TY 2013 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(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) ROGER SPOELMAN........................................................................ W. MI REG. PRES. & CEO; TRUSTEE	5.00 .......................45.00	X	X		1,036,701	129,368
(2) MICHAEL GLUHANICH........................................................................ CHAIR; TRUSTEE	2.00 .......................6.00	X	X		0	0
(3) T BRUCE FOX........................................................................ SEC & TREAS THRU 12/13; TRUSTEE	2.00 .......................6.00	X	X		0	0
(4) FRANK BEDNAREK........................................................................ TRUSTEE	2.00 .......................6.00	X			0	0
(5) MARK FAZAKERLEY........................................................................ TRUSTEE	2.00 .......................6.00	X			0	0
(6) MICHAEL K OLTHOFF........................................................................ TRUSTEE	2.00 .......................6.00	X			0	0
(7) GREGORY C PITTMAN JD........................................................................ TRUSTEE	2.00 .......................6.00	X			0	0
(8) SR MARY D PALASZEKRSM........................................................................ TRUSTEE	2.00 .......................6.00	X			0	0
(9) SR MYRA BERGMAN RSM........................................................................ TRUSTEE	2.00 .......................6.00	X			0	0
(10) YOUSIF HAMATI MD........................................................................ TRUSTEE	2.00 .......................6.00	X			8,500	0
(11) CAMILLE S JOURDEN-MARK........................................................................ TRUSTEE	2.00 .......................6.00	X			0	0
(12) REV TIMOTHY VANDER HAAR........................................................................ TRUSTEE	2.00 .......................6.00	X			0	0
(13) AMY HEISSER........................................................................ TRUSTEE	2.00 .......................6.00	X			0	0
(14) PHILIP MCCORKLE........................................................................ TRUSTEE; ST. MARYS HLTH CEO THR 8/13	2.00 .......................48.00	X			906,717	41,343
(15) GREGORY LOOMIS........................................................................ MHP INTERIM CEO	20.00 .......................30.00		X		436,406	44,784
(16) GARY ALLORE........................................................................ WEST MI REGIONAL CFO	20.00 .......................30.00		X		367,913	36,379
(17) JEFFREY ALEXANDER........................................................................ MHP VP INTEGRATED SERVICES	20.00 .......................30.00			X	294,428	25,751

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(F) Estimated amount of other compensation from the organization and related organizations
(18) F REMINGTON SPRAGUE........................................................................ MHP VP PRIMARY CARE SERVICES	20.00 .......................30.00	X			0	415,621	46,505
(19) MARY BOYD........................................................................ MHP VP NETWORK DEVELOPMENT	20.00 .......................30.00	X			0	329,519	35,559
(20) KIMBERLY MAGUIRE........................................................................ MHP VP PATIENT CARE	20.00 .......................30.00	X			0	253,302	32,740
(21) CHRISTOPHER MARQUART........................................................................ PHYSICIAN	50.00 .......................		X		884,327	0	26,965
(22) RICK EDGAR........................................................................ PHYSICIAN/ V. CHIEF OF STAFF	50.00 .......................		X		859,597	0	21,163
(23) JEREMY BARBER........................................................................ PHYSICIAN	50.00 .......................		X		789,050	0	27,236
(24) STEVEN R FOX........................................................................ PHYSICIAN	50.00 .......................		X		554,673	0	28,350
(25) NINO P SOAVE........................................................................ PHYSICIAN	50.00 .......................		X		498,351	0	28,474
(26) J RICHARD O'CONNELL........................................................................ FORMER KEY EMPLOYEE	0.00 .......................55.00			X	0	1,673,574	145,485
(27) JOSEPH SWEDISH........................................................................ FORMER KEY EMPLOYEE	0.00 .......................			X	0	1,463,995	28,888
(28) KEDRICK ADKINS........................................................................ FORMER KEY EMPLOYEE	0.00 .......................			X	0	1,808,589	1,739,236
(29) MICHAEL SLUBOWSKI........................................................................ FORMER KEY EMPLOYEE	0.00 .......................			X	0	231,799	0

(A) Name and business address	(B) Description of services	(C) Compensation
ORTHOPAEDIC ASSOC OF MKG PLC1400 MERCY DRMUSKEGONMI49444	HEALTH CARE SERVICES	1,394,390
PINE REST CHRISTIAN MENTAL HEALTH SVCSPO BOX 165GRAND RAPIDSMI49501	HEALTH CARE SERVICES	1,157,229
MUSKEGON SURGICAL ASSOCIATES1316 MERCURY DRMUSKEGONMI49444	HEALTH CARE SERVICES	773,705
WEST MICHIGAN SHARED HOSPITAL LAUNDRY3003 WALKENT DR NWGRAND RAPIDSMI49544	LAUNDRY SERVICES	544,414
WEST MICHIGAN EMERGENCY SERVICESPO BOX 1487MUSKEGONMI49443	HEALTH CARE SERVICES	497,120
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 33

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	220	220
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) ....	38,720	38,720
7	Other salaries and wages	29,599,889	27,980,442	1,619,447
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,034,359	1,923,065	111,294
9	Other employee benefits .......	5,083,085	4,804,725	278,360
10	Payroll taxes ...........	2,189,768	2,010,494	179,274
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	24,853		24,853
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	8,430,885	6,256,978	2,173,907
12	Advertising and promotion ....
13	Office expenses .......	914,719	752,050	162,669
14	Information technology ......	4,018,589	31,248	3,987,341
15	Royalties ..
16	Occupancy ...........	1,889,223	960,800	928,423
17	Travel ............	39,595	27,035	12,560
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	29,346	19,794	9,552
20	Interest ...........	1,837,682	1,837,682
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	4,223,174	2,121,838	2,101,336
23	Insurance ..............	-32,663	-32,663
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	12,404,032	12,404,032
b	BAD DEBT	4,266,286	4,266,286
c	INTERCO PURCHASED SVCS	3,027,792	1,523,884	1,503,908
d	HOSPITAL PROVIDER TAX	2,568,790	2,568,790
e	All other expenses	2,040,017	1,932,729	107,288
25	Total functional expenses. Add lines 1 through 24e	84,628,361	71,428,149	13,200,212	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 Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	6,230	1	0
2	Savings and temporary cash investments .........	15,575	2	0
3	Pledges and grants receivable, net ...........		3	0
4	Accounts receivable, net .............	19,540,499	4	0
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6	0
7	Notes and loans receivable, net .............		7	0
8	Inventories for sale or use ..............	2,534,878	8	0
9	Prepaid expenses and deferred charges ..........	1,985,542	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	0
b	Less: accumulated depreciation .....	10b		32,028,397	10c	0
11	Investments—publicly traded securities ..........	22,165,441	11	0
12	Investments—other securities. See Part IV, line 11 .....	15,836,555	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 ...........	12,097,001	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)......	106,210,118	16	0
	17	Accounts payable and accrued expenses .........	14,211,722	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	Loans and other 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 ..	72,314	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....................	105,800,986	25	0
26	Total liabilities. Add lines 17 through 25.........	120,085,022	26	0
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	-16,151,294	27	0
28	Temporarily restricted net assets ...........	1,343,769	28	0
29	Permanently restricted net assets ...........	932,621	29	0
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........	-13,874,904	33	0
34	Total liabilities and net assets/fund balances ........	106,210,118	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.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

HACKLEY HOSPITAL

Employer identification number

38-1358196

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 described in 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. See section 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 - Non-functionally integrated

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2013

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2013 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2012 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2013. 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—2012. If the organization did not check a 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—2013. 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—2012. 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) 2013

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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.)..

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 2013 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2012 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2012 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2013. 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—2012. 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) 2013

Page 4

Part IV

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013

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. SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet

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

Name of the organization

HACKLEY HOSPITAL

Employer identification number

38-1358196

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2013

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 SchCMd Bullet

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 SchCMd Bullet

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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) Total

2a	Lobbying nontaxable 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) 2013

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

7,172

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

7,172

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

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	HACKLEY HOSPITAL HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED HACKLEY HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES.

Schedule C (Form 990 or 990EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

HACKLEY HOSPITAL

Employer identification number

38-1358196

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2013

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	932,621	1,492,191	1,594,320	1,636,005	1,473,309
b	Contributions ........				500	2,600
c	Net investment earnings, gains, and losses	52,368	196,957	-11,173	118,553	160,096
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	71,800	756,527	90,956	160,738
f	Administrative expenses ....
g	End of year balance ......	913,189	932,621	1,492,191	1,594,320	1,636,005

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

Yes

(ii) related organizations ........................

3a(ii)

Yes

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(d) Book value
1a	Land .................
b	Buildings ................
c	Leasehold improvements ............
d	Equipment ................
e	Other .................
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......		0

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes









Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................

Schedule D (Form 990) 2013

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART V, LINE 4:	HACKLEY HOSPITAL'S ENDOWMENT FUNDS ARE FOR PATIENT RELATED PURPOSES INCLUDING PATIENT CARE, SPECIALIZED EQUIPMENT AND FACILITIES, AND FREE CARE AND OPERATIONS. OTHER HACKLEY ENDOWMENT FUNDS ARE FOR NURSING EDUCATION AND TRAINING. UPON HACKLEY HOSPITALS MERGER WITH MERCY HEALTH PARTNERS, THE ENDOWMENTS ARE HELD BY MERCY HEALTH PARTNERS, A RELATED ORGANIZATION.

Schedule D (Form 990) 2013

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.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

HACKLEY HOSPITAL

Employer identification number

38-1358196

Part I

Financial Assistance 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) as a factor in determining 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 as a factor in determining 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 used factors other than FPG in determining 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, as a factor in determining 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

Financial Assistance and Means-Tested Government Programs		(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) ..	2,998,143		2,998,143	3.540 %
b	Medicaid (from Worksheet 3, column a) ....	18,817,572	14,814,206	4,003,366	4.730 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	21,815,715	14,814,206	7,001,509	8.270 %
Other Benefits		86,265		86,265	0.100 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	86,265		86,265	0.100 %
f	Health professions education (from Worksheet 5) ..
g	Subsidized health services (from Worksheet 6) ..	1,976,621		1,976,621	2.340 %
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	500		500	0 %
j	Total. Other Benefits ..	2,063,386		2,063,386	2.440 %
k	Total. Add lines 7d and 7j .	23,879,101	14,814,206	9,064,895	10.710 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013

Schedule H (Form 990) 2013

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	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

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

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

1,474,000

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

450,307

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

18,505,640

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

17,229,046

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

1,276,594

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(owned 10% or more by officers, directors, trustees, key employees, and physicians—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) 2013

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number
1	MERCY HEALTH PARTNERS HACKLEY CAMPUS 1700 CLINTON AVE MUSKEGON,MI49442 WWW.MERCYHEALTHMUSKEGON.COM 1060000032	X	X	X

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	MERCY HEALTH PARTNERS HACKLEY CAMPUS
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V, SECTION C FOR URL

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	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.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If "Yes," indicate the FPG family income limit for eligibility for discounted care: 300.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	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	Residency
i	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	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 website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	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?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’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 Section C)
17	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 individual’s eligibility under the facility’s FAP?..........	17		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 Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

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?..........

