TY 2018 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) JACK R GRAVO...................................................................... DIRECTOR, CHAIRPERSON	2.00 ................. 0.00	X	X	0	0	0
(2) JOE L CARPENTER DMD...................................................................... DIRECTOR, VICE-CHAIRPERSON	2.00 ................. 0.00	X	X	0	0	0
(3) JEFFREY A HEROLD...................................................................... DIRECTOR, SECRETARY	2.00 ................. 0.00	X	X	0	0	0
(4) CHARLES G DELACEY...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(5) SR MARIAN DURKIN CSA...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(6) BRIAN MERTES ESQ...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(7) TERRY A MOORE ESQ...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(8) DONALD PETERSON III...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(9) RENEE M POWELL...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(10) MELISSA ROGERS...................................................................... DIRECTOR	1.00 ................. 39.00	X		0	559,684	65,242
(11) THOMAS J STRAUSS...................................................................... DIRECTOR	1.00 ................. 39.00	X		0	1,130,364	60,590
(12) FONDA P WILLIAMS II...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(13) PAUL HILTZ...................................................................... DIRECTOR & PRESIDENT/CEO	38.00 ................. 2.00	X	X	15,525	78,997	10,917
(14) DAVID STEWART...................................................................... SENIOR VICE PRESIDENT-CFO	38.00 ................. 2.00		X	0	343,238	42,052
(15) SR CAROLYN CAPUANO HM...................................................................... VICE PRES-MISSION & MINIST	39.00 ................. 1.00		X	0	0	0
(16) DAVID GORMSEN...................................................................... CHIEF MEDICAL OFFICER	40.00 ................. 0.00		X	277,984	0	45,764
(17) MATTHEW HEINLE...................................................................... SR VICE PRESIDENT & GE	32.00 ................. 0.00		X	139,200	0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) CINDY HICKEY........................................................................ VICE PRES-PUBLIC RELATIONS	40.00 .......................0.00	X				136,895	0	33,121
(19) JEFFREY PIKE........................................................................ VICE PRES-PHY RELATIONS &	40.00 .......................0.00	X				286,403	0	42,553
(20) THOMAS TURNER........................................................................ VICE PRES-FUND DEVELOPMENT	30.00 .......................10.00	X				216,475	0	50,263
(21) BARBARA I YINGLING........................................................................ VICE PRESIDENT & CNO	40.00 .......................0.00	X				229,072	0	37,623
(22) AHMED EL GHAMRY SABE........................................................................ EXEC DIRECTOR-CARDIOLOGY	40.00 .......................0.00		X			781,894	0	69,733
(23) ANDREW M WOJKOWSKI........................................................................ DIRECTOR, DENTAL SERVICES	40.00 .......................0.00			X		210,867	0	26,318
(24) JUSTIN MODUGNO........................................................................ DENTIST	40.00 .......................0.00			X		184,176	0	29,715
(25) TASLIMA M SHAIKH........................................................................ PHYSICIAN	40.00 .......................0.00			X		171,538	0	12,236
(26) KYLE SOBECKI........................................................................ DIRECTOR-PHARMACY SERVICES	40.00 .......................0.00			X		138,950	0	34,165
(27) RICHARD UNSWORTH........................................................................ SENIOR PHARMACIST	42.00 .......................0.00			X		139,436	0	27,877
(28) THOMAS CECCONI........................................................................ FORMER-DIRECTOR, PRESIDENT & CEO	39.00 .......................1.00				X	0	553,604	35,650
(29) DAVID CEMATE........................................................................ FORMER-SR. VICE PRESIDENT-COO	40.00 .......................0.00				X	289,689	0	15,458

(A) Name and business address	(B) Description of services	(C) Compensation
SOUND PHYSICIANS OF OHIO III PO BOX 742936 LOS ANGELES,CA90074	PHYSICIAN SERVICES	4,525,098
OHIO ANESTHESIA GROUP INC 4665 DOUGLAS CR NW 100 CANTON,OH44718	PHYSICIAN SERVICES	3,382,506
CANTON MEDICAL EDUCATION FOUNDATION 2600 SIXTH ST SW CANTON,OH44710	RESIDENCY PROGRAM	1,870,392
UNITY HEALTH NETWORK 270 FRONT STREET CUYAHOGA FALLS,OH44221	PHYSICIAN SERVICES	1,588,214
STARK COUNTY EMERGENCY PHYSICANS 5154 FULTON DR NW CANTON,OH44718	PHYSICIAN SERVICES	1,409,710
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 59

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

MERCY MEDICAL CENTER INC

Employer identification number

34-1893439

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 12, 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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. 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—2017. 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—2018. 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—2017. 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) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. 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—2017. 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) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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) 2018

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) 2018

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 (explain in Part VI). 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) 2018

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 2018 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-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

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) 2018

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.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

MERCY MEDICAL CENTER INC

Employer identification number

34-1893439

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. Don't 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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization MERCY MEDICAL CENTER INC

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization MERCY MEDICAL CENTER INC		Employer identification number 34-1893439

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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization MERCY MEDICAL CENTER INC			Employer identification number 34-1893439
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) (2018)

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

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

MERCY MEDICAL CENTER INC

Employer identification number

34-1893439

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 (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

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) 2018

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) 2015	(b) 2016	(c) 2017	(d) 2018	(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) 2018

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

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

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

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

Yes

15,353

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

15,353

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:	DURING THE YEAR, THE ORGANIZATION WAS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION, OHIO HOSPITAL ASSOCIATION AND CANTON REGIONAL CHAMBER OF COMMERCE. OF DUES PAID TO NON-CHARITABLE EXEMPT ORGANIZATIONS, $15,353 WAS ALLOCATED TO LOBBYING ACTIVITIES.

Schedule C (Form 990 or 990EZ) 2018

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.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

MERCY MEDICAL CENTER INC

Employer identification number

34-1893439

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 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2018

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 ....	671,449	568,067	537,116	310,078	139,742
b	Contributions ...	2,000	6,000	10,967	232,642	143,424
c	Net investment earnings, gains, and losses	-35,365	100,197	28,116	-3,289	27,245
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	2,500		6,696
f	Administrative expenses ....	3,163	2,815	1,436	2,315	333
g	End of year balance ......	632,421	671,449	568,067	537,116	310,078

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

The percentages 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)

Yes

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

Yes

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

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" 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 .....	4,375,143		4,375,143
b	Buildings ....	106,128,818	79,750,862	26,377,956
c	Leasehold improvements	37,998,671	3,122,936	34,875,735
d	Equipment ....	169,659,298	150,967,763	18,691,534
e	Other .....	2,787,452		2,787,453
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				87,107,821

Schedule D (Form 990) 2018

Page 3

Part VII

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

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

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

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

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

Part IX

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

(a) Description				(b) Book value

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

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
DEBT-SCHS	22,919,649
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	22,919,649
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) 2018

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
PART V, LINE 4:	THE ENDOWMENT FUND IS FOR THE SUPPORT OF MERCY MEDICAL CENTER'S DENTAL RESIDENCY PROGRAM AND CLINIC. IN 2013, THE FUNDS WERE TRANSFERRED TO THE MERCY DEVELOPMENT FOUNDATION FOR GROWTH OPPORTUNITIES AND MANAGEMENT OF THESE FUNDS.
PART X, LINE 2:	ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2018, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS.
PART VI, LINE 1(E)	OTHER = CONSTRUCTION IN PROGRESS

Schedule D (Form 990) 2018

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

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

MERCY MEDICAL CENTER INC

Employer identification number

34-1893439

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) . . .			2,501,379	245,384	2,255,995	0.800 %
b	Medicaid (from Worksheet 3, column a) . . . . .		101,539	51,215,597	37,180,260	14,035,337	4.980 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		101,539	53,716,976	37,425,644	16,291,332	5.780 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	16	59,331	794,373	60,347	734,026	0.260 %
f	Health professions education (from Worksheet 5) . . .	1		6,529,101	3,687,658	2,841,443	1.010 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	1		252,228	0	252,228	0.090 %
j	Total. Other Benefits . .	18	59,331	7,575,702	3,748,005	3,827,697	1.360 %
k	Total. Add lines 7d and 7j .	18	160,870	61,292,678	41,173,649	20,119,029	7.140 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

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)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	1	4,387	0	4,387	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	1	10,000	0	10,000	0 %
8	Workforce development
9	Other
10	Total	2	14,387		14,387	0 %

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. ......

13,332,234

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. ......

1,690,249

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).....

66,282,479

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

56,802,529

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

9,479,950

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

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?1Name, 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	MERCY MEDICAL CENTER 1320 MERCY DRIVE NW CANTON,OH44708 CANTONMERCY.ORG	X	X	X

Schedule H (Form 990) 2018

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)

	MERCY MEDICAL CENTER
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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

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): CANTONMERCY.ORG

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 17

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

Yes

If "Yes" (list url): CANTONMERCY.ORG

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) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MERCY MEDICAL CENTER
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 250.000000000000%

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)

Was widely publicized 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):

CANTONMERCY.ORG/FINANCIAL-ASSISTANCE

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

CANTONMERCY.ORG/FINANCIAL-ASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
CANTONMERCY.ORG/FINANCAL-ASSISTANCE

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)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	MERCY MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

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

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

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)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

	MERCY MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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) 2018

