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

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 07-01-2012 , 2012, and ending 06-30-2013
BCheck if applicable:
CName of organization
MERCY HEALTH PARTNERS
 
Doing Business As
SEE SCHEDULE O FOR LIST
 
Number and street (or P.O. box if mail is not delivered to street address)
1415 LEAHY STREET
 
Room/suite
City or town, state or country, and ZIP + 4
MUSKEGON, MI49442
D Employer identification number

38-2589966
E Telephone number

G Gross receipts $ 308,478,201
F Name and address of principal officer:
ROGER SPOELMAN
1415 LEAHY STREET
MUSKEGON,MI49442
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MERCY-HEALTHPARTNERS.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1984
M State of legal domicile: MI
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE ACUTE HEALTHCARE SERVICES AND HEALTHCARE SYSTEM SUPPORT
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 14
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 2011 (Part V, line 2a) ...... 5 3,932
6 Total number of volunteers (estimate if necessary) ............. 6 147
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 4,563,977
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -2,979,445
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,028,643 1,511,266
9 Program service revenue (Part VIII, line 2g) ......... 286,742,522 292,694,226
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 658,862 1,642,161
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 9,334,817 10,531,743
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 297,764,844 306,379,396
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 248,803 119,261
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) 154,122,021 159,055,383
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 54,000 54,000
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet54,000    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 138,123,722 144,023,850
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 292,548,546 303,252,494
19 Revenue less expenses. Subtract line 18 from line 12....... 5,216,298 3,126,902
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 210,360,851 210,605,498
21 Total liabilities (Part X, line 26)............. 86,984,312 86,423,769
22 Net assets or fund balances. Subtract line 21 from line 20..... 123,376,539 124,181,729
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III ...............
1
Briefly describe the organization’s mission: TO PROVIDE ACUTE HEALTHCARE SERVICES AND HEALTHCARE SYSTEM SUPPORT - SEE SCHEDULE H FOR MORE INFORMATION
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 269,898,295 including grants of $ 119,261 ) (Revenue $ 298,692,587 )
MERCY HEALTH PARTNERS OPERATES TWO NOT FOR PROFIT HOSPITALS TOTALING 200-BEDS LOCATED IN THE CITY OF MUSKEGON, MICHIGAN.MERCY HEALTH PARTNERS 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 MERCY HEALTH PARTNERS, 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.MERCY HEALTH PARTNERS ALSO GOVERNS AND MANAGES ITS SUBSIDIARIES, WHICH INCLUDE HOSPITAL ORGANIZATIONS EXEMPT UNDER SECTION 501(C)(3). THESE HOSPITALS PROVIDE NEEDED HEALTHCARE SERVICES TO THE COMMUNITIES IN WHICH THEY ARE LOCATED, AND SHARE MERCY HEALTH PARTNERS' MISSION STATEMENT.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
MISSION:THE MISSION STATEMENT FOR MERCY HEALTH PARTNERS IS AS FOLLOWS: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 expensesMediumBullet269,898,295
Form 990 (2012)
Form 990 (2012)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If “Yes,” complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions).... Click to see attachment
17
Yes
 
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H.... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............. Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V ...............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
438
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
1
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
3,932
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI ...............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
14
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
9
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletTAMARA RICCO1820 44TH STREET SEKENTWOODMI49508 (616) 685-3573
Form 990 (2012)
Form 990 (2012)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII ...............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) ROGER SPOELMAN........................................................................
W. MI REG. PRES. AND CEO; TRUSTEE
 25.00
.......................25.00 		X   X       0 724,012 125,216
(2) MICHAEL GLUHANICH........................................................................
CHAIR; TRUSTEE
 2.00
.......................   		X   X       0 0 0
(3) T BRUCE FOX........................................................................
SECRETARY & TREASURER; TRUSTEE
 2.00
.......................   		X   X       0 0 0
(4) PHILIP MCCORKLE........................................................................
TRUSTEE; ST MARYS HEALTH CARE CEO
 2.00
.......................48.00 		X           0 653,026 57,962
(5) MARK FAZAKERLEY........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(6) SR MYRA BERGMAN RSM........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(7) FRANK BEDNAREK........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(8) DANA BRYANT........................................................................
TRUSTEE THROUGH 12/12
 2.00
.......................   		X           0 0 0
(9) YOUSIF HAMATI MD........................................................................
TRUSTEE
 2.00
.......................   		X           16,800 0 0
(10) CAMILLE S JOURDEN-MARK........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(11) MICHAEL K OLTHOFF........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(12) SR MARY D PALASZEKRSM........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(13) GREGORY C PITTMAN JD........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(14) REV TIMOTHY VANDER HAAR........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(15) AMY HEISSER........................................................................
TRUSTEE AS OF 3/13
 2.00
.......................   		X           0 0 0
(16) GREGORY LOOMIS........................................................................
MHP INTERIM CEO
 25.00
.......................25.00 		    X       0 368,881 52,203
(17) GARY ALLORE........................................................................
W. MI REGIONAL CFO
 25.00
.......................25.00 		    X       0 334,125 39,015
Form 990 (2012)
Form 990 (2012)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (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) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) JOSEPH SWEDISH........................................................................
TRINITY HLTH PRES & CEO THROUGH 3/13
 2.00
.......................53.00 		      X     0 3,233,500 601,476
(19) KEDRICK ADKINS........................................................................
TRINITY PRES INTEG SYS THROUGH 6/13
 2.00
.......................53.00 		      X     0 1,821,619 126,167
(20) J RICHARD O'CONNELL........................................................................
PRES, EVP, TRINITY HEALTH DIV.
 2.00
.......................53.00 		      X     0 1,036,410 130,423
(21) F REMINGTON SPRAGUE........................................................................
VP PRIMARY CARE SERVICES
 25.00
.......................25.00 		      X     0 413,646 52,036
(22) MARY BOYD........................................................................
MHP VP NETWORK DEV
 25.00
.......................25.00 		      X     0 333,380 43,063
(23) JEFFREY ALEXANDER........................................................................
MHP VP INTEGRATED SERVICES
 25.00
.......................25.00 		      X     0 296,754 30,781
(24) KIMBERLY MAGUIRE........................................................................
MHP VP PATIENT CARE
 25.00
.......................25.00 		      X     0 254,309 36,450
(25) DAVID BONNEMA........................................................................
PHYSICIAN
 50.00
.......................   		        X   647,124 0 38,983
(26) IONUT ORAVITAN........................................................................
PHYSICIAN
 50.00
.......................   		        X   617,505 0 42,316
(27) ERIC STUART........................................................................
PHYSICIAN
 50.00
.......................   		        X   594,826 0 42,246
(28) MARK MEENGS........................................................................
PHYSICIAN
 50.00
.......................   		        X   580,475 0 40,558
(29) CHARLES ZICKUS........................................................................
PHYSICIAN
 50.00
.......................   		        X   569,032 0 39,502
(30) MICHAEL MURPHY........................................................................
FORMER KEY EMPLOYEE
 0.00
.......................   		          X 0 180,882 16,630
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 3,025,762 9,650,544 1,515,027
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet220
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
LAKESHORE ANESTHESIA SERVICES PC550 W WESTERN AVE STE BMUSKEGONMI48440 ANESTHESIA SERVICES 5,929,423
NINA JOHNSON MD PC740 LAKE DRIVEMUSKEGONMI49445 HEALTH CARE SERVICES 2,148,616
SECURITAS SECURITY SERVICE USAPO BOX 403412ATLANTAGA30384 SECURITY SERVICES 1,244,311
CHRISTMAN AIMS COMPANY208 N CAPITOL AVENUELANSINGMI48933 CONSTRUCTION SERVICES 1,170,138
DAVITA DIALYSIS GHENT2000 16TH STDENVERCO80202 HEALTH CARE SERVICES 681,683
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet25
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 57,468
d Related organizations...1d 12,500
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		1,441,298
g Noncash contributions included in lines
1a-1f:$ 		163,319
h Total. Add lines 1a-1f.......MediumBullet 1,511,266
Program Service Revenue Business Code
2a NET PATIENT SVC REV 900099 286,649,058 286,649,058    
b PHARMACY REVENUE 446110 3,691,348 1,481,191 2,210,157  
c LABORATORY REV 621500 2,353,820   2,353,820  
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 292,694,226
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 1,218,384     1,218,384
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 1,140,889 3,176
b Less: rental expenses 1,693,135 0
c Rental income or (loss) -552,246 3,176
d Net rental income or (loss).......MediumBullet -549,070     -549,070
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 450,709 23,589
b Less: cost or other basis and sales expenses 0 50,521
c Gain or (loss) 450,709 -26,932
d Net gain or (loss)..........MediumBullet 423,777     423,777
8a Gross income from fundraising events (not including
$ 57,468
of contributions reported on line 1c). See Part IV, line 18 ..
a 104,014
b Less: direct expenses ...b 84,178
c Net income or (loss) from fundraising events..MediumBullet 19,836   19,836
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 9,983
b Less: direct expenses ...b 3,897
c Net income or (loss) from gaming activities...MediumBullet 6,086     6,086
10a Gross sales of inventory, less
returns and allowances .
a 258,279
b Less: cost of goods sold ..b 267,074
c Net income or (loss) from sales of inventory..MediumBullet -8,795     -8,795
Miscellaneous Revenue Business Code
11a MEDICARE/MEDICAID HIT 900099 2,188,156 2,188,156    
b CAFETERIA 900099 501,348     501,348
c            
d All other revenue .... 8,374,182 8,374,182    
e Total. Add lines 11a–11d ...... MediumBullet 11,063,686
12 Total revenue. See Instructions......MediumBullet 306,379,396 298,692,587 4,563,977 1,611,566
Form 990 (2012)
Form 990 (2012)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response to any question in this Part IX ...............
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 21 119,261 119,261
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 .... 3,320,912   3,320,912  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 74,481 74,481    
7 Other salaries and wages 126,328,922 111,886,369 14,442,553  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 7,833,329 6,958,748 874,581  
9 Other employee benefits ....... 13,162,411 11,472,449 1,689,962  
10 Payroll taxes ........... 8,335,328 7,211,726 1,123,602  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 907,092   907,092  
c Accounting ........... 4,613   4,613  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17 54,000 54,000
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 9,818,870 8,506,231 1,312,639  
12 Advertising and promotion .... 37,194 32,180 5,014  
13 Office expenses ....... 3,137,494 2,714,560 422,934  
14 Information technology ...... 13,128,129 11,358,457 1,769,672  
15 Royalties ..        
16 Occupancy ........... 8,230,149 7,120,725 1,109,424  
17 Travel ............ 184,100 159,283 24,817  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 650,847 563,113 87,734  
20 Interest ........... 1,536,421 1,536,421    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 12,400,265 10,728,709 1,671,556  
23 Insurance .............. 2,230,603 1,929,918 300,685  
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 46,126,353 46,126,353    
b INTERCO PURCH SVCS 15,232,029 13,178,751 2,053,278  
c BAD DEBT 13,568,599 13,568,599    
d HOSPITAL PROVIDER TAX 6,693,412 6,693,412    
e All other expenses 10,137,680 7,958,549 2,179,131  
25 Total functional expenses. Add lines 1 through 24e 303,252,494 269,898,295 33,300,199 54,000
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 1,888,433 1 1,066,226
2 Savings and temporary cash investments ......... 14,900 2 14,904
3 Pledges and grants receivable, net ........... 782,876 3 1,309,402
4 Accounts receivable, net ............. 29,895,190 4 27,022,394
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  
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  
7 Notes and loans receivable, net ............. 25,648,440 7 14,326,776
8 Inventories for sale or use .............. 4,493,729 8 3,296,026
9 Prepaid expenses and deferred charges .......... 1,995,170 9 1,156,606
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 210,501,464
b Less: accumulated depreciation ..... 10b 162,120,066 49,600,455 10c 48,381,398
11 Investments—publicly traded securities .......... 20,369,576 11 39,673,794
12 Investments—other securities. See Part IV, line 11 ..... 29,797,183 12 35,622,099
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ............... 2,071,243 14 3,217,986
15 Other assets. See Part IV, line 11 ........... 43,803,656 15 35,517,887
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 210,360,851 16 210,605,498
Liabilities 17 Accounts payable and accrued expenses ......... 31,521,112 17 32,372,669
18 Grants payable .................   18  
19 Deferred revenue ................ 56,399 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 .. 35,643 23 70,716
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.................... 55,371,158 25 53,980,384
26 Total liabilities. Add lines 17 through 25......... 86,984,312 26 86,423,769
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 120,773,633 27 121,151,317
28 Temporarily restricted net assets ........... 2,602,906 28 3,030,412
29 Permanently restricted net assets ...........   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 123,376,539 33 124,181,729
34 Total liabilities and net assets/fund balances ........ 210,360,851 34 210,605,498
Form 990 (2012)
Form 990 (2012)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI ...............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
306,379,396
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
303,252,494
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
3,126,902
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
123,376,539
5
Net unrealized gains (losses) on investments ...............
5
352,325
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-2,674,037
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
124,181,729
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII ..............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
3b
 
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

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

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
MERCY HEALTH PARTNERS
 
Employer identification number

38-2589966
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
 
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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).            
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to 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) 2012

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2012
Name of the organization
MERCY HEALTH PARTNERS
 
Employer identification number

38-2589966
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 2
Name of organization
MERCY HEALTH PARTNERS
  		Employer identification number

38-2589966
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 3
Name of organization
MERCY HEALTH PARTNERS
  		Employer identification number

38-2589966
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 4
Name of organization
MERCY HEALTH PARTNERS
  		Employer identification number

38-2589966
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2012
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
MERCY HEALTH PARTNERS
 
Employer identification number

38-2589966
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

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

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

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










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2012

Schedule C (Form 990 or 990-EZ) 2012
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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2009 (b) 2010 (c) 2011 (d) 2012 (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) 2012


Schedule C (Form 990 or 990-EZ) 2012
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)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
26,934
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
10,314
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
37,248
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) 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."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; 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.
Identifier Return Reference Explanation
EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: MERCY HEALTH PARTNERS HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO NATIONAL AND REGIONAL ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED MERCY HEALTH PARTNERS WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. MERCY HEALTH PARTNERS ALSO PAID THIRD PARTY LOBBYING FIRMS DURING THE YEAR TO LOBBY FOR OR AGAINST LEGISLATION DETERMINED TO BE OF INTEREST TO MERCY HEALTH PARTNERS.
Schedule C (Form 990 or 990EZ) 2012

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MERCY HEALTH PARTNERS
 
Employer identification number

38-2589966
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds 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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a 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.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
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.
1a
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.
b
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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part 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 ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   1,358,525 1,358,525
b Buildings ................   88,629,583 59,025,564 29,604,019
c Leasehold improvements ............        
d Equipment ................   115,803,872 102,348,298 13,455,574
e Other .................   4,709,484 746,204 3,963,280
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 48,381,398
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 		10,904,724 F

(B) EQUITY METHOD INVESTMENTS 		13,085,669 C

(C) HEDGE FUNDS 		11,631,706 F






Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 35,622,099
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) MISCELLANEOUS RECEIVABLES 2,274,103
(2) INTERCOMPANY LONG TERM ASSETS 25,740,585
(3) OTHER LONG TERM ASSETS 301,380
(4) INVESTMENT IN UNCONSOLIDATED AFFILIATES 2,016,484
(5) INTERCOMPANY RECEIVABLES 5,185,335




Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 35,517,887
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
INTERCOMPANY NOTES PAYABLE 38,930,078
INTERCOMPANY ACCOUNTS PAYABLE 7,412,528
SHORT TERM GUARANTEES 1,474,692
DEFERRED COMPENSATION 2,208,163
ASSET RETIREMENT OBLIGATIONS (FIN 47) 3,041,738
LONG TERM GUARANTEES 913,185



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 53,980,384
2. Fin 48 (ASC 740) Footnote. 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) 2012

Schedule D (Form 990) 2012
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part 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
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
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Schedule D (Form 990) 2012

Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. Form 990-EZ filers are not required to complete this part. right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MERCY HEALTH PARTNERS
 
Employer identification number

38-2589966
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
 
HILLARY LYONS ASSOC
PO BOX 99
 
DIMONDALE, MI48821 		CONSULTS ON MAJOR GIFT SOLICITATIONS   No 1,222,920 54,000 1,168,920
             
             
             
             
             
             
             
             
             
Total .................right arrow 1,222,920 54,000 1,168,920
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
MI
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2012
Schedule G (Form 990 or 990-EZ) 2012
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

BENEFIT BALL
(event type) 		(b) Event #2

GOLFIN FOR GIRLS
(event type) 		(c) Other events

2
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 85,104 16,771 59,607 161,482
2 Less: Contributions . . 15,199 1,946 40,323 57,468
3 Gross income (line 1
minus line 2) . . . 		69,905 14,825 19,284 104,014
VerticalDirectExpenses 4 Cash prizes . . .   518   518
5 Noncash prizes . . 2,054 651 3,475 6,180
6 Rent/facility costs . . 2,600     2,600
7 Food and beverages . 32,280 2,266 7,622 42,168
8 Entertainment . . . 2,500 5,096   7,596
9 Other direct expenses . 12,861 1,279 10,976 25,116
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 84,178
11 Net income summary. Combine line 3, column (d), and line 10. .......... right arrow 19,836
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2012
Schedule G (Form 990 or 990-EZ) 2012
Page 3
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Identifier Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2012
Additional Data


Software ID:  
Software Version:  
SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MERCY HEALTH PARTNERS
 
Employer identification number

38-2589966
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: .........
3b
Yes
 
%
c
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.
4
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"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		1 14,303 9,680,875 1,377,924 8,302,951 2.870 %
b Medicaid (from Worksheet 3,
column a) .... 		1 51,131 30,165,563 23,744,702 6,420,861 2.220 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		2 3,308 1,331,815 337,209 994,606 0.340 %
d Total Financial Assistance
and Means-Tested
Government Programs . 		4 68,742 41,178,253 25,459,835 15,718,418 5.430 %
Other Benefits
 29 32,624 1,830,609   1,830,609 0.630 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		2 50 2,102,712 1,251,693 851,019 0.290 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7) 1   739   739 0 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		2 40 14,747   14,747 0.010 %
j Total. Other Benefits .. 34 32,714 3,948,807 1,251,693 2,697,114 0.930 %
k Total. Add lines 7d and 7j . 38 101,456 45,127,060 26,711,528 18,415,532 6.360 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
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 18 51,440 60,238 5,810 54,428 0.020 %
4 Environmental improvements 1 105        
5 Leadership development and training for community members 1 52 379   379 0 %
6 Coalition building 1 130 121,936   121,936 0.040 %
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total 21 51,727 182,553 5,810 176,743 0.060 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
5,864,446
3
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. ......
3
1,791,588
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
75,889,566
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
95,265,345
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-19,375,779
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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.......................

