TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) CHAD WABLE...................................................................... DIRECTOR	1.0 ................. 40.0	X		898,573	197,623
(2) JACI CARROLL-HANRATTY...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0
(3) MICHAEL C CULHANE...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0
(4) PETER J JACOBY M D...................................................................... DIRECTOR	3.0 ................. 0.0	X		0	0
(5) LYNETTE LETSKY-PIOMBO...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0
(6) GEORGE J STROBEL JR...................................................................... VICE CHAIRMAN	2.0 ................. 0.0	X	X	0	0
(7) EMILY ANDERSON...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0
(8) SHARON ZILAHY RN...................................................................... SECRETARY	1.0 ................. 0.0	X	X	0	0
(9) PAUL KELLY MD...................................................................... CHAIRMAN	2.0 ................. 40.0	X	X	593,536	37,387
(10) KEVIN DELGOBBO...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0
(11) JOHN A ZINNO JR...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0
(12) CARRIE FULLER...................................................................... EXECUTIVE DIRECTOR	40.0 ................. 0.0	X	X	44,655	6,501
(13) LORI A GREENE...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0
(14) PETER R DOIRON...................................................................... TREASURER	1.0 ................. 0.0	X	X	0	0
(15) LEONARD F GENOVESE...................................................................... DIRECTOR (THRU 12/31/2015)	1.0 ................. 0.0	X		0	0
(16) BRIAN M JONES CPA...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0
(17) GREGORY ONEGLIA...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0

- TIN:

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

2015

Open to Public
Inspection

Name of the organization

SAINT MARY'S HOSPITAL FOUNDATION INC

Employer identification number

22-2528400

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

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

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

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

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

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

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

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

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

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

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

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

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

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....	574,511	585,377	494,924	844,886	976,624	3,476,322
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......						0
3	The value of services or facilities furnished by a governmental unit to the organization without charge..						0
4	Total. Add lines 1 through 3	574,511	585,377	494,924	844,886	976,624	3,476,322
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)..						328,014
6	Public support. Subtract line 5 from line 4.						3,148,308

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..	574,511	585,377	494,924	844,886	976,624	3,476,322
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	123,324	380,956	472,441	286,488	112,599	1,375,808
9	Net income from unrelated business activities, whether or not the business is regularly carried on..						0
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..						0
11	Total support. Add lines 7 through 10.						4,852,130

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

64.885 %

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

60.956 %

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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.)..

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

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2015

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

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

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.

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.

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.

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.

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

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.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) 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.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

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

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

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

A family member of a person described in (a) above?

11b

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

Section B. Type I Supporting Organizations

Yes

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

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.

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.

Parent of Supported Organizations. Answer (a) and (b) below.

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.

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.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

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

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) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

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 2015 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-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

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 (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

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

OMB No. 1545-0047

2015

Name of the organization

SAINT MARY'S HOSPITAL FOUNDATION INC

Employer identification number

22-2528400

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization SAINT MARY'S HOSPITAL FOUNDATION INC

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization SAINT MARY'S HOSPITAL FOUNDATION INC		Employer identification number 22-2528400

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization SAINT MARY'S HOSPITAL FOUNDATION INC			Employer identification number 22-2528400
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose 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

(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

(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

(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) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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

2015

Open to Public Inspection

Name of the organization

SAINT MARY'S HOSPITAL FOUNDATION INC

Employer identification number

22-2528400

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on 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 ....

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

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

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

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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

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

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

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

Part V

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

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	1,459,648	1,424,616	1,342,911	1,228,902	1,076,292
b	Contributions ...	5	82,538
c	Net investment earnings, gains, and losses	8,879	-47,506	86,705	114,945	152,610
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...			5,000	936
f	Administrative expenses ....
g	End of year balance ......	1,468,532	1,459,648	1,424,616	1,342,911	1,228,902

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

72.000 %

Temporarily restricted endowment SchDMd Bullet

28.000 %

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

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

Yes

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

3a(i)

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

3a(ii)

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

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' on 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 ...
b	Buildings
c	Leasehold improvements
d	Equipment ...
e	Other ...
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on 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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
DUE TO SAINT MARY'S HOSPITAL	20,124
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	20,124
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) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on 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' on 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

THE ENDOWMENT FUNDS OF THE FOUNDATION INCLUDE PERMANENT AND TERM RESTRICTED INVESTMENTS. THE PERMANENT ENDOWMENT FUNDS INCLUDE VARIOUS WILLS AND ESTATES WHEREBY THE ORIGINAL GIFT IS PERMANENTLY RESTRICTED AND THE INCOME GENERATED IS UNRESTRICTED AND USED TO SUPPORT HOSPITAL OPERATIONS. THE TEMPORARILY RESTRICTED FUNDS INCLUDE A TOTAL OF 74 FUNDS RESTRICTED AS TO USE. THESE FUNDS ARE ORGANIZED INTO ELEVEN CATEGORIES, BASED UPON THE INTENDED USE OF THE FUND. THE CATEGORIES ARE CARDIOLOGY, CHILDREN AND FAMILY HEALTH CLINICS, EMERGENCY DEPARTMENT, DEPARTMENT OF SURGERY, NURSING DEPARTMENTS, CLINICAL DEPARTMENTS, NON-CLINICAL DEPARTMENTS, MEDICAL/SURGICAL EDUCATION, SPECIAL FUNDS, SCHOLARSHIP FUNDS AND EDUCATION FUNDS. THE FUNDS ARE USED BASED ON THE DONOR STIPULATED RESTRICTIONS.

SCHEDULE D, PART X, LINE 2

FOOTNOTE 3(L) OF THE REVIEWED NOTES TO CONSOLIDATED FINANCIAL STATEMENTS FOR SAINT MARY'S HEALTH SYSTEM, INC. FOR THE PERIOD ENDED JULY 31, 2016. THE SYSTEM, HOSPITAL AND FOUNDATION ARE TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS GENERALLY EXEMPT FROM INCOME TAXES. THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS HAVE BEEN PREPARED ON THE BASIS THAT ITS TAX-EXEMPT STATUS WILL BE MAINTAINED. THE SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOMETAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN RECOGNITION IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE SYSTEM DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITIONS FOR THE 10-MONTH PERIOD ENDED JULY 31, 2016. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF TRINITY HEALTH OF NEW ENGLAND THAT INCLUDE THE REMAINING TWO MONTHS OF ST. MARY'S HOSPITAL FOUNDATION FINANCIAL INFORMATION DID NOT CONTAIN A FIN48 (ASC 740) FOOTNOTE.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

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" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

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

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization
SAINT MARY'S HOSPITAL FOUNDATION INC

Employer identification number

22-2528400

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

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?

YesNo

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)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

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 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2015

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on 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 TOURNY (event type)	(c) Other events 1 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	378,951	220,555	65,530	665,036
2	Less: Contributions . . . .	263,395	185,352	43,073	491,820
3	Gross income (line 1 minus line 2) . . . . . .	115,556	35,203	22,457	173,216

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .
8	Entertainment . . . .
9	Other direct expenses . . .	172,115	25,104	39,782	237,001
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				237,001
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-63,785

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .	172,115	25,104	39,782	237,001

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2015

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

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

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

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

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

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 complete this part to provide any additional information (see instructions).

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

Complete if the organization answered "Yes," on 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

2015

Open to Public
Inspection

Name of the organization
SAINT MARY'S HOSPITAL FOUNDATION INC

Employer identification number
22-2528400

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on 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) SAINT MARY'S HOSPITAL INC
56 FRANKLIN STREET
WATERBURY,CT067061281

06-0646844

501(C)(3)

151,521

VARIOUS

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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)
(2)
(3)
(4)
(5)
(6)
(7)

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
GRANTS OR ASSISTANCE TO ORGANIZATIONS IN THE U.S.	SAINT MARY'S HOSPITAL FOUNDATION, INC. RAISES CONTRIBUTIONS FROM THE PUBLIC SOLELY FOR THE BENEFIT OF SAINT MARY'S HOSPITAL, INC. CONTRIBUTIONS ARE RAISED FOR SPECIFIC AND NON-SPECIFIC PURPOSES AND ARE DISTRIBUTED TO THE HOSPITAL BASED ON THE HOSPITAL'S NEEDS.

Schedule I (Form 990) 2015

Additional Data

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Software Version:

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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" on 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

2015

Open to Public Inspection

Name of the organization

SAINT MARY'S HOSPITAL FOUNDATION INC

Employer identification number

22-2528400

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

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

Travel for companions Payments for business use of personal residence

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

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

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

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

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

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

Yes

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

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

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

Any related organization?

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

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

Yes

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2015

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 on 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 on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1CHAD WABLEDIRECTOR	(i) (ii)	0 ------------- 561,766	0 ------------- 139,690	0 ------------- 197,117	0 ------------- 153,711	0 ------------- 43,912	0 ------------- 1,096,196	0 ------------- 181,258
2PAUL KELLY MDCHAIRMAN	(i) (ii)	0 ------------- 592,762	0 ------------- 0	0 ------------- 774	0 ------------- 5,300	0 ------------- 32,087	0 ------------- 630,923	0 ------------- 0

Schedule J (Form 990) 2015

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 3	SAINT MARY'S FOUNDATION'S OFFICER SALARY AND BENEFITS ARE PAID BY SAINT MARY'S HOSPITAL, BUT REIMBURSED BY THE FOUNDATION. OFFICER SALARIES ARE DETERMINED UNDER THE COMPENSATION POLICIES OF SAINT MARY'S HOSPITAL WHICH MEET THE REQUIREMENTS OF THE REBUTTABLE PRESUMPTION. THE POLICIES INCLUDE A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD AND COMPENSATION COMMITTEE. SEE FURTHER DISCUSSION ON SCHEDULE O.
SCHEDULE J, PART I, LINE 4B	SAINT MARY'S FOUNDATION DOES NOT HAVE A NONQUALIFIED RETIREMENT PLAN. HOWEVER, CHAD WABLE PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AT SAINT MARY'S HOSPITAL. THE AMOUNT OF BENEFIT ACCRUED OF $123,786 IS INCLUDED IN PART II, COLUMN (C).
SCHEDULE J, PART I, LINE 6A	SAINT MARY'S FOUNDATION DOES NOT DIRECTLY PAY BONUSES TO ITS SENIOR LEADERS. HOWEVER, INDIVIDUALS LISTED IN SCHEDULE J RECEIVE COMPENSATION FROM SAINT MARY'S HOSPITAL. EACH SENIOR LEADER OF SAINT MARY'S HOSPITAL IS PROVIDED A BONUS BASED ON NET EARNINGS AND OTHER CORPORATE GOALS. THE BONUS IS CONTINGENT ON CORPORATE GOALS AND OBJECTIVES EACH YEAR. DURING 2016, THERE WERE 5 OBJECTIVES: PEOPLE, SERVICE, QUALITY, FINANCE, AND GROWTH. THE BONUS IS COMPUTED ON A PERCENTAGE ALLOCATION FOR THE WEIGHT OF EACH OBJECTIVE WHICH IS DIFFERENT FOR EACH SENIOR LEADER BASED ON THEIR JOB FUNCTION.

Schedule J (Form 990) 2015

Additional Data

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete 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 image

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SAINT MARY'S HOSPITAL FOUNDATION INC

Employer identification number

22-2528400

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 ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( FUNDRAISING RAFFLE CONTRIBUTIONS )	X	271	73,434	FMV
26 Other ( )
27 Other ( )
28 Other ( )

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

Yes

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

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

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) (2015)

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 (Form 990) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 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