Page 8

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, 16j, 18e, 19e, 20e, 21c, 21d, 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
MERCY MEDICAL CENTER	PART V, SECTION B, LINE 5: MERCY MEDICAL CENTER'S CHNA WAS DEVELOPED THROUGH A COLLABORATIVE COMMUNITY EFFORT, GUIDED BY THE STARK COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT ADVISORY COMMITTEE, WHICH IS COMPRISED OF 29 COMMUNITY AGENCIES, INCLUDING FOUR HEALTH DISTRICTS AND THREE NONPROFIT HOSPITALS. THE STARK COUNTY COMMUNITY HEALTH ASSESSMENT PROCESS IS A COLLABORATION OF LOCAL PUBLIC HEALTH, HOSPITALS AND HEALTH CARE ORGANIZATIONS, SOCIAL SERVICES AGENCIES, NON PROFIT ORGANIZATIONS AND COMMUNITY VOLUNTEERS WHO MEET REGULARLY TO IDENTIFY COMMUNITY NEEDS AND DEVELOP A PLAN TO ADDRESS THOSE NEEDS. THE PROCESS INCLUDES THE FOLLOWING: * IDENTIFYING SOURCES OF HEALTH INFORMATION AND DATA TO COLLECT AND UPDATE (INCLUDING BOTH PRIMARY AND SECONDARY DATA SOURCES) * SURVEYING KEY INFORMANTS AND COMMUNITY MEMBERS WHO HAVE KNOWLEDGE OF OR EXPERIENCE WITH THE COMMUNITY NEEDS OR PROBLEMS * ANALYZING AND DISCUSSING ALL DATA AND ISSUES TO PRIORITIZE THE TOP HEALTH NEEDS * DEVELOPING AN IMPLEMENTATION PLAN WITH STRATEGIES TO ADDRESS THE HEATH NEEDS IDENTIFIED * COMMUNICATING WITH OTHER AGENCIES/ORGANIZATIONS IN THE COMMUNITY TO AVOID UNNECESSARY OVERLAP IN PROGRAM ACTIVITIES AND TO IDENTIFY EMERGING ISSUES AND NEW RESOURCES * DISTRIBUTING RESULTS OF THE CHA PROCESS TO THE COMMUNITY * REPEATING CYCLE EVERY THREE YEARS (ALTHOUGH SOME ACTIVITIES WILL BE DONE YEARLY WHILE OTHERS WILL BE DONE ONCE EVERY THREE YEARS)MERCY CONTRACTED WITH THE CENTER FOR MARKETING & OPINION RESEARCH (CMOR) FOR THE CHNA.
MERCY MEDICAL CENTER	PART V, SECTION B, LINE 6A: MERCY MEDICAL CENTER WORKED WITH THE OTHER TWO NOT-FOR-PROFIT COUNTY HOSPITALS, AULTMAN HOSPITAL AND ALLIANCE COMMUNITY HOSPITAL ON THE STARK COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT. MERCY USED DATA AND INFORMATION FROM THE REPORT IN REVIEWING AND UPDATING THE MERCY CHNA AND IMPLEMENTATION STRATEGY.
MERCY MEDICAL CENTER	PART V, SECTION B, LINE 6B: THE STARK COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ADVISORY COMMITTEE IS MADE UP OF A VARIETY OF HEALTH AND SOCIAL SERVICES AGENCIES AND VOLUNTEERS IN THE COMMUNITY. THE FOLLOWING AGENCIES HAVE BEEN INVOLVED IN THE CHNA PROCESS: ACCESS HEALTH STARK COUNTY; ALLIANCE COMMUNITY HOSPITAL; ALLIANCE CITY HEALTH DEPARTMENT; AULTMAN HOSPITAL; CANTON CITY HEALTH DEPARTMENT; HEALTH FOUNDATION; MERCY MEDICAL CENTER; MASSILLON CITY HEALTH DEPARTMENT; OSU EXTENSION OFFICE; PEGASUS FARM; PRESCRIPTIONS ASSISTANCE NETWORK OF STARK COUNTY; SISTERS OF CHARITY; STARK COUNTY HEALTH DEPARTMENT; STARK COUNTY MEDICAL SOCIETY; STARK COUNTY COMMUNITY ACTION AGENCY; STARK COUNTY MENTAL HEALTH & RECOVERY SERVICES BOARD; STARK PARKS; SUMMA HEALTH; AND UNITED WAY OF GREATER STARK COUNTY.
MERCY MEDICAL CENTER	PART V, SECTION B, LINE 11: DURING THE CHNA, THE FOLLOWING HEALTH NEEDS WERE IDENTIFIED FROM A COMMUNITY PERSPECTIVE AND INCORPORATED INTO MERCY'S IMPLEMENTATION PLAN, AND ARE LISTED BELOW.1. ACCESS TO HEALTHCARE INCLUDING ORAL HEALTH* CONTINUE TO OPERATE MERCY'S 10 COMMUNITY OUTPATIENT HEALTH CENTERS, STRATEGICALLY LOCATED IN STARK AND NEIGHBORING COUNTIES. THESE CENTERS PROVIDE AFFORDABLE AND ACCESSIBLE URGENT CARE, PRIMARY CARE AND AMBULATORY CARE SERVICES CLOSE IN CONVENIENTLY LOCATED SITES. CONTINUE TO SERVE UNINSURED AND UNDERINSURED PATIENTS THROUGH OUR INTERNAL MEDICINE AND OB/GYN OUTPATIENT CLINICS. CONTINUE TO GROW OUR PRIMARY CARE PHYSICIAN PRACTICES LOCATED THROUGHOUT STARK, CARROLL AND TUSCARAWAS COUNTIES. CONTINUE TO PROVIDE MUCH NEEDED ORAL HEALTH CARE THROUGH THE MERCY DENTAL SERVICES AND GENERAL PRACTICE RESIDENCY PROGRAM. THESE SERVICES ARE OFFERED AT THE MAIN HOSPITAL CAMPUS AND MERCY ST. PAUL SQUARE LOCATION, LOCATED IN UNDERSERVED NORTHEAST CANTON. THE PROGRAM OFFERS A SAFETY NET FOR UNINSURED AND UNDERINSURED PATIENTS AND PROVIDED CARE FOR 9,722 PATIENTS IN 2018. CONTINUE TO APPLY FOR AVAILABLE GRANT FUNDING TO ASSIST UNINSURED AND UNDERINSURED PATIENTS WITH THEIR DENTAL CARE. PROVIDE DENTAL SERVICES OUTREACH EDUCATION AND SCREENINGS IN AREA CHURCHES, SCHOOLS AND OUTREACH HEALTH FAIR EVENTS. CONTINUE THE MERCY DENTAL RESIDENCY PROGRAM, PROVIDING ADVANCED PRACTICE EDUCATION AND TRAINING FOR DENTISTS IN THIS COMMUNITY. CONTINUE THE GROWTH AND EXPANSION OF MERCY PROFESSIONAL CARE CORP., AN EMPLOYED NETWORK OF MERCY PHYSICIANS AND ADVANCED PRACTICE PROFESSIONALS THAT PROVIDE THIS COMMUNITY ACCESS TO QUALITY PRIMARY CARE, INCLUDING PATIENT CENTERED MEDICAL HOMES, SURGEONS, PAIN MANAGEMENT SPECIALIST, AND CARDIAC CARE INCLUDING CARDIOLOGISTS AND CARDIAC SURGEONS.2. HEROIN/OPIATE USE SUPPORTED SEVERAL COMMUNITY-WIDE EDUCATION EFFORTS SURROUNDING THIS ISSUE. CONTINUED TO DISTRIBUTE THE OPIOID EPIDEMIC EDUCATIONAL PUBLICATION WITH COMMUNITY GROUPS AND LOCAL NEWSPAPER. SUPPORTED PUBLIC EDUCATION AND AWARENESS EFFORTS OF MERCY PAIN MANAGEMENT SERVICES, AND DR. JAMESETTA LEWIS, A COMMUNITY EXPERT ON OPIOIDS AND CHRONIC PAIN. CONTINUED DISTRIBUTION OF A FREE MERCY PAIN MANAGEMENT PUBLICATION: OPIOIDS: INFORMATION, WARNINGS AND RESOURCES.3. INFANT MORTALITY CONTINUE ACTIVE PARTICIPATION IN STARK COUNTY THRIVE, A COMMUNITY-WIDE INITIATIVE AIMED AT ADDRESSING THE INFANT MORTALITY ISSUE. CONTINUE DISTRIBUTION OF FREE INFANT SLEEP SACKS AND SAFE SLEEP EDUCATIONAL MATERIALS TO ALL NEW PARENTS AT MERCY. THIS IS FUNDED WITH DONATIONS BY THE MERCY SERVICE LEAGUE WOMEN'S AUXILIARY AND QUOTA CLUB OF MASSILLON. OFFER UNINSURED AND UNDERINSURED PATIENTS PRENATAL SERVICES THROUGH THE MERCY OB/GYN CLINIC, ENCOURAGING EARLY ACCESS TO PRENATAL CARE AND HEALTHY, FULL-TERM PREGNANCIES. EDUCATION AND SUPPORT IS ALSO OFFERED THROUGH THIS SERVICE. OFFERED A FULL-TIME LACTATION CONSULTANT WHO OFFERS FREE BREASTFEEDING GUIDANCE AND CONSULTATION BEFORE AND AFTER DISCHARGE. CONTINUED TO OFFER BABY SHOWERS FOR PREGNANT WOMEN AND NEW MOTHERS TO PROVIDE HEALTH AND CHILD CARE EDUCATION. THESE SHOWERS ARE OFFERED EACH YEAR AT BOTH MERCY MEDICAL CENTER AT ST. PAUL SQUARE IN NORTHEAST CANTON AND SKYLINE TERRACE IN SOUTHEAST CANTON.4. LARGE NEED FOR MENTAL HEALTH SERVICES CONTINUE TO PROVIDE ASSISTANCE WITH REFERRALS AND PLACEMENTS FOR PATIENTS IN THE MERCY EMERGENCY DEPARTMENT AS NEEDED. COLLABORATE WITH AREA MENTAL HEALTH AGENCIES ON OPTIONS FOR IMPROVING ACCESS TO CARE. BEGAN INITIAL DISCUSSIONS AND PLANNING FOR A BEHAVIORAL HEALTH NURSE PRACTITIONER TO BEGIN OFFERING SERVICES IN THE EMERGENCY DEPARTMENT AND OUTPATIENT SETTING IN 2019. BEGAN DISCUSSIONS FOR UTILIZING BEHAVIORAL HEALTH SERVICES OF OUR SISTER HOSPITAL, ST. VINCENT CHARITY MEDICAL CENTER. PARTICIPATED AS A SPONSOR, ALONG WITH OTHER AREA HOSPITALS, MENTAL HEALTH AGENCIES, UNITED WAY AND FOUNDATIONS, FOR THE 2018 CRISIS STARK COUNTY TEEN BULLYING & SUICIDE MENTAL HEALTH TOOLKIT. THIS EDUCATIONAL GUIDE WAS DISTRIBUTED TO THOUSANDS OF FAMILIES THROUGHOUT STARK COUNTY. 5. OBESITY AND HEALTHY LIFESTYLE CHOICES CONTINUE HEALTHY LIFESTYLE PROGRAMMING THROUGH THE MISSION OUTREACH SERVICES, INCLUDING SUMMER DAY CAMPS FOR CHILDREN, THAT ARE OFFERED IN COLLABORATION WITH CANTON CITY SCHOOLS, STARK PARKS, AND OTHER AREA AGENCIES. FOCUS IS ON NUTRITION, EXERCISE, ORAL HEALTH AND HEALTHY LIFESTYLES. CONTINUE COMMUNITY PROGRAMMING AND EDUCATION THROUGH MERCY WEIGHT MANAGEMENT SERVICES. CONTINUE TO OFFER MONTHLY LUNCH & LEARN PROGRAMMING TO THE COMMUNITY AT MERCY ST. PAUL SQUARE. PROGRAMS FOCUS ON HEALTH RISKS AND DISEASE PREVENTION, INCLUDING DIABETES MANAGEMENT. CONTINUE MERCY'S SMOKING CESSATION EDUCATIONAL CLASSES AND OUTREACH EDUCATION. CONTINUE PARTICIPATION IN AREA COMMUNITY HEALTH FAIRS AND EDUCATIONAL EVENTS THAT PROMOTE HEALTHY LIFESTYLES. OFFERED MONTHLY LOW-COST BLOOD SCREENINGS AT ALL MERCY HEALTH CENTERS.
MERCY MEDICAL CENTER	PART V, SECTION B, LINE 20E: UPON ADMISSION AS A SELF-PAY PATIENT, A HOSPITAL REPRESENTATIVE MEETS WITH THE PATIENT IN THEIR ROOM AND DISCUSSES IF THEY MAY BE ELIGIBLE FOR GOVERNMENT ASSISTANCE PROGRAMS OR IF THEY QUALIFY UNDER OUR FAP.TELEPHONE CALLS ARE ATTEMPTED AS WELL AS INFORMATION IS INCLUDED IN THE STATEMENTS GOING OUT TO OUR PATIENTS ABOUT BEING ELIGIBLE FOR FINANCIAL ASSISTANCE.

Schedule H (Form 990) 2018

Page 9

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?16
Name and address		Type of Facility (describe)
1	1 - MERCY HEALTH CENTER OF NORTH CANTON 6200 WHIPPLE AVE NW NORTH CANTON,OH44720	URGENT CARE, THERAPY, IMAGING SERVICES, LAB, SPORTS MEDICINE & CARDIO REHAB
2	2 - MERCY HEALTH CENTR OF JACKSON 7337 CARITAS CIRCLE NW MASSILLON,OH44646	URGENT CARE, THERAPY, IMAGING, LAB, PAIN MGMT, CARDIO DIAG, PRIMARY CARE
3	3 - MERCY HEALTH CENTER OF MASSILLON 2935 LINCOLN WAY MASSILLON,OH44647	URGENT CARE, IMAGING SERVICES, LAB & THERAPIES
4	4 - MERCY HEALTH CENTER OF TUSCARAWAS CTY 1031 WEST HIGH AVENUE NEW PHILADELPHIA,OH44663	URGENT CARE, THERAPY, IMAGING SERVICES, LAB & CARDIO DIAG.
5	5 - MERCY HEALTH CENTER OF CARROLL COUNTY 125 CANTON ROAD CARROLLTON,OH44615	URGENT & PRIMARY CARE, IMAGING SERVICES & LAB
6	6 - MERCY HEALTH CENTER OF PLAIN 2638 EASTON NE CANTON,OH44721	URGENT CARE, IMAGING SERVICES, LAB & SPORTS MEDICINE
7	7 - MERCY FAMILY MEDICINE OF ALLIANCE 149 E SIMPSON ST ALLIANCE,OH44601	PRIMARY CARE, IMAGING SERVICES, LAB & PAIN MANAGEMENT
8	8 - MERCY HEALTH CENTER OF CARROLL COUNTY 1001 CANTON ROAD NW CARROLLTON,OH44615	THERAPY
9	9 - MERCY HEALTH CENTER OF LAKE 432 KING CHURCH AVE NW UNIONTOWN,OH44685	IMAGING SERVICES, LAB, THERAPY & SPORTS MEDICINE
10	10 - MERCY HEALTH CENTER OF LOUISVILLE 1302 WEST MAIN ST LOUISVILLE,OH44641	IMAGING SERVICES & LAB
11	11 - MERCY PRIMARY CARE-PERRY 3300 BAILEY ST NW MASSILLON,OH44646	PRIMARY CARE
12	12 - MERCY SURGICAL CARE 1330 MERCY DRIVE NW CANTON,OH44708	SURGICAL SERVICES
13	13 - MERCY ST PAUL SQUARE 1459 SUPERIOR AVE NE CANTON,OH44705	PRIMARY & DENTAL CARE
14	14 - MERCY PRIMARY CARE-BELDEN 4909 MUNSON AVENUE CANTON,OH44718	PRIMARY CARE
15	15 - MERCY PRIMARY CARE-METRO 601 CLEVELAND AVE NW CANTON,OH44702	PRIMARY CARE
16	16 - MERCY UROLOGY 1330 MERCY DRIVE NW SUITE 502 CANTON,OH44708	UROLOGY SERVICES

