TY 2011 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) SR BARBARA HAHL CSC CHAIR	20.00	X	X			0	7,960
(2) CLAUS VON ZYCHLIN PRES, CEO & V.CHAIR	17.00	X	X			742,791	100,792
(3) DOROTHY FRIDAY MD SECRETARY/TREASURER	50.00	X	X			167,050	0
(4) JACQUELINE PRIMEAU SVP & CFO	17.00		X			435,000	40,553
(5) RONALD WHITESIDE EXEC VP & SYSTEM COO	17.00		X			1,842,081	56,546
(6) PAULA AUTRY COO MT. CARMEL EAST UNTIL 4/12	50.00			X		357,678	35,771
(7) JOHN HEISLER SVP HUMAN AFFAIRS	15.00			X		413,570	36,981
(8) HUGH JONES SVP STRATEGY & SYSTEM DEV.	15.00			X		284,314	35,570
(9) JOSEPH SWEDISH TRINITY HEALTH PRES. & CEO	2.00			X		5,186,660	576,202
(10) KEDRICK ADKINS TRINITY PRES INTEGRATED SVCS	2.00			X		1,405,226	117,120
(11) J RICHARD O'CONNELL TRINITY EVP, COO-HOSP NTWKS	2.00			X		943,237	118,221
(12) MICHAEL MURPHY TRINITY EVP, HEALTH NTWKS UNTIL 4/12	2.00			X		474,370	75,538
(13) CHARLES BRETT JUSTICE VP STRATEGIC ADVANCEMENT	50.00			X		158,874	32,586
(14) THOMAS HARTRANFT DIRECTOR GENERAL SURGERY	50.00				X	362,005	41,745
(15) LARRY SWANNER ASSOC. DIRECTOR FAMILY MEDICINE	50.00				X	333,709	43,687
(16) RICHARD FANKHAUSER DIRECTOR ORTHOPEDICS	50.00				X	308,678	21,751
(17) MARK HACKMAN VP MED AFFAIRS, MT. CARMEL EAST	50.00				X	264,288	29,207

(A) Name and business address	(B) Description of services	(C) Compensation
ELFORD INC 1220 DUBLIN RD COLUMBUS,OH43215	CONSTRUCTION SERVICES	5,864,026
CONSULTANT ANESTHESIOLOGY INC PO BOX 347 BLACKLICK,OH43004	PHYSICIAN SERVICES	4,670,689
MESSER CONSTRUCTION PO BOX 183104 COLUMBUS,OH43218	CONSTRUCTION SERVICES	3,006,541
HHA SERVICES INC 22622 HARPER AVE ST CLAIR SHORES,MI48080	FOOD & FACILITY MANAGEMENT SERVICES	2,311,717
SOUND INPATIENT PHYSICIANS 1123 PACIFIC AVENUE TACOMA,WA98402	PHYSICIAN SERVICES	2,268,689
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 61

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 United States. See Part IV, line 21	167,168	167,168
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	106,038	106,038
7	Other salaries and wages	213,679,228	208,221,941	5,457,287
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	12,790,431	12,463,943	326,488
9	Other employee benefits .......	18,672,292	18,195,643	476,649
10	Payroll taxes ...........	16,292,133	15,876,684	415,449
11	Fees for services (non-employees):
a	Management ......	406,790	406,790
b	Legal .........	75,000		75,000
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......
g	Other ..........	38,397,613	25,284,380	13,113,233
12	Advertising and promotion ....	6,871	6,871
13	Office expenses .......	9,360,324	5,195,788	4,164,536
14	Information technology ......	91,874	91,874
15	Royalties ..
16	Occupancy ...........	15,689,411	15,686,883	2,528
17	Travel ............	345,124	282,647	62,477
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	266,682	201,252	65,430
20	Interest ...........	8,929,534	8,929,534
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	31,886,267	30,965,601	920,666
23	Insurance ..............	7,173,416	7,173,416
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a	MEDICAL SUPPLIES	131,923,510	129,586,694	2,336,816
b	CORPORATE ALLOCATION	102,284,842	102,284,842
c	UBI	138,401	130,842	7,559
d	BAD DEBT	55,979,522	55,979,522
e
f	All other expenses	27,484,069	25,167,437	2,316,632
25	Total functional expenses. Add lines 1 through 24f	692,146,540	662,405,790	29,740,750	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	650,351	1	0
2	Savings and temporary cash investments .......		2	0
3	Pledges and grants receivable, net .........		3	0
4	Accounts receivable, net .........	76,223,221	4	0
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		5	0
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	0
7	Notes and loans receivable, net .............	70,833	7	0
8	Inventories for sale or use ..............	11,401,284	8	0
9	Prepaid expenses and deferred charges ............	606,690	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	0
b	Less: accumulated depreciation. .....	10b		208,946,861	10c	0
11	Investments—publicly traded securities ..........		11	0
12	Investments—other securities. See Part IV, line 11 ......		12	0
13	Investments—program-related. See Part IV, line 11 ..		13	0
14	Intangible assets .........		14	0
15	Other assets. See Part IV, line 11 ...........	3,345,858	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)...	301,245,098	16	0
	17	Accounts payable and accrued expenses .	53,230,780	17
18	Grants payable ..........		18
19	Deferred revenue ..........		19
20	Tax-exempt bond liabilities ..........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	662,218	23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....	3,206,142	25	0
26	Total liabilities. Add lines 17 through 25.....	57,099,140	26	0
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	244,145,958	27	0
28	Temporarily restricted net assets .....		28
29	Permanently restricted net assets .....		29
	Organizations that do not follow SFAS 117, check here 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 .....	244,145,958	33	0
34	Total liabilities and net assets/fund balances .....	301,245,098	34	0

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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.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

MOUNT CARMEL HEALTH

Employer identification number

31-4379602

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.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

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)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(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?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2011. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2010. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2010 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2010 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2011. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2010. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2011

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) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

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, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

MOUNT CARMEL HEALTH

Employer identification number

31-4379602

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

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) 2011

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 if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ......................................	Yes No

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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) Total

2a	Lobbying non-taxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2011

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Yes

17,213

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Total. Add lines 1c through 1i ...............................

17,213

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

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

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

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, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
EXPLANATION OF LOBBYING ACTIVITIES:	PART II-B, LINE 1:	MOUNT CARMEL HEALTH HAS MADE GRANTS TO OTHER ORGANIZATIONS IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS. THESE ORGANIZATIONS HAVE PROVIDED MOUNT CARMEL HEALTH WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. MOUNT CARMEL HEALTH MADE NO CONTRIBUTIONS TO ANY LEGISLATORS OR CANDIDATES.

Schedule C (Form 990 or 990EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

2011

Open to Public Inspection

Name of the organization

MOUNT CARMEL HEALTH

Employer identification number

31-4379602

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the

following was the family income limit for eligibility for discounted care: ............

Yes

200% 250% 300% 350% 400% Other

If the organization did 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 used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............

Did the organization prepare a community benefit report during the tax year?...........

Yes

If "Yes," did the organization make it available to the public? ...............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

	(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Financial Assistance at cost (from Worksheet 1) ..	2	25,222	30,024,052	7,115,676	22,908,376	3.600 %
b Medicaid (from Worksheet 3, column a) .....	25	70,908	76,721,007	55,878,696	20,842,311	3.280 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .
dTotal Financial Assistance and Means-Tested Government Programs .....	27	96,130	106,745,059	62,994,372	43,750,687	6.880 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	3	13,967	931,458		931,458	0.150 %
f Health professions education (from Worksheet 5) ..	2	1,751	18,053,209	4,611,263	13,441,946	2.110 %
g Subsidized health services (from Worksheet 6) ..	2	2,809	1,049,852		1,049,852	0.170 %
h Research (from Worksheet 7)	1	26,859	325,296	0	325,296	0.050 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....				0
jTotal Other Benefits ...	8	45,386	20,359,815	4,611,263	15,748,552	2.480 %
kTotal. Add lines 7d and 7j. ..	35	141,516	127,104,874	67,605,635	59,499,239	9.360 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011

Schedule H (Form 990) 2011

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	2	36,278	160,046	160,046	0.030 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other	1	1	1,251	1,251	0 %
10	Total	3	36,279	161,297	161,297	0.030 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense........

18,819,212

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....

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

Enter total revenue received from Medicare (including DSH and IME).....

135,482,489

Enter Medicare allowable costs of care relating to payments on line 5.....

131,534,855

Subtract line 6 from line 5. This is the surplus or (shortfall)........

3,947,634

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures

(see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2011

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest) How many hospital facilities did the organization operate during the tax year?2 Name and address		Other (Describe)
1	MOUNT CARMEL EAST 6001 EAST BROAD STREET COLUMBUS,OH43213	X	X		X
2	MOUNT CARMEL WEST 793 WEST STATE STREET COLUMBUS,OH43222	X	X	X	X

Schedule H (Form 990) 2011

Page

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)

MOUNT CARMEL EAST

Name of Hospital Facility:

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 2011)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet the community health 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 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	Participation in the development of a community-wide community benefit plan
	d	Participation in the execution of a 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 Needs Assessment
	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 and 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	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........		9	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000% If "No," explain in Part VI the criteria the hospital facility used.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	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	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted 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 (FAP) that explained actions the hospital facility may take upon non-payment?.......		14	Yes
15	Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
16	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........		16		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
17	Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
	e	Other (describe in Part VI)

Schedule H (Form 990) 2011

Page

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	Yes
	If “No,” indicate why:
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility’s policy was not in writing
	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)
Individuals Eligible for Financial Assistance
19	Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
	a	The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
	b	The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
	c	The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
	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	Yes
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?...............................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2011

Page

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)

MOUNT CARMEL WEST

Name of Hospital Facility:

Line Number of Hospital Facility (from Schedule H, Part V, Section A):2

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet the community health 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 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	Participation in the development of a community-wide community benefit plan
	d	Participation in the execution of a 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 Needs Assessment
	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 and 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	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........		9	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000% If "No," explain in Part VI the criteria the hospital facility used.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	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	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted 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 (FAP) that explained actions the hospital facility may take upon non-payment?.......		14	Yes
15	Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
16	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........		16		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
17	Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
	e	Other (describe in Part VI)

Schedule H (Form 990) 2011

Page

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	Yes
	If “No,” indicate why:
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility’s policy was not in writing
	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)
Individuals Eligible for Financial Assistance
19	Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
	a	The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
	b	The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
	c	The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
	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	Yes
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?...............................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?9
Name and address		Type of Facility (describe)
1	MOUNT CARMEL EAST IMAGING CTR 5969 E BROAD STREET STE 100 COLUMBUS,OH43213	IMAGING
2	MOUNT CARMEL REHAB & SPORTS MEDICINE 5965 EAST BROAD STREET COLUMBUS,OH43213	REHAB/SPORTS MED/WOMEN'S HLTH
3	MOUNT CARMEL WOMEN'S HEALTH CTR 750 MOUNT CARMEL MALL SUITE 160 COLUMBUS,OH43222	WOMEN'S HEALTH CENTER
4	MOUNT CARMEL OP RADIATION THERAPY 3100 PLAZA PROPERTIES BLVD COLUMBUS,OH43219	RADIATION THERAPY
5	MC HEART FAILURE CLINIC&ANTICOAG CLINIC 85 MCNAUGHTEN COLUMBUS,OH43213	ANTICOAGULATION CLINIC & HEART FAILURE CLINIC, OTHER CARDIOLOGY
6	SIEGEL CENTER 5975 EAST BROAD STREET COLUMBUS,OH43213	O/P CANCER TREATMENT CLINIC, OCCUPATIONAL REHAB. PROGRAM
7	MOUNT CARMEL REHAB & SPORTS MEDICINE 3775 TRUEMAN COURT HILLIARD,OH43026	REHAB. & SPORTS MEDICINE
8	MOUNT CARMEL OCCUPATIONAL HLTH ARLINGATE 4171 ARLINGATE PLAZA SUITE 18 COLUMBUS,OH43228	OCCUPATIONAL HEALTH CTR
9	MOUNT CARMEL EAST OCCUPATIONAL HLTH 5969 E BROAD STREET STE 307 COLUMBUS,OH43213	OCCUPATIONAL HEALTH CTR
10

