TY 2021 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/1099-NEC)
(1) Timothy Dentry...................................................................... Trustee/Ex-Off	1.00 ................. 50.00	X	X	0	1,840,352	60,782
(2) Nicolas F Arredondo...................................................................... Physician	50.00 ................. 0.00			1,290,303	0	41,866
(3) Stephen W Rodrigue...................................................................... Physician	50.00 ................. 0.00			1,246,298	0	416
(4) John Wahlig...................................................................... Physician	50.00 ................. 0.00			1,179,976	0	40,729
(5) Bruce F Gomberg...................................................................... Physician	50.00 ................. 0.00			1,021,150	0	11,976
(6) Anthony Filer...................................................................... Treasurer	1.00 ................. 50.00		X	0	934,170	61,116
(7) Lee Thibodeau...................................................................... Physician	50.00 ................. 0.00			877,511	0	42,286
(8) Glenn Martin...................................................................... Secretary/Pt Yr	1.00 ................. 50.00		X	0	713,228	112,701
(9) Charles Therrien...................................................................... Pres/Ex-Off	50.00 ................. 0.00	X	X	482,104	0	104,672
(10) Craig Brett MD...................................................................... Trustee/Ex-Off	50.00 ................. 0.00	X		509,576	0	37,510
(11) Paul Bolin...................................................................... SVP & CPO	1.00 ................. 50.00		X	0	429,549	105,611
(12) John Southall...................................................................... VP Sr Phys Exec	50.00 ................. 0.00		X	427,743	0	39,386
(13) Bette L Neville...................................................................... Former VP, CNO	0.00 ................. 50.00			0	283,206	51,494
(14) George Eaton...................................................................... Secretary/Pt Yr	1.00 ................. 50.00		X	0	254,686	42,889
(15) Melissa Skahan...................................................................... VP Mission Int	50.00 ................. 0.00		X	248,818	0	30,470
(16) Wendy Napolitano...................................................................... VP Perf Oper	50.00 ................. 0.00		X	233,764	0	41,940
(17) David Kennedy...................................................................... VP, Finance	50.00 ................. 0.00		X	258,079	0	11,412

(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/1099-NEC)
(18) Greg Orr........................................................................ VP Medical Gr	50.00 .......................0.00		X	229,158	22,143
(19) Chris Howard........................................................................ Trustee	1.00 .......................0.00	X		0	0
(20) Arthur Batson III........................................................................ Trustee	1.00 .......................0.00	X		0	0
(21) Daniel McGarvey........................................................................ Trustee	1.00 .......................0.00	X		0	0
(22) Sister Anne-Marie Bourque........................................................................ Trustee	1.00 .......................0.00	X		0	0
(23) Laura Blaisdell MD........................................................................ Trustee	1.00 .......................0.00	X		0	0
(24) Sister Mary Morey........................................................................ Trustee	1.00 .......................0.00	X		0	0
(25) Mike Varney........................................................................ Trustee	1.00 .......................0.00	X		0	0
(26) Karen Pardue........................................................................ Trustee	1.00 .......................0.00	X		0	0
(27) Sister Judith Carey RSM........................................................................ Trustee	1.00 .......................0.00	X		0	0
(28) Douglas McKeown........................................................................ Trustee/V Chair	1.00 .......................0.00	X	X	0	0
(29) William Schirmer MD........................................................................ Trustee	1.00 .......................0.00	X		0	0
(30) Dega Dhalac........................................................................ Trustee	1.00 .......................0.00	X		0	0
(31) Debra D Taylor........................................................................ Trustee/Chair	2.00 .......................0.00	X	X	0	0
(32) Sister Patricia Pora........................................................................ Trustee	1.00 .......................0.00	X		0	0
(33) Lisa Toner........................................................................ Trustee	1.00 .......................0.00	X		0	0
(34) Victoria Morales........................................................................ Trustee	1.00 .......................0.00	X		0	0
(35) Jennifer Palminteri MD........................................................................ Trustee	1.00 .......................0.00	X		0	0
(36) James Polewaczyk........................................................................ Trustee	1.00 .......................0.00	X		0	0
(37) Robyn McDevitt........................................................................ VP Pt Cr Svcs	50.00 .......................0.00		X	0	0
(38) Mark Seelen........................................................................ VP Surgical Svc	50.00 .......................0.00		X	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
Chest Medicine Associates 100 Foden Raod Ste 103 South Portland,ME041062351	Physician & Director Svc	1,628,357
Ogrady-Peyton International 4441 Collection Center Drive Chicago,IL606930044	Temp Staffing	947,198
Spectrum Healthcare Partners 324 Gannett Dr Ste 200 South Portland,ME04106	Temp Staffing	992,787
HBCS 118 Lukens Drive New Castle,DE19720	Collection Fees	1,236,742
Seacoast Pathology Inc PO Box 100519 Atlanta,GA303840519	Laboratory Services	1,250,539
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 28

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

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

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

Mercy Hospital
Northern Light Mercy Hospital

Employer identification number

01-0211534

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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. 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—2020. 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—2021. 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—2020. 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. 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—2020. 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) 2021

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) .

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

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 on 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 on 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) 2021

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

11a

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

11b

A 35% controlled entity of a person described on 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 on 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) 2021

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) 2021

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 2021 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-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.1

- TIN:

Schedule B
(Form 990)

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

2021

Name of the organization

Mercy Hospital
Northern Light Mercy Hospital

Employer identification number

01-0211534

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) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization Mercy Hospital Northern Light 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) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization Mercy Hospital Northern Light Mercy Hospital		Employer identification number 01-0211534

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) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization Mercy Hospital Northern Light Mercy Hospital			Employer identification number 01-0211534
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) (2021)

Additional Data

Software ID:	21013475
Software Version:	2021v4.1

- TIN:

SCHEDULE C
(Form 990)

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

2021

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

Mercy Hospital
Northern Light Mercy Hospital

Employer identification number

01-0211534

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.

Cat. No. 50084S

Schedule C (Form 990) 2021

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) 2018	(b) 2019	(c) 2020	(d) 2021	(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) 2021

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

28,877

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

28,877

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 1i - Other Activities Description	Non-deductible dues
Part IV - Additional Information

Schedule C (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.1

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Mercy Hospital
Northern Light Mercy Hospital

Employer identification number

01-0211534

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) 2021

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 ....	4,116,780	3,558,084	3,506,492	3,492,269	1,997,798
b	Contributions ...	1,891,277	28,673	4,868	9,344	1,283,502
c	Net investment earnings, gains, and losses	-771,544	620,156	144,504	67,892	273,034
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	1,624,293	90,133	97,780	63,013	62,065
f	Administrative expenses ....
g	End of year balance ......	3,612,220	4,116,780	3,558,084	3,506,492	3,492,269

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 .....	9,703,734		9,703,734
b	Buildings ....	99,220,459	16,582,521	82,637,938
c	Leasehold improvements	2,203,719	1,847,416	356,303
d	Equipment ....	102,651,716	44,953,401	57,698,315
e	Other .....	1,630,688	553,459	1,077,229
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				151,473,519

Schedule D (Form 990) 2021

Page 3

Part VII

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

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
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

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

Part IX

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

(a) Description				(b) Book value
(1)A/R Workers Compensation Insurance				1,702,572
(2)Assets whose use is limited				1,682,012
(3)Beneficial Interest in Perpetual Trusts				820,923
(4)Board designated funds-Other				7,214
(5)Construction Fund				30
(6)Investment in Net Assets held @ NLHF				8,257,581
(7)Right-of-Use Operating Lease Assets				17,257,372
(8)Self Insurance & Pension Plans				5,689,790
(9)Temporarily Donor Restricted Funds				47,684
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				35,465,178

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
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	35,509,656
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) 2021

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: Intended uses of the endowment fund.

Endowment funds are designated for purposes that align within this organization's exempt purpose.

