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
Mercy Hospital
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
144 State Street
 
Room/suite
City or town, state or country, and ZIP + 4
Portland, ME041013795
D Employer identification number

01-0211534
E Telephone number

G Gross receipts $ 190,456,005
F Name and address of principal officer:
Eileen Skinner
144 State Street
Portland,ME041013795
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.mercyhospital.com
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 MediumBullet  
K Form of organization:
 
L Year of formation: 1945
M State of legal domicile: ME
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: Mercy Hospital carries out the healing work of Christ by providing clinically excellent, compassionate healthcare for all, with special concern for the poor and disadvantaged.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 28
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 22
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 1,979
6 Total number of volunteers (estimate if necessary) .... 6 477
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 929,814 1,100,877
9 Program service revenue (Part VIII, line 2g) ......... 192,724,923 186,573,567
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -11,649 1,153,624
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,003,178 1,536,041
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 195,646,266 190,364,109
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) 103,398,714 102,903,247
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet674,883    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 97,241,050 104,122,902
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 200,639,764 207,026,149
19 Revenue less expenses. Subtract line 18 from line 12...... -4,993,498 -16,662,040
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 204,837,431 206,185,828
21 Total liabilities (Part X, line 26)............ 102,906,522 119,849,704
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 101,930,909 86,336,124
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: Mercy Hospital carries out the healing work of Christ by providing clinically excellent, compassionate healthcare for all, with special concern for the poor and disadvantaged.
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 $ 172,793,771 including grants of $   ) (Revenue $ 186,573,567 )
Provide access to healthcare for all people through direct patient care at Mercy's various hospital, clinical and physician locations. In providing these services, the organization absorbs significant costs that are not reimbursed through Medicare, Medicaid or other programs. In addition, as part of our mission, we maintain a charity care program that exceeds the Federal Poverty Guidelines. The Company also provides and sponsors a number of socially responsible activities and events that have a positive impact on the lives of the residents of the Greater Portland Community.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 172,793,771
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
Yes
 
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................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
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
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
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...... Click to see attachment
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................ Click to see attachment
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........................... Click to see attachment
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............... Click to see attachment
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 ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
158
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
1,979
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
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
28
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
22
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
ME
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
Douglas W Libby
144 State Street
Portland,ME041013795
(207) 879-3000
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) Edward Ted McCarthy
Chief of Medical Staff
 40.00 X           195,223 0 26,390
(2) Eileen Skinner
President & CEO
 40.00 X   X       527,379 0 50,021
(3) Thomas W Yoder Jr
Chairman
 5.00 X   X       0 0 0
(4) Joseph R Foley
Vice Chairman
 5.00 X   X       0 0 0
(5) Karen Hart
Secretary
 5.00 X   X       0 0 0
(6) Paul Bloch MD
Trustee
 2.50 X           0 0 0
(7) Sr Barbara Brennan RSM
Trustee
 2.50 X           0 0 0
(8) Sr Patricia Flynn RSM PhD
Trustee
 2.50 X           0 0 0
(9) Joseph Gray
Trustee
 2.50 X           0 0 0
(10) Margaret Hourigan
Trustee
 2.50 X           0 0 0
(11) Lois Lengyel
Trustee
 2.50 X           0 0 0
(12) Cheryl Libby
Trustee
 2.50 X           0 0 0
(13) Paul Lones
Trustee
 2.50 X           0 0 0
(14) Daniel Merson DO
Trustee
 2.50 X           0 0 0
(15) Brenda Miley
Trustee
 2.50 X           0 0 0
(16) Lisa Miller
Trustee
 2.50 X           0 0 0
(17) John S Marr Jr
Trustee
 2.50 X           0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Thimi Mina
Trustee
 2.50 X           0 0 0
(19) Sr Mary Morey RSM
Trustee
 2.50 X           0 0 0
(20) Mary Louise Norton
Trustee
 2.50 X           0 0 0
(21) Gregg Otterbein
Trustee
 2.50 X           0 0 0
(22) Sr Patricia Pora RSM
Trustee
 2.50 X           0 0 0
(23) Jeffrey Rosenblatt MD
Chief of Medical Staff
 2.50 X           0 0 0
(24) David Small
Trustee
 2.50 X           0 0 0
(25) Sr Kathleen M Smith RSM
Trustee
 2.50 X           0 0 0
(26) Nelson A Toner Esq
Trustee
 2.50 X           0 0 0
(27) Isabella Thurston MD
Trustee
 2.50 X           0 0 0
(28) Sr Janice Turner RSM
Trustee
 2.50 X           0 0 0
(29) Bruce Wagner
Trustee
 2.50 X           0 0 0
(30) Wayne Bennett
Chief Financial Officer
 40.00     X       282,825 0 34,289
(31) Michael Hachey
SVP Ambulatory Services
 40.00       X     326,343 0 35,073
(32) Robert Nutter
VP HR & Support Services
 40.00       X     261,752 0 37,975
(33) Stephen Sears
VP Medical Affairs
 40.00       X     102,056 0 1,270
(34) Scott Rusk
VP Medical Affairs
 40.00       X     157,703 0 11,314
(35) Gregory Pomeroy
Lead Physician
 40.00         X   741,431 0 35,538
(36) Marc Hodroff
Physician
 40.00         X   470,629 0 26,527
(37) Gregory Adey
Physician
 40.00         X   469,242 0 31,036
(38) Roger Inhorn
Medical Director, Oncol
 40.00         X   369,384 0 31,399
(39) Peter Ameglio
Physician
 40.00         X   356,463 0 32,065
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 4,158,374 0 351,627
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet114
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Synernet Inc
222 St John Street Ste 329
Portland,ME04102 		Transcription services, equipment mainte 1,784,308
New Albany Healthcare Consultants LLC
68 NHigh Street
New Albany,OH43054 		Consulting/management 1,106,973
Quest Diagonostics
5763 Collection Center Drive
Chicago,IL60693 		Patient test services 1,063,073
Seabreeze Property Services
PO Box 617
Portland,ME04102 		Grounds management, maintenance & repair 885,076
Burgess Advertising & Associates Inc
1290 Congress Street
Portland,ME04102 		Advertising development and production a 548,021
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet38
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 62,499
d Related organizations...1d 5,000
e Government grants (contributions)1e 80,000
f All other contributions, gifts, grants, and
similar amounts not included above1f 		953,378
g Noncash contributions included in lines 1a-1f:$ 25,181
h Total. Add lines 1a-1f.......MediumBullet 1,100,877
Program Service Revenue Business Code
2a Patient Service Revenu 621,110 185,773,340 185,773,340    
b All Other Program Serv 621,110 800,227 800,227    
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 186,573,567
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 463,408     463,408
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 466,881  
b Less: rental expenses    
c Rental income or (loss) 466,881  
d Net rental income or (loss).......MediumBullet 466,881     466,881
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 396,857 293,359
b Less: cost or other basis and sales expenses    
c Gain or (loss) 396,857 293,359
d Net gain or (loss)..........MediumBullet 690,216     690,216
8a Gross income from fundraising events (not including
$ 62,499
of contributions reported on line 1c). See Part IV, line 18 ...
a 221,870
b Less: direct expenses ...b 91,896
c Net income or (loss) from fundraising events..MediumBullet 129,974   129,974
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a Cafeteria Income 722,210 939,186     939,186
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 939,186
12 Total revenue. See Instructions....MediumBullet 190,364,109 186,573,567 0 2,689,665
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    
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 1,745,306 1,594,306 151,000  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 79,399,349 72,279,354 6,845,737 274,258
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 2,645,495 2,409,555 222,657 13,283
9 Other employee benefits ....... 13,066,746 11,841,194 1,161,260 64,292
10 Payroll taxes ........... 6,046,351 5,365,441 659,298 21,612
11 Fees for services (non-employees):        
a Management ...... 2,418,242   2,418,242  
b Legal ......... 388,352 76,330 312,022  
c Accounting ........... 325,956   325,956  
d Lobbying ........... 102,585   102,585  
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ...... 335,274   335,274  
g Other .......... 16,629,208 12,933,725 3,580,924 114,559
12 Advertising and promotion .... 1,062,774   1,054,538 8,236
13 Office expenses ....... 40,007,723 36,312,254 3,526,301 169,168
14 Information technology ...... 4,728,287   4,728,287  
15 Royalties ..        
16 Occupancy ........... 5,262,961 4,819,197 443,764  
17 Travel ............ 89,090 58,273 29,586 1,231
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 7,108 5,618 1,490  
20 Interest ........... 2,298,632   2,298,632  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 10,839,664 8,055,697 2,776,944 7,023
23 Insurance .............. 3,051,895 2,763,029 288,866  
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 13,787,976 13,787,976    
b Dues and Subscriptions 2,139,132 281,142 1,856,769 1,221
c Loss on Extingishment o 330,016   330,016  
d Auxiliary 168,960 168,960    
e
f All other expenses 149,067 41,720 107,347  
25 Total functional expenses. Add lines 1 through 24f 207,026,149 172,793,771 33,557,495 674,883
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1  
2 Savings and temporary cash investments ....... 12,630,919 2 4,257,240
3 Pledges and grants receivable, net ......... 378,048 3  
4 Accounts receivable, net ......... 19,365,915 4 25,219,266
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 .............. 4,318,784 8 4,283,233
9 Prepaid expenses and deferred charges ............ 641,173 9 2,425,062
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 190,310,534
b Less: accumulated depreciation. ..... 10b 82,988,631 113,141,814 10c 107,321,903
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ...... 25,297,290 12 27,264,472
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14 246,167
15 Other assets. See Part IV, line 11 ........... 29,063,488 15 35,168,485
16 Total assets. Add lines 1 through 15 (must equal line 34)... 204,837,431 16 206,185,828
Liabilities 17 Accounts payable and accrued expenses . 17,218,554 17 19,100,602
18 Grants payable ..........   18  
19 Deferred revenue .......... 961,634 19 1,150,377
20 Tax-exempt bond liabilities .......... 74,110,942 20 73,886,719
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 .. 558,337 23 303,963
24 Unsecured notes and loans payable to unrelated third parties ....   24 57,846
25 Other liabilities. Complete Part X of Schedule D..... 10,057,055 25 25,350,197
26 Total liabilities. Add lines 17 through 25..... 102,906,522 26 119,849,704
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 ..... 99,734,665 27 84,203,259
28 Temporarily restricted net assets ..... 1,212,820 28 1,080,540
29 Permanently restricted net assets ..... 983,424 29 1,052,325
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 ..... 101,930,909 33 86,336,124
34 Total liabilities and net assets/fund balances ..... 204,837,431 34 206,185,828
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
190,364,109
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
207,026,149
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
-16,662,040
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
101,930,909
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
1,067,255
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
86,336,124
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
 
