TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) ROBERT CASALOU...................................................................... DIRECTOR;PRESIDENT & CEO-MICH REGION	53.00 ................. 2.00	X	X	1,452,780	69,808
(2) JAMES WOODS...................................................................... DIRECTOR; CHAIR AS OF 1/19	2.00 ................. 2.00	X	X	0	0
(3) JOSE INFANTE...................................................................... DIRECTOR; CHAIR THROUGH 12/18	2.00 ................. 2.00	X	X	0	0
(4) DALE NESBARY PHD...................................................................... DIRECTOR; VICE CHAIR AS OF 1/19	2.00 ................. 2.00	X	X	0	0
(5) RENNY ABRAHAM MD...................................................................... DIRECTOR THROUGH 12/18	2.00 ................. 0.00	X		0	0
(6) WAYMAN BRITT...................................................................... DIRECTOR AS OF 3/19	2.00 ................. 2.00	X		0	0
(7) TIMOTHY CAUGHLIN...................................................................... DIRECTOR THROUGH 12/18	2.00 ................. 0.00	X		0	0
(8) DONNA DOLEMAN...................................................................... DIRECTOR	2.00 ................. 2.00	X		0	0
(9) MICHAEL DORSEY MD...................................................................... DIRECTOR THROUGH 12/18	2.00 ................. 0.00	X		0	0
(10) F JOSEPH FLECK...................................................................... DIRECTOR THROUGH 12/18	2.00 ................. 0.00	X		0	0
(11) JAN GARFINKLE...................................................................... DIRECTOR	2.00 ................. 2.00	X		0	0
(12) MICHAEL GLUHANICH...................................................................... DIRECTOR THROUGH 12/18	2.00 ................. 2.00	X		0	0
(13) LUANN HANNASCH RSM...................................................................... DIRECTOR	2.00 ................. 2.00	X		0	0
(14) EDMUND HODGE...................................................................... DIRECTOR AS OF 1/19; TH EVP, CHRO	2.00 ................. 53.00	X		1,034,765	235,341
(15) NELSON JACOBSON...................................................................... DIRECTOR THROUGH 12/18	2.00 ................. 2.00	X		0	0
(16) CAMILLE JOURDEN-MARK...................................................................... DIRECTOR THROUGH 12/18	2.00 ................. 2.00	X		0	0
(17) MARY FRANCIS LEWANDOWSKI CSSF...................................................................... DIRECTOR	2.00 ................. 2.00	X		0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) SPENCER MAIDLOW........................................................................ DIRECTOR	2.00 .......................2.00	X					0	0	0
(19) JEAN NAGELKERK PHD........................................................................ DIRECTOR	2.00 .......................2.00	X					0	0	0
(20) JERRY NORCIA........................................................................ DIRECTOR THROUGH 12/18	2.00 .......................0.00	X					0	0	0
(21) CANETTA REID........................................................................ DIRECTOR	2.00 .......................2.00	X					0	0	0
(22) KENNETH SIKKEMA........................................................................ DIRECTOR THROUGH 12/18	2.00 .......................2.00	X					0	0	0
(23) DAVID STEINBERGER MD........................................................................ DIRECTOR	2.00 .......................2.00	X					0	0	0
(24) LINDA THIEL OP........................................................................ DIRECTOR THROUGH 12/18	2.00 .......................2.00	X					0	0	0
(25) TONYA WELLS........................................................................ DIR THR 12/18; TH VP FED ADVOCACY	2.00 .......................48.00	X					0	277,803	47,956
(26) TERRENCE WRIGHT MD........................................................................ DIRECTOR	2.00 .......................2.00	X					0	0	0
(27) STEPHEN ZONCA MD........................................................................ DIRECTOR THROUGH 12/18	2.00 .......................3.00	X					0	0	0
(28) HOWARD ZUCKERMAN........................................................................ DIRECTOR THROUGH 12/18	2.00 .......................0.00	X					0	0	0
(29) SALLY GUINDI........................................................................ SECRETARY; GEN COUNSEL-MICHIGAN	25.00 .......................25.00		X				0	462,156	49,756
(30) CAROL TARNOWSKY........................................................................ ASST SEC THR 12/18; MI DPTY GEN CSL	25.00 .......................25.00		X				0	384,286	28,423
(31) MICHAEL GUSHO........................................................................ TREASURER; CFO-MICHIGAN REGION	26.00 .......................29.00		X				0	700,075	139,526
(32) DAVID SPIVEY........................................................................ PRES & CEO ST. MARY MERCY LIVONIA	54.00 .......................1.00			X			0	838,950	51,186
(33) BILL MANNS........................................................................ PRES MHSM THR 9/18;PRES SJM AA 10/18	52.00 .......................3.00			X			0	743,682	40,082
(34) ROSALIE TOCCO-BRADLEY MD........................................................................ CMO ST JOS MERCY ANN ARBOR, LIVINGS.	50.00 .......................0.00			X			0	643,336	133,562
(35) SHANNON STRIEBICH........................................................................ PRESIDENT ST. JOSEPH MERCY OAKLAND	55.00 .......................0.00			X			0	589,512	47,323
(36) DAVID BAUMGARTNER MD........................................................................ MHSM CMO THR9/18;INT PRES 10/18-4/19	50.00 .......................0.00			X			0	542,987	49,248
(37) MATT BIERSACK MD........................................................................ INTERIM CMO MHSM AS OF 11/18	25.00 .......................25.00			X			0	380,820	34,329
(38) FABIAN FREGOLI MD........................................................................ CMO ST. JOSEPH MERCY OAKLAND	50.00 .......................0.00			X			13,659	456,859	34,695
(39) DAVID MCEWEN........................................................................ COO MERCY HEALTH ST. MARY'S	50.00 .......................0.00			X			0	445,935	39,417
(40) MICHAEL GRISDELA........................................................................ VP FIN WEST MARKET,SE MICH THR 12/18	48.00 .......................2.00			X			0	381,456	43,506
(41) MATTHEW GRIFFIN MD........................................................................ CMO ST. MARY MERCY LIVONIA	50.00 .......................0.00			X			0	374,988	41,789
(42) JOHN O'MALLEY........................................................................ PRES; ST. JOSEPH MERCY LIVINGSTON	55.00 .......................0.00			X			0	374,126	77,041
(43) ALONZO LEWIS........................................................................ INT PRES SJ MERCY AA THR 10/18; COO	55.00 .......................0.00			X			363,883	0	37,963
(44) MICHAEL SAMYN........................................................................ VP FINANCE EAST MARKET	50.00 .......................0.00			X			0	344,483	44,171
(45) DANIEL GREEN........................................................................ VP FINANCE MERCY HEALTH ST MARY'S	48.00 .......................2.00			X			8,835	324,625	41,234
(46) SARAH GILBERT........................................................................ VP OPS ST MARY MERCY LIVONIA	50.00 .......................0.00			X			233,857	0	31,980
(47) FRANK SAWYER........................................................................ SENIOR VP, OPERATIONS OAKLAND	50.00 .......................0.00			X			306,599	0	32,426
(48) LAWRENCE RAPP MD........................................................................ NEUROSURGEON (OAKLAND)	50.00 .......................0.00				X		1,520,553	0	35,512
(49) YOAV RITTER DO........................................................................ NEUROSURGEON (OAKLAND)	50.00 .......................0.00				X		1,218,691	0	37,869
(50) AHMAD ISSAWI MD........................................................................ NEUROSURGEON (SJMHS)	50.00 .......................0.00				X		1,171,365	0	33,574
(51) JASON BRODKEY MD........................................................................ NEUROSURGEON (SJMHS)	50.00 .......................0.00				X		1,073,724	0	44,471
(52) GEORGE GIBSON DO........................................................................ ORTHOPEDIC SURGEON (SJMHS)	50.00 .......................0.00				X		961,239	0	27,492
(53) GARY ALLORE........................................................................ FORMER OFFICER; PRES MH MUSKEGON	0.00 .......................55.00					X	0	567,370	48,278
(54) BENJAMIN CARTER........................................................................ FORMER OFFICER; TRINITY EVP, CFO	0.00 .......................55.00					X	0	1,665,531	67,211
(55) CYNTHIA CLEMENCE........................................................................ FMR OFFICER; TRINITY SVP, OPS CFO	0.00 .......................55.00					X	0	1,041,751	60,860
(56) PAUL NEUMANN........................................................................ FMR OFFCR; TH CHF LEGAL OFF THR 8/18	0.00 .......................55.00					X	0	1,229,277	556,844
(57) RICHARD GILFILLAN........................................................................ FORMER OFFICER; TH PRESIDENT & CEO	0.00 .......................55.00					X	0	2,823,784	127,974
(58) MARY NEFF........................................................................ FORMER KEY EMP;VP LABOR & CLIN OPS	0.00 .......................50.00					X	0	179,120	33,082
(59) JACQUELINE PRIMEAU........................................................................ FORMER KEY EMPLOYEE; TH VP, M&A	0.00 .......................50.00					X	0	238,190	26,995
(60) KATHLEEN O'CONNOR........................................................................ FORMER KEY EMP; DIR DECISION SUPPORT	0.00 .......................50.00					X	0	218,073	28,829
(61) ROGER SPOELMAN........................................................................ FORMER OFFICER; TH SVP THR 12/18	0.00 .......................55.00					X	0	1,083,418	70,858
(62) DAVID BROOKS........................................................................ FORMER KEY EMPLOYEE	0.00 .......................0.00					X	0	805,953	628,251
(63) MICHAEL K SMITH........................................................................ FORMER KEY EMPLOYEE	0.00 .......................0.00					X	0	200,900	24,193
(64) NANCY GRAEBNER........................................................................ FORMER KE; CEO SJM CHELSEA	0.00 .......................55.00					X	0	534,298	29,121
(65) RANDALL T FORSCH........................................................................ FORMER KE: CMO SJM CHELSEA	0.00 .......................50.00					X	0	187,071	10,229
(66) AGNES HAGERTY........................................................................ FORMER OFFICER; TH ASSOC COUNSEL	0.00 .......................30.00					X	0	142,848	1,304

(A) Name and business address	(B) Description of services	(C) Compensation
GRANGER CONSTRUCTION COMPANY 39475 W 13 MILE RD STE 100 NOVI,MI48377	CONSTRUCTION SERVICES	16,769,131
RONCELLI INC 6471 METROPOLITAN PKWY STERLING HEIGHTS,MI48312	CONSTRUCTION SERVICES	8,661,159
EMERGENCY PHYSICIANS MEDICAL GROUP 2000 GREEN RD STE 300 ANN ARBOR,MI48105	HEALTH CARE SERVICES	6,865,384
KASCO 226 E HUDSON AVE ROYAL OAK,MI48067	CONSTRUCTION SERVICES	5,905,475
TRIANGLE ASSOCIATES 3769 3 MILE RD NW GRAND RAPIDS,MI49534	CONSTRUCTION SERVICES	5,460,233
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 292

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

TRINITY HEALTH - MICHIGAN

Employer identification number

38-2113393

Part I

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

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

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

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

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

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

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

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

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

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

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

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

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

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

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

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

Section D. Computation of Investment Income Percentage

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

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

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

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

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

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

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

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

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

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

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

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

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

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

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

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

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

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

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

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

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

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

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

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

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

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

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

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

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

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

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2018

Name of the organization

TRINITY HEALTH - MICHIGAN

Employer identification number

38-2113393

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

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

Special Rules

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

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

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

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

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

Name of organization TRINITY HEALTH - MICHIGAN

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

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

Page 3

Name of organization TRINITY HEALTH - MICHIGAN		Employer identification number 38-2113393

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

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

Page 4


Name of organization TRINITY HEALTH - MICHIGAN			Employer identification number 38-2113393
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

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

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

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

OMB No. 1545-0047

2018

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

TRINITY HEALTH - MICHIGAN

Employer identification number

38-2113393

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

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

A Check SchCMd Bullet

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

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

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

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

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

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

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

(a)

Yes

(b)

Amount

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

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

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

Yes

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

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

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

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

Yes

112,335

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

Yes

160,257

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

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

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

272,592

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1:	TRINITY HEALTH - MICHIGAN (TH-MI) 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 ORGANIZATIONS HAVE PROVIDED TH-MI WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. SIMILARLY, THESE HEALTH CARE ORGANIZATIONS WILL ARRANGE CONFERENCES AND SEMINARS FOR MEMBER ORGANIZATIONS AND THEIR EXECUTIVES WHICH INVOLVE LEGISLATORS OR OTHER POLITICAL FIGURES AS GUEST SPEAKERS. OUR 2019 FEDERAL AND STATE ADVOCACY GOALS AND PRIORITIES INCLUDE: GOAL 1: IMPROVING THE HEALTH OF INDIVIDUALS AND COMMUNITIES EXPAND & SECURE COVERAGE: -MEDICAID -HEALTH INSURANCE MARKETPLACE -PRE-EXISTING CONDITIONS ADVANCE VALUE-BASED CARE: -HOLD PROVIDERS ACCOUNTABLE TO HEALTH OUTCOMES -WORKFORCE -TELEHEALTH -PALLIATIVE CARE ENSURE POPULATION BEHAVIORAL HEALTH: -CARE MODELS -PRIVACY -ACCESS -SUD/OPIOID ADDRESS SOCIAL INFLUENCERS OF HEALTH: -INCOME -HOUSING -ENVIRONMENT -EDUCATION -FOOD -VIOLENCE -EMPLOYMENT -TRANSPORTATION PROTECT 340B DRUG SAVINGS PROGRAM: -ENSURE SAVINGS ENABLING HOSPITALS IN VULNERABLE COMMUNITIES TO PROVIDE COMPREHENSIVE SERVICES GOAL 2: SUSTAINING THE CATHOLIC HEALTH MINISTRY BY PROTECTING TAX EXEMPTION & FAIR PAYMENT, INCLUDING SURPRISE BILLING. LOBBYING ACTIVITY PERFORMED BY TH-MI INCLUDED: - ENCOURAGEMENT OF ASSOCIATES TO WRITE LETTERS TO PUBLIC OFFICIALS - AN "ADVOCACY ACTION" WEBSITE TO ENGAGE ASSOCIATES IN FEDERAL ADVOCACY - DESIGNATE AN ADVOCACY LIAISON - ENGAGEMENT OF A LOBBYIST IN WASHINGTON, D.C. BY TRINITY HEALTH CORPORATION - LEGISLATOR VISITS - COLLABORATION WITH THE CATHOLIC HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION - ADVOCACY ACTION DAYS AT THE STATE LEVEL, ATTENDED BY TRINITY HEALTH EXECUTIVES

Return Reference

Explanation

PART II-B, LINE 1:

TRINITY HEALTH - MICHIGAN (TH-MI) 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 ORGANIZATIONS HAVE PROVIDED TH-MI WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. SIMILARLY, THESE HEALTH CARE ORGANIZATIONS WILL ARRANGE CONFERENCES AND SEMINARS FOR MEMBER ORGANIZATIONS AND THEIR EXECUTIVES WHICH INVOLVE LEGISLATORS OR OTHER POLITICAL FIGURES AS GUEST SPEAKERS. OUR 2019 FEDERAL AND STATE ADVOCACY GOALS AND PRIORITIES INCLUDE: GOAL 1: IMPROVING THE HEALTH OF INDIVIDUALS AND COMMUNITIES EXPAND & SECURE COVERAGE: -MEDICAID -HEALTH INSURANCE MARKETPLACE -PRE-EXISTING CONDITIONS ADVANCE VALUE-BASED CARE: -HOLD PROVIDERS ACCOUNTABLE TO HEALTH OUTCOMES -WORKFORCE -TELEHEALTH -PALLIATIVE CARE ENSURE POPULATION BEHAVIORAL HEALTH: -CARE MODELS -PRIVACY -ACCESS -SUD/OPIOID ADDRESS SOCIAL INFLUENCERS OF HEALTH: -INCOME -HOUSING -ENVIRONMENT -EDUCATION -FOOD -VIOLENCE -EMPLOYMENT -TRANSPORTATION PROTECT 340B DRUG SAVINGS PROGRAM: -ENSURE SAVINGS ENABLING HOSPITALS IN VULNERABLE COMMUNITIES TO PROVIDE COMPREHENSIVE SERVICES GOAL 2: SUSTAINING THE CATHOLIC HEALTH MINISTRY BY PROTECTING TAX EXEMPTION & FAIR PAYMENT, INCLUDING SURPRISE BILLING. LOBBYING ACTIVITY PERFORMED BY TH-MI INCLUDED: - ENCOURAGEMENT OF ASSOCIATES TO WRITE LETTERS TO PUBLIC OFFICIALS - AN "ADVOCACY ACTION" WEBSITE TO ENGAGE ASSOCIATES IN FEDERAL ADVOCACY - DESIGNATE AN ADVOCACY LIAISON - ENGAGEMENT OF A LOBBYIST IN WASHINGTON, D.C. BY TRINITY HEALTH CORPORATION - LEGISLATOR VISITS - COLLABORATION WITH THE CATHOLIC HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION - ADVOCACY ACTION DAYS AT THE STATE LEVEL, ATTENDED BY TRINITY HEALTH EXECUTIVES

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

TRINITY HEALTH - MICHIGAN

Employer identification number

38-2113393

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....	22,033,634	20,913,371	19,154,684	19,561,547	17,198,931
b	Contributions ...	944,923	41,203	-163,975	804,151	2,024,963
c	Net investment earnings, gains, and losses	1,775,131	1,340,233	1,958,733	-325,670	336,668
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	2,774,330	159,159		729,527	-229,498
f	Administrative expenses ....	105,014	102,014	36,071	155,817	228,513
g	End of year balance ......	21,874,344	22,033,634	20,913,371	19,154,684	19,561,547

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

0 %

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

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

Yes

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

3a(i)

Yes

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

3a(ii)

Yes

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

Yes

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

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	48,788,463		48,788,463
b	Buildings ....	1,420,248,171	702,046,314	718,201,857
c	Leasehold improvements	108,588,163	45,711,514	62,876,649
d	Equipment ....	1,124,957,172	847,288,419	277,668,753
e	Other .....	26,679,472	5,489	26,673,983
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,134,209,705

Schedule D (Form 990) 2018

Page 3

Part VII

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

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES	214,287,104	F
(B) EQUITY METHOD INVESTMENTS	339,287,914	C
(C) HEDGE FUNDS	142,858,069	F
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	696,433,087

Part VIII

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

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

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

Part IX

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

(a) Description				(b) Book value
(1) OTHER RECEIVABLES				19,181,102
(2) INTERCOMPANY ACCOUNTS RECEIVABLE				45,790,998
(3) INVESTMENT IN UNCONSOLIDATED AFFILIATES				22,159,568
(4) INTERCOMPANY OTHER LT ASSETS				134,616,993
(5) OTHER LONG-TERM ASSETS				550,808
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				222,299,469

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
INTERCOMPANY ACCOUNTS PAYABLE	78,361,528
DEFERRED COMPENSATION	13,222,081
ASSET RETIREMENT OBLIGATION (FIN 47)	1,993,080
ANNUITIES PAYABLE	1,086,848
INTERCOMPANY NOTES PAYABLE	782,996,047
OTHER CURRENT LIABILITIES	3,224,291
OTHER LONG-TERM LIABILITIES	1,841,550
LEASE OBLIGATION	1,050,292
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	883,775,717
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART V, LINE 4:	THE ORGANIZATION'S ENDOWMENT FUNDS ARE TO BE USED FOR THE FOLLOWING PURPOSES: HOSPITAL OPERATIONS SUPPORT, MEDICAL PROGRAM SUPPORT, SCHOLARSHIPS, RESEARCH, COMMUNITY SERVICE, AND VARIOUS OTHER.
SCHEDULE D, PART V	THE ENDOWMENTS REPORTED ON LINE 1 ARE HELD BY TH-MI. ENDOWMENTS HELD BY SAINT MARY'S FOUNDATION AND MERCY HOSPITAL CADILLAC FOUNDATION FOR THE BENEFIT OF TH-MI ARE REPORTED ON THE FORM 990 OF SAINT MARY'S FOUNDATION AND MERCY HOSPITAL CADILLAC FOUNDATION.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

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

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

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization
TRINITY HEALTH - MICHIGAN

Employer identification number

38-2113393

Part I

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

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

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

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

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2018

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 HOLIDAY BALL -ANN ARBOR (event type)	(b) Event #2 GALA - LIVONIA (event type)	(c) Other events 2 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	1,079,888	286,751	443,057	1,809,696
2	Less: Contributions . . . .	760,289	200,801	375,557	1,336,647
3	Gross income (line 1 minus line 2) . . . . . .	319,599	85,950	67,500	473,049

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .	70,681	8,178	11,594	90,453
7	Food and beverages . . .	197,361	49,607	63,942	310,910
8	Entertainment . . . .	24,146	8,500	10,875	43,521
9	Other direct expenses . . .	211,010	101,088	66,576	378,674
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				823,558
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-350,509

Part III

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

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

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

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

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

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

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

YesNo

If "No," explain:

10a

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

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2018

Page 3

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

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

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

13a

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

13b

100.000 %

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

Name

KIM NIETHAMMER ST JOSEPH MERCY HE

Address

5305 E HURON RIVER DR PO BOX 995
ANN ARBOR,MI48106

15a

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

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

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

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

Name

Address

Gaming manager information:

Name

KIM NIETHAMMER ST JOSEPH MERCY HE

Gaming manager compensation right arrow

$ 1,265

Description of services provided right arrow

FINANCIAL REPORTING, CASH DEPOSITS.

Director/officer Employee Independent contractor

Mandatory distributions:

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

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

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

TRINITY HEALTH - MICHIGAN

Employer identification number

38-2113393

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	2	12,620	16,213,204		16,213,204	0.670 %
b	Medicaid (from Worksheet 3, column a) . . . . .	2	164,142	321,782,253	260,623,146	61,159,107	2.540 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	9	820	9,035,711	7,493,243	1,542,468	0.060 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	13	177,582	347,031,168	268,116,389	78,914,779	3.270 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	45	81,572	6,371,327	788,549	5,582,778	0.230 %
f	Health professions education (from Worksheet 5) . . .	3	452	92,152,640	55,895,653	36,256,987	1.510 %
g	Subsidized health services (from Worksheet 6) . . . .	16	113,048	45,636,004	29,391,127	16,244,877	0.680 %
h	Research (from Worksheet 7) .			7,789,393	4,626,937	3,162,456	0.130 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	9	2,597	2,380,729	34,875	2,345,854	0.100 %
j	Total. Other Benefits . .	73	197,669	154,330,093	90,737,141	63,592,952	2.650 %
k	Total. Add lines 7d and 7j .	86	375,251	501,361,261	358,853,530	142,507,731	5.920 %

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

Schedule H (Form 990) 2018

Page

Part II

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

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	1	125	3,604	3,604	0 %
7	Community health improvement advocacy
8	Workforce development	2		43,182	43,182	0 %
9	Other
10	Total	3	125	46,786	46,786	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

62,294,139

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

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

Section B. Medicare

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

525,119,966

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

513,287,435

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

11,832,531

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 CENTER FOR DIGESTIVE CARE LLC	SURGICAL CENTER	51.000 %	49.000 %
22 FRANCES WARDE MEDICAL LABORATORY	LABORATORY SERVICES	66.670 %	33.330 %
33 WOODLAND IMAGING CENTER LLC DBA AVANT IMAGING	IMAGING SERVICES	51.000 %	49.000 %
44 HEALTH PARK CENTRAL LLC	MEDICAL OFFICE BUILDING	10.550 %	82.490 %
55 SIXTY FOURTH STREET LLC	SURGICAL CENTER	53.940 %	42.770 %
66 WATERFORD SURGICAL CENTER LLC	SURGICAL CENTER	20.000 %	67.500 %
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?5Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	ST JOSEPH MERCY ANN ARBOR 5301 MCAULEY DR YPSILANTI,MI48197 WWW.STJOESHEALTH.ORG LICENSE 1060000071	X	X	X	X
2	MERCY HEALTH ST MARY'S 200 JEFFERSON STREET SE GRAND RAPIDS,MI49503 WWW.MERCYHEALTH.COM LICENSE 1060000030	X	X	X	X
3	ST JOSEPH MERCY OAKLAND 44405 WOODWARD AVE PONTIAC,MI48341 WWW.STJOESOAKLAND.ORG LICENSE 1060000013	X	X	X	X
4	ST MARY MERCY LIVONIA 36475 FIVE MILE RD LIVONIA,MI48154 WWW.STMARYMERCY.ORG LICENSE 1060000001	X	X	X	X
5	ST JOSEPH MERCY LIVINGSTON 620 BYRON RD HOWELL,MI48843 WWW.STJOESLIVINGSTON.ORG LICENSE 1060000033	X	X	X	X

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	ST JOSEPH MERCY ANN ARBOR
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

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

Yes

6 a

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

Yes

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

Yes

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

Yes

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

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

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

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

Yes

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

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ST JOSEPH MERCY ANN ARBOR
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

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

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

WWW.STJOESANNARBOR.ORG/FA

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

WWW.STJOESANNARBOR.ORG/FA

A plain language summary of the FAP was widely available on a website (list url):
WWW.STJOESANNARBOR.ORG/FA

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	ST JOSEPH MERCY ANN ARBOR
Name of hospital facility or letter of facility reporting group

Yes

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

	ST JOSEPH MERCY ANN ARBOR
Name of hospital facility or letter of facility reporting group

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	MERCY HEALTH SAINT MARY'S
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 17

Yes

6 a

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

Yes

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

Yes

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

Yes

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

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

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17

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

Yes

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

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

10b

12a

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

12a

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

12b

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

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MERCY HEALTH SAINT MARY'S
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

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

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

WWW.MERCYHEALTH.COM/FOR-PATIENTS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE

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

WWW.MERCYHEALTH.COM/FOR-PATIENTS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
WWW.MERCYHEALTH.COM/FOR-PATIENTS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	MERCY HEALTH SAINT MARY'S
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

	MERCY HEALTH SAINT MARY'S
Name of hospital facility or letter of facility reporting group

Yes

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

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

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 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)

	ST JOSEPH MERCY OAKLAND
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 17

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..................................

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

Yes

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

Yes

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

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

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17

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

Yes

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

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

10b

12a

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

12a

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

12b

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

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ST JOSEPH MERCY OAKLAND
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

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

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

WWW.STJOESOAKLAND.ORG/SJMO-PFS

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

WWW.STJOESOAKLAND.ORG/SJMO-PFS

A plain language summary of the FAP was widely available on a website (list url):
WWW.STJOESOAKLAND.ORG/SJMO-PFS

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	ST JOSEPH MERCY OAKLAND
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

	ST JOSEPH MERCY OAKLAND
Name of hospital facility or letter of facility reporting group

Yes

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

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

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 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)

	ST MARY MERCY LIVONIA
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 17

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..................................

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. ............................

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

Yes

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

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

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17

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

Yes

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

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

10b

12a

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

12a

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

12b

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

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ST MARY MERCY LIVONIA
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

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

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

WWW.STJOESANNARBOR.ORG/FA

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

WWW.STJOESANNARBOR.ORG/FA

A plain language summary of the FAP was widely available on a website (list url):
WWW.STJOESANNARBOR.ORG/FA

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	ST MARY MERCY LIVONIA
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

	ST MARY MERCY LIVONIA
Name of hospital facility or letter of facility reporting group

Yes

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

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

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 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)

	ST JOSEPH MERCY LIVINGSTON
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 17

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..................................

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. ............................