Part X : FIN48 Footnote

Northern Light Health, its hospitals, and certain other affiliates have been determined by the Internal Revenue Service to be tax-exempt charitable organizations as described in Section 501(c)(3) or 501(c)(2) of the Internal Revenue Code (the Code) and, accordingly, are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Accordingly, no provision for federal income taxes has been recorded in the accompanying consolidated financial statements for these organizations.Tax-exempt charitable organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by FASB, assets and liabilities are established for uncertain tax positions taken or positions expected to be taken in income tax returns when such positions are judged to not meet the more-likely-than-not threshold, based upon the technical merits of the position. Estimated interest and penalties, if applicable, related to uncertain tax positions are included as a component of income tax expense. The Northern Light Health has evaluated its tax position taken or expected to be taken on income tax returns and concluded the impact to be not material.Certain of the Northern Light Health's affiliates are taxable entities. Deferred taxes related to these entities are based on the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect in the years the differences are expected to reverse. The deferred tax assets and liabilities for these entities are not material.

Schedule D (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.1

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Mercy Hospital
Northern Light Mercy Hospital

Employer identification number

01-0211534

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .		4,109	1,293,161		1,293,161	0.480 %
b	Medicaid (from Worksheet 3, column a) . . . . .		37,769	35,451,167	21,600,475	13,850,692	5.150 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		41,878	36,744,328	21,600,475	15,143,853	5.630 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	13	558	1,547,788		1,547,788	0.580 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	4		9,691		9,691
j	Total. Other Benefits . .	17	558	1,557,479		1,557,479	0.580 %
k	Total. Add lines 7d and 7j .	17	42,436	38,301,807	21,600,475	16,701,332	6.210 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

Page

Part II

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

		(a) Number of activities or programs (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	1	534,994	534,994	0.200 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	1	534,994	534,994	0.200 %

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. ......

2,416,341

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

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

Section B. Medicare

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

73,801,004

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

106,443,243

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

-32,642,239

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) 2021

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	Northern Light Mercy Hospital 175 Fore River Parkway Portland,ME04102 northernlighthealth.org/Mercy- 38065	X	X	X

Schedule H (Form 990) 2021

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)

	Northern Light 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 22

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

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): See Part V, Line 16j for URL

Other website (list url): See Part V, Line 16j for 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 22

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

Yes

If "Yes" (list url): See Part V, Line 16j for URL

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) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Northern Light 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 150.0000%
and FPG family income limit for eligibility for discounted care of 250.0000%

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):

See Part V, Line 16j for URL

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

See Part V, Line 16j for URL

A plain language summary of the FAP was widely available on a website (list url):
See Part V, Line 16j for URL

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) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	Northern Light 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) 2021

Page 7

Part VFacility Information (continued)

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

	Northern Light 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) 2021

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
Facility: Northern Light Mercy Hospital - Part V, Section B, Line 5	The Maine Shared CHNA research team conducted a statewide qualitative assessment among stakeholders to identify and prioritize significant health issues in communities across the state. The assessment, coordinated with the Maine CDC, engaged public health expertise throughout the process. Community outreach was conducted between September 2021 and January 2022. All forms of engagement included public forums, community sponsored events, and oral surveys. The purpose of these outreach efforts was to gather feedback on data and to identify health priorities, community assets, and gaps in resources to be used in health improvement planning. Virtual community forums with residents and service providers were held in the county in partnership with the Maine CDC to solicit input from individuals representing populations with health disparities including medically underserved, low-income, or minority populations. The following organizations attended the October 5 & 26, 2021 Cumberland County Shared CHNA Community Engagement Forum and provided valuable feedback on the Maine Shared CHNA.Persons representing broad interests of the community who were consulted during the engagement process (the following list was extracted from the Cumberland County CHNA report, page 22): Bridgton Hospital, Central Maine Healthcare, City of Portland, City of Portland - Public Health Division, Hospital Community Representative, Cumberland County Government, Cumberland Public Health District, From the First Tooth, Gateway Community Services, Good Shepherd Food Bank, Greater Portland Health, Healthcare Coalition of Maine, Healthy Androscoggin, Lake Region Community Health Committee, Macdonald Motors, Maine Access Immigrant Network, Maine Access Points, Maine Behavioral Healthcare, Maine Medical Center, Maine Medical Center Research Institute, Maine Medical Partners, Maine Medical Partners Pediatrics, MaineHealth, Northern Light Beacon Health, Northern Light Health, Northern Light Home Care & Hospice, Northern Light Mercy Hospital, Northern New England Poison Center, Planned Parenthood of Northern New England, Portland Public Schools, Protech Solutions / Good Grid, Rural Health & Primary Care Program; Department of Health and Human Services, Spring Harbor Hospital, The Opportunity Alliance, The Opportunity Alliance WIC, The Opportunity Alliance; Lake Region Community Health Committee, Through These Doors, Town of Raymond, United Way of Southern Maine. New this cycle was an expanded effort to reach those who may experience systemic disadvantages and therefore experience a greater rate of health disparities. Two types of outreach were piloted in this effort.One effort included nine community sponsored events hosted by organizations having statewide reach representing the following communities: Black or African Americans; people who are homeless or formerly homeless; older adults; people who are deaf or hard of hearing; people who define themselves or identify as lesbian, gay, bisexual, transgender, and queer and/or questioning (LGBTQ+); people with a disability; people with a mental health diagnosis; people with low income; and youth.Another effort included conducting oral surveys in collaboration with eight ethnic-based community organizations community health workers in order to better reach Maines immigrant population that included: 1,000 surveys were conducted in either English (32%), Somali, (24%), Arabic (23%), French (8%), Spanish (5%), Lingala (3%), and other languages including Swahili, Maay Maay, Portuguese, Oromo, Eretria, Kirundi, and Amara. When asked for their countries of origin, respondents most commonly cited the United States (212), Iraq (205), Somalia (157), The Democratic Republic of Congo (81), Djibouti (70), Kenya (30), and Mexico (29). Other countries of origin mentioned included Rwanda, Ethiopia, Angola, Syria, Guatemala, South Africa, Palestine, Puerto Rico, Morocco, Afghanistan, El Salvador, Nigeria, Canada, Burundi, Eritrea, France, Honduras, Uganda, Jamaica, Mali, Gabon, Sudan, Nicaragua, Peru, and Brazil.
Facility: Northern Light Mercy Hospital - Part V, Section B, Line 6a	The Maine Shared CHNA was conducted through a collaborative effort among Maines four largest health-care systems Central Maine Healthcare, Northern Light Health (legal name Eastern Maine Healthcare Systems), MaineGeneral Health, MaineHealth and the Maine Center for Disease Control and Prevention, an office of the Maine Department of Health and Human Services (DHHS). Northern Light Health member organizations participating in the Shared CHNA included Acadia Hospital, AR Gould Hospital, Blue Hill Hospital, CA Dean Hospital, Eastern Maine Medical Center, Inland Hospital, Maine Coast Hospital, Mayo Hospital, Mercy Hospital, and Sebasticook Valley Hospital. See Line 5s response for a comprehensive list of participating organizations, including other non-Northern Light Health hospitals who were consulted during the engagement process.
Facility: Northern Light Mercy Hospital - Part V, Section B, Line 11	Northern Light Health recently conducted their 2022 Shared Community Health Needs Assessment that will inform priority work for implementation in FY23 FY25. In FY22, Northern Light Mercy Hospital developed our plan to address significant needs identified in our 2022 Community Health Strategy (aka, implementation strategy). Though priority work from the 2022 Shared CHNA wont begin until FY23, Mercy Hospital will be prepared to implement priority work from our 2022 strategy with no gap in implementation efforts between the two CHNA cycles. While conducting the 2022 Shared CHNA research and outreach, Mercy Hospital continued to implement priority work from the final year, FY22, of the three-year 2019 Community Health Strategy (implementation years FY20, FY21, and FY22). Below reflect these efforts related to the 2019 Community Health Strategy.The data gathered from the 2019 Shared Community Health Needs Assessment (Shared CHNA) informed Mercy Hospitals Community Health Strategy (Implementation Strategy) developed with input from community stakeholders including those who serve priority populations, the local Public Health District Liaison, local business leaders, and community advocates. Priorities were selected after weighing the severity of each priority area, availability of known and effective interventions, determination that the priority area was un-addressed or under-addressed, and community collaborations underway with Mercy Hospital. A hospital task force considered the data and identified areas of significant need including priority concerns, intended actions to address the need, programs and resource allocation, planned collaborations, and population of focus. The implementation strategy was presented and adopted by the hospitals governing board. Northern Light Mercy Hospital identified five priority areas of focus addressing the significant needs identified in its 2019 CHNA as follows:Social determinants of healthActions taken by Mercy Hospital to address this priority in FY22: Northern Light Health made significant progress in Social Determinants of Health (SDOH) screening and intervention. The Northern Light Health SDOH team defined completed SDOH screening and established a system policy for minimum SDOH screening standards to provide consistency in screening guidelines. During the course of FY22, the SDOH team worked with Information Systems to continually improve the SDOH screening tool based on user recommendations and will continue to manage user requests moving forward. SDOH team leaders worked with members of Northern Light Health Quality to develop an SDOH screening dashboard that provides real-time screening rates by member organization, practice, provider, and payor type, as well as prevalence of SDOH need from positive screening results. The dashboard is undergoing validation and is anticipated to be available in FY23. Northern Light Health achieved a significant milestone in responding to social health needs when the Findhelp platform went live on September 13, 2022. Findhelp is a national social care network that will make it easier for patients and providers to find and connect with local resources. The platform is embedded within our electronic health record so that care teams can find and refer patients to resources. Community members can also access Findhelp at any time via a public portal.Substance useActions taken by Mercy Hospital to address this priority in FY22: Northern Light Mercy Hospital delivered training that allows primary care providers to obtain their x-waiver and prescribe Suboxone for opioid use disorder. This commitment ensures that all five primary care sites at Northern Light Mercy Hospital are well prepared to serve patients with substance use disorder.Access to careActions taken by Mercy Hospital to address this priority in FY22: Northern Light Mercy Hospital continued to support work at local housing authorities with outreach activities at 100 State Street and testing and vaccination at the Fore River Campus Pharmacy and within primary care offices. A survey was administered at 100 State Street to ensure that transportation was not a barrier to services offered at the Fore River Campus. Health Promotion Clinics and Urgent Care Services were offered for New Mainers at local hotels in South Portland and Yarmouth with follow up care occurring in Primary Care, Womens Health, Pediatrics, and Specialty Care. Transportation, access to medication, housing insecurity, and lack of case management added complexity for Mercys care teams.Mental health Actions taken by Mercy Hospital to address this priority in FY22: Northern Light Mercy Hospital provided trainings for nurses and providers specific to tactics to successfully engage patients with severe and persistent mental illness. These trainings were developed in response to requests from nursing staff, who were seeking greater insight, expected behaviors, proven engagement tactics, and treatments available for persons with complex trauma, personality disorders, and substance use disorders. This has a promoted dialogue and ongoing requests for education resources and training for clinical teams.Older adult health/healthy agingActions taken by Mercy Hospital to address this priority in FY22: Northern Light Mercy Hospital offered training for all primary care practices with medical leaders of Northern Light Healths Palliative Care Program on advance care planning and palliative care. In FY22, each practice was provided educational materials and specific tools to engage patients and families in advance care planning conversations. Northern Light Mercy Hospital also acquired a geriatrics practice that increased our capacity to provide care for older adults and medical direction for local nursing homes.Additional information related to actions taken by Northern Light Mercy Hospital on the above priorities can be found in their FY22 Progress Report to Our Community at https://northernlighthealth.org/2019-Community-Health-Strategy. Northern Light Mercy Hospital considered all priorities identified in the Shared CHNA, as well as other sources, through an extensive review process. Northern Light Mercy Hospital opted to work on all top five priorities as identified in the Shared CHNA.
Facility: Northern Light Mercy Hospital - Part V, Section B, Line 16j	Response for 7a (list URL) is: https://northernlighthealth.org/Mercy-HospitalResponse for 7b (list URL) is: https://northernlighthealth.org/Community-Health-Needs-Assessment/2022-CHNA-ReportsResponse for 10a (list URL) is:https://northernlighthealth.org/Community-Health-Needs-Assessment/2022-Community-Health-StrategyResponse for 16a, 16b, 16c (list URL) is https://northernlighthealth.org/Mercy-Hospital under "Pay My Bill"