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference	Explanation
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 1J: MERCY HEALTH 2013 CHNA ALSO INCLUDED:- INTRODUCTION AND MISSION REVIEW STATEMENT- LOOKING BACK AT THE 2009 CHNA: A PROGRESS REPORT- REFLECTIONS ON THE CHNA PROCESS: LESSONS LEARNED AND NEXT STEPS- 9 APPENDICES, INCLUDING (FOR ALL 3 COUNTIES): COMMUNITY, HEALTH AND ENVIRONMENTAL DATA TABLES; HEALTH DISPARITIES INDICATORS & REPORT CARD; UNIVERSITY OF WISCONSIN COUNTY HEALTH RANKINGS DATA; CALL 2-1-1 TOP HEALTH CARE AND RELATED SERVICE REQUESTS AND UNMET NEEDS; 2012 MICHIGAN PROFILE FOR HEALTH YOUTH SURVEY RESULTS; CONSUMER HEALTH ISSUES SURVEY QUESTIONNAIRE; COMMUNITY PARTICIPANTS IN FOCUS GROUPS.
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 3: THE CHNA PROCESS BEGAN WITH A STEERING COMMITTEE REPRESENTING A BROAD RANGE OF INTERESTS IN THE 3-COUNTY SERVICE AREA. PARTNER ORGANIZATIONS THAT PARTICIPATED INCLUDED: HEALTH PROJECT ADVISORY BOARD, UNITED WAY OF THE LAKESHORE, MUSKEGON COUNTY PUBLIC HEALTH, DISTRICT HEALTH DEPARTMENT #10, LAKESHORE HEALTH NETWORK, WESTSHORE PHARMACY, MERCY VNS & HARBOR HOSPICE, COMMUNITY MENTAL HEALTH SERVICES OF MUSKEGON COUNTY, WEST MICHIGAN COMMUNITY MENTAL HEALTH SYSTEM, HACKLEY COMMUNITY CARE CENTER (FQHC), MUSKEGON FAMILY CARE (FQHC), COMMUNITY ACTON LINE OF THE LAKESHORE (CALL 2-1-1), MUSKEGON AREA INTERMEDIATE SCHOOL DISTRICT, GRAND VALLEY STATE UNIVERSITY, UNITED WAY OF MASON COUNTY, CHILD ABUSE COUNCIL OF MUSKEGON COUNTY, AND PADNOS ALUMINUM. COMMUNITY PARTICIPATION AND INPUT: A SERIES OF ACTIVITIES AND CORRESPONDING STEPS WERE TAKEN TO ACHIEVE BROAD PUBLIC PARTICIPATION IN IDENTIFYING THE HEALTH CARE ISSUES AND NEEDS OF THE COMMUNITY. THE ACTIVITIES INCLUDED THE EXECUTION OF A DETAILED CONSUMER HEALTH SURVEY, ONE-ON-ONE INTERVIEWS WITH HEALTH CARE RECIPIENTS, INPUT FROM NATIVE AMERICANS GENERATED THROUGH LOCALLY ARRANGED TALKING CIRCLES, AND THE FACILITATION OF A SEQUENCE OF COMMUNITY CONVERSATIONS AND FOCUS GROUPS. A CONSUMER HEALTH ISSUES SURVEY INCORPORATED A RANGE OF QUESTIONS FOCUSING ON THE DEMOGRAPHIC CHARACTERISTICS AND PERSONAL WELL-BEING OF RESPONDENTS AND THEIR HOUSEHOLD MEMBERS, FEEDBACK ON ABILITY TO ACCESS HEALTH CARE SERVICES AND THE QUALITY OF CARE RECEIVED. SURVEY METHODOLOGIES INCLUDED VOLUNTEER-ADMINISTERED PAPER QUESTIONNAIRES AND ONLINE SURVEY VIA THE USE OF SURVEYMONKEY. FACILITATED COMMUNITY CONVERSATIONS TOOK PLACE IN TWO COUNTIES FOR A PERIOD OF 2-3 HOURS TO DISCUSS TOPICS RAISED BY THE SURVEY. FOCUS GROUPS WERE CONDUCTED AROUND THE TOPICAL AREAS RAISED IN THE SURVEYS AND FORUMS, INCLUDING ONE PHYSICIAN FOCUS GROUP. ONE-ON-ONE INTERVIEWS WERE CONDUCTED BY TRAINED INTERVIEWERS IN BOTH ENGLISH AND SPANISH WITH RESIDENTS ON THEIR HEALTH CARE EXPERIENCES.MERCY HEALTH'S 2013 CHNA INCLUDES THE FOLLOWING INFORMATION ELEMENTS: 1) DEMOGRAPHIC INFORMATION, HEALTH AND ENVIRONMENTAL DATA, DATA ON HEALTH DISPARITIES2) CONSUMER SURVEY, ADMINISTERED VIA PAPER QUESTIONNAIRES AT A VARIETY OF COMMUNITY VENUES AND ELECTRONIC MEDIA. RESPONSES TO THE SURVEY INCLUDED 2,084 SURVEYS.3) FOUR COMMUNITY FORUMS, CALLED "COMMUNITY CONVERSATIONS", IN TWO OF THE THREE COUNTIES. ABOUT 160 PEOPLE PARTICIPATED IN THE FOUR CONVERSATIONS.4) TEN FOCUS GROUPS ON DIFFERENT TOPICAL AREAS. SEVENTY-FIVE PEOPLE PARTICIPATED.5) FIFTY-TWO ONE-ON-ONE INTERVIEWS WERE CONDUCTED WITH CURRENT AND FORMER PATIENTS OF THE LOCAL HEALTH SYSTEM AND HUMAN SERVICE PROVIDERS.
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 4: THE 2013 CHNA WAS CONDUCTED WITH THE THREE HOSPITAL SYSTEM FACILITIES COMPRISING MERCY HEALTH: MERCY HEALTH/MERCY CAMPUS; MERCY HEALTH/HACKLEY CAMPUS AND MERCY HEALTH/LAKESHORE CAMPUS. THE MERCY AND HACKLEY CAMPUSES ARE ACUTE FACILITIES LOCATED IN MUSKEGON COUNTY, SERVING MUSKEGON, OCEANA AND NEWAYGO COUNTIES. THE LAKESHORE CAMPUS IS A CRITICAL CARE FACILITY SERVING OCEANA AND NEWAYGO COUNTIES
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 5D: MERCY HEALTH'S MARKETING DEPARTMENT PUBLISHED A 4-PAGE CHNA SUMMARY IN NOVEMBER 2012 AS AN INSERT IN THE LOCAL NEWSPAPER, THE MUSKEGON CHRONICLE, WITH AN APPROXIMATE CIRCULATION OF 35,000. A 10,000 COPY OVER-RUN WAS PRINTED AND HAS BEEN USED REPEATEDLY BY MERCY PERSONNEL FOR DISTRIBUTION AT MEETINGS, SPEAKING ENGAGEMENTS, CONFERENCES AND A VARIETY OF COMMUNITY OUTREACH EVENTS. IT IS ALSO AVAILABLE AT HEALTH PROJECT OFFICES AND ALL THREE MERCY HEALTH CAMPUSES.LINE 5A:HTTP://WWW.MERCYHEALTHMUSKEGON.COM/DOCUMENTS/MERCYHEALTHPARTNERS-MUSKEGON/MU68330%20HACKLEYCHNABOOK%20912.PDF
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 7: THERE ARE 3 NEEDS IDENTIFIED IN THE 2013 CHNA THAT THE HOSPITAL SYSTEM HAS NOT ADDRESSED:1. OBESITY, NUTRITION EDUCATION & ACCESS TO HEALTHY FOODS - IT WAS DETERMINED THAT THESE ISSUES ARE BEYOND THE PURVIEW AND CAPACITY FOR THE HOSPITAL SYSTEM TO ADDRESS. RATHER, DURING THE CHNA RANKING SESSIONS THEY WERE PLACED IN THE 'PUBLIC HEALTH' AND 'COMMUNITY' DOMAINS FOR TAKING LEAD ROLES. HOSPITAL LEADERSHIP DETERMINED THAT THE HOSPITAL SYSTEM DOES NOT HAVE THE HUMAN AND FINANCIAL RESOURCES NEEDED TO AFFECT THE POPULATION HEALTH CHANGE REQUIRED. THIS IS MORE APPROPRIATELY THE WORK OF PUBLIC HEALTH, THE SCHOOL DISTRICTS, AND COMMUNITY ORGANIZATIONS LIKE MSU EXTENSION. HOWEVER, THE IMPLEMENTATION STRATEGY CALLS FOR DEVELOPING STRONGER RELATIONSHIPS WITH THE ONE IN '21 COMMUNITY WELLNESS GROUP, AS WELL AS ALIGNING WITH SIMILAR GROUPS WITHIN THE EDUCATIONAL AND BUSINESS COMMUNITIES TO DEVELOP COMMUNITY WIDE STRATEGIES. 2. TEEN PREGNANCY - AS A CATHOLIC ORGANIZATION, THE HOSPITAL SYSTEM'S ETHICAL AND RELIGIOUS DIRECTIVES PROHIBIT THE DISPENSATION OF CONTRACEPTIVE INFORMATION AND DEVICES TO PATIENTS. HOWEVER, THE HOSPITAL SYSTEM HAS AN OPERATION PROGRAM TO PREVENT LOW BIRTH WEIGHT BABIES AMONG HIGH-RISK PREGNANT WOMEN - A CATEGORY OF PATIENTS THAT INCLUDES TEENAGE AND YOUNGER PREGNANT WOMEN.3. NATIVE AMERICAN HEALTH SERVICES - ALTHOUGH THE HOSPITAL SYSTEM DELIVERS ALL HEALTH SERVICES TO INDIVIDUAL NATIVE AMERICAN PATIENTS, CONTRACT ISSUES GOVERNING THE TRIBAL HEALTH CLINIC, LOCATED IN MANISTEE COUNTY, HAVE RESTRAINED ITS ABILITY TO PROVIDE SOME SERVICES TO TRIBAL MEMBERS IN OUR SERVICE AREA WHO ARE COVERED BY THEIR TRIBAL HEALTH COVERAGE, AS THIS COVERAGE DOES NOT REIMBURSE FOR CARE OUTSIDE A LIMITED RADIUS OF THE RESERVATION. HOSPITAL SYSTEM LEADERSHIP IS SEEKING APPROACHES TO RESOLVE THESE CONTRACT ISSUES.
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 12I: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 14G: DUE TO THE COMPLEXITY OF THE POLICY, COPIES OF THE FULL POLICY ARE ONLY PROVIDED ON REQUEST. STATEMENTS PROVIDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THE NUMBER(S) TO CALL ARE PROVIDED TO PATIENTS AT PRE-REGISTRATION, REGISTRATION, ON THE HOSPITAL WEBSITE, POSTINGS IN REGISTRATION AREAS AND ADMISSIONS OFFICES, AND INCLUDED ON ALL BILLING STATEMENTS SENT TO THE PATIENT/GUARANTOR.
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 20D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME BETWEEN 201% AND 300% OF THE FPG RECEIVE A WRITE OFF OF HOSPITAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE COMMERCIAL CONTRACTUAL ADJUSTMENT FOR ALL COMMERCIAL PAYERS.

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section D. 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?1
Name and address		Type of Facility (describe)
1	MERCY HEALTH PARTNERS LAKES CAMPUS 6401 PRAIRIE ST NORTON SHORES,MI49444	OUTPATIENT SERVICES, LAB, URGENT CARE, REHAB, IMAGING
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2013

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 1J: MERCY HEALTH 2013 CHNA ALSO INCLUDED:- INTRODUCTION AND MISSION REVIEW STATEMENT- LOOKING BACK AT THE 2009 CHNA: A PROGRESS REPORT- REFLECTIONS ON THE CHNA PROCESS: LESSONS LEARNED AND NEXT STEPS- 9 APPENDICES, INCLUDING (FOR ALL 3 COUNTIES): COMMUNITY, HEALTH AND ENVIRONMENTAL DATA TABLES; HEALTH DISPARITIES INDICATORS & REPORT CARD; UNIVERSITY OF WISCONSIN COUNTY HEALTH RANKINGS DATA; CALL 2-1-1 TOP HEALTH CARE AND RELATED SERVICE REQUESTS AND UNMET NEEDS; 2012 MICHIGAN PROFILE FOR HEALTH YOUTH SURVEY RESULTS; CONSUMER HEALTH ISSUES SURVEY QUESTIONNAIRE; COMMUNITY PARTICIPANTS IN FOCUS GROUPS.
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 3: THE CHNA PROCESS BEGAN WITH A STEERING COMMITTEE REPRESENTING A BROAD RANGE OF INTERESTS IN THE 3-COUNTY SERVICE AREA. PARTNER ORGANIZATIONS THAT PARTICIPATED INCLUDED: HEALTH PROJECT ADVISORY BOARD, UNITED WAY OF THE LAKESHORE, MUSKEGON COUNTY PUBLIC HEALTH, DISTRICT HEALTH DEPARTMENT #10, LAKESHORE HEALTH NETWORK, WESTSHORE PHARMACY, MERCY VNS & HARBOR HOSPICE, COMMUNITY MENTAL HEALTH SERVICES OF MUSKEGON COUNTY, WEST MICHIGAN COMMUNITY MENTAL HEALTH SYSTEM, HACKLEY COMMUNITY CARE CENTER (FQHC), MUSKEGON FAMILY CARE (FQHC), COMMUNITY ACTON LINE OF THE LAKESHORE (CALL 2-1-1), MUSKEGON AREA INTERMEDIATE SCHOOL DISTRICT, GRAND VALLEY STATE UNIVERSITY, UNITED WAY OF MASON COUNTY, CHILD ABUSE COUNCIL OF MUSKEGON COUNTY, AND PADNOS ALUMINUM. COMMUNITY PARTICIPATION AND INPUT: A SERIES OF ACTIVITIES AND CORRESPONDING STEPS WERE TAKEN TO ACHIEVE BROAD PUBLIC PARTICIPATION IN IDENTIFYING THE HEALTH CARE ISSUES AND NEEDS OF THE COMMUNITY. THE ACTIVITIES INCLUDED THE EXECUTION OF A DETAILED CONSUMER HEALTH SURVEY, ONE-ON-ONE INTERVIEWS WITH HEALTH CARE RECIPIENTS, INPUT FROM NATIVE AMERICANS GENERATED THROUGH LOCALLY ARRANGED TALKING CIRCLES, AND THE FACILITATION OF A SEQUENCE OF COMMUNITY CONVERSATIONS AND FOCUS GROUPS. A CONSUMER HEALTH ISSUES SURVEY INCORPORATED A RANGE OF QUESTIONS FOCUSING ON THE DEMOGRAPHIC CHARACTERISTICS AND PERSONAL WELL-BEING OF RESPONDENTS AND THEIR HOUSEHOLD MEMBERS, FEEDBACK ON ABILITY TO ACCESS HEALTH CARE SERVICES AND THE QUALITY OF CARE RECEIVED. SURVEY METHODOLOGIES INCLUDED VOLUNTEER-ADMINISTERED PAPER QUESTIONNAIRES AND ONLINE SURVEY VIA THE USE OF SURVEYMONKEY. FACILITATED COMMUNITY CONVERSATIONS TOOK PLACE IN TWO COUNTIES FOR A PERIOD OF 2-3 HOURS TO DISCUSS TOPICS RAISED BY THE SURVEY. FOCUS GROUPS WERE CONDUCTED AROUND THE TOPICAL AREAS RAISED IN THE SURVEYS AND FORUMS, INCLUDING ONE PHYSICIAN FOCUS GROUP. ONE-ON-ONE INTERVIEWS WERE CONDUCTED BY TRAINED INTERVIEWERS IN BOTH ENGLISH AND SPANISH WITH RESIDENTS ON THEIR HEALTH CARE EXPERIENCES.MERCY HEALTH'S 2013 CHNA INCLUDES THE FOLLOWING INFORMATION ELEMENTS: 1) DEMOGRAPHIC INFORMATION, HEALTH AND ENVIRONMENTAL DATA, DATA ON HEALTH DISPARITIES2) CONSUMER SURVEY, ADMINISTERED VIA PAPER QUESTIONNAIRES AT A VARIETY OF COMMUNITY VENUES AND ELECTRONIC MEDIA. RESPONSES TO THE SURVEY INCLUDED 2,084 SURVEYS.3) FOUR COMMUNITY FORUMS, CALLED "COMMUNITY CONVERSATIONS", IN TWO OF THE THREE COUNTIES. ABOUT 160 PEOPLE PARTICIPATED IN THE FOUR CONVERSATIONS.4) TEN FOCUS GROUPS ON DIFFERENT TOPICAL AREAS. SEVENTY-FIVE PEOPLE PARTICIPATED.5) FIFTY-TWO ONE-ON-ONE INTERVIEWS WERE CONDUCTED WITH CURRENT AND FORMER PATIENTS OF THE LOCAL HEALTH SYSTEM AND HUMAN SERVICE PROVIDERS.
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 4: THE 2013 CHNA WAS CONDUCTED WITH THE THREE HOSPITAL SYSTEM FACILITIES COMPRISING MERCY HEALTH: MERCY HEALTH/MERCY CAMPUS; MERCY HEALTH/HACKLEY CAMPUS AND MERCY HEALTH/LAKESHORE CAMPUS. THE MERCY AND HACKLEY CAMPUSES ARE ACUTE FACILITIES LOCATED IN MUSKEGON COUNTY, SERVING MUSKEGON, OCEANA AND NEWAYGO COUNTIES. THE LAKESHORE CAMPUS IS A CRITICAL CARE FACILITY SERVING OCEANA AND NEWAYGO COUNTIES
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 5D: MERCY HEALTH'S MARKETING DEPARTMENT PUBLISHED A 4-PAGE CHNA SUMMARY IN NOVEMBER 2012 AS AN INSERT IN THE LOCAL NEWSPAPER, THE MUSKEGON CHRONICLE, WITH AN APPROXIMATE CIRCULATION OF 35,000. A 10,000 COPY OVER-RUN WAS PRINTED AND HAS BEEN USED REPEATEDLY BY MERCY PERSONNEL FOR DISTRIBUTION AT MEETINGS, SPEAKING ENGAGEMENTS, CONFERENCES AND A VARIETY OF COMMUNITY OUTREACH EVENTS. IT IS ALSO AVAILABLE AT HEALTH PROJECT OFFICES AND ALL THREE MERCY HEALTH CAMPUSES.LINE 5A:HTTP://WWW.MERCYHEALTHMUSKEGON.COM/DOCUMENTS/MERCYHEALTHPARTNERS-MUSKEGON/MU68330%20HACKLEYCHNABOOK%20912.PDF
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 7: THERE ARE 3 NEEDS IDENTIFIED IN THE 2013 CHNA THAT THE HOSPITAL SYSTEM HAS NOT ADDRESSED:1. OBESITY, NUTRITION EDUCATION & ACCESS TO HEALTHY FOODS - IT WAS DETERMINED THAT THESE ISSUES ARE BEYOND THE PURVIEW AND CAPACITY FOR THE HOSPITAL SYSTEM TO ADDRESS. RATHER, DURING THE CHNA RANKING SESSIONS THEY WERE PLACED IN THE 'PUBLIC HEALTH' AND 'COMMUNITY' DOMAINS FOR TAKING LEAD ROLES. HOSPITAL LEADERSHIP DETERMINED THAT THE HOSPITAL SYSTEM DOES NOT HAVE THE HUMAN AND FINANCIAL RESOURCES NEEDED TO AFFECT THE POPULATION HEALTH CHANGE REQUIRED. THIS IS MORE APPROPRIATELY THE WORK OF PUBLIC HEALTH, THE SCHOOL DISTRICTS, AND COMMUNITY ORGANIZATIONS LIKE MSU EXTENSION. HOWEVER, THE IMPLEMENTATION STRATEGY CALLS FOR DEVELOPING STRONGER RELATIONSHIPS WITH THE ONE IN '21 COMMUNITY WELLNESS GROUP, AS WELL AS ALIGNING WITH SIMILAR GROUPS WITHIN THE EDUCATIONAL AND BUSINESS COMMUNITIES TO DEVELOP COMMUNITY WIDE STRATEGIES. 2. TEEN PREGNANCY - AS A CATHOLIC ORGANIZATION, THE HOSPITAL SYSTEM'S ETHICAL AND RELIGIOUS DIRECTIVES PROHIBIT THE DISPENSATION OF CONTRACEPTIVE INFORMATION AND DEVICES TO PATIENTS. HOWEVER, THE HOSPITAL SYSTEM HAS AN OPERATION PROGRAM TO PREVENT LOW BIRTH WEIGHT BABIES AMONG HIGH-RISK PREGNANT WOMEN - A CATEGORY OF PATIENTS THAT INCLUDES TEENAGE AND YOUNGER PREGNANT WOMEN.3. NATIVE AMERICAN HEALTH SERVICES - ALTHOUGH THE HOSPITAL SYSTEM DELIVERS ALL HEALTH SERVICES TO INDIVIDUAL NATIVE AMERICAN PATIENTS, CONTRACT ISSUES GOVERNING THE TRIBAL HEALTH CLINIC, LOCATED IN MANISTEE COUNTY, HAVE RESTRAINED ITS ABILITY TO PROVIDE SOME SERVICES TO TRIBAL MEMBERS IN OUR SERVICE AREA WHO ARE COVERED BY THEIR TRIBAL HEALTH COVERAGE, AS THIS COVERAGE DOES NOT REIMBURSE FOR CARE OUTSIDE A LIMITED RADIUS OF THE RESERVATION. HOSPITAL SYSTEM LEADERSHIP IS SEEKING APPROACHES TO RESOLVE THESE CONTRACT ISSUES.
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 12I: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 14G: DUE TO THE COMPLEXITY OF THE POLICY, COPIES OF THE FULL POLICY ARE ONLY PROVIDED ON REQUEST. STATEMENTS PROVIDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THE NUMBER(S) TO CALL ARE PROVIDED TO PATIENTS AT PRE-REGISTRATION, REGISTRATION, ON THE HOSPITAL WEBSITE, POSTINGS IN REGISTRATION AREAS AND ADMISSIONS OFFICES, AND INCLUDED ON ALL BILLING STATEMENTS SENT TO THE PATIENT/GUARANTOR.
MERCY HEALTH PARTNERS HACKLEY CAMPUS	PART V, SECTION B, LINE 20D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME BETWEEN 201% AND 300% OF THE FPG RECEIVE A WRITE OFF OF HOSPITAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE COMMERCIAL CONTRACTUAL ADJUSTMENT FOR ALL COMMERCIAL PAYERS.

