Form990
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 private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 01-01-2014 , and ending 12-31-2014
BCheck if applicable:
CName of organization
Mercy Health Foundation
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
615 Elsinore Place
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Cincinnati, OH45202
D Employer identification number

20-1072726
E Telephone number

G Gross receipts $ 30,253,255
F Name and address of principal officer:
Michael Bezney
615 Elsinore Place
Cincinnati,OH45202
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.mercy.com
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 2004
M State of legal domicile: OH
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO SUPPORT THE OPERATIONS OF MERCY HEALTH BY ENCOURAGING CHARITABLE GIVING AND EFFECTIVELY MANAGING GIFT RESOURCES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 8
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 5
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 42
6 Total number of volunteers (estimate if necessary) ............. 6 331
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 13,649,735 19,335,904
9 Program service revenue (Part VIII, line 2g) ......... 0 0
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,716,009 9,960,778
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 60,404 354,987
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 15,426,148 29,651,669
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 6,194,278 29,755,572
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) 0 3,734,127
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,572,944 2,322,850
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 7,767,222 35,812,549
19 Revenue less expenses. Subtract line 18 from line 12....... 7,658,926 -6,160,880
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 36,024,061 241,247,944
21 Total liabilities (Part X, line 26)............. 3,496,186 -745,992
22 Net assets or fund balances. Subtract line 21 from line 20..... 32,527,875 241,993,936
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 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: To carry out the charitable and educational purposes of Mercy Health by providing grants in support of programs that carry out its charitable mission.
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 $ 34,911,443 including grants of $ 29,755,572 ) (Revenue $ 0 )
MERCY HEALTH FOUNDATION AWARDED $49,755,572 IN GRANTS DURING 2014 TO PROGRAMS THAT ADDRESS THE HEALTHCARE NEEDS OF PERSONS WHO ARE POOR AND UNDERSERVED.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet34,911,443
Form 990 (2014)
Form 990 (2014)
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 I..........
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 III............................
5
 
 
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 I........................
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 II...
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 ....................
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 IV..............
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
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, 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 VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IX............
11d
 
No
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
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII .................
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 other assistance to or for any foreign organization? 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 other assistance to or for foreign individuals? 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) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ 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...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government 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 or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
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 25a................
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), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I....
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...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................
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.........
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 ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV.....................
28b
 
No
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...
28c
 
No
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.............
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........
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
 
No
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...
35b
 
 
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.............
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 VI
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 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
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
42
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, 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 FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
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.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring 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 (2014)
Form 990 (2014)
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 or note to any line 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
8
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
5
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
Yes
 
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
 
No
b
Other officers or key employees of the organization ................
15b
 
No
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
 
No
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
 
 
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, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletTRAVIS CRUM

615 ELSINORE PLACE
CINCINNATI,OH45202 (513) 639-2800
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) MICHAEL BEZNEY
 
CHAIR, MERCY HEALTH SVP & GENERAL COUNSEL
 1.00
.......................54.00 		X   X       0 1,204,433 43,782
(2) MICHAEL D CONNELLY JD
 
TRUSTEE, PRESIDENT & CEO - MERCY HEALTH
 1.00
.......................50.00 		X   X       0 2,087,458 38,377
(3) SR MARJORIE BOSSE RSM
 
VICE CHAIRPERSON
 1.00
.......................3.00 		X   X       0 0 0
(4) BRIAN CORBIN
 
TRUSTEE
 1.00
.......................3.00 		X           0 0 0
(5) SR MARIE HARTMANN
 
TRUSTEE
 1.00
.......................0 		X           0 0 0
(6) SR DORIS A GOTTEMOELLER RSM
 
TRUSTEE
 1.00
.......................2.00 		X           0 0 0
(7) JAMES P GARRETT
 
TRUSTEE
 1.00
.......................1.00 		X           0 0 0
(8) TRAVIS CRUM
 
TRUSTEE, VP CORPORATE CONTROLLER - MERCY HEALTH
 1.00
.......................50.00 		X           0 245,248 56,886
(9) PETER OWENDOFF
 
Foundation President
 40.00
.......................0 		    X       0 32,018 691
(10) ROGER LAGRECA
 
Foundation President
 40.00
.......................0 		    X       0 207,402 16,252
(11) JAMES SCHULTIS
 
Youngstown Market Foundation President
 40.00
.......................0 		        X   196,068 0 33,958
(12) TARA MILLER
 
Lourdes Foundation President
 40.00
.......................0 		        X   148,792 0 32,927
(13) KATHRYN WILLIAMS
 
Lima Market Foundation Development Director
 40.00
.......................0 		        X   192,691 0 245,354
(14) Timothy Koder
 
Toledo Market Foundation President
 40.00
.......................0 		        X   213,603 0 41,403
(15) SCOTT PEMBER
 
Lorain Market Foundation Director
 40.00
.......................0 		        X   153,577 0 31,431
(16) DEIRDRE BELUAN
 
FORMER OFFICER
 0.00
.......................40.00 		          X 0 117,150 0
(17) DEBORAH BLOOMFIELD
 
FORMER OFFICER
 0.00
.......................50.00 		          X 0 702,053 143,556
Form 990 (2014)
Form 990 (2014)
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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 904,731 4,595,762 684,617
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet5
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
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet0
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 819,725
d Related organizations...1d 3,564,000
e Government grants (contributions)1e 1,342,483
f All other contributions, gifts, grants, and
similar amounts not included above1f 		13,609,696
g Noncash contributions included in lines
1a-1f:$ 		314,293
h Total. Add lines 1a-1f.......MediumBullet 19,335,904
Program Service RevenueAmt Business Code
2a
b
c
d
e
f All other program service revenue . 0 0 0 0
g Total. Add lines 2a–2f........MediumBullet 0
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 2,740,608     2,740,608
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss) 0 0
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 7,220,170  
b Less: cost or other basis and sales expenses    
c Gain or (loss) 7,220,170 0
d Net gain or (loss)..........MediumBullet 7,220,170     7,220,170
8a Gross income from fundraising events (not including
$ 819,725
of contributions reported on line 1c). See Part IV, line 18 ..
a 956,573
b Less: direct expenses ...b 601,586
c Net income or (loss) from fundraising events..MediumBullet 354,987   354,987
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue .... 0 0 0 0
e Total. Add lines 11a–11d ...... MediumBullet 0
12 Total revenue. See Instructions......MediumBullet 29,651,669 0 0 10,315,765
Form 990 (2014)
Form 990 (2014)
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 or note to any line 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 domestic organizations and domestic governments. See Part IV, line 21 .... 29,457,949 29,457,949
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 297,623 297,623
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............    
4 Benefits paid to or for members ....    
5 Compensation of current officers, directors, trustees, and key employees ....        
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages .... 2,673,884 2,272,801 401,083  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 54,717 46,509 8,208  
9 Other employee benefits ....... 753,049 640,092 112,957  
10 Payroll taxes ........... 252,477 206,105 46,372  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 1,775   1,775  
c Accounting ........... 7,964   7,964  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 47,834 47,834    
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 1,787,978 1,519,781 268,197 0
12 Advertising and promotion .... 88,281 88,281    
13 Office expenses ....... 254,337 216,186 38,151  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 70,716 60,109 10,607  
17 Travel ............        
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 2,933 2,493 440  
23 Insurance .............. 944 802 142  
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 Bank service charges 34,732 29,522 5,210  
b Bad debt 25,356 25,356    
c
d
e All other expenses 0 0 0 0
25 Total functional expenses. Add lines 1 through 24e 35,812,549 34,911,443 901,106 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing .............   1  
2 Savings and temporary cash investments ......... 9,500 2  
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 290,000 4 10,873,133
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 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
0 6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ..........   9 84,300
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 682,361
b Less: accumulated depreciation ..... 10b 117,468 0 10c 564,893
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ..... 35,724,561 12 223,403,242
13 Investments—program-related. See Part IV, line 11 ..... 0 13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 0 15 6,322,376
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 36,024,061 16 241,247,944
Liabilities 17 Accounts payable and accrued expenses ......... 3,496,186 17 -1,024,039
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities .............   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 0 25 278,047
26 Total liabilities. Add lines 17 through 25......... 3,496,186 26 -745,992
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 .............. 32,525,078 27 109,503,666
28 Temporarily restricted net assets ........... 2,797 28 73,751,646
29 Permanently restricted net assets ...........   29 58,738,624
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 ........... 32,527,875 33 241,993,936
34 Total liabilities and net assets/fund balances ........ 36,024,061 34 241,247,944
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
29,651,669
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
35,812,549
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-6,160,880
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
32,527,875
5
Net unrealized gains (losses) on investments ...............
5
-2,440,568
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
218,067,509
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
241,993,936
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID: 14000329
Software Version: 2014v1.0
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 Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Mercy Health Foundation
 