Schedule H (Form 990) 2011

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions 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, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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: MOUNT CARMEL HEALTH REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH IN ITS ANNUAL REPORT, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.IN ADDITION, MOUNT CARMEL HEALTH INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON TRINITY HEALTH'S WEBSITE AS WELL AS MOUNT CARMEL HEALTH SYSTEM'S WEBSITE (WWW.MOUNTCARMELHEALTH.COM).
		PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM.
		PART I, L7 COL(F): THE FOLLOWING NUMBER, $55,979,522, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F).
		PART II: COMMUNITY BUILDING ACTIVITIES - MOUNT CARMEL HEALTH SYSTEM, WHICH INCLUDES MOUNT CARMEL HEALTH, CONTRIBUTED TO THE ECONOMIC AND CIVIC HEALTH OF THE SURROUNDING COMMUNITY BY SERVING IN AND CONTRIBUTING TO THE EFFORTS OF SEVERAL CHAMBERS OF COMMERCE AND OTHER CIVIC ORGANIZATIONS, BOTH IN THE CITY OF COLUMBUS AND IN SURROUNDING SUBURBS. MOUNT CARMEL'S LEADERS HAVE IDENTIFIED COMMUNITY NEEDS THROUGH THEIR SERVICE ON VARIOUS COMMUNITY BOARDS AND ADVISORY GROUPS. THEY HAVE ALSO GIVEN THEIR EXPERTISE TO THESE GROUPS AND HAVE BEEN ABLE TO ADVOCATE ON ISSUES SURROUNDING HEALTH IN THE COLUMBUS AREA.SYSTEM-WIDE SENIOR LEADERSHIP MEMBERS SERVE ON A NUMBER OF BOARDS FOR COMMUNITY AGENCIES SUCH AS THE WESTSIDE HEALTH ADVISORY BOARD, FRANKLINTON AREA COMMISSION, HILLTOP BUSINESS ASSOCIATION, THE NEW ALBANY CHAMBER OF COMMERCE, AND THE LIFELINE OF OHIO (LOOP) BOARD, THE AMERICAN HEART ASSOCIATION, YMCA, UNITED WAY, COLUMBUS PARTNERSHIP, HEART OF OHIO FEDERAL QUALIFIED HEALTH CENTER, ACCESS HEALTH COLUMBUS, CATHOLIC SOCIAL SERVICES, FRANKLINTON DEVELOPMENT ASSOCIATION, AFFORDABLE HOUSING TRUST, CENTRAL OHIO TRAUMA SYSTEM ACCESS, SIMON KENTON COUNCIL OF THE BOY SCOUTS OF AMERICA BOARD, WALK WITH A DOC, WESTERVILLE AREA CHAMBER OF COMMERCE, OHIO STATE UNIVERSITY HONORS COLLEGE ADVISORY COUNCIL AND EYE CENTER OF COLUMBUS.PROJECT ANGEL TREE SERVES MANY CHILDREN THAT NEED HELP DURING THE HOLIDAY SEASON. THESE CHILDREN HAVE A PARENT IN PRISON. ABOUT 1.7 MILLION AMERICAN CHILDREN EXPERIENCE ABANDONMENT, LONELINESS AND SHAME THAT COME FROM HAVING A PARENT IN PRISON. MANY ARE AT RISK OF FOLLOWING THEIR PARENTS DOWN THE SAME DESTRUCTIVE ROAD TO INCARCERATION. MOUNT CARMEL COLLABORATED WITH FIRST CHURCH OF GOD ON REFUGEE ROAD TO BRIGHTEN THE LIVES OF COUNTLESS CHILDREN BY PROVIDING GIFTS AND A HOLIDAY CELEBRATION WHERE THEY SOCIALIZE WITH CHILDREN AND TEENS FROM THE COMMUNITY AND CHURCH.CHILD SAFETY IS ALSO ADDRESSED AT MOUNT CARMEL THROUGH THE CAR SEAT PROGRAM. IN ORDER TO ENSURE BABY SAFETY WHILE TRAVELING IN A VEHICLE, MOUNT CARMEL PROVIDES CAR SEATS TO FAMILIES THAT CANNOT AFFORD TO PURCHASE A CAR SEAT WHEN THEY ARE READY TO LEAVE THE HOSPITAL WITH THEIR NEWBORN INFANTS. SAFETY IS A CONCERN NOT ONLY FOR THE CHILDREN BUT ALSO FOR THE GENERAL PUBLIC. MOUNT CARMEL FACILITIES RECOGNIZED THE COMMUNITY'S NEED TO BE PREPARED FOR ANY EMERGENCIES THAT MAY THREATEN THE HEALTH AND LIVES OF CITIZENS IN FRANKLIN AND SURROUNDING COUNTIES. MOUNT CARMEL HEALTH SYSTEM SAFETY AND SECURITY PERSONNEL ATTEND CITY- AND STATEWIDE MEETINGS AND PARTICIPATED IN TRAINING COMMUNITY LEADERS TO PLAN AND EXERCISE EMERGENCY RESPONSES IN THE EVENT OF DISASTER. DURING 2012, MOUNT CARMEL COLLABORATED WITH THE LOCAL RED CROSS TO DONATE EMPLOYEE TIME AND SPACE WITHIN OUR FACILITIES FOR BLOOD DONATIONS. WE WILL CONTINUE THIS COLLABORATION NEXT YEAR BECAUSE OF THE NEED ANNOUNCED IN A JULY 25, 2012 NEWS RELEASE FROM THE AMERICAN RED CROSS OF CENTRAL OHIO. THE ORGANIZATION WAS 50,000 DONATIONS SHORT OF THE TARGET FOR THE NATION. THE MOUNT CARMEL COLLEGE OF NURSING ALSO PARTICIPATED IN GIVING BACK TO OUR COMMUNITY. THE AREA SURROUNDING MOUNT CARMEL WEST SCORED AN OVERALL SCORE OF 4.8 ON THE 2009 COMMUNITY NEED INDEX WITH THE HIGHEST NEED BEING 5. THE AREA OF EDUCATIONAL NEED SCORED A 5. IN THIS AREA, 70% OF STUDENTS ENTERING KINDERGARTEN DO NOT GRADUATE. TO ASSIST WITH THIS NEED, THE MOUNT CARMEL COLLEGE OF NURSING EMPLOYEES PROVIDE TUTORING AND SCHOOL SUPPLIES TO THREE AREA ELEMENTARY SCHOOLS. THE FACULTY IS INVOLVED IN ADVOCACY ON HEALTH ISSUES IN CRETIEN DU KASAI, CONGO. THE FACULTY MEMBERS ALSO PARTICIPATE IN HEALTH SCREENINGS, FOOD PANTRIES, AND MEALS FOR THE HOMELESS AND ADOPTING CHILDREN THROUGH SCHOOL FOR CHRISTMAS AND GRADUATION GIFTS.MANY EMPLOYEES AT MOUNT CARMEL PARTICIPATE IN PROJECTS AND ORGANIZATIONS TO ASSIST THE NEEDY. EMPLOYEES GIVE WORK TIME FOR VOLUNTEERING WITH ORGANIZATIONS THAT ADVOCATE FOR THE POOR AND UNDERSERVED. THIS INCLUDES NON-PROFIT ORGANIZATIONS AND COMMUNITY BOARDS WHERE PUBLIC HEALTH POLICIES AND PLANS ARE DISCUSSED AND DECIDED. THEY ALSO SERVE AS COALITION PARTNERS, FUNDRAISERS AND EVENT ORGANIZERS FOR HEALTH RELATED EVENTS SUCH AS CANCER WALKS AND CAUSES THAT IMPROVE THE SOCIAL DETERMINATES OF HEALTH. AS IN PAST YEARS, MOUNT CARMEL HEALTH SYSTEM MADE FINANCIAL CONTRIBUTIONS IN FISCAL YEAR 2012 TO A VARIETY OF NON-PROFIT SOCIAL SERVICES AGENCIES/ORGANIZATIONS, INCLUDING THOSE THAT HELP ADDRESS HEALTH, EMERGENCY HOUSING AND SHELTER AND HUNGER. THE COMMUNITY NEED INDEX ON THE COLUMBUS WEST SIDE WHERE MOUNT CARMEL IS LOCATED IS 4.8 ON A SCALE OF 1-5 WITH 1 BEING AN AREA OF LOW NEED AND 5 AN AREA WITH THE HIGHEST LEVEL OF NEED. MOUNT CARMEL EAST HOSPITAL IS LOCATED IN AN AREA WITH A 3.8 COMMUNITY NEED INDEX. THE MOUNT CARMEL HEALTH SYSTEM HAS PROVIDED 15,010 MEALS TO LOCAL FOOD PANTRIES AND PROVIDED MEDICATION ASSISTANCE TO 2,700 PEOPLE. MOUNT CARMEL HEALTH SYSTEM IS ALSO AWARE OF THE DISPARITIES IN HEALTH CARE NATIONWIDE AND THE MCHS BOARD OF TRUSTEES APPROVED THE PLAN TO IDENTIFY AND ELIMINATE DISPARITIES AS PART OF THE TRINITY HEALTH EQUITY IN CARE INITIATIVE IN JULY OF 2009. LAST YEAR MOUNT CARMEL HOSTED A COMMUNITY HEALTHY HEART FORUM AND HEALTH FAIR WHICH TARGETED THE SURROUNDING AFRICAN-AMERICAN COMMUNITY, WHO ARE AT RISK FOR HEART ISSUES. MOUNT CARMEL IS ALSO CONCERNED ABOUT THE SAFETY OF THE GENERAL PUBLIC AND PUBLIC ACCESS TO HEALTH INFORMATION. MOUNT CARMEL HEALTH CONTINUES TO PROVIDE A CONSUMER HEALTH LIBRARY WITH FREE ACCESS TO HEALTH INFORMATION AND ASSISTANCE FROM LIBRARY STAFF FOR ALL MEMBERS OF THE COMMUNITY. MOUNT CARMEL HEALTH SYSTEM ALSO HELD EDUCATIONAL SESSIONS FOR THE COMMUNITY ON TOPICS SUCH AS SPIRITUALITY, ETHICS, AND MEDICINE, BIOETHICS FOR BABIES, HUMAN TRAFFICKING, CAREERS IN HEALTH CARE, AND VARIOUS HEALTH AND WELLNESS TOPICS. MOUNT CARMEL HAS ALSO WORKED WITH COMMUNITY AGENCIES TO ENSURE THE COMMUNITY IS PREPARED FOR EMERGENCIES OR COMMUNITY DISASTER.MOUNT CARMEL DESIRES TO PROVIDE ACCESS TO HEALTH CARE TO EVERYONE REGARDLESS OF THEIR ABILITY TO PAY. THE MOUNT CARMEL HEALTH CALL PROGRAM IS DESIGNED TO TAKE CALLS AND REFER PATIENTS INTO PRIMARY CARE. CALLS ARE DIRECTED TO THE FINANCIAL ASSISTANCE DEPARTMENT IN THE HEALTH SYSTEM IF THERE IS AN ISSUE REGARDING ABILITY TO PAY FOR CARE. REFERRALS ARE MADE TO SPECIALISTS FOR CARE ALSO.
		PART III, LINE 4: MOUNT CARMEL HEALTH IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM THOSE STATEMENTS: "SUBSTANTIALLY ALL OF THE CORPORATION'S RECEIVABLES ARE RELATED TO PROVIDING HEALTHCARE SERVICES TO PATIENTS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE. THE CORPORATION'S ESTIMATE FOR ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS BY PAYOR."COSTING METHODOLOGY FOR LINES 2 AND 3: AMOUNTS ARE CALCULATED ON LINE 2 USING A COST TO CHARGE RATIO METHODOLOGY. ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.THE ORGANIZATION IDENTIFIES MANY CHARITY PATIENTS AT THE TIME OF SERVICE AND INCLUDES A CHARITY APPLICATION WITH EVERY STATEMENT PER OHIO LAW.
		PART III, LINE 8: MOUNT CARMEL HEALTH DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CHA RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT.
		PART III, LINE 9B: THE ORGANIZATION'S COLLECTION POLICY CONTAINS THE CRITERIA FOR FINANCIAL ASSISTANCE, AND CONTAINS THE FOLLOWING VERBIAGE FOR ARRANGEMENTS WITH OUTSIDE COLLECTION AGENCIES: THE AGREEMENT MUST DEFINE THE STANDARDS AND SCOPE OF PRACTICES TO BE USED BY OUTSIDE COLLECTION AGENTS ACTING ON BEHALF OF THE MINISTRY ORGANIZATION, ALL OF WHICH MUST BE IN COMPLIANCE WITH THIS POLICY.
MOUNT CARMEL EAST		PART V, SECTION B, LINE 19D: FOR PATIENTS WITH INCOMES UP TO 200% OF FPL, NOTHING WAS CHARGED. PATIENTS WITH INCOMES AT 201 TO 400% OF FPL RECEIVED A STANDARD DISCOUNT (HIGHER THAN THAT WHICH WOULD BE OFFERED TO A NON FAP ELIGIBLE PATIENT). THESE ARE NOT CORRELATED TO ANY CONTRACTUAL DISCOUNT.
MOUNT CARMEL WEST		PART V, SECTION B, LINE 19D: FOR PATIENTS WITH INCOMES UP TO 200% OF FPL, NOTHING WAS CHARGED. PATIENTS WITH INCOMES AT 201 TO 400% OF FPL RECEIVED A STANDARD DISCOUNT (HIGHER THAN THAT WHICH WOULD BE OFFERED TO A NON FAP ELIGIBLE PATIENT). THESE ARE NOT CORRELATED TO ANY CONTRACTUAL DISCOUNT.
MOUNT CARMEL EAST		PART V, SECTION B, LINE 20: MOUNT CARMEL EAST'S SLIDING SCALE INCLUDES PATIENTS WITH INCOMES UP TO 400% OF THE FEDERAL POVERTY LEVEL. THE DISCOUNT AT THIS LEVEL IS 25%.
MOUNT CARMEL WEST		PART V, SECTION B, LINE 20: MOUNT CARMEL WEST'S SLIDING SCALE INCLUDES PATIENTS WITH INCOMES UP TO 400% OF THE FEDERAL POVERTY LEVEL. THE DISCOUNT AT THIS LEVEL IS 25%.
		PART VI, LINE 2: NEEDS ASSESSMENT - MOUNT CARMEL HEALTH SYSTEM, WHICH INCLUDES MOUNT CARMEL HEALTH, IS COMMITTED TO HELPING ASSESS AND ADDRESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH ITS OWN PROGRAMS AND SERVICES, AND IN PARTNERSHIP WITH OTHERS.MOUNT CARMEL HEALTH SYSTEM ASSESSES THE HEALTH NEEDS OF THE COMMUNITY THROUGH COMMUNITY NEEDS ASSESSMENTS EVERY THREE (3) YEARS. A COMMUNITY HEALTH NEEDS ASSESSMENT IS A POINT-IN-TIME EFFORT TO MEASURE THE HEALTH AND WELL BEING OF THE COMMUNITY. IT SERVES AS THE BASIS FOR MOUNT CARMEL'S STRATEGIC AND SUBSEQUENT ACTION PLANNING TO DEVELOP HEALTH POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS AND COLLABORATE WITH OTHER COMMUNITY HEALTHCARE PROVIDERS. THIS ASSESSMENT ALSO SERVES AS A BENCHMARK FOR FUTURE ASSESSMENT OF RELATIVE PROGRESS TOWARD ESTABLISHED COMMUNITY HEALTH OBJECTIVES.MOUNT CARMEL'S COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES THE OPPORTUNITY TO:- GAIN INSIGHTS INTO THE NEEDS AND ASSETS OF THE COMMUNITIES SERVED- IDENTIFY AND ADDRESS THE NEEDS OF VULNERABLE POPULATIONS WITHIN THE COMMUNITY- ENHANCE HOSPITAL/COMMUNITY RELATIONSHIPS AND THE OPPORTUNITY FOR COLLABORATIVE COMMUNITY ACTION, INCLUDING INVOLVEMENT WITH COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES, COMMISSIONS, ADVISORY GROUPS AND PANELS- PROVIDE THE INFORMATION REQUIRED FOR COMMUNITY OUTREACH PLANNINGMOUNT CARMEL'S COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS INVOLVES THE GATHERING OF TWO TYPES OF DATA: QUANTITATIVE (DEMOGRAPHICS, HEALTH INDICATORS, ETC.) AND QUALITATIVE (PUBLIC SURVEYS, FORUMS, FOCUS GROUPS). WHILE MOUNT CARMEL CONDUCTS SOME OF ITS OWN ORIGINAL RESEARCH IN COMPLETING THE COMMUNITY NEEDS ASSESSMENT, IT ALSO RELIES UPON THE AVAILABILITY OF DATA COLLECTED BY OTHERS WHENEVER POSSIBLE TO AVOID UNNECESSARY DUPLICATION. THE DATA HELP SUPPORT SHORT-TERM AND LONG-TERM DECISIONS ABOUT ALLOCATION OF COMMUNITY HUMAN AND CAPITAL RESOURCES.THE ASSESSMENT WAS COMPLETED IN COLLABORATION WITH OTHER HOSPITAL SYSTEMS, PUBLIC HEALTH DEPARTMENTS, OTHER COMMUNITY ORGANIZATIONS AND COMMUNITY ADVISORY BOARDS. DURING THIS PROCESS BOTH QUANTITATIVE AND QUALITATIVE DATA WERE GATHERED REFLECTING PROMINENT AREAS OF CONCERN RELATED TO COMMUNITY HEALTH. THE FULL COMMUNITY HEALTH NEEDS ASSESSMENT DOCUMENT AND 3 YEAR IMPLEMENTATION STRATEGY WILL BE AVAILABLE FOR PUBLIC VIEW ON MOUNT CARMEL'S WEBSITE IN JUNE 2013. BESIDES ITS BOARD OF TRUSTEES, MOUNT CARMEL SHARES THE FINDINGS OF ITS COMMUNITY NEEDS ASSESSMENTS WITH OTHER NON-PROFIT ORGANIZATIONS AND GOVERNMENT OFFICIALS/ENTITIES AND SEEKS TO FORM COLLABORATIVE PARTNERSHIPS TO AVOID UNNECESSARY DUPLICATION OF EFFORTS IN ADDRESSING IDENTIFIED COMMUNITY HEALTH NEEDS.
		PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MOUNT CARMEL HEALTH SYSTEM, WHICH INCLUDES MOUNT CARMEL HEALTH, IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES.- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE- BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITY.IN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION (AHA) RECOMMENDATIONS, MOUNT CARMEL HEALTH SYSTEM HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS:- PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSMOUNT CARMEL HEALTH SYSTEM IS COMMITTED TO EFFECTIVELY COMMUNICATING WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ABOUT MOUNT CARMEL'S PATIENT FINANCIAL ASSISTANCE PROGRAM AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES IS MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. THIS INFORMATION IS COMMUNICATED THROUGH PATIENT FINANCIAL SERVICES ASSOCIATES IN PATIENT REGISTRATION, CUSTOMER SERVICE, AND BILLING AND COLLECTIONS - ALL OF WHOM RECEIVE TRAINING REGARDING FEDERAL, STATE AND LOCAL PUBLIC FINANCIAL ASSISTANCE PROGRAMS AND MOUNT CARMEL'S PATIENT FINANCIAL ASSISTANCE PROGRAM. IN ADDITION, THE EXTERNAL COLLECTION AGENCIES AND EXTERNAL MEDICAID ELIGIBILITY VERIFICATION VENDOR WITH WHOM MOUNT CARMEL WORKS ALSO RECEIVE TRAINING REGARDING THESE PROGRAMS. ALL MOUNT CARMEL PATIENT FINANCIAL STATEMENTS INCLUDE A FINANCIAL ASSISTANCE APPLICATION AND PHONE NUMBER FOR PATIENTS TO CALL WITH QUESTIONS.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND WHICH MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. MOUNT CARMEL HEALTH SYSTEM UTILIZES BOTH INTERNAL RESOURCES AND AN EXTERNAL VENDOR TO ASSIST PATIENTS IN APPLYING FOR MEDICAID. INPATIENTS, EMERGENCY DEPARTMENT PATIENTS, CLINIC PATIENTS, AND PATIENTS RECEIVING HIGH-COST OUTPATIENT SERVICES ARE SCREENED TO DETERMINE WHETHER THEY QUALIFY FOR FEDERAL, STATE OR LOCAL PUBLIC FINANCIAL ASSISTANCE PROGRAMS OR MOUNT CARMEL'S PATIENT FINANCIAL ASSISTANCE PROGRAM. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE. MOUNT CARMEL HEALTH SYSTEM OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED FINANCIAL MEANS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS LIKE MEDICAID OR OTHER PUBLIC ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS COMMUNICATED VIA SIGNS THAT ARE PROMINENTLY DISPLAYED IN ALL PATIENT REGISTRATION AREAS. BROCHURES PLACED IN PATIENT REGISTRATION AREAS EDUCATE PATIENTS IN GREATER DETAIL ABOUT THE AVAILABILITY OF FEDERAL, STATE AND LOCAL ASSISTANCE PROGRAMS AS WELL AS MOUNT CARMEL'S PATIENT FINANCIAL ASSISTANCE PROGRAM. SUMMARIES OF FEDERAL, STATE AND LOCAL PUBLIC FINANCIAL ASSISTANCE PROGRAMS AND MOUNT CARMEL'S PATIENT FINANCIAL ASSISTANCE PROGRAM ALSO ARE MADE AVAILABLE THROUGH MOUNT CARMEL SERVICES THAT DIRECTLY INTERACT WITH THE COMMUNITY, INCLUDING MOUNT CARMEL COMMUNITY OUTREACH AND MOUNT CARMEL HEALTH STATIONS CLINICS; OTHER ORGANIZATIONS THAT SERVE THE UNINSURED AND UNDERINSURED SUCH AS ACCESS HEALTH COLUMBUS, SOCIAL SERVICES AGENCIES LIKE CATHOLIC SOCIAL SERVICES, HOMELESS SHELTERS, FEDERALLY QUALIFIED HEALTH CENTERS LIKE HEART OF OHIO FAMILY HEALTH CENTERS AND LOWER LIGHTS CHRISTIAN HEALTH CENTER. INFORMATION REGARDING PATIENT FINANCIAL ASSISTANCE PROGRAMS ALSO IS AVAILABLE ON MOUNT CARMEL'S WEBSITE. IN ADDITION TO ENGLISH, PATIENT FINANCIAL ASSISTANCE INFORMATION IS ALSO AVAILABLE IN SPANISH AND SOMALI FOR THOSE WITH LIMITED ENGLISH PROFICIENCY, REFLECTING OTHER PREDOMINANT LANGUAGES SPOKEN IN THE COMMUNITIES SERVED BY MOUNT CARMEL. MOUNT CARMEL ALSO HAS INTERPRETING SERVICES AVAILABLE FOR LIMITED ENGLISH PROFICIENCY PATIENTS WHO SPEAK OTHER LANGUAGES.MOUNT CARMEL HEALTH SYSTEM HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MOUNT CARMEL HEALTH SYSTEM MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. MOUNT CARMEL HEALTH SYSTEM EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION, CUSTOMER SERVICE, BILLING AND COLLECTIONS) ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES.
		PART VI, LINE 4: COMMUNITY INFORMATION - MOUNT CARMEL HEALTH SYSTEM, WHICH INCLUDES MOUNT CARMEL HEALTH, PREDOMINATELY SERVES CENTRAL OHIO, WHICH INCLUDES FRANKLIN AND FIVE CONTIGUOUS COUNTIES (DELAWARE, FAIRFIELD, LICKING, MADISON AND PICKAWAY), AND IS HOME TO NEARLY 1.7 MILLION RESIDENTS. AMONG CENTRAL OHIO HOUSEHOLDS, 20% HAVE A HOUSEHOLD INCOME OF LESS THAN $25,000, AND ANOTHER 26% HAVE A HOUSEHOLD INCOME OF BETWEEN $25,000 AND $50,000. OVER THE NEXT FIVE YEARS, CENTRAL OHIO'S POPULATION IS EXPECTED TO EXPERIENCE A HIGH GROWTH RATE (18%) IN ADULTS AGE 55 AND OLDER AND A SLIGHT DECLINE IN ADULTS BETWEEN THE AGES OF 18 AND 34. IN 2009, APPROXIMATELY 33% OF THE POPULATION OVER AGE 25 HELD A BACHELOR'S OR HIGHER DEGREE, NEARLY FIVE PERCENTAGE POINTS HIGHER THAN THE NATIONAL AVERAGE. 27% OF THE RESIDENTS OF COLUMBUS LIVE AT OR BELOW THE NATIONAL POVERTY LEVEL AND 12.5% LIVE AT OR BELOW 50% OF POVERTY LEVEL. ACCORDING TO THE 2008-2009 OHIO FAMILY HEALTH SURVEY, 138,625 ADULTS IN FRANKLIN COUNTY BETWEEN THE AGES OF 18-64, OR ABOUT 19% OF THAT POPULATION, DO NOT HAVE HEALTH INSURANCE. THIS NUMBER IS SLIGHTLY HIGHER THAN THE STATEWIDE PERCENTAGE OF 17% UNINSURED ADULTS IN THAT AGE GROUP. CENTRAL OHIO FEATURES A DIVERSE EMPLOYER BASE, INCLUDING MANUFACTURING, TRADE, EDUCATION, SERVICE, FINANCE AND AGRICULTURE. THE OHIO UNEMPLOYMENT RATE DECLINED TO 6.9% IN OCTOBER 2012.
		PART VI, LINE 5: OTHER INFORMATION - IN FISCAL YEAR 2012, PROJECTS FOR BOTH THE POOR AND BROADER COMMUNITY ARE ALSO FUNDED THROUGH THE MOUNT CARMEL FOUNDATION. ONE OF THE PROJECTS PROVIDES BREAST PUMP KITS FOR NEW MOMS AND BABIES AND ANOTHER SUPPORTS EXERCISE, AND OTHER SUPPORTIVE SERVICES FOR CANCER SURVIVORS. MOUNT CARMEL HAS A NUMBER OF CANCER FOCUSED PROGRAMS AS CANCER IS THE NUMBER ONE CAUSE OF DEATH IN FRANKLIN COUNTY AND THE AGE ADJUSTED DEATH RATE IS GREATER IN FRANKLIN COUNTY THAN THE RATE FOR THE STATE OF OHIO. MOUNT CARMEL ALSO PROVIDED MEETING SPACE FOR NUMEROUS SUPPORT GROUPS FOR INDIVIDUALS FACING EMOTIONAL AND PHYSICAL HEALTH CHALLENGES, SUCH AS GRIEF, PROSTATE CANCER, ALZHEIMER'S DISEASE, BREAST CANCER AND PULMONARY ILLNESSES. THE RESULTS OF THE COMMUNITY NEEDS ASSESSMENT ARE USED IN PLANNING THE WORK OF MOUNT CARMEL'S COMMUNITY OUTREACH PROGRAM. THE PROGRAM OPERATES A MOBILE COACH THAT SERVES AS A "MEDICAL OFFICE ON WHEELS" SERVING VULNERABLE POPULATIONS AT HOMELESS SHELTERS, SOUP KITCHENS, LOW-INCOME NEIGHBORHOODS AND IN IMMIGRANT COMMUNITIES. THE MOBILE MEDICAL CLINIC INCLUDES TWO EXAMINATION ROOMS, NURSE TRIAGE WORK STATIONS, AN ON-BOARD PHARMACY, A CLINICAL LABORATORY, AND A C-ARM RADIOGRAPHIC UNIT. IT IS STAFFED BY A PHYSICIAN, A NURSE PRACTITIONER, NURSES, AN EMERGENCY MEDICAL TECHNICIAN AND BILINGUAL CASE WORKERS. THE NEED FOR THIS PROGRAM WAS DOCUMENTED BY A COUNTY HEALTH SURVEY CONDUCTED BY THE UNIVERSITY OF WISCONSIN IN 2009. THE SURVEY SHOWED THAT 13% OF FRANKLIN COUNTY RESIDENTS WERE UNINSURED, 14% SUFFERED FROM POOR HEALTH AND 8% WERE UNEMPLOYED.THE COMMUNITY OUTREACH PROGRAM ALSO OPERATES A 39-FOOT VAN TO CONTINUE TO SUPPORT THE LOW-INCOME AND UNINSURED IN THEIR HEALTH CARE NEEDS. THIS VAN SERVES 10 COMMUNITY SITES EACH WEEK AND WORKS WITH OTHER COMMUNITY AGENCIES TO OFFER HEALTH SERVICES ON THE WEEKENDS AND EVENINGS. THE OUTREACH MOBILE COACH SERVES MANY HOMELESS IN COLUMBUS AND FRANKLIN COUNTY; MANY HAVE PHYSICAL AND MENTAL HEALTH NEEDS. TWENTY-SEVEN PERCENT OF THE HOMELESS IN COLUMBUS ARE CONSIDERED TRI-MORBID: SUBSTANCE ABUSE, MENTAL HEALTH ISSUES AND A CHRONIC MEDICAL CONDITION. THIS COMPARES WITH ONLY 22% SURVEYED IN OTHER CITIES. THE NEED FOR MENTAL HEALTH SERVICES WAS IDENTIFIED ON OUTREACH COACH. IT WAS DISCOVERED THAT MANY OF THE DIAGNOSES OUTSIDE SCOPE OF OUTREACH PROVIDERS AND IT WAS VERY DIFFICULT TO GET PATIENTS INTO MENTAL HEALTH CARE IN AN APPROPRIATE TIME.MOUNT CARMEL HEALTH CREATED A PARTNERSHIP WITH SOUTH EAST MENTAL HEALTH TO MEET THE NEEDS OF THESE PATIENTS. AS PART OF THIS PARTNERSHIP THE OUTREACH MOBILE COACH HOUSES A PSYCHIATRIC NURSE PRACTITIONER AND CASEWORKER WHO PROVIDE SERVICES ON-SITE FOR OUTREACH PATIENTS. MOUNT CARMEL PROVIDES FUNDING FOR MEDICATIONS TO BE GIVEN ON-SITE AND LABORATORY TESTING IS COMPLETED AS NEEDED ON MOBILE COACH. MOUNT CARMEL HEALTH SYSTEM PROVIDED EQUIPMENT, SUCH AS A LAPTOP, PRINTER AND MEDICAL BAG.THE MEDICAL BAG IS USED IN THE OUTREACH STREET MEDICINE PROGRAM. STREET MEDICINE IS A SERVICE MOUNT CARMEL HEALTH PROVIDES TO THE HOMELESS CITIZENS OF COLUMBUS. EACH NIGHT 1.6 MILLION MEN, WOMEN, AND CHILDREN USE TEMPORARY SHELTERS IN AMERICA. IN COLUMBUS, AN AVERAGE OF 630 PEOPLE USE TEMPORARY SHELTERS EACH NIGHT AND ARE HOMELESS LIVING ON THE LAND DURING THE DAY. THE OUTREACH DEPARTMENT FORMED A TEAM CONSISTING OF A PHYSICIAN OR NURSE PRACTITIONER, A MEDICAL TECHNICIAN, A CASE MANAGEMENT AND SOMETIMES A RN TO SEARCH OUT THESE CLIENTS AND MEET THEIR NEEDS BEFORE THEY BECOME URGENT OR LIFE THREATENING. THE TEAM LITERALLY SEARCHES THE INNER CITY AREAS FOR THE HOMELESS IN NEED OF CARE. ONCE THE TEAM HAS ESTABLISHED A TRUSTING RELATIONSHIP, MEDICAL CARE IS WELCOMED AND ACCEPTED. WE ALSO PROVIDE CONNECTIONS TO COMMUNITY RESOURCES FOR HOUSING, FOOD, AND MENTAL HEALTH SERVICES AVAILABLE ON OUR MOBILE COACH THROUGH THE PARTNERSHIP WITH SOUTHEAST MENTAL HEALTH.TO ASSIST WITH THE MULTIPLE NEEDS OF THIS COMMUNITY AND TO HELP OTHERS AROUND THE WORLD NEEDING THE SAME TYPE OF ASSISTANCE, THE FACULTY FROM THE MOUNT CARMEL COLLEGE OF NURSING MEET WITH VARIOUS COMMUNITY GROUPS TO EDUCATE THE PUBLIC AND ADVOCATE FOR SCHOOL NUTRITION, DIABETES EDUCATION, SENIOR HEALTH ISSUES, AND WORLDWIDE HEALTH ISSUES SUCH AS HUNGER AND WOMEN'S HEALTH. ONE HUNDRED PERCENT OF MOUNT CARMEL'S SURPLUS REVENUE IS INVESTED BACK INTO SUPPORTING THE ORGANIZATION'S HEALTH CARE MINISTRY. MOUNT CARMEL HEALTH SYSTEM IS GOVERNED BY A 15-MEMBER BOARD OF TRUSTEES, WITH A MAJORITY OF THE SEATS ALLOCATED TO COMMUNITY REPRESENTATIVES AND LEADERS. OUR GOVERNANCE STRUCTURE ENSURES THAT THE COMMUNITY AND ITS INTERESTS ARE STRONGLY REPRESENTED IN IMPORTANT DECISION-MAKING. IN ADDITION, TWO SEATS ON MOUNT CARMEL'S BOARD ARE ALLOCATED TO RELIGIOUS WOMEN, WHO HELP ENSURE THAT THE ORGANIZATION REMAINS TRUE TO ITS CHARITABLE MISSION.MOUNT CARMEL HEALTH SYSTEM MAINTAINS AN OPEN MEDICAL STAFF - MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS. MOUNT CARMEL ACTIVELY RECRUITS, AND EMPLOYS DOCTORS TO SERVE IN UNDERSERVED AREAS OF THE COMMUNITY. MOUNT CARMEL HEALTH SYSTEM OPERATES A GRADUATE MEDICAL EDUCATION PROGRAM THAT TRAINS PHYSICIANS IN FAMILY PRACTICE, INTERNAL MEDICINE, OBSTETRICS & GYNECOLOGY, GENERAL SURGERY, ORTHOPEDIC SURGERY AND TRANSITIONAL YEAR (FOR PHYSICIANS WHO WANT TO PURSUE SUB-SPECIALTY TRAINING). MOUNT CARMEL ALSO OPERATES A COLLEGE OF NURSING THAT IS AMONG THE LARGEST BACCALAUREATE DEGREE GRANTING PROGRAMS IN OHIO. THE COLLEGE OFFERS BACHELOR OF SCIENCE, RN TO BSN COMPLETION AND MASTER OF SCIENCE DEGREES IN NURSING. THEY ALSO OFFER A GRADUATE CERTIFICATE IN NURSING EDUCATION AND A DIETETIC INTERNSHIP. WITH ASSISTANCE FROM THE FOUNDATION, THE MOUNT CARMEL COLLEGE OF NURSING WAS ABLE TO PROVIDE 138 ACADEMIC SCHOLARSHIPS FOR EDUCATING FUTURE NURSES.
		PART VI, LINE 6: MOUNT CARMEL HEALTH IS A MEMBER ORGANIZATION OF TRINITY HEALTH, WHICH IS ONE OF THE LARGEST CATHOLIC HEALTH CARE SYSTEMS IN THE COUNTRY. BASED IN LIVONIA, MICHIGAN, TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEVELOP, AND ARE HELD ACCOUNTABLE FOR ACHIEVING, COMMUNITY BENEFIT GOALS THAT INCLUDE DEVELOPING NEEDED SERVICES OR EXPANDING ACCESS TO SERVICES FOR LOW-INCOME INDIVIDUALS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITY THROUGH PROGRAMS TO SERVE THE POOR AND UNINSURED, MANAGE CHRONIC CONDITIONS LIKE DIABETES, HEALTH EDUCATION AND PROMOTION INITIATIVES, AND OUTREACH FOR THE ELDERLY. IN FISCAL YEAR 2012, THIS INCLUDED OVER $615 MILLION IN SUCH COMMUNITY BENEFITS. THEREFORE, TRINITY HEALTH TAKES A SYSTEMS APPROACH IN ITS COMMUNITY BENEFIT PLANNING AND IMPLEMENTATION, AND IS CONSEQUENTLY ABLE TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ARE HELPING PROMOTE AND ADDRESS THE HEALTH NEEDS OF THEIR RESPECTIVE COMMUNITIES.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG.

