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) CLAUS VON ZYCHLIN...................................................................... DIR & MT CARMEL PRES/CEO THR 2/16	48.00 ................. 7.00	X	X	0	995,640	49,948
(2) ROGER SPOELMAN...................................................................... DIR & MT CARMEL INT PRES/CEO AT 2/16	1.00 ................. 54.00	X	X	0	1,161,340	50,263
(3) LISA STEIN...................................................................... DIRECTOR; VICE CHAIR	2.00 ................. 0.00	X	X	0	0	0
(4) JOHN PEREZ...................................................................... DIRECTOR; CHAIR	2.00 ................. 0.00	X	X	0	0	0
(5) STAMPP CORBIN...................................................................... DIRECTOR THROUGH 12/15	2.00 ................. 0.00	X		0	0	0
(6) JOY O'GRADY CSC...................................................................... DIRECTOR; SECRETARY THROUGH 1/16	2.00 ................. 0.00	X	X	0	0	0
(7) JORGE GOMEZ...................................................................... DIRECTOR & TREASURER THROUGH 8/15	2.00 ................. 0.00	X	X	0	0	0
(8) CHARLES HICKEY MD...................................................................... DIRECTOR	2.00 ................. 0.00	X		14,294	0	0
(9) PATRICK CAIN MD...................................................................... DIRECTOR THROUGH 12/15	2.00 ................. 0.00	X		0	0	0
(10) KATHY GATTERDAM...................................................................... DIRECTOR	2.00 ................. 0.00	X		0	0	0
(11) JUDITH ANNE BEATTIE CSC...................................................................... DIRECTOR	2.00 ................. 0.00	X		0	0	0
(12) JOHN GILLIGAN...................................................................... DIRECTOR	2.00 ................. 0.00	X		0	0	0
(13) SALLY JEFFCOAT...................................................................... DIRECTOR;EVP TRINITY WEST/MIDWEST GR	1.00 ................. 54.00	X		0	1,465,283	40,351
(14) PABLO VEGAS...................................................................... DIRECTOR	2.00 ................. 0.00	X		0	0	0
(15) JORDAN HANSELL...................................................................... DIRECTOR; TREASURER AS OF 12/15	2.00 ................. 0.00	X	X	0	0	0
(16) SHARON TACKETT...................................................................... DIRECTOR THROUGH 5/16	2.00 ................. 0.00	X		0	0	0
(17) LARRY ENGLISH...................................................................... DIRECTOR AS OF 1/16	2.00 ................. 0.00	X		0	0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) TANISHA ROBINSON........................................................................ DIRECTOR AS OF 1/16	2.00 .......................0.00	X					0	0	0
(19) KEITH COLEMAN........................................................................ MT CARMEL HEALTH SYS CFO THR 5/16	50.00 .......................5.00		X				0	507,711	34,873
(20) DANIEL POWELL........................................................................ MT CARMEL SYS INTERIM CFO AT 5/16	50.00 .......................5.00		X				0	0	0
(21) DANIEL HACKETT........................................................................ SECRETARY AT 1/16; MANAGING COUNSEL	50.00 .......................0.00		X				0	392,640	41,277
(22) UNHEE KIM........................................................................ PRESIDENT & COO,ST. ANN'S AT 8/15	55.00 .......................0.00			X			0	182,344	26,945
(23) JANET MEEKS........................................................................ PRESIDENT & COO, ST ANN'S THR 7/15	55.00 .......................0.00			X			0	428,889	28,752
(24) SEAN MCKIBBEN........................................................................ PRESIDENT & COO, MC WEST	53.00 .......................2.00			X			0	554,746	41,226
(25) BRINSLEY LEWIS........................................................................ PRESIDENT & COO, MC EAST THR 9/15	53.00 .......................2.00			X			0	648,568	558,128
(26) LYNDON CHRISTMAN........................................................................ INTERIM PRES & COO MC EAST 9/15-2/16	55.00 .......................0.00			X			311,573	0	45,311
(27) DIANE DOUCETTE........................................................................ PRESIDENT & COO, MC NEW ALBANY	55.00 .......................0.00			X			0	230,667	46,646
(28) RICHARD STRECK........................................................................ CHIEF CLINICAL OPERATIONS OFFICER	50.00 .......................0.00			X			0	603,641	33,426
(29) PHILLIP J SHUBERT MD........................................................................ DIRECTOR PERINATAL MEDICAL	50.00 .......................0.00				X		627,817	0	36,429
(30) LAURA TRAINI........................................................................ CHIEF TRANSFORM. OFFICER THR 2/16	50.00 .......................0.00				X		0	503,298	54,309
(31) CHRISTOPHER LANG........................................................................ PERINATAL MEDICAL DIRECTOR	50.00 .......................0.00				X		422,823	0	31,848
(32) GERALD GIRARDI........................................................................ PERINATAL MEDICAL DIRECTOR	50.00 .......................0.00				X		0	390,048	30,658
(33) CHARLES E SANDERS JR........................................................................ VP MEDICAL EDUCATION	50.00 .......................0.00				X		376,812	0	30,824
(34) HUGH JONES........................................................................ FORMER KE; SVP PLAN/MKTG THR 1/16	45.00 .......................5.00					X	0	340,607	39,729
(35) ANNE BROWNING........................................................................ FORMER KE; SENIOR VP HR THR 9/15	46.00 .......................4.00					X	0	262,366	30,707
(36) CHARLES BRETT JUSTICE........................................................................ FORMER KE; SYS VP STRATEGIC ADVANCMT	48.00 .......................2.00					X	199,914	0	29,487
(37) JACQUELINE PRIMEAU........................................................................ FORMER OFFICER; TRIN VP M&A	0.00 .......................50.00					X	0	302,267	30,507
(38) KEDRICK ADKINS........................................................................ FORMER KEY EMPLOYEE	0.00 .......................0.00					X	0	768,621	141

(A) Name and business address	(B) Description of services	(C) Compensation
MESSER CONSTRUCTION 5158 FISHWICK DRIVE CINCINNATI,OH45216	CONSTRUCTION SERVICES	10,615,475
DAWSON HEALTHCARE 2220 STATE ROAD 157 SUITE 150 GLEN CARBON,IL62034	HEALTHCARE SERVICES	6,092,876
TURNER CONSTRUCTION CO 535 GRISWOLD STE 200 DETROIT,MI48226	CONSTRUCTION SERVICES	5,970,335
CENTRAL OHIO ORTHO MANAG COMP 3059 E MOUND ST LOGAN,OH43138	HEALTHCARE SERVICES	5,736,214
NBBJ LLC 1555 LAKE SHORE DRIVE COLUMBUS,OH43204	CONSTRUCTION SERVICES	5,519,946
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 120

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

MOUNT CARMEL HEALTH SYSTEM

Employer identification number

31-1439334

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.) ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

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

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 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)) .........

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

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

MOUNT CARMEL HEALTH SYSTEM

Employer identification number

31-1439334

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 MOUNT CARMEL HEALTH SYSTEM

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 MOUNT CARMEL HEALTH SYSTEM		Employer identification number 31-1439334

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 MOUNT CARMEL HEALTH SYSTEM			Employer identification number 31-1439334
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 C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

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

OMB No. 1545-0047

2015

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

MOUNT CARMEL HEALTH SYSTEM

Employer identification number

31-1439334

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ...............................................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................
c	Total lobbying expenditures (add lines 1a and 1b) .......................................................................
d	Other exempt purpose expenditures .........................................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) ..........................................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ..............................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

Page 3

Part II-B

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

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

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

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

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

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

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

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

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

Yes

23,997

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

Yes

99,682

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

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

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

123,679

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

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

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

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

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

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1:	MOUNT CARMEL HEALTH SYSTEM HAS MADE GRANTS TO OTHER ORGANIZATIONS IN THE FORM OF MEMBERSHIP DUES PAID TO A NATIONAL HEALTH CARE ORGANIZATION. THIS ORGANIZATION HAS PROVIDED MOUNT CARMEL HEALTH SYSTEM WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. IN ADDITION, PAYMENTS WERE MADE TO LOBBYING FIRMS TO ASSIST WITH FEDERAL EARMARK REQUESTS AND STATE LEGISLATIVE ADVOCACY.

Return Reference

Explanation

PART II-B, LINE 1:

MOUNT CARMEL HEALTH SYSTEM HAS MADE GRANTS TO OTHER ORGANIZATIONS IN THE FORM OF MEMBERSHIP DUES PAID TO A NATIONAL HEALTH CARE ORGANIZATION. THIS ORGANIZATION HAS PROVIDED MOUNT CARMEL HEALTH SYSTEM WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. IN ADDITION, PAYMENTS WERE MADE TO LOBBYING FIRMS TO ASSIST WITH FEDERAL EARMARK REQUESTS AND STATE LEGISLATIVE ADVOCACY.

Schedule C (Form 990 or 990EZ) 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

MOUNT CARMEL HEALTH SYSTEM

Employer identification number

31-1439334

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

0.00

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

$ 0

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 ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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 ...		44,519,573		44,519,573
b	Buildings		788,326,414	440,149,810	348,176,604
c	Leasehold improvements
d	Equipment ...		539,663,561	397,468,182	142,195,379
e	Other ...	6,651,703	79,294,606	24,523	85,921,786
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					620,813,342

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) COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES	138,400,284	F
(B) EQUITY METHOD INVESTMENTS	117,640,241	C
(C) HEDGE FUNDS	83,040,170	F
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	339,080,695

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) MISCELLANEOUS RECEIVABLES				7,732,113
(2) INTERCOMPANY ACCOUNTS RECEIVABLE				313,571,631
(3) INVESTMENT IN UNCONSOL. AFFILIATES				55,424,918
(4) INTERCOMPANY OTHER LT ASSETS				67,723,022
(5) OTHER LONG-TERM ASSETS				807,355
(6) OTHER CURRENT ASSETS				1,998
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				445,261,037

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
DEFERRED COMPENSATION LIABILITY	1,596,548
INTERCOMPANY ACCOUNTS PAYABLE	17,876,062
INTERCOMPANY NOTES PAYABLE	652,371,472
LEASE OBLIGATION	675,749
OTHER CURRENT LIABILITIES	29,559
OTHER LONG TERM LIABILITIES	514,393
ASSET RETIREMENT OBLIGATION (FIN 47)	3,017,280
ANNUITIES PAYABLE	225,498
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	676,306,561
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	ENDOWMENTS HELD BY MOUNT CARMEL HEALTH SYSTEM FOUNDATION FOR THE BENEFIT OF MOUNT CARMEL HEALTH SYSTEM (MOUNT CARMEL) ARE REPORTED ON THE FORM 990 OF MOUNT CARMEL HEALTH SYSTEM FOUNDATION.
SCHEDULE D, PART II, LINE 9	MOUNT CARMEL ACQUIRED LAND THROUGH PURCHASE THAT INCLUDES A WETLAND CONSERVATION EASEMENT. THE CONSERVATION EASEMENT IS REPORTED AS LAND ON THE BALANCE SHEET OF MOUNT CARMEL.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

MOUNT CARMEL HEALTH SYSTEM

Employer identification number

31-1439334

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

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

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

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

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			22,109,810		22,109,810	1.880 %
b	Medicaid (from Worksheet 3, column a) . . . . .			212,920,946	154,636,893	58,284,053	4.950 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			235,030,756	154,636,893	80,393,863	6.830 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	15	119,817	3,613,775	697,059	2,916,716	0.250 %
f	Health professions education (from Worksheet 5) . . .	4	1,162	20,970,332	9,384,148	11,586,184	0.980 %
g	Subsidized health services (from Worksheet 6) . . . .	6	39,458	3,236,583	2,138,574	1,098,009	0.090 %
h	Research (from Worksheet 7) .	1	4,735	250		250	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	9	13,335	1,532,052	100	1,531,952	0.130 %
j	Total. Other Benefits . .	35	178,507	29,352,992	12,219,881	17,133,111	1.450 %
k	Total. Add lines 7d and 7j .	35	178,507	264,383,748	166,856,774	97,526,974	8.280 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

Page

Part II

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

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	4	272	14,644	14,644	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	4	272	14,644	14,644

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

34,352,448

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

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

Section B. Medicare

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

208,012,699

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

207,522,993

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

489,706

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 ST ANN'S MEDICAL OFFICE BUILDING II LIMITED PARTNERSHIP	MEDICAL OFFICE BLDG.	46.960 %	53.040 %
22 MCE MOB IV LIMITED PARTNERSHIP	MEDICAL OFFICE BLDG.	49.850 %	50.150 %
33 MCMC POB III LIMITED PARTNERSHIP	MEDICAL OFFICE BLDG.	30.140 %	69.860 %
44 MCE POB III	MEDICAL OFFICE BLDG.	29.150 %	70.850 %
55 MEDILUCENT MOB I	MEDICAL OFFICE BLDG.	25.200 %	74.800 %
66 EYE CENTER OF COLUMBUS	AMBULATORY SURGERY CENTER	2.690 %	94.610 %
77 TAYLOR STATION SURGICAL CENTER	AMBULATORY SURGERY CENTER	40.000 %	60.000 %
88 CANAL WINCHESTER MOB	MEDICAL OFFICE BLDG.	22.000 %	78.000 %
99 COLUMBUS CYBERKNIFE	ROBOTIC CANCER TREATMENT	35.000 %	50.000 %
1010 GREEN STREET SURGERY CENTER	AMBULATORY SURGERY CENTER	20.000 %	60.000 %
1111 ST ANNS MOB III LLC	MEDICAL OFFICE BLDG.	38.140 %	61.860 %
1212 NEW ALBANY SURGERY CENTER	AMBULATORY SURGERY CENTER	35.000 %	65.000 %
1313 BIG RUN MOB LIMITED PARTNERSHIP	MEDICAL OFFICE BLDG.	76.920 %	23.080 %
1414 EASTWIND SURGICAL LLC	AMBULATORY SURGERY CENTER	30.010 %	24.710 %

Schedule H (Form 990) 2015

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?4 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	MOUNT CARMEL EAST 6001 EAST BROAD STREET COLUMBUS,OH43213 WWW.MOUNTCARMELHEALTH.COM REGISTRATION #1027	X	X			X
2	MOUNT CARMEL WEST 793 WEST STATE STREET COLUMBUS,OH43222 WWW.MOUNTCARMELHEALTH.COM REGISTRATION #1175	X	X	X		X
3	MOUNT CARMEL ST ANN'S 500 SOUTH CLEVELAND AVENUE WESTERVILLE,OH43081 WWW.MOUNTCARMELHEALTH.COM REGISTRATION #1606	X	X	X		X
4	MOUNT CARMEL NEW ALBANY SURGICAL HOSP 7333 SMITHS MILL ROAD NEW ALBANY,OH43054 WWW.MOUNTCARMELHEALTH.COM REGISTRATION #1451	X	X		X

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	MOUNT CARMEL EAST
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

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

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

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

Yes

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

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

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H, PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MOUNT CARMEL EAST
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000% and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE

The FAP application form was widely available on a website (list url):

WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	MOUNT CARMEL EAST
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

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

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

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

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	MOUNT CARMEL WEST
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

Yes

6 a

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

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

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

Yes

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

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

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H, PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

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

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MOUNT CARMEL WEST
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000% and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE

The FAP application form was widely available on a website (list url):

WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	MOUNT CARMEL WEST
Name of hospital facility or letter of facility reporting group

Yes

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

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

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

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

Other (describe in Section C)

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	MOUNT CARMEL ST ANN'S
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

Yes

6 a

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

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

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

Yes

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

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

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H, PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

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

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MOUNT CARMEL ST ANN'S
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000% and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE

The FAP application form was widely available on a website (list url):

WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	MOUNT CARMEL ST ANN'S
Name of hospital facility or letter of facility reporting group

Yes

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

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

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

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

Other (describe in Section C)

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	MOUNT CARMEL NEW ALBANY SURGICAL HOSP
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

Yes

6 a

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

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

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

Yes

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

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

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H, PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

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

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MOUNT CARMEL NEW ALBANY SURGICAL HOSP
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000% and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE

The FAP application form was widely available on a website (list url):

WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	MOUNT CARMEL NEW ALBANY SURGICAL HOSP
Name of hospital facility or letter of facility reporting group

Yes

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

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

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

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

Other (describe in Section C)

