TY 2023 Form 990

- 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

2023

Open to Public
Inspection

Name of the organization

DUBUQUE MERCY HEALTH FOUNDATION

Employer identification number

26-2227941

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 ............................... 1

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

(i) Name of supported organization	(ii) EIN	(iii) Type of organization (described on lines 1- 10 above (see instructions))	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN		Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(A) MERCY HEALTH SERVICES-IOWA CORP (DBA MERCY MEDICAL CENTER-DUBUQUE	311373080	3		No	390,396	0

Total 1					390,396	0

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

Cat. No. 11285F

Schedule A (Form 990) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. 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—2022. 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—2023. 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—2022. 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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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—2022. 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) 2023

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) 2023

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.

Yes

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) 2023

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) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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
PART I, LINE 12G, COLUMN (VI):	DUBUQUE MERCY HEALTH FOUNDATION (THE FOUNDATION) PROVIDES AUXILIARY SERVICES TO ITS SUPPORTED ORGANIZATION.
PART IV, SECTION A, LINE 1:	THE FOUNDATION'S SUPPORTED ORGANIZATION IS NOT LISTED BY NAME IN THE GOVERNING DOCUMENTS, BUT IS DESIGNATED BY PURPOSE. THE PURPOSE OF THE FOUNDATION AS STATED IN ITS GOVERNING DOCUMENTS IS TO ADVANCE, PROMOTE, SUPPORT, AND CARRY OUT THE PURPOSES OF CATHOLIC HEALTH MINISTRIES, TRINITY HEALTH, AND MERCY HEALTH NETWORK. ITS SPECIFIC PURPOSES ARE TO ENGAGE IN THE DELIVERY OF AND TO CARRY ON, SPONSOR OR PARTICIPATE, DIRECTLY OR THROUGH ONE OR MORE AFFILIATES, IN ANY ACTIVITIES RELATED TO THE DELIVERY OF HEALTH CARE AND HEALTH CARE RELATED SERVICES AS APPROPRIATE IN CARRYING OUT THE HEALTH CARE MISSION OF CATHOLIC HEALTH MINISTRIES, TRINITY HEALTH, AND MERCY HEALTH NETWORK. SUCH ACTIVITIES INCLUDE THE SUPPORT AND ASSISTANCE OF AFFILIATES TO ACCOMPLISH THE FOREGOING PURPOSES. THE SUPPORTED ORGANIZATION LISTED IN PART I, LINE 12 IS AN AFFILIATE OF TRINITY HEALTH AND QUALIFIES AS A SEC. 509(A)(1) PUBLIC CHARITY, AND SHARES THE EXEMPT PURPOSES OF THE FOUNDATION AND TRINITY HEALTH.

Return Reference

Explanation

PART I, LINE 12G, COLUMN (VI):

DUBUQUE MERCY HEALTH FOUNDATION (THE FOUNDATION) PROVIDES AUXILIARY SERVICES TO ITS SUPPORTED ORGANIZATION.

PART IV, SECTION A, LINE 1:

THE FOUNDATION'S SUPPORTED ORGANIZATION IS NOT LISTED BY NAME IN THE GOVERNING DOCUMENTS, BUT IS DESIGNATED BY PURPOSE. THE PURPOSE OF THE FOUNDATION AS STATED IN ITS GOVERNING DOCUMENTS IS TO ADVANCE, PROMOTE, SUPPORT, AND CARRY OUT THE PURPOSES OF CATHOLIC HEALTH MINISTRIES, TRINITY HEALTH, AND MERCY HEALTH NETWORK. ITS SPECIFIC PURPOSES ARE TO ENGAGE IN THE DELIVERY OF AND TO CARRY ON, SPONSOR OR PARTICIPATE, DIRECTLY OR THROUGH ONE OR MORE AFFILIATES, IN ANY ACTIVITIES RELATED TO THE DELIVERY OF HEALTH CARE AND HEALTH CARE RELATED SERVICES AS APPROPRIATE IN CARRYING OUT THE HEALTH CARE MISSION OF CATHOLIC HEALTH MINISTRIES, TRINITY HEALTH, AND MERCY HEALTH NETWORK. SUCH ACTIVITIES INCLUDE THE SUPPORT AND ASSISTANCE OF AFFILIATES TO ACCOMPLISH THE FOREGOING PURPOSES. THE SUPPORTED ORGANIZATION LISTED IN PART I, LINE 12 IS AN AFFILIATE OF TRINITY HEALTH AND QUALIFIES AS A SEC. 509(A)(1) PUBLIC CHARITY, AND SHARES THE EXEMPT PURPOSES OF THE FOUNDATION AND TRINITY HEALTH.

Schedule A (Form 990) 2023

Additional Data

Software ID:
Software Version:

- 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

2023

Name of the organization

DUBUQUE MERCY HEALTH FOUNDATION

Employer identification number

26-2227941

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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization DUBUQUE MERCY HEALTH FOUNDATION

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) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization DUBUQUE MERCY HEALTH FOUNDATION		Employer identification number 26-2227941

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization DUBUQUE MERCY HEALTH FOUNDATION			Employer identification number 26-2227941
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) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
right arrow

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

DUBUQUE MERCY HEALTH FOUNDATION

Employer identification number

26-2227941

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 July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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
right arrow

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

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

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 ....	363,600	380,359	435,604	322,869	339,191
b	Contributions ...		41
c	Net investment earnings, gains, and losses	19,255	-16,800	-55,245	112,735	-16,322
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	40
f	Administrative expenses ....
g	End of year balance ......	382,815	363,600	380,359	435,604	322,869

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

Board designated or quasi-endowment right arrow

0 %

Permanent endowment right arrow

100.000 %

Term endowment right arrow

0 %

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

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

Yes

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

3a(i)

Yes

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

3a(ii)

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

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 .....
b	Buildings ....
c	Leasehold improvements
d	Equipment ....
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..		0

Schedule D (Form 990) 2022

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) LOCALLY HELD INVESTMENTS	5,343,587	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	5,343,587

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

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes









Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
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) 2022

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:	ENDOWMENT FUNDS ARE INTENDED FOR NURSING SCHOLARSHIPS AND GENERAL HOSPITAL USE.

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

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

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

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization
DUBUQUE MERCY HEALTH FOUNDATION

Employer identification number

26-2227941

Part I

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

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

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

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

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

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

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

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










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

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

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

Cat. No. 50083H

Schedule G (Form 990) 2023

Page 2

Part II

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

		(a) Event #1 BLACK AND WHITE GALA (event type)	(b) Event #2 (event type)	(c) Other events (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	228,665			228,665
2	Less: Contributions . . . .	206,670			206,670
3	Gross income (line 1 minus line 2) . . . . . .	21,995			21,995

4	Cash prizes . . . . .
5	Noncash prizes . . . .	6,237	6,237
6	Rent/facility costs . . . .	25,412	25,412
7	Food and beverages . . .
8	Entertainment . . . .	7,500	7,500
9	Other direct expenses . . .	36,278	36,278
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		75,427
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		-53,432

Part III

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

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .			54,569	54,569

2	Cash prizes . . . . .	25,000	25,000
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .	2,015	2,015

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

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

27,015

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

27,554

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

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

YesNo

If "No," explain:

10a

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

YesNo

If "Yes," explain:

Schedule G (Form 990) 2023

Page 3

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

YesNo

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

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

YesNo

Indicate the percentage of gaming activity conducted in:

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

13a

100.000 %

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

13b

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

Name

DAVID MOORE

Address

250 MERCY DRIVE DUBUQUE, IA52001

15a

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

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

YesNo

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

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

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

Name

Address

Gaming manager information:

Name

DAVID MOORE

Gaming manager compensation right arrow

$ 500

Description of services provided right arrow

OVERSEES RAFFLE, VERIFIES WINNERS, AND UPDATES RAFFLE LICENSE.

Director/officer Employee Independent contractor

Mandatory distributions:

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

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

YesNo

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

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

Part IV

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

Return Reference	Explanation

Schedule G (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

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

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
DUBUQUE MERCY HEALTH FOUNDATION

Employer identification number
26-2227941

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) MERCY HEALTH SERVICES - IOWA CORP DBA MERCYONE DUBUQUE MEDICAL CENTER 250 MERCY DRIVE DUBUQUE,IA52001	31-1373080	501(C)(3)	390,396	0			SUPPORT HOSPITAL PROGRAMS AND FACILITY

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2023

Page 2

Part III

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

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

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

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

Return Reference	Explanation
PART I, LINE 2:	DONATIONS MADE BY DUBUQUE MERCY HEALTH FOUNDATION TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE.

