TY 2020 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) THOMAS J STRAUSS...................................................................... PRESIDENT & CEO	29.00 ................. 11.00	X	X	0	1,032,155	67,942
(2) MELISSA ROGERS...................................................................... TRUSTEE	2.00 ................. 38.00	X		0	458,924	74,092
(3) JACK R GRAVO...................................................................... CHAIRMAN	2.00 ................. 0.00	X	X	0	0	0
(4) JOE L CARPENTER DMD...................................................................... VICE CHAIRMAN	2.00 ................. 0.00	X	X	0	0	0
(5) JEFFREY HEROLD...................................................................... SECRETARY	2.00 ................. 0.00	X	X	0	0	0
(6) CHARLES G DELACEY...................................................................... TRUSTEE	2.00 ................. 0.00	X		0	0	0
(7) SISTER MARIAN DURKIN CSA...................................................................... TRUSTEE	2.00 ................. 0.00	X		0	0	0
(8) BRIAN MERTES ESQ...................................................................... TRUSTEE	2.00 ................. 0.00	X		0	0	0
(9) TERRY A MOORE ESQ...................................................................... TRUSTEE	2.00 ................. 0.00	X		0	0	0
(10) DEAN OLIVIERI...................................................................... TRUSTEE	2.00 ................. 0.00	X		0	0	0
(11) DONALD PETERSON III...................................................................... TRUSTEE	2.00 ................. 0.00	X		0	0	0
(12) RENEE M POWELL...................................................................... TRUSTEE	2.00 ................. 0.00	X		0	0	0
(13) WILLIAM RACINE...................................................................... TRUSTEE	2.00 ................. 0.00	X		0	0	0
(14) LEEANN THORN...................................................................... TRUSTEE	2.00 ................. 0.00	X		0	0	0
(15) FONDA WILLIAMS II...................................................................... TRUSTEE	2.00 ................. 0.00	X		0	0	0
(16) DAVID STEWART...................................................................... SENIOR VP & CFO	40.00 ................. 0.00		X	0	359,859	44,292
(17) DAVID GORMSEN...................................................................... CHEIF MEDICAL OFFICER	40.00 ................. 0.00		X	307,183	0	53,242

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) BARBARA YINGLING........................................................................ VP & CNO	40.00 .......................0.00	X			269,477	0	44,170
(19) THOMAS TURNER........................................................................ VP FUND DEV & GOVT RELATIONS	40.00 .......................0.00	X			229,712	0	45,057
(20) JEFFREY PIKE........................................................................ VP PHYSICIAN REL & BUS DEV	40.00 .......................0.00	X			218,449	0	46,211
(21) CINDY HICKEY........................................................................ VP PUBLIC RELATIONS & MKTG	40.00 .......................0.00	X			143,623	0	33,428
(22) MATHEW HEINLE........................................................................ SR VP & GNERAL COUNSEL	32.00 .......................0.00	X			130,500	0	0
(23) SISTER CAROLYN CAPUANO HM........................................................................ VP MISSION & MINISTRY	40.00 .......................0.00	X			0	0	0
(24) AHMED EL GHAMRY SABE........................................................................ EXEC DIR CARDIOLOGY	40.00 .......................0.00		X		839,895	0	68,794
(25) JEFFREY MAENDEL........................................................................ PHYSICIAN	40.00 .......................0.00			X	357,256	0	29,029
(26) HEE YOON........................................................................ PHYSICIAN	40.00 .......................0.00			X	291,426	0	39,213
(27) ANDREW WOJTKOWSKI........................................................................ DIRECTOR DENTAL SERVICES	40.00 .......................0.00			X	267,997	0	39,800
(28) JUSTIN MODUGNO........................................................................ DENTIST	40.00 .......................0.00			X	196,595	0	37,128
(29) SHARON STERN........................................................................ PHYSICIAN	32.00 .......................0.00			X	206,604	0	22,011

(A) Name and business address	(B) Description of services	(C) Compensation
SOUND PHYSICIANS OF OHIO III PO BOX 742936 LOS ANGELES,CA90074	PHYSICIAN SERVICES	4,149,631
OHIO ANESTHESIA GROUP INC 4665 DOUGLAS CIRCLE 100 CANTON,OH44718	PHYSICIAN SERVICES	3,977,555
CANTON MED EDUC FOUNDATION 2600 SIXTH STREET NW CANTON,OH44710	RESIDENCY PROGRAM	1,877,144
OBHG OHIO CORP 777 LOWNDES HILL ROAD BLDG 1 GREENVILLE,SC29607	PHYSICIAN SERVICES	1,694,966
UNITY HEALTH NETWORK LLC 270 FRONT STREET CUYAHOGA FALLS,OH44221	PHYSICIAN SERVICES	1,495,076
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 55

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

CLEVELAND CLINIC MERCY HOSPITAL

Employer identification number

34-1893439

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2020

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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 5 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 2020 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2019 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2020. 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—2019. 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—2020. 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—2019. 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) 2020

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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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 5 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 2020 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2019 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2020 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2019 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2020. 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—2019. 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) 2020

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) 2020

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 lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described in 11a above?

11b

A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2020

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 0.015 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 0.035	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) 2020

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2020 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2020	(iii) Distributable Amount for 2020
1 Distributable amount for 2020 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2020:
a From 2015.......
b From 2016.......
c From 2017.......
d From 2018.......
e From 2019.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2020 distributable amount
i Carryover from 2015 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2020 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2020 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2020, 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 2020. 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 2021. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2016.....
b Excess from 2017.....
c Excess from 2018.....
d Excess from 2019.....
e Excess from 2020.....

Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020

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) 2020

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2020

Name of the organization

CLEVELAND CLINIC MERCY HOSPITAL

Employer identification number

34-1893439

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2

Name of organization CLEVELAND CLINIC MERCY HOSPITAL

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
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) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 3

Name of organization CLEVELAND CLINIC MERCY HOSPITAL		Employer identification number 34-1893439

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 4


Name of organization CLEVELAND CLINIC MERCY HOSPITAL			Employer identification number 34-1893439
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

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

OMB No. 1545-0047

2020

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

CLEVELAND CLINIC MERCY HOSPITAL

Employer identification number

34-1893439

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2020

Page 2

Part II-A

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

A Check SchCMd Bullet

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

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

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2020

Page 3

Part II-B

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

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

(a)

Yes|No

(b)

Amount

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

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

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

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

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

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

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

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

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

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

Yes

41,012

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

41,012

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1:	REPRESENTS PAYMENT OF DUES TO CERTAIN TRADE ORGANIZATIONS WHERE A PORTION OF THE DUES ARE USED TO CONDUCT LOBBYING ACTIVITIES. BRENNAN, MANNA & DIAMOND LLC WAS HIRED TO ADVOCATE BEFORE THE GOVERNOR'S OFFICE AND LEGISLATURE CONCERNING HB166, THE BUDGET BILL. SPECIFICALLY, ADVOCACY AND STRATEGIC CONSULTING CONCERNING MEDICAID ITEM MCDCD75 REGARDING CERTAIN ADJUSTMENTS TO THE MEDICAID BASE RATE FOR INPATIENT SERVICES FOR URBAN HOSPITALS AS DEFINED BY PROPOSED STATUTORY CHANGES AS WELL AS ONGOING MONITORING FOR GOVERNMENTAL ACTIONS THAT MAY IMPACT OUR MEDICAL CENTER. THE AMOUNT SPENT FOR THESE SERVICES IN 2020 WAS $22,000.

Return Reference

Explanation

PART II-B, LINE 1:

REPRESENTS PAYMENT OF DUES TO CERTAIN TRADE ORGANIZATIONS WHERE A PORTION OF THE DUES ARE USED TO CONDUCT LOBBYING ACTIVITIES. BRENNAN, MANNA & DIAMOND LLC WAS HIRED TO ADVOCATE BEFORE THE GOVERNOR'S OFFICE AND LEGISLATURE CONCERNING HB166, THE BUDGET BILL. SPECIFICALLY, ADVOCACY AND STRATEGIC CONSULTING CONCERNING MEDICAID ITEM MCDCD75 REGARDING CERTAIN ADJUSTMENTS TO THE MEDICAID BASE RATE FOR INPATIENT SERVICES FOR URBAN HOSPITALS AS DEFINED BY PROPOSED STATUTORY CHANGES AS WELL AS ONGOING MONITORING FOR GOVERNMENTAL ACTIONS THAT MAY IMPACT OUR MEDICAL CENTER. THE AMOUNT SPENT FOR THESE SERVICES IN 2020 WAS $22,000.

Schedule C (Form 990 or 990EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

CLEVELAND CLINIC MERCY HOSPITAL

Employer identification number

34-1893439

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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) 2020

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 ....	736,296	632,421	671,449	568,067	537,116
b	Contributions ...	2,000	450	2,000	6,000	10,967
c	Net investment earnings, gains, and losses	62,050	110,028	-35,365	100,197	28,116
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...		3,000	2,500		6,696
f	Administrative expenses ....	2,479	3,603	3,163	2,815	1,436
g	End of year balance ......	797,867	736,296	632,421	671,449	568,067

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

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

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

Yes

(i) Unrelated organizations .......................

3a(i)

(ii) Related organizations .......................

3a(ii)

Yes

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

Yes

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

Part VI

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

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

1a	Land .....	4,375,143		4,375,143
b	Buildings ....	147,899,728	93,409,664	54,490,064
c	Leasehold improvements
d	Equipment ....	181,003,907	165,109,824	15,894,083
e	Other .....	3,346,128		3,346,128
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				78,105,418

Schedule D (Form 990) 2020

Page 3

Part VII

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

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

Part VIII

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

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	20,213,575
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) 2020

Page 4

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

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

Part XIII

Supplemental Information

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

Return Reference	Explanation
PART V, LINE 4:	THE ENDOWMENT FUND IS FOR THE SUPPORT OF THE HOSPITAL'S DENTAL RESIDENCY PROGRAM AND CLINIC. IN 2013 THE FUNDS WERE TRANSFERRED TO THE MERCY DEVELOPMENT FOUNDATION FOR GROWTH OPPORTUNITIES AND MANAGEMENT OF THESE FUNDS.
PART X, LINE 2:	ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2020 THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS.
PART VI, LINE 1 (E)	OTHER = CONSTRUCTION IN PROGRESS

Schedule D (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

CLEVELAND CLINIC MERCY HOSPITAL

Employer identification number

34-1893439

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

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		(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) . . .	1,379,785	68,991	1,310,794	0.420 %
b	Medicaid (from Worksheet 3, column a) . . . . .	51,368,289	42,064,974	9,303,315	2.980 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	52,748,074	42,133,965	10,614,109	3.400 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	839,363	50,323	789,040	0.250 %
f	Health professions education (from Worksheet 5) . . .	6,675,107	4,030,457	2,644,650	0.850 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	134,899		134,899	0.040 %
j	Total. Other Benefits . .	7,649,369	4,080,780	3,568,589	1.140 %
k	Total. Add lines 7d and 7j .	60,397,443	46,214,745	14,182,698	4.540 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020

Schedule H (Form 990) 2020

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.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	4,395	4,395	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	399	399	0 %
8	Workforce development
9	Other
10	Total	4,794	4,794	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare 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. ......

17,426,752

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

1,756,290

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).....