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

Yes

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

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

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17

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

Yes

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

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

10b

12a

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

12a

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

12b

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

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ST JOSEPH MERCY LIVINGSTON
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

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

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

WWW.STJOESANNARBOR.ORG/FA

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

WWW.STJOESANNARBOR.ORG/FA

A plain language summary of the FAP was widely available on a website (list url):
WWW.STJOESANNARBOR.ORG/FA

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	ST JOSEPH MERCY LIVINGSTON
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

	ST JOSEPH MERCY LIVINGSTON
Name of hospital facility or letter of facility reporting group

Yes

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

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

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
ST. JOSEPH MERCY ANN ARBOR	PART V, SECTION B, LINE 3J: N/ALINE 3E: ST. JOSEPH MERCY ANN ARBOR (SJMAA) INCLUDED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS FOR SJMAA WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1. MENTAL HEALTH AND SUBSTANCE USE DISORDERS2. OBESITY AND RELATED ILLNESSES3. PRECONCEPTUAL AND PERINATAL HEALTH
MERCY HEALTH SAINT MARY'S	PART V, SECTION B, LINE 3J: N/ALINE 3E: MERCY HEALTH SAINT MARY'S (MHSM) INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS FOR MHSM WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1. MENTAL HEALTH (INCLUDING STRESS AS IT PERTAINS TO MENTAL HEALTH)2. SUBSTANCE ABUSE (INCLUDING NICOTINE PRODUCTS)3. OBESITY (INCLUDING POOR NUTRITION)4. DIABETES (INCLUDING FOOD INSECURITY AS IT RELATES TO DIABETES)
ST. JOSEPH MERCY OAKLAND	PART V, SECTION B, LINE 3J: N/ALINE 3E: ST. JOSEPH MERCY OAKLAND (SJMO) INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE CHNA IDENTIFIED 16 HEALTH NEEDS WITHIN THE SJMO SERVICE AREA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS:1. MENTAL HEALTH/SUBSTANCE ABUSE2. OBESITY/DIABETES3. HEART DISEASE4. MATERNAL HEALTH EDUCATION
ST. MARY MERCY LIVONIA	PART V, SECTION B, LINE 3J: N/ALINE 3E: ST. MARY MERCY LIVONIA (SMML) INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE 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. NUTRITION/HEALTHY EATING - INCREASE KNOWLEDGE THROUGH EDUCATION ABOUT HEALTHY EATING; INCREASE ACCESS TO AFFORDABLE FRUITS AND VEGETABLES; PROVIDE ADULTS SERVICES AND RESOURCES TO ACHIEVE A HEALTHY WEIGHT2. SUBSTANCE USE DISORDER (ABUSE) - INCREASE THE NUMBER OF PEOPLE SEEKING TREATMENT AND DECREASE DEATHS FROM OPIOIDS3. MENTAL HEALTH - INCREASE NUMBER OF PEOPLE SEEKING TREATMENT; INCREASE KNOWLEDGE THROUGH EDUCATION ABOUT MENTAL HEALTH/DEPRESSION TO REDUCE THE STIGMA4. ACCESS TO CARE - IMPROVE ACCESS TO PRIMARY CARE PROVIDERS; IMPROVE NAVIGATION AND PROVIDE HEALTH CARE RESOURCES 5. PHYSICAL ACTIVITY - INCREASE ACCESS TO/USE OF PHYSICAL ACTIVITY OPPORTUNITIES
ST. JOSEPH MERCY LIVINGSTON	PART V, SECTION B, LINE 3J: N/ALINE 3E: ST. JOSEPH MERCY LIVINGSTON (SJML) INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS FOR SJML WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1. OBESITY AND CARDIOVASCULAR DISEASE2. BEHAVIORAL HEALTH (INCLUDING MENTAL HEALTH AND SUBSTANCE ABUSE) 3. HEALTH CARE ACCESS
ST. JOSEPH MERCY ANN ARBOR	PART V, SECTION B, LINE 5: IN THE FALL OF 2018, SJMAA, AS A PART OF THE COLLABORATIVE NEEDS ASSESSMENT PROCESS WITH ST. JOSEPH MERCY CHELSEA AND MICHIGAN MEDICINE (D/B/A UNIVERSITY OF MICHIGAN HEALTH SYSTEM), CONSULTED MANY COMMUNITY ORGANIZATIONS TO TAKE INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH KEY STAKEHOLDER INTERVIEWS AND COMMUNITY SURVEYS. THE HOSPITAL COLLABORATORS, NAMED UNIFIED NEEDS ASSESSMENT IMPLEMENTATION PLAN TEAM ENGAGEMENT (UNITE), SOUGHT QUALITATIVE INPUT FROM COMMUNITY MEMBERS AND KEY STAKEHOLDERS ON WHAT THE TOP COMMUNITY HEALTH NEEDS WERE, AS WELL AS BROADER COMMUNITY NEEDS. UNITE MEMBERS COLLECTED THIS DATA IN PERSON AT MEETINGS OF WELLNESS COALITIONS, SAFETY-NET ORGANIZATIONS, FOOD PANTRIES, CIVIC CLUBS, MINISTERIAL ASSOCIATIONS, AND WASHTENAW HEALTH INITIATIVE STAKEHOLDERS. THE HOSPITALS ALSO COLLECTED THIS DATA ELECTRONICALLY, VIA A SURVEY LINK SENT TO COMMUNITY PARTNERS (INCLUDING HEALTH CARE PROVIDERS, AS WELL AS SOCIAL SERVICE PROVIDERS AND COMMUNITY-BASED ORGANIZATIONS). THESE ORGANIZATIONS PROVIDING INPUT INCLUDED: WASHTENAW COUNTY COMMUNITY MENTAL HEALTH, WASHTENAW COUNTY PUBLIC HEALTH, THE STUDENT ADVOCACY CENTER, FAITH IN ACTION, AND CATHOLIC SOCIAL SERVICES OF WASHTENAW COUNTY. THESE ORGANIZATIONS PROVIDE DIRECT SERVICES TO THE LOW-INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS IN THE SJMAA SERVICE AREA.
MERCY HEALTH SAINT MARY'S	PART V, SECTION B, LINE 5: THE CHNA WAS VERY INCLUSIVE AND COMPREHENSIVE IN INCORPORATING INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. THE DATA WAS COLLECTED THROUGH THE MONTHS OF MAY 2017 TO DECEMBER 2017. THE QUALITATIVE DATA WAS FROM A COLLECTION OF IN-PERSON AND VIDEO CONSUMER SURVEYS, PHOTOS OF COMMUNITY ENVIRONMENTS, COMMUNITY POLLS AND INPUT CARDS, AND PAPER AND ELECTRONIC SURVEYS OFFERED IN BOTH ENGLISH AND SPANISH. ADDITIONAL DATA WAS COLLECTED FROM STATE INFORMATION SOURCES SUCH AS THE MICHIGAN BEHAVIORAL RISK FACTOR SURVEYS. MORE INFORMATION ON EACH OF THESE METHODS IS DESCRIBED IN GREATER DETAIL IN THE COMMUNITY HEALTH NEEDS ASSESSMENT.SEVERAL COMMUNITY ORGANIZATIONS PROVIDED INPUT, INCLUDING THE BAXTER COMMUNITY CENTER, CALVIN COLLEGE, CATHERINE'S HEALTH CENTER, CHERRY HEALTH, CITY OF GRAND RAPIDS, COALITION TO END HOMELESSNESS, GRAND VALLEY STATE UNIVERSITY, ESSENTIAL NEEDS TASK FORCE, FAMILY FUTURES, FERRIS STATE UNIVERSITY, FIRST STEPS, GRAND RAPIDS CHAMBER OF COMMERCE, GRAND RAPIDS HQ, GRAND RAPIDS PUBLIC SCHOOLS, HEALTHY HOMES COALITION, HEART OF WEST MICHIGAN UNITED WAY, KCONNECT, KENT COUNTY HEALTH DEPARTMENT, KENT COUNTY PREVENTION COALITION (NETWORK 180), KENT INTERMEDIATE SCHOOL DISTRICT, MARY FREE BED, METRO HEALTH, OUR COMMUNITY'S CHILDREN, PREGNANCY RESOURCE CENTER, SPECTRUM HEALTH, STRONG BEGINNINGS, THE GRAND RAPIDS RED PROJECT, AND THE YMCA OF GREATER GRAND RAPIDS.THE RESULTS OF THE SURVEYS WERE FROM COMMUNITIES ACROSS KENT COUNTY AND REPRESENTED A DIVERSE POPULATION. SURVEY RESPONDENTS WERE 31% MALE AND 69% FEMALE AND REPRESENTED VARYING ETHNICITIES, INCLUDING CAUCASIAN, AFRICAN AMERICAN, HISPANIC/LATINO, AND THOSE WITH MULTIRACIAL BACKGROUNDS. AS A FIRST LANGUAGE, 91.5% OF RESPONDENTS SPOKE ENGLISH AND 7.2% SPOKE SPANISH. OF SURVEY RESPONDENTS, 33.5% EARNED AN ANNUAL INCOME OF LESS THAN $20,000 AND 7% OF SURVEY RESPONDENTS DID NOT HAVE A HIGH SCHOOL DIPLOMA. THE COMMUNITY ORGANIZATIONS WHO WERE INVOLVED IN THE CHNA PROCESS REPRESENT RESIDENTS OF ALL AGES, LOW-INCOME, HOMELESS, ETHNICALLY DIVERSE, UNINSURED/UNDERINSURED, AT-RISK YOUTH, PREGNANT WOMEN, AND THOSE STRUGGLING WITH BEHAVIORAL HEALTH AND SUBSTANCE USE CONCERNS.
ST. JOSEPH MERCY OAKLAND	PART V, SECTION B, LINE 5: BETWEEN NOVEMBER 2017 AND APRIL 2018, SJMO CONSULTED MANY COMMUNITY ORGANIZATIONS AND THEIR REPRESENTATIVES TO GAIN INSIGHT ON THE BROAD INTERESTS OF THE COMMUNITY. THE INDIVIDUALS REPRESENTED BY THE ORGANIZATIONS LISTED BELOW ARE THOSE WHO ARE ECONOMICALLY DISADVANTAGED, RACIAL AND ETHNIC MINORITIES, UNINSURED, LOW-INCOME, ELDERLY, HOMELESS, AND HAVE CHRONIC HEALTH CONDITIONS. THE ORGANIZATIONS REPRESENTED INCLUDE:GREAT START OAKLAND COUNTY, OAKLAND COUNTY LIGHT HOUSE, PONTIAC SCHOOL DISTRICT, THE CITY OF PONTIAC, OAKLAND LIVINGSTON HEALTH SERVICE AGENCY (OLSHA), OAKLAND UNIVERSITY HEALTH SCIENCES DEPARTMENT, CENTRO MULTICULTURAL LA FAMILIA, OAKLAND COUNTY HEALTH DEPARTMENT, OAKLAND COUNTY FETAL & INFANT MORTALITY REVIEW TEAM, COMMUNITY NETWORK SERVICES, OAKLAND PRIMARY HEALTH SERVICES, GARY BURNSTEIN COMMUNITY HEALTH CLINIC, HEALTHY PONTIAC WE CAN!, HOPE HOSPITALITY AND WARMING CENTER, AND OTHERS WITHIN THE COMMUNITY.THE SJMO COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WAS AVAILABLE TO COMMUNITY RESIDENTS IN ELECTRONIC AND PAPER FORMATS. THE SURVEY CONSISTED OF 32 QUESTIONS THAT COVERED MATTERS RELEVANT TO HEALTH CONDITIONS, HEALTH CARE ACCESS, BEHAVIORS AND SOCIAL DETERMINANTS OF HEALTH. THE SURVEY WAS DISTRIBUTED THROUGH A GRASS ROOTS EFFORT THAT EMPLOYED THE NETWORK AND CONTACTS OF LOCAL COMMUNITY ORGANIZATIONS. THESE COMMUNITY GROUPS AND ORGANIZATIONS SPECIFICALLY TARGETED UNDERSERVED RESIDENTS AND INDIVIDUALS REFLECTING THE BROADER COMMUNITY AS WELL. THERE WERE 721 SURVEYS COLLECTED OVER THE TWO MONTH PERIOD FROM FEBRUARY 1 THROUGH MARCH 31, 2018. SJMO ALSO FACILITATED TWO COMMUNITY FORUMS, THE FIRST AT THE PONTIAC PUBLIC LIBRARY ON THURSDAY, MARCH 29, 2018 AND THE SECOND AT WELCOME MISSIONARY BAPTIST CHURCH ON SATURDAY, APRIL 28, 2018. THE PURPOSE OF PROVIDING THESE FORUMS WAS TO OFFER RESIDENTS AN EDUCATIONAL SETTING TO REVIEW THE PURPOSE AND SCOPE OF A CHNA, REVIEW SURVEY RESULTS, GAIN INPUT ON HEALTH PRIORITIES, AND IDENTIFY UNREALIZED EMERGING HEALTH NEEDS FROM UNDERREPRESENTED MEMBERS OF THE SJMO SERVICE AREA.
ST. MARY MERCY LIVONIA	PART V, SECTION B, LINE 5: A 25-MEMBER COMMUNITY-BASED COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE LED THE ASSESSMENT PROCESS FROM JUNE 2017 THROUGH JUNE 2018, WITH THE INTENT THAT SOME OF THEM WOULD CONTINUE AS MEMBERS OF THE IMPLEMENTATION WORK GROUP(S). THESE PARTNERS INCLUDED REPRESENTATIVES FROM THE WAYNE COUNTY DEPARTMENT OF HEALTH, VETERANS & COMMUNITY HEALTH, LIVONIA AND SOUTH REDFORD SCHOOL DISTRICTS, WAYNE HOPE CLINIC, MADONNA UNIVERSITY, JOY SOUTHFIELD COMMUNITY DEVELOPMENT CORPORATION, PLYMOUTH COMMUNITY UNITED WAY, LEGAL HELP FOR VETERANS, FARMINGTON HILLS SPECIAL SERVICES, MADONNA UNIVERSITY, SCHOOLCRAFT COLLEGE, REDFORD INTERFAITH RELIEF (RIR), WESTLAND YOUTH ASSISTANCE, AUTHORITY HEALTH, KIRKSEY LIVONIA RECREATION CENTER, AND SMML REPRESENTATIVES FROM STRATEGIC PLANNING, COMMUNITY HEALTH AND ADMINISTRATION.AN ON-LINE AND PAPER SURVEY WAS CREATED IN JULY 2017 TO EVALUATE THE CHANGING HEALTH NEEDS IN THE SMML SERVICE AREA. THE SURVEY TOOL WAS BRANDED WITH THE BANNER "MAKING A DIFFERENCE IN THE HEALTH OF OUR COMMUNITY." THE SURVEY WAS COMPOSED OF 38 QUESTIONS ABOUT ACCESS TO CARE, PERSONAL HEALTH BEHAVIORS, PERCEIVED COMMUNITY HEALTH NEEDS, AND PATIENT DEMOGRAPHICS. A PAPER OR ON-LINE SURVEY WAS AVAILABLE TO THE PUBLIC FROM SEPTEMBER 7 THROUGH OCTOBER 6, 2017. THE SURVEY WAS PROMOTED AT A VARIETY OF EVENTS, POSTED ON THE HOSPITAL WEBSITE, AND DISTRIBUTED THROUGH EMAIL BLASTS TO CITY OFFICIALS, COMMUNITY LEADERS IN BUSINESSES, SCHOOLS, CHURCHES, AND SMML EMPLOYEES AND PHYSICIANS. OF THE 1,174 RESPONSES, 535 (46%) WERE PAPER SURVEYS AND 22% OF THE OVERALL RESPONSES WERE COMPLETED BY VULNERABLE POPULATIONS AT THE REDFORD INTERFAITH RELIEF FOOD PANTRY, PLYMOUTH UNITED WAY, AND WAYNE HOPE CLINIC.IN NOVEMBER 2017, SMML AND THEIR PARTNERS ORGANIZED A COMMUNITY FORUM HELD AT THURSTON HIGH SCHOOL IN REDFORD, MICHIGAN TO SHARE THE SURVEY RESULTS, GAIN ADDITIONAL INFORMATION, ENGAGE COMMUNITY MEMBERS IN DISCUSSION ABOUT PROGRAMS FOR ENCOURAGING HEALTHY BEHAVIORS, AND TO IDENTIFY GAPS FOR HEALTHY EATING, PHYSICAL ACTIVITY, ACCESS TO CARE, MENTAL HEALTH, AND SUBSTANCE ABUSE PREVENTION AND TREATMENT. THE LOCATION WAS SELECTED TO MAKE THE EVENT ACCESSIBLE. INVITATIONS TO THE FORUM WERE SENT TO COMMUNITY LEADERS AND ORGANIZATIONS WITH A FOCUS ON REPRESENTING THOSE WHO ARE UNDERSERVED OR LOW INCOME. ALSO, PERSONAL PHONE CALLS WERE MADE AND/OR EMAILS WERE SENT TO INDIVIDUALS WHO PROVIDED THEIR CONTACT INFORMATION ON THE CHNA SURVEY AND INDICATED THAT THEY WERE INTERESTED IN PROVIDING MORE INPUT INTO THE CHNA PROCESS.
ST. JOSEPH MERCY LIVINGSTON	PART V, SECTION B, LINE 5: FROM JUNE TO SEPTEMBER 2017, SJML CONSULTED OTHER COMMUNITY ORGANIZATIONS IN CONDUCTING THE MOST RECENT CHNA, INCLUDING THE LIVINGSTON COUNTY DEPARTMENT OF HEALTH, COMMUNITY MENTAL HEALTH SERVICES OF LIVINGSTON COUNTY, THE HUMAN SERVICES COLLABORATIVE BODY, AND LIVINGSTON COUNTY CATHOLIC CHARITIES. THESE ORGANIZATIONS SERVE MINORITY, UNDERREPRESENTED, AND MEDICALLY UNDERSERVED POPULATIONS IN THE COMMUNITY, INCLUDING BUT NOT LIMITED TO THOSE BELOW THE FEDERAL POVERTY LEVEL, INDIVIDUALS EXPERIENCING HOMELESSNESS, OLDER ADULTS, THOSE EXPERIENCING SUBSTANCE USE DISORDER, AND THOSE EXPERIENCING MENTAL ILLNESS.
ST. JOSEPH MERCY ANN ARBOR	PART V, SECTION B, LINE 6A: SJMAA CONDUCTED THE CHNA WITH ST. JOSEPH MERCY CHELSEA AND MICHIGAN MEDICINE (D/B/A UNIVERSITY OF MICHIGAN HEALTH SYSTEM).
MERCY HEALTH SAINT MARY'S	PART V, SECTION B, LINE 6A: MHSM CONDUCTED THE CHNA WITH METRO HEALTH HOSPITAL (UNIVERSITY OF MICHIGAN HEALTH), SPECTRUM HEALTH, AND MARY FREE BED REHABILITATION HOSPITAL.
ST. JOSEPH MERCY ANN ARBOR	PART V, SECTION B, LINE 6B: SJMAA CONDUCTED THE CHNA WITH THE WASHTENAW COUNTY HEALTH DEPARTMENT.
MERCY HEALTH SAINT MARY'S	PART V, SECTION B, LINE 6B: MHSM CONDUCTED THE CHNA WITH KENT COUNTY HEALTH DEPARTMENT AND PINE REST CHRISTIAN MENTAL HEALTH SERVICES.
ST. JOSEPH MERCY OAKLAND	PART V, SECTION B, LINE 6B: SJMO CONDUCTED THE CHNA WITH THE OAKLAND COUNTY HEALTH DEPARTMENT.
ST. JOSEPH MERCY ANN ARBOR	PART V, SECTION B, LINE 7D: SJMAA SHARES PERIODIC UPDATES ON THE PROGRESS MADE ON PROGRAMS AND SERVICES VIA POWERPOINT PRESENTATIONS AND NARRATIVE REPORTS. THESE DOCUMENTS ARE AVAILABLE FOR PARTNERS TO SHARE WITH THEIR CONSTITUENTS. SJMAA HIGHLIGHTED ITS COMMUNITY HEALTH AND WELLNESS PROGRAMS IN THE SJMHS REGIONAL COMMUNITY HEALTH AND WELL-BEING REPORT AND CONTINUES TO DISTRIBUTE THE REPORT. ADDITIONALLY, AS A UNITE GROUP, SJMAA WILL ASSESS THE MOST FEASIBLE WAY TO INFORM COMMUNITY MEMBERS OF OUR PROGRESS.
ST. JOSEPH MERCY OAKLAND	PART V, SECTION B, LINE 7D: IN COLLABORATION WITH COMMUNITY BENEFIT FUNDING RECIPIENTS, SJMO REVIEWED QUARTERLY METRICS AND REPORTS FROM PARTNER AGENCIES TO TRACK PROGRESS MADE ON IMPLEMENTATION PLAN PROGRAMS AND SERVICES. SJMO ALSO SHARED ITS CHNA WITH THE CITY OF PONTIAC AND OAKLAND COUNTY HEALTH DEPARTMENT. COPIES OF THE CHNA WERE MADE AVAILABLE FOR RETRIEVAL BY REQUEST FROM THE MAYOR'S ADMINISTRATIVE OFFICE TO ACCOMMODATE BROAD COMMUNITY ACCESS WITHIN THE HOSPITAL'S IMMEDIATE SERVICE AREA.
ST. MARY MERCY LIVONIA	PART V, SECTION B, LINE 7D: ALONG WITH ITS IMPLEMENTATION PARTNERS, SMML SHARES PERIODIC UPDATES ON THE PROGRESS MADE ON PROGRAMS AND SERVICES VIA POWERPOINT PRESENTATIONS AND NARRATIVE REPORTS. THESE DOCUMENTS ARE AVAILABLE FOR PARTNERS TO SHARE WITH THEIR CONSTITUENTS. SMML HIGHLIGHTED ITS COMMUNITY HEALTH AND WELLNESS PROGRAMS IN THE SJMHS REGIONAL COMMUNITY HEALTH AND WELL-BEING REPORT AND CONTINUES TO DISTRIBUTE THE REPORT.
ST. JOSEPH MERCY LIVINGSTON	PART V, SECTION B, LINE 7D: SJML SHARES PERIODIC UPDATES ON THE PROGRESS MADE ON PROGRAMS AND SERVICES VIA POWERPOINT PRESENTATIONS AND NARRATIVE REPORTS. THESE DOCUMENTS ARE AVAILABLE FOR PARTNERS TO SHARE WITH THEIR CONSTITUENTS. SJML HIGHLIGHTED ITS COMMUNITY HEALTH AND WELLNESS PROGRAMS IN THE SJMHS REGIONAL COMMUNITY HEALTH AND WELL-BEING REPORT AND CONTINUES TO DISTRIBUTE THE REPORT.
ST. JOSEPH MERCY ANN ARBOR	PART V, SECTION B, LINE 11: AS A PART OF THE COLLABORATIVE NEEDS ASSESSMENT PROCESS WITH SJMC AND UNIVERSITY OF MICHIGAN HEALTH SYSTEM, THE COMMUNITY HEALTH NEEDS PRIORITIZED ARE MENTAL HEALTH AND SUBSTANCE USE, OBESITY-RELATED ILLNESSES, AND PRECONCEPTUAL/PERINATAL HEALTH. THE HOSPITAL'S IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS FOR EACH SIGNIFICANT HEALTH NEED:MENTAL HEALTH & SUBSTANCE USE - IN FY19, SJMAA WORKED TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING BEHAVIORAL HEALTH IN OUR COMMUNITY BY:- CONTRIBUTING TOWARD IMPROVING ACCESS TO AND INTEGRATION OF BEHAVIORAL HEALTH SERVICES ACROSS THE LIFESPAN, SUBSTANCE USE DISORDER TREATMENT, AND SUPPORT FOR PATIENT COMPLIANCE,- ADDRESSING ACCESS TO CARE BARRIERS FOR THOSE MOST VULNERABLE IN THE COMMUNITY WE SERVE, INCLUDING EXPANDING SERVICES THROUGH OUR TRANSITION CLINIC AND ENHANCED SUPPORT THROUGH OUR GREENBROOK RECOVERY CENTER FOR THOSE EXPERIENCING CRISIS IN THE EMERGENCY DEPARTMENT AND INPATIENT,- PROVIDING EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS UTILIZING BEST PRACTICE FRAMEWORKS, INCLUDING DIDACTIC SESSIONS FOR RESIDENTS ACROSS MULTIPLE SPECIALTIES LED BY THOSE IN LONG-TERM RECOVERY, AND- ENGAGING SOCIAL SERVICE ORGANIZATIONS PROVIDING SERVICES AROUND MENTAL HEALTH AND SUBSTANCE USE DISORDER THROUGH A PUBLIC-PRIVATE FUNDING PARTNERSHIP THAT ENCOURAGES ALIGNMENT AND REDUCTION OF DUPLICATION ACROSS COMMUNITY-LEVEL OUTCOMES AROUND BEHAVIORAL HEALTH SERVICES THROUGH COORDINATED FUNDING PROGRAM OPERATIONS INVESTMENTS.OBESITY - IN FY19, SJMAA WORKED TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING RISING OBESITY RATES IN OUR COMMUNITY. SJMAA SUPPORTS THE COMMUNITY THROUGH:- EFFORTS SEEKING TO INCREASE ACCESS TO NUTRITIOUS FOODS THROUGH THE AVAILABILITY OF AFFORDABLE, LOCALLY-SOURCED OPTIONS, COUPLED WITH NUTRITION EDUCATION, TO ENCOURAGE LONG-TERM BEHAVIOR CHANGE, INCLUDING EXPANSION OF SUBSIDIZED COMMUNITY SUPPORTED AGRICULTURE (CSA) PROGRAMMING AT THE FARM AT ST. JOE'S AND FUNDING SUPPORT FOR DOUBLE UP FOOD BUCKS EXPANSION INTO GROCERY STORES, AND- ENGAGEMENT OF SOCIAL SERVICE ORGANIZATIONS PROVIDING SERVICES AROUND FOOD INSECURITY THROUGH A PUBLIC-PRIVATE FUNDING PARTNERSHIP THAT ENCOURAGES ALIGNMENT AND REDUCTION OF DUPLICATION ACROSS COMMUNITY-LEVEL OUTCOMES AROUND NUTRITION AND HUNGER RELIEF THROUGH COORDINATED FUNDING PROGRAM OPERATIONS INVESTMENTS.PRECONCEPTUAL/PERINATAL HEALTH - IN FY19, SJMAA WORKED TO IMPROVE THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES ADDRESSING PRECONCEPTUAL/PERINATAL HEALTH IN OUR COMMUNITY BY:- PROVIDING INNOVATIVE STRATEGIES TO ENSURE LOW-INCOME PREGNANT WOMEN IN THE COMMUNITY RECEIVE PRENATAL CARE IN A SUPPORTIVE ENVIRONMENT (I.E. CENTERING PREGNANCY),- SUPPORTING WOMEN IN THEIR CHOICE TO BREASTFEED THROUGH THE ACHIEVEMENT OF BABY-FRIENDLY DESIGNATION,- OFFERING WOMEN AND THEIR PARTNERS OPPORTUNITIES TO BE PREPARED TO ENTER INTO PARENTHOOD THROUGH OFFERING BIRTH, BREASTFEEDING, AND PARENTING PREPARATORY COURSES, AND-SUPPORTING INCARCERATED WOMEN THROUGH PRENATAL, BIRTH, AND POSTNATAL SUPPORT THROUGH THE MICHIGAN PRISON DOULA INITIATIVE.
