Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 07-01-2017 , and ending 06-30-2018
BCheck if applicable:
CName of organization
MOUNT CARMEL HEALTH SYSTEM
 
 
Doing business as
SEE SCHEDULE O
 
Number and street (or P.O. box if mail is not delivered to street address)
6150 EAST BROAD STREET NO WD381N
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
COLUMBUS, OH432131574
D Employer identification number

31-1439334
E Telephone number

G Gross receipts $ 1,399,364,405
F Name and address of principal officer:
EDWARD LAMB
6150 EAST BROAD STREET NO WD381N
COLUMBUS,OH432131574
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MOUNTCARMELHEALTH.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:  
L Year of formation: 1995
M State of legal domicile: OH
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES.
2 Check this box MediumBullet
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 11
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 10,940
6 Total number of volunteers (estimate if necessary) ............. 6 564
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 6,203,425
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 3,219,781
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,881,986 4,188,271
9 Program service revenue (Part VIII, line 2g) ......... 1,274,925,638 1,307,728,673
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 15,114,846 23,868,467
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 60,348,250 63,578,994
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,353,270,720 1,399,364,405
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,373,348 1,660,592
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) 536,580,689 537,667,094
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet265,353    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 697,965,763 702,648,782
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,235,919,800 1,241,976,468
19 Revenue less expenses. Subtract line 18 from line 12....... 117,350,920 157,387,937
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,206,745,391 2,297,144,733
21 Total liabilities (Part X, line 26)............. 826,141,209 862,791,715
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,380,604,182 1,434,353,018
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: WE, MOUNT CARMEL HEALTH SYSTEM AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. MOUNT CARMEL HEALTH SYSTEM IS A MEMBER OF TRINITY HEALTH.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,097,084,657 including grants of $ 1,660,592 ) (Revenue $ 1,346,669,954 )
MOUNT CARMEL HEALTH SYSTEM (MOUNT CARMEL), LOCATED IN COLUMBUS, OHIO HAS BEEN A LEADER IN PATIENT CARE FOR MORE THAN 125 YEARS. TODAY, WITH PHYSICIAN PARTNERS, THE SYSTEM PROVIDES AN ARRAY OF CUTTING-EDGE, PATIENT-FOCUSED PRIMARY AND SPECIALTY HEALTH CARE SERVICES AT FOUR CENTRAL OHIO HOSPITALS, CONTAINING 1,427 REGISTERED BEDS, AS WELL AS AN INPATIENT REHABILITATION HOSPITAL, FREESTANDING EMERGENCY CENTERS, SURGERY CENTERS, URGENT CARE CENTERS, OUTPATIENT FACILITIES, PRIMARY CARE AND SPECIALTY CARE PHYSICIAN OFFICES AND COMMUNITY OUTREACH SITES IN THE GREATER COLUMBUS AREA.MOUNT CARMEL'S TEAM OF MORE THAN 10,000 EMPLOYEES, 2,000 PHYSICIANS AND 500 VOLUNTEERS IS COMMITTED TO THE QUALITY CARE OF PATIENTS AND THEIR FAMILIES. TOGETHER, MORE THAN A HALF-MILLION PATIENTS ARE SERVED EACH YEAR. EACH YEAR MOUNT CARMEL PROVIDES TENS OF MILLIONS OF DOLLARS IN UNCOMPENSATED BENEFITS TO THE COMMUNITY. WE'RE ALSO ACTIVELY ENGAGED IN THE COMMUNITY THROUGH BUSINESS, CIVIC AND SERVICE ORGANIZATIONS, AND THROUGH OUR FINANCIAL SUPPORT OF OTHER NOT-FOR-PROFIT ORGANIZATIONS AND SOCIAL SERVICES AGENCIES.PLEASE VISIT SCHEDULE H AND OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES, RECOGNITIONS AND AWARDS: WWW.MOUNTCARMELHEALTH.COM
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet1,097,084,657
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
Yes
 
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
1,345
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
10,940
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
 
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
13
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
11
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletPAUL MORRIS6150 EAST BROAD STREET   COLUMBUS,OH43213 (614) 546-4619
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) EDWARD LAMB......................................................................
DIRECTOR; MOUNT CARMEL PRES & CEO
45.00
.................
10.00
X   X       0 912,109 197,705
(2) JOHN PEREZ......................................................................
DIRECTOR; CHAIR THR 12/17
2.00
.................
0.00
X   X       0 0 0
(3) LISA STEIN......................................................................
DIRECTOR; CHAIR AS OF 1/18
2.00
.................
0.00
X   X       0 0 0
(4) JORDAN HANSELL......................................................................
DIRECTOR; TREASURER
2.00
.................
0.00
X   X       0 0 0
(5) JUDITH ANNE BEATTIE CSC......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(6) LARRY ENGLISH......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(7) KATHY GATTERDAM......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(8) JOHN GILLIGAN......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(9) CHARLES HICKEY MD......................................................................
DIRECTOR
5.00
.................
0.00
X           4,286 0 0
(10) SALLY JEFFCOAT......................................................................
DIRECTOR; EVP TRINITY HEALTH
2.00
.................
53.00
X           0 1,517,657 43,445
(11) JOY O'GRADY CSC......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(12) TANISHA ROBINSON......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(13) PABLO VEGAS......................................................................
DIRECTOR
2.00
.................
0.00
X           0 0 0
(14) PAUL MORRIS......................................................................
MOUNT CARMEL EVP & CFO AS OF 9/17
41.00
.................
9.00
    X       0 229,195 23,142
(15) DANIEL POWELL......................................................................
MOUNT CARMEL INTERIM CFO THR 8/17
41.00
.................
9.00
    X       355,671 86,080 13,400
(16) DANIEL HACKETT......................................................................
SECRETARY; MANAGING COUNSEL
50.00
.................
0.00
    X       0 402,200 44,679
(17) UNHEE KIM......................................................................
PRESIDENT, ST. ANN'S
55.00
.................
0.00
      X     0 507,245 92,406
Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) SEAN MCKIBBEN........................................................................
PRESIDENT & COO, MC WEST
53.00
.......................2.00
      X     0 626,171 43,042
(19) MICHAEL WILKINS........................................................................
PRESIDENT & COO, MC EAST
53.00
.......................2.00
      X     0 486,038 94,408
(20) DIANE DOUCETTE........................................................................
PRESIDENT, MC NEW ALBANY
55.00
.......................0.00
      X     0 468,531 37,645
(21) RICHARD STRECK........................................................................
CMO & CHIEF QUALITY OFFICER
50.00
.......................0.00
      X     0 754,265 35,864
(22) TAUANA MCDONALD........................................................................
CHIEF ADMINISTRATIVE OFFICER
50.00
.......................0.00
        X   0 558,332 46,390
(23) PHILLIP SHUBERT MD........................................................................
SYSTEM MEDICAL DIRECTOR
49.00
.......................1.00
        X   543,061 0 41,653
(24) DANIEL WENDORFF MD........................................................................
PRESIDENT - HEALTH PARTNERS
50.00
.......................0.00
        X   440,766 0 37,745
(25) CHARLES SANDERS JR MD........................................................................
VP MEDICAL EDUCATION
50.00
.......................0.00
        X   409,470 0 37,753
(26) GERALD GIRARDI MD........................................................................
PERINATAL MEDICAL DIRECTOR
50.00
.......................0.00
        X   0 405,718 30,079
(27) CHARLES BRETT JUSTICE........................................................................
FORMER KE; SYS VP STRATEGIC ADVANCMT
48.00
.......................2.00
          X 0 342,090 41,737
(28) CLAUS VON ZYCHLIN........................................................................
FORMER OFFICER
0.00
.......................0.00
          X 0 815,897 22,518
(29) KEITH COLEMAN........................................................................
FORMER OFFICER
0.00
.......................0.00
          X 0 222,275 8,347
(30) ROGER SPOELMAN........................................................................
FORMER OFFICER; TRINITY HEALTH SVP
0.00
.......................55.00
          X 0 993,383 48,564
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 1,753,254 9,327,186 940,522
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet493
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
MESSER CONSTRUCTION

5158 FISHWICK DRIVE
CINCINNATI,OH45216
CONSTRUCTION SERVICES 70,410,075
CORNA KOKOSING CONSTRUCTION CO

6235 WESTERVILLE ROAD
WESTERVILLE,OH43081
CONSTRUCTION SERVICES 9,074,196
DAWSON HEALTHCARE

1114 DUBLIN RD
COLUMBUS,OH43215
HEALTH CARE SERVICES 5,837,034
CENTRAL OHIO ORTHOPEDIC MANAGEMENT CO

3059 E MOUND ST
LOGAN,OH43138
HEALTH CARE SERVICES 4,884,790
AVI FOODSYSTEMS INC

2590 ELM ROAD NE
WARREN,OH44483
FOOD SERVICES 3,834,578
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet116
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 3,991,832
e Government grants (contributions)1e 93,734
f All other contributions, gifts, grants, and similar amounts not included above1f 102,705
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 4,188,271
 Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 622110 1,288,690,030 1,286,948,726 1,741,304  
b SUBSIDIARY FEES 551114 19,038,643 19,038,643    
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 1,307,728,673
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 8,811,681     8,811,681
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   12,983,646 6a
b Less: rental expenses   0 6b
c Rental income or (loss)   12,983,646 6c
d Net rental income or (loss).......MediumBullet 12,983,646     12,983,646
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 702,491 14,354,295 7a
b Less: cost or other basis and sales expenses 0 0 7b
c Gain or (loss) 702,491 14,354,295 7c
d Net gain or (loss).........MediumBullet 15,056,786     15,056,786
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a PROF SERVICE AGREEMENT REV 622110 9,713,603 9,713,603    
b MANAGEMENT FEES 561499 6,906,185 6,411,714 494,471  
c CAFETERIA REVENUE 722514 5,450,642     5,450,642
d All other revenue .... 28,524,918 24,557,268 3,967,650  
e Total. Add lines 11a–11d ...... MediumBullet 50,595,348
12 Total revenue. See instructions.....MediumBullet 1,399,364,405 1,346,669,954 6,203,425 42,302,755
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 1,660,592 1,660,592
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, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 5,324,384 4,286 5,320,098  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 1,452,864   1,452,864  
7 Other salaries and wages........ 446,301,912 394,606,010 51,492,200 203,702
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 13,446,906 12,086,585 1,354,082 6,239
9 Other employee benefits ....... 39,252,393 34,446,037 4,788,574 17,782
10 Payroll taxes ........... 31,888,635 27,813,419 4,060,858 14,358
11 Fees for services (non-employees):        
a Management ...... 3,361,274 3,361,274    
b Legal ......... 821,393   821,393  
c Accounting ........... 62,477   62,477  
d Lobbying ........... 60,075   60,075  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 902,311   902,311  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 105,086,295 91,820,921 13,262,470 2,904
12 Advertising and promotion .... 8,017,424 443,981 7,573,443  
13 Office expenses ....... 9,180,812 5,854,520 3,322,116 4,176
14 Information technology ...... 52,531,256 47,226,218 5,305,038  
15 Royalties ..        
16 Occupancy ........... 37,958,409 34,138,537 3,809,594 10,278
17 Travel ............ 1,388,830 988,607 396,888 3,335
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 455,313 354,659 99,935 719
20 Interest ........... 13,939,971 13,939,971    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 91,930,562 66,190,005 25,740,557  
23 Insurance ... 7,040,310 7,040,310    
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES EXP 224,224,263 224,224,263    
b BAD DEBT EXPENSE 48,981,885 48,981,885    
c I/C PURCHASED SERVICES 40,021,439 30,603,454 9,417,985  
d UNRELATED BUS INC TAXES 1,024,974 1,024,974    
e All other expenses 55,659,509 50,274,149 5,383,500 1,860
25 Total functional expenses. Add lines 1 through 24e 1,241,976,468 1,097,084,657 144,626,458 265,353
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 26,809 1 28,682
2 Savings and temporary cash investments ......... 77,844,661 2 61,803,994
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 154,873,227 4 175,305,252
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ........... 1,485,002 7 2,557,293
8 Inventories for sale or use ............ 23,577,885 8 24,429,393
9 Prepaid expenses and deferred charges ...... 6,078,149 9 5,814,768
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,901,772,531
b Less: accumulated depreciation 10b 947,124,798 757,195,789 10c 954,647,733
11 Investments—publicly traded securities . 326,717,908 11 282,841,874
12 Investments—other securities. See Part IV, line 11 ..... 288,084,683 12 179,668,917
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ............... 40,440,837 14 40,193,519
15 Other assets. See Part IV, line 11 ........... 530,420,441 15 569,853,308
16 Total assets. Add lines 1 through 15 (must equal line 33)... 2,206,745,391 16 2,297,144,733
Liabilities 17 Accounts payable and accrued expenses ..... 136,938,554 17 146,007,794
18 Grants payable ...   18  
19 Deferred revenue ......... 319,308 19 358,253
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties .. 7,692,883 23 7,728,885
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 681,190,464 25 708,696,783
26 Total liabilities. Add lines 17 through 25.. 826,141,209 26 862,791,715
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions ..........   27  
28 Net assets with donor restrictions ...........   28  
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 1,380,604,182 32 1,434,353,018
33 Total liabilities and net assets/fund balances ........ 2,206,745,391 33 2,297,144,733
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,399,364,405
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,241,976,468
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
157,387,937
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
1,380,604,182
5
Net unrealized gains (losses) on investments ...............
5
15,650,420
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-119,289,521
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
1,434,353,018
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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 instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
MOUNT CARMEL HEALTH SYSTEM
 
Employer identification number

31-1439334
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (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.
6
 
 
7
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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 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.
9c
 
 
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
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (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?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 2019 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-2019
(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, 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 2019. 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 2020. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
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) 2019


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Name of the organization
MOUNT CARMEL HEALTH SYSTEM
 
Employer identification number

31-1439334
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that 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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
MOUNT CARMEL HEALTH SYSTEM
 
Employer identification number
31-1439334
Part I
Contributors
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
 
 
 
 

$  


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 3
Name of organization
MOUNT CARMEL HEALTH SYSTEM
 
Employer identification number

31-1439334
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 4
Name of organization
MOUNT CARMEL HEALTH SYSTEM
 
Employer identification number

31-1439334
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data


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

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

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

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
MOUNT CARMEL HEALTH SYSTEM
 
Employer identification number

31-1439334
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

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

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

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
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) 2019

Schedule C (Form 990 or 990-EZ) 2019
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2016 (b) 2017 (c) 2018 (d) 2019 (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) 2019


Schedule C (Form 990 or 990-EZ) 2019
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|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
Yes
 
35,900
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
130,507
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
 
No
 
j
Total. Add lines 1c through 1i ....................................................................................................
166,407
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: MOUNT CARMEL HEALTH SYSTEM (MOUNT CARMEL) HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED MOUNT CARMEL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. MOUNT CARMEL ALSO PAID A THIRD PARTY LOBBYING FIRM DURING THE YEAR TO LOBBY FOR OR AGAINST LEGISLATION DETERMINED TO BE OF INTEREST TO MOUNT CARMEL.
Schedule C (Form 990 or 990EZ) 2019


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," 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 instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
MOUNT CARMEL HEALTH SYSTEM
 
Employer identification number

31-1439334
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet1
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet0.00
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $ 0
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB 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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" 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 .... 31,944        
b Contributions ... 26,535 31,944      
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ...... 58,479 31,944      
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet100.000 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" 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 .....   47,574,742 47,574,742
b Buildings ....   774,404,957 493,794,024 280,610,933
c Leasehold improvements        
d Equipment ....   597,195,603 453,319,415 143,876,188
e Other ..... 6,651,703 475,945,526 11,359 482,585,870
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 954,647,733
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3) Other
(A) COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES
64,496,534 F

(B) EQUITY METHOD INVESTMENTS
78,317,220 C

(C) HEDGE FUNDS
36,855,163 F
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 179,668,917
Part VIII
Investments—Program 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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)MISCELLANEOUS RECEIVABLES 12,418,264
(2)INTERCOMPANY ACCOUNTS RECEIVABLE 421,740,149
(3)INVESTMENT IN UNCONSOL. AFFILIATES 56,715,608
(4)INTERCOMPANY OTHER LT ASSETS 78,370,985
(5)OTHER LONG-TERM ASSETS 607,471
(6)OTHER CURRENT ASSETS 831
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 569,853,308
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  
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 708,696,783
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) 2019

Schedule D (Form 990) 2019
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
SCHEDULE D, PART V ENDOWMENTS HELD BY MOUNT CARMEL HEALTH SYSTEM FOUNDATION FOR THE BENEFIT OF MOUNT CARMEL HEALTH SYSTEM (MOUNT CARMEL) ARE REPORTED ON THE FORM 990 OF MOUNT CARMEL HEALTH SYSTEM FOUNDATION. THE FUNDS WILL BE USED BY MOUNT CARMEL FOR HOSPICE/PALLIATIVE CARE, FACILITIES, GRADUATE AND CONTINUING MEDICAL EDUCATION, OB/GYN RESIDENCY EDUCATION, INTERN IMPROVEMENT, CHAPLAINCY, MCSA LABOR/DELIVERY STAFF EDUCATION, MCE STAFF EDUCATION, RADIATION ONCOLOGY DEPARTMENTS, WOMEN'S HEALTH, CANCER SERVICES, OPERATIONS, GENERAL PURPOSES, AND MISSION AND OUTREACH.
SCHEDULE D, PART II, LINE 9 MOUNT CARMEL ACQUIRED LAND THROUGH PURCHASE THAT INCLUDES A WETLAND CONSERVATION EASEMENT. THE CONSERVATION EASEMENT IS REPORTED AS LAND ON THE BALANCE SHEET OF MOUNT CARMEL.
Schedule D (Form 990) 2019


Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" 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
2019
Open to Public Inspection
Name of the organization
MOUNT CARMEL HEALTH SYSTEM
 
Employer identification number

31-1439334
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the 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.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    25,976,292   25,976,292 2.180 %
b Medicaid (from Worksheet 3, column a) . . . . .     210,727,745 166,854,362 43,873,383 3.680 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     236,704,037 166,854,362 69,849,675 5.860 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 19 183,748 4,388,023 792,081 3,595,942 0.300 %
f Health professions education (from Worksheet 5) . . . 4 2,220 21,713,712 10,251,055 11,462,657 0.960 %
g Subsidized health services (from Worksheet 6) . . . . 6 92,704 3,849,551 2,854,321 995,230 0.080 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 7 11,242 1,662,546 2,622 1,659,924 0.140 %
j Total. Other Benefits . . 36 289,914 31,613,832 13,900,079 17,713,753 1.480 %
k Total. Add lines 7d and 7j . 36 289,914 268,317,869 180,754,441 87,563,428 7.340 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support 1   8,322   8,322 0 %
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building 1   100,010   100,010 0.010 %
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total 2   108,332   108,332 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
48,981,885
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
233,332,073
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
219,147,098
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
14,184,975
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
11 ST ANN'S MEDICAL OFFICE BUILDING II LIMITED PARTNERSHIP
 