56,130,347

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

50,565,386

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

5,564,961

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

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

Schedule H (Form 990) 2020

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	CLEVELAND CLINIC MERCY HOSPITAL 1320 MERCY DRIVE NW CANTON,OH44708 CANTONMERCY.ORG	X	X	X	X

Schedule H (Form 990) 2020

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)

	CLEVELAND CLINIC MERCY HOSPITAL
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

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

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): CANTONMERCY.ORG/CHNA

Other website (list url):

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

Other (describe in Section C)

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

Yes

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

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

Yes

If "Yes" (list url): HTTPS://WWW.CANTONMERCY.ORG/CHNA

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2020

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	CLEVELAND CLINIC MERCY HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 250.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

CANTONMERCY.ORG/FINANCIAL-ASSISTANCE

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

CANTONMERCY.ORG/FINANCIAL-ASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, PAGE 8

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) 2020

Page 6

Part VFacility Information (continued)

Billing and Collections

	CLEVELAND CLINIC MERCY HOSPITAL
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 (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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) 2020

Page 7

Part VFacility Information (continued)

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

	CLEVELAND CLINIC MERCY HOSPITAL
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) 2020

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
CLEVELAND CLINIC MERCY HOSPITAL	PART V, SECTION B, LINE 5: CLEVELAND CLINIC MERCY HOSPITAL'S CHNA WAS DEVELOPED USING AND REVIEWING THE DATA GATHERED BY THE STARK COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE WHICH IS A COLLABORATIVE COMMUNITY EFFORT.THE STARK COUNTY COMMUNITY HEALTH ASSESSMENT PROCESS IS A COLLABORATION OF LOCAL PUBLIC HEALTH, HOSPITALS AND HEALTH CARE ORGANIZATIONS, SOCIAL SERVICES AGENCIES, NON PROFIT ORGANIZATIONS AND COMMUNITY VOLUNTEERS WHO MEET REGULARLY TO IDENTIFY COMMUNITY NEEDS AND DEVELOP A PLAN TO ADDRESS THOSE NEEDS. THE PROCESS IS AN ONGOING CYCLE WHICH INCLUES: BUILDING PARTNERSHIPS; COORDINATING A CONSORTIUM; ASSESSING DATA, COMMUNITY NEEDS, AND CAPACITY; AND CONDUCTING PLANNING, PRIORITIZATION, INTERVENTIONS, IMPLEMENTATION AND EVALUTATION. THE FIRST PHASE OF THE PROJECT, A COMMUNITY SURVEY, CONSISTED OF A RANDOM SAMPLE TELEPHONE SURVEY OF STARK COUNTY HOUSEHOLDS. THIS METHOD WAS USED TO ENSURE REPRESENTIVENESS OF THE POPULATION AND TO WARRANT STATISTICAL VALIDITY.THE SECOND PHASE OF THE PROJECT, SECONDARY DATA ANALYSIS, CONSISTED OF REVIEWING AND ANALYZING SECONDARY DATA SOURCES TO IDENTIFY PRIORITY AREAS OF CONCERN WHEN COMPARED TO SURVEY DATA. THE THIRD PHASE OF THE STUDY, A COMMUNITY HEALTH LEADER SURVEY, CONSISTED OF A WEB SERVEY OF COMMUNITY LEADERS WHOM ARE KNOWLEDGEABLE ABOUT PUBLIC HEALTH. A TOTAL OF 101 COMMUNITY HEALTH LEADERS COMPLETED THE WEB SURVEY.THE FOURTH AND FINAL PHASE, A COMMUNITY FOCUS GROUP, CONSISTED OF A FACILITATED DISCUSSION WITH A DEMOGRAPHIC MIX OF ADULT STARK COUNTY RESIDENTS. AFTER GATHERING AND UTILIZING THIS DATA, THE CENTER FOR MARKETING AND OPINION RESEARCH (CMOR) IDENTIFIED PRIORITY HEALTH NEEDS FOR OUR SERVICE AREAS.
CLEVELAND CLINIC MERCY HOSPITAL	PART V, SECTION B, LINE 6A: CLEVELAND CLINIC MERCY HOSPITAL WORKED WITH TWO OTHER NOT-FOR-PROFIT COUNTY HOSPITALS, AULTMAN HOSPITAL AND AULTMAN ALLIANCE COMMUNITY HOSPITAL WHO WERE PART OF THE STARK COUNTY COMMUNITY HEALTH ASSESSMENT ADVISORY COMMITTEE.
CLEVELAND CLINIC MERCY HOSPITAL	PART V, SECTION B, LINE 6B: THE STARK COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ADVISORY COMMITTEE IS MADE UP OF A VARIETY OF HEALTH AND SOCIAL SERVICES AGENCIES AND VOLUNTEERS IN THE COMMUNITY. THE FOLLOWING AGENCIES HAVE BEEN INVOLVED IN THE 2019 CHNA PROCESS: ACCESS HEALTH STARK COUNTY; ALLIANCE COMMUNITY HOSPITAL; ALLIANCE CITY HEALTH DEPARTMENT; ALLIANCE CITY HEALTH DEPARTMENT; ALLIANCE FAMILY HEALTH CENTER; AULTMAN HEALTH FOUNDATION; AULTMAN HOSPITAL, AULTMAN ALLIANCE COMMUNITY HOSPITAL, BEACON PHARMACY, CANTON CITY HEALTH DEPARTMENT; COMMQUEST, LIFECARE FAMILY HEALTH AND DENTAL CENTER (LIFECARE), MASSILLON CITY HEALTH DEPARTMENT; MERCY MEDICAL CENTER; MY COMMUNITY HEALTH CENTER (MCHC); OSU EXTENSION; PARAMOUNT ADVANTAGE; PEGASUS FARM; SISTERS OF CHARITY FOUNDATION OF CANTON; STARTFRESH; STARK COUNTY COMMUNITY ACTION AGENCY (SCCAA); STARK COUNTY FAMILY COUNCIL; STARK COUNTY HEALTH DEPARTMENT (SCHD); STARK COUNTY JOBS AND FAMILY SERVICES (SCHFS); STARK COUNTY MENTAL HEALTH & ADDICTION RECOVERY (STARKMHAR); STARK COUNTY TREATMENT ACCOUNTABILITY FOR SAFER COMMUNITIES AGENCY (TASC); STARK PARKS; AND UNITED WAY OF GREATER STARK COUNTY.
CLEVELAND CLINIC MERCY HOSPITAL	PART V, SECTION B, LINE 11: DURING THE CHNA, THE FOLLOWING HEALTH NEEDS WERE IDENTIFIED FROM A COMMUNITY PERSPECTIVE AND INCORPORATED INTO MERCY'S IMPLEMENTATION PLAN, AND ARE LISTED BELOW. 1. ACCESS TO HEALTHCARE AND DENTAL CARE * CONTINUE TO OPERATE MERCY'S 10 COMMUNITY OUTPATIENT HEALTH CENTERS, STRATEGICALLY LOCATED IN STARK AND NEIGHBORING COUNTIES. THESE CENTERS PROVIDE AFFORDABLE AND ACCESSIBLE URGENT CARE AND AMBULATORY HEALTH CARE CLOSE TO HOME. CONTINUE TO SERVE UNINSURED AND UNDERINSURED PATIENTS THROUGH OUR AMBULATORY CARE CLINIC WHICH PROVIDES INTERNAL MEDICINE AND OB/GYN CARE. CONTINUE MERCY PROFESSIONAL CARE PHYSICIANS, A NETWORK OF MEDICAL PROFESSIONAL OWNED AND MANAGED BY MERCY TO HELP ENSURE ACCESS TO PRIMARY CARE, SURGEONS, PAIN MANAGEMENT, CARDIOLGISTS, CARDIAC SURGEONS AND PULMONARY AND CRITICAL CARE PHYSICIANS. CONTINUE TO PROVIDE AND GROW DENTAL SERVICES OFFERED TO UNDERSERVED AND UNINSURED PATIENTS AT BOTH THE MAIN MERCY CAMPUS AND MERCY ST. PAUL SQUARE IN URBAN NORTHEAST CANTON. CONTINUE DENTAL SERVICE OUTREACH EFFORTS INCLUDING FREE ORAL SCREENINGS, DENTAL SCREENINGS AND EDUCATION AT SCHOOLS AND COMMUNITY HEALTH FAIRS. CONTINUE MERCY DENTAL RESIDENCY PROGRAM TO EDUCATE AND TRAIN SKILLED DENTISTS IN OUR COMMUNITY.2. HEROIN/OPIATE USE CONTINUE AND EXPAND OUR WORK IN A COLLABORATIVE AND INTERDISCIPLINARY WAY WITH AREA AGENCIES, INCLUDING COMMQUEST, STARK MENTAL HEALTH & ADDICTION RECOVERY SERVICES, AND OTHERS, TO DESIGN AND IMPLEMENT STRATEGIES THAT ADDRESS THIS NEED. SUPPORT AND MARKET MERCY PAIN MANAGEMENT SERVICES TO OUR COMMUNITY, TO PROVIDE EDUCATION AND RESOURCES FOR CHRONIC PAIN SUFFERS AND OTHERS USING OPIOIDS. UPDATE THE PAIN MANAGEMENT PUBLICATION, OPIOIDS: INFORMATION, WARNINGS AND RESOURCES AND THEN DISTRIBUTE TO AREA AGENCIES AND THE COMMUNITY AS AN INFORMATION TOOL.3. INFANT MORTALITY CONTINUE ACTIVE PARTICIPATION IN STARK COUNTY THRIVE, A COMMUNITY-WIDE INITIATIVE. CONTINUE DISTRIBUTION OF FREE INFANT SLEEP SACKS AND SAFE SLEEP EDUCATIONAL MATERIALS TO ALL NEW PARENTS AT MERCY. THIS IS FUNDED WITH DONATIONS BY THE MERCY SERVICE LEAGUE WOMEN'S AUXILIARY AND QUOTA CLUB OF MASSILLON. OFFER UNINSURED AND UNDERINSURED PATIENTS PRENATAL SERVICES THROUGH THE MERCY OB/GYN SERVICES, THEREBY ENCOURAGING EARLY ACCESS TO PRENATAL CARE AND WORKING TO ENSURE FULL-TERM PREGNANCIES. EDUCATION AND SUPPORT IS ALSO OFFERED THROUGH THIS SERVICE. CONTINUE THE HEALTHY MOM, HEALTHY BABY PRENATAL EDUCATION PROGRAM IN UNDERSERVED AREAS. THIS PROGRAM EMPHASIZE SAFE SLEEP, BREASTFEEDING AND OTHER TOPICS ENCOURAGING BETTER PREGANCY OUTCOMES. CONTINUED TO PROVIDE MOMMY EMPOWERMENT MISSION OUTREACH PROGRAMS THAT PROVIDE WOMEN'S HEALTH EDUCATION TO WOMEN OF CHILD-BEARING AGE AND THEIR SUPPORT NETWORK. INVESTIGATE OPTIONS FOR OFFERING CENTERING PREGNANCY AT MERCY MEDICAL CENTER. CONTINUE TO PROVIDE PRENATAL PROGRAMS COMPLETELY IN SPANISH TO SUPPORT LIMITED ENGLISH PROFICIENCY/SPANISH SPEAKING WOMEN AND THEIR PARTNERS/SPOUSES.4. MENTAL HEALTH SERVICES/SUICIDE CONTINUE USE OF NURSE NAVIGATORS/CASE MANAGERS IN THE EMERGENCY DEPARTMENT TO ASSIST WITH THE CRISIS INTERVENTION FOR PATIENTS AND FAMILIES IN NEED. PROVIDE ASSISTANCE WITH REFERRALS AND PLACEMENTS WHEN NEEDED. COLLABORATE WITH AREA AGENCIES, INCLUDING COLEMAN CRISIS CENTER AND STARK MENTAL HEALTH & ADDICTION RECOVERY SERVICES, ON PROGRAMS AND OPTIONS FOR IMPROVING ACCESS TO CARE. INITIATE BEHAVIORAL HEALTH SERVICES AT MERCY ST, PAUL TO BE PROVIDED BY MERCY ADVANCE PRACTICE BEHAVIORAL NURSE. INITIATE AND CONTINUE TO PROMOTE MENTAL HEALTH SERVICES PROVIDED AT MERCY HEALTH CENTER-PLAIN BY ADVANCED PRACTICE BEHAVIORAL HEALTH NURSE HOURS. CONTINUE AND EXPAND AS NEEDED THE MERCY HAVEN (HEALING AFTER VIOLENT ENCOUNTERS NETWORK) PROGRAM, PROVIDING IMMEDIATE SPECIALIZED CARE AND OPTIONS TO VICTIMS OF ASSULT. PROMOTE THE EDUCATIONAL AND AWARENESS ASPECT OF THIS PROGRAM IN THE COMMUNITY. 5. OBESITY AND HEALTHY LIFESTYLE CHOICES CONTINUE MISSION OUTREACH HEALTHY LIFESTYLE PROGRAMMING, INCLUDING THE SUMMER DAY CAMPS AND AFTER SCHOOL PROGRAMS, IN COLLABORATION WITH CANTON CITY SCHOOLS, CANTON CITY PARKS, STARK PARKS, AND OTHER COMMUNITY AGENCIES THAT FOCUS ON NUTRITION, EXERCISE AND ORAL HEALTH. CONTINUE THE MERCY WEIGHT MANAGEMENT PROGRAM. CONTINUE TO OFFER MONTHLY LUNCH & LEARN PROGRAMS AT MERCY ST. PAUL SQUARE, FOCUSING ON MODIFIABLE HEALTH RISKS AND DISEASE PREVENTION AND DIABETES MANAGEMENT. CONTINUE TO PROVIDE THE SERVICES OF A HEALTH COACH AT MERCY ST. PAUL WHO ASSISTS WITH AND SUPPORTS RESIDENTS AND PATIENTS WITH HEALTHY LIFESTYLE CHOICES AND HELPS TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. CONTINUE MERCY'S SMOKING CESSATION EDUCATIONAL CLASSES AND OUTREACH EDUCATION. CONTINUE PARTICIPATION IN APPROPRIATE COMMUNITY HEALTH FAIRS AND EDUCATIONAL EVENTS THAT PROMOTE HEALTHY LIFESTYLES. *CONTINUE COLLABORATION WITH THE STARK COUNTY DISTRICT LIBRARY TO OFFER A COMMUNITY HEALTH FAIR FEATURING FREE SCREENINGS AND EDUCATION.
CLEVELAND CLINIC MERCY HOSPITAL	PART V, SECTION B, LINE 20E: UPON ADMISSION AS A SELF-PAY PATIENT, A HOSPITAL REPRESENTATIVE MEETS WITH THE PATIENT IN THEIR ROOM WHEN PERMITTED DURING PANDEMIC RESTRICTIONS TO DISCUSS IF THEY MAY BE ELIGIBLE FOR GOVERNMENT ASSISTANCE PROGRAMS OR IF THEY QUALIFY UNDER OUR FAP. TELEPHONE CALLS TO THE ROOM WERE ATTEMPTED DURING THE PANDEMIC AND CALLS TO AUTHORIZED FAMILY MEMBERS OR POWER OF ATTORNEY WERE MADE. TELEPHONE CALLS TO THE HOME ARE ATTEMPTED. INFORMATION IS INCLUDED IN THE STATEMENTS GOING OUT TO OUR PATIENTS WITH REGARD TO ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART V, SECTION B, LINE 20A:CLEVELAND CLINIC MERCY HOSPITAL DOES PROVIDE A WRITTEN NOTICE OF THE UPCOMING EXTRAORDINARY COLLECTION ACTION THAT WILL BE TAKEN ON THE FINAL STATEMENT IF THE PATIENT DOES NOT TAKE ANY ACTION. A PLAIN LANGUAGE SUMMARY OF THE FAP IS ONLY SENT OUT IF REQUESTED BY THE PATIENT.PART V, SECTION B, LINE 20C:CLEVELAND CLINIC MERCY HOSPITAL DOES NOT PROCESS INCOMPLETE APPLICATIONS. WHEN AN APPLICATION IS MISSING INFORMATION, A LETTER IS SENT OUT TO THE PATIENT DETAILING WHAT IS STILL NEEDED. ONCE THE APPLICATION IS COMPLETED, IT IS PROCESSED.PART V, SECTION B, LINE 20D:CLEVELAND CLINIC MERCY HOSPITAL DOES NOT PERFORM PRESUMPTIVE ELIGIBILITY DETERMINATIONS.