Schedule H (Form 990) 2018

Page 10

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 7:	COST OF CHARITY WAS CALCULATED USING A COST TO CHARGE RATIO. TOTAL EXPENSES USED FOR THE RATIO DID NOT INCLUDE BAD DEBT, ANY MEDICAID PROVIDER ASSESSMENTS OR FEES, NOR ANY PROCEEDS FROM THE HCAP PROGRAM. THAT ADJUSTED EXPENSE WAS THEN DIVIDED BY CHARGES TO OBTAIN THE COST-TO-CHARGE RATIO USED.
PART I, LN 7 COL(F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $13,332,234.
PART II, COMMUNITY BUILDING ACTIVITIES:	DYNAMICALLY INVOLVED IN THE COMMUNITIES WHERE WE SERVE, MERCY HAS MULTI-FACETED OUTREACH EFFORTS IN PLACE. THESE INCLUDE: COMMUNITY OUTREACH, FAITH COMMUNITY NURSING, IMMIGRANT HEALTH OUTREACH, MERCY INTERNATIONAL MISSION OUTREACH, AND MISSION OUTREACH. COMMUNITY OUTREACH AND FAITH COMMUNITY NURSING:IT IS IMPOSSIBLE TO ENUMERATE ALL OF THE GENERAL, HEALTH RELATED COMMUNITY OUTREACH EFFORTS IN 2018. HEALTH EDUCATION PRESENTATIONS, COMMUNITY HEALTH FAIRS, AND HEALTH SCREENINGS CATEGORIZE MOST OF THESE OFFERINGS. THE PRESENCE OF MERCY AT MOST CIVIC, COMMUNITY ORIENTED EVENTS IS EVIDENT. THERE IS ALSO A STRONG PRESENCE AT COLLEGE, UNIVERSITY, AND CHURCH SPONSORED EVENTS. COMMUNITY HEALTH FAIRS HELD AT OUR VARIOUS HEALTH CENTERS WERE INITIATED IN LATE 2018. THERE HAS BEEN VERY GOOD COMMUNITY RESPONSE. OUR CARDIAC CARE CENTER, CANCER CARE CENTER, SENIOR FRIENDS AND OTHER DEPARTMENTS FREQUENTLY OFFER COMMUNITY EDUCATION SESSIONS ON TOPICS OF INTEREST AND IMPORT. ADDITIONALLY, OUR EMERGENCY AND SECURITY DEPARTMENTS REACH OUT BY PROVIDING OVER 300 BUS PASSES ANNUALLY AND CLOTHING FOR PATIENTS IN NEED. THE ENTIRE MEDICAL CENTER COLLABORATES WITH OTHER CHARITABLE ORGANIZATIONS (E.G. CATHOLIC CHARITIES, COMMUNITY CHRISTMAS) TO ASSIST COMMUNITY MEMBERS AT CHRISTMAS TIME BY ADOPTING FAMILIES. IN 2018, THIS WAS EXTENDED VIA MANY MERCY DEPARTMENTS AND THE SPIRIT OF MERCY COMMITTEE TO 20 FAMILIES DESIGNATED IN NEED BY CATHOLIC CHARITIES AND 8 FAMILIES FROM MERCY. IMMIGRANT HEALTH OUTREACH:IMMIGRANT HEALTH OUTREACH CONTINUED TO PROVIDE MUCH NEEDED SERVICES. THE COORDINATOR OF THIS PROGRAM, WHO HOLDS A BSN AND HAS BEEN PART OF OUR PROGRAM FOR SEVERAL YEARS, ACHIEVED NATIONAL CERTIFICATION IN 2017. THIS OUTSTANDING CREDENTIAL HELPS TO CONTINUE THE PROFESSIONALISM THAT HAS MARKED OUR SERVICE FROM THE BEGINNING. IN ADDITION, SEVERAL OF THE INTERPRETERS HAVE COMPLETED THE QUALIFYING PROGRAM AND ARE IN THE PROCESS OF TESTING FOR NATIONAL CERTIFICATION AS WELL. WE ARE VERY FORTUNATE TO NOW HAVE THE SERVICES OF A MERCY EMPLOYEE WHO IS A NATIVE K'ICHE SPEAKER. HE SERVES AS AN STNA ON A NURSING UNIT BUT WITH THE SUPPORT OF HIS DIRECTOR IS ABLE TO INTERPRET FOR THOSE WHO SPEAK THIS RARE DIALECT. HE HOLDS NATIONAL CERTIFICATION FOR THIS LANGUAGE AS WELL. WE CONTINUE TO SERVE MANY SPANISH SPEAKING, RECENTLY ARRIVED IMMIGRANT FAMILIES WHO DEEPLY APPRECIATE THE LANGUAGE SUPPORT THEY RECEIVE AT MERCY. DUE TO POVERTY AND, AT TIMES, IMMIGRATION STATUS, THIS IS A VERY VULNERABLE POPULATION IN NEED OF BOTH EPISODIC AND CONTINUING CARE. THANKS, IN PART, TO THE GENEROUS SUPPORT OF THE SISTERS OF CHARITY FOUNDATION OF CANTON, IMMIGRANT HEALTH OUTREACH WAS ABLE TO OFFER THE FOLLOWING IN 2018 FOR PEOPLE WHO ARE UNABLE TO SPEAK ENGLISH. ENCOUNTERS VARY IN LENGTH FROM 15 MINUTES (E.G. LAB WORK) TO 8-10 HOURS (E.G. LABOR AND DELIVERY). 1,736 PATIENT VISITS IN MERCY AMBULATORY CARE CLINICS 377 PATIENTS VISITS TO MERCY EMERGENCY DEPARTMENT 278 PATIENTS WERE SERVED IN MERCY DENTAL CLINIC AND 46 AT ST. PAUL DENTAL OFFICE 69 PATIENTS WERE SERVED IN MERCY SAME DAY SURGERY 156 BABIES WERE BORN TO IMMIGRANT MOTHERS AT MERCY 278 PATIENTS WERE SERVED IN THE OUTPATIENT LAB 469 PATIENTS WERE SERVED IN MERCY ULTRASOUND, RADIOLOGY, CT SCAN, MRI, MAMMOGRAM AND X-RAY DEPARTMENT. 155 PHYSICIAN AND VACCINATION APPOINTMENTS WERE COVERED AT ST. PAUL SQUARE. 650 ENCOUNTERS WERE SUPPORTED IN MEETINGS WITH THE MERCY FINANCIAL COUNSELOR IN THE ACC CLINIC, WITH HCAP PAPERWORK. 265 PATIENT ENCOUNTERS IN MEDICAL RECORDS, ON PATIENT UNITS, IN PHARMACY AND WITH PHYSICIAN VISITS WERE SUPPORTED 46 PATIENT VISITS WERE SUPPORTED AT VARIOUS MERCY THERAPY LOCATIONS MISSION OUTREACH:MISSION OUTREACH CONTINUED ITS TRANSFORMATIVE EVOLUTION DURING 2018. THE FOCUS, IN KEEPING WITH THE COUNTY'S HEALTH NEEDS ASSESSMENT AND OUR MISSION OF HEALING MINISTRY, CONTINUES TO BE HEALTH AND WELLNESS ORIENTED WITH MANY PROGRAMS OFFERED COLLABORATIVELY WITH CANTON CITY SCHOOLS. WE CONTINUED THE LONG (20+ YEAR) TRADITION OF OUTREACH IN SE CANTON (THE CITY'S POOREST NEIGHBORHOOD AND A FOOD DESERT) BUT ALSO CONTINUED TO EXPAND OUTREACH IN URBAN NE CANTON AS WELL (A MEDICALLY UNDERSERVED AREA AND A FOOD DESERT). SOME OF THE OUTREACH PROGRAMS WE PROVIDED IN 2018 INCLUDED: TWO PRENATAL HEALTH EDUCATION PROGRAMS, ONE HELD AT ST. PAUL'S AND THE OTHER HELD AT MERCY'S MAIN CAMPUS (PLANNED SPECIFICALLY FOR OUR LATINO POPULATION), FOR A TOTAL OF 62 PREGNANT WOMEN; PARTICIPATION IN STARK COUNTY DISTRICT LIBRARY'S YOUNG MOM'S CLUB (ALLOWED US TO PROVIDE HEALTH INFORMATION TO OVER 115 PREGNANT WOMEN); TWO SUMMER HEALTH DAY CAMPS FOR 18 ELEMENTARY CHILDREN AND 15 CANTON CITY MIDDLE SCHOOL STUDENTS. WE PARTICIPATED IN THE ALLEN ELEMENTARY SCHOOL'S OPEN HOUSE PROVIDING BLOOD PRESSURE CHECKS AND HEALTH EDUCATION MATERIALS TO OVER 85 STUDENTS AND PARENTS. A DENTAL ASSEMBLY FOR 250 ALLEN ELEMENTARY SCHOOL STUDENTS BROUGHT CHRISTMAS CHEER, EDUCATION AND A GIFT BAG OF ORAL HEALTH PRODUCTS. WE OFFERED A NUTRITION AND EXERCISE HEALTH SUMMIT FOR 93 HOLY CROSS ACADEMY CATHOLIC SCHOOL 5TH GRADERS. NE CANTON ST. PAUL'S COMMUNITY MONTHLY LUNCH AND LEARN SESSIONS PROVIDED EDUCATION ON DIABETES AND OTHER HEALTH TOPICS TO 111 COMMUNITY MEMBERS. WE CONTINUED OUR WELL WOMEN AND WHITE COAT PROGRAMS WITH CANTON CITY SCHOOLS AND 95 MIDDLE SCHOOL STUDENTS CAME TOGETHER TO LEARN ABOUT VARIOUS HEALTH TOPICS AND CAREERS PROVIDED BY HEALTH PROFESSIONALS. WE HELD THE THIRD ANNUAL CHRISTMAS WINTER WELLNESS OPEN HOUSE FOR FAMILIES AT OUR ST. PAUL SQUARE FACILITY (NE CANTON) PROVIDING HEALTH AND DENTAL EDUCATION TO OVER 135 COMMUNITY MEMBERS. IN ADDITION, THE HEARTS AND HANDS COMMITTEE OF THE MERCY SERVICE LEAGUE PROVIDED EVERYONE WITH GLOVES, HATS OR SCARVES. A BEAUTIFUL COMMUNITY EVENT, PEOPLE OF ALL AGES ENJOYED HEARTY REFRESHMENTS (SERVED BY MERCY SERVICE LEAGUE VOLUNTEERS) AND BEAUTIFUL CHRISTMAS MUSIC PROVIDED BY THE MCKINLEY STRINGS (AN ENSEMBLE OF HIGH SCHOOL STUDENTS). MERCY PERSONNEL FROM A VARIETY OF DEPARTMENTS PARTICIPATE IN OUTREACH ACTIVITIES AND PROVIDE PROFESSIONAL SUPPORT. ALL TOLD, OVER 1,300 INDIVIDUAL CONTACTS WERE MADE BY MISSION OUTREACH DURING 2018. THERE IS A WELLNESS RESOURCE COACH AT ST. PAUL'S. THE COACH (AN LPN AND DIETICIAN) ASSISTS BOTH PATIENTS AND AREA RESIDENTS WITH SUCH THINGS AS ACCESSING PRESCRIPTION ASSISTANCE, BLOOD PRESSURE MONITORING, HEALTH EDUCATION, EMERGENCY FOOD ASSISTANCE, AND TRANSPORTATION NEEDS. THE COACH ALSO ASSISTS BOTH MEDICAL AND DENTAL TEAMS AT ST. PAUL'S. OUR PROGRAM ADDRESSES SOME OF THE SOCIAL DETERMINANTS OF HEALTH, THE IMPORTANCE OF WHICH CONTINUES AS A FOCUS IN PUBLIC HEALTH. WE AGAIN WERE AWARDED AN ODH OFFICE OF MINORITY HEALTH GRANT THIS ENABLED US TO PROVIDE NE AND SE CANTON, MINORITY HEALTH MONTH EVENTS WHICH EDUCATED OVER 75 FAMILIES ON THE TOPIC OF HEALTHY EATING IN ORDER TO REDUCE DIABETES RISK. FAMILIES PARTICIPATED IN EXERCISE AND A FOOD DEMO GIVEN BY MERCY'S REGISTERED DIETITIANS. EACH FAMILY RECEIVED A CROCKPOT AS AN INCENTIVE. WE INCREASED OUR COLLABORATION WITH HARTFORD MIDDLE SCHOOL STEAMM ACADEMY AND PARTICIPATED IN THE CANTON CITY GIRLS CODE EVENT WITH CANTON, LAKE, PLAIN AND PERRY SCHOOL DISTRICTS. MERCY'S MISSION OUTREACH AND IT DEPARTMENTS CONDUCTED 4 SESSIONS, FOR A TOTAL OF 60 STUDENTS, ON THE TOPIC OF BINARY CODE AND ITS CONNECTION TO HEALTH CARE AND IT CAREERS. INTERNATIONAL MISSION OUTREACH:MERCY INTERNATIONAL MISSION OUTREACH AGAIN SENT A TEAM OF PHYSICIANS, NURSES, AND OTHERS TO AN AREA OF NOTABLE POVERTY IN THE DOMINICAN REPUBLIC TO PROVIDE SURGICAL AND CLINIC SERVICES. THE 2018 MISSION TRIP WAS BASED IN THE CITY OF SAMANA. THIS MARKED THE 26 YEARS OF SUCH SERVICE IN THE DOMINAN REPUBLIC. OTHER COMMUNITY BUILDING PROGRAMS:MERCY DENTAL SERVICES PROVIDED HEALTH EDUCATION PROGRAMS AND COMMUNITY SCREENINGS.MERCY ANGEL NETWORK (SUPPORTED BY THE MEDICAL CENTER) USES VOLUNTEERS TO DO PEER-TO-PEER MESSAGING REGARDING BREAST HEALTH, EARLY DETECTION AND SCREENING PROGRAMS TO INCREASED BREAST HEALTH AWARENESS IN THE AFRICAN AMERICAN COMMUNITY. DUE TO THEIR EFFORTS AND COMMITMENT, MORE AFRICAN AMERICAN WOMEN ARE VISITING MERCY FOR MAMMOGRAMS.*MERCY OFFERS HAVEN (HEALING AFTER VIOLENT ENCOUNTERS NETWORK), PROVIDING MEDICAL FORENSIC NURING CARE TO INDIVIDUALS IMPACTED BY VIOLENCE, DOMESTIC VIOLENCE, HUMAN TRAFFICKING, SEXUAL AND ELDER ABUSE AND NEGLECT.
PART III, LINE 2:	BAD DEBT IS ESTIMATED BASED UPON HISTORICAL REVIEWS AND CURRENT TRENDS. HISTORICAL WRITE-OFFS ARE MONITORED IN ORDER TO ESTIMATE BAD DEBT WRITE OFFS BASED UPON THE PAYOR MIX AND THE AGING OF ACCOUNTS RECEIVABLE.
PART III, LINE 3:	IT IS ESTIMATED THAT 12.7% OF BAD DEBT WRITE-OFFS MAY HAVE QUALIFIED AS CHARITY. THAT ESTIMATION EXCLUDES 63.1% OF WRITE-OFFS THAT COME FROM INSURED ACCOUNTS ASSUMING THAT THEY HAVE A GREATER ABILITY TO PAY. THAT RESULT WAS THEN SPLIT 34.4/65.6% BASED UPON THE HOSPITAL'S CHARITY TO BAD DEBT RATIO. BECAUSE A PORTION OF BAD DEBT COULD QUALIFY AS CHARITY, A PORTION OF BAD DEBT COULD BE CONSIDERED A COMMUNITY BENEFIT.