MERCY HEALTH SAINT MARY'S	PART V, SECTION B, LINE 11: IN FISCAL YEAR 2019, MHSM DIRECTLY ADDRESSED FOUR SIGNIFICANT HEALTH NEEDS: MENTAL HEALTH, SUBSTANCE ABUSE, OBESITY AND POOR NUTRITION, AND DIABETES. THE HOSPITAL'S IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS FOR EACH SIGNIFICANT HEALTH NEED:MENTAL HEALTH - WITH THE GOAL TO REDUCE BARRIERS TO ACCESS MENTAL HEALTH SERVICES, THE HOSPITAL HAS BEGUN TO INTEGRATE MENTAL HEALTH SERVICES IN THE PRIMARY CARE SETTING. THIS ALLOWS FOR A WARM TRANSITION FROM A TRUSTED MEDICAL PROVIDER TO A TRUSTED MENTAL HEALTH PROVIDER, ELIMINATING THE NEED FOR PATIENTS TO NAVIGATE THE COMPLICATED MENTAL HEALTH CARE SYSTEM ON THEIR OWN. OFFERING INTEGRATED SERVICES ALSO REDUCES TRANSPORTATION BARRIERS FOR PATIENTS. IN FY19, THREE ADDITIONAL PRIMARY CARE OFFICES BEGAN OFFERING MENTAL HEALTH SERVICES, FOR A TOTAL OF SEVEN, INCLUDING THE FQHC SITES PROVIDING 3,014 VISITS FOR MENTAL HEALTH.SUBSTANCE ABUSE - THE ADDICTION MEDICINE PROGRAM PROVIDED MEDICALLY ASSISTED TREATMENT (MAT) AND/OR SUBSTANCE USE DISORDER SERVICES TO 309 PEOPLE (176 NEW AND 133 ALREADY ESTABLISHED PATIENTS). THE PROGRAM ALSO PROVIDED MENTAL HEALTH SERVICES SPECIFICALLY RELATED TO SUBSTANCE USE TO 349 PEOPLE (88 NEW AND 261 ALREADY ESTABLISHED PATIENTS).THE HOSPITAL HAS CONNECTED WITH THE MICHIGAN TOBACCO QUIT LINE TO EMBED REFERRAL SERVICES DIRECTLY INTO THE ELECTRONIC MEDICAL RECORD TO QUICKLY AND EASILY CONNECT PATIENTS IDENTIFIED AS NICOTINE USERS TO CESSATION RESOURCES. WHILE PROVIDERS CAN REFER TO AND PATIENTS CAN ACCESS THE TOBACCO QUIT LINE THROUGH VARIOUS CHANNELS, THE DIRECT REFERRAL FROM PROVIDER TO SERVICE HAS PROVEN TO BE MOST EFFECTIVE IN TERMS OF ENGAGEMENT. THIS WILL ALSO GIVE PROVIDERS ACCESS TO PERIODIC UPDATES REGARDING THE STATUS OF THE PATIENT ON THEIR CESSATION JOURNEY.OBESITY AND POOR NUTRITION - A BODY MASS INDEX (BMI) MEASUREMENT IS CALCULATED FOR EACH PATIENT ON AN ANNUAL BASIS. IF THE BMI INDICATES THE PATIENT IS OVERWEIGHT OR OBESE, EDUCATION IS PROVIDED AND/OR A REFERRAL TO APPROPRIATE WEIGHT MANAGEMENT RESOURCES IS INITIATED. IN FY19, APPROXIMATELY 60% OF PATIENTS WHO WERE OVERWEIGHT OR OBESE RECEIVED EDUCATION OR A REFERRAL TO APPROPRIATE RESOURCES. AN INTERNAL WORK GROUP WAS FORMED TO DISCOVER AND ADDRESS WHY THE SCREENING RATE WAS IN THE 90TH PERCENTILE, YET SOME PATIENTS WHO ARE OVERWEIGHT OR OBESE ARE NOT CONNECTED TO RESOURCES. A SOLUTION WAS IDENTIFIED AND IMPLEMENTED IN THE ELECTRONIC MEDICAL RECORD AS A BETA TEST FOR ONE PROVIDER. DURING THE SEVEN-WEEK BETA TEST, THE SCREENING AND FOLLOW-UP RATE FOR THIS PROVIDER IMPROVED BY 7%. THIS SOLUTION WILL BE IMPLEMENTED IN TWO PILOT OFFICES AND WILL CONTINUE TO SPREAD ACROSS THE ORGANIZATION.TO ENSURE PEOPLE HAVE ACCESS TO FRESH FOOD TO SUPPORT THEIR HEALTH, THE HOSPITAL PROVIDES VOUCHERS FOR PRODUCE TO INCENTIVIZE PROPER NUTRITION. IN FY19, THE HOSPITAL PROVIDED 267 VOUCHERS SERVING 1,080 PEOPLE TO USE AT THE MOBILE AND COMMUNITY FARM MARKETS TO ACCESS FRESH PRODUCE, HEALTHY GRAINS, LEAN MEATS AND DAIRY PRODUCTS.THE HOSPITAL PROVIDES VARIOUS PHYSICAL ACTIVITY CLASSES THAT ARE OPEN TO THE COMMUNITY. CLASSES RANGE FROM BEGINNERS YOGA TO CARDIO DRUMMING. WITH A GOAL TO INCREASE COMMUNITY MEMBER PARTICIPATION FOR ALL COMMUNITY MEMBERS, SPECIAL ATTENTION IS BEING PAID TO OFFERING CLASSES THAT ARE INCLUSIVE AND ATTRACTIVE TO THOSE FROM ALL CULTURES AND FITNESS LEVELS. THE HOSPITAL HAS DISCUSSED PARTNERSHIPS WITH THE YMCA TO OFFER A WIDER RANGE OF PHYSICAL ACTIVITY CLASSES NEXT YEAR. IN FY19, 52 COMMUNITY MEMBERS PARTICIPATED IN THE ONSITE PHYSICAL ACTIVITY CLASSES, ACCOUNTING FOR 49% OF TOTAL CLASS PARTICIPATION.FOOD INSECURITY AND MALNOURISHMENT ARE ALSO BEING ADDRESSED AS PART OF OBESITY AND POOR NUTRITION. UTILIZING A STANDARD SCREENING TOOL TO ASSESS UNMET SOCIAL NEEDS, PATIENTS ARE SCREENED IN THE PRIMARY CARE SETTING ON AN ANNUAL BASIS. IN FY19 A BASELINE OF 3% OF PATIENTS ARE EXPERIENCING FOOD INSECURITY. SIGNIFICANT TIME WAS SPENT IN FY19 PLANNING FOR MORE ROBUST SCREENING OPPORTUNITIES (EMERGENCY DEPARTMENT, OB/GYN), ADDITIONAL SUPPORT EMBEDDED IN THE PRIMARY CARE SETTING TO RESPOND TO THE NEEDS AS THEY ARE IDENTIFIED, AND HOW TO ADDRESS FOOD INSECURITY IN THE COMMUNITY.DIABETES - WITH A GOAL TO REDUCE THE NUMBER OF THOSE WHO HAVE OR ARE AT RISK FOR PREDIABETES THAT COULD DEVELOP INTO TYPE 2 DIABETES, PROVIDERS ARE USING THE EMBEDDED REFERRAL METHOD IN THE ELECTRONIC MEDICAL RECORD TO REFER PATIENTS TO THE DIABETES PREVENTION PROGRAM OFFERED IN THE COMMUNITY. IN FY19, THE HOSPITAL MADE 204 REFERRALS TO THE PROGRAM AND HAD 85 PARTICIPANTS, RESULTING IN A 42% ENGAGEMENT RATE (IMPROVED FROM 1% IN FY17). IN THIS PROGRAM, PATIENTS LOST AN AVERAGE OF 3.3% OF THEIR TOTAL BODY WEIGHT.THE HOSPITAL ALSO FUNDED TWO COMMUNITY ORGANIZATIONS, THE HISPANIC CENTER OF WEST MICHIGAN AND THE NATIONAL KIDNEY FOUNDATION OF MICHIGAN, WITH A COMBINED GRANT OF $70,000 TO ADDRESS DIABETES, POOR NUTRITION, HEALTH EDUCATION, TRAIN LIFE COACHES AND ENROLLMENT IN FOOD ASSISTANCE PROGRAMS.
ST. JOSEPH MERCY OAKLAND	PART V, SECTION B, LINE 11: MENTAL HEALTH/SUBSTANCE ABUSE - IN FY19, SJMO CREATED A MONTHLY SUPPORT GROUP FOR FAMILIES OF THOSE DIAGNOSED WITH A MENTAL ILLNESS. SJMO CONTINUED TO CONTRIBUTE TOWARD IMPROVING ACCESS TO SUBSTANCE ABUSE TREATMENT AND SUPPORT FOR PATIENT COMPLIANCE. SJMO WILL ADDRESS ACCESS TO CARE BARRIERS AND PROVIDE EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS BEHAVIORAL HEALTH NEEDS. SJMO IS A FOUNDING PARTNER IN THE HOPE RECUPERATIVE CENTER, WHICH PROVIDES A SAFE PLACE FOR HEALING AND RECOVERY FOR HOMELESS PERSONS RECENTLY DISCHARGED FROM THE HOSPITAL. A NEWLY LAUNCHED PARTNERSHIP WITH THE LOCAL TIMEBANK IS ALSO AN INITIATIVE WHICH THE HOSPITAL ANTICIPATES WILL HELP TO ADDRESS ISSUES OF ISOLATION AND LONELINESS IN OUR COMMUNITY, ESPECIALLY AMONG THE ELDERLY. OBESITY - SJMO IMPROVED THE COORDINATION OF AND SUPPORT FOR EXISTING COMMUNITY RESOURCES TO ADDRESS RISING OBESITY RATES IN ITS COMMUNITY. IN FY19, SJMO CONTINUED MANY OBESITY PROGRAMS FROM FY18 AND ADDED ADDITIONAL INITIATIVES. "BOOT CAMP" FOR MIDDLE SCHOOL GIRLS AND SUMMER CAMPERSHIPS FOR PONTIAC SCHOOL DISTRICT STUDENTS RETURNED IN FY19. THROUGH THESE PROGRAMS, OBESITY EDUCATION AND PREVENTION STRATEGIES TAUGHT YOUTH WITH HIGH OBESITY RISK AND LOW ACCESS TO PHYSICAL ACTIVITY OPPORTUNITIES HOW TO MANAGE STRESS, STAY ACTIVE, AND IMPROVE FRESH PRODUCE CONSUMPTION. ADDITIONALLY, ALL PONTIAC PUBLIC SCHOOL TEACHERS RECEIVED A FREE MEMBERSHIP TO THE HOSPITAL'S WELLNESS CENTER. OVER 900 AREA SENIORS PARTICIPATED IN "SENIOR FIT", A FREE EXERCISE CLASS. SENIOR FIT PROGRAM SITE OFFERINGS INCREASED TO NOW INCLUDE 21 LOCATIONS AROUND OAKLAND COUNTY. WE SEEK TO INCREASE COMMUNITY ACCESS TO NUTRITIOUS FOODS, OPPORTUNITIES FOR PHYSICAL ACTIVITY, AND EDUCATION ON HEALTHY LIVING IN VARIOUS COMMUNITY VENUES. GLEANERS COOKING MATTERS, A 16-WEEK FRESH PRODUCE PREPARATION CLASS, RETURNED TO SJMO IN FY19 FOR THE FIRST TIME IN THREE YEARS, WHILE THE FRESH PRODUCE DISTRIBUTION PROGRAM SUPPORTED BY GLEANERS CONTINUES OFFERINGS THE FIRST MONDAY OF EACH MONTH THROUGHOUT THE YEAR. ADDITIONAL FY19 OBESITY PROGRAMMING INCLUDES THE EASTERN MARKET POP UP PRODUCE STAND AND PRESCRIPTION FOR HEALTH, A PHYSICIAN ENGAGED FRESH PRODUCE AND PHYSICAL ACTIVITY INITIATIVE SUPPORTING DIABETES PREVENTION AND WEIGHT MANAGEMENT PRACTICES FOR SENIORS AND FAMILIES WITHIN OAKLAND COUNTY. HEART DISEASE - SJMO WAS DESIGNATED AS THE FIRST THROMBECTOMY CAPABLE SITE IN THE STATE OF MICHIGAN. THIS RESOURCE ALLOWED PHYSICIANS IN FY19 TO REMOVE BLOOD CLOTS WITHIN THE BRAIN THROUGH A MINIMALLY INVASIVE PROCEDURE. ALL DIAGNOSTIC TESTS AND CONSULTS, SUCH AS PHYSICAL THERAPY, SPEECH PATHOLOGY AND REHABILITATION SERVICES, ARE CONDUCTED IN AN EFFECTIVE AND TIMELY MANNER. IN FY19, SJMO ALSO RECEIVED THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATIONS' GET WITH THE GUIDELINES STROKE GOLD PLUS QUALITY ACHIEVEMENT AWARD AND TARGET: STROKE HONOR ROLL ELITE PLUS AWARD. THESE AWARDS ACKNOWLEDGE THE HOSPITALS COMMITMENT TO ENSURING STOKE PATIENTS RECEIVE THE MOST APPROPRIATE TREATMENT ACCORDING TO NATIONALLY RECOGNIZED, RESEARCH-BASED GUIDELINES. HEART DISEASE WAS ALSO ADDRESSED INDIRECTLY THROUGH THE STRATEGIES FOR OBESITY.ACCESS TO MATERNAL EDUCATION RESOURCES - IN FY19, SJMO WORKED TO IMPROVE COORDINATION AND ACCESS TO EXISTING COMMUNITY RESOURCES TO HELP ADDRESS MATERNAL HEALTH SUPPORT IN ITS SERVICE AREA BY:-INTRODUCING COMMUNITY HEALTH WORKERS TO SUPPORT SMJO'S MOTHER BABY UNIT, WOMAN'S & CHILDREN'S CENTER, AND OBGYN AMBULATORY SITES. NEW AND EXPEDITING MOTHERS WITH SOCIAL SUPPORT NEEDS ARE REFERRED TO A COMMUNITY HEALTH WORKER (CHW) FOR APPROPRIATE AGENCY REFERRALS. A PARTNERSHIP WITH THE WOMAN'S, INFANTS, AND CHILDREN'S (WIC) PROGRAM WAS ALSO ESTABLISHED THROUGH THE OAKLAND COUNTY HEALTH DEPARTMENT TO FACILITATE DIRECT INPATIENT AND OUTPATIENT REFERRALS.CLINICAL COLLEAGUE SUPPORT IN THE MATERNAL HEALTH DEPARTMENT ALSO FOCUS ON IMPROVEMENT OF EXCLUSIVE BREASTFEEDING EDUCATION OPPORTUNITIES AND TRAINING FOR COLLEAGUES BEYOND CLINICAL DEPARTMENTS TO ALSO INCLUDE ADMINISTRATIVE STAFF FOR EASE OF PATIENT ACCESS.SJMO CONTINUES TO SUPPORT WOMEN IN THEIR CHOICE TO BREASTFEED THROUGH THE PROCESS OF ACHIEVING AND MAINTAINING BABY-FRIENDLY DESIGNATION WHILE ALSO ESTABLISHING AND ADVOCATING FOR ADDITIONAL BREASTFEEDING ACCESS SITES WITHIN THE HOSPITAL AND COMMUNITY.SJMO OFFERED WOMEN AND THEIR PARTNERS THE OPPORTUNITY TO PREPARE FOR PARENTHOOD BY OFFERING BIRTH, BREASTFEEDING, AND PARENTING COURSES, AND BY ASSISTING PATIENTS, NEW MOTHERS AND COMMUNITY MEMBERS IN GETTING TO MEDICAL APPOINTMENTS AND OTHER NEEDED SERVICES IN THE SJMO SERVICE AREA, WHICH SUFFERS FROM SEVERELY INADEQUATE MASS TRANSIT, THROUGH PARTNERSHIP WITH "FREEDOM ROAD".
ST. MARY MERCY LIVONIA	PART V, SECTION B, LINE 11: IN FISCAL YEAR 2019, SMML DIRECTLY ADDRESSED FIVE SIGNIFICANT HEALTH NEEDS: HEALTHY EATING/NUTRITION, SUBSTANCE ABUSE, MENTAL HEALTH, ACCESS TO CARE, AND PHYSICAL ACTIVITY. THE HOSPITAL'S IMPLEMENTATION STRATEGY OUTLINES THE FOLLOWING EFFORTS FOR EACH SIGNIFICANT HEALTH NEED:HEALTHY EATING/NUTRITION - IN PARTNERSHIP WITH UNITED DAIRY INDUSTRY OF MICHIGAN (UDIM), MADONNA UNIVERSITY DIETETICS PROGRAM, AND SOUTH REDFORD SCHOOLS, ACTIVITIES ENCOURAGING INCREASED FRUIT AND VEGETABLE INTAKE WERE CONTINUED DURING THE 2018-19 SCHOOL YEAR AT A TARGETED SCHOOL, WITH THE GOAL OF REDUCING OBESITY THROUGH IMPROVED EATING HABITS. THE ACTIVITIES INCLUDED PRESENTATIONS IN THIRD GRADE CLASSROOMS IN THE FALL AND WINTER, INCLUDING HEALTHY SNACK TASTINGS AND AN ACTIVITY. AN ALL SCHOOL ASSEMBLY WAS ALSO CONDUCTED AT ONE OF THE SCHOOLS TO EDUCATE AND ENCOURAGE HEALTHY EATING AND PHYSICAL ACTIVITY. ADDITIONALLY, THE EASTERN MARKET FARM STAND WAS OFFERED WEEKLY. SUBSTANCE ABUSE - IN COLLABORATION WITH GROWTH WORKS, INC. AND LIVONIA SAVE OUR YOUTH (LSOY), AN ADDICTION FORUM CONTINUED FOR THE FOURTH YEAR WITH THE INTENT TO REDUCE THE STIGMA, INCREASE THE DIALOGUE AROUND SUBSTANCE USE, AND ENCOURAGE TREATMENT. THE HOSPITAL ADDRESSED TRANSITIONS OF CARE THROUGH A CONTINUED COLLABORATION WITH GROWTH WORKS, INC. TO IMPLEMENT A PEER RECOVERY PROGRAM TO ADDRESS OPIOID ADDICTION. THE PROGRAM PROVIDED A TRAINED PEER COACH TO HELP THOSE WHO CONSENT THROUGH THE JOURNEY TO SOBRIETY. SMML CONTINUED TO COLLABORATE WITH GROWTH WORKS, INC. FOR FUNDING APPROPRIATIONS FROM THE STATE OF MICHIGAN THROUGH THE CONFERENCE OF WESTERN WAYNE (CWW), WHICH SUPPORTED ADDITIONAL EFFORTS PLANNED TO ADDRESS OPIOID ISSUES. A COMMUNITY FORUM ON YOUTH AND MARIJUANA WAS HOSTED BY SMML IN PARTNERSHIP WITH LIVONIA SAVE OUR YOUTH COALITION. AS PART OF THE HEALTHY LIVONIA INITIATIVE, AND IN PARTNERSHIP WITH THE WESTERN WAYNE RESCUE RECOVERY, THE LIVONIA CHAMBER OF COMMERCE, AND GROWTH WORK, PRESENTED AN OPIOIDS & FAMILY: KEN DANIELS' STORY EVENT TO INCREASE AWARENESS ABOUT SUBSTANCE USE TO COMMUNITY MEMBERS AND HIGH SCHOOL STUDENTS. SMML PROVIDED INFORMATION AND A PANELIST FOR AN OPIOID FORUM TO INFORM THE OVER 100 PARTICIPANTS OF THE ISSUES RELATED TO OPIOID USE IN THE COMMUNITY AND RESOURCES AVAILABLE. THE HOSPITAL ALSO CONDUCTED TWO COMMUNITY DRUG TAKE BACK EVENTS IN PARTNERSHIP WITH LIVONIA SAVE OUR YOUTH COALITION, THE WAYNE COUNTY SHERIFF, AND THE MICHIGAN INSTITUTE FOR CLINICAL & HEALTHY RESEARCH (MICHA), AND COLLECTED 170 POUNDS OF MEDICATIONS.MENTAL HEALTH- THE LET'S CONTINUE THE CONVERSATION FORUM FOR SCHOOL PERSONNEL TO ADDRESS YOUTH SUICIDE PREVENTION AND EXPAND ACCESS TO TOOLS AND BEST PRACTICES WAS CONTINUED, WITH TWO FORUMS OFFERED DURING FISCAL YEAR 2019. THE PROGRAMS WERE PROVIDED IN PARTNERSHIP WITH SOUTH REDFORD SCHOOLS, OAKLAND SCHOOLS, WAYNE RESA, REDFORD COMMISSION ON YOUTH AND FAMILIES, GROWTH WORKS, DETROIT WAYNE MENTAL HEALTH AUTHORITY, SPN (SUICIDE PREVENTION NETWORK) SURVIVORS, AMERICAN FOUNDATION FOR SUICIDE PREVENTION, AND LIVONIA PUBLIC SCHOOLS. SMML SUPPORTED A LOCAL PERFORMANCE OF "THE RIPPLE EFFECT", WHICH INCLUDED A PANEL OF EXPERTS ON MENTAL HEALTH, AND WAS ATTENDED BY OVER 100 PEOPLE. SMML HOSTED A SHOWCASE EVENT TARGETED AT COLLEAGUES WITH THE GOAL OF REDUCING THE STIGMA OF MENTAL HEALTH AND SUBSTANCE USE DISORDER.ACCESS TO CARE - IN FY19, SMML CONTINUED TO PROVIDE LAB SERVICES FOR WAYNE HOPE CLINIC. THESE COMMUNITY MEMBERS WOULD NOT HAVE RECEIVED DIAGNOSTIC SERVICES HAD THE PROGRAM NOT BEEN AVAILABLE. ADDITIONALLY, FUNDING FOR HEALTH & WELLNESS NAVIGATION TO REDUCE CHRONIC DISEASE BURDEN RELATED TO OBESITY (HWNRCD) AT JOY SOUTHFIELD COMMUNITY DEVELOPMENT CORPORATION (JSCDC) WAS PROVIDED AND RESULTED IN AN INCREASE IN THE UTILIZATION OF PREVENTION AND EDUCATION SERVICES RELATED TO CHRONIC DISEASES. SUPPORT FROM HWNRCD ENHANCED ACCESS TO JSCDC'S WELLNESS SERVICES BY COVENANT PATIENTS. SMML CONTINUED THE SPECIALIST CARE PROGRAM, WHICH PROVIDES FUNDING FOR FREE FOLLOW-UP CARE FOR UNINSURED PATIENTS WHO PRESENT IN THE ER AND REQUIRE ADDITIONAL CARE, BUT WHO CANNOT AFFORD IT. ADDITIONAL FUNDING SUPPORT FOR HEALTHY YOU, A DIABETES EDUCATION PROGRAM, WAS PROVIDED TO WAYNE HOPE CLINIC.A FINANCIAL AND IN-KIND INVESTMENT CONTINUED IN FY19 FOR THE DEVELOPMENT OF A FEDERALLY QUALIFIED HEALTH CLINIC IN COLLABORATION WITH COVENANT COMMUNITY CARE IN WESTLAND, WHICH OPENED IN APRIL 2019, ALONG WITH A ST. JOE'S MEDICAL GROUP OBGYN CLINIC IN THE SAME BUILDING. WORK CONTINUED ON THE HEALTHY VILLAGE CAMPUS IN THE CODY ROUGE WARRENDALE AREA OF DETROIT AS PART OF A CROSS-SECTOR, MULTI-STAKEHOLDER PARTNERSHIP. PHYSICAL ACTIVITY- AS PART OF THE HEALTHY LIVONIA INITIATIVE, IN CONJUNCTION WITH THE LIVONIA PUBLIC SCHOOLS (LPS) AND THE KIRKSEY LIVONIA RECREATION CENTER, THE FAMILY MEMBERSHIP PROGRAM WAS CONVERTED TO A SCHOLARSHIP PROGRAM IN FY19. FUNDING WAS PROVIDED FOR YOUTH WITH RESOURCE CHALLENGES SEEKING TO PARTICIPATE IN ACTIVITY PROGRAMS. THROUGH THE HEALTHY LIVONIA INITIATIVE, BI-MONTHLY WALK AND TALKS WERE CONDUCTED BEGINNING IN MAY 2019. THE PROGRAM PROVIDED HEALTH EDUCATION AND WELLNESS INFORMATION AND CONCLUDED WITH A MILE WALK IN ONE OF THE LOCAL LIVONIA PARKS. CARROT WELLNESS WAS INITIATED AS AN INCENTIVIZED WALKING PROGRAM FOR THOSE WHO LIVE AND WORK IN LIVONIA. FUNDING WAS PROVIDED TO PROVIDE ACCESS AND REWARDS FOR UP TO 2,000 COMMUNITY PARTICIPANTS IN THE CARROT APP. PARTICIPANT NUMBERS INCREASED BY APPROXIMATELY 100 EACH MONTH SINCE THE KICK-OFF IN JANUARY 2019.
ST. JOSEPH MERCY LIVINGSTON	PART V, SECTION B, LINE 11: THE THREE SIGNIFICANT COMMUNITY HEALTH NEEDS PRIORITIZED BY SJML ARE OBESITY AND CARDIOVASCULAR DISEASE, BEHAVIORAL HEALTH, AND ACCESS TO CARE. IN FY19, SJML ADDRESSED THE FOLLOWING:OBESITY AND CARDIOVASCULAR DISEASE - IN FY19, SJML PROMOTED HEALTHY WEIGHT AND REDUCING CHRONIC DISEASE RISK, INCIDENCE, AND PREVALENCE AMONG YOUTH AND ADULTS THROUGH PRESCRIPTION FOR HEALTH EXPANSION.SJML IMPROVED THE FOOD SYSTEMS INFRASTRUCTURE IN THE COMMUNITY. THIS WAS DONE THROUGH COLLABORATION, (1) TO INCREASE EQUITABLE ACCESS TO HEALTHY FOOD BY FUNDING DOUBLE UP FOOD BUCKS EXPANSION INTO GROCERY STORES, AND (2) BY PROVIDING EDUCATION AND SUPPORT FOR PRIMARY CARE PROVIDERS TO ADDRESS FOOD INSECURITY AND NUTRITION NEEDS UTILIZING BEST PRACTICE FRAMEWORKS, INCLUDING DIDACTIC SESSIONS FOR FAMILY MEDICINE RESIDENTS AROUND THE SOCIAL DETERMINANTS OF HEALTH, UTILIZING FOOD INSECURITY AS THE DISCUSSION LENS.BEHAVIORAL HEALTH - IN FY19, SJML IMPROVED MENTAL HEALTH THROUGH PREVENTION AND BY ENSURING ACCESS TO APPROPRIATE QUALITY MENTAL HEALTH SERVICES AND SUPPORTS, AND BY SUPPORTING INCREASED EFFICIENCIES IN REFERRALS TO SUPPORT PROGRAMMING, INCLUDING STEPPING STONE ENGAGEMENT CENTER. SJML BEGAN THE DEVELOPMENT OF A PEER SUPPORT PROGRAM EMBEDDED WITHIN THE EMERGENCY DEPARTMENT IN PARTNERSHIP WITH LIVINGSTON COUNTY COMMUNITY MENTAL HEALTH AND THE REGIONAL PREPAID INPATIENT HEALTH PLAN. HEALTHCARE ACCESS - SJML DEPLOYED THREE-YEAR COLLABORATIVE MATCHING COMMITMENTS WITH MICHIGAN MEDICINE AND ST. JOHN PROVIDENCE HEALTH SYSTEMS TO EXPAND HEALTH CARE TRANSPORTATION.
ST. JOSEPH MERCY ANN ARBOR	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.
MERCY HEALTH SAINT MARY'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 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.
ST. JOSEPH MERCY OAKLAND	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.
ST. MARY MERCY LIVONIA	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.
ST. JOSEPH MERCY LIVINGSTON	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.
ST. JOSEPH MERCY ANN ARBOR	PART V, SECTION B, LINE 20E: OFFERED INFORMATION FOR OTHER VARIETIES OF PAYMENT PLAN OPTIONS; USED AUTOMATED PRESUMPTIVE CHARITY FOR SELF-PAY ACCOUNTS.
ST. JOSEPH MERCY LIVINGSTON	PART V, SECTION B, LINE 20E: OFFERED INFORMATION FOR OTHER VARIETIES OF PAYMENT PLAN OPTIONS; USED AUTOMATED PRESUMPTIVE CHARITY FOR SELF-PAY ACCOUNTS.
ST. JOSEPH MERCY ANN ARBOR - PART V, SECTION B, LINE 7A	WWW.STJOESHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT/
MERCY HEALTH SAINT MARY'S - PART V, SECTION B, LINE 7A	WWW.MERCYHEALTH.COM/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
ST. JOSEPH MERCY OAKLAND - PART V, SECTION B, LINE 7A	WWW.STJOESHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT/
ST. MARY MERCY LIVONIA - PART V, SECTION B, LINE 7A	WWW.STJOESHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT/
ST. JOSEPH MERCY LIVINGSTON - PART V, SECTION B, LINE 7A	WWW.STJOESHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT/
ST. JOSEPH MERCY ANN ARBOR - 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.
MERCY HEALTH SAINT MARY'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.
ST. JOSEPH MERCY OAKLAND - 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.
ST. MARY MERCY LIVONIA - 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.
ST. JOSEPH MERCY LIVINGSTON - 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.
ST. JOSEPH MERCY ANN ARBOR - PART V, SECTION B, LINE 10A	WWW.STJOESHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT/
MERCY HEALTH SAINT MARY'S - PART V, SECTION B, LINE 10A	WWW.MERCYHEALTH.COM/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
ST. JOSEPH MERCY OAKLAND - PART V, SECTION B, LINE 10A	WWW.STJOESHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT/
ST. MARY MERCY LIVONIA - PART V, SECTION B, LINE 10A	WWW.STJOESHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT/
ST. JOSEPH MERCY LIVINGSTON - PART V, SECTION B, LINE 10A	WWW.STJOESHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT/