Schedule H (Form 990) 2020

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?18
Name and address		Type of Facility (describe)
1	1 - MERCY HEALTH CENTER OF JACKSON 7337 CARITAS CIRCLE NW MASSILLON,OH44646	URGENT CARE; THERAPY; IMAGING; LAB; PAIN MGMT; CARDIO DIAG; PRIMARY CARE
2	2 - MERCY HEALTH CENTER OF NORTH CANTON 6200 WHIPPLE AVE NW CANTON,OH44720	URGENT CARE; THERAPY; IMAGING; LAB; SPORTS MEDICINE & CARDIO REHAB
3	3 - MERCY HEALTH CENTER OF CARROLL COUNTY 125 CANTON ROAD CARROLLTON,OH44615	URGENT & PRIMARY CARE; IMAGING & LAB
4	4 - MERCY HEALTH CENTER OF MASSILLON 2935 LINCOLN WAY MASSILLON,OH44647	URGENT CARE; IMAGING; LAB, CARIDAC SERVICES & THERAPIES
5	5 - MERCY HEALTH CENTER OF TUSCARAWAS COUNTY 1031 WEST HIGH STREET NEW PHILADELPHIA,OH44663	URGENT CARE; THERAPY; IMAGING; LAB & CARDIO DIAG
6	6 - MERCY HEALTH CENTER OF PLAIN 2638 EASTON NE CANTON,OH44721	URGENT CARE; IMAGING; LAB & SPORTS MEDICINE
7	7 - MERCY HEALTH CENTER OF ALLIANCE 149 E SIMPSON STREET ALLIANCE,OH44601	PRIMARY CARE; IMAGING; LAB & PAIN MANAGEMENT
8	8 - MERCY HEALTH CENTER OF LAKE 432 KING CHURCH AVENUE NW UNIONTOWN,OH44685	IMAGING; LAB, THERPY & SPORTS MEDICINE
9	9 - MERCY HEALTH CENTER OF LOUISVILLE 1302 WEST MAIN STREET LOUISVILLE,OH44641	IMAGING SERVICES & LAB
10	10 - MERCY HEALTH CENTER OF CARROLL COUNTY 1001 CANTON ROAD CARROLLTON,OH44615	THERAPY
11	11 - MERCY UROLOGY 1330 MERCY DRIVE NW SUITE 420 CANTON,OH44708	UROLOGY SERVICES
12	12 - MERCY ST PAUL SQUARE 1459 SUERIOR AVENUE NE CANTON,OH44705	PRIMARY & DENTAL CARE
13	13 - MERCY UROLOGY 1330 MERCY DRIVE NW SUITE 502 CANTON,OH44708	UROLOGY SERVICES
14	14 - MEDICAL SURGICAL CARE 1330 MERCY DRIVE NW CANTON,OH44708	SURGICAL SERVICES
15	15 - MERCY PRIMARY CARE BELDEN 4909 MUNSON AVENUE CANTON,OH44718	PRIMARY CARE
16	16 - MERCY PRIMARY CARE - METRO 601 CLEVELAND AVE NW CANTON,OH44702	PRIMARY CARE
17	17 - MERCY RHEUMATOLOGY 1330 MERCY DRIVE NW SUITE 325 CANTON,OH44708	RHEUMATOLOGY SERVICES
18	18 - RAD-DOVER 515 UNION AVENUE SUITE 187 DOVER,OH44622	PRIMARY CARE