Schedule H (Form 990) 2013

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, line 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

HACKLEY HOSPITAL

Employer identification number

38-1358196

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 of 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
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used 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? ................

Yes

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

Cat. No. 50053T

Schedule J (Form 990) 2013

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 (E) amounts for that individual.

(A) Name and Title		(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 and Title		(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)ROGER SPOELMANW. MI REG. PRES. & CEO; TRUSTEE	(i) (ii)	0 518,579	0 397,639	0 120,483	0 105,342	0 24,026	0 1,166,069	0 26,420
(2)PHILIP MCCORKLETRUSTEE; ST. MARYS HLTH CEO THR 8/13	(i) (ii)	0 388,625	0 394,603	0 123,489	0 17,850	0 23,493	0 948,060	0 0
(3)GREGORY LOOMISMHP INTERIM CEO	(i) (ii)	0 361,420	0 69,843	0 5,143	0 28,091	0 16,693	0 481,190	0 0
(4)GARY ALLOREWEST MI REGIONAL CFO	(i) (ii)	0 296,210	0 70,163	0 1,540	0 16,425	0 19,954	0 404,292	0 0
(5)JEFFREY ALEXANDERMHP VP INTEGRATED SERVICES	(i) (ii)	0 244,116	0 48,058	0 2,254	0 21,165	0 4,586	0 320,179	0 0
(6)F REMINGTON SPRAGUEMHP VP PRIMARY CARE SERVICES	(i) (ii)	0 341,726	0 68,839	0 5,056	0 30,811	0 15,694	0 462,126	0 0
(7)MARY BOYDMHP VP NETWORK DEVELOPMENT	(i) (ii)	0 266,420	0 61,752	0 1,347	0 32,238	0 3,321	0 365,078	0 0
(8)KIMBERLY MAGUIREMHP VP PATIENT CARE	(i) (ii)	0 212,664	0 39,950	0 688	0 15,376	0 17,364	0 286,042	0 0
(9)CHRISTOPHER MARQUARTPHYSICIAN	(i) (ii)	884,327 0	0 0	0 0	12,750 0	14,215 0	911,292 0	0 0
(10)RICK EDGARPHYSICIAN/ V. CHIEF OF STAFF	(i) (ii)	829,185 0	0 0	30,412 0	11,689 0	9,474 0	880,760 0	0 0
(11)JEREMY BARBERPHYSICIAN	(i) (ii)	789,050 0	0 0	0 0	7,650 0	19,586 0	816,286 0	0 0
(12)STEVEN R FOXPHYSICIAN	(i) (ii)	553,767 0	0 0	906 0	7,650 0	20,700 0	583,023 0	0 0
(13)NINO P SOAVEPHYSICIAN	(i) (ii)	497,344 0	0 0	1,007 0	7,650 0	20,824 0	526,825 0	0 0
(14)J RICHARD O'CONNELLFORMER KEY EMPLOYEE	(i) (ii)	0 731,422	0 769,386	0 172,766	0 111,806	0 33,679	0 1,819,059	0 0
(15)JOSEPH SWEDISHFORMER KEY EMPLOYEE	(i) (ii)	0 344,758	0 0	0 1,119,237	0 21,706	0 7,182	0 1,492,883	0 0
(16)KEDRICK ADKINSFORMER KEY EMPLOYEE	(i) (ii)	0 504,488	0 873,685	0 430,416	0 1,730,702	0 8,534	0 3,547,825	0 45,090
(17)MICHAEL SLUBOWSKIFORMER KEY EMPLOYEE	(i) (ii)	0 0	0 0	0 231,799	0 0	0 0	0 231,799	0 0

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

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

Return Reference

Explanation

PART I, LINE 3

HACKLEY HOSPITAL IS A SUBSIDIARY IN THE CHE TRINITY SYSTEM. HACKLEY HOSPITAL'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, CHE TRINITY, INC. CHE TRINITY, INC. USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION FOR HACKLEY HOSPITAL'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, LINES 4A-B

THE FOLLOWING ARE PARTICIPANTS IN THE TRINITY HEALTH CASH BALANCE RESTORATION AND RETENTION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETENTION BENEFITS PLUS RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($255,000 FOR 2013). THE FOLLOWING ACCRUALS FOR 2013 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $106,281 J. RICHARD O'CONNELL - $99,056 ROGER SPOELMAN - $77,993 PART II: THE FOLLOWING INDIVIDUALS ARE VESTED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING VESTED SERP AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: MICHAEL SLUBOWSKI - $231,799 JOSEPH SWEDISH - $543,977 COLUMN F OF SCHEDULE J INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING IS A PARTICIPANT IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING SERP ACCRUAL FOR 2013 IS INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $258,812 PART II, COLUMN B (II): THE FOLLOWING INDIVIDUALS RECEIVED AMOUNTS IN 2013 FROM A LONG-TERM INCENTIVE PLAN (LTIP). PARTICIPANTS IN THE LTIP (CEOS AND CERTAIN TRINITY EXECUTIVES) WERE ELIGIBLE TO RECEIVE A PAYMENT UNDER THE PLAN ONLY IF CERTAIN CULTURE OF SAFETY SURVEY SCORE TARGETS WERE ACHIEVED BY THE END OF A THREE-YEAR PERIOD (FY11 THROUGH FY13). THE FOLLOWING LTIP AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(II): KEDRICK ADKINS - $481,462 PHILIP MCCORKLE - $205,795 J. RICHARD O'CONNELL - $399,231 ROGER SPOELMAN - $228,996 THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2013. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III): KEDRICK ADKINS - $310,298 IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES THE FOLLOWING SEVERANCE AMOUNTS, WHICH WERE UNPAID AS OF 12/31/13: KEDRICK ADKINS - $1,347,759 ($814,924 PAID IN 2014 AND $532,835 TO BE PAID IN 2015)

Schedule J (Form 990) 2013

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, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

HACKLEY HOSPITAL

Employer identification number

38-1358196

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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)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 assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2013

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) BLUE CROSS BLUE SHIELD OF MICHIGAN	F. REMINGTON SPRAGUE, KEY EMPLOYEE, IS TRUSTEE OF BLUE CROSS BLUE SHIELD-MI	29,595,752	NET REVENUE FROM PROVISION OF MEDICAL SERVICES		No
(2) PAMELA ALEXANDER	FAMILY MEMBER OF JEFFREY ALEXANDER, KEY EMPLOYEE	38,720	EMPLOYMENT ARRANGEMENT		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2013

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.
bullet

Information about Schedule N (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
HACKLEY HOSPITAL

Employer identification number
38-1358196

Part I

Liquidation, Termination, or Dissolution. Complete this part if the organization answered "Yes" to Form 990, Part IV, line 31, or Form 990-EZ, line 36.
Part I can be duplicated 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 INTO MERCY HEALTH PARTNERS	01-01-2014	107,236,275	BOOK VALUE	38-2589966	MERCY HEALTH PARTNERS 1415 LEAHY STREET MUSKEGON,MI49442	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? . . . . . . . . . . . . . . . . . . . . .

Yes

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 on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet

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

Cat. No. 50087Z

Schedule N (Form 990 or 990-EZ) (2013)

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 this part if the organization answered "Yes" to Form 990, Part IV, line 32, or Form 990-EZ, line 36. Part II can be duplicated 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? . . . . . . . . . . . . . . . . . . . . .

Yes

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 on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet

Schedule N(Form 990 or 990-EZ) (2013)

Schedule N (Form 990 or 990-EZ) (2013)

Page 3

Part III

Supplemental Information. Provide the information required by Part I, lines 2e and 6c, and Part II, line 2e. Also complete this part to provide any additional information.

Return Reference	Explanation
PART I, LINE 3:	PART 1, LINE 2A: THE FOLLOWING TRUSTEES OF HACKLEY HOSPITAL BECAME TRUSTEES OF MERCY HEALTH PARTNERS, THE SUCCESSOR CORPORATION:1) FRANK BEDNAREK2) MYRA BERGMAN3) MARK FAZAKERLEY4) T. BRUCE FOX5) MICHAEL GLUHANICH6) YOUSIF HAMATI7) AMY HEISSER8) CAMILLE JOURDEN-MARL9) MICHAEL OLTHOFF10) MARY PALASZEK11) GREGORY PITTMAN12) ROGER SPOELMAN13) TIMOTHY VANDER HAAR
PART I, LINE 6C:	HACKLEY HOSPITAL HAD NO TAX-EXEMPT BOND LIABILITIES TO DISCHARGE OR DEFEASE DURING THE TAX YEAR.

Schedule N (Form 990 or 990-EZ) (2013)

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.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

HACKLEY HOSPITAL

Employer identification number

38-1358196

Return Reference	Explanation
FORM 990, PART I, ITEM C	DBA: MERCY HEALTH PARTNERS-WORK PLACE HEALTH DBA: MERCY HEALTH PARTNERS, HACKLEY CAMPUS DBA: WORKPLACE HEALTH SAINT MARY'S DBA: WORKPLACE HEALTH WHITEHALL DBA: MERCY HEALTH HACKLEY DBA: HACKLEY CORNERSTONE FOUNDATION DBA: MCCLEES CLINIC DBA: MERCY HEALTH HACKLEY CAMPUS
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF HACKLEY HOSPITAL IS MERCY HEALTH PARTNERS. SEE LINE 7 FOR ADDITIONAL INFORMATION.
FORM 990, PART VI, SECTION A, LINE 7A	MERCY HEALTH PARTNERS IS THE SOLE MEMBER OF HACKLEY HOSPITAL. MERCY HEALTH PARTNERS HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF TRUSTEES OF HACKLEY HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B	AS SOLE MEMBER, MERCY HEALTH PARTNERS MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MERCY HEALTH PARTNERS 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	HACKLEY HOSPITAL'S FORM 990 WAS REVIEWED BY MANAGEMENT. THE MANAGEMENT REVIEW TOOK PLACE BEFORE THE FORM 990 WAS FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	HACKLEY HOSPITAL 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 HACKLEY HOSPITAL, 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 HACKLEY HOSPITAL'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO HACKLEY HOSPITAL 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 HACKLEY HOSPITAL IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO HACKLEY HOSPITAL. 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 HACKLEY HOSPITAL ON AN ANNUAL BASIS.
FORM 990, PART VI, SECTION B, LINE 15	QUESTIONS 15A AND 15B IS ANSWERED "NO" BECAUSE THE COMPENSATION FOR HACKLEY HOSPITAL KEY MANAGEMENT OFFICIALS IS ESTABLISHED AND PAID BY CHE TRINITY, A RELATED ORGANIZATION. CHE TRINITY 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 KEY MANAGEMENT OFFICIALS OF HACKLEY HOSPITAL ARE REVIEWED AT LEAST ANNUALLY BY THE CHE TRINITY BOARD OR THE CHE TRINITY 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	HACKLEY HOSPITAL IS A SUBSIDIARY ORGANIZATION IN THE CHE TRINITY HEALTH SYSTEM. CHE TRINITY 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, HACKLEY HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND CHE TRINITY'S WEBSITE. HACKLEY HOSPITAL'S AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART VII, SECTION A:	SR. MYRA BERGMAN, RSM IS A MEMBER OF THE RELIGIOUS SISTERS OF MERCY. HAVING TAKEN A VOW OF POVERTY, SR. MYRA DID NOT RECEIVE COMPENSATION FOR THE SERVICES SHE PROVIDED AS VICE PRESIDENT, MISSION SERVICES FOR SAINT MARY'S HEALTH CARE (A DIVISION OF TRINITY HEALTH - MICHIGAN). INSTEAD, A TOTAL OF $126,697 WAS PAID BY TRINITY HEALTH - MICHIGAN DIRECTLY TO THE SISTERS OF MERCY FOR SR. MYRA'S SERVICES.
FORM 990, PART XI, LINE 9:	EQUITY TRANSFERS TO/FROM AFFILIATES -157,467. INDIGENT CARE AGREEMENT CONTRIBUTION -1,425,143. INDIGENT CARE AGREEMENT REVENUE 1,501,130. MERGER OF HACKLEY HOSPITAL INTO MERCY HEALTH PARTNERS, ITS TAX-EXEMPT SOLE MEMBER 8,860,688.
FORM 990, PART XII, LINE 2:	HACKLEY HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY14 CONSOLIDATED FINANCIAL STATEMENTS OF CHE TRINITY, WHICH 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) 2013