PART III, LINE 4:	FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND A PROVISION FOR BAD DEBT, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE DETERMINED TO HAVE FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.
PART III, LINE 8:	THE AMOUNTS WERE DETERMINED BASED ON INFORMATION FROM THE MEDICARE 2018 COST REPORT.
PART III, LINE 9B:	MERCY MEDICAL CENTER HAS A CHARITY POLICY, A SELF-PAY DISCOUNT POLICY, AND A COLLECTION POLICY. TOGETHER, THESE POLICIES MAKE MANY OPTIONS KNOWN AND AVAILABLE TO THE PATIENTS IT SERVES. WHEN PATIENTS QUALIFY FOR FINANCIAL/CHARITY ASSISTANCE, THEIR ACCOUNT BALANCE IS EITHER WRITTEN OFF OR REDUCED USING A CHARITY ADJUSTMENT CODE. ANY RESIDUAL ACCOUNT BALANCE AFTER CHARITY ADJUSTMENTS ARE SUBJECT TO THE SAME COLLECTION PROCEDURES AS ALL OTHER PATIENTS.
PART VI, LINE 2:	MERCY MEDICAL CENTER COLLABORATES WITH NUMEROUS COMMUNITY ORGANIZATIONS AND SOCIAL SERVICE AGENCIES AS PART OF ITS MISSION OUTREACH AND COMMUNITY HEALTH INITIATIVES. PART OF THE COLLABORATION INVOLVES PARTICIPATION ON THE BOARD OF DIRECTORS FOR THE UNITED WAY OF GREATER STARK COUNTY, THE BEACON CHARITABLE PHARMACY, THE AMERICAN HEART ASSOCIATION, WALSH UNIVERSITY, THE AUSTIN BAILEY HEALTH & WELLNESS FOUNDATION, ARTS IN STARK AND MANY OTHERS. ALL OF THESE GROUPS HAVE A ROLE IN LOOKING AT THE OVERALL HEALTH AND WELLNESS OF OUR COMMUNITY.
PART VI, LINE 3:	THERE IS SIGNAGE IN EACH WAITING AREA STATING THAT PATIENTS MIGHT BE ELIGIBLE FOR CHARITY CARE. FINANCIAL COUNSELORS MEET WITH MANY PATIENTS AND EXPLAIN OPTIONS AVAILABLE AND GET ELIGIBLE PATIENTS SIGNED UP FOR MEDICAID, OR QUALIFIED FOR CHARITY OR HCAP. THE PATIENT BILLING STATEMENTS CONTAIN NOTICES THAT PATIENTS MIGHT BE ELIGIBLE FOR CHARITY CARE.
PART VI, LINE 4:	THE COMMUNITY SERVED BY THE HOSPITAL IS DEFINED BASED ON THE GEOGRAPHIC ORIGINS OF THE HOSPITAL'S PATIENTS. OUR PRIMARY SERVICE AREA IS STARK COUNTY, OHIO. OUR SECONDARY SERVICE AREAS ARE IN TUSCARAWAS COUNTY AND CARROLL COUNTY.THE FOLLOWING DESCRIPTION OF OUR PRIMARY AREA OF STARK COUNTY IS TAKEN DIRECTLY FROM THE 2017 STARK COUNTY INDICATORS REPORT AND UPDATED FOR 2018 NUMBERS IF AVAILABLE:POPULATION: IN 2018, THE POPULATION WAS 371,574. THE OVERALL POPULATION IN STARK COUNTY HAS BEEN SLIGHTLY DECREASING SINCE 2014. POPULATION GROWTH OR DECLINE IS POSITIVELY CORRELATED WITH THE ECONOMIC HEALTH OF THE AREA. RACIAL: STARK COUNTY IS RACIALLY AND ETHNICALLY HOMOGENOUS. MINORITY POPULATIONS REPRESENT APPROXIMATELY 12% OF THE TOTAL POPULATION. WHILE MINORITY GROUPS HAVE INCREASED IN NUMBER, THEY STILL REPRESENT A VERY SMALL, BUT INCREASING, PORTION OF THE POPULATION. STARK COUNTY IS ALSO RACIALLY AND ETHNICALLY SEGREGATED. MINORITIES LIVE IN POCKETS WITHIN THE COUNTY. THE URBAN AREAS OF STARK COUNTY (ALLIANCE, CANTON, AND MASSILLON) HAVE A MUCH HIGHER PERCENTAGE OF MINORITIES THAN THE SUBURBAN AREAS OF THE COUNTY.AGE: THE POPULATION IN STARK COUNTY, LIKE THAT OF THE STATE AND THE NATION, IS AGING. THE MEDIAN AGE IN STARK COUNTY IS 41.8 YEARS OLD WHICH IS 2.4 YEARS OLDER THAN THE STATE MEDIAN AGE AND 3.7 YEARS OLDER THAN THE NATIONAL MEDIAN AGE. THE 65 AND OLDER POPULATION, REPRESENTS 18.1 PERCENT OF THE POPULATION IN 2018.INCOME: STARK COUNTY'S STANDARD MEASURES OF INCOME (PER CAPITA, MEDIAN FAMILY AND MEDIAN HOUSEHOLD) ARE BELOW THAT OF THE STATE AS WELL AS THE NATION. THE MEDIAN HOUSEHOLD INCOME IN STARK COUNTY IS $50,117 AS COMPARED TO THE STATE OF OHIO OF $52,407. THE 2017 MEDIAN HOUSEHOLD INCOME FOR THE UNITED STATES WAS $61,372.EMPLOYMENT: UNEMPLOYMENT HAS CONSISTENTLY REMAINED AT APPROXIMATELY 4% TO 5% WITHIN STARK COUNTY SINCE 2014. PHYSICAL HEALTH: THE ENVIRONMENT, NUTRITION, ACCIDENTS, ILLNESS AND AGE ARE FACTORS THAT AFFECT PHYSICAL HEALTH. A HIGHER INFANT MORTALITY RATE IN THE AFRICAN-AMERICAN POPULATION AND AN INCREASE IN SEXUALLY TRANSMITTED INFECTIONS (STIS) ARE NEGATIVE TRENDS THAT ARE EMERGING LOCALLY. IN STARK COUNTY THERE ARE SIGNIFICANT DISPARITIES BETWEEN THE CAUCASIAN AND AFRICAN-AMERICAN POPULATIONS INCLUDING PRENATAL CARE, BIRTH WEIGHTS, INFANT MORTALITY RATES, AND STIS. HEALTH DISPARITIES ARE DIFFERENCES THAT CAN BE SEEN IN SPECIFIC POPULATIONS OF A COMMUNITY IN RELATIONS TO DISEASES, HEALTH OUTCOMES OR QUALITY OF HEALTH CARE RECEIVED. SEVERAL VARIABLES IMPACTING DISPARITIES ARE HEALTH BEHAVIORS, STATUS BEFORE CARE, ACCESS TO HEALTHCARE AND HEALTH CARE DELIVERY.BEHAVIORAL HEALTH: BEHAVIORAL HEALTH INCLUDES MENTAL HEALTH, SUBSTANCE ABUSE TREATMENT AND PREVENTION SERVICES. MANY AFFECTED WITH MENTAL ILLNESS DO NOT SEEK OR RECEIVE THE TREATMENT NEEDED. BARRIERS TO ACCESSING TREATMENT INCLUDE STIGMA, LACK OF OR INADEQUATE INSURANCE COVERAGE, LIMITED PROGRAM CAPACITY AND WAIT TIME. THE HIGHEST RATES OF MENTAL ILLNESS ARE AMONG ADULTS AGED 25 TO 34 YEARS OLD. DEPRESSIVE, BIPOLAR, ANXIETY, ALCOHOL ABUSE AND OPIOID USE DISORDERS ARE THE MOST FREQUENT DIAGNOSES AMOUNG ADULTS. THE LEADING DIAGNOSES FOR CHILDREN ARE ADJUSTMENT, CONDUCT, ATTENTION DEFICIT, ANXIETY AND DEPRESSIVE DISORDERS. UNINTENTIONAL DRUG OVERDOSE DEATHS CONTINUE TO BE A CONCERN, WHILE UNINTENDED INTERACTIONS ARE A CAUSE OF DEATH, MOST POISONINGS SEEM TO LINKED TO RECREATIONAL USE.STARK COUNTY, OHIO EXPERIENCED 12 SUICIDES AMONG MIDDLE AND HIGH SCHOOLS STUDENTS BETWEEN AUGUST OF 2017 AND MARCH OF 2018. THIS WAS MORE THAN SEVEN TIMES THE NATIONAL RATE AND 11 TIMES THE 2011-2016 COUNTY RATE. IN ORDER TO BETTER UNDERSTAND ELEMENTS CONTRIBUTING TO SUICIDE AMOUNG ADOLESCENTS AND TO EXAMINE FACTORS CONTRIBUTING TO INCREASED SUICIDAL BEHAVIORAL IN STARK COUNTY, A COLLABORATIVE PUBLIC HEALTH INITIATIVE WAS INITIATED.ACCESS TO HEALTHCARE: AS THE COST OF HEALTH INSURANCE CONTINUES TO RISE, THE DEMAND FOR HEALTHCARE SERVICES AT A FREE/SLIDING FEE IS INCREASING. MORE THAN 27,322 STARK COUNTY RESIDENTS ARE WITHOUT HEALTH INSURANCE AND THE NUMBER OF INDIVIDUALS WHO ARE UNDERINSURED CONTINUES TO INCREASE. OF CONCERN ARE THE INDIVIDUALS BETWEEN THE AGE OF 30 AND 64 WITH CHRONIC MEDICAL PROBLEMS WHO HAVE DIFFICULTY MAINTAINING EMPLOYMENT BUT ARE NOT MEDICALLY DISABLED. EVEN IF AN INDIVIDUAL IS MEDICAID ELIGIBLE, FEW HEALTHCARE PROVIDERS, ESPECIALLY SPECIALISTS, ARE WILLING TO ACCEPT NEW MEDICAID PATIENTS. HAVING INSURANCE DOES NOT GUARANTEE EASY ACCESS TO AFFORDABLE, QUALITY CARE. BUSINESSES THAT OFFER HEALTH INSURANCE HAVE INCREASED THE EMPLOYEE PREMIUM CONTRIBUTION AND/OR INCREASED THE DEDUCTIBLE PAID BY THE EMPLOYEE, OFTEN MAKING MEDICAL COVERAGE MORE DIFFICULT TO AFFORD. IN TERMS OF OUR SECONDARY MARKETS, CARROLL COUNTY HAD A POPULATION OF 27,081 AND TUSCARAWAS COUNTY HAD A POPULATION OF 92,176.
PART VI, LINE 5:	THE MAJORITY OF THE BOARD MEMBERS OF MERCY MEDICAL CENTER RESIDE IN OUR SERVICE AREA AND ARE NOT EMPLOYED OR CONTRACTED BY THE HOSPITAL. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY WHO MEET THE HOSPITAL'S CREDENTIALING CRITERIA. MERCY PROVIDES AN EXTENSIVE CONTINUING MEDICAL EDUCATION PROGRAM EACH YEAR, GOVERNED BY THE HOSPITAL'S CME COMMITTEE. APPROXIMATELY 620 PHYSICIANS AND DENTISTS ARE ON MERCY'S MEDICAL STAFF. MERCY EMPLOYS APPROXIMATELY 2,500 PEOPLE, INCLUDING MERCY PROFESSIONAL CARE CORPORATATION NETWORK OF PHYSICIANS. MERCY IS A TEACHING HOSPITAL AFFILIATED WITH NORTHEAST OHIO MEDICAL UNIVERSITY (NEOMED). OUR HOSPITAL HAS 475 LICENSED ADULT BEDS, A LEVEL II TRAUMA CENTER AND EMERGENCY DEPARTMENT THAT TREATED OVER 63,800 PATIENT VISITS, AN ACCREDITED EMERGENCY CHEST PAIN CENTER (ECPC) WITH A DEDICATED, STATE-OF-THE-ART HEART CATHETERIZATION LABORATORY LOCATED RIGHT IN THE ECPC.CENTERS OF EXCELLENCE INCLUDE MERCY HEART CENTER, MERCY CANCER CENTER, MERCY DENTAL SERVICES, MERCY ORTHOPEDIC CENTER, SURGERY CENTER, REGIONAL REHABILITATION CENTER, PRIMARY STROKE PROGRAM, AND BREAST CARE CENTER. THE HOSPITAL CONTINUES TO PROVIDE RICH COMMUNITY BENEFIT PROGRAMMING. TO DO SO IN THE CURRENT CHALLENGING HEALTH CARE ENVIRONMENT DEMONSTRATES A TRUE COMMITMENT AND ANSWER TO COMMUNITY NEEDS.
PART VI, LINE 6:	THE MEDICAL CENTER IS OWNED BY THE SISTERS OF CHARITY OF ST. AUGUSTINE HEALTH SYSTEM (SCHS). THEY OPERATE TWO HOSPITALS IN OHIO. THE SCHS HAS THREE FOUNDATIONS THAT WERE ESTABLISHED IN 1996 WITH FUNDS FROM THE SALES OF HOSPITALS IN OHIO AND SOUTH CAROLINA. THROUGH STRATEGIC GRANTMAKING, CONVENINGS AND COLLABORATION, EACH OF THE THREE FOUNDATIONS WORK TO ADDRESS ROOT CAUSES OF POVERTY, NURTURE THE GROWTH OF HEALTHY COMMUNITITIES, EMPHASIZE THE NEEDS OF YOUTH AND FAMILIES AND MEASURE THE OUTCOMES OF THESE EFFORTS.THE SCHS ALSO HAS NUMEROUS OTHER PROGRAMS AIMED AT IDENTIFYING AND ANSWERING UNMET AND EMERGING COMMUNITY NEEDS. THESE ORGANIZATIONS HAVE EVOLVED TO MEET EVER-CHANGING COMMUNITY NEEDS, CLINICAL PRACTICES AND TECHNOLOGY WITH A SHARED COMMITMENT TO REPRESENT THE COMPASSION AND EXCELLENCE THAT DISTINGUISHES CATHOLIC HEALTH CARE.THE MEDICAL CENTER HAS A FOR PROFIT PHYSICIAN GROUP. MERCY PROFESSIONAL CARE CORPORATION EMPLOYS PRIMARY CARE AND SPECIALIST PHYSICIANS WHO HAVE OFFICES IN SURROUNDING TOWNSHIPS AND COUNTIES OF THE MEDICAL CENTER AS WELL AS IN SOME UNDERSERVED AREAS OF CANTON. THE MEDICAL CENTER FUNDED THE $8.6M LOSS THIS PHYSICIAN GROUP INCURRED IN 2018.MERCY DEVELOPMENT FOUNDATION BEGAN OPERATING AS THE PHILANTHROPIC ARM OF MERCY MEDICAL CENTER ON SEPTEMBER 24, 2011. THE SOLE PURPOSE OF THE FOUNDATION IS TO CREATE, IMPLEMENT, MAINTAIN, AND STEWARD DONORS AND ORGANIZATIONS, AND TO ENCOURAGE A COMPRESHENSIVE FUNDRAISING PROGRAM TO MAXIMIZE PHILANTHROPIC SUPPORT FOR MERCY MEDICAL CENTER (HOSPITAL). THE FOUNDATION OPERATIONS PROVIDES SERVICES FOR SOLICITATION, RECEIPTING, RECORDING, AND MANAGING OF ALL PHILANTHROPIC CONTRIBUTIONS MADE TO AND FOR THE BENEFIT OF THE HOSPITAL.