9b

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 %
11 MUSKEGON SC LLC
  		AMBULATORY SURGERY CTR 34.480 % 11.490 % 54.030 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
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, and primary website address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 MERCY HEALTH PARTNERS MERCY CAMPUS
1500 E SHERMAN BLVD
MUSKEGON,MI49444
WWW.MERCYHEALTHMUSKEGON.COM 		X X   X     X      
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
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 MERCY CAMPUS
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A) 1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 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.................... 1 Yes  
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives 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 .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 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 ........ 7   No
8a 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)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c 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) 2012
Schedule H (Form 990) 2012
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
b
c
d
e
f
g
h
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
b
c
d
e
f
g
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 patient’s eligibility under the facility’s FAP:
a
b
c
d
e
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 patient’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
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?21
Name and address Type of Facility (describe)
1 MUSKEGON SURGERY CENTER
1400 MERCY DRIVE SUITE 150
MUSKEGON,MI49444 		OUTPATIENT SURGERY
2 JOHNSON FAMILY CENTER FOR CANCER CARE
1440 E SHERMAN BLVD
MUSKEGON,MI49444 		CANCER TREATMENT FACILITY
3 NORTON FAMILY PRACTICE
3535 PARK STREET SUITE 110
MUSKEGON,MI49444 		PRIMARY CARE PHYSICIAN OFFICE
4 WESTSHORE FAMILY MEDICINE
1223 MERCY DRIVE
MUSKEGON,MI49444 		PRIMARY CARE PHYSICIAN OFFICE
5 BEAR CREEK HEALTH CENTER
1877 N GETTY STREET
NORTH MUSKEGON,MI49445 		PRIMARY CARE PHYSICIAN OFFICE
6 HARBORWOOD FAMILY MEDICINE
1675 LEAHY STREET SUITE 301A
MUSKEGON,MI49442 		PRIMARY CARE PHYSICIAN OFFICE
7 HARBOUR POINTE MEDICAL ASSOCIATES
3587 HENRY STREET SUITE 200
MUSKEGON,MI49441 		PRIMARY CARE PHYSICIAN OFFICE
8 HARBORWOOD AT THE LAKES
6401 PRAIRIE STREET SUITE 1600
MUSKEGON,MI49444 		PRIMARY CARE PHYSICIAN OFFICE
9 NORTHSHORE FAMILY PRACTICE
1915 HOLTON ROAD
MUSKEGON,MI49445 		PRIMARY CARE PHYSICIAN OFFICE
10 MERCY WESTSHORE INTERNAL MEDICINE
1150 E SHERMAN BLVD SUITE 1100
MUSKEGON,MI49444 		PRIMARY CARE PHYSICIAN OFFICE
11 HART PAVILION
611 E MAIN STREET
HART,MI49420 		LAB, RADIOLOGY
12 GERIATRIC MEDICAL ASSOCIATES
1150 E SHERMAN BLVD SUITE 1125
MUSKEGON,MI49444 		PRIMARY CARE PHYSICIAN OFFICE
13 LAKES FAMILY MEDICINE
6207 HARVEY STREET
MUSKEGON,MI49444 		PRIMARY CARE PHYSICIAN OFFICE
14 MERCY HEART CENTER
1212 E SHERMAN BLVD
MUSKEGON,MI49444 		WELLNESS & REHABILITATION FACILITY
15 LAKESHORE FAMILY CARE
601 W SAVIDGE STREET
SPRING LAKE,MI49456 		PRIMARY CARE PHYSICIAN OFFICE
16 KINNEY & PARRETT FAMILY PRACTICE
1325 MERCY DRIVE
MUSKEGON,MI49444 		PRIMARY CARE PHYSICIAN OFFICE
17 HARBOUR VIEW FAMILY MEDICINE
1909 RUDDIMAN DRIVE
NORTH MUSKEGON,MI49445 		PRIMARY CARE PHYSICIAN OFFICE
18 ADULT MEDICINE SPECIALIST
6401 PRAIRIE STREET SUITE 2800
MUSKEGON,MI49444 		PRIMARY CARE PHYSICIAN OFFICE
19 WEST VIEW FAMILY MEDICINE
6401 PRAIRIE STREET SUITE 2600
MUSKEGON,MI49444 		PRIMARY CARE PHYSICIAN OFFICE
20 WOMEN'S HEALTH CENTER
1787 WAGNER
MUSKEGON,MI49444 		OBSTETRICS / GYNECOLOGY
21 SHORELINE ENT
1762 WAGNER
MUSKEGON,MI49442 		ENT PHYSICIAN OFFICE
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
8 Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
Identifier ReturnReference Explanation
    PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS.
    PART I, LINE 6A: MERCY HEALTH PARTNERS REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH IN ITS ANNUAL REPORT, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.IN ADDITION, MERCY HEALTH PARTNERS INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE.
    PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM.
    PART I, L7 COL(F): THE FOLLOWING NUMBER, $13,568,599, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F).
    PART II: COMMUNITY BUILDING ACTIVITIES - MERCY HEALTH IS ENGAGED IN THE COMMUNITY IN MANY WAYS. MERCY'S SISTER SIMONE COURTADE FUND PROVIDES GRANTS UP TO $10,000 TO SMALL NON-PROFITS THAT SERVE POOR AND UNDERSERVED POPULATIONS IN THE 3-COUNTY SERVICE AREA. THESE GRANTS ARE AWARDED TO ORGANIZATIONS THAT ADDRESS UNMET NEEDS IN THE COMMUNITIES. THE FY13 GRANTEES WERE:FIRST CONGREGATIONAL CHURCH SATURDAY MORNING BREAKFAST ADDRESSES FOOD INSECURITY OF UNDERSERVED POPULATION SEGMENTS IN THE NELSON NEIGHBORHOOD. SERVES A FREE WEEKLY BREAKFAST TO 280 PEOPLE. CATHOLIC CHARITIES LOAVES AND FISHES FOOD PANTRY PROVIDES FOOD AND REFERRALS TO 800 LOW-INCOME FAMILIES PER MONTH.CATHOLIC CHARITIES TEEN PARENT SERVICES PROVIDES HEALTH, PARENTING AND EDUCATION SERVICES TO TEENAGE PARENTS AND THEIR FAMILIES.CHRISTIANS FOR HEALTHCARE HEALTH ADVOCACY FOR LOW INCOME POPULATION SERVING AT-RISK PATIENTS WITH BP/DIABETES SCREENING AND REFERRAL TO PC HOMES.COMMUNITY ENCOMPASS MCLAUGHLIN GROWS FUNDING TO SUPPORT ORGANIC COMMUNITY FARM IN MCLAUGHLIN NEIGHBORHOOD. PROVIDES RESIDENTS ACCESS TO NUTRITIOUS, AFFORDABLE PRODUCE, FOSTERING A SENSE OF SOCIAL INTERACTION AND COMMUNITY. PRE- AND POST-TESTING IS PART OF MEASUREMENT IN THE EVALUATION SUCCESS. COMMUNITY ENCOMPASS SACRED SUDS PROVIDES LAUNDRY, SHOWER AND COMPUTER LAB ACCESS TO LOW-INCOME NEIGHBORHOOD; ORGANIZES NEIGHBORHOOD SELF-HELP AND AWARENESS PROJECTS.ESL MUSKEGON TUTOR-LEARNING ASSISTANT PROGRAM RECRUITS AND TRAINS NEW TUTORS UTILIZING THE LAUBACH ENGLISH AND READING CURRICULUM. EMPHASIS IS PLACED ON NON-ENGLISH SPEAKERS WITH AN OPTION OF STUDYING FOR THE CITIZENSHIP TEST. HOLTON COMMUNITY CENTER - HEALTH CHOICES PROGRAM ADDRESSES COMMUNITY HEALTH NEEDS BY PROVIDING FOOD PANTRY, COMMUNITY EDUCATION PROGRAMS, AND A COMMUNITY GARDEN. DEMONSTRATES COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS.LOVE INC HEALTHY EATING/HEALTHY LIVING PROVIDES THE APPLIANCES AND TRAINING NECESSARY TO RAISE THE NUTRITIONAL EDUCATIONAL LEVEL OF FAMILIES TO FOSTER STABILITY AND IMPROVED SCHOOL PERFORMANCE.MAP HEALTHY HELPING FOOD PANTRY DISTRIBUTES FOOD TO LOW-INCOME PEOPLE; PROVIDES HEALTHY EATING INFORMATION AND REFERRALS TO MSU EXTENSION FOR NUTRITION COUNSELING.MT. ZION COGIC CLUB 188PROVIDES MUSIC EDUCATION AND PERFORMANCE EXPERIENCE, MATH & READING PROGRAMS FOR STUDENTS AGES 5-8, PROMOTING CREATIVITY, COMMUNICATION, LEADERSHIP AND TEAMWORK SKILLS. KIDS FOOD BASKET SACK SUPPER PROGRAM IN MUSKEGON COUNTYPROVIDES SACK LUNCHES AT THE MARTIN LUTHER KING JR. ELEMENTARY SCHOOL. MAP COMMUNITY MEDICAL FUNDASSISTS 80 UNINSURED/UNDERINSURED PER MONTH TO OBTAIN PRESCRIPTION DRUGS, DURABLE MEDICAL EQUIPMENT AND SUPPLIES. MUSKEGON FAMILY WMCA YOUTH RECREATION PARKS PROGRAMTHE Y IS REPLACING A FOOD SERVICE AND RECREATION PROGRAM AT NEIGHBORHOOD PARKS NO LONGER OPERATED BY MUSKEGON HEIGHTS SCHOOL SYSTEM. THE 8-WEEK SUMMER PROGRAM SERVES 125-175 CHILDREN BETWEEN THE AGES OF 6 AND 16. THE MERCY HEALTH'S COLLABORATIVE, THE OCEANA COUNTY HEALTHCARE NEEDS AND OUTREACH SERVICES COMMITTEE MEETS AT THE LAKESHORE HOSPITAL TO BUILD A COMMUNITY OUTREACH & PLANNING FOR PREVENTION AND TREATMENT TO MEET THE HEALTH NEEDS OF UNDERSERVED RESIDENTS.SAFE KIDS WEST MICHIGAN IS A PROGRAM OF THE COMMUNITY DEVELOPMENT DEPARTMENT WORKING WITH WEST MICHIGAN FAMILIES TO PREVENT ACCIDENTAL INJURY TO CHILDREN AGES 0-14. COALITION BUILDINGTHE "COMMUNITY HEALTH IMPROVEMENT " PROGRAM INCLUDES COALITIONS LED BY MERCY HEALTH, TO DEVELOP COMMUNITY EFFORTS THAT ADDRESS HEALTH AND SAFETY ISSUES. THE MUSKEGON-OCEANA COUNTY HEALTH DISPARITIES REDUCTION COALITION WAS CONVENED IN 2010 TO ASSESS DISPARITIES IN ACCESS TO HEALTH CARE AND QUALITY OF CARE RELATING TO RACE, ETHNICITY AND LANGUAGE. THE COALITION COMPLETED A SECOND STRATEGIC ACTION PLAN IN AUGUST 2012 AND BEGAN IMPLEMENTING ITS PLAN IN FY13, STARTING IN JANUARY 2013. THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT NOTED DISPARITIES IN ACCESS TO CARE AND LANGUAGE SERVICES. SOCIAL SUPPORT SERVICES WERE ALSO NOTED AS SIGNIFICANT FACTORS CONTRIBUTING TO POOR HEALTH AMONG THE LOW-INCOME, UNINSURED AND MINORITY POPULATIONS OF MUSKEGON AND OCEANA COUNTIES. THE COALITION OF 59 INDIVIDUALS, REPRESENTING 33 COMMUNITY MEMBER ORGANIZATIONS FROM 3 COUNTIES, IS IN ITS THIRD YEAR OF A 3-YEAR GRANT AWARD TO IMPLEMENT ACTIVITIES AND PROGRAMS TO ADDRESS THE IDENTIFIED DISPARITIES. COALITION MEMBERS ARE CURRENTLY DISCUSSING PLANS FOR CONTINUING THE COALITION WITH SUSTAINING MEMBERS AND RESOURCES. THE COALITION WILL BE FOCUSING ON IMPROVED ACCESS TO CARE AND LANGUAGE SERVICES, HEALTH LITERACY, ASSURED QUALITY OF CARE AND SATISFACTORY PATIENT EXPERIENCE.THE HIV/AIDS COALITION IS SUPPORTED BY MERCY STAFF TO PROMOTE COMMUNITY AWARENESS, PUBLIC EDUCATION, AND TREATMENT RESOURCES. A STRATEGIC ACTION PLAN WAS COMPLETED IN 2011, AND PROGRESS IS BEING MADE ON IMPLEMENTING THE PLAN, STARTING WITH EXPANDING ITS MEMBERSHIP AND DEVELOPING PUBLIC AWARENESS EVENTS.HEALTH PROJECT'S AFRICAN AMERICAN LEADERSHIP TEAM WAS RECONVENED AND RE-CONSTITUTED IN 2012. IT IS IMPLEMENTING ITS 2012 STRATEGIC PLAN AND ASSISTING THE HOSPITAL SYSTEM IN DEVELOPING PROGRAMS AND PROCEDURES THAT AFFECT AFRICAN AMERICANS. DIABETES, HYPERTENSION, MENTAL HEALTH, HEALTH LITERACY AND PROVIDER CULTURAL COMPETENCY ARE ISSUES IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT AND CITED IN THE IMPLEMENTATION STRATEGY.DFC MUSKEGONTHE COALITION FOR A DRUG FREE MUSKEGON COUNTY CONTINUES ITS 8TH YEAR TO SUPPORT PREVENTION INITIATIVES TO REDUCE ALCOHOL, TOBACCO, AND OTHER DRUG USE OF MUSKEGON COUNTY YOUTH AND THEIR FAMILIES. THE COALITION CONVENES SIX ACTIVE SUBGROUPS FOCUSING ON DATA AND ACTIVE ISSUE-ORIENTED INITIATIVES.MUSKEGON ALCOHOL LIABILITY INITIATIVE (ALI)MUSKEGON ALI SUPPORTS ENHANCED LAW ENFORCEMENT EFFORTS AIMED AT ALCOHOL CONSUMPTION AND PURCHASE BY YOUTH, AS WELL AS STUDENT EDUCATION ON THE RISKS ASSOCIATED WITH DRINKING AND DRIVING. MUSKEGON ALI PARTNERS WITH SCHOOL SYSTEMS TO REINFORCE POSITIVE BEHAVIOR BASED ON RECOMMENDATIONS OF MICHIGAN'S INTEGRATED BEHAVIOR AND LEARNING SUPPORT INITIATIVE (MIBLSI). KNOWSMOKE THE KNOWSMOKE COALITION IS WORKING WITH THE COUNTY PUBLIC HEALTH AND COMMUNITY MENTAL HEALTH ON EFFORTS TO DESIGNATE ALL CAMPUSES, PARKS, AND BEACHES "SMOKE FREE." THE COALITION AND THE TEEN HEALTH CENTER YOUTH ADVISORY COMMITTEE WORKED TOGETHER TO DEVELOP SMOKE-FREE MESSAGES FOR DISPLAY IN SCHOOL ENVIRONMENTS.MUSKEGON AREA MEDICATION DISPOSAL PROGRAM (MAMDP)COALITION MEMBERS ESTABLISHED PERMANENT DISPOSAL SITES AT 13 POLICE STATIONS, 8 RETAIL PHARMACIES AND HOLDS TWO MEDICATION TAKE-BACK EVENTS EACH YEAR IN APRIL AND OCTOBER. THE GROUP COORDINATES LAW ENFORCEMENT AND PHYSICIAN WORKGROUP TO ENHANCE COMMUNICATION AND SHARE INFORMATION REGARDING THE TAKE BACK PROGRAMS, RISK MANAGEMENT OF DRUG USERS, AND LEGAL ISSUES SURROUNDING DIVERSION.PARTNERSHIP FOR SUCCESS II TEAM MUSKEGON IS ONE OF EIGHT COMMUNITIES INCLUDED IN THE THREE-YEAR PARTNERSHIP GRANT FROM THE MICHIGAN DEPARTMENT OF COMMUNITY HEALTH'S BUREAU OF SUBSTANCE ABUSE SERVICES. IT IS A COMPREHENSIVE EFFORT LED BY THE COALITION FOR DRUG FREE MUSKEGON COUNTY TO BRIDGE THE GAP BETWEEN PREVENTION, SUBSTANCE ABUSE TREATMENT AND PRIMARY CARE. MUSKEGON END OF LIFE COALITIONTHE HEALTH PROJECT RECONVENED THE MUSKEGON END OF LIFE COALITION TO INITIATE PROFESSIONAL TRAINING AND PUBLIC AWARENESS CAMPAIGN ON THE USE OF ADVANCE CARE DIRECTIVES. IT IS PROVIDING COMPREHENSIVE TRAINING FOR MUSKEGON COUNTY MEDICAL PROFESSIONALS. THE COALITION INCLUDES LAKESHORE HEALTH NETWORK, MERCY HEALTH HOSPICE, HARBOR HOSPICE, AND LIFE CIRCLES.
    PART III, LINE 4: MERCY HEALTH PARTNERS IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 17 OF THOSE STATEMENTS: "THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY MINISTRY ORGANIZATION AND FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE." PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - BAD DEBT EXPENSE REPORTED ON LINE 2 IS SHOWN AT COST AND WAS CALCULATED USING A COST TO CHARGE RATIO METHODOLOGY. ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.PART III, LINE 3: MERCY HEALTH PARTNERS USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR CHARITY: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FY13 WAS THE FIRST YEAR MERCY HEALTH PARTNERS UTILIZED THE PREDICTIVE MODEL WITH RESULTS USED FOR ANALYSIS ONLY. STARTING IN FY14, MERCY HEALTH PARTNERS IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL.
    PART III, LINE 8: MERCY HEALTH PARTNERS DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CHA RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT.
    PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S COLLECTION POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS.
MERCY HEALTH PARTNERS MERCY 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 MERCY 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. THESE INCLUDED THE EXECUTION OF A DETAILED CONSUMER HEALTH SURVEY; ONE-ON-ONE INTERVIEWS WITH HEALTH CARE RECIPIENTS; INPUT OF 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 MERCY 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 MERCY CAMPUS   PART V, SECTION B, LINE 5C: 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%20MERCYCHNABOOK%20912.PDF
MERCY HEALTH PARTNERS MERCY 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. THE HOSPITAL SYSTEM DOES COLLECT BMI DATA ON ALL PATIENTS WITHIN ITS PATIENT REGISTRY.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 MERCY CAMPUS   PART V, SECTION B, LINE 12H: 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 MERCY 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 MERCY 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.
    PART VI, LINE 2: MERCY HEALTH ASSESSES THE HEALTH STATUS OF ITS COMMUNITY IN THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. THE HOSPITAL MAY USE PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED, IN THE ASSESSMENT OF THE COMMUNITY. ADDITIONALLY, SEVERAL COMMUNITY COALITIONS AND WORK GROUPS ARE CONVENED AND SUPPORTED BY THE HEALTH PROJECT, MERCY HEALTH'S COMMUNITY BENEFIT SERVICE. THESE COALITIONS DESCRIBED IN PART II, QUESTION 1 ABOVE MEET REGULARLY TO DISCUSS HEALTH PROBLEMS, ISSUES AND CONCERNS AFFECTING THEIR RESPECTIVE TOPICAL AREAS AND/OR AFFINITY CONSTITUENCIES. THESE ISSUES MAY OR MAY NOT BE CITED IN THE CHNA, BUT IN ANY CASE, THE HEALTH PROJECT BRINGS THE ISSUES TO THE ATTENTION OF THE APPROPRIATE HOSPITAL SYSTEM LEADERSHIP FOR REVIEW AND RESOLUTION ACTIVITIES, IF POSSIBLE.
    PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MERCY HEALTH PARTNERS - MERCY CAMPUS IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTH CARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, MERCY HEALTH PARTNERS - MERCY CAMPUS HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: - PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSMERCY HEALTH PARTNERS - MERCY CAMPUS EFFECTIVELY COMMUNICATES WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. MERCY HEALTH PARTNERS - MERCY CAMPUS OFFERS IN-PERSON SUPPORT WITH FINANCIAL COUNSELORS, CASHIERS AND THE HEALTH PROJECT (A PART OF MERCY HEALTH). ANY REGISTRAR CAN MAKE A CONNECTION TO PATIENTS. MERCY HEALTH PARTNERS PUBLISHES THE PHONE NUMBERS FOR OUR CALL-IN SUPPORT, AND SHARED SERVICES ALSO PROVIDES PHONE SUPPORT. MERCY HEALTH PARTNERS HAS AN EXTERNAL VENDOR, FIRSTSOURCE, AND WE ALSO WORK WITH THE DEPARTMENT OF HUMAN SERVICES' STAFF.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. MERCY HEALTH PARTNERS UTILIZES AN EXTERNAL VENDOR AS AN EXTENSION OF HOSPITAL SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE.BEGINNING IN 2010, MERCY HEALTH PARTNERS - MERCY CAMPUS ESTABLISHED A SINGLE ENROLLMENT FORM, APPLICABLE TO ALL CAMPUSES, FOR FINANCIAL ASSISTANCE THAT INCLUDES GATHERING ALL THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY AND ENROLLMENT FOR A VARIETY OF ASSISTANCE PROGRAMS, INCLUDING HEALTH COVERAGE, FOOD STAMPS, PHARMACEUTICAL ASSISTANCE PROGRAMS, VISION AND HEARING SERVICES, BEHAVIORAL AND MENTAL HEALTH SERVICES, CHRONIC DISEASE SELF MANAGEMENT EDUCATION, AND DRUG AND ALCOHOL ABUSE COUNSELING AND TOBACCO CESSATION EDUCATION. THE SINGLE ENROLLMENT FORM IS USED ON ALL MERCY HEALTH PARTNER CAMPUSES. MERCY HEALTH PARTNERS BEGAN DEPLOYING COMMUNITY HEALTH WORKERS FROM THE HEALTH PROJECT AT ALL CAMPUSES, TO WORK WITH HOSPITAL DISCHARGE PATIENTS AND ENSURE THAT ALL ELIGIBLE PATIENTS ARE ENROLLED IN APPLICABLE ASSISTANCE PROGRAMS. THE HEALTH PROJECT ALSO SCREENS AND ENROLLS RESIDENTS FROM ALL PARTS OF THE SERVICE AREA, USING WIDE-REACHING OUTREACH STRATEGIES AND TECHNIQUES TO ENGAGE UNINSURED AND UNDERSERVED POPULATIONS.MERCY HEALTH PARTNERS - MERCY CAMPUS OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH THE PUBLICATION OF PATIENT BROCHURES, NOTICES OR MESSAGING INCLUDED ON PATIENT BILLS; POSTING OF NOTICES IN PUBLIC REGISTRATION AREAS, INCLUDING EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS; HOSPITAL PATIENT ACCOUNTING DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES THAT ARE LOCATED ON OUR CAMPUSES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO ACCESS HEALTH, AMERICAN RED CROSS, BENSON DRUGS, CATHOLIC CHARITIES OF WEST MICHIGAN, CITY OF MUSKEGON, CITY OF MUSKEGON HEIGHTS, COMMUNITY ACCESS LINE OF THE LAKESHORE, COMMUNITY MENTAL HEALTH SERVICES OF MUSKEGON COUNTY, COOPERATING CHURCHES, DISABILITY CONNECTION OF WEST MICHIGAN, EVERY WOMAN'S PLACE, GOODWILL INDUSTRIES, HACKLEY COMMUNITY CARE CENTER, HACKLEY PHARMACIES, LIFE COUNSELING, LIONS CLUBS OF MUSKEGON COUNTY, MISSION FOR AREA PEOPLE, MUSKEGON COUNTY PUBLIC HEALTH, MUSKEGON COUNTY DEPARTMENT OF HUMAN SERVICES/FAMILY RESOURCE CENTERS, MUSKEGON FAMILY CARE, MUSKEGON/OCEANA MICHIGAN WORKS!, THE SALVATION ARMY, SENIOR RESOURCES, URBAN LEAGUE, WESTSHORE PHARMACY, AND WEST MICHIGAN THERAPY. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON THE MERCY HEALTH PARTNERS' WEBSITE, AS WELL AS IN THE ADMISSION PACKAGE. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN SPANISH, REFLECTING THE OTHER PRIMARY LANGUAGE SPOKEN BY THE POPULATION SERVED BY OUR HOSPITAL. MERCY HEALTH PARTNERS HAS ESTABLISHED A WRITTEN POLICY, APPLICABLE TO ALL CAMPUSES, FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MERCY HEALTH MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. MERCY HEALTH PARTNERS EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, BILLING AND COLLECTIONS) ABOUT THESE POLICIES, WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES. MERCY HEALTH PARTNERS FRONTLINE REGISTRATION ASSOCIATES, CASHIERS AND THE HEALTH PROJECT RECEIVE TRAINING ON MAKING A CONNECTION TO A FINANCIAL COUNSELOR.
    PART VI, LINE 4: COMMUNITY INFORMATION - MERCY HEALTH PARTNERS - MERCY CAMPUS SERVICE AREA INCLUDES NEWAYGO, OCEANA AND MUSKEGON COUNTIES, LOCATED IN CENTRAL WEST MICHIGAN, ON OR NEAR THE SHORELINE OF LAKE MICHIGAN. TOTAL POPULATION OF THE SERVICE AREA IS ABOUT 250,000 AND IS COMPRISED OF BOTH SIGNIFICANT RURAL AND URBAN AREAS. THE RURAL AREA IS CHARACTERIZED BY A CHIEFLY AGRICULTURAL, RECREATION AND TOURISM ECONOMY. THE METROPOLITAN AREA OF ABOUT 120,000 IS COMPRISED OF FIVE CITIES; THE LARGEST OF WHICH IS THE CITY OF MUSKEGON, WITH A POPULATION OF 38,401. MUSKEGON'S ECONOMY IS LARGELY MANUFACTURING AND SERVICE INDUSTRIES. THE POPULATION IS GENERALLY DIVERSE WITH MANY ETHNIC AND RACIAL POPULATION SEGMENTS. THE METROPOLITAN AREA HAS A SIGNIFICANT AFRICAN-AMERICAN POPULATION, WHILE OCEANA COUNTY HAS A HIGHER CONCENTRATION OF HISPANIC RESIDENTS.MUSKEGON COUNTY IS HOME TO THE COUNTY'S MAJOR HOSPITAL SYSTEM, MERCY HEALTH PARTNERS, WHICH RECENTLY MERGED WITH HACKLEY HOSPITAL AND NOW INCLUDES FOUR CAMPUSES, INCLUDING LAKESHORE HOSPITAL IN OCEANA COUNTY. BASED ON THE 2010 CENSUS, THERE WERE 172,188 PEOPLE, 65,654 HOUSEHOLDS, AND 44,690 FAMILIES RESIDING IN THE COUNTY. THE RACIAL MAKEUP WAS APPROXIMATELY 80% CAUCASIAN, 14.5% BLACK AND 1.3% FOR NATIVE AMERICAN, ASIAN, AND PACIFIC ISLANDER. THE MEDIAN HOUSEHOLD INCOME WAS $38,916, AND THE MEDIAN INCOME FOR A FAMILY WAS $51,519. ABOUT 12.4% OF FAMILIES AND 18.6% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 22.4% OF THOSE UNDER AGE 18 AND 8.7% OF THOSE AGES 65 OR OVER.OCEANA COUNTY IS A RURAL COUNTY ROUGHLY 41 MILES NORTH OF MUSKEGON AND 75 MILES NORTHWEST OF GRAND RAPIDS. THE RACIAL MAKEUP ACCORDING TO THE 2010 CENSUS WAS 91.9 % CAUCASIAN, WITH AFRICAN-AMERICAN, ASIAN, AND PACIFIC ISLANDER EACH COMPRISING 1.5% OF THE TOTAL POPULATION. ROUGHLY 13% OF THE POPULATION WAS HISPANIC OR LATINO, THE HIGHEST PERCENTAGE OF LATINOS OF ANY COUNTY IN MICHIGAN. RECENT ESTIMATES SHOW THE PERCENTAGE OF LATINOS AND AFRICAN-AMERICANS TO BE INCREASING, WHILE THE PERCENTAGE OF NON-HISPANIC WHITES IS DECREASING. THE CENSUS BUREAU ESTIMATES THE 2010 COUNTY POPULATION AT 26,570. THE AVERAGE HOUSEHOLD SIZE WAS 2.6 AND THE AVERAGE FAMILY SIZE WAS 3.04 IN 2010. MEDIAN INCOME WAS $39,543.NEWAYGO COUNTY IS HOME OF NESTLE-GERBER INDUSTRIES AND THE GERBER MEMORIAL HEALTH SERVICES, LOCATED IN FREMONT. THE GEOGRAPHIC PROXIMITY OF THE TWO URBAN CENTERS RESULTS IN SOME COUNTY RESIDENTS TRAVELING TO THE MUSKEGON AREA FOR HEALTH CARE SERVICES WHILE OTHERS USE THE SERVICES AVAILABLE IN GRAND RAPIDS. BASED ON THE 2010 CENSUS, THE RACIAL MAKEUP WAS APPROXIMATELY 93.5% CAUCASIAN, 1.2% BLACK, AND 0.9% FOR NATIVE AMERICAN, ASIAN, AND PACIFIC ISLANDER. THE CENSUS BUREAU ESTIMATES THE 2010 COUNTY POPULATION AT 48,460. THE MEDIAN HOUSEHOLD INCOME WAS $43,218 AND THE MEDIAN INCOME FOR A FAMILY WAS $49,499. ABOUT 13.5% OF FAMILIES AND 17.3% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING APPROXIMATELY 24.6% OF THOSE UNDER AGE 18 AND 8.4% OF THAT AGE 65 OR OVER.
    PART VI, LINE 5: OTHER INFORMATION - THE MAJORITY OF THE GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE MERCY HEALTH PARTNER'S (LAKESHORE CAMPUS, HACKLEY CAMPUS AND MERCY CAMPUS) PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS. SINCE MERCY HEALTH PARTNERS IS THE ONLY HOSPITAL IN MUSKEGON COUNTY, STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SURPLUS FUNDS ARE ALLOCATED TO IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. THE SERVICE AREA HAS VERY HIGH RATES OF UNINSURED (MUSKEGON COUNTY 14%; OCEANA COUNTY 18%; NEWAYGO COUNTY 16%)-SO MERCY HEALTH'S FOCUS HAS BEEN ON ACCESS TO CARE. MERCY HEALTH'S HEALTH PROJECT HAS BEEN VERY PROACTIVE IN WORKING WITH MEDICAL CLINICS AND THE TWO FQHCS. THE DESIGN OF A SINGLE ENROLLMENT PROCESS HAS PROVEN TO MAKE APPLYING FOR ASSISTANCE LESS CUMBERSOME. THE NEW FORM INCLUDES ALL INFORMATION ESSENTIAL FOR DETERMINING ELIGIBILITY FOR MULTIPLE HEALTH AND HUMAN SERVICES, THUS STREAMLINING THE PROCESS OF ASSISTING PATIENTS TO RECEIVE SERVICES. THE WHEELS OF MERCY, A MOBILE UNIT, IS TAKEN TO VARIOUS AREAS THROUGH THE THREE COUNTIES, PROVIDING BLOOD PRESSURE, DIABETES, PULMONARY FUNCTION, VISION AND CHOLESTEROL SCREENINGS. ENROLLMENT ASSISTANCE INTO VARIOUS PROGRAMS IS ALSO PROVIDED. THE GOAL IS TO ALLEVIATE MANY EMERGENCY DEPARTMENT VISITS BY SCREENING AND ALERTING PATIENTS TO TREATABLE PROBLEMS THAT COULD ESCALATE INTO LIFE-THREATENING SITUATIONS.HEALTH PROJECT - PHARMACEUTICAL ACCESS PROGRAM INCLUDES TWO PROGRAMS: 1) MEANS-TESTED ELIGIBILITY SCREENING AND ENROLLMENT APPLICATION FOR PHARMACEUTICAL COMPANY PAPS; AND 2) ASSISTANCE TO PROCURE INTERIM MEDICATIONS AND SUPPLIES DURING APPLICATION PROCESS PERIOD. THIS PROGRAM COMPLEMENTS MAP'S COMMUNITY MEDICATION FUND IN PROVIDING LOW-INCOME, UNINSURED PERSONS WITH THE PRESCRIPTION DRUGS THEY NEED TO MANAGE CHRONIC DISEASES. REFERRALS ARE MADE BETWEEN THE TWO ORGANIZATIONS TO KEEP PACE WITH THE INCREASING NEED. THERE ARE NO OTHER KNOWN PROGRAMS IN THE AREA THAT SUPPLY INTERIM MEDICATIONS TO PATIENTS WAITING TO BE ENROLLED IN THE PAPS. THE HEALTH PROJECT'S PROGRAM GETS SOME SUPPORT FROM SEVERAL SMALL GRANTS, PRIVATE AND PUBLIC, AS WELL AS PROCEEDS FROM AN ANNUAL FUNDRAISING WALKATHON. HOWEVER OVER 80% OF THE FUNDING SUPPORT COMES FROM THE HOSPITAL SYSTEM.HEALTH PROJECT STAFF WERE REGIONAL LEADS FOR THE PLANNING EFFORTS AROUND THE AFFORDABLE CARE ACT ENROLLMENT PREPAREDNESS AND HEALTH REFORM. STAFF PROVIDED TECHNICAL ASSISTANCE AND COACHING TO OTHER REGIONAL HEALTH MINISTRIES WITHIN THE ORGANIZATION AS WELL AS COORDINATED STAFF TRAINING. IN PREPARATION FOR HEALTH REFORM, INTERNAL FINANCIAL ASSISTANCE POLICIES NEEDED REVIEW TO ACCOMMODATE CHANGES UNDER HEALTH REFORM. HEALTH PROJECT STAFF PROVIDED STAFF TRAINING AND INPUT ON MAKING THESE CHANGES OPERATIONAL FOR COMMUNITY BENEFIT STAFF.CHRISTIANS FOR HEALTHCARE PROVIDES BLOOD PRESSURE AND DIABETES SCREENING TO LOW-INCOME PEOPLE, REFERRALS TO PRIMARY CARE AND SOCIAL SERVICES, AS WELL AS ADVOCACY AND EDUCATION ON ACCESS TO SERVICES. LOCAL DIABETES RATES ARE SIGNIFICANTLY HIGHER THAN THE MICHIGAN AVERAGE. PERSISTENTLY HIGH RATES OF DIABETES IN MUSKEGON AND OCEANA COUNTIES, ESPECIALLY AMONG AFRICAN AMERICANS AND HISPANICS, IS A KEY FINDING OF THE 2009 AND 2012 COMMUNITY HEALTH NEEDS ASSESSMENTS. INCREASED SCREENING, PATIENT EDUCATION AND EARLY INTERVENTION TREATMENTS ARE NEEDED TO CURB THE IMPACT OF DIABETES AND ITS COMPLICATIONS. THE CHNA ALSO NOTED THE DANGER OF INCREASING IMPACTS OF CHRONIC DISEASES DUE TO HEALTH DISPARITIES IN ACCESS TO CARE EXPERIENCED BY THE POOR AND MINORITY POPULATIONS.LAKESHORE INITIATIVE FOR EVERYBODY'S KIDNEYS (LIFE-K). LIFE-K IS A MULTIDISCIPLINARY COLLABORATIVE DESIGNED TO BOLSTER THE AWARENESS OF CHRONIC KIDNEY DISEASE (CKD) IN THE COMMUNITY WHILE PROMOTING SCREENING OF AT-RISK INDIVIDUALS, EARLY DIAGNOSIS OF CKD, AND EMPHASIZING PREVENTATIVE CARE - WITH THE ULTIMATE GOAL OF REDUCING CKD PROGRESSION AND THE INCIDENCE OF END STAGE RENAL DISEASE (ESRD) IN OUR COMMUNITY. THE HEALTH PROJECT SUPPORTS THE COLLABORATIVE GROUP WITH INITIATIVES THAT INCLUDE SCREENING AND NAVIGATION TO ADDITIONAL SERVICES, INCLUDING ADDITIONAL CARE MANAGEMENT. MERCY HEALTH'S DEPARTMENTS ARE AGGRESSIVELY INVOLVED IN COMMUNITY PROGRAMS. FOR INSTANCE OUTREACH AND ENROLLMENT SPECIALISTS CONDUCT HEALTH AND HUMAN SERVICE ELIGIBILITY SCREENS ON ALL UNINSURED PATIENTS AT THE TIME OF DISCHARGE FROM THE HOSPITAL OR EMERGENCY DEPARTMENT. INCLUDED IN THE SCREENING IS ELIGIBILITY FOR MEDICAID, SCHIP OR OTHER AVAILABLE HEALTH COVERAGE, FOOD ASSISTANCE PROGRAM, MERCY HEALTH'S FINANCIAL ASSISTANCE, ET AL. MERCY HEALTH PARTICIPATES IN THE UNITED WAY DAY OF CARING. ALSO, EVERY YEAR, THE HEALTHY-U EVENT IS CONDUCTED TO EDUCATE THE COMMUNITY ABOUT HEART HEALTH, AND PROVIDE WORKSHOPS AND PROGRAMS AT NO COST. SUPPORT FOR EVENTS, SUCH AS THE AFRICAN-AMERICAN DIABETES CONFERENCE, MEN'S HEALTH FAIR AND SCREENING, AND THE WALK FOR DIABETES ARE CONDUCTED TO RAISE FUNDS FOR PHARMACEUTICAL PRODUCTS FOR PEOPLE WHO CAN'T AFFORD THEM. MERCY HEALTH CONDUCTS EXTENSIVE COMMUNITY-BASED SCREENINGS AT CHURCHES AND OTHER VENUES AROUND THE COMMUNITY. COMMUNITY SERVICES ARE PROVIDED TO BENEFIT EVERYONE IN THE COMMUNITY, SUCH AS BIRTHING CLASSES. ALL OF MERCY HEALTH SUPPORTS THE USE OF FACILITIES BY NON-PROFIT ORGANIZATIONS FOR MEETINGS AND SUPPORT OF COMMUNITY BENEFIT ACTIVITIES. A CERTAIN PERCENT OF EARNINGS FROM THE SISTER SIMONE FUND IS REDIRECTED BACK TO COMMUNITY GROUPS FOR PROJECTS TO IMPROVE THE HEALTH OF THE COMMUNITY. MEDICAL AND ADMINISTRATIVE STAFFS SIT ON COMMUNITY COALITIONS THAT TARGET AREAS OF COMMUNITY NEED, INCLUDING HIV/AIDS; DIABETES; CHILDHOOD OBESITY; HEALTH DISPARITIES, ASTHMA; ALCOHOL, TOBACCO AND SUBSTANCE ABUSE; AND YOUTH RISK BEHAVIORS. MERCY HEALTH ALSO GIVES MONEY TO SUPPORT THE COMMUNITY ACCESS LINE OF THE LAKESHORE (CALL 2-1-1) INFORMATION AND REFERRAL PHONE LINE; ACCESS HEALTH, A "3-SHARE" MODEL COMMUNITY HEALTH COVERAGE PROGRAM; AS WELL AS VISION SERVICES. MERCY HEALTH (ALL CAMPUSES) ARE INVOLVED WITH "ALIGNING FORCES FOR QUALITY: EQUITY AND LANGUAGE QUALITY" TO MEET THE TRINITY EQUITY IN CARE PROCESS OF DETERMINING WHETHER INEQUITIES EXIST IN CARE DUE TO RACE OR ETHNICITY. MERCY HEALTH'S MERCY HEALTH PHYSICIAN PARTNERS CONTINUES TO LEAD A HEALTH LITERACY INITIATIVE IN ITS PRIMARY CARE PRACTICES TO PROMOTE THE PATIENT CENTERED MEDICAL HOME CONCEPT AND THE "TEACH BACK" METHOD TO ENSURE PATIENT UNDERSTANDING OF THEIR HEALTH CONDITIONS, PLAN OF CARE AND TREATMENT REGIMENS.IN PARTNERSHIP WITH MERCY HEALTH PHYSICIAN PARTNERS, THE HEALTH PROJECT HAS BEEN OPERATING THE MUSKEGON AREA MEDICATION DISPOSAL PROJECT (MAMDP) SINCE LATE 2010. THE MEDICATION TAKE-BACK PROJECT REDUCES YOUTH ACCESS TO NON-PRESCRIBED MEDICATIONS, REDUCES THE NUMBER OF EXPIRED AND POTENTIALLY UNSAFE MEDICATIONS, ASSISTS LAW ENFORCEMENT WITH NEIGHBORHOOD SAFETY FOR THOSE SEEKING OUT DRUGS IN MEDICINE CABINETS AND REDUCES THE ENVIRONMENTAL IMPACT ON WATER QUALITY. IN FY2012, MAMDP ESTABLISHED PERMANENT BOXES IN ELEVEN POLICE STATIONS AND PERMANENT COLLECTION SITES AT FIVE MERCY HEALTH RETAIL PHARMACIES. THEY ALSO HELD TWO COLLECTION EVENTS AT AREA FIRE STATIONS. SINCE 2010, THE MAMDP PROJECT COLLECTED 12,000 POUNDS OF MEDICATIONS AND SHARPS WITH OVER 1,100 POUNDS OF THE MATERIALS WERE CLASSIFIED AS CONTROLLED SUBSTANCES. OVER 400 POUNDS OF SHARPS WERE COLLECTED.
    PART VI, LINE 6: MERCY HEALTH PARTNERS IS A MEMBER OF CHE TRINITY HEALTH, THE SECOND-LARGEST CATHOLIC HEALTH CARE SYSTEM IN THE COUNTRY. CHE TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEFINE - AND ACHIEVE - COMMUNITY BENEFIT GOALS THAT INCLUDE IMPLEMENTING NEEDED SERVICES OR EXPANDING ACCESS TO SERVICES FOR LOW-INCOME INDIVIDUALS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, CHE TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITY THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND UNINSURED, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND REACHING OUT TO UNDERSERVED POPULATIONS. OVERALL, THE ORGANIZATION INVESTS MORE THAN $800 MILLION IN SUCH COMMUNITY BENEFITS AND WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING EACH COMMUNITY'S SPECIFIC NEEDS. FOR MORE INFORMATION ABOUT CHE TRINITY HEALTH, VISIT WWW.NEWHEALTHMINISTRY.ORG.
Schedule H (Form 990) 2012
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
MERCY HEALTH PARTNERS
 