Schedule H (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization
MOUNT CARMEL HEALTH

Employer identification number
31-4379602

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2011

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Identifier	Return Reference	Explanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	PART I, LINE 2:	SCHEDULE I, PART I, LINE 2: DONATIONS MADE BY MOUNT CARMEL HEALTH TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE AND ARE CONSIDERED UNRESTRICTED WITH REGARD TO THE USE OF THE FUNDS.

Schedule I (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

Open to Public Inspection

Name of the organization

MOUNT CARMEL HEALTH

Employer identification number

31-4379602

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....

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? ....

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. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

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.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2011

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.

(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 as deferred in prior Form 990
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1) CLAUS VON ZYCHLIN	(i) (ii)	0 482,336	0 173,932	0 86,523	0 72,419	0 28,373	0 843,583	0 0
(2) DOROTHY FRIDAY MD	(i) (ii)	0 167,050	0 0	0 0	0 0	0 0	0 167,050	0 0
(3) JACQUELINE PRIMEAU	(i) (ii)	0 366,292	0 65,158	0 3,550	0 30,625	0 9,928	0 475,553	0 0
(4) RONALD WHITESIDE	(i) (ii)	0 378,136	0 94,027	0 1,369,918	0 36,370	0 20,176	0 1,898,627	0 555,919
(5) PAULA AUTRY	(i) (ii)	0 287,579	0 69,138	0 961	0 15,925	0 19,846	0 393,449	0 0
(6) JOHN HEISLER	(i) (ii)	0 297,988	0 61,070	0 54,512	0 20,751	0 16,230	0 450,551	0 0
(7) HUGH JONES	(i) (ii)	0 232,540	0 51,014	0 760	0 19,514	0 16,056	0 319,884	0 0
(8) JOSEPH SWEDISH	(i) (ii)	0 1,279,458	0 677,642	0 3,229,560	0 548,602	0 27,600	0 5,762,862	0 2,698,342
(9) KEDRICK ADKINS	(i) (ii)	0 743,978	0 316,652	0 344,596	0 103,857	0 13,263	0 1,522,346	0 143,708
(10) J RICHARD O'CONNELL	(i) (ii)	0 571,942	0 230,946	0 140,349	0 85,919	0 32,302	0 1,061,458	0 0
(11) MICHAEL MURPHY	(i) (ii)	0 402,598	0 0	0 71,772	0 48,365	0 27,173	0 549,908	0 0
(12) CHARLES BRETT JUSTICE	(i) (ii)	0 139,036	0 16,961	0 2,877	0 12,416	0 20,170	0 191,460	0 0
(13) THOMAS HARTRANFT	(i) (ii)	0 357,266	0 0	0 4,739	0 25,679	0 16,066	0 403,750	0 0
(14) LARRY SWANNER	(i) (ii)	0 304,370	0 28,041	0 1,298	0 27,836	0 15,851	0 377,396	0 0
(15) RICHARD FANKHAUSER	(i) (ii)	0 307,551	0 0	0 1,127	0 21,551	0 200	0 330,429	0 0
(16) MARK HACKMAN	(i) (ii)	0 232,479	0 25,324	0 6,485	0 27,734	0 1,473	0 293,495	0 0
(17) JOHN HOLLENBACH	(i) (ii)	0 246,023	0 0	0 4,934	0 42,803	0 20,919	0 314,679	0 0
(18) MICHAEL SLUBOWSKI	(i) (ii)	0 13,394	0 0	0 137,444	0 500	0 601	0 151,939	0 136,445

Schedule J (Form 990) 2011

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
	PART I, LINE 3	MOUNT CARMEL HEALTH IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. MOUNT CARMEL HEALTH'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MOUNT CARMEL HEALTH'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
	PART I, LINE 4B	THE FOLLOWING ARE PARTICIPANTS IN THE TRINITY HEALTH PENSION RESTORATION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($245,000 FOR 2011). THE FOLLOWING ACCRUALS FOR 2011 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $91,607 MICHAEL MURPHY - $27,513 J. RICHARD O'CONNELL - $66,279 JOSEPH SWEDISH - $255,902 CLAUS VON ZYCHLIN - $52,433 PART I, LINE 4B: THE FOLLOWING IS A PARTICIPANT IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING SERP ACCRUAL FOR 2011 IS INCLUDED IN COLUMN C OF SCHEDULE J, PART II: JOSEPH SWEDISH - $265,000 PART II: THE FOLLOWING INDIVIDUALS BECAME VESTED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) DURING CALENDAR 2011. AS A RESULT, THE VESTED AMOUNTS WERE INCLUDED IN THEIR 2011 TAXABLE INCOMES. THE FOLLOWING VESTED SERP AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: JOSEPH SWEDISH - $2,740,000 KEDRICK ADKINS - $220,648 RONALD WHITESIDE - $1,364,200 COLUMN F OF SCHEDULE J INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS.