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
MOUNT CARMEL EAST	PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS A COLLABORATIVE PROJECT LED BY CENTRAL OHIO HOSPITAL COUNCIL THAT INCLUDED FOUR COLUMBUS HEALTH SYSTEMS AND THE FOLLOWING ORGANIZATIONS: COLUMBUS AND FRANKLIN COUNTY PUBLIC HEALTH (WITH SPECIAL KNOWLEDGE OF AND EXPERTISE IN PUBLIC HEALTH); UNITED WAY OF CENTRAL OHIO AND PRIMARYONE HEALTH (REPRESENTING LOW INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS); CENTRAL OHIO AREA AGENCY ON AGING AND OHIO DEPARTMENT OF AGING (REPRESENTING THE SENIOR POPULATION); HEALTHCARE FOR THE HOMELESS (REPRESENTING THE HOMELESS POPULATION); OHIO DEPARTMENT OF HEALTH, OHIO DISABILITY AND HEALTH PROGRAM (REPRESENTING THOSE WITH DISABILITIES). THE STEERING COMMITTEE BEGAN CONDUCTING WORK SESSIONS IN JUNE 2014 AND MET PERIODICALLY UNTIL THE RELEASE OF THE CHNA ON JUNE 8, 2016. OVERVIEW OF THESE MEETINGS WAS SHARED WITH COMMUNITY MEMBERS AND INPUT AND ADVICE SOLICITED AT COMMUNITY ADVISORY MEETINGS AND COMMUNITY HEALTH PLANNING SESSIONS.
MOUNT CARMEL WEST	PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS A COLLABORATIVE PROJECT LED BY CENTRAL OHIO HOSPITAL COUNCIL THAT INCLUDED FOUR COLUMBUS HEALTH SYSTEMS AND THE FOLLOWING ORGANIZATIONS: COLUMBUS AND FRANKLIN COUNTY PUBLIC HEALTH (WITH SPECIAL KNOWLEDGE OF AND EXPERTISE IN PUBLIC HEALTH); UNITED WAY OF CENTRAL OHIO AND PRIMARYONE HEALTH (REPRESENTING LOW INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS); CENTRAL OHIO AREA AGENCY ON AGING AND OHIO DEPARTMENT OF AGING (REPRESENTING THE SENIOR POPULATION); HEALTHCARE FOR THE HOMELESS (REPRESENTING THE HOMELESS POPULATION); OHIO DEPARTMENT OF HEALTH, OHIO DISABILITY AND HEALTH PROGRAM (REPRESENTING THOSE WITH DISABILITIES). THE STEERING COMMITTEE BEGAN CONDUCTING WORK SESSIONS IN JUNE 2014 AND MET PERIODICALLY UNTIL THE RELEASE OF THE CHNA ON JUNE 8, 2016. OVERVIEW OF THESE MEETINGS WAS SHARED WITH COMMUNITY MEMBERS AND INPUT AND ADVICE SOLICITED AT COMMUNITY ADVISORY MEETINGS AND COMMUNITY HEALTH PLANNING SESSIONS.
MOUNT CARMEL ST. ANN'S	PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS A COLLABORATIVE PROJECT LED BY CENTRAL OHIO HOSPITAL COUNCIL THAT INCLUDED FOUR COLUMBUS HEALTH SYSTEMS AND THE FOLLOWING ORGANIZATIONS: COLUMBUS AND FRANKLIN COUNTY PUBLIC HEALTH (WITH SPECIAL KNOWLEDGE OF AND EXPERTISE IN PUBLIC HEALTH); UNITED WAY OF CENTRAL OHIO AND PRIMARYONE HEALTH (REPRESENTING LOW INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS); CENTRAL OHIO AREA AGENCY ON AGING AND OHIO DEPARTMENT OF AGING (REPRESENTING THE SENIOR POPULATION); HEALTHCARE FOR THE HOMELESS (REPRESENTING THE HOMELESS POPULATION); OHIO DEPARTMENT OF HEALTH, OHIO DISABILITY AND HEALTH PROGRAM (REPRESENTING THOSE WITH DISABILITIES). THE STEERING COMMITTEE BEGAN CONDUCTING WORK SESSIONS IN JUNE 2014 AND MET PERIODICALLY UNTIL THE RELEASE OF THE CHNA ON JUNE 8, 2016. OVERVIEW OF THESE MEETINGS WAS SHARED WITH COMMUNITY MEMBERS AND INPUT AND ADVICE SOLICITED AT COMMUNITY ADVISORY MEETINGS AND COMMUNITY HEALTH PLANNING SESSIONS.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP.	PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS A COLLABORATIVE PROJECT LED BY CENTRAL OHIO HOSPITAL COUNCIL THAT INCLUDED FOUR COLUMBUS HEALTH SYSTEMS AND THE FOLLOWING ORGANIZATIONS: COLUMBUS AND FRANKLIN COUNTY PUBLIC HEALTH (WITH SPECIAL KNOWLEDGE OF AND EXPERTISE IN PUBLIC HEALTH); UNITED WAY OF CENTRAL OHIO AND PRIMARYONE HEALTH (REPRESENTING LOW INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS); CENTRAL OHIO AREA AGENCY ON AGING AND OHIO DEPARTMENT OF AGING (REPRESENTING THE SENIOR POPULATION); HEALTHCARE FOR THE HOMELESS (REPRESENTING THE HOMELESS POPULATION); OHIO DEPARTMENT OF HEALTH, OHIO DISABILITY AND HEALTH PROGRAM (REPRESENTING THOSE WITH DISABILITIES). THE STEERING COMMITTEE BEGAN CONDUCTING WORK SESSIONS IN JUNE 2014 AND MET PERIODICALLY UNTIL THE RELEASE OF THE CHNA ON JUNE 8, 2016. OVERVIEW OF THESE MEETINGS WAS SHARED WITH COMMUNITY MEMBERS AND INPUT AND ADVICE SOLICITED AT COMMUNITY ADVISORY MEETINGS AND COMMUNITY HEALTH PLANNING SESSIONS.
MOUNT CARMEL EAST	PART V, SECTION B, LINE 6A: THE OTHER HOSPITAL FACILITIES INVOLVED IN CONDUCTING THE FRANKLIN COUNTY CHNA INCLUDED NATIONWIDE CHILDREN'S, OHIOHEALTH, WEXNER MEDICAL CENTER AT THE OHIO STATE UNIVERSITY, MOUNT CARMEL WEST (MC WEST), MOUNT CARMEL ST. ANN'S (MC ST. ANN'S), MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL (MC NEW ALBANY), AND DILEY RIDGE MEDICAL CENTER.
MOUNT CARMEL WEST	PART V, SECTION B, LINE 6A: THE OTHER HOSPITAL FACILITIES INVOLVED IN CONDUCTING THE FRANKLIN COUNTY CHNA INCLUDED NATIONWIDE CHILDREN'S, OHIOHEALTH, WEXNER MEDICAL CENTER AT THE OHIO STATE UNIVERSITY, MOUNT CARMEL EAST (MC EAST), MC ST. ANN'S, MC NEW ALBANY, AND DILEY RIDGE MEDICAL CENTER.
MOUNT CARMEL ST. ANN'S	PART V, SECTION B, LINE 6A: THE OTHER HOSPITAL FACILITIES INVOLVED IN CONDUCTING THE FRANKLIN COUNTY CHNA INCLUDED NATIONWIDE CHILDREN'S, OHIOHEALTH, WEXNER MEDICAL CENTER AT THE OHIO STATE UNIVERSITY, MC EAST, MC WEST, MC NEW ALBANY, AND DILEY RIDGE MEDICAL CENTER.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP.	PART V, SECTION B, LINE 6A: THE OTHER HOSPITAL FACILITIES INVOLVED IN CONDUCTING THE FRANKLIN COUNTY CHNA INCLUDED NATIONWIDE CHILDREN'S, OHIOHEALTH, WEXNER MEDICAL CENTER AT THE OHIO STATE UNIVERSITY, MC EAST, MC WEST, MC ST. ANN'S, AND DILEY RIDGE MEDICAL CENTER.
MOUNT CARMEL EAST	PART V, SECTION B, LINE 6B: THE COLLABORATIVE ORGANIZATIONS INVOLVED IN THE FRANKLIN COUNTY CHNA INCLUDED: CENTRAL OHIO AREA AGENCY ON AGING, CENTRAL OHIO TRAUMA CENTER, COLUMBUS PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, UNITED WAY OF CENTRAL OHIO, CENTRAL OHIO HOSPITAL COUNCIL, PRIMARYONE HEALTH, HEALTHCARE FOR THE HOMELESS, OHIO DEPARTMENT OF AGING, OHIO DEPARTMENT OF HEALTH OHIO DISABILITY AND HEALTH PROGRAM, AND THE OHIO STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH, CENTER FOR PUBLIC HEALTH PRACTICE.
MOUNT CARMEL WEST	PART V, SECTION B, LINE 6B: THE COLLABORATIVE ORGANIZATIONS INVOLVED IN THE FRANKLIN COUNTY CHNA INCLUDED: CENTRAL OHIO AREA AGENCY ON AGING, CENTRAL OHIO TRAUMA CENTER, COLUMBUS PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, UNITED WAY OF CENTRAL OHIO, CENTRAL OHIO HOSPITAL COUNCIL, PRIMARYONE HEALTH, HEALTHCARE FOR THE HOMELESS, OHIO DEPARTMENT OF AGING, OHIO DEPARTMENT OF HEALTH OHIO DISABILITY AND HEALTH PROGRAM, AND THE OHIO STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH, CENTER FOR PUBLIC HEALTH PRACTICE.
MOUNT CARMEL ST. ANN'S	PART V, SECTION B, LINE 6B: THE COLLABORATIVE ORGANIZATIONS INVOLVED IN THE FRANKLIN COUNTY CHNA INCLUDED: CENTRAL OHIO AREA AGENCY ON AGING, CENTRAL OHIO TRAUMA CENTER, COLUMBUS PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, UNITED WAY OF CENTRAL OHIO, CENTRAL OHIO HOSPITAL COUNCIL, PRIMARYONE HEALTH, HEALTHCARE FOR THE HOMELESS, OHIO DEPARTMENT OF AGING, OHIO DEPARTMENT OF HEALTH OHIO DISABILITY AND HEALTH PROGRAM, AND THE OHIO STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH, CENTER FOR PUBLIC HEALTH PRACTICE.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP.	PART V, SECTION B, LINE 6B: THE COLLABORATIVE ORGANIZATIONS INVOLVED IN THE FRANKLIN COUNTY CHNA INCLUDED: CENTRAL OHIO AREA AGENCY ON AGING, CENTRAL OHIO TRAUMA CENTER, COLUMBUS PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, UNITED WAY OF CENTRAL OHIO, CENTRAL OHIO HOSPITAL COUNCIL, PRIMARYONE HEALTH, HEALTHCARE FOR THE HOMELESS, OHIO DEPARTMENT OF AGING, OHIO DEPARTMENT OF HEALTH OHIO DISABILITY AND HEALTH PROGRAM, AND THE OHIO STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH, CENTER FOR PUBLIC HEALTH PRACTICE.
MOUNT CARMEL EAST	PART V, SECTION B, LINE 7D: THE CHNA FOR FRANKLIN COUNTY WAS PRESENTED TO THE PUBLIC IN AN OPEN FORUM HELD ON JUNE 8, 2016 AT THE BOAT HOUSE AT CONFLUENCE PARK, WHERE COPIES WERE SHARED WITH THE PUBLIC AND LEADERS OF COMMUNITY ORGANIZATIONS. MOUNT CARMEL HAS MADE THE DOCUMENT AVAILABLE TO THE COMMUNITY AT HTTP://WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT, WHERE INDIVIDUALS CAN READ ELECTRONICALLY, DOWNLOAD, OR PRINT A COPY. PRINT COPIES CAN BE REQUESTED BY CONTACTING THE HOSPITAL BY PHONE OR EMAIL. ELECTRONIC COPIES OF THE CHNA CAN BE ACCESSED AT HTTP://CENTRALOHIOHOSPITALS.ORG/CHNA.HTML.
MOUNT CARMEL WEST	PART V, SECTION B, LINE 7D: THE CHNA FOR FRANKLIN COUNTY WAS PRESENTED TO THE PUBLIC IN AN OPEN FORUM HELD ON JUNE 8, 2016 AT THE BOAT HOUSE AT CONFLUENCE PARK, WHERE COPIES WERE SHARED WITH THE PUBLIC AND LEADERS OF COMMUNITY ORGANIZATIONS. MOUNT CARMEL HAS MADE THE DOCUMENT AVAILABLE TO THE COMMUNITY AT HTTP://WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT, WHERE INDIVIDUALS CAN READ ELECTRONICALLY, DOWNLOAD, OR PRINT A COPY. PRINT COPIES CAN BE REQUESTED BY CONTACTING THE HOSPITAL BY PHONE OR EMAIL. ELECTRONIC COPIES OF THE CHNA CAN BE ACCESSED AT HTTP://CENTRALOHIOHOSPITALS.ORG/CHNA.HTML.
MOUNT CARMEL ST. ANN'S	PART V, SECTION B, LINE 7D: THE CHNA FOR FRANKLIN COUNTY WAS PRESENTED TO THE PUBLIC IN AN OPEN FORUM HELD ON JUNE 8, 2016 AT THE BOAT HOUSE AT CONFLUENCE PARK, WHERE COPIES WERE SHARED WITH THE PUBLIC AND LEADERS OF COMMUNITY ORGANIZATIONS. MOUNT CARMEL HAS MADE THE DOCUMENT AVAILABLE TO THE COMMUNITY AT HTTP://WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT, WHERE INDIVIDUALS CAN READ ELECTRONICALLY, DOWNLOAD, OR PRINT A COPY. PRINT COPIES CAN BE REQUESTED BY CONTACTING THE HOSPITAL BY PHONE OR EMAIL. ELECTRONIC COPIES OF THE CHNA CAN BE ACCESSED AT HTTP://CENTRALOHIOHOSPITALS.ORG/CHNA.HTML.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP.	PART V, SECTION B, LINE 7D: THE CHNA FOR FRANKLIN COUNTY WAS PRESENTED TO THE PUBLIC IN AN OPEN FORUM HELD ON JUNE 8, 2016 AT THE BOAT HOUSE AT CONFLUENCE PARK, WHERE COPIES WERE SHARED WITH THE PUBLIC AND LEADERS OF COMMUNITY ORGANIZATIONS. MOUNT CARMEL HAS MADE THE DOCUMENT AVAILABLE TO THE COMMUNITY AT HTTP://WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT, WHERE INDIVIDUALS CAN READ ELECTRONICALLY, DOWNLOAD, OR PRINT A COPY. PRINT COPIES CAN BE REQUESTED BY CONTACTING THE HOSPITAL BY PHONE OR EMAIL. ELECTRONIC COPIES OF THE CHNA CAN BE ACCESSED AT HTTP://CENTRALOHIOHOSPITALS.ORG/CHNA.HTML.
MOUNT CARMEL EAST	PART V, SECTION B, LINE 11: OBESITY:CANCER SURVIVORSHIP SERVICES HAS PROGRAMS AND SERVICES TO PREVENT DISEASE RECURRENCE AND IMPROVE OVERALL HEALTH AND WELL-BEING THROUGH PHYSICAL ACTIVITIES SUCH AS GENTLE YOGA, PILATES, AEROBICS, AND WEIGHT TRAINING.INFANT MORTALITY:MOMS2B (M2B) EMPOWERS PREGNANT WOMEN IN HIGH RISK AREAS TO DELIVER FULL TERM HEALTHY BABIES BY PROVIDING WEEKLY GROUP SESSIONS FOCUSED ON EDUCATION, NUTRITION, CLINICAL AND SOCIAL SUPPORT THAT CONTINUES THROUGH THE BABY'S FIRST YEAR. WELCOME HOME PROVIDES IN-HOME NEWBORN AND MATERNAL HEALTH AND WELLNESS ASSESSMENTS. WELCOME HOME PROVIDED 52 HOME VISITS TO FAMILIES PARTICIPATING IN M2B. OVERALL, WELCOME HOME PROVIDED 1,480 HOME VISITS. MC EAST PROVIDED FINANCIAL SUPPORT TO LOCAL FEDERAL QUALIFIED HEALTH CENTERS (FQHC'S) TO PROVIDE CARE FOR AT RISK PREGNANT WOMEN. MC EAST IS ALSO PART OF THE OHIO BETTER BIRTH OUTCOMES, GREATER COLUMBUS INFANT MORTALITY TASKFORCE, AND MANY WORKING SUB-COMMITTEES. ACCESS TO CARE:FINANCIAL ASSISTANCE WAS PROVIDED FOR 879 PATIENT VISITS. MC EAST SUPPORTS THREE COMMUNITY BASED HEALTH STATION CLINICS THAT PROVIDED INCOME-BASED CARE FOR OVER 8,500 PATIENT VISITS. THE LOW-INCOME PHARMACY ASSISTED OVER 275 LOW-INCOME PATIENTS IN ACQUIRING CRITICAL MEDICATIONS AT LOW OR NO COST THROUGH PARTNERSHIPS WITH PHARMACEUTICAL COMPANIES. MC EAST ALSO PROVIDED FINANCIAL SUPPORT FOR TWO LOCAL FQHC'S WHICH PROVIDED ACCESS TO PRIMARY CARE ON A SLIDING FEE SCALE. CHRONIC CONDITIONS:THE HEALTH STATION CLINICS FOCUS ON CHRONIC DISEASE AND HEALTH DISPARITIES BY PROVIDING SPECIALIZED DIABETIC CARE AND MANAGEMENT. MC EAST SUPPORTS THE CANCER SURVIVORSHIP SERVICES THAT INCLUDE EXERCISE CLASSES, SUPPORT GROUPS, EDUCATION PROGRAMS, GENETIC COUNSELING AND SCREENING, NURSE NAVIGATORS, AND OTHER PROGRAMS.LIMITED RESOURCES AND SCOPE OF PRACTICE WERE REASONS EACH HOSPITAL IN MOUNT CARMEL DID NOT ADDRESS ALL OF THE NEEDS IDENTIFIED IN THE FY16 CHNA. THE FOLLOWING NEEDS ARE NOT BEING ADDRESSED BY MC EAST, BUT ARE BEING ADDRESSED BY OTHER MOUNT CARMEL FACILITIES OR COLLABORATIVE PARTNERS: MENTAL HEALTH AND ADDICTION IS BEING ADDRESSED BY DILEY RIDGE MEDICAL CENTER, MC WEST AND MC ST. ANN'S, AS WELL AS COMMUNITY RESOURCES LISTED ON PAGE 18 OF THE CHNA. INFECTIOUS DISEASE IS BEING ADDRESSED BY MC WEST, MC NEW ALBANY, AND COMMUNITY RESOURCES LISTED ON PAGE 26 OF THE CHNA.
MOUNT CARMEL WEST	PART V, SECTION B, LINE 11: OBESITY:THE HEALTHY LIVING CENTER (HLC) HOSTS A MONTHLY COOKING CLASS TO TEACH ADULTS AND YOUTH THE IMPORTANCE OF HEALTHY EATING HABITS. OVER 11,500 COMMUNITY ENCOUNTERS HAS TAKEN PLACE IN THIS FACILITY.ACCESS TO CARE:THE OUTREACH MOBILE COACH SERVES LOW-INCOME AND HOMELESS INDIVIDUALS AND TARGETS AREAS WHERE THE POPULATION HAS BARRIERS TO ACCESSING HEALTHCARE. THE OUTREACH STREET MEDICINE PROGRAM PROVIDES SERVICE TO HOMELESS CITIZENS BEFORE ILLNESSES BECOME URGENT OR LIFE THREATENING. THEY ALSO PROVIDE CONNECTIONS TO COMMUNITY RESOURCES FOR ADDITIONAL NEEDS.MC WEST HELD SPECIAL EVENTS WHERE 571 INDIVIDUALS RECEIVED HEALTH SCREENINGS AND OBTAINED INFORMATION ON THEIR HEALTH CONDITIONS OR WERE REFERRED FOR ADDITIONAL ASSISTANCE. MENTAL HEALTH AND ADDICTION:THE COMMUNITY OUTREACH PROGRAM PARTNERS WITH SOUTHEAST, INC. TO PROVIDE BEHAVIORAL HEALTH SERVICES. AS PART OF THIS PARTNERSHIP THE OUTREACH MOBILE COACH HOUSES A PSYCHIATRIC NURSE PRACTITIONER AND CASEWORKER WHO PROVIDE SERVICES ON-SITE FOR MOBILE COACH AND STREET MEDICINE PATIENTS.CHRONIC CONDITIONS:MC WEST PROVIDED HEALTH, EDUCATION AND SUPPORTIVE SERVICES TO PREVENT AND MANAGE CHRONIC CONDITIONS THROUGH THE HLC, WHICH SERVED OVER 8,000 PERSONS. THE OUTREACH MOBILE COACH PROVIDED CARE TO OVER 6,000 HOMELESS, UNINSURED, AND LOW-INCOME PERSONS. PRESCRIPTIONEASE MATCHES QUALIFYING PATIENTS WITH PHARMACEUTICAL ASSISTANCE PROGRAMS, INCREASING PATIENT MEDICATION COMPLIANCE, AND FOLLOWS UP WITH PATIENTS TO ENSURE THEY HAVE RECEIVED REFILLS OR TO REENROLL. MEDICATION ASSISTANCE WAS PROVIDED TO OVER 350 INDIVIDUALS, SECURING OVER $709,000 IN FREE MEDICATION.INFECTIOUS DISEASE:THE OUTREACH MOBILE COACH PROVIDED INFLUENZA, TDAP, AND PNEUMONIA VACCINATIONS FOR THOSE FACING BARRIERS AT NO COST TO THE PATIENT. IN THE PAST YEAR, THE OUTREACH MOBILE COACH PROVIDED 362 INFLUENZA VACCINATIONS AND 48 PNEUMONIA AND TDAP VACCINATIONS.LIMITED RESOURCES AND SCOPE OF PRACTICE WERE REASONS EACH HOSPITAL IN MOUNT CARMEL DID NOT ADDRESS ALL OF THE NEEDS IDENTIFIED IN THE FY16 CHNA. THE FOLLOWING NEED IS NOT BEING ADDRESSED BY MC WEST, BUT IS BEING ADDRESSED BY OTHER MOUNT CARMEL FACILITIES AND COMMUNITY RESOURCES: INFANT MORTALITY IS BEING ADDRESSED BY MC EAST, MC ST. ANN'S, AND COMMUNITY RESOURCES LISTED ON PAGE 13 OF THE CHNA.
MOUNT CARMEL ST. ANN'S	PART V, SECTION B, LINE 11: OBESITY:MY TIME HAS CLASSES AND EVENTS PRIMARILY FOR WOMEN OVER 40. OFFERINGS INCLUDE EXERCISE AND NUTRITION CLASSES.MC ST. ANN'S VOLUNTEERS PROVIDED HEALTHY LUNCHES AND ENRICHMENT ACTIVITIES TO CHILDREN AND THEIR PARENTS PARTICIPATING IN WESTERVILLE AREA RESOURCE MINISTRY KID'S LUNCH PROGRAM. MC ST. ANN'S ALSO PARTICIPATED IN TWO FOOD DRIVES, DONATING THE FOOD TO LOCAL COMMUNITY FOOD PANTRIES.INFANT MORTALITY:MC ST. ANN'S PROVIDED CAR SEATS AND PACK-N-PLAY CRIBS TO NEW PARENTS TO ASSIST WITH BABY SAFE SLEEP AND SAFETY AS PART OF THE FOCUS ON INFANT MORTALITY AND INJURY PREVENTION. ACCESS TO CARE: MC ST. ANN'S PROVIDED FINANCIAL SUPPORT FOR A LOCAL FQHC, ENSURING ACCESS TO CARE AND ASSISTANCE WITH DISEASE PREVENTION FOR PATIENTS. MC ST. ANN'S PROVIDED FINANCIAL ASSISTANCE FOR 1,374 PATIENT VISITS. THE MEDICAL STUDENTS PROVIDED HEALTH SCREENINGS, EDUCATION, SPORTS PHYSICALS, AND PRIMARY CARE AT GRACE FREE CLINIC. THE LOW-INCOME PHARMACY ASSISTS LOW-INCOME PATIENTS IN ACQUIRING CRITICAL MEDICATIONS AT VERY LOW TO NO COST, SIGNIFICANTLY INCREASING ACCESS TO MEDICATIONS FOR 275 INDIVIDUALS.MENTAL HEALTH AND ADDICTION:MY TIME OFFERS CLASSES SUCH AS SELF-CARE TO MANAGE STRESS, STRENGTH CONCENTRATION WITH MINDFUL WALKING, AND LEARNING HOW TO EASE FEARS.CHRONIC CONDITIONS:REGISTERED NURSES SPECIALIZING IN STROKE EDUCATION AND PREVENTION TRAVEL TO AREA SCHOOLS, FAITH-BASED ORGANIZATIONS, AND BUSINESSES TO EDUCATE THE COMMUNITY ON STROKE FACTORS, RISKS, AND IDENTIFYING INDIVIDUALS SUFFERING FROM A STROKE AND WHAT SHOULD BE DONE TO PROVIDE ASSISTANCE. LIMITED RESOURCES AND SCOPE OF PRACTICE WERE REASONS EACH HOSPITAL IN MOUNT CARMEL DID NOT ADDRESS ALL OF THE NEEDS IDENTIFIED IN THE FY16 CHNA. THE FOLLOWING NEED IS NOT BEING ADDRESSED BY MC ST. ANN'S, BUT IS BEING ADDRESSED BY OTHER MOUNT CARMEL HOSPITALS AND COMMUNITY RESOURCES: INFECTIOUS DISEASE IS BEING ADDRESSED BY MC WEST, MC NEW ALBANY, AND COMMUNITY RESOURCES LISTED ON PAGE 26 OF THE CHNA.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP.	PART V, SECTION B, LINE 11: CHRONIC CONDITIONS:MC NEW ALBANY SUPPORTS THE CHURCH PARTNERSHIPS PROGRAM, ENABLING THE PROVISION OF HEALTH PROMOTION AND HEALTH EDUCATION TO FAITH-BASED ORGANIZATIONS. DURING HEALTH FAIRS AND COMMUNITY EVENTS, CHURCH PARTNERSHIPS PROVIDES HEALTH SCREENINGS AND ARE REFERRED FOR ADDITIONAL CARE IF NEEDED. THE CHURCH PARTNERSHIPS PROGRAM PROVIDED 408 HEALTH SCREENINGS.INFECTIOUS DISEASE:CHURCH PARTNERSHIPS PROVIDED HEALTH FAIRS AND VACCINATIONS TO ADDRESS INFECTIOUS DISEASE. THE CHURCH PARTNERSHIPS PROGRAM HAS PROVIDED 137 FLU VACCINATIONS. LIMITED RESOURCES AND SCOPE OF PRACTICE WERE REASONS EACH HOSPITAL IN MOUNT CARMEL DID NOT ADDRESS ALL OF THE NEEDS IDENTIFIED IN THE FY16 CHNA. THE FOLLOWING NEEDS ARE NOT BEING ADDRESSED BY MC NEW ALBANY, BUT ARE BEING ADDRESSED BY OTHER MOUNT CARMEL FACILITIES OR COLLABORATIVE PARTNERS: OBESITY IS BEING ADDRESSED AT MC EAST, MC WEST, MC ST. ANN'S, AND COMMUNITY RESOURCES LISTED ON PAGE 11 OF THE CHNA. INFANT MORTALITY IS BEING ADDRESSED BY MC EAST, MC ST. ANN'S, AND COMMUNITY RESOURCES LISTED ON PAGE 13 OF THE CHNA. ACCESS TO CARE IS BEING ADDRESSED BY MC EAST, MC WEST, MC ST. ANN'S, AND COMMUNITY RESOURCES LISTED ON PAGES 15 AND 16 OF THE CHNA. MENTAL HEALTH AND ADDICTION IS BEING ADDRESSED BY MC WEST, MC ST. ANN'S, DILEY RIDGE MEDICAL CENTER, AND COMMUNITY RESOURCES LISTED ON PAGE 18 OF THE CHNA.
MOUNT CARMEL EAST	PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.
MOUNT CARMEL WEST	PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.
MOUNT CARMEL ST. ANN'S	PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP.	PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.
MOUNT CARMEL EAST	PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE.
MOUNT CARMEL WEST	PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE.
MOUNT CARMEL ST. ANN'S	PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP.	PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE.
MOUNT CARMEL EAST - PART V, SECTION B, LINE 9:	AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.
MOUNT CARMEL WEST - PART V, SECTION B, LINE 9:	AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.
MOUNT CARMEL ST. ANN'S - PART V, SECTION B, LINE 9:	AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP. - PART V, SECTION B, LINE 9:	AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.
MOUNT CARMEL EAST - PART V, SECTION B, LINE 7A:	CHNA URL: HTTP://WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL EAST - PART V, SECTION B, LINE 10A:	IMPLEMENTATION STRATEGY URL: HTTP://WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL WEST - PART V, SECTION B, LINE 7A:	CHNA URL: HTTP://WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL WEST - PART V, SECTION B, LINE 10A:	IMPLEMENTATION STRATEGY URL: HTTP://WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL ST. ANN'S - PART V, SECTION B, LINE 7A:	CHNA URL: HTTP://WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL ST. ANN'S - PART V, SECTION B, LINE 10A:	IMPLEMENTATION STRATEGY URL: HTTP://WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL NEW ALBANY - PART V, SECTION B, LINE 7A:	CHNA URL: HTTP://WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL NEW ALBANY - PART V, SECTION B, LINE 10A:	IMPLEMENTATION STRATEGY URL: HTTP://WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT

Schedule H (Form 990) 2015

Page 8

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?79
Name and address		Type of Facility (describe)
1	1 - MOUNT CARMEL HEALTH CENTER AT WEDGEWOOD 10330 SAWMILL PKWY STE 500 POWELL,OH43065	WOMENS HEALTH
2	2 - MOUNT CARMEL MRI 1120 POLARIS PKWY STE 110 COLUMBUS,OH43240	IMAGING CENTER
3	3 - MOUNT CARMEL HEALTH SYSTEM HOSPICE 1144 DUBLIN RD COLUMBUS,OH43215	HOSPICE
4	4 - MOUNT CARMEL OUTPATIENT LAB 150 TAYLOR STATION RD STE 130 COLUMBUS,OH43213	OUTPATIENT LAB
5	5 - MOUNT CARMEL CARDIAC REHAB 150 TAYLOR STATION RD STE 350 COLUMBUS,OH43213	CARDIAC REHAB
6	6 - MOUNT CARMEL MARBLE CLIFF LAB SERVICE CE 2100 MARBLE CLIFF OFFICE PARK STE A COLUMBUS,OH43215	OUTPATIENT LAB
7	7 - MOUNT CARMEL ST ANN'S LAB SERVICE CENTE 237 W SCHROCK RD STE A WESTERVILLE,OH43081	OUTPATIENT LAB
8	8 - EYE CENTER OF COLUMBUS 262 NEIL AVE STE 500 COLUMBUS,OH43215	COMMUNITY OPTHALMIC RESOURCES
9	9 - TAYLOR STATION SURGERY CENTER 275 TAYLOR STATION RD COLUMBUS,OH43213	AMBULATORY SURGERY CENTER
10	10 - MOUNT CARMEL SLEEP MEDICINE 2760 AIRPORT DR STE 120 COLUMBUS,OH43219	SLEEP MEDICINE
11	11 - MOUNT CARMEL URGENT CARE 3000 MEADOW POND CT STE 200 GROVE CITY,OH43123	URGENT CARE
12	12 - MOUNT CARMEL GROVE CITY OUTPATIENT LAB 3000 MEADOW POND CT STE 300 GROVE CITY,OH43123	OUTPATIENT LAB
13	13 - MOUNT CARMEL HEALTH REHABILITATION SERVI 3000 MEADOW POND CT STE 600 GROVE CITY,OH43123	REHAB & SPORTS MEDICINE
14	14 - MOUNT CARMEL RADIATION THERAPY 3100 PLAZA PROPERTIES BLVD STE 120 COLUMBUS,OH43219	CANCER TREATMENT
15	15 - MOUNT CARMEL MRI 3755 RIDGE MILL DR HILLIARD,OH43026	IMAGING CENTER
16	16 - MOUNT CARMEL REHAB & SPORTS MEDICINE 3775 TRUEMAN CT STE 300 HILLIARD,OH43026	REHAB & SPORTS MEDICINE
17	17 - MOUNT CARMEL MILL RUN IMAGING CENTER 3779 TRUEMAN CT STE 200 HILLIARD,OH43026	IMAGING CENTER, WOMENS HEALTH CENTER, OUTPATIENT LAB
18	18 - MOUNT CARMEL OCCUPATIONAL HEALTH 4171 ARLINGATE PLAZA STE 18 COLUMBUS,OH43228	OCCUPATIONAL HEALTH
19	19 - BIG RUN HEALTH CENTER 4300 CLIME RD STE 105 COLUMBUS,OH43228	OUTPATIENT LAB
20	20 - MOUNT CARMEL HEALTH SYSTEM IMAGING CENTE 4300 CLIME RD STE 120 COLUMBUS,OH43228	IMAGING CENTER
21	21 - MOUNT CARMEL HEALTH SYSTEM CENTRAL OHIO 4300 CLIME RD STE 130 COLUMBUS,OH43228	SLEEP MEDICINE
22	22 - BIG RUN HEALTH CENTER 4310 CLIME RD STE D COLUMBUS,OH43228	OUTPATIENT LAB
23	23 - WESTAR HEALTH CENTER 444 N CLEVELAND AVE STE 110 WESTERVILLE,OH43082	IMAGING CENTER, OUTPATIENT LAB
24	24 - WESTAR HEALTH CENTER 444 N CLEVELAND AVE STE 220 WESTERVILLE,OH43082	ANTICOAGULATION, HEART FAILURE CENTER
25	25 - MOUNT CARMEL REHAB & SPORTS MEDICINE 444 N CLEVELAND AVE STE 310 WESTERVILLE,OH43082	REHAB & SPORTS MEDICINE
26	26 - WESTAR HEALTH CENTER 444 N CLEVELAND AVE STE 320 WESTERVILLE,OH43082	CARDIAC REHAB
27	27 - MOUNT CARMEL WEST CENTRAL MEDICAL CENTER 454 WEST CENTRAL AVE STE B DELAWARE,OH43015	IMAGING CENTER, OUTPATIENT LAB
28	28 - MOUNT CARMEL ST ANN'S WOMENS HEALTH CEN 477 COOPER RD STE 100 WESTERVILLE,OH43081	WOMENS HEALTH
29	29 - MOUNT CARMEL ST ANN'S OUTPATIENT WOUND 477 COOPER RD STE 150 WESTERVILLE,OH43081	WOUND CARE CLINIC
30	30 - MOUNT CARMEL CLINICAL CARDIOVASCULAR SPE 477 COOPER RD STE 200 WESTERVILLE,OH43081	CARDIOVASCULAR CENTER
31	31 - MOUNT CARMEL ST ANN'S FAMILY MEDICINE 477 COOPER RD STE 309 WESTERVILLE,OH43081	FAMILY MEDICINE
32	32 - MOUNT CARMEL SLEEP MEDICINE 484 COUNTY LINE RD SUITE 140 WESTERVILLE,OH43082	SLEEP MEDICINE
33	33 - MOUNT CARMEL ST ANN'S OUTPATIENT LAB 495 COOPER RD STE 100 WESTERVILLE,OH43081	OUTPATIENT LAB
34	34 - MOUNT CARMEL ST ANN'S IMAGING CENTER 495 COOPER RD STE 101 WESTERVILLE,OH43081	IMAGING CENTER
35	35 - MOUNT CARMEL ST ANN'S 495 COOPER RD STE 106 WESTERVILLE,OH43081	ENDOSCOPY & PULMONARY
36	36 - MOUNT CARMEL ST ANN'S CANCER CENTER 495 COOPER RD STE 120 WESTERVILLE,OH43081	CANCER TREATMENT
37	37 - COLUMBUS CYBERKNIFE 495 COOPER RD STE 125 WESTERVILLE,OH43081	CANCER TREATMENT
38	38 - MOUNT CARMEL ST ANN'S DIABETES SELF-MAN 495 COOPER RD STE 210A WESTERVILLE,OH43081	DIABETES SELF-MANAGEMENT
39	39 - MOUNT CARMEL ST ANN'S OUTPATIENT LAB 495 COOPER RD STE 314 WESTERVILLE,OH43081	OUTPATIENT LAB
40	40 - MOUNT CARMEL ST ANN'S SURGICAL CARE CEN 495 COOPER RD STE 410 WESTERVILLE,OH43081	SURGICAL CARE
41	41 - MOUNT CARMEL ST ANN'S GI CENTER 495 COOPER RD STE 411 WESTERVILLE,OH43081	GASTROINTESTINAL CARE
42	42 - NEW ALBANY SURGERY CENTER 5040 FOREST DR STE 100 NEW ALBANY,OH43054	AMBULATORY SURGERY CENTER
43	43 - MOUNT CARMEL HEALTH CENTER AT GROVE CITY 5300 N MEADOWS DR GROVE CITY,OH43123	EMERGENCY CARE
44	44 - MOUNT CARMEL HEALTH CENTER AT GROVE CITY 5300 N MEADOWS DR GROVE CITY,OH43123	IMAGING CENTER
45	45 - MOUNT CARMEL HEALTH CENTER AT GROVE CITY 5300 N MEADOWS DR GROVE CITY,OH43123	OUTPATIENT LAB
46	46 - MOUNT CARMEL HEALTH CENTER AT GROVE CITY 5300 N MEADOWS DR GROVE CITY,OH43123	WOMENS HEALTH
47	47 - MOUNT CARMEL SEDALIA MEDICAL CENTER 5339 HENDRON RD GROVEPORT,OH43125	OCCUPATIONAL HEALTH
48	48 - MOUNT CARMEL SEDALIA LAB SERVICE CENTER 5343 HENDRON RD GROVEPORT,OH43125	OUTPATIENT LAB
49	49 - MOUNT CARMEL HEALTH CENTER AT GROVE CITY 5350 N MEADOWS DR STE 220 GROVE CITY,OH43123	ANTICOAGULATION, HEART FAILURE CENTER, CARDIAC REHAB
50	50 - MOUNT CARMEL HEALTH CENTER AT GROVE CITY 5350 N MEADOWS DR STE 240 GROVE CITY,OH43123	REHAB & SPORTS MEDICINE
51	51 - MOUNT CARMEL COLUMBUS CARDIOLOGY CONSULT 5350 N MEADOWS DR STE 260 GROVE CITY,OH43123	CARDIOLOGY CENTER
52	52 - MOUNT CARMEL NEW ALBANY HEALTH AND WELLN 55 N HIGH ST NEW ALBANY,OH43054	OUTPATIENT LAB
53	53 - MOUNT CARMEL EAST TESTING 5825 WESTBOURNE AV COLUMBUS,OH43213	STRESS TESTS AND NON-INVASIVE VASCULAR TESTING
54	54 - MOUNT CARMEL EAST WOMENS HEALTH 5965 E BROAD ST STE 100 COLUMBUS,OH43213	WOMENS HEALTH
55	55 - MOUNT CARMEL EAST ANTICOAGULATION HEART 5965 E BROAD ST STE 200 COLUMBUS,OH43213	ANTICOAGULATION, HEART FAILURE CENTER, HYPERTENSION CENTER
56	56 - MOUNT CARMEL EAST REHAB & SPORTS MEDICIN 5965 E BROAD ST STE 390 COLUMBUS,OH43213	REHAB & SPORTS MEDICINE
57	57 - MOUNT CARMEL EAST IMAGING CENTER 5969 E BROAD ST STE 100 COLUMBUS,OH43213	IMAGING CENTER
58	58 - MOUNT CARMEL EAST OCCUPATIONAL HEALTH 5969 E BROAD ST STE 307 COLUMBUS,OH43213	OCCUPATIONAL HEALTH
59	59 - MOUNT CARMEL WOUND & OSTOMY CARE CENTER 5975 E BROAD ST STE 204 COLUMBUS,OH43213	WOUND CENTER
60	60 - MOUNT CARMEL EAST INFUSION SERVICES 5975 E BROAD ST STE 300 COLUMBUS,OH43213	CANCER TREATMENT
61	61 - MOUNT CARMEL PICKERINGTON MEDICAL CENTER 641 HILL ROAD NORTH SUITE D PICKERINGTON,OH43147	OUTPATIENT LAB
62	62 - MOUNT CARMEL EAST BROAD STREET URGENT CA 6435 E BROAD ST THROUGH 9/30/2015 COLUMBUS,OH43213	URGENT CARE
63	63 - MOUNT CARMEL EAST BROAD STREET URGENT CA 6495 E BROAD ST SINCE 10/1/2015 COLUMBUS,OH43213	URGENT CARE
64	64 - MOUNT CARMEL COLUMBUS CARDIOLOGY CONSULT 6670 PERIMETER DR STE 100 DUBLIN,OH43016	CARDIOLOGY CENTER
65	65 - MOUNT CARMEL SPORTS MEDICINE SPECIALISTS 7100 GRAPHICS WAY STE 2200 OPENS DEC 2 LEWIS CENTER,OH43035	REHAB & SPORTS MEDICINE
66	66 - MOUNT CARMEL WEST ANTICOAGULATION 730 W RICH ST COLUMBUS,OH43222	ANTICOAGULATION, HEART FAILURE CENTER
67	67 - MOUNT CARMEL WEST REHAB & SPORTS MEDICIN 745 W STATE ST STE 700 COLUMBUS,OH43222	REHAB & SPORTS MEDICINE
68	68 - MOUNT CARMEL HEALTH CARDIAC IMAGING SERV 745 W STATE ST STE 750 COLUMBUS,OH43222	CARDIOLOGY CENTER
69	69 - MOUNT CARMEL WEST OUTPATIENT LAB 750 MOUNT CARMEL MALL RM 180 COLUMBUS,OH43222	OUTPATIENT LAB
70	70 - MOUNT CARMEL WEST WOMENS HEALTH 750 MOUNT CARMEL MALL STE 160 COLUMBUS,OH43222	WOMENS HEALTH
71	71 - CANAL WINCHESTER MEDICAL OFFICE BUILDING 7901 DILEY ROAD STE 205 CANAL WINCHESTER,OH43110	OUTPATIENT LAB
72	72 - MOUNT CARMEL HEART & VASCULAR SPECIALIST 7901 DILEY ROAD STE 230 CANAL WINCHESTER,OH43110	CARDIAC IMAGING
73	73 - MOUNT CARMEL METROWEST INTERNAL MEDICINE 815 WEST BROAD ST STE 200 COLUMBUS,OH43222	INTERNAL MEDICINE
74	74 - MOUNT CARMEL PATASKALA MEDICAL CENTER OU 8200 HAZELTON-ETNA ROAD SW SUITE 50 PATASKALA,OH43062	OUTPATIENT LAB
75	75 - MOUNT CARMEL OUTPATIENT LAB 85 MCNAUGHTEN RD STE 100 COLUMBUS,OH43213	OUTPATIENT LAB
76	76 - MOUNT CARMEL EAST VASCULAR SERVICES 85 MCNAUGHTEN RD STE 200 COLUMBUS,OH43213	VASCULAR SERVICES
77	77 - MOUNT CARMEL EAST COLUMBUS CARDIOLOGY CO 85 MCNAUGHTEN RD STE 300 COLUMBUS,OH43213	CARDIOLOGY CENTER
78	78 - MOUNT CARMEL EAST CARDIAC IMAGING 85 MCNAUGHTEN RD STE 350 COLUMBUS,OH43213	CARDIAC IMAGING
79	79 - EASTWIND SURGICAL CENTER 955 EASTWIND DRIVE STE 150 WESTERVILLE,OH43081	NEUROSURGERY CENTER

Schedule H (Form 990) 2015

Page 9

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 3C:	IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS.
PART I, LINE 6A:	MOUNT CARMEL REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.IN ADDITION, MOUNT CARMEL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. MOUNT CARMEL ALSO SUBMITS ITS COMMUNITY HEALTH NEEDS ASSESSMENT, IMPLEMENTATION STRATEGY AND SCHEDULE H TO THE OHIO DEPARTMENT OF HEALTH.
PART I, LINE 7:	THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM.
PART I, LN 7 COL(F):	THE FOLLOWING NUMBER, $34,352,448, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F).
PART II, COMMUNITY BUILDING ACTIVITIES:	MOUNT CARMEL HOSPITALS CONTRIBUTED TO THE ECONOMIC AND CIVIC HEALTH OF THE SURROUNDING COMMUNITIES BY SERVING IN AND CONTRIBUTING TO THE EFFORTS OF SEVERAL CHAMBERS OF COMMERCE AND OTHER CIVIC ORGANIZATIONS, BOTH IN THE CITY OF COLUMBUS AND IN SURROUNDING SUBURBS. MOUNT CARMEL'S LEADERS HAVE IDENTIFIED COMMUNITY NEEDS THROUGH THEIR SERVICE ON VARIOUS COMMUNITY BOARDS AND ADVISORY GROUPS. THEY HAVE ALSO GIVEN THEIR EXPERTISE TO THESE GROUPS AND HAVE BEEN ABLE TO ADVOCATE ON ISSUES SURROUNDING HEALTH IN THE COLUMBUS AREA, SUCH AS INFANT MORTALITY. AS IN PAST YEARS, MOUNT CARMEL MADE FINANCIAL CONTRIBUTIONS IN FISCAL YEAR 2016 TO A VARIETY OF NON-PROFIT SOCIAL SERVICES AGENCIES/ORGANIZATIONS, INCLUDING THOSE THAT HELP ADDRESS HEALTH, HOUSING, AND HUNGER. MOUNT CARMEL HOSPITALS RESPONDED TO THE COMMUNITY NEED FOR BLOOD DONATIONS BY PROVIDING SPACE AND TIME FOR COLLEAGUES TO DONATE AT THEIR FACILITY ON FIVE OCCASIONS DURING THE FISCAL YEAR. SAFETY IS ALSO A CONCERN FOR THE GENERAL PUBLIC. MOUNT CARMEL FACILITIES RECOGNIZED THE COMMUNITY'S NEED TO BE PREPARED FOR ANY EMERGENCIES THAT MAY THREATEN THE HEALTH AND LIVES OF CITIZENS IN FRANKLIN AND SURROUNDING COUNTIES. MOUNT CARMEL SAFETY AND SECURITY PERSONNEL ATTEND CITY AND STATEWIDE MEETINGS AND PARTICIPATE IN TRAINING COMMUNITY LEADERS TO PLAN AND EXERCISE EMERGENCY RESPONSES IN THE EVENT OF DISASTER. THE MOUNT CARMEL SAFETY AND SECURITY PERSONNEL TEACH VARIOUS SAFETY PROGRAMS TO MANY OTHER COLUMBUS AREA FIRST RESPONDERS.FRANKLINTON IS AN AREA IN COLUMBUS THAT HAS ONE OF THE LOWEST HIGH SCHOOL GRADUATION RATES IN THE CITY. WITH THE MOUNT CARMEL COLLEGE OF NURSING (MC COLLEGE OF NURSING) LOCATED IN FRANKLINTON, NURSING STUDENTS PROVIDE TUTORING AND HEALTH EDUCATION FOR STUDENTS AT STARLING ELEMENTARY AND AVONDALE ELEMENTARY SCHOOLS TO HELP IMPROVE LITERACY AND MATH SKILLS FOR STUDENTS IN SUPPORT OF THEIR SUCCESS AND COMMUNITY HEALTH. COLLEAGUES ADVOCATE FOR POLICY CHANGES AFFECTING HEALTHCARE, NUTRITION AND PERTINENT SOCIAL ISSUES. THIS INCLUDES PARTICIPATING ON VARIOUS BOARDS OF DIRECTORS, MEETINGS WITH LOCAL AND STATE GOVERNMENT OFFICIALS, PARTICIPATING/PRESENTING WEBINARS/SEMINARS, AND COALITION INVOLVEMENT TO IMPROVE THE LIVES OF THE COMMUNITY.
PART III, LINE 2:	METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.
PART III, LINE 3:	MOUNT CARMEL USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR CHARITY: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, MOUNT CARMEL IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, MOUNT CARMEL IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL.
PART III, LINE 4:	MOUNT CARMEL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 15 OF THOSE STATEMENTS: "THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY THE HEALTH MINISTRIES AND FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE."PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION.
PART III, LINE 8:	MOUNT CARMEL DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT.
PART III, LINE 9B:	THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S COLLECTION POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS.
PART VI, LINE 2:	NEEDS ASSESSMENT - MOUNT CARMEL ASSESSES THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, MOUNT CARMEL HOSPITALS MAY USE PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED.
PART VI, LINE 3:	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MOUNT CARMEL IS COMMITTED TO:-PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES-CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES-ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE -BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, MOUNT CARMEL HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: -PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS-MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS-OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS-IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER-IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSMOUNT CARMEL COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTHCARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. FINANCIAL ASSISTANCE APPLICATIONS WILL BE ACCEPTED UNTIL ONE YEAR AFTER THE FIRST BILLING STATEMENT TO THE PATIENT. MOUNT CARMEL OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN ARABIC, CANTONESE, FRENCH, JAPANESE, KOREAN, MANDARIN, NEPALI, RUSSIAN, SOMALI, SPANISH AND VIETNAMESE, REFLECTING OTHER LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. MOUNT CARMEL HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MOUNT CARMEL MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER.
PART VI, LINE 4:	COMMUNITY INFORMATION - MOUNT CARMEL PREDOMINATELY SERVES CENTRAL OHIO, WHICH INCLUDES FRANKLIN AND FIVE CONTIGUOUS COUNTIES (DELAWARE, FAIRFIELD, LICKING, MADISON AND PICKAWAY), AND IS HOME TO NEARLY 1.9 MILLION RESIDENTS. AMONG CENTRAL OHIO HOUSEHOLDS, 20% HAVE A HOUSEHOLD INCOME OF LESS THAN $25,000, AND ANOTHER 26% HAVE A HOUSEHOLD INCOME OF BETWEEN $25,000 AND $50,000. THE MAJORITY OF THE POPULATION RESIDES IN FRANKLIN COUNTY. CENTRAL OHIO'S POPULATION IS EXPECTED TO EXPERIENCE A HIGH GROWTH RATE (18%) IN ADULTS AGE 55 AND OLDER AND A SLIGHT DECLINE IN ADULTS BETWEEN THE AGES OF 18 AND 34. IN 2015, APPROXIMATELY 37% OF THE FRANKLIN COUNTY POPULATION OVER AGE 25 HELD A BACHELOR'S OR HIGHER DEGREE, NEARLY 4% HIGHER THAN THE NATIONAL AVERAGE. OF COLUMBUS RESIDENTS, 13.2% LIVE AT OR BELOW THE NATIONAL POVERTY LEVEL AND 8.9% LIVE AT OR BELOW 50% OF POVERTY LEVEL. ACCORDING TO THE OHIO COUNTY PROFILES FOR FRANKLIN COUNTY, 167,731 ADULTS IN FRANKLIN COUNTY BETWEEN THE AGES OF 18-64, OR ABOUT 13.4% OF THAT POPULATION, DO NOT HAVE HEALTH INSURANCE. THIS NUMBER IS SLIGHTLY HIGHER THAN THE STATEWIDE PERCENTAGE OF 17% UNINSURED ADULTS IN THAT AGE GROUP. CENTRAL OHIO FEATURES A DIVERSE EMPLOYER BASE, INCLUDING GOVERNMENT, MANUFACTURING, TRADE, EDUCATION, SERVICE, FINANCE AND AGRICULTURE. THE OHIO UNEMPLOYMENT RATE WAS 4.7% IN SEPTEMBER 2016. THE UNEMPLOYMENT RATE FOR FRANKLIN COUNTY IN AUGUST 2016 WAS AN ESTIMATED 3.9%. THE COMMUNITY NEED INDEX ON THE COLUMBUS WEST SIDE, WHERE MC WEST IS LOCATED, IS 4.6 ON A SCALE OF 1-5, WITH 1 BEING AN AREA OF LOW NEED AND 5 AN AREA WITH THE HIGHEST LEVEL OF NEED. MC EAST IS LOCATED IN AN AREA WITH A 4.0 COMMUNITY NEED INDEX. MC ST. ANN'S IS LOCATED IN AN AREA WITH THE COMMUNITY NEED INDEX OF 2.4, WHICH IS MUCH LOWER THAN THE OTHER FACILITIES BUT WITH POCKETS OF HIGHER NEED WITHIN ITS SERVICE AREA. MC NEW ALBANY IS LOCATED IN AN AREA WITH A COMMUNITY NEED INDEX OF 2.4. THERE ARE FOUR ADULT HOSPITAL SYSTEMS AND ONE PEDIATRIC HOSPITAL SYSTEM IN THE COLUMBUS AREA. THERE ARE ALSO 11 FEDERALLY QUALIFIED HEATH CENTERS IN THE SAME AREA.
PART VI, LINE 5:	OTHER INFORMATION - MOUNT CARMEL IS GOVERNED BY A 13-MEMBER BOARD OF DIRECTORS, WITH A MAJORITY OF THE SEATS ALLOCATED TO COMMUNITY REPRESENTATIVES AND LEADERS. OUR GOVERNANCE STRUCTURE ENSURES THAT THE COMMUNITY AND ITS INTERESTS ARE STRONGLY REPRESENTED IN IMPORTANT DECISION MAKING. IN ADDITION, TWO SEATS ON MOUNT CARMEL'S BOARD ARE ALLOCATED TO RELIGIOUS WOMEN, WHO HELP ENSURE THAT THE ORGANIZATION REMAINS TRUE TO ITS CHARITABLE MISSION. MOUNT CARMEL HOSPITALS MAINTAIN AN OPEN MEDICAL STAFF - MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS. MOUNT CARMEL ACTIVELY RECRUITS AND EMPLOYS DOCTORS TO SERVE IN UNDER-SERVED AREAS OF THE COMMUNITY. MOUNT CARMEL OPERATES A GRADUATE MEDICAL EDUCATION PROGRAM AND ALSO A COLLEGE OF NURSING. THE MOUNT CARMEL HEALTH SYSTEM FOUNDATION AND THE MC COLLEGE OF NURSING PROVIDED 238 STUDENTS WITH 65 DIFFERENT ACADEMIC SCHOLARSHIPS FOR EDUCATING FUTURE NURSES. THE GRADUATE MEDICAL EDUCATION PROGRAM OPERATES CLINICS FOR BOTH EDUCATION PURPOSES AND TO IMPROVE ACCESS AND CARE CONTINUITY FOR PATIENTS WITHOUT INSURANCE.THE FACULTY FROM MC COLLEGE OF NURSING AND MEDICAL EDUCATION MET WITH REPRESENTATIVES FROM CONGRESS AND VARIOUS COMMUNITY GROUPS TO EDUCATE THE PUBLIC AND ADVOCATE FOR SCHOOL NUTRITION, DIABETES EDUCATION, AND SENIOR HEALTH ISSUES. IN THE SPRING OF 2016, AS AN ALTERNATIVE TO THE TRADITIONAL SPRING BREAK VACATION, TWO FACULTY MEMBERS AND 13 STUDENTS ATTENDING MC COLLEGE OF NURSING WENT TO BROWARD COUNTY, FLORIDA TO VOLUNTEER WITH HABITAT FOR HUMANITY. THE TEAM ASSISTED IN THE PLANNING AND CONSTRUCTION OF HOMES TO PROVIDE A HAND UP FOR HARD WORKING, LOW-INCOME FAMILIES. THE SURGICAL DEPARTMENT AT MC WEST HAS DISCOVERED HOW TO REDUCE WASTE AND HELP THE COMMUNITY. THROUGH A PARTNERSHIP WITH SHARE, THE CLEAN, UNUSED INSTRUMENT STERILIZATION WRAPS ARE DONATED TO BE USED AS INSULATION MATERIAL FOR HANDMADE SLEEPING BAGS CREATED FOR THE HOMELESS. MC WEST ALSO PROVIDES COMMUNITY MEETING ROOMS AND CLASSROOMS FOR PUBLIC USE. THE HOSPITAL PRESENTED EDUCATIONAL SESSIONS FOR THE COMMUNITY ON TOPICS SUCH AS SPIRITUALITY, ETHICS, HUMAN TRAFFICKING, CAREERS IN HEALTH CARE, AND VARIOUS WELLNESS TOPICS. OVER 770 COMMUNITY RELATED EVENTS HAVE BEEN HOSTED IN THIS FACILITY OVER THE PAST YEAR.THE MOUNT CARMEL PERINATAL AREAS AT MC WEST, MC EAST AND MC ST. ANN'S ARE WORKING TOWARDS RECEIVING BABY-FRIENDLY STATUS AND IMPROVING BREASTFEEDING RATES AMONG MOTHERS IN THE SERVICE AREA. BABY FRIENDLY HOSPITALS ARE HOSPITALS THAT ARE RECOGNIZED FOR ENCOURAGING BREASTFEEDING AND MOTHER/BABY BONDING, WHICH IS KNOWN TO PROVIDE HEALTH BENEFITS FOR INFANTS, CHILDREN, AND MOTHERS. RECENTLY CERTIFIED THROUGH OHIO FIRST STEPS, AN OHIO HOSPITAL ASSOCIATION INITIATIVE, FOR FOUR OUT OF TEN STEPS TOWARD BABY-FRIENDLY STATUS HAVE BEEN ACCOMPLISHED, COMPLETING THE DISCOVERY PHASE. MOUNT CARMEL IS CURRENTLY IN THE DEVELOPMENT PHASE.
PART VI, LINE 6:	MOUNT CARMEL IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEFINE - AND ACHIEVE - SPECIFIC COMMUNITY HEALTH AND WELL-BEING GOALS. IN FISCAL YEAR 2016, GOALS INCLUDED 1) PARTNERING WITH COMMUNITY ORGANIZATIONS IN INSURANCE ENROLLMENT ACTIVITIES TARGETED AT UNINSURED INDIVIDUALS TO IMPROVE ACCESS TO HEALTHCARE, 2) PARTICIPATING IN LOCAL ADVOCACY EFFORTS AIMED AT CURBING TOBACCO USE AND PREVENTING OBESITY, AND 3) DEVELOPING A STRATEGY WITH MULTI-DISCIPLINARY TEAMS TO OPTIMIZE CARE FOR VULNERABLE PERSONS, WITH PARTICULAR FOCUS ON THOSE WHO ARE DUALLY ENROLLED IN MEDICAID AND MEDICARE. TRINITY HEALTH APPRECIATES THE IMPACT SOCIAL DETERMINANTS SUCH AS ADEQUATE HOUSING, SAFETY, ACCESS TO FOOD, EDUCATION, INCOME, AND HEALTH COVERAGE HAVE ON THE HEALTH OF THE COMMUNITY. IN FISCAL YEAR 2016, TRINITY HEALTH LAUNCHED THE TRANSFORMING COMMUNITIES INITIATIVE (TCI), AWARDING EIGHT COMMUNITIES FUNDING TO IMPROVE THE HEALTH AND WELL-BEING OF THEIR COMMUNITIES IN PARTNERSHIP WITH THE LOCAL TRINITY HEALTH MEMBER HOSPITAL. THE AWARDED PROGRAMS FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL CHANGES THAT SPECIFICALLY IMPACT COMMUNITY IDENTIFIED AREAS OF NEED AND THAT WILL REDUCE OBESITY AND TOBACCO USE.AS A SYSTEM, TRINITY HEALTH SUPPORTED PROGRAMS AND ORGANIZATIONS WHO ADDRESS THESE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE GRANTING SEVEN DACA "DREAMERS" LOW INTEREST LOANS, ENABLING RECIPIENTS TO ATTEND MEDICAL SCHOOL AT STRITCH SCHOOL OF MEDICINE, AND PROVIDING A GRANT TO THE U.S. SOCCER FOUNDATION TO FUND ITS SOCCER FOR SUCCESS PROGRAM IN NINE COMMUNITIES, OFFERING STUDENTS IN UNDERSERVED AREAS THE OPPORTUNITY TO SAFELY AND COST-EFFECTIVELY ENGAGE IN A HEALTHY AND ACTIVE LIFESTYLE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO OUR COMMUNITIES THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND UNINSURED, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND REACHING OUT TO UNDERSERVED POPULATIONS. ANNUALLY, THE ORGANIZATION INVESTS NEARLY $1 BILLION IN SUCH COMMUNITY BENEFITS AND WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING THE SPECIFIC NEEDS OF EACH COMMUNITY.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG.