Employer identification number
38-2589966
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance






















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
 
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2012

Schedule I (Form 990) 2012
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance












Part IV
Supplemental Information.
Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Identifier Return Reference Explanation
SCHEDULE I, PART I, LINE 2:   DONATIONS MADE BY MERCY HEALTH PARTNERS TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H.
Schedule I (Form 990) 2012


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MERCY HEALTH PARTNERS
 
Employer identification number

38-2589966
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......
2
 
 
3
Indicate which, if any, of the following the 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.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)ROGER SPOELMANW. MI REG. PRES. AND CEO; TRUSTEE (i)
(ii)		 0
467,996 		0
155,249 		0
100,767 		0
103,021 		0
22,195 		0
849,228 		0
25,924
(2)PHILIP MCCORKLETRUSTEE; ST MARYS HEALTH CARE CEO (i)
(ii)		 0
427,388 		0
142,458 		0
83,180 		0
25,000 		0
32,962 		0
710,988 		0
0
(3)GREGORY LOOMISMHP INTERIM CEO (i)
(ii)		 0
299,220 		0
65,260 		0
4,401 		0
35,430 		0
16,773 		0
421,084 		0
0
(4)GARY ALLOREW. MI REGIONAL CFO (i)
(ii)		 0
271,400 		0
61,821 		0
904 		0
18,951 		0
20,064 		0
373,140 		0
0
(5)JOSEPH SWEDISHTRINITY HLTH PRES & CEO THROUGH 3/13 (i)
(ii)		 0
1,402,192 		0
786,411 		0
1,044,897 		0
572,762 		0
28,714 		0
3,834,976 		0
520,902
(6)KEDRICK ADKINSTRINITY PRES INTEG SYS THROUGH 6/13 (i)
(ii)		 0
784,856 		0
366,716 		0
670,047 		0
112,792 		0
13,375 		0
1,947,786 		0
265,335
(7)J RICHARD O'CONNELLPRES, EVP, TRINITY HEALTH DIV. (i)
(ii)		 0
607,209 		0
284,428 		0
144,773 		0
97,104 		0
33,319 		0
1,166,833 		0
0
(8)F REMINGTON SPRAGUEVP PRIMARY CARE SERVICES (i)
(ii)		 0
334,652 		0
74,043 		0
4,951 		0
37,632 		0
14,404 		0
465,682 		0
0
(9)MARY BOYDMHP VP NETWORK DEV (i)
(ii)		 0
268,486 		0
63,551 		0
1,343 		0
38,644 		0
4,419 		0
376,443 		0
0
(10)JEFFREY ALEXANDERMHP VP INTEGRATED SERVICES (i)
(ii)		 0
238,239 		0
57,336 		0
1,179 		0
26,213 		0
4,568 		0
327,535 		0
0
(11)KIMBERLY MAGUIREMHP VP PATIENT CARE (i)
(ii)		 0
205,121 		0
48,525 		0
663 		0
18,904 		0
17,546 		0
290,759 		0
0
(12)DAVID BONNEMAPHYSICIAN (i)
(ii)		 646,025
0 		0
0 		1,099
0 		16,863
0 		22,120
0 		686,107
0 		0
0
(13)IONUT ORAVITANPHYSICIAN (i)
(ii)		 617,505
0 		0
0 		0
0 		21,318
0 		20,998
0 		659,821
0 		0
0
(14)ERIC STUARTPHYSICIAN (i)
(ii)		 593,264
0 		0
0 		1,562
0 		20,734
0 		21,512
0 		637,072
0 		0
0
(15)MARK MEENGSPHYSICIAN (i)
(ii)		 580,475
0 		0
0 		0
0 		25,000
0 		15,558
0 		621,033
0 		0
0
(16)CHARLES ZICKUSPHYSICIAN (i)
(ii)		 566,566
0 		0
0 		2,466
0 		22,600
0 		16,902
0 		608,534
0 		0
0
(17)MICHAEL MURPHYFORMER KEY EMPLOYEE (i)
(ii)		 0
139,488 		0
0 		0
41,394 		0
4,650 		0
11,980 		0
197,512 		0
0
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 3
Part III
Supplemental Information
Complete this part to 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.
Identifier Return Reference Explanation
  PART I, LINE 3 MERCY HEALTH PARTNERS IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. MERCY HEALTH PARTNERS' CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MERCY HEALTH PARTNERS' CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
  PART I, LINE 4B THE FOLLOWING ARE PARTICIPANTS IN THE TRINITY HEALTH 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 ($250,000 FOR 2012). THE FOLLOWING ACCRUALS FOR 2012 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $100,292 RICHARD O'CONNELL - $77,104 ROGER SPOELMAN - $68,609 JOSEPH SWEDISH - $543,977 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: KEDRICK ADKINS - $185,540 JOSEPH SWEDISH - $530,000 COLUMN F OF SCHEDULE J INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS.
Schedule J (Form 990) 2012