Schedule H (Form 990) 2021

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?
Name and address		Type of Facility (describe)
1	Northern Light Womens Health 195 Fore River Parkway Suite 310 Portland,ME04102	Medical Office Building - Physician Svc
2	Northern Light Breast Care 195 Fore River Parkway Suite 250 Portland,ME04102	Medical Office Building - Physician Svc
3	Northern Light PrimaryUrgent Care 19 South Gorham Crossing Gorham,ME04038	Medical Office Building - Physician Svc
4	Northern Light Cancer Care 195 Fore River Parkway Suite 360 Portland,ME04102	Medical Office Building - Physician Svc
5	Northern Light Lymphedema Care 1364 Congress Street Suite 3 Portland,ME04102	Medical Office Building - Physician Svc
6	Northern Light Spine Surgery 195 Fore River Parkway Suite 440 Portland,ME04102	Medical Office Building - Physician Svc
7	Northern Light Endocrinology and Diabetes Care 155 Fore River Parkway Portland,ME04102	Medical Office Building - Physician Svc
8	Northern Light Cardiovascular Care 195 Fore River Parkway Suite 460 Portland,ME04102	Medical Office Building - Physician Svc
9	Northern Light Gastroenterology 155 Fore River Parkway Suite 130 Portland,ME04102	Medical Office Building - Physician Svc
10	Northern Light Womens Imaging 195 Fore River Parkway Suite 260 Portland,ME04102	Medical Office Building - Mammography Svc
11	Northern Light Pain Management 195 Fore River Parkway Suite 120 Portland,ME04102	Medical Office Building - Physician Svc
12	Northern Light Physical Therapy 1364 Congress Street Suite 3 Portland,ME04102	Medical Office Building - Physical Therapy Svc
13	Northern Light Primary Care 25 Long Creek Drive South Portland,ME04106	Medical Office Building - Physician Svc
14	Northern Light Internal Medicine 43 Baxter Boulevard Portland,ME04101	Medical Office Building - Physician Svc
15	Northern Light Surgery 195 Fore River Parkway Suite 210 Portland,ME04102	Medical Office Building - Physician Svc
16	Northern Light Primary Care 75 Gray Road Falmouth,ME04105	Medical Office Building - Physician Svc
17	Northern Light PrimaryUrgent Care 409 Roosevelt Trail Windham,ME04062	Medical Office Building - Physician Svc
18	Northern Light Wound and Hyperbaric Medicine 155 Fore River Parkway Suite 110 Portland,ME04102	Medical Office Building - Physician Svc
19	Northern Light Primary Care 385 Route One Yarmouth,ME04096	Medical Office Building - Physician Svc
20	Dr Harry E Davis Pediatrics 195 Fore River Parkway Suite 160 Portland,ME04102	Medical Office Building - Physician Svc
21	Dr Harry E Davis Pedatrics 385 Route One Yarmouth,ME04096	Medical Office Building - Physician Svc
22	Dr Harry E Davis Pediatrics 409 Roosevelt Trail Windham,ME04062	Medical Office Building - Physician Svc
23	Northern Light Ear Nose and Throat Care 195 Fore River Parkway Suite 420 Portland,ME04102	Medical Office Building - Physician Svc
24	Northern Light Mercy Midwives 527 Ocean Avenue Portland,ME04103	Medical Office Building - Physician Svc
25	Northern Light Orthopedics 20 Northbrook Drive Falmouth,ME04105	Medical Office Building - Physician Svc
26	Northern Light Mercy Outpatient Specialty & Surgery Center 155 Fore River Parkway Portland,ME04102	Medical Office Building - Physician Svc