No
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
 
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


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

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

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

01-0211534
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

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

Additional Data


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

01-0211534
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
Mercy Hospital
  		Employer identification number

01-0211534
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
Mercy Hospital
  		Employer identification number

01-0211534
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
Mercy Hospital
  		Employer identification number

01-0211534
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


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

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

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

01-0211534
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

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

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

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

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










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

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

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


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
Yes
 
500
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
85,250
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
16,835
j
Total. lines 1c through 1i ...................................
102,585
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Explanation of Other Lobbying Activities: Part II-B, Line 1i: Percentage of dues paid to Maine Hospital Association (MHA) and American Hospital Association (AMA) used by MHA and AHA for lobbying purposes.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

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

01-0211534
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 .... 983,424 873,360 1,086,370
b Contributions ........ 4,188 31,500 1,500
c Investment earnings or losses ... 64,713 78,564 -214,510
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ...... 1,052,325 983,424 873,360
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet100.000 %
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)
 
No
(ii) related organizations ........................
3a(ii)
 
No
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 .................   6,251,723 6,251,723
b Buildings ................   102,687,455 33,834,099 68,853,356
c Leasehold improvements ............   3,144,243 1,219,168 1,925,075
d Equipment ................   71,426,824 44,773,106 26,653,718
e Other .................   6,800,289 3,162,258 3,638,031
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 107,321,903
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    
(3)Other
(A) Marketable Equity Securities 		15,521,892 F

(B) Marketable Debt Securities 		4,510,876 F

(C) Alternative Investments 		7,231,704 F






Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 27,264,472
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
(1) Due from Third-Party Payors 30,709,226
(2) Other Accounts Receivable 2,607,436
(3) Unamortized Financing 709,223
(4) Other Assets 850,326
(5) Market Value Swap Asset 292,274




Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 35,168,485
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
Market Value Swap Liability 322,405
Workers Compensation Reserve 2,981,000
Accrued Pension Liability 1,866,698
Other Reserves 2,949,399
Due to Third Party Payors 4,123,879
Asset Retirement Obligation 412,702
Due to Related Companies 12,694,114


Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 25,350,197
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

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

Additional Data


Software ID:  
Software Version:  




SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
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
Mercy Hospital
 
Employer identification number

01-0211534
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

Gary's House Golf
(event type) 		(b) Event #2

Mercy Golf
(event type) 		(c) Other Events

2
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 147,414 56,356 80,599 284,369
2 Less: Charitable
contributions . . . 		33,175 25,692 3,632 62,499
3 Gross income (line 1
minus line 2) . . . 		114,239 30,664 76,967 221,870
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . . 4,750 1,400   6,150
6 Rent/facility costs . . 1,000   2,290 3,290
7 Food and beverages . . 15,882 6,083 4,520 26,485
8 Entertainment . . .     900 900
9 Other direct expenses . 25,270 20,364 9,437 55,071
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 91,896
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow 129,974
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2010
Additional Data


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

01-0211534
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
Yes
 
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
 
No
6a
Does the organization prepare an annual community benefit report?.............
6a
 
No
6b
If "Yes," does the organization make it available to the public? ..............
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
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) .. 		    5,941,086   5,941,086 2.870 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    34,285,979 25,830,693 8,455,286 4.080 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs ..... 		    40,227,065 25,830,693 14,396,372 6.950 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    1,296,272 615,549 680,723 0.330 %
f Health professions education
(from Worksheet 5) .. 		    183,517 36,934 146,583 0.070 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		           
jTotal Other Benefits ...     1,479,789 652,483 827,306 0.400 %
kTotal. Add lines 7d and 7j. ..     41,706,854 26,483,176 15,223,678 7.350 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members     8,365   8,365 0 %
6 Coalition building            
7 Community health improvement advocacy     132,976   132,976 0.060 %
8 Workforce development            
9 Other            
10 Total     141,341   141,341 0.060 %
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
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
7,716,122
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
232,519
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
60,567,727
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
73,155,859
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-12,588,132
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 Mercy Hospital
144 State Street
Portland,ME04101 		X X         X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