MEDICAL OFFICE BLDG. 47.000 %   53.000 %
22 MCE MOB IV LIMITED PARTNERSHIP
 
MEDICAL OFFICE BLDG. 49.840 %   50.160 %
33 MCE POB III
 
MEDICAL OFFICE BLDG. 29.080 %   70.920 %
44 MEDILUCENT MOB I
 
MEDICAL OFFICE BLDG. 25.130 %   74.870 %
55 EYE CENTER OF COLUMBUS
 
AMBULATORY SURGERY CENTER 2.640 % 5.000 % 89.720 %
66 TAYLOR STATION SURGICAL CENTER
 
AMBULATORY SURGERY CENTER 40.000 %   60.000 %
77 COLUMBUS CYBERKNIFE
 
ROBOTIC CANCER TREATMENT 35.000 %   50.000 %
88 ST ANNS MOB III LLC
 
MEDICAL OFFICE BLDG. 38.140 %   55.590 %
99 NEW ALBANY SURGERY CENTER
 
AMBULATORY SURGERY CENTER 35.000 %   65.000 %
1010 BIG RUN MOB LIMITED PARTNERSHIP
 
MEDICAL OFFICE BLDG. 76.920 %   23.080 %
1111 EASTWIND SURGICAL LLC
 
AMBULATORY SURGERY CENTER 30.780 %   21.210 %
12
13
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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?4Name, 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)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 MOUNT CARMEL EAST
6001 EAST BROAD STREET
COLUMBUS,OH43213
WWW.MOUNTCARMELHEALTH.COM
REGISTRATION #1027
X X         X      
2 MOUNT CARMEL WEST
793 WEST STATE STREET
COLUMBUS,OH43222
WWW.MOUNTCARMELHEALTH.COM
REGISTRATION #1175
X X   X     X      
3 MOUNT CARMEL ST ANN'S
500 SOUTH CLEVELAND AVENUE
WESTERVILLE,OH43081
WWW.MOUNTCARMELHEALTH.COM
REGISTRATION #1606
X X   X     X      
4 MOUNT CARMEL NEW ALBANY SURGICAL HOSP
7333 SMITHS MILL ROAD
NEW ALBANY,OH43054
WWW.MOUNTCARMELHEALTH.COM
REGISTRATION #1451
X X       X        
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
MOUNT CARMEL EAST
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SCHEDULE H, PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
MOUNT CARMEL EAST
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE
b
WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
MOUNT CARMEL EAST
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
MOUNT CARMEL EAST
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
MOUNT CARMEL WEST
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
2
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SCHEDULE H, PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
MOUNT CARMEL WEST
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE
b
WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
MOUNT CARMEL WEST
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
MOUNT CARMEL WEST
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
MOUNT CARMEL ST ANN'S
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
3
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SCHEDULE H, PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
MOUNT CARMEL ST ANN'S
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE
b
WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
MOUNT CARMEL ST ANN'S
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
MOUNT CARMEL ST ANN'S
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
MOUNT CARMEL NEW ALBANY SURGICAL HOSP
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
4
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SCHEDULE H, PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
MOUNT CARMEL NEW ALBANY SURGICAL HOSP
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE
b
WWW.MOUNTCARMELHEALTH.COM/FINANCIALASSISTANCE
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
MOUNT CARMEL NEW ALBANY SURGICAL HOSP
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
MOUNT CARMEL NEW ALBANY SURGICAL HOSP
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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, 20a, 20b, 20c, 20d, 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
MOUNT CARMEL EAST PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: MOUNT CARMEL HEALTH SYSTEM (MOUNT CARMEL) INCLUDED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1) OBESITY2) INFANT MORTALITY3) ACCESS TO CARE4) MENTAL HEALTH AND ADDICTION5) CHRONIC CONDITIONS6) INFECTIOUS DISEASES
MOUNT CARMEL WEST PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: MOUNT CARMEL INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1) OBESITY2) INFANT MORTALITY3) ACCESS TO CARE4) MENTAL HEALTH AND ADDICTION5) CHRONIC CONDITIONS6) INFECTIOUS DISEASES
MOUNT CARMEL ST. ANN'S PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: MOUNT CARMEL INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1) OBESITY2) INFANT MORTALITY3) ACCESS TO CARE4) MENTAL HEALTH AND ADDICTION5) CHRONIC CONDITIONS6) INFECTIOUS DISEASES
MOUNT CARMEL NEW ALBANY SURGICAL HOSP. PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: MOUNT CARMEL INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1) OBESITY2) INFANT MORTALITY3) ACCESS TO CARE4) MENTAL HEALTH AND ADDICTION5) CHRONIC CONDITIONS6) INFECTIOUS DISEASES
MOUNT CARMEL EAST PART V, SECTION B, LINE 5: THE MOUNT CARMEL CHNA WAS A COLLABORATIVE PROJECT LED BY CENTRAL OHIO HOSPITAL COUNCIL THAT INCLUDED FOUR COLUMBUS HEALTH SYSTEMS AND THE FOLLOWING ORGANIZATIONS: COLUMBUS PUBLIC HEALTH AND FRANKLIN COUNTY PUBLIC HEALTH (WITH SPECIAL KNOWLEDGE OF AND EXPERTISE IN PUBLIC HEALTH); UNITED WAY OF CENTRAL OHIO AND PRIMARYONE HEALTH (REPRESENTING LOW-INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS); CENTRAL OHIO AREA AGENCY ON AGING AND OHIO DEPARTMENT OF AGING (REPRESENTING THE SENIOR POPULATION); HEALTHCARE FOR THE HOMELESS (REPRESENTING THE HOMELESS POPULATION); AND OHIO DEPARTMENT OF HEALTH, OHIO DISABILITY AND HEALTH PROGRAM (REPRESENTING THOSE WITH DISABILITIES). THE INPUT WAS GATHERED THROUGH THIS STEERING COMMITTEE, WHICH BEGAN CONDUCTING WORK SESSIONS IN JUNE 2014 AND MET PERIODICALLY TO DISCUSS DATA SETS TO INCLUDE OR OMIT DEPENDING ON ITS NEGATIVE IMPACT TO THE HEALTH OF THE COMMUNITY. AN OVERVIEW OF MEETINGS WAS SHARED WITH COMMUNITY MEMBERS, AND INPUT AND ADVICE WAS SOLICITED AT COMMUNITY ADVISORY MEETINGS AND COMMUNITY HEALTH PLANNING SESSIONS. BY JUNE 2015, COMMUNITY MEMBERS PROVIDED FEEDBACK REGARDING THE TOP NEEDS, AND THEN THE CHNA WAS RELEASED ON JUNE 8, 2016.
MOUNT CARMEL WEST PART V, SECTION B, LINE 5: THE MOUNT CARMEL CHNA WAS A COLLABORATIVE PROJECT LED BY CENTRAL OHIO HOSPITAL COUNCIL THAT INCLUDED FOUR COLUMBUS HEALTH SYSTEMS AND THE FOLLOWING ORGANIZATIONS: COLUMBUS PUBLIC HEALTH AND FRANKLIN COUNTY PUBLIC HEALTH (WITH SPECIAL KNOWLEDGE OF AND EXPERTISE IN PUBLIC HEALTH); UNITED WAY OF CENTRAL OHIO AND PRIMARYONE HEALTH (REPRESENTING LOW-INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS); CENTRAL OHIO AREA AGENCY ON AGING AND OHIO DEPARTMENT OF AGING (REPRESENTING THE SENIOR POPULATION); HEALTHCARE FOR THE HOMELESS (REPRESENTING THE HOMELESS POPULATION); AND OHIO DEPARTMENT OF HEALTH, OHIO DISABILITY AND HEALTH PROGRAM (REPRESENTING THOSE WITH DISABILITIES). THE INPUT WAS GATHERED THROUGH THIS STEERING COMMITTEE, WHICH BEGAN CONDUCTING WORK SESSIONS IN JUNE 2014 AND MET PERIODICALLY TO DISCUSS DATA SETS TO INCLUDE OR OMIT DEPENDING ON ITS NEGATIVE IMPACT TO THE HEALTH OF THE COMMUNITY. AN OVERVIEW OF MEETINGS WAS SHARED WITH COMMUNITY MEMBERS, AND INPUT AND ADVICE WAS SOLICITED AT COMMUNITY ADVISORY MEETINGS AND COMMUNITY HEALTH PLANNING SESSIONS. BY JUNE 2015, COMMUNITY MEMBERS PROVIDED FEEDBACK REGARDING THE TOP NEEDS, AND THEN THE CHNA WAS RELEASED ON JUNE 8, 2016.
MOUNT CARMEL ST. ANN'S PART V, SECTION B, LINE 5: THE MOUNT CARMEL CHNA WAS A COLLABORATIVE PROJECT LED BY CENTRAL OHIO HOSPITAL COUNCIL THAT INCLUDED FOUR COLUMBUS HEALTH SYSTEMS AND THE FOLLOWING ORGANIZATIONS: COLUMBUS PUBLIC HEALTH AND FRANKLIN COUNTY PUBLIC HEALTH (WITH SPECIAL KNOWLEDGE OF AND EXPERTISE IN PUBLIC HEALTH); UNITED WAY OF CENTRAL OHIO AND PRIMARYONE HEALTH (REPRESENTING LOW-INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS); CENTRAL OHIO AREA AGENCY ON AGING AND OHIO DEPARTMENT OF AGING (REPRESENTING THE SENIOR POPULATION); HEALTHCARE FOR THE HOMELESS (REPRESENTING THE HOMELESS POPULATION); AND OHIO DEPARTMENT OF HEALTH, OHIO DISABILITY AND HEALTH PROGRAM (REPRESENTING THOSE WITH DISABILITIES). THE INPUT WAS GATHERED THROUGH THIS STEERING COMMITTEE, WHICH BEGAN CONDUCTING WORK SESSIONS IN JUNE 2014 AND MET PERIODICALLY TO DISCUSS DATA SETS TO INCLUDE OR OMIT DEPENDING ON ITS NEGATIVE IMPACT TO THE HEALTH OF THE COMMUNITY. AN OVERVIEW OF MEETINGS WAS SHARED WITH COMMUNITY MEMBERS, AND INPUT AND ADVICE WAS SOLICITED AT COMMUNITY ADVISORY MEETINGS AND COMMUNITY HEALTH PLANNING SESSIONS. BY JUNE 2015, COMMUNITY MEMBERS PROVIDED FEEDBACK REGARDING THE TOP NEEDS, AND THEN THE CHNA WAS RELEASED ON JUNE 8, 2016.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP. PART V, SECTION B, LINE 5: THE MOUNT CARMEL CHNA WAS A COLLABORATIVE PROJECT LED BY CENTRAL OHIO HOSPITAL COUNCIL THAT INCLUDED FOUR COLUMBUS HEALTH SYSTEMS AND THE FOLLOWING ORGANIZATIONS: COLUMBUS PUBLIC HEALTH AND FRANKLIN COUNTY PUBLIC HEALTH (WITH SPECIAL KNOWLEDGE OF AND EXPERTISE IN PUBLIC HEALTH); UNITED WAY OF CENTRAL OHIO AND PRIMARYONE HEALTH (REPRESENTING LOW-INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS); CENTRAL OHIO AREA AGENCY ON AGING AND OHIO DEPARTMENT OF AGING (REPRESENTING THE SENIOR POPULATION); HEALTHCARE FOR THE HOMELESS (REPRESENTING THE HOMELESS POPULATION); AND OHIO DEPARTMENT OF HEALTH, OHIO DISABILITY AND HEALTH PROGRAM (REPRESENTING THOSE WITH DISABILITIES). THE INPUT WAS GATHERED THROUGH THIS STEERING COMMITTEE, WHICH BEGAN CONDUCTING WORK SESSIONS IN JUNE 2014 AND MET PERIODICALLY TO DISCUSS DATA SETS TO INCLUDE OR OMIT DEPENDING ON ITS NEGATIVE IMPACT TO THE HEALTH OF THE COMMUNITY. AN OVERVIEW OF MEETINGS WAS SHARED WITH COMMUNITY MEMBERS, AND INPUT AND ADVICE WAS SOLICITED AT COMMUNITY ADVISORY MEETINGS AND COMMUNITY HEALTH PLANNING SESSIONS. BY JUNE 2015, COMMUNITY MEMBERS PROVIDED FEEDBACK REGARDING THE TOP NEEDS, AND THEN THE CHNA WAS RELEASED ON JUNE 8, 2016.
MOUNT CARMEL EAST PART V, SECTION B, LINE 6A: THE OTHER HOSPITAL FACILITIES INVOLVED IN CONDUCTING THE FRANKLIN COUNTY CHNA INCLUDED NATIONWIDE CHILDREN'S, OHIOHEALTH, WEXNER MEDICAL CENTER AT THE OHIO STATE UNIVERSITY, MOUNT CARMEL WEST (MC WEST), MOUNT CARMEL ST. ANN'S (MC ST. ANN'S), MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL (MC NEW ALBANY), AND DILEY RIDGE MEDICAL CENTER.
MOUNT CARMEL WEST PART V, SECTION B, LINE 6A: THE OTHER HOSPITAL FACILITIES INVOLVED IN CONDUCTING THE FRANKLIN COUNTY CHNA INCLUDED NATIONWIDE CHILDREN'S, OHIOHEALTH, WEXNER MEDICAL CENTER AT THE OHIO STATE UNIVERSITY, MOUNT CARMEL EAST (MC EAST), MC ST. ANN'S, MC NEW ALBANY, AND DILEY RIDGE MEDICAL CENTER.
MOUNT CARMEL ST. ANN'S PART V, SECTION B, LINE 6A: THE OTHER HOSPITAL FACILITIES INVOLVED IN CONDUCTING THE FRANKLIN COUNTY CHNA INCLUDED NATIONWIDE CHILDREN'S, OHIOHEALTH, WEXNER MEDICAL CENTER AT THE OHIO STATE UNIVERSITY, MC EAST, MC WEST, MC NEW ALBANY, AND DILEY RIDGE MEDICAL CENTER.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP. PART V, SECTION B, LINE 6A: THE OTHER HOSPITAL FACILITIES INVOLVED IN CONDUCTING THE FRANKLIN COUNTY CHNA INCLUDED NATIONWIDE CHILDREN'S, OHIOHEALTH, WEXNER MEDICAL CENTER AT THE OHIO STATE UNIVERSITY, MC EAST, MC WEST, MC ST. ANN'S, AND DILEY RIDGE MEDICAL CENTER.
MOUNT CARMEL EAST PART V, SECTION B, LINE 6B: THE COLLABORATIVE ORGANIZATIONS INVOLVED IN THE FRANKLIN COUNTY CHNA INCLUDED: CENTRAL OHIO AREA AGENCY ON AGING, CENTRAL OHIO TRAUMA CENTER, COLUMBUS PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, UNITED WAY OF CENTRAL OHIO, CENTRAL OHIO HOSPITAL COUNCIL, PRIMARYONE HEALTH, HEALTHCARE FOR THE HOMELESS, OHIO DEPARTMENT OF AGING, OHIO DEPARTMENT OF HEALTH OHIO DISABILITY AND HEALTH PROGRAM, AND THE OHIO STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH, CENTER FOR PUBLIC HEALTH PRACTICE.
MOUNT CARMEL WEST PART V, SECTION B, LINE 6B: THE COLLABORATIVE ORGANIZATIONS INVOLVED IN THE FRANKLIN COUNTY CHNA INCLUDED: CENTRAL OHIO AREA AGENCY ON AGING, CENTRAL OHIO TRAUMA CENTER, COLUMBUS PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, UNITED WAY OF CENTRAL OHIO, CENTRAL OHIO HOSPITAL COUNCIL, PRIMARYONE HEALTH, HEALTHCARE FOR THE HOMELESS, OHIO DEPARTMENT OF AGING, OHIO DEPARTMENT OF HEALTH OHIO DISABILITY AND HEALTH PROGRAM, AND THE OHIO STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH, CENTER FOR PUBLIC HEALTH PRACTICE.
MOUNT CARMEL ST. ANN'S PART V, SECTION B, LINE 6B: THE COLLABORATIVE ORGANIZATIONS INVOLVED IN THE FRANKLIN COUNTY CHNA INCLUDED: CENTRAL OHIO AREA AGENCY ON AGING, CENTRAL OHIO TRAUMA CENTER, COLUMBUS PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, UNITED WAY OF CENTRAL OHIO, CENTRAL OHIO HOSPITAL COUNCIL, PRIMARYONE HEALTH, HEALTHCARE FOR THE HOMELESS, OHIO DEPARTMENT OF AGING, OHIO DEPARTMENT OF HEALTH OHIO DISABILITY AND HEALTH PROGRAM, AND THE OHIO STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH, CENTER FOR PUBLIC HEALTH PRACTICE.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP. PART V, SECTION B, LINE 6B: THE COLLABORATIVE ORGANIZATIONS INVOLVED IN THE FRANKLIN COUNTY CHNA INCLUDED: CENTRAL OHIO AREA AGENCY ON AGING, CENTRAL OHIO TRAUMA CENTER, COLUMBUS PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, UNITED WAY OF CENTRAL OHIO, CENTRAL OHIO HOSPITAL COUNCIL, PRIMARYONE HEALTH, HEALTHCARE FOR THE HOMELESS, OHIO DEPARTMENT OF AGING, OHIO DEPARTMENT OF HEALTH OHIO DISABILITY AND HEALTH PROGRAM, AND THE OHIO STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH, CENTER FOR PUBLIC HEALTH PRACTICE.
MOUNT CARMEL EAST PART V, SECTION B, LINE 7D: THE CHNA FOR FRANKLIN COUNTY WAS PRESENTED TO THE PUBLIC IN AN OPEN FORUM HELD ON JUNE 8, 2016 AT THE BOAT HOUSE AT CONFLUENCE PARK, WHERE COPIES WERE SHARED WITH THE PUBLIC AND LEADERS OF COMMUNITY ORGANIZATIONS. MOUNT CARMEL HAS MADE THE DOCUMENT AVAILABLE TO THE COMMUNITY AT WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT, WHERE INDIVIDUALS CAN READ ELECTRONICALLY, DOWNLOAD, OR PRINT A COPY. PRINT COPIES CAN BE REQUESTED BY CONTACTING THE HOSPITAL BY PHONE OR EMAIL. ELECTRONIC COPIES OF THE CHNA CAN ALSO BE ACCESSED AT WWW.CENTRALOHIOHOSPITALS.ORG/CHNA.HTML.
MOUNT CARMEL WEST PART V, SECTION B, LINE 7D: THE CHNA FOR FRANKLIN COUNTY WAS PRESENTED TO THE PUBLIC IN AN OPEN FORUM HELD ON JUNE 8, 2016 AT THE BOAT HOUSE AT CONFLUENCE PARK, WHERE COPIES WERE SHARED WITH THE PUBLIC AND LEADERS OF COMMUNITY ORGANIZATIONS. MOUNT CARMEL HAS MADE THE DOCUMENT AVAILABLE TO THE COMMUNITY AT WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT, WHERE INDIVIDUALS CAN READ ELECTRONICALLY, DOWNLOAD, OR PRINT A COPY. PRINT COPIES CAN BE REQUESTED BY CONTACTING THE HOSPITAL BY PHONE OR EMAIL. ELECTRONIC COPIES OF THE CHNA CAN ALSO BE ACCESSED AT WWW.CENTRALOHIOHOSPITALS.ORG/CHNA.HTML.
MOUNT CARMEL ST. ANN'S PART V, SECTION B, LINE 7D: THE CHNA FOR FRANKLIN COUNTY WAS PRESENTED TO THE PUBLIC IN AN OPEN FORUM HELD ON JUNE 8, 2016 AT THE BOAT HOUSE AT CONFLUENCE PARK, WHERE COPIES WERE SHARED WITH THE PUBLIC AND LEADERS OF COMMUNITY ORGANIZATIONS. MOUNT CARMEL HAS MADE THE DOCUMENT AVAILABLE TO THE COMMUNITY AT WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT, WHERE INDIVIDUALS CAN READ ELECTRONICALLY, DOWNLOAD, OR PRINT A COPY. PRINT COPIES CAN BE REQUESTED BY CONTACTING THE HOSPITAL BY PHONE OR EMAIL. ELECTRONIC COPIES OF THE CHNA CAN ALSO BE ACCESSED AT WWW.CENTRALOHIOHOSPITALS.ORG/CHNA.HTML.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP. PART V, SECTION B, LINE 7D: THE CHNA FOR FRANKLIN COUNTY WAS PRESENTED TO THE PUBLIC IN AN OPEN FORUM HELD ON JUNE 8, 2016 AT THE BOAT HOUSE AT CONFLUENCE PARK, WHERE COPIES WERE SHARED WITH THE PUBLIC AND LEADERS OF COMMUNITY ORGANIZATIONS. MOUNT CARMEL HAS MADE THE DOCUMENT AVAILABLE TO THE COMMUNITY AT WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT, WHERE INDIVIDUALS CAN READ ELECTRONICALLY, DOWNLOAD, OR PRINT A COPY. PRINT COPIES CAN BE REQUESTED BY CONTACTING THE HOSPITAL BY PHONE OR EMAIL. ELECTRONIC COPIES OF THE CHNA CAN ALSO BE ACCESSED AT WWW.CENTRALOHIOHOSPITALS.ORG/CHNA.HTML.
MOUNT CARMEL EAST PART V, SECTION B, LINE 11: OBESITY:IN FY 2018, CANCER SURVIVORSHIP SERVICES HAD PROGRAMS AND SERVICES THAT HELPED CANCER SURVIVORS ACHIEVE A HEALTHIER LIFESTYLE BY INCORPORATING PHYSICAL ACTIVITY INTO THEIR LIVES ON A DAILY BASIS. SURVIVORS ALSO HAD OPPORTUNITIES TO UNDERSTAND HOW VARIOUS NUTRITIONAL FACTORS AFFECT WEIGHT MAINTENANCE.URBAN HEALTH MANAGEMENT'S DIABETES PREVENTION PROGRAM NOT ONLY FOCUSED ON PREVENTING DIABETES, BUT ALSO ASSISTED PARTICIPANTS IN DEVELOPING HEALTHY HABITS THAT MAY LEAD TO WEIGHT LOSS.INFANT MORTALITY:MOMS2B (M2B), A COLLABORATION BETWEEN OHIO STATE UNIVERSITY AND MOUNT CARMEL'S WELCOME HOME PROGRAM, IS A PROGRAM THAT EMPOWERS PREGNANT WOMEN IN HIGH-RISK AREAS TO DELIVER HEALTHY BABIES. WEEKLY GROUP SESSIONS THAT FOCUSED ON EDUCATION, NUTRITION, CLINICAL, AND SOCIAL SUPPORT WERE OFFERED THROUGH THE PROGRAM AND CONTINUED THROUGH BABY'S FIRST YEAR. WELCOME HOME PROVIDED IN-HOME NEWBORN AND MATERNAL HEALTH AND WELLNESS ASSESSMENTS AND HOME VISITS TO FAMILIES PARTICIPATING IN M2B. OVERALL, IN FY 2018, WELCOME HOME PROVIDED SERVICES TO OVER 12,000 HOUSEHOLDS. ADDITIONALLY, IN FY 2018, MC EAST PROVIDED FINANCIAL SUPPORT TO LOCAL FEDERAL QUALIFIED HEALTH CENTERS (FQHC) TO PROVIDE CARE FOR AT-RISK PREGNANT WOMEN. MC EAST IS PART OF THE OHIO BETTER BIRTH OUTCOMES AND PROVIDED SUPPORT FOR CELEBRATE ONE. ACCESS TO CARE:IN FY 2018, FINANCIAL ASSISTANCE WAS PROVIDED TO 1,123 PATIENTS. MC EAST SUPPORTED THREE COMMUNITY-BASED HEALTH STATION CLINICS THAT PROVIDED INCOME-BASED CARE FOR OVER 10,000 PATIENT VISITS. IN FY 2018, THE LOW-INCOME PHARMACY ASSISTED OVER 6,100 LOW-INCOME PATIENTS/COMMUNITY ENCOUNTERS IN ACQUIRING CRITICAL MEDICATIONS AT LOW OR NO COST THROUGH PARTNERSHIPS WITH PHARMACEUTICAL COMPANIES. ADDITIONALLY, MC EAST PROVIDED FINANCIAL SUPPORT FOR TWO LOCAL FQHC'S, WHICH PROVIDED ACCESS TO PRIMARY CARE ON A SLIDING FEE SCALE. CHRONIC CONDITIONS:THE HEALTH STATION CLINICS, PART OF MOUNT CARMEL, FOCUSED ON CHRONIC DISEASE AND HEALTH DISPARITIES BY PROVIDING CARE FOR CHRONIC CONDITIONS WITHIN THE AREAS IDENTIFIED IN THE CHNA AS HAVING THE HIGHEST NEED. MC EAST SUPPORTED THE CANCER SURVIVORSHIP SERVICES THAT INCLUDED EXERCISE CLASSES, SUPPORT GROUPS, EDUCATION PROGRAMS, GENETIC COUNSELING AND SCREENING, NURSE NAVIGATORS, AND OTHER PROGRAMS TO OVER 9,400 INDIVIDUALS. MOUNT CARMEL'S URBAN HEALTH MANAGEMENT PROGRAM PROVIDED COMMUNITY-BASED DIABETES PREVENTION SERVICES, WHICH TEACH AT-RISK COMMUNITY MEMBERS AND THEIR SUPPORT PERSON HOW TO IMPROVE THEIR HEALTH TO AVOID THE ONSET OF TYPE 2 DIABETES.LIMITED RESOURCES AND SCOPE OF PRACTICE WERE REASONS EACH HOSPITAL IN MOUNT CARMEL DID NOT ADDRESS ALL OF THE NEEDS IDENTIFIED IN THE FY 2016 CHNA. THE FOLLOWING NEEDS ARE NOT BEING ADDRESSED BY MC EAST, BUT ARE BEING ADDRESSED BY OTHER MOUNT CARMEL FACILITIES OR COLLABORATIVE PARTNERS: MENTAL HEALTH AND ADDICTION IS BEING ADDRESSED BY DILEY RIDGE MEDICAL CENTER, MC WEST AND MC ST. ANN'S, AS WELL AS COMMUNITY RESOURCES LISTED ON PAGE 18 OF THE CHNA. INFECTIOUS DISEASE IS BEING ADDRESSED BY MC WEST, MC NEW ALBANY, AND COMMUNITY RESOURCES LISTED ON PAGE 26 OF THE CHNA.
MOUNT CARMEL WEST PART V, SECTION B, LINE 11: OBESITY:MC WEST'S HEALTHY LIVING CENTER (HLC) HOSTED MONTHLY COOKING CLASSES TO TEACH ADULTS AND YOUTH THE IMPORTANCE OF HEALTHY EATING HABITS AND MAINTAINING A HEALTHY WEIGHT. FITNESS CLASSES AS WELL AS EDUCATIONAL EVENTS ABOUT UNDERSTANDING EATING DISORDERS ARE HOSTED AND CO-SPONSORED BY HLC. OVER 38,000 COMMUNITY ENCOUNTERS TOOK PLACE IN THIS FACILITY IN FY 2018.SOCCER FOR SUCCESS IS AN EVIDENCE-BASED, HEALTH-CENTERED, AFTER-SCHOOL MENTORING MODEL THAT IS DESIGNED TO ELIMINATE CHILDHOOD OBESITY AND PROMOTE HEALTHY LIFESTYLES FOR UNDERSERVED CHILDREN AND YOUTH. THIS IS A PARTNERSHIP BETWEEN MOUNT CARMEL AND COLUMBUS RECREATION AND PARKS. THERE WERE 212 PARTICIPANTS IN ITS SPRING SEASON.ACCESS TO CARE:THE MOBILE MEDICAL COACH AND STREET MEDICINE (MEDICAL COACH) PROGRAM SERVED OVER 27,000 LOW-INCOME AND HOMELESS INDIVIDUALS IN TARGETED AREAS WHERE THE POPULATION HAS BARRIERS ACCESSING HEALTH CARE. THE MEDICAL COACH PROVIDED SERVICES TO HOMELESS CITIZENS BEFORE THEIR ILLNESSES BECAME URGENT OR LIFE THREATENING. THE PROGRAM ALSO PROVIDED INDIVIDUALS WITH CONNECTIONS TO COMMUNITY RESOURCES TO ADDRESS ADDITIONAL NEEDS.MC WEST HELD SPECIAL EVENTS FOR 5,995 INDIVIDUALS WHO RECEIVED HEALTH SCREENINGS AND OBTAINED INFORMATION ON THEIR HEALTH CONDITIONS OR WERE REFERRED FOR ADDITIONAL ASSISTANCE. MC WEST ALSO PROVIDED FINANCIAL ASSISTANCE TO 1,652 PATIENTS.MENTAL HEALTH AND ADDICTION:THE MEDICAL COACH PARTNERED WITH SOUTHEAST, INC. (SEMH) TO PROVIDE BEHAVIORAL HEALTH SERVICES TO MOUNT CARMEL OUTREACH PATIENTS. IN THIS PARTNERSHIP, THE TEAM COLLABORATED WITH A SEMH PSYCHIATRIC NURSE PRACTITIONER AND CASEWORKER, WHO PROVIDED ON-SITE SERVICES AT FIVE DIFFERENT CLINICS.MC WEST IS PART OF PROJECT DAWN (DEATHS AVOIDED WITH NALOXONE), A COMMUNITY-BASED OVERDOSE EDUCATION AND NALOXONE DISTRIBUTION PROGRAM. THE PROGRAM EDUCATED PARTICIPANTS ON HOW TO RECOGNIZE THE SYMPTOMS OF OVERDOSE, TO PERFORM RESCUE BREATHING, TO CALL EMERGENCY SERVICES, AND TO ADMINISTER NALOXONE TO EXTEND LIVES. MC WEST PROVIDED EDUCATION AND NALOXONE TO 4,601 COMMUNITY MEMBERS IN FY 2018.CHRONIC CONDITIONS:MC WEST PROVIDED HEALTH EDUCATION AND SUPPORTIVE SERVICES TO PREVENT AND MANAGE CHRONIC CONDITIONS THROUGH THE HLC, WHICH SERVED OVER 38,000 PERSONS IN FY 2018. THE MEDICAL COACH PROVIDED CARE TO OVER 27,000 HOMELESS, UNINSURED, UNDERINSURED, AND LOW-INCOME PERSONS FOR VARIOUS CONDITIONS, INCLUDING CHRONIC CONDITIONS. MC WEST'S PRESCRIPTIONEASE INITIATIVE MATCHED QUALIFYING PATIENTS WITH PHARMACEUTICAL ASSISTANCE PROGRAMS, INCREASING PATIENT MEDICATION COMPLIANCE, AND FOLLOWED UP WITH PATIENTS TO ENSURE THEY HAVE RECEIVED REFILLS OR TO REENROLL IN THE PROGRAM. THE MEDICATION ASSISTANCE PROGRAM HELPED OVER 781 INDIVIDUALS, SECURING OVER $538,000 IN FREE MEDICATION IN FY 2018.INFECTIOUS DISEASE:THE MEDICAL COACH PROVIDED INFLUENZA AND TDAP VACCINATIONS FOR THOSE FACING BARRIERS, AT NO COST TO THE PATIENT. COMBINED, NEARLY 300 INDIVIDUALS WERE VACCINATED.LIMITED RESOURCES AND SCOPE OF PRACTICE WERE REASONS EACH HOSPITAL IN MOUNT CARMEL DID NOT ADDRESS ALL OF THE NEEDS IDENTIFIED IN THE FY 2016 CHNA.THE FOLLOWING NEED IS NOT BEING ADDRESSED BY MC WEST, BUT IS BEING ADDRESSED BY OTHER MOUNT CARMEL FACILITIES AND COMMUNITY RESOURCES: INFANT MORTALITY IS BEING ADDRESSED BY MC EAST, MC ST. ANN'S, AND COMMUNITY RESOURCES LISTED ON PAGE 13 OF THE CHNA.