Schedule I (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

DUBUQUE MERCY HEALTH FOUNDATION

Employer identification number

26-2227941

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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) 2023

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)
1KAY TAKES DIR; PRESIDENT EASTERN IOWA REGION	(i) (ii)	0 ------------- 446,221	0 ------------- 159,918	0 ------------- 85,550	0 ------------- 24,750	0 ------------- 37,873	0 ------------- 754,312	0 ------------- 0
2KIM DUWE REGIONAL VP FINANCE THROUGH 12/23	(i) (ii)	0 ------------- 247,699	0 ------------- 51,472	0 ------------- 5,028	0 ------------- 18,708	0 ------------- 34,007	0 ------------- 356,914	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

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

Return Reference

Explanation

PART I, LINE 3

DUBUQUE MERCY HEALTH FOUNDATION (THE FOUNDATION) IS A SUBSIDIARY OF MERCYONE DUBUQUE MEDICAL CENTER, A DIVISION OF MERCY HEALTH SERVICES - IOWA (MHS-IA). THE FOUNDATION'S EXECUTIVE DIRECTOR IS PAID DIRECTLY BY MHS-IA. MHS-IA USED THE FOLLOWING METHOD TO ESTABLISH THE COMPENSATION OF THE FOUNDATION'S EXECUTIVE DIRECTOR: -COMPENSATION SURVEY OR STUDY

PART I, LINE 4B

THE FOLLOWING IS A PARTICIPANT IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2023. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. PARTICIPANTS' VESTED BENEFITS WERE PAID OUT IN 2023, AND THEIR NON-VESTED BENEFITS FOR 2023 WERE ACCRUED. THE FOLLOWING PAYOUT FOR 2023 FOR THE PLAN IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KAY TAKES - $70,410

Schedule J (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

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

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

DUBUQUE MERCY HEALTH FOUNDATION

Employer identification number

26-2227941

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 ..	X		600	FMV
5 Clothing and household goods .......	X		2,070	FMV
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	5	37,440	SELLING PRICE
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	1	140	FMV
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( HOTEL STAY )	X	2	5,250	COST
26 Other ( JEWELRY )	X	1	5,000	COST
27 Other ( GIFT CARDS )	X	5	2,550	COST
28 Other ( MISCELLANEOUS )	X	29	2,458

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

Yes

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) (2023)

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
PART I, LINE 32B:	FOR ANY STOCK CONTRIBUTIONS RECEIVED, THE TREASURY DEPARTMENT OF TRINITY HEALTH, A RELATED ORGANIZATION, HAS ESTABLISHED A PROCESS TO WORK WITH ITS EXTERNAL BANK TO ENSURE THE SECURITIES ARE SOLD IN A TIMELY MANNER AND THE PROCEEDS ARE INVESTED FOR THE BENEFIT OF THE ORGANIZATION.

Schedule M (Form 990) (2023)

Additional Data

Software ID:
Software Version:

- 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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

DUBUQUE MERCY HEALTH FOUNDATION

Employer identification number

26-2227941

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2	KAY TAKES, DUBUQUE MERCY HEALTH FOUNDATION BOARD MEMBER, AND STACEY HINES, DUBUQUE MERCY HEALTH FOUNDATION BOARD MEMBER, HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF DUBUQUE MERCY HEALTH FOUNDATION (THE FOUNDATION) IS MERCY HEALTH SERVICES-IOWA. SEE LINE 7 FOR ADDITIONAL INFORMATION.
FORM 990, PART VI, SECTION A, LINE 7A	MERCY HEALTH SERVICES-IOWA IS THE SOLE MEMBER OF THE FOUNDATION. MERCY HEALTH SERVICES-IOWA HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF THE FOUNDATION.
FORM 990, PART VI, SECTION A, LINE 7B	AS SOLE MEMBER, MERCY HEALTH SERVICES-IOWA MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MERCY HEALTH SERVICES-IOWA MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, AND MODIFICATIONS TO GOVERNING DOCUMENTS. AS THE PARENT OF THE NATIONAL TRINITY HEALTH SYSTEM, CERTAIN POWERS ARE RESERVED TO TRINITY HEALTH CORPORATION. THESE INCLUDE THE AUTHORITY TO ADOPT OR MODIFY THE ORGANIZATION'S GOVERNING DOCUMENTS, TO APPROVE MAJOR CHANGES SUCH AS A MERGER OR DISSOLUTION, AND TO APPROVE SIGNIFICANT FINANCE MATTERS IN EXCESS OF CERTAIN LIMITS ESTABLISHED BY TRINITY HEALTH CORPORATION.
FORM 990, PART VI, SECTION A, LINE 8B	LINE 8B IS ANSWERED "NO" BECAUSE THE FOUNDATION HAD NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11B	PRIOR TO FILING, THE FORM 990 FOR THE FOUNDATION IS REVIEWED BY MANAGEMENT. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	THE FOUNDATION HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF THE FOUNDATION, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, AND KEY EMPLOYEES. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF THE FOUNDATION AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO THE INTEGRITY AND COMPLIANCE OFFICER, WHO COLLABORATES WITH INTERNAL LEGAL COUNSEL TO ASSESS THE CONFLICT AND IDENTIFY A CONFLICT MANAGEMENT PLAN WHEN NECESSARY. ADDITIONALLY, THE INTEGRITY AND COMPLIANCE OFFICER ALONG WITH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF THE FOUNDATION ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO THE FOUNDATION OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF THE FOUNDATION IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF THE FOUNDATION. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 15	QUESTION 15A IS ANSWERED "NO" BECAUSE THE COMPENSATION FOR THE FOUNDATION'S EXECUTIVE DIRECTOR IS ESTABLISHED BY MERCY HEALTH SERVICES - IOWA (D/B/A MERCYONE DUBUQUE MEDICAL CENTER), A RELATED ORGANIZATION. QUESTION 15B IS ANSWERED "NO" BECAUSE THE COMPENSATION FOR CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF THE FOUNDATION IS ESTABLISHED BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING CEO AND VICE PRESIDENT FINANCE COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THE CEO AND VICE PRESIDENT FINANCE OF THE FOUNDATION ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS.
FORM 990, PART VI, SECTION C, LINE 19	THE FOUNDATION IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. THE FOUNDATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINES 5 AND 7:	INDIVIDUALS WHO WORK AT THE FOUNDATION ARE ON THE PAYROLL OF A RELATED ORGANIZATION. THESE INDIVIDUALS' SALARIES AND BENEFITS ARE ALLOCATED TO THE FOUNDATION AND ARE REPORTED ON PART IX, LINES 5 AND 7.
FORM 990, PART XI, LINE 9:	EQUITY TRANSFERS TO/FROM AFFILIATES 4,258.
FORM 990, PART XII, LINE 2:	THE FOUNDATION'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY24 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM.