Schedule H (Form 990) 2020

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
PART I, LINE 6A:	THE CLEVELAND CLINIC FOUNDATIONPART I, LINE 6B:ON FEBRUARY 1, 2021 CLEVELAND CLINIC BECAME THE SOLE MEMBER OF CLEVELAND CLINIC MERCY HOSPITAL (MERCY), FORMERLY KNOWN AS MERCY MEDICAL CENTER. MERCY'S 2020 COMMUNITY BENEFIT RESULTS ARE DISCUSSED IN THE CLEVELAND CLINIC'S ENTERPRISE-WIDE COMMUNITY BENEFIT REPORT.
PART I, LINE 7:	COST OF CHARITY WAS CALCULATED USING A COST TO CHARGE RATIO. TOTALEXPENSES USED FOR THE RATIO DID NOT INCLUDE BAD DEBT, ANY MEDICAIDPROVIDER ASSESSMENTS OR FEES, NOR ANY PROCEEDS FROM THE HCAP PROGRAM.THAT ADJUSTED EXPENSE WAS THEN DIVIDED BY CHARGES TO OBTAIN THECOST-TO-CHARGE RATIO USED.PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $17,426,752.
PART II, COMMUNITY BUILDING ACTIVITIES:	DYNAMICALLY INVOLVED IN THE COMMUNITIES WHERE WE SERVE, MERCY HAS MULTI-FACETED OUTREACH EFFORTS IN PLACE. THESE INCLUDE: COMMUNITY OUTREACH, FAITH COMMUNITY NURSING, IMMIGRANT HEALTH OUTREACH, MERCY INTERNATIONAL MISSION OUTREACH, AND MISSION OUTREACH.COMMUNITY OUTREACH: MERCY'S MISSION OUTREACH CONTINUED TO SERVE THE COMMUNITY EVEN DURING THE CHALLENGES OF THE 2020 COVID PANDEMIC. THE FOCUS, IN KEEPING WITH THE PRIORITIES OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND OUR MISSION OF HEALING MINISTRY, CONTINUED TO BE HEALTH AND WELLNESS ORIENTED WITH MANY PROGRAMS OFFERED COLLABORATIVELY WITH CANTON CITY SCHOOLS. WE CONTINUED THE LONG (25+ YEAR) TRADITION OF OUTREACH IN SOUTH EAST CANTON (THE CITY'S POOREST NEIGHBORHOOD AND A FOOD DESERT) BUT ALSO CONTINUED TO EXPAND OUTREACH IN URBAN NORTH EAST CANTON (A MEDICALLY UNDERSERVED AREA AND A FOOD DESERT). SOME OF THE OUTREACH PROGRAMS PROVIDED IN 2020 INCLUDED: ONE PRENATAL HEALTH EDUCATION PROGRAM, HELD AT MERCY'S MAIN CAMPUS (PLANNED SPECIFICALLY FOR THE LATINO POPULATION AND PRESENTED IN SPANISH), FOR A TOTAL OF 35 PREGNANT WOMEN; ONE SUMMER HEALTH WEEKLY OUTREACH PROGRAM THAT PROVIDED CRAFTS AND HEALTHY SNACKS TO 30 NEIGHBORHOOD CHILDREN IN NORTH EAST CANTON (THIS WAS COVID SAFE AND OFFERED IN PLACE OF THE USUAL DAY CAMP); THREE AFTER-SCHOOL HEALTH PROGRAMS IN PARTNERSHIP WITH CANTON CITY SCHOOL DISTRICT FOR A TOTAL OF 82 ELEMENTARY SCHOOL AGE CHILDREN. A VIRTUAL DENTAL ASSEMBLY FOR 250 ALLEN ELEMENTARY SCHOOL STUDENTS BROUGHT THE CHILDREN CHRISTMAS CHEER, EDUCATION AND A GIFT BAG OF ORAL HEALTH PRODUCTS. MERCY'S URBAN NORTH EAST CANTON ST. PAUL SQUARE HEALTH FACILITY COMMUNITY MONTHLY LUNCH AND LEARN SESSIONS PROVIDED EDUCATION ON DIABETES AND OTHER HEALTH TOPICS TO 68 PARTICIPANTS. FOR OUR ANNUAL CHRISTMAS WINTER WELLNESS, WE HOSTED A GIVEAWAY FOR FAMILIES AT OUR ST. PAUL SQUARE FACILITY AND WE PROVIDED WINTER WELLNESS CARE PACKAGES TO OVER 100 FAMILIES. IN ORDER TO SUPPORT FAMILIES SUFFERING FROM THE HEALTH AND ECONOMIC EFFECTS OF THE COVID-19 PANDEMIC, WE PROVIDED HEALTHY, READY TO WARM AND EAT MEALS, FAMILY GAMES, HOUSEHOLD ITEMS AND HYGIENE PRODUCTS TO OVER 6,060 COMMUNITY MEMBERS IN SOUTH EAST CANTON OVER A 7-MONTH PERIOD. MERCY PERSONNEL FROM A VARIETY OF DEPARTMENTS PARTICIPATED IN OUTREACH ACTIVITIES AND PROVIDED PROFESSIONAL SUPPORT. MISSION OUTREACH WORKS WITH MERCY NUTRITION SERVICES, SUPPLY CHAIN, AND THE DEVELOPMENT FOUNDATION AS WELL. ALL TOLD, OVER 6,625 INDIVIDUAL CONTACTS WERE MADE BY MISSION OUTREACH DURING 2020. WITH THE ASSISTANCE OF A GENEROUS GRANT FROM THE SISTERS OF THE HUMILITY OF MARY (HM SISTERS) MERCY WAS ABLE TO KEEP A WELLNESS RESOURCE COACH AT ST. PAUL'S. THE COACH ASSISTED BOTH PATIENTS AND AREA RESIDENTS WITH SUCH THINGS AS ACCESSING PRESCRIPTION ASSISTANCE, BLOOD PRESSURE MONITORING, HEALTH EDUCATION, EMERGENCY FOOD ASSISTANCE, AND TRANSPORTATION NEEDS. THE COACH ALSO ASSISTED BOTH MEDICAL AND DENTAL TEAMS AT ST. PAUL'S. A SECOND GRANT FROM THE HM SISTERS COVERED THE COST OF THE EXTENSIVE FAMILY MEAL PROGRAM IN SOUTH EAST CANTON. THE HM SISTERS ALLOWED US TO REPURPOSE WELL OVER $30,000 IN ORDER TO MEET EMERGENCY NEEDS IN THE COMMUNITY ENCOUNTERED BECAUSE OF COVID. IMMIGRANT HEALTH OUTREACH CONTINUED TO PROVIDE MUCH NEEDED SERVICES. THE NEW COORDINATOR OF THIS PROGRAM HOLDS AN ASSOCIATE DEGREE IN RADIOLOGY TECHNOLOGY AND HAS BEEN PART OF OUR MERCY TEAM FOR A NUMBER OF YEARS, WORKING IN PATIENT ACCESS. OUR SKILLED INTERPRETERS, A NUMBER OF WHOM HOLD NATIONAL CERTIFICATION, CONTINUE TO SERVE MANY SPANISH SPEAKING, RECENTLY ARRIVED IMMIGRANT FAMILIES WHO DEEPLY APPRECIATE THE LANGUAGE SUPPORT THEY RECEIVE AT MERCY. DUE TO POVERTY AND, AT TIMES, IMMIGRATION STATUS, THIS IS A VERY VULNERABLE POPULATION IN NEED OF BOTH EPISODIC AND CONTINUING CARE. THANKS, IN PART, TO THE GENEROUS SUPPORT OF THE SISTERS OF CHARITY FOUNDATION OF CANTON, AS WELL AS TO FUNDING FOR LANGUAGE SUPPORT FROM THE SISTERS OF THE HUMILITY OF MARY, IMMIGRANT HEALTH OUTREACH WAS ABLE TO OFFER THE FOLLOWING IN 2020 FOR PEOPLE WHO ARE UNABLE TO SPEAK ENGLISH. ENCOUNTERS VARY IN LENGTH FROM 15 MINUTES (E.G. LAB WORK) TO 8-10 HOURS (E.G. LABOR AND DELIVERY). THE FOLLOWING IS NOT INCLUSIVE OF ALL SERVICES PROVIDED. 1,936 PATIENT VISITS IN MERCY AMBULATORY CARE CLINICS 77 PATIENTS VISITS TO MERCY EMERGENCY DEPARTMENT 78 PATIENTS SERVED IN MERCY DENTAL CLINIC AND 34 AT ST. PAUL DENTAL OFFICE 39 PATIENTS WERE SERVED IN MERCY SAME DAY SURGERY 172 BABIES WERE BORN TO IMMIGRANT MOTHERS AT MERCY 304 PATIENTS WERE SERVED IN THE OUTPATIENT LAB 452 PATIENTS WERE SERVED IN MERCY ULTRASOUND, RADIOLOGY, CT SCAN, MRI, MAMMOGRAM AND X-RAY DEPARTMENT. 135 PHYSICIAN AND VACCINATION APPOINTMENTS WERE COVERED AT ST. PAUL SQUARE. 244 ENCOUNTERS WERE SUPPORTED IN MEETINGS WITH THE MERCY FINANCIAL COUNSELOR IN THE ACC CLINIC, WITH HCAP PAPERWORK. 149 PATIENT ENCOUNTERS IN MEDICAL RECORDS, ON PATIENT UNITS, IN PHARMACY AND PHYSICIAN VISITS WERE SUPPORTED 35 PATIENT VISITS WERE SUPPORTED AT VARIOUS MERCY THERAPY LOCATIONS TOTAL OF 3,626 FOR ALL PATIENT ENCOUNTERS AND CLOSE TO 5,000 HOURS OF INTERPRETATION. NOTE: THIS IS ABOUT 1,000 FEWER HOURS THAN 2019 DUE TO COVID-19.
PART III, LINE 2:	BAD DEBT IS ESTIMATED BASED UPON HISTORICAL REVIEWS AND CURRENT TRENDS. HISTORICAL WRITE-OFFS ARE MONITORED IN ORDER TO ESTIMATE BAD DEBT WRITE OFFS BASED UPON THE PAYOR MIX AND THE AGING OF ACCOUNTS RECEIVABLE.
PART III, LINE 3:	IT'S ESTIMATED THAT 10.1% OF BAD DEBT WRITE-OFFS MAY HAVE QUALIFIED AS CHARITY. THAT ESTIMATION EXCLUDES THE 57.1% OF WRITE-OFFS FROM PEOPLE WITH INSURANCE ASSUMING THEY HAVE A BETTER ABILITY TO PAY. THAT RESULT WAS THEN SPLIT 23.5/76.5% BASED UPON THE CHARITY TO BAD DEBT WRITE-OFF RATIO.
PART III, LINE 4:	FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND A PROVISION FOR BAD DEBT, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE DETERMINED TO HAVE FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY), FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE, THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. ACCOUNTS RECEIVABLE FOOTNOTE IS DISCLOSED IN THE FINANCIAL STATEMENTS IN NOTE 2 ON PAGE 8.
PART III, LINE 8:	THE AMOUNTS WERE DETERMINED BASED ON INFORMATION FROM THE MEDICARE 2020 COST REPORT.
PART III, LINE 9B:	CLEVELAND CLINIC MERCY HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY THAT INCLUDES OUR SELF-PAY DISCOUNTS. IN ADDITION, WE HAVE A SEPARATE COLLECTION POLICY. THESE POLICIES MAKE MANY OPTIONS KNOWN AND AVAILABLE TO THE PATIENTS IT SERVES. WHEN PATIENTS QUALIFY FOR FINANCIAL/CHARITY ASSISTANCE, THEIR ACCOUNT BALANCE IS EITHER WRITTEN OFF OR REDUCED USING A CHARITY ADJUSTMENT CODE. ANY RESIDUAL ACCOUNT BALANCE AFTER CHARITY ADJUSTMENTS ARE SUBJECT TO THE SAME COLLECTION PROCEDURES AS ALL OTHER PATIENTS.
PART VI, LINE 2:	CLEVELAND CLINIC MERCY HOSPITAL COLLABORATES WITH NUMEROUS COMMUNITY ORGANIZATIONS AND SOCIAL SERVICE AGENCIES AS PART OF ITS MISSION OUTREACH AND COMMUNITY HEALTH INITIATIVES. PART OF THE COLLABORATION INVOLVES PARTICIPATION ON THE BOARD OF DIRECTORS FOR THE UNITED WAY OF GREATER STARK COUNTY, THE BEACON CHARITABLE PHARMACY, THE AMERICAN HEART ASSOCIATION, WALSH UNIVERSITY, THE AUSTIN BAILEY HEALTH & WELLNESS FOUNDATION, ARTS IN STARK, ACCESS HEALTH STARK COUNTY, URBAN LEAGUE, COMPASSION DELIVERED AND MANY OTHERS. ALL OF THESE GROUPS HAVE A ROLE IN LOOKING AT THE OVERALL HEALTH AND WELLNESS OF OUR COMMUNITY.
PART VI, LINE 3:	THERE IS SIGNAGE IN EACH WAITING AREA STATING THAT PATIENTS MIGHT BE ELIGIBLE FOR CHARITY CARE, FINANCIAL COUNSELORS MEET WITH MANY PATIENTS AND EXPLAIN OPTIONS AVAILABLE AND GET ELIGIBLE PATIENTS SIGNED UP FOR MEDICAID, OR QUALIFIED FOR CHARITY OR HCAP, THE PATIENT BILLING STATEMENTS CONTAIN NOTICES THAT PATIENTS MIGHT BE ELIGIBLE FOR CHARITY CARE.
PART VI, LINE 4:	THE COMMUNITY SERVED BY THE HOSPITAL IS DEFINED BASED ON THE GEOGRAPHIC ORIGINS OF THE HOSPITAL'S PATIENTS. OUR PRIMARY SERVICE AREA IS STARK COUNTY, OHIO. OUR SECONDARY SERVICE AREAS ARE IN TUSCARAWAS COUNTY AND CARROLL COUNTY. THE FOLLOWING DESCRIPTION OF OUR PRIMARY AREA OF STARK COUNTY IS TAKEN DIRECTLY FROM THE 2017 STARK COUNTY INDICATORS REPORT AND UPDATED FOR 2020 NUMBERS AND THE COMMUNITY ASESSMENT-2020 EDITION REPORT: POPULATION: IN 2020, THE POPULATION WAS 370,606. THE OVERALL POPULATION IN STARK COUNTY HAS BEEN SLIGHTLY DECREASING SINCE 2014.RACIAL: STARK COUNTY IS RACIALLY AND ETHNICALLY HOMOGENOUS. MINORITY POPULATIONS REPRESENT APPROXIMATELY 13.5% OF THE TOTAL POPULATION. WHILE MINORITY GROUPS HAVE INCREASED IN NUMBER, THEY STILL REPRESENT A VERY SMALL, BUT INCREASING, PORTION OF THE POPULATION. STARK COUNTY IS ALSO RACIALLY AND ETHNICALLY SEGREGATED. MINORITIES LIVE IN POCKETS WITHIN THE COUNTY. THE URBAN AREAS OF STARK COUNTY (ALLIANCE, CANTON, AND MASSILLON) HAVE A MUCH HIGHER PERCENTAGE OF MINORITIES THAN THE SUBURBAN AREAS OF THE COUNTY. AGE: THE POPULATION IN STARK COUNTY, LIKE THAT OF THE STATE AND THE NATION, IS AGING. ADULTS AGES 60 AND OLDER OUTNUMBER CHILDREN UNDER AGE 18. STARK COUNTY HAS A SLIGHTLY OLDER POPULATION THAN OHIO AS A WHOLE, YET CANTON HAS A SLIGHTLY YOUNGER POPULATION. ALLIANCE HAS THE HIGHEST PERCENTAGE OF RESIDENTS UNDER AGE 25. INCOME: STARK COUNTY'S STANDARD MEASURES OF INCOME (PER CAPITA, MEDIAN FAMILY AND MEDIAN HOUSEHOLD) ARE BELOW THAT OF THE STATE AS WELL AS THE NATION. THE MEDIAN HOUSEHOLD INCOME IN STARK COUNTY IS $52,190.STARK COUNTY'S POVERTY RATE, AT 10%, IS BETTER THAN THE OHIO AVERAGE, AND MOST MUNICIPALITIES WITHIN THE COUNTY ARE BELOW STARK'S COUNTY'S RATE. HOWEVER, THE POVERTY RATE IN CANTON IS MORE THAN TWICE THAT OF THE COUNTY AS A WHOLE, WHILE ALLIANCE IS 1.5 TIMES AS HIGH. THE POVERTY IS CONCENTRATED WITHIN CERTAIN AREAS OF STARK COUNTY, MAINLY THE LARGER CITIES. EMPLOYMENT: UNEMPLOYMENT HAS CONSISTENTLY REMAINED AT APPROXIMATELY 4% TO 5% WITHIN STARK COUNTY SINCE 2014. PHYSICAL HEALTH: THE ENVIRONMENT, NUTRITION, ACCIDENTS, ILLNESS AND AGE ARE FACTORS THAT AFFECT PHYSICAL HEALTH. A HIGHER INFANT MORTALITY RATE IN THE AFRICAN-AMERICAN POPULATION AND AN INCREASE IN SEXUALLY TRANSMITTED INFECTIONS (STIS) ARE NEGATIVE TRENDS THAT ARE EMERGING LOCALLY. IN STARK COUNTY THERE ARE SIGNIFICANT DISPARITIES BETWEEN THE CAUCASIAN AND AFRICAN-AMERICAN POPULATIONS INCLUDING PRENATAL CARE, BIRTH WEIGHTS, INFANT MORTALITY RATES, AND STIS. HEALTH DISPARITIES ARE DIFFERENCES THAT CAN BE SEEN IN SPECIFIC POPULATIONS OF A COMMUNITY IN RELATIONS TO DISEASES, HEALTH OUTCOMES OR QUALITY OF HEALTH CARE RECEIVED. SEVERAL VARIABLES IMPACTING DISPARITIES ARE HEALTH BEHAVIORS, STATUS BEFORE CARE, ACCESS TO HEALTHCARE AND HEALTHCARE DELIVERY. BEHAVIORAL HEALTH: BEHAVIORAL HEALTH INCLUDES MENTAL HEALTH, SUBSTANCE ABUSE TREATMENT AND PREVENTION SERVICES. MANY AFFECTED WITH MENTAL ILLNESS DO NOT SEEK OR RECEIVE THE TREATMENT NEEDED. BARRIERS TO ACCESSING TREATMENT INCLUDE STIGMA, LACK OF OR INADEQUATE INSURANCE COVERAGE, LIMITED PROGRAM CAPACITY AND WAIT TIME. THE HIGHEST RATES OF MENTAL ILLNESS ARE AMONG ADULTS AGED 25 TO 34 YEARS OLD, DEPRESSIVE, BIPOLAR, ANXIETY, ALCOHOL ABUSE AND OPIOID USE DISORDERS ARE THE MOST FREQUENT DIAGNOSES AMOUNG ADULTS. THE LEADING DIAGNOSES FOR CHILDREN ARE ADJUSTMENT, CONDUCT, ATTENTION DEFICIT, ANXIETY AND DEPRESSIVE DISORDERS.UNINTENTIONAL DRUG OVERDOSE DEATHS CONTINUE TO BE A CONCERN, WHILE UNINTENDED INTERACTIONS ARE A CAUSE OF DEATH, MOST POISONINGS SEEM TO LINKED TO RECREATIONAL USE. DRUG OVERDOSES: THERE WERE MORE THAN 5,000 EMGERGENCY DEPARTMENT VISITS FOR OVERDOSES IN STARK COUNTY BETWEEN 2012 AND 2018. EMERGENCY VISITS TO MEDICAL PROVIDERS DUE TO DRUG OVERDOSE PEAKED IN STARK COUNTY IN 2017. WHILE OPIOID OVERDOSES ARE A SUBSTANTIAL SHARE OF TOTAL OVERDOSES, THIS DATA INCLUDES OTHER DRUGS AS WELL. THE AVERAGE AGE OF PEOPLE WHO OVERDOSED IN STARK COUNTY WAS SLIGHTLY YOUNGER THAN THE STATE AVERAGE. ACCESS TO HEALTHCARE: OVERALL, 8.2% OF STARK COUNTY'S POPULATION IS UNINSURED. AS THE COST OF HEALTH INSURANCE CONTINUES TO RISE, THE DEMAND FOR HEALTHCARE SERVICES AT A FREE/SLIDING FEE IS INCREASING. MORE STARK COUNTY RESIDENTS ARE WITHOUT HEALTH INSURANCE AND THE NUMBER OF INDIVIDUALS WHO ARE UNDERINSURED CONTINUES TO INCREASE. OF CONCERN ARE THE INDIVIDUALS BETWEEN THE AGE OF 30 AND 64 WITH CHRONIC MEDICAL PROBLEMS WHO HAVE DIFFICULTY MAINTAINING EMPLOYMENT BUT ARE NOT MEDICALLY DISABLED. EVEN IF AN INDIVIDUAL IS MEDICAID ELIGIBLE, FEW HEALTHCARE PROVIDERS, ESPECIALLY SPECIALISTS, ARE WILLING TO ACCEPT NEW MEDICAID PATIENTS, HAVING INSURANCE DOES NOT GUARANTEE EASY ACCESS TO AFFORDABLE, QUALITY CARE. BUSINESSES THAT OFFER HEALTH INSURANCE HAVE INCREASED THE EMPLOYEE PREMIUM CONTRIBUTION AND/OR INCREASED THE DEDUCTIBLE PAID BY THE EMPLOYEE, OFTEN MAKING MEDICAL COVERAGE MORE DIFFICULT TO AFFORD, IN TERMS OF OUR SECONDARY MARKETS, CARROLL COUNTY HAD A POPULATION OF 26,914 AND TUSCARAWAS COUNTY HAD A POPULATION OF 91,987,
PART VI, LINE 5:	THE MAJORITY OF THE BOARD MEMBERS OF THE HOSPITAL RESIDE IN OUR SERVICE AREA AND ARE NOT EMPLOYED OR CONTRACTED BY THE HOSPITAL. MERCY EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY WHO MEET THE HOSPITAL'S CREDENTIALING CRITERIA, MERCY PROVIDES AN EXTENSIVE CONTINUING MEDICAL EDUCATION PROGRAM EACH YEAR, GOVERNED BY THE HOSPITAL'S CME COMMITTEE.APPROXIMATELY 635 PHYSICIANS AND DENTISTS ARE ON THE HOSPITAL STAFF INCLUDING MERCY PROFESSIONAL CARE CORPORATION NETWORK OF PHYSICIANS, MERCY EMPLOYS APPROXIMATELY 2,525 PEOPLE. MERCY IS A TEACHING HOSPITAL AFFILIATED WITH NORTHEAST OHIO MEDICAL UNIVERSITY (NEOMED). OUR HOSPITAL HAS 475 LICENSED ADULT BEDS, A LEVEL II TRAUMA CENTER AND EMERGENCY DEPARTMENT THAT HAD 50,749 PATIENT VISITS, AN ACCREDITED EMERGENCY CHEST PAIN CENTER (ECPC) WITH A DEDICATED, STATE-OF-THE-ART HEART CATHETERIZATION LABORATORY LOCATED RIGHT IN THE ECPC. CURRENTLY THE CENTERS OF EXCELLENCE INCLUDE MERCY HEART CENTER, MERCY CANCER CENTER, MERCY EMERGENCY DEPARTMENT AND TRAUMA CENTER, MERCY SURGERY AND ROBOTIC SURGERY CENTER AND MERCY DENTAL CENTER.MERCY CONTINUES TO PROVIDE RICH COMMUNITY BENEFIT PROGRAMMING, TO DO SO IN THE CURRENT CHALLENGING HEALTH CARE ENVIRONMENT DEMONSTRATES A TRUE COMMITMENT AND ANSWER TO COMMUNITY NEEDS.
PART VI, LINE 6:	THE HOSPITAL IS OWNED BY THE SISTERS OF CHARITY OF ST. AUGUSTINE HEALTH SYSTEM (SCHS). THEY OPERATE TWO HOSPITALS IN OHIO.THE SCHS HAS THREE FOUNDATIONS THAT WERE ESTABLISHED IN 1996 WITH FUNDS FROM THE SALES OF HOSPITALS IN OHIO AND SOUTH CAROLINA, THROUGH STRATEGIC GRANTMAKING, CONVENINGS AND COLLABORATION, EACH OF THE THREE FOUNDATIONS WORK TO ADDRESS ROOT CAUSES OF POVERTY, NURTURE THE GROWTH OF HEALTHY COMMUNITITIES, EMPHASIZE THE NEEDS OF YOUTH AND FAMILIES AND MEASURE THE OUTCOMES OF THESE EFFORTS. THE SCHS ALSO HAS NUMEROUS OTHER PROGRAMS AIMED AT IDENTIFYING AND ANSWERING UNMET AND EMERGING COMMUNITY NEEDS, THESE ORGANIZATIONS HAVE EVOLVED TO MEET EVER-CHANGING COMMUNITY NEEDS, CLINICAL PRACTICES AND TECHNOLOGY WITH A SHARED COMMITMENT TO REPRESENT THE COMPASSION AND EXCELLENCE THAT DISTINGUISHES CATHOLIC HEALTH CARE. MERCY HAS A FOR PROFIT PHYSICIAN GROUP. MERCY PROFESSIONAL CARE CORPORATION EMPLOYS PRIMARY CARE AND SPECIALIST PHYSICIANS WHO HAVE OFFICES IN SURROUNDING TOWNSHIPS AND COUNTIES OF THE MEDICAL CENTER AS WELL AS IN SOME UNDERSERVED AREAS OF CANTON, THE MEDICAL CENTER FUNDED THE $12M LOSS THIS PHYSICIAN GROUP INCURRED IN 2020.MERCY DEVELOPMENT FOUNDATION BEGAN OPERATING AS THE PHILANTHROPIC ARM OF MERCY ON SEPTEMBER 24, 2011. THE SOLE PURPOSE OF THE FOUNDATION IS TO CREATE, IMPLEMENT, MAINTAIN, AND STEWARD DONORS AND ORGANIZATIONS, AND TO ENCOURAGE A COMPRESHENSIVE FUNDRAISING PROGRAM TO MAXIMIZE PHILANTHROP C SUPPORT FOR THE HOSPITAL. THE FOUNDATION OPERATIONS PROVIDES SERVICES FOR GRANT WRITING, SOLICITATION, RECEIPTING , RECORDING, AND MANAGING OF ALL PHILANTHROPIC CONTRIBUTIONS MADE TO AND FOR THE BENEFIT OF THE HOSPITAL.