MOUNT CARMEL ST. ANN'S PART V, SECTION B, LINE 11: OBESITY:MC ST. ANN'S MY TIME PROGRAM HAS CLASSES AND EVENTS PRIMARILY FOR WOMEN OVER 40 AND OFFERS EXERCISE AND NUTRITION CLASSES. IN FY 2018, MY TIME SERVED OVER 8,000 INDIVIDUALS.INFANT MORTALITY:IN FY 2018, MC ST. ANN'S PROVIDED CAR SEATS AND PACK-N-PLAY CRIBS TO NEW PARENTS TO ASSIST WITH BABY SAFE SLEEP AND SAFETY AS PART OF THE FOCUS ON INFANT MORTALITY AND INJURY PREVENTION. ACCESS TO CARE: MC ST. ANN'S PROVIDED FINANCIAL SUPPORT FOR A LOCAL FQHC, ENSURING ACCESS TO CARE AND ASSISTANCE WITH DISEASE PREVENTION FOR PATIENTS. MC ST. ANN'S ALSO PROVIDED FINANCIAL ASSISTANCE TO 2,084 PATIENTS. MENTAL HEALTH AND ADDICTION:THE MY TIME PROGRAM, DESCRIBED ABOVE, ALSO OFFERED CLASSES SUCH AS SELF-CARE TO MANAGE STRESS, BUILD RESILIENCE DURING TURBULENT TIMES, AND LEARN HOW TO MANAGE ONESELF DURING CONFRONTATIONAL INTERACTIONS.CHRONIC CONDITIONS:REGISTERED NURSES SPECIALIZING IN STROKE EDUCATION AND PREVENTION TRAVELED TO AREA SCHOOLS, FAITH-BASED ORGANIZATIONS, AND BUSINESSES TO EDUCATE THE COMMUNITY ON STROKE FACTORS, RISKS, AND HOW TO IDENTIFY INDIVIDUALS WHO ARE SUFFERING FROM A STROKE AND WHAT SHOULD BE DONE TO PROVIDE ASSISTANCE.URBAN HEALTH MANAGEMENT COMMUNITY HEALTH WORKERS ASSISTED COMMUNITY MEMBERS IN LOWERING THEIR RISK AND ONSET OF DIABETES THROUGH THE CDC RECOGNIZED DIABETES PREVENTION PROGRAM. LIMITED RESOURCES AND SCOPE OF PRACTICE WERE REASONS EACH HOSPITAL IN MOUNT CARMEL DID NOT ADDRESS ALL OF THE NEEDS IDENTIFIED IN THE FY 2016 CHNA. THE FOLLOWING NEED IS NOT BEING ADDRESSED BY MC ST. ANN'S, BUT IS BEING ADDRESSED BY OTHER MOUNT CARMEL HOSPITALS AND COMMUNITY RESOURCES: INFECTIOUS DISEASE IS BEING ADDRESSED BY MC WEST, MC NEW ALBANY, AND COMMUNITY RESOURCES LISTED ON PAGE 26 OF THE CHNA.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP. PART V, SECTION B, LINE 11: CHRONIC CONDITIONS:MC NEW ALBANY SUPPORTED THE CHURCH PARTNERSHIPS PROGRAM, ENABLING THE PROVISION OF HEALTH PROMOTION AND HEALTH EDUCATION TO FAITH-BASED ORGANIZATIONS. DURING HEALTH FAIRS AND COMMUNITY EVENTS, CHURCH PARTNERSHIPS PROVIDED INDIVIDUALS WITH HEALTH SCREENINGS AND REFERRALS FOR ADDITIONAL CARE, IF NEEDED. IN FY 2018, THE CHURCH PARTNERSHIPS PROGRAM MADE BLOOD PRESSURE, BLOOD GLUCOSE, AND VISION SCREENINGS AVAILABLE TO THE PUBLIC.INFECTIOUS DISEASE:IN FY 2018, THE CHURCH PARTNERSHIPS PROGRAM PROVIDED INFLUENZA VACCINATIONS AS WELL AS PROPER HANDWASHING EDUCATION AT COMMUNITY EVENTS TO ADDRESS INFECTIOUS DISEASES.LIMITED RESOURCES AND SCOPE OF PRACTICE WERE REASONS EACH HOSPITAL IN MOUNT CARMEL DID NOT ADDRESS ALL OF THE NEEDS IDENTIFIED IN THE FY 2016 CHNA. THE FOLLOWING NEEDS ARE NOT BEING ADDRESSED BY MC NEW ALBANY, BUT ARE BEING ADDRESSED BY OTHER MOUNT CARMEL FACILITIES OR COLLABORATIVE PARTNERS: OBESITY IS BEING ADDRESSED AT MC EAST, MC WEST, MC ST. ANN'S, AND COMMUNITY RESOURCES LISTED ON PAGE 11 OF THE CHNA. INFANT MORTALITY IS BEING ADDRESSED BY MC EAST, MC ST. ANN'S, AND COMMUNITY RESOURCES LISTED ON PAGE 13 OF THE CHNA. ACCESS TO CARE IS BEING ADDRESSED BY MC EAST, MC WEST, MC ST. ANN'S, AND COMMUNITY RESOURCES LISTED ON PAGES 15 AND 16 OF THE CHNA. MENTAL HEALTH AND ADDICTION IS BEING ADDRESSED BY MC WEST, MC ST. ANN'S, DILEY RIDGE MEDICAL CENTER, AND COMMUNITY RESOURCES LISTED ON PAGE 18 OF THE CHNA.
MOUNT CARMEL EAST PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.
MOUNT CARMEL WEST PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.
MOUNT CARMEL ST. ANN'S PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP. PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.
MOUNT CARMEL EAST - PART V, SECTION B, LINE 9: AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.
MOUNT CARMEL WEST - PART V, SECTION B, LINE 9: AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.
MOUNT CARMEL ST. ANN'S - PART V, SECTION B, LINE 9: AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.
MOUNT CARMEL NEW ALBANY SURGICAL HOSP. - PART V, SECTION B, LINE 9: AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.
MOUNT CARMEL EAST - PART V, SECTION B, LINE 7A: CHNA URL: WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL EAST - PART V, SECTION B, LINE 10A: IMPLEMENTATION STRATEGY URL: WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL WEST - PART V, SECTION B, LINE 7A: CHNA URL: WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL WEST - PART V, SECTION B, LINE 10A: IMPLEMENTATION STRATEGY URL: WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL ST. ANN'S - PART V, SECTION B, LINE 7A: CHNA URL: WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL ST. ANN'S - PART V, SECTION B, LINE 10A: IMPLEMENTATION STRATEGY URL: WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL NEW ALBANY - PART V, SECTION B, LINE 7A: CHNA URL: WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
MOUNT CARMEL NEW ALBANY - PART V, SECTION B, LINE 10A: IMPLEMENTATION STRATEGY URL: WWW.MOUNTCARMELHEALTH.COM/COMMUNITY-BENEFIT
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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?81
Name and address Type of Facility (describe)
1 1 - MOUNT CARMEL HEALTH CENTER-GROVE CITY
5300 N MEADOWS DR
GROVE CITY,OH43123
EMERGENCY CARE
2 2 - MOUNT CARMEL HEALTH CENTER-GROVE CITY
5300 N MEADOWS DR
GROVE CITY,OH43123
IMAGING CENTER
3 3 - MOUNT CARMEL HEALTH CENTER-GROVE CITY
5300 N MEADOWS DR
GROVE CITY,OH43123
OUTPATIENT LAB DRAWS
4 4 - MOUNT CARMEL HEALTH CENTER-GROVE CITY
5300 N MEADOWS DR
GROVE CITY,OH43123
WOMENS HEALTH
5 5 - MOUNT CARMEL CARE CONTINUUM SERVICES
1144 DUBLIN RD
COLUMBUS,OH43215
HOSPICE
6 6 - NEW ALBANY SURGERY CENTER
5040 FOREST DR STE 100
NEW ALBANY,OH43054
AMBULATORY SURGERY CENTER
7 7 - TAYLOR STATION SURGERY CENTER
275 TAYLOR STATION RD
COLUMBUS,OH43213
AMBULATORY SURGERY CENTER
8 8 - EYE CENTER OF COLUMBUS
262 NEIL AVE STE 500
COLUMBUS,OH43215
COMMUNITY OPTHALMIC RESOURCES
9 9 - MOUNT CARMEL ST ANN'S INFUSION THERAPY
495 COOPER RD STE 115
WESTERVILLE,OH43081
INFUSION THERAPY
10 10 - MOUNT CARMEL ANTICOAGULATION
495 COOPER RD STE 330
WESTERVILLE,OH43081
ANTICOAGULATION, HEART FAILURE CENTER
11 11 - MOUNT CARMEL ST ANN'S OUTPATIENT LAB
495 COOPER RD STE 100
WESTERVILLE,OH43081
OUTPATIENT LAB DRAWS
12 12 - MOUNT CARMEL ST ANN'S IMAGING CENTER
495 COOPER RD STE 101
WESTERVILLE,OH43081
IMAGING CENTER
13 13 - MOUNT CARMEL ST ANN'S ENDOSCOPY & PULMON
495 COOPER RD STE 106
WESTERVILLE,OH43081
ENDOSCOPY & PULMONARY
14 14 - MOUNT CARMEL ST ANN'S CANCER CENTER
495 COOPER RD STE 120
WESTERVILLE,OH43081
CANCER TREATMENT
15 15 - COLUMBUS CYBERKNIFE
495 COOPER RD STE 125
WESTERVILLE,OH43081
CANCER TREATMENT
16 16 - MOUNT CARMEL ST ANN'S DIABETES MGMT
495 COOPER RD STE 210A
WESTERVILLE,OH43081
DIABETES SELF-MANAGEMENT
17 17 - MOUNT CARMEL ST ANN'S OUTPATIENT LAB
495 COOPER RD STE 314
WESTERVILLE,OH43081
OUTPATIENT LAB DRAWS
18 18 - MOUNT CARMEL ST ANN'S SURGICAL CARE CEN
495 COOPER RD STE 410
WESTERVILLE,OH43081
SURGICAL CARE
19 19 - MOUNT CARMEL ST ANN'S GI CENTER
495 COOPER RD STE 411
WESTERVILLE,OH43081
GASTROINTESTINAL CARE
20 20 - MOUNT CARMEL ST ANN'S ANTICOAGULATION CE
7100 GRAPHICS WAY STE 1500
LEWIS CENTER,OH43035
ANTICOAGULATION
21 21 - MOUNT CARMEL ST ANN'S CARDIOVASCULAR SER
7100 GRAPHICS WAY STE 1500
LEWIS CENTER,OH43035
CARDIOVASCULAR CENTER
22 22 - MOUNT CARMEL LEWIS CENTER LAB SERVICE CE
7100 GRAPHICS WAY STE 1600
LEWIS CENTER,OH43035
OUTPATIENT LAB DRAWS
23 23 - MOUNT CARMEL ST ANN'S OCCUPATION HLTH
7100 GRAPHICS WAY STE 1650
LEWIS CENTER,OH43035
OCCUPATIONAL HEALTH
24 24 - MOUNT CARMEL ST ANN'S IMAGING SERVICES
7100 GRAPHICS WAY STE 1700
LEWIS CENTER,OH43035
IMAGING CENTER
25 25 - MOUNT CARMEL ST ANN'S WOMENS HEALTH CEN
7100 GRAPHICS WAY STE 1800
LEWIS CENTER,OH43035
WOMENS HEALTH
26 26 - MOUNT CARMEL ST ANN'S EMERGENCY CARE
7100 GRAPHICS WAY STE 1900
LEWIS CENTER,OH43035
EMERGENCY CARE
27 27 - MOUNT CARMEL ST ANN'S CARDIAC REHAB
7100 GRAPHICS WAY STE 2100
LEWIS CENTER,OH43035
CARDIAC REHABILITATION
28 28 - MOUNT CARMEL FITNESS & HEALTH
7100 GRAPHICS WAY STE 2200
LEWIS CENTER,OH43035
PHYSICAL THERAPY
29 29 - MOUNT CARMEL SPORTS MEDICINE SPECIAL
7100 GRAPHICS WAY STE 2400
LEWIS CENTER,OH43035
REHAB & SPORTS MEDICINE
30 30 - MOUNT CARMEL WOUND CARE CENTER EAST
5965 E BROAD ST STE 120
COLUMBUS,OH43213
WOUND CARE CLINIC
31 31 - MOUNT CARMEL EAST WOMENS HEALTH
5965 E BROAD ST STE 100
COLUMBUS,OH43213
WOMENS HEALTH
32 32 - MOUNT CARMEL EAST ANTICOAGULATION CTR
5965 E BROAD ST STE 200
COLUMBUS,OH43213
ANTICOAGULATION, HEART FAILURE CENTER, HYPERTENSION CENTER
33 33 - MOUNT CARMEL EAST REHAB & SPORTS MED
5965 E BROAD ST STE 390
COLUMBUS,OH43213
REHAB & SPORTS MEDICINE, PHYSICAL THERAPY
34 34 - MOUNT CARMEL ST ANN'S WOMENS HEALTH CEN
477 COOPER RD STE 100
WESTERVILLE,OH43081
WOMENS HEALTH
35 35 - MOUNT CARMEL ST ANN'S OP WOUND CARE
477 COOPER RD STE 150
WESTERVILLE,OH43081
WOUND CARE CLINIC
36 36 - MOUNT CARMEL CLINICAL CARDIOVASCULAR SPE
477 COOPER RD STE 200
WESTERVILLE,OH43081
CARDIOVASCULAR CENTER
37 37 - MOUNT CARMEL ST ANN'S FAMILY MEDICINE
477 COOPER RD STE 309
WESTERVILLE,OH43081
FAMILY MEDICINE
38 38 - MOUNT CARMEL OUTPATIENT LAB
85 MCNAUGHTEN RD STE 100
COLUMBUS,OH43213
OUTPATIENT LAB DRAWS
39 39 - MOUNT CARMEL EAST VASCULAR SERVICES
85 MCNAUGHTEN RD STE 200
COLUMBUS,OH43213
VASCULAR SERVICES
40 40 - MOUNT CARMEL EAST CARDIAC IMAGING
85 MCNAUGHTEN RD STE 350
COLUMBUS,OH43213
CARDIAC IMAGING
41 41 - EASTWIND SURGICAL CENTER
955 EASTWIND DRIVE STE 150
WESTERVILLE,OH43081
NEUROSURGERY CENTER
42 42 - MOUNT CARMEL URGENT CARE
3000 MEADOW POND CT STE 200
GROVE CITY,OH43123
URGENT CARE
43 43 - MOUNT CARMEL GROVE CITY OUTPATIENT LAB
3000 MEADOW POND CT STE 300
GROVE CITY,OH43123
OUTPATIENT LAB DRAWS
44 44 - MOUNT CARMEL HEALTH REHAB SERVICES
3000 MEADOW POND CT STE 600
GROVE CITY,OH43123
REHAB & SPORTS MEDICINE
45 45 - MOUNT CARMEL HEALTH CENTER-GROVE CITY
5350 N MEADOWS DR STE 220
GROVE CITY,OH43123
ANTICOAGULATION, HEART FAILURE CENTER, CARDIAC REHAB
46 46 - MOUNT CARMEL HEALTH CENTER-GROVE CITY
5350 N MEADOWS DR STE 240
GROVE CITY,OH43123
REHAB & SPORTS MEDICINE
47 47 - MOUNT CARMEL HEALTH CENTER-GROVE CITY
5350 N MEADOWS DR STE 260
GROVE CITY,OH43123
NUCLEAR MEDICINE & CARDIAC IMAGING
48 48 - MOUNT CARMEL EAST IMAGING CENTER
5969 E BROAD ST STE 100
COLUMBUS,OH43213
IMAGING CENTER
49 49 - MOUNT CARMEL EAST OCCUPATIONAL HEALTH
5969 E BROAD ST STE 307
COLUMBUS,OH43213
OCCUPATIONAL HEALTH
50 50 - MOUNT CARMEL WEST REHAB & SPORTS MED
745 W STATE ST STE 700
COLUMBUS,OH43222
REHAB & SPORTS MEDICINE, PHYSICAL THERAPY
51 51 - MOUNT CARMEL HEALTH CARDIAC IMAGING
745 W STATE ST STE 750
COLUMBUS,OH43222
CARDIOLOGY CENTER
52 52 - MOUNT CARMEL WEST OUTPATIENT LAB
750 MOUNT CARMEL MALL RM 180
COLUMBUS,OH43222
OUTPATIENT LAB DRAWS
53 53 - MOUNT CARMEL WEST WOMENS HEALTH
750 MOUNT CARMEL MALL STE 160
COLUMBUS,OH43222
WOMENS HEALTH
54 54 - MOUNT CARMEL WOUND & OSTOMY CARE CTR
5975 E BROAD ST STE 204
COLUMBUS,OH43213
WOUND & OSTOMY CARE
55 55 - MOUNT CARMEL EAST INFUSION SERVICES
5975 E BROAD ST STE 300
COLUMBUS,OH43213
CANCER TREATMENT
56 56 - MOUNT CARMEL REHABILITATION HOSPITAL IN
597 EXECUTIVE CAMPUS DR
WESTERVILLE,OH43082
INPATIENT REHABILITATION HOSPITAL
57 57 - MOUNT CARMEL OUTPATIENT LAB
150 TAYLOR STATION RD STE 130
COLUMBUS,OH43213
OUTPATIENT LAB DRAWS
58 58 - MOUNT CARMEL CARDIAC REHAB
150 TAYLOR STATION RD STE 350
COLUMBUS,OH43213
CARDIAC AND PULMONARY REHAB
59 59 - MOUNT CARMEL CARDIAC IMAGING
7901 DILEY ROAD STE 230
CANAL WINCHESTER,OH43110
CARDIAC IMAGING
60 60 - MOUNT CARMEL OUTPATIENT LAB
7901 DILEY ROAD STE 205
CANAL WINCHESTER,OH43110
OUTPATIENT LAB DRAWS
61 61 - MOUNT CARMEL SLEEP MEDICINE
2760 AIRPORT DR STE 120
COLUMBUS,OH43219
SLEEP MEDICINE
62 62 - MOUNT CARMEL SLEEP MEDICINE
484 COUNTY LINE RD SUITE 140
WESTERVILLE,OH43082
SLEEP MEDICINE
63 63 - MOUNT CARMEL E BROAD ST URGENT CARE
6495 E BROAD ST SINCE 10/1/2015
COLUMBUS,OH43213
URGENT CARE
64 64 - MOUNT CARMEL RADIATION THERAPY
3100 PLAZA PROPERTIES BLVD STE 120
COLUMBUS,OH43219
CANCER TREATMENT
65 65 - MOUNT CARMEL MRI CENTER
3755 RIDGE MILL DR
HILLIARD,OH43026
IMAGING CENTER
66 66 - MOUNT CARMEL REHAB & SPORTS MEDICINE
3775 TRUEMAN CT STE 300
HILLIARD,OH43026
REHAB & SPORTS MEDICINE, PHYSICAL THERAPY
67 67 - MOUNT CARMEL MILL RUN IMAGING CENTER
3779 TRUEMAN CT STE 200
HILLIARD,OH43026
IMAGING CENTER, WOMENS HEALTH CENTER, OUTPATIENT LAB
68 68 - MOUNT CARMEL OCCUPATIONAL HEALTH
4171 ARLINGATE PLAZA STE 18
COLUMBUS,OH43228
OCCUPATIONAL HEALTH
69 69 - MOUNT CARMEL REHAB & SPORTS MEDICINE
444 N CLEVELAND AVE STE 310
WESTERVILLE,OH43082
CARDIAC REHAB & SPORTS MEDICINE
70 70 - MOUNT CARMEL EAST TESTING
5825 WESTBOURNE AV
COLUMBUS,OH43213
STRESS TESTS AND NON-INVASIVE VASCULAR TESTING
71 71 - MOUNT CARMEL CARDIAC IMAGING
6670 PERIMETER DR STE 100
DUBLIN,OH43016
CARDIOLOGY CENTER
72 72 - MOUNT CARMEL WEST ANTICOAGULATION
730 W RICH ST
COLUMBUS,OH43222
ANTICOAGULATION, HEART FAILURE CENTER
73 73 - MOUNT CARMEL METROWEST INTERNAL MED
815 WEST BROAD ST STE 200
COLUMBUS,OH43222
INTERNAL MEDICINE
74 74 - MOUNT CARMEL HEALTH CENTER-WEDGEWOOD
10330 SAWMILL PKWY STE 500
POWELL,OH43065
OUTPATIENT LAB DRAWS
75 75 - MOUNT CARMEL MARBLE CLIFF LAB SERVICE CE
2100 MARBLE CLIFF OFFICE PARK STE A
COLUMBUS,OH43215
OUTPATIENT LAB DRAWS
76 76 - MOUNT CARMEL ST ANN'S LAB SERV CTR
237 W SCHROCK RD STE A
WESTERVILLE,OH43081
OUTPATIENT LAB DRAWS
77 77 - MOUNT CARMEL SEDALIA LAB SERVICE CTR
5343 HENDRON RD
GROVEPORT,OH43125
OUTPATIENT LAB DRAWS
78 78 - MOUNT CARMEL NEW ALBANY HEALTH & WELL
55 N HIGH ST
NEW ALBANY,OH43054
OUTPATIENT LAB DRAWS
79 79 - MOUNT CARMEL PICKERINGTON MEDICAL CTR
641 HILL ROAD NORTH SUITE D
PICKERINGTON,OH43147
OUTPATIENT LAB DRAWS
80 80 - MOUNT CARMEL PATASKALA MEDICAL CENTER OU
8200 HAZELTON-ETNA ROAD SW SUITE 50
PATASKALA,OH43062
OUTPATIENT LAB DRAWS
81 81 - WESTAR HEALTH CENTER
444 N CLEVELAND AVE STE 320
WESTERVILLE,OH43082
CARDIAC REHAB
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS.
PART I, LINE 6A: MOUNT CARMEL REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.IN ADDITION, MOUNT CARMEL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. MOUNT CARMEL ALSO SUBMITS THE COMMUNITY HEALTH NEEDS ASSESSMENT AND PLAN WITH THE OHIO DEPARTMENT OF HEALTH EVERY THIRD YEAR IN ACCORDANCE WITH STATE OF OHIO REQUIREMENTS.
PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM.
PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $48,981,885, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F).
PART II, COMMUNITY BUILDING ACTIVITIES: IN FY 2018, MOUNT CARMEL HOSPITALS CONTRIBUTED TO THE ECONOMIC AND CIVIC HEALTH OF THE SURROUNDING COMMUNITIES BY SERVING IN AND CONTRIBUTING TO THE EFFORTS OF SEVERAL CHAMBERS OF COMMERCE AND OTHER CIVIC ORGANIZATIONS IN THE CITY OF COLUMBUS, AS WELL AS SURROUNDING SUBURBS AND COUNTIES. MOUNT CARMEL'S LEADERS HAVE GIVEN THEIR EXPERTISE TO THESE GROUPS AND HAVE BEEN ABLE TO ADVOCATE ON ISSUES IMPACTING THE HEALTH OF CENTRAL OHIO CITIZENS, SUCH AS THE NUMBER ONE HEALTH INDICATOR NOTED IN FRANKLIN COUNTY HEALTHMAP 2016: OBESITY. AS IN PAST YEARS, MOUNT CARMEL MADE FINANCIAL CONTRIBUTIONS IN FISCAL YEAR 2018 TO A VARIETY OF NON-PROFIT SOCIAL SERVICES AGENCIES/ORGANIZATIONS, INCLUDING THOSE ADDRESSING HEALTH, HOUSING, AND HUNGER. COLLEAGUES PARTICIPATE IN MULTIPLE FOOD DRIVES COLLECTING MONETARY AND NON-PERISHABLE FOOD ITEMS FOR VARIOUS FOOD PANTRIES IN THE CENTRAL OHIO AREA. HEALTH SYSTEM ADVOCATES MET WITH GOVERNMENT OFFICIALS REGARDING HUNGER AND BUDGET ITEMS TO ENSURE THE SUPPLY OF FOOD TO RECIPIENTS OF MEALS ON WHEELS.COLLEAGUES PARTICIPATE ON VARIOUS BOARDS OF DIRECTORS, MEET WITH LOCAL AND STATE GOVERNMENT OFFICIALS, PARTICIPATE IN AND PRESENT WEBINARS/SEMINARS, AND ARE INVOLVED IN COALITIONS TO IMPROVE THE LIVES OF THE COMMUNITY.
PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.
PART III, LINE 3: MOUNT CARMEL USES A PREDICTIVE MODEL THAT INCORPORATES DISTINCT VARIABLES, SUCH AS SOCIO-ECONOMIC SCORE AND ESTIMATED FEDERAL POVERTY LEVEL (FPL) TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, MOUNT CARMEL IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, MOUNT CARMEL IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL.
PART III, LINE 4: MOUNT CARMEL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 14 OF THOSE STATEMENTS: "THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY THE HEALTH MINISTRIES FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE."PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION.
PART III, LINE 8: MOUNT CARMEL DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT.
PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S COLLECTION POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS.
PART VI, LINE 2: NEEDS ASSESSMENT - MOUNT CARMEL ASSESSES THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, MOUNT CARMEL HOSPITALS MAY USE PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES, AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MOUNT CARMEL COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES, FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS, AND OTHER COMMUNITY-BASED CHARITABLE PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. MOUNT CARMEL OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. MOUNT CARMEL HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MOUNT CARMEL MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER.
PART VI, LINE 4: COMMUNITY INFORMATION - MOUNT CARMEL PREDOMINATELY SERVES CENTRAL OHIO, WHICH INCLUDES FRANKLIN AND FIVE CONTIGUOUS COUNTIES (DELAWARE, FAIRFIELD, LICKING, MADISON AND PICKAWAY), AND IS HOME TO NEARLY 2 MILLION RESIDENTS. AMONG FRANKLIN COUNTY HOUSEHOLDS, 27.1% HAVE AN INCOME OF LESS THAN $30,000, AND ANOTHER 19.1% HAVE A HOUSEHOLD INCOME OF BETWEEN $30,000 AND $50,000. IN 2017, APPROXIMATELY 38.4% OF THE FRANKLIN COUNTY POPULATION OVER AGE 25 HELD A BACHELOR'S OR HIGHER DEGREE. OF THE FRANKLIN COUNTY RESIDENTS, 34.4% LIVE AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL AND 8.3% LIVE BELOW 50% OF POVERTY LEVEL. ACCORDING TO THE OHIO COUNTY PROFILES FOR FRANKLIN COUNTY, 9.6% OF ADULTS IN FRANKLIN COUNTY BETWEEN THE AGES OF 18-64 DO NOT HAVE HEALTH INSURANCE. CENTRAL OHIO FEATURES A DIVERSE EMPLOYER BASE, INCLUDING GOVERNMENT, MANUFACTURING, TRADE, EDUCATION, SERVICE, FINANCE AND AGRICULTURE. THE OHIO UNEMPLOYMENT RATE WAS 4.9% IN JULY 2018. THE UNEMPLOYMENT RATE FOR FRANKLIN COUNTY IN JULY 2018 WAS AN ESTIMATED 4.1%. THE COMMUNITY NEED INDEX ON THE COLUMBUS' WEST SIDE, WHERE MC WEST IS LOCATED, IS 4.6 ON A SCALE OF 1-5, WITH 1 BEING AN AREA OF LOW NEED AND 5 AN AREA WITH THE HIGHEST LEVEL OF NEED. MC EAST IS LOCATED IN AN AREA WITH A 4.2 COMMUNITY NEED INDEX. MC ST. ANN'S IS LOCATED IN AN AREA WITH A COMMUNITY NEED INDEX OF 2.6, WHICH IS MUCH LOWER THAN THE OTHER FACILITIES BUT WITH POCKETS OF HIGHER NEED WITHIN ITS SERVICE AREA. MC NEW ALBANY IS LOCATED IN AN AREA WITH A COMMUNITY NEED INDEX OF 2. ACCORDING TO OHIO COUNTY PROFILES, 16 REGISTERED HOSPITALS ARE LOCATED WITHIN FRANKLIN COUNTY, OFFERING THE COMMUNITY A TOTAL OF 6,060 BEDS. THESE 16 FACILITIES CONSIST OF FOUR ADULT HOSPITAL SYSTEMS, ONE PEDIATRIC HOSPITAL SYSTEM, AND 11 FEDERALLY QUALIFIED HEALTH CENTERS IN FRANKLIN COUNTY.
PART VI, LINE 5: OTHER INFORMATION - MOUNT CARMEL IS GOVERNED BY A 13-MEMBER BOARD OF DIRECTORS, WITH A MAJORITY OF THE SEATS ALLOCATED TO COMMUNITY REPRESENTATIVES AND LEADERS. OUR GOVERNANCE STRUCTURE ENSURES THAT THE COMMUNITY AND ITS INTERESTS ARE STRONGLY REPRESENTED IN IMPORTANT DECISION MAKING. IN ADDITION, TWO SEATS ON MOUNT CARMEL'S BOARD ARE ALLOCATED TO RELIGIOUS WOMEN, WHO HELP ENSURE THAT THE ORGANIZATION REMAINS TRUE TO ITS CHARITABLE MISSION. MOUNT CARMEL HOSPITALS MAINTAIN AN OPEN MEDICAL STAFF - MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS. MOUNT CARMEL ACTIVELY RECRUITS AND EMPLOYS DOCTORS TO SERVE IN UNDER-SERVED AREAS OF THE COMMUNITY. MOUNT CARMEL OPERATES A GRADUATE MEDICAL EDUCATION PROGRAM AND A COLLEGE OF NURSING. THE MOUNT CARMEL HEALTH SYSTEM FOUNDATION AND THE MC COLLEGE OF NURSING PROVIDED 169 STUDENTS WITH 51 DIFFERENT ACADEMIC SCHOLARSHIPS FOR EDUCATING FUTURE NURSES. THE GRADUATE MEDICAL EDUCATION PROGRAM OPERATES CLINICS FOR BOTH EDUCATION PURPOSES AND TO IMPROVE ACCESS AND CARE CONTINUITY FOR PATIENTS WITHOUT INSURANCE.MOUNT CARMEL PROVIDED MANY LEARNING OPPORTUNITIES TO THE COMMUNITY IN FY 2018. THE HEALTH SYSTEM HELPED PROFESSIONALS CONTINUE THEIR EDUCATION AND STRIVED TO INSPIRE FUTURE HEALTH CARE PROVIDERS, AND EDUCATED EMERGENCY MEDICAL SERVICE PROFESSIONALS AND FIRE FIGHTERS IN VARIOUS TOWNSHIPS AND COUNTIES TO STAY ABREAST ON THE MOST MODERN AND APPROPRIATE EMERGENCY TREATMENT OPTIONS. MC WEST, MC EAST AND MC ST. ANN'S HAVE WORKED TOWARD ACHIEVING BABY-FRIENDLY STATUS AND ARE IN THE DISSEMINATION PHASE OF BABY-FRIENDLY USA'S CRITERIA. MC EAST AND MC WEST HAVE APPLIED FOR THE FINAL THREE STEPS OF A TEN-STEP PROCESS FOR OHIO FIRST STEPS, AN OHIO HOSPITAL ASSOCIATION INITIATIVE.MOUNT CARMEL HEALTH SYSTEM HAS PARTNERED WITH FRANKLIN COUNTY PUBLIC HEALTH (FCPH) TO EXTEND THEIR FARM TO SCHOOL PROGRAM. THE FARM TO SCHOOL PROGRAM HAD THREE COMPONENTS: PROCUREMENT, EDUCATION, AND SCHOOL GARDENS. FCPH HAD SUCCESSFULLY EXECUTED PROCUREMENT AND EDUCATION, BUT THEY HAD YET TO EXPAND THE PROGRAM TO INCLUDE SCHOOL GARDENS. WITH THE ASSISTANCE OF MOUNT CARMEL, A TOTAL OF 22 TOWER GARDENS HAVE BEEN MADE AVAILABLE FOR PLACEMENT IN FAIRFIELD AND FRANKLIN COUNTY SCHOOL SYSTEMS. THE THREE COMPONENTS OF THE FARM TO SCHOOL PROGRAM AID IN CHILDREN TRYING HEALTHY LOCAL FOODS, LEARNING ABOUT THOSE FOODS, AND THEN GAINING THE SKILLS AND KNOWLEDGE TO GROW THEIR OWN. IN TURN, THIS INCREASES CHILDREN'S CONFIDENCE AND DEVELOPS CRITICAL THINKING SKILLS BY BECOMING MORE INFORMED FOOD CONSUMERS WHILE ALSO COMBATING THE INCREASING RATES OF CHILDHOOD OBESITY AND CHRONIC DISEASE.
PART VI, LINE 6: MOUNT CARMEL IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER MINISTRIES DEFINE - AND ACHIEVE - SPECIFIC COMMUNITY HEALTH AND WELL-BEING GOALS. IN FISCAL YEAR 2018, EVERY MINISTRY FOCUSED ON FOUR GOALS: 1. REDUCE TOBACCO USE 2. REDUCE OBESITY PREVALENCE3. ADDRESS AT LEAST ONE SIGNIFICANT HEALTH NEED IDENTIFIED IN THE MINISTRY COMMUNITY HEALTH NEEDS ASSESSMENT4. ADDRESS AT LEAST ONE SOCIAL DETERMINANT OF HEALTH TRINITY HEALTH ACKNOWLEDGES THE IMPACT SOCIAL DETERMINANTS SUCH AS ADEQUATE HOUSING, SAFETY, ACCESS TO FOOD, EDUCATION, INCOME, AND HEALTH COVERAGE HAVE ON THE HEALTH OF THE COMMUNITY. IN FISCAL YEAR 2016, TRINITY HEALTH LAUNCHED THE TRANSFORMING COMMUNITIES INITIATIVE (TCI) TO ADVANCE COMMUNITY PARTNERSHIPS THAT FOCUS ON IMPROVING THE HEALTH AND WELL-BEING IN COMMUNITIES SERVED BY THE MINISTRIES OF TRINITY HEALTH. TCI IS AN INNOVATIVE FUNDING MODEL AND TECHNICAL ASSISTANCE INITIATIVE SUPPORTING EIGHT COMMUNITIES USING POLICY, SYSTEM, AND ENVIRONMENTAL (PSE) CHANGE STRATEGIES TO PREVENT TOBACCO USE AND CHILDHOOD OBESITY, AS WELL AS ADDRESS SOCIAL DETERMINANTS OF HEALTH. TRINITY HEALTH INVESTED $3.6 MILLION IN FISCAL YEAR 2018 IN TCI. IN FISCAL YEAR 2018, TRINITY HEALTH LAUNCHED THE GOOD SAMARITAN INITIATIVE (GSI) TO SUPPORT THE MOST VULNERABLE PATIENTS' SOCIAL AND ECONOMIC NEEDS IN OUR SYSTEM THROUGH INTEGRATING COMMUNITY HEALTH WORKERS AS PART OF CARE TEAMS ACROSS NINE MINISTRIES. TRINITY HEALTH INVESTED OVER $260,000 IN FISCAL YEAR 2018 IN GSI. ADDITIONALLY, TRINITY HEALTH INVESTED $500,000 IN ELEVEN GRANTS TO IMPROVE THE BUILT ENVIRONMENT ACROSS EIGHT MINISTRIES. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO OUR COMMUNITIES THROUGH PROMOTING WELLNESS AND DEVELOPING PROGRAMS SPECIFICALLY SUPPORTING THOSE WHO ARE POOR AND VULNERABLE, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, AND MOVING FORWARD POLICY, SYSTEM AND ENVIRONMENTAL CHANGE. THE ORGANIZATION WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING THE SPECIFIC NEEDS OF EACH COMMUNITY. IN FISCAL YEAR 2018, TRINITY HEALTH INVESTED OVER $1.1 BILLION IN SUCH COMMUNITY BENEFITS.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG.
Schedule H (Form 990) 2019
Additional Data


