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) JOHN LOEWENBERG CHAIRMAN- PARTIAL YEAR THROUGH 4/19	5.0 ................. 0	X	X	0	0
(2) RAMONA THOMAS CLO- PARTIAL YEAR THROUGH 4/19	50.0 ................. 0	X	X	389,962	80,355
(3) MICHAEL MAROONE CHAIRMAN AS OF 5/19	5.0 ................. 0	X	X	0	0
(4) EVAN COLLINS MD DIRECTOR PARTIAL YEAR THROUGH 4/19	5.0 ................. 0	X		0	0
(5) PETER DAYTON MD DIRECTOR PARTIAL YEAR THROUGH 4/19	5.0 ................. 0	X		0	0
(6) LYNN FRANK DIRECTOR PARTIAL YEAR THROUGH 4/19	5.0 ................. 0	X		0	0
(7) ELMIRA GAINEY DIRECTOR PARTIAL YEAR THROUGH 4/19	5.0 ................. 0	X		0	0
(8) MARY-JO HORTON DIRECTOR PARTIAL YEAR THROUGH 4/19	5.0 ................. 0	X		0	0
(9) PAMELA HOUGHTEN DIRECTOR PARTIAL YEAR THROUGH 4/19	5.0 ................. 0	X		0	0
(10) GEORGE RITTERSBACH MD DIRECTOR PARTIAL YEAR THROUGH 4/19	50.0 ................. 0	X		373,788	39,482
(11) JOHN DOODY DIRECTOR PARTIAL YEAR THROUGH 4/19	5.0 ................. 0	X		0	0
(12) PATRICIA NOONAN DIRECTOR PARTIAL YEAR THROUGH 4/19	5.0 ................. 0	X		0	0
(13) THEORA WEBB DIRECTOR AS OF 5/19	5.0 ................. 0	X		0	0
(14) H WILLIAM LICHTENBERGER DIRECTOR AS OF 5/19	5.0 ................. 0	X		0	0
(15) TIFFANY WEAKLEY MD DIRECTOR PARTIAL YEAR THROUGH 4/19	5.0 ................. 0	X		35,250	0
(16) JEFFREY GLICKMAN MD DIRECTOR PARTIAL YEAR THROUGH 4/19	50.0 ................. 0	X		408,031	12,322
(17) HOWARD ROBBINS MD DIRECTOR PARTIAL YEAR THROUGH 4/19	5.0 ................. 0	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)
(18) NANCYANN TAYLOR DIRECTOR PARTIAL YEAR THROUGH 4/19	5.0 .......................50.0	X			0	0	0
(19) WYNNE LEE NUNEZ MD DIRECTOR PARTIAL YEAR THROUGH 4/19	5.0 .......................0	X			0	0	0
(20) GEORGE MCLAIN MD DIRECTOR PARTIAL YEAR THROUGH 4/19	5.0 .......................0	X			0	0	0
(21) FREDERIC SALERNO DIRECTOR AS OF 5/19	1.0 .......................0.0	X			0	0	0
(22) ROBERT E RICH JR DIRECTOR AS OF 5/19	5.0 .......................0	X			0	0	0
(23) WAEL BARSOUM MD DIRECTOR AS OF 5/19	5.0 .......................50.0	X			0	1,137,589	41,001
(24) WAYNE HOCKMEYER PhD DIRECTOR AS OF 5/19	5.0 .......................0	X			0	0	0
(25) BETH MOONEY DIRECTOR AS OF 5/19	5.0 .......................0	X			0	0	0
(26) WILLIAM MACDONALD III DIRECTOR AS OF 5/19	5.0 .......................0	X			0	0	0
(27) MICHAEL PETRAS DIRECTOR AS OF 5/19	5.0 .......................0	X			0	0	0
(28) LEE SCOTT DIRECTOR AS OF 5/19	5.0 .......................0	X			0	0	0
(29) ROBERT WEBER DIRECTOR AS OF 5/19	5.0 .......................0	X			0	0	0
(30) TOMISLAV MIHALJEVIC MD DIRECTOR AS OF 5/19	5.0 .......................50.0	X			0	2,978,003	45,693
(31) JOSEPH IANNOTTI MD DIRECTOR AS OF 5/19	5.0 .......................50.0	X			0	1,045,593	45,228
(32) CHARLES CLEAVER CFO- PARTIAL YEAR THROUGH 4/19	50.0 .......................0		X		610,588	0	159,833
(33) ROBERT LORD PRESIDENT	50.0 .......................1.0		X		945,659	0	311,505
(34) MARIAN WOSSUM CLO PARTIAL YEAR THROUGH 11/18	50.0 .......................0		X		60,183	0	19,832
(35) EDMUND COLLINS CIO- PARTIAL YEAR THROUGH 4/19	50.0 .......................0		X		461,348	0	81,369
(36) MIGUEL COTY CMCO- PARTIAL YEAR THROUGH 4/19	50.0 .......................0		X		346,593	0	85,930
(37) LIBBY FLIPPO CNO- PARTIAL YEAR THROUGH 4/19	50.0 .......................0		X		418,194	0	97,078
(38) ANGIE METCALF CHRO- PARTIAL YEAR THROUGH 3/19	50.0 .......................0		X		433,797	0	98,767
(39) FERNANDO PETRY DO CMO- PARTIAL YEAR THROUGH 4/19	50.0 .......................0		X		509,171	0	110,579
(40) JESSICA MCLAIN CPO- PARTIAL YEAR THROUGH 4/19	1.0 .......................50.0		X		0	320,782	83,652
(41) LAURENCE ROTHSTEIN MD CPGO- PARTIAL YEAR THROUGH 4/19	50.0 .......................0		X		538,470	0	106,436
(42) MICHAEL MOEHRING ASSISTANT TREASURER AS OF 5/19	50.0 .......................0		X		221,194	0	51,042
(43) STEVEN C GLASS CFO & TREASURER AS OF 5/19	5.0 .......................50.0		X		0	1,654,712	42,994
(44) TIMOTHY LONGVILLE CAO & CONTROLLER AS OF 5/19	5.0 .......................50.0		X		0	390,696	18,094
(45) DAVID W ROWAN SECRETARY AS OF 5/19	5.0 .......................50.0		X		0	1,631,352	46,847
(46) BARBARA DEL CASTILLO ASSISTANT SECRETARY AS OF 5/19	5.0 .......................50.0		X		0	495,656	40,768
(47) JASON OBLANDER ASSISTANT SECRETARY AS OF 5/19	5.0 .......................50.0		X		0	213,269	21,244
(48) Daniel Edelman CPO-PARTIAL YEAR THROUGH 3/19	50.0 .......................0		X		408,348	0	39,710
(49) JOHN AFSHAR MD NEUROSURGEON	50.0 .......................0			X	1,598,213	0	161,493
(50) JOHN VIOLA MD PHYSICIAN	50.0 .......................0			X	1,157,804	0	140,493
(51) JOHN ROBINSON MD NEUROSURGEON	50.0 .......................0			X	1,024,978	0	161,493
(52) ALEXANDER DEBONET MD PHYSICIAN	50.0 .......................0			X	622,398	0	76,493
(53) OSZKAR SZENTIRMAI NEUROSURGEON	50.0 .......................0			X	911,443	0	97,239

(A) Name and business address	(B) Description of services	(C) Compensation
DIAGNOSTIC IMAGING SERVICES INC PO BOX 4 STUART,FL34995	RADIOLOGY PROFESSIONAL READS	3,389,349
SOUTHERN SCRIPTS LLC 411 BIENVILLE ST NATCHITOCHES,LA71457	PHARMACY BENEFIT SOLUTIONS	3,209,048
ROBINS & MORTON GROUP 400 SHADES CREEK PKWY BIRMINGHAM,AL35209	CONSTRUCTION	1,334,222
MICHAUD MITTELMARK MARKOWITZ 621 NW 53RD ST 260 BOCA RATON,FL33487	ATTORNEY	891,846
CARDIOLOGY ASSOCIATES OF STUART 1027 SE OCEAN BLVD STUART,FL34996	CARDIOLOGY	746,785
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 18

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

Attach to Form 990 or Form 990-EZ.
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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

Martin Memorial Medical Center Inc

Employer identification number

59-0637874

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:	18007697
Software Version:	2018v3.1

- 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

Martin Memorial Medical Center Inc

Employer identification number

59-0637874

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 Martin Memorial Medical Center Inc

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

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

Page 3

Name of organization Martin Memorial Medical Center Inc		Employer identification number 59-0637874

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 Martin Memorial Medical Center Inc			Employer identification number 59-0637874
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:	18007697
Software Version:	2018v3.1

- 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

Martin Memorial Medical Center Inc

Employer identification number

59-0637874

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). Click to see attachment

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.)		(a) Filing organization's totals	(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................	0	0
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................	59,158	59,158
c	Total lobbying expenditures (add lines 1a and 1b) ...................................................................	59,158	59,158
d	Other exempt purpose expenditures ........................................................................	516,606,231	521,285,852
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............................................	516,665,389	521,345,010
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.	1,000,000	1,000,000
	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) .................................................	250,000	250,000
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................	0	0
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................	0	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	1,000,000	1,000,000	1,000,000	1,000,000	4,000,000

b	Lobbying ceiling amount (150% of line 2a, column(e))					6,000,000

c	Total lobbying expenditures	65,557	69,960	68,176	59,158	262,851

d	Grassroots nontaxable amount	250,000	250,000	250,000	250,000	1,000,000

e	Grassroots ceiling amount (150% of line 2d, column (e))					1,500,000

f	Grassroots lobbying expenditures	0	0	0	0	0

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

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

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

(a)