Schedule H (Form 990) 2018

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?101
Name and address		Type of Facility (describe)
1	1 - (ANN ARBOR) ST JOS MERCY BRIGHTON 7575 GRAND RIVER RD BRIGHTON,MI48114	LAB, IMAGING, THERAPY, AMBULATORY SURG., EMPLOYED PHYS, ONCOLOGY, 24 HR EMER
2	2 - (AA) REICHERT HEALTH CENTER 5333 MCAULEY DR YPSILANTI,MI48197	LAB, IMAGING, AMBULATORY SURG., EMPLOYED PHYSICIANS
3	3 - (AA) ST JOSEPH MERCY CANTON HEALTH 1600 CANTON CENTER RD CANTON,MI48188	LAB, IMAGING, THERAPY, ONCOLOGY, AMBULATORY SURGERY, URGENT CARE
4	4 - (AA) MICHIGAN HEART & VASCULAR INST 5325 ELLIOTT DR YPSILANTI,MI48197	CARDIOVASCULAR CARE
5	5 - (AA) MICHIGAN ORTHOPEDIC CENTER 5315 ELLIOTT DR YPSILANTI,MI48197	ORTHOPEDIC CARE
6	6 - (AA) ELLEN THOMPSON WOMEN'S CENTER 5320 ELLIOTT DR YPSILANTI,MI48197	WOMEN'S HEALTH
7	7 - (AA) MARIAN PROFESSIONAL BUILDING 14555 LEVAN RD LIVONIA,MI48154	RADIATION ONCOLOGY, REHAB, MRI, EMPLOYED PHYSICIANS
8	8 - (AA) SLEEP DISORDERS CENTER 5305 ELLIOTT DR YPSILANTI,MI48197	SLEEP CLINIC
9	9 - (AA) HAAB HEALTH BUILDING 111 N HURON ST YPSILANTI,MI48197	EMPLOYED PHYSICIANS
10	10 - (AA) ST JOS MERCY CHEMICAL DEPENDENT 2008 HOGBACK RD ANN ARBOR,MI48105	BEHAVIORAL MEDICINE
11	11 - (AA) CENTER FOR DIGESTIVE CARE 5300 ELLIOTT DR YPSILANTI,MI48197	DIGESTIVE CARE
12	12 - (AA) BROOKLYN FAMILY PRACTICE 107 CHICAGO BLVD BROOKLYN,MI49230	FAMILY PRACTICE
13	13 - (AA) COUNTRY CREEK VILLAGE SHOPPING 7025 E MICHIGAN AVENUE SUITE C SALINE,MI48176	LAB, URGENT CARE, IMAGING
14	14 - (AA) SAMARITAN CENTER 5555 CONNER DETROIT,MI48213	INDIGENT CARE
15	15 - (AA) ST JOSEPH MERCY ARBOR HEALTH 990 W ANN ARBOR TRAIL PLYMOUTH,MI48170	LAB
16	16 - (AA) FAMILY MEDICINE OF STOCKBRIDGE 4525 S M-52 STOCKBRIDGE,MI49285	EMPLOYED PHYSICIANS
17	17 - (AA) PARKWAY MEDICAL CENTER 2345 S HURON PKWY ANN ARBOR,MI48104	LAB
18	18 - (AA) ST JOSEPH MERCY BEHAVIORAL SVCS 2200 CANTON CENTER RD CANTON,MI48188	BEHAVIORAL MEDICINE
19	19 - (AA) HURON OAKS 5401 MCAULEY DR YPSILANTI,MI48197	BEHAVIORAL MEDICINE
20	20 - (AA) HURON PROFESSIONAL BUILDING 704 W HURON ST ANN ARBOR,MI48103	LAB
21	21 - (AA) GENOA MEDICAL CENTER 2305 GENOA BUSINESS PARK DR BRIGHTON,MI48114	LAB
22	22 - (AA) DIAGNOSTIC SERVICES CENTER 202 E VAN RIPER RD FOWLERVILLE,MI48836	LAB, IMAGING
23	23 - (AA) ARBOR SCIO PROFESSIONAL BLDG 6360 JACKSON RD ANN ARBOR,MI48103	LAB
24	24 - (AA) ARBOR PARK CENTRE 4972 CLARK RD YPSILANTI,MI48197	LAB
25	25 - (AA) CHERRY HILL LAB 49650 CHERRY HILL RD CANTON,MI48187	LAB
26	26 - (AA) TOWSLEY HEALTH BUILDING 5361 MCAULEY DR YPSILANTI,MI48197	NURSING HOME, EMPLOYED PHYS.
27	27 - (OTHER) FRANCES WARDE MEDICAL LAB 300 W TEXTILE RD ANN ARBOR,MI48104	LAB
28	28 - (GRAND RAPIDS) WEGE BUILDING 300 LAFAYETTE GRAND RAPIDS,MI49503	LAB, FAMILY PRACTICE, INTERNAL MEDICINE PRACTICE
29	29 - (GR) SAINT MARY'S SOUTHWEST 2373 64TH STREET SW BYRON CENTER,MI49315	AMBULATORY SURGICAL CTR, REHAB, LAB, IMAGING, FAMILY PRACTICE, CARDIO AND ER
30	30 - (GR) ADVANTAGE HEALTH BUILDING 1471 EAST BELTLINE GRAND RAPIDS,MI49525	LAB, IMAGING, REHAB, EMPLOYED PHYS., URGENT CARE, OB
31	31 - (GR) CLINICA SANTA MARIA 730 GRANDVILLE AVE SW GRAND RAPIDS,MI49503	INDIGENT PRIMARY CARE CENTER
32	32 - (GR) PINE REST 300 68TH STREET SE GRAND RAPIDS,MI49548	MENTAL HEALTH
33	33 - (GR) SPARTA FAMILY HEALTH CENTER 475 S STATE ST SPARTA,MI49345	FAMILY PRACTICE CENTER
34	34 - (GR) BROWNING CLAYTOR HEALTH CENTER 1246 MADISON SE GRAND RAPIDS,MI49507	FAMILY PRACTICE CENTER
35	35 - (GR) HEARTSIDE HEALTH CLINIC 359 S DIVISION GRAND RAPIDS,MI49503	INDIGENT PRIMARY CARE CENTER
36	36 - (GR) RIVERTOWN BUILDING 3380 44TH STREET SW GRANDVILLE,MI49418	LAB, IMAGING, REHAB, FAMILY PRACTICE
37	37 - (GR) STANDALE BUILDING 1175 WILSON AVE NW WALKER,MI49534	LAB, IMAGING, REHAB, FAMILY PRACTICE
38	38 - (GR) 310 LAFAYETTE BUILDING 310 LAFAYETTE SE GRAND RAPIDS,MI49503	IMMUNOLOGY, VASCULAR, INFECTIOUS DISEASE, AND PULMONOLOGY
39	39 - (GR) ADVANTAGE HEALTH BUILDING 10047 CROSS ROADS COURT CADEDONIA,MI49316	LAB, IMAGING, REHAB, FAMILY PRACTICE
40	40 - (GR) ADVENT REHAB 1375 W GREEN ST HASTINGS,MI49058	REHAB
41	41 - (GR) ADVENT REHAB 1915 GEORGETOWN CENTER DR JENISON,MI49428	REHAB
42	42 - (GR) CHERRY BUILDING 245 CHERRY ST GRAND RAPIDS,MI48503	PEDIATRIC CLINIC, FAMILY MEDICINE, OB, NEUROSCIENCES, AND SLEEP
43	43 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 933 THREE MILE NW GRAND RAPIDS,MI49504	LAB, REHAB, FAMILY PRACTICE
44	44 - (GR) ADVANTAGE HEALTH BUILDING 7782 20TH AVENUE JENISON,MI49428	FAMILY PRACTICE CENTER
45	45 - (GR) SOUTHEAST ADVANTAGE HEALTH BLDG 2080 44TH ST SE KENTWOOD,MI49508	REHAB, LAB, FAMILY PRACTICE
46	46 - (GR) ADVANTAGE HEALTH BUILDING 6050 NORTHLAND DR NE ROCKFORD,MI49341	FAMILY PRACTICE CENTER, URGENT CARE, LAB, IMAGING, WOMEN'S HEALTH, REHAB
47	47 - (GR) WYOMING FAMILY PRACTICE 950 36TH STREET SW WYOMING,MI49509	FAMILY PRACTICE CENTER
48	48 - (GR) ADVENT REHAB 7575 EAST FULTON ADA,MI49355	REHAB
49	49 - (GR) ADVENT REHAB 1000 EAST PARIS ST 222 GRAND RAPIDS,MI49546	REHAB
50	50 - (GR) ADVENT REHAB 150 JEFFERSON SE ST 100 GRAND RAPIDS,MI49503	REHAB
51	51 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 771 KENNMORE SE GRAND RAPIDS,MI49547	FAMILY PRACTICE
52	52 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 2093 HEALTH DRIVE SUITE 300 WYOMING,MI49519	VASCULAR
53	53 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 2144 EAST PARIS SE GRAND RAPIDS,MI49546	INTERNAL MEDICINE
54	54 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 1000 EAST PARIS STE 222 GRAND RAPIDS,MI49546	CARDIOVASCULAR
55	55 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 260 JEFFERSON SE STE 115 GRAND RAPIDS,MI49503	CONCIERGE MEDICINE
56	56 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 3290 NORTH WELLNESS DRIVE HOLLAND,MI49424	FAMILY PRACTICE
57	57 - (GR) MERCY HEALTH DENTAL CLINIC 781 36TH STREET SE GRAND RAPIDS,MI49548	DENTAL CLINIC
58	58 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 250 CHERRY ST SE GRAND RAPIDS,MI49503	ONCOLOGY
59	59 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 3925 32ND AVE STE 300 HUDSONVILLE,MI49426	FAMILY PRACTICE & URGENT CARE
60	60 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 801 BROADWAY STREET NW GRAND RAPIDS,MI49504	FAMILY PRACTICE
61	61 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 301 N MAIN SHERIDAN,MI49315	VASCULAR
62	62 - (GR) MERCY HEALTH PHYSICIAN PARTNERS 1309 SHELDON RD GRAND HAVEN,MI49444	NEUROLOGY
63	63 - (LIVONIA) OUTPAITENT SURGERY CENTER - ENDO 36622 5 MILE RD SUITE 201 LIVONIA,MI48154	SURGICAL CENTER
64	64 - (LIV) OUTPATIENT SURGERY CENTER 36622 5 MILE RD SUITE 201 LIVONIA,MI48154	SURGICAL CENTER
65	65 - (LIV) WESTSIDE OBGYN 36650 5 MILE RD SUITE 101 LIVONIA,MI48154	OB/GYN PRACTICE
66	66 - (LIV) SJMG PRIMARY CARE FREEDOM 20206 FARMINGTON RD LIVONIA,MI48152	INTERNAL MEDICINE PRACTICE
67	67 - (LIV) SJMG PRIMARY CARE LIVONIA 14600 FARMINGTON RD SUITE 105 LIVONIA,MI48154	INTERNAL MEDICINE, SLEEP LAB
68	68 - (LIV) SJMG PC WEST FARM HILLS 36650 GRAND RIVER AVE SUITE 101 FARMINGTON HILLS,MI48335	OB/GYN PRACTICE
69	69 - (LIV) SJMG PRIMARY CARE REDFORD 26400 PLYMOUTH RD REDFORD,MI48239	FAMILY PRACTICE
70	70 - (LIV) WESTSIDE UROGYNECOLOGY 36650 5 MILE RD SUITE 101 LIVONIA,MI48154	UROLOGY, OB/GYN
71	71 - (LIV) CRNA OSC 36622 5 MILE RD SUITE 201 LIVONIA,MI48154	SURGICAL CENTER
72	72 - (LIV) SJMG PRIMARY CARE BUCKINGHAM 29105 BUCKINGHAM ST SUITE 11 LIVONIA,MI48154	PHYSICAL MEDICINE & REHAB
73	73 - (LIV) SJMG PC EAST FARM HILLS 30852 W 10 MILE RD FARMINGTON HILLS,MI48336	INTERNAL MEDICINE
74	74 - (LIV) URGENT CARE SCHOOLCRAFT 39201 7 MILE RD LIVONIA,MI48152	URGENT CARE
75	75 - (LIV) SJMG WESTLAND OBGYN 32932 WARREN ROAD SUITE 100 WESTLAND,MI48185	OB/GYN PRACTICE
76	76 - (LIV) CATHERINE'S PLACE RET FAC 28750 W ELEVEN MILE RD FARMINGTON HILLS,MI48336	NURSING HOME FACILITY
77	77 - (OAKLAND)SJMO MEDICAL OFFICE BUIDING 44555 WOODWARD AVE PONTIAC,MI48341	COLORECTAL SURGERY, NEUROLOGY, LAB, NEUROSURGERY, RADIOLOGY, OTHER SURGERY
78	78 - (OA) INDEPENDENCE POINTE 7210 ORTONVILLE RD CLARKSTON,MI48346	LAB, RADIOLOGY
79	79 - (OA) BALD MOUNTAIN REGIONAL MEDICAL 1375 S LAPEER RD LAKE ORION,MI48360	URGENT CARE, LAB, RADIOLOGY, INTERNAL MED/PEDS
80	80 - (OA) WOODWARD PROFESSIONAL BUILDING 44428 WOODWARD AVE PONTIAC,MI48341	REHAB, OB/GYN CLINIC, PARTIAL PSYCH HOSPITAL
81	81 - (OA) WATERFORD SURGICAL CENTER 5220 HIGHLAND RD WATERFORD,MI48327	SURGICAL CENTER
82	82 - (OA) KAROTECH BUILDING 2630 UNION LAKE RD COMMERCE TOWNSHIP,MI48382	LAB, PEDIATRICS
83	83 - (OA) MERCY MEDICAL GROUP-OAKLAND PHYSICI 5210 HIGHLAND RD WATERFORD,MI48327	INTERNAL MEDICINE, URGENT CARE, LAB, RADIOLOGY, ENDOCRINOLOGY
84	84 - (OA) AUBURN HILLS DIAGNOSTICS 719 S OPDYKE ROAD AUBURN HILLS,MI48326	CARDIOLOGY, RADIOLOGY, LAB
85	85 - (OA) SLEEP DISORDERS CLINIC 3100 CROSS CREEK PKWY AUBURN HILLS,MI48341	SLEEP CLINIC
86	86 - (OA) WATERFORD LAB 5800 HIGHLAND RD WATERFORD,MI48327	LAB
87	87 - (OA) LEXUS PROFESSIONAL BUILDING 44200 WOODWARD AVE PONTIAC,MI48341	LAB, OB/GYN
88	88 - (OA) SHORES III PROFESSIONAL BLDG 2300 HAGGERTY RD WEST BLOOMFIELD,MI48323	RADIOLOGY
89	89 - (OA) WHITE LAKE URGENT CARE 320 TOWN CENTER BLVD WHITE LAKE TWP,MI48386	URGENT CARE, LAB, RADIOLOGY, REHAB
90	90 - (OA) AFFINITY PEDIATRICS & INTERN MED 5820 HIGHLAND ROAD WATERFORD,MI48328	INTERNAL MEDICINE/PEDIATRICS
91	91 - (OA) MERCY MEDICAL GROUP-ROCHESTER 1854 W AUBURN RD ROCHESTER HILLS,MI48309	INTERNAL MEDICINE/PEDS, ENDOCRINOLOGY
92	92 - (OA) CLARKSTON FAMILY PRACTICE 6770 DIXIE HWY CLARKSTON,MI48346	OB/GYN, FAMILY MED
93	93 - (OA) MERCY MED GROUP-BLOOMFIELD HILLS 1750 TELEGRAPH RD BLOOMFIELD HILLS,MI48302	OB/GYN
94	94 - (OA) BLOOMFIELD HILLS PEDIATRICS 43750 WOODWARD AVE BLOOMFIELD HILLS,MI48302	PEDIATRICS
95	95 - (OA) DAVISBURG FAMILY MEDICINE 10740 DIXIE HIGHWAY DAVISBURG,MI48350	FAMILY MEDICINE, LAB
96	96 - (OA) OAKLAND MEDICAL GROUP 3950 S ROCHESTER ROAD ROCHESTER HILLS,MI48307	OB/GYN
97	97 - (OA) BLOOMFIELD HILLS IM 2520 S TELEGRAPH RD BLOOMFIELD HILLS,MI48302	INTERNAL MEDICINE
98	98 - (OA) MERCY PLACE 55 CLINTON ST PONTIAC,MI48342	OUTPATIENT CLINIC
99	99 - (OA) OAKLAND MEDICAL GROUP 27301 DEQUINDRE ROAD MADISON HEIGHTS,MI48071	OB/GYN
100	100 - (OA) CLARKSTON NEUROSURGERY 7650 DIXIE HIGHWAY CLARKSTON,MI48346	NEUROSURGERY
101	101 - (OA)CLARKSTON MEDICAL BUILDING 5701 BOW POINTE DR CLARKSTON,MI48346	COLORECTAL SURGERY