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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
2019
Open to Public
Inspection
Name of the organization
MOUNT CARMEL HEALTH SYSTEM
 
Employer identification number
31-1439334
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) AMERICAN HEART ASSOCIATION
5455 N HIGH ST
COLUMBUS,OH43214
13-5613797 501(C)(3) 30,000       COMMUNITY BENEFIT
(2) ARTHRITIS FOUNDATION CENTRAL OHIO
3740 RIDGE MILL DR
HILLIARD,OH43026
58-1341679 501(C)(3) 7,500       COMMUNITY BENEFIT
(3) BOY SCOUTS OF AMERICA
807 KINNEAR ROAD
COLUMBUS,OH432121421
22-1576300 501(C)(3) 9,000       COMMUNITY BENEFIT
(4) CATHOLIC CONFERENCE OF OHIO
9 E LONG ST STE 201
COLUMBUS,OH43215
53-0196617 501(C)(3) 5,735       COMMUNITY BENEFIT
(5) CATHOLIC SOCIAL SERVICES
197 E GAY ST
COLUMBUS,OH43215
31-4379437 501(C)(3) 5,000       COMMUNITY BENEFIT
(6) LEWIS CENTER BUSINESS ASSOCIATION INC - CELEBRATE COMMUNITY
1497 COTTONWOOD DR
LEWIS CENTER,OH43035
32-0147224 501(C)(6) 15,000       COMMUNITY BENEFIT
(7) THE CENTER FOR FAMILY SAFETY AND HEALING
655 E LIVINGSTON AV
COLUMBUS,OH43205
02-0627166 501(C)(3) 15,000       NEW ALBANY CLASSIC SPONSORSHIP
(8) CHARITABLE PHARMACY OF CENTRAL OHIO
200 E LIVINGSTON AVE
COLUMBUS,OH43215
27-0147099 501(C)(3) 25,000       COMMUNITY BENEFIT
(9) CITY OF GROVE CITY
4035 BROADWAY
GROVE CITY,OH43123
31-6400527 MUNICIPALITY 5,000       COMMUNITY BENEFIT
(10) COLUMBUS 2020
150 S FRONT ST STE 200
COLUMBUS,OH43215
27-1509190 501(C)(6) 30,000       COMMUNITY BENEFIT
(11) COLUMBUS METROPOLITAN CLUB
100 E BROAD ST STE 100
COLUMBUS,OH43215
31-0889324 501(C)(3) 11,630       COMMUNITY BENEFIT
(12) COLUMBUS PARTNERSHIP (GREATER COLUMBUS CHAMBER OF COMMERCE)
150 S FRONT ST
COLUMBUS,OH43215
31-4152950 501(C)(6) 56,000       COMMUNITY BENEFIT
(13) COMMUNITY ARTS PROJECT
867 MOUNT VERNON AVE
COLUMBUS,OH43203
23-7065803 501(C)(3) 5,000       COMMUNITY BENEFIT
(14) FRANKLINTON FARMS
867 W TOWN ST
COLUMBUS,OH43222
45-4023198 501(C)(3) 20,000       COMMUNITY BENEFIT
(15) FRATERNAL ORDER OF POLICE
6800 SCHROCK HILL CT
COLUMBUS,OH43229
31-0809152 501(C)(8) 21,822       COMMUNITY BENEFIT
(16) GAHANNA CONVENTION & VISITORS BUREAU
167 MILL ST
GAHANNA,OH432303013
80-0322167 501(C)(6) 18,000       COMMUNITY BENEFIT
(17) EPILEPSY FOUNDATION OF GREATER CINCINNATI & COLUMBUS
895 CENTRAL AVE STE 550
CINCINNATI,OH452025757
23-7284156 501(C)(3) 5,000       COMMUNITY BENEFIT
(18) HEART OF OHIO FAMILY HEALTH CENTER
882 S HAMILTON ROAD
COLUMBUS,OH43213
38-3765547 501(C)(3) 300,000       COMMUNITY BENEFIT
(19) KIDSMILES PEDIATRIC DENTAL CLINIC
770 BETHEL RD
COLUMBUS,OH43214
26-3706958 501(C)(3) 5,000       COMMUNITY BENEFIT
(20) LOWER LIGHTS CHRISTIAN HEALTH CENTER INC
1160 W BROAD ST
COLUMBUS,OH43222
31-1810355 501(C)(3) 250,000       COMMUNITY BENEFIT
(21) MARCH OF DIMES FOUNDATION
2831 E MAIN ST 2ND FL
COLUMBUS,OH43209
13-1846366 501(C)(3) 12,500       MARCH FOR BABIES SPONSOR
(22) NEW ALBANY CHAMBER OF COMMERCE
55 W MAIN ST
NEW ALBANY,OH43054
31-1221292 501(C)(6) 10,125       COMMUNITY BENEFIT
(23) NEW ALBANY COMMUNITY EVENTS BOARD
PO BOX 188
NEW ALBANY,OH43054
26-2037123 501(C)(4) 5,000       FREEDOM PRESENTING SPONSORSHIP
(24) SUSAN G KOMEN BREAST CANCER FOUNDATION
929 EASTWIND DR STE 211
WORTHINGTON,OH43085
75-2844651 501(C)(3) 25,240       COMMUNITY BENEFIT
(25) PANCREATIC CANCER ACTION NETWORK
1500 ROSECRANS AVE
MANHATTAN BEACH,CA90266
33-0841281 501(C)(3) 10,000       COMMUNITY BENEFIT
(26) GROVE CITY FOOD PANTRY
2710 COLUMBUS ST
GROVE CITY,OH43123
33-1126888 501(C)(3) 7,500       COMMUNITY BENEFIT
(27) GROVE CITY AREA CHAMBER
4069 BROADWAY
GROVE CITY,OH43123
31-0922925 501(C)(6) 14,950       COMMUNITY BENEFIT
(28) ROTARY CLUB OF WESTERVILLE
PO BOX 595
WESTERVILLE,OH43086
31-6050404 501(C)(4) 15,000       COMMUNITY BENEFIT
(29) NATIONAL MULTIPLE SCLEROSIS SOC
6155 ROCKSIDE RD STE 202
INDEPENDENCE,OH44131
13-5661935 501(C)(3) 7,500       COMMUNITY BENEFIT
(30) THE BUCKEYE RANCH
5665 HOOVER ROAD
GROVE CITY,OH43123
31-0642111 501(C)(3) 5,000       COMMUNITY BENEFIT
(31) RONALD MCDONALD HOUSE CHARITIES OF CENTRAL OHIO INC
711 E LIVINGSTON AVE
COLUMBUS,OH43205
31-0890152 501(C)(3) 5,000       COMMUNITY BENEFIT
(32) WALK WITH A DOC
495 COOPER RD STE 209
WESTERVILLE,OH43081
26-3253701 501(C)(3) 5,000       COMMUNITY BENEFIT
(33) WESTERVILLE AREA CHAMBER OF COMMERCE
90 COMMERCE PARK DR
WESTERVILLE,OH43082
31-0737083 501(C)(6) 15,690       COMMUNITY BENEFIT
(34) WESTERVILLE AREA RESOURCE MINISTRY (WARM)
150 HEATHERDOWN DR
WESTERVILLE,OH43081
31-1640355 501(C)(3) 17,500       COMMUNITY BENEFIT
(35) WESTERVILLE PARKS FOUNDATION (BUNNY HOP)
350 N CLEVELAND AVE
WESTERVILLE,OH43082
31-1719247 501(C)(3) 5,000       COMMUNITY BENEFIT
(36) WESTERVILLE SUNRISE ROTARY (CHILLY OPEN)
PO BOX 1200
WESTERVILLE,OH430861200
31-1481931 501(C)(3) 10,000       COMMUNITY BENEFIT
(37) WESTERVILLE VISITORS BUREAU
20 W MAIN ST
WESTERVILLE,OH43081
31-1233383 501(C)(6) 10,000       COMMUNITY BENEFIT
(38) UNITED NEGRO COLLEGE FUND
341 S THIRD ST STE 203
COLUMBUS,OH43215
13-1624241 501(C)(3) 8,500       COMMUNITY BENEFIT
(39) YMCA OF CENTRAL OHIO
40 W LONG ST
COLUMBUS,OH43215
31-4379594 501(C)(3) 10,000       ANNUAL GIVING GIFT
(40) UNITED WAY OF FRANKLIN COUNTY
360 S THIRD ST
COLUMBUS,OH43215
31-4393712 501(C)(3) 5,000       COMMUNITY BENEFIT
(41) BOYS & GIRLS CLUBS OF COLUMBUS INC
1108 CITY PARK AVE STE 301
COLUMBUS,OH43206
31-4387575 501(C)(3) 10,000       COMMUNITY BENEFIT
(42) COLUMBUS RUNNING COMPANY CHARITY FUND
6465 PERIMETER DR
DUBLIN,OH43016
02-0803171 501(C)(3) 5,000       COMMUNITY BENEFIT
(43) FRANKLINTON BOARD OF TRADE INC
PO BOX 23315
COLUMBUS,OH43223
31-1159107 501(C)(3) 9,550       SPONSORSHIP NATIONAL NIGHT OUT
(44) NEW ALBANY COMMUNITY FOUNDATION
220 MARKET ST STE 205
NEW ALBANY,OH43054
31-1409264 501(C)(3) 25,000       COMMUNITY BENEFIT
(45) OHIO STATE UNIVERSITY FOUNDATION
1480 W LANE AV
COLUMBUS,OH43221
31-1145986 501(C)(3) 21,000       COMMUNITY BENEFIT
(46) CITY OF POWELL
47 HALL ST
POWELL,OH430658357
31-0858049 MUNICIPALITY 15,000       FESTIVAL SPONSORSHIP
(47) LEUKEMIA AND LYMPHOMA SOCIETY
3 INTERNATIONAL DRIVE SUITE 200
RYE BROOK,NY10573
13-5644916 501(C)(3) 5,000       COMMUNITY BENEFIT
(48) MADISON HEALTH FOUNDATION
210 N MAIN ST
LONDON,OH43140
23-7423524 501(C)(3) 5,000       COMMUNITY BENEFIT
(49) MARTIN LUTHER KING BREAKFAST COMMITTEE INC
PO BOX 83134
COLUMBUS,OH43204
31-1225276 501(C)(3) 5,300       COMMUNITY BENEFIT
(50) INDEPENDENTS DAY INC
78 E CHESTNUT ST STE 307
COLUMBUS,OH43215
45-2824975 501(C)(3) 7,000       COMMUNITY BENEFIT
(51) MAIN STREET DELAWARE INC
20 E WINTER ST
DELAWARE,OH43015
31-1679916 501(C)(3) 5,000       COMMUNITY BENEFIT
(52) IMPACT OHIO
172 E STATE ST STE 400
COLUMBUS,OH43215
  5,000       COMMUNITY BENEFIT
(53) WELD INC
6478 WINCHESTER BLVD STE 120
CANAL WINCHESTER,OH43110
45-4542456 501(C)(3) 5,000       COMMUNITY BENEFIT
(54) AMERICAN CANCER SOCIETY OF OHIO
5555 FRANTZ ROAD
DUBLIN,OH43016
13-1788491 501(C)(3) 10,000       COMMUNITY BENEFIT
(55) CATHOLIC DIOCESE OF COLUMBUS
198 E BROAD ST
COLUMBUS,OH43215
31-4379603 501(C)(3) 11,000       COMMUNITY BENEFIT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
43
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
12
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019