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

HACKLEY HOSPITAL

Employer identification number

38-1358196

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) 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 entity?
(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)	LINE 9	TRINITY HEALTH-MICHIGAN		No
(2) ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR,FL34684 58-1492325	MANAGEMENT & SUPPORT SERVICES	FL	501(C)(3)	LINE 11B, II	CATHOLIC HEALTH EAST		No
(3) AMICARE HOSPICE SERVICES INC 20555 VICTOR PARKWAY LIVONIA,MI48152 38-2949053	PROVIDE HOSPICE SERVICES	MI	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES INC		No
(4) AUXILIARY OF HOLY ROSARY HOSPITAL 351 SW 9TH STREET ONTARIO,OR97914 94-3059469	SUPPORT SERVICES OF RELATED HOSPITAL	OR	501(C)(3)	LINE 9	SAINT ALPHONSUS MEDICAL CENTER-ONTARIO		No
(5) BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR,IA51245 42-1500277	ACUTE/AMBULATORY HEALTHCARE SERVICES	IA	501(C)(3)	LINE 3	MERCY HEALTH SERVICES-IOWA CORP		No
(6) BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR,IA51245 26-2973307	SUPPORT THE SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	LINE 11A, I	BAUM HARMON MERCY HOSPITAL		No
(7) BEECHWOOD INC 2212 BURDETT AVE TROY,NY12180 14-1651563	REAL ESTATE HOLDING	NY	501(C)(2)	N/A	LTC (EDDY) INC		No
(8) BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS,NY12159 14-1717028	INDEPENDENT/ASSISTED LIVING RETIREMENT COMMUNITY	NY	501(C)(3)	LINE 9	LTC (EDDY) INC		No
(9) BRIGHTSIDE INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 04-2182395	BEHAVIORAL CARE	MA	501(C)(3)	LINE 9	SISTERS OF PROVIDENCE HEALTH SYSTEM INC		No
(10) CAPITAL REGION GERIATRIC CENTER INC 421 WEST COLUMBIA ST COHOES,NY12047 14-1701597	NURSING HOME	NY	501(C)(3)	LINE 9	LTC (EDDY) INC		No
(11) 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)	LINE 11B, II	TRINITY HEALTH-MICHIGAN		No
(12) CATHOLIC HEALTH EAST 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 23-2929748	MANAGEMENT SERVICES	PA	501(C)(3)	LINE 11C, III-FI	CHE TRINITY INC		No
(13) CHE TRINITY INC 20555 VICTOR PARKWAY LIVONIA,MI48152 90-0931907	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IN	501(C)(3)	LINE 11B, II	N/A		No
(14) CHE TRINITY INC (FKA TRINITY HEALTH CORPORATION) 20555 VICTOR PARKWAY LIVONIA,MI48152 35-1443425	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IN	501(C)(3)	LINE 11B, II	CHE TRINITY INC		No
(15) COLUMBUS ACQUISITION CORP 111 CENTRAL AVENUE NEWARK,NJ07102 26-2616342	INACTIVE ENTITY	NJ	501(C)(3)	LINE 9	SAINT MICHAELS MEDICAL CENTER		No
(16) COMMUNITY HEALTH PARTNERS OF SOUTH BEND PO BOX 3998 SOUTH BEND,IN46619 26-3051440	HEALTHCARE SERVICES	IN	501(C)(3)	LINE 3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC		No
(17) CONTINUING CARE MANAGEMENT SERVICES NETWORK 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 35-2336834	MANAGEMENT & SUPPORT SERVICES	PA	501(C)(3)	LINE 11B, II	CATHOLIC HEALTH EAST		No
(18) CRANBROOK HOSPICE CARE 1111 W LONG LAKE RD STE 102 TROY,MI48098 38-3320699	PROVIDE HOSPICE HEALTH SERVICES	MI	501(C)(3)	LINE 11A, I	TRINITY HOME HEALTH SERVICES INC		No
(19) DILEY RIDGE MEDICAL CENTER 6150 EAST BROAD STREET COLUMBUS,OH43213 34-2032340	HOSPITAL CAMPUS IN FAIRFIELD COUNTY OHIO	OH	501(C)(3)	LINE 3	MOUNT CARMEL HEALTH SYSTEM		No
(20) DUBUQUE MERCY HEALTH FOUNDATION INC 250 MERCY DRIVE DUBUQUE,IA52001 26-2227941	SUPPORT SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	LINE 11A, I	MERCY HEALTH SERVICES-IOWA CORP		No
(21) DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE,IA52040 20-5383271	SUPPORT SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	LINE 11A, I	MERCY HEALTH SERVICES-IOWA CORP		No
(22) EAST NORRITON PHYSICIAN SERVICES C/O ONE WEST ELM STREET CONSHOHOCKEN,PA19428 23-2515999	PHYSICIAN SERVICES	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(23) EDDY LICENSED HOME CARE AGENCY 433 RIVER ST SUITE 3000 TROY,NY12180 14-1818568	HOME HEALTH	NY	501(C)(3)	LINE 3	LTC(EDDY) INC		No
(24) EMPIRE HOME INFUSION SERVICES INC 10 BLACKSMITH DRIVE MALTA,NY12020 14-1795732	HOME CARE	NY	501(C)(3)	LINE 9	HOME AIDE SERVICE OF EASTERN NEW YORK INC		No
(25) FARREN CARE CENTER INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 04-2501711	LONG TERM CARE	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC		No
(26) FRANCISCAN ELDERCARE CORPORATION PO BOX 2500 WILMINGTON,DE19805 22-3008680	ELDERCARE	DE	501(C)(3)	LINE 9	ST FRANCIS HOSPITAL		No
(27) GLEN EDDY INC ONE GLEN EDDY DRIVE NISKAYUNA,NY12309 14-1794150	INDEPENDENT/ASSISTED LIVING COMMUNITY	NY	501(C)(3)	LINE 9	LTC (EDDY) INC		No
(28) GLOBAL HEALTH MINISTRY 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 23-3068656	HEALTH CARE	PA	501(C)(3)	LINE 7	CATHOLIC HEALTH EAST		No
(29) GOOD SAMARITAN HOSPITAL INC 5401 LAKE OCONEE PARKWAY GREENSBORO,GA30642 26-1720984	HOSPITAL	GA	501(C)(3)	LINE 3	SAINT JOSEPH'S HEALTH SYSTEM INC		No
(30) GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION 701 W NORTH AVE MELROSE PARK,IL60160 36-3332852	SUPPORT SERVICES OF RELATED HOSPITAL	IL	501(C)(3)	LINE 9	GOTTLIEB MEMORIAL HOSPITAL		No
(31) GOTTLIEB MEMORIAL FOUNDATION 701 W NORTH AVE MELROSE PARK,IL60160 74-3260011	SUPPORT SERVICES OF RELATED HOSPITAL	IL	501(C)(3)	LINE 11C, III-FI	N/A		No
(32) GOTTLIEB MEMORIAL HOSPITAL 701 W NORTH AVE MELROSE PARK,IL60160 36-2379649	HEALTHCARE SERVICES	IL	501(C)(3)	LINE 3	LOYOLA UNIVERSITY HEALTH SYSTEM		No
(33) HACKLEY HOSPITAL 1700 CLINTON ST PO BOX 3302 MUSKEGON,MI49443 38-1358196	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 3	MERCY HEALTH PARTNERS		No
(34) HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST PO BOX 3302 MUSKEGON,MI49443 38-2299878	SELF INSURANCE FOR GENERAL AND MALPRACTICE LIABILITY	MI	501(C)(3)	LINE 11C, III-FI	MERCY HEALTH PARTNERS		No
(35) HACKLEY LIFE COUNSELING 1352 TERRACE ST MUSKEGON,MI49442 38-1386362	COUNSELING, EDUCATION, AND SUPPORT	MI	501(C)(3)	LINE 9	MERCY HEALTH PARTNERS		No
(36) HAWTHORNE RIDGE INC 30 COMMUNITY WAY EAST GREENBUSH,NY12061 80-0102840	INDEPENDENT/ASSISTED LIVING RETIREMENT COMMUNITY	NY	501(C)(3)	LINE 9	LTC (EDDY) INC		No
(37) HERITAGE HOUSE NURSING CENTER INC 2920 TIBBITS AVE TROY,NY12180 14-1725101	NURSING HOME	NY	501(C)(3)	LINE 9	LTC (EDDY) INC		No
(38) HOLY CROSS CARENET INC PO BOX 9184 FARMINGTON HILLS,MI48333 52-1945054	LONG-TERM CARE AND REHABILITATION FOR THE ELDERLY	MD	501(C)(3)	LINE 9	TRINITY CONTINUING CARE SERVICES		No
(39) HOLY CROSS HEALTH FOUNDATION INC 11801 TECH ROAD SILVER SPRING,MD20904 20-8428450	CHARITABLE FUNDRAISING	MD	501(C)(3)	LINE 11A, I	HOLY CROSS HEALTH INC		No
(40) HOLY CROSS HEALTH INC 1500 FOREST GLEN RD SILVER SPRING,MD20910 52-0738041	HEALTHCARE SERVICES	MD	501(C)(3)	LINE 3	CHE TRINITY INC (FKA TRINITY HEALTH CORP)		No
(41) HOLY CROSS HOSPITAL INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 59-0791028	HOSPITAL-HEALTHCARE PROVIDER	FL	501(C)(3)	LINE 3	CATHOLIC HEALTH EAST		No
(42) HOLY CROSS LONG TERM CARE INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 65-0787320	MEDICAL SERVICES	FL	501(C)(3)	LINE 3	HOLY CROSS HOSPITAL INC		No
(43) HOLY CROSS MEDICAL CENTER 20555 VICTOR PARKWAY LIVONIA,MI48152 95-1985442	HEALTHCARE SERVICES (FORMERLY)	CA	501(C)(3)	LINE 3	CHE TRINITY INC (FKA TRINITY HEALTH CORP)		No
(44) HOLY CROSS MEDICAL PROPERTIES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 65-0666283	MEDICAL BUILDING REAL ESTATE MANAGEMENT	FL	501(C)(2)	N/A	HOLY CROSS HOSPITAL INC		No
(45) HOME AIDE SERVICE OF EASTERN NEW YORK 433 RIVER ST SUITE 3000 TROY,NY12180 14-1514867	HOME CARE	NY	501(C)(3)	LINE 9	LTC (EDDY) INC		No
(46) HOSPICE OF NORTH IOWA 232 SECOND STREET SE MASON CITY,IA50401 42-1173708	HOSPICE HEALTH CARE SERVICES	IA	501(C)(3)	LINE 7	MERCY HEALTH SERVICES-IOWA CORP		No
(47) HOSPICE OF SIOUXLAND 4300 HAMILTON BLVD SIOUX CITY,IA51104 38-3320710	HOSPICE SERVICES	IA	501(C)(3)	LINE 11A, I	N/A		No
(48) HOSPICE OF WASHTENAW II 806 AIRPORT BLVD ANN ARBOR,MI48108 38-3320707	HOSPICE HEALTH CARE SERVICES	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN		No
(49) 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)	LINE 9	TRINITY HEALTH-MICHIGAN		No
(50) INTRACOASTAL HEALTH SYSTEMS INC 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 65-0556413	MANAGEMENT & SUPPORT SERVICES	PA	501(C)(3)	LINE 11A, I	CATHOLIC HEALTH EAST		No
(51) JAMES A EDDY MEMORIAL GERIATRIC CENTER INC 2256 BURDETT AVE TROY,NY12180 22-2570478	NURSING HOME	NY	501(C)(3)	LINE 9	LTC (EDDY) INC		No
(52) LAKESHORE COMMUNITY HOSPITAL INC 72 S STATE STREET SHELBY,MI49455 38-2549295	ACUTE HEALTHCARE SERVICES	MI	501(C)(3)	LINE 3	MERCY HEALTH PARTNERS		No
(53) LANGHORNE MRI INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2519529	INACTIVE ENTITY	PA	501(C)(3)	LINE 9	ST MARY MEDICAL CENTER		No
(54) LANGHORNE PHYSICIAN SERVICES INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2571699	PHYSICIAN SERVICES	PA	501(C)(3)	LINE 9	ST MARY MEDICAL CENTER		No
(55) LIFE AT LOURDES INC 1600 HADDON AVENUE CAMDEN,NJ08108 26-1854750	ELDERLY CARE	NJ	501(C)(3)	LINE 3	OUR LADY OF LOURDES HEALTH CARE SERVICES		No
(56) LIFE AT ST FRANCIS HEALTHCARE INC 7TH CLAYTON STREETS WILMINGTON,DE19805 45-2569214	ELDERLY CARE	DE	501(C)(3)	LINE 9	ST FRANCIS HOSPITAL		No
(57) LIFE ST FRANCIS CORPORATION 601 HAMILTON AVENUE TRENTON,NJ08629 22-2797282	HEALTH SERVICES	NJ	501(C)(3)	LINE 11A, I	ST FRANCIS MEDICAL CENTER TRENTON NJ		No
(58) LIFE ST JOSEPH OF THE PINES INC 100 GOSSMAN DRIVE SUITE B SOUTHERN PINES,NC28387 27-2159847	HEALTHCARE SERVICES	NC	501(C)(3)	LINE 3	ST JOSEPH'S OF THE PINES INC		No
(59) LIFE ST MARY 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 26-2976184	ELDERLY CARE	PA	501(C)(3)	LINE 9	ST MARY MEDICAL CENTER		No
(60) LOURDES ANCILLARY SERVICES 1600 HADDON AVENUE CAMDEN,NJ08103 22-2568525	SUPPORTING ORGANIZATION	NJ	501(C)(3)	LINE 11B, II	OUR LADY OF LOURDES HEALTH CARE SERVICES		No
(61) LOURDES CARDIOLOGY SERVICES PC 1600 HADDON AVENUE CAMDEN,NJ08103 27-4357794	CARDIOLOGY SERVICES	NJ	501(C)(3)	LINE 3	OUR LADY OF LOURDES HEALTH CARE SERVICES		No
(62) LOURDES DIALYSIS AT INNOVA INC 1600 HADDON AVENUE CAMDEN,NJ08108 26-3237625	HOSPITAL	NJ	501(C)(3)	LINE 3	OUR LADY OF LOURDES HEALTH CARE SERVICES		No
(63) LOURDES MEDICAL CENTER OF BURLINGTON COUNTY 218 SUNSET ROAD WILLINGBORO,NJ08046 22-3612265	HOSPITAL	NJ	501(C)(3)	LINE 3	OUR LADY OF LOURDES HEALTH CARE SERVICES		No
(64) LOYOLA UNIVERSITY HEALTH SYSTEM 2160 SOUTH FIRST AVENUE MAYWOOD,IL60153 36-3342448	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IL	501(C)(3)	LINE 11B, II	CHE TRINITY INC (FKA TRINITY HEALTH CORP)		No
(65) LOYOLA UNIVERSITY MEDICAL CENTER 2160 SOUTH FIRST AVENUE MAYWOOD,IL60153 36-4015560	HEALTHCARE SERVICES	IL	501(C)(3)	LINE 3	LOYOLA UNIVERSITY HEALTH SYSTEM		No
(66) LTC (EDDY) INC 2212 BURDETT AVE TROY,NY12180 22-2564710	ELDERLY HEALTH/HOUSING SUPPORTING ORG	NY	501(C)(3)	LINE 11A, I	NORTHEAST HEALTH INC		No
(67) MARIAN COMMUNITY HOSPITAL 3805 WEST CHESTER PIKE NO 100 NEWTOWN SQUARE,PA19073 24-0711230	HOSPITAL	PA	501(C)(3)	LINE 3	MAXIS HEALTH SYSTEM		No
(68) MARIAN COMMUNITY HOSPITAL AUXILIARY 3805 WEST CHESTER PIKE NO 100 NEWTOWN SQUARE,PA19073 25-1874733	FUNDRAISING	PA	501(C)(3)	LINE 11B, II	MAXIS HEALTH SYSTEM		No
(69) MARIAN HOME HEALTHCARE 801 5TH STREET SIOUX CITY,IA51101 38-3320705	PROVIDE HOME HEALTH CARE SERVICES	IA	501(C)(3)	LINE 11A, I	MERCY HEALTH SERVICES-IOWA CORP		No
(70) MARYCREST HEIGHTS PO BOX 9184 FARMINGTON HILLS,MI48333 27-0291722	PROVIDES HOUSING FOR ELDERLY INDIVIDUALS	MI	501(C)(3)	LINE 11A, I	TRINITY CONTINUING CARE SERVICES		No
(71) MAXIS FOUNDATION 3805 WEST CHESTER PIKE NO 100 NEWTOWN SQUARE,PA19073 23-2330090	FUNDRAISING	PA	501(C)(3)	LINE 11B, II	MAXIS HEALTH SYSTEM		No
(72) MAXIS HEALTH SYSTEM 3805 WEST CHESTER PIKE NO 100 NEWTOWN SQUARE,PA19073 91-1940902	HEALTH CARE SYSTEM	PA	501(C)(3)	LINE 11B, II	CATHOLIC HEALTH EAST		No
(73) MAXIS MEDICAL SERVICES 3805 WEST CHESTER PIKE NO 100 NEWTOWN SQUARE,PA19073 23-2577185	PHYSICIAN PRACTICES	PA	501(C)(3)	LINE 3	MAXIS HEALTH SYSTEM		No
(74) MCAULEY CENTER INC 275 STEELE ROAD WEST HARTFORD,CT06117 06-1058086	INDEPENDENT LIVING	CT	501(C)(3)	LINE 9	MERCY COMMUNITY HEALTH INC		No
(75) MCAULEY CLINIC CORPORATION PO BOX 992 ANN ARBOR,MI48106 38-2561013	HEALTHCARE SERVICES (FORMERLY)	MI	501(C)(3)	LINE 3	CATHERINE MCAULEY HEALTH SERVICES CORP		No
(76) MCAULEY MINISTRIES 3333 FIFTH AVENUE PITTSBURGH,PA15213 94-3436142	MANAGEMENT & SUPPORT SERVICES	PA	501(C)(3)	LINE 11A, I	PITTSBURGH MERCY HEALTH SYSTEM		No
(77) MEMORIAL HOSPITAL ALBANY NY 600 NORTHERN BLVD ALBANY,NY12204 14-1338457	GENERAL HOSPITAL	NY	501(C)(3)	LINE 3	NORTHEAST HEALTH INC		No
(78) MERCY AMICARE HOME HEALTHCARE OAKLAND 1111 W LONG LAKE RD STE 102 TROY,MI48098 38-3320698	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	LINE 11A, I	TRINITY HOME HEALTH SERVICES INC		No
(79) MERCY AMICARE HOME HEALTHCARE PORT HURON 505 HURON AVENUE PORT HURON,MI48060 38-3320701	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	LINE 11A, I	TRINITY HOME HEALTH SERVICES INC		No
(80) MERCY CARES FOR KIDS INC 310 SOUTH MANNING BLVD ALBANY,NY12208 14-1717564	DAY CARE CENTER	NY	501(C)(3)	LINE 9	ST PETER'S HEALTH CARE SERVICES		No
(81) MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET CONSHOHOCKEN,PA19428 23-1352191	ACUTE CARE HOSPITAL	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(82) MERCY COMMUNITY HEALTH INC 2021 ALBANY AVENUE WEST HARTFORD,CT06117 06-1492707	MANAGEMENT & SUPPORT SERVICES	CT	501(C)(3)	LINE 11A, I	CATHOLIC HEALTH EAST		No