Schedule H (Form 990) 2018

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
PART I, LINE 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:	TRINITY HEALTH - MICHIGAN (TH-MI) 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, THE HOSPITAL DIVISIONS OF TH-MI INCLUDE A COPY OF THEIR MOST RECENT SCHEDULE H ON THEIR RESPECTIVE WEBSITES. TRINITY HEALTH ALSO INCLUDES TH-MI'S MOST RECENTLY FILED SCHEDULE H ON ITS WEBSITE.
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 HOSPITALS' COST ACCOUNTING SYSTEM.
PART I, LN 7 COL(F):	THE FOLLOWING NUMBER, $62,294,139, 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:	TO ASSIST IN ADDRESSING THE EDUCATIONAL DISPARITIES IN DETROIT, SMML HAS BEEN ONE OF THE CORPORATE SPONSORS OF THE DETROIT CRISTO REY SCHOOL SINCE IT OPENED. CRISTO REY IS A COLLEGE PREP CATHOLIC HIGH SCHOOL, ONE OF SEVERAL AROUND THE COUNTRY, FOR LOW-INCOME KIDS WHO OTHERWISE WOULD NOT BE ABLE TO AFFORD PRIVATE SCHOOL. THE VAST MAJORITY OF STUDENTS ARE EITHER HISPANIC OR BLACK, AND MOST OF THEM WILL BE THE FIRST IN THEIR FAMILY TO GO TO COLLEGE. THIS UNIQUE EDUCATIONAL MODEL PREPARES STUDENTS FOR COLLEGE AND FOR WORK. ONE DAY A WEEK, BEGINNING FRESHMAN YEAR, THE STUDENTS GO TO WORK FOR A PROFESSIONAL COMPANY. THE COMPANY, IN TURN, AGREES TO PAY 60% OF THE STUDENT'S SCHOOL TUITION. STUDENTS INTERESTED IN HEALTH CARE TRADE THEIR SCHOOL UNIFORMS FOR HOSPITAL SCRUBS AS THEY TRAVEL ONCE PER WEEK TO SMML FOR THEIR WORK-EXPERIENCE IN THE MIRACLE OF LIFE BIRTHING CENTER. BESIDES THE WORK EXPERIENCE, THEY ARE MENTORED AND GUIDED BY THE 60 EMPLOYEES WORKING IN THIS DEPARTMENT. IN COLLABORATION WITH LIVONIA PUBLIC SCHOOLS, SMML ENGAGED IN WORK TO IMPROVE/INCREASE EDUCATION AND SKILLS TRAINING FOR FUTURE EMPLOYMENT BY PROVIDING STUDENT JOB RESPONSIBILITIES FOR THE LIVONIA PUBLIC SCHOOLS, LIVONIA TRANSITION PROGRAM FOR STUDENTS AGES 18-26 SEEKING CERTIFICATION AND EXPANDING THE JOB MARKET AND DEVELOPMENT RECRUITMENT PARTNERSHIPS WITH A HIGHLY QUALIFIED WORKFORCE.SMML PARTICIPATED IN THE LIVONIA SAVE OUR YOUTH COALITION AND SUPPORTED WORK TO REDUCE THE STIGMA OF SUBSTANCE USE DISORDER AND MENTAL HEALTH.
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:	TH-MI USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, TH-MI IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, TH-MI IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL.
PART III, LINE 4:	TH-MI IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE PATIENT ACCOUNTS RECEIVABLE, ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS FOOTNOTE FROM PAGE 14 OF THOSE STATEMENTS: "THE CORPORATION HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE CORPORATION'S HEALTH MINISTRIES AT AMOUNTS DIFFERENT FROM ESTABLISHED RATES. ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYERS AND OTHER CHANGES IN ESTIMATES ARE INCLUDED IN NET PATIENT SERVICE REVENUE AND ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED.FOR PATIENT ACCOUNTS RECEIVABLE RESULTING FROM REVENUE RECOGNIZED PRIOR TO JULY 1, 2018, PATIENT ACCOUNTS RECEIVABLE WERE REPORTED AT ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS, AND OTHERS FOR SERVICES RENDERED. PRIOR TO THIS DATE, AN ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS ESTABLISHED TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. GENERALLY, THIS ALLOWANCE WAS ESTIMATED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY THE HEALTH MINISTRIES FOR EACH TYPE OF PAYER. UNDER THE PROVISIONS OF ACCOUNTING STANDARDS UPDATE ("ASU") NO. 2014-09 "REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606)," WHICH WAS ADOPTED EFFECTIVE JULY 1, 2018, AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE SUBSEQUENT TO THE ADOPTION OF ASU NO. 2014-09 ON JULY 1, 2018, THE ESTIMATED UNCOLLECTABLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE."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:	TH-MI 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 HOSPITALS' COLLECTION POLICIES CONTAIN 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 EACH ORGANIZATION'S COLLECTION POLICY. THE HOSPITALS HAVE 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 - THE HOSPITALS IN TH-MI ASSESS THE HEALTH STATUS OF THEIR COMMUNITIES, 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 THEIR OVERALL COMMUNITIES. IN THE ASSESSMENT OF THEIR COMMUNITIES, THE HOSPITALS MAY USE PATIENT DATA, PUBLIC HEALTH DATA, COMMITTEE MEETINGS WITH MEDICAL STAFF (PHYSICIANS) AND DEPARTMENT STAFF, 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 - TH-MI 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. TH-MI 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. TH-MI HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. [NAME OF REPORTING ENTITY] 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:	ST. JOSEPH MERCY ANN ARBOR:SAINT JOSEPH MERCY HEALTH SYSTEM (SJMHS) IS A SUBURBAN HEALTH CARE NETWORK SERVING WASHTENAW, LIVINGSTON, EASTERN JACKSON, LENAWEE, MONROE, WESTERN WAYNE, AND SOUTHWESTERN OAKLAND COUNTIES. THE SJMHS HEALTH CARE NETWORK INCLUDES FIVE HOSPITALS: ST. JOSEPH MERCY ANN ARBOR, ST. MARY MERCY HOSPITAL IN LIVONIA, ST. JOSEPH MERCY CHELSEA, ST. JOSEPH MERCY OAKLAND IN PONTIAC, AND SAINT JOSEPH MERCY LIVINGSTON IN HOWELL. COMBINED, THESE HOSPITALS ARE LICENSED FOR 1,726 INPATIENT BEDS. THE SJMAA SERVICE AREA IS DEFINED AS THE POPULATION OF WASHTENAW COUNTY. WASHTENAW COUNTY IS ESTIMATED TO HAVE A POPULATION OF 358,081 AS OF DECEMBER 2014 (SEMCOG). THE POPULATION UNDER AGE 18 HAS CONSISTENTLY DECLINED OVER THE PAST FOUR YEARS WHILE THE OVER-65 POPULATION HAS GROWN. IN 2014, 12% OF THE POPULATION WAS 65 AND OLDER. WASHTENAW COUNTY'S POPULATION IS RACIALLY DIVERSE WITH 76.2% WHITE, 13.9% BLACK, 9.4% ASIAN, AND 0.6% NATIVE AMERICAN IN JULY 2014. INCOME AND POVERTY ARE SIGNIFICANT INDICATORS OF HEALTH AND LIFE EXPECTANCY. EDUCATION LEVEL IS ALSO SIGNIFICANTLY CONNECTED WITH INCOME LEVEL AND POVERTY. IN WASHTENAW COUNTY, THE MEDIAN HOUSEHOLD INCOME IS $60,805. THIS IS SIGNIFICANTLY HIGHER THAN THE MEDIAN INCOME OF MICHIGAN IN GENERAL, WHICH IS $49,087. IT IS ALSO HIGHER THAN THE U.S. MEDIAN INCOME OF $52,482. HOWEVER, OBSERVING THE PERCENTAGE OF THOSE LIVING IN POVERTY BASED ON GEOGRAPHICAL LOCATION DEMONSTRATES THAT THERE ARE SPECIFIC AREAS OF WASHTENAW COUNTY THAT ARE EXPERIENCING HIGHER RATES OF POVERTY COMPARED TO THE REST OF THE COUNTY AND THE STATE.MERCY HEALTH SAINT MARY'S GRAND RAPIDS:KENT COUNTY IS CONSIDERED THE PRIMARY MARKET AREA OF MHSM. KENT COUNTY IS LOCATED IN WESTERN MICHIGAN AND IS THE FOURTH LARGEST POPULOUS COUNTY IN THE STATE. THE COUNTY IS COMPOSED OF 21 TOWNSHIPS, FIVE VILLAGES, AND NINE CITIES COVERING 864 SQUARE MILES. GRAND RAPIDS IS THE COUNTY SEAT AND IS 30 MILES FROM LAKE MICHIGAN. THE HEALTH CARE RESOURCES IN KENT COUNTY INCLUDE MERCY HEALTH SAINT MARY'S, METROPOLITAN HEALTH (UNIVERSITY OF MICHIGAN HEALTH), SPECTRUM HEALTH-BUTTERWORTH CAMPUS, SPECTRUM HEALTH-BLODGETT CAMPUS, PINE REST CHRISTIAN MENTAL HEALTH SERVICES, AND MARY FREE BED REHABILITATION HOSPITAL. IN ADDITION, THE HEALTH DEPARTMENT OPERATES SIX PUBLIC HEALTH CLINICS THROUGHOUT THE COUNTY THAT OFFER PERSONAL HEALTH SERVICES. THERE WERE AN ESTIMATED 653,786 PEOPLE RESIDING IN KENT COUNTY AS OF JULY 1, 2018. THE MEDIAN HOUSEHOLD INCOME FOR KENT COUNTY IS $57,302 WITH 10.4% OF RESIDENTS LIVING IN POVERTY. TWENTY-FOUR PERCENT (24.1%) OF THE POPULATION IS BELOW THE AGE OF 18 AND 13.7% IS 65 YEARS OF AGE AND OLDER. EIGHTY-TWO PERCENT (82.3%) OF THE POPULATION IS WHITE, 10.5% BLACK, AND 10.7% LATINO. EIGHTY-NINE PERCENT (89.8%) ARE HIGH SCHOOL GRADUATES AND 34.7% HAVE A BACHELOR'S DEGREE OR HIGHER. AS OF AUGUST 2019 THE UNEMPLOYMENT RATE IS 3.1%, UP FROM 2.7% FROM AUGUST 2018.ST. JOSEPH MERCY OAKLAND (PONTIAC):THE GEOGRAPHIC BOUNDARY FOR SJMO ENCOMPASSES THE COMBINED GEOGRAPHY OF OAKLAND COUNTY. THE HOSPITAL'S PRIMARY SERVICE AREA IS DEFINED AS THE CONTIGUOUS ZIP CODES WHERE 80% OF THE HOSPITAL'S ADMISSIONS ORIGINATE. THE PRIMARY SERVICE AREA OF SJMO INCLUDES OAKLAND COUNTY, SPECIFICALLY THE CITY OF PONTIAC, LOCATED IN SOUTHEASTERN MICHIGAN. OAKLAND COUNTY IS THE SECOND MOST POPULATED COUNTY IN MICHIGAN BEHIND WAYNE COUNTY, WITH APPROXIMATELY 1.2 MILLION RESIDENTS IN 62 CITIES, VILLAGES, AND TOWNSHIPS. THE ROBERT WOOD JOHNSON FOUNDATION RANKS OAKLAND COUNTY AS THE 9TH HEALTHIEST COUNTY IN MICHIGAN. HOWEVER, SJMO IS LOCATED IN PONTIAC, MI, AN AREA DESIGNATED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION AS MEDICALLY UNDERSERVED FOR HAVING TOO FEW PRIMARY CARE PROVIDERS, HIGH INFANT MORTALITY, HIGH POVERTY, AND HIGH ELDERLY POPULATION. AS A RESULT, THE CHNA REVIEW WAS CONDUCTED TO ANALYZE NEEDS IN PONTIAC AS WELL AS OAKLAND COUNTY OVERALL. PONTIAC IS A MIDWEST POSTINDUSTRIAL COMMUNITY. RESIDENTS LEFT THIS ONCE-THRIVING CITY DUE TO A DIMINISHING AUTO INDUSTRY. THE COMMUNITY NOW SUFFERS FROM INCREASING POVERTY AND HARDSHIP. PONTIAC, LIKE MOST CITIES IN THE NATION, FACED A RECESSION IN 2009. THE BANKRUPTCY OF GM AND CHRYSLER LEFT THE CITY IN A FINANCIAL CRISIS. UNEMPLOYMENT SOARED, TAX REVENUES DECLINED, AND THE LOCAL GOVERNMENT CUT ESSENTIAL SERVICES. PONTIAC IS A UNIQUE COMMUNITY NOT BECAUSE IT IS PLAGUED BY EXCESSIVE POVERTY BUT BECAUSE IT IS SURROUNDED BY AFFLUENT COMMUNITIES, CREATING A SILO OF UNDERSERVED RESIDENTS. PONTIAC IS THE ONLY FEDERALLY DESIGNATED MEDICALLY UNDERSERVED COMMUNITY IN OAKLAND COUNTY SINCE 1994.ST. MARY MERCY LIVONIA: LOCATED IN WESTERN WAYNE COUNTY, THE SERVICE AREA OF SMML FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT WAS DEFINED AS CITIES WITHIN A FIVE MILE RADIUS OF THE HOSPITAL. THIS INCLUDES ZIP CODES OF WESTLAND, CANTON, LIVONIA, NORTHVILLE CITY, NORTHVILLE TOWNSHIP, PLYMOUTH, PLYMOUTH TOWNSHIP, REDFORD, FARMINGTON HILLS, AND FARMINGTON. THE MAJORITY OF THESE CITIES ARE LOCATED IN WESTERN WAYNE COUNTY; HOWEVER, FARMINGTON HILLS LIES WITHIN SOUTHERN OAKLAND COUNTY LINES. WHEN THE CHNA WAS COMPLETED, THE POPULATION FOR THESE COMMUNITIES WAS 475,178 RESIDENTS. THE HOSPITAL'S COMMUNITY IS PREDOMINANTLY CAUCASIAN WITH SOME AFRICAN AMERICAN, HISPANIC, AND ASIAN COMMUNITY RESIDENTS.ST. JOSEPH MERCY LIVINGSTON: THE SERVICE AREA FOR SJML IS DEFINED AS LIVINGSTON COUNTY, AS THE MAJORITY OF PATIENTS SERVED BY THE HOSPITAL ARE FROM THIS COUNTY. LIVINGSTON COUNTY IS LOCATED ON THE SOUTHEAST SIDE OF MICHIGAN, BORDERED BY WASHTENAW, GENESEE, SHIAWASSEE, OAKLAND, INGHAM AND JACKSON COUNTIES. THE CENSUS BUREAU 2017 ESTIMATED THE POPULATION AT 189,651, AN INCREASE FROM THE LAST CYCLE'S CHNA. AS OF THE 2000-2010 CENSUS, A 15% POPULATION INCREASE WAS IDENTIFIED AND FUTURE PROJECTIONS SHOW A CONTINUED INCREASE. MALE AND FEMALE POPULATIONS ARE ROUGHLY EQUAL. THE POPULATION SEEING THE LARGEST INCREASE IS 65 AND OVER, WITH A 66% INCREASE RECORDED IN THE 2000-2010 CENSUS, AND A PROJECTED INCREASE THROUGH 2040 IDENTIFIED BY SOUTHEAST MICHIGAN COUNCIL OF GOVERNMENTS. WHITE INDIVIDUALS MAKE UP 96.7% OF THE POPULATION. INDIVIDUALS EXPERIENCING ANY DISABILITY MAKE UP 10% OF THE POPULATION IN THE COUNTY, COMPARED TO 14% IN MICHIGAN AND 12.5% IN THE U.S.
PART VI, LINE 5:	PROMOTION OF COMMUNITY HEALTH: TH-MI HOSPITALS COLLABORATE WITH OTHERS IN THE COMMUNITY TO ACHIEVE IMPROVEMENTS IN HEALTH AND ACCESS TO HEALTH CARE.SAINT JOSEPH MERCY HEALTH SYSTEM (ANN ARBOR):THE WASHTENAW HEALTH PLAN (WHP) REPRESENTS A PARTNERSHIP BETWEEN WASHTENAW COUNTY, THE UNIVERSITY OF MICHIGAN AND SJMHS TO PROVIDE PRIMARY MEDICAL CARE SERVICES FOR THE MOST VULNERABLE AND DISENFRANCHISED IN THE COMMUNITY. SJMHS SUPPORTS THIS PROGRAM BY PROVIDING STAFF SUPPORT TO HELP PATIENTS GAIN ACCESS TO A MEDICAL HOME. THE HOSPITALS ALSO PROVIDE THIS POPULATION WITH FREE OR REDUCED-FEE CLINICAL SERVICES.SJMAA WAS THE LEAD AGENCY IN THE ORIGINATION OF THE WASHTENAW HOUSING ALLIANCE (WHA), A COALITION OF NINE SOCIAL SERVICE AGENCIES DEALING WITH HOUSING OF VARIOUS TYPES, WHOSE MISSION IS TO END HOMELESSNESS IN WASHTENAW COUNTY. IN ADDITION, SJMHS AND ITS BOARD MEMBERS WERE KEY IN BUILDING THE DELONIS CENTER IN DOWNTOWN ANN ARBOR. THIS CENTER PROVIDES NEEDED ACCOMMODATIONS FOR THE HOMELESS, AS WELL AS SOCIAL AND HEALTH SUPPORT SERVICES. IN 2015, SJMAA BECAME A PART OF THE WASHTENAW COUNTY COORDINATED FUNDERS, A PUBLIC-PRIVATE COLLABORATIVE FUNDING PARTNERSHIP WORKING TO FUND SOCIAL SERVICES AGENCIES ACROSS COMMUNITY-LEVEL OUTCOMES IN THE AGING, SAFETY NET HEALTH, CRADLE TO CAREER, NUTRITION, AND HOUSING AND HOMELESSNESS SECTORS. SJMAA ALSO SUPPORTS AVALON HOUSING'S FUSE PROGRAM, WHICH PROVIDES CARE AND RESOURCES TO HOMELESS INDIVIDUALS EXPERIENCING MENTAL HEALTH, SUBSTANCE USE DISORDER, AND CHRONIC ILLNESSES, BY SECURING HOUSING AND NECESSARY SOCIAL SERVICES THROUGH A PERMANENT SUPPORTIVE HOUSING MODEL.SJMAA IS A PARTNER IN THE COLLABORATIVE FUNDING MODEL, WASHTENAW COORDINATED FUNDING. THE MODEL CONSISTS OF SEVEN PARTNERS MEETING THE NEEDS OF OUR COMMUNITY'S MOST VULNERABLE IN FOUR PRIORITY AREAS THROUGH THREE FUNDING COMPONENTS INTENDED TO: SUPPORT HUMAN SERVICES PROGRAMMING; BUILD NONPROFIT CAPACITY; AND FOSTER COMMUNITY COLLABORATION AND SYSTEMS-LEVEL CHANGE. THE THREE DISTINCT COMPONENTS WITHIN THE MODEL (SECTOR LEADERS, PROGRAM OPERATIONS FUNDING AND CAPACITY BUILDING GRANTS) ARE DESIGNED TO PREVENT GAPS AND AVOID REDUNDANCIES IN SERVICES, WHILE STREAMLINING APPLICATION AND REPORTING PROCEDURES FOR GRANTEES. SJMAA IS CONTRIBUTING FUNDING TO THE MODEL, AND DEDICATING STAFF TIME AND OTHER RESOURCES EACH YEAR. ALL FUNDING DISTRIBUTED THROUGH THIS MODEL IS ALIGNED WITH SJMAA'S PRIORITY HEALTH AREAS OF BEHAVIORAL HEALTH AND OBESITY.MERCY HEALTH SAINT MARY'S GRAND RAPIDS: IN APRIL 2016, MHSM OPENED A CONCIERGE MEDICINE DEPARTMENT WHICH PROVIDES 24/7 ACCESS TO A PRIMARY CARE PHYSICIAN. TO ALIGN WITH MHSM'S MISSION STATEMENT TO PROVIDE CARE FOR THE POOR AND UNDERSERVED, 10% OF THE REVENUE FROM THE CONCIERGE MEDICINE DEPARTMENT WILL BE REALLOCATED TO FUND PROGRAMS THAT SUPPORT THE POOR AND UNDERSERVED MEMBERS OF THE COMMUNITY. IN FY19, THE TOTAL GRANT AMOUNT AWARDED WAS $100,000 WHICH WAS GIFTED TO THREE COMMUNITY ORGANIZATIONS WITH PROGRAMS THAT ALIGN WITH MHSM'S CHNA IMPLEMENTATION STRATEGY.THE FAMILY OUTREACH CENTER WAS GRANTED $20,000 TO PROVIDE BEHAVIORAL HEALTH TREATMENT AND SUPPORT SERVICES TO THOSE WHO ARE UNDOCUMENTED, UNINSURED, OR UNDERINSURED WITH LIMITED INCOME. TO ACCOMPLISH THIS, BEHAVIORAL HEALTH COUNSELING WILL BE INTEGRATED WITH PRIMARY CARE SERVICES AT THREE COMMUNITY CLINICS SERVING VULNERABLE POPULATIONS.THE INNER CITY CHRISTIAN FEDERATION (ICCF) RECEIVED $40,000 FOR RESIDENT ENGAGEMENT AND PERMANENT SUPPORTIVE HOUSING, WHICH RESULTED IN THE FOLLOWING: INCREASED ATTENDANCE IN RESIDENT EVENTS; NEW PARTNERSHIPS WITH GRAAHI AND THE YWCA, WHO HELD 18 MENTAL HEALTH AWARENESS RELATED SESSIONS; PROVIDED 136 RESIDENTS WITH CASE MANAGEMENT AND SUPPORTS SUCH AS HOUSING STABILITY, EDUCATION, CHILD CARE, EMPLOYMENT, AND TRAUMA INFORMED CARE; AND MADE 120 REFERRALS TO OTHER COMMUNITY RESOURCES TO HELP PROVIDE MENTAL HEALTH SUPPORTS FOR RESIDENTS.THE GRAND RAPIDS AFRICAN AMERICAN HEALTH INSTITUTE RECEIVED $40,000 TO EXPAND ITS DIABETES EMPOWERMENT NETWORK. THIS PROGRAM IS TARGETED TOWARD AFRICAN AMERICAN MEN AMONG WHOM THERE ARE EVIDENT RACIAL DISPARITIES REGARDING DIABETES. IN FY19, GRAAHI COMPLETED TWO FIVE-WEEK SESSIONS OF THE DIABETES EMPOWERMENT NETWORK PROGRAM, WITH 12 MEN ATTENDING ALL FIVE CLASSES AND GRADUATING FROM EACH OF THE TWO COURSES. PARTICIPANTS WERE GIVEN A SELF-ASSESSMENT PRIOR TO CLASS; POST-TESTS SHOWED IMPROVED KNOWLEDGE ON DIABETES PREVENTION, SELF-MANAGEMENT AND NUTRITION TO ASSIST IN THEIR SELF-CARE MANAGEMENT GOALS.ST. JOSEPH MERCY OAKLAND (PONTIAC): SJMO CONTINUES TO STRENGTHEN ITS SENIOR FIT PROGRAM, EXPANDING TO SERVE MORE THAN 900 SENIORS IN 21 LOCATIONS ACROSS OAKLAND COUNTY, PROVIDING BASIC PRE AND POST HEALTH SCREENING, AND A THREE-TIMES-A-WEEK EXERCISE PROGRAM FOR SENIORS. THIS PROGRAM SUPPORTS BOTH THEIR PHYSICAL AND EMOTIONAL HEALTH. THROUGH THE MERCY SUPPORT PROGRAM, OVER 1,200 LOW-INCOME AND AT-RISK PERSONS WERE SERVED, WHILE MORE THAN 7,500 PATIENTS WERE SERVED THROUGH THE INDIGENT PROCUREMENTS AND MERCY SUPPORT PRESCRIPTION PROGRAMS.AS A CERTIFIED "BABY-FRIENDLY" HOSPITAL, WE ACTIVELY SUPPORT AND PROMOTE BREASTFEEDING AND MOTHER/BABY BONDING, WHICH IS KNOWN TO PROVIDE HEALTH BENEFITS FOR INFANTS, CHILDREN, AND MOTHERS. A WEEKLY BREASTFEEDING SUPPORT GROUP CONTINUES TO BE OFFERED, SERVING OVER 200 MOTHERS THROUGH THE YEAR. THE GROUP OFFERS SUPPORT AND ENCOURAGEMENT TO MOTHERS IN THE COMMUNITY WHO MAKE THE CHOICE TO BREASTFEED. THE GROUP CONTINUES TO GROW AND IS WELL RECEIVED. COMMUNITY HEALTH AND WELL-BEING WORKED WITH THE OAKLAND COUNTY BOARD OF COMMISSIONERS AND HEALTH AND PARKS DEPARTMENTS TO INITIATE A BAN ON SMOKING IN OAKLAND COUNTY PARKS THROUGH THE HEALTHY COMMUNITIES AND ENVIRONMENT SUBCOMMITTEE. THIS EFFORT DID NOT RESULT IN A SMOKING BAN WITHIN THE COUNTY PARKS BUT DID BRING SUBSTANTIAL ATTENTION AND FOCUS ON THE HEALTH CHALLENGES RELATED TO SMOKING AND INFLUENCE ON SMOKING AMONG YOUTH.SJMO INTRODUCED THE PRESCRIPTION FOR HEALTH PROGRAM TO PATIENTS IN FY18 AS A GRANT FUNDED COMMUNITY PARTNER. IN FY19, A SECOND PRESCRIPTION FOR HEALTH GRANT REQUEST WAS MADE TO THE CENTER FOR DISEASE CONTROL IN COLLABORATION WITH OAKLAND UNIVERSITY AND OAKLAND COUNTY HEALTH DEPARTMENT. THIS GRANT WAS AWARDED AND WILL BE INITIATED FOR TWO YEARS THROUGH FY21. THROUGH COMMUNITY HEALTH PROMOTION, A TEAM OF CONTINGENT COMMUNITY HEALTH WORKERS (CHWS) HAS BEEN INTRODUCED TO DEPLOY SOCIAL DETERMINANT OF HEALTH SCREENINGS. THESE CHWS UTILIZE A TECHNOLOGY CALLED "WELLOPP" TO SCREEN, IDENTIFY AND REFER THOSE IN NEED OF SOCIAL SUPPORT RESOURCES TO THE APPROPRIATE COMMUNITY AGENCIES THROUGH A CLOSED LOOP REFERRAL SYSTEM. THE PROCESS OF IDENTIFYING AND SUPPORTING MARGINALIZED PATIENTS WITH SOCIAL SUPPORT RESOURCES AIMS TO REDUCE READMISSIONS AND IMPROVE OVERALL PATIENT HEALTH PREVENTION PRACTICES. ST. MARY MERCY LIVONIA: SMML CONTINUED TO OFFER ROBUST INPATIENT BEHAVIORAL MEDICINE SERVICES TO RESPOND TO THE COMMUNITY NEEDS. PSYCHIATRIC SOCIAL WORKERS IN EMERGENCY CARE ASSIST PATIENTS AND THEIR FAMILIES IN THE AUTHORIZATION PROCESS FOR INPATIENT ADMISSION OR IN CONNECTING THEM WITH OUTPATIENT SERVICES AVAILABLE IN THE COMMUNITY. COMPLEX CARE COORDINATORS WERE IMPLEMENTED IN THE AMBULATORY NETWORK AND THROUGH THE EMERGENCY DEPARTMENT TO ASSIST WITH NAVIGATION.SMML CONTINUED TO PROVIDE MEETING SPACE FOR A VARIETY OF SUBSTANCE USE DISORDER AND MENTAL HEALTH SUPPORT GROUPS, INCLUDING EMOTIONS ANONYMOUS. THE HOSPITAL ALSO PROVIDED MEETING SPACE FOR OVEREATERS ANONYMOUS TO SUPPORT ADULTS IN THEIR EFFORTS TO ACHIEVE AND MAINTAIN A HEALTHY WEIGHT.THE PEER RECOVERY COACHING PROGRAM SERVED AS A CATALYST FOR BUDGET ALLOCATIONS IN THE MICHIGAN STATE BUDGET. THE FUNDS WERE USED TO ENHANCE THE ST. MARY MERCY BEHAVIORAL HEALTH UNIT, SUCH AS ADDITIONAL PEER RECOVERY COACH RESOURCES AS WELL AS SPECIALIZED TRAUMA THERAPY. SMML ACTIVELY PARTNERED WITH THE PUBLIC SAFETY DEPARTMENTS OF WESTERN WAYNE COUNTY AND LOCAL JUDICIARY ENTITIES, AS WELL AS COMMUNITY ORGANIZATIONS LIKE GROWTH WORKS TO DEVELOP A 'SAFETY NET' APPROACH ENTITLED "WESTERN WAYNE RESCUE RECOVERY". THIS COLLABORATION WILL HELP CONNECT INDIVIDUALS WITH THE LEGAL AND MEDICAL RESOURCES THEY NEED TO HELP SUPPORT THEM ON THEIR JOURNEY TO RECOVERY.ST. JOSEPH MERCY LIVINGSTON:SJML ACTIVELY SUPPORTS COMMUNITY ENTITIES, INCLUDING LIVINGSTON COUNTY PUBLIC HEALTH, LIVINGSTON COUNTY CATHOLIC CHARITIES (WHICH HOUSES THE LIVINGSTON COUNTY SUBSTANCE ABUSE PREVENTION COALITION), LIVINGSTON COUNTY COMMUNITY MENTAL HEALTH, AND THE LOCAL HUMAN SERVICES COLLABORATIVE BODY. SUPPORT FOR THESE ORGANIZATIONS INCLUDES BUT IS NOT LIMITED TO: SEATS ON VARIOUS BOARDS, SJML STAFF MEMBERS' PRESENCE AT WORKGROUPS WITHIN COLLABORATIONS SUPPORTING THE WORK OF THESE AGENCIES, AND MONETARY OR IN-KIND STAFF TIME AT EVENTS PROMOTING HEALTH TO THE GENERAL PUBLIC. SJML ALSO SUPPORTS THE LOCAL FOOD BANK THROUGH DONATIONS.
PART VI, LINE 6:	TH-MI 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 HOSPITALS DEFINE - AND ACHIEVE - SPECIFIC COMMUNITY HEALTH AND WELL-BEING GOALS. IN FISCAL YEAR 2019, EVERY TRINITY HEALTH ENTITY FOCUSED ON: 1. REDUCING TOBACCO USE 2. REDUCING OBESITY PREVALENCE3. ADDRESSING AT LEAST ONE SIGNIFICANT HEALTH NEED IDENTIFIED BY THEIR HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT4. ADDRESSING AT LEAST ONE SOCIAL INFLUENCER OF HEALTH TRINITY HEALTH ACKNOWLEDGES THAT SOCIAL INFLUENCERS OF HEALTH - SUCH AS ADEQUATE HOUSING, PERSONAL SAFETY AND ACCESS TO FOOD, EDUCATION, INCOME, AND HEALTH COVERAGE - HAVE A SIGNIFICANT IMPACT ON THE HEALTH OF ITS COMMUNITIES. IN AN EFFORT TO ADDRESS SOME OF THESE INFLUENCERS, TRINITY HEALTH LAUNCHED THE TRANSFORMING COMMUNITIES INITIATIVE (TCI) IN FISCAL YEAR 2016 TO ADVANCE COMMUNITY PARTNERSHIPS THAT FOCUS ON IMPROVING THE HEALTH AND WELL-BEING IN COMMUNITIES SERVED BY THE HOSPITALS OF TRINITY HEALTH. TCI IS A SHARED FUNDING MODEL AND TECHNICAL-ASSISTANCE INITIATIVE SUPPORTING EIGHT TRINITY HEALTH HOSPITALS AND THEIR COMMUNITY PARTNERS TO IMPLEMENT POLICY, SYSTEM, AND ENVIRONMENTAL CHANGE STRATEGIES TO PREVENT TOBACCO USE AND CHILDHOOD OBESITY, AND TO AFFECT CHANGE RELATED TO THE SOCIAL INFLUENCERS OF HEALTH. IN FISCAL YEAR 2019, TRINITY HEALTH INVESTED $3.7 MILLION IN TCI AND HAS LEVERAGED OVER $6.5 MILLION IN COMMUNITY MATCH FUNDING TO DATE. ADDITIONALLY, TRINITY HEALTH'S GOOD SAMARITAN INITIATIVE (GSI) INVESTED $751,000 IN NINE REGIONAL HEALTH MINISTRIES TO SUPPORT THE INTEGRATION OF 16 COMMUNITY HEALTH WORKERS INTO CARE MANAGEMENT TEAMS. TRINITY HEALTH CONTINUES TO EXPAND THE NATIONAL DIABETES PREVENTION PROGRAM THROUGH THE SUPPORT OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION. IN ADDITION TO THE PROGRAMMATIC SPENDING DESCRIBED ABOVE, THE SYSTEM DEPLOYED NEW AND RENEWED LOANS OF $5.3 MILLION FOR PLACE-BASED INVESTING TO IMPROVE ACCESS TO AFFORDABLE HOUSING, HEALTHY FOODS, EDUCATION, AND ECONOMIC DEVELOPMENT. THE COMMUNITY-INVESTING PROGRAM ALSO HAS OUTSTANDING LOAN COMMITMENTS OF $6.0 MILLION TO COMMUNITY INFRASTRUCTURE PROJECTS, WHICH WILL BE DEPLOYED IN FUTURE YEARS.TRINITY HEALTH AND ITS MEMBER HOSPITALS ARE COMMITTED TO THE DELIVERY OF PEOPLE-CENTERED CARE AND SERVING AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN THE COMMUNITIES THEY SERVE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITIES AND IS COMMITTED TO ADDRESSING THE UNIQUE NEEDS OF EACH COMMUNITY. IN FISCAL YEAR 2019, TRINITY HEALTH INVESTED NEARLY $1.2 BILLION IN COMMUNITY BENEFIT, SUCH AS INITIATIVES SUPPORTING THOSE WHO ARE POOR AND VULNERABLE, HELPING TO MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, AND MOVING FORWARD POLICY, SYSTEM, AND ENVIRONMENTAL CHANGE.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG.

Schedule H (Form 990) 2018

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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

2018

Open to Public
Inspection

Name of the organization
TRINITY HEALTH - MICHIGAN

Employer identification number
38-2113393

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) ANN ARBOR YMCA 400 W WASHINGTON ST ANN ARBOR,MI48103	38-1525162	501(C)(3)	25,000	YPSILANTI YMCA EARLY CHILDHOOD COLLABORATIVE - WASH COORDINATED FUNDING
(2) AVALON HOUSING 1327 JONES DR STE 102 ANN ARBOR,MI48105	38-3086920	501(C)(3)	150,000	2019 FUNDING FOR FUSE PROGRAM
(3) CATHOLIC SOCIAL SERVICES OF WASHTENAW COUNTY 4925 PACKARD RD ANN ARBOR,MI48108	38-1654500	501(C)(3)	30,000	BEHAVIORAL HEALTH SERICES & COOKING FOR A CAUSE
(4) CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION 2929 PLYMOUTH RD STE 245 ANN ARBOR,MI48105	27-1017827	501(C)(3)	60,000	PROGRAM SUPPORT 2019 WASHTENAW HEALTH INITIATIVE OPERATING EXPENSES
(5) CORNER HEALTH CENTER 47 N HURON ST YPSILANTI,MI48197	38-2329742	501(C)(3)	30,000	HERE FOR YOUTH AND FAMILY SHELTER HEALTH ASSESSMENT
(6) EASTERN MARKET CORPORATION 2934 RUSSELL ST DETROIT,MI48207	32-0030432	501(C)(3)	50,000	2018 FARM STAND & FOOD ACCESS SUPPORT
(7) ELE'S PLACE INC 1145 W OAKLAND LANSING,MI48915	38-2976751	501(C)(3)	10,000	ANN ARBOR HOME FOR HEALING HEARTS CAMPAIGN
(8) FAIR FOOD NETWORK 205 E WASHINGTON ST NO B ANN ARBOR,MI48104	26-4143394	501(C)(3)	50,000	NI FOOD/AGRIC FINI GRANT INNOV TECH & EXP GEOGRAPHIES PROG
(9) FOOD GATHERERS PO BOX 131037 ANN ARBOR,MI48113	38-2853858	501(C)(3)	15,000	LOCAL FOOD BANKS CORPORATE GIVING PROGRAM - FOOD SECURITY NETWORK
(10) GROWING HOPE INC 922 W MICHIGAN AVE YPSILANTI,MI48197	74-3091845	501(C)(3)	20,000	YPSILANTI FARMERS MARKET & MOBILE FARM STAND SPONSORSHIP
(11) HURON WATERLOO PATHWAYS INITIATIVE 14800 EAST OLD US 12 CHELSEA,MI48118	82-1605735	501(C)(3)	46,667	DEVELOPMENT OF THE BORDER-TO-BORDER TRAIL SPONSORSHIP
(12) JEWISH FAMILY SERVICES OF WASHTENAW COUNTY INC 2245 S STATE ST SUITE 200 ANN ARBOR,MI48104	41-2147486	501(C)(3)	46,249	CAPACITY BUILDING GRANT AND SENIOR SOCIAL INTEGRATION
(13) LIVINGSTON COUNTY CATHOLIC CHARITIES 2020 E GRAND RIVER AVE STE 104 HOWELL,MI48843	38-2570420	501(C)(3)	128,221	PRESCRIPTION FOR HEALTH PROGRAM - LIVINGSTON COUNTY
(14) MAKE-A-WISH FOUNDATION OF MICHIGAN 2300 GENOA BUSINESS PARK DRIVE ROOM/SUITE 290 BRIGHTON,MI48114	38-2505812	501(C)(3)	50,000	WISH-A-MILE GOLD SPONSORSHIP & WHSH 3ALL SEMI LEAD SPONSORSHIP
(15) MICHIGAN ABILITY PARTNERS 3810 PACKARD RD SUITE 260 ANN ARBOR,MI48018	38-2595768	501(C)(3)	15,000	PERMANENT HOUSING SUPPORTS
(16) MIGHTY OAK PROJECT INC 3676 S STATE ST ANN ARBOR,MI48108	81-5293606	501(C)(3)	30,000	2018 SPONSORSHIP
(17) STUDENT ADVOCACY CENTER OF MICHIGAN INC 124 PEARL ST STE 504 YPSILANTI,MI48197	38-2058667	501(C)(3)	45,000	CHECK AND CONNECT AND EDUCATION ADVOCACY
(18) UNITED WAY OF WASHTENAW COUNTY 2305 PLATT ROAD ANN ARBOR,MI48104	38-1951024	501(C)(3)	33,333	WILLIAM J FILETI MEMORAL FUND SUPPORT FOR FUTURES FUND
(19) UNIVERSITY MUSICAL SOCIETY 881 NORTH UNIVERSITY AVENUE ANN ARBOR,MI48109	38-1545881	501(C)(3)	25,000	2018-19 UMS SPONSORSHIP - MARTHA GRAHAM DANCE CO PERFORMANCES
(20) WASHTENAW COUNTY PUBLIC HEALTH DEPARTMENT 555 TOWNER ST YPSILANTI,MI48198	38-6004894	COUNTY GOVERNMENT	156,099	PRESCRIPTION FOR HEALTH PROGRAM - WASHTENAW COUNTY
(21) WASHTENAW HEALTH PLAN 555 TOWNER ST YPSILANTI,MI48198	02-0585175	501(C)(3)	200,000	WHP ONGOING OPERATIONS SUPPORT
(22) WASHTENAW HOUSING ALLIANCE PO BOX 7993 ANN ARBOR,MI48104	38-3551639	501(C)(3)	35,000	DEVELOPMENT EFFORTS SISTER YVONNE GELLISE FUND FOR PERM SUPP HOUSING SVCS
(23) ST FRANCES CABRINI CLINIC 1234 PORTER ST DETROIT,MI48226	38-3129349	501(C)(3)	250,000	COMMUNITY SUPPORT
(24) SAY DETROIT FAMILY HEALTH CLINIC 29836 TELEGRAPH ROAD SOUTHFIELD,MI48034	20-4786626	501(C)(3)	100,000	COMMUNITY SUPPORT
(25) FERRIS FOUNDATION 420 OAK ST PARK 101 BIG RAPIDS,MI49307	38-6115813	501(C)(3)	5,000	COMMUNITY SUPPORT
(26) GRAND RAPIDS CHAMBER OF COMMERCE 250 MONROE AVE NW STE 150 GRAND RAPIDS,MI49503	38-0592500	501(C)(6)	10,000	COMMUNITY SUPPORT
(27) GRAND RAPIDS SYMPHONY 300 OTTAWA AVE NW STE 100 GRAND RAPIDS,MI49503	38-6005447	501(C)(3)	9,000	COMMUNITY SUPPORT
(28) GRAND RAPIDS URBAN LEAGUE 745 EASTERN AVE SE GRAND RAPIDS,MI49503	38-1359259	501(C)(3)	15,000	COMMUNITY SUPPORT
(29) GRCC FOUNDATION 143 BOSTWICK AVENUE GRAND RAPIDS,MI49503	38-6100380	501(C)(3)	5,000	COMMUNITY SUPPORT
(30) HEART OF WEST MICHIGAN 118 COMMERCE AVE SW SUITE 100 GRAND RAPIDS,MI49503	38-1360923	501(C)(3)	25,000	COMMUNITY SUPPORT
(31) MEL TROTTER MINISTRIES 225 COMMERCE AVE SW GRAND RAPIDS,MI49503	38-1410467	501(C)(3)	105,000	COMMUNITY SUPPORT
(32) RETHINKING DEMENTIA 1551 FRANKLIN ST SE GRAND RAPIDS,MI49506	81-5378097	501(C)(3)	25,000	COMMUNITY SUPPORT
(33) THE RIGHT PLACE INC 125 OTTAWA AVE NE STE 450 GRAND RAPIDS,MI49503	38-3262801	501(C)(6)	25,000	COMMUNITY SUPPORT
(34) SAN JUAN DIEGO ACADEMY 1650 GODFREY AVE SW WYOMING,MI49509	45-2103252	501(C)(3)	11,000	COMMUNITY SUPPORT
(35) WEST MI CENTER FOR ARTS & TECHNOLOGY 98 FULTON ST E STE 202 GRAND RAPIDS,MI49503	74-3120354	501(C)(3)	20,000	COMMUNITY SUPPORT
(36) YMCA OF GREATER GRAND RAPIDS 475 LAKE MICHIGAN DRIVE NW GRAND RAPIDS,MI49504	38-1358058	501(C)(3)	5,000	COMMUNITY SUPPORT
(37) MERCY EDUCATION PROJECT 1450 HOWARD STREET DETROIT,MI48216	38-3209556	501(C)(3)	5,000	SUPPORT 13TH ANNUAL DOORWAY TO THE FUTURE DINNER
(38) LIVONIA PUBLIC SCHOOLS EDUCATION FOUNDATION 15125 FARMINGTON ROAD LIVONIA,MI48154	20-1085968	501(C)(3)	7,500	SUPPORT BACK-TO-SCHOOL PARTY AND FALL LUNCHEON
(39) LEADERS ADVANCING & HELPING COMMUNITIES 835 MASON ST SUITE A-160 DEARBORN,MI48124	38-3081799	501(C)(3)	9,000	LAHC SCHOLARSHIP PROGRAM, THREE SCHOLARSHIPS
(40) HOPE MEDICAL CLINIC INC PO BOX 980311 YPSILANTI,MI48198	38-2469007	501(C)(3)	5,000	SUPPORT THE REDESIGNED INITIATIVE - HEALTHY YOU
(41) GREATER DETROIT AREA HEALTH COUNCIL 407 EAST FORT STREET 6TH FLOOR DETROIT,MI48226	38-1360904	501(C)(3)	7,500	SUPPORT ANNUAL OPIOID ABUSE AND HEROIN OVERDOSE SUMMIT
(42) DETROIT EMPLOYMENT SOULUTIONS CORPORATION 440 E CONGRESS 4TH FLOOR DETROIT,MI48226	38-3353746	501(C)(3)	50,000	SUPPORT STUDENT EMPLOYMENT AND PROGRAMMING FOR YOUTH
(43) COVENANT COMMUNITY CARE INC 559 WEST GRAND BOULEVARD DETROIT,MI48216	38-3533998	501(C)(3)	450,000	SUPPORT THE DEVELOPMENT OF COVENANT CLINIC SITES
(44) COURAGEOUS 12925 AUBURN AVENUE DETROIT,MI48223	90-0786010	501(C)(3)	20,000	SUPPORT FOR CAMP COURAGEOUS AND THE 2019 COURAGEOUS GAMES
(45) CITY OF LIVONIA 33000 CIVIC CENTER DRIVE LIVONIA,MI48154	38-6005820	CITY GOVERNMENT	70,000	SUPPORT HEALTHY LIVONIA - TATIGIAN BRIDGE PROJECT
(46) CHARTER TOWNSHIP OF NORTHVILLE 700 WEST BASELINE ROAD NORTHVILLE,MI48167	38-6007235	CITY GOVERNMENT	10,000	SUPPORT THE CONTINUATION OF REDUCED NORTHVILLE TRANSPORTATION FEES
(47) UNITED STROKE ALLIANCE 2000 W PIONEER PKWY STE 16 PEORIA,IL61615	64-0954851	501(C)(3)	19,500	SPONSORSHIP
(48) GARY BURNSTEIN COMMUNITY HEALTH 7402 DAVENTRY WOODS DR WEST BLOOMFIELD,MI48322	32-0015321	501(C)(3)	13,000	SPONSORSHIP
(49) FREEDOM ROAD TRANSPORTATION AUTHORITY 2633 SOUTH LAPEER ROAD STE H ORION CHARTER TOWNSHIP,MI48360	35-2212929	501(C)(3)	25,000	SPONSORSHIP
(50) OAKLAND UNIVERSITY 507 GOLF VIEW ROCHESTER,MI48309	38-1714400	501(C)(3)	10,000	SPONSORSHIP
(51) WATERFORD PROFESSIONAL FIREFIGHTERS UNION 2495 CRESCENT LAKE ROAD WATERFORD,MI48329	20-5170194	501(C)(3)	5,000	SPONSORSHIP