Employer identification number

20-1072726
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
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
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 listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... 2,086,481 2,819,509 13,559,917 13,649,735 19,335,904 51,451,546
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 2,086,481 2,819,509 13,559,917 13,649,735 19,335,904 51,451,546
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).. 35,917,027
6 Public support. Subtract line 5 from line 4. 15,534,519
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
7 Amounts from line 4.. 2,086,481 2,819,509 13,559,917 13,649,735 19,335,904 51,451,546
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... 201,210 234,024 222,952 305,709 2,740,608 3,704,503
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 VI.).. 107,583 135,831 113,283 104,996 956,573 1,418,266
11 Total support Add lines 7 through 10. 56,574,315
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 section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
27.46 %
15
15
0 %
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.) ..            
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors (explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7   Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2014 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2014 		(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2015. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A, Part II, Line 17a 10% Facts and Circumstances Test explanation Mercy Health Foundation was historically classified as a Section 509(a)(3) Type I organization. On January 1, 2014 the nature and amount of support the Foundation receives materially changed when ten other foundations, originally separate entities within the Mercy Health system and all of which traditionally receive public support, merged into Mercy Health Foundation. In 2014 Mercy Health Foundation applied for and was granted a change in status to a Section 509(a)(1) organization. To demonstrate how the merged Mercy Health Foundation would now qualify as a Section 509(a)(1) organization, the application included a pro forma 2012 Schedule A Part II support schedule which aggregated the contributions of all of the foundations for the period 2008 - 2012 and reflected the direct public support these foundations would have provided, had the contributions they received been included on a Mercy Health Foundation support schedule. The pro forma 2012 Schedule A calculated a public support percentage of 65.37%. The support schedule included in the Mercy Health Foundation 2014 Schedule A includes 2010 - 2014 amounts for Mercy Health Foundation only. The ten formerly separate legal entities continue to function, operationally unchanged, within Mercy Health Foundation. Each continues its program to solicit funds from the community in which it resides and from governmental units. The public support received is used to provide, on a continuing basis, grants and other assistance to Section 501(c)(3) hospitals and other regional and community organizations whose mission is to address the healthcare and other needs of the general public, and especially of the poor and underserved.
Schedule A, Part II, Line 10 Other Income DESCRIPTION - SPECIAL EVENT REVENUE, COLUMN A - 107583.0, COLUMN B - 135831.0, COLUMN C - 113283.0, COLUMN D - 104996.0, COLUMN E - 956573.0, COLUMN F - 1418266.0;
Schedule A (Form 990 or 990-EZ) 2014

Additional Data


Software ID: 14000329
Software Version: 2014v1.0
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.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
Mercy Health Foundation
 
Employer identification number

20-1072726
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 its Form 990PF, Part I, line 2, 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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
Mercy Health Foundation
  		Employer identification number

20-1072726
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


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
Mercy Health Foundation
  		Employer identification number

20-1072726
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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
Mercy Health Foundation
  		Employer identification number

20-1072726
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. 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) (2014)

Additional Data


Software ID: 14000329
Software Version: 2014v1.0
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 Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
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) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Mercy Health Foundation
 
Employer identification number

20-1072726
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) 2014

Schedule C (Form 990 or 990-EZ) 2014
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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2011 (b) 2012 (c) 2013 (d) 2014 (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) 2014


Schedule C (Form 990 or 990-EZ) 2014
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
 
6,293
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
6,293
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
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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C, Part II-B, Line 1 Description of activities reported on Line 1A through 1I The primary purpose for lobbying activities is to enhance Mercy Health's public position on legislative and regulatory issues that impact patient care throughout its healthcare system. Mercy Health focuses on public policy issues that extend its healing ministry to those who are poor and underserved in the communities it serves. To carry out these efforts, Mercy Health partners with expert consultants and professional trade associations to build awareness and execute specific strategies that will yield a favorable outcome for patient care in the Mercy Health facilities where they are treated. Grants paid to other organizations of $6,293 constitute issue-based lobbying support.
Schedule C (Form 990 or 990EZ) 2014

Additional Data


Software ID: 14000329
Software Version: 2014v1.0

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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Mercy Health Foundation
 
Employer identification number

20-1072726
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 value of contributions to (during year)    
3 Aggregate value of 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)
Revenue 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
Revenue 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) 2014

Schedule D (Form 990) 2014
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, for escrow or custodial account liability?
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 .... 68,146,907 63,918,694 79,022,497 76,127,070 59,996,181
b Contributions ........ 92,374 2,918,149 1,541,931 1,513,548 14,753,275
c Net investment earnings, gains, and losses 93,379 2,993,064 1,691,129 2,689,201 2,920,231
d Grants or scholarships .....   1,683,000 0 3,678,195 682,862
e Other expenditures for facilities
and programs ........ 		  0 18,251,929 -2,474,793 452,236
f Administrative expenses ....   0 84,934 103,920 407,519
g End of year balance ...... 68,332,660 68,146,907 63,918,694 79,022,497 76,127,070
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet4.77 %
b
Permanent endowment SchDMd Bullet89.99 %
c
Temporarily restricted endowment SchDMd Bullet5.24 %
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)
Yes
 
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ................. 525,000 20,000 545,000
b Buildings ................   65,000 56,875 8,125
c Leasehold improvements ............        
d Equipment ................   42,526 30,758 11,768
e Other .................   29,835 29,835 0
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 564,893
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) Mercy Health Investment Management Program 		223,403,242 F








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 223,403,242
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
Other long-term liabilities 278,047








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 278,047
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D, Part V, Line 4 Intended uses of endowment funds THE ENDOWMENT FUNDS ARE RESTRICTED FOR VARIOUS USES RELATED TO THE EXEMPT PURPOSES OF THE AFFILIATED ENTITIES SUPPORTED BY THE FOUNDATION.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE COMPANY (MERCY HEALTH AND AFFILIATED ENTITIES) COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AT DECEMBER 31, 2014 AND 2013, AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT DECEMBER 31, 2014 OR 2013.
Schedule D (Form 990) 2014

Additional Data


Software ID: 14000329
Software Version: 2014v1.0




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Mercy Health Foundation
 
Employer identification number

20-1072726
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17. Form 990-EZ
filers are not required to complete this part.
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
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2014
Schedule G (Form 990 or 990-EZ) 2014
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

Gala
(event type) 		(b) Event #2

Golf Tournament
(event type) 		(c) Other events

19
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 307,291 202,241 1,266,766 1,776,298
2 Less: Contributions . . 290,575 13,515 515,635 819,725
3 Gross income (line 1
minus line 2) . . . 		16,716 188,726 751,131 956,573
VerticalDirectExpenses 4 Cash prizes . . .     17,830 17,830
5 Noncash prizes . .   1,305 58,407 59,712
6 Rent/facility costs . . 2,850 17,577 112,423 132,850
7 Food and beverages . 21,724 24,942 112,073 158,739
8 Entertainment . . . 56,395   32,150 88,545
9 Other direct expenses . 16,051 8,803 119,056 143,910
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 601,586
11 Net income summary. Subtract line 10 from line 3, column (d)........... right arrow 354,987
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. Subtract line 7 from line 1, column (d) ......... right arrow  
9
Enter the state(s) in which the organization conducts gaming activities:
a
Is the organization licensed to conduct 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) 2014
Schedule G (Form 990 or 990-EZ) 2014
Page 3
11
Does the organization conduct 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 activities conducted 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. 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 provide any additional information (see instructions).
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2014
Additional Data