Schedule H (Form 990) 2021

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 - Related Organization Community Benefit Report	The Northern Light Mercy Hospital community benefit report is contained in an annual community benefit report prepared by Northern Light Health which is the parent organization of all related organizations.
Part I, Line 7 - Explanation of Costing Methodology	Ratio of Patient Care Cost-to-Charges is used in calculations.
Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense	The costing methology used to determine the amount is cost to charge ratio.
Part III, Line 4 - Bad Debt Expense	Patient and trade accounts receivable are stated at the amount management expects to collect from outstanding balances. See Footnote 2 of the attached financial statements, page 16 to 19 - Patient Service Revenue and Accounts Receivable section.
Part III, Line 8 - Explanation Of Shortfall As Community Benefit	Medicare losses should be treated as a community benefit because the losses are incurred in performing an important public service, and Maine hospitals experience one of the lowest Medicare reimbursement rates in the country.
Part III, Line 9b - Provisions On Collection Practices For Qualified Patients	All account guarantors who express an inability to pay inpatient and outpatient services will be screened for eligibility for charity care using an application and guidelines established by Northern Light Mercy Hospital. An account may be reconsidered for charity care at any time when new information is available about a patient's inability to pay.
Part VI, Line 3 - Patient Education of Eligibility for Assistance	Northern Light Health Financial Counselors screen patients for federal, state or government programs and brochures are displayed at all Northern Light locations. Financial Assistance is widely publicized within the community by the following methods:Offered by receiving a conspicuous written notice on their billing statementsListed on the Northern Light Health web portal www.northernlighthealth.org/billing Posters are displayed in public locations in each hospital facilityCommunity posters are displayed outside of the organization (Food Cupboards, Libraries, Auditoriums, Churches, Banks)Packets are provided at all check in locations which include an application, instructions, and a Financial Assistance Policy (FAP) Plain Language Summary
Part VI, Line 4 - Community Information	Located in Portland, Maine, Northern Light Mercy Hospital has a service area comprised of both primary and secondary service areas, together referred to as the total service area. Total service areas (TSAs) are developed by the Northern Light Health Planning department based on neighboring zip codes from which a majority of a hospitals inpatient admissions originate. TSAs can sometimes overlap due to hospital locations or because of the specialty services provided by the hospitals.Towns representing Mercy Hospitals primary service area include: Buxton, Cape Elizabeth, Casco, Cornish, Cumberland, East Baldwin, Falmouth, Freeport, Gorham, Gray, Hollis, Limington, North Yarmouth, Old Orchard Beach, Portland, Pownal, Raymond, Saco, Scarborough, South Portland, Standish, Steep Falls, West Baldwin, Westbrook, Windham, and Yarmouth. Towns representing Mercy Hospitals secondary service area include: Acton, Alfred, Bath, Biddeford, Bridgton, Brownfield, Brunswick, Denmark, Durham, East Waterboro, Fryeburg, Harpswell, Harrison, Hiram, Kennebunk, Kennebunkport, Lebanon, Limerick, Lovell, Naples, New Gloucester, North Waterboro, Parsonsfield, Poland, Porter, Sanford, Sebago, Shapleigh, Springvale, Topsham, Waterboro, Waterford, and West Newfield.Cumberland Countys race/ethnicity and selected demographics are provided below for Mercy Hospital based on the hospitals physical location in Cumberland County.Cumberland County - Race/Ethnicity: American Indian/Alaskan Native 0.2% (578), Asian 2.2% (6,350), Black/African American 3.0% (8,863), Native Hawaiian or Pacific Islander 0.0% (34), White 91.7% (268,151), Some other race 0.4% (1,091), Two or more races 2.5% (7,240), Hispanic 2.1% (6,061), Non-Hispanic 97.9% (286,246), Total county population 292,307.Cumberland County - Selected Demographics: Median household income $73,072, Unemployment rate 5.3%, Individuals living in poverty 9.0%, Children living in poverty 9.2%, 65+ living alone 29.8%, Veterans 7.2%, Gay, lesbian, and bisexual (high school students) 12.1%, Gay, lesbian and bisexual (adults) 4.4%, Transgender youth (high school students) 1.7%, Persons with a disability 11.4%.Other hospitals serving the Northern Light Mercy Hospital community: Based on the State of Maines definition of hospital service area, Northern Light Mercy Hospitals community is served by an additional two other hospitals, New England Rehabilitation Hospital and Maine Medical Center per Hospital Service Area (HSA) designation. Additionally, the Health Resources & Services Administration designated Mercy Hospitals service area as having a total of 22 medically underserved populations.
Part VI, Line 4 - Community Building Activities	Northern Light Mercy Hospitals community building activities include Garys House that provides affordable housing for families of patients in Portland area hospitals.
Part VI, Line 5 - Promotion of Community Health	Northern Light Mercy Hospital furthers its exempt purpose by promoting the health of the community through the following grant activity in FY22:Health Care Support Services: Maine Cancer Foundation piloting Uber Health provide reliable transportation for cancer patients in the Portland area; Medication-Assisted Treatment Mercy Medical Neighborhood & Improving access to quality Care Social and Environmental Improvement Activities: McAuley Bangor Residence (OSA) - Develop housing-based programs employing evidence-based strategies in a holistic approach to recovery for vulnerable families affect by substance abuse. Program must treat mother affected by substance abuse with at least one child under 10 years of age.The majority of Northern Light Mercy Hospitals Board of Directors resides in the primary service area and is not employees or independent contractors. Mercy also has an open medical staff. Northern Light Mercy Hospital donates food weekly as part of a food rescue program to local food pantries and soup kitchens. Northern Light Mercy Hospital also provides money to the City of Portlands Minority Health Department each year in support of the Community Health Outreach Workers, whose role is to provide health education, outreach, and patient navigation for vulnerable populations.
Part VI, Line 6 - Affilated Health Care System	The 2022 Maine Shared Community Health Needs Assessment (CHNA) was conducted by Northern Light Health in collaboration with several member/affiliated hospitals, non-affiliated hospitals as well as public health and community organizations across the state. The Maine Shared CHNA informs initiatives to promote community health across the system as well as within each member hospitals local service area. Each member hospital adopted a local implementation strategy referred to as a Community Health Strategy and annual community health improvement plans, tailored to meet local needs.Northern Light Mercy Hospital participated two CHNA public forums to garner feedback and insights from local community members.
Part VI, Line 7 - States Filing of Community Benefit Report	N/A

Schedule H (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.1

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Mercy Hospital
Northern Light Mercy Hospital

Employer identification number

01-0211534

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 .....

Yes

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1Anthony Filer Treasurer	(i) (ii)	------------- 574,255	------------- 344,462	------------- 15,453	------------- 26,100	------------- 35,016	------------- 995,286	-------------
2Bette L Neville Former VP, CNO	(i) (ii)	------------- 273,718	-------------	------------- 9,488	------------- 18,854	------------- 32,640	------------- 334,700	-------------
3Bruce F Gomberg Physician	(i) (ii)	998,086 -------------	-------------	23,064 -------------	-------------	11,976 -------------	1,033,126 -------------	-------------
4Charles Therrien Pres/Ex-Off	(i) (ii)	385,680 -------------	25 -------------	96,399 -------------	82,114 -------------	22,558 -------------	586,776 -------------	69,744 -------------
5Craig Brett MD Trustee/Ex-Off	(i) (ii)	455,012 -------------	31,011 -------------	23,553 -------------	7,250 -------------	30,260 -------------	547,086 -------------	-------------
6David Kennedy VP, Finance	(i) (ii)	218,625 -------------	37,374 -------------	2,080 -------------	10,295 -------------	1,117 -------------	269,491 -------------	-------------
7George Eaton Secretary/Pt Yr	(i) (ii)	------------- 244,831	-------------	------------- 9,855	------------- 20,537	------------- 22,352	------------- 297,575	-------------
8Glenn Martin Secretary/Pt Yr	(i) (ii)	------------- 426,623	------------- 161,695	------------- 124,910	------------- 90,651	------------- 22,050	------------- 825,929	------------- 80,809
9Greg Orr VP Medical Gr	(i) (ii)	184,639 -------------	28,423 -------------	16,096 -------------	-------------	22,143 -------------	251,301 -------------	-------------
10John Southall VP Sr Phys Exec	(i) (ii)	349,189 -------------	77,379 -------------	1,175 -------------	10,017 -------------	29,369 -------------	467,129 -------------	-------------
11John Wahlig Physician	(i) (ii)	903,697 -------------	253,497 -------------	22,782 -------------	7,250 -------------	33,479 -------------	1,220,705 -------------	-------------
12Lee Thibodeau Physician	(i) (ii)	536,064 -------------	300,773 -------------	40,674 -------------	7,250 -------------	35,036 -------------	919,797 -------------	-------------
13Melissa Skahan VP Mission Int	(i) (ii)	198,250 -------------	46,668 -------------	3,900 -------------	5,019 -------------	25,451 -------------	279,288 -------------	-------------
14Nicolas F Arredondo Physician	(i) (ii)	744,991 -------------	522,130 -------------	23,182 -------------	7,250 -------------	34,616 -------------	1,332,169 -------------	-------------
15Paul Bolin SVP & CPO	(i) (ii)	------------- 381,000	------------- 19,733	------------- 28,816	------------- 74,824	------------- 30,787	------------- 535,160	-------------
16Stephen W Rodrigue Physician	(i) (ii)	1,243,976 -------------	-------------	2,322 -------------	-------------	416 -------------	1,246,714 -------------	-------------
17Timothy Dentry Trustee/Ex-Off	(i) (ii)	------------- 1,006,465	------------- 377,555	------------- 456,332	------------- 25,716	------------- 35,066	------------- 1,901,134	------------- 436,044
18Wendy Napolitano VP Perf Oper	(i) (ii)	185,712 -------------	44,009 -------------	4,043 -------------	9,119 -------------	32,821 -------------	275,704 -------------	-------------

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
Part I, Line 1a: Relevant information in regards to selections on 1a.	The following received a wellness program incentive:Nicolas Arredondo, highest compensated employee $300Greg Orr, officer 30The benefit is available for all employees.
Part I, Line 7: Non-Fixed payments not listed above	Physician bonuses reported in Part II, column (ii) are based on worked RVUs.