Schedule H (Form 990) 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
MOUNT CARMEL HEALTH SYSTEM

Employer identification number
31-1439334

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) AMERICAN HEART ASSOCIATION 5455 N HIGH ST COLUMBUS,OH43214	13-5613797	501(C)(3)	8,250	COMMUNITY BENEFIT
(2) AMERICAN COLLEGE OF PHYSICIANS 190 N INDEPENDENCE MALL WEST PHILADELPHIA,PA191061572	23-1520302	501(C)(3)	7,155	COMMUNITY BENEFIT
(3) AMERICAN COLLEGE OF SURGEONS PO BOX 92425 CHICAGO,IL606752425	36-2192800	501(C)(3)	15,500	COMMUNITY BENEFIT
(4) ARTHRITIS FOUNDATION 3740 RIDGE MILL DR HILLIARD,OH43026	27-4014560	501(C)(3)	6,500	COMMUNITY BENEFIT
(5) BOY SCOUTS OF AMERICA 807 KINNEAR ROAD COLUMBUS,OH432121421	22-1576300	501(C)(3)	6,000	COMMUNITY BENEFIT
(6) CATHOLIC CONFERENCE OF OHIO 9 E LONG ST STE 201 COLUMBUS,OH43215	53-0196617	501(C)(3)	5,735	COMMUNITY BENEFIT
(7) CATHOLIC SOCIAL SERVICES 197 E GAY ST COLUMBUS,OH43215	31-4379437	501(C)(3)	5,000	COMMUNITY BENEFIT
(8) CELEBRATE COMMUNITY 1497 COTTONWOOD DR LEWIS CENTER,OH43035	32-0147224	501(C)(6)	17,000	COMMUNITY BENEFIT
(9) THE CENTER FOR FAMILY SAFETY AND HEALING 655 E LIVINGSTON AV COLUMBUS,OH43205	02-0627166	501(C)(3)	27,064	COMMUNITY BENEFIT
(10) CENTRAL OHIO HOSPITAL COUNCIL 155 E BROAD ST FL 23 COLUMBUS,OH43215	26-2795133	501(C)(3)	200,315	COMMUNITY BENEFIT
(11) CENTRAL OHIO TRANSIT AUTHORITY 33 N HIGH ST COLUMBUS,OH43215	31-0800546	GOV'T AUTHORITY	12,213	COMMUNITY BENEFIT
(12) CHILDRENS HUNGER ALLIANCE 1105 SCHROCK RD COLUMBUS,OH43229	23-7303509	501(C)(3)	5,500	COMMUNITY BENEFIT
(13) CITY OF GROVE CITY 4035 BROADWAY GROVE CITY,OH43123	31-6400527	CITY GOVERNMENT	22,450	COMMUNITY BENEFIT
(14) COLUMBUS 2020 150 S FRONT ST STE 200 COLUMBUS,OH43215	27-1509190	501(C)(6)	60,000	COMMUNITY BENEFIT
(15) COLUMBUS METROPOLITAN CLUB 100 E BROAD ST STE 100 COLUMBUS,OH43215	31-0889324	501(C)(3)	6,170	COMMUNITY BENEFIT
(16) COLUMBUS COMMUNITY CLINICAL ONCOLOGY PROGRAM (COLUMBUS NCORP) 1335 DUBLIN RD STE 124-A COLUMBUS,OH43215	31-1290751	501(C)(3)	24,180	COMMUNITY BENEFIT
(17) DELAWARE COUNTY FOUNDATION 3954 N HAMPTON DR POWELL,OH43065	31-1450786	501(C)(3)	7,500	SPONSORSHIP ORANGE TOWNSHIP VETERANS MEMORIAL"
(18) FRANKLINTON GARDENS 909 W RICH ST COLUMBUS,OH43222	45-4023198	501(C)(3)	20,000	COMMUNITY BENEFIT
(19) GAHANNA CONVENTION & VISITORS BUREAU 167 MILL ST GAHANNA,OH432303013	80-0322167	501(C)(6)	19,750	COMMUNITY BENEFIT
(20) GLADDEN COMMUNITY HOUSE 183 HAWKES AV COLUMBUS,OH43223	31-4379476	501(C)(3)	6,100	GOLD SPONSORSHIP - MARCHING FOR MORE
(21) GROVE CITY AREA CHAMBER 4069 BROADWAY GROVE CITY,OH43123	31-0922925	501(C)(6)	17,615	COMMUNITY BENEFIT
(22) HEART OF OHIO FAMILY HEALTH CENTER 882 S HAMILTON ROAD COLUMBUS,OH43213	38-3765547	501(C)(3)	525,000	COMMUNITY BENEFIT
(23) KIDSMILES PEDIATRIC DENTAL CLINIC 770 BETHEL RD COLUMBUS,OH43214	26-3706958	501(C)(3)	5,000	COMMUNITY BENEFIT
(24) LOWER LIGHTS CHRISTIAN HEALTH CENTER INC 1160 W BROAD ST COLUMBUS,OH43222	31-1810355	501(C)(3)	371,667	COMMUNITY BENEFIT
(25) MARCH OF DIMES FOUNDATION 2831 E MAIN ST 2ND FL COLUMBUS,OH43209	13-1846366	501(C)(3)	8,000	MARCH FOR BABIES SPONSOR
(26) NEW ALBANY CHAMBER OF COMMERCE 55 W MAIN ST NEW ALBANY,OH43054	31-1221292	501(C)(6)	10,000	COMMUNITY BENEFIT
(27) NEW ALBANY COMMUNITY EVENTS BOARD PO BOX 188 NEW ALBANY,OH43054	26-2037123	501(C)(3)	5,000	FREEDOM PRESENTING SPONSORSHIP
(28) OHIO HOSPITAL ASSOCIATION 155 E BROAD ST COLUMBUS,OH43215	31-4270340	501(C)(6)	57,284	COMMUNITY BENEFIT
(29) OHIO UNIVERSITY 1 OHIO UNIVERSITY ATHENS,OH45701	31-6402113	STATE GOV'T-UNIV	30,021	COMMUNITY BENEFIT
(30) PANCREATIC CANCER ACTION NETWORK 1500 ROSECRANS AV MANHATTAN BEACH,CA90266	33-0841281	501(C)(3)	5,000	COMMUNITY BENEFIT
(31) GROVE CITY FOOD PANTRY 2710 COLUMBUS ST GROVE CITY,OH43123	33-1126888	501(C)(3)	6,500	COMMUNITY BENEFIT
(32) PICKERINGTON AREA CHAMBER 13 W COLUMBUS ST PICKERINGTON,OH43147	31-0946334	501(C)(6)	6,530	COMMUNITY BENEFIT
(33) ROTARY CLUB OF WESTERVILLE PO BOX 595 WESTERVILLE,OH43086	31-6050404	501(C)(3)	20,000	COMMUNITY BENEFIT
(34) ST STEPHENS COMMUNITY HOUSE 1500 E 17TH AV COLUMBUS,OH43219	31-4379568	501(C)(3)	5,250	COMMUNITY BENEFIT
(35) THE BUCKEYE RANCH 5665 HOOVER ROAD GROVE CITY,OH43123	31-0642111	501(C)(3)	5,000	COMMUNITY BENEFIT
(36) VIOLET FESTIVAL PO BOX 361 PICKERINGTON,OH43147	31-1518034	501(C)(4)	30,000	COMMUNITY BENEFIT
(37) WALK WITH A DOC 495 COOPER RD STE 411 WESTERVILLE,OH43081	26-3253701	501(C)(3)	5,000	COMMUNITY BENEFIT
(38) WESTERVILLE AREA CHAMBER OF COMMERCE 90 COMMERCE PARK DR WESTERVILLE,OH43082	31-0737083	501(C)(6)	9,370	COMMUNITY BENEFIT
(39) WESTERVILLE AREA RESOURCE MINISTRY (WARM) 150 HEATHERDOWN DR WESTERVILLE,OH43081	31-1640355	501(C)(3)	17,500	COMMUNITY BENEFIT
(40) WESTERVILLE PARKS FOUNDATION (BUNNY HOP) 350 N CLEVELAND AVE WESTERVILLE,OH43082	31-6401113	501(C)(3)	6,056	COMMUNITY BENEFIT
(41) WESTERVILLE SUNRISE ROTARY (CHILLY OPEN) PO BOX 1200 WESTERVILLE,OH430861200	31-1481931	501(C)(3)	10,000	COMMUNITY BENEFIT
(42) WESTERVILLE VISITORS BUREAU 20 W MAIN ST WESTERVILLE,OH43081	31-1233383	501(C)(6)	7,000	COMMUNITY BENEFIT
(43) WORTHINGTON AREA CHAMBER OF COMMERCE INC 25 W NEW ENGLAND AV WORTHINGTON,OH43085	31-1037348	501(C)(6)	6,800	COMMUNITY BENEFIT
(44) YMCA OF CENTRAL OHIO 40 W LONG ST COLUMBUS,OH43215	31-4379594	501(C)(3)	7,500	ANNUAL GIVING GIFT

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
PART I, LINE 2:	DONATIONS MADE BY MOUNT CARMEL HEALTH SYSTEM TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H.

Schedule I (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" 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

MOUNT CARMEL HEALTH SYSTEM

Employer identification number

31-1439334

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

Yes

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

Yes

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

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

Only 501(c)(3), 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? .........................

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)
1CLAUS VON ZYCHLINDIR & MT CARMEL PRES/CEO THR 2/16	(i) (ii)	0 ------------- 595,071	0 ------------- 205,975	0 ------------- 194,594	0 ------------- 11,925	0 ------------- 38,023	0 ------------- 1,045,588	0 ------------- 31,396
2ROGER SPOELMANDIR & MT CARMEL INT PRES/CEO AT 2/16	(i) (ii)	0 ------------- 581,891	0 ------------- 258,109	0 ------------- 321,340	0 ------------- 24,988	0 ------------- 25,275	0 ------------- 1,211,603	0 ------------- 152,962
3SALLY JEFFCOATDIRECTOR;EVP TRINITY WEST/MIDWEST GR	(i) (ii)	0 ------------- 789,885	0 ------------- 352,425	0 ------------- 322,973	0 ------------- 11,925	0 ------------- 28,426	0 ------------- 1,505,634	0 ------------- 29,838
4KEITH COLEMANMT CARMEL HEALTH SYS CFO THR 5/16	(i) (ii)	0 ------------- 413,430	0 ------------- 86,832	0 ------------- 7,449	0 ------------- 11,075	0 ------------- 23,798	0 ------------- 542,584	0 ------------- 0
5DANIEL HACKETTSECRETARY AT 1/16; MANAGING COUNSEL	(i) (ii)	0 ------------- 303,029	0 ------------- 87,036	0 ------------- 2,575	0 ------------- 11,925	0 ------------- 29,352	0 ------------- 433,917	0 ------------- 0
6UNHEE KIMPRESIDENT & COO,ST. ANN'S AT 8/15	(i) (ii)	0 ------------- 141,571	0 ------------- 30,000	0 ------------- 10,773	0 ------------- 22,113	0 ------------- 4,832	0 ------------- 209,289	0 ------------- 0
7JANET MEEKSPRESIDENT & COO, ST ANN'S THR 7/15	(i) (ii)	0 ------------- 219,094	0 ------------- 117,627	0 ------------- 92,168	0 ------------- 19,089	0 ------------- 9,663	0 ------------- 457,641	0 ------------- 0
8SEAN MCKIBBENPRESIDENT & COO, MC WEST	(i) (ii)	0 ------------- 342,067	0 ------------- 119,682	0 ------------- 92,997	0 ------------- 12,762	0 ------------- 28,464	0 ------------- 595,972	0 ------------- 0
9BRINSLEY LEWISPRESIDENT & COO, MC EAST THR 9/15	(i) (ii)	0 ------------- 294,964	0 ------------- 132,677	0 ------------- 220,927	0 ------------- 523,982	0 ------------- 34,146	0 ------------- 1,206,696	0 ------------- 0
10LYNDON CHRISTMANINTERIM PRES & COO MC EAST 9/15-2/16	(i) (ii)	147,336 ------------- 0	0 ------------- 0	164,237 ------------- 0	44,931 ------------- 0	380 ------------- 0	356,884 ------------- 0	0 ------------- 0
11DIANE DOUCETTEPRESIDENT & COO, MC NEW ALBANY	(i) (ii)	0 ------------- 200,341	0 ------------- 25,000	0 ------------- 5,326	0 ------------- 34,622	0 ------------- 12,024	0 ------------- 277,313	0 ------------- 0
12RICHARD STRECKCHIEF CLINICAL OPERATIONS OFFICER	(i) (ii)	0 ------------- 492,558	0 ------------- 103,013	0 ------------- 8,070	0 ------------- 11,925	0 ------------- 21,501	0 ------------- 637,067	0 ------------- 0
13PHILLIP J SHUBERT MDDIRECTOR PERINATAL MEDICAL	(i) (ii)	623,011 ------------- 0	0 ------------- 0	4,806 ------------- 0	19,382 ------------- 0	17,047 ------------- 0	664,246 ------------- 0	0 ------------- 0
14LAURA TRAINICHIEF TRANSFORM. OFFICER THR 2/16	(i) (ii)	0 ------------- 410,997	0 ------------- 85,906	0 ------------- 6,395	0 ------------- 31,773	0 ------------- 22,536	0 ------------- 557,607	0 ------------- 0
15CHRISTOPHER LANGPERINATAL MEDICAL DIRECTOR	(i) (ii)	422,432 ------------- 0	0 ------------- 0	391 ------------- 0	11,925 ------------- 0	19,923 ------------- 0	454,671 ------------- 0	0 ------------- 0
16GERALD GIRARDIPERINATAL MEDICAL DIRECTOR	(i) (ii)	0 ------------- 348,547	0 ------------- 39,096	0 ------------- 2,405	0 ------------- 11,925	0 ------------- 18,733	0 ------------- 420,706	0 ------------- 0
17CHARLES E SANDERS JRVP MEDICAL EDUCATION	(i) (ii)	352,875 ------------- 0	20,613 ------------- 0	3,324 ------------- 0	11,925 ------------- 0	18,899 ------------- 0	407,636 ------------- 0	0 ------------- 0
18HUGH JONESFORMER KE; SVP PLAN/MKTG THR 1/16	(i) (ii)	0 ------------- 284,009	0 ------------- 56,160	0 ------------- 438	0 ------------- 15,900	0 ------------- 23,829	0 ------------- 380,336	0 ------------- 0
19ANNE BROWNINGFORMER KE; SENIOR VP HR THR 9/15	(i) (ii)	0 ------------- 203,942	0 ------------- 57,545	0 ------------- 879	0 ------------- 11,925	0 ------------- 18,782	0 ------------- 293,073	0 ------------- 0
20CHARLES BRETT JUSTICEFORMER KE; SYS VP STRATEGIC ADVANCMT	(i) (ii)	177,162 ------------- 0	18,556 ------------- 0	4,196 ------------- 0	8,871 ------------- 0	20,616 ------------- 0	229,401 ------------- 0	0 ------------- 0
21JACQUELINE PRIMEAUFORMER OFFICER; TRIN VP M&A	(i) (ii)	0 ------------- 301,121	0 ------------- 0	0 ------------- 1,146	0 ------------- 21,398	0 ------------- 9,109	0 ------------- 332,774	0 ------------- 0
22KEDRICK ADKINSFORMER KEY EMPLOYEE	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 768,621	0 ------------- 0	0 ------------- 141	0 ------------- 768,762	0 ------------- 767,689

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

PART I, LINE 3

MOUNT CARMEL HEALTH SYSTEM (MOUNT CARMEL) IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. MOUNT CARMEL'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MOUNT CARMEL'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

PART I, LINES 4A-B

THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2015. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KEDRICK ADKINS - $532,835 LYNDON CHRISTMAN - $163,052 BRINSLEY LEWIS - $108,134 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES THE FOLLOWING SEVERANCE AMOUNTS, WHICH WERE UNPAID AS OF 12/31/15: LYNDON CHRISTMAN - $44,931 (PAID IN 2016) BRINSLEY LEWIS - $512,057 ($413,462 PAID IN 2016 AND $98,595 TO BE PAID IN 2017) THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2015. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. BENEFITS FOR PARTICIPANTS VESTED IN A PLAN WERE PAID OUT IN 2015, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2015. THE FOLLOWING PAYOUTS FOR 2015 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KEDRICK ADKINS - $234,854 SALLY JEFFCOAT - $158,659 BRINSLEY LEWIS - $91,831 SEAN MCKIBBEN - $78,949 JANET MEEKS - $79,975 ROGER SPOELMAN - $140,561 CLAUS VON ZYCHLIN - $137,989 THE FOLLOWING ACCRUALS FOR 2015 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: DIANE DOUCETTE - $26,159 UNHEE KIM - $20,313 COLUMN (F) OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH RESTORATION OR RETENTION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($265,000 FOR 2015). THE FOLLOWING PAYOUTS FOR 2015 FOR THESE PLANS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: SALLY JEFFCOAT - $29,838 ROGER SPOELMAN - $158,434 CLAUS VON ZYCHLIN - $31,396 COLUMN (F) OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS.