Schedule J (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

MOUNT CARMEL HEALTH

Employer identification number

31-4379602

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?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

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?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

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) 2011

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) SUSAN BRUMM	FAMILY MEMBER OF DOROTHY FRIDAY SECRETARY/TREASURER	106,038	EMPLOYMENT ARRANGEMENT		No
(2) DOROTHY FRIDAY	SECRETARY/TREASURER	169,256	AMOUNT PAID TO DOROTHY FRIDAY DURING FISCAL YEAR JUNE 30, 2012 FOR PHYSICIAN SERVICES RENDERED TO MOUNT CARMEL HEALTH		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) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE N
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Liquidation, Termination, Dissolution or Significant Disposition of Assets

Complete if the organization answered "Yes" to Form 990, Part IV, lines 31 or 32 or Form 990-EZ, line 36.
bullet

Attach certified copies of any articles of dissolution, resolutions or plans.
bullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization
MOUNT CARMEL HEALTH

Employer identification number
31-4379602

Part I

Liquidation, Termination or Dissolution. Complete if the organization answered "Yes" to Form 990, Part IV, line 31, or Form 990-EZ, line
36. Use Part III if additional space is needed.

1(a)Description of asset(s) distributed or transaction expenses paid	(b)Date of distribution	(c)Fair market value of asset(s) distributed or amount of transaction expenses	(d)Method of determining FMV for asset(s) distributed or transaction expenses	(e)EIN of recipient	(f)Name and address of recipient	(g)IRC section of recipient(s) (if tax-exempt) or type of entity
MERGER OF MOUNT CARMEL HEALTH INTO MOUNT CARMEL HEALTH SYSTEM	07-01-2012	308,976,420	BOOK VALUE	31-1439334	MOUNT CARMEL HEALTH SYSTEM 6150 EAST BROAD STREET COLUMBUS,OH432131574	501(C)(3)

Yes

Did or will any officer, director, trustee, or key employee of the organization:

Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .

Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .

Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . .

Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution? . . . . .

If the organization answered "Yes" to any of the questions in this line, provide the name of the person involved and explain in Part III. bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.

Cat. No. 50087Z

Schedule N (Form 990 or 990-EZ) 2011

Page 2

Part I

Liquidation, Termination or Dissolution (continued)

Note. If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B), line 16 (Total assets), and line 26 (Total liabilities), should equal -0-.

Yes

Did the organization distribute its assets in accordance with its governing instrument(s)? If “No,” describe in Part III . . . . . . . . . . .

Yes

Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate? . . . . . .

Yes

If “Yes,” did the organization provide such notice? . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

Did the organization discharge or pay all of its liabilities in accordance with state laws? . . . . . . . . . . . . . . . . .

Yes

Did the organization have any tax-exempt bonds outstanding during the year? . . . . . . . . . . . . . . . . . . . .

Did the organization discharge or defease all of its tax-exempt bond liabilities during the tax year in accordance with the Internal Revenue Code and state laws? .

If ‘Yes’ to line 6b, describe in Part III how the organization defeased or otherwise settled these liabilities. If “No,” explain in Part III.

Part II

Sale, Exchange, Disposition or Other Transfer of More Than 25% of the Organization's Assets. Complete if the organization answered "Yes" to Form 990, Part IV, line 32, or Form 990-EZ, line 36. Use Part III if additional space is needed.

1(a)Description of asset(s) distributed or transaction expenses paid	(b)Date of distribution	(c)Fair market value of asset(s) distributed or amount of transaction expenses	(d)Method of determining FMV for asset(s) distributed or transaction expenses	(e)EIN of recipient	(f)Name and address of recipient	(g)IRC section of recipient(s) (if tax-exempt) or type of entity

Yes

Did or will any officer, director, trustee, or key employee of the organization:

Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .

Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .

Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .

Receive, or become entitled to, compensation or other similar payments as a result of the organization’s significant disposition of assets? . . . . . . .

If the organization answered "Yes" to any of the questions in this line, provide the name of the person involved and explain in Part III.

Schedule N(Form 990 or 990-EZ) 2011

Schedule N (Form 990 or 990-EZ) 2011

Page 3

Part III

Supplemental Information. Complete to provide the information required by Parts I and II,
and any additional information.

Identifier	Return Reference	Explanation
		PART I, LINE 7C: MOUNT CARMEL HEALTH HAD NO TAX-EXEMPT BOND LIABILITIES TO DISCHARGE OR DEFEASE DURING THE TAX YEAR.

Schedule N (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

Open to Public
Inspection

Name of the organization

MOUNT CARMEL HEALTH

Employer identification number

31-4379602

Identifier	Return Reference	Explanation
	FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF MOUNT CARMEL HEALTH IS MOUNT CARMEL HEALTH SYSTEM. SEE LINE 7 FOR ADDITIONAL INFORMATION.
	FORM 990, PART VI, SECTION A, LINE 7A	MOUNT CARMEL HEALTH SYSTEM IS THE SOLE MEMBER OF MOUNT CARMEL HEALTH. MOUNT CARMEL HEALTH SYSTEM HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF TRUSTEES OF MOUNT CARMEL HEALTH.
	FORM 990, PART VI, SECTION A, LINE 7B	AS SOLE MEMBER, MOUNT CARMEL HEALTH SYSTEM MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MOUNT CARMEL HEALTH SYSTEM MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS.
	FORM 990, PART VI, SECTION B, LINE 11	PRIOR TO FILING, THE FORM 990 FOR MOUNT CARMEL HEALTH IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE FINANCE COMMITTEE AS WELL AS THE BOARD OF TRUSTEES. THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE.
	FORM 990, PART VI, SECTION B, LINE 12C	MOUNT CARMEL HEALTH HAS ADOPTED A CONFLICT OF INTEREST POLICY WHICH CONTAINS THE ELEMENTS IN THE MODEL CONFLICT OF INTEREST POLICY ISSUED BY THE IRS. IT APPLIES TO ALL "INTERESTED PERSONS" OF MOUNT CARMEL HEALTH, WHICH INCLUDES TRUSTEES, PRINCIPAL OFFICERS AND EXECUTIVES, AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. INTERESTED PERSONS ARE REQUIRED TO ACT AT ALL TIMES IN A MANNER CONSISTENT WITH MOUNT CARMEL HEALTH'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MOUNT CARMEL HEALTH OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE BOARD OF TRUSTEES OF MOUNT CARMEL HEALTH IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO MOUNT CARMEL HEALTH. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE REVIEWED WITH THE BOARD OF TRUSTEES OF MOUNT CARMEL HEALTH ON AN ANNUAL BASIS.
	FORM 990, PART VI, SECTION B, LINE 15	TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF MOUNT CARMEL HEALTH ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS.
	FORM 990, PART VI, SECTION C, LINE 19	MOUNT CARMEL HEALTH IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE ANNUAL REPORT (WHICH INCLUDES COMMUNITY BENEFIT MINISTRY INFORMATION) AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, MOUNT CARMEL HEALTH INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON TRINITY HEALTH'S WEBSITE AS WELL AS MOUNT CARMEL HEALTH SYSTEM'S WEBSITE (WWW.MOUNTCARMELHEALTH.COM).
ESTIMATE OF THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS:	FORM 990, PART VII, SECTION A, LINE 1 , COLUMN B:	THE HOURS LISTED IN COLUMN B OF PART VII, SECTION A, LINE 1 REFLECT ONLY THE INDIVIDUALS' AVERAGE WEEKLY HOURS SPENT DIRECTLY ON THE ACTIVITIES OF THE REPORTING ORGANIZATION. IN ADDITION, THESE ARE THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: KEDRICK ADKINS - 53 HOURS SR. BARBARA HAHL, CSC - 35 HOURS JOHN HEISLER - 37 HOURS HUGH JONES - 37 HOURS MICHAEL MURPHY - 53 HOURS J. RICHARD O'CONNELL - 53 HOURS JACQUELINE PRIMEAU - 47 HOURS JOSEPH SWEDISH - 53 HOURS CLAUS VON ZYCHLIN - 47 HOURS RONALD WHITESIDE - 42 HOURS
	FORM 990, PART VII, SECTION A:	SR. BARBARA HAHL IS A MEMBER OF THE CONGREGATION OF THE SISTERS OF THE HOLY CROSS. HAVING TAKEN A VOW OF POVERTY, SR. BARBARA DID NOT RECEIVE COMPENSATION FOR THE SERVICES SHE PROVIDED TO MOUNT CARMEL HEALTH SYSTEM EXCEPT FOR INSURANCE BENEFITS ($4,832) AND THE USE OF A LEASED CAR ($3,128). INSTEAD, A TOTAL OF $244,980 WAS PAID BY MOUNT CARMEL HEALTH SYSTEM DIRECTLY TO THE SISTERS OF THE HOLY CROSS FOR SR. BARBARA'S SERVICES.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 365,784. EQUITY TRANSFERS TO AFFILIATES: -2,513,579. MERGER OF MOUNT CARMEL HEALTH INTO MOUNT CARMEL HEALTH SYSTEM: -248,743,218. TOTAL TO FORM 990, PART XI, LINE 5: -250,891,013.
	FORM 990, PART XII, LINE 2:	MOUNT CARMEL HEALTH'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY12 CONSOLIDATED FINANCIAL STATEMENTS OF ITS SOLE MEMBER, MOUNT CARMEL HEALTH SYSTEM, AS WELL AS THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. BOTH SETS OF CONSOLIDATED FINANCIAL STATEMENTS WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