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

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

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

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

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?  
Name and address Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    Part I, Line 6a: The organization's community benefit activities are included in Catholic Health East's Community Benefit Report.
    Part I, Line 7: The method used was a cost to charge ratio derived from the most recent Medicare Cost Report data.
    Part I, L7 Col(f): The amount of bad debt expense the organization included on Form 990, Part IX, Line 25 , column (a) but subtracted for purposes of calculating the percentage in Schedule H, Part 1 line 7, column (f) is 13,787,976.
    Part II: Outreach and Community Building with the City of Portland - Public Health Impact:- The Portland Free Clinic is a collaborative effort between Mercy Hospital and the City of Portland's Public Health Department. Clinic patients are predominantly individuals without insurance, including individuals who are ineligible for Medicaid (MaineCare). In 2010, Mercy provided cash subsidization of approximately $180,000 to the Clinic, not including volunteer hours. During calendar year 2010, Free Clinic statistics were as follow: 558 patients were seen; there were 1910 individual visits. Mercy Hospital is the preferred referral provider for patients of the Portland Free Clinic for hospital admissions, diagnostic testing and laboratory work. There were a total of 95 non-English speaking patient encounters in 2010; with the largest group speaking Spanish.- Mercy is also home to the state's largest behavioral health provider, the Mercy Recovery Center (MRC). MRC is staffed with 65 full time employees, including Physicians, Substance Abuse and Behavioral Health Specialists, Administrators and Program Support personnel. The MRC provides approximately $1,000,000 in free care annually to about 700 patients without insurance.- Mercy is an active participant on the Cumberland District Public Health Council of which Colleen Hilton, Executive Director of Mercy's VNA Home Health & Hospice division, is the Executive Director. - Additional Participation on Community Boards and Committees by Mercy staff includes (but is not limited to): Portland's Community Police Advisory Board; Maine Health Management Coalition; St. Joseph's College, Daniel Hanley Center for Health Leadership, Maine Health and Higher Educational Facilities Authority, Portland Stage Company, Park Danforth, Synernet, Greater Portland Landmarks, community health fairs; and volunteering for community health events such as Legs for Life and others.Addressing the Needs of the Multicultural Community: - Mercy interpreter services for consumers and families who interact with Mercy are being improved through Mercy's participation in a Robert Wood Johnson funded, Aligning Forces for Quality, language improvement collaborative. By providing a trained medical interpreter for all patients with a language barrier, both the quality and safety of multicultural patients' experience with the healthcare system is enhanced.- Mercy Hospital offers free English as a Second Language, ESL classes, to all volunteers, community members and employees.- In 2010, Mercy participated in the City of Portland's 5th Annual Multicultural Exercise for Health and Love, during which Mercy provided screening services and health counseling. Portland Area Residential Services Consortium: Mercy Hospital has convened the Portland Area Residential Services Consortium (PARC) and developed a community-based residential model to serve as an alternative to the traditional, bundled, 28-day residential treatment model for patients that battle substance abuse. The traditional model is not cost effective, and as a result, beds are expensive and of limited availability. The PARC project has two goals: 1) to increase residential treatment capacity in greater Portland and 2) to develop a client-centric, cost-effective and sustainable program using the elements of the collaborative, community-based residential model. Through collaboration among agencies that already offer services that our clients need, we can provide unbundled, individualized treatment services, thereby reducing cost and increasing efficiency.The PARC model is safe, sober housing with outpatient substance abuse treatment services; case management and referral; a web-based shared medical record, and peer support and navigation. Treatment for all clients begins with two key elements: therapy-based intensive outpatient treatment from a substance abuse agency, and safe housing in a supported sober living environment. The homes are staffed 24-hours a day with a knowledgeable Case Manager, called a Care Coordinator . The length of stay at sober houses is flexible, with a goal for every client to discharge to an appropriate transitional, supported, and/or permanent housing situation.Secondly, instead of creating an artificial treatment environment that disappears on discharge day, the clients are provided with resources and life skills for healthier, long-term functionality. Care Coordinators make referrals, help clients navigate community services, assist with transportation, and provide milieu support. During 2010, the program served 35 patients and expects to serve 75 patients in year one of operation. The Advisory Committee is a group of community stakeholders who meet bimonthly to advise the PARC project. Its function is to: 1) serve as a public relations forum; 2) identify unmet needs in the community; 3) engage stakeholders; 4) assist in strategic planning for the next three years; 5) advocate for the initiative; 6) insure sustainability; and 7) network (connect to other organizations, initiatives and funding). Mercy also provides supportive services that lie outside these descriptions, and enhance our non-profit profile. McAuley Residence:McAuley Residence is Mercy Hospital's transitional housing program for women. The residents may have their children live with them at McAuley Residence. It is currently located across the street from the Mercy Hospital State Street Campus, in the heart of Portland. The 24-month program serves needy women and their children primarily from southern Maine, but some may come from other parts of the state. The program's mission is to provide an empowering environment where a woman can gain stability, build life skills, develop goals, and lead a more meaningful, holistic life. At McAuley Residence, the residents have access to clinical staff and a diverse group of providers, to help them gain a solid foothold in society. Most women who come to the program have been abused at one time, and are recovering from addiction, are homeless, have no savings, no job, have not completed their education, have not had recent medical or dental care, and have little knowledge about available resources. In the past 22 years, McAuley Residence has served over 200 women and children.Gary's House (Hospitality House): Gary's House is a hospitality home for families of patients undergoing medical treatment in Portland area hospitals. Founded by Mercy Hospital in 1998, Gary's House provides a supportive and economical ($15 per night) home away from home at a time of great stress. In 2010, 474 families were served and an elevator was added in 2009 to ensure that guests with mobility concerns can stay comfortably at Gary's House.Global Health Ministry: Global Health Ministry is an independent 501(c)(3) organization sponsored by Hope Ministries and serves as a supportive health corporation of Catholic Health East of which Mercy Health System of Maine is a member. Each year Mercy Hospital encourages clinical and non-clinical employees to participate in a missionary trip to one of Global Health Ministry's sites to provide healthcare services and education. Since 1989, Global Health Ministry has sent teams of healthcare professionals to provincial villages and distressed urban areas in Latin America and the Caribbean to help people with little or no access to professional healthcare. Founded as Global Outreach, today's Global Health Ministry has served thousands of people through the dedicated work of hundreds of volunteers. Mission site development includes: Chulucanas, Peru; Esquipulas, Guatemala; Port au Prince, Haiti, and Kingston, Jamaica. In response to the devastation in Haiti, Mercy Hospital donated medical supplies and equipment that was picked up by the International Medical Equipment Collaborative and transported via container ship to Haiti. Mercy employees also donated funds to the American Red Cross and to Konbit Sante Cap-Haitien Health Partnership, a 501(c)3 not-for-profit corporation organized in the State of Maine. Konbit Sante's mission is to support the development of a sustainable health care system to meet the needs of the Cap-Haitien community with maximum local direction and support.
    Part III, Line 4: Mercy Hospital provides an allowance for doubtful accounts for estimated losses resulting from the unwillingness of patients or third-party payors to make payments for services. The allowance is determined by analyzing historical data and trends. Accounts receivable are written off against the allowance for doubtful accounts when managment determines that recovery is unlikely and refers collection efforts to a third-party collector under contract. Recoveries of bad debt write-offs reduce bad debt expense. The costing methodology used for determining Mercy Hospital's bad debt expense at cost is applying a cost to charge ratio on the value of the organizations bad debt expense. To determine the estimated amount of bad debt expense (at cost) attributable to patients eligible under the organizations's charity care policy, the calculated percentage of total charity care to total gross patient revenue was applied to the total bad debt expense. The resulting amount was multiplied by the Medicare cost to charge ratio. Although our charity care policies and procedures make every effort to indentify thoses patients who are eligible for charity care before the billing process begins, often it is not possible to make an appropriate determination until after the billing and collection cycle has commenced. The rationale for including bad debt amounts in community benefits would be to account for those patients who were classified as bad debt expense, but would have qualified for charity care if sufficient information had been availiable to make a determination of their eligibility.Discounts on patient accounts are not considered to be bad debts.
    Part III, Line 8: The costing methodology to determine Mercy Hopsital's Medicare shortfall is calculated by applying a cost-to-charge ratio on the value of gross Medicare revenue to determine an estimate of total revenue received from Medicare and comparing this amount to allowable costs of care.
    Part III, Line 9b: Mercy Hospital's written debt collection policy clearly states that patients who are known to qualify for charity care or financial assistance are covered under Mercy Hospital's charity care policy. The charity care policy outlines specific parameters for collection practices for charity care patients.
    Part VI, Line 2: Aligning community services using community identified health indicators:Mercy Hospital works to align our services with the health needs of the community by using the health indicators listed in the Community Health Profile for Cumberland County, annual data provided by Portland's Public Health Division, and a comprehensive asset map and analysis provided by Catholic Health East. These health indicators are as follows: Health Status; Access to Health Care; Physical Activity; Asthma; Tobacco Use; Diabetes; Nutrition; Hypertension; Overweight and Obesity; Mammogram; Medical Care Costs; Pap Smear, Alcohol/Drug Abuse, and Safety/Security/ Domestic Violence. The indicators targeted by Mercy's outreach efforts include: (1) Access to Health Care; (2) Alcohol/Drug Abuse; (3) Health Status; (4) Medical Care Costs.; (5) Nutrition.; and (6) Diabetes.The following are examples of Mercy Hospital community services and the relevant community health indicator: (1) Access to Health Care - Portland Free Clinic, Wellness Clinics, Volunteer Services, School of Radiology, Community Health Outreach Workers (CHOW), Mercy's OB Clinic, and Interpreter's Training Sponsorship; (2) Alcohol/Drug Abuse - HOME Team and Portland's Area Regional Consortium Advisory Board; (3) Health Status - Cancer Support Groups, Pastoral Care-Hospice Visits, McAuley Residence and Hearts to Souls Event; (4) Medical Care Costs - Portland Free Clinic, Advanced Patient Advocacy, McAuley Residence, and Community Health Outreach Worker Training; (5) Nutrition - Nutrition Education and Counseling and "Cooking for One" Class; and (6) Diabetes - Diabetes Self-Management Education Program.HOME Team:Chronically homeless persons in Portland use an inordinate amount of resources without benefit of improved health status or overall quality of life. Many of these homeless individuals end up in hospital emergency departments and the Cumberland County Jail at great cost to the local municipalities and state. In July 2010, the HOME Team - Mobile Van Unit with Street Intervention Workers - was launched to engage chronically homeless individuals in services that will get them off the streets and into safe, stabilized situations. By going to the streets and reaching out directly to this group, the HOME Team has formed relationships, identified unmet social service needs, and made appropriate referrals to community programs. Through active assessment, intervention and referral services, the team has guided these individuals to the appropriate services by accessing the current service delivery system and has markedly reduced the number of contacts with Portland Police and Fire and Rescue. An analysis from July 2010 through December 2010 showed that the HOME Team had 5192 contacts during the six months of operation or roughly 200 contacts per week. The team achieved a 10% reduction in Emergency Department visits at Mercy Hospital and a 30% reduction at Maine Medical Center for this target population. The data also suggests a significant drop in the number of police responses to high frequency users who were passed out on the street. It should be noted that police policy changed in May of 2010 as to when they would respond to calls for service involving layouts. Given the resources of the HOME Team, police no longer respond to initial calls, they do respond if they receive a second call. Even when controlling for this change in police policy, the data suggests an 82 percent drop in police responses to calls for individuals who were passed out on the street.Community Health Outreach Workers:Through a partnership with the City of Portland, Mercy employs two Community Health Outreach Workers (CHOW) to assist with community outreach and care navigation for patients with diverse backgrounds. The Latino CHOW works primarily at the Portland Community Free Clinic coordinating care and assisting patients with access to follow up care with a Mercy provider or specialist. The Somali CHOW works in Mercy's Fore River Family Practice and manages a case load of patients, ensuring that patients with chronic disease or behavioral health concerns successfully navigate the system of care. Both of the CHOWs provide necessary translation of documents or flyers.Mattina R. Proctor Diabetes Center:The Diabetes Self-Management Education Program (DSME) at Mercy Hospital assists persons with diabetes in acquiring the knowledge, skills, and attitudes necessary to achieve and maintain good diabetes control. DSME is offered in group or individual sessions that include general DSME, insulin initiation/adjustment, self blood glucose management, gestational diabetes counseling, and insulin pump therapy. The target audience is newly diagnosed or previously diagnosed adults with diabetes, which includes Type 1, Type 2, and gestational diabetes and their significant others. Both the nurse and dietician conduct an individual needs assessment with each client and clients attending group classes have a post-assessment interview within one month of completing the classes. A follow-up group is offered monthly continuing for up to one year. Education services for patients are scheduled at intervals based on individual needs and assessment of health status, knowledge, skills, and attitudes, behavioral goal achievement, and post-partum clinical outcomes. Education materials are offered in various languages and literacy levels. A detailed follow up plan for each patient is communicated to the referring provider. Our professional staff includes an Endocrinologist Medical Director, Nurse Manager, RN Clinical Dietician, and RN Diabetes Educator.Mercy's OB Clinic:In 2010, the Mercy Hospital OB Clinic provided low risk prenatal care for 927 patients; many of whom have diverse backgrounds and limited English proficiency. The clinic is open two days per week and staffed with Nurse Midwives and Professional Nurses. Staff administers a psycho-social assessment to include a risk assessment for domestic violence, nutritional screens, prenatal lab work, adolescent screens for young women under 18 years of age and add appropriate supports to foster safe and healthy delivery. Referrals occur from the community and primary care physicians. Mercy's School of Radiology:In partnership with Southern Maine Community College, Mercy Hospital offers a two-year associates degree program in radiologic technology with didactic and clinical training. Clinical sites include all of Mercy Hospital locations that offer x-ray services and Maine Medical Center for specific training in certain aspects of clinical competency. The program graduates eight to ten students annually that are well prepared for the radiologic technology examination boards. This program supports the need for skilled technicians in new urgent care sites, expanded Emergency Departments, cardiac catheterization and vascular intervention labs and expanding mammography sites throughout the State of Maine.Mercy's Volunteer Program:In 2010, over 477 volunteers gave of their skills, time and energy to our healthcare system. Their contribution was as varied as the individuals providing the support services to patients and clerical assistance to staff. Volunteers provided support in most hospital departments and at primary and specialty care sites throughout the year - in filing records, escorting patients, knitting for The Birthplace, registering patients for Mercy's flu and vascular clinics, greeting visitors, staffing the Gift Shop, and assisting with childcare in our transitional housing program. Portland is one of nine designated Refugee Resettlement Communities in the United States and welcomes primary and secondary immigrants as well as those seeking political asylum from around the world. The Manager of Mission Services works closely with the Department of Health and Human Services to develop meaningful roles for mothers involved in Maine's welfare to work program called ASPIRE (Additional Support for People in Retraining and Employment) and new immigrants to assist them to become accustomed to the workplace environment. In 2010, Mercy offered English as a second language classes for volunteers and staff in partnership with Portland's Adult Education. Mercy's Employee Health office provided TB tests, flu shots, and inoculations for measles, mumps, rubella, and varicella for 83 senior and 76 junior volunteers. Thirteen volunteers required additional lab work and chest xrays as a result of positive TB tests.
    Part VI, Line 3: The following is taken from our charity care policy and describes how the organization informs and educates patients on charity care: Public Notice of the availibility of assistance through this policy is made through each of the following means: 1. Posting notices in a visible manner in locations where there is a high volume of inpatient or outpatient admitting/registration, such as emergency departments, billing offices, admitting offices, and hospital outpatient service settings. 2. Posting notice of availiablity of assistance and contact names and phone numbers on the organization's website. 3. Providing unisured patients a matrix outlining the types of financial assistance available. Upon request, a full text copy of the Charity Care policy should be made available. 4. Making available to the public on a reasonable basis: the annual charity care provided; the unreimbursed costs of care provided to the benificiaries of government programs that serve the poor (being defined as shorfalls between costs and off-setting reimbursement/revenue that the organization experiences in providing care under the Medicaid and local/county indigent programs for care provided to Medicare beneficiaries who are dually eligible for Medicaid). Posted notices (as listed above) shall be in the primary languages(s) of the service area and in a manner consistent with all applicable federal and state laws and regulations. Should any provision of this Policy conflict with the State of Maine requirements surrounding Charity Care, State law shall supersede the conflicting policy provision and the facility shall act in conformance with applicable State law.
    Part VI, Line 4: The geographic area served by Mercy Hospital programs is primarily Cumberland and York counties in south coastal Maine. Two distinct geographic exceptions are the Mercy Recovery Center, Maine's largest addiction treatment facility, which serves patients statewide, and the Northern New England Eating Disorders Program, the only such program located north of Massachusetts. The "community" can be defined in micro fashion, i.e. the city and discreet neighborhood in which Mercy is located, and in macro fashion, i.e. the larger geographical service area (primarily the two counties, but with a widening catchment area). Portland and the West End - Mercy's acute care campuses at Fore River and State Street are located in the West End neighborhood of Portland (Cumberland County), the state's most populous city (pop. 63,591). While population density for the state as a whole is 37 people per square mile, and for Portland itself is 3,029 people per square mile, in the West End (the state's most densely populated neighborhood) the density measure is 10,568 people per square mile. While median income is lower in Portland than in the rest of the state, median income in the West End is lower than Portland's by $7,800 ($35,770 vs. $43,603). In addition, while as a designated Refugee Resettlement City, Portland has a more culturally and ethnically diverse population than Maine (9.4% vs. 3.6% non-white), a larger percentage of residents are foreign born (8.1% vs. 7.6%) in the West End than in the rest of Portland. Portland is home to the largest population of Somali, Sudanese, Rwandan and other pan-African populations in Maine, as well as large populations of Hispanics, Asians, Russians and other ethnic groups. In summary, Portland is more densely populated, poorer and more culturally diverse than the rest of Maine, and our immediate neighborhood, the West End, is even more so in all three categories. Portland is also home to a significant population of homeless individuals, drawn to the city by the network of homeless-serving social service agencies, including a dedicated FQHC (Federally Qualified Health Center) operated by the City of Portland Public Health Division, located less than a mile from Mercy's State Street Campus. This FQHC is strictly for homeless individuals, though Portland Public Health and Mercy Hospital collaborate to provide clinic based services to the poor who are Medicaid (MaineCare) ineligible by subsidizing the Portland Free Clinic with funding and volunteers. A second FQHC, the Portland Community Health Center for MaineCare eligible individuals and children opened in 2009. Mercy Hospital provides the necessary ancillary services and referrals for inpatient admissions from the FQHCs.Mercy's involvement in a wide range of community benefit initiatives to improve the health and lives of individuals and families in the City of Portland is discussed elsewhere in this narrative. Overall Service Area - While the Portland community is a major focus of Mercy healthcare and community involvement, the organization's catchment area (Cumberland and York counties, and wider) also includes more rural areas such as Gorham ("very rural" designation, with a pop. of 4,302) , Standish ("rural" pop. 9,895) , and Buxton ("rural" pop. 8,072) . To facilitate access to primary care - the basic building block of healthcare reform - in these outlying rural areas, Mercy has established primary care practice (PCP) sites in several of them: Windham; Gorham; Standish; and West Falmouth. These are in addition to PCP sites in Portland and Westbrook. Both the micro and macro communities share some common demographic themes, and in fact share them with the rest of Maine - populations that are more socioeconomically challenged, older, and have higher rates of chronic illness than much of the US. Poverty is a known determinant of poor health, and the percentage of people living below the poverty level is higher in the City of Portland (14.1%) than in Maine (12.6%) and nationally (13.2%). US Census figures for 2008 also reveal that the city of Portland, Cumberland County, York County, and the State of Maine all have higher percentages of residents over age 65 than the US as a whole (13.9%, 13.9%, 14.6%, 15.1% vs. the US average of 12.8%). The elderly have higher rates of chronic illness such as heart disease, stroke, diabetes, cancer and osteoporosis, and present a special challenge to Mercy (addressed by our VNA Home Health & Hospice division). While Portland has one of the few city-based public health departments in the state (Portland Public Health, with whom Mercy collaborates to provide care to the poor and disadvantaged), Maine is in the process of developing a statewide public health system with eight distinct districts, to address community health needs, including (but not limited to) reducing disparities and lowering the rate of chronic illness, Emergency Department utilization, etc. Mercy's service area is included within two of these districts: the Cumberland District and the York District. Our involvement with community and public health initiatives is discussed elsewhere in this narrative.
    Part VI, Line 6:
    Part VI, Line 6: In addition to the activities listed in Part VI, Line 2, the Hospital maintains an open medical staff and is governed by a board consisting largely of independent members.Part VI, Line 7:CHE's Community Benefit report is filed in AL, CT, DE, FL, GA, ME, MA, NJ, NY, NC an PA.Part VI, Line 2 - Continued:Advanced Patient AdvocacyMercy Hospital utilizes the services of Advanced Patient Advocacy to assist patients who do not have insurance or have minimal health coverage in covering medical costs. Advanced Patient Advocacy educates patients about their coverage options, helps patients navigate the complex federal, state and community program application process, and connects and enrolls patients with coverage that best meets the patient's needs and provides the best reimbursement for the healthcare services.
Schedule H (Form 990) 2010
Additional Data