Schedule H (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
MERCY MEDICAL CENTER INC

Employer identification number
34-1893439

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	(f) Method of valuation (book, FMV, appraisal, other)	(h) Purpose of grant or assistance
(1) AMERICAN CANCER SOCIETY 525 NORTH BROAD STREET CANFIELD,OH44406	13-1788491	501 C (3)	10,000		RELAY FOR LIFE CORPORATE SPONSORSHIP
(2) AMERICAN HEART ASSOCIATION PO BOX 4002907 DES MOINES,LA503402907	13-5613797	501 C (3)	6,500		SPONORSHIPS
(3) ARTS IN STARK 1001 MARKET AVE N CANTON,OH44702	34-6609771	501 C (3)	7,000		CORPORATE CONTRIBUTION-ANNUAL ARTS CAMPAIGN
(4) CANTON REGIONAL CHAMBER OF COMMERCE 222 MARKET AVE N CANTON,OH44702	34-0129930	501 C (6)	55,250		PRO-FOOTBALL HALL OF FAME ENSHRINEMENT FESTIVAL BALLOON CLASSIC AND VARIOUS SPONSORHSIPS
(5) NORTH CANTON CITY SCHOOLS 525 E 7TH ST NORTH CANTON,OH44720	34-6002035		16,500		SPONSORSHIP
(6) COPLEY OHIO NEWPAPERS INC (DBA REPOSITORY) 500 MARKET AVE S CANTON,OH44702	31-1714372		10,000		COMMUNITY EDUCATION - HERION AWARENESS
(7) STARK DEVELOPMENT BOARD 400 3RD STREET SE SUITE 310 CANTON,OH44702	34-1476938	501 C (3)	12,000	BOOK	CORPORATE CONTRIBUTION-3 YEAR PLEDGE
(8) UNITED WAY OF GREATER STARK COUNTY 401 MARKET AVE N CANTON,OH44702	13-4254191	501 C (3)	40,000		CORPORATE CONTRIBUTION
(9) WOMEN'S IMPACT INC PO BOX 35152 CANTON,OH447355152	32-0384984	501 C (3)	5,440		SPONSORSHIP

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) 2018

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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash 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:	MERCY MEDICAL CENTER DOES NOT AWARD GRANT FUNDING. IT DOES PROVIDE SUPPORT FOR LOCAL ORGANIZATIONS AS PART OF ITS' COMMUNITY RELATIONS. IF SPONSORSHIPS ARE FOR NATIONAL ORGANIZATIONS, THEY MUST BE CENTERED ON A LOCAL OR REGIONAL EVENT.

Schedule I (Form 990) 2018

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

MERCY MEDICAL CENTER INC

Employer identification number

34-1893439

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 .........

Yes

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? ..

Yes

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 nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

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) 2018

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)
1MELISSA ROGERS DIRECTOR	(i) (ii)	0 ------------- 430,419	0 ------------- 127,065	0 ------------- 2,200	0 ------------- 45,842	0 ------------- 19,400	0 ------------- 624,926	0 ------------- 0
2THOMAS J STRAUSS DIRECTOR	(i) (ii)	0 ------------- 1,108,266	0 ------------- 0	0 ------------- 22,098	0 ------------- 45,865	0 ------------- 14,725	0 ------------- 1,190,954	0 ------------- 0
3DAVID STEWART SENIOR VICE PRESIDENT-CFO	(i) (ii)	0 ------------- 340,068	0 ------------- 0	0 ------------- 3,170	0 ------------- 27,852	0 ------------- 14,200	0 ------------- 385,290	0 ------------- 0
4DAVID GORMSEN CHIEF MEDICAL OFFICER	(i) (ii)	274,524 ------------- 0	0 ------------- 0	3,460 ------------- 0	26,832 ------------- 0	18,932 ------------- 0	323,748 ------------- 0	0 ------------- 0
5CINDY HICKEY VICE PRES-PUBLIC RELATIONS	(i) (ii)	134,247 ------------- 0	0 ------------- 0	2,648 ------------- 0	11,791 ------------- 0	21,330 ------------- 0	170,016 ------------- 0	0 ------------- 0
6JEFFREY PIKE VICE PRES-PHY RELATIONS &	(i) (ii)	217,603 ------------- 0	67,504 ------------- 0	1,296 ------------- 0	13,000 ------------- 0	29,553 ------------- 0	328,956 ------------- 0	0 ------------- 0
7THOMAS TURNER VICE PRES-FUND DEVELOPMENT	(i) (ii)	211,596 ------------- 0	0 ------------- 0	4,879 ------------- 0	18,026 ------------- 0	32,237 ------------- 0	266,738 ------------- 0	0 ------------- 0
8BARBARA I YINGLING VICE PRESIDENT & CNO	(i) (ii)	228,138 ------------- 0	0 ------------- 0	934 ------------- 0	21,845 ------------- 0	15,778 ------------- 0	266,695 ------------- 0	0 ------------- 0
9AHMED EL GHAMRY SABE EXEC DIRECTOR-CARDIOLOGY	(i) (ii)	486,111 ------------- 0	280,285 ------------- 0	15,498 ------------- 0	28,835 ------------- 0	40,898 ------------- 0	851,627 ------------- 0	0 ------------- 0
10ANDREW M WOJKOWSKI DIRECTOR, DENTAL SERVICES	(i) (ii)	195,899 ------------- 0	0 ------------- 0	14,968 ------------- 0	13,195 ------------- 0	13,123 ------------- 0	237,185 ------------- 0	0 ------------- 0
11JUSTIN MODUGNO DENTIST	(i) (ii)	171,914 ------------- 0	0 ------------- 0	12,262 ------------- 0	9,377 ------------- 0	20,338 ------------- 0	213,891 ------------- 0	0 ------------- 0
12TASLIMA M SHAIKH PHYSICIAN	(i) (ii)	171,412 ------------- 0	0 ------------- 0	126 ------------- 0	5,477 ------------- 0	6,759 ------------- 0	183,774 ------------- 0	0 ------------- 0
13KYLE SOBECKI DIRECTOR-PHARMACY SERVICES	(i) (ii)	138,367 ------------- 0	0 ------------- 0	583 ------------- 0	8,418 ------------- 0	25,747 ------------- 0	173,115 ------------- 0	0 ------------- 0
14RICHARD UNSWORTH SENIOR PHARMACIST	(i) (ii)	135,712 ------------- 0	1,470 ------------- 0	2,254 ------------- 0	11,961 ------------- 0	15,916 ------------- 0	167,313 ------------- 0	0 ------------- 0
15THOMAS CECCONI FORMER-DIRECTOR, PRESIDENT & CEO	(i) (ii)	0 ------------- 98,392	0 ------------- 0	0 ------------- 455,212	0 ------------- 21,925	0 ------------- 13,725	0 ------------- 589,254	0 ------------- 0
16DAVID CEMATE FORMER-SR. VICE PRESIDENT-COO	(i) (ii)	0 ------------- 0	0 ------------- 0	289,689 ------------- 0	0 ------------- 0	15,458 ------------- 0	305,147 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2018

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	THE REVIEW AND APPROVAL OF EXECUTIVE COMPENSATION IS THE RESPONSIBILITY OF THE BOARD. THIS THEN IS SUBJECT TO REVIEW BY THE MEMBER SISTERS OF CHARITY HEALTH SYSTEM. THE BOARD USES REPORTS FROM INDEPENDENT COMPENSATION CONSULTANTS, SURVEYORS OR STUDIES TO ASSIST IN THE REVIEW. IN MOST CASES, THESE REPORTS ARE OBTAINED FROM THE SAME SOURCES USED BY THE MEMBER.
PART I, LINES 4A-B	THOMAS CECCONI RECEIVED A TWO YEAR TERMINATION AGREEMENT FOR 2018 & 2019. THE TOTAL AMOUNT OF THIS AGREEMENT IS FOR $980,398. DAVID CEMATE ALSO RECEIVED AN 18 MONTH TERMINATION AGREEMENT STARTING IN SEPTEMBER OF 2018. THE TOTAL AMOUNT OF THIS AGREEMENT IS FOR $465,768. SUPPLEMENTAL EXECUTIVE RETIREMENT PAYMENTS (SERP) WERE MADE BY THE RELATED ORGANIZATION TO MELISSA ROGERS ($18,500), THOMAS STRAUSS ($18,500) AND PAUL HILTZ ($6,370). THERE IS ALSO A 457 PLAN AND DAVID GORMSEN AND AHMED EL GHAMRY SABE PARTICIPATED IN 2018. EACH ONE INDIVIDUALLY CONTRIBUTED $18,500 INTO THE PLAN.
PART I, LINE 7	CERTAIN EXECUTIVE OFFICERS WERE AWARDED DISCRETIONARY BONUSES AND A SUPPLEMENTAL INSURANCE POLICY. ALL BONUSES ARE APPROVED BY THE SCHS BOARD MEMBERS.