Schedule I (Form 990) 2019
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: DONATIONS MADE BY MOUNT CARMEL HEALTH SYSTEM TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H.
Schedule I (Form 990) 2019



Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" 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
2019
Open to Public Inspection
Name of the organization
MOUNT CARMEL HEALTH SYSTEM
 
Employer identification number

31-1439334
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
 
No
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1EDWARD LAMB
DIRECTOR; MOUNT CARMEL PRES & CEO
(i)

(ii)
0
-------------
699,122
0
-------------
180,010
0
-------------
32,977
0
-------------
169,214
0
-------------
28,491
0
-------------
1,109,814
0
-------------
0
2SALLY JEFFCOAT
DIRECTOR; EVP TRINITY HEALTH
(i)

(ii)
0
-------------
898,754
0
-------------
388,608
0
-------------
230,295
0
-------------
12,150
0
-------------
31,295
0
-------------
1,561,102
0
-------------
0
3PAUL MORRIS
MOUNT CARMEL EVP & CFO AS OF 9/17
(i)

(ii)
0
-------------
101,115
0
-------------
0
0
-------------
128,080
0
-------------
17,368
0
-------------
5,774
0
-------------
252,337
0
-------------
0
4DANIEL POWELL
MOUNT CARMEL INTERIM CFO THR 8/17
(i)

(ii)
355,671
-------------
85,793
0
-------------
0
0
-------------
287
9,781
-------------
2,369
0
-------------
1,250
365,452
-------------
89,699
0
-------------
0
5DANIEL HACKETT
SECRETARY; MANAGING COUNSEL
(i)

(ii)
0
-------------
310,031
0
-------------
86,018
0
-------------
6,151
0
-------------
12,150
0
-------------
32,529
0
-------------
446,879
0
-------------
0
6UNHEE KIM
PRESIDENT, ST. ANN'S
(i)

(ii)
0
-------------
391,761
0
-------------
108,529
0
-------------
6,955
0
-------------
75,938
0
-------------
16,468
0
-------------
599,651
0
-------------
0
7SEAN MCKIBBEN
PRESIDENT & COO, MC WEST
(i)

(ii)
0
-------------
357,571
0
-------------
141,419
0
-------------
127,181
0
-------------
12,150
0
-------------
30,892
0
-------------
669,213
0
-------------
28,089
8MICHAEL WILKINS
PRESIDENT & COO, MC EAST
(i)

(ii)
0
-------------
374,096
0
-------------
103,983
0
-------------
7,959
0
-------------
73,502
0
-------------
20,906
0
-------------
580,446
0
-------------
0
9DIANE DOUCETTE
PRESIDENT, MC NEW ALBANY
(i)

(ii)
0
-------------
358,601
0
-------------
100,327
0
-------------
9,603
0
-------------
12,150
0
-------------
25,495
0
-------------
506,176
0
-------------
0
10RICHARD STRECK
CMO & CHIEF QUALITY OFFICER
(i)

(ii)
0
-------------
519,760
0
-------------
144,618
0
-------------
89,887
0
-------------
12,150
0
-------------
23,714
0
-------------
790,129
0
-------------
0
11TAUANA MCDONALD
CHIEF ADMINISTRATIVE OFFICER
(i)

(ii)
0
-------------
314,822
0
-------------
134,155
0
-------------
109,355
0
-------------
16,200
0
-------------
30,190
0
-------------
604,722
0
-------------
0
12PHILLIP SHUBERT MD
SYSTEM MEDICAL DIRECTOR
(i)

(ii)
539,172
-------------
0
0
-------------
0
3,889
-------------
0
15,523
-------------
0
26,130
-------------
0
584,714
-------------
0
0
-------------
0
13DANIEL WENDORFF MD
PRESIDENT - HEALTH PARTNERS
(i)

(ii)
381,008
-------------
0
57,072
-------------
0
2,686
-------------
0
16,200
-------------
0
21,545
-------------
0
478,511
-------------
0
0
-------------
0
14CHARLES SANDERS JR MD
VP MEDICAL EDUCATION
(i)

(ii)
353,430
-------------
0
53,546
-------------
0
2,494
-------------
0
12,150
-------------
0
25,603
-------------
0
447,223
-------------
0
0
-------------
0
15GERALD GIRARDI MD
PERINATAL MEDICAL DIRECTOR
(i)

(ii)
0
-------------
363,672
0
-------------
39,515
0
-------------
2,531
0
-------------
12,150
0
-------------
17,929
0
-------------
435,797
0
-------------
0
16CHARLES BRETT JUSTICE
FORMER KE; SYS VP STRATEGIC ADVANCMT
(i)

(ii)
0
-------------
278,845
0
-------------
62,820
0
-------------
425
0
-------------
16,200
0
-------------
25,537
0
-------------
383,827
0
-------------
0
17CLAUS VON ZYCHLIN
FORMER OFFICER
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
815,897
0
-------------
0
0
-------------
22,518
0
-------------
838,415
0
-------------
705,428
18KEITH COLEMAN
FORMER OFFICER
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
222,275
0
-------------
0
0
-------------
8,347
0
-------------
230,622
0
-------------
189,998
19ROGER SPOELMAN
FORMER OFFICER; TRINITY HEALTH SVP
(i)

(ii)
0
-------------
614,701
0
-------------
211,406
0
-------------
167,276
0
-------------
20,250
0
-------------
28,314
0
-------------
1,041,947
0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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 1A MOUNT CARMEL HEALTH SYSTEM (MOUNT CARMEL) PAID $11,820 TO THE COLUMBUS CLUB FOR DUES IN CALENDAR 2017. EDWARD LAMB UTILIZED THE CLUB FOR BUSINESS PURPOSES. BECAUSE THE CLUB WAS USED 100% FOR BUSINESS, THE DUES WERE NOT REPORTED AS TAXABLE INCOME.
PART I, LINE 3 MOUNT CARMEL IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. MOUNT CARMEL'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MOUNT CARMEL'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINES 4A-B THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2017. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KEITH COLEMAN - $189,998 CLAUS VON ZYCHLIN - $615,576 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2017. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. BENEFITS FOR PARTICIPANTS VESTED IN A PLAN WERE PAID OUT IN 2017, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2017. THE FOLLOWING PAYOUTS FOR 2017 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KEITH COLEMAN - $33,570 SALLY JEFFCOAT - $199,865 TAUANA MCDONALD - $69,180 SEAN MCKIBBEN - $84,193 ROGER SPOELMAN - $141,449 RICHARD STRECK - $80,102 CLAUS VON ZYCHLIN - $106,127 THE FOLLOWING ACCRUALS FOR 2017 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: UNHEE KIM - $63,788 EDWARD LAMB - $157,064 PAUL MORRIS - $15,833 MICHAEL WILKINS - $61,352 THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH RESTORATION OR RETENTION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($270,000 FOR 2017). THE FOLLOWING PAYOUTS FOR 2017 FOR THESE PLANS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: DANIEL HACKETT - $3,206 SEAN MCKIBBEN - $29,070 CLAUS VON ZYCHLIN - $99,955 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS.
Schedule J (Form 990) 2019

Additional Data


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

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

Complete to provide information for responses to specific questions on
Form 990 or 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
2019
Open to Public
Inspection
Name of the organization
MOUNT CARMEL HEALTH SYSTEM
 
Employer identification number

31-1439334
Return Reference Explanation
FORM 990, PAGE 1 DOING BUSINESS AS NAMES: DASH CAFE HEALTHY LIVING CENTER HEALTHIER YOU MATERNA - TEA MC FITNESS MC FITNESS & HEALTH MC FITNESS CENTER MOUNT CARMEL CARE CONTINUUM SERVICES MOUNT CARMEL EAST MOUNT CARMEL HEALTH MOUNT CARMEL HOSPICE AND PALLIATIVE CARE MOUNT CARMEL NEW ALBANY HOSPITAL MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL MOUNT CARMEL ST. ANN'S MOUNT CARMEL WEST MOUNT CARMEL GROVE CITY MOUNT CARMEL MEDICAL CENTER MOUNT CARMEL URGENT CARE MOUNT CARMEL SLEEP MEDICINE
FORM 990, PART VI, SECTION A, LINE 2 LISA STEIN AND LARRY ENGLISH, BOARD MEMBERS OF MOUNT CARMEL HEALTH SYSTEM (MOUNT CARMEL), HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 3 MOUNT CARMEL HAS CONTRACTED WITH CENTRAL OHIO ORTHOPEDIC MANAGEMENT COMPANY TO MANAGE THE ORTHOPEDIC PROGRAM OF MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL (MC NEW ALBANY). IN 2017, MOUNT CARMEL PAID $4,884,790 TO THE MANAGEMENT COMPANY, WHICH COVERED BOTH EXECUTIVE MANAGEMENT OF MC NEW ALBANY AND PHYSICIAN LEADERSHIP OF THE ORTHOPEDIC PROGRAM. UNDER THE MANAGEMENT SERVICES AGREEMENT, CENTRAL OHIO ORTHOPEDIC MANAGEMENT COMPANY MANAGES THE DAY-TO-DAY OPERATION, MANAGEMENT, AND SUPERVISION OF MC NEW ALBANY AND ITS ORTHOPEDIC PROGRAM. INCLUDED IN THE AGREEMENT IS THE PROVISION BY THE MANAGEMENT COMPANY OF A CHIEF OPERATING OFFICER, SENIOR VICE PRESIDENT OF CLINICAL SERVICES, SENIOR FINANCIAL ANALYST, AND CHIEF NURSING OFFICER FOR THE HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MOUNT CARMEL IS TRINITY HEALTH CORPORATION. SEE LINE 7 FOR ADDITIONAL INFORMATION.
FORM 990, PART VI, SECTION A, LINE 7A TRINITY HEALTH CORPORATION IS THE SOLE MEMBER OF MOUNT CARMEL. TRINITY HEALTH CORPORATION HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF MOUNT CARMEL.
FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, TRINITY HEALTH CORPORATION MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. TRINITY HEALTH CORPORATION MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, AND MODIFICATIONS TO GOVERNING DOCUMENTS.
FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR MOUNT CARMEL IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS PRIOR TO FILING. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C MOUNT CARMEL HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF MOUNT CARMEL, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF MOUNT CARMEL AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO INTERNAL LEGAL COUNSEL AND THE INTEGRITY AND COMPLIANCE OFFICER, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF MOUNT CARMEL (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MOUNT CARMEL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF MOUNT CARMEL (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF MOUNT CARMEL. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 15 QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF MOUNT CARMEL IS ESTABLISHED BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING CEO AND CFO COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THE CEO AND CFO OF MOUNT CARMEL ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS.
FORM 990, PART VI, SECTION C, LINE 19 MOUNT CARMEL IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, MOUNT CARMEL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. MOUNT CARMEL'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9: EQUITY TRANSFERS TO AFFILIATES -120,935,028. TRANSFER INTEREST IN MCHC LLC JOINT VENTURE TO AFFILIATE -4,655,293. CHANGE IN EQUITY IN UNCONSOLIDATED AFFILIATES 6,300,800.
FORM 990, PART XII, LINE 2: MOUNT CARMEL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY18 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
MOUNT CARMEL HEALTH SYSTEM
 
Employer identification number

31-1439334
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) HEALTH COLLABORATIVE OF CENTRAL OHIO LLC
6150 E BROAD STREET
COLUMBUS,OH43213
46-5603895
ACCOUNTABLE CARE ORGANIZATION OH 0 0 MOUNT CARMEL HEALTH SYSTEM
 
(2) MOUNT CARMEL HEALTH PARTNERS LLC
6150 E BROAD STREET
COLUMBUS,OH43213
47-1139205
ACCOUNTABLE CARE ORGANIZATION OH 3,325,372 6,867,497 MOUNT CARMEL HEALTH SYSTEM
 








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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP
245 STATE ST SE

GRAND RAPIDS,MI49503
27-2491974
HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN
 
Yes
 
(2)ALLEGANY FRANCISCAN MINISTRIES INC
33920 US HIGHWAY 19 NORTH SUITE 269

PALM HARBOR,FL34684
58-1492325
GRANT MAKING FL 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION
 
Yes
 
(3)ASYLUM HILL FAMILY MEDICINE CENTER INC
114 WOODLAND STREET

HARTFORD,CT06105
06-1450170
HEALTH CARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC
 
Yes
 
(4)BAUM HARMON MERCY HOSPITAL
255 NORTH WELCH AVENUE

PRIMGHAR,IA51245
42-1500277
HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP
 
Yes
 
(5)BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION
255 NORTH WELCH AVENUE

PRIMGHAR,IA51245
26-2973307
FOUNDATION IA 501(C)(3) LINE 12A, I BAUM HARMON MERCY HOSPITAL
 
Yes
 
(6)BEECHWOOD INC
2212 BURDETT AVE

TROY,NY12180
14-1651563
TITLE HOLDING COMPANY NY 501(C)(2) N/A LTC (EDDY) INC
 
Yes
 
(7)BETHLEHEM HAVEN OF PITTSBURGH
905 WATSON STREET

PITTSBURGH,PA15219
25-1436685
HOMELESS SHELTER PA 501(C)(3) LINE 7 PITTSBURGH MERCY HEALTH SYSTEM INC
 
Yes
 
(8)BEVERWYCK INC
40 AUTUMN DRIVE

SLINGERLANDS,NY12159
14-1717028
SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC
 
Yes
 
(9)BRIGHTSIDE INC
1221 MAIN STREET SUITE 213

HOLYOKE,MA01040
04-2182395
HEALTH CARE SERVICES MA 501(C)(3) LINE 10 THE MERCY HOSPITAL INC
 
Yes
 
(10)CAPITAL REGION GERIATRIC CENTER INC
421 WEST COLUMBIA STREET

COHOES,NY12047
14-1701597
LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC
 
Yes
 
(11)CARING PARTNERS HOME HEALTH INC
1200 EARHART RD

ANN ARBOR,MI48105
20-1681131
HOME HEALTH SERVICES MI 501(C)(3) LINE 10 GLACIER HILLS INC
 
Yes
 
(12)CATHERINE MCAULEY HEALTH SERVICES CORP
PO BOX 995

ANN ARBOR,MI48106
38-2507173
HEALTH CARE SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN
 
Yes
 
(13)CATHOLIC HEALTH MINISTRIES
20555 VICTOR PARKWAY

LIVONIA,MI48152
GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM VT 501(C)(3) LINE 1 N/A
 
No
(14)COLUMBUS ACQUISITION CORP
111 CENTRAL AVENUE

NEWARK,NJ07102
26-2616342
INACTIVE ENTITY NJ 501(C)(3) LINE 10 SAINT MICHAEL'S MEDICAL CENTER
 
Yes
 
(15)DILEY RIDGE MEDICAL CENTER
6150 EAST BROAD STREET

COLUMBUS,OH43213
34-2032340
HEALTH CARE AND HOSPITAL SERVICES OH 501(C)(3) LINE 3 MOUNT CARMEL HEALTH SYSTEM
 
Yes
 
(16)DUBUQUE MERCY HEALTH FOUNDATION
250 MERCY DRIVE

DUBUQUE,IA52001
26-2227941
FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP
 
Yes
 
(17)DYERSVILLE HEALTH FOUNDATION INC
1111 3RD STREET SW

DYERSVILLE,IA52040
20-5383271
FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP
 
Yes
 
(18)EAST NORRITON PHYSICIANS SERVICES INC
ONE WEST ELM STREET SUITE 100

CONSHOHOCKEN,PA19428
23-2515999
HEALTH CARE SERVICES PA 501(C)(3) LINE 3 MERCY PHYSICIAN NETWORK
 
Yes
 
(19)EDDY LICENSED HOME CARE AGENCY
433 RIVER ST SUITE 3000

TROY,NY12180
14-1818568
HOME HEALTH SERVICES NY 501(C)(3) LINE 3 LTC (EDDY) INC
 
Yes
 
(20)EMBRACING AGE INC
333 BUTTERNUT DRIVE

DEWITT,NY13214
46-1051881
PACE PROGRAM NY 501(C)(3) LINE 10 ST JOSEPH'S HEALTH INC
 
Yes
 
(21)EMPIRE HOME INFUSION SERVICE INC
10 BLACKSMITH DRIVE

MALTA,NY12020
14-1795732
HOME HEALTH SERVICES NY 501(C)(3) LINE 10 HOME AIDE SERVICE OF EASTERN NEW YORK INC
 
Yes
 
(22)FARREN CARE CENTER INC
1221 MAIN STREET SUITE 213

HOLYOKE,MA01040
04-2501711
LONG TERM CARE MA 501(C)(3) LINE 3 THE MERCY HOSPITAL INC
 
Yes
 
(23)FRANCISCAN ELDERCARE CORPORATION
PO BOX 2500

WILMINGTON,DE19805
22-3008680
LONG TERM CARE (INACTIVE) DE 501(C)(3) LINE 10 ST FRANCIS HOSPITAL
 
Yes
 
(24)GLACIER HILLS FOUNDATION
1200 EARHART RD

ANN ARBOR,MI48105
20-8072723
FOUNDATION MI 501(C)(3) LINE 12A, I GLACIER HILLS INC
 
Yes
 
(25)GLACIER HILLS INC
1200 EARHART RD

ANN ARBOR,MI48105
38-1891500
SENIOR LIVING COMMUNITY MI 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES
 
Yes
 
(26)GLEN EDDY INC
1 GLEN EDDY DRIVE

NISKAYUNA,NY12309
14-1794150
SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC
 
Yes
 
(27)GLOBAL HEALTH MINISTRY
20555 VICTOR PARKWAY

LIVONIA,MI48152
42-1253527
HEALTH CARE SERVICES MI 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION
 
Yes
 
(28)GOOD SAMARITAN HOSPITAL INC
5401 LAKE OCONEE PARKWAY

GREENSBORO,GA30642
26-1720984
HEALTH CARE AND HOSPITAL SERVICES GA 501(C)(3) LINE 3 ST MARY'S HEALTH CARE SYSTEM INC
 
Yes
 
(29)GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION
701 W NORTH AVE

MELROSE PARK,IL60160
36-3332852
HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 GOTTLIEB MEMORIAL HOSPITAL
 
Yes
 
(30)GOTTLIEB MEMORIAL FOUNDATION
701 WEST NORTH AVENUE

MELROSE PARK,IL60160
74-3260011
FOUNDATION IL 501(C)(3) LINE 12C, III-FI N/A
 
No
(31)GOTTLIEB MEMORIAL HOSPITAL
701 W NORTH AVE

MELROSE PARK,IL60160
36-2379649
HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM
 
Yes
 
(32)GRAND RAPIDS MEDICAL EDUCATION PARTNERS
945 OTTAWA AVE NW

GRAND RAPIDS,MI49503
23-7270669
MEDICAL EDUCATION TRAINING PROGRAMS MI 501(C)(3) LINE 12A, I TRINITY HEALTH-MICHIGAN
 
Yes
 
(33)HACKLEY LIFE COUNSELING
125 E SOUTHERN AVENUE

MUSKEGON,MI49442
38-1386362
HEALTH CARE SERVICES MI 501(C)(3) LINE 10 MERCY HEALTH PARTNERS
 
Yes
 
(34)HAWTHORNE RIDGE INC
30 COMMUNITY WAY

EAST GREENBUSH,NY12061
80-0102840
SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC
 
Yes
 
(35)HEART CENTER OF GREATER WATERBURY INC
PO BOX 2153

WATERBURY,CT06722
83-0416893
MANAGEMENT CT 501(C)(3) LINE 12A, I N/A
 
No
(36)HERITAGE HOUSE NURSING CENTER INC
2920 TIBBITS AVE

TROY,NY12180
14-1725101
LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC
 
Yes
 
(37)HOLY CROSS CARENET INC
PO BOX 9184

FARMINGTON HILLS,MI48152
52-1945054
LONG TERM CARE MD 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES
 
Yes
 
(38)HOLY CROSS HEALTH FOUNDATION INC
1500 FOREST GLEN ROAD

SILVER SPRING,MD20910
20-8428450
FOUNDATION MD 501(C)(3) LINE 7 HOLY CROSS HEALTH INC
 
Yes
 
(39)HOLY CROSS HEALTH INC
1500 FOREST GLEN ROAD

SILVER SPRING,MD20910
52-0738041
HEALTH CARE AND HOSPITAL SERVICES MD 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
Yes
 
(40)HOLY CROSS HOSPITAL INC
4725 NORTH FEDERAL HIGHWAY

FT LAUDERDALE,FL33308
59-0791028
HEALTH CARE AND HOSPITAL SERVICES FL 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
Yes
 