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

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

DUBUQUE MERCY HEALTH FOUNDATION

Employer identification number

26-2227941

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)ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 200 JEFFERSON AVE SE GRAND RAPIDS,MI49503 27-2491974	HEALTH CARE SERVICES	MI	501(C)(3)	LINE 10	TRINITY HEALTH-MICHIGAN	Yes
(2)ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR,FL34684 58-1492325	GRANT MAKING	FL	501(C)(3)	LINE 12A, I	TRINITY HEALTH CORPORATION	Yes
(3)ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD,CT06105 06-1450170	HEALTH CARE SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH OF NEW ENGLAND CORP INC	Yes
(4)BAUM HARMON MERCY HOSPITAL 801 5TH STREET SIOUX CITY,IA51101 42-1500277	HEALTH CARE AND HOSPITAL SERVICES	IA	501(C)(3)	LINE 3	MERCY HEALTH SERVICES-IOWA CORP	Yes
(5)BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION 801 5TH STREET SIOUX CITY,IA51101 26-2973307	FOUNDATION	IA	501(C)(3)	LINE 12A, I	BAUM HARMON MERCY HOSPITAL	Yes
(6)BEECHWOOD INC 2212 BURDETT AVE TROY,NY12180 14-1651563	TITLE HOLDING COMPANY	NY	501(C)(2)	N/A	LTC (EDDY) INC	Yes
(7)BETHLEHEM HAVEN OF PITTSBURGH 905 WATSON STREET PITTSBURGH,PA15219 25-1436685	HOMELESS SHELTER	PA	501(C)(3)	LINE 7	PITTSBURGH MERCY HEALTH SYSTEM INC	Yes
(8)BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS,NY12159 14-1717028	SENIOR LIVING COMMUNITY	NY	501(C)(3)	LINE 10	LTC (EDDY) INC	Yes
(9)BRIGHTSIDE INC 114 WOODLAND STREET HARTFORD,CT06105 04-2182395	HEALTH CARE SERVICES	MA	501(C)(3)	LINE 10	THE MERCY HOSPITAL INC	Yes
(10)CAPITAL REGION GERIATRIC CENTER INC 421 WEST COLUMBIA STREET COHOES,NY12047 14-1701597	LONG TERM CARE	NY	501(C)(3)	LINE 10	LTC (EDDY) INC	Yes
(11)CATHERINE MCAULEY HEALTH SERVICES CORP 5315 ELLIOTT DR 102 YPSILANTI,MI48197 38-2507173	HEALTH CARE SERVICES	MI	501(C)(3)	LINE 3	TRINITY HEALTH-MICHIGAN	Yes
(12)CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVENUE DES MOINES,IA50314 42-0680448	HEALTH CARE AND HOSPITAL SERVICES	IA	501(C)(3)	LINE 3	MERCY HEALTH NETWORK INC	Yes
(13)CATHOLIC HEALTH MINISTRIES 20555 VICTOR PARKWAY LIVONIA,MI48152	GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM	VT	501(C)(3)	LINE 1	N/A		No
(14)CENTRAL COMMUNITY HOSPITAL 901 DAVIDSON ST NW ELKADER,IA52043 42-0818642	HEALTH CARE AND HOSPITAL SERVICES	IA	501(C)(3)	LINE 3	MERCY COMMUNITY HOSPITAL GROUP LLC	Yes
(15)COVENANT FOUNDATION INC 3421 WEST NINTH STREET WATERLOO,IA50702 42-1295784	FOUNDATION	IA	501(C)(3)	LINE 7	COVENANT MEDICAL CENTER INC	Yes
(16)COVENANT MEDICAL CENTER INC 3421 WEST NINTH STREET WATERLOO,IA50702 42-1264647	HEALTH CARE AND HOSPITAL SERVICES	IA	501(C)(3)	LINE 3	WHEATON FRANCISCAN HEALTHCARE-IOWA INC	Yes
(17)DILEY RIDGE MEDICAL CENTER 3100 EASTON SQUARE PL STE 300 COLUMBUS,OH43219 34-2032340	HEALTH CARE AND HOSPITAL SERVICES	OH	501(C)(3)	LINE 3	MOUNT CARMEL HEALTH SYSTEM	Yes
(18)DUBUQUE MERCY HEALTH FOUNDATION 250 MERCY DRIVE DUBUQUE,IA52001 26-2227941	FOUNDATION	IA	501(C)(3)	LINE 12A, I	MERCY HEALTH SERVICES-IOWA CORP		No
(19)DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE,IA52040 20-5383271	FOUNDATION	IA	501(C)(3)	LINE 12A, I	MERCY HEALTH SERVICES-IOWA CORP	Yes
(20)EDDY LICENSED HOME CARE AGENCY 433 RIVER ST SUITE 3000 TROY,NY12180 14-1818568	HOME HEALTH SERVICES	NY	501(C)(3)	LINE 3	LTC (EDDY) INC	Yes
(21)EMBRACING AGE INC 333 BUTTERNUT DRIVE DEWITT,NY13214 46-1051881	PACE PROGRAM	NY	501(C)(3)	LINE 12B, II	ST JOSEPH'S HEALTH INC	Yes
(22)EMPIRE HOME INFUSION SERVICE INC 10 BLACKSMITH DRIVE MALTA,NY12020 14-1795732	HOME HEALTH SERVICES	NY	501(C)(3)	LINE 10	HOME AIDE SERVICE OF EASTERN NEW YORK INC	Yes
(23)FARREN CARE CENTER INC PO BOX 9184 FARMINGTON HILLS,MI48333 04-2501711	LONG TERM CARE	MA	501(C)(3)	LINE 3	TRINITY CONTINUING CARE SERVICES	Yes
(24)FRANCISCAN ELDERCARE CORPORATION PO BOX 2500 WILMINGTON,DE19805 22-3008680	LONG TERM CARE (INACTIVE)	DE	501(C)(3)	LINE 10	ST FRANCIS HOSPITAL INC	Yes
(25)GENESIS HEALTH SERVICES FOUNDATION 1227 E RUSHOLME STREET DAVENPORT,IA52803 42-1421670	FOUNDATION	IA	501(C)(3)	LINE 7	GENESIS HEALTH SYSTEM	Yes
(26)GENESIS HEALTH SYSTEM 1227 E RUSHOLME STREET DAVENPORT,IA52803 42-1418847	HEALTH CARE AND HOSPITAL SERVICES	IA	501(C)(3)	LINE 3	MERCY HEALTH NETWORK INC	Yes
(27)GENESIS HEALTH SYSTEM (IL) 801 ILLINI DRIVE SILVIS,IL61282 36-3616314	HEALTH CARE AND HOSPITAL SERVICES	IL	501(C)(3)	LINE 3	MERCY HEALTH NETWORK INC	Yes
(28)GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST 1227 E RUSHOLME STREET DAVENPORT,IA52803 39-1905171	EMPLOYEE BENEFIT TRUST	IA	501(C)(3)	LINE 12A, I	GENESIS HEALTH SYSTEM	Yes
(29)GENESIS MEDICAL CENTER ALEDO 409 NW 9TH AVENUE ALEDO,IL61231 45-4475683	HEALTH CARE AND HOSPITAL SERVICES	IL	501(C)(3)	LINE 3	GENESIS HEALTH SYSTEM (IL)	Yes
(30)GLACIER HILLS FOUNDATION 1200 EARHART RD ANN ARBOR,MI48105 20-8072723	FOUNDATION	MI	501(C)(3)	LINE 12A, I	GLACIER HILLS INC	Yes
(31)GLACIER HILLS INC 1200 EARHART RD ANN ARBOR,MI48105 38-1891500	SENIOR LIVING COMMUNITY	MI	501(C)(3)	LINE 10	TRINITY CONTINUING CARE SERVICES	Yes
(32)GLEN EDDY INC 1 GLEN EDDY DRIVE NISKAYUNA,NY12309 14-1794150	SENIOR LIVING COMMUNITY	NY	501(C)(3)	LINE 10	LTC (EDDY) INC	Yes
(33)GLOBAL HEALTH MINISTRY 20555 VICTOR PARKWAY LIVONIA,MI48152 42-1253527	HEALTH CARE SERVICES	MI	501(C)(3)	LINE 12A, I	TRINITY HEALTH CORPORATION	Yes
(34)GOOD SAMARITAN HOSPITAL INC 5401 LAKE OCONEE PARKWAY GREENSBORO,GA30642 26-1720984	HEALTH CARE AND HOSPITAL SERVICES	GA	501(C)(3)	LINE 3	TRINITY HEALTH GEORGIA INC	Yes
(35)GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION 701 W NORTH AVE MELROSE PARK,IL60160 36-3332852	HEALTH CARE AND HOSPITAL SERVICES	IL	501(C)(3)	LINE 3	LOYOLA UNIVERSITY HEALTH SYSTEM	Yes
(36)GOTTLIEB MEMORIAL FOUNDATION 701 WEST NORTH AVENUE MELROSE PARK,IL60160 74-3260011	FOUNDATION	IL	501(C)(3)	LINE 12D, III-O	N/A		No
(37)GOTTLIEB MEMORIAL HOSPITAL 701 W NORTH AVE MELROSE PARK,IL60160 36-2379649	HEALTH CARE AND HOSPITAL SERVICES	IL	501(C)(3)	LINE 3	LOYOLA UNIVERSITY HEALTH SYSTEM	Yes
(38)HAWTHORNE RIDGE INC 30 COMMUNITY WAY EAST GREENBUSH,NY12061 80-0102840	SENIOR LIVING COMMUNITY	NY	501(C)(3)	LINE 10	LTC (EDDY) INC	Yes
(39)HEARTWOOD LODGE TRINITY HEALTH PO BOX 530009 LIVONIA,MI48152 38-2602971	HEALTH CARE SERVICES	MI	501(C)(3)	LINE 10	TRINITY CONTINUING CARE SERVICES	Yes
(40)HERITAGE HOUSE NURSING CENTER INC 2920 TIBBITS AVE TROY,NY12180 14-1725101	LONG TERM CARE	NY	501(C)(3)	LINE 10	LTC (EDDY) INC	Yes
(41)HOLY CROSS CARENET INC PO BOX 530009 LIVONIA,MI48152 52-1945054	LONG TERM CARE	MD	501(C)(3)	LINE 10	TRINITY CONTINUING CARE SERVICES	Yes
(42)HOLY CROSS HEALTH FOUNDATION INC 1500 FOREST GLEN ROAD SILVER SPRING,MD20910 20-8428450	FOUNDATION	MD	501(C)(3)	LINE 7	HOLY CROSS HEALTH INC	Yes
(43)HOLY CROSS HEALTH INC 1500 FOREST GLEN ROAD SILVER SPRING,MD20910 52-0738041	HEALTH CARE AND HOSPITAL SERVICES	MD	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(44)HOLY CROSS HOSPITAL INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 59-0791028	HEALTH CARE AND HOSPITAL SERVICES	FL	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(45)HOLY CROSS OUTPATIENT SERVICES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 46-5421068	HEALTH CARE SERVICES	FL	501(C)(3)	LINE 10	HOLY CROSS HOSPITAL INC	Yes
(46)HOLY CROSS PRIMARY CARE INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 81-2531495	HEALTH CARE SERVICES	FL	501(C)(3)	LINE 10	HOLY CROSS HOSPITAL INC	Yes
(47)HOLY CROSS SENIOR SERVICES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE,FL33308 83-2256461	HEALTH CARE SERVICES	FL	501(C)(3)	LINE 10	HOLY CROSS HOSPITAL INC	Yes