(83) MERCY COMMUNITY HOMECARE SERVICES 2021 ALBANY AVENUE WEST HARTFORD,CT06117 06-1488137	IN HOME HEALTH CARE	CT	501(C)(3)	LINE 9	MERCY COMMUNITY HEALTH INC		No
(84) MERCY FAMILY SUPPORT 1001 BALTIMORE PIKE SUITE 310 SPRINGFIELD,PA19064 23-2325059	HOME HEALTH	PA	501(C)(3)	LINE 9	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(85) MERCY FOUNDATION INC 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-3227350	SUPPORTS THE SERVICES OF RELATED HEALTH CARE SYSTEM	IL	501(C)(3)	LINE 11A, I	MERCY HEALTH SYSTEM OF CHICAGO		No
(86) MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE 684 HARVEY STREET MUSKEGON,MI49442 38-3321856	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	LINE 11A, I	TRINITY HOME HEALTH SERVICES INC		No
(87) MERCY HEALTH FOUNDATION OF SOUTHEASTERN PENNSYLVANIA C/O ONE WEST ELM STREET CONSHOHOCKEN,PA19428 23-2829864	FUNDRAISING	PA	501(C)(3)	LINE 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(88) MERCY HEALTH NETWORK 1111 6TH AVENUE DES MOINES,IA50314 42-1478417	HEALTHCARE MANAGEMENT	DE	501(C)(3)	LINE 11A, I	N/A		No
(89) MERCY HEALTH PARTNERS 1415 LEAHY STREET MUSKEGON,MI49442 38-2589966	HEALTHCARE SYSTEM SUPPORT	MI	501(C)(3)	LINE 3	TRINITY HEALTH-MICHIGAN		No
(90) MERCY HEALTH PLAN C/O ONE WEST ELM STREET CONSHOHOCKEN,PA19428 22-2483605	HEALTH PLANS	PA	501(C)(3)	LINE 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(91) MERCY HEALTH SERVICES - IOWA CORP 1000 4TH STREET SW MASON CITY,IA50401 31-1373080	HEALTHCARE SERVICES	DE	501(C)(3)	LINE 3	TRINITY HEALTH-MICHIGAN		No
(92) MERCY HEALTH SYSTEM OF CHICAGO 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-3163327	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IL	501(C)(3)	LINE 11A, I	CHE TRINITY INC (FKA TRINITY HEALTH CORP)		No
(93) 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)	LINE 11C, III-FI	MERCY HEALTH SYSTEM OF CHICAGO		No
(94) MERCY HEALTH SYSTEM OF MAINE 144 STATE STREET PORTLAND,ME04101 01-0484074	MANAGEMENT & SUPPORT SERVICES	ME	501(C)(3)	LINE 11C, III-FI	CATHOLIC HEALTH EAST		No
(95) MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET CONSHOHOCKEN,PA19428 23-2212638	MANAGEMENT & SUPPORT SERVICES	PA	501(C)(3)	LINE 11B, II	CATHOLIC HEALTH EAST		No
(96) MERCY HEALTHCARE CENTER 114 WAWBEEK AVENUE TUPPER LAKE,NY12986 15-0532211	IN DISSOLUTION	NY	501(C)(3)	LINE 3	CATHOLIC HEALTH EAST		No
(97) MERCY HEALTHCARE FOUNDATION-CLINTON 1410 NORTH 4TH ST CLINTON,IA52732 42-1316126	FUNDRAISING AND FINANCIAL ASSISTANCE FOR HOSPITAL CHARITABLE SERVICES	IA	501(C)(3)	LINE 11C, III-FI	N/A		No
(98) MERCY HOME HEALTH 1001 BALTIMORE PIKE SUITE 310 SPRINGFIELD,PA19064 23-1352099	HOME HEALTH	PA	501(C)(3)	LINE 9	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(99) MERCY HOME HEALTH SERVICES 1001 BALTIMORE PIKE SUITE 310 SPRINGFIELD,PA19064 23-2325058	HOME HEALTH	PA	501(C)(3)	LINE 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(100) MERCY HOSPITAL 144 STATE STREET PORTLAND,ME04101 01-0211534	HOSPITAL	ME	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF MAINE		No
(101) MERCY HOSPITAL AND MEDICAL CENTER 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-2170152	HEALTHCARE SERVICES	IL	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF CHICAGO		No
(102) MERCY HOSPITAL CADILLAC FOUNDATION 400 HOBART CADILLAC,MI49601 20-3357131	SUPPORT THE SERVICES OF RELATED HOSPITAL	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN		No
(103) MERCY HOSPITAL GIFT SHOP 2601 ELECTRIC AVE PORT HURON,MI48060 38-1630480	VOLUNTEER SERVICE AUXILIARY	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN		No
(104) MERCY HOSPITAL INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 04-3398280	ACUTE CARE	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC		No
(105) MERCY HOSPITAL INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 59-0791034	HOSPITAL	FL	501(C)(3)	LINE 3	CATHOLIC HEALTH EAST		No
(106) MERCY JEANNETTE HOSPITAL 3805 WEST CHESTER PIKE NEWTOWN SQUARE,PA19073 25-1310602	INACTIVE ENTITY	PA	501(C)(3)	LINE 9	PITTSBURGH MERCY HEALTH SYSTEM		No
(107) MERCY LIFE CENTER CORPORATION 1200 REEDSDALE STREET PITTSBURGH,PA15233 25-1604115	COMMUNITY TREATMENT	PA	501(C)(3)	LINE 9	PITTSBURGH MERCY HEALTH SYSTEM		No
(108) MERCY LIFE OF ALABAMA PO BOX 1090 101 VILLA DRIVE DAPHNE,AL36526 27-3163002	HOSPITAL	AL	501(C)(3)	LINE 3	MERCY MEDICAL CORPORATION		No
(109) MERCY LIFE INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 45-3086711	ACUTE CARE	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC		No
(110) MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET CONSHOHOCKEN,PA19428 23-2627944	PHYSICIAN PRACTICES	PA	501(C)(3)	LINE 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(111) MERCY MEDICAL CENTER - CLINTON INC 1410 NORTH 4TH ST CLINTON,IA52732 42-1336618	PROVIDE QUALITY HEALTH CARE	DE	501(C)(3)	LINE 3	MERCY HEALTH SERVICES-IOWA CORP		No
(112) MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION 801 5TH STREET SIOUX CITY,IA51102 14-1880022	SUPPORT THE SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	LINE 7	MERCY HEALTH SERVICES-IOWA CORP		No
(113) MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA 1000 4TH STREET SW MASON CITY,IA50401 42-1229151	SUPPORT THE SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	LINE 11C, III-FI	N/A		No
(114) MERCY MEDICAL CORPORATION PO BOX 1090 101 VILLA DRIVE DAPHNE,AL36526 63-6002215	HOSPITAL	AL	501(C)(3)	LINE 3	CATHOLIC HEALTH EAST		No
(115) MERCY MEDICAL DEVELOPMENT INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 59-2789194	OUTPATIENT SERVICES	FL	501(C)(3)	LINE 9	MERCY HOSPITAL INC		No
(116) MERCY MISSION SERVICES INC 3661 SOUTH MIAMI AVENUE MIAMI,FL33133 65-0435764	HEALTH CARE	FL	501(C)(3)	LINE 11A, I	MERCY HOSPITAL INC		No
(117) MERCY NORTH HOMECARE AND HOSPICE 7985 MACKINAW TRAIL CADILLAC,MI49601 38-3313897	HOME HEALTH AND HOSPICE SERVICES	MI	501(C)(3)	LINE 11A, I	TRINITY HOME HEALTH SERVICES INC		No
(118) MERCY ONCOLOGY SERVICES INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 45-4884805	ONCOLOGY MEDICAL SERVICES	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC		No
(119) MERCY OUTPATIENT SERVICES INC DBA SISTER EMMANUEL HOSPITAL 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 51-0461511	HOSPITAL	FL	501(C)(3)	LINE 3	MERCY HOSPITAL INC		No
(120) MERCY PHYSICIAN GROUP INC 1512 12TH AVENUE ROAD NAMPA,ID83686 20-8192593	PROVIDE QUALITY HEALTH CARE	ID	501(C)(3)	LINE 9	SAINT ALPHONSUS MEDICAL CENTER-NAMPA		No
(121) MERCY SENIOR CARE INC 300 CHATILLON ROAD PO BOX 866 ROME,GA30162 58-1366508	COMMUNITY OUTREACH	GA	501(C)(3)	LINE 7	SAINT JOSEPH'S HEALTH SYSTEM INC		No
(122) MERCY SERVICES CORPORATION 2021 ALBANY AVENUE WEST HARTFORD,CT06117 06-1453323	SUPPORT SERVICES	CT	501(C)(3)	LINE 1	MERCY COMMUNITY HEALTH INC		No
(123) MERCY SERVICES DOWNTOWN INC 424 DECATUR STREET ATLANTA,GA30312 27-2046353	REAL ESTATE HOLDING COMPANY	GA	501(C)(3)	LINE 11B, II	SAINT JOSEPH'S HEALTH SYSTEM INC		No
(124) MERCY SERVICES FOR AGING NON-PROFIT HOUSING CORPORATION PO BOX 9184 FARMINGTON HILLS,MI48333 38-2719605	PROVIDES LONG-TERM CARE FOR THE ELDERLY	MI	501(C)(3)	LINE 11B, II	TRINITY CONTINUING CARE SERVICES		No
(125) MERCY SPECIALIST PHYSICIANS INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 26-4033168	NEUROSURGERY MEDICAL SERVICES	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC		No
(126) MERCY SUBURBAN HOSPITAL ONE WEST ELM STREET CONSHOHOCKEN,PA19428 23-1396763	ACUTE CARE HOSPITAL	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(127) MERCY UIHLEIN HEALTH CORPORATION 185 OLD MILITARY ROAD LAKE PLACID,NY12946 16-1535133	MGT. & SUPPORT SERVICES	NY	501(C)(3)	LINE 11B, II	MERCY HEALTHCARE CENTER		No
(128) MERCYKNOLL INC 2021 ALBANY AVENUE WEST HARTFORD,CT06117 06-0757380	SKILLED NURSING	CT	501(C)(3)	LINE 3	MERCY COMMUNITY HEALTH INC		No
(129) MIDWEST MEDFLIGHT 1300 VICTORS WAY ANN ARBOR,MI48108 38-2684671	AEROMEDICAL TRANSPORT	MI	501(C)(3)	LINE 9	TRINITY HEALTH-MICHIGAN		No
(130) MISSION HEALTH CORPORATION 37595 SEVEN MILE ROAD LIVONIA,MI48152 38-3181557	FACILITY USED FOR AMBULATORY CARE	DE	501(C)(3)	LINE 11A, I	N/A		No
(131) MOUNT CARMEL COLLEGE OF NURSING 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1308555	COLLEGE OF NURSING	OH	501(C)(3)	LINE 2	MOUNT CARMEL HEALTH SYSTEM		No
(132) 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
(133) 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
(134) MOUNT CARMEL HEALTH SYSTEM 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1439334	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	OH	501(C)(3)	LINE 3	CHE TRINITY INC (FKA TRINITY HEALTH CORP)		No
(135) MOUNT CARMEL HEALTH SYSTEM FOUNDATION 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1113966	SUPPORT SERVICES OF RELATED HOSPITAL	OH	501(C)(3)	LINE 11A, I	MOUNT CARMEL HEALTH SYSTEM		No
(136) MOUNT CARMEL HOME CARE LLC 1144 DUBLIN ROAD SUITE B COLUMBUS,OH43215 26-2729300	PROVIDE HOME HEALTH CARE SERVICES	OH	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES INC		No
(137) MRI MOBILE SERVICES OF WEST MICHIGAN 1820 - 44TH STREET KENTWOOD,MI49508 38-3073745	OPERATE MAGNETIC IMAGING RESONANCE (FORMERLY)	MI	501(C)(3)	LINE 9	TRINITY HEALTH-MICHIGAN		No
(138) MUSKEGON COMMUNITY HEALTH PROJECT 565 W WESTERN AVE MUSKEGON,MI49440 91-1932918	FACILITATE AND COORDINATE HEALTHCARE AND RELATED SERVICES	MI	501(C)(3)	LINE 7	MERCY HEALTH PARTNERS		No
(139) NAZARETH HEALTH CARE FOUNDATION 2701 HOLME AVENUE PHILADELPHIA,PA19152 23-2300951	FUNDRAISING	PA	501(C)(3)	LINE 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(140) NAZARETH HOSPITAL 2601 HOLME AVENUE PHILADELPHIA,PA19152 23-2794121	ACUTE CARE HOSPITAL	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(141) NAZARETH PHYSICIAN SERVICES INC ONE WEST ELM STREET CONSHOHOCKEN,PA19428 20-3261266	PHYSICIAN PRACTICES	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(142) NE PHYSICIAN SERVICES ONE WEST ELM STREET CONSHOHOCKEN,PA19428 23-2497355	PHYSICIAN PRACTICES	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(143) NORTHEAST HEALTH INC 2212 BURDETT AVE TROY,NY12180 04-2450756	SUPPORTING ORGANIZATION	NY	501(C)(3)	LINE 11B, II	ST PETER'S HEALTH PARTNERS		No
(144) OAKLAND MERCY HOSPITAL 601 EAST 2ND STREET OAKLAND,NE68045 20-8072234	HEALTHCARE SERVICES	NE	501(C)(3)	LINE 3	MERCY HEALTH SERVICES-IOWA CORP		No
(145) OAKLAND MERCY HOSPITAL FOUNDATION 601 EAST 2ND STREET OAKLAND,NE68045 31-1678345	SUPPORT SERVICES OF RELATED HOSPITAL	NE	501(C)(3)	LINE 11C, III-FI	N/A		No
(146) OSUMOUNT CARMEL HEALTH ALLIANCE 793 WEST STATE STREET COLUMBUS,OH43222 31-1654603	COOPERATIVE HEALTH CARE DELIVERY SYSTEM	OH	501(C)(3)	LINE 11A, I	N/A		No
(147) OUR LADY OF LOURDES HEALTH CARE SERVICES 1600 HADDON AVENUE CAMDEN,NJ08103 22-2568528	MANAGEMENT & SUPPORT SERVICES	NJ	501(C)(3)	LINE 11B, II	CATHOLIC HEALTH EAST		No
(148) OUR LADY OF LOURDES HEALTH FOUNDATION INC 1600 HADDON AVENUE CAMDEN,NJ08103 22-2351960	FOUNDATION	NJ	501(C)(3)	LINE 7	OUR LADY OF LOURDES HEALTH CARE SERVICES		No
(149) OUR LADY OF LOURDES MEDICAL CENTER 1600 HADDON AVENUE CAMDEN,NJ08103 21-0635001	HOSPITAL	NJ	501(C)(3)	LINE 3	OUR LADY OF LOURDES HEALTH CARE SERVICES		No
(150) OUR LADY OF MERCY LIFE CENTER 2 MERCYCARE LANE GUILDERLAND,NY12084 14-1743506	NURSING HOME FACILITY	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH CARE SERVICES		No
(151) PIONEER VALLEY CARDIOLOGY ASSOCIATES INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 45-4208896	CARDIOLOGY SERVICES	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC		No
(152) PITTSBURGH MERCY HEALTH SYSTEM 3333 5TH AVENUE PITTSBURGH,PA15213 25-1464211	MANAGEMENT & SUPPORT SERVICES	PA	501(C)(3)	LINE 11B, II	CATHOLIC HEALTH EAST		No
(153) PORT HURON MERCY FAMILY CARE INC 2601 ELECTRIC AVE PORT HURON,MI48060 20-1855647	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN		No
(154) PROFESSIONAL MED TEAM 965 FORK STREET MUSKEGON,MI49442 38-2638284	MEDICAL CARE, TRANSPORTATION AND EDUCATION	MI	501(C)(3)	LINE 9	TRINITY HEALTH-MICHIGAN		No
(155) PROFESSIONAL OFFICE CORPORATION 1303 EAST HERNDON AVE FRESNO,CA93720 94-2839324	HEALTHCARE SERVICES	CA	501(C)(3)	LINE 11A, I	SAINT AGNES MEDICAL CENTER		No
(156) PROVIDENCE PLACE INC 5 GAMELIN STREET HOLYOKE,MA01040 04-3404084	RETIREMENT COMMUNITY	MA	501(C)(3)	LINE 9	SISTERS OF PROVIDENCE HEALTH SYSTEM INC		No
(157) SAINT AGNES MEDICAL CENTER 1303 EAST HERNDON AVE FRESNO,CA93720 94-1437713	HEALTHCARE SERVICES	CA	501(C)(3)	LINE 3	CHE TRINITY INC (FKA TRINITY HEALTH CORP)		No
(158) SAINT ALPHONSUS BUILDING COMPANY INC 1055 NORTH CURTIS RD BOISE,ID83706 82-0401011	SUPPORT SERVICES OF RELATED HOSPITAL	ID	501(C)(3)	LINE 11A, I	SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC		No
(159) SAINT ALPHONSUS DIVERSIFIED CARE INC 1055 NORTH CURTIS RD BOISE,ID83706 94-3028978	SUPPORT SERVICES OF RELATED HOSPITAL	ID	501(C)(3)	LINE 11A, I	SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC		No
(160) SAINT ALPHONSUS FOUNDATION-BAKER CITY INC 3325 POCAHONTAS ROAD BAKER CITY,OR97814 94-3164869	SUPPORT SERVICES OF RELATED HOSPITAL	OR	501(C)(3)	LINE 7	SAINT ALPHONSUS MEDICAL CENTER - BAKER CITY		No
(161) SAINT ALPHONSUS FOUNDATION-ONTARIO INC 351 SW 9TH STREET ONTARIO,OR97914 20-2683560	SUPPORT SERVICES OF RELATED HOSPITAL	OR	501(C)(3)	LINE 11A, I	SAINT ALPHONSUS MEDICAL CENTER-ONTARIO		No