2015

Open to Public
Inspection

Name of the organization

SAINT MARY'S HOSPITAL FOUNDATION INC

Employer identification number

22-2528400

Return Reference	Explanation
FORM 990, PART III, LINE 4A	SAINT MARY'S HOSPITAL FOUNDATION, INC. RAISES CONTRIBUTIONS FROM THE PUBLIC SOLELY FOR THE BENEFIT OF SAINT MARY'S HOSPITAL, INC. CONTRIBUTIONS ARE RAISED FOR SPECIFIC AND NON-SPECIFIC PURPOSES AND DISTRIBUTED TO THE HOSPITAL BASED ON THE HOSPITAL'S NEEDS. SAINT MARY'S HOSPITAL HAS MANY IMPORTANT SERVICE ACCOMPLISHMENTS IN THE AREAS OF INPATIENT SERVICES AND OUTPATIENT SERVICES. THE HOSPITAL ALSO PROVIDES MANY COMMUNITY BENEFITS. INPATIENT SERVICES SAINT MARY'S REMAINS COMMITTED TO PROVIDING THE HIGHEST QUALITY CARE FOR OUR PATIENTS. THE HOSPITAL PROVIDED INPATIENT TREATMENT FOR 11,715 INPATIENTS IN 2016, WITH AN AVERAGE LENGTH OF STAY OF 4 DAYS. SAINT MARY'S THREE LARGEST PROGRAMS ARE SURGERY, CARDIOLOGY AND MEDICINE. IN 2016, 1,168 PATIENTS CHOSE TO HAVE GENERAL SURGERY AT SAINT MARY'S, STAYING AT THE HOSPITAL FOR A TOTAL OF 6,192 DAYS AND GENERATED $23 MILLION IN REVENUE; 1,367 PATIENTS CHOSE SAINT MARY'S FOR CARDIAC CARE, STAYING IN THE HOSPITAL FOR A TOTAL OF 5,626 DAYS AND GENERATING $22 MILLION IN REVENUE; AND 4,044 PATIENTS RECEIVED INPATIENT MEDICAL CARE, STAYING IN THE HOSPITAL FOR A TOTAL OF 16,440 DAYS, AND GENERATING $40 MILLION IN REVENUE. AS THE HOSPITAL CONTINUES TO DISTINGUISH ITSELF AS A LEADING PROVIDER OF HEALTHCARE SERVICES IN THE REGION, IT HAS GARNERED RECOGNITION FROM STATE AND NATIONAL ORGANIZATIONS FOR PROVIDING OUTSTANDING PATIENT CARE. SAINT MARY'S HOSPITAL IS RANKED AS THE TOP-PERFORMING HOSPITAL IN CONNECTICUT FOR DELIVERING PERCUTANEOUS CORONARY INTERVENTION (PCI), A LIFE-SAVING PROCEDURE THAT OPENS THE BLOCKED ARTERIES OF HEART ATTACK PATIENTS. THE NATIONAL STANDARD STATES THAT PATIENTS SHOULD RECEIVE THIS PROCEDURE WITHIN 90 MINUTES OF ARRIVAL AT THE HOSPITAL. ACCORDING TO THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID (CMS), 100 PERCENT OF PATIENTS WHO REQUIRE ANGIOPLASTY RECEIVE IT AT SAINT MARY'S WITHIN 90 MINUTES OF ARRIVAL. THIS RANKS SAINT MARY'S AS THE NUMBER ONE PERFORMING HOSPITAL IN CONNECTICUT, AND SIGNIFICANTLY AHEAD OF THE NATIONAL AVERAGE, WHICH IS 79 PERCENT OF PATIENTS BEING TREATED WITHIN 90 MINUTES. IN ADDITION, SINCE 2007, SAINT MARY'S HOSPITAL HAS CONSISTENTLY BEEN RECOGNIZED BY THE AMERICAN HEART ASSOCIATION, THE AMERICAN COLLEGE OF CARDIOLOGY AND OTHER ORGANIZATIONS FOR OUTSTANDING CARE OF HEART ATTACK AND HEART FAILURE PATIENTS. THESE ACHIEVEMENTS ARE THE RESULT OF OUR COMMITMENT TO CONTINUOUS QUALITY IMPROVEMENT THROUGH OUR INVOLVEMENT IN THE NATIONAL GET WITH THE GUIDELINES (GWTG) PROGRAM AND AMERICAN COLLEGE OF CARDIOLOGY'S NATIONAL CARDIOVASCULAR DATA REGISTRY (NCDR) ACTION REGISTRY, AND OUR ROLE AS ONE OF THE NATION'S FIRST ACC PATIENT NAVIGATOR HOSPITALS. THIS RECOGNITION INDICATES THAT SAINT MARY'S IS DEDICATED TO PROVIDING THE BEST CARDIAC CARE IN THE COUNTRY FOR OUR PATIENTS. IN ADDITION, SAINT MARY'S CONSISTENTLY FOLLOWED THE TREATMENT GUIDELINES IN ACTION REGISTRY-GWTGTM FOR EIGHT CONSECUTIVE QUARTERS IN ACTION REGISTRY-GWTG AND MET A PERFORMANCE STANDARD OF 90% FOR SPECIFIC PERFORMANCE MEASURES TO RECEIVE THE 2016 AWARD. ACTION REGISTRY-GWTG IS A PARTNERSHIP BETWEEN THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION AND THE AMERICAN HEART ASSOCIATION WITH PARTNERING SUPPORT FROM THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS AND THE SOCIETY OF CARDIOVASCULAR PATIENT CARE. IN FISCAL YEAR 2016, SAINT MARY'S HOSPITAL HAS EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL AND THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S HEART-CHECK MARK FOR ADVANCED CERTIFICATION FOR PRIMARY STROKE CENTERS. THE GOLD SEAL OF APPROVAL AND THE HEART-CHECK MARK REPRESENT SYMBOLS OF QUALITY FROM THEIR RESPECTIVE ORGANIZATIONS. IN ADDITION, SAINT MARY'S ADDED A TELEMEDICINE COMPONENT TO HOW WE DELIVER STROKE CARE. TELEMEDICINE IS A CLOUD-BASED METHOD OF CONNECTING DOCTORS WITH PATIENTS REMOTELY, SIMILAR TO SKYPE OR VIDEO CONFERENCING. AT SAINT MARY'S HOSPITAL, WE USE INTOUCH HEALTH ROBOTS TO CONNECT NEUROLOGISTS FROM THE GREATER WATERBURY AREA TO OUR PATIENTS WITH A POTENTIAL STROKE. WHEN PATIENTS PRESENT TO THE EMERGENCY DEPARTMENT WITH SUDDEN ONSET OF STROKE SYMPTOMS, WE MOVE QUICKLY. THE INTOUCH HEALTH ROBOT ENABLES THE PATIENT TO BE SEEN AND EVALUATED BY THE LOCAL NEUROLOGIST IN A TIMELY MANNER. IN THE 2016 FISCAL YEAR, SAINT MARY'S SCORED IN THE TOP 20 PERCENT OF ALL HOSPITALS IN A NATIONAL COMPARISON GROUP TO RECEIVE THE 2016 COMMUNITY VALUE FIVE STAR AWARD AND WAS AMONG A SMALLER SUBSET TO RECEIVE THE 2016 COMMUNITY VALUE 100 AWARD, MAKING IT ONE THE HIGHEST SCORING FACILITIES IN THE COUNTRY. IN ADDITION, SAINT MARY'S IS A LEADER IN SURGICAL SERVICES. OUR PHYSICIANS PROVIDE BOTH IN-PATIENT AND OUT-PATIENT SURGERY IN THE AREAS OF GI, ONCOLOGY, THORACIC, VASCULAR, LAPAROSCOPY, TRAUMA, GYNECOLOGY, UROLOGY, NEUROSURGERY, ORTHOPEDICS, CARDIOTHORACIC, PLASTIC, BARIATRIC AND ENDOCRINE SURGERY AT SAINT MARY'S HOSPITAL. OUR EXPERIENCED SURGEONS PERFORM ADVANCED ROBOTIC-ASSISTED PROCEDURES UTILIZING TWO DAVINCI ROBOTIC SURGICAL SYSTEMS. THIS INNOVATIVE TECHNOLOGY IS BECOMING THE STANDARD OF CARE FOR MANY COMPLEX SURGICAL PROCEDURES WITH APPLICATIONS FOR GYNECOLOGIC, UROLOGIC, THORACIC, CARDIAC AND GENERAL SURGERY. AS THE LEADING PROVIDER OF SURGICAL SERVICES IN THE REGION, SAINT MARY'S IS COMMITTED TO PROVIDING THE HIGHEST QUALITY AND SUPERIOR SERVICE FOR OUR PATIENTS. DURING FISCAL YEAR 2016, SAINT MARY'S PERFORMED 563 SURGERIES USING THE DAVINCI ROBOTIC SURGICAL SYSTEMS. IN ADDITION, THE HOSPITAL OFFERS A COMPREHENSIVE SIX-YEAR TRAINING PROGRAM IN GENERAL SURGERY. SAINT MARY'S HOSPITAL IS COMMUNITY BASED AND BOASTS A CLOSE AFFILIATION TO YALE UNIVERSITY IN NEARBY NEW HAVEN, CONNECTICUT, AND THE UNIVERSITY OF CONNECTICUT IN FARMINGTON, CONNECTICUT. HISTORICALLY, NEARLY ONE HALF OF THE RESIDENTS COMPLETING THIS PROGRAM HAVE PURSUED FURTHER TRAINING IN CARDIOTHORACIC, COLON AND RECTAL, PLASTIC AND RECONSTRUCTIVE, SURGICAL ONCOLOGY, OR VASCULAR SURGERY. SAINT MARY'S ALSO OFFERS A FOUR-BED NEUROSPINE INTENSIVE CARE UNIT (NEUROICU). THIS NEW UNIT ALLOWS SAINT MARY'S TO CARE FOR PATIENTS WHO REQUIRE SPECIALIZED CARE FOLLOWING SURGICAL TREATMENT OF BRAIN TUMORS, HEAD TRAUMA, OR STROKES. THE NEUROICU FEATURES NEW, STATE-OF-THE-ART EQUIPMENT THAT ALLOWS SECOND-TO-SECOND MONITORING OF CRITICALLY-ILL PATIENTS. IN ADDITION, SAINT MARY'S HOSPITAL HAS BEEN RECOGNIZED BY ANTHEM BLUECROSS WITH A BLUE DISTINCTION CENTER DESIGNATION IN THE AREA OF BARIATRIC SURGERY. BLUE DISTINCTION CENTERS ARE NATIONALLY-DESIGNATED HEALTHCARE FACILITIES SHOWN TO DELIVER QUALITY SPECIALTY CARE BASED ON OBJECTIVE MEASURES THAT WERE DEVELOPED WITH INPUT FROM THE MEDICAL COMMUNITY FOR PATIENT SAFETY AND BETTER HEALTH OUTCOMES. AS A LEADER IN BARIATRIC SURGERY SAINT MARY'S GAINED ACCREDITATION BY THE AMERICAN COLLEGE OF SURGEONS (ACS) METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM (MBSAQIP) AND THE AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY (ASMBS). THIS ACCREDITATION "FORMALLY ACKNOWLEDGES THE COMMITMENT TO PROVIDING AND SUPPORTING QUALITY IMPROVEMENT AND PATIENT SAFETY EFFORTS FOR METABOLIC AND BARIATRIC SURGERY PATIENTS. AS AN ACCREDITED PROGRAM SAINT MARY'S HAS DEMONSTRATED THAT THE CENTER MEETS THE NEEDS OF OUR PATIENTS BY PROVIDING MULTIDISCIPLINARY, HIGH-QUALITY, PATIENT-CENTERED CARE. IMPROVEMENT AND PATIENT SAFETY EFFORTS FOR METABOLIC AND BARIATRIC SURGERY PATIENTS. AS AN ACCREDITED PROGRAM SAINT MARY'S HAS DEMONSTRATED THAT THE CENTER MEETS THE NEEDS OF OUR PATIENTS BY PROVIDING MULTIDISCIPLINARY, HIGH-QUALITY, PATIENT-CENTERED CARE.
FORM 990, PART III, LINE 4A (CONT.)	SAINT MARY'S HEALTH SYSTEM EXTENDS FROM WATERBURY TO WOLCOTT, NAUGATUCK, SOUTHBURY AND PROSPECT. IN 2016, 253,992 PATIENTS CHOSE SAINT MARY'S FOR OUTPATIENT CARE. THE HOSPITAL'S TWO LARGEST PROGRAMS ARE ITS EMERGENCY DEPARTMENT, WHICH PROVIDED TREATMENT TO 64,952 PATIENTS IN 2016, GENERATING $29 MILLION IN REVENUE, AND AMBULATORY SURGERY. IN 2016, 15,598 PATIENTS CHOSE TO HAVE OUTPATIENT SURGERY AT SAINT MARY'S, GENERATING $52 MILLION IN REVENUE. OUTPATIENT SERVICES INCLUDE BUT ARE NOT LIMITED TO: MEDICAL IMAGING, BLOOD DRAW AND LAB SERVICES, CARDIAC AND PULMONARY REHABILITATION CLASSES, NUTRITIONAL COUNSELING AND EXPECTANT PARENT CLASSES. SAINT MARY'S SATELLITE FACILITIES INCLUDE HEALTH AND WELLNESS CENTERS PROVIDING CERTIFIED URGENT CARE CENTERS, BLOOD DRAW STATIONS AND X-RAY SERVICES IN NAUGATUCK, CHESHIRE, WATERBURY, AND WOLCOTT; OUTPATIENT REHABILITATION THERAPY OFFICES IN WATERBURY, WOLCOTT AND NAUGATUCK; OUTPATIENT SLEEP DISORDERS CENTERS IN WATERBURY AND WOLCOTT; THE BREAST & ONCOLOGY CENTERS IN SOUTHBURY AND PROSPECT, AND OCCUPATIONAL THERAPY IN WATERBURY. SAINT MARY'S HAS BEEN RECOGNIZED AT THE STATE AND NATIONAL LEVELS AS A DISTINGUISHED PROVIDER OF OUTPATIENT SERVICES. ONE ADDITION TO THE OUTPATIENT SERVICES INCLUDED THE LIONS LOW VISION CENTER WHICH IS ONE OF ONLY FIVE CENTERS IN CONNECTICUT AND THE ONLY CETNER OF ITS KIND IN GREATER WATERBURY. SPECIALISTS COLLABORATE WITH PATIENTS' EYE CARE PROFESSIONALS AND HELP PATIENTS MAKE THE MOST OF THEIR AVAILABLE VISION WITH EXERCISES, COMPENSATORY STRATEGIES, AND TRAINING WITH LOW VISION AIDES. SAINT MARY'S IS AMONG THE LARGEST AND BUSIEST EMERGENCY DEPARTMENTS IN THE STATE OF CONNECTICUT. IN FACT, WITH APPROXIMATELY 70,000 EMERGENCY VISITS PER YEAR, WE RANK AS THE 9TH BUSIEST IN THE STATE. THE SAINT MARY'S EMERGENCY DEPARTMENTS IS A CERTIFIED LEVEL 2 TRAUMA CENTER, AND ALL PHYSICIANS ARE BOARD CERTIFIED IN EMERGENCY MEDICINE. THE EMERGENCY DEPARTMENT PLAYS A CRITICAL ROLE IN HELPING SAINT MARY'S ACHIEVE ITS EXTRAORDINARY PERFORMANCE WITH DOOR-TO-BALLOON TIME, A MEASURE OF THE TIME IT TAKES A HEART ATTACK VICTIM TO HAVE HIS OR HER BLOCKED ARTERIES OPENED. SAINT MARY'S MEDIAN DOOR-TO-BALLOON TIME IS 60 MINUTES. SAINT MARY'S DOOR-TO-BALLOON TIME IS 30 MINUTES FASTER THAN NATIONAL GUIDELINES SET BY THE AMERICAN COLLEGE OF CARDIOLOGY FOR OPENING BLOCKED ARTERIES. THE DEPARTMENT ALSO PROVIDES AMBULATORY CARE SERVICES, WHICH ARE DESIGNED TO ACCOMMODATE NON-EMERGENT, LOWER ACUITY NEEDS. THIS UNIT CONTAINS A PEDIATRIC CENTER, WHICH IS STAFFED BY PEDIATRICIANS EACH AFTERNOON. FINALLY, THE EMERGENCY DEPARTMENT CONTAINS A DEDICATED BEHAVIORAL HEALTH AREA, SUPPORTED BY A PSYCHIATRIST, SOCIAL WORKER AND SPECIALIZED NURSES. THIS UNIT PROVIDES A MUCH NEEDED RESOURCE FOR SERVING OUR PATIENT POPULATION, AND HAS SEEN CONTINUED GROWTH AND INCREASE IN DEMAND. SAINT MARY'S CANCER PROGRAM WAS AWARDED A THREE-YEAR ACCREDITATION FROM THE AMERICAN COLLEGE OF SURGEONS' COMMISSION ON CANCER WITH COMMENDATION. ONLY 40 PERCENT OF ALL U.S. HOSPITALS SURVEYED BY THE COMMISSION ACHIEVE THIS LEVEL OF RECOGNITION. ACS ACCREDITATION ENSURES THAT PATIENTS WHO CHOOSE SAINT MARY'S FOR CANCER CARE HAVE ACCESS TO A COMPLETE RANGE OF STATE-OF-THE-ART SERVICES AND EQUIPMENT, A TEAM THAT COORDINATES THE BEST AVAILABLE TREATMENT OPTIONS, AND ACCESS TO CLINICAL TRIALS AND NEW TREATMENT OPTIONS, AS WELL AS EARLY DETECTION PROGRAMS, EDUCATION AND SUPPORT SERVICES. SAINT MARY'S WOUND HEALING CENTER IS STAFFED BY A SPECIALIZED TEAM OF PHYSICIANS, SURGEONS, NURSES AND TECHNICIANS, WHO COLLABORATE TO PRODUCE THE BEST POSSIBLE OUTCOMES. ON AVERAGE, 92 PERCENT OF PATIENTS WHO COME TO THE CENTER WITH CHRONIC WOUNDS THAT HAVE RESISTED TRADITIONAL TREATMENT ACHIEVE SUCCESSFUL RESULTS WITHIN 14 WEEKS. SPECIALIZED WOUND CARE ALSO HELPS PATIENTS WITH DIABETIC ULCERS, PRESSURE ULCERS, INFECTIONS AND COMPROMISED SKIN GRAFTS. IN ADDITION THE CENTER OFFERS HYPERBARIC OXYGEN THERAPY, WHICH IS PARTICULARLY EFFECTIVE FOR PATIENTS WHO SUFFER FROM RADIATION DAMAGE OR FACE THE POSSIBILITY OF AMPUTATION.
FORM 990, PART IV, LINE 12B & PART XII, LINE 2A&2B	SAINT MARY'S HOSPITAL FOUNDATION, INC. MERGED WITH TRINITY HEALTH OF NEW ENGLAND EFFECTIVE AUGUST 1, 2016 AND AS A RESULT THERE ARE NO AUDITED FINANCIAL STATEMENTS FOR ST. MARY'S HOSPITAL FOUNDATION, INC. COVERING THE ENTIRE TAX YEAR. HOWEVER, THERE ARE AUDITOR REVIEWED FINANCIAL STATEMENTS COVERING THE PERIOD LEADING UP TO THE MERGER FROM 10/1/2015 THROUGH 7/31/2016 AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR TRINITY HEALTH OF NEW ENGLAND THAT INCLUDE THE REMAINING TWO MONTHS OF ST. MARY'S HOSPITAL FOUNDATION, INC. FINANCIAL INFORMATION.
FORM 990, PART VI, SECTION A, LINE 4	EFFECTIVE AUGUST 1, 2016, SAINT MARY'S HEALTH SYSTEM MERGED INTO SAINT MARY'S HOSPITAL, INC. AND SAINT MARY'S HOSPITAL, INC. BECAME THE SOLE MEMBER OF SAINT MARY'S HOSPITAL FOUNDATION. THE BYLAWS OF THE ORGANIZATION HAVE BEEN UPDATED TO REFLECT THIS MEMBER SUBSTITUTION. FORM 990, PART VI, SECTION A, LINE 6 & 7A SAINT MARY'S HEALTH SYSTEM MERGED INTO SAINT MARY'S HOSPITAL, INC. EFFECTIVE AUGUST 1, 2016. PRIOR TO THE MERGER SAINT MARY'S HEALTH SYSTEM, INC. WAS THE SOLE MEMBER OF SAINT MARY'S HOSPITAL FOUNDATION, INC. AND APPOINTED THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING DISCLOSURE ONLY APPLIES TO THE PERIOD PRIOR TO THE TRINITY MERGER EFFECTIVE AUGUST 1, 2016. PURSUANT TO THE PROVISIONS OF SECTION 33-1080(B) OF THE CONNECTICUT REVISED NON-STOCK CORPORATION ACT AND THE AMENDED AND RESTATED CERTIFICATE OF INCORPORATION OF THE CORPORATION, THERE SHALL BE RESERVED TO THE ARCHBISHOP OF THE HARTFORD ROMAN CATHOLIC ARCHDIOCESE OF HARTFORD (UNLESS SPECIFICALLY DELEGATED BY HIM) THE FOLLOWING RIGHTS AND POWERS: (A)TO APPROVE THE MISSION OR PURPOSE AND THE PHILOSOPHY OF THE CORPORATION AND OF ANY SAINT MARY'S SUBSIDIARIES. (B)TO APPROVE THE ACQUISITION, ALIENATION OR CONVEYANCE OF THE REAL PROPERTY OF THE CORPORATION THAT IS VALUED AT AN AMOUNT GREATER THAN THAT ESTABLISHED BY THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS PURSUANT TO CANON LAW OR TO PLACE A MORTGAGE ON SUCH PROPERTY OR TO BORROW FUNDS IN AMOUNTS GREATER THAN THOSE ESTABLISHED BY THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS PURSUANT TO CANON LAW, WHETHER IN A SINGLE TRANSACTION OR A SERIES OF RELATED TRANSACTIONS. (C)TO APPROVE THE DISPOSAL OF ALL OR SUBSTANTIALLY ALL OF THE PHYSICAL ASSETS OF THE CORPORATION AND TO APPROVE THE MERGER OR CONSOLIDATION OF THE CORPORATION. (D)TO APPROVE THE AMENDMENT OF THE CERTIFICATE OF INCORPORATION OR THE BYLAWS OF THE CORPORATION. CORPORATION.
FORM 990, PART VI, SECTION B, QUESTION 11A	THE FINANCE COMMITTEE OF TRINITY HEALTH OF NEW ENGLAND CORPORATION, INC. HAS THE RESPONSIBILITY FOR OVERSEEING THE REVIEW OF THE FORM 990 INCLUDING ENSURING APPROPRIATE DIRECTORS AND MANAGEMENT PERSONNEL HAVE REVIEWED, ANY ISSUES ARE COMMUNICATED TO THE COMMITTEE AND FORMS 990 ARE AVAILABLE TO THE BOARD OF DIRECTORS. A COMPLETE COPY OF THE ORGANIZATIONS FINAL FORM 990, INCLUDING ALL REQUIRED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, WAS PROVIDED TO EACH MEMBER OF THE BOARD BEFORE ITS FILING WITH THE IRS VIA THE BOARD'S INTERNAL SECURE WEB PORTAL
FORM 990, PART VI, SECTION B, QUESTION 12C	ANNUALLY, EACH DIRECTOR, OFFICER, AND BOARD COMMITTEE MEMBER OF ST. MARY'S HOSPITAL AND ANY OF ITS AFFILIATES, AS APPROPRIATE, WILL SIGN A STATEMENT WHICH AFFIRMS THAT THE PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; AND 3) HAS AGREED TO COMPLY WITH THE POLICY. THE STATEMENTS WILL BE DISTRIBUTED ANNUALLY BY THE COMPLIANCE OFFICER AND RETURNED TO THE CEO OR DELEGATED PERSON, WHERE THEY WILL BE RECORDED, REVIEWED, SUMMARIZED AND PRESENTED TO THE CHAIRPERSON OF THE BOARD, AS WELL AS TO THE AUDIT AND GOVERNANCE COMMITTEES, WHERE THEY EXISTS. CONFLICT OF INTEREST STATEMENTS WILL BE MAINTAINED FOR A MINIMUM OF SEVEN YEARS BY THE COMPLIANCE OFFICER. CONFLICT OF INTEREST FORMS PROVIDED BY OFFICERS, DIRECTORS AND BOARD COMMITTEE MEMBERS WILL BE FORWARDED TO THE COMPLIANCE OFFICER, ALONG WITH A STATEMENT OF IMPACT AS TO THE EFFECT OF THE CONFLICT OF INTEREST ON THE BUSINESS AND ANY ACTION TAKEN TO MINIMIZE THE EFFECT. THEY WILL BE MAINTAINED BY THE COMPLIANCE OFFICER FOR A MINIMUM OF SEVEN YEARS.
FORM 990, PART VI, SECTION B, QUESTIONS 15A & 15B	THE PROCESS FOR DETERMINING THE COMPENSATION OF THE HOSPITAL'S TOP MANAGEMENT OFFICIALS, INCLUDING THE CEO, ALL OFFICERS, AND KEY EMPLOYEES, MEET THE THREE REQUIREMENTS OF THE REBUTTABLE PRESUMPTION. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE. THE COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS FOR THE PURPOSE OF ASSISTING THE BOARD TO FULFILL ITS RESPONSIBILY TO THE HOSPITAL AND THE COMMUNITY TO ENSURE THE COMPENSATION IS IN ACCORDANCE WITH THE HOSPITAL'S POLICIES. THE COMMITTEE IS COMPRISED OF SIX DIRECTORS WHO ARE INDEPENDENT OF MANAGEMENT AND THE HOSPITAL AND FREE OF ANY CONFLICTS OF INTEREST THAT WOULD INTERFERE WITH THEIR EXERCISE OF INDEPENDENT JUDGEMENT. PRIOR TO MAKING ANY COMPENSATION DECISIONS, THE EXECUTIVE COMPENSATION COMMITTEE OBTAINED AND RELIED UPON APPROPRIATE DATA AS TO COMPARABILITY. THE COMMITTEE CONTRACTS AN INDEPENDENT COMPENSATION CONSULTANT AND UTILIZES LOCAL AND NATIONAL COMPENSATION SURVERY'S TO SET COMPENSATION LEVELS. FINALLY, THE EXECUTIVE COMPENSATION COMMITTEE ADEQUATELY AND TIMELY DOCUMENTED THE BASIS FOR SETTING COMPENSATION CONCURRENTLY WITH THE MAKING OF THE DETERMINATION.
FORM 990, PART VI, SECTION C, QUESTION 19	COPIES OF THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
COMPENSATION	SALARIES FOR SAINT MARY'S HOSPITAL AND SAINT MARY'S FOUNDATION ARE ALL PAID BY SAINT MARY'S HOSPITAL. SAINT MARY'S HOSPITAL ISSUES ALL W-2 FORMS. THE SALARIES SHOWN ON THIS TAX RETURN REPRESENT THE PROPER SALARY ALLOCATION FOR WORK PERFORMED AT THIS ENTITY BUT PAID BY SAINT MARY'S HOSPITAL.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SAINT MARY'S HOSPITAL FOUNDATION INC