(48)HOME AIDE SERVICE OF EASTERN NEW YORK INC 433 RIVER ST SUITE 3000 TROY,NY12180 14-1514867	HOME HEALTH SERVICES	NY	501(C)(3)	LINE 10	LTC (EDDY) INC	Yes
(49)HOSPICE OF NORTH IOWA 232 SECOND STREET SE MASON CITY,IA50401 42-1173708	HOSPICE SERVICES	IA	501(C)(3)	LINE 10	MERCY HEALTH SERVICES-IOWA CORP	Yes
(50)HOSPICE OF NORTH OTTAWA COMMUNITY INC PO BOX 532020 LIVONIA,MI48153 38-2370192	HOSPICE SERVICES	MI	501(C)(3)	LINE 10	TRINITY HOME HEALTH SERVICES	Yes
(51)HOUSE OF MERCY 1111 6TH AVENUE DES MOINES,IA50314 42-1323808	HEALTH CARE SERVICES	IA	501(C)(3)	LINE 7	CATHOLIC HEALTH INITIATIVES - IOWA CORP	Yes
(52)IHA HEALTH SERVICES CORPORATION 24 FRANK LLOYD WRIGHT DR LOBBY J ANN ARBOR,MI48105 38-3316559	HEALTH CARE SERVICES	MI	501(C)(3)	LINE 10	TRINITY HEALTH-MICHIGAN	Yes
(53)JOHNSON MEMORIAL HOSPITAL INC 114 WOODLAND STREET HARTFORD,CT06105 47-5676956	HEALTH CARE AND HOSPITAL SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH OF NEW ENGLAND CORP INC	Yes
(54)LANGHORNE MRI INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2519529	HEALTH CARE SERVICES (INACTIVE)	PA	501(C)(3)	LINE 10	ST MARY MEDICAL CENTER	Yes
(55)LIFE AT LOURDES INC 2475 MCCLELLAN AVENUE PENNSAUKEN,NJ08109 26-1854750	PACE PROGRAM	NJ	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(56)LIFE AT ST FRANCIS HEALTHCARE INC 1072 JUSTISON STREET WILMINGTON,DE19801 45-2569214	PACE PROGRAM	DE	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(57)LIFE ST JOSEPH OF THE PINES INC 4900 RAEFORD ROAD FAYETTEVILLE,NC28304 27-2159847	PACE PROGRAM	NC	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(58)LIFE ST MARY 2500 NORTHGATE ROAD TREVOSE,PA19053 26-2976184	PACE PROGRAM	PA	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(59)LOYOLA MEDICINE TRANSPORT LLC 905 W NORTH AVE MELROSE PARK,IL60160 47-4147171	TRANSPORTATION SERVICES	IL	501(C)(3)	LINE 10	LOYOLA UNIVERSITY MEDICAL CENTER	Yes
(60)LOYOLA UNIVERSITY HEALTH SYSTEM 2160 SOUTH FIRST AVENUE MAYWOOD,IL60153 36-3342448	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	IL	501(C)(3)	LINE 12C, III-FI	TRINITY HEALTH CORPORATION	Yes
(61)LOYOLA UNIVERSITY MEDICAL CENTER 2160 SOUTH FIRST AVENUE MAYWOOD,IL60153 36-4015560	HEALTH CARE AND HOSPITAL SERVICES	IL	501(C)(3)	LINE 3	LOYOLA UNIVERSITY HEALTH SYSTEM	Yes
(62)LTC (EDDY) INC 2212 BURDETT AVE TROY,NY12180 22-2564710	MANAGEMENT SERVICES FOR LONG TERM CARE	NY	501(C)(3)	LINE 12B, II	ST PETER'S HEALTH PARTNERS	Yes
(63)MAXIS HEALTH SYSTEM 20555 VICTOR PARKWAY LIVONIA,MI48152 91-1940902	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	PA	501(C)(3)	LINE 12A, I	TRINITY HEALTH CORPORATION	Yes
(64)MCAULEY CENTER INC 275 STEELE ROAD WEST HARTFORD,CT06117 06-1058086	SENIOR LIVING COMMUNITY	CT	501(C)(3)	LINE 10	MERCY COMMUNITY HEALTH INC	Yes
(65)MCAULEY MINISTRIES 3333 FIFTH AVENUE PITTSBURGH,PA15213 94-3436142	GRANT MAKING	PA	501(C)(3)	LINE 12B, II	PITTSBURGH MERCY HEALTH SYSTEM INC	Yes
(66)MEDIC EMS 1204 E HIGH STREET DAVENPORT,IA52803 42-1186903	AMBULANCE TRANSFERS	IA	501(C)(3)	LINE 12C, III-FI	N/A		No
(67)MERCY AUXILARY 814 13TH AVE N UNIT 6A CLINTON,IA53732 42-1348035	VOLUNTEER SERVICE AUXILIARY	IA	501(C)(3)	LINE 12A, I	N/A		No
(68)MERCY AUXILIARY OF CENTRAL IOWA 1111 6TH AVENUE DES MOINES,IA50314 42-6076069	VOLUNTEER SERVICE AUXILIARY	IA	501(C)(3)	LINE 12A, I	MERCY FOUNDATION OF DES MOINES IOWA	Yes
(69)MERCY CARE CENTER 3753 SOUTH COTTAGE GROVE AVE CHICAGO,IL60653 85-3904921	HEALTH CARE AND HOSPITAL SERVICES	IL	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(70)MERCY CARE FOUNDATION INC 424 DECATUR STREET ATLANTA,GA30312 58-1448522	FOUNDATION	GA	501(C)(3)	LINE 7	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes
(71)MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PENNSYLVANIA 3805 W CHESTER PIKE STE 100 NEWTOWN SQUARE,PA19073 23-1352191	HEALTH CARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(72)MERCY CLINICS INC 1111 6TH AVENUE DES MOINES,IA50314 42-1193699	HEALTH CARE SERVICES	IA	501(C)(3)	LINE 10	CATHOLIC HEALTH INITIATIVES - IOWA CORP	Yes
(73)MERCY COLLEGE OF HEALTH SCIENCES 928 6TH AVENUE DES MOINES,IA50309 42-1511682	COLLEGE OF HEALTH SCIENCE	IA	501(C)(3)	LINE 2	CATHOLIC HEALTH INITIATIVES - IOWA CORP	Yes
(74)MERCY COMMUNITY HEALTH INC 2021 ALBANY AVENUE WEST HARTFORD,CT06117 06-1492707	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	CT	501(C)(3)	LINE 12B, II	TRINITY CONTINUING CARE SERVICES	Yes
(75)MERCY FAMILY SUPPORT 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 23-2325059	HOME HEALTH SERVICES	PA	501(C)(3)	LINE 10	MERCY HOME HEALTH SERVICES	Yes
(76)MERCY FOUNDATION OF DES MOINES IOWA 1111 6TH AVENUE DES MOINES,IA50314 23-7358794	FOUNDATION	IA	501(C)(3)	LINE 7	CATHOLIC HEALTH INITIATIVES - IOWA CORP	Yes
(77)MERCY FOUNDATION INC 2160 SOUTH FIRST AVENUE MAYWOOD,IL60153 36-3227350	FOUNDATION	IL	501(C)(3)	LINE 7	MERCY HEALTH SYSTEM OF CHICAGO	Yes
(78)MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE PO BOX 532020 LIVONIA,MI48153 38-3321856	HOME HEALTH SERVICES	MI	501(C)(3)	LINE 10	TRINITY HOME HEALTH SERVICES	Yes
(79)MERCY HEALTH FOUNDATION OF SOUTHEASTERN PENNSYLVANIA 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 23-2829864	FOUNDATION	PA	501(C)(3)	LINE 12B, II	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(80)MERCY HEALTH NETWORK INC 411 LAUREL STREET SUITE 200 DES MOINES,IA50314 42-1478417	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	DE	501(C)(3)	LINE 12B, II	TRINITY HEALTH CORPORATION	Yes
(81)MERCY HEALTH PARTNERS 1500 E SHERMAN BLVD MUSKEGON,MI49444 38-2589966	HEALTH CARE AND HOSPITAL SERVICES	MI	501(C)(3)	LINE 3	TRINITY HEALTH-MICHIGAN	Yes
(82)MERCY HEALTH PLAN 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 22-2483605	MEDICAID MANAGED CARE PLAN	PA	501(C)(3)	LINE 12B, II	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(83)MERCY HEALTH SERVICES - IOWA CORP 1000 4TH STREET SW MASON CITY,IA50401 31-1373080	HEALTH CARE AND HOSPITAL SERVICES	DE	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(84)MERCY HEALTH SYSTEM OF CHICAGO 2160 SOUTH FIRST AVENUE MAYWOOD,IL60153 36-3163327	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	IL	501(C)(3)	LINE 12B, II	TRINITY HEALTH CORPORATION	Yes
(85)MERCY HEALTHCARE FOUNDATION - CLINTON 1410 N 4TH ST CLINTON,IA52732 42-1316126	FOUNDATION	IA	501(C)(3)	LINE 7	MERCY MEDICAL CENTER - CLINTON INC	Yes
(86)MERCY HOME HEALTH PO BOX 532020 LIVONIA,MI48153 23-1352099	HOME HEALTH SERVICES	PA	501(C)(3)	LINE 10	TRINITY HOME HEALTH SERVICES	Yes
(87)MERCY HOME HEALTH SERVICES 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 23-2325058	MANAGEMENT SERVICES FOR HOME HEALTH	PA	501(C)(3)	LINE 12B, II	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(88)MERCY HOSPITAL AND MEDICAL CENTER 2160 SOUTH FIRST AVENUE MAYWOOD,IL60153 36-2170152	HEALTH CARE AND HOSPITAL SERVICES	IL	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF CHICAGO	Yes
(89)MERCY HOSPITAL CADILLAC FOUNDATION 318 RIVER RIDGE DR NW SUITE 100 WALKER,MI49544 20-3357131	FOUNDATION	MI	501(C)(3)	LINE 12A, I	TRINITY HEALTH-MICHIGAN	Yes
(90)MERCY HOSPITAL OF FRANCISCAN SISTERS INC 201 8TH AVENUE SE OELWEIN,IA50662 42-1178403	HEALTH CARE AND HOSPITAL SERVICES	IA	501(C)(3)	LINE 3	WHEATON FRANCISCAN HEALTHCARE-IOWA INC	Yes
(91)MERCY LIFE 1930 SOUTH BROAD STREET PHILADELPHIA,PA19145 23-2840137	PACE PROGRAM	PA	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(92)MERCY LIFE CENTER CORPORATION 1200 REEDSDALE STREET PITTSBURGH,PA15233 25-1604115	COMMUNITY OUTREACH	PA	501(C)(3)	LINE 10	PITTSBURGH MERCY HEALTH SYSTEM INC	Yes