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MERCY HEALTH PARTNERS
 
Employer identification number

38-2589966
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-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?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of 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) 2012
Schedule L (Form 990 or 990-EZ) 2012
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) CYNTHIA L MEYERING FAMILY MEMBER OF KIMBERLY MAGUIRE, KEY EMPLOYEE 36,853 EMPLOYMENT ARRANGEMENT   No
(2) BLUE CROSS BLUE SHIELD OF MICHIGAN
  		F. REMINGTON SPRAGUE, KEY EMPLOYEE, IS TRUSTEE OF BLUE CROSS BLUE SHIELD-MI 31,330,578 NET REVENUE FROM PROVISION OF MEDICAL SERVICES   No
(3) COMERICA BANK
  		T. BRUCE FOX, OFFICER AND TRUSTEE, IS AN EMPLOYEE OF COMERICA BANK 102,192 BANKING SERVICES   No
(4) MUSKEGON SC LLC
  		YOUSIF HAMATI, TRUSTEE, IS A GREATER THAN 5% PARTNER IN MUSKEGON SC, LLC 613,711 OUTPATIENT SURGERY SERVICES   No
(5) SARAH VANDER HAAR FAMILY MEMBER OF REV. TIM VANDER HAAR, TRUSTEE 37,629 EMPLOYMENT ARRANGEMENT   No
(6) MUSKEGON SC LLC
  		MARY BOYD,KEY EMP & GREGORY LOOMIS,OFFICER, ARE BOTH BD MBRS OF MUSKEGON SC 613,711 OUTPATIENT SURGERY SERVICES   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MERCY HEALTH PARTNERS
 
Employer identification number

38-2589966
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 1 163,319 SELLING PRICE
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
Yes
 
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2012)
Schedule M (Form 990) (2012)
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Identifier Return Reference Explanation
THIRD PARTY USE: PART I, LINE 32B: LPL FINANCIAL SERVICES SERVES AS STOCK BROKER IN THE EVENT THAT GIFTS OF STOCK ARE RECEIVED.
Schedule M (Form 990) (2012)
Additional Data


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

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

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
MERCY HEALTH PARTNERS
 
Employer identification number

38-2589966
Identifier Return Reference Explanation
  FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MERCY HEALTH PARTNERS IS TRINITY HEALTH - MICHIGAN. SEE LINE 7 FOR ADDITIONAL INFORMATION.
  FORM 990, PART VI, SECTION A, LINE 7A TRINITY HEALTH - MICHIGAN IS THE SOLE MEMBER OF MERCY HEALTH PARTNERS. TRINITY HEALTH - MICHIGAN HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF TRUSTEES OF MERCY HEALTH PARTNERS.
  FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, TRINITY HEALTH - MICHIGAN MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. TRINITY HEALTH - MICHIGAN MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS.
  FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING, THE FORM 990 FOR MERCY HEALTH PARTNERS IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD OF TRUSTEES. THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE.
  FORM 990, PART VI, SECTION B, LINE 12C MERCY HEALTH PARTNERS 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 MERCY HEALTH PARTNERS, 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 MERCY HEALTH PARTNERS' CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MERCY HEALTH PARTNERS 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 MERCY HEALTH PARTNERS IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO MERCY HEALTH PARTNERS. 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 MERCY HEALTH PARTNERS ON AN ANNUAL BASIS.
  FORM 990, PART VI, SECTION B, LINE 15 TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF MERCY HEALTH PARTNERS ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS.
  FORM 990, PART VI, SECTION C, LINE 19 MERCY HEALTH PARTNERS IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE ANNUAL REPORT (WHICH INCLUDES COMMUNITY BENEFIT MINISTRY INFORMATION) AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, MERCY HEALTH PARNTERS INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE.
TRUSTEES: 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 $161,313 WAS PAID BY TRINITY HEALTH - MICHIGAN DIRECTLY TO THE SISTERS OF MERCY FOR SR. MYRA'S SERVICES.
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: EQUITY TRANSFERS TO AFFILIATES: -3,151,608. INDIGENT CARE AGREEMENT REVENUE: 1,377,924. INDIGENT CARE AGREEMENT CONTRIBUTION: -1,411,439. EQUITY GAIN IN UNCONSOLIDATED AFFILIATES: 629,221. OTHER TRANSACTIONS: -118,135.
  FORM 990, PART XII, LINE 2: MERCY HEALTH PARTNER'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY13 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM.
  FORM 990, PAGE 1, DOING BUSINESS AS NAMES: MERCY HEALTH PARTNERS, MUSKEGON GENERAL CAMPUS MERCY HEALTH PARTNERS, MERCY CAMPUS MERCY HEALTH PARTNERS-ORTHOTICS AND PROSTHETICS MERCY HEALTH MERCY MERCY HEALTH PHYSICIAN PARTNERS-MUSKEGON MERCY HEALTH MUSKEGON MERCY HEALTH GENERAL CAMPUS MERCY HEALTH LAKES VILLAGE MERCY HEALTH MERCY CAMPUS MERCY HEALTH PHARMACY - WOLF LAKE MERCY HEALTH PHARMACY - GLENSIDE MERCY HEALTH PHARMACY - HACKLEY PROFESSIONAL MERCY HEALTH PHARMACY - WESTHORE PROFESSIONAL
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

Additional Data


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

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MERCY HEALTH PARTNERS
 
Employer identification number

38-2589966
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to 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" to 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?
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) 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
(3) AUXILIARY OF HOLY ROSARY HOSPITAL

351 SW 9TH STREET

ONTARIO,OR97914
94-3059469 		SUPPORTS SERVICES OF RELATED HOSPITAL OR 501(C)(3) LINE 9 SAINT ALPHONSUS MEDICAL CENTER-ONTARIO
 
 
No
(4) BAUM HARMON MERCY HOSPITAL

255 NORTH WELCH AVENUE

PRIMGHAR,IA51245
42-1500277 		ACUTE/AMBULATORY HEALTHCARE SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(5) BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION

255 NORTH WELCH AVENUE

PRIMGHAR,IA51245
26-2973307 		SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) LINE 11A, I BAUM HARMON MERCY HOSPITAL
 
 
No
(6) CATHERINE MCAULEY HEALTH SERVICES CORP

PO BOX 995

ANN ARBOR,MI48106
38-2507173 		FURTHER TRINITY HEALTH ACTIVITIES, ORGANIZE AND DEVELOP MEDICAL SERVICES MI 501(C)(3) LINE 11B, II TRINITY HEALTH-MICHIGAN
 
 
No
(7) 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
(8) 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
(9) 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
(10) 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
(11) DUBUQUE MERCY HEALTH FOUNDATION INC

250 MERCY DRIVE

DUBUQUE,IA52001
26-2227941 		SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) LINE 11A, I MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(12) DYERSVILLE HEALTH FOUNDATION INC

1111 3RD STREET SW

DYERSVILLE,IA52040
20-5383271 		SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) LINE 11A, I MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(13) GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION

701 W NORTH AVE

MELROSE PARK,IL60160
36-3332852 		SUPPORT THE SERVICES OF RELATED HOSPITAL IL 501(C)(3) LINE 9 GOTTLIEB MEMORIAL HOSPITAL
 
 
No
(14) GOTTLIEB MEMORIAL FOUNDATION

701 W NORTH AVE

MELROSE PARK,IL60160
74-3260011 		SUPPORT THE SERVICES OF RELATED HOSPITAL IL 501(C)(3) LINE 11C, III-FI N/A
 
No
(15) 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
(16) HACKLEY HOSPITAL

1700 CLINTON ST PO BOX 3302

MUSKEGON,MI494433302
38-1358196 		HEALTHCARE SERVICES MI 501(C)(3) LINE 3 MERCY HEALTH PARTNERS
 
Yes
 
(17) HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST

PO BOX 3302

MUSKEGON,MI494433302
38-2299878 		SELF INSURANCE FOR GENERAL AND MALPRACTICE LIABILITY MI 501(C)(3) LINE 11C, III-FI MERCY HEALTH PARTNERS
 
Yes
 
(18) HACKLEY LIFE COUNSELING

1352 TERRACE ST

MUSKEGON,MI494423545
38-1386362 		COUNSELING, EDUCATION, AND SUPPORT MI 501(C)(3) LINE 9 MERCY HEALTH PARTNERS
 
Yes
 
(19) HACKLEY VISITING NURSE SERVICES AND HOSPICE INC

888 TERRACE ST

MUSKEGON,MI49440
38-1359598 		PROVIDE HOME HEALTH CARE SERVICES MI 501(C)(3) LINE 7 MERCY HEALTH PARTNERS
 
Yes
 
(20) 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
(21) 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
(22) HOLY CROSS HEALTH INC

1500 FOREST GLEN RD

SILVER SPRING,MD209101484
52-0738041 		HEALTHCARE SERVICES MD 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
 
No
(23) HOLY CROSS MEDICAL CENTER

20555 VICTOR PARKWAY

LIVONIA,MI48152
95-1985442 		HEALTHCARE SERVICES (FORMERLY) CA 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
 
No
(24) HOSPICE OF NORTH IOWA

232 SECOND STREET SE

MASON CITY,IA504016208
42-1173708 		HOSPICE HEALTH CARE SERVICES IA 501(C)(3) LINE 7 MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(25) HOSPICE OF SIOUXLAND

4300 HAMILTON BLVD

SIOUX CITY,IA51104
38-3320710 		HOSPICE SERVICES IA 501(C)(3) LINE 11A, I N/A
 
No
(26) 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
(27) 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
(28) LAKESHORE COMMUNITY HOSPITAL INC

72 S STATE STREET

SHELBY,MI494551228
38-2549295 		ACUTE HEALTHCARE SERVICES MI 501(C)(3) LINE 3 MERCY HEALTH PARTNERS
 
Yes
 
(29) LOYOLA UNIVERSITY HEALTH SYSTEM

2160 SOUTH FIRST AVENUE

MAYWOOD,IL60153
36-3342448 		HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT IL 501(C)(3) LINE 11B, II TRINITY HEALTH CORPORATION
 
 
No
(30) 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
(31) 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
(32) 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
(33) 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
(34) 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
(35) 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
(36) 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
(37) 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
(38) MERCY HEALTH NETWORK

1111 6TH AVENUE

DES MOINES,IA50314
42-1478417 		HEALTHCARE MANAGEMENT DE 501(C)(3) LINE 11A, I N/A
 
No
(39) MERCY HEALTH PARTNERS

1415 LEAHY STREET

MUSKEGON,MI49442
38-2589966 		HEALTHCARE SYSTEM SUPPORT MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN
 
Yes
 
(40) 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
(41) 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 TRINITY HEALTH CORPORATION
 
 
No
(42) 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
(43) MERCY HEALTHCARE FOUNDATION

1410 N 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
(44) 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
(45) MERCY HOSPITAL CADILLAC FOUNDATION

400 HOBART

CADILLAC,MI496012331
20-3357131 		SUPPORT THE SERVICES OF RELATED HOSPITAL MI 501(C)(3) LINE 11A, I TRINITY HEALTH-MICHIGAN
 
 
No
(46) 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
(47) MERCY MEDICAL CENTER - CLINTON INC

1410 NORTH 4TH ST

CLINTON,IA527322940
42-1336618 		TO PROVIDE QUALITY HEALTH CARE DE 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(48) 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
(49) MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA

1000 4TH STREET SW

MASON CITY,IA504012800
42-1229151 		SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) LINE 11C, III-FI N/A
 
No
(50) 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
(51) MERCY PHYSICIAN GROUP INC

1512 12TH AVENUE ROAD

NAMPA,ID83686
20-8192593 		TO PROVIDE QUALITY HEALTH CARE ID 501(C)(3) LINE 9 SAINT ALPHONSUS MEDICAL CENTER-NAMPA
 
 
No
(52) MERCY SERVICES FOR AGING NON-PROFIT HOUSING CORPORATION

PO BOX 9184

FARMINGTON HILLS,MI483339184
38-2719605 		PROVIDES LONG-TERM CARE FOR THE ELDERLY MI 501(C)(3) LINE 11B, II TRINITY CONTINUING CARE SERVICES
 
 
No
(53) MIDWEST MEDFLIGHT

1300 VICTORS WAY

ANN ARBOR,MI48108
38-2684671 		AEROMEDICAL TRANSPORT MI 501(C)(3) LINE 9 TRINITY HEALTH-MICHIGAN
 
 
No
(54) 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
(55) 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
(56) 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
(57) 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
(58) MOUNT CARMEL HEALTH SYSTEM

6150 EAST BROAD STREET

COLUMBUS,OH43213
31-1439334 		HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT OH 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
 
No
(59) MOUNT CARMEL HEALTH SYSTEM FOUNDATION

6150 EAST BROAD STREET

COLUMBUS,OH43213
31-1113966 		SUPPORT THE SERVICES OF RELATED HOSPITAL OH 501(C)(3) LINE 11A, I MOUNT CARMEL HEALTH SYSTEM
 
 
No
(60) 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
(61) 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
(62) MUSKEGON COMMUNITY HEALTH PROJECT

565 W WESTERN AVENUE

MUSKEGON,MI49440
91-1932918 		FACILITATE AND COORDINATE HEALTHCARE AND RELATED SERVICES MI 501(C)(3) LINE 7 MERCY HEALTH PARTNERS
 
Yes
 
(63) 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
(64) OAKLAND MERCY HOSPITAL FOUNDATION

601 E 2ND STREET

OAKLAND,NE68045
31-1678345 		SUPPORTS SERVICES OF RELATED HOSPITAL NE 501(C)(3) LINE 11C, III-FI N/A
 
No
(65) 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
(66) 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
(67) PROFESSIONAL MED TEAM

965 FORK STREET

MUSKEGON,MI494423257
38-2638284 		MEDICAL CARE, TRANSPORTATION AND EDUCATION MI 501(C)(3) LINE 9 TRINITY HEALTH-MICHIGAN
 
 
No
(68) 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
(69) SAINT AGNES MEDICAL CENTER

1303 EAST HERNDON AVE

FRESNO,CA93720
94-1437713 		HEALTHCARE SERVICES CA 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
 
No
(70) SAINT ALPHONSUS BUILDING COMPANY INC

1055 NORTH CURTIS RD

BOISE,ID83706
82-0401011 		SUPPORTS SERVICES OF RELATED HOSPITAL ID 501(C)(3) LINE 11A, I SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC
 
 
No
(71) SAINT ALPHONSUS DIVERSIFIED CARE INC

1055 NORTH CURTIS RD

BOISE,ID83706
94-3028978 		SUPPORTS SERVICES OF RELATED HOSPITAL ID 501(C)(3) LINE 11A, I SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC
 
 
No
(72) SAINT ALPHONSUS FOUNDATION-BAKER CITY INC

3325 POCAHONTAS ROAD

BAKER CITY,OR97814
94-3164869 		SUPPORT THE SERVICES OF RELATED HOSPITAL OR 501(C)(3) LINE 7 SAINT ALPHONSUS MEDICAL CENTER - BAKER CITY
 
 
No
(73) SAINT ALPHONSUS FOUNDATION-ONTARIO INC

351 SW 9TH STREET

ONTARIO,OR97914
20-2683560 		SUPPORT THE SERVICES OF RELATED HOSPITAL OR 501(C)(3) LINE 11A, I SAINT ALPHONSUS MEDICAL CENTER-ONTARIO
 
 
No
(74) 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 TRINITY HEALTH CORPORATION
 