Employer identification number

22-2528400

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)Advantage HealthSaint Mary's Medical Gr 245 State St SE GRAND RAPIDS,MI49503 27-2491974	HEALTHCARE SE	MI	501(C)(3)	9	Trinity Heal	Yes
(2)Albany Memorial Hospital 600 Northern Blvd Albany,NY12204 14-1338457	HEALTHCARE AN	NY	501(C)(3)	3	St Peter's	Yes
(3)Allegany Franciscan Ministries Inc 33920 US Highway 19 North Palm Harbor,FL34684 58-1492325	GRANT MAKING	FL	501(C)(3)	11	Trinity Heal	Yes
(4)Asylum Hill Family Medicine Center Inc 114 Woodland Street Hartford,CT06105 22-2528399	HEALTHCARE SE	CT	501(C)(3)	3	Trinity Heal	Yes
(5)BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR,IA51245 42-1500277	HEALTHCARE AN	IA	501(C)(3)	3	Mercy Health	Yes
(6)BAUM HARMON MERCY HSPTL & CLINICS FDN 255 NORTH WELCH AVENUE PRIMGHAR,IA51245 26-2973307	FOUNDATION	IA	501(C)(3)	11	Baum Harmon	Yes
(7)Beechwood Inc 2212 Burdett Ave Troy,NY12180 14-1651563	TITLE HOLDING	NY	501(C)(2)		LTC (Eddy)	Yes
(8)Bethlehem Haven of Pittsburgh 905 Watson Street Pittsburgh,PA15219 25-1436685	HOMELESS SHEL	PA	501(C)(3)	7	Pittsburgh M	Yes
(9)Beverwyck Inc 40 Autumn Drive Slingerlands,NY12159 14-1717028	SENIOR LIVING	NY	501(C)(3)	9	LTC (Eddy)	Yes
(10)Brightside Inc 1221 Main Street Holyoke,MA01040	HEALTHCARE SE	MA	501(C)(3)	9	The Mercy Ho	Yes
(11)Capital Region Geriatric Center Inc 421 West Columbia St Cohoes,NY12047 14-1701597	LONG TERM CAR	NY	501(C)(3)	9	LTC (Eddy)	Yes
(12)Caring Partners Home Health Inc 1200 Earhart Rd Ann Arbor,MI48105 20-1681131	Home Health S	MI	501(C)(3)	9	Glacier Hill	Yes
(13)CATHERINE MCAULEY HEALTH SERVICES CORP PO BOX 995 ANN ARBOR,MI48106 38-2507173	HEALTHCARE SE	MI	501(C)(3)	3	Trinity Heal	Yes
(14)Catholic Health Ministries 20555 VICTOR PARKWAY LIVONIA,MI48152	Governance an	MI	501(C)(3)	1	NA
(15)Columbus Acquisition Corp 111 Central Avenue Newark,NJ07102 26-2616342	INACTIVE ENTI	NJ	501(C)(3)	9	Saint Michae	Yes
(16)Community Health Partners of South Bend PO Box 3998 SOUTH BEND,IN46619 26-3051440	HEALTHCARE SE	IN	501(C)(3)	3	Saint Joseph	Yes
(17)Cranbrook Hospice Care 1111 W LONG LAKE RD TROY,MI48098 38-3320699	HOSPICE SERVI	MI	501(C)(3)	9	Trinity Home	Yes
(18)Diley Ridge Medical Center 6150 EAST BROAD STREET COLUMBUS,OH43213 34-2032340	HEALTHCARE AN	OH	501(C)(3)	3	Mount Carmel	Yes
(19)Dubuque Mercy Health Foundation 250 MERCY DRIVE DUBUQUE,IA52001 26-2227941	FOUNDATION	IA	501(C)(3)	11	Mercy Health	Yes
(20)Dyersville Health Foundation Inc 1111 3RD STREET SW DYERSVILLE,IA52040 20-5383271	FOUNDATION	IA	501(C)(3)	11	Mercy Health	Yes
(21)East Norriton Physicians Services Inc One West Elm Street Conshohocken,PA19428 23-2515999	HEALTHCARE SE	PA	501(C)(3)	3	Mercy Physic	Yes
(22)Eddy Licensed Home Care Agency 433 River St Suite 3000 Troy,NY12180 14-1818568	HOME HEALTH S	NY	501(C)(3)	3	LTC (Eddy)	Yes
(23)Embracing Age Inc 333 Butternut Drive Dewitt,NY13214 46-1051881	PACE PROGRAM	NY	501(C)(3)	9	St Joseph's	Yes
(24)Empire Home Infusion Service Inc 10 Blacksmith Drive Malta,NY12020 14-1795732	HOME HEALTH S	NY	501(C)(3)	9	LTC (Eddy)	Yes
(25)Farren Care Center Inc c/o SPHS 1221 Main Street Holyoke,MA01040	LONG TERM CAR	MA	501(C)(3)	3	The Mercy Ho	Yes
(26)Franciscan Eldercare Corporation PO Box 2500 Wilmington,DE19805 22-3008680	LONG TERM CAR	DE	501(C)(3)	9	St Francis	Yes
(27)Glacier Hills Foundation 1200 Earhart Rd Ann Arbor,MI48105 20-8072723	Foundation	MI	501(C)(3)	11	Glacier Hill	Yes
(28)Glacier Hills Inc 1200 Earhart Rd Ann Arbor,MI48105 38-1891500	Senior Living	MI	501(C)(3)	9	Trinity Cont	Yes
(29)Glen Eddy Inc One Glen Eddy Drive Niskayuna,NY12309 14-1794150	SENIOR LIVING	NY	501(C)(3)	9	LTC (Eddy)	Yes
(30)Global Health Ministry 20555 VICTOR PARKWAY LIVONIA,MI48152 42-1253527	HEALTHCARE SE	MI	501(C)(3)	11	Trinity Heal	Yes
(31)Good Samaritan Hospital Inc 5401 Lake Oconee Parkway Greensboro,GA30642 26-1720984	HEALTHCARE AN	GA	501(C)(3)	3	St Mary's H	Yes
(32)Gottlieb Community Health Services Corpo 701 W North Ave Melrose Park,IL60160 36-3332852	COMMUNITY OUT	IL	501(C)(3)	9	Gottlieb Mem	Yes
(33)Gottlieb Memorial Foundation 701 W North Ave Melrose Park,IL60160 74-3260011	FOUNDATION	IL	501(C)(3)	13	NA
(34)Gottlieb Memorial Hospital 701 W North Ave Melrose Park,IL60160 36-2379649	HEALTHCARE AN	IL	501(C)(3)	3	Loyola Unive	Yes
(35)Grand Rapids Medical Education Partners 945 Ottawa Ave NW Grand Rapids,MI49503 23-7270669	MEDICAL EDUCA	MI	501(C)(3)	11	Trinity Heal	Yes
(36)Hackley Hospital Self Insurance Professi PO BOX 3302 MUSKEGON,MI49443 38-2299878	SELF INSURANC	MI	501(C)(3)	12	Mercy Health	Yes
(37)Hackley Life Counseling 125 E Southern Avenue MUSKEGON,MI49442 38-1386362	HEALTHCARE SE	MI	501(C)(3)	9	Mercy Health	Yes
(38)Hawthorne Ridge Inc 30 Community Way East Greenbush,NY12061 80-0102840	SENIOR LIVING	NY	501(C)(3)	9	LTC (Eddy)	Yes
(39)Heart Center of Greater Waterbury Inc PO Box 2153 Waterbury,CT06722 83-0416893	Management	CT	501(C)(3)	11	NA
(40)Heritage House Nursing Center Inc 2920 Tibbits Ave Troy,NY12180 14-1725101	LONG TERM CAR	NY	501(C)(3)	9	LTC (Eddy)	Yes
(41)Holy Cross Carenet Inc PO BOX 9184 FARMINGTON HILLS,MI48152 52-1945054	LONG TERM CAR	MD	501(C)(3)	9	Trinity Cont	Yes
(42)Holy Cross Health Foundation Inc 1500 FOREST GLEN RD SILVER SPRING,MD20910 20-8428450	FOUNDATION	MD	501(C)(3)	7	Holy Cross H	Yes
(43)Holy Cross Health Inc 1500 FOREST GLEN RD SILVER SPRING,MD20910 52-0738041	HEALTHCARE AN	MD	501(C)(3)	3	Trinity Heal	Yes
(44)Holy Cross Hospital Inc 4725 North Federal Highway Ft Lauderdale,FL33308 59-0791028	HEALTHCARE AN	FL	501(C)(3)	3	Trinity Heal	Yes
(45)Holy Cross Medical Properties Inc 4725 North Federal Highway Ft Lauderdale,FL33308 65-0666283	BUILDING MANA	FL	501(C)(2)		Holy Cross H	Yes
(46)Holy Cross Outpatient Services Inc 4725 North Federal Highway Ft Lauderdale,FL33308 46-5421068	HEALTHCARE SE	FL	501(C)(3)	9	Holy Cross H	Yes
(47)Holy Cross Primary Care Inc 4725 North Federal Highway Ft Lauderdale,FL33308 81-2531495	HEALTHCARE SE	FL	501(C)(3)	9	Holy Cross H	Yes
(48)Home & Community Health Services Inc 201 CHESTNUT HILL ROAD STAFFORD SPRINGS,CT06076 81-0723591	HOME HEALTH S	CT	501(C)(3)	9	Trinity Heal	Yes
(49)Home Aide Service of Eastern New York I 433 River St Troy,NY12180 14-1514867	HOME HEALTH S	NY	501(C)(3)	9	LTC (Eddy)	Yes
(50)Hospice of North Iowa 232 SECOND STREET SE MASON CITY,IA50401 42-1173708	HOSPICE SERVI	IA	501(C)(3)	9	Mercy Health	Yes
(51)Hospice of Siouxland 4300 Hamilton Blvd SIOUX CITY,IA51104 38-3320710	HOSPICE SERVI	IA	501(C)(3)	11	NA
(52)Hospice of Washtenaw II 806 AIRPORT BLVD ANN ARBOR,MI48108 38-3320707	HOSPICE SERVI	MI	501(C)(3)	11	Trinity Heal	Yes
(53)IHA Health Services Corporation 24 Frank Lloyd Wright Dr Lobby J Ann Arbor,MI48106 38-3316559	HEALTHCARE SE	MI	501(C)(3)	9	Trinity Heal	Yes
(54)Johnson Health Care Inc 201 CHESTNUT HILL ROAD STAFFORD SPRINGS,CT06076 81-0709903	HEALTHCARE SE	CT	501(C)(3)	9	Trinity Heal	Yes
(55)Johnson Memorial Hospital Inc 201 CHESTNUT HILL ROAD STAFFORD SPRINGS,CT06076 47-5676956	HEALTHCARE AN	CT	501(C)(3)	3	Trinity Heal	Yes
(56)Johnson Memorial Medical Center Inc 201 CHESTNUT HILL ROAD STAFFORD SPRINGS,CT06076 81-0696923	HEALTHCARE SY	CT	501(C)(3)	12	Trinity Heal	Yes
(57)Langhorne MRI Inc 1201 Langhorne-Newtown Road Langhorne,PA19047 23-2519529	HEALTHCARE SE	PA	501(C)(3)	9	St Mary Med	Yes
(58)Langhorne Physician Services Inc 1201 Langhorne-Newtown Road Langhorne,PA19047 23-2571699	HEALTHCARE SE	PA	501(C)(3)	9	St Mary Med	Yes
(59)Life at Lourdes Inc 2475 McClellan Avenue Pennsauken,NJ08109 26-1854750	PACE PROGRAM	NJ	501(C)(3)	3	Our Lady of	Yes
(60)LIFE at St Francis Healthcare Inc 7th and Clayton Streets Wilmington,DE19805 45-2569214	PACE PROGRAM	DE	501(C)(3)	9	St Francis	Yes
(61)Life St Francis Corporation 1435 Liberty Street Hamilton,NJ08629 22-2797282	PACE program	NJ	501(C)(3)	9	St Francis	Yes
(62)Life St Joseph of the Pines Inc 100 Gossman Drive Southern Pines,NC28387 27-2159847	PACE PROGRAM	NC	501(C)(3)	3	St Joseph o	Yes
(63)LIFE St Mary 1201 Langhorne-Newtown Road Langhorne,PA19047 26-2976184	PACE PROGRAM	PA	501(C)(3)	9	St Mary Med	Yes
(64)Lourdes Ancillary Services 1600 Haddon Avenue Camden,NJ08103 22-2568525	VOLUNTEER SER	NJ	501(C)(3)	12	Our Lady of	Yes
(65)Lourdes Cardiology Services PC 1600 Haddon Avenue Camden,NJ08103 27-4357794	HEALTHCARE SE	NJ	501(C)(3)	3	Our Lady of	Yes
(66)Lourdes Medical Center of Burlington Cou 218 Sunset Road Willingboro,NJ08046 22-3612265	HEALTHCARE AN	NJ	501(C)(3)	3	Our Lady of	Yes
(67)LOYOLA MEDICINE TRANSPORT LLC 905 W North Ave Melrose Park,IL60160 47-4147171	TRANSPORATION	IL	501(C)(3)	9	Loyola Unive	Yes
(68)Loyola University Health System 2160 South First Avenue Maywood,IL60153 36-3342448	HEALTHCARE SY	IL	501(C)(3)	12	Trinity Heal	Yes
(69)Loyola University Medical Center 2160 South First Avenue Maywood,IL60153 36-4015560	HEALTHCARE AN	IL	501(C)(3)	3	Loyola Unive	Yes
(70)LTC (Eddy) Inc 2212 Burdett Ave Troy,NY12180 22-2564710	MANAGEMENT SE	NY	501(C)(3)	12	St Peter's	Yes
(71)Marian Community Hospital 3805 West Chester Pike Newtown Square,PA19073 24-0711230	HEALTHCARE SE	PA	501(C)(3)	9	Maxis Health	Yes
(72)Marian Home Healthcare 801 5TH STREET SIOUX CITY,IA51101 38-3320705	HOME HEALTH S	IA	501(C)(3)	11	Mercy Health	Yes
(73)Maxis Health System 3805 West Chester Pike Newtown Square,PA19073 91-1940902	HEALTHCARE SY	PA	501(C)(3)	11	Trinity Heal	Yes
(74)McAuley Center Inc 275 Steele Road West Hartford,CT06117	SENIOR LIVING	CT	501(C)(3)	9	Mercy Commun	Yes
(75)McAuley Clinic Corporation PO BOX 992 ANN ARBOR,MI48106 38-2561013	HEALTHCARE SE	MI	501(C)(3)	3	Catherine Mc	Yes
(76)McAuley Ministries 3333 Fifth Avenue Pittsburgh,PA15213 94-3436142	GRANT MAKING	PA	501(C)(3)	12	Pittsburgh M	Yes
(77)Mercy Amicare Home Healthcare Oakland 1111 W LONG LAKE RD TROY,MI48098 38-3320698	HOME HEALTH S	MI	501(C)(3)	9	Trinity Home	Yes
(78)Mercy Amicare Home Healthcare Port Huro 17410 COLLEGE PARKWAY LIVONIA,MI48152 38-3320701	HOME HEALTH S	MI	501(C)(3)	9	Trinity Home	Yes
(79)Mercy Care Foundation 424 Decatur Street Atlanta,GA30312 58-1448522	FOUNDATION	GA	501(C)(3)	7	Saint Joseph	Yes
(80)Mercy Catholic Medical Center of Southea One West Elm Street Conshohocken,PA19428 23-1352191	HEALTHCARE AN	PA	501(C)(3)	3	Mercy Health	Yes
(81)Mercy Community Health Inc 2021 Albany Avenue West Hartford,CT06117	HEALTHCARE SY	CT	501(C)(3)	12	Trinity Cont	Yes
(82)Mercy Family Support 1001 Baltimore Pike Springfield,PA19064 23-2325059	HOME HEALTH S	PA	501(C)(3)	9	Mercy Home H	Yes