Yes

(b)

Amount

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

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

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

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

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

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

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

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

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

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

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

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
Schedule C, Part II-A Description of lobbying	Martin Health System has retained the services of consultants in Tallahassee for the purpose of monitoring legislative and regulatory healthcare-related issues that might affect it or the community it serves, and communicating the System's views on those issues to appropriate elected officials and regulators.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:	18007697
Software Version:	2018v3.1

- 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

Martin Memorial Medical Center Inc

Employer identification number

59-0637874

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 ....	10,267,340	8,249,523	7,098,167	6,480,115	6,742,012
b	Contributions ...	72,523	2,019,361	915,974	203,324	16,254
c	Net investment earnings, gains, and losses	-658,982	506,875	727,298	597,404	-82,356
d	Grants or scholarships ...	358,635	508,419	491,916	182,676	195,795
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....					0
g	End of year balance ......	9,322,246	10,267,340	8,249,523	7,098,167	6,480,115

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

Board designated or quasi-endowment SchDMd Bullet

19.9 %

Permanent endowment SchDMd Bullet

31.92 %

Temporarily restricted endowment SchDMd Bullet

48.18 %

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

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

Yes

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

3a(i)

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

3a(ii)

Yes

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

Yes

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

Part VI

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

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

1a	Land .....	23,080,728		23,080,728
b	Buildings ....	358,003,752	171,595,241	186,408,511
c	Leasehold improvements
d	Equipment ....	443,451,745	280,846,570	162,605,175
e	Other .....	22,515,981	9,724,431	12,791,550
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				384,885,964

Schedule D (Form 990) 2018

Page 3

Part VII

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

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

Part VIII

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

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

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

Part IX

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

(a) Description				(b) Book value
(1) Due from affiliates				790,590
(2) Interest receivable				235
(3) Interest in Martin Memorial Foundation				26,415,510
(4) Physician guarantee
(5) Bond issuance cost				447,901
(6) Investment in affiliates				7,624,564
(7) Other assets				2,189,345
(8) Operating lease				17,092,404
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				54,560,549

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
Self insurance reserve	10,322,216
Allowance Insurance Audit	454,158
Asset retirement obligation	1,708,711
Deferred pension
Other liabilities	18,516
Due to affiliates	23,609,247
Operating Lease	17,092,404
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	53,205,252
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

Schedule D, Part V, Line 4 Intended uses of endowment funds

Martin Memorial Foundation, Inc. (a related organization) holds the endowment funds with the intended purpose to support Martin Memorial Medical Center, Inc. ("MMMC"). The funds are used by MMMC for a variety of patient care activities and programs including support of the Cancer Center, support of nursing education, for the purchase of medical equipment, support of the Heart Center, and other general healthcare activities.

Schedule D (Form 990) 2018

Additional Data

Software ID:	18007697
Software Version:	2018v3.1

- 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

Martin Memorial Medical Center Inc

Employer identification number

59-0637874

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 25000 %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			17,836,569	0	17,836,569	3.93 %
b	Medicaid (from Worksheet 3, column a) . . . . .			45,816,909	21,074,584	24,742,325	5.45 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .			0	0	0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	63,653,478	21,074,584	42,578,894	9.37 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			68,327	0	68,327	0.02 %
f	Health professions education (from Worksheet 5) . . .			7,874,147	0	7,874,147	1.73 %
g	Subsidized health services (from Worksheet 6) . . . .			0	0	0	0 %
h	Research (from Worksheet 7) .			0	0	0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			209,926	0	209,926	0.05 %
j	Total. Other Benefits . .	0	0	8,152,400	0	8,152,400	1.79 %
k	Total. Add lines 7d and 7j .	0	0	71,805,878	21,074,584	50,731,294	11.17 %

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	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing					0	0 %
2	Economic development					0	0 %
3	Community support	1	0	442	0	442	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members					0	0 %
6	Coalition building					0	0 %
7	Community health improvement advocacy					0	0 %
8	Workforce development	1	86	64,087	0	64,087	0.01 %
9	Other					0	0 %
10	Total	2	86	64,529	0	64,529	0.01 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

45,224,000

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. ......

11,758,240

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).....

133,653,789

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

171,766,275

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

-38,112,486

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1TREASURE COAST INTEGRATED HEALTHCARE LLC	CLINICALLY INTEGRATED NETWORK	51 %	0 %	49 %
2TRADITION SURGERY CENTER LLC	SURGICAL VENTURES	32.54 %	0 %	48 %
3STUART SURGERY CENTER	SURGICAL VENTURES	45.88 %	0 %	26 %
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?3Name, 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)					Facility reporting group
1	MARTIN MEMORIAL MEDICAL CENTER 200 HOSPITAL AVE STUART,FL34994 www.martinhealth.org 4102	X	X	X	a
2	CLEVELAND CLINIC TRADITION HOSPITAL 10000 SW INNOVATION WAY PORT ST LUCIE,FL34987 WWW.MARTINHEALTH.ORG 4102	X	X	X	a
3	CLEVELAND CLINIC MARTIN SOUTH HOSPITAL 2100 SE SALERNO ROAD STUART,FL34997 WWW.MARTINHEALTH.ORG 4102	X	X	X	a

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)

	a
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...............

Yes

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

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

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

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

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

Hospital facility’s website (list url):

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

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

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

If "Yes" (list url):

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

10b

Yes

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)

	a
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 250.0% and FPG family income limit for eligibility for discounted care of 400.0%

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):

https://www.martinhealth.org/patient-financial-assistance-policy

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

https://www.martinhealth.org/patient-financial-assistance-policy

A plain language summary of the FAP was widely available on a website (list url):
https://www.martinhealth.org/patient-financial-assistance-policy

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

	a
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)

	a
Name of hospital facility or letter of facility reporting group

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 2	On January 1, 2019, the Medical Center was acquired by The Cleveland Clinic Foundation through non-cash business combination transactions.
Schedule H, Part V, Section B, Line 3E	The significant health needs of the community are included and prioritized within the CHNA.
Schedule H, Part V, Section B, Line 5 Facility a, 1	Facility a, 1 - MARTIN MEMORIAL MEDICAL CENTER. MARTIN MEMORIAL ENGAGED WITH CARNAHAN GROUP TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT; IN ADDITION THERE WAS A DESIGNATED ASSOCIATE THAT HELPED TO COORDINATE THE ENTIRE PROCESS. INFORMATION WAS GATHERED BY CONDUCTING INTERVIEWS WITH INDIVIDUALS REPRESENTING COMMUNITY HEALTH AND PUBLIC SERVICE ORGANIZATIONS INCLUDING THE UNITED WAY OF MARTIN AND ST. LUCIE COUNTY, COUNTY HEALTH DEPARTMENTS, SCHOOL HEALTH SERVICES, MEDICAL PROFESSIONALS: INCLUDING PHYSICIANS, HOSPITAL ADMINISTRATION, OTHER HOSPITAL STAFF, AND ORGANIZATIONS WHOSE MISSION IS TO SERVE THE MEDICALLY UNDERSERVED AND LOW INCOME POPULATIONS IN THE COMMUNITY TO OBTAIN A DIVERSE AND ACCURATE REPRESENTATION.
Schedule H, Part V, Section B, Line 11 Facility a, 1	Facility a, 1 - MARTIN MEMORIAL MEDICAL CENTER, INC.. MARTIN MEMORIAL IS TAKING A MULTI-FACETED APPROACH TO ADDRESSING THE 6 MAJOR HEALTH DISPARITIES IN OUR COMMUNITY- DIABETES, OBESITY, CANCER, ACCESS AND AFFORDABILITY, MENTAL HEALTH, AND SUBSTANCE ABUSE. WE ARE WORKING WITH COMMUNITY PARTNERS INCLUDING THE LOCAL PUBLIC HEALTH ENTITES AND OTHER NON-PROFIT ORGANIZATIONS ON COMMUNITY-WIDE PROGRAMS TO ADDRESS ACCESS AND OBESITY INITIATIVES. WE HAVE A MULTITUDE OF PROGRAMS FOR DIABETES INCLUDING DIABETES PREVENTION PROGRAMS AND SUPPORT GROUPS, WHICH WE EXPANDED TO SERVE BOTH COUNTIES. WE ARE ENGAGED WITH LOCAL COMMUNITY BASED ORGANIZATIONS IN SOME OF OUR UNDERSERVED NEIGHBORHOODS TO CONDUCT FREE HEALTH SCREENINGS INCLUDING FREE FLU SHOTS IN NEIGHBORHOODS WHERE DIABETES, POOR NUTRITION, OBESITY AND LACK OF RESOURCES ARE PREVALENT. IN ADDITION, WE OFFER PROSTATE SCREENINGS TO THE COMMUNITY AND LAUNCHED A LUNG NAVIGATOR PROGRAM THAT OFFERS A LOW COST LOW DOSE CT PROGRAM TO CATCH LUNG CANCER EARLY. WE CURRENTLY HAVE A COMPREHENSIVE HEALTH MANAGEMENT PROGRAM WHICH IS AN EVIDENCE BASED FREE OF CHARGE PROGRAM THAT TAKES CHRONIC DISEASE PATIENTS AND PLACES THEM IN THE CARE OF PHARMACISTS TO HELP CONTROL THEIR DIABETES, OBESITY AND OTHER COMPLICATED DISEASES. WE PARTNER WITH OUR LOCAL VOLUNTEERS IN MEDICINE CLINIC TO PROVIDE FREE FITNESS MEMBERSHIPS TO THE PEOPLE THAT USE THEIR SERVICES TO ADDRESS OBESITY. ALTHOUGH WE DO NOT OFFER MENTAL HEALTH OR SUBSTANCE ABUSE SERVICES WITHIN OUR HEALTH SYSTEM, WE HAVE CREATED PARTNERSHIPS WITH OTHER PROVIDERS OF THOSE SERVICES TO ENHANCE COMMUNITY EDUCATION AND AWARENESS ON MENTAL HEALTH, SUICIDE AND SUBSTANCE ABUSE ISSUES. AS THE SUBSTANCE ABUSE EPIDEMIC HAS SPREAD TO OUR SERVICE AREA WE HAVE JOINED THE TREASURE COAST OPIOID TASK FORCE AND HEAD UP THE HEALTHCARE SUBCOMMITTEE TO WORK ON ADDRESSING THAT NEED. WE CONTINUALLY LOOK FOR OPPORTUNITIES TO GET OUT AND EDUCATE THE COMMUNITY, PROVIDING FREE LECTURES ON HEALTH RELATED TOPICS TO A MULTITUDE OF ENTITIES THROUGHOUT THE COMMUNITY. CARING FOR THE COMMUNITY IS AT THE CENTER OF WHAT WE DO.