Software ID: 14000329
Software Version: 2014v1.0
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.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Mercy Health Foundation
 
Employer identification number
20-1072726
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 Domestic Organizations and Domestic Governments. 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 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
(1) MERCY HEALTH YOUNGSTOWN LLC
1044 BELMONT AVENUE
YOUNGSTOWN,OH44501 		34-0505560 501(C)(3) 2,565,708       MISSION SUPPORT
(2) JEWISH HOSPITAL
4777 E GALBRAITH RD
CINCINNATI,OH45236 		27-1408630 501(C)(3) 2,244,801       MISSION SUPPORT
(3) MERCY HEALTH PARTNERS - LOURDES INC
1530 LONE OAK ROAD
PADUCAH,KY42003 		61-0600313 501(C)(3) 1,963,318       MISSION SUPPORT
(4) Mercy Health - Regional Medical Center LLC
3700 KOLBE ROAD
LORAIN,OH44053 		34-0714704 501(C)(3) 1,413,262       MISSION SUPPORT
(5) MERCY HEALTH - TIFFIN HOSPITAL LLC
45 ST LAWRENCE DRIVE
TIFFIN,OH44883 		34-4431174 501(C)(3) 1,335,439       MISSION SUPPORT
(6) MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC
2213 CHERRY STREET
TOLEDO,OH43608 		34-4428250 501(C)(3) 995,585       MISSION SUPPORT
(7) MERCY HEALTH
615 ELSINORE PLACE
CINCINNATI,OH45202 		31-1161086 501(C)(3) 916,667       BEHAVIORAL HEALTH
(8) MERCY HEALTH - FAIRFIELD HOSPITAL LLC
3000 MACK ROAD
FAIRFIELD,OH45014 		31-0538532 501(C)(3) 731,863       MISSION SUPPORT
(9) MERCY HEALTH - ANDERSON HOSPITAL LLC
7500 STATE ROAD
CINCINNATI,OH45255 		31-0537085 501(C)(3) 635,893       MISSION SUPPORT
(10) MERCY HEALTH - WEST HOSPITAL LLC
3300 MERCY HEALTH BLVD
CINCINNATI,OH45211 		31-1091597 501(C)(3) 629,181       MISSION SUPPORT
(11) CATHOLIC MEDICAL MISSION BOARD
10 WEST 17TH ST
NEW YORK,NY10011 		13-5602319 501(C)(3) 538,000       MISSION SUPPORT
(12) MERCY FRANCISCAN AT ST RAPHAEL INC
610 HIGH STREET
HAMILTON,OH45011 		20-2934871 501(C)(3) 531,509       MISSION SUPPORT
(13) MERCY HEALTH
615 ELSINORE PLACE
CINCINNATI,OH45202 		31-1161086 501(C)(3) 458,333       LEADERSHIP FOUNDATION INITIATIVE
(14) MERCY HEALTH NORTH LLC
2200 JEFFERSON AVENUE
TOLEDO,OH43604 		34-1344482 501(C)(3) 427,000       MISSION SUPPORT
(15) MERCY HEALTH
615 ELSINORE PLACE
CINCINNATI,OH45202 		31-1161086 501(C)(3) 401,500       SHARED SERVICES PROGRAM SUPPORT
(16) MERCY HEALTH PHYSICIANS LLC
615 ELSINORE PLACE
CINCINNATI,OH45202 		46-3521617 501(C)(3) 394,000       MISSION SUPPORT
(17) MERCY FRANCISCAN SOCIAL MINISTRIES INC
1800 LOGAN STREET
CINCINNATI,OH45210 		31-1222942 501(C)(3) 387,533       MISSION SUPPORT
(18) BURLINGAME REGIONAL COMMUNITY OF THE SISTERS OF MERCY
2300 ADELINE DRIVE
BURLINGAME,CA94010 		94-6071848 501(C)(3) 333,000       CORPORATE INITIATIVE
(19) UNITED WAY OF GREATER CINCINNATI
2400 RADING ROAD
CINCINNATI,OH45202 		31-0537502 501(C)(3) 265,000       2014 CAMPAIGN & LOANED EXECUTIVE PROGRAM
(20) MERCY HEALTH PHYSICIANS CINCINNATI LLC
4600 MCAULEY PLACE
CINCINNATI,OH45242 		31-1007881 501(C)(3) 259,627       MISSION SUPPORT
(21) COMMUNITY MERCY HEALTH PARTNERS
ONE SOUTH LIMESTONE ST
SPRINGFIELD,OH45502 		31-0785684 501(C)(3) 256,376       HOSPITAL MISSION SUPPORT
(22) CINCINNATI SPORTSMEDICINE
10663 MONTGOMERY ROAD
CINCINNATI,OH45242 		31-1158604 501(C)(3) 200,000       MISSION SUPPORT
(23) MERCY HEALTH NORTH LLC
2200 JEFFERSON AVENUE
TOLEDO,OH43604 		34-1344482 501(C)(3) 188,403       SENIOR OUTREACH PROGRAM
(24) CATHOLIC RELIEF SERVICES
228 W LEXINGTON ST
BALTIMORE,MD21201 		13-5563422 501(C)(3) 170,000       ST FRANCIS DE SALES HOSPITAL & HOSPITAL NETWORK
(25) BETHANY HOUSE SERVICES
1841 FAIRMONT AVENUE
CINCINNATI,OH45214 		31-1101401 501(C)(3) 160,297       MISSION SUPPORT
(26) Mercy Health - Regional Medical Center LLC
3700 KOLBE ROAD
LORAIN,OH44053 		34-0714704 501(C)(3) 157,795       RESOURCE MOTHERS & PARISH NURSING PROGRAM
(27) MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC
2213 CHERRY STREET
TOLEDO,OH43608 		34-4428250 501(C)(3) 150,000       REVITALIZE CHERRY STREET PROGRAM
(28) MERCY HEALTH - ALLEN HOSPITAL LLC
200 W LORAIN STREET
OBERLIN,OH44074 		34-0864230 501(C)(3) 150,000       HOSPITAL MISSION SUPPORT
(29) MERCY HEALTH - CLERMONT HOSPITAL LLC
3000 HOSPITAL DRIVE
BATAVIA,OH45103 		31-0830955 501(C)(3) 134,000       HOSPITAL MISSION SUPPORT
(30) URBAN LEAGUE OF GREATER CINCINNATI
3458 READING ROAD
CINCINNATI,OH45229 		31-0565428 501(C)(3) 130,000       CONFERENCE TITLE SPONSORSHIP HOST CITY NIGHT & HERITAGE PROGRAM
(31) ROCKING HORSE CHILDRENS HEALTH CENTER
651 S LIMESTONE STREET
SPRINGFIELD,OH45505 		31-1593544 501(C)(3) 123,761       MISSION SUPPORT
(32) CENTER FOR CREATIVE LEADERSHIP
ONE LEADERSHIP PLACE
GREENSBORO,NC27438 		23-7079591 501(C)(3) 113,499       MISSION SUPPORT
(33) LISC
245 N SUPERIOR 2ND FLOOR
TOLEDO,OH43604 		13-3030229 501(C)(3) 100,000       BUILDING SUSTAINABLE COMMUNITIES PROGRAM