(83)Mercy Foundation Inc 2525 South Michigan Avenue Chicago,IL60616 36-3227350	FOUNDATION	IL	501(C)(3)	7	Mercy Health	Yes
(84)Mercy General Health Partners Amicare H 888 Terrace Street MUSKEGON,MI49440 38-3321856	HOSPICE & HOM	MI	501(C)(3)	9	Trinity Home	Yes
(85)Mercy Health Foundation of Southeastern One West Elm Street Conshohocken,PA19428 23-2829864	FOUNDATION	PA	501(C)(3)	12	Mercy Health	Yes
(86)Mercy Health Network Inc 1111 6th Avenue Des Moines,IA50314 42-1478417	HEALTHCARE SY	DE	501(C)(3)	12	NA
(87)Mercy Health Partners 1500 E Sherman Blvd MUSKEGON,MI49444 38-2589966	HEALTHCARE AN	MI	501(C)(3)	3	Trinity Heal	Yes
(88)Mercy Health Plan One West Elm Street Conshohocken,PA19428 22-2483605	MEDICAID MANA	PA	501(C)(3)	12	Mercy Health	Yes
(89)Mercy Health Services - Iowa Corp 1000 4TH STREET SW MASON CITY,IA50401 31-1373080	HEALTHCARE AN	DE	501(C)(3)	3	Trinity Heal	Yes
(90)Mercy Health System of Chicago 2525 South Michigan Avenue Chicago,IL60616 36-3163327	HEALTHCARE SY	IL	501(C)(3)	12	Trinity Heal	Yes
(91)Mercy Health System of Southeastern Penn One West Elm Street Conshohocken,PA19428 23-2212638	HEALTHCARE SY	PA	501(C)(3)	13	Trinity Heal	Yes
(92)Mercy Healthcare Center 114 Wawbeek Avenue Tupper Lake,NY12986 15-0532211	HEALTHCARE AN	NY	501(C)(3)	3	Mercy Uihlei	Yes
(93)Mercy Healthcare Foundation - Clinton 1410 N 4TH ST CLINTON,IA52732 42-1316126	FOUNDATION	IA	501(C)(3)	7	NA
(94)Mercy Home Health 1001 Baltimore Pike Springfield,PA19064 23-1352099	HOME HEALTH S	PA	501(C)(3)	9	Mercy Home H	Yes
(95)Mercy Home Health Services 1001 Baltimore Pike Springfield,PA19064 23-2325058	MANAGEMENT SE	PA	501(C)(3)	12	Mercy Health	Yes
(96)Mercy Hospital and Medical Center 2525 South Michigan Avenue Chicago,IL60616 36-2170152	HEALTHCARE AN	IL	501(C)(3)	3	Mercy Health	Yes
(97)Mercy Hospital Cadillac Foundation 1820 44th ST SE KENTWOOD,MI49508 20-3357131	FOUNDATION	MI	501(C)(3)	11	Trinity Heal	Yes
(98)Mercy Hospital Inc 4725 North Federal Highway Ft Lauderdale,FL33308 59-0791034	HEALTHCARE SE	FL	501(C)(3)	12	Trinity Heal	Yes
(99)Mercy Life Center Corporation 1200 Reedsdale Street Pittsburgh,PA15233 25-1604115	COMMUNITY OUT	PA	501(C)(3)	9	Pittsburgh M	Yes
(100)Mercy LIFE of Alabama PO Box 7957 Mobile,AL36670 27-3163002	PACE PROGRAM	AL	501(C)(3)	3	Trinity Heal	Yes
(101)Mercy LIFE Inc c/o SPHS 1221 Main Street Holyoke,MA01040 45-3086711	PACE PROGRAM	MA	501(C)(3)	3	Sisters of P	Yes
(102)Mercy Management of Southeastern Pennsyl One West Elm Street Conshohocken,PA19428 23-2627944	HEALTHCARE SE	PA	501(C)(3)	3	Mercy Physic	Yes
(103)Mercy Medical Center - Clinton Inc 1410 NORTH 4TH ST CLINTON,IA52732 42-1336618	HEALTHCARE AN	DE	501(C)(3)	3	Mercy Health	Yes
(104)Mercy Medical Center - Sioux City Founda 801 5TH STREET SIOUX CITY,IA51102 14-1880022	FOUNDATION	IA	501(C)(3)	7	Mercy Health	Yes
(105)Mercy Medical Center Foundation - North 1000 4TH STREET SW MASON CITY,IA50401 42-1229151	FOUNDATION	IA	501(C)(3)	7	Mercy Health	Yes
(106)Mercy Medical Corporation PO Box 7957 Mobile,AL36670 63-6002215	PACE PROGRAM	AL	501(C)(3)	9	Trinity Heal	Yes
(107)Mercy Medical Group Inc c/o SPHS 1221 Main Street Holyoke,MA01040 45-4884805	HEALTHCARE SE	MA	501(C)(3)	3	The Mercy Ho	Yes
(108)MERCY PHYSICIAN NETWORK ONE WEST ELM STREET CONSHOHOCKEN,PA19428 46-1187365	MANAGEMENT SE	PA	501(C)(3)	12	Mercy Health	Yes
(109)Mercy Senior Care Inc 424 Decatur Street Atlanta,GA30312 58-1366508	COMMUNITY OUT	GA	501(C)(3)	7	Saint Joseph	Yes
(110)Mercy Services Downtown Inc 424 Decatur Street Atlanta,GA30312 27-2046353	TITLE HOLDING	GA	501(C)(3)	12	Saint Joseph	Yes
(111)Mercy Services for Aging Nonprofit Housi PO BOX 9184 FARMINGTON HILLS,MI48333 38-2719605	LONG TERM CAR	MI	501(C)(3)	9	Trinity Cont	Yes
(112)Mercy Specialist Physicians Inc c/o SPHS 1221 Main Street Holyoke,MA01040 26-4033168	HEALTHCARE SE	MA	501(C)(3)	3	The Mercy Ho	Yes
(113)Mercy Suburban Hospital One West Elm Street Conshohocken,PA19428 23-1396763	HEALTHCARE AN	PA	501(C)(3)	3	Mercy Health	Yes
(114)Mercy Uihlein Health Corporation 3805 West Chester Pike Newtown Square,NY19073 16-1535133	HEALTHCARE SY	NY	501(C)(3)	12	Trinity Heal	Yes
(115)Mission Health Corporation 37595 Seven Mile Road LIVONIA,MI48152 38-3181557	BUILDING MANA	DE	501(C)(3)	11	NA
(116)Mount Carmel College of Nursing 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1308555	COLLEGE OF NU	OH	501(C)(3)	2	Mount Carmel	Yes
(117)Mount Carmel Health Insurance Company 6150 EAST BROAD STREET COLUMBUS,OH43213 25-1912781	HEALTH INSURA	OH	501(C)(4)		Mount Carmel	Yes
(118)Mount Carmel Health Plan Inc 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1471229	MEDICARE HMO	OH	501(C)(4)		Mount Carmel	Yes
(119)Mount Carmel Health System 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1439334	HEALTHCARE AN	OH	501(C)(3)	3	Trinity Heal	Yes
(120)MOUNT CARMEL HEALTH SYSTEM FOUNDATION 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1113966	FOUNDATION	OH	501(C)(3)	11	MOUNT CARMEL	Yes
(121)Mount Carmel Home Care LLC 501 West Schrock Road Westerville,OH43081 26-2729300	HOME HEALTH S	OH	501(C)(3)	9	Trinity Home	Yes
(122)Mount Sinai Hospital Foundation Inc 500 Blue Hills Avenue Hartford,CT06112 22-2584082	FOUNDATION	CT	501(C)(3)	13	NA
(123)Mount Sinai Rehabilitation Hospital Inc 114 Woodland Street Hartford,CT06105	HEALTHCARE AN	CT	501(C)(3)	3	Trinity Heal	Yes
(124)Mount St Joseph 7 Hightower Street Waterville,ME04901	Healthcare Se	ME	501(C)(3)	3	Mercy Commun	Yes
(125)MRI Mobile Services of West Michigan 1820 44TH STREET KENTWOOD,MI49508 38-3073745	HEALTHCARE SE	MI	501(C)(3)	9	Trinity Heal	Yes
(126)MUSKEGON COMMUNITY HEALTH PROJECT 565 W WESTERN AVENUE MUSKEGON,MI49440 91-1932918	COMMUNITY OUT	MI	501(C)(3)	7	MERCY HEALTH	Yes
(127)Nazareth Health Care Foundation 2701 Holme Avenue Philadelphia,PA19152 23-2300951	FOUNDATION	PA	501(C)(3)	11	Nazareth Hos	Yes
(128)Nazareth Hospital 2601 Holme Avenue Philadelphia,PA19152 23-2794121	HEALTHCARE AN	PA	501(C)(3)	3	Mercy Health	Yes
(129)Nazareth Physician Services Inc One West Elm Street Suite 100 Conshohocken,PA19428 20-3261266	HEALTHCARE SE	PA	501(C)(3)	3	Mercy Physic	Yes
(130)NE Physician Services Inc One West Elm Street Suite 100 Conshohocken,PA19428 23-2497355	HEALTHCARE SE	PA	501(C)(3)	3	Mercy Physic	Yes
(131)Oakland Mercy Hospital 601 EAST 2ND STREET OAKLAND,NE68045 20-8072234	HEALTHCARE AN	NE	501(C)(3)	3	Mercy Health	Yes
(132)Oakland Mercy Hospital Foundation 601 E 2nd Street OAKLAND,NE68045 31-1678345	FOUNDATION	NE	501(C)(3)	11	Oakland Merc	Yes
(133)One Thousand Corporation 1000 Asylum Avenue Hartford,CT06105	BUILDING MANA	CT	501(C)(2)		SAINT FRANCI	Yes
(134)OSUMOUNT CARMEL HEALTH ALLIANCE 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1654603	COOPERATIVE H	OH	501(C)(3)	11	NA
(135)Our Lady of Lourdes Health Care Services 1600 Haddon Avenue Camden,NJ08103 22-2568528	HEALTHCARE SY	NJ	501(C)(3)	12	Maxis Health	Yes
(136)Our Lady of Lourdes Health Foundation I 1600 Haddon Avenue Camden,NJ08103 22-2351960	FOUNDATION	NJ	501(C)(3)	7	Our Lady of	Yes
(137)Our Lady of Lourdes Medical Center 1600 Haddon Avenue Camden,NJ08103 21-0635001	HEALTHCARE AN	NJ	501(C)(3)	3	Our Lady of	Yes
(138)Our Lady of Mercy Life Center 2 Mercycare Lane Guilderland,NY12084 14-1743506	LONG TERM CAR	NY	501(C)(3)	3	St Peter's	Yes
(139)Pioneer Valley Cardiology Associates In c/o SPHS 1221 Main Street Suite 2 Holyoke,MA01040 45-4208896	HEALTHCARE SE	MA	501(C)(3)	3	The Mercy Ho	Yes
(140)Pittsburgh Mercy Health System 3333 5th Avenue Pittsburgh,PA15213 25-1464211	HEALTHCARE SY	PA	501(C)(3)	12	Trinity Heal	Yes
(141)Probility Therapy Services 2058 S State Street Ann Arbor,MI48104 20-2020239	HEALTHCARE SE	MI	501(C)(3)	9	Trinity Heal	Yes
(142)Professional Med Team 965 FORK STREET MUSKEGON,MI49442 38-2638284	HEALTHCARE SE	MI	501(C)(3)	9	Mercy Health	Yes
(143)Riverbend Medical Group Inc 271 Carew St Springfield,MA01104 81-1807730	Healthcare Se	MA	501(C)(3)	3	The Mercy Ho	Yes
(144)SJ Management Company of Syracuse Inc 301 Prospect Avenue Syracuse,NY13203 27-1763712	HEALTHCARE SY	NY	501(C)(3)	13	St Joseph's	Yes
(145)Saint Agnes Medical Center 1303 EAST HERNDON AVE FRESNO,CA93720 94-1437713	HEALTHCARE AN	CA	501(C)(3)	3	Trinity Heal	Yes
(146)Saint Agnes Medical Foundation (FKA Prof 1303 EAST HERNDON AVE FRESNO,CA93720 94-2839324	Healthcare se	CA	501(C)(3)	11	Saint Agnes	Yes
(147)Saint Alphonsus Building Company Inc 1055 NORTH CURTIS RD BOISE,ID83706 82-0401011	BUILDING MANA	ID	501(C)(3)	9	Saint Alphon	Yes
(148)Saint Alphonsus Diversified Care Inc 1055 NORTH CURTIS RD BOISE,ID83706 94-3028978	HEALTHCARE SY	ID	501(C)(3)	11	Saint Alphon	Yes
(149)Saint Alphonsus Foundation-Baker City I 3325 POCAHONTAS ROAD BAKER CITY,OR97814 94-3164869	FOUNDATION	OR	501(C)(3)	7	SAINT ALPHON	Yes
(150)Saint Alphonsus Foundation-Ontario Inc 351 SW 9TH STREET ONTARIO,OR97914 20-2683560	FOUNDATION	OR	501(C)(3)	7	SAINT ALPHON	Yes
(151)SAINT ALPHONSUS HEALTH SYSTEM INC 1055 N CURTIS ROAD BOISE,ID83706 27-1929502	HEALTHCARE SY	ID	501(C)(3)	12	Trinity Heal	Yes
(152)Saint Alphonsus Medical Center Ontario V 351 SW 9TH STREET ONTARIO,OR97914 94-3059469	VOLUNTEER SER	OR	501(C)(3)	9	SAINT ALPHON	Yes
(153)SAINT ALPHONSUS MEDICAL CENTER-BAKER CIT 3325 POCAHONTAS ROAD BAKER CITY,OR97814 27-1790052	HEALTHCARE AN	OR	501(C)(3)	3	SAINT ALPHON	Yes
(154)Saint Alphonsus Medical Center-Nampa Hea 1512 12TH AVENUE ROAD NAMPA,ID83686 26-1737256	FOUNDATION	ID	501(C)(3)	7	SAINT ALPHON	Yes
(155)SAINT ALPHONSUS MEDICAL CENTER-NAMPA In 1512 12TH AVENUE ROAD NAMPA,ID83686 82-0200896	HEALTHCARE AN	ID	501(C)(3)	3	SAINT ALPHON	Yes
(156)SAINT ALPHONSUS MEDICAL CENTER-ONTARIO 351 SW 9TH STREET ONTARIO,OR97914 27-1789847	HEALTHCARE AN	OR	501(C)(3)	3	SAINT ALPHON	Yes
(157)Saint Alphonsus Regional Medical Center 1055 NORTH CURTIS RD BOISE,ID83706 82-0200895	HEALTHCARE AN	ID	501(C)(3)	3	SAINT ALPHON	Yes
(158)Saint Francis Emergency Medical Group I 114 Woodland Street Hartford,CT06105 45-1994612	HEALTHCARE SE	CT	501(C)(3)	12	Saint Franci	Yes
(159)Saint Francis Hospital and Medical Cente 114 Woodland Street Hartford,CT06105	FOUNDATION	CT	501(C)(3)	12	Saint Franci	Yes
(160)Saint Francis Medical Group Inc 114 Woodland Street Hartford,CT06105	HEALTHCARE SE	CT	501(C)(3)	3	Trinity Heal	Yes
(161)Saint James Care Inc 111 Central Avenue Newark,NJ07102 26-2616230	INACTIVE ENTI	NJ	501(C)(3)	9	Saint Michae	Yes