Schedule H (Form 990) 2020

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
CLEVELAND CLINIC MERCY HOSPITAL

Employer identification number
34-1893439

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVE DALLAS,TX75231	13-5613797	501(C)(3)	35,000	SPONSORSHIP
(2) ARTS IN STARK 900 CLEVELAND AVE NW CANTON,OH44702	34-6609771	501(C)(3)	6,500	COMMUNITY SUPPORT
(3) CANTON REGIONAL CHAMBER OF COMMERCE 222 MARKET AVE N CANTON,OH44702	34-0129930	501(C)(6)	9,000	SPONSORSHIP
(4) UNITED WAY OF GREATER STARK COUNTY 401 MARKET AVE N SUITE 300 CANTON,OH44702	13-4254191	501(C)(3)	50,000	COMMUNITY SUPPORT
(5) CANTON REPOSITORY 500 MARKET STREET CANTON,OH44702	31-1714372	C CORP	9,000	SPONSORSHIP

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2020

Page 2

Part III

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

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

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

Return Reference	Explanation
PART 1, LINE 2:	CLEVELAND CLINIC MERCY HOSPITAL DOES NOT AWARD GRANT FUNDING. IT DOES PROVIDE SUPPORT FOR LOCAL ORGANIZATIONS AS PART OF ITS COMMUNITY RELATIONS. IF SPONSORSHIPS ARE FOR NATIONAL ORGANIZATIONS, THEY MUST BE CENTERED ON A LOCAL OR REGIONAL EVENT.