MOUNT CARMEL HEALTH

Employer identification number

31-4379602

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
(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	Yes	No
(1) ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS,MI49503 27-2491974	HEALTHCARE SERVICES	MI	501(C)(3)	9	TRINITY HEALTH-MICHIGAN		No
(2) AMICARE HOSPICE SERVICES INC 20555 VICTOR PARKWAY LIVONIA,MI48152 38-2949053	PROVIDE HOSPICE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC		No
(3) AUXILIARY OF HOLY ROSARY HOSPITAL 351 SW 9TH STREET ONTARIO,OR97914 94-3059469	SUPPORTS SERVICES OF RELATED HOSPITAL	OR	501(C)(3)	9	SAINT ALPHONSUS MEDICAL CENTER-ONTARIO		No
(4) BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR,IA51245 42-1500277	ACUTE/AMBULATORY HEALTHCARE SERVICES	IA	501(C)(3)	3	MERCY HEALTH SERVICES-IOWA CORP		No
(5) BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR,IA51245 26-2973307	SUPPORT THE SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	11, TYPE I	BAUM HARMON MERCY HOSPITAL		No
(6) CATHERINE MCAULEY HEALTH SERVICES CORP PO BOX 995 ANN ARBOR,MI48106 38-2507173	FURTHER TRINITY HEALTH ACTIVITIES, ORGANIZE AND DEVELOP MEDICAL SERVICES	MI	501(C)(3)	11, TYPE II	TRINITY HEALTH-MICHIGAN		No
(7) COMMUNITY HEALTH PARTNERS OF SOUTH BEND PO BOX 3998 SOUTH BEND,IN46619 26-3051440	HEALTHCARE SERVICES	IN	501(C)(3)	3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC		No
(8) CRANBROOK HOSPICE CARE 281 ENTERPRISE COURT BLOOMFIELD HILLS,MI48302 38-3320699	PROVIDE HOSPICE HEALTH SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC		No
(9) DILEY RIDGE MEDICAL CENTER 6150 EAST BROAD STREET COLUMBUS,OH43213 34-2032340	HOSPITAL CAMPUS IN FAIRFIELD COUNTY OHIO	OH	501(C)(3)	3	MOUNT CARMEL HEALTH SYSTEM		No
(10) DUBUQUE MERCY HEALTH FOUNDATION INC 250 MERCY DRIVE DUBUQUE,IA52001 26-2227941	SUPPORT THE SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	11, TYPE I	MERCY HEALTH SERVICES-IOWA CORP		No
(11) DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE,IA52040 20-5383271	SUPPORT THE SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	11, TYPE I	MERCY HEALTH SERVICES-IOWA CORP		No
(12) GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION 701 W NORTH AVE MELROSE PARK,IL60160 36-3332852	SUPPORT THE SERVICES OF RELATED HOSPITAL	IL	501(C)(3)	9	GOTTLIEB MEMORIAL HOSPITAL		No
(13) GOTTLIEB MEMORIAL FOUNDATION 701 W NORTH AVE MELROSE PARK,IL60160 74-3260011	SUPPORT THE SERVICES OF RELATED HOSPITAL	IL	501(C)(3)	11, TYPE III-FI	N/A		No
(14) GOTTLIEB MEMORIAL HOSPITAL 701 W NORTH AVE MELROSE PARK,IL60160 36-2379649	HEALTHCARE SERVICES	IL	501(C)(3)	3	LOYOLA UNIVERSITY HEALTH SYSTEM		No
(15) HACKLEY HOSPITAL 1700 CLINTON ST PO BOX 3302 MUSKEGON,MI494433302 38-1358196	HEALTHCARE SERVICES	MI	501(C)(3)	3	MERCY HEALTH PARTNERS		No
(16) HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST PO BOX 3302 MUSKEGON,MI494433302 38-2299878	SELF INSURANCE FOR GENERAL AND MALPRACTICE LIABILITY	MI	501(C)(3)	11, TYPE III-FI	MERCY HEALTH PARTNERS		No
(17) HACKLEY LIFE COUNSELING 1352 TERRACE ST MUSKEGON,MI494423545 38-1386362	COUNSELING, EDUCATION, AND SUPPORT	MI	501(C)(3)	9	MERCY HEALTH PARTNERS		No
(18) HACKLEY VISITING NURSE SERVICES AND HOSPICE INC 888 TERRACE ST MUSKEGON,MI49440 38-1359598	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	7	MERCY HEALTH PARTNERS		No
(19) HOLY CROSS CARENET INC PO BOX 9184 FARMINGTON HILLS,MI48333 52-1945054	LONG-TERM CARE AND REHABILITATION FOR THE ELDERLY	MD	501(C)(3)	9	TRINITY CONTINUING CARE SERVICES		No
(20) HOLY CROSS HOSPITAL FOUNDATION INC 11801 TECH ROAD SILVER SPRING,MD20904 20-8428450	CHARITABLE FUNDRAISING	MD	501(C)(3)	11, TYPE I	HOLY CROSS HOSPITAL OF SILVER SPRING		No
(21) HOLY CROSS HOSPITAL OF SILVER SPRING INC 1500 FOREST GLEN RD SILVER SPRING,MD209101484 52-0738041	HEALTHCARE SERVICES	MD	501(C)(3)	3	TRINITY HEALTH CORPORATION		No
(22) HOLY CROSS MEDICAL CENTER 20555 VICTOR PARKWAY LIVONIA,MI48152 95-1985442	HEALTHCARE SERVICES (FORMERLY)	CA	501(C)(3)	3	TRINITY HEALTH CORPORATION		No
(23) HOSPICE OF NORTH IOWA 232 SECOND STREET SE MASON CITY,IA504016208 42-1173708	HOSPICE HEALTH CARE SERVICES	IA	501(C)(3)	7	MERCY HEALTH SERVICES-IOWA CORP		No
(24) HOSPICE OF WASHTENAW II 806 AIRPORT BLVD ANN ARBOR,MI48108 38-3320707	HOSPICE HEALTH CARE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH-MICHIGAN		No
(25) HPCN 1675 LEAHY STREET MUSKEGON,MI49442 30-0207909	HEALTHCARE SERVICES	MI	501(C)(3)	11, TYPE II	MERCY HEALTH PARTNERS		No
(26) IHA HEALTH SERVICES CORPORATION 24 FRANK LLOYD WRIGHT DR LOBBY J ANN ARBOR,MI48106 38-3316559	PROVIDES OFFICE-BASED MEDICAL CARE	MI	501(C)(3)	9	TRINITY HEALTH-MICHIGAN		No
(27) LAKESHORE COMMUNITY HOSPITAL INC 72 S STATE STREET SHELBY,MI494551228 38-2549295	ACUTE HEALTHCARE SERVICES	MI	501(C)(3)	3	MERCY HEALTH PARTNERS		No
(28) LOYOLA UNIVERSITY HEALTH SYSTEM 2160 SOUTH FIRST AVENUE MAYWOOD,IL60153 36-3342448	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IL	501(C)(3)	11, TYPE II	TRINITY HEALTH CORPORATION		No
(29) LOYOLA UNIVERSITY MEDICAL CENTER 2160 SOUTH FIRST AVENUE MAYWOOD,IL60153 36-4015560	HEALTHCARE SERVICES	IL	501(C)(3)	3	LOYOLA UNIVERSITY HEALTH SYSTEM		No
(30) MARIAN HOME HEALTHCARE 801 5TH STREET SIOUX CITY,IA51101 38-3320705	PROVIDE HOME HEALTH CARE SERVICES	IA	501(C)(3)	11, TYPE I	MERCY HEALTH SERVICES-IOWA CORP		No
(31) MCAULEY CLINIC CORPORATION PO BOX 992 ANN ARBOR,MI48106 38-2561013	HEALTHCARE SERVICES (FORMERLY)	MI	501(C)(3)	3	CATHERINE MCAULEY HEALTH SERVICES CORP		No
(32) MERCY AMICARE HOME HEALTHCARE OAKLAND 281 ENTERPRISE COURT BLOOMFIELD HILLS,MI483020312 38-3320698	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC		No
(33) MERCY AMICARE HOME HEALTHCARE PORT HURON 505 HURON AVENUE PORT HURON,MI48060 38-3320701	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC		No
(34) MERCY FOUNDATION INC 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-3227350	SUPPORTS THE SERVICES OF RELATED HEALTH CARE SYSTEM	IL	501(C)(3)	11, TYPE I	MERCY HEALTH SYSTEM OF CHICAGO		No
(35) MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE 684 HARVEY STREET MUSKEGON,MI49442 38-3321856	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC		No
(36) MERCY HEALTH PARTNERS 1415 LEAHY STREET MUSKEGON,MI49442 38-2589966	HEALTHCARE SYSTEM SUPPORT	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH-MICHIGAN		No
(37) MERCY HEALTH SERVICES - IOWA CORP 1000 4TH STREET SW MASON CITY,IA50401 31-1373080	HEALTHCARE SERVICES	DE	501(C)(3)	3	TRINITY HEALTH-MICHIGAN		No
(38) MERCY HEALTH SYSTEM OF CHICAGO 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-3163327	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IL	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION		No
(39) MERCY HEALTH SYSTEM OF CHICAGO LIABILITY SELF INSURANCE TRUST BK OF AMERICA 231 S LASALLE CHICAGO,IL60697 91-2092113	SELF INSURANCE FOR PROFESSIONAL AND COMPREHENSIVE LIABILITY	IL	501(C)(3)	11, TYPE III-FI	MERCY HEALTH SYSTEM OF CHICAGO		No
(40) MERCY HEALTHCARE FOUNDATION 1410 N 4TH ST CLINTON,IA52732 42-1316126	FUNDRAISING AND FINANCIAL ASSISTANCE FOR HOSPITAL CHARITABLE SERVICES	IA	501(C)(3)	11, TYPE I	MERCY MEDICAL CENTER-CLINTON		No
(41) MERCY HOSPITAL AND MEDICAL CENTER 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-2170152	HEALTHCARE SERVICES	IL	501(C)(3)	3	MERCY HEALTH SYSTEM OF CHICAGO		No
(42) MERCY HOSPITAL CADILLAC FOUNDATION 400 HOBART CADILLAC,MI496012331 20-3357131	SUPPORT THE SERVICES OF RELATED HOSPITAL	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH-MICHIGAN		No
(43) MERCY HOSPITAL GIFT SHOP 2601 ELECTRIC AVE PORT HURON,MI48060 38-1630480	VOLUNTEER SERVICE AUXILIARY	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH-MICHIGAN		No
(44) MERCY MEDICAL CENTER - CLINTON INC 1410 NORTH 4TH ST CLINTON,IA527322940 42-1336618	TO PROVIDE QUALITY HEALTH CARE	DE	501(C)(3)	3	MERCY HEALTH SERVICES-IOWA CORP		No
(45) MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION 801 5TH STREET SIOUX CITY,IA51102 14-1880022	SUPPORT THE SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	7	MERCY HEALTH SERVICES-IOWA CORP		No
(46) MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA 1000 4TH STREET SW MASON CITY,IA504012800 42-1229151	SUPPORT THE SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	11, TYPE III-FI	MERCY HEALTH SERVICES-IOWA CORP		No
(47) MERCY NORTH HOMECARE AND HOSPICE 7985 MACKINAW TRAIL CADILLAC,MI49601 38-3313897	HOME HEALTH AND HOSPICE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC		No
(48) MERCY PHYSICIAN GROUP INC 1512 12TH AVENUE ROAD NAMPA,ID83686 20-8192593	TO PROVIDE QUALITY HEALTH CARE	ID	501(C)(3)	9	SAINT ALPHONSUS MEDICAL CENTER-NAMPA		No
(49) MERCY SERVICES FOR AGING NON-PROFIT HOUSING CORPORATION PO BOX 9184 FARMINGTON HILLS,MI483339184 38-2719605	PROVIDES LONG-TERM CARE FOR THE ELDERLY	MI	501(C)(3)	11, TYPE II	TRINITY CONTINUING CARE SERVICES INC		No
(50) MIDWEST MEDFLIGHT 1300 VICTORS WAY ANN ARBOR,MI48108 38-2684671	AEROMEDICAL TRANSPORT	MI	501(C)(3)	9	TRINITY HEALTH-MICHIGAN		No
(51) MOUNT CARMEL CARE CONTINUUM SERVICES CORP 793 WEST STATE STREET COLUMBUS,OH43222 31-1126211	COOPERATIVE HOSPITAL SERVICE ORGANIZATION	OH	501(C)(3)	3	MOUNT CARMEL HEALTH SYSTEM		No
(52) MOUNT CARMEL COLLEGE OF NURSING 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1308555	COLLEGE OF NURSING	OH	501(C)(3)	2	MOUNT CARMEL HEALTH	Yes
(53) MOUNT CARMEL HEALTH 6150 EAST BROAD STREET COLUMBUS,OH43213 31-4379602	HEALTHCARE SERVICES	OH	501(C)(3)	3	MOUNT CARMEL HEALTH SYSTEM	Yes
(54) MOUNT CARMEL HEALTH INSURANCE COMPANY 6150 EAST BROAD STREET COLUMBUS,OH43213 25-1912781	HEALTH INSURANCE	OH	501(C)(4)	N/A	MOUNT CARMEL HEALTH SYSTEM		No
(55) MOUNT CARMEL HEALTH PLAN INC 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1471229	MEDICARE HMO FOR SENIORS	OH	501(C)(4)	N/A	MOUNT CARMEL HEALTH SYSTEM		No
(56) MOUNT CARMEL HEALTH SYSTEM 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1439334	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	OH	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION		No
(57) MOUNT CARMEL HEALTH SYSTEM FOUNDATION 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1113966	SUPPORT THE SERVICES OF RELATED HOSPITAL	OH	501(C)(3)	11, TYPE I	MOUNT CARMEL HEALTH SYSTEM		No
(58) MOUNT CARMEL HOME CARE LLC 1144 DUBLIN ROAD SUITE B COLUMBUS,OH43215 26-2729300	PROVIDE HOME HEALTH CARE SERVICES	OH	501(C)(3)	9	TRINITY HOME HEALTH SERVICES INC		No
(59) MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL 7333 SMITHS MILL RD NEW ALBANY,OH43054 87-0790288	HEALTHCARE SERVICES	OH	501(C)(3)	3	MOUNT CARMEL HEALTH SYSTEM		No
(60) MRI MOBILE SERVICES OF WEST MICHIGAN 1820 - 44TH STREET KENTWOOD,MI49508 38-3073745	OPERATE MAGNETIC IMAGING RESONANCE (FORMERLY)	MI	501(C)(3)	9	TRINITY HEALTH-MICHIGAN		No
(61) MUSKEGON COMMUNITY HEALTH PROJECT 565 W WESTERN AVENUE MUSKEGON,MI49440 91-1932918	FACILITATE AND COORDINATE HEALTHCARE AND RELATED SERVICES	MI	501(C)(3)	7	MERCY HEALTH PARTNERS		No
(62) OAKLAND MERCY HOSPITAL 601 EAST 2ND STREET OAKLAND,NE68045 20-8072234	HEALTHCARE SERVICES	NE	501(C)(3)	3	MERCY HEALTH SERVICES-IOWA CORP		No
(63) OAKLAND MERCY HOSPITAL FOUNDATION 601 E 2ND STREET OAKLAND,NE68045 31-1678345	SUPPORTS SERVICES OF RELATED HOSPITAL	NE	501(C)(3)	11, TYPE III-FI	OAKLAND MERCY HOSPITAL		No
(64) PORT HURON MERCY FAMILY CARE INC 2601 ELECTRIC AVE PORT HURON,MI48060 20-1855647	HEALTHCARE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH-MICHIGAN		No
(65) PROFESSIONAL MED TEAM 965 FORK STREET MUSKEGON,MI494423257 38-2638284	MEDICAL CARE, TRANSPORTATION AND EDUCATION	MI	501(C)(3)	9	TRINITY HEALTH-MICHIGAN		No
(66) PROFESSIONAL OFFICE CORPORATION 1303 EAST HERNDON AVE FRESNO,CA93720 94-2839324	HEALTHCARE SERVICES	CA	501(C)(3)	11, TYPE I	SAINT AGNES MEDICAL CENTER		No
(67) SAINT AGNES MEDICAL CENTER 1303 EAST HERNDON AVE FRESNO,CA93720 94-1437713	HEALTHCARE SERVICES	CA	501(C)(3)	3	TRINITY HEALTH CORPORATION		No
(68) SAINT ALPHONSUS BUILDING COMPANY INC 1055 NORTH CURTIS RD BOISE,ID83706 82-0401011	SUPPORTS SERVICES OF RELATED HOSPITAL	ID	501(C)(3)	11, TYPE I	SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC		No
(69) SAINT ALPHONSUS DIVERSIFIED CARE INC 1055 NORTH CURTIS RD BOISE,ID83706 94-3028978	SUPPORTS SERVICES OF RELATED HOSPITAL	ID	501(C)(3)	11, TYPE I	SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC		No
(70) SAINT ALPHONSUS FOUNDATION-BAKER CITY INC 3325 POCAHONTAS ROAD BAKER CITY,OR97814 94-3164869	SUPPORT THE SERVICES OF RELATED HOSPITAL	OR	501(C)(3)	7	SAINT ALPHONSUS MEDICAL CENTER - BAKER CITY		No
(71) SAINT ALPHONSUS FOUNDATION-ONTARIO INC 351 SW 9TH STREET ONTARIO,OR97914 20-2683560	SUPPORT THE SERVICES OF RELATED HOSPITAL	OR	501(C)(3)	11, TYPE I	SAINT ALPHONSUS MEDICAL CENTER-ONTARIO		No
(72) SAINT ALPHONSUS HEALTH SYSTEM INC 1055 N CURTIS ROAD BOISE,ID83706 27-1929502	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	ID	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION		No
(73) SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY 3325 POCAHONTAS ROAD BAKER CITY,OR97814 27-1790052	TO PROVIDE QUALITY HEALTH CARE	OR	501(C)(3)	3	SAINT ALPHONSUS HEALTH SYSTEM INC		No
(74) SAINT ALPHONSUS MEDICAL CENTER-NAMPA 1512 12TH AVENUE ROAD NAMPA,ID83686 82-0200896	TO PROVIDE QUALITY HEALTH CARE	ID	501(C)(3)	3	SAINT ALPHONSUS HEALTH SYSTEM INC		No
(75) SAINT ALPHONSUS MEDICAL CENTER-NAMPA HEALTH FOUNDATION INC 1512 12TH AVENUE ROAD NAMPA,ID83686 26-1737256	SUPPORT THE SERVICES OF RELATED HOSPITAL	ID	501(C)(3)	7	SAINT ALPHONSUS MEDICAL CENTER-NAMPA		No
(76) SAINT ALPHONSUS MEDICAL CENTER-ONTARIO 351 SW 9TH STREET ONTARIO,OR97914 27-1789847	TO PROVIDE QUALITY HEALTH CARE	OR	501(C)(3)	3	SAINT ALPHONSUS HEALTH SYSTEM INC		No
(77) SAINT ALPHONSUS REGIONAL MEDICAL CENTER 1055 NORTH CURTIS RD BOISE,ID83706 82-0200895	HEALTHCARE SERVICES	ID	501(C)(3)	3	SAINT ALPHONSUS HEALTH SYSTEM INC		No
(78) SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC 1915 LAKE AVENUE PO BOX 670 PLYMOUTH,IN46563 35-1142669	HEALTHCARE SERVICES	IN	501(C)(3)	3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC		No
(79) SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC PO BOX 1935 SOUTH BEND,IN466341935 35-0868157	HEALTHCARE SERVICES	IN	501(C)(3)	3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC		No
(80) SAINT JOSEPH REGIONAL MEDICAL CENTER MISHAWAKA AUXILIARY INC 5215 HOLY CROSS PARKWAY MISHAWAKA,IN46545 35-6033285	HOSPITAL SERVICE AUXILIARY	IN	501(C)(4)	N/A	SAINT JOSEPH REGIONAL MEDICAL CENTER-S BEND		No
(81) SAINT JOSEPH REGIONAL MEDICAL CENTER PLYMOUTH AUXILIARY INC 1915 LAKE AVENUE PLYMOUTH,IN46563 35-6043563	HOSPITAL SERVICE AUXILIARY	IN	501(C)(3)	11, TYPE II	SAINT JOSEPH REGIONAL MEDICAL CENTER-PLYMOUTH		No
(82) SAINT JOSEPH REGIONAL MEDICAL CENTER INC 801 EAST LASALLE AVE SOUTH BEND,IN46617 35-1568821	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IN	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION		No
(83) SAINT JOSEPH'S TOWER INC PO BOX 9184 FARMINGTON HILLS,MI483339184 31-1040468	PROVIDES HOUSING FOR LOW INCOME ELDERLY INDIVIDUALS	IN	501(C)(3)	9	TRINITY CONTINUING CARE SERVICES-INDIANA		No
(84) SAINT MARY'S AMICARE HOME HEALTHCARE 1430 MONROE NW GRAND RAPIDS,MI49505 38-3320700	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC		No
(85) SAINT MARY'S FOUNDATION (FKA SAINT MARY'S DORAN FOUNDATION) 200 JEFFERSON ST SE GRAND RAPIDS,MI49503 38-1779602	SUPPORTS SERVICES OF RELATED HOSPITAL	MI	501(C)(3)	7	TRINITY HEALTH-MICHIGAN		No
(86) ST JOSEPH MERCY OAKLAND FOUNDATION 44405 WOODWARD AVE PONTIAC,MI48341 35-2356789	SUPPORTS SERVICES OF RELATED HOSPITAL	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH-MICHIGAN		No
(87) ST ANN'S HOSPITAL 500 SOUTH CLEVELAND AVE WESTERVILLE,OH43081 31-4412701	HEALTHCARE SERVICES	OH	501(C)(3)	3	MOUNT CARMEL HEALTH SYSTEM		No
(88) THE FOUNDATION OF SAINT JOSEPH REGIONAL MEDICAL CENTER 4215 EDISON LAKES PARKWAY MISHAWAKA,IN46545 35-1654543	SUPPORTS SERVICES OF RELATED HOSPITAL	IN	501(C)(3)	11, TYPE I	SAINT JOSEPH REGIONAL MEDICAL CENTER INC		No
(89) TRI-HOSPITAL MRI CENTER 4190 24TH AVENUE FORT GRATIOT,MI48054 38-2884297	MRI SERVICES	MI	501(C)(3)	3	TRINITY HEALTH-MICHIGAN		No
(90) TRINITY CONTINUING CARE SERVICES PO BOX 9184 FARMINGTON HILLS,MI483339184 38-2559656	MANAGEMENT SERVICES FOR LONG TERM CARE AND SENIOR LIVING FACILITIES	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION		No
(91) TRINITY CONTINUING CARE SERVICES - INDIANA INC PO BOX 9184 FARMINGTON HILLS,MI483339184 93-0907047	PROVIDES LONG-TERM CARE AND RESIDENTIAL HOUSING	IN	501(C)(3)	9	TRINITY CONTINUING CARE SERVICES		No
(92) TRINITY HEALTH - MICHIGAN 20555 VICTOR PARKWAY LIVONIA,MI48152 38-2113393	HEALTHCARE SERVICES	MI	501(C)(3)	3	TRINITY HEALTH CORPORATION		No
(93) TRINITY HEALTH CORPORATION 20555 VICTOR PARKWAY LIVONIA,MI48152 35-1443425	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IN	501(C)(3)	11, TYPE I	N/A		No
(94) TRINITY HEALTH INTERNATIONAL 20555 VICTOR PARKWAY LIVONIA,MI48152 42-1253527	HEALTHCARE TRAINING AND SUPPORT SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION		No
(95) TRINITY HEALTH WELFARE BENEFIT TRUST 20555 VICTOR PARKWAY LIVONIA,MI48152 20-8151733	RETIREE MEDICAL AND RETIREE LIFE INSURANCE COVERAGE	MI	501(C)(9)	N/A	TRINITY HEALTH CORPORATION		No
(96) TRINITY HOME HEALTH SERVICES INC 17410 COLLEGE PARKWAY LIVONIA,MI48152 38-2621935	HOME HEALTH CARE SYSTEM MANAGEMENT SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION		No