(93)MERCY LIFE OF ALABAMA PO BOX 7957 MOBILE,AL36670 27-3163002	PACE PROGRAM	AL	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(94)MERCY LIFE INC 200 HILLSIDE CIRCLE WEST SPRINGFIELD,MA01089 45-3086711	PACE PROGRAM	MA	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(95)MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 23-2627944	HEALTH CARE SERVICES	PA	501(C)(3)	LINE 3	MERCY PHYSICIAN NETWORK	Yes
(96)MERCY MEDICAL CENTER - CENTERVILLE 1 ST JOSEPHS DRIVE CENTERVILLE,IA52544 42-0680308	HEALTH CARE AND HOSPITAL SERVICES	IA	501(C)(3)	LINE 3	CATHOLIC HEALTH INITIATIVES - IOWA CORP	Yes
(97)MERCY MEDICAL CENTER - CLINTON INC 1410 NORTH 4TH ST CLINTON,IA52732 42-1336618	HEALTH CARE AND HOSPITAL SERVICES	DE	501(C)(3)	LINE 3	MERCY HEALTH SERVICES-IOWA CORP	Yes
(98)MERCY MEDICAL CENTER - NEWTON 204 N 4TH AVE E NEWTON,IA50208 42-1470935	HEALTH CARE AND HOSPITAL SERVICES	IA	501(C)(3)	LINE 3	CATHOLIC HEALTH INITIATIVES - IOWA CORP	Yes
(99)MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION 801 5TH STREET SIOUX CITY,IA51101 14-1880022	FOUNDATION	IA	501(C)(3)	LINE 7	MERCY HEALTH SERVICES-IOWA CORP	Yes
(100)MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA 1000 4TH STREET SW MASON CITY,IA50401 42-1229151	FOUNDATION	IA	501(C)(3)	LINE 7	MERCY HEALTH SERVICES-IOWA CORP	Yes
(101)MERCY MEDICAL GROUP INC 114 WOODLAND STREET HARTFORD,CT06105 45-4884805	HEALTH CARE SERVICES	MA	501(C)(3)	LINE 3	THE MERCY HOSPITAL INC	Yes
(102)MERCY SENIOR CARE INC 424 DECATUR STREET ATLANTA,GA30312 58-1366508	COMMUNITY OUTREACH	GA	501(C)(3)	LINE 7	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes
(103)MERCY SERVICES DOWNTOWN INC 424 DECATUR STREET ATLANTA,GA30312 27-2046353	TITLE HOLDING COMPANY	GA	501(C)(3)	LINE 12B, II	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes
(104)MERCY SERVICES FOR AGING NONPROFIT HOUSING CORPORATION PO BOX 530009 LIVONIA,MI48152 38-2719605	LONG TERM CARE	MI	501(C)(3)	LINE 10	TRINITY CONTINUING CARE SERVICES	Yes
(105)MERCY SPECIALIST PHYSICIANS INC 114 WOODLAND STREET HARTFORD,CT06105 26-4033168	HEALTH CARE SERVICES	MA	501(C)(3)	LINE 3	THE MERCY HOSPITAL INC	Yes
(106)MERCY SUBURBAN HOSPITAL 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 23-1396763	HEALTH CARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(107)MOUNT CARMEL COLLEGE OF NURSING 3100 EASTON SQUARE PL STE 300 COLUMBUS,OH43219 31-1308555	COLLEGE OF NURSING	OH	501(C)(3)	LINE 2	MOUNT CARMEL HEALTH SYSTEM	Yes
(108)MOUNT CARMEL HEALTH INSURANCE COMPANY 3100 EASTON SQUARE PL STE 300 COLUMBUS,OH43219 25-1912781	HEALTH INSURANCE	OH	501(C)(4)	N/A	MOUNT CARMEL HEALTH SYSTEM	Yes
(109)MOUNT CARMEL HEALTH PLAN OF CONNECTICUT INC 3100 EASTON SQUARE PL STE 300 COLUMBUS,OH43219 87-3948434	MEDICARE HMO	CT	501(C)(4)	N/A	MOUNT CARMEL HEALTH PLAN INC	Yes
(110)MOUNT CARMEL HEALTH PLAN OF IDAHO INC 3100 EASTON SQUARE PL STE 300 COLUMBUS,OH43219 83-1422704	MEDICARE HMO	ID	501(C)(4)	N/A	MOUNT CARMEL HEALTH PLAN INC	Yes
(111)MOUNT CARMEL HEALTH PLAN OF NEW YORK INC 3100 EASTON SQUARE PL STE 300 COLUMBUS,OH43219 83-3278543	MEDICARE HMO	NY	501(C)(4)	N/A	MOUNT CARMEL HEALTH PLAN INC	Yes
(112)MOUNT CARMEL HEALTH PLAN INC 3100 EASTON SQUARE PL STE 300 COLUMBUS,OH43219 31-1471229	MEDICARE HMO	OH	501(C)(4)	N/A	MOUNT CARMEL HEALTH SYSTEM	Yes
(113)MOUNT CARMEL HEALTH SYSTEM 3100 EASTON SQUARE PL STE 300 COLUMBUS,OH43219 31-1439334	HEALTH CARE AND HOSPITAL SERVICES	OH	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(114)MOUNT CARMEL HEALTH SYSTEM FOUNDATION 3100 EASTON SQUARE PL STE 300 COLUMBUS,OH43219 31-1113966	FOUNDATION	OH	501(C)(3)	LINE 12A, I	MOUNT CARMEL HEALTH SYSTEM	Yes
(115)MOUNT SINAI HOSPITAL FOUNDATION INC 114 WOODLAND STREET HARTFORD,CT06105 22-2584082	FOUNDATION	CT	501(C)(3)	LINE 12C, III-FI	N/A		No
(116)MOUNT SINAI REHABILITATION HOSPITAL INC 114 WOODLAND STREET HARTFORD,CT06105 06-1422973	HEALTH CARE AND HOSPITAL SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH OF NEW ENGLAND CORP INC	Yes
(117)MOUNT ST JOSEPH 20555 VICTOR PARKWAY LIVONIA,MI48152 01-0274998	LONG TERM CARE	ME	501(C)(3)	LINE 3	MERCY COMMUNITY HEALTH INC	Yes
(118)MUSKEGON COMMUNITY HEALTH PROJECT 1675 LEAHY ST SUITE 210 MUSKEGON,MI49442 91-1932918	COMMUNITY OUTREACH	MI	501(C)(3)	LINE 7	MERCY HEALTH PARTNERS	Yes
(119)NAZARETH HOSPITAL 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 23-2794121	HEALTH CARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(120)NAZARETH PHYSICIAN SERVICES INC 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 20-3261266	HEALTH CARE SERVICES	PA	501(C)(3)	LINE 3	MERCY PHYSICIAN NETWORK	Yes
(121)NORTH OTTAWA HOSPITAL AUXILIARY INC 1309 SHELDON ROAD GRAND HAVEN,MI49417 38-6088836	FUNDRAISING	MI	501(C)(3)	LINE 12D, III-O	N/A		No
(122)NORTHEAST IOWA REAL ESTATE INVESTMENTS LTD 3421 WEST NINTH STREET WATERLOO,IA50702 42-1207432	TITLE HOLDING COMPANY	IA	501(C)(2)	N/A	WHEATON FRANCISCAN HEALTHCARE-IOWA INC	Yes
(123)OAKLAND MERCY HOSPITAL PO BOX 203 SIOUX CITY,IA51102 20-8072234	HEALTH CARE AND HOSPITAL SERVICES	NE	501(C)(3)	LINE 3	MERCY HEALTH SERVICES-IOWA CORP	Yes
(124)OAKLAND MERCY HOSPITAL FOUNDATION PO BOX 203 SIOUX CITY,IA51102 31-1678345	FOUNDATION	NE	501(C)(3)	LINE 12A, I	OAKLAND MERCY HOSPITAL	Yes
(125)OSUMOUNT CARMEL HEALTH ALLIANCE 3100 EASTON SQUARE PL STE 300 COLUMBUS,OH43219 31-1654603	COOPERATIVE HEALTH CARE DELIVERY SYSTEM	OH	501(C)(3)	LINE 12A, I	N/A		No
(126)OUR LADY OF MERCY LIFE CENTER 2 MERCYCARE LANE GUILDERLAND,NY12084 14-1743506	LONG TERM CARE	NY	501(C)(3)	LINE 3	LTC (EDDY) INC	Yes
(127)PIONEER VALLEY CARDIOLOGY ASSOCIATES INC 114 WOODLAND STREET HARTFORD,CT06105 45-4208896	HEALTH CARE SERVICES	MA	501(C)(3)	LINE 3	THE MERCY HOSPITAL INC	Yes
(128)PITTSBURGH MERCY HEALTH SYSTEM INC 3333 5TH AVENUE PITTSBURGH,PA15213 25-1464211	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	PA	501(C)(3)	LINE 12B, II	TRINITY HEALTH CORPORATION	Yes
(129)PROBILITY THERAPY SERVICES 2058 S STATE STREET ANN ARBOR,MI48104 20-2020239	HEALTH CARE SERVICES	MI	501(C)(3)	LINE 10	TRINITY HEALTH-MICHIGAN	Yes
(130)PROFESSIONAL MED TEAM 965 FORK STREET MUSKEGON,MI49442 38-2638284	HEALTH CARE SERVICES	MI	501(C)(3)	LINE 10	MERCY HEALTH PARTNERS	Yes
(131)RIVERBEND MEDICAL GROUP INC 114 WOODLAND STREET HARTFORD,CT06105 81-1807730	HEALTH CARE SERVICES	MA	501(C)(3)	LINE 3	THE MERCY HOSPITAL INC	Yes
(132)SJ MANAGEMENT COMPANY OF SYRACUSE INC 301 PROSPECT AVENUE SYRACUSE,NY13203 27-1763712	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	NY	501(C)(3)	LINE 12A, I	ST JOSEPH'S HOSPITAL HEALTH CENTER	Yes
(133)SAINT AGNES MEDICAL CENTER 1303 EAST HERNDON AVE FRESNO,CA93720 94-1437713	HEALTH CARE AND HOSPITAL SERVICES	CA	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(134)SAINT AGNES MEDICAL FOUNDATION 1303 EAST HERNDON AVE FRESNO,CA93720 94-2839324	HEALTH CARE SERVICES	CA	501(C)(3)	LINE 12A, I	SAINT AGNES MEDICAL CENTER	Yes
(135)SAINT ALPHONSUS DIVERSIFIED CARE INC 1055 NORTH CURTIS ROAD BOISE,ID83706 94-3028978	HEALTH CARE SYSTEM SUPPORT	ID	501(C)(3)	LINE 12A, I	SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC	Yes
(136)SAINT ALPHONSUS FOUNDATION-BAKER CITY INC 3325 POCAHONTAS ROAD BAKER CITY,OR97814 94-3164869	FOUNDATION	OR	501(C)(3)	LINE 7	SAINT ALPHONSUS MEDICAL CENTER -BAKER CITY INC	Yes
(137)SAINT ALPHONSUS FOUNDATION-ONTARIO INC 351 SW 9TH STREET ONTARIO,OR97914 20-2683560	FOUNDATION	OR	501(C)(3)	LINE 7	SAINT ALPHONSUS MEDICAL CENTER -ONTARIO INC	Yes
(138)SAINT ALPHONSUS HEALTH SYSTEM INC 1055 NORTH CURTIS ROAD BOISE,ID83706 27-1929502	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	ID	501(C)(3)	LINE 12B, II	TRINITY HEALTH CORPORATION	Yes
(139)SAINT ALPHONSUS MEDICAL CENTER ONTARIO VOLUNTEERS 351 SW 9TH STREET ONTARIO,OR97914 94-3059469	VOLUNTEER SERVICE AUXILIARY	OR	501(C)(3)	LINE 10	SAINT ALPHONSUS MEDICAL CENTER -ONTARIO INC	Yes