(41)HOLY CROSS OUTPATIENT SERVICES INC
4725 NORTH FEDERAL HIGHWAY

FT LAUDERDALE,FL33308
46-5421068
HEALTH CARE SERVICES FL 501(C)(3) LINE 10 HOLY CROSS HOSPITAL INC
 
Yes
 
(42)HOLY CROSS PRIMARY CARE INC
4725 NORTH FEDERAL HIGHWAY

FT LAUDERDALE,FL33308
81-2531495
HEALTH CARE SERVICES FL 501(C)(3) LINE 10 HOLY CROSS HOSPITAL INC
 
Yes
 
(43)HOME & COMMUNITY HEALTH SERVICES INC
114 WOODLAND STREET

HARTFORD,CT06105
81-0723591
HOME HEALTH SERVICES CT 501(C)(3) LINE 10 TRINITY HEALTH OF NEW ENGLAND CORP INC
 
Yes
 
(44)HOME AIDE SERVICE OF EASTERN NEW YORK INC
433 RIVER ST SUITE 3000

TROY,NY12180
14-1514867
HOME HEALTH SERVICES NY 501(C)(3) LINE 10 LTC (EDDY) INC
 
Yes
 
(45)HOSPICE OF NORTH IOWA
232 SECOND STREET SE

MASON CITY,IA50401
42-1173708
HOSPICE SERVICES IA 501(C)(3) LINE 10 MERCY HEALTH SERVICES-IOWA CORP
 
Yes
 
(46)HOSPICE OF SIOUXLAND
4300 HAMILTON BLVD

SIOUX CITY,IA51104
38-3320710
HOSPICE SERVICES IA 501(C)(3) LINE 12A, I N/A
 
No
(47)IHA HEALTH SERVICES CORPORATION
24 FRANK LLOYD WRIGHT DR LOBBY J

ANN ARBOR,MI48106
38-3316559
HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN
 
Yes
 
(48)JOHNSON MEMORIAL HOSPITAL INC
114 WOODLAND STREET

HARTFORD,CT06105
47-5676956
HEALTH CARE AND HOSPITAL SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC
 
Yes
 
(49)LANGHORNE MRI INC
1201 LANGHORNE-NEWTOWN ROAD

LANGHORNE,PA19047
23-2519529
HEALTH CARE SERVICES (INACTIVE) PA 501(C)(3) LINE 10 ST MARY MEDICAL CENTER
 
Yes
 
(50)LANGHORNE PHYSICIAN SERVICES INC
1201 LANGHORNE-NEWTOWN ROAD

LANGHORNE,PA19047
23-2571699
HEALTH CARE SERVICES PA 501(C)(3) LINE 10 ST MARY MEDICAL CENTER
 
Yes
 
(51)LIFE AT LOURDES INC
2475 MCCLELLAN AVENUE

PENNSAUKEN,NJ08109
26-1854750
PACE PROGRAM NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES
 
Yes
 
(52)LIFE AT ST FRANCIS HEALTHCARE INC
7TH AND CLAYTON STREETS

WILMINGTON,DE19805
45-2569214
PACE PROGRAM DE 501(C)(3) LINE 10 ST FRANCIS HOSPITAL
 
Yes
 
(53)LIFE ST FRANCIS CORPORATION
7500 K JOHNSON BOULEVARD

BORDENTOWN,NJ08505
22-2797282
PACE PROGRAM NJ 501(C)(3) LINE 10 ST FRANCIS MEDICAL CENTER TRENTON NJ
 
Yes
 
(54)LIFE ST JOSEPH OF THE PINES INC
100 GOSSMAN DRIVE

SOUTHERN PINES,NC28387
27-2159847
PACE PROGRAM NC 501(C)(3) LINE 3 ST JOSEPH OF THE PINES INC
 
Yes
 
(55)LIFE ST MARY
1201 LANGHORNE-NEWTOWN ROAD

LANGHORNE,PA19047
26-2976184
PACE PROGRAM PA 501(C)(3) LINE 10 ST MARY MEDICAL CENTER
 
Yes
 
(56)LOURDES ANCILLARY SERVICES
1600 HADDON AVENUE

CAMDEN,NJ08103
22-2568525
VOLUNTEER SERVICE AUXILIARY NJ 501(C)(3) LINE 12B, II OUR LADY OF LOURDES HEALTH CARE SERVICES
 
Yes
 
(57)LOURDES CARDIOLOGY SERVICES PC
1600 HADDON AVENUE

CAMDEN,NJ08103
27-4357794
HEALTH CARE SERVICES NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES
 
Yes
 
(58)LOURDES MEDICAL CENTER OF BURLINGTON COUNTY
218 SUNSET ROAD

WILLINGBORO,NJ08046
22-3612265
HEALTH CARE AND HOSPITAL SERVICES NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES
 
Yes
 
(59)LOYOLA MEDICINE TRANSPORT LLC
905 W NORTH AVE

MELROSE PARK,IL60160
47-4147171
TRANSPORATION SERVICES IL 501(C)(3) LINE 10 LOYOLA UNIVERSITY MEDICAL CENTER
 
Yes
 
(60)LOYOLA UNIVERSITY HEALTH SYSTEM
2160 SOUTH FIRST AVENUE

MAYWOOD,IL60153
36-3342448
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT IL 501(C)(3) LINE 12B, II TRINITY HEALTH CORPORATION
 
Yes
 
(61)LOYOLA UNIVERSITY MEDICAL CENTER
2160 SOUTH FIRST AVENUE

MAYWOOD,IL60153
36-4015560
HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM
 
Yes
 
(62)LTC (EDDY) INC
2212 BURDETT AVE

TROY,NY12180
22-2564710
MANAGEMENT SERVICES FOR LONG TERM CARE NY 501(C)(3) LINE 12B, II ST PETER'S HEALTH PARTNERS
 
Yes
 
(63)MARIAN HOME HEALTHCARE
801 5TH STREET

SIOUX CITY,IA51101
38-3320705
HOME HEALTH SERVICES (INACTIVE) IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP
 
Yes
 
(64)MAXIS HEALTH SYSTEM
3805 WEST CHESTER PIKE STE 100

NEWTOWN SQUARE,PA19073
91-1940902
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT (INACTIVE) PA 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION
 
Yes
 
(65)MCAULEY CENTER INC
275 STEELE ROAD

WEST HARTFORD,CT06117
06-1058086
SENIOR LIVING COMMUNITY CT 501(C)(3) LINE 10 MERCY COMMUNITY HEALTH INC
 
Yes
 
(66)MCAULEY CLINIC CORPORATION
PO BOX 992

ANN ARBOR,MI48106
38-2561013
HEALTH CARE SERVICES (INACTIVE) MI 501(C)(3) LINE 3 CATHERINE MCAULEY HEALTH SERVICES CORP
 
Yes
 
(67)MCAULEY MINISTRIES
3333 FIFTH AVENUE

PITTSBURGH,PA15213
94-3436142
GRANT MAKING PA 501(C)(3) LINE 12B, II PITTSBURGH MERCY HEALTH SYSTEM INC
 
Yes
 
(68)MEMORIAL HOSPITAL ALBANY NY
600 NORTHERN BLVD

ALBANY,NY12204
14-1338457
HEALTH CARE AND HOSPITAL SERVICES NY 501(C)(3) LINE 3 ST PETER'S HEALTH PARTNERS
 
Yes
 
(69)MERCY AMICARE HOME HEALTHCARE OAKLAND
17410 COLLEGE PARKWAY STE 150

LIVONIA,MI48152
38-3320698
HOME HEALTH SERVICES MI 501(C)(3) LINE 10 TRINITY HOME HEALTH SERVICES
 
Yes
 
(70)MERCY CARE FOUNDATION INC
424 DECATUR STREET

ATLANTA,GA30312
58-1448522
FOUNDATION GA 501(C)(3) LINE 7 SAINT JOSEPH'S HEALTH SYSTEM INC
 
Yes
 
(71)MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PENNSYLVANIA
ONE WEST ELM STREET SUITE 100

CONSHOHOCKEN,PA19428
23-1352191
HEALTH CARE AND HOSPITAL SERVICES PA 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
Yes
 
(72)MERCY COMMUNITY HEALTH INC
2021 ALBANY AVENUE

WEST HARTFORD,CT06117
06-1492707
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT CT 501(C)(3) LINE 12B, II TRINITY CONTINUING CARE SERVICES
 
Yes
 
(73)MERCY FAMILY SUPPORT
1001 BALTIMORE PIKE SUITE 310

SPRINGFIELD,PA19064
23-2325059
HOME HEALTH SERVICES PA 501(C)(3) LINE 10 MERCY HOME HEALTH SERVICES
 
Yes
 
(74)MERCY FOUNDATION INC
2525 SOUTH MICHIGAN AVENUE

CHICAGO,IL60616
36-3227350
FOUNDATION IL 501(C)(3) LINE 7 MERCY HEALTH SYSTEM OF CHICAGO
 
Yes
 
(75)MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE
888 TERRACE STREET

MUSKEGON,MI49440
38-3321856
HOME HEALTH SERVICES MI 501(C)(3) LINE 10 TRINITY HOME HEALTH SERVICES
 
Yes
 
(76)MERCY HEALTH FOUNDATION OF SOUTHEASTERN PENNSYLVANIA
ONE WEST ELM STREET SUITE 100

CONSHOHOCKEN,PA19428
23-2829864
FOUNDATION PA 501(C)(3) LINE 12B, II MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
Yes
 
(77)MERCY HEALTH NETWORK INC
1111 6TH AVENUE

DES MOINES,IA50314
42-1478417
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT DE 501(C)(3) LINE 12B, II N/A
 
No
(78)MERCY HEALTH PARTNERS
1500 E SHERMAN BLVD

MUSKEGON,MI49444
38-2589966
HEALTH CARE AND HOSPITAL SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN
 
Yes
 
(79)MERCY HEALTH PLAN
ONE WEST ELM STREET SUITE 100

CONSHOHOCKEN,PA19428
22-2483605
MEDICAID MANAGED CARE PLAN PA 501(C)(3) LINE 12B, II MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
Yes
 
(80)MERCY HEALTH SERVICES - IOWA CORP
1000 4TH STREET SW

MASON CITY,IA50401
31-1373080
HEALTH CARE AND HOSPITAL SERVICES DE 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
Yes
 
(81)MERCY HEALTH SYSTEM OF CHICAGO
2525 SOUTH MICHIGAN AVENUE

CHICAGO,IL60616
36-3163327
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT IL 501(C)(3) LINE 12B, II TRINITY HEALTH CORPORATION
 
Yes
 
(82)MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
ONE WEST ELM STREET SUITE 100

CONSHOHOCKEN,PA19428
23-2212638
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT PA 501(C)(3) LINE 12C, III-FI TRINITY HEALTH CORPORATION
 
Yes
 
(83)MERCY HEALTHCARE CENTER
114 WAWBEEK AVENUE

TUPPER LAKE,NY12986
15-0532211
HEALTH CARE AND HOSPITAL SERVICES (INACTIVE) NY 501(C)(3) LINE 3 MERCY UIHLEIN HEALTH CORPORATION
 
Yes
 
(84)MERCY HEALTHCARE FOUNDATION - CLINTON
1410 N 4TH ST

CLINTON,IA52732
42-1316126
FOUNDATION IA 501(C)(3) LINE 7 N/A
 
No
(85)MERCY HOME HEALTH
1001 BALTIMORE PIKE SUITE 310

SPRINGFIELD,PA19064
23-1352099
HOME HEALTH SERVICES PA 501(C)(3) LINE 10 MERCY HOME HEALTH SERVICES
 
Yes
 
(86)MERCY HOME HEALTH SERVICES
1001 BALTIMORE PIKE SUITE 310

SPRINGFIELD,PA19064
23-2325058
MANAGEMENT SERVICES FOR HOME HEALTH PA 501(C)(3) LINE 12B, II MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
Yes
 
(87)MERCY HOSPITAL AND MEDICAL CENTER
2525 SOUTH MICHIGAN AVENUE

CHICAGO,IL60616
36-2170152
HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF CHICAGO
 
Yes
 
(88)MERCY HOSPITAL CADILLAC FOUNDATION
1820 44TH ST SE

KENTWOOD,MI49508
20-3357131
FOUNDATION MI 501(C)(3) LINE 12A, I TRINITY HEALTH-MICHIGAN
 
Yes
 
(89)MERCY LIFE CENTER CORPORATION
1200 REEDSDALE STREET

PITTSBURGH,PA15233
25-1604115
COMMUNITY OUTREACH PA 501(C)(3) LINE 10 PITTSBURGH MERCY HEALTH SYSTEM INC
 
Yes
 
(90)MERCY LIFE OF ALABAMA
PO BOX 7957

MOBILE,AL36670
27-3163002
PACE PROGRAM AL 501(C)(3) LINE 3 TRINITY HEALTH PACE
 
Yes
 
(91)MERCY LIFE INC
1221 MAIN STREET SUITE 213

HOLYOKE,MA01040
45-3086711
PACE PROGRAM MA 501(C)(3) LINE 3 SISTERS OF PROVIDENCE CARE CENTERS INC
 
Yes
 
(92)MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
ONE WEST ELM STREET SUITE 100

CONSHOHOCKEN,PA19428
23-2627944
HEALTH CARE SERVICES PA 501(C)(3) LINE 3 MERCY PHYSICIAN NETWORK
 
Yes
 
(93)MERCY MEDICAL CENTER - CLINTON INC
1410 NORTH 4TH ST

CLINTON,IA52732
42-1336618
HEALTH CARE AND HOSPITAL SERVICES DE 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP
 
Yes
 
(94)MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION
801 5TH STREET

SIOUX CITY,IA51102
14-1880022
FOUNDATION IA 501(C)(3) LINE 7 MERCY HEALTH SERVICES-IOWA CORP
 
Yes
 
(95)MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA
1000 4TH STREET SW

MASON CITY,IA50401
42-1229151
FOUNDATION IA 501(C)(3) LINE 7 MERCY HEALTH SERVICES-IOWA CORP
 
Yes
 
(96)MERCY MEDICAL CORPORATION
PO BOX 7957

MOBILE,AL36670
63-6002215
PACE PROGRAM AL 501(C)(3) LINE 10 TRINITY HEALTH CORPORATION
 
Yes
 
(97)MERCY MEDICAL GROUP INC
1221 MAIN STREET SUITE 213

HOLYOKE,MA01040
45-4884805
HEALTH CARE SERVICES MA 501(C)(3) LINE 3 THE MERCY HOSPITAL INC
 
Yes
 
(98)MERCY PHYSICIAN NETWORK
ONE WEST ELM STREET SUITE 100

CONSHOHOCKEN,PA19428
46-1187365
MANAGEMENT SERVICES FOR PHYSICIAN SERVICE ORGANIZATIONS PA 501(C)(3) LINE 12B, II MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
Yes
 
(99)MERCY SENIOR CARE INC
424 DECATUR STREET

ATLANTA,GA30312
58-1366508
COMMUNITY OUTREACH GA 501(C)(3) LINE 7 SAINT JOSEPH'S HEALTH SYSTEM INC
 
Yes
 
(100)MERCY SERVICES DOWNTOWN INC
424 DECATUR STREET

ATLANTA,GA30312
27-2046353
TITLE HOLDING COMPANY GA 501(C)(3) LINE 12B, II SAINT JOSEPH'S HEALTH SYSTEM INC
 
Yes
 
(101)MERCY SERVICES FOR AGING NONPROFIT HOUSING CORPORATION
PO BOX 9184

FARMINGTON HILLS,MI48333
38-2719605
LONG TERM CARE MI 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES
 
Yes
 
(102)MERCY SPECIALIST PHYSICIANS INC
1221 MAIN STREET SUITE 213

HOLYOKE,MA01040
26-4033168
HEALTH CARE SERVICES MA 501(C)(3) LINE 3 THE MERCY HOSPITAL INC
 
Yes
 
(103)MERCY SUBURBAN HOSPITAL
ONE WEST ELM STREET SUITE 100

CONSHOHOCKEN,PA19428
23-1396763
HEALTH CARE AND HOSPITAL SERVICES PA 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
Yes
 
(104)MERCY UIHLEIN HEALTH CORPORATION
3805 WEST CHESTER PIKE SUITE 100

NEWTOWN SQUARE,PA19073
16-1535133
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT (INACTIVE) NY 501(C)(3) LINE 12B, II TRINITY HEALTH CORPORATION
 
Yes
 
(105)MISSION HEALTH CORPORATION
37595 SEVEN MILE ROAD

LIVONIA,MI48152
38-3181557
BUILDING MANAGEMENT SERVICES DE 501(C)(3) LINE 12A, I N/A
 
No
(106)MOUNT CARMEL COLLEGE OF NURSING
6150 EAST BROAD STREET

COLUMBUS,OH43213
31-1308555
COLLEGE OF NURSING OH 501(C)(3) LINE 2 MOUNT CARMEL HEALTH SYSTEM
 
Yes
 
(107)MOUNT CARMEL HEALTH INSURANCE COMPANY
6150 EAST BROAD STREET

COLUMBUS,OH43213
25-1912781
HEALTH INSURANCE OH 501(C)(4) N/A MOUNT CARMEL HEALTH SYSTEM
 
Yes
 
(108)MOUNT CARMEL HEALTH PLAN INC
6150 EAST BROAD STREET

COLUMBUS,OH43213
31-1471229
MEDICARE HMO OH 501(C)(4) N/A MOUNT CARMEL HEALTH SYSTEM
 
Yes
 
(109)MOUNT CARMEL HEALTH SYSTEM
6150 EAST BROAD STREET

COLUMBUS,OH43213
31-1439334
HEALTH CARE AND HOSPITAL SERVICES OH 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
 
No
(110)MOUNT CARMEL HEALTH SYSTEM FOUNDATION
6150 EAST BROAD STREET

COLUMBUS,OH43213
31-1113966
FOUNDATION OH 501(C)(3) LINE 12A, I MOUNT CARMEL HEALTH SYSTEM
 
Yes
 
(111)MOUNT SINAI HOSPITAL FOUNDATION INC
114 WOODLAND STREET

HARTFORD,CT06105
22-2584082
FOUNDATION CT 501(C)(3) LINE 12C, III-FI N/A
 
No
(112)MOUNT SINAI REHABILITATION HOSPITAL INC
114 WOODLAND STREET

HARTFORD,CT06105
06-1422973
HEALTH CARE AND HOSPITAL SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC
 
Yes
 
(113)MOUNT ST JOSEPH
7 HIGHTOWER STREET

WATERVILLE,ME04901
01-0274998
LONG TERM CARE ME 501(C)(3) LINE 3 MERCY COMMUNITY HEALTH INC
 
Yes
 
(114)MRI MOBILE SERVICES OF WEST MICHIGAN
1820 44TH STREET

KENTWOOD,MI49508
38-3073745
HEALTH CARE SERVICES (INACTIVE) MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN
 
Yes
 
(115)MUSKEGON COMMUNITY HEALTH PROJECT
565 W WESTERN AVENUE

MUSKEGON,MI49440
91-1932918
COMMUNITY OUTREACH MI 501(C)(3) LINE 7 MERCY HEALTH PARTNERS
 
Yes
 
(116)NAZARETH HEALTH CARE FOUNDATION
2701 HOLME AVENUE

PHILADELPHIA,PA19152
23-2300951
FOUNDATION PA 501(C)(3) LINE 12A, I NAZARETH HOSPITAL
 
Yes
 
(117)NAZARETH HOSPITAL
2601 HOLME AVENUE

PHILADELPHIA,PA19152
23-2794121
HEALTH CARE AND HOSPITAL SERVICES PA 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
Yes
 
(118)NAZARETH PHYSICIAN SERVICES INC
ONE WEST ELM STREET SUITE 100

CONSHOHOCKEN,PA19428
20-3261266
HEALTH CARE SERVICES PA 501(C)(3) LINE 3 MERCY PHYSICIAN NETWORK
 
Yes
 
(119)NE PHYSICIAN SERVICES INC
ONE WEST ELM STREET SUITE 100

CONSHOHOCKEN,PA19428
23-2497355
HEALTH CARE SERVICES (INACTIVE) PA 501(C)(3) LINE 3 MERCY PHYSICIAN NETWORK
 
Yes
 
(120)OAKLAND MERCY HOSPITAL
601 EAST 2ND STREET

OAKLAND,NE68045
20-8072234
HEALTH CARE AND HOSPITAL SERVICES NE 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP
 
Yes
 
(121)OAKLAND MERCY HOSPITAL FOUNDATION
601 E 2ND STREET

OAKLAND,NE68045
31-1678345
FOUNDATION NE 501(C)(3) LINE 12A, I OAKLAND MERCY HOSPITAL
 
Yes
 
(122)OSUMOUNT CARMEL HEALTH ALLIANCE
6150 EAST BROAD STREET

COLUMBUS,OH43213
31-1654603
COOPERATIVE HEALTH CARE DELIVERY SYSTEM OH 501(C)(3) LINE 12A, I N/A
 
No
(123)OUR LADY OF LOURDES HEALTH CARE SERVICES INC
1600 HADDON AVENUE

CAMDEN,NJ08103
22-2568528
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT NJ 501(C)(3) LINE 12B, II MAXIS HEALTH SYSTEM
 
Yes
 
(124)OUR LADY OF LOURDES HEALTH FOUNDATION INC
1600 HADDON AVENUE

CAMDEN,NJ08103
22-2351960
FOUNDATION NJ 501(C)(3) LINE 7 OUR LADY OF LOURDES HEALTH CARE SERVICES
 
Yes
 
(125)OUR LADY OF LOURDES MEDICAL CENTER INC
1600 HADDON AVENUE

CAMDEN,NJ08103
21-0635001
HEALTH CARE AND HOSPITAL SERVICES NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES
 
Yes
 
(126)OUR LADY OF MERCY LIFE CENTER
2 MERCYCARE LANE

GUILDERLAND,NY12084
14-1743506
LONG TERM CARE NY 501(C)(3) LINE 3 ST PETER'S HOSPITAL
 
Yes
 
(127)PIONEER VALLEY CARDIOLOGY ASSOCIATES INC
1221 MAIN STREET SUITE 213

HOLYOKE,MA01040
45-4208896
HEALTH CARE SERVICES MA 501(C)(3) LINE 3 THE MERCY HOSPITAL INC
 
Yes
 
(128)PITTSBURGH MERCY HEALTH SYSTEM INC
3333 5TH AVENUE

PITTSBURGH,PA15213
25-1464211
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT PA 501(C)(3) LINE 12B, II TRINITY HEALTH CORPORATION
 
Yes
 
(129)PROBILITY THERAPY SERVICES
2058 S STATE STREET

ANN ARBOR,MI48104
20-2020239
HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN
 
Yes
 
(130)PROFESSIONAL MED TEAM
965 FORK STREET

MUSKEGON,MI49442
38-2638284
HEALTH CARE SERVICES MI 501(C)(3) LINE 10 MERCY HEALTH PARTNERS
 
Yes
 
(131)RIVERBEND MEDICAL GROUP INC
271 CAREW ST

SPRINGFIELD,MA01104
81-1807730
HEALTH CARE SERVICES MA 501(C)(3) LINE 3 THE MERCY HOSPITAL INC
 
Yes
 
(132)SJ MANAGEMENT COMPANY OF SYRACUSE INC
301 PROSPECT AVENUE

SYRACUSE,NY13203
27-1763712
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT NY 501(C)(3) LINE 12A, I ST JOSEPH'S HOSPITAL HEALTH CENTER
 
Yes
 
(133)SAINT AGNES MEDICAL CENTER
1303 EAST HERNDON AVE

FRESNO,CA93720
94-1437713
HEALTH CARE AND HOSPITAL SERVICES CA 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
Yes
 
(134)SAINT AGNES MEDICAL FOUNDATION
1303 EAST HERNDON AVE

FRESNO,CA93720
94-2839324
HEALTH CARE SERVICES CA 501(C)(3) LINE 12A, I SAINT AGNES MEDICAL CENTER
 
Yes
 
(135)SAINT ALPHONSUS BUILDING COMPANY INC
1055 NORTH CURTIS RD

BOISE,ID83706
82-0401011
BUILDING MANAGEMENT SERVICES ID 501(C)(3) LINE 10 SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC
 
Yes
 
(136)SAINT ALPHONSUS DIVERSIFIED CARE INC
1055 NORTH CURTIS RD

BOISE,ID83706
94-3028978
HEALTH CARE SYSTEM SUPPORT ID 501(C)(3) LINE 12A, I SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC
 