Schedule I (Form 990) 2020

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow

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

Attach to Form 990.
Graphic Arrow

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

CLEVELAND CLINIC MERCY HOSPITAL

Employer identification number

34-1893439

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2020

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)
1THOMAS J STRAUSS PRESIDENT & CEO	(i) (ii)	0 ------------- 1,009,207	0 ------------- 0	0 ------------- 22,948	0 ------------- 48,192	0 ------------- 19,750	0 ------------- 1,100,097	0 ------------- 0
2AHMED EL GHAMRY SABE EXEC DIR CARDIOLOGY	(i) (ii)	508,675 ------------- 0	308,272 ------------- 0	22,948 ------------- 0	30,902 ------------- 0	37,892 ------------- 0	908,689 ------------- 0	0 ------------- 0
3MELISSA ROGERS TRUSTEE	(i) (ii)	0 ------------- 456,494	0 ------------- 0	0 ------------- 2,430	0 ------------- 48,192	0 ------------- 25,900	0 ------------- 533,016	0 ------------- 0
4DAVID STEWART SENIOR VP & CFO	(i) (ii)	0 ------------- 356,523	0 ------------- 0	0 ------------- 3,336	0 ------------- 28,692	0 ------------- 15,600	0 ------------- 404,151	0 ------------- 0
5JEFFREY MAENDEL PHYSICIAN	(i) (ii)	248,742 ------------- 0	20,000 ------------- 0	88,514 ------------- 0	16,049 ------------- 0	12,980 ------------- 0	386,285 ------------- 0	0 ------------- 0
6DAVID GORMSEN CHEIF MEDICAL OFFICER	(i) (ii)	305,062 ------------- 0	0 ------------- 0	2,121 ------------- 0	28,740 ------------- 0	24,502 ------------- 0	360,425 ------------- 0	0 ------------- 0
7HEE YOON PHYSICIAN	(i) (ii)	269,018 ------------- 0	22,207 ------------- 0	201 ------------- 0	12,255 ------------- 0	26,958 ------------- 0	330,639 ------------- 0	0 ------------- 0
8BARBARA YINGLING VP & CNO	(i) (ii)	268,480 ------------- 0	0 ------------- 0	997 ------------- 0	27,864 ------------- 0	16,306 ------------- 0	313,647 ------------- 0	0 ------------- 0
9ANDREW WOJTKOWSKI DIRECTOR DENTAL SERVICES	(i) (ii)	264,121 ------------- 0	0 ------------- 0	3,876 ------------- 0	22,747 ------------- 0	17,053 ------------- 0	307,797 ------------- 0	0 ------------- 0
10THOMAS TURNER VP FUND DEV & GOVT RELATIONS	(i) (ii)	226,961 ------------- 0	0 ------------- 0	2,751 ------------- 0	19,012 ------------- 0	26,045 ------------- 0	274,769 ------------- 0	0 ------------- 0
11JEFFREY PIKE VP PHYSICIAN REL & BUS DEV	(i) (ii)	214,383 ------------- 0	0 ------------- 0	4,066 ------------- 0	12,224 ------------- 0	33,987 ------------- 0	264,660 ------------- 0	0 ------------- 0
12JUSTIN MODUGNO DENTIST	(i) (ii)	191,710 ------------- 0	4,381 ------------- 0	504 ------------- 0	13,056 ------------- 0	24,072 ------------- 0	233,723 ------------- 0	0 ------------- 0
13SHARON STERN PHYSICIAN	(i) (ii)	202,490 ------------- 0	0 ------------- 0	4,114 ------------- 0	11,391 ------------- 0	10,620 ------------- 0	228,615 ------------- 0	0 ------------- 0
14CINDY HICKEY VP PUBLIC RELATIONS & MKTG	(i) (ii)	140,428 ------------- 0	0 ------------- 0	3,195 ------------- 0	12,358 ------------- 0	21,070 ------------- 0	177,051 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2020

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
PART I, LINE 3	THE REVIEW AND APPROVAL OF EXECUTIVE COMPENSATION IS THE RESPONSIBILITY OF THE BOARD AND IS SUBJECT TO REVIEW BY THE MEMBER SISTERS OF CHARITY HEALTH SYSTEM. THE BOARD USES REPORTS FROM INDEPENDENT COMPENSATION CONSULTANTS, SURVEYORS OR STUDIES TO ASSIST IN THE REVIEW. IN MOST CASES, THESE REPORTS ARE OBTAINED FROM THE SAME SOURCES USED BY THE MEMBER.
PART I, LINE 4B	SUPPLEMENTAL EXECUTIVE RETIREMENT PAYMENTS (SERP) WERE MADE BY THE RELATED ORGANIZATION TO MELISSA ROGERS ($19,500) AND THOMAS STRAUSS ($19,500). THERE IS ALSO A 457(F) PLAN. DAVID GORMSEN AND AHMED EL GHAMRY SABE PARTICIPATED IN 2020. EACH ONE INDIVIDUALLY CONTRIBUTED $19,500 INTO THE PLAN.
PART I, LINE 7	CERTAIN PHYSICIAN AGREEMENTS CONTAIN LANGUAGE THAT ALLOW FOR ADDITIONAL COMPENSATION OUTSIDE THEIR BASE COMPENSATION. SUPPLEMENTAL INSURANCE POLICIES WERE PAID FOR CERTAIN EXECUTIVE OFFICERS.

Schedule J (Form 990) 2020

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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 instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
CLEVELAND CLINIC MERCY HOSPITAL

Employer identification number
34-1893439

Part Ⅰ

Bond Issues

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

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	35,000,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............	35,000,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2019, a current refunding issue)? ........	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2019, an advance refunding issue)? ........		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

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

Cat. No. 50193E

Schedule K (Form 990) 2020

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	4.270 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %
6 Total of lines 4 and 5 .............	4.270 %
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...	X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......
b Exception to rebate? ........
c No rebate due? .........
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X