Schedule J (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.1

- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
Mercy Hospital
Northern Light Mercy Hospital

Employer identification number
01-0211534

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	Maine Health & Higher Edu	01-0314384	56042RH88	05-01-2021	101,765,219	Refinance 2020 & 2014 Bonds		X		X	X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	2,310,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	101,765,219
4 Gross proceeds in reserve funds .............	6,455,850
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............	81,060,000
7 Issuance costs from proceeds ...............	933,374
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............	13,315,995
12 Other unspent proceeds .............
13 Year of substantial completion .............	2021
	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 2020, 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 2020, 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) 2021

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 ....
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 .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...
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? .......	X
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? .....

Schedule K (Form 990) 2021

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 ..........	NA
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 ..........	NA
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) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.1

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Mercy Hospital
Northern Light Mercy Hospital

Employer identification number

01-0211534

Part I

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

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

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

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

Part II

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

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






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

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990) 2021

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Jennifer Palminteri MD	officer=partner	1,707,591	contractual provide servi		No

Part V

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

Return Reference	Explanation
Schedule L, Part V Supplemental Information	Jennifer Palminteri, board member is partner of Chest Medicine Associates who contractually provides services to Northern Light Mercy Hospital.

Schedule L (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.1

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

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

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Mercy Hospital
Northern Light Mercy Hospital

Employer identification number

01-0211534

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......	X		10,456	FMV
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...	X	6	5,756	FMV
20 Drugs and medical supplies .	X	1	570	FMV
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Gift Certificate )	X	1	8,000	FMV
26 Other ( Gift Certificate )	X	1	7,000	FMV
27 Other ( Gift Cert )	X	18	18,113	FMV
28 Other ( Jewelry )	X	2	475	FMV

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

Yes

30a

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

30a

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

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

Yes

32a

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

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

32a

If "Yes," describe in Part II.

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

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2021)

Page 2

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

Return Reference	Explanation

Schedule M (Form 990) (2021)