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

01-0211534
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
 
No
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
Yes
 
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) Edward Ted McCarthy (i)
(ii)		 172,624
0 		4,900
0 		17,699
0 		8,180
0 		18,210
0 		221,613
0 		0
0
(2) Eileen Skinner (i)
(ii)		 356,495
0 		63,063
0 		107,821
0 		15,386
0 		34,635
0 		577,400
0 		0
0
(3) Wayne Bennett (i)
(ii)		 205,392
0 		24,887
0 		52,546
0 		9,851
0 		24,438
0 		317,114
0 		0
0
(4) Michael Hachey (i)
(ii)		 233,315
0 		34,325
0 		58,703
0 		10,413
0 		24,660
0 		361,416
0 		0
0
(5) Robert Nutter (i)
(ii)		 196,449
0 		32,274
0 		33,029
0 		13,233
0 		24,742
0 		299,727
0 		0
0
(6) Scott Rusk (i)
(ii)		 150,874
0 		0
0 		6,829
0 		0
0 		11,314
0 		169,017
0 		0
0
(7) Gregory Pomeroy (i)
(ii)		 488,987
0 		250,000
0 		2,444
0 		10,413
0 		25,125
0 		776,969
0 		0
0
(8) Marc Hodroff (i)
(ii)		 371,016
0 		75,000
0 		24,613
0 		10,413
0 		16,114
0 		497,156
0 		0
0
(9) Gregory Adey (i)
(ii)		 369,671
0 		75,000
0 		24,571
0 		10,413
0 		20,623
0 		500,278
0 		0
0
(10) Roger Inhorn (i)
(ii)		 349,122
0 		0
0 		20,262
0 		10,413
0 		20,986
0 		400,783
0 		0
0
(11) Peter Ameglio (i)
(ii)		 327,484
0 		5,000
0 		23,979
0 		9,946
0 		22,119
0 		388,528
0 		0
0





Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  Part I, Line 4b The following individuals received taxable SERP payments: Wayne Bennett - $22,804; Michael Hachey - $25,602; Robert Nutter - $24,740; Colleen Hilton - $14,420; Eileen Skinner - $96,262.
  Part I, Line 6 An individual listed on Form 990 Part VII Section A received incentive compensation related to the contribution margin associated with office-based services. Under this arrangement, the individual was paid (a) up to 17.5% of the excess of the current year's actual contribution margin over the prior year's contribution margin and (b) up to 17.5% of the excess of the current year's actual contribution margin over the budgeted contribution margin with a combined payment cap not to exceed $120,000.
  Part I, Line 7 Company compensation programs include various incentive/bonus programs where fixed payments measured in terms of a percentage of base salary may be made in relation to performance or goal achievements.
Supplemental Information Part III Part I, Line 3: The organization relied on a related organization that used one or more of the methods described below to establish the top management official's compensation: - Compensation committee - Independent compensation committee - Written employment contract - Compensation survey or study - Approval by the board or compensation committee.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Mercy Hospital
 
Employer identification number
01-0211534
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A Maine Health and Higher Educational Facilities Authority
  		01-0314384 560425G61 12-20-2006 68,400,000 Construction of Fore River Hosp.   X   X   X
B Maine Health and Higher Educational Facilities Authority
  		01-0314384 560427JA5 06-24-2010 11,275,000 Refinancing 1998A Bonds   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 68,400,000 11,275,000    
4 Gross proceeds in reserve funds . . 4,710,502 1,097,744    
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 496,240 112,393    
8 Credit enhancement from proceeds. 195,080      
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . . 62,998,175      
11 Other spent proceeds . . 10,064,863 10,064,863    
12 Other unspent proceeds. . .        
13 Year of substantial completion . . . 2008 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X X          
15 Were the bonds issued as part of an advance refunding issue?   X   X        
16 Has the final allocation of proceeds been made? . . X   X          
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X          
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X            
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X              
b Are there any research agreements that may result in private business use of bond-financed property? . .   X            
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X              
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet        
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet        
6 Total of lines 4 and 5 . . .. . . . . .        
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X        
2 Is the bond issue a variable rate issue? X     X        
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X        
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? . X     X        
b Name of provider . Pallas Capital
Corporation 		 
  		 