(162) SAINT ALPHONSUS HEALTH SYSTEM INC 1055 N CURTIS ROAD BOISE,ID83706 27-1929502	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	ID	501(C)(3)	LINE 11A, I	CHE TRINITY INC (FKA TRINITY HEALTH CORP)		No
(163) SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY INC 3325 POCAHONTAS ROAD BAKER CITY,OR97814 27-1790052	PROVIDE QUALITY HEALTH CARE	OR	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC		No
(164) SAINT ALPHONSUS MEDICAL CENTER-NAMPA HEALTH FOUNDATION INC 1512 12TH AVENUE ROAD NAMPA,ID83686 26-1737256	SUPPORT SERVICES OF RELATED HOSPITAL	ID	501(C)(3)	LINE 7	SAINT ALPHONSUS MEDICAL CENTER-NAMPA		No
(165) SAINT ALPHONSUS MEDICAL CENTER-NAMPA INC 1512 12TH AVENUE ROAD NAMPA,ID83686 82-0200896	PROVIDE QUALITY HEALTH CARE	ID	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC		No
(166) SAINT ALPHONSUS MEDICAL CENTER-ONTARIO INC 351 SW 9TH STREET ONTARIO,OR97914 27-1789847	PROVIDE QUALITY HEALTH CARE	OR	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC		No
(167) SAINT ALPHONSUS REGIONAL MEDICAL CENTER 1055 NORTH CURTIS RD BOISE,ID83706 82-0200895	HEALTHCARE SERVICES	ID	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC		No
(168) SAINT JAMES CARE INC 111 CENTRAL AVENUE NEWARK,NJ07102 26-2616230	INACTIVE ENTITY	NJ	501(C)(3)	LINE 9	SAINT MICHAELS MEDICAL CENTER		No
(169) SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC 1915 LAKE AVENUE PO BOX 670 PLYMOUTH,IN46563 35-1142669	HEALTHCARE SERVICES	IN	501(C)(3)	LINE 3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC		No
(170) SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC PO BOX 1935 SOUTH BEND,IN46634 35-0868157	HEALTHCARE SERVICES	IN	501(C)(3)	LINE 3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC		No
(171) 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
(172) SAINT JOSEPH REGIONAL MEDICAL CENTER PLYMOUTH AUXILIARY INC 1915 LAKE AVENUE PLYMOUTH,IN46563 35-6043563	HOSPITAL SERVICE AUXILIARY	IN	501(C)(3)	LINE 11B, II	SAINT JOSEPH REGIONAL MEDICAL CENTER-PLYMOUTH		No
(173) SAINT JOSEPH REGIONAL MEDICAL CENTER INC 801 EAST LASALLE AVE SOUTH BEND,IN46617 35-1568821	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IN	501(C)(3)	LINE 11A, I	CHE TRINITY INC (FKA TRINITY HEALTH CORP)		No
(174) SAINT JOSEPH'S HEALTH SYSTEM INC 424 DECATUR STREET ATLANTA,GA30312 58-1744848	MANAGEMENT & SUPPORT SERVICES	GA	501(C)(3)	LINE 11B, II	CATHOLIC HEALTH EAST		No
(175) SAINT JOSEPH'S MERCY CARE SERVICES INC 424 DECATUR STREET ATLANTA,GA30312 58-1752700	COMMUNITY OUTREACH	GA	501(C)(3)	LINE 7	SAINT JOSEPH'S HEALTH SYSTEM INC		No
(176) SAINT JOSEPH'S MERCY FOUNDATION INC 424 DECATUR STREET ATLANTA,GA30312 58-1448522	FUNDRAISING	GA	501(C)(3)	LINE 11B, II	SAINT JOSEPH'S HEALTH SYSTEM INC		No
(177) SAINT JOSEPH'S TOWER INC PO BOX 9184 FARMINGTON HILLS,MI48333 31-1040468	PROVIDES HOUSING FOR LOW INCOME ELDERLY INDIVIDUALS	IN	501(C)(3)	LINE 9	TRINITY CONTINUING CARE SERVICES-INDIANA		No
(178) SAINT MARY HOME II INC 2021 ALBANY AVENUE WEST HARTFORD,CT06117 06-1164104	ELDERLY CARE	CT	501(C)(3)	LINE 3	MERCY COMMUNITY HEALTH INC		No
(179) SAINT MARY'S AMICARE HOME HEALTHCARE 1430 MONROE NW GRAND RAPIDS,MI49505 38-3320700	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	LINE 11A, I	TRINITY HOME HEALTH SERVICES INC		No
(180) SAINT MARY'S FOUNDATION 200 JEFFERSON ST SE GRAND RAPIDS,MI49503 38-1779602	SUPPORT SERVICES OF RELATED HOSPITAL	MI	501(C)(3)	LINE 7	TRINITY HEALTH-MICHIGAN		No
(181) SAINT MICHAELS MEDICAL CENTER 111 CENTRAL AVENUE NEWARK,NJ07102 26-2616046	HOSPITAL	NJ	501(C)(3)	LINE 3	CATHOLIC HEALTH EAST		No
(182) SAMARITAN CHILD CARE CENTER INC 2213 BURDETT AVE TROY,NY12180 14-1710225	CHILD DAY CARE	NY	501(C)(3)	LINE 9	NORTHEAST HEALTH INC		No
(183) SAMARITAN HOSPITAL OF TROY NEW YORK 2215 BURDETT AVE TROY,NY12180 14-1338544	GENERAL HOSPITAL	NY	501(C)(3)	LINE 3	NORTHEAST HEALTH INC		No
(184) SENIOR CARE CONNECTION INC 504 STATE ST SCHENECTADY,NY12305 14-1708754	PACE PROGRAM	NY	501(C)(3)	LINE 9	LTC (EDDY) INC		No
(185) SETON AUXILIARY INC 1300 MASSACHUSETTS AVENUE TROY,NY12180 14-1505031	SUPPORTING ORGANIZATION	NY	501(C)(3)	LINE 9	SETON HEALTH SYSTEM INC		No
(186) SETON HEALTH AT SCHUYLER RIDGE RESIDENTIAL HEALTHCARE 1 ABELE BLVD CLIFTON PARK,NY12065 14-1756230	SKILLED NURSING	NY	501(C)(3)	LINE 9	SETON HEALTH SYSTEM INC		No
(187) SETON HEALTH FOUNDATION INC 1300 MASSACHUSETTS AVENUE TROY,NY12180 22-2345416	SUPPORTING ORGANIZATION	NY	501(C)(3)	LINE 11A, I	SETON HEALTH SYSTEM INC		No
(188) SETON HEALTH SYSTEM INC 1300 MASSACHUSETTS AVENUE TROY,NY12180 14-1776186	HOSPITAL	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS		No
(189) SETON LICENSED HOME CARE INC 1300 MASSACHUSETTS AVENUE TROY,NY12180 14-1809134	LICENSED HOME HEALTH AGENCY	NY	501(C)(3)	LINE 3	SETON HEALTH SYSTEM INC		No
(190) SHAKER PROPERTIES INC 2212 BURDETT AVE TROY,NY12180 22-3119822	REAL ESTATE HOLDING	NY	501(C)(2)	N/A	NORTHEAST HEALTH INC		No
(191) SISTERS OF PROVIDENCE CARE CENTERS INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 22-2541103	LONG TERM CARE	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC		No
(192) SISTERS OF PROVIDENCE HEALTH SYSTEM INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 04-3398374	MANAGEMENT & SUPPORT SERVICES	MA	501(C)(3)	LINE 11A, I	CATHOLIC HEALTH EAST		No
(193) SSJ HEALTH FOUNDATION INC 3661 SOUTH MIAMI AVENUE MIAMI,FL33133 59-1709438	FUNDRAISING	FL	501(C)(3)	LINE 7	MERCY HOSPITAL INC		No
(194) ST JOSEPH MERCY OAKLAND FOUNDATION 44405 WOODWARD AVE PONTIAC,MI48341 35-2356789	SUPPORT SERVICES OF RELATED HOSPITAL	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN		No
(195) ST AGNES CONTINUING CARE CENTER ONE WEST ELM STREET CONSHOHOCKEN,PA19428 23-2840137	CONTINUING CARE SERVICES	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(196) ST AGNES CONTINUING CARE CENTER FOUNDATION ONE WEST ELM STREET CONSHOHOCKEN,PA19428 23-2415137	FUNDRAISING	PA	501(C)(3)	LINE 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA		No
(197) ST FRANCIS FOUNDATION PO BOX 2500 WILMINGTON,DE19805 51-0374158	FOUNDATION	DE	501(C)(3)	LINE 11B, II	ST FRANCIS HOSPITAL		No
(198) ST FRANCIS HOSPITAL PO BOX 2500 WILMINGTON,DE19805 51-0064326	HOSPITAL	DE	501(C)(3)	LINE 3	CATHOLIC HEALTH EAST		No
(199) ST FRANCIS HOSPITAL INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR,FL34684 59-0624442	GRANT-MAKING ORGANIZATION	FL	501(C)(3)	LINE 11A, I	ALLEGANY FRANCISCAN MINISTRIES INC		No
(200) ST FRANCIS MEDICAL CENTER FOUNDATION INC 601 HAMILTON AVENUE TRENTON,NJ08629 52-1025476	FOUNDATION	NJ	501(C)(3)	LINE 11A, I	ST FRANCIS MEDICAL CENTER TRENTON NJ		No
(201) ST FRANCIS MEDICAL CENTER TRENTON NJ 601 HAMILTON AVENUE TRENTON,NJ08629 22-3431049	HOSPITAL	NJ	501(C)(3)	LINE 3	CATHOLIC HEALTH EAST		No
(202) ST JAMES MERCY FOUNDATION INC 411 CANISTEO STREET HORNELL,NY14843 16-1486437	FOUNDATION	NY	501(C)(3)	LINE 7	ST JAMES MERCY HEALTH SYSTEM INC		No
(203) ST JAMES MERCY HEALTH SYSTEM INC 411 CANISTEO STREET HORNELL,NY14843 22-3127184	MANAGEMENT & SUPPORT SERVICES	NY	501(C)(3)	LINE 11B, II	CATHOLIC HEALTH EAST		No
(204) ST JAMES MERCY HOSPITAL 411 CANISTEO STREET HORNELL,NY14843 16-0743310	HOSPITAL	NY	501(C)(3)	LINE 3	ST JAMES MERCY HEALTH SYSTEM INC		No
(205) ST JOSEPH OF THE PINES INC 100 GOSSMAN DRIVE SUITE B SOUTHERN PINES,NC28387 56-0694200	HOSPITAL	NC	501(C)(3)	LINE 3	CATHOLIC HEALTH EAST		No
(206) ST MARY HOME INCORPORATED 2021 ALBANY AVENUE WEST HARTFORD,CT06117 06-0646843	SKILLED NURSING	CT	501(C)(3)	LINE 3	MERCY COMMUNITY HEALTH INC		No
(207) ST MARY MEDICAL CENTER 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-1913910	HOSPITAL	PA	501(C)(3)	LINE 3	CATHOLIC HEALTH EAST		No
(208) ST MARY MEDICAL CENTER FOUNDATION INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2567468	FOUNDATION	PA	501(C)(3)	LINE 7	ST MARY MEDICAL CENTER		No
(209) ST MARY'S FOUNDATION INC 1230 BAXTER STREET ATHENS,GA30606 58-2544232	FUNDRAISING	GA	501(C)(3)	LINE 11B, II	ST MARY'S HEALTH CARE SYSTEM INC		No
(210) ST MARY'S HEALTH CARE SYSTEM INC 1230 BAXTER STREET ATHENS,GA30606 58-0566223	HOSPITAL	GA	501(C)(3)	LINE 3	CATHOLIC HEALTH EAST		No
(211) ST MARY'S HIGHLAND HILLS INC 1230 BAXTER STREET ATHENS,GA30606 02-0576648	ASSISTED LIVING & RETIREMENT COMMUNITY	GA	501(C)(3)	LINE 3	ST MARY'S HEALTH CARE SYSTEM INC		No
(212) ST MARY'S MEDICAL GROUP INC 1230 BAXTER STREET ATHENS,GA30606 26-1858563	HOSPITAL / PHYSICIAN SERVICES	GA	501(C)(3)	LINE 3	ST MARY'S HEALTH CARE SYSTEM INC		No
(213) ST MICHAEL'S FOUNDATION INC 111 CENTRAL AVENUE NEWARK,NJ07102 22-3311976	FOUNDATION	NJ	501(C)(3)	LINE 11A, I	SAINT MICHAELS MEDICAL CENTER		No
(214) ST PETER'S AUXILIARY 315 SOUTH MANNING BLVD ALBANY,NY12208 22-2843206	AUXILIARY	NY	501(C)(3)	LINE 11A, I	ST PETER'S HEALTH CARE SERVICES		No
(215) ST PETER'S HEALTH CARE SERVICES 315 SOUTH MANNING BLVD ALBANY,NY12208 22-2702507	MANAGEMENT & SUPPORT SERVICES	NY	501(C)(3)	LINE 9	ST PETER'S HEALTH PARTNERS		No
(216) ST PETER'S HEALTH PARTNERS 315 SOUTH MANNING BLVD ALBANY,NY12208 45-3570715	MANAGEMENT & SUPPORT SERVICES	NY	501(C)(3)	LINE 11B, II	CATHOLIC HEALTH EAST		No
(217) ST PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES PC 315 SOUTH MANNING BLVD ALBANY,NY12208 46-1177336	PHYSICIANS PRACTICE	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS		No
(218) ST PETER'S HOSPITAL 315 SOUTH MANNING BLVD ALBANY,NY12208 14-1348692	HOSPITAL	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH CARE SERVICES		No
(219) ST PETER'S HOSPITAL FOUNDATION INC 319 SOUTH MANNING BLVD SUITE 114 ALBANY,NY12208 22-2262982	FUNDRAISING & PUBLIC RELATIONS	NY	501(C)(3)	LINE 7	ST PETER'S HEALTH CARE SERVICES		No
(220) SUNNYVIEW HOSPITAL & REHABILITATION CENTER FOUNDATION 1270 BELMONT AVE SCHENECTADY,NY12308 22-2505127	SUPPORTING FOUNDATION	NY	501(C)(3)	LINE 11A, I	SUNNYVIEW HOSPITAL & REHABILITATION CTR		No
(221) SUNNYVIEW HOSPITAL & REHABILITATION CTR 1270 BELMONT AVE SCHENECTADY,NY12308 14-1338386	REHABILITATION HOSPITAL	NY	501(C)(3)	LINE 3	NORTHEAST HEALTH INC		No
(222) THE COMMUNITY HOSPICE FOUNDATION INC 295 VALLEY VIEW BLVD RENSSELAER,NY12144 22-2692940	FUNDRAISING & PUBLIC RELATIONS	NY	501(C)(3)	LINE 7	THE COMMUNITY HOSPICE INC		No
(223) THE COMMUNITY HOSPICE INC 295 VALLEY VIEW BLVD RENSSELAER,NY12144 14-1608921	SERVING SERIOUSLY ILL PEOPLE & THEIR FAMILIES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH CARE SERVICES		No
(224) THE FOUNDATION OF SAINT JOSEPH REGIONAL MEDICAL CENTER 4215 EDISON LAKES PARKWAY MISHAWAKA,IN46545 35-1654543	SUPPORT SERVICES OF RELATED HOSPITAL	IN	501(C)(3)	LINE 11A, I	SAINT JOSEPH REGIONAL MEDICAL CENTER INC		No
(225) THE MARJORIE DOYLE ROCKWELL CENTER INC 421 WEST COLUMBIA ST COHOES,NY12047 14-1793885	ADULT HOME/ALZHEIMERS	NY	501(C)(3)	LINE 9	LTC (EDDY) INC		No
(226) THE NORTHEAST HEALTH FOUNDATION INC 2224 BURDETT AVE TROY,NY12180 22-2743478	SUPPORTING FOUNDATION	NY	501(C)(3)	LINE 7	NORTHEAST HEALTH INC		No
(227) TRI-COUNTY HUMAN SERVICES CENTER INC 3805 WEST CHESTER PIKE NO 100 NEWTOWN SQUARE,PA19073 23-1938528	BEHAVIORAL HEALTH ORGANIZATION	PA	501(C)(3)	LINE 7	MAXIS HEALTH SYSTEM		No
(228) TRI-HOSPITAL EMERGENCY MEDICAL SERVICES 309 GRAND RIVER PORT HURON,MI48060 38-2485700	PROVIDE EMERGENCY AMBULANCE SERVICES	MI	501(C)(3)	LINE 11D, III-O	N/A		No
(229) TRI-HOSPITAL MRI CENTER 4190 24TH AVENUE FORT GRATIOT,MI48054 38-2884297	MRI SERVICES	MI	501(C)(3)	LINE 3	TRINITY HEALTH-MICHIGAN		No
(230) TRINITY CONTINUING CARE SERVICES PO BOX 9184 FARMINGTON HILLS,MI48333 38-2559656	MANAGEMENT SERVICES FOR LONG TERM CARE AND SENIOR LIVING FACILITIES	MI	501(C)(3)	LINE 11A, I	CHE TRINITY INC (FKA TRINITY HEALTH CORP)		No
(231) TRINITY CONTINUING CARE SERVICES - INDIANA INC PO BOX 9184 FARMINGTON HILLS,MI48333 93-0907047	PROVIDES LONG-TERM CARE AND RESIDENTIAL HOUSING	IN	501(C)(3)	LINE 9	TRINITY CONTINUING CARE SERVICES		No
(232) TRINITY HEALTH - MICHIGAN 20555 VICTOR PARKWAY LIVONIA,MI48152 38-2113393	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 3	CHE TRINITY INC (FKA TRINITY HEALTH CORP)		No
(233) TRINITY HEALTH INTERNATIONAL 20555 VICTOR PARKWAY LIVONIA,MI48152 42-1253527	HEALTHCARE TRAINING AND SUPPORT SERVICES	MI	501(C)(3)	LINE 11A, I	CHE TRINITY INC (FKA TRINITY HEALTH CORP)		No
(234) 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	CHE TRINITY INC (FKA TRINITY HEALTH CORP)		No
(235) TRINITY HOME HEALTH SERVICES INC 17410 COLLEGE PARKWAY LIVONIA,MI48152 38-2621935	HOME HEALTH CARE SYSTEM MANAGEMENT SERVICES	MI	501(C)(3)	LINE 11A, I	CHE TRINITY INC (FKA TRINITY HEALTH CORP)		No
(236) UIHLEIN MERCY CENTER 185 OLD MILITARY ROAD TUPPER LAKE,NY12986 15-0532190	IN DISSOLUTION	NY	501(C)(3)	LINE 3	MERCY HEALTHCARE CENTER		No
(237) UNIVERSITY HEIGHTS PROPERTY COMPANY INC 111 CENTRAL AVENUE NEWARK,NJ07102 22-3100162	MEDICAL PROPERTY HOLDING COMPANY	NJ	501(C)(2)	N/A	SAINT MICHAELS MEDICAL CENTER		No
(238) VILLA MARY IMMACULATE 301 HACKETT BLVD ALBANY,NY12208 14-1438749	NURSING HOME & PHYSICAL REHAB	NY	501(C)(3)	LINE 3	ST PETER'S HOSPITAL		No
(239) VNA HOME HEALTH & HOSPICE 50 FODEN ROAD SOUTH PORTLAND,ME04106 01-0246804	HOME HEALTH & HOSPICE	ME	501(C)(3)	LINE 11A, I	MERCY HEALTH SYSTEM OF MAINE		No
(240) WARDE SERVICE CORPORATION INC 159 WOLF ROAD 3RD FLOOR ALBANY,NY12205 14-1732097	SUPPORTING & STRENGTHING THE MINISTRIES OF REL. SR. MERCY	NY	501(C)(3)	LINE 9	ST PETER'S HEALTH CARE SERVICES		No
(241) WESTSHORE HEALTH NETWORK 1820 44TH STREET KENTWOOD,MI49508 38-3280200	SUPPORT SERVICES	MI	501(C)(4)	N/A	MERCY HEALTH PARTNERS		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2013