Additional Data

Software ID:	21013475
Software Version:	2021v4.1

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

Mercy Hospital
Northern Light Mercy Hospital

Employer identification number

01-0211534

Return Reference	Explanation
Form 990, Part III, Line 4d: Other Program Services Description	OTHER PROGRAM SERVICES 4: Charity care provided (at cost): 4,109 persons served OTHER PROGRAM SERVICES 5: Please see the following excerpt from the Northern Light Health Annual Report 2022 to the Community for details of comminity benefit projects at NLH members:Northern Light HealthPromisesAnnual Report 2022A promise made must be a promise kept. - AristotleWhen people keep their promises to us, we feel valued, respected, and appreciated. At Northern Light Health, we understand the importance of making a promise and doing the work to keep it.Our promise to the people and communities we serve across our great state of Maine is to make healthcare work for you. This means that we promise to get better every day by raising quality through teamwork, efficiency, and innovation. We promise to guide the way for our patients and their families, through the care experience. We live in a big, rural state, and we know access to care can be challenging for some people in our communities. So, we are committed to improving access. And last, but certainly not least, we promise to see patients as diverse individuals with their own unique needs.In this annual report, we highlight the ways our valued employees and community partners are working together to keep our promises to the communities we serve. From helping firefighters access lung cancer studies at world-class research hospitals, to helping busy parents schedule pediatrics appointments on their own time, and using the latest in diagnostic technology to help people with congestive heart failure stay out of the hospital. We are also helping the state address a critical shortage of psychiatric inpatient beds while addressing the state's long-term community-based mental and behavioral health needs.These stories in this report are just a few examples of the promises we work hard to keep every day. This work inspires us. We hope it inspires you too.Timothy J. Dentry, MBAPresident & CEONorthern Light HealthKathy CoreyBoard ChairNorthern Light HealthAcadia for AllEmerald Forcier is walking an aisle of gleaming white chairs carefully set on a lush green lawn overlooking the Penobscot River. Her husband, Kurt is hustling along on a lawn tractor, making sure the lawn is short and neat for the upcoming wedding the couple plans to host at their venue, Penobscot Bay Weddings in Winterport. As her four-year-old daughter, Maisie picks wildflowers, Forcier is holding her 8-month-old son Miles in her arms while she thinks about all the work she has left to do in the wedding tent. I often say to friends and family when they ask how I'm doing, I'm like, I am exhausted. We're starting a new business. And yet the deep, important things are wonderful.But seven years ago, things were not wonderful for Forcier in terms of her mental health. She was living on the island of Bali; she was having difficulty getting the medications to manage her depression, and she was in a suicidal state. She moved back to the United States and attended an inpatient treatment program, which she credits with saving her life. After six months of hard work restarting her life, she was back in Maine, but her health insurance was due to expire at the beginning of the new year. Despite spending four weeks consistently trying, Forcier could not access any outpatient provider to renew her prescriptions. Desperate for help, she ended up in a hospital emergency department on New Year's Eve 2015. Even then, she was sent away multiple times because psychiatric care was not available.I remember what it was like when I had reached my rock bottom and I needed inpatient services. I also remember the fear and helplessness of being stuck in the emergency department, unable to access the care I needed. I frankly cannot even imagine the terror and the sadness of experiencing both of these things at once. The day a person needs inpatient care is one of the worst days of their life. To be stuck in an emergency department with nowhere to go is a devastating experience far too many people face, and I cannot imagine a child or their parent going through that.Forcier's experience is unfortunately all too common. Across Maine, there simply are not enough inpatient beds and people who end up in crisis situations turn to hospital emergency departments.Nadia Mendiola, MD, an adolescent psychiatrist at Northern Light Acadia Hospital, sees it all too often. She says it's particularly troubling when children get stuck in these emergency departments for several weeks, or even months, waiting for an inpatient bed. Emergency care physicians, they're wonderful at their job but they're not psychiatrists. They have limited options, they have limited space, and you're talking about kids who can't even function in a big home or a big school and now you're confining them to a little spot. It's just not conducive to good care.This is one of the reasons why Northern Light Acadia Hospital is undertaking an ambitious expansion project to double the number of its single occupancy rooms. The 50,000 square feet expansion will add 50 pediatric inpatient rooms as well as new group and individual treatment spaces. The 50 existing inpatient rooms are being remodeled to single occupancy, adult inpatient rooms to better meet current behavioral healthcare standards.Acadia President Scott Oxley knows the expansion is needed. Unfortunately, the kids we see today are sicker than they were 30 years ago, so we need more circulation space, more room for group therapies. And really, our existing facility does not accommodate that, shares Oxley.In addition to the new inpatient rooms, there will also be an expansion of the Mood and Memory clinic for patients with Alzheimer's disease and dementia, and an endowment created for workforce development, recruitment, and retention. All this work requires substantial investment, and Oxley says community support thus far has been exceptional.Long term, the key to our success is early detection, early intervention, keeping folks in their communities, and keeping them out of the highest level of care. The reality is there's such a shortage of inpatient beds, that the need is urgent for inpatient beds while we work strategically and collaboratively on the longer-term plan.For more information about the Capital Campaign go to northernlight.org/AcadiaForAll Donors have given generously to the Acadia for All campaign including the Stephen and Tabitha King Foundation which donated one million dollars. OTHER PROGRAM SERVICES 6: Bingo!How's your heart health?Beverly Fowler is her name and Bingo is her game. Every Monday and Wednesday, Fowler leaves her Bangor apartment and heads to the Bangor Elks Lodge to have lunch with friends, play a few card games, and set up for evening Bingo. Usually on a Monday night, we get between 80 and 100 people, which is a good, good evening. Some winter nights, if it's snowing or something, we only get about 70, but that's still pretty good, she says. Fowler also plays Tuesdays, Thursdays, Fridays, and Sundays. Saturday is a free day, she says with a chuckle.At 83 years old, Fowler enjoys staying active and socializing, but managing her congestive heart failure was slowing her down. I kept filling up with fluids and ending up in the hospital for a week at a time. That's happened three or four times, says Fowler.Alan Jansujwicz, MD, general cardiologist and director of Northern Light Cardiovascular Care is working to improve the quality of life of patients like Beverly by keeping them out of the hospital. We know patients with heart failure end up being hospitalized over the course of time and each hospitalization matters. The statistics say that if you're hospitalized with heart failure, over the next six months to a year, your risk of not doing well is higher than before you were hospitalized, says Dr. Jansujwicz.Now, Northern Light Health is offering a new option to patients like Fowler, so they can monitor their condition and correct course before needing hospitalization. A remote monitoring device is implanted in the patient's pulmonary artery through a blood vessel in the groin. It measures pulmonary artery pressure and sends information to a receiver that resembles a giant pillow, which the patient lays on to take daily readings. The receiver records and sends the information to a secure website where a patient care manager like Janet Glidden, RN, BSN, MBA, reviews it. If Glidden sees troubling changes in a patient's numbers, she can call them and talk about what's happening. I'll look at their readings, and if I see they are ranging up, I'll call. They may not feel like there's any change, but I'll say, Your numbers are up. What did you do differently yesterday?' It almost always relates to diet or having too many fluids, Glidden shares.If the pressure's going up, it tells us the patient might be heading toward heart failure. Maybe we can stop that before it happens by increasing their therapies as opposed to them just slowly
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et	George Eaton, officer and Mike Varney, board member are board members of Galen Cole Family Foundation.
Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents	Amended Bylaws as follows:(1)Amended Article I (Name, Purpose, Registered Agent, Office, Seal), Section 1 (Name) added The Corporation is duly registered in the State of Maine to carry on activities under the assumed name Northern Light Mercy Hospital..(2)Amended Article I (Name, Purpose, Registered Agent, Office, Seal), Section 2 (Purposes and Disposition of Assets) Changed Sisters of Mercy to Sisters of Mercy of the Americas, (Sisters of Mercy).(3)Amended Article III (Board), Section 2 (Number and Tenure; Qualifications) under subsection b. Qualifications changed Northeast Community to Sisters of Mercy.(4)Amended Article III (Board), Section 5 (Annual Meeting and Regular Meetings) (a)Removed in Portland, Maine from the first sentence of Section 5: The Annual Meeting of the Corporation for the election of the Board of Trustees shall be held in Portland, Maine during the month of January in each year, at such time and place as shall be fixed by the Board of Trustees and set forth in the notice of the meeting.(5)Amended Article III (Board), Section 12 (Participation in Meeting by Telephone) (a)Changed Section name to Remote Participation in Meeting(b)Changed to Board members, or members of any Board committee, may participate in a meeting of the Board or such committee by, or conduct the meeting through the use of, any means of communication by which all persons participating in the meeting may simultaneously hear each other during the meeting, and such participation in a meeting shall constitute presence in person at such meeting(6)Amended Article V (Committees), Section 4 (Designations) - added although a non-Trustee committee member may chair a committee meeting in the absence of the committee chair to the end of the third sentence in Section 4, which now reads: Individuals other than Trustees may serve on all committees, provided nevertheless that the chair of each committee shall always be a Trustee, although a non-Trustee committee member may chair a committee meeting in the absence of the committee chair.(7)Amended Article V (Committees), Section 7 (Governance Committee) changed Northeast Community to Sisters of Mercy.(8)Amended Article V (Committees), Section 8 (Quality and Professional Affairs Committee) removed the last sentence of Section 8: A majority of the Committee must be independent as defined in Article VIII when functioning with such delegated authority.(9)Amended Article V (Committees), Section 11 (Catholic Identity and Ministry Committee) changed Northeast Community to Sisters of Mercy.(10)Amended Article VIII (Fiduciary Duty; Prohibited Transactions; Divided Loyalty; Independence), Section 5 (Independent Trustee) (a)Changed in subsection b. $10,000 to $100,000 in Neither the Trustee nor any member of the immediate family of the Trustee has, within any of the last three fiscal years of the Corporation, accepted payments from the Corporation and/or its affiliates aggregating in excess of $10,000 other than compensation to an immediate family member employed by the Corporation or any of its affiliates in a non-executive capacity, compensation for former services as chair or President, or benefits received under a tax-qualified retirement plan.(b)Changed in subsection e. $80,000 to $100,000 and $4,000,000 to $5,000,000 in Neither the Trustee nor any member of the immediate family of the Trustee is, or has been within the last three years, a partner, member, shareholder or executive officer of a company that made payments to, or received payments from, the Corporation and/or its affiliates in an amount which, in any of the last three fiscal years of the Corporation, equaled or exceeded (i) $80,000, or (ii) 2% of such companys consolidated gross revenues if such companys consolidated gross revenues were less than $4,000,000, in any of such three fiscal years.(11)Amended Article IX (Indemnification), Section 1 (Indemnification) - changed to read as follows:(a)The Corporation (i) shall in all cases indemnify any person who is or was at the time of the conduct in question, a trustee, officer or member of a committee of the Board of Trustees, or a director, officer or a member of a committee of the Board of Directors of the Corporations Member (Mandatory Indemnitees), and (ii) may (subject to subsection (c) of this section) indemnify any other person, who is or was a party or is threatened to be made a party to any threatened, pending or completed action, suit or proceeding, whether civil, criminal, administrative or investigative, by reason of the fact that such person is or was a trustee, officer, employee or agent of the Corporation or the Corporations Member, or is or was serving at the request of the Corporation as a director, officer, trustee, partner, fiduciary, employee or agent of another corporation, partnership, joint venture, trust, pension or other employee benefit plan or other enterprise (Discretionary Indemnitees) by reason of the fact that such person is or was a Board member, officer, employee or agent of the Corporation or is or was serving at the request of the Corporation as a director, officer, employee or agent of another corporation, partnership, joint venture, trust or other enterprise, against expenses, including attorneys' fees, judgments, fines and amounts paid in settlement, actually and reasonably incurred by such person in connection with such action, suit or proceeding. Nevertheless, no indemnification shall be provided for any person with respect to any matter as to which such person shall have been finally adjudicated in any action, suit or proceeding not to have acted in good faith in the reasonable belief that such person's action was in the best interests of the Corporation or, with respect to any criminal action or proceeding, had reasonable cause to believe that such person's conduct was unlawful. The termination of any action, suit or proceeding by judgment, order or conviction adverse to such person or by settlement or plea of nolo contendere or its equivalent shall not of itself create a presumption that such person did not act in good faith in the reasonable belief that such person's action was in the best interests of the Corporation or, with respect to any criminal action or proceeding, had reasonable cause to believe that such person's conduct was unlawful.(b)Indemnification of Mandatory Indemnitees shall be required in all cases regardless of the capacity in which such Trustee or a Director of the Corporations Member is or was made or threatened to be made a party to the action, suit or proceeding.(c)Indemnification of Discretionary Indemnitees under subsection (a)(ii), unless ordered by a court or required by these Bylaws, shall be made by the Corporation only as authorized in the specific case upon a determination that indemnification is proper in the circumstances and in the best interests of the Corporation. Where such a determination is required under this subsection, that determination shall be made by the Board of Directors of the Member and a majority vote of the Board of Trustees by Trustees who were not parties to that action, suit or proceeding. Provided, however, that if more than half of the Trustees are involved in such action, suit or proceeding, the determination shall be made by a majority vote of a committee of five disinterested Trustees chosen by the disinterested Trustees at a regular or special meeting. If there are fewer than five (5) disinterested Trustees, the determination shall be based upon the opinion of independent legal counsel retained by the Corporation for such purpose. Such a determination once made may not be revoked and, upon the making of that determination, the person being indemnified may enforce the indemnification against the Corporation by a separate action notwithstanding any attempted or actual subsequent action by the Board of Trustees or the Board of Directors of the Member.(12)Amended Article IX (Indemnification), Section 2 (Advances Against Expenses) added by a Mandatory or Discretionary Indemnitee and provided, however that advances for expenses incurred by Discretionary Indemnitees shall be made to the extent authorized for such Discretionary Indemnitee in accordance with Section 1(c) above.
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder	Mercy Hospital d/b/a Northern Light Mercy Hospital (the Corporation) is a Maine nonprofit corporation. Eastern Maine Healthcare Systems, d/b/a Northern Light Health (NLH), also a Maine nonprofit corporation, is the sole voting corporate member of the Corporation.
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body	Each year at their annual meeting, the directors elect replacements for those directors whose terms are expiring. Election of directors is subject to ratification by the NLH Board of Directors.
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders	The NLH President has authority to appoint and remove the SVP, President of the Corporation. NLH also has joint and superior authority to approve, disapprove or initiate action with respect to the following matters: I. amendments to the corporations Articles of Incorporation or Bylaws;II. changes in legal form of organization of the Corporation;III. election of the Directors/Trustees of the Corporation;IV. action concerning the Corporations operating budget and capital expenditures;V. the Corporations acquisition of assets or assumption of liabilities of an unaffiliated third party;VI. transfer of 5% or more of the assets of the Corporation;VII. financing transactions concerning the Corporation; VIII. merger, consolidation, sale, lease, mortgage, pledge or other disposition of all or substantially all assets of the Corporation; IX. add or revise a health care service of the Corporation;X. discontinue or close a health care service of the Corporation;XI. action concerning the Corporations role in the NLH Strategic Plan;XII. action concerning the Corporations participation in key strategic affiliations with third parties not affiliated with NLH; andXIII. dissolution of the Corporation.
Form 990, Part VI, Line 11b: Form 990 Review Process	Form 990 is reviewed by the VP of Finance of Northern Light Mercy Hospital. It is also provided to each board member either electronically or in hard copy with an opportunity to ask questions prior to filing with the IRS.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	The organization requests updates of potential conflicts and relationships from the officers and Board members on an annual basis. The request requires disclosure of all business relationships, board memberships, and family relationships. A database is maintained that is compared to payroll records and the accounts payable vendor list to identify any potential conflicts of interest. Transactions are reviewed for reasonableness as an arm's length transaction.The first agenda item for board meetings and board committee meetings is for members to declare any conflict of interest with upcoming agenda items or deliberations. At any point when consideration is being given to purchase/contract with a party in interest, the member with the conflict is either excused from the discussion and consideration process or abstains from voting on the matter.All transactions identified with parties in interest are disclosed within the Form 990. All are deemed to be arm's length transactions.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management	The President of Northern Light Mercy Hospital and the system Chief Executive Officer (CEO) who serves on the board ex-officio are employed by the system parent, Eastern Maine Healthcare Systems d/b/a Northern Light Health (NLH).The NLH Executive Performance Management Committee (the Committee) is responsible to monitor and evaluate the performance of the NLH CEO. It shall have authority to set the compensation of the NLH CEO, and to review the recommendations of the NLH CEO with respect to the compensation of the Presidents of the Member Organizations and other key management personnel. The Committee is comprised entirely of independent Directors per NLH bylaws.Process:The Committee meets regularly throughout the fiscal year at the discretion of the Committee chair as well as on call of the Chair of the NLH board. In carrying out its duties pursuant to the Bylaws, the Committee:-Assures that the executive compensation program is administered in a manner consistent with the NLH executive compensation philosophy.-Reviews and updates the NLH executive compensation philosophy which serves as the foundation on which all current and future executive compensation decisions are made.-Assures that value of compensation provided by NLH does not exceed the value of services provided by the executive.-Reviews annual incentive compensation criteria for eligible executives, as defined by the NLH CEO.-Reviews periodic compensation survey information and provides expert input to proposed changes to the executive compensation program.-Assures that a formal and timely performance management system is in place for executives.-Reviews incentive compensation criteria scoring and associated pay schedules for officers and key employees.-Provides any public statements regarding executive compensation practices at NLH deemed appropriate.-Maintains minutes of the meeting and communicates actions to the NLH Board of Directors.To accomplish this, the committee uses an external consultant with access to comparative data from independent sources and include national as well as regional data points. The NLH CEO reviews all direct report compensation actions with the committee. In addition, the NLH CEO ensures that any subsidiary policies and practices governing executive compensation are consistent with the committee's philosophy and practices statement.Form 990, Part VI, Line 15b - Compensation Review & Approval Process - Officers & Key EmployeesCompensation of other officers and key employees of the organization is established by the Human Resources department who utilize external market research to establish compensation ranges for specific positions. On an annual basis, the compensation ranges are compared to the updated survey information.The hiring manager will determine where the employee will fall within the ranges established by the Human Resources department based on experience and credentials.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	Northern Light Mercy Hospital makes its governing documents, conflict of interest policy and financial statements available to the public upon request.
Other Changes In Net Assets Or Fund Balances - Other Decreases	Change in net assets held @ NLH Foundation = -$982971
Other Changes In Net Assets Or Fund Balances - Other Decreases	Change in net unrealized losses on investments = -$413369