(162)Saint Joseph Pace Inc 20555 VICTOR PARKWAY LIVONIA,MI48152 47-3129127	PACE PROGRAM	IN	501(C)(3)	7	Trinity Heal	Yes
(163)Saint Joseph Regional Medical Center - P PO BOX 670 PLYMOUTH,IN46563 35-1142669	HEALTHCARE AN	IN	501(C)(3)	3	Saint Joseph	Yes
(164)Saint Joseph Regional Medical Center - S 5215 Holy Cross Parkway MISHAWAKA,IN46545 35-0868157	HEALTHCARE AN	IN	501(C)(3)	3	Saint Joseph	Yes
(165)Saint Joseph Regional Medical Center Mis 5215 Holy Cross Parkway MISHAWAKA,IN46545 35-6033285	VOLUNTEER SER	IN	501(C)(4)		Saint Joseph	Yes
(166)Saint Joseph Regional Medical Center Ply 1915 LAKE AVENUE PLYMOUTH,IN46563 35-6043563	VOLUNTEER SER	IN	501(C)(3)	12	Saint Joseph	Yes
(167)Saint Joseph Regional Medical Center In 5215 Holy Cross Parkway MISHAWAKA,IN46545 35-1568821	HEALTHCARE SY	IN	501(C)(3)	12	Trinity Heal	Yes
(168)Saint Joseph's Health System Inc 424 Decatur Street Atlanta,GA30312 58-1744848	HEALTHCARE SY	GA	501(C)(3)	13	Trinity Heal	Yes
(169)Saint Joseph's Mercy Care Services Inc 424 Decatur Street Atlanta,GA30312 58-1752700	HEALTHCARE SE	GA	501(C)(3)	7	Saint Joseph	Yes
(170)Saint Joseph's Tower Inc PO BOX 9184 FARMINGTON HILLS,MI48333 31-1040468	SENIOR LIVING	IN	501(C)(3)	9	Trinity Cont	Yes
(171)Saint Mary's Amicare Home Healthcare 1430 MONROE NW STE 120 GRAND RAPIDS,MI49505 38-3320700	HOME HEALTH S	MI	501(C)(3)	9	Trinity Home	Yes
(172)Saint Mary's Foundation 200 JEFFERSON ST SE GRAND RAPIDS,MI49503 38-1779602	FOUNDATION	MI	501(C)(3)	7	Trinity Heal	Yes
(173)Saint Mary's Hospital Inc 56 Franklin Street Waterbury,CT06706 06-0646844	HEALTHCARE AN	CT	501(C)(3)	3	Trinity Heal	Yes
(174)Saint Michael's Medical Center 111 Central Avenue Newark,NJ07102 26-2616046	HEALTHCARE AN	NJ	501(C)(3)	3	Maxis Health	Yes
(175)Samaritan Child Care Center Inc 2213 Burdett Ave Troy,NY12180 14-1710225	CHILD CARE	NY	501(C)(3)	9	St Peter's	Yes
(176)Samaritan Hospital 2215 Burdett Ave Troy,NY12180 14-1338544	HEALTHCARE AN	NY	501(C)(3)	3	St Peter's	Yes
(177)Senior Care Connection Inc 504 State St Schenectady,NY12305 14-1708754	PACE PROGRAM	NY	501(C)(3)	9	LTC (Eddy)	Yes
(178)Seton Auxiliary Inc 1300 Massachusetts Avenue Troy,NY12180 14-1505031	VOLUNTEER SER	NY	501(C)(3)	9	Seton Health	Yes
(179)Seton Health at Schuyler Ridge Residenti 1 Abele Blvd Clifton Park,NY12065 14-1756230	LONG TERM CAR	NY	501(C)(3)	9	Seton Health	Yes
(180)Seton Health Foundation Inc 1300 Massachusetts Avenue Troy,NY12180 22-2345416	FOUNDATION	NY	501(C)(3)	11	Seton Health	Yes
(181)Seton Health System Inc 1300 Massachusetts Avenue Troy,NY12180 14-1776186	HEALTHCARE AN	NY	501(C)(3)	3	St Peter's	Yes
(182)Sisters of Providence Care Centers Inc c/o SPHS 1221 Main Street S Holyoke,MA01040 22-2541103	LONG TERM CAR	MA	501(C)(3)	3	The Mercy Ho	Yes
(183)Sisters of Providence Health System Inc 1221 Main Street Suite 213 Holyoke,MA01040	HEALTHCARE SY	MA	501(C)(3)	12	Trinity Heal	Yes
(184)SJHSJOC Holdings Inc 424 Decatur Street Atlanta,GA30312 47-2299757	HEALTHCARE SY	GA	501(C)(3)	12	Saint Joseph	Yes
(185)St Agnes Continuing Care Center One West Elm Street Conshohocken,PA19428 23-2840137	PACE PROGRAM	PA	501(C)(3)	3	Mercy Health	Yes
(186)St Agnes Continuing Care Center Foundat One West Elm Street Conshohocken,PA19428 23-2415137	FOUNDATION	PA	501(C)(3)	11	St Agnes Co	Yes
(187)St Francis Foundation PO Box 2500 Wilmington,DE19805 51-0374158	FOUNDATION	DE	501(C)(3)	11	St Francis	Yes
(188)St Francis Hospital and Medical Center 114 Woodland Street Hartford,CT06105	HEALTHCARE AN	CT	501(C)(3)	3	Trinity Heal	Yes
(189)St Francis Hospital Inc PO Box 2500 Wilmington,DE19805 51-0064326	HEALTHCARE AN	DE	501(C)(3)	3	Trinity Heal	Yes
(190)St Francis Medical Center Foundation I 601 Hamilton Avenue Trenton,NJ08629 52-1025476	FOUNDATION	NJ	501(C)(3)	7	St Francis	Yes
(191)St Francis Medical Center Trenton NJ 601 Hamilton Avenue Trenton,NJ08629 22-3431049	HEALTHCARE AN	NJ	501(C)(3)	3	Maxis Health	Yes
(192)St James Mercy Health System Inc 411 Canisteo Street Hornell,NY14843 22-3127184	HEALTHCARE SY	NY	501(C)(3)	12	Trinity Heal	Yes
(193)St Joseph Mercy Oakland Foundation 44405 WOODWARD AVE PONTIAC,MI48341 35-2356789	FOUNDATION	MI	501(C)(3)	11	Trinity Heal	Yes
(194)St Joseph of the Pines Inc 100 Gossman Drive Southern Pines,NC28387 56-0694200	LONG TERM CAR	NC	501(C)(3)	3	Trinity Cont	Yes
(195)St Joseph's College of Nursing at St J 206 Prospect Avenue Syracuse,NY13203 20-2497520	COLLEGE OF NU	NY	501(C)(3)	2	St Joseph's	Yes
(196)St Joseph's Health Center Properties I 301 Prospect Avenue Syracuse,NY13203 23-7219294	BUILDING MANA	NY	501(C)(3)	12	St Joseph's	Yes
(197)St Joseph's Health Inc 301 Prospect Avenue Syracuse,NY13203 47-4754987	HEALTHCARE SY	NY	501(C)(3)	12	Trinity Heal	Yes
(198)St Joseph's Hospital Health Center 301 Prospect Avenue Syracuse,NY13203 15-0532254	HEALTHCARE AN	NY	501(C)(3)	3	St Joseph's	Yes
(199)St Joseph's Hospital Health Center Foun 301 Prospect Avenue Syracuse,NY13203 22-2149775	FOUNDATION	NY	501(C)(3)	11	St Joseph's	Yes
(200)St Joseph's Medical PC 301 Prospect Avenue Syracuse,NY13203 27-3899821	HEALTHCARE SE	NY	501(C)(3)	11	St Joseph's	Yes
(201)St Joseph's Physician Health PC 301 Prospect Avenue Syracuse,NY13203 16-1516863	HEALTHCARE SE	NY	501(C)(3)	11	St Joseph's	Yes
(202)St Mary Building and Development 1201 Langhorne-Newtown Road Langhorne,PA19047 46-1827502	TITLE HOLDING	PA	501(C)(2)		St Mary Med	Yes
(203)St Mary Emergency Medical Services 1201 Langhorne-Newtown Road Langhorne,PA19047 46-5354512	HEALTHCARE SE	PA	501(C)(3)	9	St Mary Med	Yes
(204)St Mary Home Incorporated 2021 Albany Avenue West Hartford,CT06117	LONG TERM CAR	CT	501(C)(3)	3	Mercy Commun	Yes
(205)St Mary Medical Center 1201 Langhorne-Newtown Road Langhorne,PA19047 23-1913910	HEALTHCARE AN	PA	501(C)(3)	3	Trinity Heal	Yes
(206)St Mary Medical Center Foundation Inc 1201 Langhorne-Newtown Road Langhorne,PA19047 23-2567468	FOUNDATION	PA	501(C)(3)	7	St Mary Med	Yes
(207)St Mary's Foundation Inc 1230 Baxter Street Athens,GA30606 58-2544232	FOUNDATION	GA	501(C)(3)	11	St Mary's H	Yes
(208)St Mary's Good Samaritan Foundation In 1230 Baxter Street Athens,GA30606 81-1660088	Foundation	GA	501(C)(3)	11	St Mary's H	Yes
(209)St Mary's Health Care System Inc 1230 Baxter Street Athens,GA30606 58-0566223	HEALTHCARE AN	GA	501(C)(3)	3	Trinity Heal	Yes
(210)St Mary's Highland Hills Inc 1230 Baxter Street Athens,GA30606	SENIOR LIVING	GA	501(C)(3)	3	St Mary's H	Yes
(211)St Mary's Medical Group Inc 1230 Baxter Street Athens,GA30606 26-1858563	HEALTHCARE SE	GA	501(C)(3)	3	St Mary's H	Yes
(212)ST MARY'S SACRED HEART HOSPITAL INC 367 Clear Creek Parkway Lavonia,GA30553 47-3752176	HEALTHCARE AN	GA	501(C)(3)	3	St Mary's H	Yes
(213)St Michael's Foundation Inc 111 Central Avenue Newark,NJ07102 22-3311976	FOUNDATION	NJ	501(C)(3)	11	Saint Michae	Yes
(214)St Peter's Health Partners 315 South Manning Blvd Albany,NY12208 45-3570715	HEALTHCARE SY	NY	501(C)(3)	12	Trinity Heal	Yes
(215)St Peter's Health Partners Medical Asso 315 South Manning Blvd Albany,NY12208 46-1177336	HEALTHCARE SE	NY	501(C)(3)	3	St Peter's	Yes
(216)St Peter's Hospital 315 South Manning Blvd Albany,NY12208 14-1348692	HEALTHCARE AN	NY	501(C)(3)	3	St Peter's	Yes
(217)St Peter's Hospital Foundation Inc 310 South Manning Blvd Albany,NY12208 22-2262982	FOUNDATION	NY	501(C)(3)	7	St Peter's	Yes
(218)Sunnyview Hospital & Rehabilitation Cent 1270 Belmont Ave Schenectady,NY12308 14-1338386	HEALTHCARE AN	NY	501(C)(3)	3	St Peter's	Yes
(219)Sunnyview Hospital & Rehab CTR Foundati 1270 Belmont Ave Schenectady,NY12308 22-2505127	FOUNDATION	NY	501(C)(3)	11	Sunnyview Ho	Yes
(220)The Community Hospice Foundation Inc 295 Valley View Blvd Rensselaer,NY12144 22-2692940	FOUNDATION	NY	501(C)(3)	7	The Communit	Yes
(221)The Community Hospice Inc 295 Valley View Blvd Rensselaer,NY12144 14-1608921	HOSPICE SERVI	NY	501(C)(3)	3	St Peter's	Yes
(222)The Foundation of Saint Joseph Regional 707 East Cedar Street South Bend,IN46617 35-1654543	FOUNDATION	IN	501(C)(3)	7	Saint Joseph	Yes
(223)The James A Eddy Memorial Geriatric Cen 2256 Burdett Ave Troy,NY12180 22-2570478	LONG TERM CAR	NY	501(C)(3)	9	LTC (Eddy)	Yes
(224)The Marjorie Doyle Rockwell Center Inc 421 West Columbia St Cohoes,NY12047 14-1793885	LONG TERM CAR	NY	501(C)(3)	9	LTC (Eddy)	Yes
(225)The Northeast Health Foundation Inc 310 South Manning Blvd Albany,NY12208 22-2743478	FOUNDATION	NY	501(C)(3)	7	St Peter's	Yes
(226)The Women's Auxiliary of Saint Francis H 114 Woodland Street Hartford,CT06105	VOLUNTEER SER	CT	501(C)(3)	12	NA
(227)Tri-Hospital Emergency Medical Services 309 Grand River PORT HURON,MI48060 38-2485700	HEALTHCARE SE	MI	501(C)(3)	11	NA
(228)Tri-Hospital MRI Center 4190 24TH AVENUE FORT GRATIOT,MI48054 38-2884297	HEALTHCARE SE	MI	501(C)(3)	3	TRINITY HEAL	Yes
(229)Trinity Continuing Care Services PO BOX 9184 FARMINGTON HILLS,MI48333 38-2559656	LONG TERM CAR	MI	501(C)(3)	9	Trinity Heal	Yes
(230)Trinity Continuing Care Services - India PO BOX 9184 FARMINGTON HILLS,MI48333 93-0907047	LONG TERM CAR	IN	501(C)(3)	9	Trinity Cont	Yes
(231)Trinity Health - Michigan 20555 VICTOR PARKWAY LIVONIA,MI48152 38-2113393	HEALTHCARE AN	MI	501(C)(3)	3	Trinity Heal	Yes
(232)Trinity Health - New England Inc 114 Woodland Street Hartford,CT06105	Healthcare Sy	CT	501(C)(3)	11	Trinity Heal	Yes
(233)Trinity Health Corporation 20555 VICTOR PARKWAY LIVONIA,MI48152 35-1443425	HEALTHCARE SY	IN	501(C)(3)	12	Catholic Hea	Yes
(234)Trinity Health LIFE Pennsylvania Inc 20555 VICTOR PARKWAY LIVONIA,MI48152 47-5244984	PACE PROGRAM	PA	501(C)(3)	9	Trinity Heal	Yes
(235)Trinity Health Pace 20555 VICTOR PARKWAY LIVONIA,MI48152 47-3073124	PACE Program	MI	501(C)(3)	12	Trinity Heal	Yes
(236)Trinity Health Welfare Benefit Trust 20555 VICTOR PARKWAY LIVONIA,MI48152 20-8151733	RETIREE MEDIC	MI	501(C)(9)		Trinity Heal	Yes
(237)Trinity Home Health Services 17410 COLLEGE PARKWAY LIVONIA,MI48152 38-2621935	MANAGEMENT SE	MI	501(C)(3)	9	Trinity Heal	Yes
(238)Uihlein Mercy Center 3805 West Chester Pike Newtown Square,PA19073 15-0532190	HEALTHCARE SE	NY	501(C)(3)	3	Mercy Uihlei	Yes
(239)University Heights Property Company Inc 111 Central Avenue Newark,NJ07102 22-3100162	TITLE HOLDING	NJ	501(C)(2)		Saint Michae	Yes
(240)Villa Mary Immaculate 301 Hackett Blvd Albany,NY12208 14-1438749	LONG TERM CAR	NY	501(C)(3)	3	St Peter's	Yes
(241)WESTSHORE HEALTH NETWORK 1820 44TH STREET KENTWOOD,MI49508 38-3280200	HEALTH NETWOR	MI	501(C)(4)		Mercy Health	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2015