Schedule J (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
MERCY MEDICAL CENTER INC

Employer identification number
34-1893439

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CLEVELAND-CUYAHOGA COUNTY PORT AUTHORITY	34-1029691		05-18-2016	35,000,000	REFINANCING SERIES 2000 BONDS		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	35,000,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............	35,000,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X
15 Were the bonds issued as part of an advance refunding issue? .....		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X

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

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %
6 Total of lines 4 and 5 .............	0 %
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...	X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......
b Exception to rebate? ........
c No rebate due? .........
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part Ⅵ

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

Return Reference	Explanation

Schedule K (Form 990) 2018

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

MERCY MEDICAL CENTER INC

Employer identification number

34-1893439

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) 2018

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) STARK COUNTY ER PHYSICIANS	CHIEF MED. OFFICER	1,409,710	PHYSICIANS		No
(2) BRENNAN MANNA & DIAMOND LLC	MATTHEW HEINLE, SR. VICE PRESIDENT & GENERAL COUNSEL	102,048	LEGAL SERVICES		No

Part V

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

Return Reference

Explanation

FORM 990, PART IV

(A) NAME OF PERSON: STARK COUNTY EMERGENCY PHYSICIANS(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DAVID GORMSEN, CHIEF MEDICAL OFFICER, IS A SHAREHOLDER OF STARK COUNTY EMERGENCY PHYSICIANS.(C) DESCRIPTION OF TRANSACTION: STARK COUNTY EMERGENCY PHYSICIANS PROVIDES MERCY MEDICAL CENTER WITH PHYSICIAN COVERAGE AT AN URGENT CARE CENTER AND THE EMERGENCY ROOM DEPARTMENT. THESE TRANSACTIONS WERE DONE AT ARM'S LENGTH.

Schedule L (Form 990 or 990-EZ) 2018

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

MERCY MEDICAL CENTER INC

Employer identification number

34-1893439

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	THE SISTERS OF CHARITY HEALTH SYSTEM IS THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	UNDER MERCY MEDICAL CENTER'S ORGANIZATION DOCUMENTS, SISTERS OF CHARITY HEALTH SYSTEM'S BOARD OF DIRECTORS APPOINTS ALL MEMBERS OF MERCY MEDICAL CENTER'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	CERTAIN DECISIONS OF THE GOVERNING BODY MUST BE APPROVED BY THE SISTERS OF CHARITY OF ST. AUGUSTINE HEALTH SYSTEM, INC. EXAMPLES OF SOME OF THESE DECISIONS WOULD BE APPROVALS OF ANNUAL BUDGET, PURCHASE OF LAND, UNBUDGETED CAPITAL OVER A CERTAIN THRESHOLD AND LONG TERM LEASES.
FORM 990, PART VI, SECTION B, LINE 11B	AFTER FORM 990 IS COMPLETED AND REVIEWED INTERNALLY, IT IS SUBMITTED TO OUR AUDITORS FOR THEIR REVIEW. THEY REVIEW IT FOR COMPLETENESS AS WELL AS ANY CONCERNS THAT THEY IDENTIFY WITHIN THE DOCUMENTS AND WORKSHEETS OF THE TAX SOFTWARE. IF THEY IDENTIFY ITEMS THAT NEED ATTENTION, THE STAFF WOULD REVIEW THE APPROPRIATE ITEMS AND MAKE THE NEEDED CORRECTIONS. THE RETURN IS THEN PROVIDED TO THE CFO FOR HIS REVIEW AND APPROVAL. THE RETURN IS MADE AVAILABLE TO THE FULL BOARD THROUGH A WEB PORTAL THAT THEY CAN ACCESS BEFORE IT IS FILED WITH THE IRS. ANY QUESTIONS OR CONCERNS THAT THEY WOULD HAVE ARE SENT TO EITHER THE PRESIDENT OR CHIEF FINANCIAL OFFICER OF THE MEDICAL CENTER.
FORM 990, PART VI, SECTION B, LINE 12C	MERCY MEDICAL CENTER HAS 17 COMPLIANCE POLICIES AND PROCEDURES THAT ESTABLISH BRIGHT-LINE RULES TO HELP EMPLOYEES CARRY OUT THEIR JOB FUNCTIONS IN A MANNER THAT ENSURES COMPLIANCE WITH APPLICABLE LAWS AND REGULATIONS AND FURTHERS MERCY'S MISSION. WRITTEN COMPLIANCE POLICIES AND PROCEDURES HAVE BEEN IMPLEMENTED THROUGHOUT MERCY, INCLUDING LEGAL, BILLING, CLINICAL AREAS, FINANCE, ETC. THERE ARE ROUTINE AUDITS TO VALIDATE THE EFFECTIVENESS OF THESE INTERNAL POLICIES. OUR ADMINISTRATIVE DIRECTOR OF LABORATORIES IS OUR CHIEF COMPLIANCE OFFICER. IT IS HER RESPONSIBILITY TO MONITOR OUR COMPLIANCE PROGRAM. SHE REPORTS DIRECTLY TO THE AUDIT AND COMPLIANCE COMMITTEE WHO REPORTS TO THE BOARD. TWO COMPLIANCE COMMITTEES (OPERATIONS & ADMINISTRATION) SUPPORT THIS POSITION. A COMPLETE SET OF OUR COMPLIANCE POLICIES CAN BE FOUND ON MERCY'S INTRANET WHICH IS AVAILABLE TO ALL EMPLOYEES. YEARLY TRAINING IS DONE FOR ALL EMPLOYEES AND QUARTERLY UPDATES GIVEN TO THE BOARD THROUGH THE BOARD'S JOINT AUDIT & COMPLIANCE COMMITTEE. HANDBOOKS WERE DEVELOPED TO AID IN THE COMMUNICATION AND UNDERSTANDING OF OUR COMPLIANCE POLICIES. MERCY MEDICAL CENTER SET UP EFFECTIVE LINES OF COMMUNICATION TO REPORT A SUSPECTED COMPLIANCE VIOLATION, SUCH AS A HOTLINE. THE HOTLINE RECEIVES COMPLAINTS AND CONCERNS WHILE PROTECTING WHISTLEBLOWERS FROM RETAILIATION. THE HOTLINE NUMBER IS POSTED AT ALL TIME CLOCKS AND IN THE MONTHLY EMPLOYEE NEWSLETTER. A SYSTEM WIDE STANDARDIZED "CODE OF CONDUCT AND ETHICAL BEHAVIOR" BOOKLET IS AVAILABLE FOR ALL SYSTEM HOSPITALS. THIS BOOKLET IS REVIEWED AND REVISED BY THE SISTERS OF CHARITY HEALTH SYSTEM. THIS BOOKLET IS AVAILABLE TO ALL EMPLOYEES THROUGH THE INTRANET AT EACH FACILITY. EDUCATION IS ALSO PROVIDED TO THE BOARD OF TRUSTEES BY OUR IN-HOUSE LEGAL COUNSEL. AS PART OF THIS TRAINING, EACH BOARD MEMBER RECEIVED A COPY OF THE REVISED CODE OF CONDUCT AND ETHICAL BEHAVIOR BOOKLET THAT IS HANDED OUT TO OUR EMPLOYEES. YEARLY, THE MEMBERS COMPLETE CONFLICT AND DISCLOSURE STATEMENTS THAT ARE REVIEWED BY OUR LEGAL DEPARTMENT.
FORM 990, PART VI, SECTION B, LINE 15	THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS SERVES AS THE EXECUTIVE COMPENSATION COMMITTEE. IT IS THEIR RESPONSIBILITY TO REVIEW THE COMPENSATION AND BENEFITS FOR THE CEO AND ALL VICE PRESIDENTS. THE RECOMMENDATIONS FOR SALARY CHANGES ARE BASED ON THE ANNUAL PERFORMANCE EVALUATIONS OF EACH EXECUTIVE. BONUS CONSIDERATIONS REFLECT INDIVIDUAL PERFORMANCE ON THE JOB AS WELL AS HOW THE HOSPITAL DID IN MEETING QUALITY, MISSION AND FINANCIAL GOALS. ALL SALARY RANGES AND BENEFITS FOR OFFICERS ARE EVALUATED ANNUALLY BY MERCER CONSULTING AND ANY CHANGES ARE SUBJECT TO BOARD REVIEW AND APPROVAL. THE COMMITTEE DETERMINES WHETHER IT WISHES TO ACCEPT THE CEO'S RECOMMENDATIONS OR OFFER ITS OWN SUGGESTIONS REGARDING THE POSITIONS THAT REPORT TO HIM. THE COMMITTEE VOTES TO APPROVE ANY CHANGES WHICH ARE THEN IMPLEMENTED BY THE HOSPITAL. THAT SAME COMMITTEE ALSO DETERMINES THE CEO'S COMPENSATION AND BONUS. THEY MEET WITH THE CEO TO REVIEW HIS PERFORMANCE ON AN ANNUAL BASIS. THEY THEN MEET WITHOUT THE CEO PRESENT TO FURTHER DISCUSS AND OPENLY CRITIQUE HIS PERFORMANCE. IT IS DURING THEIR EXECUTIVE SESSIONS THAT THEY DETERMINE WHETHER ANY ADJUSTMENT IN COMPENSATION WILL BE MADE THAT YEAR AND ALSO DETERMINES THE AWARDING OF ANY BONUS. IN THE EVALUATION OF THE CEO, THE COMMITTEE USES THE SAME INDEPENDENT AGENCY, MERCER CONSULTING, TO EVALUATE THE CEO'S TOTAL COMPENSATION RANGE AS WELL AS ALL BENEFITS.
FORM 990, PART VI, SECTION C, LINE 18	FORM 990, 990T & FORM 1023 ARE AVAILABLE UPON REQUEST
FORM 990, PART VI, SECTION C, LINE 19	FINANCIAL STATEMENTS, THE CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST
FORM 990, PART IX, LINE 11G	OTHER CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 29,795,125. MANAGEMENT AND GENERAL EXPENSES 4,866,325. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,661,450.
FORM 990, PART XI, LINE 9:	CASH TRANSFER TO MERCY PROFESSIONAL CARE CORP -9,935,339. CASH TRANSFER FROM MERCY DEVELOPMENT FOUNDATION 679,260. DONATED CAPITAL 380,612. NET ASSETS CHANGE FROM RESTRICTION 8,848. DISTRIBUTIONS FROM MERCY MEDICAL CENTER HOME HOME HEALTH & HOSPICE LLC 1,044,000.
FORM 990, PART XII, LINE 2C:	THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT HAS BEEN CHARGED WITH OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTING FIRM. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
PART III LINE 4A	CONTINUATION OF ACCOMPLISHMENTS COMMUNITY BENEFIT REPORT BOARD MEMBERS, LEADERS, CAREGIVERS, EMPLOYEES AND FRIENDS OF THE HEALTH SYSTEM AND OUR MINISTRIES PARTICIPATED IN A SERIES OF MEETINGS. THE COMMUNITY BENEFIT ENCOMPASSES OUR: COSTS FOR ASSISTING PATIENTS WHO ARE UNABLE TO FULLY PAY FOR THEIR CARE; COMMUNITY OUTREACH SERVICES; CONTRIBUTIONS TO SUPPORT OUR COMMUNITY PARTNERS AND OTHER NON-PROFIT ORGANIZATIONS; COVERING THE GAP BETWEEN THE EXPENSE OF PROVIDING CARE TO MEDICAID PATIENTS AND THE REIMBURSEMENT WE RECEIVE. OUR COLLECTIVE MISSION RESPONDS TO THE NEEDS OF THE PEOPLE WE SERVE IN WAYS LIKE NO ONE ELSE. WE HAVE A BOLD VISION TO BE A BEACON OF HOPE DEVOTED TO HEALING AND ADDRESSING THE UNMET NEEDS OF INDIVIDUALS, FAMILIES AND COMMUNITIES THROUGH A NETWORK OF INNOVATIVE SERVICES.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