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.1

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Mercy Hospital
Northern Light Mercy Hospital

Employer identification number

01-0211534

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)Eastern Maine Healthcare Systems EMHS 43 Whiting Hill Road Brewer,ME04412 01-0527066	Supporting org for healthcare affiliates	ME	501(c)(3)	12 Type II	N/A		No
(2)Acadia Hospital Corp AHC 43 Whiting Hill Road Brewer,ME04412 01-0459837	Provide healthcare services	ME	501(c)(3)	3	EMHS		No
(3)Acadia Healthcare Inc AHI 43 Whiting Hill Road Brewer,ME04412 22-3183888	Provide healthcare services	ME	501(c)(3)	10	AHC		No
(4)Eastern Maine Medical Center PO Box 404 489 State St Bangor,ME044020404 01-0211501	Provide healthcare services	ME	501(c)(3)	3	EMHS		No
(5)Eastern Maine Medical Center Auxiliary 43 Whiting Hill Road Brewer,ME04412 01-0377901	Fund raising for exempt EMMC	ME	501(c)(3)	10	EMMC		No
(6)Northern Light Health Foundation 43 Whiting Hill Road Ste 400 Brewer,ME04412 22-2514163	Raise and manage funds for exempt orgs	ME	501(c)(3)	12 Type II	EMHS		No
(7)Rosscare 43 Whiting Hill Road Brewer,ME04412 01-0391038	Provide services to elderly	ME	501(c)(3)	PF	EMHS		No
(8)Inland Hospital 200 Kennedy Memorial Drive Waterville,ME04901 01-0217211	Provide healthcare services	ME	501(c)(3)	3	EMHS		No
(9)Lakewood 220 Kennedy Memorial Drive Waterville,ME04901 01-0421234	Provide skilled and long-term nursing ca	ME	501(c)(3)	3	Inland Hospital		No
(10)CA Dean Memorial Hospital Pritham Avenue PO Box 1129 Greenville,ME044411129 04-3341666	Provide healthcare services	ME	501(c)(3)	3	EMHS		No
(11)Blue Hill Memorial Hospital 57 Water Street Blue Hill,ME046145231 01-0227195	Provide healthcare services	ME	501(c)(3)	3	EMHS		No
(12)Sebasticook Valley Health SVH 447 North Main Street Pittsfield,ME04967 01-0263628	Provide healthcare services	ME	501(c)(3)	3	EMHS		No
(13)The Aroostook Medical Center TAMC PO Box 151 140 Academy Street Presque Isle,ME047690151 01-0372148	Provide healthcare services	ME	501(c)(3)	3	EMHS		No
(14)VNA Home Health & Hospice 225 Gorham Rd Ste 200 South Portland,ME04106 01-0246804	Provide home health and hospice services	ME	501(c)(3)	10	EMHS		No
(15)Eastern Maine Healthcare Real Estate 43 Whiting Hill Road Brewer,ME04412 01-0391036	Leases of real estate	ME	501(c)(2)		EMHS		No
(16)WorkHealth LLC 43 Whiting Hill Road Brewer,ME04412 47-4315094	Provide healthcare services	ME	501(c)(3)	12 Type II	EMHS		No
(17)Maine Coast Regional Health Facilities 50 Union Street Ellsworth,ME04605 01-0198331	Provide healthcare services	ME	501(c)(3)	3	EMHS		No
(18)Maine Coast Medical Realty 50 Union Street Ellsworth,ME04605 01-0390918	Lease medical facilities	ME	501(c)(3)	12 Type I	MCH		No
(19)Beacon Health LLC 43 Whiting Hill Road Brewer,ME04412 45-2967056	Accountable care organization	ME	501(c)(3)	12 Type II	EMHS		No
(20)Beacon Rural Health LLC 43 Whiting Hill Road Brewer,ME04412 47-4483187	Accountable care organization	ME	501(c)(3)	12 Type II	EMHS		No
(21)Beacon Health ACO Holdings LLC 43 Whiting Hill Road Brewer,ME04412 36-4903784	Accountable care organization	ME	501(c)(3)	12 Type II	EMHS		No
(22)LTC LLC 43 Whiting Hill Road Brewer,ME04412 01-0211501	Operation of nursing homes	ME	501(c)(3)	3	EMMC		No
(23)Northern Light Medical Transport 43 Whiting Hill Rd Brewer,ME04412 83-0911574	Ambulance	ME	501(c)(3)	10	EMHS		No
(24)M Drug LLC 43 Whiting Hill Road Brewer,ME04412 27-2175482	Pharmacy	ME	501(c)(3)	3	EMMC		No
(25)MRH Corp dba NL Mayo Hospital 897 W Main Street DoverFoxcroft,ME04426 84-3689003	Provide healthcare services	ME	501(c)(3)	3	EMHS		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