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (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

MOUNT CARMEL HEALTH SYSTEM

Employer identification number

31-1439334

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

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

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

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No










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

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2015

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1)		109,846			No
(2) JOHN C HICKEY	FAMILY MEMBER OF CHARLES HICKEY, MCHS TRUSTEE	20,667	EMPLOYMENT ARRANGEMENT		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 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

MOUNT CARMEL HEALTH SYSTEM

Employer identification number

31-1439334

Return Reference	Explanation
FORM 990, PAGE 1	DOING BUSINESS AS NAMES: DASH CAFE HEALTHY LIVING CENTER HEALTHIER YOU MC FITNESS MC FITNESS & HEALTH MC FITNESS CENTER MOUNT CARMEL CARE CONTINUUM SERVICES MOUNT CARMEL EAST MOUNT CARMEL HEALTH MOUNT CARMEL HOSPICE AND PALLIATIVE CARE MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL MOUNT CARMEL ST. ANN'S MOUNT CARMEL WEST MOUNT CARMEL GROVE CITY MOUNT CARMEL MEDICAL CENTER MOUNT CARMEL URGENT CARE MOUNT CARMEL SLEEP MEDICINE
FORM 990, PART VI, SECTION A, LINE 2	LISA STEIN AND LARRY ENGLISH, BOARD MEMBERS OF MOUNT CARMEL HEALTH SYSTEM (MOUNT CARMEL), HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 3	MOUNT CARMEL HAS CONTRACTED WITH CENTRAL OHIO ORTHOPEDIC MANAGEMENT COMPANY TO MANAGE THE OPTHOPEDIC PROGRAM OF MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL. IN 2015 MCHS PAID $5,736,214 TO THE MANAGEMENT COMPANY, WHICH COVERED BOTH EXECUTIVE MANAGEMENT OF MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL AND PHYSICIAN LEADERSHIP OF THE ORTHOPEDIC PROGRAM. UNDER THE MANAGEMENT SERVICES AGREEMENT, CENTRAL OHIO ORTHOPEDIC MANAGES THE DAY-TO-DAY OPERATION, MANAGEMENT, AND SUPERVISION OF MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL AND ITS ORTHOPEDIC PROGRAM. INCLUDED IN THE AGREEMENT IS THE PROVISION BY THE MANAGEMENT COMPANY OF A CHIEF OPERATING OFFICER, SENIOR VICE PRESIDENT OF CLINICAL SERVICES, SENIOR FINANCIAL ANALYST, AND CHIEF NURSING OFFICER FOR THE HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF MOUNT CARMEL IS TRINITY HEALTH CORPORATION. SEE LINE 7 FOR ADDITIONAL INFORMATION.
FORM 990, PART VI, SECTION A, LINE 7A	TRINITY HEALTH CORPORATION IS THE SOLE MEMBER OF MOUNT CARMEL. TRINITY HEALTH CORPORATION HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF MOUNT CARMEL.
FORM 990, PART VI, SECTION A, LINE 7B	AS SOLE MEMBER, TRINITY HEALTH CORPORATION MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. TRINITY HEALTH CORPORATION MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, AND MODIFICATIONS TO GOVERNING DOCUMENTS.
FORM 990, PART VI, SECTION B, LINE 11	PRIOR TO FILING, THE FORM 990 FOR MOUNT CARMEL IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD OF DIRECTORS. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	MOUNT CARMEL HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF MOUNT CARMEL, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF MOUNT CARMEL AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO INTERNAL LEGAL COUNSEL AND THE INTEGRITY AND COMPLIANCE OFFICER, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF MOUNT CARMEL (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MOUNT CARMEL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF MOUNT CARMEL (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF MOUNT CARMEL. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 15	QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF MOUNT CARMEL IS ESTABLISHED BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING CEO AND CFO COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THE CEO AND CFO OF MOUNT CARMEL ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS.
FORM 990, PART VI, SECTION C, LINE 19	MOUNT CARMEL IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, MOUNT CARMEL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. MOUNT CARMEL'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:	EQUITY TRANSFERS TO AFFILIATES -42,788,197. CHANGE IN EQUITY IN UNCONSOLIDATED AFFILIATES 10,517,418.
FORM 990, PART XII, LINE 2:	MOUNT CARMEL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY16 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 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

MOUNT CARMEL HEALTH SYSTEM

Employer identification number

31-1439334

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
(1) HEALTH COLLABORATIVE OF CENTRAL OHIO LLC 6150 E BROAD STREET COLUMBUS,OH43213 46-5603895	ACCOUNTABLE CARE ORGANIZATION	OH	279,295	80,908	MOUNT CARMEL HEALTH SYSTEM
(2) MOUNT CARMEL HEALTH PARTNERS LLC 6150 E BROAD STREET COLUMBUS,OH43213 47-1139205	ACCOUNTABLE CARE ORGANIZATION	OH	6,442,238	3,305,178	MOUNT CARMEL HEALTH SYSTEM