 
No
(75) SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY INC

3325 POCAHONTAS ROAD

BAKER CITY,OR97814
27-1790052 		TO PROVIDE QUALITY HEALTH CARE OR 501(C)(3) LINE 3 SAINT ALPHONSUS HEALTH SYSTEM INC
 
 
No
(76) SAINT ALPHONSUS MEDICAL CENTER-NAMPA INC

1512 12TH AVENUE ROAD

NAMPA,ID83686
82-0200896 		TO PROVIDE QUALITY HEALTH CARE ID 501(C)(3) LINE 3 SAINT ALPHONSUS HEALTH SYSTEM INC
 
 
No
(77) SAINT ALPHONSUS MEDICAL CENTER-NAMPA HEALTH FOUNDATION INC

1512 12TH AVENUE ROAD

NAMPA,ID83686
26-1737256 		SUPPORT THE SERVICES OF RELATED HOSPITAL ID 501(C)(3) LINE 7 SAINT ALPHONSUS MEDICAL CENTER-NAMPA
 
 
No
(78) SAINT ALPHONSUS MEDICAL CENTER-ONTARIO INC

351 SW 9TH STREET

ONTARIO,OR97914
27-1789847 		TO PROVIDE QUALITY HEALTH CARE OR 501(C)(3) LINE 3 SAINT ALPHONSUS HEALTH SYSTEM INC
 
 
No
(79) 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
(80) 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
(81) SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC

PO BOX 1935

SOUTH BEND,IN466341935
35-0868157 		HEALTHCARE SERVICES IN 501(C)(3) LINE 3 SAINT JOSEPH REGIONAL MEDICAL CENTER INC
 
 
No
(82) 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
(83) 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
(84) 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 TRINITY HEALTH CORPORATION
 
 
No
(85) SAINT JOSEPH'S TOWER INC

PO BOX 9184

FARMINGTON HILLS,MI483339184
31-1040468 		PROVIDES HOUSING FOR LOW INCOME ELDERLY INDIVIDUALS IN 501(C)(3) LINE 9 TRINITY CONTINUING CARE SERVICES-INDIANA
 
 
No
(86) 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
(87) SAINT MARY'S FOUNDATION

200 JEFFERSON ST SE

GRAND RAPIDS,MI49503
38-1779602 		SUPPORTS SERVICES OF RELATED HOSPITAL MI 501(C)(3) LINE 7 TRINITY HEALTH-MICHIGAN
 
 
No
(88) ST JOSEPH MERCY OAKLAND FOUNDATION

44405 WOODWARD AVE

PONTIAC,MI48341
35-2356789 		SUPPORTS SERVICES OF RELATED HOSPITAL MI 501(C)(3) LINE 11A, I TRINITY HEALTH-MICHIGAN
 
 
No
(89) THE FOUNDATION OF SAINT JOSEPH REGIONAL MEDICAL CENTER

4215 EDISON LAKES PARKWAY

MISHAWAKA,IN46545
35-1654543 		SUPPORTS SERVICES OF RELATED HOSPITAL IN 501(C)(3) LINE 11A, I SAINT JOSEPH REGIONAL MEDICAL CENTER INC
 
 
No
(90) 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
(91) TRI-HOSPITAL MRI CENTER

4190 24TH AVENUE

FORT GRATIOT,MI48054
38-2884297 		MRI SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN
 
 
No
(92) TRINITY CONTINUING CARE SERVICES

PO BOX 9184

FARMINGTON HILLS,MI483339184
38-2559656 		MANAGEMENT SERVICES FOR LONG TERM CARE AND SENIOR LIVING FACILITIES MI 501(C)(3) LINE 11A, I TRINITY HEALTH CORPORATION
 
 
No
(93) TRINITY CONTINUING CARE SERVICES - INDIANA INC

PO BOX 9184

FARMINGTON HILLS,MI483339184
93-0907047 		PROVIDES LONG-TERM CARE AND RESIDENTIAL HOUSING IN 501(C)(3) LINE 9 TRINITY CONTINUING CARE SERVICES
 
 
No
(94) TRINITY HEALTH - MICHIGAN

20555 VICTOR PARKWAY

LIVONIA,MI48152
38-2113393 		HEALTHCARE SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
 
No
(95) 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
(96) TRINITY HEALTH INTERNATIONAL

20555 VICTOR PARKWAY

LIVONIA,MI48152
42-1253527 		HEALTHCARE TRAINING AND SUPPORT SERVICES MI 501(C)(3) LINE 11A, I TRINITY HEALTH CORPORATION
 
 
No
(97) TRINITY HEALTH WELFARE BENEFIT TRUST

20555 VICTOR PARKWAY

LIVONIA,MI48152
20-8151733 		RETIREE MEDICAL AND RETIREE LIFE INSURANCE COVERAGE MI 501(C)(9) N/A TRINITY HEALTH CORPORATION
 
 
No
(98) 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 TRINITY HEALTH CORPORATION
 
 
No
(99) 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
(100) 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
(101) MERCY HOSPITAL

144 STATE STREET

PORTLAND,MA04101
01-0211534 		HOSPITAL ME 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF MAINE
 
 
No
(102) MERCY HEALTH SYSTEM OF MAINE

144 STATE STREET

PORTLAND,MA04101
01-0484074 		MANAGEMENT & SUPPORT SERVICES ME 501(C)(3) LINE 11C, III-FI CATHOLIC HEALTH EAST
 
 
No
(103) 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
(104) ST MARY'S WOODLAND VILLAGE INC

1300 MASSACHUSETTS AVENUE

TROY,NY12180
14-1675183 		DISCONTINUED OPERATIONS NY 501(C)(3) LINE 9 SETON HEALTH SYSTEM INC
 
 
No
(105) MERCY CARE FOR KIDS INC

310 SOUTH MANNING BLVD

ALBANY,NY12208
14-1717564 		DAY CARE CENTER NY 501(C)(3) LINE 9 ST PETER'S HEALTH CARE SERVICES
 
 
No
(106) 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
(107) ST PETER'S AUXILIARY

315 SOUTH MANNING BLVD

ALBANY,NY01228
22-2843206 		AUXILIARY NY 501(C)(3) LINE 11A, I ST PETER'S HEALTH CARE SERVICES
 
 
No
(108) 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
(109) 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
(110) ST PETER'S HOSPITAL FOUNDATION INC

319 SOUTH MANNING BLVD SUITE 309

ALBANY,NY12208
22-2262982 		FUNDRAISING & PUBLIC RELATIONS NY 501(C)(3) LINE 7 ST PETER'S HEALTH CARE SERVICES
 
 
No
(111) 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
(112) 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
(113) 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
(114) 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
(115) 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
(116) 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
(117) MEMORIAL HOSPITAL ALBANY NY

600 NORTHERN BLVD

ALBANY,NY12204
14-1338457 		GENERAL HOSPITAL NY 501(C)(3) LINE 3 NORTHEAST HEALTH INC
 
 
No
(118) 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
(119) THE NORTHEAST HEALTH FOUNDATION INC

2224 BURDETT AVE

TROY,NY12180
22-2743478 		SUPPORTING FOUNDATION NY 501(C)(3) LINE 7 NORTHEAST HEALTH INC
 
 
No
(120) 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
(121) SHAKER PROPERTIES INC

2212 BURDETT AVE

TROY,NY12180
22-3119822 		REAL ESTATE HOLDING NY 501(C)(2) N/A NORTHEAST HEALTH INC
 
 
No
(122) SUNNYVIEW HOSPITAL & REHABILITATION CTR

1270 BELMONT AVE

SCHENECTADY,NY12308
14-1338386 		REHABILITATION HOSPITAL NY 501(C)(3) LINE 3 LTC (EDDY) INC
 
 
No
(123) 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
(124) 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
(125) HERITAGE HOUSE NURSING CENTER INC

2920 TIBBITS AVE

TROY,NY12180
14-1725101 		NURSING HOME NY 501(C)(3) LINE 9 LTC (EDDY) INC
 
 
No
(126) 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
(127) BEVERWYCK INC

40 AUTUMN DRIVE

SLINGERLANDS,NY12159
14-1717028 		INDEPENDENT/ASSISTED LIVING RETIREMENT COMMUNITY NY 501(C)(3) LINE 9 LTC (EDDY) INC
 
 
No
(128) 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
(129) 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
(130) BEECHWOOD INC

2212 BURDETT AVE

TROY,NY12180
14-1651563 		REAL ESTATE HOLDING NY 501(C)(2) N/A LTC (EDDY) INC
 
 
No
(131) SENIOR CARE CONNECTION INC

504 STATE ST

SCHENECTADY,NY12305
14-1708754 		PACE PROGRAM NY 501(C)(3) LINE 9 LTC (EDDY) INC
 
 
No
(132) HOME AID SERVICE OF EASTERN NEW YORK INC

433 RIVER ST SUITE 3000

TROY,NY12180
14-1514867 		HOME CARE NY 501(C)(3) LINE 9 LTC (EDDY) INC
 
 
No
(133) SETON HEALTH SYSTEM INC

1300 MASSACHUSETTS AVENUE

TROY,NY12180
14-1776186 		HOSPITAL NY 501(C)(3) LINE 3 ST PETER'S HEALTH PARTNERS
 
 
No
(134) 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
(135) SETON HEALTH FOUNDATION

1300 MASSACHUSETTS AVENUE

TROY,NY12180
22-2345416 		SUPPORTING ORGANIZATION NY 501(C)(3) LINE 11A, I SETON HEALTH SYSTEM INC
 
 
No
(136) SETON AUXILIARY INC

1300 MASSACHUSETTS AVENUE

TROY,NY12180
14-1505031 		SUPPORTING ORGANIZATION NY 501(C)(3) LINE 9 SETON HEALTH SYSTEM INC
 
 
No
(137) 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
(138) EMPIRE HOME INFUSION SERVICE INC

10 BLACKSMITH DRIVE

MALTA,NY12020
14-1795732 		HOME CARE NY 501(C)(3) LINE 9 HOME AID SERVICE OF EASTERN NEW YORK INC
 
 
No
(139) 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
(140) 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
(141) 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
(142) 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
(143) BRIGHTSIDE INC

C/O SPHS 1221 MAIN STREET SUITE 108

HOLYOKE,MA01040
04-2182395 		BEHAVIORAL CARE MA 501(C)(3) LINE 9 SISTERS OF PROVIDENCE HEALTH SYSTEM INC
 
 
No
(144) FARREN CARE CENTER INC

C/O SPHS 1221 MAIN STREET SUITE 108

HOLYOKE,MA01040
04-2501711 		LONG TERM CARE MA 501(C)(3) LINE 3 SISTERS OF PROVIDENCE HEALTH SYSTEM INC
 
 
No
(145) MERCY HOSPITAL INC

C/O SPHS 1221 MAIN STREET SUITE 108

HOLYOKE,MA01040
04-3398280 		ACUTE CARE MA 501(C)(3) LINE 3 SISTERS OF PROVIDENCE HEALTH SYSTEM INC
 
 
No
(146) MERCY SPECIALIST PHYSICIANS INC

C/O SPHS 1221 MAIN STREET SUITE 108

HOLYOKE,MA01040
26-4033168 		NEUROSURGERY MEDICAL SERVICES MA 501(C)(3) LINE 3 SISTERS OF PROVIDENCE HEALTH SYSTEM INC
 
 
No
(147) SISTERS OF PROVIDENCE CARE CENTERS INC

C/O SPHS 1221 MAIN STREET SUITE 108

HOLYOKE,MA01040
22-2541103 		LONG TERM CARE MA 501(C)(3) LINE 3 SISTERS OF PROVIDENCE HEALTH SYSTEM INC
 
 
No
(148) SISTERS OF PROVIDENCE HEALTH SYSTEM INC

C/O SPHS 1221 MAIN STREET SUITE 108

HOLYOKE,MA01040
04-3398374 		MANAGEMENT & SUPPORT SERVICES MA 501(C)(3) LINE 11A, I CATHOLIC HEALTH EAST
 
 
No
(149) MERCY LIFE INC

C/O SPHS 1221 MAIN STREET SUITE 108

HOLYOKE,MA01040
45-3086711 		ACUTE CARE MA 501(C)(3) LINE 3 SISTERS OF PROVIDENCE HEALTH SYSTEM INC
 
 
No
(150) PIONEER VALLEY CARDIOLOGY ASSOCIATES INC

C/O SPHS 1221 MAIN STREET SUITE 213

HOLYOKE,MA01040
45-4208896 		CARDIOLOGY SERVICES MA 501(C)(3) LINE 4 SISTERS OF PROVIDENCE HEALTH SYSTEM INC
 
 
No
(151) MERCY ONCOLOGY SERVICES INC

C/O SPHS 1221 MAIN STREET SUITE 213

HOLYOKE,MA01040
45-4884805 		ONCOLOGY MEDICAL SERVICES MA 501(C)(3) N/A SISTERS OF PROVIDENCE HEALTH SYSTEM INC
 
 
No
(152) MCAULEY CENTER INC

275 STEELE ROAD

WEST HARTFORD,CT06117
06-1058086 		INDEPENDENT LIVING CT 501(C)(3) LINE 9 MERCY COMMUNITY HEALTH INC
 
 
No
(153) 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
(154) 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
(155) MERCY SERVICES

2021 ALBANY AVENUE

WEST HARTFORD,CT06117
06-1453323 		SUPPORT SERVICES CT 501(C)(3) LINE 1 MERCY COMMUNITY HEALTH INC
 
 
No
(156) MERCYKNOLL INC

2021 ALBANY AVENUE

WEST HARTFORD,CT06117
06-0757380 		SKILLED NURSING CT 501(C)(3) LINE 3 MERCY COMMUNITY HEALTH INC
 
 
No
(157) 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
(158) 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
(159) MERCY HEALTHCARE CENTER

114 WAWBEEK AVENUE

TUPPER LAKE,NY12986
15-0532211 		IN DISSOLUTION NY 501(C)(3) LINE 3 CATHOLIC HEALTH EAST
 
 
No
(160) 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
(161) UIHLEIN MERCY CENTER

185 OLD MILITARY ROAD

TUPPER LAKE,NY12986
15-0532190 		IN DISSOLUTION NY 501(C)(3) LINE 3 MERCY HEALTHCARE CENTER
 
 
No
(162) 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
(163) 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
(164) 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
(165) MAXIS MEDICAL SERVICES

100 LINCOLN AVE

CARBONDALE,PA18407
23-2577185 		PHYSICIAN PRACTICES PA 501(C)(3) LINE 3 MAXIS HEALTH SYSTEM
 
 
No
(166) MARIAN COMMUNITY HOSPITAL

100 LINCOLN AVE

CARBONDALE,PA18407
24-0711230 		HOSPITAL PA 501(C)(3) LINE 3 MAXIS HEALTH SYSTEM
 
 
No
(167) MARIAN COMMUNITY HOSPITAL AUXILIARY

100 LINCOLN AVE

CARBONDALE,PA18407
25-1874733 		FUNDRAISING PA 501(C)(3) LINE 11B, II MAXIS HEALTH SYSTEM
 
 
No
(168) MAXIS FOUNDATION

100 LINCOLN AVE

CARBONDALE,PA18407
23-2330090 		FUNDRAISING PA 501(C)(3) LINE 11B, II MAXIS HEALTH SYSTEM
 
 
No
(169) MAXIS HEALTH SYSTEM

100 LINCOLN AVE

CARBONDALE,PA18407
91-1940902 		HEALTH CARE SYSTEM PA 501(C)(3) LINE 11B, II MAXIS HEALTH SYSTEM
 
 
No
(170) TRI-COUNTY HUMAN SERVICES CENTER INC

PO BOX 517

CARBONDALE,PA18407
23-1938528 		BEHAVIORAL HEALTH ORGANIZATION PA 501(C)(3) LINE 7 MAXIS HEALTH SYSTEM
 
 
No
(171) COLUMBUS ACQUISITION CORP

1160 RAYMOND BOULEVARD

NEWARK,NJ07102
26-2616342 		INACTIVE ENTITY NJ 501(C)(3) LINE 9 SAINT MICHAELS MEDICAL CENTER
 
 
No
(172) SAINT MICHAELS MEDICAL CENTER

111 CENTRAL AVENUE

NEWARK,NJ07102
26-2616046 		HOSPITAL NJ 501(C)(3) LINE 3 CATHOLIC HEALTH EAST
 
 
No
(173) ST JAMES CARE INC

1160 RAYMOND BOULEVARD

NEWARK,NJ07102
26-2616230 		INACTIVE ENTITY NJ 501(C)(3) LINE 9 SAINT MICHAELS MEDICAL CENTER
 
 
No
(174) ST MICHAEL'S FOUNDATION INC

1160 RAYMOND BOULEVARD

NEWARK,NJ07102
22-3311976 		FOUNDATION NJ 501(C)(3) LINE 11A, I SAINT MICHAELS MEDICAL CENTER
 
 
No
(175) UNIVERSITY HEIGHTS PROPERTY COMPANY INC

1160 RAYMOND BOULEVARD

NEWARK,NJ07102
22-3100162 		MEDICAL PROPERTY HOLDING COMPANY NJ 501(C)(2) N/A SAINT MICHAELS MEDICAL CENTER
 
 
No
(176) 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
(177) ST FRANCIS MEDICAL CENTER FOUNDATION NJ