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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) ADVENT REHABILITATION LLC 607 Dewey Avenue GRAND RAPIDS,MI49504 38-3306673	REHABILITATION TH	MI	TRINITY HEALTH-	RELATED						Yes
(2) BIG RUN MEDICAL OFFICE BUILDING LIMITED 793 W STATE STREET COLUMBUS,OH43222 31-1608125	MEDICAL OFFICE BU	OH	MOUNT CARMEL HE	RELATED						Yes
(3) Catherine Horan Building Associates LP 1221 Main Street Holyoke,MA01040	Property Manageme	MA	Catherine Horan	Rental						Yes
(4) Centennial Surgunit LLC 502 Centennial Blvd Voorhees,NJ08043 22-3580847	Healthcare Servic	NJ	Our Lady of Lou	Related						Yes
(5) Center for Digestive Care LLC 5300 Elliott Drive Ypsilanti,MI48197	Provide Gastroint	MI	TRINITY HEALTH-	RELATED						Yes
(6) Central New Jersey Heart Services LLC PO Box 148 Bayonne,NJ07002 20-8525458	Cardiac Program	NJ	St Francis Med	Related						Yes
(7) CLINTON IMAGING SERVICES LLC 615 Valley View Dr Moline,IL61265 41-2044739	MRI DIAGNOSTIC SE	IA	MERCY MEDICAL C	RELATED						Yes
(8) Diagnostic Imaging of Southbury LLC 385 Main Street South Southbury,CT06488	Imaging Center	CT	Saint Mary's Ho	Related						Yes
(9) FOREST PARK IMAGING LLC 1000 4TH STREET SW MASON CITY,IA50401 13-4365966	X-RAY AND MAMMOGR	IA	MERCY HEALTH SE	RELATED						Yes
(10) FRANCES WARDE MEDICAL LABORATORY 300 WEST TEXTILE ROAD ANN ARBOR,MI48104 38-2648446	LABORATORY	MI	TRINITY HEALTH-	UNRELATED						Yes
(11) Gateway Health Plan LP 444 Liberty Ave Pittsburgh,PA15222 25-1691945	Medicaid & Medica	PA	Mercy Health Pl	Related						Yes
(12) GREATER HARTFORD LITHOTRIPSY LLC 144 WOODLAND ST Hartford,CT06105	Lithotripsy servi	CT	St Francis Hos	RELATED						Yes
(13) HAWARDEN Regional Health CLINICS LLC 1122 AVENUE L HAWARDEN,IA51023 20-1444339	MEDICAL CLINIC	IA	MERCY MEDICAL S	RELATED						Yes
(14) Idaho ASC Holdings LLC 1055 N Curtis Road Boise,ID83706 36-4729605	Holding company f	ID	Saint Alphonsus	Related						Yes
(15) Innovative Health Alliance of New York 14 Columbia Circle Drive Albany,NY12203 46-5676066	Accountable Care	NY	St Peter's Hea	Related						Yes
(16) Loyola Ambulatory Surgery Center at Oakb 569 Brookwood Village Birmingham,AL35209 36-4119522	Surgical Services	IL	Loyola Universi	RELATED						Yes
(17) MAGNETIC RESONANCE SERVICES PARTNERSHIP 1416 SIXTH STREET SW MASON CITY,IA50401 42-1328388	MRI SERVICES	IA	MERCY HEALTH SE	RELATED						Yes
(18) MASON CITY AMBULATORY SURGERY CENTER LL 990 4TH STREET SW MASON CITY,IA50401 20-1960348	SURGERY-SAME DAY	IA	MERCY HEALTH SE	RELATED						Yes
(19) MCE MOB IV LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 42-1544707	MEDICAL OFFICE BU	OH	MOUNT CARMEL HE	RELATED						Yes
(20) MDRMRI Technical Services LLC 5640 East Taft Road 3770 Syracuse,NY13220 16-1590982	MRI SERVICES	NY	St Joseph's Ho	RELATED						Yes
(21) MEDILUCENT MOB I 793 W STATE STREET COLUMBUS,OH43222 20-4911370	MEDICAL OFFICE BU	OH	MOUNT CARMEL HE	RELATED						Yes
(22) Medworks LLC 375 East Cedar Street Newington,CT06111	Rehabilitation se	CT	Saint Francis H	RELATED						Yes
(23) Mercy Advanced MRI LLC 2525 SOUTH MICHIGAN AVE CHICAGO,IL60616 26-2116721	Sublease MRI Equi	IL	Mercy Hospital	RELATED						Yes
(24) MERCY HEART CTR OP SERVICES LLC 1000 4TH STREET SW MASON CITY,IA50401 13-4237594	CARDIOVASCULAR SE	IA	MERCY HEALTH SE	RELATED						Yes
(25) MercyManor Partnership PO Box 10086 Toledo,OH43699 52-1931012	Nursing Home	PA	Mercy Managemen	Related						Yes
(26) MercyUSP Health Ventures LLC 15305 Dallas Parkway Addison,TX75001 47-1290300	Outpatient Surger	IA	MERCY HEALTH SE	RELATED						Yes
(27) MOUNT CARMEL EAST POB III LIMITED PARTNE 793 W STATE STREET COLUMBUS,OH43222 31-1369473	MEDICAL OFFICE BU	OH	MOUNT CARMEL HE	RELATED						Yes
(28) Naugatuck Valley MRI Limited Partnership 1389 West Main St Waterbury,CT06708	Imaging Center	CT	Saint Mary's Ho	Related						Yes
(29) Nazareth Medical Office Building Associa 2601 Holme Ave Philadelphia,PA19152 23-2388040	Medical Office Bu	PA	Nazareth Hospit	Other						Yes
(30) Physicians Outpatient Surgery Center LL 1000 NE 56th Street Oakland Park,FL33334 35-2325646	Ambulatory Surger	FL	Holy Cross Hosp	Related						Yes
(31) Radisson SJH Properties LLC 5000 Campuswood Drive East Syracuse,NY13057 46-1892799	Medical office bu	NY	St Joseph's He	RELATED						Yes
(32) SARMED OUTPATIENT PHARMACY LLC 999 N CURTIS RD BOISE,ID83706 51-0483218	PHARMACY	ID	SAINT ALPHONSUS	RELATED						Yes
(33) SIXTY FOURTH STREET LLC 2373 64TH ST BYRON CENTER,MI49315 20-2443646	PROVIDE OUTPATIEN	MI	TRINITY HEALTH-	RELATED						Yes
(34) SJLS LLC 7650 SE 27th St Mercer Island,WA98040 20-1796650	Dialysis services	NY	SJ Management C	RELATED						Yes
(35) SJV Management LLC 200 Century Pkwy Mount Laurel,NJ08054 20-2273476	Radiology	NJ	Health Manageme	Related						Yes
(36) SMMC MOB II LP 1201 Langhorne-Newtown Road Langhorne,PA19047 36-4559869	Investment and op	PA	St Mary Medica	Rental						Yes
(37) St Agnes Long-Term Intensive Care LLP One West Elm St Conshohocken,PA19428 20-0984882	Long Term Intensi	PA	St Agnes Conti	Related						Yes
(38) ST ALPHONSUS CALDWELL CANCER CTR LLC 3123 MEDICAL DR CALDWELL,ID83605 82-0526861	health care servi	ID	SAINT ALPHONSUS	RELATED						Yes
(39) ST ANN'S MEDICAL OFFICE BLDG II LIMITED 793 W STATE STREET COLUMBUS,OH43222 31-1603660	MEDICAL OFFICE BU	OH	MOUNT CARMEL HE	RELATED						Yes
(40) St Joseph's Imaging Associates PLLC 104 Union Ave Suite 905 Syracuse,NY13203 16-1104293	Radiology service	NY	St Joseph's Me	RELATED						Yes
(41) St Mary Rehabilitation Hospital LLP 680 South Forth Street Louisville,KY40202 27-3938747	Healthcare Servic	DE	St Mary Medica	Related						Yes
(42) St Peter's Ambulatory Surgery Center L 1375 Washington Avenue Albany,NY12206 46-0463892	Outpatient Surger	NY	St Peter's Hos	Investment						Yes
(43) TAMARACK MEDICAL CLINIC LLC 402 Lake Cascade Parkway Cascade,ID83611 20-1637921	OUTPATIENT MEDICA	ID	SAINT ALPHONSUS	RELATED						Yes
(44) The Ambulatory Surgery Center at St Mary 1203 Langhorne-Newtown Road Langhorne,PA19047 23-2871206	Outpatient Surger	PA	St Mary Medica	Related						Yes
(45) Total Laundry Collaborative LLC 114 Woodland Street Hartford,CT06105 20-8335788	Laundry services	CT	St Francis Hos	UNRELATED						Yes
(46) Trinity Health Partners LLC 20555 Victor Parkway Livonia,MI48152 47-2798085	Population health	DE	Trinity Health	Related						Yes
(47) WOODLAND IMAGING CENTER LLC 5301 E HURON RIVER DR ANN ARBOR,MI48106 76-0820959	RADIOLOGY/ IMAGIN	MI	TRINITY HEALTH-	RELATED						Yes