Yes
 
(137)SAINT ALPHONSUS FOUNDATION-BAKER CITY INC
3325 POCAHONTAS ROAD

BAKER CITY,OR97814
94-3164869
FOUNDATION OR 501(C)(3) LINE 7 SAINT ALPHONSUS MEDICAL CENTER - BAKER CITY
 
Yes
 
(138)SAINT ALPHONSUS FOUNDATION-ONTARIO INC
351 SW 9TH STREET

ONTARIO,OR97914
20-2683560
FOUNDATION OR 501(C)(3) LINE 7 SAINT ALPHONSUS MEDICAL CENTER-ONTARIO
 
Yes
 
(139)SAINT ALPHONSUS HEALTH SYSTEM INC
1055 N CURTIS ROAD

BOISE,ID83706
27-1929502
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT ID 501(C)(3) LINE 12B, II TRINITY HEALTH CORPORATION
 
Yes
 
(140)SAINT ALPHONSUS MEDICAL CENTER ONTARIO VOLUNTEERS
351 SW 9TH STREET

ONTARIO,OR97914
94-3059469
VOLUNTEER SERVICE AUXILIARY OR 501(C)(3) LINE 10 SAINT ALPHONSUS MEDICAL CENTER-ONTARIO
 
Yes
 
(141)SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY INC
3325 POCAHONTAS ROAD

BAKER CITY,OR97814
27-1790052
HEALTH CARE AND HOSPITAL SERVICES OR 501(C)(3) LINE 3 SAINT ALPHONSUS HEALTH SYSTEM INC
 
Yes
 
(142)SAINT ALPHONSUS MEDICAL CENTER-NAMPA HEALTH FOUNDATION INC
4300 E FLAMINGO AVENUE

NAMPA,ID83687
26-1737256
FOUNDATION ID 501(C)(3) LINE 7 SAINT ALPHONSUS MEDICAL CENTER-NAMPA
 
Yes
 
(143)SAINT ALPHONSUS MEDICAL CENTER-NAMPA INC
4300 E FLAMINGO AVENUE

NAMPA,ID83687
82-0200896
HEALTH CARE AND HOSPITAL SERVICES ID 501(C)(3) LINE 3 SAINT ALPHONSUS HEALTH SYSTEM INC
 
Yes
 
(144)SAINT ALPHONSUS MEDICAL CENTER-ONTARIO INC
351 SW 9TH STREET

ONTARIO,OR97914
27-1789847
HEALTH CARE AND HOSPITAL SERVICES OR 501(C)(3) LINE 3 SAINT ALPHONSUS HEALTH SYSTEM INC
 
Yes
 
(145)SAINT ALPHONSUS REGIONAL MEDICAL CENTER
1055 NORTH CURTIS RD

BOISE,ID83706
82-0200895
HEALTH CARE AND HOSPITAL SERVICES ID 501(C)(3) LINE 3 SAINT ALPHONSUS HEALTH SYSTEM INC
 
Yes
 
(146)SAINT FRANCIS EMERGENCY MEDICAL GROUP INC
114 WOODLAND STREET

HARTFORD,CT06105
45-1994612
HEALTH CARE SERVICES CT 501(C)(3) LINE 12B, II TRINITY HEALTH OF NEW ENGLAND PNO INC
 
Yes
 
(147)SAINT FRANCIS HOSPITAL AND MEDICAL CENTER
114 WOODLAND STREET

HARTFORD,CT06105
06-0646813
HEALTH CARE AND HOSPITAL SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC
 
Yes
 
(148)SAINT FRANCIS HOSPITAL AND MEDICAL CENTER FOUNDATION INC
114 WOODLAND STREET

HARTFORD,CT06105
06-1008255
FOUNDATION CT 501(C)(3) LINE 7 SAINT FRANCIS HOSPITAL AND MEDICAL CENTER
 
Yes
 
(149)SAINT JAMES CARE INC
111 CENTRAL AVENUE

NEWARK,NJ07102
26-2616230
INACTIVE ENTITY NJ 501(C)(3) LINE 10 SAINT MICHAEL'S MEDICAL CENTER
 
Yes
 
(150)SAINT JOSEPH PACE INC
20555 VICTOR PARKWAY

LIVONIA,MI48152
47-3129127
PACE PROGRAM IN 501(C)(3) LINE 10 TRINITY HEALTH PACE
 
Yes
 
(151)SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC
PO BOX 670

PLYMOUTH,IN46563
35-1142669
HEALTH CARE AND HOSPITAL SERVICES IN 501(C)(3) LINE 3 SAINT JOSEPH REGIONAL MEDICAL CENTER INC
 
Yes
 
(152)SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC
5215 HOLY CROSS PARKWAY

MISHAWAKA,IN46545
35-0868157
HEALTH CARE AND HOSPITAL SERVICES IN 501(C)(3) LINE 3 SAINT JOSEPH REGIONAL MEDICAL CENTER INC
 
Yes
 
(153)SAINT JOSEPH REGIONAL MEDICAL CENTER PLYMOUTH AUXILIARY INC
1915 LAKE AVENUE

PLYMOUTH,IN46563
35-6043563
VOLUNTEER SERVICE AUXILIARY IN 501(C)(3) LINE 12A, I SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC
 
Yes
 
(154)SAINT JOSEPH REGIONAL MEDICAL CENTER INC
5215 HOLY CROSS PARKWAY

MISHAWAKA,IN46545
35-1568821
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT IN 501(C)(3) LINE 12B, II TRINITY HEALTH CORPORATION
 
Yes
 
(155)SAINT JOSEPH'S HEALTH SYSTEM INC
424 DECATUR STREET

ATLANTA,GA30312
58-1744848
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT GA 501(C)(3) LINE 12C, III-FI TRINITY HEALTH CORPORATION
 
Yes
 
(156)SAINT JOSEPH'S MERCY CARE SERVICES INC
424 DECATUR STREET

ATLANTA,GA30312
58-1752700
HEALTH CARE SERVICES GA 501(C)(3) LINE 7 SAINT JOSEPH'S HEALTH SYSTEM INC
 
Yes
 
(157)SAINT JOSEPH'S TOWER INC
PO BOX 9184

FARMINGTON HILLS,MI48333
31-1040468
SENIOR LIVING COMMUNITY IN 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES - INDIANA INC
 
Yes
 
(158)SAINT MARY'S AMICARE HOME HEALTHCARE
1430 MONROE NW STE 120

GRAND RAPIDS,MI49505
38-3320700
HOME HEALTH SERVICES MI 501(C)(3) LINE 10 TRINITY HOME HEALTH SERVICES
 
Yes
 
(159)SAINT MARY'S FOUNDATION
200 JEFFERSON ST SE

GRAND RAPIDS,MI49503
38-1779602
FOUNDATION MI 501(C)(3) LINE 7 TRINITY HEALTH-MICHIGAN
 
Yes
 
(160)SAINT MARY'S HOSPITAL FOUNDATION INC
114 WOODLAND STREET

HARTFORD,CT06105
22-2528400
FOUNDATION CT 501(C)(3) LINE 7 SAINT MARY'S HOSPITAL INC
 
Yes
 
(161)SAINT MARY'S HOSPITAL INC
114 WOODLAND STREET

HARTFORD,CT06105
06-0646844
HEALTH CARE AND HOSPITAL SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC
 
Yes
 
(162)SAINT MICHAEL'S MEDICAL CENTER INC
111 CENTRAL AVENUE

NEWARK,NJ07102
26-2616046
HEALTH CARE AND HOSPITAL SERVICES NJ 501(C)(3) LINE 3 MAXIS HEALTH SYSTEM
 
Yes
 
(163)SAMARITAN CHILD CARE CENTER INC
2215 BURDETT AVE

TROY,NY12180
14-1710225
CHILD CARE SERVICES NY 501(C)(3) LINE 10 ST PETER'S HEALTH PARTNERS
 
Yes
 
(164)SAMARITAN HOSPITAL
2215 BURDETT AVE

TROY,NY12180
14-1338544
HEALTH CARE AND HOSPITAL SERVICES NY 501(C)(3) LINE 3 ST PETER'S HEALTH PARTNERS
 
Yes
 
(165)SENIOR CARE CONNECTION INC
504 STATE STREET

SCHENECTADY,NY12305
14-1708754
PACE PROGRAM NY 501(C)(3) LINE 10 LTC (EDDY) INC
 
Yes
 
(166)SETON AUXILIARY INC
1300 MASSACHUSETTS AVENUE

TROY,NY12180
14-1505031
VOLUNTEER SERVICE AUXILIARY NY 501(C)(3) LINE 10 SETON HEALTH SYSTEM INC
 
Yes
 
(167)SETON HEALTH AT SCHUYLER RIDGE RESIDENTIAL HEALTHCARE
ONE ABELE BLVD

CLIFTON PARK,NY12065
14-1756230
LONG TERM CARE NY 501(C)(3) LINE 10 SETON HEALTH SYSTEM INC
 
Yes
 
(168)SETON HEALTH FOUNDATION INC
310 S MANNING BLVD

ALBANY,NY12208
22-2345416
FOUNDATION NY 501(C)(3) LINE 12A, I SETON HEALTH SYSTEM INC
 
Yes
 
(169)SETON HEALTH SYSTEM INC
1300 MASSACHUSETTS AVENUE

TROY,NY12180
14-1776186
HEALTH CARE AND HOSPITAL SERVICES NY 501(C)(3) LINE 3 ST PETER'S HEALTH PARTNERS
 
Yes
 
(170)SISTERS OF PROVIDENCE CARE CENTERS INC
1221 MAIN STREET SUITE 213

HOLYOKE,MA01040
22-2541103
LONG TERM CARE MA 501(C)(3) LINE 3 THE MERCY HOSPITAL INC
 
Yes
 
(171)SJHSJOC HOLDINGS INC
424 DECATUR STREET

ATLANTA,GA30312
47-2299757
HEALTH CARE SYSTEM SUPPORT GA 501(C)(3) LINE 12B, II SAINT JOSEPH'S HEALTH SYSTEM INC
 
Yes
 
(172)ST AGNES CONTINUING CARE CENTER
ONE WEST ELM STREET SUITE 100

CONSHOHOCKEN,PA19428
23-2840137
PACE PROGRAM PA 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
 
Yes
 
(173)ST AGNES CONTINUING CARE CENTER FOUNDATION
ONE WEST ELM STREET SUITE 100

CONSHOHOCKEN,PA19428
23-2415137
FOUNDATION PA 501(C)(3) LINE 12A, I ST AGNES CONTINUING CARE CENTER
 
Yes
 
(174)ST FRANCIS FOUNDATION
PO BOX 2500

WILMINGTON,DE19805
51-0374158
FOUNDATION DE 501(C)(3) LINE 12A, I ST FRANCIS HOSPITAL
 
Yes
 
(175)ST FRANCIS HOSPITAL INC
PO BOX 2500

WILMINGTON,DE19805
51-0064326
HEALTH CARE AND HOSPITAL SERVICES DE 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
Yes
 
(176)ST FRANCIS MEDICAL CENTER FOUNDATION INC
601 HAMILTON AVENUE

TRENTON,NJ08629
52-1025476
FOUNDATION NJ 501(C)(3) LINE 7 ST FRANCIS MEDICAL CENTER TRENTON NJ
 
Yes
 
(177)ST FRANCIS MEDICAL CENTER TRENTON NJ
601 HAMILTON AVENUE

TRENTON,NJ08629
22-3431049
HEALTH CARE AND HOSPITAL SERVICES NJ 501(C)(3) LINE 3 MAXIS HEALTH SYSTEM
 
Yes
 
(178)ST JAMES MERCY HEALTH SYSTEM INC
411 CANISTEO STREET

HORNELL,NY14843
22-3127184
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT (INACTIVE) NY 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION
 
Yes
 
(179)ST JOSEPH OF THE PINES INC
100 GOSSMAN DRIVE

SOUTHERN PINES,NC28387
56-0694200
LONG TERM CARE NC 501(C)(3) LINE 3 TRINITY CONTINUING CARE SERVICES
 
Yes
 
(180)ST JOSEPH'S COLLEGE OF NURSING AT ST JOSEPH'S HOSPITAL HEALTH CENTER
206 PROSPECT AVENUE

SYRACUSE,NY13203
20-2497520
COLLEGE OF NURSING NY 501(C)(3) LINE 2 ST JOSEPH'S HOSPITAL HEALTH CENTER
 
Yes
 
(181)ST JOSEPH'S HEALTH CENTER PROPERTIES INC
301 PROSPECT AVENUE

SYRACUSE,NY13203
23-7219294
BUILDING MANAGEMENT SERVICES NY 501(C)(3) LINE 12B, II ST JOSEPH'S HEALTH INC
 
Yes
 
(182)ST JOSEPH'S HEALTH INC
301 PROSPECT AVENUE

SYRACUSE,NY13203
47-4754987
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT NY 501(C)(3) LINE 12C, III-FI TRINITY HEALTH CORPORATION
 
Yes
 
(183)ST JOSEPH'S HOSPITAL HEALTH CENTER
301 PROSPECT AVENUE

SYRACUSE,NY13203
15-0532254
HEALTH CARE AND HOSPITAL SERVICES NY 501(C)(3) LINE 3 ST JOSEPH'S HEALTH INC
 
Yes
 
(184)ST JOSEPH'S HOSPITAL HEALTH CENTER FOUNDATION INC
301 PROSPECT AVENUE

SYRACUSE,NY13203
22-2149775
FOUNDATION NY 501(C)(3) LINE 12B, II ST JOSEPH'S HEALTH INC
 
Yes
 
(185)ST JOSEPH'S MEDICAL PC
301 PROSPECT AVENUE

SYRACUSE,NY13203
27-3899821
HEALTH CARE SERVICES NY 501(C)(3) LINE 12A, I ST JOSEPH'S HOSPITAL HEALTH CENTER
 
Yes
 
(186)ST JOSEPH'S PHYSICIAN HEALTH PC
301 PROSPECT AVENUE

SYRACUSE,NY13203
16-1516863
HEALTH CARE SERVICES NY 501(C)(3) LINE 12A, I ST JOSEPH'S HOSPITAL HEALTH CENTER
 
Yes
 
(187)ST MARY BUILDING AND DEVELOPMENT
1201 LANGHORNE-NEWTOWN ROAD

LANGHORNE,PA19047
46-1827502
TITLE HOLDING COMPANY PA 501(C)(2) N/A ST MARY MEDICAL CENTER
 
Yes
 
(188)ST MARY EMERGENCY MEDICAL SERVICES
1201 LANGHORNE-NEWTOWN ROAD

LANGHORNE,PA19047
46-5354512
HEALTH CARE SERVICES PA 501(C)(3) LINE 10 ST MARY MEDICAL CENTER
 
Yes
 
(189)ST MARY HOME INCORPORATED
2021 ALBANY AVENUE

WEST HARTFORD,CT06117
06-0646843
LONG TERM CARE CT 501(C)(3) LINE 3 MERCY COMMUNITY HEALTH INC
 
Yes
 
(190)ST MARY MEDICAL CENTER
1201 LANGHORNE-NEWTOWN ROAD

LANGHORNE,PA19047
23-1913910
HEALTH CARE AND HOSPITAL SERVICES PA 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
Yes
 
(191)ST MARY MEDICAL CENTER FOUNDATION INC
1201 LANGHORNE-NEWTOWN ROAD

LANGHORNE,PA19047
23-2567468
FOUNDATION PA 501(C)(3) LINE 7 ST MARY MEDICAL CENTER
 
Yes
 
(192)ST MARY'S FOUNDATION INC
1230 BAXTER STREET

ATHENS,GA30606
58-2544232
FOUNDATION GA 501(C)(3) LINE 12A, I ST MARY'S HEALTH CARE SYSTEM INC
 
Yes
 
(193)ST MARY'S GOOD SAMARITAN FOUNDATION INC
1230 BAXTER STREET

ATHENS,GA30606
81-1660088
FOUNDATION GA 501(C)(3) LINE 12A, I ST MARY'S HEALTH CARE SYSTEM INC
 
Yes
 
(194)ST MARY'S HEALTH CARE SYSTEM INC
1230 BAXTER STREET

ATHENS,GA30606
58-0566223
HEALTH CARE AND HOSPITAL SERVICES GA 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
Yes
 
(195)ST MARY'S HIGHLAND HILLS INC
1230 BAXTER STREET

ATHENS,GA30606
02-0576648
SENIOR LIVING COMMUNITY GA 501(C)(3) LINE 3 ST MARY'S HEALTH CARE SYSTEM INC
 
Yes
 
(196)ST MARY'S MEDICAL GROUP INC
1230 BAXTER STREET

ATHENS,GA30606
26-1858563
HEALTH CARE SERVICES GA 501(C)(3) LINE 3 ST MARY'S HEALTH CARE SYSTEM INC
 
Yes
 
(197)ST MARY'S SACRED HEART HOSPITAL INC
367 CLEAR CREEK PARKWAY

LAVONIA,GA30553
47-3752176
HEALTH CARE AND HOSPITAL SERVICES GA 501(C)(3) LINE 3 ST MARY'S HEALTH CARE SYSTEM INC
 
Yes
 
(198)ST PETER'S HEALTH PARTNERS
315 SOUTH MANNING BLVD

ALBANY,NY12208
45-3570715
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT NY 501(C)(3) LINE 12B, II TRINITY HEALTH CORPORATION
 
Yes
 
(199)ST PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES PC
315 SOUTH MANNING BLVD

ALBANY,NY12208
46-1177336
HEALTH CARE SERVICES NY 501(C)(3) LINE 3 ST PETER'S HEALTH PARTNERS
 
Yes
 
(200)ST PETER'S HOSPITAL
315 SOUTH MANNING BLVD

ALBANY,NY12208
14-1348692
HEALTH CARE AND HOSPITAL SERVICES NY 501(C)(3) LINE 3 ST PETER'S HEALTH PARTNERS
 
Yes
 
(201)ST PETER'S HOSPITAL FOUNDATION INC
310 SOUTH MANNING BLVD

ALBANY,NY12208
22-2262982
FOUNDATION NY 501(C)(3) LINE 7 ST PETER'S HEALTH PARTNERS
 
Yes
 
(202)SUNNYVIEW HOSPITAL AND REHABILITATION CENTER
1270 BELMONT AVENUE

SCHENECTADY,NY12308
14-1338386
HEALTH CARE AND HOSPITAL SERVICES NY 501(C)(3) LINE 3 ST PETER'S HEALTH PARTNERS
 
Yes
 
(203)SUNNYVIEW HOSPITAL AND REHABILITATION CENTER FOUNDATION INC
1270 BELMONT AVE

SCHENECTADY,NY12308
22-2505127
FOUNDATION NY 501(C)(3) LINE 12A, I SUNNYVIEW HOSPITAL AND REHABILITATION CENTER
 
Yes
 
(204)THE COMMUNITY HOSPICE FOUNDATION INC
445 NEW KARNER RD

ALBANY,NY12205
22-2692940
FOUNDATION NY 501(C)(3) LINE 7 THE COMMUNITY HOSPICE INC
 
Yes
 
(205)THE COMMUNITY HOSPICE INC
445 NEW KARNER RD

ALBANY,NY12205
14-1608921
HOSPICE SERVICES NY 501(C)(3) LINE 3 ST PETER'S HEALTH PARTNERS
 
Yes
 
(206)THE FOUNDATION OF SAINT JOSEPH REGIONAL MEDICAL CENTER INC
707 EAST CEDAR STREET STE 175

SOUTH BEND,IN46617
35-1654543
FOUNDATION IN 501(C)(3) LINE 7 SAINT JOSEPH REGIONAL MEDICAL CENTER INC
 
Yes
 
(207)THE JAMES A EDDY MEMORIAL GERIATRIC CENTER INC
2256 BURDETT AVE

TROY,NY12180
22-2570478
LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC
 
Yes
 
(208)THE MARJORIE DOYLE ROCKWELL CENTER INC
421 WEST COLUMBIA ST

COHOES,NY12047
14-1793885
LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC
 
Yes
 
(209)THE MERCY HOSPITAL INC
1221 MAIN STREET SUITE 213

HOLYOKE,MA01040
04-3398280
HEALTH CARE AND HOSPITAL SERVICES MA 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC
 
Yes
 
(210)THE NORTHEAST HEALTH FOUNDATION INC
310 SOUTH MANNING BLVD

ALBANY,NY12208
22-2743478
FOUNDATION NY 501(C)(3) LINE 7 ST PETER'S HEALTH PARTNERS
 
Yes
 
(211)THE WOMEN'S AUXILIARY OF SAINT FRANCIS HOSPITAL AND MEDICAL CENTER INC
114 WOODLAND STREET

HARTFORD,CT06105
06-0660403
VOLUNTEER SERVICE AUXILIARY CT 501(C)(3) LINE 12B, II N/A
 
No
(212)THHS OAKLAND FKA CRANBROOK HOSPICE CARE
17410 COLLEGE PARKWAY STE 150

LIVONIA,MI48152
38-3320699
HOSPICE SERVICES (INACTIVE) MI 501(C)(3) LINE 10 TRINITY HOME HEALTH SERVICES
 
Yes
 
(213)TRI-HOSPITAL EMERGENCY MEDICAL SERVICES
309 GRAND RIVER

PORT HURON,MI48060
38-2485700
HEALTH CARE SERVICES MI 501(C)(3) LINE 12A, I N/A
 
No
(214)TRINITY CONTINUING CARE SERVICES
PO BOX 9184

FARMINGTON HILLS,MI48333
38-2559656
LONG TERM CARE MI 501(C)(3) LINE 10 TRINITY HEALTH CORPORATION
 
Yes
 
(215)TRINITY CONTINUING CARE SERVICES - INDIANA
PO BOX 9184

FARMINGTON HILLS,MI48333
93-0907047
LONG TERM CARE IN 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES
 
Yes
 
(216)TRINITY CONTINUING CARE SERVICES - MASSACHUSETTS
PO BOX 9184

FARMINGTON HILLS,MI48333
82-4005577
LONG TERM CARE MI 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES
 
Yes
 
(217)TRINITY HEALTH - MICHIGAN
20555 VICTOR PARKWAY

LIVONIA,MI48152
38-2113393
HEALTH CARE AND HOSPITAL SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION
 
Yes
 
(218)TRINITY HEALTH CORPORATION
20555 VICTOR PARKWAY

LIVONIA,MI48152
35-1443425
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT IN 501(C)(3) LINE 12B, II CATHOLIC HEALTH MINISTRIES
 
Yes
 
(219)TRINITY HEALTH LIFE PENNSYLVANIA INC
20555 VICTOR PARKWAY

LIVONIA,MI48152
47-5244984
PACE PROGRAM PA 501(C)(3) LINE 10 TRINITY HEALTH PACE
 
Yes
 
(220)TRINITY HEALTH OF NEW ENGLAND CORPORATION INC
114 WOODLAND STREET

HARTFORD,CT06105
06-1491191
HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT CT 501(C)(3) LINE 12C, III-FI TRINITY HEALTH CORPORATION
 
Yes
 
(221)TRINITY HEALTH OF NEW ENGLAND PROVIDER NETWORK ORGANIZATION INC
114 WOODLAND STREET

HARTFORD,CT06105
06-1450168
HEALTH CARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC
 