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?33
Name and address		Type of Facility (describe)
1	Martin Rehabilitation Center 11602 SE Federal Hwy Hobe Sound,FL33455	Rehabilitation Center
2	Martin Bariatric and Metabolic Surgery Center 3496 NW Federal Hwy Jensen Beach,FL34957	Morbid obesity consulting
3	Martin Medical Health & Fitness 11602 SE Federal Hwy Hobe Sound,FL33455	Medically directed fitness center.
4	David L Smythe Wound Center 314 Hospital Ave Stuart,FL34994	Wound Care Center
5	Martin Pediatric and Aquatics Therapy 3496 NW Federal Hwy Jensen Beach,FL34957	Pediatric Rehabilitation Center
6	MMMC Pediatric Rehab 1095 NW St Lucie W Blvd Port St Lucie,FL34986	Pediatric Rehabilitation Center
7	Martin Rehabilitation Center 509 Riverside Drive Stuart,FL34994	Rehabilitation Center
8	East Ocean Lab Drawing Station 2392 SE Ocean Blvd Stuart,FL34996	blood draw station
9	MMMC Wound Center 1095 NW St Lucie W Blvd Port St Lucie,FL34984	Wound Care Center
10	MARTIN MEMORIAL MEDICAL CENTER 1095 ST LUCIE WEST BLVD PORT ST LUCIE,FL34986	EMERGENCY ROOM
11	Martin Rehabilitation Center 1095 SW St Lucie West Blvd Port St Lucie,FL34986	Rehabilitation Center
12	Richard C Raub Rehabilitation Center 2195 SE Ocean Blvd Stuart,FL34996	Rehabilitation Center
13	Martin Medical Radiation Oncology 1095 SW St Lucie West Blvd Port St Lucie,FL34986	Radiation Oncology Treatment Center
14	Martin Medical Health & Fitness 3066 SW Martin Downs Blvd Palm City,FL34950	Medically directed fitness center.
15	Martin Rehabilitation Center 6001 SE Tower Drive Stuart,FL34997	Rehabilitation Center
16	Martin Medical Outpatient Surgery Center 509 Riverside Drive Stuart,FL34995	Outpatient surgery department
17	Martin Medical Back and Spine Center 10050 SW Innovation Way Port St Lucie,FL34986	Neurosurgeons office.
18	Martin Rehabilitation Center 3066 SW Martin Downs Blvd Palm City,FL34950	Rehabilitation Center
19	St Lucie West lab Drawing Station 1095 SW St Lucie West Blvd Port St Lucie,FL34986	Blood draw station
20	Martin Occupational Health Services 2384 E Ocean Blvd Stuart,FL34996	MartinOccupational Health Services
21	Robert and Carol Weissman Cancer Center 501 Osceola Street Stuart,FL34994	Cancer Center
22	Martin Medical Sleep Disorders Center 3066 SW Martin Downs Blvd Palm City,FL34950	Sleep Disorders Center
23	Martin Medical Back and Spine Center 509 Riverside Drive Stuart,FL34994	Neurosurgeons offices
24	Martin Medical Health & Fitness 3496 NW Federal Hwy Jensen Beach,FL34957	Medically directed fitness center.
25	Palm City Lab Drawing Station 3066 SW Martin Downs Blvd Palm City,FL34950	Blood draw station
26	Martin Medical Cardio Rehab 308 Hospital Ave Stuart,FL34994	Cardiac care rehabilitation
27	Martin Rehabilitation Center 1651 SE Tiffany Port St Lucie,FL34952	Rehabilitation Center
28	Port St Lucie Lab Drawing Station 1651 SE Tiffany Port St Lucie,FL34952	Blood draw station
29	Martin Medical Health & Fitness 6001 SE Tower Drive Stuart,FL34997	Medically directed fitness center.
30	Martin Chronic Disease 2150 SE Salerno Road Stuart,FL34997	CHRONIC DISEASE CENTER
31	LAB DRAWING STATION- TRADITION MEDICAL CENTER 10050 SW INNOVATION WAY PORT ST LUCIE,FL34987	BLOOD DRAW STATION
32	TREASURE COAST MEDICAL PAVILION FOR HEALTH AND HEALING 3496 NW FEDERAL HWY SUITE F JENSEN BEACH,FL34957	HEALTH AND HEALING
33	STUART SURGERY CENTER 2096 SE OCEAN BLVD STUART,FL34996	SURGICAL