(140)SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY INC 3325 POCAHONTAS ROAD BAKER CITY,OR97814 27-1790052	HEALTH CARE AND HOSPITAL SERVICES	OR	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC	Yes
(141)SAINT ALPHONSUS MEDICAL CENTER-NAMPA HEALTH FOUNDATION INC 4300 E FLAMINGO AVENUE NAMPA,ID83687 26-1737256	FOUNDATION	ID	501(C)(3)	LINE 7	SAINT ALPHONSUS MEDICAL CENTER -NAMPA INC	Yes
(142)SAINT ALPHONSUS MEDICAL CENTER-NAMPA INC 4300 E FLAMINGO AVENUE NAMPA,ID83687 82-0200896	HEALTH CARE AND HOSPITAL SERVICES	ID	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC	Yes
(143)SAINT ALPHONSUS MEDICAL CENTER-ONTARIO INC 351 SW 9TH STREET ONTARIO,OR97914 27-1789847	HEALTH CARE AND HOSPITAL SERVICES	OR	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC	Yes
(144)SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC 1055 NORTH CURTIS ROAD BOISE,ID83706 82-0200895	HEALTH CARE AND HOSPITAL SERVICES	ID	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC	Yes
(145)SAINT FRANCIS EMERGENCY MEDICAL GROUP INC 114 WOODLAND STREET HARTFORD,CT06105 45-1994612	HEALTH CARE SERVICES	CT	501(C)(3)	LINE 12B, II	TRINITY HEALTH OF NEW ENGLAND PNO INC	Yes
(146)SAINT FRANCIS HOSPITAL AND MEDICAL CENTER 114 WOODLAND STREET HARTFORD,CT06105 06-0646813	HEALTH CARE AND HOSPITAL SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH OF NEW ENGLAND CORP INC	Yes
(147)SAINT FRANCIS HOSPITAL AND MEDICAL CENTER FOUNDATION INC 114 WOODLAND STREET HARTFORD,CT06105 06-1008255	FOUNDATION	CT	501(C)(3)	LINE 7	SAINT FRANCIS HOSPITAL AND MEDICAL CENTER	Yes
(148)SAINT JOSEPH PACE INC 20555 VICTOR PARKWAY LIVONIA,MI48152 47-3129127	PACE PROGRAM	IN	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(149)SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC PO BOX 670 PLYMOUTH,IN46563 35-1142669	HEALTH CARE AND HOSPITAL SERVICES	IN	501(C)(3)	LINE 3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	Yes
(150)SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC 5215 HOLY CROSS PARKWAY MISHAWAKA,IN46545 35-0868157	HEALTH CARE AND HOSPITAL SERVICES	IN	501(C)(3)	LINE 3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	Yes
(151)SAINT JOSEPH REGIONAL MEDICAL CENTER INC 5215 HOLY CROSS PARKWAY MISHAWAKA,IN46545 35-1568821	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	IN	501(C)(3)	LINE 12C, III-FI	TRINITY HEALTH CORPORATION	Yes
(152)SAINT JOSEPH'S HEALTH SYSTEM INC 424 DECATUR STREET ATLANTA,GA30312 58-1744848	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	GA	501(C)(3)	LINE 12C, III-FI	TRINITY HEALTH CORPORATION	Yes
(153)SAINT JOSEPH'S MERCY CARE SERVICES INC 424 DECATUR STREET ATLANTA,GA30312 58-1752700	HEALTH CARE SERVICES	GA	501(C)(3)	LINE 10	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes
(154)SAINT JOSEPH'S TOWER INC PO BOX 530009 LIVONIA,MI48152 31-1040468	SENIOR LIVING COMMUNITY	IN	501(C)(3)	LINE 10	TRINITY CONTINUING CARE SERVICES-INDIANA INC	Yes
(155)SAINT MARY HOME INCORPORATED 2021 ALBANY AVENUE WEST HARTFORD,CT06117 06-0646843	LONG TERM CARE	CT	501(C)(3)	LINE 3	MERCY COMMUNITY HEALTH INC	Yes
(156)SAINT MARY'S AMICARE HOME HEALTHCARE PO BOX 532020 LIVONIA,MI48153 38-3320700	HOME HEALTH SERVICES	MI	501(C)(3)	LINE 10	TRINITY HOME HEALTH SERVICES	Yes
(157)SAINT MARY'S FOUNDATION 200 JEFFERSON ST SE GRAND RAPIDS,MI49503 38-1779602	FOUNDATION	MI	501(C)(3)	LINE 7	TRINITY HEALTH-MICHIGAN	Yes
(158)SAINT MARY'S HOSPITAL FOUNDATION INC 114 WOODLAND STREET HARTFORD,CT06105 22-2528400	FOUNDATION	CT	501(C)(3)	LINE 7	SAINT MARY'S HOSPITAL INC	Yes
(159)SAINT MARY'S HOSPITAL INC 114 WOODLAND STREET HARTFORD,CT06105 06-0646844	HEALTH CARE AND HOSPITAL SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH OF NEW ENGLAND CORP INC	Yes
(160)SAMARITAN HOSPITAL 2215 BURDETT AVE TROY,NY12180 14-1338544	HEALTH CARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes
(161)SAMARITAN HOSPITAL AND THE EDDY FOUNDATION 310 SOUTH MANNING BLVD ALBANY,NY12208 22-2743478	FOUNDATION	NY	501(C)(3)	LINE 7	ST PETER'S HEALTH PARTNERS	Yes
(162)SARTORI HEALTH CARE FOUNDATION INC 3421 WEST NINTH STREET WATERLOO,IA50702 42-1240996	FOUNDATION	IA	501(C)(3)	LINE 7	SARTORI MEMORIAL HOSPITAL INC	Yes
(163)SARTORI MEMORIAL HOSPITAL INC 515 COLLEGE STREET CEDAR FALLS,IA50613 42-0758901	HEALTH CARE AND HOSPITAL SERVICES	IA	501(C)(3)	LINE 3	WHEATON FRANCISCAN HEALTHCARE-IOWA INC	Yes
(164)SENIOR CARE CONNECTION INC 1938 CURRY ROAD SCHENECTADY,NY12303 14-1708754	PACE PROGRAM	NY	501(C)(3)	LINE 10	LTC (EDDY) INC	Yes
(165)SETON HEALTH AT SCHUYLER RIDGE RESIDENTIAL HEALTHCARE ONE ABELE BLVD CLIFTON PARK,NY12065 14-1756230	LONG TERM CARE	NY	501(C)(3)	LINE 10	LTC (EDDY) INC	Yes
(166)SIOUXLAND PARAMEDICS INC PO BOX 3349 SIOUX CITY,IA51102 42-1185707	MEDICAL TRANSPORTATION SERVICES	IA	501(C)(3)	LINE 12A, I	N/A		No
(167)SJHSJOC HOLDINGS INC 424 DECATUR STREET ATLANTA,GA30312 47-2299757	HEALTH CARE SYSTEM SUPPORT	GA	501(C)(3)	LINE 12B, II	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes
(168)ST FRANCIS HOSPITAL INC PO BOX 2500 WILMINGTON,DE19805 51-0064326	HEALTH CARE AND HOSPITAL SERVICES	DE	501(C)(3)	LINE 3	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(169)ST JAMES MERCY HEALTH SYSTEM INC 20555 VICTOR PARKWAY LIVONIA,MI48152 22-3127184	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT (INACTIVE)	NY	501(C)(3)	LINE 12A, I	TRINITY HEALTH CORPORATION	Yes
(170)ST JOSEPH MERCY CHELSEA INC 775 SOUTH MAIN ST CHELSEA,MI48118 82-4757260	HEALTH CARE AND HOSPITAL SERVICES	MI	501(C)(3)	LINE 3	TRINITY HEALTH-MICHIGAN	Yes
(171)ST JOSEPH OF THE PINES INC 100 GOSSMAN DRIVE SOUTHERN PINES,NC28387 56-0694200	LONG TERM CARE	NC	501(C)(3)	LINE 10	TRINITY CONTINUING CARE SERVICES	Yes
(172)ST JOSEPH'S COLLEGE OF NURSING AT ST JOSEPH'S HOSPITAL HEALTH CENTER 206 PROSPECT AVENUE SYRACUSE,NY13203 20-2497520	COLLEGE OF NURSING	NY	501(C)(3)	LINE 2	ST JOSEPH'S HOSPITAL HEALTH CENTER	Yes
(173)ST JOSEPH'S HEALTH AT HOME INC PO BOX 532020 LIVONIA,MI48152 87-1012253	HOME HEALTH SERVICES	NY	501(C)(3)	LINE 10	TRINITY HOME HEALTH SERVICES	Yes
(174)ST JOSEPH'S HEALTH CENTER PROPERTIES INC 301 PROSPECT AVENUE SYRACUSE,NY13203 23-7219294	BUILDING MANAGEMENT SERVICES	NY	501(C)(3)	LINE 12B, II	ST JOSEPH'S HEALTH INC	Yes
(175)ST JOSEPH'S HEALTH INC 301 PROSPECT AVENUE SYRACUSE,NY13203 47-4754987	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	NY	501(C)(3)	LINE 12B, II	TRINITY HEALTH CORPORATION	Yes
(176)ST JOSEPH'S HOSPITAL HEALTH CENTER 301 PROSPECT AVENUE SYRACUSE,NY13203 15-0532254	HEALTH CARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST JOSEPH'S HEALTH INC	Yes
(177)ST JOSEPH'S HOSPITAL HEALTH CENTER FOUNDATION INC 301 PROSPECT AVENUE SYRACUSE,NY13203 22-2149775	FOUNDATION	NY	501(C)(3)	LINE 12B, II	ST JOSEPH'S HEALTH INC	Yes
(178)ST JOSEPH'S MEDICAL PC 301 PROSPECT AVENUE SYRACUSE,NY13203 27-3899821	HEALTH CARE SERVICES	NY	501(C)(3)	LINE 12A, I	ST JOSEPH'S HOSPITAL HEALTH CENTER	Yes
(179)ST JOSEPH'S PHYSICIAN HEALTH PC 315 SOUTH MANNING BLVD ALBANY,NY12208 16-1516863	HEALTH CARE SERVICES	NY	501(C)(3)	LINE 12A, I	ST PETER'S HEALTH PARTNERS	Yes
(180)ST MARY BUILDING AND DEVELOPMENT 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 46-1827502	TITLE HOLDING COMPANY	PA	501(C)(2)	N/A	ST MARY MEDICAL CENTER	Yes
(181)ST MARY EMERGENCY MEDICAL SERVICES 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 46-5354512	HEALTH CARE SERVICES	PA	501(C)(3)	LINE 10	ST MARY MEDICAL CENTER	Yes