  		 
 
c Term of GIC . . 2.500000000000      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . X              
5 Were any gross proceeds invested beyond an available temporary period? .   X   X        
6 Did the bond issue qualify for an exception to rebate? . . .   X X          
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Part III, Line 3a:   The organization has entered into various management and service contracts. Collectively, these contracts do not constitute an amount of private business use that exceeds the prescribed percentage.
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Mercy Hospital
 
Employer identification number

01-0211534
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) UNUM
  		Joseph R. Foley, Board Member 102,968 Mercy Hospital purchases employee LTC insurance from UNUM, where Mr. Foley is an executive and an officer.   No
(2) Yvonne Bonney Mina
  		Spouse of Mr. Thimi Mina, Board Member 152,939 Mr. Thimi Mina, a Board Member of Mercy Hospital, is married to Yvonne Bonney Mina, an employee of Mercy Hospital who was paid a salary for her work as a CRNA in 2010.   No
(3) Sysco North New England
  		Gregory Otterbein, Board Member 744,118 Mercy Hospital purchases food services from Sysco North New England, where Mr. Otterbein is President.   No
(4) Maine Cardiology Associates
  		Jeffrey Rosenblatt, MD, Board Member 247,623 Payment for physician services related to cardiology to Maine Cardiology Associates, where Dr. Jeffrey Rosenblatt is a partner.   No
(5) Maine Surgical Care Group
  		Paul Bloch, MD, Board Member 97,810 Payment for physician services related to vascular services to Maine Surgical Care Group, where Dr. Paul Bloch is a partner.   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Mercy Hospital
 
Employer identification number

01-0211534
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 8 25,181 Cost or selling price
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( Other: )        
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule M (Form 990) 2010
Additional Data


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

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

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

01-0211534
Identifier Return Reference Explanation
Form 990, Part VI, Section A, line 6   Yes. Mercy Health System of Maine (MHSM) is the sole Member of Mercy Hospital.
Form 990, Part VI, Section A, line 7a   Yes. Mercy Health System of Maine (MHSM) is the sole Member of Mercy Hospital. Mercy Health System of Maine approves all members of the Board of Trustees of Mercy Hospital.
Form 990, Part VI, Section A, line 7b   Yes. Mercy Health System of Maine has reserved powers in the following areas: changes in articles of incorporation; in key and non-key by-laws provisions, appoint and remove Trustees; approve philosophy and mission, strategic plan, operating plan and budget, significant financial transactions, significant budget variances and establishment or dissolution of organizational relationships.
Form 990, Part VI, Section B, line 11   Yes. The Board of Directors/Trustees received education about the revised Form 990 during the October Board meeting. The Board discussed significant issues included in the draft Form 990 for Mercy Health System of Maine and for Mercy Hospital during this meeting. The Finance and Audit Committee of Mercy Health System of Maine received education about the revised Form 990 at the September Committee meeting and reviewed the Form 990 for Mercy Health System of Maine and Mercy Hospital at the October Committee meeting. The Finance Committee approved Form 990 for Mercy Health System of Maine and Mercy Hospital for submission to the IRS during the October Finance Committee meeting.
  Form 990, Part VI, Section B, line 12c Mercy Hospital Attachment A to the Bylaws sets forth the organization's conflict-of-interest policy and processes. Annually, all those serving Mercy Hospital in a fiduciary capacity, including directors, trustees, officers, non-Board committee members and key employees receive a copy of the policy and annual disclosure statement to be completed. Disclosures of financial interest or other reportable circumstances as defined in the policy are submitted and reviewed by the organization's Chairman of the Board and Compliance Officer. Summary information is reported to the Governance Committee and entire Board. This is available to the Board throughout the year as business comes before the Board or management for action. The policy contains a continuing affirmative obligation on all affected individuals to disclose compensation or other circumstances throughout the year which may rise to the level of an actual or apparent conflict. The determination of whether a disclosed financial or other interest constitutes a conflict of interest is made by the Board or an appropriate committee thereof comprised of dis- interested persons and without the participation of the affected individual except to respond to questions about the disclosure. The policy further addresses the procedure for the Board's further consideration of the proposed transaction/matter without the participation of the affected person and the documentation of the proceedings. Lastly, the policy addresses potential disciplinary action for violations of the policy. The policy is available to the public upon request.
  Form 990, Part VI, Section B, line 15 Mercy Hospital's process for determining compensation includes the following: The Board has an independent committee review and approve all elements of remuneration for all disqualified parties, as well as other key management. The Board/committee has an established compensation philosophy which details the objectives of market positioning and pay elements. The committee engages with external consultants to provide market data comparing Mercy Hospital roles to similarly sized health systems utilizing both title and job content comparisons. The committee reviews the market analysis, approves any salary adjustments for the executive and employed physician populations, considers both reasonableness and effectiveness of all remunerative programs and establishes the performance expectations which are incorporated into the incentive plan. All of these discussions and decisions are documented through the provision of meeting minutes.
  Form 990, Part VI, Section C, line 19 Organizational articles of incorporation, corporate bylaws, governance policies, conflict of interest policy and audited financial statements are available upon request. IRS Form 990 is posted on the Mercy Hospital website.
Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 1,047,783. Change in Present Value of Pledges -4,449. Transfers to/from Affliliates 86,420. Charitable Contributions Adjustment -62,499. Total to Form 990, Part XI, Line 5: 1,067,255.
Explanation of financial statements: Form 990, Part XII, Line 2a & 2b: Financial statements were audited on a consolidated basis.
  Form 990, Part VII, Section A: Individuals compensated by a related organization have responsibilities and perform services for Mercy Hospital and Mercy Health System. The amount of compensation appearing in Columns (E) and (F) reflect the services performed for the entire health system as a whole and not merely a single organization within the health system.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


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

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Mercy Hospital
 
Employer identification number

01-0211534
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) Mercy Health System of Maine

144 State Street

Portland,ME04101
01-0484074 		Management & Support Services ME 501(c)(3) Line 11c, III-FI Catholic Health East
 
 
No
(2) Mercy Care for Kids Inc

310 South Manning Blvd

Albany,NY12208
14-1717564 		Day care center NY 501(c)(3) Line 9 St Peter's Health Care Services
 
 
No
(3) Our Lady of Mercy Life Center

2 Mercycare Lane

Guilderland,NY12084
14-1743506 		Nursing Home Facility NY 501(c)(3) Line 3 St Peter's Health Care Services
 
 
No
(4) St Peter's Auxiliary

315 South Manning Blvd

Albany,NY01228
22-2843206 		Auxiliary NY 501(c)(3) Line 11a, I St Peter's Health Care Services
 
 
No
(5) St Peter's Health Care Services

315 South Manning Blvd

Albany,NY12208
22-2702507 		Management & Support Services NY 501(c)(3) Line 9 Catholic Health East
 
 
No
(6) St Peter's Hospital

315 South Manning Blvd

Albany,NY12208
14-1348692 		Hospital NY 501(c)(3) Line 3 St Peter's Health Care Services
 
 
No
(7) St Peter's Hospital Foundation Inc

319 South Manning Blvd Suite 309

Albany,NY12208
22-2262982 		Fundraising & Public Relations NY 501(c)(3) Line 7 St Peter's Health Care Services
 
 
No
(8) St Peter's Licensed Home Care Agency

159 Wolf Road

Albany,NY12205
14-1818568 		Home Health NY 501(c)(3) Line 3 St Peter's Health Care Services
 
 
No
(9) The Community Hospice Foundation Inc

295 Valley View Blvd

Rensselaer,NY12144
22-2692940 		Fundraising & Public Relations NY 501(c)(3) Line 7 St Peter's Health Care Services
 
 
No
(10) The Community Hospice Inc

295 Valley View Blvd

Rensselaer,NY12144
14-1608921 		Serving seriously ill people & their families NY 501(c)(3) Line 3 St Peter's Health Care Services
 
 
No
(11) Villa Mary Immaculate

301 Hackett Blvd

Albany,NY12208
14-1438749 		Nursing Home & Physical Rehab NY 501(c)(3) Line 3 St Peter's Health Care Services
 
 
No
(12) Warde Service Corporation Inc

159 Wolf Road 3rd Floor

Albany,NY12205
14-1732097 		Supporting & strengthing the ministries of rel. sr. mercy NY 501(c)(3) Line 9 St Peter's Health Care Services
 
 
No
(13) Brightside Inc

c/o SPHS 1221 Main Street Suite 108

Holyoke,MA01040
04-2182395 		Behavioral Care MA 501(c)(3) Line 9 Sisters of Providence Health System Inc
 
 
No
(14) Farren Care Center Inc

c/o SPHS 1221 Main Street Suite 108

Holyoke,MA01040
04-2501711 		Long Term Care MA 501(c)(3) Line 3 Sisters of Providence Health System Inc
 
 
No
(15) Mercy Hospital Inc

c/o SPHS 1221 Main Street Suite 108

Holyoke,MA01040
04-3398280 		Acute Care MA 501(c)(3) Line 3 Sisters of Providence Health System Inc
 
 
No
(16) Mercy Specialist Physicians Inc

c/o SPHS 1221 Main Street No 108

Holyoke,MA01040
26-4033168 		Neurosurgery Medical Services MA 501(c)(3) Line 3 Sisters of Providence Health System Inc
 
 
No
(17) Sisters of Providence Care Centers Inc

c/o SPHS 1221 Main Street Suite 108

Holyoke,MA01040
22-2541103 		Long Term Care MA 501(c)(3) Line 3 Sisters of Providence Health System Inc
 