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
Schedule H, Part V, Section B, Line 3	On January 1, 2019, the Medical Center was acquired by The Cleveland Clinic Foundation through non-cash business combination transactions. As pursuant to the exception for acquired hospitals in Treasury Regulation § 1.501(r)-3(d)(1), Martin's next community health needs assessment will be due with the return ending 12/31/2020.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	45224000
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	The cost-to-charge ratio derived from worksheet 2 was used for these calculations.
Schedule H, Part II Community Building Activities	Martin Memorial has programs targeted at addressing community-wide workforce issues. Martin Memorial joined with the Martin County School District to form Project Search, which is a one year high school transition program. It is offered through the school district and provides training and education which leads to possible employment for individuals with disabilities. It serves as a workforce alternative for students ages 18-21 in their last year of high school, or students 18-21 that graduated with a special diploma. We provide a training classroom, a business liaison, and a rotational internship for on the job training for all participants. In addition to Project Search we have workforce development programs that are school-based programs focused on healthcare careers. Students are able to come in and learn about healthcare careers and job shadow in critical national shortage areas.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	MARTIN MEMORIAL ACCOUNTS FOR BAD DEBT EXPENSE USING A RESERVE METHODOLOGY WHICH ESTIMATES HISTORICAL WRITE-OFFS AS A PERCENTAGE OF PATIENT ACCOUNTS RECEIVABLE. THE ESTIMATED BAD DEBT ON CURRENT ACCOUNTS WHICH WILL BE WRITTEN OFF IN FUTURE PERIODS IS ACCRUED AS EXPENSE IN THE INCOME STATEMENT AND IS EVALUATED MONTHLY. BAD DEBT EXPENSE IS REPORTED AT GROSS IN ACCORDANCE WITH FINANCIAL STATEMENT PRESENTATION IN THE SEPTEMBER 30, 2019 AUDITED FINANCIAL STATEMENTS.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	The Medical Center attempts to qualify all non-insured patients for Medicaid or other means-tested programs. Any patient that is ineligible for Medicaid or other means-tested programs and does not have insurance is classified as self pay. The bad debt is primarily based on unpaid self pay balances. Martin does not use any portion of bad debt in its financial assistance calculation. Martin estimates that 20 percent of the bad debt expense is attributable to patients who may have qualified for financial assistance if it was possible to obtain sufficient information to determine their eligibility. Martin Memorial considers this portion of bad debt to be community benefit.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Below is the text of the footnote from the organization's audited financial statements that discusses bad debt expense. Patient accounts receivable are reduced by an allowance for estimated uncollectible accounts. In evaluating the collectability of accounts receivable, the Medical Center analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for estimated uncollectible accounts and provision for uncollectible accounts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for estimated uncollectible accounts. For receivables associated with services provided to patients who have third-party insurance coverage, the Medical Center analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Medical Center records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The Medical Center regularly performs hindsight procedures to evaluate historical write-off and collection experience throughout the year to assist in determining the reasonableness of its process for estimating the allowance for uncollectible accounts. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for estimated uncollectible accounts.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	Martin Memorial's mission is to serve the health care needs of its patients within the community. Martin Memorial considers the provision of care to patients, despite reporting a Medicare operating shortfall, to be a community benefit. The shortfall of $38,112,486 represents unreimbursed services to members of our community. These services are a vital part of the health care Martin Memorial provides to these patients. Only by providing these services below cost are we able to meet the needs of these patients. The data used to determine the revenue and cost amounts came directly from the Medicare Cost Report.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	Martin Memorial interviews potential financial assistance patients/guarantors to determine the payment sources, ascertain whether a referral for a medical economic social payment source is advisable or determine if the patient qualifies for financial assistance. Martin Memorial looks at the patients' income, family size, and other pertinent financial indicators, such as the amount of medical bills. Martin Memorial uses the State of Florida HCCB Charity/Uncompensated Care Guidelines (250% of the current Federal Poverty Guidelines) as a threshold for granting financial assistance. In certain instances where medical indigency is ascertained, financial assistance would be approved for cases that exceed the HCCB income threshold guidelines. After the interview, if full or partial payment is not anticipated, the account is converted to a financial assistance status, and will not be considered bad debt. Once converted to financial assistance the patient is not expected to make payments and is not pursued for payment. If the patient is known to be under a current financial assistance provision, the computer system alerts MMMC and the system adjusts the balance so that the patient is not billed.
Schedule H, Part V, Section B, Line 16a FAP website	a - MARTIN MEMORIAL MEDICAL CENTER: Line 16a URL: https://www.martinhealth.org/patient-financial-assistance-policy;
Schedule H, Part V, Section B, Line 16b FAP Application website	a - MARTIN MEMORIAL MEDICAL CENTER: Line 16b URL: https://www.martinhealth.org/patient-financial-assistance-policy;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	a - MARTIN MEMORIAL MEDICAL CENTER: Line 16c URL: https://www.martinhealth.org/patient-financial-assistance-policy;
Schedule H, Part VI, Line 2 Needs assessment	Identifying the health care needs of our communities is imperative so that we can best serve our residents and provide them with exceptional care. Our Community Health Needs Assessment was extremely helpful in identifying the local needs that are priority areas that we can address. As a hospital system It showed us the opportunities where we are able to fill those gaps. Some of the ways that we assess those needs, in addition to the Community Health Needs Assessment, are to stay active and engaged with other organizations that directly serve these vulnerable populations. Examples of these are the quarterly Community Conversations in Martin County, led by the United Way of Martin County and representing over 50 organizations county-wide. The Council of Social Agencies in St. Lucie also has a very similar goal of bringing these organizations together. Hurricane preparedness, dental and oral hygiene for our pediatric age groups, to obesity and nutrition classes for the homeless population are some of the topics that were discussed. By having these open conversations many needs are able to be discussed and change can then be facilitated. Additionally, the hospital system attends monthly meetings for the Inter-Agency Coalition and Healthy St. Lucie. We collaborate with these groups to enhance our knowledge and reach. The hospital system continues to evaluate and collaborate to meet the ever-changing needs of the residents and community members in the areas that we serve.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Financial assistance programs are posted in the lobbies of the three emergency departments, admitting areas and written on patient statements and billing. Information is also available on Martin Memorial's website and all collection notices also contain information about financial assistance. Estimates for procedures are provided to the patients upon request and are available in Spanish and Creole in addition to English.
Schedule H, Part VI, Line 4 Community information	Martin Memorial serves Martin County and portions of St. Lucie County, a population of approximately 368,983. Most of the area has traditionally been a retirement community, with a substantial population of seasonal residents. However, substantial growth in St. Lucie County has included many younger families who live there year-round. Our 2016 Community Health Needs Assessment showed that within five years substantial population growth is expected among residents ages 65 and older (13.4%) along with a slight population growth of individuals aged 20-44 (3.6%). In Martin County, nearly 30% of Martin County residents are over age 65 and in Port St. Lucie, only 21% are older than 65. The most common race/ethnicity in Martin Memorial's community is white (64.95%) followed by Hispanic (16.6%) and black/African American (14.7%). Substantial population growth is expected for Hispanics (12.1%). Median household income is $51,703 in Martin County and $42,665 in St. Lucie County. In Martin County 12% of individuals live below the poverty line and in St. Lucie County 18.4% of individuals live below the poverty line. The percentage of children living below poverty level -Martin County: 19.2%, St. Lucie County: 28.2%. St. Lucie County has a slightly higher incidence of children living in poverty than the state average of 24.1%. Martin Memorial Medical Center is the only hospital in Martin County, Florida. Martin Memorial opened our third hospital, Tradition Medical Center, in December 2013 in Western St. Lucie County. In October 2017 the Tradition Medical Center expansion was completed, which doubled our number of beds available for patients.
Schedule H, Part VI, Line 5 Promotion of community health	Martin Memorial has a multifaceted approach to promoting community health. Our board of directors is comprised of community members seeking to ensure we provide access to high-quality care. Throughout the year, Martin Memorial provides free or low-cost educational opportunities and health screenings which are aimed at disease prevention and target the underserved population in the community. In January 2014 we were one of the first hospitals in the area to launch a Comprehensive Health Management program that focuses on patients with severe chronic diseases which focuses on managing complicated diseases to improve their health and quality of life. This current program is unable to be reimbursed from any type of insurance and is completely free of charge to people referred into this program. The organization also offers free support groups for patients and family members that are facing ongoing management of chronic diseases. Martin Memorial associates provide countless hours of volunteer service to not-for-profit agencies and organizations, with an emphasis on those with a mission to enhance community health. Martin Memorial offers numerous sponsorships intended to promote the health and well-being of our communities, including the support of two local free health clinics that help the medically underserved population. Martin Memorial is collaborating with local community organizations to create programs that promote the overall health of the community and county wide health initiatives. We have worked with the health departments in both Martin and St. Lucie County to develop a community wide plan that focuses on healthy lifestyle. In addition, a majority of the governing body of Martin Memorial is comprised of people who reside in the organization's primary service area and who are neither employees, independent contractors, nor family members thereof. In addition, the organization extends medical staff privileges to all qualified physicians in the community. Martin Memorial periodically conducts a physician needs assessment that reviews the makeup of both our medical staff as well as the physician community in our service area as a whole. This provides an overview of what physician specialties may be needed in our community.
Schedule H, Part VI, Line 6 Affiliated health care system	Martin Memorial belongs to a group of affiliated companies that provide diagnostic and ambulance services to the local community and fundraising for the benefit of Martin Memorial Medical Center. Martin Memorial also has for-profit affiliates providing physician services to the local community as well as billing and collection services for the affiliated companies. There are limited partnerships that own medical office buildings which primarily house affiliated companies' medical offices and clinics as well as an affiliation with ambulatory surgery centers. On Jan 1, 2019 we became affiliated with Cleveland Clinic. We now continue to work to serve our communities in the most impactful way. Community is a designated care priority for Cleveland Clinic Martin Health.

Schedule H (Form 990) 2018

Additional Data

Software ID:	18007697
Software Version:	2018v3.1

- TIN:

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

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Martin Memorial Medical Center Inc

Employer identification number
59-0637874

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) HANDS OF ST LUCIE COUNTY 3855 US-1 FT PIERCE,FL34982	26-3945016	501(C)(3)	12,500	0	N/A	N/A	HEALTHCARE

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) HEALTH CARE FOR INDIGENT PATIENTS	210	187,491	0	N/A	N/A
(2) SHELTER / TRANSPORTATION / FOOD	460	109,168	0	N/A	N/A
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	Health care assistance is provided to oncology patients that have a financial need including help paying for medical expenses, food, shelter and transportation. The organization's Social Services Department also assists indigent patients that are being discharged with pharmacy items. Grants are closely monitored and assessments are made to ensure they are used for the intended purposes.