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) ST. JOSEPH MERCY ANN ARBOR & LIVINGSTON NURSING SCHOLARSHIPS	10	14,317	FAIR MARKET VALUE	SCHOLARSHIPS
(2) ST. JOSEPH MERCY OAKLAND NURSING SCHOLARSHIPS	10	10,750	FAIR MARKET VALUE	SCHOLARSHIPS
(3) CANCER PATIENT SERVICES	924	31,662	FAIR MARKET VALUE	SERVICES
(4) CANCER PATIENT GIFT CARDS	160	4,030	FAIR MARKET VALUE	GIFT CARDS
(5) PATIENT TRANSPORTATION	34	1,637	FAIR MARKET VALUE	TRANSPORTATION
(6) PAITENT MEDS	11	761	FAIR MARKET VALUE	MEDS
(7) PATIENT NEEDS (VARIOUS)	342	34,010	FAIR MARKET VALUE	VARIOUS NEEDS
(8) PATIENT LODGING	57	8,318	FAIR MARKET VALUE	LODGING

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 TRINITY HEALTH - MICHIGAN 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) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

TRINITY HEALTH - MICHIGAN

Employer identification number

38-2113393

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2018

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1ROBERT CASALOU DIRECTOR;PRESIDENT & CEO-MICH REGION	(i) (ii)	0 ------------- 919,844	0 ------------- 343,251	0 ------------- 189,685	0 ------------- 12,375	0 ------------- 57,433	0 ------------- 1,522,588	0 ------------- 0
2EDMUND HODGE DIRECTOR AS OF 1/19; TH EVP, CHRO	(i) (ii)	0 ------------- 690,677	0 ------------- 320,401	0 ------------- 23,687	0 ------------- 197,197	0 ------------- 38,144	0 ------------- 1,270,106	0 ------------- 0
3TONYA WELLS DIR THR 12/18; TH VP FED ADVOCACY	(i) (ii)	0 ------------- 214,762	0 ------------- 61,655	0 ------------- 1,386	0 ------------- 20,625	0 ------------- 27,331	0 ------------- 325,759	0 ------------- 0
4SALLY GUINDI SECRETARY; GEN COUNSEL-MICHIGAN	(i) (ii)	0 ------------- 344,297	0 ------------- 100,923	0 ------------- 16,936	0 ------------- 16,500	0 ------------- 33,256	0 ------------- 511,912	0 ------------- 0
5CAROL TARNOWSKY ASST SEC THR 12/18; MI DPTY GEN CSL	(i) (ii)	0 ------------- 293,039	0 ------------- 84,430	0 ------------- 6,817	0 ------------- 16,500	0 ------------- 11,923	0 ------------- 412,709	0 ------------- 0
6MICHAEL GUSHO TREASURER; CFO-MICHIGAN REGION	(i) (ii)	0 ------------- 559,136	0 ------------- 127,867	0 ------------- 13,072	0 ------------- 106,133	0 ------------- 33,393	0 ------------- 839,601	0 ------------- 0
7DAVID SPIVEY PRES & CEO ST. MARY MERCY LIVONIA	(i) (ii)	0 ------------- 490,795	0 ------------- 154,579	0 ------------- 193,576	0 ------------- 20,625	0 ------------- 30,561	0 ------------- 890,136	0 ------------- 0
8BILL MANNS PRES MHSM THR 9/18;PRES SJM AA 10/18	(i) (ii)	0 ------------- 441,775	0 ------------- 181,322	0 ------------- 120,585	0 ------------- 8,250	0 ------------- 31,832	0 ------------- 783,764	0 ------------- 0
9ROSALIE TOCCO-BRADLEY MD CMO ST JOS MERCY ANN ARBOR, LIVINGS.	(i) (ii)	0 ------------- 505,096	0 ------------- 121,208	0 ------------- 17,032	0 ------------- 93,270	0 ------------- 40,292	0 ------------- 776,898	0 ------------- 0
10SHANNON STRIEBICH PRESIDENT ST. JOSEPH MERCY OAKLAND	(i) (ii)	0 ------------- 411,590	0 ------------- 105,143	0 ------------- 72,779	0 ------------- 16,500	0 ------------- 30,823	0 ------------- 636,835	0 ------------- 0
11DAVID BAUMGARTNER MD MHSM CMO THR9/18;INT PRES 10/18-4/19	(i) (ii)	0 ------------- 435,241	0 ------------- 98,696	0 ------------- 9,050	0 ------------- 16,500	0 ------------- 32,748	0 ------------- 592,235	0 ------------- 0
12MATT BIERSACK MD INTERIM CMO MHSM AS OF 11/18	(i) (ii)	0 ------------- 309,086	0 ------------- 71,463	0 ------------- 271	0 ------------- 12,375	0 ------------- 21,954	0 ------------- 415,149	0 ------------- 0
13FABIAN FREGOLI MD CMO ST. JOSEPH MERCY OAKLAND	(i) (ii)	13,637 ------------- 380,192	0 ------------- 74,869	22 ------------- 1,798	287 ------------- 9,588	972 ------------- 23,848	14,918 ------------- 490,295	0 ------------- 0
14DAVID MCEWEN COO MERCY HEALTH ST. MARY'S	(i) (ii)	0 ------------- 358,787	0 ------------- 82,744	0 ------------- 4,404	0 ------------- 12,375	0 ------------- 27,042	0 ------------- 485,352	0 ------------- 0
15MICHAEL GRISDELA VP FIN WEST MARKET,SE MICH THR 12/18	(i) (ii)	0 ------------- 311,492	0 ------------- 66,183	0 ------------- 3,781	0 ------------- 12,375	0 ------------- 31,131	0 ------------- 424,962	0 ------------- 0
16MATTHEW GRIFFIN MD CMO ST. MARY MERCY LIVONIA	(i) (ii)	0 ------------- 338,739	0 ------------- 30,800	0 ------------- 5,449	0 ------------- 15,510	0 ------------- 26,279	0 ------------- 416,777	0 ------------- 0
17JOHN O'MALLEY PRES; ST. JOSEPH MERCY LIVINGSTON	(i) (ii)	0 ------------- 288,908	0 ------------- 73,350	0 ------------- 11,868	0 ------------- 58,946	0 ------------- 18,095	0 ------------- 451,167	0 ------------- 0
18ALONZO LEWIS INT PRES SJ MERCY AA THR 10/18; COO	(i) (ii)	298,266 ------------- 0	65,148 ------------- 0	469 ------------- 0	12,375 ------------- 0	25,588 ------------- 0	401,846 ------------- 0	0 ------------- 0
19MICHAEL SAMYN VP FINANCE EAST MARKET	(i) (ii)	0 ------------- 282,469	0 ------------- 58,588	0 ------------- 3,426	0 ------------- 16,500	0 ------------- 27,671	0 ------------- 388,654	0 ------------- 0
20DANIEL GREEN VP FINANCE MERCY HEALTH ST MARY'S	(i) (ii)	8,815 ------------- 263,250	0 ------------- 59,471	20 ------------- 1,904	437 ------------- 16,063	750 ------------- 23,984	10,022 ------------- 364,672	0 ------------- 0
21SARAH GILBERT VP OPS ST MARY MERCY LIVONIA	(i) (ii)	195,900 ------------- 0	37,535 ------------- 0	422 ------------- 0	17,879 ------------- 0	14,101 ------------- 0	265,837 ------------- 0	0 ------------- 0
22FRANK SAWYER SENIOR VP, OPERATIONS OAKLAND	(i) (ii)	223,501 ------------- 0	44,561 ------------- 0	38,537 ------------- 0	11,847 ------------- 0	20,579 ------------- 0	339,025 ------------- 0	0 ------------- 0
23LAWRENCE RAPP MD NEUROSURGEON (OAKLAND)	(i) (ii)	1,517,065 ------------- 0	0 ------------- 0	3,488 ------------- 0	12,375 ------------- 0	23,137 ------------- 0	1,556,065 ------------- 0	0 ------------- 0
24YOAV RITTER DO NEUROSURGEON (OAKLAND)	(i) (ii)	1,218,013 ------------- 0	0 ------------- 0	678 ------------- 0	12,375 ------------- 0	25,494 ------------- 0	1,256,560 ------------- 0	0 ------------- 0
25AHMAD ISSAWI MD NEUROSURGEON (SJMHS)	(i) (ii)	1,143,932 ------------- 0	27,000 ------------- 0	433 ------------- 0	12,375 ------------- 0	21,199 ------------- 0	1,204,939 ------------- 0	0 ------------- 0
26JASON BRODKEY MD NEUROSURGEON (SJMHS)	(i) (ii)	1,045,322 ------------- 0	27,000 ------------- 0	1,402 ------------- 0	20,625 ------------- 0	23,846 ------------- 0	1,118,195 ------------- 0	0 ------------- 0
27GEORGE GIBSON DO ORTHOPEDIC SURGEON (SJMHS)	(i) (ii)	959,361 ------------- 0	600 ------------- 0	1,278 ------------- 0	0 ------------- 0	27,492 ------------- 0	988,731 ------------- 0	0 ------------- 0
28GARY ALLORE FORMER OFFICER; PRES MH MUSKEGON	(i) (ii)	0 ------------- 409,891	0 ------------- 120,411	0 ------------- 37,068	0 ------------- 16,500	0 ------------- 31,778	0 ------------- 615,648	0 ------------- 0
29BENJAMIN CARTER FORMER OFFICER; TRINITY EVP, CFO	(i) (ii)	0 ------------- 957,849	0 ------------- 442,453	0 ------------- 265,229	0 ------------- 12,375	0 ------------- 54,836	0 ------------- 1,732,742	0 ------------- 0
30CYNTHIA CLEMENCE FMR OFFICER; TRINITY SVP, OPS CFO	(i) (ii)	0 ------------- 630,543	0 ------------- 250,135	0 ------------- 161,073	0 ------------- 20,625	0 ------------- 40,235	0 ------------- 1,102,611	0 ------------- 0
31PAUL NEUMANN FMR OFFCR; TH CHF LEGAL OFF THR 8/18	(i) (ii)	0 ------------- 497,581	0 ------------- 321,119	0 ------------- 410,577	0 ------------- 518,865	0 ------------- 37,979	0 ------------- 1,786,121	0 ------------- 0
32RICHARD GILFILLAN FORMER OFFICER; TH PRESIDENT & CEO	(i) (ii)	0 ------------- 1,429,249	0 ------------- 909,391	0 ------------- 485,144	0 ------------- 12,375	0 ------------- 115,599	0 ------------- 2,951,758	0 ------------- 0
33MARY NEFF FORMER KEY EMP;VP LABOR & CLIN OPS	(i) (ii)	0 ------------- 113,829	0 ------------- 61,390	0 ------------- 3,901	0 ------------- 20,251	0 ------------- 12,831	0 ------------- 212,202	0 ------------- 0
34JACQUELINE PRIMEAU FORMER KEY EMPLOYEE; TH VP, M&A	(i) (ii)	0 ------------- 151,187	0 ------------- 80,916	0 ------------- 6,087	0 ------------- 13,995	0 ------------- 13,000	0 ------------- 265,185	0 ------------- 0
35KATHLEEN O'CONNOR FORMER KEY EMP; DIR DECISION SUPPORT	(i) (ii)	0 ------------- 194,042	0 ------------- 22,844	0 ------------- 1,187	0 ------------- 10,989	0 ------------- 17,840	0 ------------- 246,902	0 ------------- 0
36ROGER SPOELMAN FORMER OFFICER; TH SVP THR 12/18	(i) (ii)	0 ------------- 635,635	0 ------------- 262,008	0 ------------- 185,775	0 ------------- 20,625	0 ------------- 50,233	0 ------------- 1,154,276	0 ------------- 0
37DAVID BROOKS FORMER KEY EMPLOYEE	(i) (ii)	0 ------------- 289,237	0 ------------- 207,453	0 ------------- 309,263	0 ------------- 601,727	0 ------------- 26,524	0 ------------- 1,434,204	0 ------------- 0
38MICHAEL K SMITH FORMER KEY EMPLOYEE	(i) (ii)	0 ------------- 141,454	0 ------------- 52,801	0 ------------- 6,645	0 ------------- 3,003	0 ------------- 21,190	0 ------------- 225,093	0 ------------- 0
39NANCY GRAEBNER FORMER KE; CEO SJM CHELSEA	(i) (ii)	0 ------------- 323,410	0 ------------- 114,495	0 ------------- 96,393	0 ------------- 16,500	0 ------------- 12,621	0 ------------- 563,419	0 ------------- 0
40RANDALL T FORSCH FORMER KE: CMO SJM CHELSEA	(i) (ii)	0 ------------- 151,007	0 ------------- 34,127	0 ------------- 1,937	0 ------------- 5,554	0 ------------- 4,675	0 ------------- 197,300	0 ------------- 0
41AGNES HAGERTY FORMER OFFICER; TH ASSOC COUNSEL	(i) (ii)	0 ------------- 43,478	0 ------------- 0	0 ------------- 99,370	0 ------------- 1,304	0 ------------- 0	0 ------------- 144,152	0 ------------- 0

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference

Explanation

PART I, LINE 3

TRINITY HEALTH - MICHIGAN (TH-MI) IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. TH-MI'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 TH-MI'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 2018. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: DAVID BROOKS - $289,074 PAUL NEUMANN - $192,948 IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES THE FOLLOWING SEVERANCE AMOUNTS, WHICH WERE UNPAID AS OF 12/31/18: DAVID BROOKS - $589,352 ($582,629 PAID IN 2019, $6,723 TO BE PAID IN 2020) PAUL NEUMANN - $506,490 (PAID IN 2019) THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2018. 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 2018, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2018. THE FOLLOWING PAYOUTS FOR 2018 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: GARY ALLORE - $25,413 DAVID BROOKS - $0 BENJAMIN CARTER - $232,182 ROBERT CASALOU - $162,094 CYNTHIA CLEMENCE - $138,843 RICHARD GILFILLAN, MD - $399,833 NANCY GRAEBNER - $77,284 SALLY GUINDI - $0 BILL MANNS - $100,722 PAUL NEUMANN - $172,542 DAVID SPIVEY - $104,480 ROGER SPOELMAN - $148,355 SHANNON STRIEBICH - $64,832 THE FOLLOWING ACCRUALS FOR 2018 IS INCLUDED IN COLUMN C OF SCHEDULE J, PART II: MICHAEL GUSHO - $85,508 EDMUND HODGE - $184,822 JOHN O'MALLEY - $46,571 ROSALIE TOCCO-BRADLEY, MD - $80,895 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 ($275,000 FOR 2018). THE FOLLOWING PAYOUTS FOR 2018 FOR THESE PLANS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: DAVID BAUMGARTNER, MD - $0 FABIAN FREGOLI, MD - $0 DANIEL GREEN - $0 MATTHEW GRIFFIN, MD - $0 MICHAEL GRISDELA - $0 SALLY GUINDI - $3,030 DAVID MCEWEN - $0 JACQUELINE PRIMEAU - $2,382 MICHAEL SAMYN - $0 CAROL TARNOWSKY - $2,098

Schedule J (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

TRINITY HEALTH - MICHIGAN

Employer identification number

38-2113393

Part I

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

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

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

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

Part II

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

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






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

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2018

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) JANEL CARTER	FAMILY MEMBER OF BENJAMIN CARTER, FORMER OFFICER	43,200	EMPLOYMENT ARRANGEMENT		No
(2) BRIAN GRISDELA	FAMILY MEMBER OF MICHAEL GRISDELA, KEY EMPLOYEE	30,757	EMPLOYMENT ARRANGEMENT		No
(3) SCOTT GILBERT	FAMILY MEMBER OF SARAH GILBERT, KEY EMPLOYEE	88,815	EMPLOYMENT ARRANGEMENT		No
(4) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	270,577	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(5) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	5,621,236	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(6) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	127,533	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(7) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	390,635	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(8) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	686,126	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(9) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	101,000	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(10) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	275,051	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(11) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	1,373,578	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(12) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	294,075	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(13) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	286,580	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(14) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	16,769,131	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(15) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	695,569	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(16) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	761,525	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(17) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	439,644	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(18) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	588,926	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(19) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	175,870	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(20) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	992,953	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(21) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	3,651,293	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(22) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	805,537	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(23) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	440,487	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(24) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	137,777	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(25) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	1,139,759	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(26) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	401,416	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(27) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	362,829	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(28) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	474,895	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(29) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	615,950	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(30) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	500,000	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(31) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	186,237	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(32) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	996,773	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(33) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	113,016	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(34) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	185,075	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(35) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	104,489	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(36) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	3,659,213	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(37) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	661,283	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(38) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	191,546	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(39) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	1,083,196	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(40) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	6,865,384	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No
(41) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	733,415	DONOR PROVIDED GOODS/SERVICES TO TH-MI		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

TRINITY HEALTH - MICHIGAN

Employer identification number

38-2113393

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....	X	22	15,952	DONOR PROVIDED VALUE
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..	X		282	DONOR PROVIDED VALUE
5 Clothing and household goods .......	X		19,146	DONOR PROVIDED VALUE
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X		48,100	MEDIAN VAL-TRAN DATE
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .	X	10	7,823	DONOR PROVIDED VALUE
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( MISCELLANEOUS )	X	4	35,340	DONOR PROVIDED VALUE
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which is not required to be used for exempt purposes for the entire holding period? ...................

30a

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

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

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

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

32a

Yes

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2018)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 32B:	SPECIAL EVENT COMMITTEE VOLUNTEERS SOLICIT NON-CASH CONTRIBUTIONS FROM LOCAL BUSINESSES. THEY SOLICIT ITEMS TO BE USED DURING THE SPECIAL EVENT, SUCH AS FOOD, PLUS ITEMS TO BE SOLD AT THE EVENT AUCTION.