(34) STRATEGIES TO END HOMELESSNESS INC
2368 VICTORY PKWY
CINCINNATI,OH45206 		20-8286347 501(C)(3) 100,000       HOMELESS TO HOMES INITIATIVE
(35) XAVIER UNIVERSITY INTERFAITH MEDICAL MISSION
3800 VICTORY PKWY
CINCINNATI,OH45207 		31-0537516 501(C)(3) 97,500       INTERFAITH GUATEMALA MISSION & NURSING SCHOLARSHIPS
(36) MERCY SACRED HEART INC
2120 PAYNE STREET
LOUISVILLE,KY40206 		61-1318326 501(C)(3) 73,931       MISSION SUPPORT
(37) MERCY FRANCISCAN SENIOR HEALTH AND HOUSING SERVICES INC
7010 ROWAN HILLS DRIVE
CINCINNATI,OH45227 		31-1308729 501(C)(3) 70,430       MISSION SUPPORT
(38) CINCINNATI USA REGIONAL CHAMBER OF COMMERCE
3 EAST FOURTH STREET
CINCINNATI,OH45202 		31-0239310 501(C)(6) 50,000       REDI CINCINNATI SUPPORT
(39) MERCY COLLEGE OF OHIO FOUNDATION INC
2221 MADISON AVENUE
TOLEDO,OH43604 		14-1963204 501(C)(3) 40,000       MISSION SUPPORT
(40) MERCY HEALTH - ST CHARLES HOSPITAL LLC
2600 NAVARRE AVENUE
TOLEDO,OH43616 		34-4445373 501(C)(3) 32,031       HOSPITAL MISSION SUPPORT
(41) HEARTBEAT PREGNANCY SUPPORT CENTER
4041 W SYLVANIA AVENUE
TOLEDO,OH43623 		31-1002913 501(C)(3) 30,000       COMMUNITY FUND AWARD
(42) MERCY HEALTH - WILLARD HOSPITAL LLC
1100 NEAL ZICK ROAD
WILLARD,OH44890 		34-1577110 501(C)(3) 27,461       HOSPITAL MISSION SUPPORT
(43) DEPAUL CRISTO REY HIGH SCHOOL
1133 CLIFTON HILLS AVENUE
CINCINNATI,OH45220 		27-2417727 501(C)(3) 27,000       CORPORATE WORK STUDY TEAM SUPPORT
(44) OHIO EQUINE AND AGRICULTURAL ASSOCIATION
4122 LAYBOURNE ROAD
SPRINGFIELD,OH45505 		38-3655657 501(C)(3) 26,025       MISSION SUPPORT
(45) ACCESS HEALTH MAHONING VALLEY
418 MAIN AVENUE SW
WARREN,OH44481 		27-4576650 501(C)(3) 25,000       MISSION SUPPORT
(46) INITIATIVE ON CATHOLIC SOCIAL THOUGHT
213 RYAN HALL
GEORGETOWN UNIVERSITY
WASHINGTON,DC20057 		53-0196603 501(C)(3) 25,000       CATHOLIC SOCIAL THOUGHT AND PUBLIC LIFE INITIATIVE
(47) NATIONAL UNDERGROUND RAILROAD FREEDOM CENTER
50 E FREEDOM WAY
CINCINNATI,OH45202 		31-1436217 501(C)(3) 25,000       MISSION SUPPORT
(48) OWENSBORO HEALTH FOUNDATION
2211 MAYFAIR AVENUE
OWENSBORO,KY42301 		61-1251763 501(C)(3) 25,000       MERCY REACH OWENSBORO PROGRAM SUPPORT
(49) MERCY HEALTH CINCINNATI LLC
4600 MCAULEY PLACE
CINCINNATI,OH45242 		31-1063783 501(C)(3) 24,400       MISSION SUPPORT
(50) ABILITY CENTER OF GREATER TOLEDO
5605 MONROE STREET
SYLVANIA,OH43560 		34-4428597 501(C)(3) 20,000       COMMUNITY FUND AWARD
(51) COMMUNITY MERCY HEALTH PARTNERS
ONE SOUTH LIMESTONE ST
SPRINGFIELD,OH45502 		31-0785684 501(C)(3) 20,000       MED ASSIST PROGRAM
(52) HEALTH POLICY INSTITUTE OF OHIO
37 W BROAD STREET
COLUMBUS,OH43215 		30-0186863 501(C)(3) 20,000       MISSION SUPPORT
(53) MARCUM & WALLACE MEMORIAL HOSPITAL INC
60 MERCY COURT
IRVINE,KY40336 		61-0927491 501(C)(3) 20,000       HOSPITAL MISSION SUPPORT
(54) MERCY FRANCISCAN AT ST JOHN
1233 MAIN STREET
CINCINNATI,OH45202 		31-1222942 501(C)(3) 20,000       MISSION SUPPORT
(55) MOBILITY FOUNDATION
11110 RESERVOIR ROAD
ADA,OH45810 		51-0545760 501(C)(3) 20,000       MISSION SUPPORT
(56) ST RITA'S MEDICAL CENTER LLC
730 W MARKET STREET
LIMA,OH45801 		34-1105619 501(C)(3) 20,000       HOSPITAL MISSION SUPPORT
(57) ST VINCENT DE PAUL COMMUNITY PHARMACY OF CINCINNATI
1125 BANK STREET
CINCINNATI,OH45214 		30-0272954 501(C)(3) 20,000       CHARITABLE PHARMACY PROGRAM SUPPORT
(58) FUND FOR OUR ECONOMIC FUTURE
1360 E 9TH STREET
CLEVELAND,OH44114 		27-0606927 501(C)(3) 16,667       MISSION SUPPORT
(59) OHIO CHAMBER OF COMMERCE
P O BOX 15159
COLUMBUS,OH43215 		31-4357206 501(C)(6) 15,600       2015 MEMBERSHIP
(60) ALL AFRICA CONFERENCE SISTER TO SISTER
2715 BAINBRIDGE AVE
BRONX,NY10458 		37-1424584 501(C)(3) 15,000       SISTER TO SISTER REFUGE HOUSE
(61) FARM LABOR RESEARCH PROJECT
1221 BROADWAY STREET
TOLEDO,OH43609 		34-1329126 501(C)(3) 15,000       CLINIC FOR MIGRANT WORKERS SUPPORT
(62) THE DAUGHTER PROJECT
P O BOX 255
PERRYSBURG,OH43552 		26-4557801 501(C)(3) 15,000       RECOVERY FOR VICTIMS OF HUMAN TRAFFICKING
(63) MERCY NEIGHBORHOOD MINISTRIES
1602 MADISON ROAD
2ND FLOOR
CINCINNATI,OH45206 		31-1376693 501(C)(3) 15,000       MISSION SUPPORT
(64) NAHSE ANNUAL EDUCATIONAL CONFERENCE
1050 CONNECTICUT AVE NW
WASHINGTON,DC20036 		62-1312239 501(C)(3) 15,000       CONFERENCE SPONSORSHIP
(65) PREVENT BLINDNESS OHIO
1500 WEST THIRD AVE
CINCINNATI,OH45212 		31-6063433 501(C)(3) 15,000       MISSION SUPPORT
(66) CENTER FOR CLOSING THE HEALTH GAP IN GREATER CINCINNATI
3120 BURNET AVE
CINCINNATI,OH45229 		20-0902286 501(C)(3) 12,500       HEALTH EXPO SPONSORSHIP
(67) CATHOLIC CHARITIES
1933 SPIELBUSCH AVENUE
TOLEDO,OH43604 		34-4428254 501(C)(3) 12,000       FAMILY SUPPORT AND GUIDANCE PROGRAM SUPPORT
(68) ABERCRUMBIE GROUP
10301 GIVERNY BLVD
CINCINNATI,OH45241 		30-0520187 501(C)(3) 10,000       HEALTHCARE SUPPLIER DIVERSITY SYMPOSIUM SUPPORT