Schedule I (Form 990) 2018

Additional Data

Software ID:	18007697
Software Version:	2018v3.1

- 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

Martin Memorial Medical Center Inc

Employer identification number

59-0637874

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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)
1RAMONA THOMAS CLO- PARTIAL YEAR THROUGH 4/19	(i) (ii)	237,085 ------------- 0	152,877 ------------- 0	0 ------------- 0	48,947 ------------- 0	31,408 ------------- 0	470,317 ------------- 0	0 ------------- 0
2GEORGE RITTERSBACH MD DIRECTOR PARTIAL YEAR THROUGH 4/19	(i) (ii)	273,782 ------------- 0	100,006 ------------- 0	0 ------------- 0	0 ------------- 0	39,482 ------------- 0	413,270 ------------- 0	0 ------------- 0
3JEFFREY GLICKMAN MD DIRECTOR PARTIAL YEAR THROUGH 4/19	(i) (ii)	328,582 ------------- 0	79,449 ------------- 0	0 ------------- 0	0 ------------- 0	12,322 ------------- 0	420,353 ------------- 0	0 ------------- 0
4WAEL BARSOUM MD DIRECTOR AS OF 5/19	(i) (ii)	0 ------------- 1,039,904	0 ------------- 0	0 ------------- 97,685	0 ------------- 27,500	0 ------------- 13,501	0 ------------- 1,178,590	0 ------------- 0
5TOMISLAV MIHALJEVIC MD DIRECTOR AS OF 5/19	(i) (ii)	0 ------------- 2,678,622	0 ------------- 0	0 ------------- 299,381	0 ------------- 27,500	0 ------------- 18,193	0 ------------- 3,023,696	0 ------------- 0
6JOSEPH IANNOTTI MD DIRECTOR AS OF 5/19	(i) (ii)	0 ------------- 950,469	0 ------------- 0	0 ------------- 95,124	0 ------------- 27,500	0 ------------- 17,728	0 ------------- 1,090,821	0 ------------- 0
7CHARLES CLEAVER CFO- PARTIAL YEAR THROUGH 4/19	(i) (ii)	416,532 ------------- 0	128,971 ------------- 0	65,085 ------------- 0	117,091 ------------- 0	42,742 ------------- 0	770,421 ------------- 0	63,116 ------------- 0
8ROBERT LORD PRESIDENT	(i) (ii)	660,019 ------------- 0	285,513 ------------- 0	127 ------------- 0	271,528 ------------- 0	39,977 ------------- 0	1,257,164 ------------- 0	0 ------------- 0
9EDMUND COLLINS CIO- PARTIAL YEAR THROUGH 4/19	(i) (ii)	296,777 ------------- 0	108,311 ------------- 0	56,260 ------------- 0	41,385 ------------- 0	39,984 ------------- 0	542,717 ------------- 0	56,260 ------------- 0
10MIGUEL COTY CMCO- PARTIAL YEAR THROUGH 4/19	(i) (ii)	233,625 ------------- 0	88,293 ------------- 0	24,675 ------------- 0	48,728 ------------- 0	37,202 ------------- 0	432,523 ------------- 0	24,576 ------------- 0
11LIBBY FLIPPO CNO- PARTIAL YEAR THROUGH 4/19	(i) (ii)	320,631 ------------- 0	97,563 ------------- 0	0 ------------- 0	58,616 ------------- 0	38,462 ------------- 0	515,272 ------------- 0	0 ------------- 0
12ANGIE METCALF CHRO- PARTIAL YEAR THROUGH 3/19	(i) (ii)	301,532 ------------- 0	94,369 ------------- 0	37,896 ------------- 0	56,237 ------------- 0	42,530 ------------- 0	532,564 ------------- 0	37,797 ------------- 0
13FERNANDO PETRY DO CMO- PARTIAL YEAR THROUGH 4/19	(i) (ii)	395,826 ------------- 0	112,545 ------------- 0	800 ------------- 0	67,837 ------------- 0	42,742 ------------- 0	619,750 ------------- 0	0 ------------- 0
14JESSICA MCLAIN CPO- PARTIAL YEAR THROUGH 4/19	(i) (ii)	0 ------------- 213,406	0 ------------- 107,255	0 ------------- 121	0 ------------- 59,659	0 ------------- 23,993	0 ------------- 404,434	0 ------------- 0
15LAURENCE ROTHSTEIN MD CPGO- PARTIAL YEAR THROUGH 4/19	(i) (ii)	260,625 ------------- 0	126,613 ------------- 0	151,232 ------------- 0	69,095 ------------- 0	37,341 ------------- 0	644,906 ------------- 0	19,028 ------------- 0
16MICHAEL MOEHRING ASSISTANT TREASURER AS OF 5/19	(i) (ii)	167,967 ------------- 0	53,227 ------------- 0	0 ------------- 0	8,949 ------------- 0	42,093 ------------- 0	272,236 ------------- 0	0 ------------- 0
17STEVEN C GLASS CFO & TREASURER AS OF 5/19	(i) (ii)	0 ------------- 1,508,404	0 ------------- 0	0 ------------- 146,308	0 ------------- 24,583	0 ------------- 18,411	0 ------------- 1,697,706	0 ------------- 0
18TIMOTHY LONGVILLE CAO & CONTROLLER AS OF 5/19	(i) (ii)	0 ------------- 374,996	0 ------------- 0	0 ------------- 15,700	0 ------------- 185	0 ------------- 17,909	0 ------------- 408,790	0 ------------- 0
19DAVID W ROWAN SECRETARY AS OF 5/19	(i) (ii)	0 ------------- 1,480,468	0 ------------- 0	0 ------------- 150,884	0 ------------- 27,500	0 ------------- 19,347	0 ------------- 1,678,199	0 ------------- 0
20BARBARA DEL CASTILLO ASSISTANT SECRETARY AS OF 5/19	(i) (ii)	0 ------------- 472,572	0 ------------- 0	0 ------------- 23,084	0 ------------- 27,483	0 ------------- 13,285	0 ------------- 536,424	0 ------------- 0
21JASON OBLANDER ASSISTANT SECRETARY AS OF 5/19	(i) (ii)	0 ------------- 209,595	0 ------------- 0	0 ------------- 3,674	0 ------------- 5,837	0 ------------- 15,407	0 ------------- 234,513	0 ------------- 0
22Daniel Edelman CPO-PARTIAL YEAR THROUGH 3/19	(i) (ii)	320,413 ------------- 0	87,577 ------------- 0	358 ------------- 0	15,900 ------------- 0	23,810 ------------- 0	448,058 ------------- 0	0 ------------- 0
23JOHN AFSHAR MD NEUROSURGEON	(i) (ii)	847,082 ------------- 0	660,147 ------------- 0	90,984 ------------- 0	119,400 ------------- 0	42,093 ------------- 0	1,759,706 ------------- 0	90,984 ------------- 0
24JOHN VIOLA MD PHYSICIAN	(i) (ii)	794,229 ------------- 0	263,372 ------------- 0	100,203 ------------- 0	98,400 ------------- 0	42,093 ------------- 0	1,298,297 ------------- 0	100,203 ------------- 0
25JOHN ROBINSON MD NEUROSURGEON	(i) (ii)	845,154 ------------- 0	83,725 ------------- 0	96,099 ------------- 0	119,400 ------------- 0	42,093 ------------- 0	1,186,471 ------------- 0	96,099 ------------- 0
26ALEXANDER DEBONET MD PHYSICIAN	(i) (ii)	396,926 ------------- 0	225,093 ------------- 0	379 ------------- 0	34,400 ------------- 0	42,093 ------------- 0	698,891 ------------- 0	0 ------------- 0
27OSZKAR SZENTIRMAI NEUROSURGEON	(i) (ii)	830,451 ------------- 0	80,992 ------------- 0	0 ------------- 0	42,802 ------------- 0	54,437 ------------- 0	1,008,682 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments	The nonqualified Defined Benefit SERP Plan has a tax adjustment factor in its benefit calculation.
Schedule J, Part I, Line 4a Severance or change-of-control payment	DR. ROTHSTEIN RECEIVED A SEVERANCE PAYMENT OF $132,204.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	COMPENSATION REPORTED IN THE FORM 990, PARTICULARLY BENEFIT COSTS, MAY BE CONFUSING, ESPECIALLY WHEN MAKING COMPARISONS FROM ONE ORGANIZATION TO ANOTHER OR EVEN FROM ONE YEAR TO ANOTHER FOR THE SAME ORGANIZATION. RETIREMENT BENEFIT COSTS VARY WIDELY DEPENDING ON THE TYPE OF PLAN - DEFINED BENEFIT OR CONTRIBUTION, AND THE AGE AND TENURE OF THE EXECUTIVE. MARTIN MEMORIAL MAINTAINS SEVERAL UNFUNDED SUPPLEMENTAL RETIREMENT PLANS. THE AMOUNT ACCRUED (NOT PAID) WAS $237,128 FOR MR. LORD, $32,828 FOR MR. COTY, $41,385 FOR MR. COLLINS, $40,337 FOR MS. METCALF, $82,691 FOR MR. CLEAVER, $42,716 FOR MS. FLIPPO, $51,937 FOR DR. PETRY, $32,748 FOR MS. MCLAIN, $33,047 FOR MS. THOMAS, $34,695 FOR DR. ROTHSTEIN, $85,000 FOR DR. AFSHAR, $85,000 FOR DR. ROBINSON, $64,000 FOR DR. VIOLA, AND $8,402 FOR DR. SZENTIRMAI. THE FOLLOWING PARTICIPANTS IN THIS PLAN RECEIVED DISTRIBUTIONS: $63,116 FOR MR. CLEAVER, $56,259 FOR MR. COLLINS, $24,576 FOR MR. COTY, $37,797 FOR MS. METCALF, $19,028 FOR DR. ROTHSTEIN, $90,984 FOR DR. AFSHAR, $100,203 FOR DR. VIOLA, AND $96,099 FOR DR. ROBINSON. DR. DEBONET, MR. MOEHRING, MR. SOSKA, MS. CLARK, MS. WOSSUM, AND DR. EDELMAN DO NOT PARTICIPATE IN THESE PLANS. THE FOLLOWING INDIVIDUALS PARTICIPATE IN A NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN AND/OR A QUALIFIED DEFINED BENEFIT PLAN WITH THE CLEVELAND CLINIC FOUNDATION, AND THE ANNUAL INCREASE OR DECREASE IN THE ACTUARIAL VALUE IS INCLUDED IN SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION: STEVEN GLASS- $2,917 DECREASE, JASON OBLANDER- $638 DECREASE, CHRISTOPHER SOSKA- $6,080 DECREASE, AND TIMOTHY LONGVILLE- $27,315 DECREASE.