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	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) Affiliated Management Services Corporati 1300 Massachusetts Avenue Troy,NY12180 14-1668024	Real Estate	NY	Seton Health Sy	C CORP			Yes
(2) Carbondale Physicians' Services Inc 100 Lincoln Ave Carbondale,PA18407 23-2365077	Pharmacy	PA	Marian Communit	C CORP			Yes
(3) Catherine Horan Building Corp 1233 Main Street Holyoke,MA01040	Building Manageme	MA	System Coordina	C CORP			Yes
(4) Chestnut Risk Services Ltd 11 Victoria Street HAMILTON BD	Insurance	BD	Saint Michael's	C CORP			Yes
(5) Diversified Community Services Inc 1233 Main Street Holyoke,MA01040	Medical Services	MA	System Coordina	C CORP			Yes
(6) FHS Services Inc 333 Butternut Drive Dewitt,NY13214 27-2995699	Medical Services	NY	Franciscan Asso	C CORP			Yes
(7) Franciscan Associates Inc 333 Butternut Drive Dewitt,NY13214 20-2991688	Medical services	NY	St Joseph's He	C CORP			Yes
(8) Franciscan Health Support Inc 333 Butternut Drive Dewitt,NY13214 16-1236354	Medical Services	NY	Franciscan Asso	C CORP			Yes
(9) Franciscan Management Services Inc 333 Butternut Drive Dewitt,NY13214 16-1351193	MANAGEMENT SERVIC	NY	Franciscan Asso	C CORP			Yes
(10) Franklin Medical Group PC 56 Franklin St Waterbury,CT06706	Physician Office	CT	Saint Mary's Ho	C CORP			Yes
(11) GOTTLIEB MANAGEMENT SERVICES INC 701 W NORTH AVE MELROSE PARK,IL60160 36-3330529	MANAGEMENT SERVIC	IL	Gottlieb Commun	C CORP			Yes
(12) HEF INC 1820 44TH STREET SE KENTWOOD,MI49508 38-3086401	OFFICE STAFFING	MI	HACKLEY HEALTH	C CORP			Yes
(13) Hackley Health Management Inc 1820 44TH STREET SE KENTWOOD,MI49508 38-2961814	WEIGHT MANAGEMENT	MI	HACKLEY HEALTH	C CORP			Yes
(14) HACKLEY HEALTH VENTURES INC 1820 44TH STREET SE KENTWOOD,MI49508 38-2589959	OTHER MEDICAL SER	MI	MERCY HEALTH PA	C CORP			Yes
(15) HACKLEY HEALTHCARE EQUIPMENT CORP 1820 44TH STREET SE KENTWOOD,MI49508 38-2578569	HOME MEDICAL EQUI	MI	HACKLEY HEALTH	C CORP			Yes
(16) HACKLEY PROFESSIONAL PHARMACY Inc 1820 44TH STREET SE KENTWOOD,MI49508 38-2447870	PHARMACY	MI	HACKLEY HEALTH	C CORP			Yes
(17) Health Care Management Administrators I 333 Butternut Drive Dewitt,NY13214 16-1450960	Healthcare Manage	NY	Franciscan Asso	C CORP			Yes
(18) Health Management Services Org Inc 500 Grove Street Haddon Heights,NJ08035 22-3366580	Medical Administr	NJ	Lourdes Ancilla	C CORP			Yes
(19) HOLY CROSS PRIVATE HOME SERVICES CORP 1500 Forest Glen Rd SILVER SPRING,MD20910 52-1986562	HOME CARE SERVICE	MD	MARYLAND CARE G	C CORP			Yes
(20) HPC CO-OWNERS ASSOCIATION 1700 CLINTON MUSKEGON,MI49442 27-0734448	CONDOMINIUM ASSOC	MI	HACKLEY HEALTH	C CORP			Yes
(21) HURON ARBOR CORPORATION 5301 EAST HURON RIVER DR ANN ARBOR,MI48106 38-2475644	PROVIDES OFFICE R	MI	TRINITY HEALTH-	C CORP			Yes
(22) IHA Affiliation Corporation 24 Frank Lloyd Wright Dr ANN ARBOR,MI48106 38-3188895	Medical Managemen	MI	IHA Health Serv	C CORP			Yes
(23) Langhorne Services II Inc 1201 Langhorne-Newtown Road Langhorne,PA19047 25-3795549	General Partner o	PA	St Mary Medica	C CORP			Yes
(24) Langhorne Services Inc 1201 Langhorne-Newtown Road Langhorne,PA19047 23-2625981	General Partner o	PA	St Mary Medica	C CORP			Yes
(25) LifeCare Physicians PC 601 Hamilton Avenue Trenton,NJ08629 26-1649038	Health Care Servi	NJ	St Francis Med	C CORP			Yes
(26) Lourdes Medical Associates PA 500 Grove Street Haddon Heights,NJ08035 22-3361862	Medical Services	NJ	Our Lady of Lou	C CORP			Yes
(27) Lourdes Urgent Care Services PC 1600 Haddon Avenue Camden,NJ08103 46-4188202	Urgent Care Cente	NJ	Our Lady of Lou	C CORP			Yes
(28) MARYLAND CARE GROUP INC 1500 Forest Glen Rd SILVER SPRING,MD20910 52-1815313	HEALTHCARE HOLDIN	MD	Holy Cross Heal	C CORP			Yes
(29) MCMC Eastwick Inc c/o MHS One West Elm Street Conshohocken,PA19428 23-2184261	Medical Office Bu	PA	Mercy Health Sy	C CORP			Yes
(30) MEDNOW INC 1512 12TH AVENUE ROAD NAMPA,ID83686 82-0389927	Medical Services	ID	SAINT ALPHONSUS	C CORP			Yes
(31) Mercy Home Care Inc 1233 Main Street Holyoke,MA01040	Health Care Servi	MA	System Coordina	C CORP			Yes
(32) Mercy Inpatient Medical Associates Inc 1233 Main Street Holyoke,MA01040	Medical Services	MA	System Coordina	C CORP			Yes
(33) MERCY MEDICAL SERVICES 801 5TH STREET SIOUX CITY,IA51101 42-1283849	PRIMARY CARE PHYS	IA	MERCY HEALTH SE	C CORP			Yes
(34) MERCY SERVICES CORPORATION 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-3227348	Dormant	IL	Mercy Health Sy	C CORP			Yes
(35) MOUNT CARMEL HEALTH PROVIDERS INC 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1382442	MEDICAL SERVICES	OH	MOUNT CARMEL HE	C CORP			Yes
(36) Nursing Network Inc 4725 North Federal Highway Fort Lauderdale,FL33308 59-1145192	Medical Services	FL	Holy Cross Hosp	C CORP			Yes
(37) Physicians Medical Office Building Condo 1221 Main Street Holyoke,MA01040	Property Manageme	MA	Sisters of Prov	C CORP			Yes
(38) Saint Alphonsus Health Alliance Inc 1055 NORTH CURTIS ROAD BOISE,ID83706 82-0524649	Accountable Care	ID	Saint Alphonsus	C CORP			Yes
(39) SAINT ALPHONSUS PHYSICIANS PA 1055 NORTH CURTIS ROAD BOISE,ID83706 33-1078261	Health Care Servi	ID	ST ALPHONSUS RE	C CORP			Yes
(40) Saint Francis Behavioral Health Group P 114 Woodland Street Hartford,CT06105	Medical Services	CT	Saint Francis H	C CORP			Yes
(41) Saint Francis Care Medical Group PC 114 Woodland Street Hartford,CT06105	Medical Services	CT	Saint Francis H	C CORP			Yes
(42) Samaritan Medical Office Building Inc 2212 Burdett Avenue Troy,NY12180 14-1607244	Real Estate	NY	St Peter's Hea	C CORP			Yes
(43) SJM Properties Inc 411 Canisteo Street Hornell,NY14843 16-1294991	Property Holdings	NY	St James Mercy	C CORP			Yes
(44) SJPE Practice Management Services Inc 301 Prospect Ave Syracuse,NY13203 45-4164964	MANAGEMENT SERVIC	NY	St Joseph's Ho	C CORP			Yes
(45) SJRMC Holdings Inc 5215 Holy Cross Parkway Mishawaka,IN46545 47-4763735	Property Holdings	IN	Saint Joseph Re	C CORP			Yes
(46) St Elizabeth Health Support Services I 2209 Genesee Street Utica,NY13501 16-1540486	Medical Services	NY	Franciscan Mana	C CORP			Yes
(47) St Mary's Highland Hills Village Inc 1230 Baxter Street Athens,GA30606 58-2276801	Assisted Living	GA	St Mary's Heal	C CORP			Yes
(48) System Coordinated Services Inc 1233 Main Street Holyoke,MA01040	Lab Services	MA	Mercy Hospital	C CORP			Yes
(49) THRE SERVICES LLC 20555 VICTOR PARKWAY LIVONIA,MI48152 45-2603654	REAL ESTATE BROKE	MI	Trinity Health-	C CORP			Yes
(50) TRINITY ASSURANCE LTD PO BOX 1051 GRAND CAYMAN,GRAND CAYMAN CJ 98-0453602	PROVISION OF INSU	CJ	TRINITY HEALTH-	C CORP			Yes
(51) TRINITY HEALTH ACO INC 20555 VICTOR PARKWAY LIVONIA,MI48152 47-3794666	Accountable Care	DE	TRINITY HEALTH	C CORP			Yes
(52) TRINITY HEALTH EMPLOYEE BENEFIT TRUST 20555 VICTOR PARKWAY LIVONIA,MI48152 38-3410377	GRANTOR TRUST	MI	TRINITY HEALTH	TRUST			Yes
(53) Trinity Senior Services Management Inc PO Box 9184 Farmington Hills,MI48333 37-1572595	Senior Services	PA	Trinity Continu	C CORP			Yes
(54) WEST SHORE PROFESSIONAL BUILDING CONDOMI 1820 44TH STREET SE KENTWOOD,MI49508 38-2700166	CONDOMINIUM ASSOC	MI	MERCY HEALTH PA	C CORP			Yes
(55) WORKPLACE HEALTH OF GRAND HAVEN Inc 1820 44TH STREET SE KENTWOOD,MI49508 38-3112035	OCCUPATIONAL HEAL	MI	HACKLEY HEALTH	C CORP			Yes