MERCY MEDICAL CENTER INC

Employer identification number

34-1893439

Part I

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

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)SISTERS OF CHARITY OF ST AUGUSTINE HEALTH SYSTEM INC (SCHS) 2475 EAST 22ND ST CLEVELAND,OH44115 34-1379356	CHARITABLE ORGANIZATION	OH	501 (C) (3)	12A	N/A		No
(2)SISTERS OF CHARITY OF ST AUGUSTINEROMAN CATHOLIC CHURCH 5232 BROADVIEW ROAD RICHFIELD,OH44286 34-0714763	RELIGIOUS ORDER OF WOMEN	OH	501 (C) (3)	1	N/A		No
(3)SCPH LEGACY CORP (PHLC) 2475 EAST 22ND ST CLEVELAND,OH44115 57-0314409	CHARITABLE ORGANIZATION	OH	501 (C) (3)	12A	SCHS	Yes
(4)PROVIDENCE HOSPITALS DEVELOPMENT FOUNDATION 2475 EAST 22ND ST CLEVELAND,OH44115 27-1140183	CHARITABLE ORGANIZATION	SC	501 (C) (3)	12A	PHLC	Yes
(5)REGINA HEALTH CENTER 5232 BROADVIEW ROAD RICHFIELD,OH44286 34-1722394	RETIREMENT COMMUNITY	OH	501 (C) (3)	10	SCHS	Yes
(6)ST VINCENT CHARITY MEDICAL CENTER (SVCMC) 2351 EAST 22ND STREET CLEVELAND,OH44115 34-0714756	HOSPITAL	OH	501 (C) (3)	3	SCHS	Yes
(7)ST VINCENT CHARITY DEVELOPMENT FOUNDATION 2351 EAST 22ND STREET CLEVELAND,OH44115 27-1602445	CHARITABLE ORGANIZATION	OH	501 (C) (3)	12A	SVCMC	Yes
(8)MERCY DEVELOPMENT FOUNDATION 1320 MERCY DRIVE NW CANTON,OH44708 35-2408321	CHARITABLE ORGANIZATION	OH	501 (C) (3)	12A	MERCY MEDICAL CENTER	Yes
(9)ST JOHN HOSPTIAL 2475 EAST 22ND ST CLEVELAND,OH44115 34-0714504	CHARITABLE ORGANIZATION	OH	501 (C) (3)	12A	SCHS	Yes
(10)HEALTHY LEARNERS 2749 LAUREL STREET COLUMBIA,SC29204 57-1127197	CHARITABLE ORGANIZATION	SC	501 (C) (3)	12A	SCHS	Yes
(11)JOSEPH'S HOME 2412 COMMUNITY COLLEGE AVENUE CLEVELAND,OH44115 34-0901676	CHARITABLE ORGANIZATION	OH	501 (C) (3)	10	SCHS	Yes
(12)SISTERS OF CHARITY FOUNDATION OF CLEVELAND 2475 EAST 22ND ST FOURTH FLOOR CLEVELAND,OH44115 34-1832698	CHARITABLE ORGANIZATION	OH	501 (C) (3)	12A	SCHS	Yes
(13)SISTERS OF CHARITY FOUNDATION OF CANTON ( 400 MARKET AVE N STE 300 CANTON,OH44702 34-1832697	CHARITABLE ORGANIZATION	OH	501 (C) (3)	12A	SCHS	Yes
(14)EARLY CHILDHOOD RESOURCE CENTER 1718 CLEVELAND AVENUE NW CANTON,OH44703 34-0714462	CHARITABLE ORGANIZATION	OH	501 (C) (3)	12A	SISTERS OF CHARITY FDN OF CANTON	Yes
(15)SISTERS OF CHARITY FOUNDATION OF SC 2711 MIDDLEBURG DRIVE SUITE 115 COLUMBIA,SC29204 57-0708391	CHARITABLE ORGANIZATION	SC	501 (C) (3)	12A	SCHS	Yes
(16)SOUTH CAROLINA CENTER FOR FATHERS AND FAMILIES 2711 MIDDLEBURG DRIVE SUITE 111 COLUMBIA,SC29204 36-4506347	CHARITABLE ORGANIZATION	SC	501 (C) (3)	7	SISTERS OF CHARITY FOUNDATION OF SC	Yes
(17)LIGHT OF HEARTS VILLA 283 UNION ST BEDFORD,OH44146 36-1619270	CHARITABLE ORGANIZATION	OH	501 (C) (3)	12A	SCHS	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

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) MERCY MEDICAL CENTER HOME HEALTH & HOSPICE LLC 4369 WHIPPLE AVE NW CANTON,OH44178 81-0687167	MEDICAL SERVICES	OH	MERCY MEDICAL CENTER INC	RELATED	883,140	1,688,956		No			No	60.000 %

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) MERCY PROFESSIONAL CARE CORPORATION 1320 MERCY DR NW CANTON,OH44708 34-1873008	MEDICAL SERVICES	OH	MERCY MEDICAL CENTER	C	-8,674,971	2,179,019	100.000 %	Yes
(2) SCHS INSURANCE CO LTD 62 FORUM LANE-3RD FLOOR GRAND CAYMAN KY1-1203 CJ 98-0679825	INSURANCE	CJ	N/A	C				Yes
(3) ST VINCENT MEDICAL GROUP 2475 EAST 22ND STREET CLEVELAND,OH44115 34-1634990	MEDICAL SERVICES	OH	N/A	C				Yes

Schedule R (Form 990) 2018

Page 3

Part V

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

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

Yes

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

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

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

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) MERCY PRFOESSIONAL CARE CORPORATION	R	9,935,339	BOOK
(2) MERCY MEDICAL CENTER HOME HEALTH & HOSPICE LLC	C	1,044,000	BOOK
(3) MERCY DEVELOPMENT FOUNDATION	O	55,939	BOOK
(4) MERCY DEVELOPMENT FOUNDATION	S	679,260	BOOK
(5) MERCY DEVELOPMENT FOUNDATION	C	324,063	BOOK
(6) MERCY PRFOESSIONAL CARE CORPORATION	J	171,589	BOOK

Schedule R (Form 990) 2018

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) 2018

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) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE SERVICES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	3,009
6	Total number of volunteers (estimate if necessary) .............	6	274
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,103,653
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	981,406	757,660
9	Program service revenue (Part VIII, line 2g) .........	289,518,329	314,503,829
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	640,589	682,958
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	8,654,726	8,537,929
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	299,795,050	324,482,376
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	183,750	162,690
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)	146,603,209	142,442,218
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	167,266,413	176,466,653
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	314,053,372	319,071,561
19	Revenue less expenses. Subtract line 18 from line 12.......	-14,258,322	5,410,815
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	185,490,079	177,901,246
21	Total liabilities (Part X, line 26).............	127,790,529	123,255,041
22	Net assets or fund balances. Subtract line 21 from line 20.....	57,699,550	54,646,205