Schedule J (Form 990) 2018

Additional Data

Software ID:	18007697
Software Version:	2018v3.1

- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Martin Memorial Medical Center Inc

Employer identification number
59-0637874

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Martin County Health Facilities Authority	36-2646523		12-15-2010	24,095,000	Acquisition of medical equipment		X		X		X
B	Martin County Health Facilities Authority	36-2646523		09-24-2013	26,555,000	Refund 5/2007 bond issue		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	6,675,000		8,675,000
2 Amount of bonds legally defeased ..............	0		0
3 Total proceeds of issue ..................	24,242,680		26,555,000
4 Gross proceeds in reserve funds .............	0		0
5 Capitalized interest from proceeds .............	0		0
6 Proceeds in refunding escrows ...............	0		0
7 Issuance costs from proceeds ...............	202,903		0
8 Credit enhancement from proceeds .............	0		0
9 Working capital expenditures from proceeds .............	0		0
10 Capital expenditures from proceeds .............	24,039,777		0
11 Other spent proceeds .............	0		26,555,000
12 Other unspent proceeds .............	0		0
13 Year of substantial completion .............	2013		2013
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X	X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X
16 Has the final allocation of proceeds been made? ..........	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

Part Ⅲ

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

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

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X
b Exception to rebate? ........		X		X
c No rebate due? .........	X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X	X
b Name of provider ..........			Wells Fargo
c Term of hedge .........			2500 %
d Was the hedge superintegrated? ......				X
e Was the hedge terminated? ........				X

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

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

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
Schedule K, Part II, Line 3 Total proceeds of issue	The total proceeds of issue shown in Part II, Line 3 are different than the issue price shown in Part I because the figure in Part II includes investment earnings on the proceeds. This is consistent with the form instructions.
Schedule K, Part IV, Line 2c COLUMN A	Issuer name: Martin County Health Facilities Authority The calculation for computing no rebate due was performed on 11/15/2019
Schedule K, Part IV, Line 2c COLUMN B	Issuer name: Martin County Health Facilities Authority The calculation for computing no rebate due was performed on 11/15/2019

Schedule K (Form 990) 2018

Additional Data

Software ID:	18007697
Software Version:	2018v3.1

- 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

Martin Memorial Medical Center Inc

Employer identification number

59-0637874

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) ANNE LORD	SISTER-IN-LAW OF ROB LORD, OFFICER OF MARTIN MEDICAL CENTER	60,133	COMPENSATION		No
(2) PATRICK FOGARTY	NEPHEW OF ROB LORD, OFFICER OF MARTIN MEDICAL CENTER	44,873	COMPENSATION		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:	18007697
Software Version:	2018v3.1

- 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

Martin Memorial Medical Center Inc

Employer identification number

59-0637874

Return Reference	Explanation
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	GEORGE MCLAIN MD AND JESSICA MCLAIN - Family relationship, CHARLES CLEAVER, EDMUND COLLINS, MIGUEL COTY, LIBBY FLIPPO, ROB LORD, JESSICA MCLAIN, ANGIE METCALF, AND FERNANDO PETRY - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholders	Martin Memorial Health Systems, Inc. a 501(c)(3) tax exempt corporation, is the sole member of Martin Memorial Medical Center, Inc.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	The Member of Martin Memorial Medical Center may select, replace or remove the members of the governing body.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	The Sole Member of the Medical Center expressly reserves the following powers, to be exercised by it in its sole discretion: -To select or replace and to remove, with or without cause, Directors of the Medical Center; and -To amend the Articles of Incorporation; -To amend the Bylaws of the Medical Center; -Adopt any annual or long-term capital or operational budget or any changes therein; -Authorize the Medical Center to enter into any contract or engage in any transaction which is not provided for in an annual or long-term capital or operational budget approved by the Sole Member of the Medical Center where the amount involved exceeds $100,000.00; -Adopt any new, or any changes to the existing, long-term or master institutional plans of the Medical Center; -Authorize the Medical Center to engage in, or enter into, any transaction providing for or requiring a Certificate of Need. However, the President/ CEO of the Medical Center, or the Executive Committee of the Sole Member, may submit a letter of intent and/or an application for a Certificate of Need at any time without prior authorization. The Board of Directors of the Sole Member shall subsequently either ratify the action or vote to withdraw the letter of intent or the application. -Adopt a plan of dissolution of the Medical Center; -Authorize the Medical Center to engage in, or enter into, any transaction providing for the sale, lease, mortgage or other disposition of the assets of the Medical Center not contemplated as part of the capital or operating budget; however, it is understood that this does not preclude the sale of fully depreciated assets, assets to be scrapped and taken out of service, or assets to be traded in on the purchase of new assets approved as part of the budgeting process. -Adopt a plan of merger or consolidation of the Medical Center with another corporation; -Organize or acquire, or authorize the organization or acquisition of, any subsidiary or affiliate of the Medical Center ("affiliate" shall include any corporation, association, partnership, trust, joint venture or other entity directly or indirectly controlling, controlled by, or under common control with the Medical Center).
Form 990, Part VI, Line 11b Review of form 990 by governing body	The Form 990 is reviewed in detail by internal management to ensure the accuracy and completeness of the return prior to filing with the IRS. The Form 990 is made available to all members of the Board of Directors subsequent to the filing of the form.
Form 990, Part VI, Line 12c Conflict of interest policy	The Corporate Compliance Officer surveys each director, officer and key employee of Martin Memorial Medical Center and related affiliated companies. These annual surveys are designed to determine if any potential conflicts of interest exist. The Corporate Compliance officer educates board members, officers and key employees of their responsibility to report any possible conflicts of interest that may arise between annual surveys. The Corporate Compliance Officer also monitors and investigates any possible conflicts that may arise. If a potential or actual conflict of interest exists, the individual with the conflict will abstain from voting on any issues or participating in discussions that are related to the conflict of interest.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	Executive compensation at Martin Memorial Health System ("MMHS") is governed and controlled by the Compensation & Retirement Committee of the Board of Directors according to policies set by the board as a whole. The committee is made up entirely of community leaders, none of whom are employed by Martin Memorial Medical Center ("MMMC"). The committee determines pay levels at MMHS in comparison with other not-for-profit hospitals and health systems like MMHS in size and complexity and which serve similar types of communities. It looks at national data but also takes into consideration data from similar health systems in the Southeast region of the country. The committee reviews comparability data on salary levels, incentive pay, and benefit costs, assessing each element of compensation independently and total compensation in aggregate. The committee retains independent consultants to gather comparability data on executive compensation in the MMHS' peer group. These consultants regularly assist the committee in making its determination that executive compensation at MMHS remains reasonable and consistent with the board-approved MMHS executive compensation philosophy. The committee approves compensation for all listed executives every year. The committee diligently follows best practices in governing executive compensation, including the process prescribed by the IRS for governing executive compensation in the tax-exempt sector. It is committed to accurately disclosing executive compensation on Form 990.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	Compensation of other officers and key employees follows the same process as described in Part VI, Line 15a.
Form 990, Part VI, Line 19 Required documents available to the public	Martin Memorial Medical Center does not make its governing documents, conflict of interest policy, or financial statements available to the public.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	TRANSFER TO AFFILIATE - -33381205; CHANGE IN NET ASSETS HELD AT MARTIN FOUNDATION - -480320; MIN PENSION LIABILITY ADJUSTMENT - -6297878; UNREALIZED LOSS ON SWAP AGREEMENT - -878177; RETIREE HEALTH LIABILITY ADJUSTMENT - 215873; NET ASSETS TEMPORARILY RELEASED - -6516807; CCF TRANSFER TO AFFILIATES - 40276696; RATE RESET ON SWAP - -350795;
990 Part IV Lines 11f and 12b	ON JANUARY 1, 2019, THE MEDICAL CENTER WAS ACQUIRED BY THE CLEVELAND CLINIC FOUNDATION THROUGH NON-CASH BUSINESS COMBINATION TRANSACTIONS. AS A NONRECOGNIZED SUBSEQUENT EVENT, EFFECTIVE JANUARY 1, 2019, THE FINANCIAL RESULTS OF THE MEDICAL CENTER WILL BE INCLUDED IN THE FINANCIAL STATEMENTS OF THE CLEVELAND CLINIC FOUNDATION.

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:	18007697
Software Version:	2018v3.1