(182)ST MARY MEDICAL CENTER 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-1913910	HEALTH CARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(183)ST MARY'S FOUNDATION INC 1230 BAXTER STREET ATHENS,GA30606 58-2544232	FOUNDATION	GA	501(C)(3)	LINE 12B, II	TRINITY HEALTH GEORGIA INC	Yes
(184)ST MARY'S GOOD SAMARITAN FOUNDATION INC 1230 BAXTER STREET ATHENS,GA30606 81-1660088	FOUNDATION	GA	501(C)(3)	LINE 12B, II	TRINITY HEALTH GEORGIA INC	Yes
(185)ST MARY'S HIGHLAND HILLS INC 1230 BAXTER STREET ATHENS,GA30606 02-0576648	SENIOR LIVING COMMUNITY	GA	501(C)(3)	LINE 10	TRINITY HEALTH GEORGIA INC	Yes
(186)ST MARY'S HOSPITAL INC 1230 BAXTER STREET ATHENS,GA30606 58-0566223	HEALTH CARE AND HOSPITAL SERVICES	GA	501(C)(3)	LINE 3	TRINITY HEALTH GEORGIA INC	Yes
(187)ST MARY'S MEDICAL GROUP INC 1230 BAXTER STREET ATHENS,GA30606 26-1858563	HEALTH CARE SERVICES	GA	501(C)(3)	LINE 3	TRINITY HEALTH GEORGIA INC	Yes
(188)ST MARY'S SACRED HEART HOSPITAL INC 367 CLEAR CREEK PARKWAY LAVONIA,GA30553 47-3752176	HEALTH CARE AND HOSPITAL SERVICES	GA	501(C)(3)	LINE 3	TRINITY HEALTH GEORGIA INC	Yes
(189)ST PETER'S HEALTH PARTNERS 315 SOUTH MANNING BLVD ALBANY,NY12208 45-3570715	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	NY	501(C)(3)	LINE 12B, II	TRINITY HEALTH CORPORATION	Yes
(190)ST PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES PC 315 SOUTH MANNING BLVD ALBANY,NY12208 46-1177336	HEALTH CARE SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes
(191)ST PETER'S HOSPITAL 315 SOUTH MANNING BLVD ALBANY,NY12208 14-1348692	HEALTH CARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes
(192)ST PETER'S HOSPITAL FOUNDATION INC 310 SOUTH MANNING BLVD ALBANY,NY12208 22-2262982	FOUNDATION	NY	501(C)(3)	LINE 7	ST PETER'S HEALTH PARTNERS	Yes
(193)SUNNYVIEW HOSPITAL AND REHABILITATION CENTER 1270 BELMONT AVENUE SCHENECTADY,NY12308 14-1338386	HEALTH CARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes
(194)SUNNYVIEW HOSPITAL AND REHABILITATION CENTER FOUNDATION INC 1270 BELMONT AVE SCHENECTADY,NY12308 22-2505127	FOUNDATION	NY	501(C)(3)	LINE 7	SUNNYVIEW HOSPITAL AND REHABILITATION CENTER	Yes
(195)THE AUXILIARY OF ST JOSEPH'S HOSPITAL HEALTH CENTER INC 301 PROSPECT AVENUE SYRACUSE,NY13203 20-3018640	VOLUNTEER SERVICE AUXILIARY	NY	501(C)(3)	LINE 12C, III-FI	ST JOSEPH'S HOSPITAL HLTH CTR FOUNDATION INC	Yes
(196)THE COMMUNITY HOSPICE FOUNDATION INC 445 NEW KARNER RD ALBANY,NY12205 22-2692940	FOUNDATION	NY	501(C)(3)	LINE 7	THE COMMUNITY HOSPICE INC	Yes
(197)THE COMMUNITY HOSPICE INC 445 NEW KARNER RD ALBANY,NY12205 14-1608921	HOSPICE SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes
(198)THE FOUNDATION OF SAINT JOSEPH REGIONAL MEDICAL CENTER INC 707 EAST CEDAR STREET STE 100 SOUTH BEND,IN46617 35-1654543	FOUNDATION	IN	501(C)(3)	LINE 7	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	Yes
(199)THE JAMES A EDDY MEMORIAL GERIATRIC CENTER INC 2256 BURDETT AVE TROY,NY12180 22-2570478	LONG TERM CARE	NY	501(C)(3)	LINE 10	LTC (EDDY) INC	Yes
(200)THE MARJORIE DOYLE ROCKWELL CENTER INC 421 WEST COLUMBIA ST COHOES,NY12047 14-1793885	LONG TERM CARE	NY	501(C)(3)	LINE 10	LTC (EDDY) INC	Yes
(201)THE MERCY HOSPITAL INC 114 WOODLAND STREET HARTFORD,CT06105 04-3398280	HEALTH CARE AND HOSPITAL SERVICES	MA	501(C)(3)	LINE 3	TRINITY HEALTH OF NEW ENGLAND CORP INC	Yes
(202)THE WOMEN'S AUXILIARY OF ST FRANCIS HOSPITAL & MEDICAL CENTER 114 WOODLAND STREET HARTFORD,CT06105 06-0660403	VOLUNTEER SERVICE AUXILIARY	CT	501(C)(3)	LINE 12B, II	N/A		No
(203)TRI-HOSPITAL EMERGENCY MEDICAL SERVICES 309 GRAND RIVER PORT HURON,MI48060 38-2485700	HEALTH CARE SERVICES	MI	501(C)(3)	LINE 12A, I	N/A		No
(204)TRINITY CONTINUING CARE SERVICES PO BOX 530009 LIVONIA,MI48152 38-2559656	LONG TERM CARE	MI	501(C)(3)	LINE 10	TRINITY HEALTH CORPORATION	Yes
(205)TRINITY CONTINUING CARE SERVICES - INDIANA PO BOX 530009 LIVONIA,MI48152 93-0907047	LONG TERM CARE	IN	501(C)(3)	LINE 10	TRINITY CONTINUING CARE SERVICES	Yes
(206)TRINITY CONTINUING CARE SERVICES - MASSACHUSETTS PO BOX 530009 LIVONIA,MI48152 82-4005577	LONG TERM CARE	MI	501(C)(3)	LINE 10	TRINITY CONTINUING CARE SERVICES	Yes
(207)TRINITY HEALTH - MICHIGAN 20555 VICTOR PARKWAY LIVONIA,MI48152 38-2113393	HEALTH CARE AND HOSPITAL SERVICES	MI	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes
(208)TRINITY HEALTH CORPORATION 20555 VICTOR PARKWAY LIVONIA,MI48152 35-1443425	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	IN	501(C)(3)	LINE 12B, II	CATHOLIC HEALTH MINISTRIES	Yes
(209)TRINITY HEALTH GEORGIA INC 1230 BAXTER STREET ATHENS,GA30606 88-0878641	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	GA	501(C)(3)	LINE 12B, II	TRINITY HEALTH CORPORATION	Yes
(210)TRINITY HEALTH GRAND HAVEN HOSPITAL (FKA NORTH OTTAWA COMMUNITY HOSPITAL) 1309 SHELDON ROAD GRAND HAVEN,MI49417 38-3330803	HEALTH CARE AND HOSPITAL SERVICES	MI	501(C)(3)	LINE 3	MERCY HEALTH PARTNERS	Yes
(211)TRINITY HEALTH LIFE PENNSYLVANIA INC 20555 VICTOR PARKWAY LIVONIA,MI48152 47-5244984	PACE PROGRAM	PA	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(212)TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2571699	HEALTH CARE SERVICES	PA	501(C)(3)	LINE 10	TRINITY HEALTH OF THE MID-ATLANTIC REGION	Yes
(213)TRINITY HEALTH OF NEW ENGLAND CORPORATION INC 114 WOODLAND STREET HARTFORD,CT06105 06-1491191	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	CT	501(C)(3)	LINE 12B, II	TRINITY HEALTH CORPORATION	Yes
(214)TRINITY HEALTH OF NEW ENGLAND EMERGENCY MEDICAL SERVICES INC 114 WOODLAND STREET HARTFORD,CT06105 83-3546613	HEALTH CARE SERVICES	CT	501(C)(3)	LINE 10	TRINITY HEALTH OF NEW ENGLAND CORP INC	Yes
(215)TRINITY HEALTH OF NEW ENGLAND PROVIDER NETWORK ORGANIZATION INC 114 WOODLAND STREET HARTFORD,CT06105 06-1450168	HEALTH CARE SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH OF NEW ENGLAND CORP INC	Yes
(216)TRINITY HEALTH OF THE MID-ATLANTIC REGION 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 23-2212638	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	PA	501(C)(3)	LINE 12B, II	TRINITY HEALTH CORPORATION	Yes
(217)TRINITY HEALTH PACE 20555 VICTOR PARKWAY LIVONIA,MI48152 47-3073124	PACE PROGRAM	MI	501(C)(3)	LINE 12B, II	TRINITY HEALTH CORPORATION	Yes
(218)TRINITY HEALTH PACE ALEXANDRIA INC 3403 GOVERNMENT STREET ALEXANDRIA,LA71302 92-3433625	PACE PROGRAM	LA	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(219)TRINITY HEALTH PACE OF MONTGOMERY COUNTY INC 200 PERRY PARKWAY GAITHERSBURG,MD20877 92-3450659	PACE PROGRAM	MD	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(220)TRINITY HEALTH PACE OF PENSACOLA INC 5020 COMMERCE PARK CIRCLE PENSACOLA,FL32505 92-2940854	PACE PROGRAM	FL	501(C)(3)	LINE 10	TRINITY HEALTH PACE	Yes
(221)TRINITY HEALTH PLAN OF MICHIGAN INC 3100 EASTON SQUARE PL STE 300 COLUMBUS,OH43219 84-3836552	MEDICARE HMO	MI	501(C)(4)	N/A	MOUNT CARMEL HEALTH PLAN INC	Yes
(222)TRINITY HEALTH SPECIALTY HOSPITAL - GRAND HAVEN 1309 SHELDON ROAD GRAND HAVEN,MI49417 93-3727867	HEALTH CARE AND HOSPITAL SERVICES	MI	501(C)(3)	LINE 3	MERCY HEALTH PARTNERS	Yes
(223)TRINITY HEALTH WELFARE BENEFIT TRUST 20555 VICTOR PARKWAY LIVONIA,MI48152 20-8151733	RETIREE MEDICAL AND RETIREE LIFE INSURANCE	MI	501(C)(9)	N/A	TRINITY HEALTH CORPORATION	Yes
(224)TRINITY HOME HEALTH SERVICES PO BOX 532020 LIVONIA,MI48153 38-2621935	MANAGEMENT SERVICES FOR HOME HEALTH SYSTEM	MI	501(C)(3)	LINE 10	TRINITY HEALTH CORPORATION	Yes
(225)VILLA MARY IMMACULATE 301 HACKETT BLVD ALBANY,NY12208 14-1438749	LONG TERM CARE	NY	501(C)(3)	LINE 3	ST PETER'S HOSPITAL	Yes
(226)WHEATON FRANCISCAN HEALTHCARE-IOWA INC 3421 WEST NINTH STREET WATERLOO,IA50702 42-1177001	HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT	IA	501(C)(3)	LINE 12B, II	MERCY HEALTH NETWORK INC	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