Schedule R (Form 990) 2015

Page 3

Part V

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

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

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

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

Yes

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

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

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

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

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

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

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

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

Schedule R (Form 990) 2015

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) 2015

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	844,886	997,240
9	Program service revenue (Part VIII, line 2g) .........	0	0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	286,488	112,599
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-64,376	-63,785
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,066,998	1,046,054
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	555,243	151,521
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)	200,695	283,209
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 39,878
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	238,785	213,353
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	994,723	648,083
19	Revenue less expenses. Subtract line 18 from line 12.......	72,275	397,971
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	4,952,674	5,633,104
21	Total liabilities (Part X, line 26).............	44,431	83,639
22	Net assets or fund balances. Subtract line 21 from line 20.....	4,908,243	5,549,465

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 455,714 including grants of $ 151,521 ) (Revenue $ )
	SAINT MARY'S HOSPITAL FOUNDATION, INC. RAISES CONTRIBUTIONS FROM THE PUBLIC SOLELY FOR THE BENEFIT OF SAINT MARY'S HOSPITAL, INC. CONTRIBUTIONS ARE RAISED FOR SPECIFIC AND NON-SPECIFIC PURPOSES AND DISTRIBUTED TO THE HOSPITAL BASED ON THE HOSPITAL'S NEEDS. PLEASE SEE STATEMENT 1 FOR A DESCRIPTION OF SAINT MARY'S HOSPITAL'S PROGRAM SERVICE ACCOMPLISHMENTS.

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 expenses455,714

(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
(A) Name and Title
(18) KATIE SPIZZIRRI........................................................................ EXEC. DIRECTOR (THRU 10/2015)	40.0 .......................0.0	X	X	0	56,703	10,783
(19) CHARLES J BOULIER III........................................................................ DIRECTOR (THRU 12/31/2015)	1.0 .......................0.0	X		0	0	0
(20) ROBIN SILLS RN........................................................................ DIRECTOR	1.0 .......................0.0	X		0	88,374	20,087

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	1,681,841	272,381

1	Briefly describe the organization’s mission or most significant activities: SAINT MARY'S HOSPITAL FOUNDATION'S PRIMARY PURPOSE IS TO RAISE MONEY IN SUPPORT OF SAINT MARY'S HOSPITAL, INC.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	13
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	98
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

(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 0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	491,820
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	505,420

g	Noncash contributions included in lines 1a-1f:$ 73,434
h Total.Add lines 1a-1f.......		997,240

		Business Code
2a
b
c
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....		0

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			112,599		112,599
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss)......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss).....			0
8a	Gross income from fundraising events (not including $ 491,820of contributions reported on line 1c). See Part IV, line 18 ....
	a		173,216
b	Less: direct expenses ...b		237,001
c	Net income or (loss) from fundraising events..			-63,785		-63,785
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..			0
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..			0
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See Instructions......			1,046,054		48,814

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	151,521	151,521
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	183,108	183,108
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	79,528	79,528
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	0
9	Other employee benefits .......	20,573	20,573
10	Payroll taxes ...........	0
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	10,000		10,000
c	Accounting ...........	30,000		30,000
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	28,938		28,938
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	0
12	Advertising and promotion ....	4,250		4,250
13	Office expenses .......	54,738	10,938	24,613	19,187
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	12,504		12,504
17	Travel ............	171		171
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	645		645
23	Insurance ...	0
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	PUBLIC AND EMPLOYEE RELATION	22,786	2,095		20,691
b	CONTRACT FEES	41,117		41,117
c	BAD DEBT EXPENSES	2,425	2,425
d	MISCELLANEOUS	5,779	5,526	253
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	648,083	455,714	152,491	39,878
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			768,360	1	1,138,423
2	Savings and temporary cash investments .........			593,918	2	31,433
3	Pledges and grants receivable, net ......			43,776	3	29,297
4	Accounts receivable, net .............			0	4	0
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net ....			0	7	0
8	Inventories for sale or use ........			0	8	0
9	Prepaid expenses and deferred charges ......			16,903	9	10,200
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	0
b	Less: accumulated depreciation	10b	0	3,621	10c	0
11	Investments—publicly traded securities .			3,526,096	11	4,423,751
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			0	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)...			4,952,674	16	5,633,104

17	Accounts payable and accrued expenses .....	22,456	17	63,515
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
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	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
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	21,975	25	20,124
26	Total liabilities. Add lines 17 through 25..	44,431	26	83,639

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	2,059,816	27	2,571,785
28	Temporarily restricted net assets ...........	1,798,000	28	1,927,248
29	Permanently restricted net assets	1,050,427	29	1,050,432
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	4,908,243	33	5,549,465
34	Total liabilities and net assets/fund balances ........	4,952,674	34	5,633,104