(69) THE CINCINNATI ART MUSEUM
953 EDEN PARK DRIVE
CINCINNATI,OH45202 		31-0536653 501(C)(3) 10,000       MISSION SUPPORT
(70) CINCINNATI GREEN BERET GOLF CLASSIC
18756 STONE OAK PKWY
SAN ANTONIO,TX78258 		27-1206961 501(C)(3) 10,000       EVENT SUPPORT
(71) FOUNDATION OF AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES
ONE NORTH FRANKLIN
CHICAGO,IL60606 		36-0724325 501(C)(3) 10,000       INNOVATION HEALTHCARE LEADERSHIP FUND SUPPORT
(72) LEADERSHIP CONFERENCE OF WOMEN RELIGIOUS
8808 CAMERON STREET
SILVER SPRING,MD20910 		43-6033728 501(C)(3) 10,000       LCWR 2014 ASSEMBLY SUPPORT
(73) EMANUEL COMMUNITY CENTER
1308 RACE STREET
CINCINNATI,OH45202 		31-0537060 501(C)(3) 7,500       MISSION SUPPORT
(74) ZOOLOGICAL SOCIETY OF CINCINNATI
3400 VINE STREET
CINCINNATI,OH45220 		31-0537171 501(C)(3) 7,500       ZOO LA LA ANIMAL ENCOUNTER SPONSORSHIP
(75) NATIONAL ASSOCIATION OF CATHOLIC CHAPLAINS
4915 S HOWELL AVE
MILWAUKEE,WI53207 		39-1368967 501(C)(3) 7,000       EVENT SPONSORSHIP
(76) HEALTHY MOMS AND BABIES INC
2270 BANNING ROAD
CINCINNATI,OH45239 		31-1155292 501(C)(3) 6,500       MISSION SUPPORT
(77) THE ASSUMPTION VILLAGE
9800 MARKET STREET
NORTH LIMA,OH44452 		34-1013695 501(C)(3) 5,753       MISSION SUPPORT
(78) USO METROPOLITAN WASHINGTON
228 MCNAIR RD BLDG 405
FORT MYER,VA22211 		53-0204665 501(C)(3) 5,600       2014 TABLE SPONSOR
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
76
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
2
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. 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
(1) SPRINGFIELD MARKET MED ASSIST PROGRAM 1939 118,806      
(2) LOURDES HOSPITAL PATIENT MISSION FUND 512 22,562      
(3) LOURDES HOSPITAL ASSOCIATE MISSION FUND 46 27,201      
(4) LORAIN MARKET CARING FOR OUR OWN FUND 20 9,697      
(5) NORTHERN MARKET CHARITABLE PHARMACY 109 8,280      
(6) NORTHERN MARKET TRANSPORTATION SERVICES 1644 29,782      
(7) NORTHERN MARKET HEALTH CAMPS 973 48,174      
(8) NORTHERN MARKET FOOD SERVICES 881 4,385      
(9) Mercy Health We Care Grants 0 17,954      
(10) Cincinnati market individual grant assistance 2 10,782      
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds Any organization receiving funds over $5,000 must complete an accompanied "Verification of Use of a Grant or Other Assistance from the Mercy Health Foundation" form. Organizations signing the form "Attest that the grant/assistance provided by the Foundation is being used for the purpose intended as stated in the request to the Foundation and that additional documentation to support usage of the grant/assistance as stated will be provided to the Foundation upon request." The Verification from must be submitted within 30 days of receiving the grant or assistance. Second notices are sent if the form is not returned within the allocated time frame. No additional grant or assistance will be provided until the form is signed and returned to the Foundation. To the extent additional information is required, requests will be made to the grantee. When the Foundation supports a Mercy Health initiative, the manager of the initiative is expected to attend a Foundation board meeting annually in-person during the course of the Foundation's support for the initiative. This attendance is to report the current year's status of the initiative, and plans for the following year if the Foundation is being asked to continue support or has already made a multi-year commitment.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Any organization receiving funds over $5,000 must complete an accompanied "Verification of Use of a Grant or Other Assistance from the Mercy Health Foundation" form. Organizations signing the form "Attest that the grant/assistance provided by the Foundation is being used for the purpose intended as stated in the request to the Foundation and that additional documentation to support usage of the grant/assistance as stated will be provided to the Foundation upon request." The Verification from must be submitted within 30 days of receiving the grant or assistance. Second notices are sent if the form is not returned within the allocated time frame. No additional grant or assistance will be provided until the form is signed and returned to the Foundation. To the extent additional information is required, requests will be made to the grantee. When the Foundation supports a Mercy Health initiative, the manager of the initiative is expected to attend a Foundation board meeting annually in-person during the course of the Foundation's support for the initiative. This attendance is to report the current year's status of the initiative, and plans for the following year if the Foundation is being asked to continue support or has already made a multi-year commitment.
Schedule I (Form 990) 2014