601 HAMILTON AVENUE

TRENTON,NJ08629
52-1025476 		FOUNDATION NJ 501(C)(3) LINE 11A, I ST FRANCIS MEDICAL CENTER TRENTON NJ
 
 
No
(178) ST FRANCIS MEDICAL CENTER TRENTON NJ

601 HAMILTON AVENUE

TRENTON,NJ08629
22-3431049 		HOSPITAL NJ 501(C)(3) LINE 3 CATHOLIC HEALTH EAST
 
 
No
(179) LANGHORNE MRI INC

1201 LANGHORNE-NEWTOWN ROAD

LANGHORNE,PA19047
23-2519529 		INACTIVE ENTITY PA 501(C)(3) LINE 9 ST MARY MEDICAL CENTER
 
 
No
(180) LANGHORNE PHYSICIAN SERVICES INC

1201 LANGHORNE-NEWTOWN ROAD

LANGHORNE,PA19047
23-2571699 		PHYSICIAN SERVICES PA 501(C)(3) LINE 9: 509(A)(2) ST MARY MEDICAL CENTER
 
 
No
(181) LIFE ST MARY

1201 LANGHORNE-NEWTOWN ROAD

LANGHORNE,PA19047
26-2976184 		ELDERLY CARE PA 501(C)(3) LINE 9 ST MARY MEDICAL CENTER
 
 
No
(182) ST MARY MEDICAL CENTER

1201 LANGHORNE-NEWTOWN ROAD

LANGHORNE,PA19047
23-1913910 		HOSPITAL PA 501(C)(3) LINE 3 CATHOLIC HEALTH EAST
 
 
No
(183) 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
(184) 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
(185) 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
(186) MERCY FAMILY SUPPORT

1001 BALTIMORE PIKE SUITE 301

SPRINGFIELD,PA19064
23-2325059 		HOME HEALTH PA 501(C)(3) LINE 9 MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
 
No
(187) 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
(188) 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
(189) 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
(190) 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
(191) MERCY HOME HEALTH SERVICES

1001 BALTIMORE PIKE SUITE 301

SPRINGFIELD,PA19064
23-2325058 		HOME HEALTH PA 501(C)(3) LINE 11B, II MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
 
No
(192) 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
(193) 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
(194) 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
(195) 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
(196) NAZARETH PHYSICIAN SERVICES INC

2601 HOLME AVENUE

PHILADELPHIA,PA19152
20-3261266 		PHYSICIAN PRACTICES PA 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
 
No
(197) NE PHYSICIAN SERVICES

2601 HOLME AVENUE

PHILADELPHIA,PA19152
23-2497355 		PHYSICIAN PRACTICES PA 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
 
No
(198) ST AGNES CONTINUING CARE CENTER

1900 S BROAD STREET

PHILADELPHIA,PA19145
23-2840137 		CONTINUING CARE SERVICES PA 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
 
No
(199) ST AGNES CONTINUING CARE CENTER FOUNDATION

1900 S BROAD STREET

PHILADELPHIA,PA19145
23-2415137 		FUNDRAISING PA 501(C)(3) LINE 11B, II MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
 
No
(200) 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
(201) 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
(202) 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
(203) LOURDES MEDICAL CENTER BURLINGTON COUNTY

218 SUNSET ROAD

WILLINGBORO,NJ08046
22-3612265 		HOSPITAL NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES
 
 
No
(204) 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
(205) 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
(206) 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
(207) LOURDES CARDIOLOGY SERVICES PC

1600 HADDON AVENUE

CAMDEN,NJ08108
27-4357794 		CARDIOLOGY SERVICES NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES
 
 
No
(208) FRANCISCAN ELDERCARE CORPORATION

PO BOX 2500

WILMINGTON,DE19805
22-3008680 		ELDERCARE DE 501(C)(3) LINE 9 ST FRANCIS HOSPITAL
 
 
No
(209) ST FRANCIS FOUNDATION

PO BOX 2500

WILMINGTON,DE19805
51-0374158 		FOUNDATION DE 501(C)(3) LINE 11B, II ST FRANCIS HOSPITAL
 
 
No
(210) ST FRANCIS HOSPITAL

PO BOX 2500

WILMINGTON,DE19805
51-0064326 		HOSPITAL DE 501(C)(3) LINE 3 CATHOLIC HEALTH EAST
 
 
No
(211) LIFE AT ST FRANCIS HEALTHCARE INC

7TH CLAYTON STREETS

WILMINGTON,DE19805
45-2569214 		ELDERLY CARE DE 501(C)(3) LINE 3 ST FRANCIS HOSPITAL
 
 
No
(212) MCAULEY MINISTRIES

MCAULEY HALL 3333 FIFTH AVENUE

PITTSBURGH,PA15213
94-3436142 		MANAGEMENT & SUPPORT SERVICES PA 501(C)(3) LINE 9 PITTSBURGH MERCY HEALTH SYSTEM
 
 
No
(213) 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
(214) MERCY LIFE CENTER CORPORATION

1200 REEDSDALE STREET

PITTSBURGH,PA15233
25-1604115 		COMMUNITY TREATMENT PA 501(C)(3) LINE 9 PITTSBURGH MERCY HEALTH SYSTEM
 
 
No
(215) 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
(216) ST JOSEPH'S OF THE PINES INC

100 GOSSMAN DRIVE SUITE B

SOUTHERN PINES,NC28387
56-0694200 		HOSPITAL NC 501(C)(3) LINE 3 CATHOLIC HEALTH EAST
 
 
No
(217) 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
(218) 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
(219) 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
(220) 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
(221) 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
(222) 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
(223) 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
(224) 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
(225) 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
(226) 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
(227) GOOD SAMARITAN HOSPITAL INC

1201 SILOAM ROAD

GREENSBORO,GA30462
26-1720984 		HOSPITAL GA 501(C)(3) LINE 3 SAINT JOSEPH'S HEALTH SYSTEM INC
 
 
No
(228) MERCY MEDICAL CORPORATION

PO BOX 1090 101 VILLA DRIVE

DAPHNE,AL36526
63-6002215 		HOSPITAL AL 501(C)(3) LINE 3 CATHOLIC HEALTH EAST
 
 
No
(229) 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
(230) 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
(231) 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
(232) 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
(233) HOLY CROSS LONG-TERM INC

4725 NORTH FEDERAL HIGHWAY

FT LAUDERDALE,FL33308
65-0787320 		MEDICAL SERVICES FL 501(C)(3) LINE 3 HOLY CROSS HOSPITAL INC
 
 
No
(234) 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
(235) SSJ HEALTH FOUNDATION INC

3663 SOUTH MIAMI AVENUE

MIAMI,FL33133
59-1709438 		FUNDRAISING FL 501(C)(3) LINE 7 MERCY HOSPITAL INC
 
 
No
(236) MERCY HOSPITAL INC

3663 SOUTH MIAMI AVENUE

MIAMI,FL33133
59-0791034 		HOSPITAL FL 501(C)(3) LINE 3 CATHOLIC HEALTH EAST
 
 
No
(237) MERCY MEDICAL DEVELOPMENT INC

3663 SOUTH MIAMI AVENUE

MIAMI,FL33133
59-2789194 		OUTPATIENT SERVICES FL 501(C)(3) LINE 9 MERCY HOSPITAL INC
 
 
No
(238) MERCY MISSION SERVICES INC

3663 SOUTH MIAMI AVENUE

MIAMI,FL33133
65-0435764 		HEALTH CARE FL 501(C)(3) LINE 11A, I MERCY HOSPITAL INC
 
 
No
(239) MERCY OUTPATIENT SERVICES INC DBA SISTER EMMANUEL HOSPITAL

3663 SOUTH MIAMI AVENUE

MIAMI,FL33133
51-0461511 		HOSPITAL FL 501(C)(3) LINE 3 MERCY HOSPITAL INC
 
 
No
(240) 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
(241) INTRACOASTAL HEALTH SYSTEMS

3805 WEST CHESTER PIKE SUITE 100

NEWTOWN SQUARE,PA19073
65-0556413 		MANAGEMENT & SUPPORT SERVICES PA 501(C)(3) LINE 11A, I CATHOLIC HEALTH EAST
 
 
No
(242) 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
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No
(1) 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) CENTER FOR DIGESTIVE CARE LLC

5300 ELLIOTT DRIVE
YPSILANTI,MI48197
03-0447062 		PROVIDE GASTROINTESTINAL SERVICES MI N/A
                  
(4) CENTRAL OHIO SLEEP MEDICINE LTD

6150 EAST BROAD STREET
COLUMBUS,OH43213
31-1701029 		SLEEP MEDICINE SERVICES OH N/A
                  
(5) CLINTON IMAGING SERVICES LLC

615 VALLEY VIEW DR STE 202
MOLINE,IL61265
41-2044739 		MRI DIAGNOSTIC SERVICES IA N/A
                  
(6) FOREST PARK IMAGING LLC

1000 4TH STREET SW
MASON CITY,IA50401
13-4365966 		X-RAY AND MAMMOGRAPHY SERVICES IA N/A
                  
(7) FRANCES WARDE MEDICAL LABORATORY

300 WEST TEXTILE ROAD
ANN ARBOR,MI48104
38-2648446 		LABORATORY MI N/A
                  
(8) FRESNO IMAGING CENTER

1303 E HERNDON AVE
FRESNO,CA93720
77-0363563 		DIAGNOSTIC IMAGING CA N/A
                  
(9) HAWARDEN REGIONAL HEALTH CLINICS LLC

1122 AVENUE L
HAWARDEN,IA51023
20-1444339 		MEDICAL CLINIC IA N/A
                  
(10) IDAHO GYNONCOLOGY SERVICES LLC

1055 N CURTIS RD
BOISE,ID83706
20-2975807 		PROVIDE GYN ONCOLOGY SERVICES ID N/A
                  
(11) INTERMOUNTAIN MEDICAL IMAGING LLC

877 WEST MAIN ST STE 603
BOISE,ID83702
82-0514422 		PROVIDE IMAGING SERVICES ID N/A
                  
(12) LOYOLA AMBULATORY SURGERY CENTER

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
36-4119522 		SURGICAL SERVICES IL N/A
                  
(13) MAGNETIC RESONANCE SERVICES PARTNERSHIP

1416 SIXTH STREET SW
MASON CITY,IA50401
42-1328388 		MRI SERVICES IA N/A
                  
(14) MASON CITY AMBULATORY SURGERY CENTER LLC

990 4TH STREET SW
MASON CITY,IA50401
20-1960348 		SURGERY-SAME DAY IA N/A
                  
(15) MCE MOB IV LIMITED PARTNERSHIP

793 W STATE STREET
COLUMBUS,OH43222
42-1544707 		MEDICAL OFFICE BUILDING RENTAL OH N/A
                  
(16) MCMC POB III LIMITED PARTNERSHIP

793 W STATE STREET
COLUMBUS,OH43222
31-1392994 		MEDICAL OFFICE BUILDING RENTAL OH N/A
                  
(17) MEDILUCENT MOB I

793 W STATE STREET
COLUMBUS,OH43222
20-4911370 		MEDICAL OFFICE BUILDING RENTAL OH N/A
                  
(18) MERCY ADVANCED MRI LLC

2525 SOUTH MICHIGAN AVE
CHICAGO,IL60616
26-2116721 		SUBLEASE MRI EQUIPMENT IL N/A
                  
(19) MERCY HEART & VASCULAR LLC

2525 SOUTH MICHIGAN AVE
CHICAGO,IL60616
20-5272726 		SUBLEASE CT EQUIPMENT IL N/A
                  
(20) MERCY HEART CTR OP SERVICES LLC

1000 4TH STREET SW
MASON CITY,IA50401
13-4237594 		CARDIOVASCULAR SERVICES IA N/A
                  
(21) MICHIANA HEALTH INFORMATION NETWORK LLC

215 WEST MADISON STREET
SOUTH BEND,IN46601
35-2050128 		COMMUNITY BASED CLINICAL INFO SYS & DATA DEPOSITORY IN N/A
                  
(22) MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP

793 W STATE STREET
COLUMBUS,OH43222
31-1369473 		MEDICAL OFFICE BUILDING RENTAL OH N/A
                  
(23) NEWCO AMBULATORY SURGERY CTR LLP

4190 24TH AVENUE
FORT GRATIOT,MI48059
30-0136708 		OUTPATIENT SURGERY CENTER MI N/A
                  
(24) SARMED OUTPATIENT PHARMACY LLC

999 N CURTIS RD STE 102
BOISE,ID83706
51-0483218 		PHARMACY ID N/A
                  
(25) SIXTY FOURTH STREET LLC

2373 64TH ST STE 2200
BYRON CENTER,MI49315
20-2443646 		PROVIDE OUTPATIENT SURGICAL CARE MI N/A
                  
(26) ST ALPHONSUS CALDWELL CANCER CTR LLC

3123 MEDICAL DR
CALDWELL,ID83605
82-0526861 		RADIATION ONCOLOGY ID N/A
                  
(27) ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP

793 W STATE STREET
COLUMBUS,OH43222
31-1603660 		MEDICAL OFFICE BUILDING RENTAL OH N/A
                  
(28) TAMARACK MEDICAL CLINIC LLC

402 OLD STATE HWY
CASCADE,ID83611
20-1637921 		OUTPATIENT MEDICAL SERVICES ID N/A
                  
(29) WESTAR MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP

793 W STATE STREET
COLUMBUS,OH43222
31-1784409 		MEDICAL OFFICE BUILDING RENTAL OH N/A
                  
(30) WOODLAND IMAGING CENTER LLC

5301 E HURON RIVER DR
ANN ARBOR,MI48106
76-0820959 		RADIOLOGY/IMAGING MI N/A
                  
(31) ST PETER'S AMBULATORY SURGERY CENTER LLC

1375 WASHINGTON AVENUE STE 201
ALBANY,NY12206
46-0463892 		OUTPATIENT SURGERY NY N/A
                  
(32) CATHERINE HORAN BUILDING LIMITED PARTNERSHIP

1221 MAIN STREET ROOM 108
HOLYOKE,MA010400000
04-2723429 		PROPERTY MANAGEMENT MA N/A
                  
(33) WESTERN MASSACHUSETTS PETCT IMAGING CENTER LLC

100 BAYVIEW CIRCLE STE 400
NEWPORT BEACH,CA92660
20-4744663 		OUTPATIENT MEDICAL SERVICES DE N/A
                  
(34) CENTRAL NEW JERSEY HEART SERVICES LLC

29 E 29TH STREET 2ND FLOOR
BAYONNE,NJ07002
20-8525458 		CARDIAC PROGRAM NJ N/A
                  
(35) SMMC MOB II LP

1201 LANGHORNE-NEWTOWN ROAD
LANGHORNE,PA19047
36-4559869 		INVESTMENT AND OPERATION OF A MEDICAL BUILDING PA N/A
                  
(36) THE AMBULATORY SURGERY CENTER AT ST MARY LLC

1203 LANGHORNE-NEWTOWN ROAD
LANGHORNE,PA19047
23-2871206 		OUTPATIENT SURGERY PA N/A
                  
(37) EAST NORRITON MEDICAL ASSOCIATES

ONE WEST ELM STREET
CONSHOHOCKEN,PA19428
23-2319531 		MEDICAL OFFICE BUILDING PA N/A
                  
(38) GATEWAY HEALTH PLAN

300 GRANT STREET
PITTSBURGH,PA15219
25-1691945 		MEDICAID & MEDICARE/SPECIAL NEEDS MANAGED CARE ORGANIZATION PA N/A
                  
(39) MERCYMANOR PARTNERSHIP

PO BOX 10086
TOLEDO,OH436990086
52-1931012 		NURSING HOME PA N/A
                  
(40) ST AGNES LONG TERM INTENSIVE CARE LLP

C/O MERCY HEALTH SYSTEM ONE WEST EL
CONSHOHOCKEN,PA19428
20-0984882 		LONG TERM INTENSIVE CARE PA N/A
                  
(41) NAZARETH MEDICAL OFFICE BUILDING ASSOCIATES LP

C/O NAZARETH HOSPITAL 2601 HOLME AV
PHILADELPHIA,PA19152
23-2388040 		MEDICAL OFFICE BUILDING PA N/A
                  
(42) SJV MANAGEMENT LLC

200 CENTURY PKWY STE 200E
MOUNT LAUREL,NJ08054
20-2273476 		RADIOLOGY NJ N/A
                  
(43) PHYSICIANS OUTPATIENT SURGERY CENTER LLC

1000 NE 56TH STREET
OAKLAND PARK,FL33334
35-2325646 		AMBULATORY SURGERY CENTER FL N/A
                  
(44) CENTER FOR SURGERY & DIGESTIVE ORDERS

3641 SOUTH MIAMI AVENUE
MIAMI,FL33133
51-0438152 		OUTPATIENT MEDICAL SERVICES FL N/A
                  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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?
Yes No
(1) COMMUNITY HEALTH VENTURES INC