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	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(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 V-UBI 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
(2) BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 31-1608125	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
(3) CATHERINE HORAN BUILDING LIMITED PARTNERSHIP 1221 MAIN STREET ROOM 108 HOLYOKE,MA01040 04-2723429	PROPERTY MANAGEMENT	MA	N/A
(4) CENTER FOR DIGESTIVE CARE LLC 5300 ELLIOTT DRIVE YPSILANTI,MI48197 03-0447062	PROVIDE GASTROINTESTINAL SERVICES	MI	N/A
(5) CENTRAL NEW JERSEY HEART SERVICES LLC 29 E 29TH STREET 2ND FLOOR BAYONNE,NJ07002 20-8525458	CARDIAC PROGRAM	NJ	N/A
(6) CENTRAL OHIO SLEEP MEDICINE LTD 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1701029	SLEEP MEDICINE SERVICES	OH	N/A
(7) CLINTON IMAGING SERVICES LLC 615 VALLEY VIEW DR STE 202 MOLINE,IL61265 41-2044739	MRI DIAGNOSTIC SERVICES	IA	N/A
(8) EAST NORRITON MEDICAL ASSOCIATES ONE WEST ELM STREET CONSHOHOCKEN,PA19428 23-2319531	MEDICAL OFFICE BUILDING	PA	N/A
(9) FOREST PARK IMAGING LLC 1000 4TH STREET SW MASON CITY,IA50401 13-4365966	X-RAY AND MAMMOGRAPHY SERVICES	IA	N/A
(10) FRANCES WARDE MEDICAL LABORATORY 300 WEST TEXTILE ROAD ANN ARBOR,MI48104 38-2648446	LABORATORY	MI	N/A
(11) FRESNO IMAGING CENTER 1303 E HERNDON AVE FRESNO,CA93720 77-0363563	DIAGNOSTIC IMAGING	CA	N/A
(12) GATEWAY HEALTH PLAN 300 GRANT STREET PITTSBURGH,PA15219 25-1691945	MEDICAID & MEDICARE/SPECIAL NEEDS MANAGED CARE ORGANIZATION	PA	N/A
(13) HAWARDEN REGIONAL HEALTH CLINICS LLC 1122 AVENUE L HAWARDEN,IA51023 20-1444339	MEDICAL CLINIC	IA	N/A
(14) IDAHO GYNONCOLOGY SERVICES LLC 1055 N CURTIS RD BOISE,ID83706 20-2975807	PROVIDE GYN ONCOLOGY SERVICES	ID	N/A
(15) INTERMOUNTAIN MEDICAL IMAGING LLC 877 WEST MAIN ST STE 603 BOISE,ID83702 82-0514422	PROVIDE IMAGING SERVICES	ID	N/A
(16) LOYOLA AMBULATORY SURGERY CENTER 3000 RIVERCHASE GALLERIA STE 500 BIRMINGHAM,AL35244 36-4119522	SURGICAL SERVICES	IL	N/A
(17) MAGNETIC RESONANCE SERVICES PARTNERSHIP 1416 SIXTH STREET SW MASON CITY,IA50401 42-1328388	MRI SERVICES	IA	N/A
(18) MASON CITY AMBULATORY SURGERY CENTER LLC 990 4TH STREET SW MASON CITY,IA50401 20-1960348	SURGERY-SAME DAY	IA	N/A
(19) MCE MOB IV LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 42-1544707	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
(20) MEDILUCENT MOB I 793 W STATE STREET COLUMBUS,OH43222 20-4911370	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
(21) MERCY ADVANCED MRI LLC 2525 SOUTH MICHIGAN AVE CHICAGO,IL60616 26-2116721	SUBLEASE MRI EQUIPMENT	IL	N/A
(22) MERCY HEART CTR OP SERVICES LLC 1000 4TH STREET SW MASON CITY,IA50401 13-4237594	CARDIOVASCULAR SERVICES	IA	N/A
(23) MERCYMANOR PARTNERSHIP PO BOX 10086 TOLEDO,OH43699 52-1931012	NURSING HOME	PA	N/A
(24) MICHIANA HEALTH INFORMATION NETWORK LLC 215 WEST MADISON STREET SOUTH BEND,IN46601 35-2050128	COMMUNITY BASED CLINICAL INFO SYS & DATA DEPOSITORY	IN	N/A
(25) MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 31-1369473	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
(26) NAZARETH MEDICAL OFFICE BUILDING ASSOCIATES LP C/O NAZARETH HOSP 2601 HOLME AVE PHILADELPHIA,PA19152 23-2388040	MEDICAL OFFICE BUILDING	PA	N/A
(27) NEWCO AMBULATORY SURGERY CTR LLP 4190 24TH AVENUE FORT GRATIOT,MI48059 30-0136708	OUTPATIENT SURGERY CENTER	MI	N/A
(28) PHYSICIANS OUTPATIENT SURGERY CENTER LLC 1000 NE 56TH STREET OAKLAND PARK,FL33334 35-2325646	AMBULATORY SURGERY CENTER	FL	N/A
(29) SARMED OUTPATIENT PHARMACY LLC 999 N CURTIS RD STE 102 BOISE,ID83706 51-0483218	PHARMACY	ID	N/A
(30) SIXTY FOURTH STREET LLC 2373 64TH ST STE 2200 BYRON CENTER,MI49315 20-2443646	PROVIDE OUTPATIENT SURGICAL CARE	MI	N/A
(31) SJV MANAGEMENT LLC 200 CENTURY PKWY STE 200E MOUNT LAUREL,NJ08054 20-2273476	RADIOLOGY	NJ	N/A
(32) SMMC MOB II LP 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 36-4559869	INVESTMENT AND OPERATION OF A MEDICAL BUILDING	PA	N/A
(33) ST AGNES LONG-TERM INTENSIVE CARE LLP C/O MHS ONE WEST ELM ST STE 100 CONSHOHOCKEN,PA19428 20-0984882	LONG TERM INTENSIVE CARE	PA	N/A
(34) ST ALPHONSUS CALDWELL CANCER CTR LLC 3123 MEDICAL DR CALDWELL,ID83605 82-0526861	RADIATION ONCOLOGY	ID	N/A
(35) ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 31-1603660	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
(36) ST PETER'S AMBULATORY SURGERY CENTER LLC 1375 WASHINGTON AVENUE STE 201 ALBANY,NY12206 46-0463892	OUTPATIENT SURGERY	NY	N/A
(37) TAMARACK MEDICAL CLINIC LLC 402 OLD STATE HWY CASCADE,ID83611 20-1637921	OUTPATIENT MEDICAL SERVICES	ID	N/A
(38) THE AMBULATORY SURGERY CENTER AT ST MARY LLC 1203 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2871206	OUTPATIENT SURGERY	PA	N/A
(39) WESTERN MASSACHUSETTS PETCT IMAGING CENTER LLC 100 BAYVIEW CIRCLE STE 400 NEWPORT BEACH,CA92660 20-4744663	OUTPATIENT MEDICAL SERVICES	DE	N/A
(40) WOODLAND IMAGING CENTER LLC 5301 E HURON RIVER DR ANN ARBOR,MI48106 76-0820959	RADIOLOGY/IMAGING	MI	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) AFFILIATED MANAGEMENT SERVICES CORPORATION INC 1300 MASSACHUSETTS AVENUE TROY,NY12180 14-1668024	REAL ESTATE	NY	N/A	C					No
(2) CARBONDALE AREA PHYSICIANS' ASSOCIATION PC 100 LINCOLN AVE CARBONDALE,PA18407 23-2801677	MEDICAL INSURANCE CONTRACTING	PA	N/A	C					No
(3) CARBONDALE AREA PHYSICIANS' PHO INC 100 LINCOLN AVE CARBONDALE,PA18407 23-2801676	INACTIVE	PA	N/A	C					No
(4) CARBONDALE PHYSICIANS' SERVICES INC 100 LINCOLN AVE CARBONDALE,PA18407 23-2365077	PHARMACY	PA	N/A	C					No
(5) CATHERINE HORAN BUILDING INC C/O SPHS 1221 MAIN STREET SUITE 108 HOLYOKE,MA01040 04-2938160	BUILDING MANAGEMENT	MA	N/A	C					No
(6) CATHOLIC HEALTH EAST SENIOR SERVICES 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 37-1572595	SENIOR SERVICES	PA	N/A	C					No
(7) CHESTNUT RISK SERVICES LTD 11 VICTORIA STREET HAMILTON BD	INSURANCE	BD	N/A	C					No
(8) COMMUNITY HEALTH VENTURES INC 565 W WESTERN AVE MUSKEGON,MI49440 38-3522260	SOFTWARE MARKETING	MI	N/A	C					No
(9) DIVERSIFIED COMMUNITY SERVICES INC C/O SPHS 1221 MAIN STREET SUITE 108 HOLYOKE,MA01040 04-3128890	MEDICAL SERVICES	MA	N/A	C					No
(10) GATEWAY HEALTH PLAN INC 600 GRANT STREET PITTSBURGH,PA15219 25-1505506	HEALTH CARE	PA	N/A	C					No
(11) GATEWAY HEALTH PLAN INC OF OHIO 600 GRANT STREET PITTSBURGH,PA15219 30-0282076	HEALTH CARE	PA	N/A	C					No
(12) GEORGIA HEALTH ENTERPRISES LLC 1230 BAXTER STREET ATHENS,GA30606 54-1806329	HEALTHCARE	GA	N/A	C					No
(13) GHE PHYSICIANS PC 3500 PIEDMONT ROAD ATLANTA,GA30305 58-2277939	PRACTICE MANAGEMENT	GA	N/A	C					No
(14) GOTTLIEB MANAGEMENT SERVICES INC 701 W NORTH AVE MELROSE PARK,IL60160 36-3330529	MANAGEMENT SERVICES	IL	N/A	C					No
(15) HACKLEY HEALTH MANAGEMENT CENTER 1415 LEAHY ST MUSKEGON,MI49442 38-2961814	WEIGHT MANAGEMENT	MI	N/A	C					No
(16) HACKLEY HEALTH VENTURES INC 1415 LEAHY ST MUSKEGON,MI49442 38-2589959	OTHER MEDICAL SERVICES	MI	N/A	C					No
(17) HACKLEY HEALTHCARE EQUIPMENT 1415 LEAHY ST MUSKEGON,MI49442 38-2578569	HOME MEDICAL EQUIPMENT	MI	N/A	C					No
(18) HACKLEY PROFESSIONAL CENTER 1415 LEAHY ST MUSKEGON,MI49442 38-3024797	REAL ESTATE RENTAL	MI	N/A	C					No
(19) HACKLEY PROFESSIONAL PHARMACY 1415 LEAHY ST MUSKEGON,MI49442 38-2447870	PHARMACY	MI	N/A	C					No
(20) HEALTH MANAGEMENT SERVICES ORG INC 500 GROVE STREET SUITE 100 HADDON HEIGHTS,NJ08035 22-3366580	HEALTH CARE BILLING	NJ	N/A	C					No
(21) HEF INC 1415 LEAHY ST MUSKEGON,MI49442 38-3086401	OFFICE STAFFING	MI	N/A	C					No
(22) HOLY CROSS PRIVATE HOME SERVICES CORP 11801 TECH ROAD SILVER SPRING,MD20904 52-1986562	HOME CARE SERVICES	MD	N/A	C					No
(23) HPC CO-OWNERS ASSOCIATION 1700 CLINTON MUSKEGON,MI49442 27-0734448	CONDOMINIUM ASSOCIATION	MI	HACKLEY HEALTH VENTURES INC	C	19	109,365	25.000 %	Yes
(24) HURON ARBOR CORPORATION 5301 EAST HURON RIVER DR PO BOX 992 ANN ARBOR,MI48106 38-2475644	PROVIDES OFFICE RENTAL SPACE	MI	N/A	C					No
(25) IHA AFFILIATION CORPORATION 24 FRANK LLOYD WRIGHT DR LOBBY J ANN ARBOR,MI48106 38-3188895	MEDICAL MANAGEMENT	MI	N/A	C					No
(26) JEANNETTE MEDICAL PROVIDERS 3805 WEST CHESTER PIKE NEWTOWN SQUARE,PA19073 25-1787334	HOLDING COMPANY	PA	N/A	C					No
(27) JEANNETTE OBGYN GROUP 1 INC 3805 WEST CHESTER PIKE NEWTOWN SQUARE,PA19073 23-2890748	HOLDING COMPANY	PA	N/A	C					No
(28) JEANNETTE PRIMARY CARE GROUP 1 INC 3805 WEST CHESTER PIKE NEWTOWN SQUARE,PA19073 23-2890743	HOLDING COMPANY	PA	N/A	C					No
(29) LANGHORNE SERVICES II INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 25-3795549	GENERAL PARTNER OF LMOB PARTNERS, II	PA	N/A	C					No
(30) LANGHORNE SERVICES INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2625981	GENERAL PARTNER OF LMOB PARTNERS,	PA	N/A	C					No
(31) LIFECARE PHYSICIANS PC 601 HAMILTON AVENUE TRENTON,NJ08629 26-1649038	HEALTH CARE SERVICES	NJ	N/A	C					No
(32) LOURDES MEDEICAL ASSOCIATES PA 500 GROVE STREET SUITE 100 HADDON HEIGHTS,NJ08035 22-3361862	MEDICAL SERVICES	NJ	N/A	C					No
(33) MARYLAND CARE GROUP INC 11801 TECH ROAD SILVER SPRING,MD20904 52-1815313	HEALTHCARE HOLDING	MD	N/A	C					No
(34) MCMC EASTWICK INC C/O MHS ONE WEST ELM STREET STE 100 CONSHOHOCKEN,PA19428 23-2184261	MEDICAL OFFICE BUILDINGS	PA	N/A	C					No
(35) MEDNOW INC 1512 12TH AVENUE ROAD NAMPA,ID83686 82-0389927	OUTPATIENT PHARMACY	ID	N/A	C					No
(36) MERCY INPATIENT MEDICAL ASSOCIATES INC C/O SPHS 1221 MAIN STREET SUITE 108 HOLYOKE,MA01040 04-3029929	MEDICAL SERVICES	MA	N/A	C					No
(37) MERCY MEDICAL SERVICES 801 5TH STREET SIOUX CITY,IA51101 42-1283849	PRIMARY CARE PHYSICIANS	IA	N/A	C					No
(38) MERCY SERVICES CORPORATION 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-3227348	DORMANT	IL	N/A	C					No
(39) MICHIGAN ATHLETIC CLUB 2500 BURTON GRAND RAPIDS,MI49546 38-2647304	ATHLETIC CLUB	MI	N/A	C					No
(40) MOUNT CARMEL HEALTH PROVIDERS INC 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1382442	MEDICAL SERVICES	OH	N/A	C					No
(41) NORTH IOWA MERCY MEDICAL SERVICES INC 1000 4TH ST SW MASON CITY,IA50401 42-1382308	MEDICAL SERVICES	IA	N/A	C					No
(42) NURSING NETWORK INC 4725 NORTH FEDERAL HIGHWAY FORT LAUDERDALE,FL33308 59-1145192	MEDICAL SERVICES	FL	N/A	C					No
(43) PHYSICIANS MEDICAL OFFICE BUILDING CONDOMINIUM TRUST 1221 MAIN STREET ROOM 108 HOLYOKE,MA01040 04-6608649	PROPERTY MANAGEMENT	MA	N/A	C					No
(44) PRIORITY PLUS OF CALIFORNIA PO BOX 27230 FRESNO,CA93729 77-0395267	FORMERLY HLTH MGMT NOW DISCONTINUED OPERATIONS	CA	N/A	C					No
(45) PROVIDENCE HOME CARE INC C/O SPHS 1221 MAIN STREET SUITE 108 HOLYOKE,MA01040 04-3317426	HEALTH CARE SERVICES	MA	N/A	C					No
(46) SAINT ALPHONSUS PHYSICIANS PA 1055 NORTH CURTIS ROAD BOISE,ID83706 33-1078261	PHYSICIANS	ID	N/A	C					No
(47) SAINT MARY'S HEALTH MANAGEMENT COMPANY 1640 EAST PARIS SE GRAND RAPIDS,MI49546 38-3450733	ATHLETIC CLUB	MI	N/A	C					No
(48) SAMARITAN MEDICAL OFFICE BUILDING INC 2212 BURDETT AVENUE TROY,NY12180 14-1607244	REAL ESTATE	NY	N/A	C					No
(49) SJM PROPERTIES INC 411 CANISTEO STREET HORNELL,NY14843 16-1294991	PROPERTY HOLDINGS	NY	N/A	C					No
(50) ST MARY'S HIGHLAND HILLS VILLAGE INC 1230 BAXTER STREET ATHENS,GA30606 58-2276801	ASSISTED LIVING	GA	N/A	C					No
(51) STELLA MARIS INSURANCE COMPANY LIMITED PO BOX 69 GRAND CAYMAN,CAYMAN ISLANDSKY1-1102 CJ 98-0632008	INSURANCE	CJ	N/A	C					No
(52) SURGERY CENTER FINANCING CORPORATION 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1531102	FINANCE, INSURANCE AND REAL ESTATE	OH	N/A	C					No
(53) SYSTEM COORDINATED SERVICES INC C/O SPHS 1221 MAIN STREET SUITE 108 HOLYOKE,MA01040 04-2938181	LAB SERVICES	MA	N/A	C					No
(54) THRE SERVICES LLC 20555 VICTOR PARKWAY LIVONIA,MI48152 45-2603654	REAL ESTATE BROKERAGE SERVICES	MI	N/A	C					No
(55) TRINITY HEALTH EMPLOYEE BENEFIT TRUST 20555 VICTOR PARKWAY LIVONIA,MI48152 38-3410377	GRANTOR TRUST	MI	N/A	T					No
(56) VENZKE INSURANCE COMPANY LTD PO BOX 1051 GRAND CAYMAN GRAND CAYMAN CJ 98-0453602	PROVISION OF INSURANCE COVERAGE	CJ	N/A	C					No
(57) WEST SHORE PROFESSIONAL BUILDING CONDOMINIUM 1820 44TH STREET SE KENTWOOD,MI49508 38-2700166	CONDOMINIUM ASSOCIATION	MI	N/A	C					No
(58) WORKPLACE HEALTH OF GRAND HAVEN 1415 LEAHY ST MUSKEGON,MI49442 38-3112035	OCCUPATIONAL HEALTH	MI	N/A	C					No