- 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

Martin Memorial Medical Center Inc

Employer identification number

59-0637874

Part I

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

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)MARTIN MEMORIAL HEALTH SYSTEMS PO BOX 9033 STUART,FL34995 59-2307522	SUPPORTS MARTIN MEMORIAL MEDICAL CENTER AND COASTAL CARE CORPORATION	FL	501(c)(3)	Type II	NA		No
(2)MARTIN MEMORIAL FOUNDATION PO BOX 9033 STUART,FL349959033 59-2343938	FUNDRAISING	FL	501(c)(3)	7	MMHS		No
(3)COASTAL CARE CORPORATION PO BOX 9033 STUART,FL349959033 59-2333374	HEALTHCARE	FL	501(c)(3)	3	MMHS		No
(4)MARTIN MEMORIAL HOSPITAL AUXILIARY PO BOX 9033 STUART,FL349959033 23-7115443	PROMOTE PURPOSES & ACTIVITIES OF MARTIN MEMORIAL HEALTH SYSTEMS & AFFILIATES	FL	501(c)(3)	10	MMHS		No
(5)COMMUNITY WEST FOUNDATION 800 SHARON DRIVE STE C WESTLAKE,OH44145 34-1456398	ADVANCE THE HEALTH AND WELL-BEING OF THE COMMUNITY	OH	501(c)(3)	7	NA		No
(6)THREE ARCHES FOUNDATION 14601 DETROIT AVENUE STE 240 LAKEWOOD,OH44107 34-6519834	SUPPORT LAKEWOOD HOSPITAL ASSOCIATION	OH	501(c)(3)	Type I	NA		No
(7)NATIONAL HEALTHCARE RESEARCH & EDUCATION FINANCE CORP 2001 ROSS AVENUE DALLAS,TX75201 31-1707979	SUPPORT CHARITABLE PURPOSES OF HOSPITALS & UNIVERSITIES	TX	501(c)(3)	Type III-FI	NA		No
(8)WO WALKER CENTER INC 10700 EUCLID AVENUE CLEVELAND,OH44106 91-1818256	HEALTH CARE SERVICES	OH	501(c)(3)	Type III-FI	NA		No
(9)AUXILIARY BOARD OF FAIRVIEW GENERAL HOSPITAL 18101 LORAIN AVENUE CLEVELAND,OH44111 23-7108198	SUPPORT FAIRVIEW HOSPITAL	OH	501(c)(3)	Type III-O	NA		No
(10)TUSCARAWAS VALLEY REGIONAL CANCER CENTER 659 BOULEVARD DOVER,OH44622 34-0000100	PHYSICIAN HOSPITAL AND ORGANIZATION	OH	501(c)(3)	3	NA		No
(11)UNION HOSPITAL AUXILIARY 659 BOULEVARD DOVER,OH44622 34-1204928	SUPPORT THE UNION HOSPITAL ASSOCIATION	OH	501(c)(3)	10	NA		No
(12)Indian River Memorial Hospital Inc 1000 36th Street Vero Beach,FL32960 59-2496294	Hospital	FL	501(c)(3)	3	NA		No
(13)Health Systems of Indian River Inc 1000 36th Street Vero Beach,FL32960 65-0705680	Healthcare	FL	501(c)(3)	Type II	NA		No
(14)Indian River Health Services Inc 1000 36th Street Vero Beach,FL32960 65-0029298	Healthcare	FL	501(c)(3)	Type I	NA		No
(15)Indian River Hospital Foundation Inc 1000 36th Street Vero Beach,FL32960 59-0760215	Fund Raising	FL	501(c)(3)	Type I	NA		No
(16)Hospital Auxiliary of the Indian River Memorial Hospital Inc 1000 36th Street Vero Beach,FL32960 59-1003707	Supporting	FL	501(c)(3)	Type III-FI	NA		No
(17)THE CLEVELAND CLINIC FOUNDATION 6801 BRECKSVILLE RD RK 1-85 INDEPENDENCE,OH44131 34-0714585	HOSPITAL	OH	501(c)(3)	3	NA		No
(18)CLEVELAND CLINIC FLORIDA REGIONAL HEALTH SYSTEM NONPROFIT CORPORATION 2950 CLEVELAND CLINIC BLVD WESTON,FL33331 83-2249666	SUPPORTING	FL	501(c)(3)	Type II	NA		No

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) MEDICAL CENTER AT ST LUCIE WEST LTD PO BOX 9033 STUART,FL34995 65-0504863	MEDICAL OFFICES	FL	MMMC	Related	662,072	7,446,172		No			No	99 %
(2) MEDICAL CENTER AT HOBE SOUND LTD PO BOX 9033 STUART,FL34995 65-0748232	MEDICAL OFFICES	FL	MMMC	Related	69,324	1,844,181		No			No	99 %
(3) TREASURE COAST INTEGRATED HEALTHCARE LLC PO BOX 9010 STUART,FL34995 82-0708813	CLINICALLY INTEGRATED NETWORK	FL	MMMC	Related	0	256,042		No		Yes		51 %
(4) MARTIN SURGICAL VENTURES LLC 9131 ANSON WAY SUITE 304 RALEIGH,NC27615 32-0496475	SURGICAL VENTURES	NC	MMMC	Related	-448,360	-168,777		No			No	62 %
(5) TRADITION SURGERY CENTER LLC 9131 ANSON WAY SUITE 304 RALEIGH,NC27615 36-4837780	SURGICAL VENTURES	NC	NA	N/A				No
(6) STUART SURGERY CENTER 2096 SE OCEAN BLVD STUART,FL34996 82-2542219	SURGICAL VENTURES	FL	NA	N/A
(7) CCFMHS RENAL CARE COMPANY LTD 9500 EUCLID AVENUE CLEVELAND,OH44195 34-1863789	MEDICAL SERVICES	OH	NA	N/A
(8) CLEVELAND HEALTH NETWORK MSO LLC 4700 ROCKSIDE ROAD STE 200 INDEPENDENCE,OH44131 31-1566180	MEDICAL SERVICES	OH	NA	N/A
(9) PROGNOSTIX LLC 10000 CEDAR AVENUE CLEVELAND,OH44106 30-0624422	MEDICAL SERVICES	OH	NA	N/A
(10) EXCELERATE STRATEGIC HEALTH SOURCING LLC 9500 EUCLID AVENUE CLEVELAND,OH44195 46-1810992	HEALTH CARE OP & MGMT	DE	NA	N/A
(11) AKRON SURGICAL ASSOCIATES LLC 4125 MEDINA ROAD AKRON,OH44333 01-0672877	AMBULATORY SURGERY CENTER	OH	NA	N/A
(12) MEDISTRY LLC 3029 PROSPECT AVENUE CLEVELAND,OH44115 45-4880352	DATA HOSTING & RELATED SVCS	DE	NA	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) MARTIN MEMORIAL PHYSICIAN CORPORATION PO BOX 9010 STUART,FL34995 65-0556041	PHYSICIAN OFFICES	FL	NA	C Corporation					No
(2) MEDICAL & FINANCIAL MANAGEMENT PO BOX 9033 STUART,FL349959033 59-2320501	BILLING AND COLLECTIONS	FL	NA	C Corporation					No
(3) CSC CONDOMINIUM ASSOCIATION PO BOX 9033 STUART,FL34995 59-2843163	CONDOMINIUM ASSOCIATION	FL	MMMC	C Corporation	36,844	368,528	64.42 %	Yes
(4) 33 GROSVENOR PLACE LIMITED	LEASE HOLDING COMPANY	JE	NA	C Corporation					No
(5) AKRON GENERAL INNOVATIONS INC 1 AKRON GENERAL AVENUE AKRON,OH44307 38-3928798	PARTNERSHIP INVESTMENTS	OH	NA	C Corporation					No
(6) AKRON GENERAL MANAGED CARE ASSOCIATION INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 34-1784985	SUPPORTING SERVICES	OH	NA	C Corporation					No
(7) CCF BOLTON INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 20-4596571	BUSINESS SERVICES	OH	NA	C Corporation					No
(8) CCHS INDEMNITY CO LTD 98-0207086	INSURANCE COMPANY	CJ	NA	C Corporation					No
(9) CELLX TECHNOLOGIES INC 10000 CEDAR AVENUE CLEVELAND,OH44106 82-2405500	MEDICAL TECHNOLOGY	DE	NA	C Corporation					No
(10) CLEVELAND CLINIC CANADA-TORONTO INC	HEALTH CARE SERVICES	CA	NA	C Corporation					No
(11) CLEVELAND CLINIC EMR INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 20-4856025	MEDICAL SERVICES	OH	NA	C Corporation					No
(12) CLEVELAND CLINIC HEALTH SYSTEM PHYSICIAN ORGANIZATION 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 34-1877409	MEDICAL SERVICES	OH	NA	C Corporation					No
(13) CLEVELAND CLINIC LONDON LTD	HOSPITAL OPERATING COMPANY	UK	NA	C Corporation					No
(14) CLEVELAND CLINIC SAUDI ARABIA (A LIMITED LIABILITY COMPANY)	MEDICAL SERVICES	SA	NA	C Corporation					No
(15) CLEVELAND CLINIC UK HOLDINGS LTD	HOLDING COMPANY	UK	NA	C Corporation					No
(16) CLEVELAND HEALTH NETWORK 6000 WEST CREEK ROAD STE 20 INDEPENDENCE,OH44131 34-1770780	MEDICAL SERVICES	OH	NA	C Corporation					No
(17) CLEVELAND HEALTH NETWORK MANAGED CARE ORGANIZATION 6000 WEST CREEK ROAD STE 20 INDEPENDENCE,OH44131 34-1808138	HEALTH CARE SERVICES	OH	NA	C Corporation					No
(18) CLINIC MEDICAL SOLUTIONS INC 18101 LORAIN AVENUE CLEVELAND,OH44111 34-1695388	HEALTH CARE SERVICES	OH	NA	C Corporation					No
(19) CMCD INC 1000 E WASHINGTON STREET MEDINA,OH44256 34-1256599	REAL ESTATE	OH	NA	C Corporation					No
(20) CORA SENTA TECHNOLOGIES INC 10000 CEDAR AVENUE CLEVELAND,OH44106 82-4335548	INACTIVE	DE	NA	C Corporation					No
(21) CUSTOM ORTHOPAEDIC SOLUTIONS INC 10000 CEDAR AVENUE CLEVELAND,OH44106 27-4838981	MEDICAL TECHNOLOGY	DE	NA	C Corporation					No
(22) ENHALE MEDICAL INC 10000 CEDAR AVENUE CLEVELAND,OH44106 82-1613340	SLEEP APNEA TREATMENT	DE	NA	C Corporation					No
(23) INFUSEON THERAPEUTICS INC 10000 CEDAR AVENUE CLEVELAND,OH44106 46-1776182	SCIENTIFIC RESEARCH	DE	NA	C Corporation					No
(24) ION-VAC INC 10000 CEDAR AVENUE CLEVELAND,OH44106 46-1560044	SCIENTIFIC RESEARCH	DE	NA	C Corporation					No
(25) LAKEWOOD HEALTHCARE FOUNDATION 14519 DETROIT AVENUE LAKEWOOD,OH44107 34-1574608	HEALTH CARE SERVICES	OH	NA	C Corporation					No
(26) MCZ INC 1000 E WASHINGTON STREET MEDINA,OH44256 34-1256598	LEASING	OH	NA	C Corporation					No
(27) MEDINVEST INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 20-3978297	INACTIVE	OH	NA	C Corporation					No
(28) MERIDIA HEALTH VENTURES INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 34-1533871	HEALTH CARE SERVICES	OH	NA	C Corporation					No
(29) MERLOT ORTHOPEDIX INC 10000 CEDAR AVENUE CLEVELAND,OH44106 11-3779414	MEDICAL DEVICE MANUFACTURING	DE	NA	C Corporation					No
(30) NEOMEDICS INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 02-0656818	BUSINESS SERVICES	OH	NA	C Corporation					No
(31) NEUROTHERAPIA INC 10000 CEDAR AVENUE CLEVELAND,OH44106 47-3977513	MEDICAL TECHNOLOGY	DE	NA	C Corporation					No
(32) OPTOQUEST CORPORATION 10000 CEDAR AVENUE CLEVELAND,OH44106 26-3589643	SCIENTIFIC RESEARCH	DE	NA	C Corporation					No
(33) PINE FALLS CONDOMINIUM ASSOCIATES INC 6100 WEST CREEK SUITE 25 INDEPENDENCE,OH44131 34-1617589	CONDO RENTALS	OH	NA	C Corporation					No
(34) RENOVO BIOSCIENCES INC 10000 CEDAR AVENUE CLEVELAND,OH44106 34-1956569	MEDICAL TECHNOLOGY	DE	NA	C Corporation					No
(35) RENOVO NEURAL INC 10000 CEDAR AVENUE CLEVELAND,OH44106 80-0185146	MEDICAL TECHNOLOGY	DE	NA	C Corporation					No
(36) SHIELD BIOTECH INC 10000 CEDAR AVENUE CLEVELAND,OH44106 46-2880975	MEDICAL TECHNOLOGY	DE	NA	C Corporation					No
(37) VIVERE PHARMA INC 10000 CEDAR AVENUE CLEVELAND,OH44106 47-5397125	INACTIVE	DE	NA	C Corporation					No
(38) CLEVELAND CLINIC UK FINANCING PLC	FINANCING ENTITY	UK	NA	C Corporation					No
(39) UNION CARE CORPORATION 659 BOULEVARD DOVER,OH44622 34-1556177	HEALTH CARE SERVICES	OH	NA	C Corporation					No
(40) UNION PHARMACEUTICAL CARE INC 659 BOULEVARD DOVER,OH44622 04-3588229	RETAIL PHARMACY SALES	OH	NA	C Corporation					No
(41) CASHEL NEURAL INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 82-4625105	SCIENTIFIC RESEARCH	DE	NA	C Corporation					No
(42) NEW COS INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 82-4828042	SCIENTIFIC RESEARCH	DE	NA	C Corporation					No
(43) TMAO INC 6801 BRECKSVILLE ROAD INDEPENDENCE,OH44131 82-4850194	INACTIVE	DE	NA	C Corporation					No
(44) Charitable Remainder Trusts (14)	N/A	OH	NA	Trust					No
(45) Medical Campus Management Inc PO Box 9003 Stuart,FL349959033 65-0605328	Management Services	FL	NA	C Corporation					No
(46) Medical & Financial Management Inc PO Box 9033 STUART,FL34995 59-2320501	BILLING & COLLECTIONS	FL	NA	C Corporation					No