Schedule M (Form 990) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

TRINITY HEALTH - MICHIGAN

Employer identification number

38-2113393

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF TH-MI 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 TH-MI. TRINITY HEALTH CORPORATION HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF TH-MI.
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 TH-MI IS REVIEWED BY SENIOR MANAGEMENT. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM WILL BE REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AFTER THE RETURN HAS BEEN FILED.
FORM 990, PART VI, SECTION B, LINE 12C	TH-MI 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 TH-MI, 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 TH-MI 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 TH-MI (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO TH-MI OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF TH-MI (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 TH-MI. 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 THE CEO AND CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF TH-MI IS ESTABLISHED AND PAID BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING COMPENSATION FOR THESE INDIVIDUALS, 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 THESE INDIVIDUALS 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. FOR OTHER EXECUTIVES WHO ARE NOT PART OF THE REBUTTABLE PRESUMPTION PROCESS, TRINITY HEALTH USES A MARKET ANALYSIS TO DETERMINE THE APPROPRIATENESS OF THE EXECUTIVE'S COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19	TH-MI 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, TH-MI INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. TH-MI'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:	EQUITY TRANSFERS TO AFFILIATES -125,049,610. CHANGE IN DEFERRED RETIREMENT COSTS 337,696. INCOME FROM DISCONTINUED OPERATIONS 407,236. OTHER TRANSACTIONS 2,426,685. ASSET IMPAIRMENT -4,005,248. NET ASSETS RELEASED FROM RESTRICTIONS FOR CAPITAL ACQUISITIONS -241,712. TH-MI CONTRIBUTION TO SJM CHELSEA, INC. -88,552,166. EXTERNAL FINANCIAL INTEREST-SJM CHELSEA, INC. 60,000,000.
FORM 990, PART XII, LINE 2:	TH-MI'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY19 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM.
FORM 990, PAGE 1, DOING BUSINESS AS NAMES:	ST. MARY MERCY OUTPATIENT PHARMACY,THE BOUTIQUE AT MERCY HEALTH,ANN ARBOR SPINE CENTER,CLINXUS,MERCY CANCER CENTER,MERCY ENDOCRINOLOGY,MERCY FAMILY CARE,MERCY HEALTH CLINXUS,MERCY HEALTH DENTAL CLINIC,MERCY HEALTH PHARMACY-ROCKFORD,MERCY HEALTH-MUSKEGON CMH PHARMACY,MERCY SPECIALTY CARE,MERCY SURGERY CARE,MICHIGAN BRAIN AND SPINE INSTITUTE,MRI MOBILE SERVICES OF WEST MICHIGAN,SJMH MEDICAL PRACTICE,SJMH URGENT CARES,ST JOSEPH MERCY HOSPITAL, PONTIAC,ST. JOE'S MEDICAL GROUP - BLOOMFIELD PRIMARY CARE,ST. JOE'S MEDICAL GROUP - WATERFORD ADULT AND PEDIATRIC MEDICINE,ST. JOSEPH MERCY ANN ARBOR-CANCER CENTER,ST. JOSEPH MERCY BRIGHTON-CANCER CENTER,ST. JOSEPH MERCY CANTON-CANCER CENTER,ST. JOSEPH MERCY GREENBROOK,ST. JOSEPH MERCY LIVINGSTON-CANCER CENTER,ST. JOSEPH MERCY OAKLAND - IMAGE ENHANCEMENT CENTER,ST. JOSEPH MERCY OAKLAND-CANCER CENTER,ST. JOSEPH MERCY PROFESSIONAL PHARMACY,ST. MARY MERCY - CANCER CENTER,THE BOUTIQUE AT MERCY HEALTH, LACKS CANCER CENTER,CANTON CENTER FOR ADVANCED MEDICINE AND SURGERY,CHELSEACARE,CHELSEACARE PHARMACY,INSPIRIT CANCER SUPPORT SERVICES,MERCY HEALTH - GRAND RAPIDS,MERCY HEALTH ASTHMA NETWORK,MERCY HEALTH PHARMACY - CATHEDRAL SQUARE,MERCY HEALTH PHARMACY - HOME INFUSION,MERCY HEALTH PHARMACY - HUDSONVILLE,MERCY HEALTH PHARMACY - LONG TERM CARE,MERCY HEALTH PHARMACY - SOUTHWEST,MERCY HEALTH PHARMACY - WEGE CENTER,MERCY HEALTH ROCKFORD CAMPUS,MERCY HEALTH SAINT MARY'S,MERCY HEALTH SOUTHWEST CAMPUS,MERCY OB/GYN PARTNERS,MERCY PHYSICIAN NETWORK,MERCY PROFESSIONAL SERVCES,PROFESSIONAL FINANCIAL SERVICES,SAINT JOSEPH MERCY CANTON HEALTH CENTER,SAINT JOSEPH MERCY CENTER FOR ADVANCED MEDICINE AND SURGERY,SAINT JOSEPH MERCY LIVINGSTON HOSPITAL,SAINT JOSEPH MERCY PHARMACY - HOWELL,SAINT JOSEPH MERCY PHARMACY - REICHERT,SAINT JOSEPH MERCY PHARMACY - SALINE,SAINT JOSEPH MERCY PHARMACY - TOWERS,SAINT JOSEPH MERCY SALINE HOSPITAL,SAINT MARY'S FAMILY PHARMACY - SW CAMPUS,SAINT MARY'S FAMILY PHARMACY - WEGE,SAINT MARY'S HEALTH SERVICES,SAINT MARY'S HOME INFUSION PROGRAM,SAMARITAN HEALTH CENTER, DETROIT,SJMH MEDICAL PRACTICE- SMHC,SOPHIA'S HOUSE,SRSLY,ST JOSEPH MERCY ANN ARBOR INFUSION PHARMACY,ST. JOSEPH HOSPITAL, PONTIAC,ST. JOSEPH MERCY ANN ARBOR,ST. JOSEPH MERCY CANTON,ST. JOSEPH MERCY CHELSEA-CANCER CENTER,ST. JOSEPH MERCY HOSPITAL, ANN ARBOR,ST. JOSEPH MERCY LIVINGSTON,ST. JOSEPH MERCY OAKLAND,ST. JOSEPH MERCY SALINE,ST. JOSEPH MERCY SALINE HEALTH CENTER,ST. MARY MERCY HOSPITAL PROFESSIONAL,ST. MARY MERCY LIVONIA,ST. MARY MERCY PHYSICIAN PRACTICES,ST. MARY'S HOSPITAL, GRAND RAPIDS,THE FARM AT SAINT JOSEPH MERCY HEALTH SYSTEM,THE FARM AT ST. JOE'S,WESTSIDE OBSTETRICS AND GYNECOLOGY,ASTHMA NETWORK,ASTHMA NETWORK OF W MI,ASTHMA NETWORK OF WEST MICHIGAN,BROWNING CLAYTOR HEALTH CENTER,CANTON HEALTH CENTER,MCAULEY HEALTH CENTER,MERCY GENERAL HEALTH PARTNERS,MERCY HEALTH PHARMACY-MARY FREE BED,MERCYELITE,MERCYELITE PHYSICAL THERAPY,MERCYELITE SPORTS PERFORMANCE,RICHARD J. LACKS CANCER CENTER,ST. JOE'S MEDICAL GROUP - BLOOMFIELD HILLS PEDIATRICS,ST. JOE'S MEDICAL GROUP - DAVISBURG FAMILY MEDICINE,ST. JOE'S MEDICAL GROUP - OB/GYN OF MICHIGAN,ST. JOSEPH MERCY OAKLAND - AUBURN HILLS DIAGNOSTICS,ST. JOSEPH MERCY OAKLAND - CLARKSTON IMAGING CENTER,ADVANCED LAPAROSCOPIC SURGICAL ASSOCIATES (ASLA),CHELSEA PROFESSIONAL SERVICES,HEARTSIDE HEALTH CLINIC,MERCY ADVANTAGE,MERCY HEALTH PHARMACY SOLUTIONS,MERCY HEALTH SERVICES,MERCY MEDICAL CENTER - NOVI,MERCY NORTH OUTPATIENT PHARMACY,MERCY PRIMARY CARE CENTER - DETROIT,MERCY PRIMARY CARE CENTER - DETROIT PHARMACY,MICHIGAN BARIATRIC INSTITUTE (MBI),MICHIGAN CANCER INSTITUTE,MICHIGAN HEART,MICHIGAN STROKE NETWORK,MICHIGAN STROKE NETWORK REGISTRY,SAINT JOSEPH MERCY HEALTH SYSTEM CENTER FOR BEHAVORIAL MEDICINE,SAINT MARY'S ADVANCED SPECIALTY CARE,SAINT MARY'S FAMILY PHARMACY - ECS,SAINT MARY'S LTC PHARMACY,SAINT MARY'S MERCY WOUND CARE CENTER,SJMO ROCHESTER HILLS OB/GYN,SPARTA FAMILY HEALTH CENTER,ST. MARY MERCY HOSPITAL,ST. MARY MERCY ONCOLOGY PRACTICE,ST. MARY MERCY OUTPATIENT PSYCHIATRIC SERVICES,ST. MARY MERCY WOUND CARE CENTER,ANN ARBOR HOME INFUSION PHARMACY,CARE (CONFIDENTIAL ASSISTANCE AND REFERRAL FOR EMPLOYEES),CHELSEA COMMUNITY HOSPITAL,CHELSEA COMMUNITY HOSPITAL CHILDREN'S CENTER,CHELSEA ORTHOPEDIC SPECIALISTS,CHELSEACARE HOME HEALTH,CLINICA SANTA MARIA,CONFIDENTIAL ASSISTANCE AND REFERRAL FOR EMPLOYEES,DEXTER INTERNAL MEDICINE AND PEDIATRICS,EVANGELICAL DEACONESS HOSPITAL,FAMILY MEDICINE OF STOCKBRIDGE,HEALTH EXPLORATION STATION,MERCY HEALTH SERVICES NORTH,MERCY HOSPITAL OUTPATIENT PHARMACY,MERCY MEDICAL GROUP,MERCY OUTPATIENT PHARMACY,MERCY PATHOLOGY,MERCY SURGERY CARE NETWORK,MERCY SURGICAL CARE,MUSKEGON GENERAL HOSPITAL,SAINT JOSEPH MERCY HEALTH NETWORK,SAINT JOSEPH MERCY HEALTH SYSTEM,SAINT MARY'S FAMILY PHARMACY - LTC,SAINT MARY'S FAMILY PHARMACY-CATHEDRAL SQUARE,SAINT MARY'S FAMILY PHARMACY-SOUTHWEST,SAINT MARY'S FAMILY PHARMACY-WEGE CENTER,SAINT MARY'S HEALTH CARE,SAINT MARY'S HEALTH CARE, PROFESSIONAL FINANCIAL SERVICES,SAINT MARY'S MERCY HOSPITAL,SAINT MARY'S MERCY MEDICAL CENTER,SAINT MARY'S MERCY WEGE CENTER,SAINT MARYS'S FAMILY PHARMACY WEGE CENTER FOR HEALTH AND LEARNING,SISTERS OF MERCY HEALTH CORPORATION,SJMHS LIVINGSTON ORTHOPEDIC SURGICAL GROUP,SJMHS ORTHOPEDIC SERVICES,SJMHS SPECIALTY PHYSICIANS,SPORTX,ST. JOE'S MEDICAL GROUP,ST. JOSEPH MERCY - BRIGHTON,ST. JOSEPH MERCY HOSPITAL - SMHC,ST. JOSEPH MERCY HOSPITAL, PONTIAC,ST. JOSEPH MERCY OAKLAND URGENT CARE-BIRMINGHAM,THE SHOPPE AT SAINT MARY'S,WEST MICHIGAN REGIONAL HEART AND VASCULAR INSTITUTE,WESTSHORE FAMILY MEDICINE,WHITE OAK INN,WOMEN'S HEALTH CENTER,MERCY PHYSICIAN PARTNERS,ST. JOSEPH MERCY PORT HURON - CANCER CENTER,ST. JOSEPH MERCY PORT HURTON,BALD MOUNTAIN DIAGNOSTIC IMAGING,CADILLAC OCCUPATIONAL MEDICINE,HEALTHFIRST MEDICAL CENTER,MERCY CADILLAC ANESTHESIA,MERCY CADILLAC CANCER CENTER,MERCY CADILLAC PHYSICIAN NETWORK,MERCY HOSPITAL GRAYLING D/B/A MERCY HEALTH CANCER CENTER,MERCY PHYSICIAN NETWORK CADILLAC,ST. JOSEPH MERCY PORT HURON,ST. JOSEPH MERCY CHELSEA,CHELSEA COMMUNITY HOSPITAL, A MEMBER OF THE SAINT JOSEPH MERCY HEALTH SYSTEM

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

TRINITY HEALTH - MICHIGAN

Employer identification number

38-2113393

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) OAKLAND HEALTH ALLIANCE LLC 44405 WOODWARD AVE PONTIAC,MI48341 82-2021072	ACCOUNTABLE CARE ORGANIZATION	MI	0	401,364	TRINITY HEALTH-MICHIGAN
(2) SAINT MARY'S PHARMACY LLC 200 JEFFERSON AVE SE GRAND RAPIDS,MI49503 38-3404443	PHARMACY	MI	0	0	TRINITY HEALTH-MICHIGAN
(3) SOUTHEAST MICHIGAN CLINICAL NETWORK LLC 20555 VICTOR PARKWAY LIVONIA,MI48152 47-3856789	ACCOUNTABLE CARE ORGANIZATION	MI	2,197,992	1,655,351	TRINITY HEALTH-MICHIGAN
(4) THE CARE ALLIANCE 36475 FIVE MILE ROAD LIVONIA,MI48154 46-5648536	ACCOUNTABLE CARE ORGANIZATION	MI	0	38,586	TRINITY HEALTH-MICHIGAN
(5) THE SAINT JOSEPH MERCY HEALTH PARTNERS CLINICALLY INT NETWORK PO BOX 995 ANN ARBOR,MI48106 47-1340852	ACCOUNTABLE CARE ORGANIZATION	MI	0	26,371	TRINITY HEALTH-MICHIGAN
(6) WESTERN CARE ALLIANCE LLC 36475 FIVE MILE ROAD LIVONIA,MI48154 46-5620128	ACCOUNTABLE CARE ORGANIZATION	MI	0	951,879	TRINITY HEALTH-MICHIGAN

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS,MI49503 27-2491974	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 114 WOODLAND STREET HARTFORD,CT06105 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)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
(15)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
(16)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
(17)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
(18)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
(19)EMBRACING AGE INC 333 BUTTERNUT DRIVE DEWITT,NY13214 46-1051881	PACE PROGRAM	NY	501(C)(3)	LINE 12B, II	ST JOSEPH'S HEALTH INC	Yes
(20)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
(21)FARREN CARE CENTER INC 114 WOODLAND STREET HARTFORD,CT06105 04-2501711	LONG TERM CARE	MA	501(C)(3)	LINE 3	THE MERCY HOSPITAL INC	Yes
(22)FRANCISCAN ELDERCARE CORPORATION PO BOX 2500 WILMINGTON,DE19805 22-3008680	LONG TERM CARE (INACTIVE)	DE	501(C)(3)	LINE 10	ST FRANCIS HOSPITAL INC	Yes
(23)GLACIER HILLS FOUNDATION 1200 EARHART RD ANN ARBOR,MI48105 20-8072723	FOUNDATION	MI	501(C)(3)	LINE 12A, I	GLACIER HILLS INC	Yes
(24)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
(25)GLEN EDDY INC 1 GLEN EDDY DRIVE NISKAYUNA,NY12309 14-1794150	SENIOR LIVING COMMUNITY	NY	501(C)(3)	LINE 10	LTC (EDDY) INC	Yes
(26)GLOBAL HEALTH MINISTRY 20555 VICTOR PARKWAY LIVONIA,MI48152 42-1253527	HEALTH CARE SERVICES	MI	501(C)(3)	LINE 12A, I	TRINITY HEALTH CORPORATION	Yes
(27)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
(28)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	LOYOLA UNIVERSITY HEALTH SYSTEM	Yes
(29)GOTTLIEB MEMORIAL FOUNDATION 701 WEST NORTH AVENUE MELROSE PARK,IL60160 74-3260011	FOUNDATION	IL	501(C)(3)	LINE 12C, III-FI	N/A		No
(30)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
(31)HACKLEY LIFE COUNSELING 125 E SOUTHERN AVENUE MUSKEGON,MI49442 38-1386362	HEALTH CARE SERVICES	MI	501(C)(3)	LINE 10	MERCY HEALTH PARTNERS	Yes
(32)HAWTHORNE RIDGE INC 30 COMMUNITY WAY EAST GREENBUSH,NY12061 80-0102840	SENIOR LIVING COMMUNITY	NY	501(C)(3)	LINE 10	LTC (EDDY) INC	Yes
(33)HEART CENTER OF GREATER WATERBURY INC 114 WOODLAND STREET HARTFORD,CT06105 83-0416893	MANAGEMENT	CT	501(C)(3)	LINE 12A, I	N/A		No
(34)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
(35)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
(36)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
(37)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
(38)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
(39)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
(40)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
(41)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
(42)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
(43)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
(44)HOSPICE OF SIOUXLAND 4300 HAMILTON BLVD SIOUX CITY,IA51104 38-3320710	HOSPICE SERVICES	IA	501(C)(3)	LINE 12A, I	N/A		No
(45)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
(46)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
(47)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
(48)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
(49)LIFE AT LOURDES INC 2475 MCCLELLAN AVENUE PENNSAUKEN,NJ08109 26-1854750	PACE PROGRAM	NJ	501(C)(3)	LINE 3	TRINITY HEALTH PACE	Yes
(50)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 INC	Yes
(51)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
(52)LIFE ST JOSEPH OF THE PINES INC 100 GOSSMAN DRIVE SOUTHERN PINES,NC28387 27-2159847	PACE PROGRAM	NC	501(C)(3)	LINE 3	TRINITY HEALTH PACE	Yes
(53)LIFE ST MARY 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 26-2976184	PACE PROGRAM	PA	501(C)(3)	LINE 10	ST MARY MEDICAL CENTER	Yes
(54)LOURDES ANCILLARY SERVICES 1600 HADDON AVENUE CAMDEN,NJ08103 22-2568525	HEALTH CARE SYSTEM SUPPORT	NJ	501(C)(3)	LINE 12B, II	OUR LADY OF LOURDES HEALTH CARE SERVICES	Yes
(55)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
(56)LOYOLA MEDICINE TRANSPORT LLC 905 W NORTH AVE MELROSE PARK,IL60160 47-4147171	TRANSPORTATION SERVICES	IL	501(C)(3)	LINE 10	LOYOLA UNIVERSITY MEDICAL CENTER	Yes
(57)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
(58)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
(59)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
(60)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
(61)MAXIS HEALTH SYSTEM 3805 WEST CHESTER PIKE STE 100 NEWTOWN SQUARE,PA19073 91-1940902	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	PA	501(C)(3)	LINE 12A, I	TRINITY HEALTH CORPORATION	Yes
(62)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
(63)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
(64)MCAULEY MINISTRIES 3333 FIFTH AVENUE PITTSBURGH,PA15213 94-3436142	GRANT MAKING	PA	501(C)(3)	LINE 12B, II	PITTSBURGH MERCY HEALTH SYSTEM INC	Yes
(65)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
(66)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
(67)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
(68)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	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(69)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
(70)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
(71)MERCY FOUNDATION INC 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-3227350	FOUNDATION	IL	501(C)(3)	LINE 7	MERCY HEALTH SYSTEM OF CHICAGO	Yes
(72)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
(73)MERCY HEALTH FOUNDATION OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 23-2829864	FOUNDATION	PA	501(C)(3)	LINE 12B, II	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(74)MERCY HEALTH NETWORK INC 1449 NW 128TH ST BLDG 5 CLIVE,IA50325 42-1478417	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	DE	501(C)(3)	LINE 12B, II	N/A		No
(75)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
(76)MERCY HEALTH PLAN ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 22-2483605	MEDICAID MANAGED CARE PLAN	PA	501(C)(3)	LINE 12B, II	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(77)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
(78)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
(79)MERCY HEALTHCARE FOUNDATION - CLINTON 1410 N 4TH ST CLINTON,IA52732 42-1316126	FOUNDATION	IA	501(C)(3)	LINE 7	N/A		No
(80)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
(81)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	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(82)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
(83)MERCY HOSPITAL CADILLAC FOUNDATION 1820 44TH ST SE KENTWOOD,MI49508 20-3357131	FOUNDATION	MI	501(C)(3)	LINE 12A, I	TRINITY HEALTH-MICHIGAN	Yes
(84)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
(85)MERCY LIFE OF ALABAMA PO BOX 7957 MOBILE,AL36670 27-3163002	PACE PROGRAM	AL	501(C)(3)	LINE 3	TRINITY HEALTH PACE	Yes
(86)MERCY LIFE INC 1221 MAIN STREET SUITE 213 HOLYOKE,MA01040 45-3086711	PACE PROGRAM	MA	501(C)(3)	LINE 3	TRINITY HEALTH PACE	Yes
(87)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
(88)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
(89)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
(90)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
(91)MERCY MEDICAL CORPORATION PO BOX 7957 MOBILE,AL36670 63-6002215	PACE PROGRAM	AL	501(C)(3)	LINE 10	TRINITY HEALTH CORPORATION	Yes
(92)MERCY MEDICAL GROUP INC 114 WOODLAND STREET HARTFORD,CT06105 45-4884805	HEALTH CARE SERVICES	MA	501(C)(3)	LINE 3	THE MERCY HOSPITAL INC	Yes
(93)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	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(94)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
(95)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
(96)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
(97)MERCY SPECIALIST PHYSICIANS INC 114 WOODLAND STREET HARTFORD,CT06105 26-4033168	HEALTH CARE SERVICES	MA	501(C)(3)	LINE 3	THE MERCY HOSPITAL INC	Yes
(98)MERCY SUBURBAN HOSPITAL ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 23-1396763	HEALTH CARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(99)MISSION HEALTH CORPORATION 37595 SEVEN MILE ROAD LIVONIA,MI48152 38-3181557	BUILDING MANAGEMENT SERVICES	DE	501(C)(3)	LINE 12A, I	N/A		No
(100)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
(101)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
(102)MOUNT CARMEL HEALTH PLAN OF IDAHO INC 6150 EAST BROAD STREET COLUMBUS,OH43213 83-1422704	MEDICARE HMO	ID	501(C)(4)	N/A	MOUNT CARMEL HEALTH PLAN INC	Yes
(103)MOUNT CARMEL HEALTH PLAN OF NEW YORK INC 6150 EAST BROAD STREET COLUMBUS,OH43213 83-3278543	MEDICARE HMO	NY	501(C)(4)		MOUNT CARMEL HEALTH PLAN INC	Yes
(104)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
(105)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	Yes
(106)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
(107)MOUNT SINAI HOSPITAL FOUNDATION INC 114 WOODLAND STREET HARTFORD,CT06105 22-2584082	FOUNDATION	CT	501(C)(3)	LINE 12C, III-FI	N/A		No
(108)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
(109)MOUNT ST JOSEPH 7 HIGHTOWER STREET WATERVILLE,ME04901 01-0274998	LONG TERM CARE	ME	501(C)(3)	LINE 3	MERCY COMMUNITY HEALTH INC	Yes
(110)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
(111)MUSKEGON COMMUNITY HEALTH PROJECT 565 W WESTERN AVENUE MUSKEGON,MI49440 91-1932918	COMMUNITY OUTREACH	MI	501(C)(3)	LINE 7	MERCY HEALTH PARTNERS	Yes
(112)NAZARETH HEALTH CARE FOUNDATION 2701 HOLME AVENUE PHILADELPHIA,PA19152 23-2300951	FOUNDATION	PA	501(C)(3)	LINE 12A, I	NAZARETH HOSPITAL	Yes
(113)NAZARETH HOSPITAL 2601 HOLME AVENUE PHILADELPHIA,PA19152 23-2794121	HEALTH CARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(114)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
(115)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
(116)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
(117)OAKLAND MERCY HOSPITAL FOUNDATION 601 E 2ND STREET OAKLAND,NE68045 31-1678345	FOUNDATION	NE	501(C)(3)	LINE 12A, I	OAKLAND MERCY HOSPITAL	Yes
(118)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
(119)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
(120)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
(121)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
(122)PIONEER VALLEY CARDIOLOGY ASSOCIATES INC 114 WOODLAND STREET HARTFORD,CT06105 45-4208896	HEALTH CARE SERVICES	MA	501(C)(3)	LINE 3	THE MERCY HOSPITAL INC	Yes
(123)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
(124)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
(125)PROFESSIONAL MED TEAM 965 FORK STREET MUSKEGON,MI49442 38-2638284	HEALTH CARE SERVICES	MI	501(C)(3)	LINE 10	MERCY HEALTH PARTNERS	Yes
(126)RIVERBEND MEDICAL GROUP INC 114 WOODLAND STREET HARTFORD,CT06105 81-1807730	HEALTH CARE SERVICES	MA	501(C)(3)	LINE 3	THE MERCY HOSPITAL INC	Yes
(127)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
(128)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
(129)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
(130)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
(131)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
(132)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
(133)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
(134)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
(135)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
(136)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
(137)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
(138)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
(139)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
(140)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
(141)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
(142)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
(143)SAINT JOSEPH PACE INC 20555 VICTOR PARKWAY LIVONIA,MI48152 47-3129127	PACE PROGRAM	IN	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(144)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
(145)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
(146)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
(147)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
(148)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
(149)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
(150)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
(151)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
(152)SAINT MARY'S FOUNDATION 200 JEFFERSON ST SE GRAND RAPIDS,MI49503 38-1779602	FOUNDATION	MI	501(C)(3)	LINE 7	TRINITY HEALTH-MICHIGAN	Yes
(153)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
(154)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
(155)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
(156)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
(157)SENIOR CARE CONNECTION INC 504 STATE STREET SCHENECTADY,NY12305 14-1708754	PACE PROGRAM	NY	501(C)(3)	LINE 10	LTC (EDDY) INC	Yes
(158)SETON AUXILIARY INC 1300 MASSACHUSETTS AVENUE TROY,NY12180 14-1505031	VOLUNTEER SERVICE AUXILIARY	NY	501(C)(3)	LINE 10	SETON HEALTH SYSTEM INC	Yes
(159)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
(160)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
(161)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
(162)SISTERS OF PROVIDENCE CARE CENTERS INC 114 WOODLAND STREET HARTFORD,CT06105 22-2541103	LONG TERM CARE	MA	501(C)(3)	LINE 3	THE MERCY HOSPITAL INC	Yes
(163)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
(164)ST AGNES CONTINUING CARE CENTER ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN,PA19428 23-2840137	PACE PROGRAM	PA	501(C)(3)	LINE 3	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(165)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
(166)ST FRANCIS FOUNDATION PO BOX 2500 WILMINGTON,DE19805 51-0374158	FOUNDATION	DE	501(C)(3)	LINE 12A, I	ST FRANCIS HOSPITAL INC	Yes
(167)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
(168)ST FRANCIS MEDICAL ASSOCIATES PA 601 HAMILTON AVENUE TRENTON,NJ08629 83-2199054	HEALTH CARE SERVICES	NJ	501(C)(3)	LINE 3	ST FRANCIS MEDICAL CENTER TRENTON NJ	Yes
(169)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
(170)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
(171)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
(172)ST JOSEPH MERCY CHELSEA INC 775 S MAIN ST CHELSEA,MI48118 82-4757260	MEDICAL SERVICES	MI	501(C)(3)	LINE 3	TRINITY HEALTH-MICHIGAN	Yes
(173)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
(174)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
(175)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
(176)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
(177)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
(178)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
(179)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
(180)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
(181)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
(182)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
(183)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
(184)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
(185)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
(186)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
(187)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
(188)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
(189)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
(190)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
(191)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
(192)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
(193)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
(194)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
(195)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
(196)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
(197)SUNNYVIEW HOSPITAL AND REHABILITATION CENTER FOUNDATION INC 1270 BELMONT AVE SCHENECTADY,NY12308 22-2505127	FOUNDATION	NY	501(C)(3)	LINE 7	SUNNYVIEW HOSPITAL AND REHABILITATION CENTER	Yes
(198)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
(199)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
(200)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
(201)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
(202)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
(203)THE MERCY HOSPITAL INC 114 WOODLAND STREET HARTFORD,CT06105 04-3398280	HEALTH CARE AND HOSPITAL SERVICES	MA	501(C)(3)	LINE 3	TRINITY HEALTH OF NEW ENGLAND CORP INC	Yes
(204)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
(205)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
(206)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
(207)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
(208)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
(209)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
(210)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
(211)TRINITY HEALTH - MICHIGAN 20555 VICTOR PARKWAY LIVONIA,MI48152 38-2113393	HEALTH CARE AND HOSPITAL SERVICES	MI	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION		No
(212)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
(213)TRINITY HEALTH LIFE PENNSYLVANIA INC 20555 VICTOR PARKWAY LIVONIA,MI48152 47-5244984	PACE PROGRAM	PA	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(214)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
(215)TRINITY HEALTH OF NEW ENGLAND EMERGENCY MEDICAL SERVICES INC 114 WOODLAND STREET HARTFORD,CT06105 83-3546613	HEALTH CARE SERVICES	CT	501(C)(3)	LINE 10	TRINITY HEALTH OF NEW ENGLAND CORP INC	Yes
(216)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
(217)TRINITY HEALTH OF THE MID-ATLANTIC REGION (FKA MERCY HEALTH SYSTEM OF SEPA) 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
(218)TRINITY HEALTH PACE 20555 VICTOR PARKWAY LIVONIA,MI48152 47-3073124	PACE PROGRAM	MI	501(C)(3)	LINE 12B, II	TRINITY HEALTH CORPORATION	Yes
(219)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
(220)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
(221)VILLA MARY IMMACULATE 301 HACKETT BLVD ALBANY,NY12208 14-1438749	LONG TERM CARE	NY	501(C)(3)	LINE 3	ST PETER'S HOSPITAL	Yes
(222)VIRTUA OUR LADY OF LOURDES HOSPITAL 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
(223)VIRTUA WILLINGBORO HOSPITAL INC 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
(224)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) 2018