Additional Data


Software ID: 14000329
Software Version: 2014v1.0


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Mercy Health Foundation
 
Employer identification number

20-1072726
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
directors, trustees, officers, including 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), 501(c)(4), and 501(c)(29) organizations 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
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in 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) 2014

Schedule J (Form 990) 2014
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 in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1MICHAEL BEZNEY
  CHAIR, MERCY HEALTH SVP & GENERAL COUNSEL 		(i)
(ii)		 0
...............................
554,415 		0
...............................
150,549 		0
...............................
499,469 		0
...............................
15,600 		0
...............................
28,182 		0
...............................
1,248,215 		0
...............................
264,659
2MICHAEL D CONNELLY JD
  TRUSTEE, PRESIDENT & CEO - MERCY HEALTH 		(i)
(ii)		 0
...............................
1,163,994 		0
...............................
556,488 		0
...............................
366,976 		0
...............................
18,200 		0
...............................
20,177 		0
...............................
2,125,835 		0
...............................
0
3TRAVIS CRUM
  TRUSTEE, VP CORPORATE CONTROLLER - MERCY HEALTH 		(i)
(ii)		 0
...............................
203,647 		0
...............................
39,911 		0
...............................
1,690 		0
...............................
32,048 		0
...............................
24,838 		0
...............................
302,134 		0
...............................
0
4DEIRDRE BELUAN
  FORMER OFFICER 		(i)
(ii)		 0
...............................
117,150 		0
...............................
0 		0
...............................
0 		0
...............................
0 		0
...............................
0 		0
...............................
117,150 		0
...............................
0
5DEBORAH BLOOMFIELD
  FORMER OFFICER 		(i)
(ii)		 0
...............................
541,196 		0
...............................
157,500 		0
...............................
3,357 		0
...............................
122,873 		0
...............................
20,683 		0
...............................
845,609 		0
...............................
0
6ROGER LAGRECA
  Foundation President 		(i)
(ii)		 0
...............................
159,142 		0
...............................
0 		0
...............................
48,260 		0
...............................
8,173 		0
...............................
8,079 		0
...............................
223,654 		0
...............................
0
7JAMES SCHULTIS
  Youngstown Market Foundation President 		(i)
(ii)		 177,587
...............................
0 		16,887
...............................
0 		1,594
...............................
0 		26,240
...............................
0 		7,718
...............................
0 		230,026
...............................
0 		0
...............................
0
8TARA MILLER
  Lourdes Foundation President 		(i)
(ii)		 129,063
...............................
0 		18,711
...............................
0 		1,018
...............................
0 		15,883
...............................
0 		17,044
...............................
0 		181,719
...............................
0 		0
...............................
0
9KATHRYN WILLIAMS
  Lima Market Foundation Development Director 		(i)
(ii)		 169,093
...............................
0 		18,315
...............................
0 		5,283
...............................
0 		229,555
...............................
0 		15,799
...............................
0 		438,045
...............................
0 		0
...............................
0
10Timothy Koder
  Toledo Market Foundation President 		(i)
(ii)		 205,917
...............................
0 		5,778
...............................
0 		1,908
...............................
0 		25,658
...............................
0 		15,745
...............................
0 		255,006
...............................
0 		0
...............................
0
11SCOTT PEMBER
  Lorain Market Foundation Director 		(i)
(ii)		 147,852
...............................
0 		4,242
...............................
0 		1,483
...............................
0 		10,456
...............................
0 		20,975
...............................
0 		185,008
...............................
0 		0
...............................
0
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part I, Line 4b Terms and conditions of the Cincinnati Market SERP The Cincinnati Market SERP is a deferred compensation plan which provides employment continuation incentives to all executive council members. It provides annual credits of a specified percentage of compensation. A benefit is calculated for any individual whose compensation is limited in the qualified cash balance plan due to income which exceeds the IRS maximum. The benefit is based upon Form W-2 compensation and is equal to the amount excluded from the qualified plan. Participants must complete a two tiered vesting provision. participants must be vested under the base qualified plan and must count 24 months after termination during which they do not compete with Mercy Health Cincinnati LLC. Amounts includible as taxable compensation for listed individuals due to executive benefit plan participation in the reporting year were as follows: Deborah Bloomfield $0.
Schedule J, Part I, Line 4b Terms and conditions of Mercy Health 457(f) executive retention plan The Mercy Health executive retention plan is a deferred compensation plan which provides employment continuation incentives to persons selected by the Board of Trustees or its delegate. It provides annual credits of a specified percentage of compensation and annual interest credits. Participants vest and cease to receive credits after 5 years of plan participation provided they remain employed. Vesting and cessation of credits occur earlier for death or total disability while employed, involuntary termination of employment within 24 months after a change in control of the organization, or, for certain participants, upon being offered a specified promotion. Payment of the vested account balance in a lump sum occurs upon vesting. Amounts includable as taxable compensation for listed individuals due to retention plan participation in the reporting year were as follows: Michael Bezney $367,889.
Schedule J, Part I, Line 4b Terms and conditions of the Youngstown Market SERP The Youngstown Market SERP Plan is a deferred compensation plan which provides supplemental retirement benefits to persons selected by the Mercy Health Youngstown LLC Board of trustees or its delegate. The Plan provides annual credits of a specified percentage of compensation and annual interest credits. Participants vest 100% in their accounts after three years of service, except for participants who had attained at least ten years of service at plan inception, who had immediate vesting. Vesting occurs earlier upon death or total disability. Payments are made during employment for required tax withholding. The vested account balance is paid as a lump sum after termination of employment. Amounts includible as taxable compensation for listed individuals due to SERP participation in the reporting year are as follows: James Schultis $0.
Schedule J, Part I, Line 4b Terms and conditions of the Mercy Health System SERP The Mercy Health System SERP is a non-qualified deferred compensation plan which provides supplemental retirement benefits to persons selected by the Board of Trustees or its delegate. The plan provides for annual credits of a specified percentage of an eligible participants base salary paid in a plan year and interest credits. Plan participants vest in plan credits after completing a three year class vesting schedule or earlier for death or total disability or reaching age 60 while employed, or due to involuntary separation of employment other than for cause. Payments during employment are made for required tax withholding and reduce the participants account balance. Distribution of the vested account balance in a lump sum occurs after termination of employment. Amounts includible as taxable compensation for listed individuals due to SERP participation in the reporting year were as follows: Deborah Bloomfield $0; Travis Crum $0; Timothy Koder $0; Roger LaGreca $0; Tara Miller $0; Scott Pember $0; James Schultis $0.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Mercy Health Foundation relies upon Mercy Health to establish compensation of the organization's CEO/Executive Director. Mercy Health utilized a compensation committee, an independent compensation consultant, a compensation survey or study, and approval by board or compensation committee to establish the top management official's compensation.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE MERCY HEALTH SERP PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATES. IT PROVIDES ANNUAL CREDITS OF A SPECIFICED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST 50%, 75%, AND 100% IN THEIR ACCOUNTS AFTER 5, 6, AND 7 YEARS OF SERVICE, RESPECTFULLY. VESTING OCCURS EARLIER FOR DEATH OR TOTAL DISABILITY OR REACHING AGE 60 WHILE EMPLOYED, OR INVOLUNTARY TERMINATION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHNAGE IN CONTROL OF THE ORGANIZATION OR DUE TO POSITION ELIMIATION. PAYMENTS DURING EMPLOYMENT ARE MADE FOR REQUIRED TAX WITHHOLDINGS. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS AFTER TERMINATION OF EMPLOYMENT. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO SERP PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: MICHAEL BEZNEY $109,878; MICHAEL CONNELLY $335,383.
Schedule J, Part I, Line 7 Non-fixed payments The organization provides annual incentive compensation for listed individuals. The organization's Board of Trustees establishes objective thresholds for quality, community benefit, and financial performance which must be achieved for incentives to be awarded. The Board also establishes threshold, target and maximum levels for incentive awards. Within these established parameters, the Board determines the CEO's incentive award and incentive awards for other listed individuals are determined by the listed individual's supervisor and disclosed to the Board. The Board may authorize modified incentive awards when appropriate in its judgment.
Schedule J (Form 990) 2014

Additional Data


Software ID: 14000329
Software Version: 2014v1.0
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.
Right pointing arrow large imageInformation about Schedule M (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Mercy Health Foundation
 
Employer identification number

20-1072726
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 .        
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 ... X 1 314,293 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
1
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 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
 
No
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) (2014)
Schedule M (Form 990) (2014)
Page 2
Part II
Supplemental Information. 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.
Return Reference Explanation
Schedule M, Part I, Line 17 Description of charitable gift annuity The Foundation received 25 acres of undeveloped land, including a house and a barn. The appraised value of this property is $525,000. This contribution is subject to a charitable gift annuity liability of $210,707. Therefore $314,293 was recognized as contribution revenue at the time of the gift.
Schedule M, Part I Explanations of reporting method for number on contributions Real estate - Other: Reporting the number of contributions.
Schedule M, Part I, Line 17 Number of contributions or items contributed Reporting the number of contributions.
Schedule M (Form 990) (2014)
Additional Data


Software ID: 14000329
Software Version: 2014v1.0
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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Mercy Health Foundation
 
Employer identification number

20-1072726
Return Reference Explanation
Form 990, Part VI, Line 15a Determining the compensation of the top management official The compensation of the top management official is determined by Mercy Health, a related tax-exempt organization.
Form 990, Part VI, Line 4 Significant changes to organizational documents The Amended Code of Regulations creates two classes of trustees: System and Market. The member elects system trustees whose powers and actions relate to the Corporation as a whole, including the budget, expenditures and finances of the Corporation, the management and investment of Corporate funds and choice of investment advisors and similar service providers, the election of Corporate officers, the designation of the Corporate CEO, and the establishment of Corporate committees and appointment of committee members. System trustees elect market trustees who exercise authority over the actions of the Corporation relevant to and affecting the Markets, including control in the market they serve over fund-raising, development of a culture of philanthropy, and the use of Foundation funds in the Market. Market trustees exercise these powers only as to the market in which they were appointed. Market trustees exercise no powers reserved to the System trustees. Only system trustees attend regular Corporate board meetings, although market trustees may be invited to attend, and each system trustee has one vote. Market trustees attend regular meetings in their particular market as they determine, and each has one vote in the market they serve.
Form 990, Part VI, Line 6 Classes of members or stockholders MERCY HEALTH IS THE MEMBER OF MERCY HEALTH FOUNDATION.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Mercy Health elects all trustees who have full voting rights.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Certain matters require approval of Mercy Health, the Foundation's Corporate Member. The regulations of the organization describe the level of approval required for various decisions.
Form 990, Part VI, Line 11b Review of form 990 by governing body THE FORM 990 IS PREPARED BY THE Mercy Health TAX DEPARTMENT AND REVIEWED BY MANAGEMENT. ONCE THE FORM 990 IS REVIEWED AND APPROVED BY ALL APPLICABLE PARTIES A COPY OF THE FINAL VERSION IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING.
Form 990, Part VI, Line 12c Conflict of interest policy All board members are covered by the Mercy Health conflict of interest policy, which requires disclosure on an annual basis. All potential conflicts of interest are reviewed by the Mercy health Corporate Compliance Officer. At the beginning of each board meeting all board members are requested to disclose any conflicts of interest. Board members determined to have a conflict of interest are prohibited from participating in deliberations and decision-making for the transaction in which the conflict exists.
Form 990, Part VI, Line 19 Required documents available to the public The governing documents and financial statements are available upon request. The conflict of interest policy is posted on the Mercy Health website.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances Net asset transfers at merger of related foundations - XXX-XX-XXXX; Other changes is net assets - 3176300;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