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 295,283,186 including grants of $ 162,690 ) (Revenue $ 314,712,732 )
	MERCY MEDICAL CENTER, A MINISTRY OF THE SISTERS OF CHARITY HEALTH SYSTEM, OPERATES A 476-BED HOSPITAL SERVICE STARK, CARROLL, WAYNE, HOLMES AND TUSCARAWAS COUNTIES AND PARTS OF SOUTHEASTERN OHIO. IT HAS 650 MEMBERS ON ITS MEDICAL STAFF AND EMPLOYS OVER 2,500 PEOPLE. MERCY OPERATES OUTPATIENT HEALTH CENTERS IN ALLIANCE, CARROLL COUNTY, JACKSON TOWNSHIP, LAKE TOWNSHIP, LOUISVILLE, MASSILLON, NORTH CANTON, PLAIN TOWNSHIP AND TUSCARAWAS COUNTY. A CATHOLIC HOSPITAL, MERCY MEDICAL CENTER UPHOLDS THE MISSION AND PHILOSOPHY OF THE SISTERS OF ST. AUGUSTINE AND CONTINUES TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITY.ACCOMPLISHMENTS:NEW MERCY HEALTH CENTER OF PLAIN OPENED ITS NEW LOCATION IN THE REVITALIZED OAKWOOD SQUARE PLAZA, LOCATED AT 2638 EASTON STREET, NE, NORTH CANTON. MERCY HEALTH CENTER OF PLAIN OFFERS STATCARE, PRIMARY CARE, SPORTS MEDICINE, RADIOLOGY AND LABORATORY SERVICES. EXPRESS CHECK IN AT MERCY STATCAREMERCY STATCARE EXPRESS CHECK IN WENT LIVE AT ALL MERCY STATCARE LOCATIONS, WHICH MEANS A SPOT CAN BE SAVED ONLINE FOR STATCARE IMMEDIATE CARE. MERCY DEDICATED HUSEYIN 'SAM' SARIKAYA MEMORIAL LABORATORYTHANKS TO THE GENEROSITY OF DR. SAM SARIKAYA, A PATHOLOGIST AT MERCY MEDICAL CENTER FOR MORE THAN 40 YEARS, MERCY DEVELOPMENT FOUNDATION HELD A SPECIAL BLESSING AND DEDICATION CEREMONY FOR THE HUSEYIN 'SAM' SARIKAYA, MD, MEMORIAL LABORATORY AT THE MEDICAL CENTER. MERCY PRIMARY CARE PERRY AND LAKE ACHIEVE RECOGNITION AS PATIENT-CENTERED MEDICAL HOMESMERCY PRIMARY CARE PERRY AND MERCY PRIMARY CARE LAKE ACHIEVED RECOGNITION AS PATIENT-CENTERED MEDICAL HOMES (PCMH) BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA). SIMILAR TO A TRADITIONAL FAMILY OR INTERNAL MEDICINE PRACTICE, A MERCY PCMH OFFERS THE DAY-TO-DAY HEALTH CARE ITS PATIENTS NEED, IN ADDITION PATIENTS PLAY AN ACTIVE ROLE IN THEIR OWN HEALTH CARE. MERCY PILOTED MEDS TO BEDS PROGRAMMERCY PILOTED ITS NEW MEDS TO BEDS PROGRAM ON SEVERAL NURSING UNITS. MEDS TO BEDS IS A BEDSIDE MEDICATION DELIVERY SERVICE SO THAT AFTER A HOSPITAL STAY, PATIENTS DO NOT NEED TO MAKE AN EXTRA TRIP OR WAIT IN LONG LINES AT THE PHARMACY. IT WILL BE ROLLED OUT TO ALL UNITS IN PHASES.NEW ORTHOPEDIC AND EXTENDED RECOVERY UNIT OPENEDMERCY'S NEWLY CONSTRUCTED ORTHOPEDIC AND EXTENDED RECOVERY UNIT OPENED. WITH 27 PRIVATE BEDS, THIS STATE-OF-THE-ART UNIT ALLOWS MERCY PHYSICIANS AND NURSES TO MONITOR AND CARE FOR PATIENTS WHO HAVE UNDERGONE ORTHOPEDIC SURGERY, INCLUDING JOINT REPLACEMENT, AS WELL AS CARE FOR POST-OPERATIVE PATIENTS. IT ALSO INCLUDES A DEDICATED PHYSICAL AND OCCUPATIONAL THERAPY AREA.MERCY TRAUMA SERVICES PREPARES COMMUNITY WITH STOP THE BLEED TRAININGMERCY TRAUMA SERVICES PROVIDED THE ONLY TRAINING IN THE AREA FOR COMMUNITY STOP THE BLEED CLASSES. STOP THE BLEED IS A NATION-WIDE INITIATIVE THAT MERCY BROUGHT TO THE STARK COUNTY AND SURROUNDING COMMUNITY. MERCY TRAUMA SERVICES WAS VERY BUSY TRAINING COMMUNITY ORGANIZATIONS, SCHOOL OFFICIALS AND EDUCATORS AND CHURCHES HOW TO STOP/STEM THE FLOW OF BLOOD, ESPECIALLY IN MASS SHOOTING SITUATIONS, UNTIL PROFESSIONAL EMS ARRIVE.MERCY PROVIDES ONLY TACTICAL EMERGENCY CASUALTY PARAMEDIC TRAINING (TECC) IN THE AREAMERCY TRAUMA SERVICES INITIATED THE ONLY TACTICAL EMERGENCY CASUALTY CARE (TECC) TRAINING FOR PARAMEDICS IN THE AREA. MERCY RECEIVED TRAINING REQUESTS FROM FIRE/EMT DEPARTMENTS ALL OVER OHIO AND PENNSYLVANIA. THIS WAS A WONDERFUL PARTNERSHIP TO HELP FIRST RESPONDERS WORK MORE EFFICIENTLY AND SAFELY ALONGSIDE POLICE OFFICERS WHEN CASUALTIES NEED TREATMENT.MERCY MEDICAL CENTER FIRST IN STARK COUNTY TO USE GERM ZAPPING ROBOTS IN APRIL OF 2018 MERCY BECAME THE FIRST AND ONLY HEALTH-CARE FACILITY IN STARK COUNTY TO DISINFECT HOSPITAL SURFACES USING ROBOTS THAT SAFELY EMIT GERMICIDAL ULTRAVIOLET (UVC) RAYS MORE INTENSE THAN SUNLIGHT TO DESTROY MICROORGANISMS, EVEN IN SHADOWED AREAS. THE HOSPITAL ALSO PURCHASED THE LIGHTSTRIKE DISINFECTION POD, A PORTABLE DISINFECTION CONTAINMENT UNIT THAT CAN RAPIDLY DISINFECT HIGH-TOUCH MOBILE EQUIPMENT LIKE WHEELCHAIRS, COMPUTER WORKSTATIONS, AND IV POLES.MERCY MEDICAL CENTER AWARDS/RECOGNITIONS 2018(MAY HAVE BEEN FOR 2017 BUT WERE NOT ANNOUNCED UNTIL 2018)MERCY MEDICAL CENTER RECEIVES AN "A" RATING FROM LEAPFROGIN NOVEMBER OF 2018, MERCY MEDICAL CENTER WAS AWARDED AN 'A' FROM THE LEAPFROG GROUP'S FALL 2018 HOSPITAL SAFETY GRADE. THE DESIGNATION RECOGNIZES MERCY MEDICAL CENTER'S EFFORTS IN PROTECTING PATIENTS FROM HARM AND MEETING THE HIGHEST STANDARDS IN THE UNITED STATES. THE LEAPFROG GROUP IS A NATIONAL ORGANIZATION COMMITTED TO IMPROVING HEALTH CARE QUALITY AND SAFETY FOR CONSUMERS AND PURCHASERS. MERCY BOUTIQUE RECENTLY RECEIVED ITS THREE-YEAR REACCREDITATION FROM THE AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS (ABC). THE ABC ACCREDITATION VERIFIES THAT MERCY ADHERES TO THE HIGHEST STANDARDS IN PROSTHETICS AND PROVIDES SUPERIOR PATIENT CARE.MERCY MEDICAL CENTER RECEIVED THE 2017 HEALTHY WORKSITE SILVER LEVEL AWARD FROM THE HEALTHY BUSINESS COUNCIL OF OHIO FOR DEMONSTRATING A COMMITMENT TO THE HEALTH AND WELLBEING OF ITS EMPLOYEES. THIS ACHIEVEMENT DEMONSTRATES MERCY'S EFFORTS TO PROVIDE EMPLOYEES WITH PROGRAMS THAT ENCOURAGE PHYSICAL ACTIVITY, BETTER NUTRITION AND THE PREVENTION OR CESSATION OF TOBACCO.THE AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER AGAIN GAVE MERCY CANCER CENTER FULL THREE-YEAR ACCREDITATION WITH COMMENDATION FOR A SURVEY CONDUCTED ON NOVEMBER 3. AMONG BRONZE, SILVER AND GOLD LEVELS OF COMMENDATION, MERCY RECEIVED THE HIGHEST GOLD STATUS ON ALL SEVEN OF THE MOST SIGNIFICANT STANDARDS. ADDITIONALLY, OUR REPORT CITES FULL COMPLIANCE WITH THE OTHER 27 NON-COMMENDATION STANDARDS. THIS ACHIEVEMENT IS A DIRECT REFLECTION OF THE GREAT PHYSICIANS AND STAFF INVOLVED WITH MERCY CANCER CENTER.MERCY OUTPATIENT DIABETES EDUCATION PROGRAM HAS BEEN AWARDED CONTINUED RECOGNITION FROM THE AMERICAN DIABETES ASSOCIATION (ADA). THIS PROGRAM OFFERS HIGH-QUALITY EDUCATION SERVICES TO THE PATIENTS IT SERVES. THE ADA EDUCATION RECOGNITION EFFORT IS A VOLUNTARY PROCESS, WHICH ASSURES THAT APPROVED EDUCATION PROGRAMS HAVE MET THE NATIONAL STANDARDS FOR DIABETES SELF-MANAGEMENT EDUCATION. THE ACCREDITATION COMMITTEE OF THE COLLEGE OF AMERICAN PATHOLOGISTS (CAP) ACCREDITED MERCY DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE IN 2018. MERCY IS ONE OF MORE THAN 7,700 CAP-ACCREDITED FACILITIES WORLDWIDE. MERCY CANCER CENTER WAS RECENTLY PRESENTED WITH THE 2017 OUTSTANDING ACHIEVEMENT AWARD BY THE COMMISSION ON CANCER (COC) OF THE AMERICAN COLLEGE OF SURGEONS (ACS). MERCY MEDICAL CENTER IS ONE OF A SELECT GROUP OF ONLY 32 U.S. HEALTH CARE FACILITIES WITH ACCREDITED CANCER PROGRAMS TO RECEIVE THIS NATIONAL HONOR FOR SURVEYS PERFORMED LAST YEAR. THE AWARD ACKNOWLEDGES CANCER PROGRAMS THAT ACHIEVE EXCELLENCE IN PROVIDING QUALITY CARE TO CANCER PATIENTS. THE 32 AWARD-WINNING CANCER CARE PROGRAMS REPRESENT APPROXIMATELY SEVEN PERCENT OF PROGRAMS SURVEYED BY THE COC IN 2017. MORE IMPRESSIVELY, THIS IS THE FOURTH CONSECUTIVE TIME THE HONOR HAS BEEN BESTOWED ON MERCY CANCER CENTER SINCE 2008. VERY FEW CANCERS CENTERS NATIONALLY HAVE EVER ACHIEVED THIS STATUS, WHICH PUTS MERCY CANCER CENTER IN A VERY ELITE CLASS. MERCY MEDICAL CENTER HAS RECEIVED THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES-STROKE GOLD PLUS QUALITY ACHIEVEMENT AWARD.MERCY HEART CENTER RECEIVED THE AMERICAN COLLEGE OF CARDIOLOGY'S NCDR ACTION REGISTRY PLATINUM PERFORMANCE ACHIEVEMENT AWARD FOR 2018. MERCY MEDICAL CENTER IS ONE OF ONLY 203 HOSPITALS NATIONWIDE TO RECEIVE THE HONOR. MERCY MEDICAL CENTER HAS RECEIVED THE AMERICAN HEART ASSOCIATION'S GET WITH THE GUIDELINES-HEART FAILURE GOLD PLUS QUALITY ACHIEVEMENT AWARD. THE AWARD RECOGNIZES THE HOSPITAL'S COMMITMENT TO ENSURING HEART FAILURE PATIENTS RECEIVE THE MOST APPROPRIATE TREATMENT ACCORDING TO NATIONALLY RECOGNIZED, RESEARCH-BASED GUIDELINES BY THE LATEST SCIENTIFIC EVIDENCE. THE TRAUMA CENTER AT MERCY MEDICAL CENTER EMERGENCY SERVICES WAS AGAIN VERIFIED AS A LEVEL II TRAUMA CENTER BY THE VERIFICATION REVIEW COMMITTEE (VRC), AN AD HOC COMMITTEE OF THE COMMITTEE ON TRAUMA (COT) OF THE AMERICAN COLLEGE OF SURGEONS (ACS). THIS ACHIEVEMENT RECOGNIZES MERCY'S DEDICATION TO PROVIDING OPTIMAL CARE FOR INJURED PATIENTS.FOR THE 10TH CONSECUTIVE YEAR, MERCY MEDICAL CENTER WAS AGAIN AWARDED THE U.S. EPA'S ENERGY STAR CERTIFICATIONONE OF ONLY THREE HOSPITALS IN THE U.S., AND THE ONLY ONE IN OHIO, TO EARN THIS DESIGNATION. EACH YEAR THE HOSPITAL'S MAIN CAMPUS, A FACILITY OF ONE MILLION SQUARE FEET THAT'S A BLEND OF OLD AND NEW CONSTRUCTION, SAVES APPROXIMATELY $976,000 IN ENERGY COSTS. ON AVERAGE, ENERGY STAR-CERTIFIED BUILDINGS AND PLANTS USE 35 PERCENT LESS ENERGY, CAUSE 35 PERCENT FEWER GREENHOUSE GAS EMISSIONS, AND ARE LESS EXPENSIVE TO OPERATE THAN THEIR PEERSALL WITHOUT SACRIFICES IN PERFORMANCE OR COMFORT.

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 expenses295,283,186

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,218,104	2,665,887	639,277

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	745,681

f	All other contributions, gifts, grants, and similar amounts not included above		1f	11,979

g	Noncash contributions included in lines 1a - 1f:$ 11,979
h Total. Add lines 1a-1f.......		757,660

		Business Code
2a	PATIENT CARE	621110	313,046,589	313,046,589
b	PROGRAM RENTAL INCOME	532000	1,457,240	1,457,240
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		314,503,829

3 Investment income (including dividends, interest, and othersimilar amounts) ......			664,051			664,051
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	280,200
b	Less: cost or other basis and sales expenses	261,293
c	Gain or (loss)	18,907
d	Net gain or (loss).....			18,907			18,907
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	PHARMACY		621500	3,162,261			3,162,261
b	CAFETERIA		621110	1,589,521			1,589,521
c	LAB SERVICES		621110	973,873		973,873
d	All other revenue ....			2,812,274	208,903	129,780	2,473,591
e	Total. Add lines 11a–11d ......			8,537,929
12	Total revenue. See Instructions......			324,482,376	314,712,732	1,103,653	7,908,331

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	162,690	162,690
2	Grants and other assistance to domestic individuals. See Part IV, line 22
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	2,771,025		2,771,025
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	111,219,289	102,875,218	8,344,071
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	5,893,725	5,451,557	442,168
9	Other employee benefits .......	14,331,169	13,255,993	1,075,176
10	Payroll taxes ...........	8,227,010	7,609,790	617,220
11	Fees for services (non-employees):
a	Management ......	1,675,617	1,675,617
b	Legal .........	353,722	13,628	340,094
c	Accounting ...........	105,000		105,000
d	Lobbying ...........	15,353		15,353
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	34,661,450	29,795,125	4,866,325
12	Advertising and promotion ....	1,091,423	1,091,423
13	Office expenses .......	12,746,156	11,039,175	1,706,981
14	Information technology ......	9,940,168	9,194,421	745,747
15	Royalties ..
16	Occupancy ...........	12,255,207	11,834,876	420,331
17	Travel ............	302,976	236,472	66,504
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	148,080	100,466	47,614
20	Interest ...........	3,405,687	3,369,664	36,023
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	11,667,529	11,544,118	123,411
23	Insurance ...	3,681,263	3,405,081	276,182
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	56,862,125	56,862,125
b	PATIENT BAD DEBT	13,332,234	13,332,234
c	STATE FRANCHISE TAX	4,886,075	4,886,075
d	MEMBER ASSESSMENT	3,991,821	2,993,866	997,955
e	All other expenses	5,344,767	4,553,572	791,195
25	Total functional expenses. Add lines 1 through 24e	319,071,561	295,283,186	23,788,375	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			8,100	1	8,293
2	Savings and temporary cash investments .........			11,694,440	2	13,781,397
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			34,314,167	4	39,564,293
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 ....				7
8	Inventories for sale or use ........			4,522,266	8	4,276,488
9	Prepaid expenses and deferred charges ......			3,487,353	9	5,618,320
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	320,949,382
b	Less: accumulated depreciation	10b	233,841,561	93,017,805	10c	87,107,821
11	Investments—publicly traded securities .			36,496,965	11	25,333,594
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			1,948,983	15	2,211,040
16	Total assets. Add lines 1 through 15 (must equal line 34)...			185,490,079	16	177,901,246

17	Accounts payable and accrued expenses .....	57,364,883	17	56,852,618
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	33,502,318	20	31,892,909
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 ..	11,731,101	23	11,589,865
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	25,192,227	25	22,919,649
26	Total liabilities. Add lines 17 through 25..	127,790,529	26	123,255,041

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	57,546,740	27	54,484,548
28	Temporarily restricted net assets ...........	152,810	28	161,657
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 ...........	57,699,550	33	54,646,205
34	Total liabilities and net assets/fund balances ........	185,490,079	34	177,901,246