 
No
(18) Sisters of Providence Health System Inc

c/o SPHS 1221 Main Street Suite 108

Holyoke,MA01040
04-3398374 		Management & Support Services MA 501(c)(3) Line 11a, I Catholic Health East
 
 
No
(19) McAuley Center Inc

275 Steele Road

West Hartford,CT06117
06-1058086 		Independent Living CT 501(c)(3) Line 9 Mercy Community Health Inc
 
 
No
(20) Mercy Community Health Inc

2021 Albany Avenue

West Hartford,CT06117
06-1492707 		Management & Support Services CT 501(c)(3) Line 11a, I Catholic Health East
 
 
No
(21) Mercy Community HomeCare Services

2021 Albany Avenue

West Hartford,CT06117
06-1488137 		In Home Health Care CT 501(c)(3) Line 9 Mercy Community Health Inc
 
 
No
(22) Mercy Services

2021 Albany Avenue

West Hartford,CT06117
06-1453323 		Support Services CT 501(c)(3) Line 1 Mercy Community Health Inc
 
 
No
(23) Mercyknoll Inc

2021 Albany Avenue

West Hartford,CT06117
06-0757380 		Skilled Nursing CT 501(c)(3) Line 3 Mercy Community Health Inc
 
 
No
(24) Saint Mary Home II Inc

2021 Albany Avenue

West Hartford,CT06117
06-1164104 		Elderly Care CT 501(c)(3) Line 3 Mercy Community Health Inc
 
 
No
(25) St Mary Home Incorporated

2021 Albany Avenue

West Hartford,CT06117
06-0646843 		Skilled Nursing CT 501(c)(3) Line 3 Mercy Community Health Inc
 
 
No
(26) Mercy Healthcare Center

114 Wawbeek Avenue

Tupper Lake,NY12986
15-0532211 		Hospital NY 501(c)(3) Line 3 Catholic Health East
 
 
No
(27) Mercy Uihlein Health Corporation

185 Old Military Road

Lake Placid,NY12946
16-1535133 		Hospital NY 501(c)(3) Line 11b, II Mercy Healthcare Center
 
 
No
(28) Uihlein Mercy Center

185 Old Military Road

Lake Placid,NY12946
15-0532190 		Hospital NY 501(c)(3) Line 3 Mercy Healthcare Center
 
 
No
(29) St James Mercy Foundation Inc

411 Canisteo Street

Hornell,NY14843
16-1486437 		Foundation NY 501(c)(3) Line 7 St James Mercy Health System Inc
 
 
No
(30) St James Mercy Health System Inc

411 Canisteo Street

Hornell,NY14843
22-3127184 		Management & Support Services NY 501(c)(3) Line 11b, II Catholic Health East
 
 
No
(31) St James Mercy Hospital

411 Canisteo Street

Hornell,NY14843
16-0743310 		Hospital NY 501(c)(3) Line 3 St James Mercy Health System Inc
 
 
No
(32) Marian Community Hospital

100 Lincoln Avenue

Carbondale,PA18407
24-0711230 		Hospital PA 501(c)(3) Line 3 Maxis Health System
 
 
No
(33) Marian Community Hospital Auxiliary

100 Lincoln Avenue

Carbondale,PA18407
25-1874733 		Fundraising PA 501(c)(3) Line 11b, II Maxis Health System
 
 
No
(34) Maxis Foundation

100 Lincoln Avenue

Carbondale,PA18407
23-2330090 		Fundraising PA 501(c)(3) Line 11b, II Maxis Health System
 
 
No
(35) Maxis Health System

100 Lincoln Avenue

Carbondale,PA18407
91-1940902 		Health Care System PA 501(c)(3) Line 11b, II Catholic Health East
 
 
No
(36) Maxis Medical Services

100 Lincoln Avenue

Carbondale,PA18407
23-2577185 		Physician Practices PA 501(c)(3) Line 3 Maxis Health System
 
 
No
(37) Tri-County Human Services Center Inc

PO Box 517

Carbondale,PA18407
23-1938528 		Behavioral Health Organization PA 501(c)(3) Line 7 Maxis Health System
 
 
No
(38) Columbus Acquisition Corp

1160 Raymond Boulevard

Newark,NJ07102
26-2616342 		Inactive Entity NJ 501(c)(3) Line 9 Saint Michaels Medical Center
 
 
No
(39) Saint Michaels Medical Center

111 Central Avenue

Newark,NJ07102
26-2616046 		Hospital NJ 501(c)(3) Line 3 Catholic Health East
 
 
No
(40) St James Care Inc

1160 Raymond Boulevard

Newark,NJ07102
26-2616230 		Inactive Entity NJ 501(c)(3) Line 9 Saint Michaels Medical Center
 
 
No
(41) St Michaels Medical Center Foundation

1160 Raymond Boulevard

Newark,NJ07102
22-3311976 		Foundation NJ 501(c)(3) Line 11a, I Saint Michaels Medical Center
 
 
No
(42) University Heights Property Company Inc

1160 Raymond Boulevard

Newark,NJ07102
22-3100162 		Medical Property Holding Company NJ 501(c)(2)   Saint Michaels Medical Center
 
 
No
(43) Life St Francis Corporation

601 Hamilton Avenue

Trenton,NJ08629
22-2797282 		Health Services NJ 501(c)(3) Line 11a, I St Francis Medical Center Trenton NJ
 
 
No
(44) St Francis Medical Center Foundation NJ

601 Hamilton Avenue

Trenton,NJ08629
52-1025476 		Foundation NJ 501(c)(3) Line 11a, I St Francis Medical Center Trenton NJ
 
 
No
(45) St Francis Medical Center Trenton NJ

601 Hamilton Avenue

Trenton,NJ08629
22-3431049 		Hospital NJ 501(c)(3) Line 3 Catholic Health East
 
 
No
(46) Langhorne MRI Inc

1201 Langhorne-Newtown Road

Langhorne,PA19047
23-2519529 		Inactive Entity PA 501(c)(3) Line 9 St Mary Medical Center
 
 
No
(47) Langhorne Physician Services Inc

1201 Langhorne-Newtown Road

Langhorne,PA19047
23-2571699 		Physician Services PA 501(c)(3) Line 9 St Mary Medical Center
 
 
No
(48) LIFE St Mary

1201 Langhorne-Newtown Road

Langhorne,PA19047
26-2976184 		Elderly Care PA 501(c)(3) Line 9 St Mary Medical Center
 
 
No
(49) St Mary Medical Center

1201 Langhorne-Newtown Road

Langhorne,PA19047
23-1913910 		Hospital PA 501(c)(3) Line 3 Catholic Health East
 
 
No
(50) St Mary Medical Center Foundation Inc

1201 Langhorne-Newtown Road

Langhorne,PA19047
23-2567468 		Foundation PA 501(c)(3) Line 7 St Mary Medical Center
 
 
No
(51) East Norriton Physician Services

c/o One West Elm Street

Conshohocken,PA19428
23-2515999 		Physician Services PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania
 
 
No
(52) Mercy Catholic Medical Center of Southeastern Pennsylvania

One West Elm Street

Conshohocken,PA19428
23-1352191 		Acute Care Hospital PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania
 
 
No
(53) Mercy Family Support

1001 Baltimore Pike Suite 301

Springfield,PA19064
23-2325059 		Home Health PA 501(c)(3) Line 9 Mercy Health System of Southeastern Pennsylvania
 
 
No
(54) Mercy Health Foundation of Southeastern Pennsylvania

c/o MHS One West Elm Street

Conshohocken,PA19428
23-2829864 		Fundraising PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania
 
 
No
(55) Mercy Health Plan

c/o One West Elm Street

Conshohocken,PA19428
22-2483605 		Health Plans PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania
 
 
No
(56) Mercy Health System of Southeastern Pennsylvania

One West Elm Street

Conshohocken,PA19428
23-2212638 		Management & Support Services PA 501(c)(3) Line 11b, II Catholic Health East
 
 
No
(57) Mercy Home Health

1001 Baltimore Pike Suite 310

Springfield,PA19064
23-1352099 		Home Health PA 501(c)(3) Line 9 Mercy Health System of Southeastern Pennsylvania
 
 
No
(58) Mercy Home Health Services

1001 Baltimore Pike Suite 301

Springfield,PA19064
23-2325058 		Home Health PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania
 
 
No
(59) Mercy Management of Southeastern Pennsylvania

One West Elm Street

Conshohocken,PA19428
23-2627944 		Physician Practices PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania
 
 
No
(60) Mercy Suburban Hospital

One West Elm Street

Conshohocken,PA19428
23-1396763 		Acute Care Hospital PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania
 
 
No
(61) Nazareth Health Care Foundation

2701 Holme Avenue

Philadelphia,PA19152
23-2300951 		Fundraising PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania
 
 
No
(62) Nazareth Hospital

2601 Holme Avenue

Philadelphia,PA19152
23-2794121 		Acute Care Hospital PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania
 
 
No
(63) Nazareth Physician Services Inc

2601 Holme Avenue

Philadelphia,PA19152
20-3261266 		Physician Practices PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania
 
 
No
(64) NE Physician Services

2601 Holme Avenue

Philadelphia,PA19152
23-2497355 		Physician Practices PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania
 
 
No
(65) St Agnes Continuing Care Center

1900 S Broad Street

Philadelphia,PA19145
23-2840137 		Continuing Care Services PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania
 
 
No
(66) St Agnes Continuing Care Center Foundation

1900 S Broad Street

Philadelphia,PA19145
23-2415137 		Fundraising PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania
 
 
No
(67) Life at Lourdes Inc

1600 Haddon Avenue

Camden,NJ08108
26-1854750 		Elderly Care NJ 501(c)(3) Line 3 Our Lady of Lourdes Health Care Services
 
 
No
(68) Lourdes Ancillary Services

1600 Haddon Avenue

Camden,NJ08103
22-2568525 		Supporting Organization NJ 501(c)(3) Line 11b, II Our Lady of Lourdes Health Care Services
 