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2011

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 VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) ADVENT REHABILITATION LLC 607 DEWEY AVENUE SUITE 300 GRAND RAPIDS,MI49504 38-3306673	REHABILITATION THERAPY SERVICES	MI	N/A	N/A				No			No
(2) BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 31-1608125	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A				No			No
(3) CENTER FOR DIGESTIVE CARE LLC 5300 ELLIOTT DRIVE YPSILANTI,MI48197 03-0447062	PROVIDE GASTROINTESTINAL SERVICES	MI	N/A	N/A				No			No
(4) CENTRAL OHIO SLEEP MEDICINE LTD 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1701029	SLEEP MEDICINE SERVICES	OH	N/A	N/A				No			No
(5) CLINTON IMAGING SERVICES LLC 615 VALLEY VIEW DR STE 202 MOLINE,IL61265 41-2044739	MRI DIAGNOSTIC SERVICES	IA	N/A	N/A				No			No
(6) FOREST PARK IMAGING LLC 1000 4TH STREET SW MASON CITY,IA50401 13-4365966	X-RAY AND MAMMOGRAPHY SERVICES	IA	N/A	N/A				No			No
(7) FRANCES WARDE MEDICAL LABORATORY 300 WEST TEXTILE ROAD ANN ARBOR,MI48104 38-2648446	LABORATORY	MI	N/A	N/A				No			No
(8) FRESNO IMAGING CENTER 1303 E HERNDON AVE FRESNO,CA93720 77-0363563	DIAGNOSTIC IMAGING	CA	N/A	N/A				No			No
(9) HAWARDEN REGIONAL HEALTH CLINICS LLC 1122 AVENUE L HAWARDEN,IA51023 20-1444339	MEDICAL CLINIC	IA	N/A	N/A				No			No
(10) IDAHO GYNONCOLOGY SERVICES LLC 1055 N CURTIS RD BOISE,ID83706 20-2975807	PROVIDE GYN ONCOLOGY SERVICES	ID	N/A	N/A				No			No
(11) INTERMOUNTAIN MEDICAL IMAGING LLC 877 WEST MAIN ST STE 603 BOISE,ID83702 82-0514422	PROVIDE IMAGING SERVICES	ID	N/A	N/A				No			No
(12) LOYOLA AMBULATORY SURGERY CENTER 1S224 SUMMIT AVE STE 201 OAKBROOK TERRACE,IL60181 36-4119522	SURGICAL SERVICES	IL	N/A	N/A				No			No
(13) MAGNETIC RESONANCE SERVICES PARTNERSHIP 1416 SIXTH STREET SW MASON CITY,IA50401 42-1328388	MRI SERVICES	IA	N/A	N/A				No			No
(14) MASON CITY AMBULATORY SURGERY CENTER LLC 990 4TH STREET SW MASON CITY,IA50401 20-1960348	SURGERY-SAME DAY	IA	N/A	N/A				No			No
(15) MCE MOB IV LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 42-1544707	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A				No			No
(16) MCMC POB III LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 31-1392994	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A				No			No
(17) MEDILUCENT MOB I 793 W STATE STREET COLUMBUS,OH43222 20-4911370	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A				No			No
(18) MERCY ADVANCED MRI LLC 2525 SOUTH MICHIGAN AVE CHICAGO,IL60616 26-2116721	SUBLEASE MRI EQUIPMENT	IL	N/A	N/A				No			No
(19) MERCY HEART & VASCULAR LLC 2525 SOUTH MICHIGAN AVE CHICAGO,IL60616 20-5272726	SUBLEASE CT EQUIPMENT	IL	N/A	N/A				No			No
(20) MERCY HEART CTR OP SERVICES LLC 1000 4TH STREET SW MASON CITY,IA50401 13-4237594	CARDIOVASCULAR SERVICES	IA	N/A	N/A				No			No
(21) MERCY OUTPATIENT SURGERY CENTER LLC 1512 12TH AVENUE ROAD NAMPA,ID83686 84-1380439	OUTPATIENT SURGERY	ID	N/A	N/A				No			No
(22) MICHIANA HEALTH INFORMATION NETWORK LLC 215 WEST MADISON STREET SOUTH BEND,IN46601 35-2050128	COMMUNITY BASED CLINICAL INFO SYS & DATA DEPOSITORY	IN	N/A	N/A				No			No
(23) MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 31-1369473	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A				No			No
(24) NEWCO AMBULATORY SURGERY CTR LLP 4190 24TH AVENUE FORT GRATIOT,MI48059 30-0136708	OUTPATIENT SURGERY CENTER	MI	N/A	N/A				No			No
(25) RIVERVIEW MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 31-1531135	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A				No			No
(26) SARMED OUTPATIENT PHARMACY LLC 999 N CURTIS RD STE 102 BOISE,ID83706 51-0483218	PHARMACY	ID	N/A	N/A				No			No
(27) SIXTY FOURTH STREET LLC 2373 64TH ST STE 2200 BYRON CENTER,MI49315 20-2443646	PROVIDE OUTPATIENT SURGICAL CARE	MI	N/A	N/A				No			No
(28) ST ALPHONSUS CALDWELL CANCER CTR LLC 3123 MEDICAL DR CALDWELL,ID83605 82-0526861	RADIATION ONCOLOGY	ID	N/A	N/A				No			No
(29) ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 31-1603660	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A				No			No
(30) TAMARACK MEDICAL CLINIC LLC 610 VILLAGE DRIVE DONNELLY,ID83615 20-1637921	OUTPATIENT MEDICAL SERVICES	ID	N/A	N/A				No			No
(31) WESTAR MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 31-1784409	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A				No			No
(32) WOODLAND IMAGING CENTER LLC 5301 E HURON RIVER DR ANN ARBOR,MI48106 76-0820959	RADIOLOGY/IMAGING	MI	N/A	N/A				No			No