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS,MI49503 27-2491974	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 9	TRINITY HEALTH-MICHIGAN	Yes
(2)ALBANY MEMORIAL HOSPITAL 600 NORTHERN BLVD ALBANY,NY12204 14-1338457	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes
(3)ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR,FL34684 58-1492325	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	FL	501(C)(3)	LINE 11A, I	TRINITY HEALTH CORPORATION	Yes
(4)AMICARE HOSPICE SERVICES INC 20555 VICTOR PARKWAY LIVONIA,MI48152 38-2949053	HOSPICE SERVICES	MI	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES	Yes
(5)ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD,CT06105 06-1450170	HEALTHCARE SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH - NEW ENGLAND INC	Yes
(6)BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR,IA51245 42-1500277	HEALTHCARE AND HOSPITAL SERVICES	IA	501(C)(3)	LINE 3	MERCY HEALTH SERVICES-IOWA CORP	Yes
(7)BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR,IA51245 26-2973307	FOUNDATION	IA	501(C)(3)	LINE 11A, I	BAUM HARMON MERCY HOSPITAL	Yes
(8)BEECHWOOD INC 2212 BURDETT AVE TROY,NY12180 14-1651563	TITLE HOLDING COMPANY	NY	501(C)(2)	N/A	LTC (EDDY) INC	Yes
(9)BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS,NY12159 14-1717028	SENIOR LIVING COMMUNITY	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes
(10)BRIGHTSIDE INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 04-2182395	HEALTHCARE SERVICES	MA	501(C)(3)	LINE 9	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes
(11)CAPITAL REGION GERIATRIC CENTER INC 421 WEST COLUMBIA ST COHOES,NY12047 14-1701597	LONG TERM CARE	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes
(12)CATHERINE MCAULEY HEALTH SERVICES CORP PO BOX 995 ANN ARBOR,MI48106 38-2507173	HEALTHCARE SERVICES (INACTIVE)	MI	501(C)(3)	LINE 3	TRINITY HEALTH-MICHIGAN	Yes
(13)CATHOLIC HEALTH MINISTRIES 20555 VICTOR PARKWAY LIVONIA,MI48152	GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM	VT	501(C)(3)	LINE 1	N/A		No
(14)COLUMBUS ACQUISITION CORP 111 CENTRAL AVENUE NEWARK,NJ07102 26-2616342	INACTIVE ENTITY	NJ	501(C)(3)	LINE 9	SAINT MICHAEL'S MEDICAL CENTER	Yes
(15)COMMUNITY HEALTH PARTNERS OF SOUTH BEND PO BOX 3998 SOUTH BEND,IN46619 26-3051440	HEALTHCARE SERVICES	IN	501(C)(3)	LINE 3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	Yes
(16)CRANBROOK HOSPICE CARE 1111 W LONG LAKE RD STE 102 TROY,MI48098 38-3320699	HOSPICE SERVICES	MI	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES	Yes
(17)DILEY RIDGE MEDICAL CENTER 6150 EAST BROAD STREET COLUMBUS,OH43213 34-2032340	HEALTHCARE AND HOSPITAL SERVICES	OH	501(C)(3)	LINE 3	MOUNT CARMEL HEALTH SYSTEM	Yes
(18)DUBUQUE MERCY HEALTH FOUNDATION INC 250 MERCY DRIVE DUBUQUE,IA52001 26-2227941	FOUNDATION	IA	501(C)(3)	LINE 11A, I	MERCY HEALTH SERVICES-IOWA CORP	Yes
(19)DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE,IA52040 20-5383271	FOUNDATION	IA	501(C)(3)	LINE 11A, I	MERCY HEALTH SERVICES-IOWA CORP	Yes
(20)EAST NORRITON PHYSICIAN SERVICES ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 23-2515999	HEALTHCARE SERVICES	PA	501(C)(3)	LINE 3	MERCY PHYSICIAN NETWORK	Yes
(21)EDDY LICENSED HOME CARE AGENCY INC 433 RIVER ST SUITE 3000 TROY,NY12180 14-1818568	HOME HEALTH SERVICES	NY	501(C)(3)	LINE 3	LTC (EDDY) INC	Yes
(22)EMBRACING AGE INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT,NY13214 46-1051881	PACE PROGRAM	NY	501(C)(3)	LINE 9	ST JOSEPH'S HEALTH INC	Yes
(23)EMPIRE HOME INFUSION SERVICE INC 10 BLACKSMITH DRIVE MALTA,NY12020 14-1795732	HOME HEALTH SERVICES	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes
(24)FARREN CARE CENTER INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 04-2501711	LONG TERM CARE	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes
(25)FRANCISCAN ELDERCARE CORPORATION PO BOX 2500 WILMINGTON,DE19805 22-3008680	LONG TERM CARE (INACTIVE)	DE	501(C)(3)	LINE 9	ST FRANCIS HOSPITAL	Yes
(26)GLEN EDDY INC ONE GLEN EDDY DRIVE NISKAYUNA,NY12309 14-1794150	SENIOR LIVING COMMUNITY	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes
(27)GLOBAL HEALTH MINISTRY 20555 VICTOR PARKWAY LIVONIA,MI48152 42-1253527	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH CORPORATION	Yes
(28)GOOD SAMARITAN HOSPITAL INC 5401 LAKE OCONEE PARKWAY GREENSBORO,GA30642 26-1720984	HEALTHCARE AND HOSPITAL SERVICES	GA	501(C)(3)	LINE 3	ST MARY'S HEALTH CARE SYSTEM INC	Yes
(29)GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION 701 W NORTH AVE MELROSE PARK,IL60160 36-3332852	COMMUNITY OUTREACH	IL	501(C)(3)	LINE 9	GOTTLIEB MEMORIAL HOSPITAL	Yes
(30)GOTTLIEB MEMORIAL FOUNDATION 701 W NORTH AVE MELROSE PARK,IL60160 74-3260011	FOUNDATION	IL	501(C)(3)	LINE 11C, III-FI	N/A		No
(31)GOTTLIEB MEMORIAL HOSPITAL 701 W NORTH AVE MELROSE PARK,IL60160 36-2379649	HEALTHCARE AND HOSPITAL SERVICES	IL	501(C)(3)	LINE 3	LOYOLA UNIVERSITY HEALTH SYSTEM	Yes
(32)GRAND RAPIDS MEDICAL EDUCATION PARTNERS INC 945 OTTAWA AVE NW GRAND RAPIDS,MI49503 23-7270669	MEDICAL EDUCATION TRAINING PROGRAMS	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN	Yes
(33)HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST PO BOX 3302 MUSKEGON,MI49443 38-2299878	SELF INSURANCE	MI	501(C)(3)	LINE 11B, II	MERCY HEALTH PARTNERS	Yes
(34)HACKLEY LIFE COUNSELING 125 E SOUTHERN AVENUE MUSKEGON,MI49442 38-1386362	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 9	MERCY HEALTH PARTNERS	Yes
(35)HAWTHORNE RIDGE INC 30 COMMUNITY WAY EAST GREENBUSH,NY12061 80-0102840	SENIOR LIVING COMMUNITY	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes
(36)HERITAGE HOUSE NURSING CENTER INC 2920 TIBBITS AVE TROY,NY12180 14-1725101	LONG TERM CARE	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes
(37)HOLY CROSS CARENET INC PO BOX 9184 FARMINGTON HILLS,MI48152 52-1945054	LONG TERM CARE	MD	501(C)(3)	LINE 9	HOLY CROSS HEALTH INC	Yes
(38)HOLY CROSS HEALTH FOUNDATION INC 11801 TECH ROAD SILVER SPRING,MD20904 20-8428450	FOUNDATION	MD	501(C)(3)	LINE 7	HOLY CROSS HEALTH INC	Yes
(39)HOLY CROSS HEALTH INC 1500 FOREST GLEN RD SILVER SPRING,MD20910 52-0738041	HEALTHCARE AND HOSPITAL SERVICES	MD	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(40)HOLY CROSS HOSPITAL INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 59-0791028	HEALTHCARE AND HOSPITAL SERVICES	FL	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(41)HOLY CROSS MEDICAL PROPERTIES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 65-0666283	BUILDING MANAGEMENT SERVICES	FL	501(C)(2)	N/A	HOLY CROSS HOSPITAL INC	Yes
(42)HOLY CROSS OUTPATIENT SERVICES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 46-5421068	HEALTHCARE SERVICES	FL	501(C)(3)	LINE 9	HOLY CROSS HOSPITAL INC	Yes
(43)HOLY CROSS PRIMARY CARE INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 81-2531495	HEALTHCARE SERVICES	FL	501(C)(3)	LINE 9	HOLY CROSS HOSPITAL INC	Yes
(44)HOME & COMMUNITY HEALTH SERVICES INC 201 CHESTNUT HILL ROAD STAFFORD SPRINGS,CT06076 81-0723591	HOME HEALTH SERVICES	CT	501(C)(3)	LINE 9	TRINITY HEALTH - NEW ENGLAND INC	Yes
(45)HOME AIDE SERVICE OF EASTERN NEW YORK INC 433 RIVER ST SUITE 3000 TROY,NY12180 14-1514867	HOME HEALTH SERVICES	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes
(46)HOSPICE OF NORTH IOWA 232 SECOND STREET SE MASON CITY,IA50401 42-1173708	HOSPICE SERVICES	IA	501(C)(3)	LINE 9	MERCY HEALTH SERVICES-IOWA CORP	Yes
(47)HOSPICE OF SIOUXLAND 4300 HAMILTON BLVD SIOUX CITY,IA51104 38-3320710	HOSPICE SERVICES	IA	501(C)(3)	LINE 11A, I	N/A		No
(48)HOSPICE OF WASHTENAW II 806 AIRPORT BLVD ANN ARBOR,MI48108 38-3320707	HOSPICE SERVICES (INACTIVE)	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN	Yes
(49)IHA HEALTH SERVICES CORPORATION 24 FRANK LLOYD WRIGHT DR LOBBY J ANN ARBOR,MI48106 38-3316559	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 9	TRINITY HEALTH-MICHIGAN	Yes
(50)JOHNSON HEALTH CARE INC 201 CHESTNUT HILL ROAD STAFFORD SPRINGS,CT06076 81-0709903	HEALTHCARE SERVICES	CT	501(C)(3)	LINE 9	TRINITY HEALTH - NEW ENGLAND INC	Yes
(51)JOHNSON MEMORIAL HOSPITAL INC 201 CHESTNUT HILL ROAD STAFFORD SPRINGS,CT06076 47-5676956	HEALTHCARE AND HOSPITAL SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH - NEW ENGLAND INC	Yes
(52)JOHNSON MEMORIAL MEDICAL CENTER INC 201 CHESTNUT HILL ROAD STAFFORD SPRINGS,CT06076 81-0696923	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	CT	501(C)(3)	LINE 11B, II	TRINITY HEALTH - NEW ENGLAND INC	Yes
(53)LANGHORNE MRI INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2519529	HEALTHCARE SERVICES (INACTIVE)	PA	501(C)(3)	LINE 9	ST MARY MEDICAL CENTER	Yes
(54)LANGHORNE PHYSICIAN SERVICES INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2571699	HEALTHCARE SERVICES	PA	501(C)(3)	LINE 9	ST MARY MEDICAL CENTER	Yes
(55)LIFE AT LOURDES INC 2475 MCCLELLAN AVENUE PENNSAUKEN,NJ08109 26-1854750	PACE PROGRAM	NJ	501(C)(3)	LINE 3	OUR LADY OF LOURDES HEALTH CARE SERVICES	Yes
(56)LIFE AT ST FRANCIS HEALTHCARE INC 7TH CLAYTON STREETS WILMINGTON,DE19805 45-2569214	PACE PROGRAM	DE	501(C)(3)	LINE 9	ST FRANCIS HOSPITAL	Yes
(57)LIFE ST FRANCIS CORPORATION 1435 LIBERTY STREET HAMILTON,NJ08629 22-2797282	PACE PROGRAM	NJ	501(C)(3)	LINE 9	ST FRANCIS MEDICAL CENTER TRENTON NJ	Yes
(58)LIFE ST JOSEPH OF THE PINES INC 100 GOSSMAN DRIVE SOUTHERN PINES,NC28387 27-2159847	PACE PROGRAM	NC	501(C)(3)	LINE 3	ST JOSEPH OF THE PINES INC	Yes
(59)LIFE ST MARY 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 26-2976184	PACE PROGRAM	PA	501(C)(3)	LINE 9	ST MARY MEDICAL CENTER	Yes
(60)LOURDES ANCILLARY SERVICES 1600 HADDON AVENUE CAMDEN,NJ08103 22-2568525	VOLUNTEER SERVICE AUXILIARY	NJ	501(C)(3)	LINE 11B, II	OUR LADY OF LOURDES HEALTH CARE SERVICES	Yes
(61)LOURDES CARDIOLOGY SERVICES PC 1600 HADDON AVENUE CAMDEN,NJ08103 27-4357794	HEALTHCARE SERVICES	NJ	501(C)(3)	LINE 3	OUR LADY OF LOURDES HEALTH CARE SERVICES	Yes
(62)LOURDES MEDICAL CENTER OF BURLINGTON COUNTY 218 SUNSET ROAD WILLINGBORO,NJ08046 22-3612265	HEALTHCARE AND HOSPITAL SERVICES	NJ	501(C)(3)	LINE 3	OUR LADY OF LOURDES HEALTH CARE SERVICES	Yes
(63)LOYOLA MEDICINE TRANSPORT LLC 905 W NORTH AVE MELROSE PARK,IL60160 47-4147171	TRANSPORATION SERVICES	IL	501(C)(3)	LINE 9	LOYOLA UNIVERSITY MEDICAL CENTER	Yes
(64)LOYOLA UNIVERSITY HEALTH SYSTEM 2160 SOUTH FIRST AVENUE MAYWOOD,IL60153 36-3342448	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IL	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes
(65)LOYOLA UNIVERSITY MEDICAL CENTER 2160 SOUTH FIRST AVENUE MAYWOOD,IL60153 36-4015560	HEALTHCARE AND HOSPITAL SERVICES	IL	501(C)(3)	LINE 3	LOYOLA UNIVERSITY HEALTH SYSTEM	Yes
(66)LTC (EDDY) INC 2212 BURDETT AVE TROY,NY12180 22-2564710	MANAGEMENT SERVICES FOR LONG TERM CARE	NY	501(C)(3)	LINE 11B, II	ST PETER'S HEALTH PARTNERS	Yes
(67)MARIAN COMMUNITY HOSPITAL 3805 WEST CHESTER PIKE STE 100 NEWTOWN SQUARE,PA19073 24-0711230	HEALTHCARE SERVICES (INACTIVE)	PA	501(C)(3)	LINE 9	MAXIS HEALTH SYSTEM	Yes
(68)MARIAN HOME HEALTHCARE 801 5TH STREET SIOUX CITY,IA51101 38-3320705	HOME HEALTH SERVICES (INACTIVE)	IA	501(C)(3)	LINE 11A, I	MERCY HEALTH SERVICES-IOWA CORP	Yes
(69)MARYCREST HEIGHTS PO BOX 9184 FARMINGTON HILLS,MI48333 27-0291722	SENIOR LIVING COMMUNITY	MI	501(C)(3)	LINE 9	TRINITY CONTINUING CARE SERVICES	Yes
(70)MAXIS HEALTH SYSTEM 3805 WEST CHESTER PIKE STE 100 NEWTOWN SQUARE,PA19073 91-1940902	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT (INACTIVE)	PA	501(C)(3)	LINE 11A, I	TRINITY HEALTH CORPORATION	Yes
(71)MCAULEY CENTER INC 275 STEELE ROAD WEST HARTFORD,CT06117 06-1058086	SENIOR LIVING COMMUNITY	CT	501(C)(3)	LINE 9	MERCY COMMUNITY HEALTH INC	Yes
(72)MCAULEY CLINIC CORPORATION PO BOX 992 ANN ARBOR,MI48106 38-2561013	HEALTHCARE SERVICES (INACTIVE)	MI	501(C)(3)	LINE 3	CATHERINE MCAULEY HEALTH SERVICES CORP	Yes
(73)MCAULEY MINISTRIES 3333 FIFTH AVENUE PITTSBURGH,PA15213 94-3436142	GRANT MAKING	PA	501(C)(3)	LINE 11B, II	PITTSBURGH MERCY HEALTH SYSTEM	Yes
(74)MERCY AMICARE HOME HEALTHCARE OAKLAND 1111 W LONG LAKE RD STE 102 TROY,MI48098 38-3320698	HOME HEALTH SERVICES	MI	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES	Yes
(75)MERCY AMICARE HOME HEALTHCARE PORT HURON 17410 COLLEGE PARKWAY STE 150 LIVONIA,MI48152 38-3320701	HOME HEALTH SERVICES	MI	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES	Yes
(76)MERCY CARE FOUNDATION 424 DECATUR STREET ATLANTA,GA30312 58-1448522	FOUNDATION	GA	501(C)(3)	LINE 7	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes
(77)MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 23-1352191	HEALTHCARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes
(78)MERCY COMMUNITY HEALTH INC 2021 ALBANY AVENUE WEST HARTFORD,CT06117 06-1492707	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	CT	501(C)(3)	LINE 11B, II	TRINITY CONTINUING CARE SERVICES	Yes
(79)MERCY FAMILY SUPPORT 1001 BALTIMORE PIKE SUITE 310 SPRINGFIELD,PA19064 23-2325059	HOME HEALTH SERVICES	PA	501(C)(3)	LINE 9	MERCY HOME HEALTH SERVICES	Yes
(80)MERCY FOUNDATION INC 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-3227350	FOUNDATION	IL	501(C)(3)	LINE 7	MERCY HEALTH SYSTEM OF CHICAGO	Yes
(81)MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE 888 TERRACE STREET MUSKEGON,MI49440 38-3321856	HOSPICE & HOME HEALTH SERVICES	MI	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES	Yes
(82)MERCY HEALTH FOUNDATION OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 23-2829864	FOUNDATION	PA	501(C)(3)	LINE 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes
(83)MERCY HEALTH NETWORK INC 1111 6TH AVENUE DES MOINES,IA50314 42-1478417	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	DE	501(C)(3)	LINE 11B, II	N/A		No
(84)MERCY HEALTH PARTNERS 1500 E SHERMAN BLVD MUSKEGON,MI49444 38-2589966	HEALTHCARE AND HOSPITAL SERVICES	MI	501(C)(3)	LINE 3	TRINITY HEALTH-MICHIGAN	Yes
(85)MERCY HEALTH PLAN ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 22-2483605	MEDICAID MANAGED CARE PLAN	PA	501(C)(3)	LINE 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes
(86)MERCY HEALTH SERVICES - IOWA CORP 1000 4TH STREET SW MASON CITY,IA50401 31-1373080	HEALTHCARE AND HOSPITAL SERVICES	DE	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(87)MERCY HEALTH SYSTEM OF CHICAGO 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-3163327	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IL	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes
(88)MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 23-2212638	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	PA	501(C)(3)	LINE 11C, III-FI	TRINITY HEALTH CORPORATION	Yes
(89)MERCY HEALTHCARE CENTER 114 WAWBEEK AVENUE TUPPER LAKE,NY12986 15-0532211	HEALTHCARE AND HOSPITAL SERVICES (INACTIVE)	NY	501(C)(3)	LINE 3	MERCY UIHLEIN HEALTH CORPORATION	Yes
(90)MERCY HEALTHCARE FOUNDATION-CLINTON 1410 N 4TH ST CLINTON,IA52732 42-1316126	FOUNDATION	IA	501(C)(3)	LINE 7	N/A		No
(91)MERCY HOME HEALTH 1001 BALTIMORE PIKE SUITE 310 SPRINGFIELD,PA19064 23-1352099	HOME HEALTH SERVICES	PA	501(C)(3)	LINE 9	MERCY HOME HEALTH SERVICES	Yes
(92)MERCY HOME HEALTH SERVICES 1001 BALTIMORE PIKE SUITE 310 SPRINGFIELD,PA19064 23-2325058	MANAGEMENT SERVICES FOR HOME HEALTH	PA	501(C)(3)	LINE 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes
(93)MERCY HOSPITAL AND MEDICAL CENTER 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-2170152	HEALTHCARE AND HOSPITAL SERVICES	IL	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF CHICAGO	Yes
(94)MERCY HOSPITAL CADILLAC FOUNDATION 1820 44TH ST SE KENTWOOD,MI49508 20-3357131	FOUNDATION	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN	Yes
(95)MERCY HOSPITAL GIFT SHOP 2601 ELECTRIC AVE PORT HURON,MI48060 38-1630480	VOLUNTEER SERVICE AUXILIARY	MI	501(C)(3)	LINE 9	TRINITY HEALTH-MICHIGAN	Yes
(96)MERCY HOSPITAL INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 04-3398280	HEALTHCARE AND HOSPITAL SERVICES	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes
(97)MERCY HOSPITAL INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 59-0791034	HEALTHCARE SERVICES (INACTIVE)	FL	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes
(98)MERCY LIFE CENTER CORPORATION 1200 REEDSDALE STREET PITTSBURGH,PA15233 25-1604115	COMMUNITY OUTREACH	PA	501(C)(3)	LINE 9	PITTSBURGH MERCY HEALTH SYSTEM	Yes
(99)MERCY LIFE OF ALABAMA PO BOX 7957 MOBILE,AL36670 27-3163002	PACE PROGRAM	AL	501(C)(3)	LINE 3	TRINITY HEALTH PACE	Yes
(100)MERCY LIFE INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 45-3086711	PACE PROGRAM	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE CARE CENTERS INC	Yes
(101)MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 23-2627944	HEALTHCARE SERVICES	PA	501(C)(3)	LINE 3	MERCY PHYSICIAN NETWORK	Yes
(102)MERCY MEDICAL CENTER - CLINTON INC 1410 NORTH 4TH ST CLINTON,IA52732 42-1336618	HEALTHCARE AND HOSPITAL SERVICES	DE	501(C)(3)	LINE 3	MERCY HEALTH SERVICES-IOWA CORP	Yes
(103)MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION 801 5TH STREET SIOUX CITY,IA51102 14-1880022	FOUNDATION	IA	501(C)(3)	LINE 7	MERCY HEALTH SERVICES-IOWA CORP	Yes
(104)MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA 1000 4TH STREET SW MASON CITY,IA50401 42-1229151	FOUNDATION	IA	501(C)(3)	LINE 7	MERCY HEALTH SERVICES-IOWA CORP	Yes
(105)MERCY MEDICAL CORPORATION PO BOX 7957 MOBILE,AL36670 63-6002215	HOSPICE & HOME HEALTH SERVICES	AL	501(C)(3)	LINE 9	TRINITY HEALTH CORPORATION	Yes
(106)MERCY MEDICAL GROUP C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 45-4884805	HEALTHCARE SERVICES	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes
(107)MERCY PHYSICIAN NETWORK ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 46-1187365	MANAGEMENT SERVICES FOR PHYSICIAN SERVICE ORGANIZATIONS	PA	501(C)(3)	LINE 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes
(108)MERCY SENIOR CARE INC 424 DECATUR STREET ATLANTA,GA30312 58-1366508	COMMUNITY OUTREACH	GA	501(C)(3)	LINE 7	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes
(109)MERCY SERVICES DOWNTOWN INC 424 DECATUR STREET ATLANTA,GA30312 27-2046353	TITLE HOLDING COMPANY	GA	501(C)(3)	LINE 11B, II	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes
(110)MERCY SERVICES FOR AGING NON-PROFIT HOUSING CORPORATION PO BOX 9184 FARMINGTON HILLS,MI48333 38-2719605	LONG TERM CARE	MI	501(C)(3)	LINE 9	TRINITY CONTINUING CARE SERVICES	Yes
(111)MERCY SPECIALIST PHYSICIANS INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 26-4033168	HEALTHCARE SERVICES	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes
(112)MERCY SUBURBAN HOSPITAL ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 23-1396763	HEALTHCARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes
(113)MERCY UIHLEIN HEALTH CORPORATION 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,NY19073 16-1535133	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT (INACTIVE)	NY	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes
(114)MISSION HEALTH CORPORATION 37595 SEVEN MILE ROAD LIVONIA,MI48152 38-3181557	BUILDING MANAGEMENT SERVICES	DE	501(C)(3)	LINE 11A, I	N/A		No
(115)MOUNT CARMEL COLLEGE OF NURSING 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1308555	COLLEGE OF NURSING	OH	501(C)(3)	LINE 2	MOUNT CARMEL HEALTH SYSTEM	Yes
(116)MOUNT CARMEL HEALTH INSURANCE COMPANY 6150 EAST BROAD STREET COLUMBUS,OH43213 25-1912781	HEALTH INSURANCE	OH	501(C)(4)	N/A	MOUNT CARMEL HEALTH SYSTEM	Yes
(117)MOUNT CARMEL HEALTH PLAN INC 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1471229	MEDICARE HMO	OH	501(C)(4)	N/A	MOUNT CARMEL HEALTH SYSTEM	Yes
(118)MOUNT CARMEL HEALTH SYSTEM 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1439334	HEALTHCARE AND HOSPITAL SERVICES	OH	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION		No
(119)MOUNT CARMEL HEALTH SYSTEM FOUNDATION 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1113966	FOUNDATION	OH	501(C)(3)	LINE 11A, I	MOUNT CARMEL HEALTH SYSTEM	Yes
(120)MOUNT CARMEL HOME CARE LLC 501 WEST SCHROCK ROAD WESTERVILLE,OH43081 26-2729300	HOME HEALTH SERVICES	OH	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES	Yes
(121)MOUNT SINAI HOSPITAL FOUNDATION INC 500 BLUE HILLS AVENUE HARTFORD,CT06112 22-2584082	FOUNDATION	CT	501(C)(3)	LINE 11C, III-FI	N/A		No
(122)MOUNT SINAI REHABILITATION HOSPITAL INC 114 WOODLAND STREET HARTFORD,CT06105 06-1422973	HEALTHCARE AND HOSPITAL SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH - NEW ENGLAND INC	Yes
(123)MRI MOBILE SERVICES OF WEST MICHIGAN 1820 44TH STREET KENTWOOD,MI49508 38-3073745	HEALTHCARE SERVICES (INACTIVE)	MI	501(C)(3)	LINE 9	TRINITY HEALTH-MICHIGAN	Yes
(124)MUSKEGON COMMUNITY HEALTH PROJECT 565 W WESTERN AVENUE MUSKEGON,MI49440 91-1932918	COMMUNITY OUTREACH	MI	501(C)(3)	LINE 7	MERCY HEALTH PARTNERS	Yes
(125)NAZARETH HEALTH CARE FOUNDATION 2701 HOLME AVENUE PHILADELPHIA,PA19152 23-2300951	FOUNDATION	PA	501(C)(3)	LINE 11A, I	NAZARETH HOSPITAL	Yes
(126)NAZARETH HOSPITAL 2601 HOLME AVENUE PHILADELPHIA,PA19152 23-2794121	HEALTHCARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes
(127)NAZARETH PHYSICIAN SERVICES INC ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 20-3261266	HEALTHCARE SERVICES	PA	501(C)(3)	LINE 3	MERCY PHYSICIAN NETWORK	Yes
(128)NE PHYSICIAN SERVICES INC ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 23-2497355	HEALTHCARE SERVICES (INACTIVE)	PA	501(C)(3)	LINE 3	MERCY PHYSICIAN NETWORK	Yes
(129)NORTHEAST HEALTH INC 2212 BURDETT AVE TROY,NY12180 04-2450756	HEALTHCARE SYSTEM SUPPORT	NY	501(C)(3)	LINE 11B, II	ST PETER'S HEALTH PARTNERS	Yes
(130)OAKLAND MERCY HOSPITAL 601 EAST 2ND STREET OAKLAND,NE68045 20-8072234	HEALTHCARE AND HOSPITAL SERVICES	NE	501(C)(3)	LINE 3	MERCY HEALTH SERVICES-IOWA CORP	Yes
(131)OAKLAND MERCY HOSPITAL FOUNDATION 601 E 2ND STREET OAKLAND,NE68045 31-1678345	FOUNDATION	NE	501(C)(3)	LINE 11C, III-FI	N/A		No
(132)ONE THOUSAND CORPORATION 1000 ASYLUM AVENUE HARTFORD,CT06105 06-0922325	BUILDING MANAGEMENT SERVICES	CT	501(C)(2)	N/A	SAINT FRANCIS HOSPITAL AND MEDICAL CENTER	Yes
(133)OSUMOUNT CARMEL HEALTH ALLIANCE 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1654603	COOPERATIVE HEALTHCARE DELIVERY SYSTEM	OH	501(C)(3)	LINE 11A, I	N/A		No
(134)OUR LADY OF LOURDES HEALTH CARE SERVICES 1600 HADDON AVENUE CAMDEN,NJ08103 22-2568528	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	NJ	501(C)(3)	LINE 11B, II	MAXIS HEALTH SYSTEM	Yes
(135)OUR LADY OF LOURDES HEALTH FOUNDATION INC 1600 HADDON AVENUE CAMDEN,NJ08103 22-2351960	FOUNDATION	NJ	501(C)(3)	LINE 7	OUR LADY OF LOURDES HEALTH CARE SERVICES	Yes
(136)OUR LADY OF LOURDES MEDICAL CENTER 1600 HADDON AVENUE CAMDEN,NJ08103 21-0635001	HEALTHCARE AND HOSPITAL SERVICES	NJ	501(C)(3)	LINE 3	OUR LADY OF LOURDES HEALTH CARE SERVICES	Yes
(137)OUR LADY OF MERCY LIFE CENTER 2 MERCYCARE LANE GUILDERLAND,NY12084 14-1743506	LONG TERM CARE	NY	501(C)(3)	LINE 3	ST PETER'S HOSPITAL	Yes
(138)PIONEER VALLEY CARDIOLOGY ASSOCIATES INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 45-4208896	HEALTHCARE SERVICES	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes
(139)PITTSBURGH MERCY HEALTH SYSTEM 3333 5TH AVENUE PITTSBURGH,PA15213 25-1464211	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	PA	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes
(140)PORT HURON MERCY FAMILY CARE INC 2601 ELECTRIC AVE PORT HURON,MI48060 20-1855647	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN	Yes
(141)PROBILITY THERAPY SERVICES 2058 S STATE STREET ANN ARBOR,MI48104 20-2020239	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 9	TRINITY HEALTH-MICHIGAN	Yes
(142)PROFESSIONAL MED TEAM 965 FORK STREET MUSKEGON,MI49442 38-2638284	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 9	MERCY HEALTH PARTNERS	Yes
(143)SAINT AGNES MEDICAL CENTER 1303 EAST HERNDON AVE FRESNO,CA93720 94-1437713	HEALTHCARE AND HOSPITAL SERVICES	CA	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(144)SAINT AGNES MEDICAL FOUNDATION (FKA PROFESSIONAL OFFICE CORPORATION) 1303 EAST HERNDON AVE FRESNO,CA93720 94-2839324	HEALTHCARE SERVICES	CA	501(C)(3)	LINE 11A, I	SAINT AGNES MEDICAL CENTER	Yes
(145)SAINT ALPHONSUS BUILDING COMPANY INC 1055 NORTH CURTIS RD BOISE,ID83706 82-0401011	BUILDING MANAGEMENT SERVICES	ID	501(C)(3)	LINE 9	SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC	Yes
(146)SAINT ALPHONSUS DIVERSIFIED CARE INC 1055 NORTH CURTIS RD BOISE,ID83706 94-3028978	HEALTHCARE SYSTEM SUPPORT	ID	501(C)(3)	LINE 11A, I	SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC	Yes
(147)SAINT ALPHONSUS FOUNDATION-BAKER CITY INC 3325 POCAHONTAS ROAD BAKER CITY,OR97814 94-3164869	FOUNDATION	OR	501(C)(3)	LINE 7	SAINT ALPHONSUS MEDICAL CENTER - BAKER CITY	Yes
(148)SAINT ALPHONSUS FOUNDATION-ONTARIO INC 351 SW 9TH STREET ONTARIO,OR97914 20-2683560	FOUNDATION	OR	501(C)(3)	LINE 7	SAINT ALPHONSUS MEDICAL CENTER-ONTARIO	Yes
(149)SAINT ALPHONSUS HEALTH SYSTEM INC 1055 N CURTIS ROAD BOISE,ID83706 27-1929502	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	ID	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes
(150)SAINT ALPHONSUS MEDICAL CENTER ONTARIO VOLUNTEERS 351 SW 9TH STREET ONTARIO,OR97914 94-3059469	VOLUNTEER SERVICE AUXILIARY	OR	501(C)(3)	LINE 9	SAINT ALPHONSUS MEDICAL CENTER-ONTARIO	Yes
(151)SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY INC 3325 POCAHONTAS ROAD BAKER CITY,OR97814 27-1790052	HEALTHCARE AND HOSPITAL SERVICES	OR	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC	Yes
(152)SAINT ALPHONSUS MEDICAL CENTER-NAMPA HEALTH FOUNDATION INC 1512 12TH AVENUE ROAD NAMPA,ID83686 26-1737256	FOUNDATION	ID	501(C)(3)	LINE 7	SAINT ALPHONSUS MEDICAL CENTER-NAMPA	Yes
(153)SAINT ALPHONSUS MEDICAL CENTER-NAMPA INC 1512 12TH AVENUE ROAD NAMPA,ID83686 82-0200896	HEALTHCARE AND HOSPITAL SERVICES	ID	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC	Yes
(154)SAINT ALPHONSUS MEDICAL CENTER-ONTARIO INC 351 SW 9TH STREET ONTARIO,OR97914 27-1789847	HEALTHCARE AND HOSPITAL SERVICES	OR	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC	Yes
(155)SAINT ALPHONSUS REGIONAL MEDICAL CENTER 1055 NORTH CURTIS RD BOISE,ID83706 82-0200895	HEALTHCARE AND HOSPITAL SERVICES	ID	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC	Yes
(156)SAINT FRANCIS EMERGENCY MEDICAL GROUP INC 114 WOODLAND STREET HARTFORD,CT06105 45-1994612	HEALTHCARE SERVICES	CT	501(C)(3)	LINE 11B, II	SAINT FRANCIS MEDICAL GROUP INC	Yes
(157)SAINT FRANCIS FOUNDATION INC 114 WOODLAND STREET HARTFORD,CT06105 06-1008255	FOUNDATION	CT	501(C)(3)	LINE 11B, II	TRINITY HEALTH - NEW ENGLAND INC	Yes
(158)SAINT FRANCIS HOSPITAL AND MEDICAL CENTER 114 WOODLAND STREET HARTFORD,CT06105 06-0646813	HEALTHCARE AND HOSPITAL SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH - NEW ENGLAND INC	Yes
(159)SAINT FRANCIS MEDICAL GROUP INC 114 WOODLAND STREET HARTFORD,CT06105 06-1450168	HEALTHCARE SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH - NEW ENGLAND INC	Yes
(160)SAINT JAMES CARE INC 111 CENTRAL AVENUE NEWARK,NJ07102 26-2616230	INACTIVE ENTITY	NJ	501(C)(3)	LINE 9	SAINT MICHAEL'S MEDICAL CENTER	Yes
(161)SAINT JOSEPH PACE INC 20555 VICTOR PARKWAY LIVONIA,MI48152 47-3129127	PACE PROGRAM	IN	501(C)(3)	LINE 7	TRINITY HEALTH PACE	Yes
(162)SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC PO BOX 670 PLYMOUTH,IN46563 35-1142669	HEALTHCARE AND HOSPITAL SERVICES	IN	501(C)(3)	LINE 3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	Yes
(163)SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC 5215 HOLY CROSS PARKWAY MISHAWAKA,IN46545 35-0868157	HEALTHCARE AND HOSPITAL SERVICES	IN	501(C)(3)	LINE 3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	Yes
(164)SAINT JOSEPH REGIONAL MEDICAL CENTER MISHAWAKA AUXILIARY INC 5215 HOLY CROSS PARKWAY MISHAWAKA,IN46545 35-6033285	VOLUNTEER SERVICE AUXILIARY	IN	501(C)(4)	N/A	SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC	Yes
(165)SAINT JOSEPH REGIONAL MEDICAL CENTER PLYMOUTH AUXILIARY INC 1915 LAKE AVENUE PLYMOUTH,IN46563 35-6043563	VOLUNTEER SERVICE AUXILIARY	IN	501(C)(3)	LINE 11B, II	SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC	Yes
(166)SAINT JOSEPH REGIONAL MEDICAL CENTER INC 5215 HOLY CROSS PARKWAY MISHAWAKA,IN46545 35-1568821	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IN	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes
(167)SAINT JOSEPH'S HEALTH SYSTEM INC 424 DECATUR STREET ATLANTA,GA30312 58-1744848	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	GA	501(C)(3)	LINE 11C, III-FI	TRINITY HEALTH CORPORATION	Yes
(168)SAINT JOSEPH'S MERCY CARE SERVICES INC 424 DECATUR STREET ATLANTA,GA30312 58-1752700	HEALTHCARE SERVICES	GA	501(C)(3)	LINE 7	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes
(169)SAINT JOSEPH'S TOWER INC PO BOX 9184 FARMINGTON HILLS,MI48333 31-1040468	SENIOR LIVING COMMUNITY	IN	501(C)(3)	LINE 9	TRINITY CONTINUING CARE SERVICES - INDIANA INC	Yes
(170)SAINT MARY'S AMICARE HOME HEALTHCARE 1430 MONROE NW STE 120 GRAND RAPIDS,MI49505 38-3320700	HOME HEALTH SERVICES	MI	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES	Yes
(171)SAINT MARY'S FOUNDATION 200 JEFFERSON ST SE GRAND RAPIDS,MI49503 38-1779602	FOUNDATION	MI	501(C)(3)	LINE 7	TRINITY HEALTH-MICHIGAN	Yes
(172)SAINT MICHAEL'S MEDICAL CENTER 111 CENTRAL AVENUE NEWARK,NJ07102 26-2616046	HEALTHCARE AND HOSPITAL SERVICES	NJ	501(C)(3)	LINE 3	MAXIS HEALTH SYSTEM	Yes
(173)SAMARITAN CHILD CARE CENTER INC 2213 BURDETT AVE TROY,NY12180 14-1710225	CHILD CARE	NY	501(C)(3)	LINE 9	ST PETER'S HEALTH PARTNERS	Yes
(174)SAMARITAN HOSPITAL 2215 BURDETT AVE TROY,NY12180 14-1338544	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes
(175)SENIOR CARE CONNECTION INC 504 STATE ST SCHENECTADY,NY12305 14-1708754	PACE PROGRAM	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes
(176)SETON AUXILIARY INC 1300 MASSACHUSETTS AVENUE TROY,NY12180 14-1505031	VOLUNTEER SERVICE AUXILIARY	NY	501(C)(3)	LINE 9	SETON HEALTH SYSTEM INC	Yes
(177)SETON HEALTH AT SCHUYLER RIDGE RESIDENTIAL HEALTHCARE 1 ABELE BLVD CLIFTON PARK,NY12065 14-1756230	LONG TERM CARE	NY	501(C)(3)	LINE 9	SETON HEALTH SYSTEM INC	Yes
(178)SETON HEALTH FOUNDATION INC 1300 MASSACHUSETTS AVENUE TROY,NY12180 22-2345416	FOUNDATION	NY	501(C)(3)	LINE 11A, I	SETON HEALTH SYSTEM INC	Yes
(179)SETON HEALTH SYSTEM INC 1300 MASSACHUSETTS AVENUE TROY,NY12180 14-1776186	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes
(180)SISTERS OF PROVIDENCE CARE CENTERS INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 22-2541103	LONG TERM CARE	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes
(181)SISTERS OF PROVIDENCE HEALTH SYSTEM INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 04-3398374	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	MA	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes
(182)SJ MANAGEMENT COMPANY OF SYRACUSE INC 301 PROSPECT AVENUE SYRACUSE,NY13203 27-1763712	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	NY	501(C)(3)	LINE 11C, III-FI	ST JOSEPH'S HOSPITAL HEALTH CENTER	Yes
(183)SJHSJOC HOLDINGS INC 424 DECATUR STREET ATLANTA,GA30312 47-2299757	HEALTHCARE SYSTEM SUPPORT	GA	501(C)(3)	LINE 11B, II	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes
(184)ST AGNES CONTINUING CARE CENTER ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 23-2840137	PACE PROGRAM	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes
(185)ST AGNES CONTINUING CARE CENTER FOUNDATION ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 23-2415137	FOUNDATION	PA	501(C)(3)	LINE 11A, I	ST AGNES CONTINUING CARE CENTER	Yes
(186)ST FRANCIS FOUNDATION PO BOX 2500 WILMINGTON,DE19805 51-0374158	FOUNDATION	DE	501(C)(3)	LINE 11A, I	ST FRANCIS HOSPITAL	Yes
(187)ST FRANCIS HOSPITAL INC PO BOX 2500 WILMINGTON,DE19805 51-0064326	HEALTHCARE AND HOSPITAL SERVICES	DE	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(188)ST FRANCIS MEDICAL CENTER FOUNDATION INC 601 HAMILTON AVENUE TRENTON,NJ08629 52-1025476	FOUNDATION	NJ	501(C)(3)	LINE 7	ST FRANCIS MEDICAL CENTER TRENTON NJ	Yes
(189)ST FRANCIS MEDICAL CENTER TRENTON NJ 601 HAMILTON AVENUE TRENTON,NJ08629 22-3431049	HEALTHCARE AND HOSPITAL SERVICES	NJ	501(C)(3)	LINE 3	MAXIS HEALTH SYSTEM	Yes
(190)ST JAMES MERCY HEALTH SYSTEM INC 411 CANISTEO STREET HORNELL,NY14843 22-3127184	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	NY	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes
(191)ST JAMES MERCY HOSPITAL 411 CANISTEO STREET HORNELL,NY14843 16-0743310	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST JAMES MERCY HEALTH SYSTEM INC	Yes
(192)ST JOSEPH MERCY OAKLAND FOUNDATION 44405 WOODWARD AVE PONTIAC,MI48341 35-2356789	FOUNDATION	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN	Yes
(193)ST JOSEPH OF THE PINES INC 100 GOSSMAN DRIVE SOUTHERN PINES,NC28387 56-0694200	LONG TERM CARE	NC	501(C)(3)	LINE 3	TRINITY CONTINUING CARE SERVICES	Yes
(194)ST JOSEPH'S COLLEGE OF NURSING AT ST JOSEPH'S HOSPITAL HEALTH CENTER 206 PROSPECT AVENUE SYRACUSE,NY13203 20-2497520	COLLEGE OF NURSING	NY	501(C)(3)	LINE 2	ST JOSEPH'S HOSPITAL HEALTH CENTER	Yes
(195)ST JOSEPH'S HEALTH CENTER PROPERTIES INC 301 PROSPECT AVENUE SYRACUSE,NY13203 23-7219294	BUILDING MANAGEMENT SERVICES	NY	501(C)(3)	LINE 11B, II	ST JOSEPH'S HEALTH INC	Yes
(196)ST JOSEPH'S HEALTH INC 301 PROSPECT AVENUE SYRACUSE,NY13203 47-4754987	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	NY	501(C)(3)	LINE 11A, I	TRINITY HEALTH CORPORATION	Yes
(197)ST JOSEPH'S HOSPITAL HEALTH CENTER 301 PROSPECT AVENUE SYRACUSE,NY13203 15-0532254	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST JOSEPH'S HEALTH INC	Yes
(198)ST JOSEPH'S HOSPITAL HEALTH CENTER FOUNDATION INC 301 PROSPECT AVENUE SYRACUSE,NY13203 22-2149775	FOUNDATION	NY	501(C)(3)	LINE 11A, I	ST JOSEPH'S HEALTH INC	Yes
(199)ST JOSEPH'S MEDICAL PC 301 PROSPECT AVENUE SYRACUSE,NY13203 27-3899821	HEALTHCARE SERVICES	NY	501(C)(3)	LINE 11A, I	ST JOSEPH'S HOSPITAL HEALTH CENTER	Yes
(200)ST JOSEPH'S PHYSICIAN HEALTH PC 301 PROSPECT AVENUE SYRACUSE,NY13203 16-1516863	HEALTHCARE SERVICES	NY	501(C)(3)	LINE 11A, I	ST JOSEPH'S HOSPITAL HEALTH CENTER	Yes
(201)ST MARY BUILDING AND DEVELOPMENT COMPANY 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 46-1827502	TITLE HOLDING COMPANY	PA	501(C)(2)	N/A	ST MARY MEDICAL CENTER	Yes
(202)ST MARY EMERGENCY MEDICAL SERVICES 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 46-5354512	HEALTHCARE SERVICES	PA	501(C)(3)	LINE 9	ST MARY MEDICAL CENTER	Yes
(203)ST MARY HOME INCORPORATED 2021 ALBANY AVENUE WEST HARTFORD,CT06117 06-0646843	LONG TERM CARE	CT	501(C)(3)	LINE 3	MERCY COMMUNITY HEALTH INC	Yes
(204)ST MARY MEDICAL CENTER 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-1913910	HEALTHCARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(205)ST MARY MEDICAL CENTER FOUNDATION INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2567468	FOUNDATION	PA	501(C)(3)	LINE 7	ST MARY MEDICAL CENTER	Yes
(206)ST MARY'S FOUNDATION INC 1230 BAXTER STREET ATHENS,GA30606 58-2544232	FOUNDATION	GA	501(C)(3)	LINE 11A, I	ST MARY'S HEALTH CARE SYSTEM INC	Yes
(207)ST MARY'S HEALTH CARE SYSTEM INC 1230 BAXTER STREET ATHENS,GA30606 58-0566223	HEALTHCARE AND HOSPITAL SERVICES	GA	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(208)ST MARY'S HIGHLAND HILLS INC 1230 BAXTER STREET ATHENS,GA30606 02-0576648	SENIOR LIVING COMMUNITY	GA	501(C)(3)	LINE 3	ST MARY'S HEALTH CARE SYSTEM INC	Yes
(209)ST MARY'S MEDICAL GROUP INC 1230 BAXTER STREET ATHENS,GA30606 26-1858563	HEALTHCARE SERVICES	GA	501(C)(3)	LINE 3	ST MARY'S HEALTH CARE SYSTEM INC	Yes
(210)ST MARY'S SACRED HEART HOSPITAL INC 367 CLEAR CREEK PARKWAY LAVONIA,GA30553 47-3752176	HEALTHCARE AND HOSPITAL SERVICES	GA	501(C)(3)	LINE 3	ST MARY'S HEALTH CARE SYSTEM INC	Yes
(211)ST MICHAEL'S FOUNDATION INC 111 CENTRAL AVENUE NEWARK,NJ07102 22-3311976	FOUNDATION	NJ	501(C)(3)	LINE 11A, I	SAINT MICHAEL'S MEDICAL CENTER	Yes
(212)ST PETER'S HEALTH CARE SERVICES 315 SOUTH MANNING BLVD ALBANY,NY12208 22-2702507	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	NY	501(C)(3)	LINE 9	ST PETER'S HEALTH PARTNERS	Yes
(213)ST PETER'S HEALTH PARTNERS 315 SOUTH MANNING BLVD ALBANY,NY12208 45-3570715	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	NY	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes
(214)ST PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES PC 315 SOUTH MANNING BLVD ALBANY,NY12208 46-1177336	HEALTHCARE SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes
(215)ST PETER'S HOSPITAL 315 SOUTH MANNING BLVD ALBANY,NY12208 14-1348692	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes
(216)ST PETER'S HOSPITAL FOUNDATION INC 319 SOUTH MANNING BLVD ALBANY,NY12208 22-2262982	FOUNDATION	NY	501(C)(3)	LINE 7	ST PETER'S HEALTH PARTNERS	Yes
(217)SUNNYVIEW HOSPITAL & REHABILITATION CENTER 1270 BELMONT AVE SCHENECTADY,NY12308 14-1338386	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes
(218)SUNNYVIEW HOSPITAL & REHABILITATION CENTER FOUNDATION INC 1270 BELMONT AVE SCHENECTADY,NY12308 22-2505127	FOUNDATION	NY	501(C)(3)	LINE 11A, I	SUNNYVIEW HOSPITAL & REHABILITATION CENTER	Yes
(219)THE COMMUNITY HOSPICE FOUNDATION INC 295 VALLEY VIEW BLVD RENSSELAER,NY12144 22-2692940	FOUNDATION	NY	501(C)(3)	LINE 7	THE COMMUNITY HOSPICE INC	Yes
(220)THE COMMUNITY HOSPICE INC 295 VALLEY VIEW BLVD RENSSELAER,NY12144 14-1608921	HOSPICE SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes
(221)THE FOUNDATION OF SAINT JOSEPH REGIONAL MEDICAL CENTER 707 EAST CEDAR STREET SOUTH BEND,IN46617 35-1654543	FOUNDATION	IN	501(C)(3)	LINE 7	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	Yes
(222)THE JAMES A EDDY MEMORIAL GERIATRIC CENTER INC 2256 BURDETT AVE TROY,NY12180 22-2570478	LONG TERM CARE	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes
(223)THE MARJORIE DOYLE ROCKWELL CENTER INC 421 WEST COLUMBIA ST COHOES,NY12047 14-1793885	LONG TERM CARE	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes
(224)THE NORTHEAST HEALTH FOUNDATION INC 2224 BURDETT AVE TROY,NY12180 22-2743478	FOUNDATION	NY	501(C)(3)	LINE 7	ST PETER'S HEALTH PARTNERS	Yes
(225)THE WOMEN'S AUXILIARY OF SAINT FRANCIS HOSPITAL AND MEDICAL CENTER INC 114 WOODLAND STREET HARTFORD,CT06105 06-0660403	VOLUNTEER SERVICE AUXILIARY	CT	501(C)(3)	LINE 11A, I	N/A		No
(226)TRI-HOSPITAL EMERGENCY MEDICAL SERVICES 309 GRAND RIVER PORT HURON,MI48060 38-2485700	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 11D, III-O	N/A		No
(227)TRI-HOSPITAL MRI CENTER 4190 24TH AVENUE FORT GRATIOT,MI48054 38-2884297	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 3	TRINITY HEALTH-MICHIGAN	Yes
(228)TRINITY CONTINUING CARE SERVICES PO BOX 9184 FARMINGTON HILLS,MI48333 38-2559656	LONG TERM CARE	MI	501(C)(3)	LINE 9	TRINITY HEALTH CORPORATION	Yes
(229)TRINITY CONTINUING CARE SERVICES - INDIANA INC PO BOX 9184 FARMINGTON HILLS,MI48333 93-0907047	LONG TERM CARE	IN	501(C)(3)	LINE 9	TRINITY CONTINUING CARE SERVICES	Yes
(230)TRINITY HEALTH - MICHIGAN 20555 VICTOR PARKWAY LIVONIA,MI48152 38-2113393	HEALTHCARE AND HOSPITAL SERVICES	MI	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(231)TRINITY HEALTH - NEW ENGLAND INC (FKA SAINT FRANCIS CARE INC) 114 WOODLAND STREET HARTFORD,CT06105 06-1491191	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	CT	501(C)(3)	LINE 11A, I	TRINITY HEALTH CORPORATION	Yes
(232)TRINITY HEALTH CORPORATION 20555 VICTOR PARKWAY LIVONIA,MI48152 35-1443425	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IN	501(C)(3)	LINE 11B, II	CATHOLIC HEALTH MINISTRIES	Yes
(233)TRINITY HEALTH LIFE PENNSYLVANIA INC 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 47-5244984	PACE PROGRAM	PA	501(C)(3)	LINE 9	TRINITY HEALTH PACE	Yes
(234)TRINITY HEALTH PACE 20555 VICTOR PARKWAY LIVONIA,MI48152 47-3073124	PACE PROGRAM	MI	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes
(235)TRINITY HEALTH WELFARE BENEFIT TRUST 20555 VICTOR PARKWAY LIVONIA,MI48152 20-8151733	RETIREE MEDICAL AND RETIREE LIFE INSURANCE	MI	501(C)(9)	N/A	TRINITY HEALTH CORPORATION	Yes
(236)TRINITY HOME HEALTH SERVICES 17410 COLLEGE PARKWAY STE 150 LIVONIA,MI48152 38-2621935	MANAGEMENT SERVICES FOR HOME HEALTH SYSTEM	MI	501(C)(3)	LINE 9	TRINITY HEALTH CORPORATION	Yes
(237)UIHLEIN MERCY CENTER 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 15-0532190	HEALTHCARE SERVICES (INACTIVE)	NY	501(C)(3)	LINE 3	MERCY UIHLEIN HEALTH CORPORATION	Yes
(238)UNIVERSITY HEIGHTS PROPERTY COMPANY INC 111 CENTRAL AVENUE NEWARK,NJ07102 22-3100162	TITLE HOLDING COMPANY	NJ	501(C)(2)	N/A	SAINT MICHAEL'S MEDICAL CENTER	Yes
(239)VILLA MARY IMMACULATE 301 HACKETT BLVD ALBANY,NY12208 14-1438749	LONG TERM CARE	NY	501(C)(3)	LINE 3	ST PETER'S HOSPITAL	Yes
(240)WESTSHORE HEALTH NETWORK 1820 44TH STREET KENTWOOD,MI49508 38-3280200	HEALTH NETWORK	MI	501(C)(4)	N/A	MERCY HEALTH PARTNERS	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?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) ADVENT REHABILITATION LLC 607 DEWEY AVENUE SUITE 300 GRAND RAPIDS,MI49504 38-3306673	REHABILITATION THERAPY SERVICES	MI	N/A
(2) BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 31-1608125	MEDICAL OFFICE BUILDING RENTAL	OH	MOUNT CARMEL HEALTH SYSTEM	RELATED	38,074	788,042		No		Yes		76.920 %
(3) CATHERINE HORAN BUILDING ASSOCIATES LP 1221 MAIN STREET SUITE 105 HOLYOKE,MA01040 04-2723429	PROPERTY MANAGEMENT	MA	N/A
(4) CENTENNIAL SURGUNIT LLC 502 CENTENNIAL BLVD SUITE 1 VOORHEES,NJ08043 22-3580847	HEALTHCARE SERVICES	NJ	N/A
(5) CENTER FOR DIGESTIVE CARE LLC 5300 ELLIOTT DRIVE YPSILANTI,MI48197 03-0447062	PROVIDE GASTROINTESTINAL SERVICES	MI	N/A
(6) CENTRAL NEW JERSEY HEART SERVICES LLC PO BOX 148 BAYONNE,NJ07002 20-8525458	CARDIAC PROGRAM	NJ	N/A
(7) CLINTON IMAGING SERVICES LLC 615 VALLEY VIEW DR STE 202 MOLINE,IL61265 41-2044739	MRI DIAGNOSTIC SERVICES	IA	N/A
(8) EAST NORRITON MEDICAL ASSOCIATES ONE WEST ELM STREET CONSHOHOCKEN,PA19428 23-2319531	MEDICAL OFFICE BUILDING	PA	N/A
(9) FOREST PARK IMAGING LLC 1000 4TH STREET SW MASON CITY,IA50401 13-4365966	X-RAY AND MAMMOGRAPHY SERVICES	IA	N/A
(10) FRANCES WARDE MEDICAL LABORATORY 300 WEST TEXTILE ROAD ANN ARBOR,MI48104 38-2648446	LABORATORY	MI	N/A
(11) FRESNO IMAGING CENTER 1303 E HERNDON AVE FRESNO,CA93720 77-0363563	FORMERLY DIAGNOSTIC IMAGING, IN DISSOLUTION	CA	N/A
(12) GATEWAY HEALTH PLAN LP 444 LIBERTY AVE PITTSBURGH,PA15222 25-1691945	MEDICAID & MEDICARE/SPECIAL NEEDS MANAGED CARE ORGANIZATION	PA	N/A
(13) GREATER HARTFORD LITHOTRIPSY LLC 144 WOODLAND ST HARTFORD,CT06105 06-1578891	LITHOTRIPSY SERVICES	CT	N/A
(14) HAWARDEN REGIONAL HEALTH CLINICS LLC 1122 AVENUE L HAWARDEN,IA51023 20-1444339	MEDICAL CLINIC	IA	N/A
(15) IDAHO ASC HOLDINGS LLC 1055 N CURTIS ROAD BOISE,ID83706 36-4729605	HOLDING COMPANY FOR AMBULATORY SURGERY	ID	N/A
(16) INNOVATIVE HEALTH ALLIANCE OF NEW YORK LLC 14 COLUMBIA CIRCLE DRIVE ALBANY,NY12203 46-5676066	ACCOUNTABLE CARE ORGANIZATION	NY	N/A
(17) LOYOLA AMBULATORY SURGERY CENTER AT OAKBROOK LP 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM,AL35209 36-4119522	SURGICAL SERVICES	IL	N/A
(18) MAGNETIC RESONANCE SERVICES PARTNERSHIP 1416 SIXTH STREET SW MASON CITY,IA50401 42-1328388	MRI SERVICES	IA	N/A
(19) MASON CITY AMBULATORY SURGERY CENTER LLC 990 4TH STREET SW MASON CITY,IA50401 20-1960348	SURGERY-SAME DAY	IA	N/A
(20) MCE MOB IV LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 42-1544707	MEDICAL OFFICE BUILDING RENTAL	OH	MOUNT CARMEL HEALTH SYSTEM	RELATED	283,319	3,684,364		No		Yes		49.850 %
(21) MCMC POB III LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 31-1392994	MEDICAL OFFICE BUILDING RENTAL	OH	MOUNT CARMEL HEALTH SYSTEM	RELATED	-1,004			No		Yes		30.140 %
(22) MDRMRI TECHNICAL SERVICES LLC 5640 EAST TAFT ROAD 3770 SYRACUSE,NY13220 16-1590982	MRI SERVICES	NY	N/A
(23) MEDILUCENT MOB I 793 W STATE STREET COLUMBUS,OH43222 20-4911370	MEDICAL OFFICE BUILDING RENTAL	OH	MOUNT CARMEL HEALTH SYSTEM	RELATED	178,740	1,891,883		No		Yes		25.200 %
(24) MEDWORKS LLC 375 EAST CEDAR STREET NEWINGTON,CT06111 06-1490483	REHABILITATION SERVICES	CT	N/A
(25) MERCY ADVANCED MRI LLC 2525 SOUTH MICHIGAN AVE CHICAGO,IL60616 26-2116721	SUBLEASE MRI EQUIPMENT	IL	N/A
(26) MERCY HEART CTR OP SERVICES LLC 1000 4TH STREET SW MASON CITY,IA50401 13-4237594	CARDIOVASCULAR SERVICES	IA	N/A
(27) MERCYMANOR PARTNERSHIP PO BOX 10086 TOLEDO,OH43699 52-1931012	NURSING HOME	PA	N/A
(28) MERCYUSP HEALTH VENTURES LLC 15305 DALLAS PARKWAY STE 1600 LB 28 ADDISON,TX75001 47-1290300	OUTPATIENT SURGERY	IA	N/A
(29) MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 31-1369473	MEDICAL OFFICE BUILDING RENTAL	OH	MOUNT CARMEL HEALTH SYSTEM	RELATED	243,371	1,549,305		No		Yes		29.150 %
(30) NAZARETH MEDICAL OFFICE BUILDING ASSOCIATES LP C/O NAZARETH HOSP 2601 HOLME AVE PHILADELPHIA,PA19152 23-2388040	MEDICAL OFFICE BUILDING	PA	N/A
(31) NEWCO AMBULATORY SURGERY CTR LLP 4190 24TH AVENUE FORT GRATIOT,MI48059 30-0136708	OUTPATIENT SURGERY CENTER	MI	N/A
(32) PHYSICIANS OUTPATIENT SURGERY CENTER LLC 1000 NE 56TH STREET OAKLAND PARK,FL33334 35-2325646	AMBULATORY SURGERY CENTER	FL	N/A
(33) RADISSON SJH PROPERTIES LLC 5000 CAMPUSWOOD DRIVE SUITE 100 EAST SYRACUSE,NY13057 46-1892799	MEDICAL OFFICE BUILDING	NY	N/A
(34) SARMED OUTPATIENT PHARMACY LLC 999 N CURTIS RD STE 102 BOISE,ID83706 51-0483218	PHARMACY	ID	N/A
(35) SIXTY FOURTH STREET LLC 2373 64TH ST STE 2200 BYRON CENTER,MI49315 20-2443646	PROVIDE OUTPATIENT SURGICAL CARE	MI	N/A
(36) SJLS LLC 7650 SE 27TH ST STE 200 MERCER ISLAND,WA98040 20-1796650	DIALYSIS SERVICES	NY	N/A
(37) SJV MANAGEMENT LLC 200 CENTURY PKWY STE 200E MOUNT LAUREL,NJ08054 20-2273476	RADIOLOGY	NJ	N/A
(38) SMMC MOB II LP 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 36-4559869	INVESTMENT AND OPERATION OF A MEDICAL BUILDING	PA	N/A
(39) ST AGNES LONG-TERM INTENSIVE CARE LLP C/O MHS ONE WEST ELM ST STE 100 CONSHOHOCKEN,PA19428 20-0984882	LONG TERM INTENSIVE CARE	PA	N/A
(40) ST ALPHONSUS CALDWELL CANCER CTR LLC 3123 MEDICAL DR CALDWELL,ID83605 82-0526861	HEALTH CARE SERVICES	ID	N/A
(41) ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP 793 W STATE STREET COLUMBUS,OH43222 31-1603660	MEDICAL OFFICE BUILDING RENTAL	OH	MOUNT CARMEL HEALTH SYSTEM	RELATED	93,121	1,570,997		No		Yes		46.960 %
(42) ST JOSEPH'S IMAGING ASSOCIATES PLLC 104 UNION AVE SUITE 905 SYRACUSE,NY13203 16-1104293	RADIOLOGY SERVICES	NY	N/A
(43) ST MARY REHABILITATION HOSPITAL LLP 680 SOUTH FORTH STREET LOUISVILLE,KY40202 27-3938747	HEALTHCARE SERVICES	DE	N/A
(44) ST PETER'S AMBULATORY SURGERY CENTER LLC 1375 WASHINGTON AVENUE STE 201 ALBANY,NY12206 46-0463892	OUTPATIENT SURGERY	NY	N/A
(45) TAMARACK MEDICAL CLINIC LLC 402 LAKE CASCADE PARKWAY CASCADE,ID83611 20-1637921	OUTPATIENT MEDICAL SERVICES	ID	N/A
(46) THE AMBULATORY SURGERY CENTER AT ST MARY LLC 1203 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2871206	OUTPATIENT SURGERY	PA	N/A
(47) TOTAL LAUNDRY COLLABORATIVE LLC 114 WOODLAND STREET HARTFORD,CT06105 20-8335788	LAUNDRY SERVICES	CT	N/A
(48) TRINITY HEALTH PARTNERS LLC 20555 VICTOR PARKWAY LIVONIA,MI48152 47-2798085	POPULATION HEALTH MANAGEMENT	DE	N/A
(49) WOODLAND IMAGING CENTER LLC 5301 E HURON RIVER DR ANN ARBOR,MI48106 76-0820959	RADIOLOGY/IMAGING	MI	N/A