Schedule K (Form 990) 2020

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...		X

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation

Schedule K (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

CLEVELAND CLINIC MERCY HOSPITAL

Employer identification number

34-1893439

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	THE SISTERS OF CHARITY HEALTH SYSTEM IS THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	UNDER THE ORGANIZATION DOCUMENTS, SISTERS OF CHARITY HEALTH SYSTEM'S BOARD OF DIRECTORS APPOINTS ALL MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	CERTAIN DECISIONS OF THE GOVERNING BODY MUST BE APPROVED BY THE SISTERS OF CHARITY OF ST. AUGUSTINE HEALTH SYSTEM, INC. EXAMPLES OF SOME OF THESE DECISIONS WOULD BE APPROVALS OF ANNUAL BUDGET, PURCHASE OF LAND, UNBUDGETED CAPIAL OVER A CERTAIN THRESHOLD AND LONG TERM LEASES.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS REVIEWED BY EXPERIENCED AND QUALIFIED MEMBERS OF THE FINANCE DIVISION TAX DEPARTMENT AS WELL AS THE CHIEF FINANCIAL OFFICER (CF0). THE RETURN IS THEN SENT TO A PAID PREPARER WHO CONDUCTS AN IN DEPTH REVIEW OF THE RETURN. IN ADDITION, THE ENTIRE RETURN IS ALSO REVIEWED BY THE MEMBERS OF THE BOARD OF TRUSTEES. THE RETURN IS MADE AVAILABLE THROUGH A WEB PORTAL THAT THEY CAN ACCESS BEFORE IT IS FILED WITH THE IRS. ANY QUESTIONS OR CONCERNS THAT THEY WOULD HAVE ARE SENT TO EITHER THE PRESIDENT OR CFO OF THE HOSPITAL.
FORM 990, PART VI, SECTION B, LINE 12C	THE HOSPITAL HAS COMPLIANCE POLICIES AND PROCEDURES THAT ESTABLISH BRIGHT-LINE RULES TO HELP EMPLOYEES CARRY OUT THEIR JOB FUNCTIONS IN A MANNER THAT ENSURES COMPLIANCE WITH APPLICABLE LAWS AND REGULATIONS AND FURTHERS THE HOSPITAL'S MISSION. WRITTEN COMPLIANCE POLICIES AND PROCEDURES HAVE BEEN IMPLEMENTED THROUGHOUT THE HOSPITAL, INCLUDING LEGAL, BILLING, CLINICAL AREAS, FINANCE, ETC. THERE ARE ROUTINE AUDITS TO VALIDATE THE EFFECTIVENES OF THESE INTERNAL POLICIES. OUR ADMINISTRATIVE DIRECTOR OF LABORATORIES IS OUR CHIEF COMPLIANCE OFFICER. IT IS HER RESPONSIBILITY TO MONITOR OUR COMPLIANCE PROGRAM. SHE REPORTS DIRECTLY TO THE AUDIT AND COMPLIANCE COMMITTEE WHO REPORTS TO THE BOARD. TWO COMPLIANCE COMMITTEES (OPERATIONS & ADMINISTRATION) SUPPORT THIS POSITION. A COMPLETE SET OF OUR COMPLIANCE POLICIES CAN BE FOUND ON THE HOSPITAL'S INTRANET WHICH IS AVAILABLE TO ALL EMPLOYEES. YEARLY TRAINING IS DONE FOR ALL EMPLOYEES AND QUARTERLY UPDATES ARE GIVEN TO THE BOARD THROUGH THE BOARD'S JOINT AUDIT & COMPLIANCE COMMITTEE. HANDBOOKS WERE DEVELOPED TO AID IN THE COMMUNICATION AND UNDERSTANDING OF OUR COMPLIANCE POLICIES. THE HOSPITAL SET UP EFFECTIVE LINES OF COMMUNICATION TO REPORT A SUSPECTED COMPLIANCE VIOLATION. THE HOTLINE RECEIVES COMPLAINTS AND CONCERNS WHILE PROTECTING WHISTLEBLOWERS FROM RETALIATION. THE HOTLINE NUMBER IS POSTED AT ALL TIME CLOCKS AND IN THE MONTLY EMPLOYEE NEWSLETTER. A SYSTEM-WIDE STANDARDIZED "CODE OF CONDUCT AND ETHICAL BEHAVIOR" BOOKLET IS AVAILABLE FOR ALL SYSTEM HOSPITALS. THIS BOOKET IS REVIEWED AND REVISED BY THE SISTERS OF CHARITY HEALTH SYSTEM. THIS BOOKET IS AVAILABLE TO ALL EMPLOYEES THROUGH THE INTRANET AT EACH FACILITY. EDUCATION IS ALSO PROVIDED TO THE BOARD OF TRUSTEES BY OUR IN-HOUSE LEGAL COUNSEL. AS PART OF THIS TRAINING, EACH BOARD MEMBER RECEIVED A COPY OF THE REVISED CODE OF CONDUCT AND ETHICAL BEHAVIOR BOOKLET THAT IS HANDED OUT TO OUR EMPLOYEES. YEARLY, THE MEMBERS COMPLETE CONFLICT AND DISCLOSURE STATEMENTS THAT ARE REVIEWED BY OUR LEGAL DEPARTMENT.
FORM 990, PART VI, SECTION B, LINE 15	THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS SERVES AS THE EXECUTIVE COMPENSATION COMMITTEE. IT IS THEIR RESPONSIBILITY TO REVIEW THE COMPENSATION AND BENEFITS FOR THE CEO AND ALL VICE PRESIDENTS. THE RECOMMENDATIONS FOR SALARY CHANGES ARE BASED ON THE ANNUAL PERFORMANCE EVALUATIONS OF EACH EXECUTIVE. THIS REVIW IS DONE YEARLY. BONUS CONSIDERATIONS REFLECT INDIVIDUAL PERFORMANCE ON THE JOB AS WELL AS HOW THE HOSPITAL DID IN MEETING QUALITY, MISSION AND FINANCIAL GOALS. ALL SALARY RANGES AND BENEFITS FOR OFFICERS ARE EVALUATED ANNUALY BY MERCER CONSULTING AND ANY CHANGES ARE SUBJECT TO BOARD REVIEW AND APPROVAL. THE COMMITTEE DETERMINES WHETHER IT WISHES TO ACCEPT THE CEO'S RECOMMENDATIONS OR OFFER ITS OWN SUGGESTIONS REGARDING THE POSITIONS THAT REPORT TO HIM. THE COMMITTEE VOTES TO APPROVE ANY CHANGES WHICH ARE THEN IMPLEMENTED BY THE HOSPITAL. THAT SAME COMMITTEE ALSO DETERMINES THE CEO'S COMPENSATION AND BONUS. THEY MEET WITH THE CEO TO REVIEW HIS PERFORMANCE ON AN ANNUAL BASIS. THEY THEN MEET WITHOUT THE CEO PRESENT TO FURTHER DISCUSS AND OPENLY CRITIQUE HIS PERFORMANCE. IT IS DURING THEIR EXECUTIVE SESSIONS THAT THEY DETERMINE WHETHR ANY ADJUSTMENT IN COMPENSATION WILL BE MADE THAT YEAR AND ALSO DETERMINES THE AWARDING OF ANY BONUS. IN THE EVALUATION OF THE CEO, THE COMMITTEE USES THE SAME INDEPENDENT AGENCY, MERCER CONSUTLING, TO EVALUATE THE CEO'S TOTAL COMPENSATION RANGE AS WELL AS ALL BENEFITS.
FORM 990, PART VI, SECTION C, LINE 18	FORM 990, 990-T, AND FORM 1023 ARE AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19	FINANCIAL STATEMENTS, THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART VIII, LINE 1E	ENACTED ON MARCH 27, 2020 BY THE FEDERAL GOVERNMENT, THE CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY (CARES) ACT WAS ESTABLISHED, WHICH AUTHORIZES $100 BILLION TO BE ADMINISTERED THROUGH GRANTS AND OTHER MECHANISMS TO HOSPITALS, PUBLIC ENTITIES, NOT-FOR-PROFIT ENTITIES, AND MEDICARE- AND MEDICAID ENROLLED SUPPLIERS AND INSTITUTIONAL PROVIDERS. THE PURPOSE OF THESE FUNDS IS TO REIMBURSE PROVIDERS FOR LOST REVENUE ATTRIBUTABLE TO THE CORONAVIRUS PANDEMIC, SUCH AS FORGONE REVENUE FROM CANCELED PROCEDURES, AND TO PROVIDE SUPPORT FOR RELATED HEALTH CARE EXPENSES, SUCH AS CONSTRUCTING TEMPORARY STRUCTURES OR EMERGENCY OPERATION CENTERS; RETROFITTING FACILITIES; PURCHASING MEDICAL SUPPLIES AND EQUIPMENT, INCLUDING PERSONAL PROTECTIVE EQUIPMENT AND TESTING SUPPLIES; AND INCREASING WORKFORCE. FURTHER, THESE RELIEF FUNDS ENSURE UNINSURED PATIENTS ARE RECEIVING TESTING AND TREATMENT FOR COVID-19. THE HOSPITAL RECEIVED $18,973,403 OF PAYMENTS AS PART OF GENERAL AND TARGETED DISTRIBUTIONS OF THE CARES ACT PROVIDER RELIEF FUND. AS OF DECEMBER 31, 2020, THE HOSPITAL HAS RECOGNIZED $18,973,403 AS GRANT REVENUE ON THE CONSOLIDATED STATEMENT OF OPERATIONS. THE HOSPITAL HAS ASSERTED THAT IT HAS MET THE CONDITIONS AND RESTRICTIONS OUTLINED WITHIN THE HHS' PUBLISHED TERMS AND CONDITIONS FOR THE CARES ACT AS OF DECEMBER 31, 2020. IN JANUARY 2021, THE HOSPITAL RECEIVED AN ADDITIONAL $11,797,747 FROM THE PROVIDER RELIEF FUND, WHICH IS NOT RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DUE TO THE TIMING OF THE AWARD. FOR PROVIDER RELIEF FUND DISTRIBUTIONS THAT ARE NOT SUPPORTED BY 2020 EXPENSES AND LOST REVENUE, THE HOSPITAL HAS AN ADDITIONAL SIX MONTHS FROM JANUARY 1, 2021 TO JUNE 30, 2021 IN WHICH TO USE AMOUNTS REMAINING TOWARD EXPENSES ATTRIBUTABLE TO COVID-19 BUT NOT REIMBURSED BY OTHER SOURCES AND/OR LOST PATIENT CARE REVENUE. HHS IS ENTITLED TO RECOUP PROVIDER RELIEF FUNDS THAT ARE UNUSED AS FOR THE PURPOSES DISCLOSED ABOVE.
FORM 990, PART XI, LINE 9:	CASH TRANSFER TO MERCY PROFESSIONAL CARE CORP -10,215,455. CASH TRANSFER FROM MERCY DEVELOPMENT FOUNDATION 191,314. DONATED CAPITAL 165,420. CHANGE IN RESTRICTED FUNDS 13,173. DISTRIBUTIONS FROM MERCY MEDICAL CENTER HOME HEALTH & HOSPICE LLC 282,600. RECLASS LONG TERM LOAN FROM MERCY PROFESSIONAL CARE CORPORATION 10,822,799.
FORM 990, PART XII, LINE 2C:	THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT HAS BEEN CHARGED WITH OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTING FIRM. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
FORM 990, PART XII, LINE 3B:	THE REQUIRED SINGLE AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 HAS NOT BEEN COMPLETED YET FOR THE CALENDAR YEAR END 12/31/2020, BUT PLANS TO BE COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN THE RELEVANT OMB GUIDANCE.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

CLEVELAND CLINIC MERCY HOSPITAL

Employer identification number

34-1893439

Part I

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

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

Part II

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

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

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

Cat. No. 50135Y

Schedule R (Form 990) 2020

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	(k) Percentage ownership
(1) MERCY MEDICAL CENTER HOME HEALTH & HOSPICE LLC 4369 WHIPPLE AVE NW CANTON,OH44178 81-0687167	MEDICAL SERVICES	OH	MERCY MEDICAL CENTER INC	RELATED	1,438,770	3,981,048		No			No	60.000 %

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) MERCY PROFESSIONAL CARE CORPORATION 1320 MERCY DRIVE NW CANTON,OH44708 34-1873008	MEDICAL SERVICES	OH	MERCY MEDICAL CENTER	C	-12,054,783	5,748,827	100.000 %	Yes
(2) SCHS INSURANCE CO LTD 62 FORUM LANE 3RD FLOOR CAYMAN ISLANDS CJ 98-0679825	INSURANCE	CJ	N/A	C				Yes
(3) ST VINCENT MEDICAL GROUP 2475 EAST 22ND STREET CLEVELAND,OH44115 34-1634990	MEDICAL SERVICES	OH	N/A	C				Yes

Schedule R (Form 990) 2020

Page 3

Part V

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

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

Yes

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

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

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

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

Yes

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

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

Yes

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

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

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

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

Yes

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

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
(1) MERCY PROFESSIONAL CARE CORPORATION	R	10,215,455
(2) MERCY MEDICAL CENTER HOME HEALTH AND HOSPICE LLC	C	282,600
(3) MERCY PROFESSIONAL CARE CORPORATION	J	198,944
(4) MERCY DEVELOPMENT FOUNDATION	C	191,314
(5) MERCY DEVELOPMENT FOUNDATION	O	112,967

Schedule R (Form 990) 2020

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2020

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) 2020

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE SERVICES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	3,044
6	Total number of volunteers (estimate if necessary) .............	6	18
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,048,583
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	705,678	19,640,396
9	Program service revenue (Part VIII, line 2g) .........	336,355,202	303,028,443
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	843,577	-38,892
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	8,850,568	8,493,980
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	346,755,025	331,123,927
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	199,725	109,500
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	150,881,902	146,458,619
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	188,926,542	183,323,286
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	340,008,169	329,891,405
19	Revenue less expenses. Subtract line 18 from line 12.......	6,746,856	1,232,522
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	170,595,707	189,855,989
21	Total liabilities (Part X, line 26).............	120,973,548	137,618,352
22	Net assets or fund balances. Subtract line 21 from line 20.....	49,622,159	52,237,637

