Part VI, Section A, Line 7b | Notwithstanding any other provision in the Bylaws, the Board of Directors does not have any authority to make any decision, expend any corporation funds, incur any liability or take any other action on behalf of the Corporation if to do so would constitute a Major Decision, unless such decision, expenditure, incurrence or tother action has been approved by the Members. |
| F990_P06_S0A_L08b | Form 990, Part VI, Section A, Line 8b | There are no committees other than the governing body. |
| F990_P06_S0A_L09 | Form 990, Part VI, Section A, Line 9 | Debra Herring and Frank Torti have terminated after the tax year ended December 31, 2010 and there is no forwarding address for either. |
| F990_P06_S0B_L11a | Form 990, Part VI, Section B, Line 11a | Form 990,Part VI, Section B, Line 11 - Once the Form 990 is completed, it is reviewed by the person who has possession of the organizations books. Once any needed changes are made, a copy of the Form 990 is presented to the Board members for their review and approval. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | Pursuant to the Member's Agreement, each Director, officer and member of a committee with board-delegated power shall annually sign a statement which affirms that such person has received, understands and will comply with the conflict of interest policy. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | The Monroe Cancer Center governing documents, conflict of interest statements and financial statements are available to the public upon request. |
| F990_P11_S00_L05 | Form 990, Part XI, Line 5 | Emma L Bixby Medical Center, Karmanos Cancer Center and Mercy Memorial Hospital System are equal partners in this joint venture. Bixby and Mercy each contributed $1,100,000 and Karmanos contributed their CON valued at $1,100,000. |
| Software ID: | 10000077 |
| Software Version: | v1.00 |