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) AFFILIATED MANAGEMENT SERVICES CORPORATION INC 1300 MASSACHUSETTS AVENUE TROY,NY12180 14-1668024	REAL ESTATE	NY	N/A	C				Yes
(2) CARBONDALE PHYSICIANS' SERVICES INC 100 LINCOLN AVE CARBONDALE,PA18407 23-2365077	PHARMACY	PA	N/A	C				Yes
(3) CATHERINE HORAN BUILDING CORP 1233 MAIN STREET HOLYOKE,MA01040 04-2938160	BUILDING MANAGEMENT	MA	N/A	C				Yes
(4) CHESTNUT RISK SERVICES LTD 11 VICTORIA STREET HAMILTON BD	INSURANCE	BD	N/A	C				Yes
(5) DIVERSIFIED COMMUNITY SERVICES INC 1233 MAIN STREET HOLYOKE,MA01040 04-3128890	MEDICAL SERVICES	MA	N/A	C				Yes
(6) FHS SERVICES INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT,NY13214 27-2995699	MEDICAL SERVICES	NY	N/A	C				Yes
(7) FRANCISCAN ASSOCIATES INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT,NY13214 20-2991688	MEDICAL SERVICES	NY	N/A	C				Yes
(8) FRANCISCAN HEALTH SUPPORT INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT,NY13214 16-1236354	MEDICAL SERVICES	NY	N/A	C				Yes
(9) FRANCISCAN MANAGEMENT SERVICES INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT,NY13214 16-1351193	MANAGEMENT SERVICES	NY	N/A	C				Yes
(10) GOTTLIEB MANAGEMENT SERVICES INC 701 W NORTH AVE MELROSE PARK,IL60160 36-3330529	MANAGEMENT SERVICES	IL	N/A	C				Yes
(11) HEF INC 1820 44TH STREET SE KENTWOOD,MI49508 38-3086401	OFFICE STAFFING	MI	N/A	C				Yes
(12) HACKLEY HEALTH MANAGEMENT INC 1820 44TH STREET SE KENTWOOD,MI49508 38-2961814	WEIGHT MANAGEMENT	MI	N/A	C				Yes
(13) HACKLEY HEALTH VENTURES INC 1820 44TH STREET SE KENTWOOD,MI49508 38-2589959	OTHER MEDICAL SERVICES	MI	N/A	C				Yes
(14) HACKLEY HEALTHCARE EQUIPMENT CORP 1820 44TH STREET SE KENTWOOD,MI49508 38-2578569	HOME MEDICAL EQUIPMENT	MI	N/A	C				Yes
(15) HACKLEY PROFESSIONAL CENTER INC 1820 44TH STREET SE KENTWOOD,MI49508 38-3024797	REAL ESTATE RENTAL	MI	N/A	C				Yes
(16) HACKLEY PROFESSIONAL PHARMACY INC 1820 44TH STREET SE KENTWOOD,MI49508 38-2447870	PHARMACY	MI	N/A	C				Yes
(17) HEALTH CARE MANAGEMENT ADMINISTRATORS INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT,NY13214 16-1450960	HEALTHCARE MANAGEMENT	NY	N/A	C				Yes
(18) HEALTH MANAGEMENT SERVICES ORG INC 500 GROVE STREET SUITE 100 HADDON HEIGHTS,NJ08035 22-3366580	MEDICAL ADMINISTRATION	NJ	N/A	C				Yes
(19) HOLY CROSS PRIVATE HOME SERVICES CORP 11801 TECH ROAD SILVER SPRING,MD20904 52-1986562	HOME CARE SERVICES	MD	N/A	C				Yes
(20) HPC CO-OWNERS ASSOCIATION 1700 CLINTON MUSKEGON,MI49442 27-0734448	CONDOMINIUM ASSOCIATION	MI	N/A	C				Yes
(21) HURON ARBOR CORPORATION 5301 EAST HURON RIVER DR YPSILANTI,MI48197 38-2475644	PROVIDES OFFICE RENTAL SPACE	MI	N/A	C				Yes
(22) IHA AFFILIATION CORPORATION 24 FRANK LLOYD WRIGHT DR LOBBY J ANN ARBOR,MI48106 38-3188895	MEDICAL MANAGEMENT	MI	N/A	C				Yes
(23) LANGHORNE SERVICES II INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 25-3795549	GENERAL PARTNER OF LMOB PARTNERS, II	PA	N/A	C				Yes
(24) LANGHORNE SERVICES INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2625981	GENERAL PARTNER OF LMOB PARTNERS	PA	N/A	C				Yes
(25) LIFECARE PHYSICIANS PC 601 HAMILTON AVENUE TRENTON,NJ08629 26-1649038	HEALTH CARE SERVICES	NJ	N/A	C				Yes
(26) LOURDES MEDICAL ASSOCIATES PA 500 GROVE STREET SUITE 100 HADDON HEIGHTS,NJ08035 22-3361862	MEDICAL SERVICES	NJ	N/A	C				Yes
(27) LOURDES URGENT CARE SERVICES PC 1600 HADDON AVENUE CAMDEN,NJ08103 46-4188202	URGENT CARE CENTER	NJ	N/A	C				Yes
(28) MARYLAND CARE GROUP INC 11801 TECH ROAD SILVER SPRING,MD20904 52-1815313	HEALTHCARE HOLDING	MD	N/A	C				Yes
(29) MCMC EASTWICK INC C/O MHS ONE WEST ELM STREET STE 100 CONSHOHOCKEN,PA19428 23-2184261	MEDICAL OFFICE BUILDINGS	PA	N/A	C				Yes
(30) MEDNOW INC 1512 12TH AVENUE ROAD NAMPA,ID83686 82-0389927	MEDICAL SERVICES	ID	N/A	C				Yes
(31) MERCY INPATIENT MEDICAL ASSOCIATES INC 1233 MAIN STREET HOLYOKE,MA01040 04-3029929	MEDICAL SERVICES	MA	N/A	C				Yes
(32) MERCY MEDICAL SERVICES 801 5TH STREET SIOUX CITY,IA51101 42-1283849	PRIMARY CARE PHYSICIANS	IA	N/A	C				Yes
(33) MERCY SERVICES CORPORATION 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-3227348	DORMANT	IL	N/A	C				Yes
(34) MOUNT CARMEL HEALTH PROVIDERS INC 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1382442	MEDICAL SERVICES	OH	MOUNT CARMEL HEALTH SYSTEM	C	-65,001,015	45,572,956	100.000 %	Yes
(35) NURSING NETWORK INC 4725 NORTH FEDERAL HIGHWAY FORT LAUDERDALE,FL33308 59-1145192	MEDICAL SERVICES	FL	N/A	C				Yes
(36) PHYSICIANS MEDICAL OFFICE BUILDING CONDOMINIUM TRUST 1221 MAIN STREET SUITE 108 HOLYOKE,MA01040 04-6608649	PROPERTY MANAGEMENT	MA	N/A	C				Yes
(37) PRIORITY PLUS OF CALIFORNIA PO BOX 27230 FRESNO,CA93729 77-0395267	FORMERLY HLTH MGMT NOW DISCONTINUED OPERATIONS	CA	N/A	C				Yes
(38) PROVIDENCE HOME CARE INC 1233 MAIN STREET HOLYOKE,MA01040 04-3317426	HEALTH CARE SERVICES	MA	N/A	C				Yes
(39) SAINT ALPHONSUS HEALTH ALLIANCE INC 1055 NORTH CURTIS ROAD BOISE,ID83706 82-0524649	ACCOUNTABLE CARE ORGANIZATION	ID	N/A	C				Yes
(40) SAINT ALPHONSUS PHYSICIANS PA 1055 NORTH CURTIS ROAD BOISE,ID83706 33-1078261	HEALTH CARE SERVICES (INACTIVE)	ID	N/A	C				Yes
(41) SAINT FRANCIS BEHAVIORAL HEALTH GROUP PC 114 WOODLAND STREET HARTFORD,CT06105 06-1384686	MEDICAL SERVICES	CT	N/A	C				Yes
(42) SAINT FRANCIS CARE MEDICAL GROUP PC 114 WOODLAND STREET HARTFORD,CT06105 06-1432373	MEDICAL SERVICES	CT	N/A	C				Yes
(43) SAMARITAN MEDICAL OFFICE BUILDING INC 2212 BURDETT AVENUE TROY,NY12180 14-1607244	REAL ESTATE	NY	N/A	C				Yes
(44) SJM PROPERTIES INC 411 CANISTEO STREET HORNELL,NY14843 16-1294991	PROPERTY HOLDINGS	NY	N/A	C				Yes
(45) SJPE PRACTICE MANAGEMENT SERVICES INC 301 PROSPECT AVE SYRACUSE,NY13203 45-4164964	MANAGEMENT SERVICES	NY	N/A	C				Yes
(46) SJRMC HOLDINGS INC 5215 HOLY CROSS PARKWAY MISHAWAKA,IN46545 47-4763735	PROPERTY HOLDINGS	IN	N/A	C				Yes
(47) ST ELIZABETH HEALTH SUPPORT SERVICES INC 2209 GENESEE STREET UTICA,NY13501 16-1540486	MEDICAL SERVICES	NY	N/A	C				Yes
(48) ST MARY'S HIGHLAND HILLS VILLAGE INC 1230 BAXTER STREET ATHENS,GA30606 58-2276801	ASSISTED LIVING	GA	N/A	C				Yes
(49) SYSTEM COORDINATED SERVICES INC 1233 MAIN STREET HOLYOKE,MA01040 04-2938161	LAB SERVICES	MA	N/A	C				Yes
(50) THRE SERVICES LLC 20555 VICTOR PARKWAY LIVONIA,MI48152 45-2603654	REAL ESTATE BROKERAGE SERVICES	MI	N/A	C				Yes
(51) TRINITY ASSURANCE LTD PO BOX 1051 GRAND CAYMAN GRAND CAYMAN CJ 98-0453602	PROVISION OF INSURANCE COVERAGE	CJ	N/A	C				Yes
(52) TRINITY HEALTH ACO INC 20555 VICTOR PARKWAY LIVONIA,MI48152 47-3794666	ACCOUNTABLE CARE ORGANIZATION	DE	N/A	C				Yes
(53) TRINITY HEALTH EMPLOYEE BENEFIT TRUST 20555 VICTOR PARKWAY LIVONIA,MI48152 38-3410377	GRANTOR TRUST	MI	N/A	T				Yes
(54) TRINITY SENIOR SERVICES MANAGEMENT INC PO BOX 9184 FARMINGTON HILLS,MI48333 37-1572595	SENIOR SERVICES	PA	N/A	C				Yes
(55) WEST SHORE PROFESSIONAL BUILDING CONDOMINIUM 1820 44TH STREET SE KENTWOOD,MI49508 38-2700166	CONDOMINIUM ASSOCIATION	MI	N/A	C				Yes
(56) WORKPLACE HEALTH OF GRAND HAVEN INC 1820 44TH STREET SE KENTWOOD,MI49508 38-3112035	OCCUPATIONAL HEALTH	MI	N/A	C				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 .....................