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) ADVENT REHABILITATION LLC 607 DEWEY AVENUE SUITE 300 GRAND RAPIDS,MI49504 38-3306673	REHABILITATION THERAPY SERVICES	MI	TRINITY HEALTH-MICHIGAN DBA ST MARY'S HEALTH CARE	RELATED	521,150	4,825,136		No		Yes		50.000 %
(2) BH VENTURE ONE LP 905 WATSON STREET PITTSBURGH,PA15219 38-4098074	REAL ESTATE	PA	N/A
(3) BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1608125	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
(4) CATHERINE HORAN BUILDING ASSOCIATES LP 1221 MAIN STREET SUITE 105 HOLYOKE,MA01040 04-2723429	PROPERTY MANAGEMENT	MA	N/A
(5) CENTENNIAL SURGUNIT LLC 502 CENTENNIAL BLVD SUITE 1 VOORHEES,NJ08043 22-3580847	HEALTH CARE SERVICES	NJ	N/A
(6) CENTER FOR DIGESTIVE CARE LLC 5300 ELLIOTT DRIVE YPSILANTI,MI48197 03-0447062	PROVIDE GASTROINTESTINAL SERVICES	MI	TRINITY HEALTH-MICHIGAN	RELATED	2,352,052	925,872		No			No	51.000 %
(7) CENTRAL NEW JERSEY HEART SERVICES LLC 45 SAPPHIRE DRIVE PRINCETON,NJ08550 20-8525458	CARDIAC PROGRAM	NJ	N/A
(8) CLINTON IMAGING SERVICES LLC 1410 N 4TH STREET CLINTON,IA52732 41-2044739	MRI DIAGNOSTIC SERVICES	IA	N/A
(9) DIAGNOSTIC IMAGING OF SOUTHBURY LLC 385 MAIN STREET SOUTH SOUTHBURY,CT06488 06-1487582	IMAGING CENTER	CT	N/A
(10) FOREST PARK IMAGING LLC 1000 4TH STREET SW MASON CITY,IA50401 13-4365966	X-RAY AND MAMMOGRAPHY SERVICES	IA	N/A
(11) FRANCES WARDE MEDICAL LABORATORY 300 WEST TEXTILE ROAD ANN ARBOR,MI48104 38-2648446	LABORATORY	MI	TRINITY HEALTH-MICHIGAN	UNRELATED	298,481	1,364,333		No		Yes		66.670 %
(12) GATEWAY HEALTH PLAN LP 444 LIBERTY AVE SUITE 2100 PITTSBURGH,PA15222 25-1691945	MEDICAID & MEDICARE/SPECIAL NEEDS MANAGED CARE ORGANIZATION	PA	N/A
(13) GREATER HARTFORD LITHOTRIPSY LLC 114 WOODLAND STREET HARTFORD,CT06105 06-1578891	LITHOTRIPSY SERVICES	CT	N/A
(14) HAWARDEN REGIONAL HEALTH CLINICS LLC 1122 AVENUE L HAWARDEN,IA51023 20-1444339	MEDICAL CLINIC	IA	N/A
(15) HEART INSTITUTE OF ST MARY LLC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 45-4903701	CARDIOVASCULAR SERVICES	PA	N/A
(16) LOYOLA AMBULATORY SURGERY CENTER AT OAKBROOK LP 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM,AL35209 36-4119522	SURGICAL SERVICES	IL	N/A
(17) MAGNETIC RESONANCE SERVICES PARTNERSHIP 1416 SIXTH STREET SW MASON CITY,IA50401 42-1328388	MRI SERVICES	IA	N/A
(18) MASON CITY AMBULATORY SURGERY CENTER LLC 990 4TH STREET SW MASON CITY,IA50401 20-1960348	SURGERY-SAME DAY	IA	N/A
(19) MCE MOB IV LIMITED PARTNERSHIP 6150 EAST BROAD STREET COLUMBUS,OH43213 42-1544707	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
(20) MDRMRI TECHNICAL SERVICES LLC 5640 EAST TAFT ROAD 3770 SYRACUSE,NY13220 16-1590982	MRI SERVICES	NY	N/A
(21) MEDILUCENT MOB I 6150 EAST BROAD STREET COLUMBUS,OH43213 20-4911370	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
(22) MEDWORKS LLC 375 EAST CEDAR STREET NEWINGTON,CT06111 06-1490483	REHABILITATION SERVICES	CT	N/A
(23) MERCY HEART CTR OP SERVICES LLC 1000 4TH STREET SW MASON CITY,IA50401 13-4237594	CARDIOVASCULAR SERVICES	IA	N/A
(24) MERCYMANOR PARTNERSHIP PO BOX 10086 TOLEDO,OH43699 52-1931012	NURSING HOME	PA	N/A
(25) MERCYUSP HEALTH VENTURES LLC 15305 DALLAS PARKWAY STE 1600 LB 28 ADDISON,TX75001 47-1290300	OUTPATIENT SURGERY	IA	N/A
(26) MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1369473	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
(27) NAUGATUCK VALLEY MRI LLC 385 MAIN STREET SOUTH SOUTHBURY,CT06488 06-1239526	IMAGING CENTER	CT	N/A
(28) NAZARETH MEDICAL OFFICE BUILDING ASSOCIATES LP C/O NAZARETH HOSP 2601 HOLME AVE PHILADELPHIA,PA19152 23-2388040	MEDICAL OFFICE BUILDING	PA	N/A
(29) OSWEGO HEALTH HOME CARE LLC 113 SCHUYLER STREET FULTON,NY13069 47-2463736	HOME HEALTH CARE	NY	N/A
(30) PHYSICIANS OUTPATIENT SURGERY CENTER LLC 1000 NE 56TH STREET OAKLAND PARK,FL33334 35-2325646	AMBULATORY SURGERY CENTER	FL	N/A
(31) PRIMARY CARE PHYSICIAN CENTER LLC 2160 SOUTH FIRST AVENUE MAYWOOD,IL75202 36-4038505	OFFICE BUILDING RENTAL	IL	N/A
(32) RADISSON SJH PROPERTIES LLC 5000 CAMPUSWOOD DRIVE SUITE 101 EAST SYRACUSE,NY13057 46-1892799	MEDICAL OFFICE BUILDING	NY	N/A
(33) SAINT AGNESUSP SURGERY CENTERS LLC 15305 DALLAS PARKWAY STE 1600 LB 28 ADDISON,TX75001 36-4896811	MEDICAL SERVICES	CA	N/A
(34) SARMED OUTPATIENT PHARMACY LLC 999 N CURTIS RD STE 102 BOISE,ID83706 51-0483218	PHARMACY	ID	N/A
(35) SIXTY FOURTH STREET LLC 2373 64TH ST STE 2200 BYRON CENTER,MI49315 20-2443646	PROVIDE OUTPATIENT SURGICAL CARE	MI	TRINITY HEALTH-MICHIGAN DBA ST MARY'S HEALTH CARE	RELATED	441,666	1,292,435		No			No	53.940 %
(36) SJLS LLC 7650 SE 27TH ST STE 200 MERCER ISLAND,WA98040 20-1796650	DIALYSIS SERVICES	NY	N/A
(37) SJV MANAGEMENT LLC 200 CENTURY PKWY STE 200E MOUNT LAUREL,NJ08054 20-2273476	RADIOLOGY	NJ	N/A
(38) SMMC MOB II LP 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 36-4559869	INVESTMENT AND OPERATION OF A MEDICAL BUILDING	PA	N/A
(39) ST AGNES LONG-TERM INTENSIVE CARE LLP C/O MHS ONE WEST ELM ST STE 100 CONSHOHOCKEN,PA19428 20-0984882	LONG TERM INTENSIVE CARE	PA	N/A
(40) ST ALPHONSUS CALDWELL CANCER CTR LLC 3123 MEDICAL DR CALDWELL,ID83605 82-0526861	HEALTH CARE SERVICES	ID	N/A
(41) ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1603660	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
(42) ST JOSEPH'S IMAGING ASSOCIATES PLLC 104 UNION AVE SUITE 905 SYRACUSE,NY13203 16-1104293	RADIOLOGY SERVICES	NY	N/A
(43) ST MARY REHABILITATION HOSPITAL LLP 680 SOUTH FOURTH STREET LOUISVILLE,KY40202 27-3938747	HEALTH CARE SERVICES	DE	N/A
(44) ST PETER'S AMBULATORY SURGERY CENTER LLC 1375 WASHINGTON AVENUE STE 201 ALBANY,NY12206 46-0463892	OUTPATIENT SURGERY	NY	N/A
(45) THE AMBULATORY SURGERY CENTER AT ST MARY LLC 1203 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 27-2871206	OUTPATIENT SURGERY	PA	N/A
(46) TRINITY HEALTH OF NEW ENGLAND ACO LLC 95 WOODLAND STREET 4TH FLOOR HARTFORD,CT06105 83-3165256	ACCOUNTABLE CARE ORGANIZATION	CT	N/A
(47) WOODLAND IMAGING CENTER LLC 5301 E HURON RIVER DR ANN ARBOR,MI48106 76-0820959	RADIOLOGY/ IMAGING	MI	TRINITY HEALTH-MICHIGAN	RELATED	717,380	2,365,040		No			No	51.000 %
(48) WOODLAND PARTNERS REAL ESTATE LLC 129 WOODLAND STREET HARTFORD,CT06105 83-3371094	REAL ESTATE	CT	N/A

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) CALIFORNIA HEALTHCARE MANAGEMENT PARTERS INC 1303 E HERNDON AVE FRESNO,CA93720 82-0961647	MANAGEMENT SERVICES	CA	N/A	C				Yes
(2) CATHERINE HORAN BUILDING CORPORATION 114 WOODLAND STREET HARTFORD,CT06105 04-2938160	BUILDING MANAGEMENT	MA	N/A	C				Yes
(3) CENTRAL VALLEY HEALTH PLAN INC 1303 E HERNDON AVE FRESNO,CA93720 61-1846844	HEALTH INSURANCE	CA	N/A	C				Yes
(4) DIVERSIFIED COMMUNITY SERVICES INC 114 WOODLAND STREET HARTFORD,CT06105 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 114 WOODLAND STREET HARTFORD,CT06105 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) HACKLEY HEALTH MANAGEMENT INC 1820 44TH STREET SE KENTWOOD,MI49508 38-2961814	WEIGHT MANAGEMENT	MI	N/A	C				Yes
(12) HACKLEY HEALTH VENTURES INC 1820 44TH STREET SE KENTWOOD,MI49508 38-2589959	OTHER MEDICAL SERVICES	MI	N/A	C				Yes
(13) HACKLEY HEALTHCARE EQUIPMENT CORP 1820 44TH STREET SE KENTWOOD,MI49508 38-2578569	HOME MEDICAL EQUIPMENT	MI	N/A	C				Yes
(14) HACKLEY PROFESSIONAL PHARMACY INC 1820 44TH STREET SE KENTWOOD,MI49508 38-2447870	PHARMACY	MI	N/A	C				Yes
(15) HEALTH CARE MANAGEMENT ADMINISTRATORS INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT,NY13214 16-1450960	HEALTH CARE MANAGEMENT	NY	N/A	C				Yes
(16) HEALTH MANAGEMENT SERVICES ORG INC 500 GROVE STREET SUITE 100 HADDON HEIGHTS,NJ08035 22-3366580	MEDICAL ADMINISTRATION	NJ	N/A	C				Yes
(17) HOLY CROSS PRIVATE HOME SERVICES CORP 1500 FOREST GLEN RD SILVER SPRING,MD20910 52-1986562	HOME CARE SERVICES	MD	N/A	C				Yes
(18) HURON ARBOR CORPORATION 5301 EAST HURON RIVER DR ANN ARBOR,MI48106 38-2475644	PROVIDES OFFICE RENTAL SPACE	MI	N/A	C				Yes
(19) IHA AFFILIATION CORPORATION 24 FRANK LLOYD WRIGHT DR LOBBY J ANN ARBOR,MI48106 38-3188895	MEDICAL MANAGEMENT	MI	N/A	C				Yes
(20) LANGHORNE SERVICES II INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 26-3795549	GENERAL PARTNER OF LMOB PARTNERS, II	PA	N/A	C				Yes
(21) LANGHORNE SERVICES INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2625981	GENERAL PARTNER OF LMOB PARTNERS	PA	N/A	C				Yes
(22) LOURDES MEDICAL ASSOCIATES PA 500 GROVE STREET SUITE 100 HADDON HEIGHTS,NJ08035 22-3361862	MEDICAL SERVICES	NJ	N/A	C				Yes
(23) LOURDES URGENT CARE SERVICES PC 1600 HADDON AVENUE CAMDEN,NJ08103 46-4188202	URGENT CARE CENTER	NJ	N/A	C				Yes
(24) MACNEAL HEALTH PROVIDERS INC 750 PASQUINELLI DRIVE SUITE 216 WESTMONT,IL60059 36-3361297	MEDICAL SERVICES	IL	N/A	C				Yes
(25) MARYLAND CARE GROUP INC 1500 FOREST GLEN RD SILVER SPRING,MD20910 52-1815313	HEALTH CARE HOLDING	MD	N/A	C				Yes
(26) MCMC EASTWICK INC C/O MHS ONE WEST ELM STREET STE 100 CONSHOHOCKEN,PA19428 23-2184261	MEDICAL OFFICE BUILDINGS	PA	N/A	C				Yes
(27) MEDNOW INC 4300 E FLAMINGO AVE NAMPA,ID83687 82-0389927	MEDICAL SERVICES	ID	N/A	C				Yes
(28) MERCY INPATIENT MEDICAL ASSOCIATES INC 114 WOODLAND STREET HARTFORD,CT06105 04-3029929	MEDICAL SERVICES	MA	N/A	C				Yes
(29) MERCY MEDICAL SERVICES 801 5TH STREET SIOUX CITY,IA51101 42-1283849	PRIMARY CARE PHYSICIANS	IA	N/A	C				Yes
(30) MERCY SERVICES CORPORATION 2525 SOUTH MICHIGAN AVENUE CHICAGO,IL60616 36-3227348	DORMANT	IL	N/A	C				Yes
(31) MOUNT CARMEL HEALTH PROVIDERS INC 6150 EAST BROAD STREET COLUMBUS,OH43213 31-1382442	MEDICAL SERVICES	OH	N/A	C				Yes
(32) NURSING NETWORK INC 4725 NORTH FEDERAL HIGHWAY FORT LAUDERDALE,FL33308 59-1145192	MEDICAL SERVICES	FL	N/A	C				Yes
(33) PROVIDENCE HOMECARE INC 114 WOODLAND STREET HARTFORD,CT06105 04-3317426	HEALTH CARE SERVICES	MA	N/A	C				Yes
(34) SAINT ALPHONSUS HEALTH ALLIANCE INC 1055 NORTH CURTIS ROAD BOISE,ID83706 82-0524649	ACCOUNTABLE CARE ORGANIZATION	ID	N/A	C				Yes
(35) SAINT ALPHONSUS PHYSICIANS PA 1055 NORTH CURTIS ROAD BOISE,ID83706 33-1078261	HEALTH CARE SERVICES (INACTIVE)	ID	N/A	C				Yes
(36) SAINT FRANCIS BEHAVIORAL HEALTH GROUP PC 114 WOODLAND STREET HARTFORD,CT06105 06-1384686	MEDICAL SERVICES	CT	N/A	C				Yes
(37) SAINT FRANCIS CARE MEDICAL GROUP PC 114 WOODLAND STREET HARTFORD,CT06105 06-1432373	MEDICAL SERVICES	CT	N/A	C				Yes
(38) SAMARITAN MEDICAL OFFICE BUILDING INC 2212 BURDETT AVENUE TROY,NY12180 14-1607244	REAL ESTATE	NY	N/A	C				Yes
(39) SJM PROPERTIES INC 411 CANISTEO STREET HORNELL,NY14843 16-1294991	PROPERTY HOLDINGS	NY	N/A	C				Yes
(40) SJPE PRACTICE MANAGEMENT SERVICES INC 301 PROSPECT AVE SYRACUSE,NY13203 45-4164964	MANAGEMENT SERVICES	NY	N/A	C				Yes
(41) SJRMC HOLDINGS INC 5215 HOLY CROSS PARKWAY MISHAWAKA,IN46545 47-4763735	PROPERTY HOLDINGS	IN	N/A	C				Yes
(42) ST ELIZABETH HEALTH SUPPORT SERVICES INC 23 CAMPION ROAD NEW HARTFORD,NY13413 16-1540486	MEDICAL SERVICES	NY	N/A	C				Yes
(43) SYSTEM COORDINATED SERVICES INC 114 WOODLAND STREET HARTFORD,CT06105 04-2938161	LAB SERVICES	MA	N/A	C				Yes
(44) THRE SERVICES LLC 20555 VICTOR PARKWAY LIVONIA,MI48152 45-2603654	REAL ESTATE BROKERAGE SERVICES	MI	TRINITY HEALTH-MICHIGAN	C		33,466	99.000 %	Yes
(45) TRI-HOSPITAL MRI CENTER 2800 DEQUINDRE WARREN,MI48092 38-2884297	HEALTH CARE SERVICES	MI	TRINITY HEALTH-MICHIGAN	C	-37,624	10,788	55.000 %	Yes
(46) TRINITY ASSURANCE LTD PO BOX 1159 GRAND CAYMAN GRAND CAYMAN CJ 98-0453602	SELF-INSURANCE	CJ	N/A	C				Yes
(47) TRINITY HEALTH ACO INC 20555 VICTOR PARKWAY LIVONIA,MI48152 47-3794666	ACCOUNTABLE CARE ORGANIZATION	DE	N/A	C				Yes
(48) TRINITY HEALTH EMPLOYEE BENEFIT TRUST 20555 VICTOR PARKWAY LIVONIA,MI48152 38-3410377	GRANTOR TRUST	MI	N/A	T				Yes
(49) TRINITY SENIOR SERVICES MANAGEMENT INC PO BOX 9184 FARMINGTON HILLS,MI48333 37-1572595	SENIOR SERVICES	PA	N/A	C				Yes
(50) 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) 2018

Page 3

Part V

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) PROBILITY THERAPY SERVICES	P	57,315	PER BOOKS
(2) PROBILITY THERAPY SERVICES	Q	504,529	PER BOOKS
(3) IHA HEALTH SERVICES CORPORATION	C	566,573	PER BOOKS
(4) IHA HEALTH SERVICES CORPORATION	L	183,622	PER BOOKS
(5) IHA HEALTH SERVICES CORPORATION	M	28,566,755	PER BOOKS
(6) IHA HEALTH SERVICES CORPORATION	P	33,056,556	PER BOOKS
(7) IHA HEALTH SERVICES CORPORATION	Q	6,991,591	PER BOOKS
(8) WOODLAND IMAGING CENTER LLC	K	627,568	PER BOOKS
(9) WOODLAND IMAGING CENTER LLC	L	103,873	PER BOOKS
(10) WOODLAND IMAGING CENTER LLC	M	5,314,507	PER BOOKS
(11) WOODLAND IMAGING CENTER LLC	Q	1,132,058	PER BOOKS
(12) HURON ARBOR CORPORATION	C	29,193,718	PER BOOKS
(13) HURON ARBOR CORPORATION	K	1,471,085	PER BOOKS
(14) HURON ARBOR CORPORATION	Q	1,347,418	PER BOOKS
(15) TRINITY CONTINUING CARE SERVICES	Q	917,921	PER BOOKS
(16) TRINITY HEALTH CORPORATION	B	51,964,485	PER BOOKS
(17) TRINITY HEALTH CORPORATION	L	502,866	PER BOOKS
(18) TRINITY HEALTH CORPORATION	M	218,200,542	PER BOOKS
(19) TRINITY HEALTH CORPORATION	P	56,862,590	PER BOOKS
(20) TRINITY HEALTH CORPORATION	Q	21,245,092	PER BOOKS
(21) TRINITY HEALTH CORPORATION	R	32,598,640	PER BOOKS
(22) MERCY HEALTH PARTNERS	L	4,108,537	PER BOOKS
(23) MERCY HEALTH PARTNERS	P	165,107	PER BOOKS
(24) MERCY HEALTH PARTNERS	Q	9,710,217	PER BOOKS
(25) MERCY HEALTH PARTNERS	S	1,363,673	PER BOOKS
(26) SIXTY FOUTH STREET LLC	C	329,681	PER BOOKS
(27) ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP	L	133,320	PER BOOKS
(28) ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP	P	482,791	PER BOOKS
(29) ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP	Q	2,197,773	PER BOOKS
(30) SAINT MARY'S FOUNDATION	B	990,759	PER BOOKS
(31) SAINT MARY'S FOUNDATION	C	1,177,357	PER BOOKS
(32) SAINT MARY'S FOUNDATION	Q	181,968	PER BOOKS
(33) CENTER FOR DIGESTIVE CARE LLC	C	2,411,702	PER TAX RETURN
(34) WOODLAND IMAGING CENTER LLC	B	1,613,867	PER TAX RETURN
(35) WOODLAND IMAGING CENTER LLC	C	2,096,120	PER TAX RETURN
(36) ADVENT REHABILITATION LLC	B	4,165,845	PER TAX RETURN
(37) ADVENT REHABILITATION LLC	C	415,000	PER TAX RETURN
(38) FRANCES WARDE MEDICAL LABORATORY	C	205,764	PER TAX RETURN
(39) SIXTY FOUTH STREET LLC	C	329,676	PER TAX RETURN
(40) CATHERINE MCAULEY HEALTH SERVICES CORP	B	77,922,082	PER BOOKS
(41) CATHERINE MCAULEY HEALTH SERVICES CORP	L	267,286	PER BOOKS
(42) ST JOSEPH MERCY CHELSEA INC	B	111,208,521	PER BOOKS
(43) ST JOSEPH MERCY CHELSEA INC	L	10,376,086	PER BOOKS
(44) ST JOSEPH MERCY CHELSEA INC	M	402,051	PER BOOKS
(45) ST JOSEPH MERCY CHELSEA INC	P	373,598	PER BOOKS
(46) ST JOSEPH MERCY CHELSEA INC	Q	90,304,687	PER BOOKS
(47) TRINITY HEALTH ACO INC	S	4,864,186	PER BOOKS
(48) WOODLAND IMAGING CENTER LLC	C	2,096,120	PER TAX RETURN
(49) WOODLAND IMAGING CENTER LLC	B	1,613,867	PER TAX RETURN
(50) CENTER FOR DIGESTIVE CARE LLC	C	2,411,702	PER TAX RETURN
(51) ADVENT REHABILITATION LLC	C	415,000	PER TAX RETURN
(52) ADVENT REHABILITATION LLC	B	4,165,845	PER TAX RETURN
(53) WARD LAB MEDICAL LABORATORY	C	205,764	PER TAX RETURN
(54) MISSION HEALTH CORPORATION	S	250,000	PER BOOKS
(55) MISSION HEALTH CORPORATION	K	118,507	PER BOOKS

Schedule R (Form 990) 2018

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	13
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	20,176
6	Total number of volunteers (estimate if necessary) .............	6	1,312
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	58,816,189
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	21,854,490	38,069,376
9	Program service revenue (Part VIII, line 2g) .........	2,591,042,025	2,490,975,826
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	66,997,232	65,357,818
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	89,884,696	76,919,522
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	2,769,778,443	2,671,322,542
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	3,810,522	4,161,851
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)	1,109,117,133	1,092,824,171
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 3,781,280
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,388,015,319	1,369,864,701
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,500,942,974	2,466,850,723
19	Revenue less expenses. Subtract line 18 from line 12.......	268,835,469	204,471,819
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	3,702,529,144	3,727,484,444
21	Total liabilities (Part X, line 26).............	1,207,204,934	1,151,941,640
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,495,324,210	2,575,542,804

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 2,347,333,793 including grants of $ 4,161,851 ) (Revenue $ 2,493,764,653 )
	TRINITY HEALTH-MICHIGAN (TH-MI), A HEALTH CARE AND HOSPITAL SYSTEM, HAS BEEN A LEADER IN PATIENT CARE FOR MORE THAN 100 YEARS, COMMITTED TO THE QUALITY CARE OF PATIENTS AND THEIR FAMILIES. TH-MI OPERATES FIVE HOSPITALS ACROSS MICHIGAN, CONTAINING 1,533 STAFFED BEDS, AS WELL AS OUTPATIENT HEALTH CENTERS, URGENT CARE FACILITIES, PHYSICIAN OFFICES AND SPECIALTY CENTERS, AND COMMUNITY OUTREACH SITES. DURING FISCAL YEAR 2019, TH-MI HOSPITALS' EMPLOYEES, PHYSICIANS AND VOLUNTEERS PROVIDED OVER 399,000 DAYS OF CARE, AND PROVIDED HEALTH CARE SERVICES FOR OVER 2.8 MILLION OUTPATIENT VISITS, AND OVER 318,000 EMERGENCY ROOM VISITS.TH-MI OPERATES MERCY PRIMARY CARE CENTER IN DETROIT, PROVIDING MEDICAL SERVICES TO UNINSURED AND UNDERINSURED ADULTS, AS WELL AS SPECIAL PERSONAL ASSISTANCE SERVICES TO THE HOMELESS, INCLUDING SHOWERS AND CLEAN CLOTHING, AND ASSISTANCE IN ACCESSING EXISTING COMMUNITY PROGRAMS FOR HOUSING AND SUBSTANCE ABUSE TREATMENT.IN FISCAL 2019, TH-MI HOSPITALS PROVIDED OVER $142 MILLION IN UNCOMPENSATED BENEFITS TO THE COMMUNITY. TH-MI IS ACTIVELY ENGAGED IN THE COMMUNITY THROUGH BUSINESS, CIVIC AND SERVICE ORGANIZATIONS, AND THROUGH ITS FINANCIAL SUPPORT OF OTHER NOT-FOR-PROFIT ORGANIZATIONS AND SOCIAL SERVICES AGENCIES.PLEASE VISIT SCHEDULE H AND OUR WEBSITES FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES, RECOGNITIONS AND AWARDS: WWW.STJOESHEALTH.ORG AND WWW.MERCYHEALTH.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 expenses2,347,333,793

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	6,872,405	21,671,208	3,243,709

1a	Federated campaigns..		1a	50,651
b	Membership dues..		1b
c	Fundraising events..		1c	1,336,647
d	Related organizations		1d	3,573,987
e	Government grants (contributions)		1e	6,457,464

f	All other contributions, gifts, grants, and similar amounts not included above		1f	26,650,627

g	Noncash contributions included in lines 1a - 1f:$ 126,643
h Total. Add lines 1a-1f.......		38,069,376

		Business Code
2a	NET PATIENT SERVICE REVENUE	622110	2,307,793,656	2,307,793,656
b	PHARMACY REVENUE	446110	158,998,470	122,713,799	36,284,671
c	LABORATORY REVENUE	621500	24,183,700	1,654,526	22,529,174
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		2,490,975,826

3 Investment income (including dividends, interest, and othersimilar amounts) ......			30,598,384			30,598,384
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		9,870,690
b	Less: rental expenses		8,562,358
c	Rental income or (loss)		1,308,332
d	Net rental income or (loss)......			1,308,332			1,308,332
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	432,373	34,673,427
b	Less: cost or other basis and sales expenses	346,366	0
c	Gain or (loss)	86,007	34,673,427
d	Net gain or (loss).....			34,759,434			34,759,434
8a	Gross income from fundraising events (not including $ 1,336,647of contributions reported on line 1c). See Part IV, line 18 ....
	a		473,049
b	Less: direct expenses ...b		823,558
c	Net income or (loss) from fundraising events..			-350,509			-350,509
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a		4,961,736
b	Less: cost of goods sold ..b		2,799,119
c	Net income or (loss) from sales of inventory..			2,162,617			2,162,617
Business Code			Miscellaneous Revenue
11a	CAFETERIA REVENUE		722514	12,194,066			12,194,066
b	PROVIDER INCENTIVE		622110	4,518,307	4,518,307
c	GOV'T SUBSIDY-EHR		622110	122,986	122,986
d	All other revenue ....			56,963,723	56,961,379	2,344
e	Total. Add lines 11a–11d ......			73,799,082
12	Total revenue. See Instructions......			2,671,322,542	2,493,764,653	58,816,189	80,672,324

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	4,056,366	4,056,366
2	Grants and other assistance to domestic individuals. See Part IV, line 22	105,485	105,485
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	9,621,729		9,621,729
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	1,232,717	162,772	1,069,945
7	Other salaries and wages	913,006,942	860,849,309	50,097,947	2,059,686
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	28,171,536	26,591,465	1,580,071
9	Other employee benefits .......	77,701,421	72,950,945	4,538,513	211,963
10	Payroll taxes ...........	63,089,826	58,850,156	4,099,256	140,414
11	Fees for services (non-employees):
a	Management ......	489,397	457,528	31,869
b	Legal .........	2,302,630		2,302,630
c	Accounting ...........	1,053		1,053
d	Lobbying ...........	160,257		160,257
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	2,600,018		2,600,018
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	174,765,958	167,680,618	5,920,273	1,165,067
12	Advertising and promotion ....	11,797,490	11,026,023	768,027	3,440
13	Office expenses .......	22,868,933	21,306,979	1,484,155	77,799
14	Information technology ......	96,052,577	89,797,649	6,254,928
15	Royalties ..
16	Occupancy ...........	47,062,296	43,968,047	3,062,630	31,619
17	Travel ............	2,010,215	1,868,226	130,133	11,856
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	3,311,880	3,079,176	214,483	18,221
20	Interest ...........	31,693,621	31,693,621
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	135,084,886	126,283,201	8,796,359	5,326
23	Insurance ...	12,630,969	11,808,442	822,527
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	510,923,547	510,923,547
b	I/C PURCHASED SERVICES	129,144,856	120,734,765	8,409,878	213
c	HOSPITAL PROVIDER TAX	68,280,362	68,280,362
d	BAD DEBT EXPENSE	62,294,139	62,294,139
e	All other expenses	56,389,617	52,564,972	3,768,969	55,676
25	Total functional expenses. Add lines 1 through 24e	2,466,850,723	2,347,333,793	115,735,650	3,781,280
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			5,758,136	1	3,813,145
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......			7,807,043	3	28,923,402
4	Accounts receivable, net .............			308,888,889	4	297,587,498
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....			85,384,924	7	151,870,232
8	Inventories for sale or use ........			40,081,816	8	38,687,447
9	Prepaid expenses and deferred charges ......			14,986,861	9	17,681,142
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	2,729,261,441
b	Less: accumulated depreciation	10b	1,595,051,736	1,199,148,565	10c	1,134,209,705
11	Investments—publicly traded securities .			1,047,018,621	11	1,103,701,481
12	Investments—other securities. See Part IV, line 11 .....			660,049,817	12	696,433,087
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			33,470,101	14	32,277,836
15	Other assets. See Part IV, line 11 ...........			299,934,371	15	222,299,469
16	Total assets. Add lines 1 through 15 (must equal line 34)...			3,702,529,144	16	3,727,484,444

17	Accounts payable and accrued expenses .....	246,444,662	17	250,825,441
18	Grants payable ...		18
19	Deferred revenue .........	55,248,203	19	1,690,502
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..	17,438,732	23	15,649,980
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	888,073,337	25	883,775,717
26	Total liabilities. Add lines 17 through 25..	1,207,204,934	26	1,151,941,640

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	2,437,579,985	27	2,502,772,522
28	Temporarily restricted net assets ...........	38,219,249	28	50,895,938
29	Permanently restricted net assets	19,524,976	29	21,874,344
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	2,495,324,210	33	2,575,542,804
34	Total liabilities and net assets/fund balances ........	3,702,529,144	34	3,727,484,444