565 W WESTERN AVE
MUSKEGON,MI49440
38-3522260 		SOFTWARE MARKETING MI N/A
 C       Yes  
(2) GOTTLIEB MANAGEMENT SERVICES INC

701 W NORTH AVE
MELROSE PARK,IL60160
36-3330529 		MANAGEMENT SERVICES IL N/A
 C         No
(3) HACKLEY HEALTH MANAGEMENT CENTER

1415 LEAHY ST
MUSKEGON,MI49442
38-2961814 		WEIGHT MANAGEMENT MI HACKLEY HEALTH VENTURES INC
  		C 172,892 666,449 100.000 % Yes  
(4) HACKLEY HEALTH VENTURES INC

1415 LEAHY ST
MUSKEGON,MI49442
38-2589959 		OTHER MEDICAL SERVICES MI MERCY HEALTH PARTNERS
  		C -38,561 532,863 100.000 % Yes  
(5) HACKLEY HEALTHCARE EQUIPMENT

1415 LEAHY ST
MUSKEGON,MI49442
38-2578569 		HOME MEDICAL EQUIPMENT MI HACKLEY HEALTH VENTURES INC
  		C 295,674 2,837,203 100.000 % Yes  
(6) HACKLEY PROFESSIONAL CENTER

1415 LEAHY ST
MUSKEGON,MI49442
38-3024797 		REAL ESTATE RENTAL MI HACKLEY HEALTH VENTURES INC
  		C -28,953 1,815,908 100.000 % Yes  
(7) HACKLEY PROFESSIONAL PHARMACY

1415 LEAHY ST
MUSKEGON,MI49442
38-2447870 		PHARMACY MI HACKLEY HEALTH VENTURES INC
  		C 66,593 2,893,719 100.000 % Yes  
(8) HEF INC

1415 LEAHY ST
MUSKEGON,MI49442
38-3086401 		OFFICE STAFFING MI HACKLEY HEALTH VENTURES INC
  		C     100.000 % Yes  
(9) HOLY CROSS PRIVATE HOME SERVICES CORP

11801 TECH ROAD
SILVER SPRING,MD20904
52-1986562 		HOME CARE SERVICES MD N/A
 C         No
(10) HPC CO-OWNERS ASSOCIATION

1700 CLINTON
MUSKEGON,MI49442
27-0734448 		CONDOMINIUM ASSOCIATION MI N/A
 C       Yes  
(11) HURON ARBOR CORPORATION

5301 EAST HURON RIVER DR PO BOX 992
ANN ARBOR,MI48106
38-2475644 		PROVIDES OFFICE RENTAL SPACE MI N/A
 C         No
(12) IHA AFFILIATION CORPORATION

24 FRANK LLOYD WRIGHT DR LOBBY J
ANN ARBOR,MI48106
38-3188895 		MEDICAL MANAGEMENT MI N/A
 C         No
(13) MARYLAND CARE GROUP INC

11801 TECH ROAD
SILVER SPRING,MD20904
52-1815313 		HEALTHCARE HOLDING MD N/A
 C         No
(14) MEDNOW INC

1512 12TH AVENUE ROAD
NAMPA,ID83686
82-0389927 		OUTPATIENT PHARMACY ID N/A
 C         No
(15) MERCY MEDICAL SERVICES

801 5TH STREET
SIOUX CITY,IA51101
42-1283849 		PRIMARY CARE PHYSICIANS IA N/A
 C         No
(16) MERCY SERVICES CORPORATION

2525 SOUTH MICHIGAN AVENUE
CHICAGO,IL60616
36-3227348 		DORMANT IL N/A
 C         No
(17) MICHIGAN ATHLETIC CLUB

2500 BURTON
GRAND RAPIDS,MI49546
38-2647304 		ATHLETIC CLUB MI N/A
 C         No
(18) MOUNT CARMEL HEALTH PROVIDERS INC

6150 EAST BROAD STREET
COLUMBUS,OH43213
31-1382442 		MEDICAL SERVICES OH N/A
 C         No
(19) NORTH IOWA MERCY MEDICAL SERVICES INC

1000 4TH ST SW
MASON CITY,IA50401
42-1382308 		MEDICAL SERVICES IA N/A
 C         No
(20) PRIORITY PLUS OF CALIFORNIA

PO BOX 27230
FRESNO,CA93729
77-0395267 		FORMERLY HLTH MGMT NOW DISCONTINUED OPERATIONS CA N/A
 C         No
(21) SAINT ALPHONSUS PHYSICIANS PA

1055 NORTH CURTIS ROAD
BOISE,ID837061370
33-1078261 		PHYSICIANS ID N/A
 C         No
(22) SAINT MARY'S HEALTH MANAGEMENT COMPANY

1640 EAST PARIS SE
GRAND RAPIDS,MI49546
38-3450733 		ATHLETIC CLUB MI N/A
 C         No
(23) SURGERY CENTER FINANCING CORPORATION

6150 EAST BROAD STREET
COLUMBUS,OH43213
31-1531102 		FINANCE, INSURANCE AND REAL ESTATE OH N/A
 C         No
(24) THRE SERVICES LLC

20555 VICTOR PARKWAY
LIVONIA,MI48152
45-2603654 		REAL ESTATE BROKERAGE SERVICES MI N/A
 C         No
(25) TRINITY HEALTH EMPLOYEE BENEFIT TRUST

20555 VICTOR PARKWAY
LIVONIA,MI48152
38-3410377 		GRANTOR TRUST MI N/A
 T         No
(26) VENZKE INSURANCE COMPANY LTD

PO BOX 1051 GRAND CAYMAN
GRAND CAYMAN    
CJ
98-0453602 		PROVISION OF INSURANCE COVERAGE CJ N/A
 C         No
(27) WEST SHORE PROFESSIONAL BUILDING CONDOMINIUM

1820 44TH STREET SE
KENTWOOD,MI49508
38-2700166 		CONDOMINIUM ASSOCIATION MI MERCY HEALTH PARTNERS
  		C 125 261,679 92.340 % Yes  
(28) WESTSHORE HEALTH NETWORK

1820 44TH STREET
KENTWOOD,MI49508
38-3280200 		PHYSICIAN HOSPITAL ORGANIZATION MI N/A
 C         No
(29) WORKPLACE HEALTH OF GRAND HAVEN

1415 LEAHY ST
MUSKEGON,MI49442
38-3112035 		OCCUPATIONAL HEALTH MI HACKLEY HEALTH VENTURES INC
  		C 97,664 596,357 80.000 % Yes  
(30) SAMARITAN MEDICAL OFFICE BUILDING INC

2212 BURDETT AVENUE
TROY,NY12180
14-1607244 		REAL ESTATE NY N/A
 C         No
(31) AFFILIATED MANAGEMENT SERVICES CORPORATION INC

1300 MASSACHUSETTS AVENUE
TROY,NY12180
14-1668024 		REAL ESTATE NY N/A
 C         No
(32) CATHERINE HORAN BUILDING INC

C/O SPHS 1221 MAIN STREET SUITE 108
HOLYOKE,MA010400000
04-2938160 		BUILDING MANAGEMENT MA N/A
 C         No
(33) DIVERSIFIED COMMUNITY SERVICES INC

C/O SPHS 1221 MAIN STREET SUITE 108
HOLYOKE,MA010400000
04-3128890 		MEDICAL SERVICES MA N/A
 C         No
(34) MERCY INPATIENT MEDICAL ASSOCIATES INC

C/O SPHS 1221 MAIN STREET SUITE 108
HOLYOKE,MA010400000
04-3029929 		MEDICAL SERVICES MA N/A
 C         No
(35) PROVIDENCE HOME CARE INC

C/O SPHS 1221 MAIN STREET SUITE 108
HOLYOKE,MA010400000
04-3317426 		HEALTH CARE SERVICES MA N/A
 C         No
(36) SYSTEM COORDINATED SERVICES INC

C/O SPHS 1221 MAIN STREET SUITE 108
HOLYOKE,MA010400000
04-2938181 		LAB SERVICES MA N/A
 C         No
(37) PHYSICIANS MEDICAL OFFICE BUILDING CONDOMINIUM TRUST

1221 MAIN STREET ROOM 108
HOLYOKE,MA010400000
04-6608649 		PROPERTY MANAGEMENT MA N/A
 C         No
(38) SJM PROPERTIES INC

411 CANISTEO STREET
HORNELL,NY148482101
16-1294991 		PROPERTY HOLDINGS NY N/A
 C         No
(39) CARBONDALE AREA PHYSICIANS' ASSOCIATION PC

100 LINCOLN AVE
CARBONDALE,PA18407
23-2801677 		MEDICAL INSURANCE CONTRACTING PA N/A
 C         No
(40) CARBONDALE AREA PHYSICIANS' PHO INC

100 LINCOLN AVE
CARBONDALE,PA18407
23-2801676 		INACTIVE PA N/A
 C         No
(41) CARBONDALE PHYSICIANS' SERVICES INC

100 LINCOLN AVE
CARBONDALE,PA18407
23-2365077 		PHARMACY PA N/A
 C         No
(42) CHESTNUT RISK SERVICES LTD

11 VICTORIA STREET
HAMILTON    
BD
INSURANCE BD N/A
 C         No
(43) LIFECARE PHYSICIANS PC

601 HAMILTON AVENUE
TRENTON,NJ086291986
26-1649038 		HEALTH CARE SERVICES NJ N/A
 C         No
(44) MULTICARE PLUS INC

601 HAMILTON AVENUE
TRENTON,NJ086291986
22-3435844 		INACTIVE NJ N/A
 C         No
(45) LANGHORNE SERVICES II INC

1201 LANGHORNE-NEWTOWN ROAD
LANGHORNE,PA19047
25-3795549 		GENERAL PARTNER OF LMOB PARTNERS, II PA N/A
 C         No
(46) LANGHORNE SERVICES INC

1201 LANGHORNE-NEWTOWN ROAD
LANGHORNE,PA19047
23-2625981 		GENERAL PARTNER OF LMOB PARTNERS, PA N/A
 C         No
(47) GATEWAY HEALTH PLAN INC

600 GRANT STREET
PITTSBURGH,PA15219
25-1505506 		HEALTH CARE PA N/A
 C         No
(48) GATEWAY HEALTH PLAN INC OF OHIO

600 GRANT STREET
PITTSBURGH,PA15219
30-0282076 		HEALTH CARE PA N/A
 C         No
(49) MCMC EASTWICK INC

C/O MHS ONE WEST ELM STREET
CONSHOHOCKEN,PA19428
23-2184261 		MEDICAL OFFICE BUILDINGS PA N/A
 C         No
(50) HEALTH MANAGEMENT SERVICES ORG INC

500 GROVE STREET SUITE 100
HADDON HEIGHTS,NJ08035
22-3366580 		HEALTH CARE BILLING NJ N/A
 C         No
(51) LOURDES MEDEICAL ASSOCIATES PA

500 GROVE STREET SUITE 100
HADDON HEIGHTS,NJ08035
22-3361862 		MEDICAL SERVICES NJ N/A
 C         No
(52) JEANNETTE MEDICAL PROVIDERS

3805 WEST CHESTER PIKE
NEWTOWN SQUARE,PA19073
25-1787334 		HOLDING COMPANY PA N/A
 C         No
(53) JEANNETTE OBGYN GROUP 1 INC

3805 WEST CHESTER PIKE
NEWTOWN SQUARE,PA19073
23-2890748 		HOLDING COMPANY PA N/A
 C         No
(54) JEANNETTE PRIMARY CARE GROUP 1 INC

3805 WEST CHESTER PIKE
NEWTOWN SQUARE,PA19073
23-2890743 		HOLDING COMPANY PA N/A
 C         No
(55) GEORGIA HEALTH ENTERPRISES LLC

1230 BAXTER STREET
ATHENS,GA30606
54-1806329 		HEALTHCARE GA N/A
 C         No
(56) ST MARY'S HIGHLAND HILLS VILLAGE INC

1660 JENNINGS MILL PKLY
BOGART,GA30622
58-2276801 		ASSISTED LIVING GA N/A
 C         No
(57) GHE PHYSICIANS PC

3500 PIEDMONT ROAD
ATLANTA,GA30305
58-2277939 		PRACTICE MANAGEMENT GA N/A
 C         No
(58) NURSING NETWORK INC

4725 NORTH FEDERAL HIGHWAY
FORT LAUDERDALE HIGHWA,FL333080000
59-1145192 		MEDICAL SERVICES FL N/A
 C         No
(59) MERCY PHYSICIAN GROUP INC

3663 SOUTH MIAMI AVENUE
MIAMI,FL33133
20-2970015 		HEALTH CARE FL N/A
 C         No
(60) STELLA MARIS INSURANCE COMPANY LIMITED

PO BOX 69
GRAND CAYMAN,CAYMAN ISLANDSKY1-1102
CJ
98-0078266 		INSURANCE CJ N/A
 C         No
(61) CATHOLIC HEALTH EAST SENIOR SERVICES

3805 WEST CHESTER PIKE SUITE 100
NEWTOWN SQUARE,PA19073
37-1572595 		SENIOR SERVICES PA N/A
 C         No
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to 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
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) TRINITY HEALTH - MICHIGAN

 L 510,380 PER BOOKS
(2) TRINITY HEALTH - MICHIGAN

 M 4,666,295 PER BOOKS
(3) TRINITY HEALTH - MICHIGAN

 P 2,408,058 PER BOOKS
(4) TRINITY HEALTH CORPORATION

 B 3,152,004 PER BOOKS
(5) TRINITY HEALTH CORPORATION

 M 33,719,919 PER BOOKS
(6) TRINITY HEALTH CORPORATION

 P 31,971,314 PER BOOKS
(7) TRINITY HEALTH CORPORATION

 R 1,769,980 PER BOOKS
(8) HACKLEY HOSPITAL

 L 11,375,637 PER BOOKS
(9) HACKLEY HOSPITAL

 P 309,075 PER BOOKS
(10) HACKLEY HOSPITAL

 Q 9,724,569 PER BOOKS
(11) LAKESHORE COMMUNITY HOSPITAL INC

 L 1,650,538 PER BOOKS
(12) LAKESHORE COMMUNITY HOSPITAL INC

 Q 1,074,382 PER BOOKS
(13) HACKLEY HEALTHCARE EQUIPMENT

 Q 115,351 PER BOOKS
(14) WESTSHORE HEALTH NETWORK

 L 191,939 PER BOOKS
(15) WESTSHORE HEALTH NETWORK

 Q 434,952 PER BOOKS
(16) HACKLEY PROFESSIONAL PHARMACY

 Q 95,518 PER BOOKS
(17) PROFESSIONAL MED TEAM

 Q 190,548 PER BOOKS
(18) HACKLEY LIFE COUNSELING

 L 62,124 PER BOOKS
(19) HACKLEY LIFE COUNSELING

 Q 81,735 PER BOOKS
(20) HACKLEY HEALTH VENTURES INC

 L 179,848 PER BOOKS
(21) HACKLEY PROFESSIONAL CENTER

 P 627,459 PER BOOKS
(22) HPC CO-OWNERS ASSOCATION

 P 50,253 PER BOOKS
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(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? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation

Additional Data


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