Yes

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

Yes

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

Yes

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

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

Yes

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) ......................

Yes

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) TRINITY HOME HEALTH SERVICES	M	145,275	PER BOOKS
(2) TRINITY HEALTH-MICHIGAN	M	2,355,103	PER BOOKS
(3) SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC	L	85,763	PER BOOKS
(4) MOUNT CARMEL COLLEGE OF NURSING	C	53,992	PER BOOKS
(5) MOUNT CARMEL COLLEGE OF NURSING	K	258,643	PER BOOKS
(6) MOUNT CARMEL HEALTH SYSTEM FOUNDATION	B	2,343,430	PER BOOKS
(7) MOUNT CARMEL HEALTH SYSTEM FOUNDATION	C	3,163,793	PER BOOKS
(8) MOUNT CARMEL HEALTH PROVIDERS INC	B	8,000,000	PER BOOKS
(9) MOUNT CARMEL HEALTH PROVIDERS INC	L	2,847,886	PER BOOKS
(10) MOUNT CARMEL HEALTH PROVIDERS INC	M	8,054,274	PER BOOKS
(11) MOUNT CARMEL HEALTH PROVIDERS INC	A	2,072,232	PER BOOKS
(12) MOUNT CARMEL HEALTH PROVIDERS INC	P	473,526	PER BOOKS
(13) TRINITY HEALTH CORPORATION	P	27,399,885	PER BOOKS
(14) TRINITY HEALTH CORPORATION	Q	5,699,965	PER BOOKS
(15) TRINITY HEALTH CORPORATION	R	21,183,080	PER BOOKS
(16) TRINITY HEALTH CORPORATION	C	492,894	PER BOOKS
(17) TRINITY HEALTH CORPORATION	B	30,746,490	PER BOOKS
(18) TRINITY HEALTH CORPORATION	S	300,608	PER BOOKS
(19) TRINITY HEALTH CORPORATION	M	101,839,970	PER BOOKS
(20) TRINITY HEALTH ACO INC	S	279,295	PER BOOKS
(21) MCE MOB IV LIMITED PARTNERSHIP	C	214,514	PER TAX RETURN
(22) MEDILUCENT MOB I	C	197,748	PER TAX RETURN
(23) MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP	C	137,392	PER TAX RETURN
(24) ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP	C	85,658	PER TAX RETURN
(25) TRINITY HEALTH CORPORATION	E	152,000,000	PER BOOKS
(26) DILEY RIDGE MEDICAL CENTER	L	1,642,606	PER BOOKS
(27) MOUNT CARMEL HEALTH PLAN	L	118,552,790	PER BOOKS
(28) MOUNT CARMEL HEALTH INSURANCE COMPANY	L	2,269,380	PER BOOKS
(29) DILEY RIDGE MEDICAL CENTER	C	9,800,000	PER BOOKS

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:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE HEALTHCARE AND HOSPITAL SERVICES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	11,496
6	Total number of volunteers (estimate if necessary) .............	6	978
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	6,587,955
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	2,218,630

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	3,364,320	3,749,170
9	Program service revenue (Part VIII, line 2g) .........	1,177,388,305	1,229,018,773
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	24,032,316	-2,820,142
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	62,558,623	63,325,680
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,267,343,564	1,293,273,481
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,248,848	1,690,941
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)	495,841,295	527,584,999
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 268,543
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	638,957,440	682,577,061
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,136,047,583	1,211,853,001
19	Revenue less expenses. Subtract line 18 from line 12.......	131,295,981	81,420,480
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,864,209,817	2,052,818,353
21	Total liabilities (Part X, line 26).............	661,839,266	819,113,951
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,202,370,551	1,233,704,402

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 981,723,941 including grants of $ 1,690,941 ) (Revenue $ 1,268,389,590 )
	MOUNT CARMEL HEALTH SYSTEM (MOUNT CARMEL), LOCATED IN COLUMBUS, OHIO HAS BEEN A LEADER IN PATIENT CARE FOR MORE THAN 125 YEARS. TODAY, WITH PHYSICIAN PARTNERS, THE SYSTEM PROVIDES AN ARRAY OF CUTTING-EDGE, PATIENT-FOCUSED PRIMARY AND SPECIALTY HEALTHCARE SERVICES AT FOUR CENTRAL OHIO HOSPITALS, CONTAINING 1,427 REGISTERED BEDS, AS WELL AS A FREESTANDING EMERGENCY DEPARTMENT, SURGERY CENTERS, OUTPATIENT FACILITIES, PHYSICIAN OFFICES AND COMMUNITY OUTREACH SITES IN THE GREATER COLUMBUS AREA.MOUNT CARMEL'S TEAM OF MORE THAN 10,000 EMPLOYEES, 1,600 PHYSICIANS AND 900 VOLUNTEERS IS COMMITTED TO THE QUALITY CARE OF PATIENTS AND THEIR FAMILIES. TOGETHER, MORE THAN A HALF-MILLION PATIENTS ARE SERVED EACH YEAR. EACH YEAR MOUNT CARMEL PROVIDES TENS OF MILLIONS OF DOLLARS IN UNCOMPENSATED BENEFITS TO THE COMMUNITY. WE'RE ALSO ACTIVELY ENGAGED IN THE COMMUNITY THROUGH BUSINESS, CIVIC AND SERVICE ORGANIZATIONS, AND THROUGH OUR FINANCIAL SUPPORT OF OTHER NOT-FOR-PROFIT ORGANIZATIONS AND SOCIAL SERVICES AGENCIES.PLEASE VISIT SCHEDULE H AND OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES, RECOGNITIONS AND AWARDS: WWW.MOUNTCARMELHEALTH.COM

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 expenses981,723,941

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,953,233	9,738,676	1,311,785

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	3,656,687
e	Government grants (contributions)		1e	7,000

f	All other contributions, gifts, grants, and similar amounts not included above		1f	85,483

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		3,749,170

			Business Code
2a	NET PATIENT SVC REV	622110	1,208,126,203	1,206,485,527	1,640,676
b	SUBSIDIARY FEES	551114	20,892,570	20,892,570
c
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			1,229,018,773

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			9,204,661			9,204,661
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		11,712,437
b	Less: rental expenses		0
c	Rental income or (loss)		11,712,437
d	Net rental income or (loss)......			11,712,437			11,712,437
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	813,402
b	Less: cost or other basis and sales expenses	2,532,590	10,305,615
c	Gain or (loss)	-1,719,188	-10,305,615
d	Net gain or (loss).....			-12,024,803			-12,024,803
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	MANAGEMENT FEES		561499	6,251,571	5,426,163	825,408
b	CAFETERIA REVENUE		722514	5,534,323			5,534,323
c	MEDICARE/MEDICAID HIT		622110	2,182,302	2,182,302
d	All other revenue ....			37,645,047	33,403,028	4,121,871	120,148
e	Total. Add lines 11a–11d ......			51,613,243
12	Total revenue. See Instructions......			1,293,273,481	1,268,389,590	6,587,955	14,546,766

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	1,690,941	1,690,941
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	5,220,256	14,294	5,205,962
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	923,477	20,667	902,810
7	Other salaries and wages	431,954,192	381,685,932	50,071,217	197,043
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	16,563,541	14,607,334	1,948,666	7,541
9	Other employee benefits .......	39,265,190	34,478,772	4,768,619	17,799
10	Payroll taxes ...........	33,658,343		33,658,343
11	Fees for services (non-employees):
a	Management ......	3,702,375	3,702,375
b	Legal .........	1,309,635		1,309,635
c	Accounting ...........
d	Lobbying ...........	54,075		54,075
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	1,033,330		1,033,330
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	95,178,653	73,546,435	21,627,311	4,907
12	Advertising and promotion ....	4,399,275	243,619	4,155,656
13	Office expenses .......	11,168,570	7,122,095	4,041,395	5,080
14	Information technology ......	55,404,017	1,363,465	54,040,552
15	Royalties ..
16	Occupancy ...........	31,897,972	27,424,183	4,443,158	30,631
17	Travel ............	1,362,214	969,661	389,282	3,271
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	537,592	418,749	117,994	849
20	Interest ...........	19,145,393	19,145,393
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	89,464,400	64,111,677	25,352,721	2
23	Insurance ...	7,681,419	7,679,064	2,355
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES EXP	217,827,190	217,827,190
b	BAD DEBT EXPENSE	34,352,448	34,352,448
c	I/C PURCHASED SERVICES	33,426,603	25,560,538	7,866,065
d	UNRELATED BUS INC TAXES	1,256,037	1,256,037
e	All other expenses	73,375,863	64,503,072	8,871,371	1,420
25	Total functional expenses. Add lines 1 through 24e	1,211,853,001	981,723,941	229,860,517	268,543
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 ........			26,729	1	27,043
2	Savings and temporary cash investments .........			42,372,414	2	69,509,694
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			155,965,081	4	155,492,920
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net ....			1,432,556	7	1,399,564
8	Inventories for sale or use ........			19,270,850	8	20,894,753
9	Prepaid expenses and deferred charges ......			3,707,823	9	4,960,878
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,458,455,857
b	Less: accumulated depreciation	10b	837,642,515	561,388,358	10c	620,813,342
11	Investments—publicly traded securities .			335,362,767	11	354,517,272
12	Investments—other securities. See Part IV, line 11 .....			333,945,286	12	339,080,695
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			41,281,473	14	40,861,155
15	Other assets. See Part IV, line 11 ...........			369,456,480	15	445,261,037
16	Total assets. Add lines 1 through 15 (must equal line 34)...			1,864,209,817	16	2,052,818,353

17	Accounts payable and accrued expenses .....	124,920,790	17	134,847,530
18	Grants payable ...		18
19	Deferred revenue .........	721,518	19	108,072
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..	6,562,959	23	7,851,788
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	529,633,999	25	676,306,561
26	Total liabilities. Add lines 17 through 25..	661,839,266	26	819,113,951

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	1,202,370,551	27	1,233,704,402
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	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 ...........	1,202,370,551	33	1,233,704,402
34	Total liabilities and net assets/fund balances ........	1,864,209,817	34	2,052,818,353