Schedule R (Form 990) 2018

Page 3

Part V

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

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

Yes

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) MEDICAL CENTER AT ST LUCIE WEST LTD	J	1,477,751	FMV
(2) MEDICAL CENTER AT HOBE SOUND LTD	J	203,193	FMV

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:	18007697
Software Version:	2018v3.1

1	Briefly describe the organization’s mission or most significant activities: To provide better care of the sick, investigation into their problems and further education of those who serve.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	5,394
6	Total number of volunteers (estimate if necessary) .............	6	1,278
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	30,790
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) .........	4,584,274	2,319,643
9	Program service revenue (Part VIII, line 2g) .........	516,640,022	559,424,331
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	11,383,665	31,509,803
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	5,613,225	6,467,552
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	538,221,186	599,721,329
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	333,954	309,159
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	255,082,147	266,173,551
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	262,213,251	302,141,692
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	517,629,352	568,624,402
19	Revenue less expenses. Subtract line 18 from line 12.......	20,591,834	31,096,927
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	699,419,017	689,877,804
21	Total liabilities (Part X, line 26).............	421,540,886	411,161,805
22	Net assets or fund balances. Subtract line 21 from line 20.....	277,878,131	278,715,999

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 516,665,389 including grants of $ 309,159 ) (Revenue $ 563,603,524 )
	MARTIN MEMORIAL MEDICAL CENTER PROVIDED 118,849 PATIENT DAYS OF SERVICE AT ITS THREE HOSPITALS. THE MEDICAL CENTER ALSO PROVIDED CARE TO 120,286 PATIENTS THROUGH ITS FOUR EMERGENCY DEPARTMENTS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. THE MEDICAL CENTER PROVIDES A NUMBER OF COMMUNITY HEALTH CARE EDUCATION OPPORTUNITIES AND HEALTH SCREENING THROUGHOUT THE YEAR.

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 expenses516,665,389

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	11,475,412	9,867,652	2,316,972

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	2,291,450
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	28,193

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		2,319,643

		Business Code
2a	Patient Services	622110	559,372,995	559,372,995
b	Rental to affiliates	531120	51,336	51,336
c
d
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f ....		559,424,331

3 Investment income (including dividends, interest, and othersimilar amounts) ......			7,850,000			7,850,000
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		777,302
b	Less: rental expenses		856,029
c	Rental income or (loss)	0	-78,727
d	Net rental income or (loss)......			-78,727			-78,727
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	420,895	195,316,863
b	Less: cost or other basis and sales expenses	184,987	171,892,968
c	Gain or (loss)	235,908	23,423,895
d	Net gain or (loss).....			23,659,803			23,659,803
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	Cafeteria		624210	2,336,296			2,336,296
b	Laboratory services		621511	30,790		30,790
c	Support Services to Affiliates		561000	4,179,193	4,179,193
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			6,546,279
12	Total revenue. See Instructions......			599,721,329	563,603,524	30,790	33,767,372

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	12,500	12,500
2	Grants and other assistance to domestic individuals. See Part IV, line 22	296,659	296,659
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 ....	9,223,562		9,223,562
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	205,223,782	186,885,843	18,337,939
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	11,816,650	11,621,437	195,213
9	Other employee benefits .......	25,605,474	23,644,817	1,960,657
10	Payroll taxes ...........	14,304,083	13,414,915	889,168
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	391,638	33,250	358,388
c	Accounting ...........	354,995		354,995
d	Lobbying ...........	59,158	59,158
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	541,808		541,808
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	22,886,079	20,382,665	2,503,414	0
12	Advertising and promotion ....	1,341,015	1,104,179	236,836
13	Office expenses .......	9,735,195	6,168,339	3,566,856
14	Information technology ......	7,619,066	3,126,645	4,492,421
15	Royalties ..
16	Occupancy ...........	34,472,869	28,991,867	5,481,002
17	Travel ............	374,760	287,311	87,449
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	209,691	167,185	42,506
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	40,642,283	37,128,580	3,513,703
23	Insurance ...	8,106,157	8,106,157
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	Bad Debt	45,224,000	45,224,000
b	Indigent Tax	5,402,270	5,402,270
c	Patient Transport	2,187,260	2,187,260
d	Medical supplies	99,766,538	99,704,953	61,585
e	All other expenses	22,826,910	22,715,399	111,511	0
25	Total functional expenses. Add lines 1 through 24e	568,624,402	516,665,389	51,959,013	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			21,064,000	1	23,044,000
2	Savings and temporary cash investments .........			14,176,766	2	0
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			54,045,905	4	61,257,003
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
				0	6	0
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			10,474,731	8	10,870,485
9	Prepaid expenses and deferred charges ......			6,136,616	9	3,019,571
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	847,052,206
b	Less: accumulated depreciation	10b	462,166,242	369,904,592	10c	384,885,964
11	Investments—publicly traded securities .			180,173,000	11	152,240,232
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			43,443,407	15	54,560,549
16	Total assets. Add lines 1 through 15 (must equal line 34)...			699,419,017	16	689,877,804

17	Accounts payable and accrued expenses .....	65,760,074	17	37,040,231
18	Grants payable ...		18
19	Deferred revenue .........	6,223	19	6,223
20	Tax-exempt bond liabilities .........	306,108,975	20	318,134,650
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..	0	22	2,775,449
23	Secured mortgages and notes payable to unrelated third parties ..		23
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	49,665,614	25	53,205,252
26	Total liabilities. Add lines 17 through 25..	421,540,886	26	411,161,805

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	248,874,272	27	256,628,000
28	Temporarily restricted net assets ...........	29,003,859	28	22,087,999
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	277,878,131	33	278,715,999
34	Total liabilities and net assets/fund balances ........	699,419,017	34	689,877,804