Yes
 
(222)TRINITY HEALTH PACE
20555 VICTOR PARKWAY

LIVONIA,MI48152
47-3073124
PACE PROGRAM MI 501(C)(3) LINE 12B, II TRINITY HEALTH CORPORATION
 
Yes
 
(223)TRINITY HEALTH WELFARE BENEFIT TRUST
20555 VICTOR PARKWAY

LIVONIA,MI48152
20-8151733
RETIREE MEDICAL AND RETIREE LIFE INSURANCE MI 501(C)(9) N/A TRINITY HEALTH CORPORATION
 
Yes
 
(224)TRINITY HOME HEALTH SERVICES
17410 COLLEGE PARKWAY STE 150

LIVONIA,MI48152
38-2621935
MANAGEMENT SERVICES FOR HOME HEALTH SYSTEM MI 501(C)(3) LINE 10 TRINITY HEALTH CORPORATION
 
Yes
 
(225)UIHLEIN MERCY CENTER
3805 WEST CHESTER PIKE SUITE 100

NEWTOWN SQUARE,PA19073
15-0532190
HEALTH CARE SERVICES (INACTIVE) NY 501(C)(3) LINE 3 MERCY UIHLEIN HEALTH CORPORATION
 
Yes
 
(226)VILLA MARY IMMACULATE
301 HACKETT BLVD

ALBANY,NY12208
14-1438749
LONG TERM CARE NY 501(C)(3) LINE 3 ST PETER'S HOSPITAL
 
Yes
 
(227)WESTSHORE HEALTH NETWORK
1820 44TH STREET

KENTWOOD,MI49508
38-3280200
HEALTH NETWORK MI 501(C)(4) N/A MERCY HEALTH PARTNERS
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) ADVENT REHABILITATION LLC

607 DEWEY AVENUE SUITE 300
GRAND RAPIDS,MI49504
38-3306673
REHABILITATION THERAPY SERVICES MI N/A
                 
(2) BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP

6150 EAST BROAD STREET
COLUMBUS,OH43213
31-1608125
MEDICAL OFFICE BUILDING RENTAL OH MOUNT CARMEL HEALTH SYSTEM
 
RELATED 51,897 734,953   No   Yes   76.920 %
(3) CATHERINE HORAN BUILDING ASSOCIATES LP

1221 MAIN STREET SUITE 105
HOLYOKE,MA01040
04-2723429
PROPERTY MANAGEMENT MA N/A
                 
(4) CENTENNIAL SURGUNIT LLC

502 CENTENNIAL BLVD SUITE 1
VOORHEES,NJ08043
22-3580847
HEALTH CARE SERVICES NJ N/A
                 
(5) CENTER FOR DIGESTIVE CARE LLC

5300 ELLIOTT DRIVE
YPSILANTI,MI48197
03-0447062
PROVIDE GASTROINTESTINAL SERVICES MI N/A
                 
(6) CENTRAL NEW JERSEY HEART SERVICES LLC

45 SAPPHIRE DRIVE
PRINCETON,NJ08550
20-8525458
CARDIAC PROGRAM NJ N/A
                 
(7) CLINTON IMAGING SERVICES LLC

615 VALLEY VIEW DR STE 202
MOLINE,IL61265
41-2044739
MRI DIAGNOSTIC SERVICES IA N/A
                 
(8) DIAGNOSTIC IMAGING OF SOUTHBURY LLC

385 MAIN STREET SOUTH
SOUTHBURY,CT06488
06-1487582
IMAGING CENTER CT N/A
                 
(9) FOREST PARK IMAGING LLC

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

300 WEST TEXTILE ROAD
ANN ARBOR,MI48104
38-2648446
LABORATORY MI N/A
                 
(11) GATEWAY HEALTH PLAN LP

444 LIBERTY AVE SUITE 2100
PITTSBURGH,PA15222
25-1691945
MEDICAID & MEDICARE/SPECIAL NEEDS MANAGED CARE ORGANIZATION PA N/A
                 
(12) GREATER HARTFORD LITHOTRIPSY LLC

114 WOODLAND ST
HARTFORD,CT06105
06-1578891
LITHOTRIPSY SERVICES CT N/A
                 
(13) HAWARDEN REGIONAL HEALTH CLINICS LLC

1122 AVENUE L
HAWARDEN,IA51023
20-1444339
MEDICAL CLINIC IA N/A
                 
(14) HEART INSITUTE OF ST MARY LLC

1201 LANGHORNE-NEWTOWN ROAD
LANGHORNE,PA19047
45-4903701
CARDIOVASCULAR SERVICES PA N/A
                 
(15) IDAHO ASC HOLDINGS LLC

1055 N CURTIS ROAD
BOISE,ID83706
36-4729605
HOLDING COMPANY FOR AMBULATORY SURGERY ID N/A
                 
(16) INNOVATIVE HEALTH ALLIANCE OF NEW YORK LLC

14 COLUMBIA CIRCLE DRIVE
ALBANY,NY12203
46-5676066
ACCOUNTABLE CARE ORGANIZATION NY N/A
                 
(17) LOYOLA AMBULATORY SURGERY CENTER AT OAKBROOK LP

569 BROOKWOOD VILLAGE SUITE 901
BIRMINGHAM,AL35209
36-4119522
SURGICAL SERVICES IL N/A
                 
(18) MAGNETIC RESONANCE SERVICES PARTNERSHIP

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

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

6150 EAST BROAD STREET
COLUMBUS,OH43213
42-1544707
MEDICAL OFFICE BUILDING RENTAL OH MOUNT CARMEL HEALTH SYSTEM
 
RELATED 220,596 3,352,451   No   Yes   49.840 %
(21) MDRMRI TECHNICAL SERVICES LLC

5640 EAST TAFT ROAD 3770
SYRACUSE,NY13220
16-1590982
MRI SERVICES NY N/A
                 
(22) MEDILUCENT MOB I

6150 EAST BROAD STREET
COLUMBUS,OH43213
20-4911370
MEDICAL OFFICE BUILDING RENTAL OH MOUNT CARMEL HEALTH SYSTEM
 
RELATED 19,499 1,688,302   No   Yes   25.130 %
(23) MEDWORKS LLC

375 EAST CEDAR STREET
NEWINGTON,CT06111
06-1490483
REHABILITATION SERVICES CT N/A
                 
(24) MERCY ADVANCED MRI LLC

2525 SOUTH MICHIGAN AVE
CHICAGO,IL60616
26-2116721
SUBLEASE MRI EQUIPMENT IL N/A
                 
(25) MERCY HEART CTR OP SERVICES LLC

1000 4TH STREET SW
MASON CITY,IA50401
13-4237594
CARDIOVASCULAR SERVICES IA N/A
                 
(26) MERCYMANOR PARTNERSHIP

PO BOX 10086
TOLEDO,OH43699
52-1931012
NURSING HOME PA N/A
                 
(27) MERCYUSP HEALTH VENTURES LLC

15305 DALLAS PARKWAY STE 1600 LB 28
ADDISON,TX75001
47-1290300
OUTPATIENT SURGERY IA N/A
                 
(28) MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP

6150 EAST BROAD STREET
COLUMBUS,OH43213
31-1369473
MEDICAL OFFICE BUILDING RENTAL OH MOUNT CARMEL HEALTH SYSTEM
 
RELATED 282,321 1,589,896   No   Yes   29.080 %
(29) NAUGATUCK VALLEY MRI LLC

385 MAIN STREET SOUTH
SOUTHBURY,CT06488
06-1239526
IMAGING CENTER CT N/A
                 
(30) NAZARETH MEDICAL OFFICE BUILDING ASSOCIATES LP

C/O NAZARETH HOSP 2601 HOLME AVE
PHILADELPHIA,PA19152
23-2388040
MEDICAL OFFICE BUILDING PA N/A
                 
(31) OSWEGO HEALTH HOME CARE LLC

113 SCHUYLER STREET
FULTON,NY13069
47-2463736
HOME HEALTH CARE NY N/A
                 
(32) PHYSICIANS OUTPATIENT SURGERY CENTER LLC

1000 NE 56TH STREET
OAKLAND PARK,FL33334
35-2325646
AMBULATORY SURGERY CENTER FL N/A
                 
(33) PRIMARY CARE PHYSICIAN CENTER LLC

1445 ROSS AVENUE SUITE 1400
DALLAS,TX75202
36-4038505
OFFICE BUILDING RENTAL IL N/A
                 
(34) RADISSON SJH PROPERTIES LLC

5000 CAMPUSWOOD DRIVE SUITE 100
EAST SYRACUSE,NY13057
46-1892799
MEDICAL OFFICE BUILDING NY N/A
                 
(35) SARMED OUTPATIENT PHARMACY LLC

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

2373 64TH ST STE 2200
BYRON CENTER,MI49315
20-2443646
PROVIDE OUTPATIENT SURGICAL CARE MI N/A
                 
(37) SJLS LLC

7650 SE 27TH ST STE 200
MERCER ISLAND,WA98040
20-1796650
DIALYSIS SERVICES NY N/A
                 
(38) SJV MANAGEMENT LLC

200 CENTURY PKWY STE 200E
MOUNT LAUREL,NJ08054
20-2273476
RADIOLOGY NJ N/A
                 
(39) SMMC MOB II LP

1201 LANGHORNE-NEWTOWN ROAD
LANGHORNE,PA19047
36-4559869
INVESTMENT AND OPERATION OF A MEDICAL BUILDING PA N/A
                 
(40) ST AGNES LONG-TERM INTENSIVE CARE LLP

C/O MHS ONE WEST ELM ST STE 100
CONSHOHOCKEN,PA19428
20-0984882
LONG TERM INTENSIVE CARE PA N/A
                 
(41) ST ALPHONSUS CALDWELL CANCER CTR LLC

3123 MEDICAL DR
CALDWELL,ID83605
82-0526861
HEALTH CARE SERVICES ID N/A
                 
(42) ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP

6150 EAST BROAD STREET
COLUMBUS,OH43213
31-1603660
MEDICAL OFFICE BUILDING RENTAL OH MOUNT CARMEL HEALTH SYSTEM
 
RELATED -901 1,585,966   No   Yes   47.000 %
(43) ST JOSEPH'S IMAGING ASSOCIATES PLLC

104 UNION AVE SUITE 905
SYRACUSE,NY13203
16-1104293
RADIOLOGY SERVICES NY N/A
                 
(44) ST MARY REHABILITATION HOSPITAL LLP

680 SOUTH FOURTH STREET
LOUISVILLE,KY40202
27-3938747
HEALTH CARE SERVICES DE N/A
                 
(45) ST PETER'S AMBULATORY SURGERY CENTER LLC

1375 WASHINGTON AVENUE STE 201
ALBANY,NY12206
46-0463892
OUTPATIENT SURGERY NY N/A
                 
(46) TAMARACK MEDICAL CLINIC LLC

402 LAKE CASCADE PARKWAY
CASCADE,ID83611
20-1637921
OUTPATIENT MEDICAL SERVICES ID N/A
                 
(47) THE AMBULATORY SURGERY CENTER AT ST MARY LLC

1203 LANGHORNE-NEWTOWN ROAD
LANGHORNE,PA19047
27-2871206
OUTPATIENT SURGERY PA N/A
                 
(48) WOODLAND IMAGING CENTER LLC

5301 E HURON RIVER DR
ANN ARBOR,MI48106
76-0820959
RADIOLOGY/ IMAGING MI N/A
                 
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) AFFILIATED MANAGEMENT SERVICES CORPORATION INC

1300 MASSACHUSETTS AVENUE
TROY,NY12180
14-1668024
REAL ESTATE NY N/A
C       Yes  
(2) CATHERINE HORAN BUILDING CORPORATION

1233 MAIN STREET
HOLYOKE,MA01040
04-2938160
BUILDING MANAGEMENT MA N/A
C       Yes  
(3) CHESTNUT RISK SERVICES LTD

11 VICTORIA STREET
HAMILTON    
BD
INSURANCE BD N/A
C       Yes  
(4) DIVERSIFIED COMMUNITY SERVICES INC

1233 MAIN STREET
HOLYOKE,MA01040
04-3128890
MEDICAL SERVICES MA N/A
C       Yes  
(5) FHS SERVICES INC

333 BUTTERNUT DRIVE SUITE 100
DEWITT,NY13214
27-2995699
MEDICAL SERVICES NY N/A
C       Yes  
(6) FRANCISCAN ASSOCIATES INC

333 BUTTERNUT DRIVE SUITE 100
DEWITT,NY13214
20-2991688
MEDICAL SERVICES NY N/A
C       Yes  
(7) FRANCISCAN HEALTH SUPPORT INC

333 BUTTERNUT DRIVE SUITE 100
DEWITT,NY13214
16-1236354
MEDICAL SERVICES NY N/A
C       Yes  
(8) FRANCISCAN MANAGEMENT SERVICES INC

333 BUTTERNUT DRIVE SUITE 100
DEWITT,NY13214
16-1351193
MANAGEMENT SERVICES NY N/A
C       Yes  
(9) FRANKLIN MEDICAL GROUP PC

56 FRANKLIN ST
WATERBURY,CT06706
06-1470493
PHYSICIAN OFFICE CT N/A
C       Yes  
(10) GOTTLIEB MANAGEMENT SERVICES INC

701 W NORTH AVE
MELROSE PARK,IL60160
36-3330529
MANAGEMENT SERVICES IL N/A
C       Yes  
(11) HEF INC

1820 44TH STREET SE
KENTWOOD,MI49508
38-3086401
OFFICE STAFFING MI N/A
C       Yes  
(12) HACKLEY HEALTH MANAGEMENT CENTER

1820 44TH STREET SE
KENTWOOD,MI49508
38-2961814
WEIGHT MANAGEMENT MI N/A
C       Yes  
(13) HACKLEY HEALTH VENTURES INC

1820 44TH STREET SE
KENTWOOD,MI49508
38-2589959
OTHER MEDICAL SERVICES MI N/A
C       Yes  
(14) HACKLEY HEALTHCARE EQUIPMENT

1820 44TH STREET SE
KENTWOOD,MI49508
38-2578569
HOME MEDICAL EQUIPMENT MI N/A
C       Yes  
(15) HACKLEY PROFESSIONAL PHARMACY

1820 44TH STREET SE
KENTWOOD,MI49508
38-2447870
PHARMACY MI N/A
C       Yes  
(16) HEALTH CARE MANAGEMENT

333 BUTTERNUT DRIVE SUITE 100
DEWITT,NY13214
16-1450960
HEALTH CARE MANAGEMENT NY N/A
C       Yes  
(17) HEALTH MANAGEMENT SERVICES ORG INC

500 GROVE STREET SUITE 100
HADDON HEIGHTS,NJ08035
22-3366580
MEDICAL ADMINISTRATION NJ N/A
C       Yes  
(18) HOLY CROSS PRIVATE HOME SERVICES CORP

1500 FOREST GLEN RD
SILVER SPRING,MD20910
52-1986562
HOME CARE SERVICES MD N/A
C       Yes  
(19) HURON ARBOR CORPORATION

5301 EAST HURON RIVER DR
ANN ARBOR,MI48106
38-2475644
PROVIDES OFFICE RENTAL SPACE MI N/A
C       Yes  
(20) IHA AFFILIATION CORPORATION

24 FRANK LLOYD WRIGHT DR LOBBY J
ANN ARBOR,MI48106
38-3188895
MEDICAL MANAGEMENT MI N/A
C       Yes  
(21) LANGHORNE SERVICES II INC

1201 LANGHORNE-NEWTOWN ROAD
LANGHORNE,PA19047
26-3795549
GENERAL PARTNER OF LMOB PARTNERS, II PA N/A
C       Yes  
(22) LANGHORNE SERVICES INC

1201 LANGHORNE-NEWTOWN ROAD
LANGHORNE,PA19047
23-2625981
GENERAL PARTNER OF LMOB PARTNERS PA N/A
C       Yes  
(23) LOURDES MEDICAL ASSOCIATES PA

500 GROVE STREET SUITE 100
HADDON HEIGHTS,NJ08035
22-3361862
MEDICAL SERVICES NJ N/A
C       Yes  
(24) LOURDES URGENT CARE SERVICES PC

1600 HADDON AVENUE
CAMDEN,NJ08103
46-4188202
URGENT CARE CENTER NJ N/A
C       Yes  
(25) MACNEAL HEALTH PROVIDERS INC

750 PASQUINELLI DR SUITE 216
WESTMONT,IL60559
36-3361297
MEDICAL SERVICES IL N/A
C       Yes  
(26) MARYLAND CARE GROUP INC

1500 FOREST GLEN RD
SILVER SPRING,MD20910
52-1815313
HEALTH CARE HOLDING MD N/A
C       Yes  
(27) MCMC EASTWICK INC

C/O MHS ONE WEST ELM STREET STE 100
CONSHOHOCKEN,PA19428
23-2184261
MEDICAL OFFICE BUILDINGS PA N/A
C       Yes  
(28) MEDNOW INC

1512 12TH AVENUE ROAD
NAMPA,ID83686
82-0389927
MEDICAL SERVICES ID N/A
C       Yes  
(29) MERCY HOME CARE INC

1233 MAIN STREET
HOLYOKE,MA01040
04-3317426
HEALTH CARE SERVICES MA N/A
C       Yes  
(30) MERCY INPATIENT MEDICAL ASSOCIATES INC

1233 MAIN STREET
HOLYOKE,MA01040
04-3029929
MEDICAL SERVICES MA N/A
C       Yes  
(31) MERCY MEDICAL SERVICES

801 5TH STREET
SIOUX CITY,IA51101
42-1283849
PRIMARY CARE PHYSICIANS IA N/A
C       Yes  
(32) MERCY SERVICES CORPORATION

2525 SOUTH MICHIGAN AVENUE
CHICAGO,IL60616
36-3227348
DORMANT IL N/A
C       Yes  
(33) MOUNT CARMEL HEALTH PROVIDERS INC

6150 EAST BROAD STREET
COLUMBUS,OH43213
31-1382442
MEDICAL SERVICES OH MOUNT CARMEL HEALTH SYSTEM
 
C -64,121,129 92,009,115 100.000 % Yes  
(34) NURSING NETWORK INC

4725 NORTH FEDERAL HIGHWAY
FORT LAUDERDALE,FL33308
59-1145192
MEDICAL SERVICES FL N/A
C       Yes  
(35) SAINT ALPHONSUS HEALTH ALLIANCE INC

1055 NORTH CURTIS ROAD
BOISE,ID83706
82-0524649
ACCOUNTABLE CARE ORGANIZATION ID N/A
C       Yes  
(36) SAINT ALPHONSUS PHYSICIANS PA

1055 NORTH CURTIS ROAD
BOISE,ID83706
33-1078261
HEALTH CARE SERVICES (INACTIVE) ID N/A
C       Yes  
(37) SAINT FRANCIS BEHAVIORAL HEALTH GROUP PC

114 WOODLAND STREET
HARTFORD,CT06105
06-1384686
MEDICAL SERVICES CT N/A
C       Yes  
(38) SAINT FRANCIS CARE MEDICAL GROUP PC

114 WOODLAND STREET
HARTFORD,CT06105
06-1432373
MEDICAL SERVICES CT N/A
C       Yes  
(39) SAMARITAN MEDICAL OFFICE BUILDING INC

2212 BURDETT AVENUE
TROY,NY12180
14-1607244
REAL ESTATE NY N/A
C       Yes  
(40) SJM PROPERTIES INC

411 CANISTEO STREET
HORNELL,NY14843
16-1294991
PROPERTY HOLDINGS NY N/A
C       Yes  
(41) SJPE PRACTICE MANAGEMENT SERVICES INC

301 PROSPECT AVE
SYRACUSE,NY13203
45-4164964
MANAGEMENT SERVICES NY N/A
C       Yes  
(42) SJRMC HOLDINGS INC

5215 HOLY CROSS PARKWAY
MISHAWAKA,IN46545
47-4763735
PROPERTY HOLDINGS IN N/A
C       Yes  
(43) ST ELIZABETH HEALTH SUPPORT SERVICES INC

2209 GENESEE STREET
UTICA,NY13501
16-1540486
MEDICAL SERVICES NY N/A
C       Yes  
(44) ST MARY'S HIGHLAND HILLS VILLAGE INC

1230 BAXTER STREET
ATHENS,GA30606
58-2276801
ASSISTED LIVING GA N/A
C       Yes  
(45) SYSTEM COORDINATED SERVICES INC

1233 MAIN STREET
HOLYOKE,MA01040
04-2938161
LAB SERVICES MA N/A
C       Yes  
(46) THRE SERVICES LLC

20555 VICTOR PARKWAY
LIVONIA,MI48152
45-2603654
REAL ESTATE BROKERAGE SERVICES MI N/A
C       Yes  
(47) TRI-HOSPITAL MRI CENTER

4190 24TH AVENUE
FORT GRATIOT,MI48054
38-2884297
HEALTH CARE SERVICES MI N/A
C       Yes  
(48) TRINITY ASSURANCE LTD

PO BOX 1159 GRAND CAYMAN
GRAND CAYMAN    
CJ
98-0453602
SELF-INSURANCE CJ N/A
C       Yes  
(49) TRINITY HEALTH ACO INC

20555 VICTOR PARKWAY
LIVONIA,MI48152
47-3794666
ACCOUNTABLE CARE ORGANIZATION DE N/A
C       Yes  
(50) TRINITY HEALTH EMPLOYEE BENEFIT TRUST

20555 VICTOR PARKWAY
LIVONIA,MI48152
38-3410377
GRANTOR TRUST MI N/A
T       Yes  
(51) TRINITY SENIOR SERVICES MANAGEMENT INC

PO BOX 9184
FARMINGTON HILLS,MI48333
37-1572595
SENIOR SERVICES PA N/A
C       Yes  
(52) WORKPLACE HEALTH OF GRAND HAVEN INC

1820 44TH STREET SE
KENTWOOD,MI49508
38-3112035
OCCUPATIONAL HEALTH MI N/A
C       Yes  
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) MERCY HEALTH SERVICES - IOWA CORP

L 88,951 PER BOOKS
(2) TRINITY HOME HEALTH SERVICES

B 4,655,293 PER BOOKS
(3) TRINITY HEALTH CORPORATION

B 38,124,116 PER BOOKS
(4) TRINITY HEALTH CORPORATION

C 102,361 PER BOOKS
(5) TRINITY HEALTH CORPORATION

E 50,000,000 PER BOOKS
(6) TRINITY HEALTH CORPORATION

L 313,987 PER BOOKS
(7) TRINITY HEALTH CORPORATION

M 108,454,415 PER BOOKS
(8) TRINITY HEALTH CORPORATION

P 24,391,092 PER BOOKS
(9) TRINITY HEALTH CORPORATION

Q 12,036,958 PER BOOKS
(10) TRINITY HEALTH CORPORATION

R 27,368,653 PER BOOKS
(11) TRINITY HEALTH ACO INC

L 1,799,978 PER BOOKS
(12) TRINITY HEALTH - MICHIGAN

M 2,263,286 PER BOOKS
(13) MOUNT CARMEL HEALTH PLAN INC

L 128,851,940 PER BOOKS
(14) MOUNT CARMEL HEALTH INSURANCE COMPANY

L 1,132,468 PER BOOKS
(15) MOUNT CARMEL COLLEGE OF NURSING

B 3,730,266 PER BOOKS
(16) MOUNT CARMEL COLLEGE OF NURSING

K 271,176 PER BOOKS
(17) DILEY RIDGE MEDICAL CENTER

C 10,150,000 PER BOOKS
(18) DILEY RIDGE MEDICAL CENTER

L 1,766,654 PER BOOKS
(19) MOUNT CARMEL HEALTH SYSTEM FOUNDATION

B 2,394,646 PER BOOKS
(20) MOUNT CARMEL HEALTH SYSTEM FOUNDATION

C 3,991,832 PER BOOKS
(21) MOUNT CARMEL HEALTH SYSTEM FOUNDATION

L 1,449,722 PER BOOKS
(22) MOUNT CARMEL HEALTH PROVIDERS INC

A 2,700,837 PER BOOKS
(23) MOUNT CARMEL HEALTH PROVIDERS INC

B 74,060,338 PER BOOKS
(24) MOUNT CARMEL HEALTH PROVIDERS INC

L 277,414 PER BOOKS
(25) MOUNT CARMEL HEALTH PROVIDERS INC

M 9,892,680 PER BOOKS
(26) MOUNT CARMEL HEALTH PROVIDERS INC

P 645,308 PER BOOKS
(27) MCE MOB IV LIMITED PARTNERSHIP

C 190,199 PER TAX RETURN
(28) MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP

C 237,022 PER TAX RETURN
(29) ST ANN'S MEDICAL OFFICE BUILDING II LIMITED PARTNERSHIP

C 50,820 PER TAX RETURN
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) 2019

Additional Data


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