 
No
(69) Lourdes Dialysis at Innova Inc

1600 Haddon Avenue

Camden,NJ08108
26-3237625 		Hospital NJ 501(c)(3) Line 3 Our Lady of Lourdes Health Care Services
 
 
No
(70) Lourdes Medical Center Burlington County

218 Sunset Road

Willingboro,NJ08046
22-3612265 		Hospital NJ 501(c)(3) Line 3 Our Lady of Lourdes Health Care Services
 
 
No
(71) Our Lady of Lourdes Health Care Services

1600 Haddon Avenue

Camden,NJ08103
22-2568528 		Management & Support Services NJ 501(c)(3) Line 11b, II Catholic Health East
 
 
No
(72) Our Lady of Lourdes Health Foundation Inc

1600 Haddon Avenue

Camden,NJ08103
22-2351960 		Foundation NJ 501(c)(3) Line 7 Our Lady of Lourdes Health Care Services
 
 
No
(73) Our Lady of Lourdes Medical Center

1600 Haddon Avenue

Camden,NJ08103
21-0635001 		Hospital NJ 501(c)(3) Line 3 Our Lady of Lourdes Health Care Services
 
 
No
(74) Franciscan Eldercare Corporation

PO Box 2500

Wilmington,DE19805
22-3008680 		Eldercare DE 501(c)(3) Line 9 St Francis Hospital
 
 
No
(75) St Francis Foundation

PO Box 2500

Wilmington,DE19805
51-0374158 		Foundation DE 501(c)(3) Line 11b, II St Francis Hospital
 
 
No
(76) St Francis Hospital

PO Box 2500

Wilmington,DE19805
51-0064326 		Hospital DE 501(c)(3) Line 3 Catholic Health East
 
 
No
(77) McAuley Ministries

McAuley Hall 3333 Fifth Avenue

Pittsburgh,PA15213
94-3436142 		Management & Support Services PA 501(c)(3) Line 9 Pittsburgh Mercy Health System
 
 
No
(78) Mercy Jeannette Hospital

3805 West Chester Pike

Newtown Square,PA19073
25-1310602 		Inactive Entity PA 501(c)(3) Line 9 Pittsburgh Mercy Health System
 
 
No
(79) Mercy Life Center Corporation

1200 Reedsdale Street

Pittsburgh,PA15233
25-1604115 		Community Treatment PA 501(c)(3) Line 9 Pittsburgh Mercy Health System
 
 
No
(80) Pittsburgh Mercy Foundation

1200 Reedsdale Street

Pittsburgh,PA15233
25-1479026 		Foundation PA 501(c)(3) Line 11b, II Pittsburgh Mercy Health System
 
 
No
(81) Pittsburgh Mercy Health System

3333 5th Avenue

Pittsburgh,PA15213
25-1464211 		Management & Support Services PA 501(c)(3) Line 11b, II Catholic Health East
 
 
No
(82) St Joseph's of the Pines Inc

100 Gossman Drive Suite B

Southern Pines,NC28387
56-0694200 		Hospital NC 501(c)(3) Line 3 Catholic Health East
 
 
No
(83) Life St Joseph of the Pines Inc

100 Gossman Drive Suite B

Southern Pines,NC28387
27-2159847 		Healthcare Services NC 501(c)(3) Line 3 St Joseph's of the Pines Inc
 
 
No
(84) Mercy Senior Care Inc

212 West Third Street PO Box 866

Rome,GA30162
58-1366508 		Community Outreach GA 501(c)(3) Line 7 Saint Joseph's Health System Inc
 
 
No
(85) Saint Joseph's at East Georgia Inc

1201 Siloam Road

Greensboro,GA30462
26-1720984 		Hospital GA 501(c)(3) Line 3 Saint Joseph's Health System Inc
 
 
No
(86) Saint Joseph's Health System Inc

5673 Peachtree-Dunwoody Road Suite

Atlanta,GA30342
58-1744848 		Management & Support Services GA 501(c)(3) Line 11b, II Catholic Health East
 
 
No
(87) Saint Joseph's Hospital of Atlanta Inc

5673 Peachtree-Dunwoody Road Suite

Atlanta,GA30342
58-0566257 		Hospital GA 501(c)(3) Line 3 Saint Joseph's Health System Inc
 
 
No
(88) Saint Joseph's Mercy Care Services Inc

5673 Peachtree-Dunwoody Road Suite

Atlanta,GA30342
58-1752700 		Community Outreach GA 501(c)(3) Line 7 Saint Joseph's Health System Inc
 
 
No
(89) Saint Joseph's Mercy Foundation Inc

5673 Peachtree-Dunwoody Road Suite

Atlanta,GA30342
58-1448522 		Fundraising GA 501(c)(3) Line 11b, II Saint Joseph's Health System Inc
 
 
No
(90) Saint Joseph's Translational Research Institute Inc

5673 Peachtree-Dunwoody Road Suite

Atlanta,GA30342
80-0079841 		Research GA 501(c)(3) Line 4 Saint Joseph's Health System Inc
 
 
No
(91) Mercy Services Downtown Inc

5673 Peachtree-Dunwoody Road Suite

Atlanta,GA30342
27-2046353 		Real Estate Holding Company GA 501(c)(3) Line 11b, II Saint Joseph's Health System Inc
 
 
No
(92) St Mary's Health Care System Inc

1230 Baxter Street

Athens,GA30606
58-0566223 		Hospital GA 501(c)(3) Line 3 Catholic Health East
 
 
No
(93) St Mary's Foundation Inc

1230 Baxter Street

Athens,GA30606
58-2544232 		Fundraising GA 501(c)(3) Line 11b, II St Mary's Health Care System Inc
 
 
No
(94) St Mary's Highland Hills Inc

1230 Baxter Street

Athens,GA30606
02-0576648 		Assisted Living & Retirement Community GA 501(c)(3) Line 3 St Mary's Health Care System Inc
 
 
No
(95) St Mary's Medical Group Inc

1230 Baxter Street

Athens,GA30606
26-1858563 		Hospital / Physician Services GA 501(c)(3) Line 3 St Mary's Health Care System Inc
 
 
No
(96) Mercy Medical Corporation

PO Box 1090 101 Villa Drive

Daphne,AL36526
63-6002215 		Hospital AL 501(c)(3) Line 3 Catholic Health East
 
 
No
(97) Allegany Franciscan Ministries Inc

33920 US Highway 19 North Suite 269

Palm Harbor,FL34684
58-1492325 		Management & Support Services FL 501(c)(3) Line 11b, II Catholic Health East
 
 
No
(98) St Francis Hospital Inc

33920 US Highway 19 North Suite 269

Palm Harbor,FL34684
59-0624442 		Hospital FL 501(c)(3) Line 11a, I Allegany Franciscan Ministries Inc
 
 
No
(99) Holy Cross Hospital Inc

4725 North Federal Highway

Ft Lauderdale,FL33308
59-0791028 		Hospital FL 501(c)(3) Line 3 Catholic Health East
 
 
No
(100) Holy Cross Long-Term Inc

4725 North Federal Highway

Ft Lauderdale,FL33308
65-0787320 		Medical Services FL 501(c)(3) Line 3 Holy Cross Hospital Inc
 
 
No
(101) Holy Cross Medical Properties Inc

4725 North Federal Highway

Ft Lauderdale,FL33308
65-0666283 		Medical Building Real Estate Management FL 501(c)(2)   Holy Cross Hospital Inc
 
 
No
(102) Mercy Hospital Foundation Inc

3663 South Miami Avenue

Miami,FL33133
59-1709438 		Fundraising FL 501(c)(3) Line 7 Mercy Hospital Inc
 
 
No
(103) Mercy Hospital Inc

3663 South Miami Avenue

Miami,FL33133
59-0791034 		Hospital FL 501(c)(3) Line 3 Catholic Health East
 
 
No
(104) Mercy Medical Development Inc

3663 South Miami Avenue

Miami,FL33133
59-2789194 		Outpatient Services FL 501(c)(3) Line 9 Mercy Hospital Inc
 
 
No
(105) Mercy Mission Services Inc

3663 South Miami Avenue

Miami,FL33133
65-0435764 		Health Care FL 501(c)(3) Line 11a, I Mercy Hospital Inc
 
 
No
(106) Catholic Health East

3805 West Chester Pike Suite 100

Newtown Square,PA19073
23-2929748 		Management Services PA 501(c)(3) Line 11a, I N/A
 
No
(107) Continuing Care Management Services Network

3805 West Chester Pike Suite 100

Newtown Square,PA19073
35-2336834 		Management & Support Services PA 501(c)(3) Line 11b, II Catholic Health East
 
 
No
(108) Global Health Ministry

3805 West Chester Pike Suite 100

Newtown Square,PA19073
23-3068656 		Health Care PA 501(c)(3) Line 7 Catholic Health East
 
 
No
(109) Mercy Jeanette Hospital Foundation

600 Jefferson Avenue

Jeannette,PA15644
25-1462863 		Foundation PA 501(c)(3) Line 7 Pittsburgh Mercy Health System
 
 
No
(110) VNA Home Health & Hospice

50 Foden Road

South Portland,ME04106
01-0246804 		Home Health & Hospice ME 501(c)(3) Line 11a, I Mercy Health System of Maine
 
 
No
(111) Providence Place Inc

5 Gamelin Street

Holyoke,MA01040
04-3404084 		Retirement Community MA 501(c)(3) Line 9 Sisters of Providence Health System Inc
 
 
No
(112) Intercoastal Health Systems

3805 West Chester Pike Suite 100

Newtown Square,PA19073
65-0556413 		Management & Support Services PA 501(c)(3) Line 11a, I Catholic Health East
 
 
No
(113) Mercy Outpatient Services Inc DBA Sister Emmanuel Hospital

3663 South Miami Avenue

Miami,FL33133
51-0461511 		Hospital FL 501(c)(3) Line 3 Mercy Hospital Inc
 
 
No
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) Catherine Horan Building Limited Partnership