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 303,897,954 including grants of $ 109,500 ) (Revenue $ 304,863,993 )
	CLEVELAND CLINIC MERCY HOSPITAL OPERATES A 476-BED HOSPITAL SERVICING STARK, CARROLL, WAYNE, HOLMES AND TUSCARAWAS COUNTIES AND PARTS OF SOUTHEASTERN OHIO. IT HAS OVER 600 MEMBERS ON ITS MEDICAL STAFF AND EMPLOYS OVER 2,500 PEOPLE. MERCY OPERATES OUTPATIENT HEALTH CENTERS IN ALLIANCE, CARROLL COUNTY, JACKSON TOWNSHIP, LAKE TOWNSHIP, LOUISVILLE, MASSILLON, NORTH CANTON, PLAIN TOWNSHIP AND TUSCARAWS COUNTY. A CATHOLIC HOSPITAL, MERCY MEDICAL CENTER UPHOLDS THE MISSION AND PHILOSOPHY OF THE SISTERS OF ST. AUGUSTINE AND CONTINUES TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITY.CLEVELAND CLINIC MERCY HOSPITAL WAS AWARDED AN 'A' FROM THE LEAPFROG GROUP'S FALL 2020 HOSPITAL SAFETY GRADE. THE DESIGNATION RECOGNIZED MERCY MEDICAL CENTER'S EFFORTS IN PROTECTING PATIENTS FROM HARM AND MEETING THE HIGHEST SAFETY STANDARDS IN THE UNITED STATES. THE LEAPFROG GROUP IS A NATIONAL ORGANIZATION COMMITTED TO IMPROVING HEALTH CARE QUALITY AND SAFETY FOR CONSUMERS AND PURCHASERS. THE SAFETY GRADE ASSIGNS AN A, B, C, D OR F GRADE TO HOSPITALS ACROSS THE COUNTRY BASED ON THEIR PERFORMANCE IN PREVENTING MEDICAL ERRORS, INFECTIONS AND OTHER HARMS AMONG PATIENTS IN THEIR CARE.CLEVELAND CLINIC MERCY HOSPITAL HAS RECEIVED THE MISSION: LIFELINE GOLD RECEIVING QUALITY ACHIEVEMENT AWARD FOR IMPLEMENTING SPECIFIC QUALITY IMPROVEMENT MEASURES OUTLINED BY THE AMERICAN HEART ASSOCIATION FOR THE TREATMENT OF PATIENTS WHO SUFFER SEVERE HEART ATTACKS.CLEVELAND CLINIC MERCY HOSPITAL RECEIVED THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES GOLD PLUS QUALITY ACHIEVEMENT AWARD. THE AWARD RECOGNIZED THE HOSPITAL'S COMMITMENT TO ENSURING STROKE PATIENTS RECEIVE THE MOST APPROPRIATE TREATMENT ACCORDING TO NATIONALLY RECOGNIZED, RESEARCH-BASED GUIDELINES BASED ON THE LATEST SCIENTIFIC EVIDENCE.CLEVELAND CLINIC MERCY HOSPITAL RECEIVED THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S (AHA/ASA)GET WITH THE GUIDELINES HEART FAILURE GOLD PLUS ACHIEVEMENT AWARD. MERCY ALSO QUALIFIED TO BE RECOGNIZED AS A RECIPIENT OF THE AHA/ASA'S TARGET: HEART FAILURE HONOR ROLL WITH TARGET: TYPE 2 DIABETES HONOR ROLL AWARD.THE HEALTHY BUSINESS COUNCIL OF OHIO (HBCO) RECOGNIZED CLEVELAND CLINIC MERCY HOSPITAL WITH THE 2019 HEALTHY WORKSITE GOLD LEVEL AWARD DURING THE 16TH ANNUAL HEALTHY WORKSITE AWARDS PRESENTATION ON JANUARY 23, 2020, AT THE NATIONWIDE HOTEL AND CONFERENCE CENTER IN COLUMBUS, OHIO. MERCY WAS AMONG 34 OHIO LARGE EMPLOYERS (1,001 OR MORE EMPLOYEES) RECOGNIZED WITH THE GOLD LEVEL AWARD FOR DEMONSTRATING A COMMITMENT TO EMPLOYEE WELLNESS THROUGH COMPREHENSIVE WORKSITE HEALTH PROMOTION AND WELLNESS PROGRAMS. APPLICANTS WERE SCORED ON THE EXTENT THEIR WELLNESS PROGRAMS FACILITATE AND ENCOURAGE EMPLOYEE HEALTH, ENHANCE PRODUCTIVITY AND ENSURE A HEALTHY WORK ENVIRONMENT.THE AMERICAN COLLEGE OF CARDIOLOGY (ACC) RECOGNIZED CLEVELAND CLINIC MERCY HOSPITAL FOR ITS DEMONSTRATED EXPERTISE AND COMMITMENT IN TREATING PATIENTS WITH HEART FAILURE. MERCY WAS AWARDED HEART FAILURE ACCREDITATION IN APRIL BASED ON A RIGOROUS REVIEW OF THE STAFF'S ABILITY TO EVALUATE, DIAGNOSE AND TREAT PATIENTS WITH HEART FAILURE THROUGH PRE-HOSPITAL CARE, EARLY STABILIZATION, ACUTE CARE, TRANSITIONAL CARE, CLINICAL QUALITY MEASURE AND MORE. HOSPITALS THAT EMPLOY AN EVIDENCE-BASED, PROTOCOL-DRIVEN AND SYSTEMATIC APPROACH TO MANAGING HEART FAILURE HAVE BEEN ABLE TO REDUCE TIME TO TREATMENT, AND ARE ABLE TO IDENTIFY AND PREDICT HIGH-RISK PATIENTS WHILE ALSO REDUCING LENGTH-OF-STAY AND HOSPITAL READMISSIONS.MERCY SLEEP LABS AT THE MAIN HOSPITAL AND JACKSON ACHIEVED ACCREDITATION RENEWAL FOR FIVE YEARS FROM THE AMERICAN ACADEMY OF SLEEP MEDICINE. SINCE 1977, THE AMERICAN ACADEMY OF SLEEP MEDICINE (AASM) STANDARDS FOR ACCREDITATION HAVE BEEN THE "GOLD STANDARD" BY WHICH THE MEDICAL COMMUNITY AND THE PUBLIC EVALUATE SLEEP MEDICINE FACILITIES. BY ACHIEVING ACCREDITATION, A SLEEP CENTER DEMONSTRATES A COMMITMENT TO PROVIDING QUALITY DIAGNOSTIC SERVICES AND MANAGEMENT OF SLEEP PATIENTS.MERCY SLEEP CENTER ACHIEVED REACCREDITATION AS AN A-STEP INTRODUCTORY COURSE PROVIDER FOR A PERIOD OF TWO YEARS BY THE AMERICAN ACADEMY OF SLEEP MEDICINE (AASM). BY SUCCESSFULLY COMPLETING THE REACCREDITATION PROCESS AND UPHOLDING THE A-STEP STANDARDS FOR ACCREDITATION, MERCY HAS SHOWN ITS DEDICATION TO THE ADVANCEMENT OF EDUCATION FOR SLEEP TECHNOLOGISTS.MERCY MEDICAL CENTER EARNED THE U.S. ENVIRONMENTAL PROTECTION AGENCY'S (EPA) ENERGY STAR CERTIFICATION FOR SUPERIOR ENERGY PERFORMANCE. THIS IS THE 12TH YEAR IN A ROW THAT MERCY HAS EARNED THE ENERGY STAR, REFLECTING A LEGACY OF CONTINUED ENERGY SAVINGS. ENERGY STAR CERTIFIED BUILDINGS AND PLANTS ARE VERIFIED TO PERFORM IN THE TOP 25 PERCENT OF BUILDINGS NATIONWIDE, BASED ON WEATHER-NORMALIZED SOURCE ENERGY USE THAT TAKES INTO ACCOUNT OCCUPANCY, HOURS OF OPERATION, AND OTHER KEY METRICS.MERCY PRIMARY CARE LAKE COMPLETED A SUCCESSFUL AUDIT FROM THE STATE FOR COMPREHENSIVE PRIMARY CARE (CPC) DESIGNATION REPRESENTING ALL OF PROCORP. THE AUDITING TEAM WAS VERY IMPRESSED WITH NOT ONLY THE PREPARATION BUT ALSO THE KNOWLEDGE THE QUALITY TEAM AND LAKE TEAM PRESENTED. THE AUDITORS WERE APPRECIATIVE OF THE CARE AND FOLLOW-THROUGH PROCORP PROVIDES TO ITS MEMBERS.NOTABLE ACHIEVEMENTS:NEW MUSCULOSKELETAL CENTER OPENSMERCY MUSCULOSKELETAL CENTER OPENED IN 2020. THE CENTER WILL TREAT CONDITIONS SUCH AS PAIN IN THE KNEE, ANKLE OR SHOULDER, AS WELL AS OTHER INJURIES TO THE MUSCLES, TENDONS, LIGAMENTS, BONES, NECK AND BACK. NEXT DAY APPOINTMENTS ARE AVAILABLE.MERCY MEDICAL CENTER WAS THE FIRST IN OHIO TO OFFER AQUABLATION THERAPY FOR BPH,A MINIMALLY INVASIVE SURGICAL PROCEDURE TO TREAT NON-CANCEROUS ENLARGED PROSTATE.THE BENEFITS INCLUDE SIGNIFICANT REDUCTION IN BPH SYMPTOMS WITH REDUCED SIDE EFFECTS WHEN COMPARED TO TRADITIONAL SURGERY.

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 expenses303,897,954

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,458,717	1,850,938	644,409

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	19,622,396

f	All other contributions, gifts, grants, and similar amounts not included above		1f	18,000

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		19,640,396

		Business Code
2a	PATIENT CARE	621110	301,779,906	301,779,906
b	PROGRAM RENTAL INCOME	532000	1,248,537	1,248,537
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		303,028,443

3 Investment income (including dividends, interest, and othersimilar amounts) ......			-95,993			-95,993
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	142,265		7a
b	Less: cost or other basis and sales expenses	85,164		7b
c	Gain or (loss)	57,101		7c
d	Net gain or (loss).........			57,101			57,101
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	PHARMACY		446110	3,441,101			3,441,101
b	OTHER REVENUE		900099	2,919,619	1,835,550	74,066	1,010,003
c	CAFETERIA		722514	1,158,743			1,158,743
d	All other revenue ....			974,517		974,517
e	Total. Add lines 11a–11d ......			8,493,980
12	Total revenue. See instructions.....			331,123,927	304,863,993	1,048,583	5,570,955

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	109,500	109,500
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	2,562,635		2,562,635
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........	113,600,674	102,477,741	11,122,933
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	6,150,987	5,548,728	602,259
9	Other employee benefits .......	14,590,627	13,162,021	1,428,606
10	Payroll taxes ...........	9,553,696	8,618,269	935,427
11	Fees for services (non-employees):
a	Management ......	1,506,935	1,506,935
b	Legal .........	536,968	19,813	517,155
c	Accounting ...........	105,000		105,000
d	Lobbying ...........	41,012	41,012
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	32,809,087	29,097,425	3,711,662
12	Advertising and promotion ....	1,047,481	1,047,481
13	Office expenses .......	4,058,543	2,840,794	1,217,749
14	Information technology ......	9,961,126	8,985,807	975,319
15	Royalties ..
16	Occupancy ...........	11,726,495	11,227,660	498,835
17	Travel ............	90,683	75,463	15,220
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	116,001	43,509	72,492
20	Interest ...........	2,716,580	2,685,548	31,032
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	10,830,158	10,706,747	123,411
23	Insurance ...	5,065,183	4,569,238	495,945
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	68,938,756	68,938,756
b	PATIENT BAD DEBT	17,426,752	17,426,752
c	STATE FRANCHISE TAX	6,135,909	6,135,909
d	MEMBER ASSESSMENT	3,876,400	2,907,300	969,100
e	All other expenses	6,334,217	5,725,546	608,671
25	Total functional expenses. Add lines 1 through 24e	329,891,405	303,897,954	25,993,451	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			8,395	1	8,394
2	Savings and temporary cash investments .........			12,015,631	2	23,365,994
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			40,278,808	4	32,193,135
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			4,445,083	8	4,734,087
9	Prepaid expenses and deferred charges ......			5,716,093	9	5,939,076
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	336,624,906
b	Less: accumulated depreciation	10b	258,519,488	82,919,307	10c	78,105,418
11	Investments—publicly traded securities .			22,954,219	11	43,960,560
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			2,258,171	15	1,549,325
16	Total assets. Add lines 1 through 15 (must equal line 33)...			170,595,707	16	189,855,989

17	Accounts payable and accrued expenses .....	56,789,460	17	71,995,182
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	30,161,131	20	28,299,004
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	12,479,292	23	17,110,591
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	21,543,665	25	20,213,575
26	Total liabilities. Add lines 17 through 25..	120,973,548	26	137,618,352

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	49,466,695	27	52,069,000
28	Net assets with donor restrictions ...........	155,464	28	168,637
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	49,622,159	32	52,237,637
33	Total liabilities and net assets/fund balances ........	170,595,707	33	189,855,989