Software ID: 14000329
Software Version: 2014v1.0
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Mercy Health Foundation
 
Employer identification number

20-1072726
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) MERCY HEALTH
615 ELSINORE PLACE

CINCINNATI,OH45202
31-1161086 		HEALTHCARE SYSTEM PARENT OH 501(c)(3 3 NA
 
 
No
(2) MERCY HEALTH FOUNDATION
615 ELSINORE PLACE

CINCINNATI,OH45202
20-1072726 		FUNDRAISING OH 501(c)(3 7 MERCY HEALTH
 
 
No
(3) MERCY HEALTH RETIREMENT TRUST
615 ELSINORE PLACE

CINCINNATI,OH45202
31-6046304 		RETIREMENT TRUST OH 501(c)(3 7 MERCY HEALTH
 
 
No
(4) COMMUNITY HEALTH PARTNERS PHYSICIANS OFFICE BUILDINGS
3700 KOLBE ROAD

LORAIN,OH44053
34-1268828 		MEDICAL OFFICE RENTAL OH 501(c)(3 9 MERCY HEALTH - REGIONAL MEDICAL CENTER LLC
 
 
No
(5) ALLEN MEDICAL CENTER MEDICAL OFFICE BUILDING
200 WEST LORAIN ST

OBERLIN,OH44074
36-4504991 		MEDICAL OFFICE RENTAL OH 501(c)(3 Type II MERCY HEALTH - ALLEN HOSPITAL LLC
 
 
No
(6) MERCY FRANCISCAN SENIOR HEALTH AND HOUSING SERVICES INC
7010 ROWAN HILLS DR

CINCINNATI,OH45227
31-1308729 		RETIREMENT HOME OH 501(c)(3 9 MERCY HEALTH CINCINNATI LLC
 
 
No
(7) MERCY SACRED HEART INC
2120 PAYNE STREET

LOUISVILLE,KY40206
61-1318326 		RETIREMENT HOME KY 501(c)(3 9 MERCY HEALTH CINCINNATI LLC
 
 
No
(8) MERCY LONG TERM CARE INITIATIVE
4915 CHARLESTOWN RD

NEW ALBANY,IN47150
31-1332491 		RETIREMENT HOME IN 501(c)(3 9 MERCY HEALTH CINCINNATI LLC
 
 
No
(9) MERCY FRANCISCAN SOCIAL MINISTRIES INC
1800 LOGAN STREET

CINCINNATI,OH45210
31-1222942 		LOW INCOME HOUSING OH 501(c)(3 7 MERCY HEALTH CINCINNATI LLC
 
 
No
(10) MERCY FRANCISCAN AT ST RAPHAEL INC
610 HIGH STREET

HAMILTON,OH45011
20-2934871 		SOCIAL SERVICES OH 501(c)(3 7 MERCY HEALTH CINCINNATI LLC
 
 
No
(11) COMMUNITY MERCY HEALTH SYSTEM
ONE S LIMESTONE ST

SPRINGFIELD,OH45502
30-0272454 		MARKET PARENT OH 501(c)(3 Type I MERCY HEALTH
 
 
No
(12) COMMUNITY MERCY HEALTH PARTNERS
ONE S LIMESTONE ST

SPRINGFIELD,OH45502
31-0785684 		HOSPITAL OH 501(c)(3 3 COMMUNITY MERCY HEALTH SYSTEM
 
 
No
(13) C H HEALTH SERVICES COMPANY
ONE S LIMESTONE ST

SPRINGFIELD,OH45502
31-1181984 		HOSPITAL OH 501(c)(3 3 COMMUNITY MERCY HEALTH SYSTEM
 
 
No
(14) CLARKE & CHAMPAIGN COUNTIES HEALTH INFORMATION EXCHANGE
1150 E HOME ROAD

SPRINGFIELD,OH45503
26-0698515 		MEDICAL INFORMATION EXCHANGE OH 501(c)(3 9 COMMUNITY MERCY HEALTH SYSTEM
 
 
No
(15) THE WALLACE S MURRAY AND FRANCES RABBITTS MURRAY MEMORIAL TRUST
ONE S LIMESTONE ST

SPRINGFIELD,OH45502
34-6827136 		INDIGENT MEDICAL CARE OH 501(c)(3 Type I NA
 
 
No
(16) MERCY PROPERTY HOLDINGS
2200 JEFFERSON AVENUE

TOLEDO,OH43604
30-0699825 		TITLE HOLDING COMPANY OH 501(c)(2   MERCY HEALTH NORTH LLC
 
 
No
(17) MERCY HOME CARE INC
2200 JEFFERSON AVENUE

TOLEDO,OH43604
34-1587572 		HOME HEALTHCARE OH 501(c)(3 9 MERCY HEALTH NORTH LLC
 
 
No
(18) MERCY COLLEGE OF OHIO
2221 MADISON AVENUE

TOLEDO,OH43604
34-1726619 		MEDICAL COLLEGE OH 501(c)(3 2 MERCY HEALTH NORTH LLC
 
 
No
(19) MERCY COLLEGE OF OHIO FOUNDATION INC
2221 MADISON AVENUE

TOLEDO,OH43604
14-1963204 		FOUNDATION OH 501(c)(3 Type I MERCY COLLEGE OF OHIO
 
 
No
(20) LIFESTAR AMBULANCE INC
2200 JEFFERSON AVENUE

TOLEDO,OH43604
34-1354653 		MEDICAL TRANSPORTATION OH 501(c)(3 Type II MERCY HEALTH NORTH LLC
 
 
No
(21) RSM MEDICAL FOUNDATION
2200 JEFFERSON AVENUE

TOLEDO,OH43624
34-1693671 		HOSPITAL OH 501(c)(3 3 MERCY HEALTH NORTH LLC
 
 
No
(22) SIMON OUTREACH SERVICES
2600 NAVARRE AVENUE

OREGON,OH43616
34-1383325 		MEDICAL OFFICE RENTAL OH 501(c)(3 Type II MERCY HEALTH - ST CHARLES HOSPITAL LLC
 
 
No
(23) FARLEY HEALTHCARE CORPORATION
2200 JEFFERSON AVENUE

TOLEDO,OH43604
34-1363204 		HEALTH SERVICES OH 501(c)(3 9 MERCY HEALTH NORTH LLC
 
 
No
(24) NEW VISION MEDICAL LABORATORIES INC
750 W HIGH ST STE 400

LIMA,OH45801
34-1937267 		MEDICAL LAB SERVICES OH 501(c)(3 Type II ST RITA'S MEDICAL CENTER LLC
 
 
No
(25) THE ASSUMPTION VILLAGE
9800 N MARKET STREET

NORTH LIMA,OH44452
34-1013695 		NURSING HOME OH 501(c)(3 9 MERCY HEALTH YOUNGSTOWN LLC
 
 
No
(26) HOSPICE OF THE VALLEY
5190 MARKET STREET

YOUNGSTOWN,OH44512
34-1288745 		HOSPICE SERVICES OH 501(c)(3 9 MERCY HEALTH YOUNGSTOWN LLC
 
 
No
(27) HUMILITY HOUSE
755 OHLTOWN ROAD

AUSTINTOWN,OH44515
34-1894783 		NURSING HOME OH 501(c)(3 9 MERCY HEALTH YOUNGSTOWN LLC
 
 
No
(28) ST JOSEPH HEALTH CENTER AUXILIARY
677 EASTLAND SE

WARREN,OH44484
34-6556121 		FUNDRAISING OH 501(c)(3 9 MERCY HEALTH YOUNGSTOWN LLC
 
 
No
(29) MERCY HEALTH PARTNERS - LOURDES INC
1530 LONE OAK ROAD

PADUCAH,KY42003
61-0600313 		HOSPITAL KY 501(c)(3 3 MERCY HEALTH
 
 
No
(30) LOURDES HOSPITAL AUXILIARY GIFT SHOP
1530 LONE OAK ROAD

PADUCAH,KY42003
61-0927805 		FUNDRAISING KY 501(c)(3 Type I MERCY HEALTH FOUNDATION
 
 
No
(31) MARCUM AND WALLACE MEMORIAL HOSPITAL INC
60 MERCY COURT

IRVINE,KY40336
61-0927491 		HOSPITAL KY 501(c)(3 3 MERCY HEALTH PARTNERS - LOURDES INC
 
 
No
(32) MERCY HEALTH PARTNERS INC
615 ELSINORE PLACE

CINCINNATI,OH45202
73-1627534 		MARKET PARENT TN 501(c)(3 Type I MERCY HEALTH
 
 
No
(33) MERCY HEALTH PARTNERS - NORTHEAST REGION INC
615 ELSINORE PLACE

CINCINNATI,OH45202