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	(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

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) Affiliated Healthcare Systems AHS 43 Whiting Hill Road Brewer,ME04412 01-0385322	Holding co.	ME	EMHS	C					No
(2) Affiliated Laboratory Inc 43 Whiting Hill Road Brewer,ME04412 01-0381283	Clinical lab	ME	AHS	C					No
(3) Affiliated Healthcare Management 43 Whiting Hill Road Brewer,ME04412 01-0349339	Hlthcr mgmt	ME	AHS	C					No
(4) Beacon Direct 43 Whiting Hill Road Brewer,ME04412 37-1864965	Healthcare Self Funded TPA	ME	EMHS	C					No

Schedule R (Form 990) 2021

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

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

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

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

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

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

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

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

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

Yes

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

Yes

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

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

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

Yes

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

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

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2021

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) 2021

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) 2021

Additional Data

Software ID:	21013475
Software Version:	2021v4.1

1	Briefly describe the organization’s mission or most significant activities: Mercy Hospital d/b/a Northern Light Mercy Hospital carries out the healing work of Christ by providing clinically excellent, compassionate healthcare for all, with special concern for the poor and disadvantaged.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	21
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	17
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	1,654
6	Total number of volunteers (estimate if necessary) .............	6	46
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	6,318,386	12,822,394
9	Program service revenue (Part VIII, line 2g) .........	246,553,773	242,866,596
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-879,510	161,906
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,291,837	3,030,813
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	253,284,486	258,881,709
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	130,918,143	136,085,025
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	111,710,664	132,825,006
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	242,628,807	268,910,031
19	Revenue less expenses. Subtract line 18 from line 12.......	10,655,679	-10,028,322
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	246,085,431	235,749,919
21	Total liabilities (Part X, line 26).............	189,674,825	190,763,975
22	Net assets or fund balances. Subtract line 21 from line 20.....	56,410,606	44,985,944

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 188,442,026 including grants of $ ) (Revenue $ 245,721,796 )
	Provide healthcare services regardless of ability to pay as well as education, research and promotion of health. Provided other uncompensated care (at cost) of $2,416,341

4b	(Code: ) (Expenses $ 32,642,239 including grants of $ ) (Revenue $ )
	Medicare shortfalls (at cost) 40,842 persons served

4c	(Code: ) (Expenses $ 13,850,692 including grants of $ ) (Revenue $ )
	Medicaid shortfalls (at cost) 37,769 persons served

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 1,293,161 including grants of $ ) (Revenue $ )
4e	Total program service expenses236,228,118

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	8,004,480	4,455,191	859,399

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	3,572,037
e	Government grants (contributions)		1e	8,220,936

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,029,421

g	Noncash contributions included in lines 1a - 1f:$		1g	50,370

h Total. Add lines 1a-1f.......		12,822,394

		Business Code
2a	Cafeteria	722514	558,663		558,663
b	Education	611710	20,342	20,342
c	Net Patient Care Service	621990	242,287,591	242,287,591
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		242,866,596

3 Investment income (including dividends, interest, and othersimilar amounts) ......			524,350			524,350
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		217,149	6a
b	Less: rental expenses		48,988	6b
c	Rental income or (loss)		168,161	6c
d	Net rental income or (loss).......			168,161			168,161
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	25,300		7a
b	Less: cost or other basis and sales expenses	387,744		7b
c	Gain or (loss)	-362,444		7c
d	Net gain or (loss).........			-362,444			-362,444
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..			0
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..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	26,237
b	Less: cost of goods sold ..		10b	18,785
c	Net income or (loss) from sales of inventory..			7,452			7,452
Business Code			Miscellaneous Revenue
11a	340b Pharmacy Benefits		621990	2,838,200	2,838,200
b	Meaningful Use		621990	17,000	17,000
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			2,855,200
12	Total revenue. See instructions.....			258,881,709	245,163,133		896,182

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	2,676,775	1,820,508	856,267
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0
7	Other salaries and wages........	110,397,949	104,346,428	6,051,521
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,438,308	3,242,697	195,611
9	Other employee benefits .......	12,607,771	11,880,743	727,028
10	Payroll taxes ...........	6,964,222	6,515,327	448,895
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	13,168	13,168
c	Accounting ...........	32,483		32,483
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	11,175	8,900	2,275
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	42,519,977	24,385,010	18,134,967
12	Advertising and promotion ....	909,570	909,570
13	Office expenses .......	6,641,976	5,338,848	1,303,128
14	Information technology ......	11,621,738	10,960,560	661,178
15	Royalties ..	0
16	Occupancy ...........	9,486,459	7,594,118	1,892,341
17	Travel ............	66,397	61,016	5,381
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	412,139	396,804	15,335
20	Interest ...........	3,271,851	2,605,761	666,090
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	7,566,225	6,443,256	1,122,969
23	Insurance ...	5,112,080	4,821,246	290,834
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 Expense	35,966,029	35,966,029
b	Taxes & Licensing	5,488,927	5,483,559	5,368
c	Repairs & Maintenance	2,793,894	2,550,664	243,230
d	Dues & Subscriptions	300,101	295,581	4,520
e	All other expenses	610,817	588,325	22,492
25	Total functional expenses. Add lines 1 through 24e	268,910,031	236,228,118	32,681,913	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 ........			14,000,143	1	5,600
2	Savings and temporary cash investments .........			667,720	2	800,326
3	Pledges and grants receivable, net ......				3	0
4	Accounts receivable, net .............			42,498,642	4	40,815,507
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	0
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	0
7	Notes and loans receivable, net ...........			32,673	7	34,887
8	Inventories for sale or use ............			4,604,219	8	3,077,729
9	Prepaid expenses and deferred charges ......			1,356,710	9	926,173
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	215,410,316
b	Less: accumulated depreciation	10b	63,936,797	132,346,197	10c	151,473,519
11	Investments—publicly traded securities .				11	0
12	Investments—other securities. See Part IV, line 11 .....				12	0
13	Investments—program-related. See Part IV, line 11 ..				13	0
14	Intangible assets ...............			3,151,000	14	3,151,000
15	Other assets. See Part IV, line 11 ...........			47,428,127	15	35,465,178
16	Total assets. Add lines 1 through 15 (must equal line 33)...			246,085,431	16	235,749,919

17	Accounts payable and accrued expenses .....	42,726,525	17	56,748,289
18	Grants payable ...		18
19	Deferred revenue .........	14,559,671	19	4,893,137
20	Tax-exempt bond liabilities .........	94,347,998	20	92,083,117
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 ..	2,492,154	23	1,529,776
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	35,548,477	25	35,509,656
26	Total liabilities. Add lines 17 through 25..	189,674,825	26	190,763,975

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	45,995,382	27	35,967,256
28	Net assets with donor restrictions ...........	10,415,224	28	9,018,688
	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 ...........	56,410,606	32	44,985,944
33	Total liabilities and net assets/fund balances ........	246,085,431	33	235,749,919