Schedule R (Form 990) 2013

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

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 Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

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

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) TRINITY HEALTH - MICHIGAN	M	531,305	PER BOOKS
(2) TRINITY HEALTH - MICHIGAN	P	319,435	PER BOOKS
(3) TRINITY HEALTH CORPORATION	M	823,482	PER BOOKS
(4) TRINITY HEALTH CORPORATION	R	2,153,226	PER BOOKS
(5) MERCY HEALTH PARTNERS	B	157,467	PER BOOKS
(6) MERCY HEALTH PARTNERS	L	430,318	PER BOOKS
(7) MERCY HEALTH PARTNERS	M	5,739,996	PER BOOKS
(8) MERCY HEALTH PARTNERS	P	5,311,811	PER BOOKS
(9) HACKLEY LIFE COUNSELING	S	62,593	PER BOOKS
(10) HACKLEY PROFESSIONAL CENTER	P	63,612	PER BOOKS
(11) HACKLEY PROFESSIONAL CENTER	S	60,748	PER BOOKS
(12) MPC CO-OWNERS ASSOCIATION	Q	122,999	PER BOOKS
(13) MERCY HEALTH PARTNERS	R	-8,860,687	PER BOOKS

Schedule R (Form 990) 2013

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 V?UBI 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 V?UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2013

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE HEALTHCARE SERVICES
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	193
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,176,715	208,711
9	Program service revenue (Part VIII, line 2g) .........	175,326,899	86,055,040
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-1,642,839	1,343,211
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,978,393	1,290,020
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	177,839,168	88,896,982
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	7,700	220
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)	80,742,948	38,945,821
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–24e)....	91,444,673	45,682,320
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	172,195,321	84,628,361
19	Revenue less expenses. Subtract line 18 from line 12.......	5,643,847	4,268,621
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	106,210,118	0
21	Total liabilities (Part X, line 26).............	120,085,022	0
22	Net assets or fund balances. Subtract line 21 from line 20.....	-13,874,904	0

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 71,428,149 including grants of $ 220 ) (Revenue $ 87,393,394 )
	HACKLEY HOSPITAL IS A 201-BED, NOT-FOR-PROFIT HOSPITAL LOCATED IN THE CITY OF MUSKEGON, MICHIGAN, WITH A 100-YEAR TRADITION OF PROVIDING QUALITY MEDICAL SERVICES TO THE POPULATION OF WESTERN MICHIGAN.HACKLEY HOSPITAL PROVIDES HEALTH CARE SERVICES REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, OR THE ABILITY TO PAY. ALTHOUGH REIMBURSEMENT OF SERVICES RENDERED IS CRITICAL TO THE OPERATION AND FINANCIAL STABILITY OF HACKLEY HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS HAVE THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THE HOSPITAL'S MISSION, THE COMMUNITY IS PROVIDED THE FOLLOWING:1) FREE OR SUBSIDIZED MEDICAL CARE TO INCOME-ELIGIBLE PATIENTS,2) SUBSIDIZED CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS,3) DONATED COMMUNITY HEALTH ACTIVITIES AND PROGRAMS.SEE SCHEDULE H FOR MORE INFORMATION.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	MISSION:WE, CHE TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES.

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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses71,428,149

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,585,998	9,227,064	2,438,226

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		4,197
e	Government grants (contributions)1e		204,514

f	All other contributions, gifts, grants, and similar amounts not included above1f

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			208,711
			Business Code
2a	NET PATIENT SVC REV		622110	86,055,040	86,055,040
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			86,055,040
3	Investment income (including dividends, interest, and other similar amounts).......			319,800			319,800
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	406,993
b	Less: rental expenses	767,405
c	Rental income or (loss)	-360,412
d	Net rental income or (loss).......			-360,412			-360,412
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	468,695	554,716
b	Less: cost or other basis and sales expenses	0	0
c	Gain or (loss)	468,695	554,716
d	Net gain or (loss)..........			1,023,411			1,023,411
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		95,197
b	Less: cost of goods sold ..b		107,714
c	Net income or (loss) from sales of inventory..			-12,517			-12,517
Miscellaneous Revenue			Business Code
11a	OTHER RELATED REVENUE		622110	1,338,354	1,338,354
b	CAFETERIA		621110	324,595			324,595
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			1,662,949
12	Total revenue. See Instructions......			88,896,982	87,393,394	0	1,294,877


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			6,230	1	0
2	Savings and temporary cash investments .........			15,575	2	0
3	Pledges and grants receivable, net ...........				3	0
4	Accounts receivable, net .............			19,540,499	4	0
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6	0
7	Notes and loans receivable, net .............				7	0
8	Inventories for sale or use ..............			2,534,878	8	0
9	Prepaid expenses and deferred charges ..........			1,985,542	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	0
b	Less: accumulated depreciation .....	10b		32,028,397	10c	0
11	Investments—publicly traded securities ..........			22,165,441	11	0
12	Investments—other securities. See Part IV, line 11 .....			15,836,555	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 ...........			12,097,001	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)......			106,210,118	16	0
17	Accounts payable and accrued expenses .........			14,211,722	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	Loans and other 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 ..			72,314	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....................			105,800,986	25	0
26	Total liabilities. Add lines 17 through 25.........			120,085,022	26	0
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			-16,151,294	27	0
28	Temporarily restricted net assets ...........			1,343,769	28	0
29	Permanently restricted net assets ...........			932,621	29	0
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........			-13,874,904	33	0
34	Total liabilities and net assets/fund balances ........			106,210,118	34	0