1221 Main Street Room 108
Holyoke,MA010400000
04-2723429 		Property Management MA N/A
                  
(2) AmeriHealth Mercy Health Plan

200 Stevens Drive Suite 350
Philadelphia,PA19113
23-2859523 		Medicaid Managed Care Organization PA N/A
                 50.000 %
(3) Amerihealth Mercy of Indiana LLC

200 STEVENS DRIVE Suite 350
Philadelphia,PA19113
20-4948091 		PREPAID HEALTH CARE SERVICES IN N/A
                 50.000 %
(4) East Norriton Medical Associates

2701 Dekalb Pike
Norristown,PA19401
23-2319531 		Medical Office Building PA N/A
                 12.560 %
(5) East Norriton Medical Associates

2701 Dekalb Pike
Norristown,PA19401
23-2319531 		Medical Office Building PA N/A
                 40.930 %
(6) Gateway Health Plan

300 Grant Street
Pittsburgh,PA15219
25-1691945 		Medicaid & Medicare/Special Needs Managed Care Organization PA N/A
                 50.000 %
(7) Keystone Mercy Health Plan

100 Stevens Drive
Philadelphia,PA19113
23-2842344 		Medicaid Managed Care Organization PA N/A
                 50.000 %
(8) Langhorne MOB Partners LP

1201 Langhorne-Newtown Road
Langhorne,PA19047
23-2622772 		Investment and operation of a medical building PA N/A
                 28.956 %
(9) SMMC MOB II LP

1201 Langhorne-Newtown Road
Langhorne,PA19047
36-4559869 		Investment and operation of a medical building PA N/A
                 74.520 %
(10) MercyManor Partnership

PO Box 10086
Toledo,OH436990086
52-1931012 		Nursing Home PA N/A
                 50.000 %
(11) Nazareth Medical Office Building Associates LP

c/o Nazareth Hospital 2601 Holme Av
Philadelphia,PA19152
23-2388040 		Medical Office Building PA N/A
                 1.000 %
(12) Nazareth Medical Office Building Associates LP

c/o Nazareth Hospital 2601 Holme Av
Philadelphia,PA19152
23-2388040 		Medical Office Building PA N/A
                 47.460 %
(13) St Agnes Long Term Intensive Care LLP

1900 S Broad Street
Philadelphia,PA19145
20-0984882 		Long Term Intensive Care PA N/A
                 60.000 %
(14) St Agnes Long Term Intensive Care LLP

1900 S Broad Street
Philadelphia,PA19145
20-0984882 		Long Term Intensive Care PA N/A
                 40.000 %
(15) St Peter's Ambulatory Surgery Center LLC

1375 Washington Avenue Ste 201
Albany,NY12206
46-0463892 		Surgery NY N/A
                 34.750 %
(16) Outpatient Surgical Management LLC

5673 Peachtree Dunwoody Rd Ste 550
Atlanta,GA30342
20-8004929 		Outpatient Medical Services GA N/A
                 51.000 %
(17) CV Partners LLC

5665 Peachtree Dunwoody Road
Atlanta,GA303421764
26-3881202 		Outpatient Medical Services GA N/A
                 50.000 %
(18) Gwinnett Cardiovascular Servies LLC

1000 Medical Center Boulevard
Lawrenceville,GA30045
26-3870307 		Cardiology GA N/A
                 50.000 %
(19) Central New Jersey Heart Services LLC

10720 Sikes Places Ste 300
Charlotte,NC28277
20-8525458 		Cardiac Program NJ N/A
                 63.905 %
(20) Physicians Outpatient Surgery Center LLC

1000 NE 56th
Oakland Park,FL33334
35-2325646 		Ambulatory Surgery Center FL N/A
                 73.000 %
(21) Center for Surgery & Digestive Orders

3641 South Miami Avenue
Miami,FL33133
51-0438152 		Outpatient Medical Services FL N/A
                 50.000 %
(22) SJV Management LLC

200 Century Pkwy Ste 200E
Mount Laurel,NJ08054
20-2273476 		Medical Services NJ N/A
                 50.000 %
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) Catherine Horan Building Inc
c/o SPHS 1221 Main Street Suite 108
Holyoke,MA010400000
04-2938180 		Building Management MA N/A
 C      
(2) Diversified Community Services Inc
c/o SPHS 1221 Main Street Suite 108
Holyoke,MA010400000
04-3128890 		Medical Services MA N/A
 C      
(3) Mercy Inpatient Medical Associates Inc
c/o SPHS 1221 Main Street Suite 108
Holyoke,MA010400000
04-3029829 		Medical Services MA N/A
 C      
(4) Providence Home Care Inc
c/o SPHS 1221 Main Street Suite 108
Holyoke,MA010400000
04-3317426 		Health Care Services MA N/A
 C      
(5) System Coordinated Services Inc
c/o SPHS 1221 Main Street Suite 108
Holyoke,MA010400000
04-2938181 		Lab Services MA N/A
 C      
(6) Physicians Medical Office Building Condominium Trust
1221 Main Street Room 108
Holyoke,MA010400000
04-6608649 		Property Management MA N/A
 C      
(7) SJM Properties
411 Canisteo Street
Hornell,NY148482104
16-1294991 		Property Holdings NY N/A
 C      
(8) Carbondale Area Physicians' Association PC
100 Lincoln Ave
Carbondale,PA18407
23-2801677 		Medical Insurance Contracting PA N/A
 C      
(9) Carbondale Area Physicians' PHO Inc
100 Lincoln Ave
Carbondale,PA18407
23-2801676 		Inactive PA N/A
 C      
(10) Carbondale Physicians' Services Inc
100 Lincoln Ave
Carbondale,PA18407
23-2365077 		Pharmacy PA N/A
 C      
(11) Chestnut Risk Services Ltd
11 Victoria Street
Hamilton    
BD
Insurance BD N/A
 C      
(12) LifeCare Physicians PC
601 Hamilton Avenue
Trenton,NJ086291986
26-1649038 		Health Care Services NJ N/A
 C      
(13) Multicare Plus Inc
601 Hamilton Avenue
Trenton,NJ086291986
22-3435844 		Inactive NJ N/A
 C      
(14) Langhorne Services II Inc
1201 Langhorne-Newtown Road
Langhorne,PA190470000
25-3795549 		General Partner of LMOB Partners, II PA N/A
 C      
(15) Langhorne Services Inc
1201 Langhorne-Newtown Road
Langhorne,PA190470000
23-2625981 		General Partner of LMOB Partners PA N/A
 C      
(16) AMHP Holdings Corp
200 Stevens Drive
Philadelphia,PA19113
26-1144363 		Behavioral Health PA N/A
 C      
(17) Select Health of South Carolina Inc
4390 Belle Oaks Drive Suite 400
Charleston,SC29405
57-1032456 		Health Maintenance Organization SC N/A
 C      
(18) Gateway Health Plan Inc
600 Grant Street
Pittsburgh,PA15219
25-1505506 		Health Care PA N/A
 C      
(19) Gateway Health Plan Inc of Ohio
600 Grant Street
Pittsburgh,PA15219
30-0282076 		Health Care PA N/A
 C      
(20) MCMC Eastwick Inc
c/o MHS One West Elm Street
Conshohocken,PA19428
23-2184261 		Medical Office Buildings PA N/A
 C      
(21) Community Behavioral Healthcare Network of PA Inc
8040 Carlson Road
Harrisburg,PA17112
25-1765391 		Behavioral Health PA N/A
 C      
(22) Health Management Services Org Inc
500 Grove Street Suite 100
Haddon Heights,NJ08035
22-3366580 		Health Care Billing NJ N/A
 C      
(23) Jeannette Medical Providers
3805 West Chester Pike
Newtown Square,PA19073
25-1787334 		Holding Company PA N/A
 C      
(24) Jeannette OBGYN Group 1 Inc
3805 West Chester Pike
Newtown Square,PA19073
23-2890748 		Holding Company PA N/A
 C      
(25) Jeannette Primary Care Group 1 Inc
3805 West Chester Pike
Newtown Square,PA19073
23-2890743 		Holding Company PA N/A
 C      
(26) Saint Joseph's Service Corporation Inc
5673 Peachtree Dunwoody Road
Atlanta,GA303421769
58-1750815 		Service Provider GA N/A
 C      
(27) Saint Joseph's Real Estate Management Corp
5673 Peachtree Dunwoody Road
Atlanta,GA303421769
58-1657768 		Investment Company GA N/A
 C      
(28) Magnetic Resonance Imaging Inc
5673 Peachtree Dunwoody Road
Atlanta,GA303421769
58-1609308 		Holding Company GA N/A
 C      
(29) ACTx
5673 Peachtree Dunwoody Road
Atlanta,GA303421769
83-0345672 		Research GA N/A
 C      
(30) Georgia Health Enterprises LLC
11440 Commerce Park Drive
Reston,VA20191
54-1806329 		Healthcare VA N/A
 C      
(31) St Mary's Highland Hills Village Inc
1660 Jennings Mill Road
Bogart,GA30622
58-2276801 		Assisted Living GA N/A
 C      
(32) GHE Physicians PC
3500 Piedmont Road
Atlanta,GA30305
58-2277939 		Practice Management GA N/A
 C      
(33) Nursing Network Inc
4725 North Federal Highway
Fort Lauderdale Highwa,FL333080000
59-1145192 		Medical Services FL N/A
 C      
(34) Mercy Physician Group Inc
3663 South Miami Avenue
Miami,FL33133
20-2970015 		Health Care FL N/A
 C      
(35) Stella Maris Insurance Company Limited
PO Box 69
Grand Cayman,Cayman IslandsKY1-1102
CJ
98-0078266 		Insurance CJ N/A
 C      
(36) Catholic Health East Senior Services
3805 West Chester Pike Suite 100
Newtown Square,PA19073
37-1572595 		Senior Services PA N/A
 C      
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
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) Mercy Health System of Maine

 O 2,418,242  
(2) Visiting Nurse and Hospice Association

 P 96,000  
(3) Catholic Health East

 O 4,926,042  
(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


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