23-2813196 		MARKET PARENT PA 501(c)(3 Type I MERCY HEALTH
 
 
No
(34) MERCY HOSPITAL OF WILKES-BARRE
746 JEFFERSON AVENUE

SCRANTON,PA18510
24-0795625 		HOSPITAL PA 501(c)(3 3 MERCY HEALTH PARTNERS - NORTHEAST REGION INC
 
 
No
(35) MERCY HEALTH CARE CENTER
746 JEFFERSON AVENUE

SCRANTON,PA18510
23-2322809 		HOSPITAL PA 501(c)(3 3 MERCY HEALTH PARTNERS - NORTHEAST REGION INC
 
 
No
(36) HEALTHSPAN PARTNERS
615 ELSINORE PLACE

CINCINNATI,OH45202
46-3055925 		MARKET PARENT OH 501(c)(3 Type II MERCY HEALTH
 
 
No
(37) HEALTHSPAN INTEGRATED CARE
1001 LAKESIDE AVE SUITE 1200

CLEVELAND,OH44114
34-0922268 		HMO OH 501(c)(3 9 HEALTHSPAN PARTNERS
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No
(1) NWO Integrated Laboratories Mercy LLC

2200 Jefferson Avenue
Toledo,OH43624
34-1898285 		Laboratory services OH NA
  		N/A                
(2) Tiffin Ambulatory Surgical Associates

45 St Lawrence Drive
Tiffin,OH44833
37-1567866 		Ambulatory Surgery Center OH NA
  		N/A                
(3) New Vision Medical Lab LLC

750 W High Street
Lima,OH45801
34-1913433 		Lab Services OH NA
  		N/A                
(4) West Central Ohio Group Ltd

801 Medical Drive
Lima,OH45804
34-1848147 		Orthopedic Hospital OH NA
  		N/A                
(5) Kidney Services of West Central Ohio

750 W High Street Suite 100
Lima,OH45801
06-1644264 		Dialysis Center OH NA
  		N/A                
(6) West Central Ohio Regional Healthcare Alliance Ltd

2615 Fort Amanda Road
Lima,OH45805
34-1817078 		Healthcare quality OH NA
  		N/A                
(7) Urologic Oncology of Mahoning Valley LLC

1044 Belmont Ave
Youngstown,OH44501
26-2989686 		Radiation Therapy OH NA
  		N/A                
(8) HMHPUSP Surgery Centers LLC

15305 Dallas Pkwy Ste 1600
Addison,TX75001
27-1953122 		Surgery Center TX NA
  		N/A                
(9) OSC-HMHP LLC

6505 Market St Bldg B Ste 101
Boardman,OH44512
01-0724836 		Orthopedic Surgery Center OH NA
  		N/A                
(10) Lourdes Ambulatory Surgery Center

225 Medical Center Drive
Paducah,KY42003
61-1258960 		Surgery Center KY NA
  		N/A                
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) CHP INSURANCE LTD

615 ELSINORE PLACE
CINCINNATI,OH45202
98-0621978 		INSURANCE CJ NA
  		C Corporation         No
(2) NORTHPARKE MEDICAL COMMONS CONDO ASSN

333 N LIMESTONE ST
SPRINGFIELD,OH45503
31-1391230 		REAL PROPERTY MGMNT OH NA
  		C Corporation         No
(3) NORTHSIDE CORPORATION

2200 JEFFERSON AVENUE
TOLEDO,OH43604
34-1318438 		RESIDENT RENTALS OH NA
  		C Corporation         No
(4) MERCY WORK SOLUTIONS

2200 JEFFERSON AVENUE
TOLEDO,OH43604
30-0066340 		WORKERS COMPENSATION OH NA
  		C Corporation         No
(5) MERCY HEALTH SYSTEM PHO

2200 JEFFERSON AVENUE
TOLEDO,OH43604
34-1778321 		MEDICAL SERVICES OH NA
  		C Corporation         No
(6) MCAULEY MANAGEMENT SERVICES INC

730 W MARKET STREET
LIMA,OH45801
34-1379037 		PROPERTY RENTAL OH NA
  		C Corporation         No
(7) LIMA MEDICAL SUPPLIES INC

730 W MARKET STREET
LIMA,OH45801
34-0944477 		MEDICAL EQUIPMENT OH NA
  		C Corporation         No
(8) COMMUNITY HEALTH PARTNERS ENTERPRISES INC

3700 KOLBE ROAD
LORAIN,OH44053
34-1455525 		HOLDING COMPANY OH NA
  		C Corporation         No
(9) AMC PHYSICIANS INC

200 W LORAIN STREET
OBERLIN,OH44074
37-1439554 		PHYSICIAN SERVICES OH NA
  		C Corporation         No
(10) MERCY HEALTH VENTURES INC

4600 MCAULEY PLACE
CINCINNATI,OH45242
31-1185477 		DIVERSIFIED ACTIVITIES OH NA
  		C Corporation         No
(11) MERCY FRANCISCAN AT WINTON WOODS I INC

10290 MILL ROAD
CINCINNATI,OH45231
31-1658668 		LOW-INCOME HOUSING OH NA
  		C Corporation         No
(12) HEALTH DYNAMICS INC

900 E OAK HILL AVENUE
KNOXVILLE,TN37917
62-1247729 		MEDICAL EQUIPMENT SALES TN NA
  		C Corporation         No
(13) HEALTH VENTURES INC & SUBSIDIARIES

P O BOX 1788
KNOXVILLE,TN37901
62-1175587 		MEDICAL SERVICES TN NA
  		C Corporation         No
(14) ANNE KILCAWLEY CHRISTMAN FOUNDATION

100 FEDERAL PLAZA EAST
YOUNGSTOWN,OH44503
35-6735706 		BENEFICIAL TRUST OH NA
  		Trust         No
(15) RALPH EWE TRUST

270 PARK AVENUE
NEW YORK,NY10017
34-6866422 		BENEFICIAL TRUST NY NA
  		Trust         No
(16) ELIZABETH HINES CATES TRUST

PNC 1900 E 9TH ST
CLEVELAND,OH44114
34-6515678 		BENEFICIAL TRUST OH NA
  		Trust         No
(17) WILLIS PARK TRUST

PNC 1900 E 9TH ST
CLEVELAND,OH44114
34-6519904 		BENEFICIAL TRUST OH NA
  		Trust         No
(18) ERMA GIBSON BALDWIN TRUST

PNC 1900 E 9TH ST
CLEVELAND,OH44114
34-6515566 		BENEFICIAL TRUST OH NA
  		Trust         No
(19) HEALTHSPAN INC

225 PICTORIA DR
CINCINNATI,OH45246
31-1431434 		INSURANCE OH NA
  		C Corporation         No
(20) HEALTHSPAN SOLUTIONS INC

615 ELSINORE PLACE
CINCINNATI,OH45202
30-0810766 		CONSULTING OH NA
  		C Corporation         No
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
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
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved





Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 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) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2014
Additional Data


Software ID: 14000329
Software Version: 2014v1.0