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)
(1) COMMUNITY HEALTH VENTURES INC 565 W WESTERN AVE MUSKEGON,MI49440 38-3522260	SOFTWARE MARKETING	MI	N/A	C
(2) GOTTLIEB MANAGEMENT SERVICES INC 701 W NORTH AVE MELROSE PARK,IL60160 36-3330529	MANAGEMENT SERVICES	IL	N/A	C
(3) HACKLEY HEALTH MANAGEMENT CENTER 1415 LEAHY ST MUSKEGON,MI49442 38-2961814	WEIGHT MANAGEMENT	MI	N/A	C
(4) HACKLEY HEALTH VENTURES INC 1415 LEAHY ST MUSKEGON,MI49442 38-2589959	OTHER MEDICAL SERVICES	MI	N/A	C
(5) HACKLEY HEALTHCARE EQUIPMENT 1415 LEAHY ST MUSKEGON,MI49442 38-2578569	HOME MEDICAL EQUIPMENT	MI	N/A	C
(6) HACKLEY PROFESSIONAL CENTER 1415 LEAHY ST MUSKEGON,MI49442 38-3024797	REAL ESTATE RENTAL	MI	N/A	C
(7) HACKLEY PROFESSIONAL PHARMACY 1415 LEAHY ST MUSKEGON,MI49442 38-2447870	PHARMACY	MI	N/A	C
(8) HEF INC 1415 LEAHY ST MUSKEGON,MI49442 38-3086401	OFFICE STAFFING	MI	N/A	C
(9) HOLY CROSS PRIVATE HOME SERVICES CORP 11801 TECH ROAD SILVER SPRING,MD20904 52-1986562	HOME CARE SERVICES	MD	N/A	C
(10) HPC CO-OWNERS ASSOCIATION 1700 CLINTON MUSKEGON,MI49442 27-0734448	CONDOMINIUM ASSOCIATION	MI	N/A	C
(11) HURON ARBOR CORPORATION 5301 EAST HURON RIVER DR PO BOX 992 ANN ARBOR,MI48106 38-2475644	PROVIDES OFFICE RENTAL SPACE	MI	N/A	C
(12) IHA AFFILIATION CORPORATION 24 FRANK LLOYD WRIGHT DR LOBBY J ANN ARBOR,MI48106 38-3188895	MEDICAL MANAGEMENT	MI	N/A	C
(13) LOYOLA UNIVERSITY OF CHICAGO INSURANCE CO LTD 23 LIME TREE BAY AVENUE GRAND CAYMAN CJ	PROVISION OF INSURANCE COVERAGE	CJ	N/A	C
(14) MARYLAND CARE GROUP INC 11801 TECH ROAD SILVER SPRING,MD20904 52-1815313	HEALTHCARE HOLDING	MD	N/A	C
(15) MEDNOW INC 1512 12TH AVENUE ROAD NAMPA,ID83686 82-0389927	OUTPATIENT PHARMACY	ID	N/A	C
(16) MERCY MEDICAL SERVICES 801 5TH STREET SIOUX CITY,IA51101 42-1283849	PRIMARY CARE PHYSICIANS	IA	N/A	C
(17) MERCY SERVICES CORPORATION 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-3227348	DORMANT	IL	N/A	C
(18) MICHIGAN ATHLETIC CLUB 2500 BURTON GRAND RAPIDS,MI49546 38-2647304	ATHLETIC CLUB	MI	N/A	C
(19) MOUNT CARMEL BEHAVIORAL HEALTHCARE SERVICES INC 6150 EAST BROAD STREET COLUMBUS,OH43213 31-0971510	BEHAVIORAL HEALTHCARE SERVICES	OH	N/A	C
(20) MOUNT CARMEL HEALTH PROVIDERS INC 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1382442	MEDICAL SERVICES	OH	N/A	C
(21) NORTH IOWA MERCY MEDICAL SERVICES INC 1000 4TH ST SW MASON CITY,IA50401 42-1382308	MEDICAL SERVICES	IA	N/A	C
(22) PRIORITY PLUS OF CALIFORNIA PO BOX 27230 FRESNO,CA93729 77-0395267	FORMERLY HLTH MGMT NOW DISCONTINUED OPERATIONS	CA	N/A	C
(23) SAINT ALPHONSUS PHYSICIANS PA 1055 NORTH CURTIS ROAD BOISE,ID837061370 33-1078261	PHYSICIANS	ID	N/A	C
(24) SAINT MARY'S HEALTH MANAGEMENT COMPANY 1640 EAST PARIS SE GRAND RAPIDS,MI49546 38-3450733	ATHLETIC CLUB	MI	N/A	C
(25) SURGERY CENTER FINANCING CORPORATION 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1531102	FINANCE, INSURANCE AND REAL ESTATE	OH	N/A	C
(26) THRE SERVICES LLC 20555 VICTOR PARKWAY LIVONIA,MI48152 45-2603654	REAL ESTATE BROKERAGE SERVICES	MI	N/A	C
(27) TRINITY HEALTH EMPLOYEE BENEFIT TRUST 20555 VICTOR PARKWAY LIVONIA,MI48152 38-3410377	GRANTOR TRUST	MI	N/A	T
(28) VENZKE INSURANCE COMPANY LTD PO BOX 1051 GRAND CAYMAN GRAND CAYMAN CJ 98-0453602	PROVISION OF INSURANCE COVERAGE	CJ	N/A	C
(29) WESTSHORE HEALTH NETWORK 1820 44TH STREET KENTWOOD,MI49508 38-3280200	PHYSICIAN HOSPITAL ORGANIZATION	MI	N/A	C
(30) WORKPLACE HEALTH OF GRAND HAVEN 1415 LEAHY ST MUSKEGON,MI49442 38-3112035	OCCUPATIONAL HEALTH	MI	N/A	C

Schedule R (Form 990) 2011

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

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 . . . . . . . . . . . . . . . . . . . . . . .

Yes

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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) MOUNT CARMEL COLLEGE OF NURSING	J	65,556	PER BOOKS
(2) MOUNT CARMEL HEALTH SYSTEM	B	2,512,859	PER BOOKS
(3) MOUNT CARMEL HEALTH SYSTEM	J	153,340	PER BOOKS
(4) MOUNT CARMEL HEALTH SYSTEM	P	56,274	PER BOOKS
(5) MOUNT CARMEL HEALTH PROVIDERS INC	A	168,933	PER BOOKS
(6) MOUNT CARMEL HEALTH PROVIDERS INC	O	714,119	PER BOOKS
(7) MOUNT CARMEL HEALTH PLAN INC	K	63,251,349	PER BOOKS
(8) TRINITY HEALTH CORPORATION	Q	9,158,913	PER BOOKS
(9) MOUNT CARMEL HEALTH SYSTEM	Q	102,284,842	PER BOOKS
(10) MOUNT CARMEL HEALTH INSURANCE CO	K	533,378	PER BOOKS

Schedule R (Form 990) 2011

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)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2011

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: HEALTH CARE AND RELATED ACTIVITIES
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a).....	3	3
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	1
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	0
6	Total number of volunteers (estimate if necessary) ....	6	548
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	2,108,056
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	226,765

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	1,371
9	Program service revenue (Part VIII, line 2g) .........	673,270,421	691,254,274
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	124,734	674,804
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	6,832,921	6,961,146
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	680,228,076	698,891,595
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	118,346	167,168
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)	258,089,866	261,540,122
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	411,896,284	430,439,250
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	670,104,496	692,146,540
19	Revenue less expenses. Subtract line 18 from line 12.......	10,123,580	6,745,055
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	301,245,098	0
21	Total liabilities (Part X, line 26).............	57,099,140	0
22	Net assets or fund balances. Subtract line 21 from line 20.....	244,145,958	0

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	Signature of officer	Date

	Type or print name and title.


4a	(Code: ) (Expenses $ 662,405,790 including grants of $ 167,168 ) (Revenue $ 691,954,612 )
	MOUNT CARMEL HEALTH, A MEMBER OF MOUNT CARMEL HEALTH SYSTEM AND TRINITY HEALTH, IS COMPRISED OF TWO ACUTE CARE HOSPITALS WHICH SERVE THE GREATER COLUMBUS, OHIO AREA. MOUNT CARMEL HEALTH PROVIDED OVER 178,000 PATIENT DAYS OF HEALTH CARE SERVICES DURING FY12. FOR MORE INFORMATION ON SPECIFIC SERVICES PROVIDED, PLEASE SEE MOUNT CARMEL HEALTH'S WEBSITE AT WWW.MOUNTCARMELHEALTH.COM.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	MISSIONTHE MISSION STATEMENT FOR THE HOSPITAL IS AS FOLLOWS: WE SERVE TOGETHER IN TRINITY HEALTH IN THE SPIRIT OF THE GOSPEL TO HEAL BODY, MIND AND SPIRIT TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND TO STEWARD THE RESOURCES ENTRUSTED TO US.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 662,405,790

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	0	14,081,326	1,435,053

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)			(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
(A) Name and Title
(18) JOHN HOLLENBACH PHYSICIAN	50.00	X		0	250,957	63,722
(19) MICHAEL SLUBOWSKI FORMER KEY EMPLOYEE	0.00		X	0	150,838	1,101

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		1,371
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			1,371
			Business Code
2a	NET PATIENT SVC REV		900,099	691,254,274	689,146,218	2,108,056
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			691,254,274
3	Investment income (including dividends, interest
	and other similar amounts).....			144,866			144,866
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross rents	652,513	51,823
b	Less: rental expenses	0	5,218
c	Rental income or (loss)	652,513	46,605
d	Net rental income or (loss).......			699,118			699,118
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		830,000
b	Less: cost or other basis and sales expenses		300,062
c	Gain or (loss)		529,938
d	Net gain or (loss)..........			529,938			529,938
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
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...
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..
Miscellaneous Revenue			Business Code
11a	CAFETERIA REVENUE		900,099	2,920,749			2,920,749
b	OTHER REVENUE		900,099	2,808,394	2,808,394
c	PARKING REVENUE		900,099	532,885			532,885
d	All other revenue ....
e	Total. Add lines 11a–11d ......			6,262,028
12	Total revenue. See Instructions....			698,891,595	691,954,612	2,108,056	4,827,556


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			650,351	1	0
2	Savings and temporary cash investments .......				2	0
3	Pledges and grants receivable, net .........				3	0
4	Accounts receivable, net .........			76,223,221	4	0
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........				5	0
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	0
7	Notes and loans receivable, net .............			70,833	7	0
8	Inventories for sale or use ..............			11,401,284	8	0
9	Prepaid expenses and deferred charges ............			606,690	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	0
b	Less: accumulated depreciation. .....	10b		208,946,861	10c	0
11	Investments—publicly traded securities ..........				11	0
12	Investments—other securities. See Part IV, line 11 ......				12	0
13	Investments—program-related. See Part IV, line 11 ..				13	0
14	Intangible assets .........				14	0
15	Other assets. See Part IV, line 11 ...........			3,345,858	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)...			301,245,098	16	0
17	Accounts payable and accrued expenses .			53,230,780	17
18	Grants payable ..........				18
19	Deferred revenue ..........				19
20	Tax-exempt bond liabilities ..........				20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			662,218	23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....			3,206,142	25	0
26	Total liabilities. Add lines 17 through 25.....			57,099,140	26	0
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			244,145,958	27	0
28	Temporarily restricted net assets .....				28
29	Permanently restricted net assets .....				29
	Organizations that do not follow SFAS 117, check here 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 .....			244,145,958	33	0
34	Total liabilities and net assets/fund balances .....			301,245,098	34	0