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
(1) ADVENT REHABILITATION LLC 625 KENMOOR AVE SE SUITE 100 GRAND RAPIDS,MI49546 38-3306673	REHABILITATION THERAPY SERVICES	MI	N/A				No		Yes
(2) BH VENTURE ONE LP 905 WATSON STREET PITTSBURGH,PA15219 38-4098074	REAL ESTATE	PA	N/A				No		Yes
(3) BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP 6150 EAST BROAD STREET COLUMBUS,OH48213 31-1608125	MEDICAL OFFICE BUILDING RENTAL	OH	N/A				No		Yes
(4) CENTER FOR DIGESTIVE CARE LLC 5300 ELLIOTT DRIVE YPSILANTI,MI48197 03-0447062	PROVIDE GASTROINTESTINAL SERVICES	MI	N/A				No			No
(5) CLINTON IMAGING SERVICES LLC 1410 N 4TH STREET CLINTON,IA52732 41-2044739	MRI DIAGNOSTIC SERVICES	IA	N/A				No			No
(6) CONVENIENT CARE LLC 10319 JEFFERSON HIGHWAY BATON ROUGE,LA70809 72-1439481	URGENT CARE CENTER	LA	N/A				No		Yes
(7) DIAGNOSTIC IMAGING OF SOUTHBURY LLC 385 MAIN STREET SOUTH SOUTHBURY,CT06488 06-1487582	IMAGING CENTER	CT	N/A				No		Yes
(8) EVERETT ROAD ASC LLC 30 CENTURY HILL DRIVE LATHAM,NY12110 83-3542382	MEDICAL SERVICES	NY	N/A				No		Yes
(9) FOREST PARK IMAGING LLC 1000 4TH STREET SW MASON CITY,IA50401 13-4365966	X-RAY AND MAMMOGRAPHY SERVICES	IA	N/A				No		Yes
(10) GENGASTRO LLC 2222 53RD AVENUE BETTENDORF,IA52722 56-2315623	AMBULATORY SURGERY CENTER	IA	N/A				No			No
(11) GENRAD IMAGING ILLINOIS LLC 1970 E 53RD STREET DAVENPORT,IA52807 47-3785124	DIAGNOSTIC IMAGING CENTER	IL	N/A				No		Yes
(12) GENRAD IMAGING LLC 1970 E 53RD STREET DAVENPORT,IA52807 45-3571628	DIAGNOSTIC IMAGING CENTER	IA	N/A				No		Yes
(13) HAWARDEN REGIONAL HEALTH CLINICS LLC 1111 11TH ST HAWARDEN,IA51023 20-1444339	MEDICAL CLINIC	IA	N/A				No		Yes
(14) HEALTHRISE BUSINESS INTELLIGENCE LLC 18000 W 9 MILE FL 10 SOUTHFIELD,MI48075 84-5053960	REVENUE CYCLE MANAGEMENT	DE	N/A				No			No
(15) HURON GASTRO ENDOSCOPY CENTER LLC 5300 ELLIOTT DRIVE YPSILANTI,MI48197 85-3580801	MEDICAL SERVICES	MI	N/A				No			No
(16) INTERMOUNTAIN MEDICAL IMAGING LLC 877 WEST MAIN ST STE 603 BOISE,ID83702 82-0514422	IMAGING CENTER	ID	N/A				No		Yes
(17) LAKE CHARLES URGENT CARE LLC 10319 JEFFERSON HIGHWAY BATON ROUGE,LA70809 27-2272979	URGENT CARE CENTER	LA	N/A				No		Yes
(18) LANGHORNE MOB PARTNERS LP 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2622772	MEDICAL OFFICE BUILDING RENTAL	PA	N/A				No		Yes
(19) LCMC URGENT CARE LLC 10319 JEFFERSON HIGHWAY BATON ROUGE,LA70809 30-0951534	URGENT CARE CENTER	DE	N/A				No		Yes
(20) LOYOLA AMBULATORY SURGERY CENTER AT OAKBROOK LP 1 WESTBROOK CORP CTR WESTCHESTER,IL60154 36-4119522	SURGICAL SERVICES	IL	N/A				No		Yes
(21) MAGNETIC RESONANCE SERVICES PARTNERSHIP 1416 SIXTH STREET SW MASON CITY,IA50401 42-1328388	MRI SERVICES	IA	N/A				No		Yes
(22) MASON CITY AMBULATORY SURGERY CENTER LLC 990 4TH STREET SW MASON CITY,IA50401 20-1960348	SURGERY-SAME DAY	IA	N/A				No		Yes
(23) MCE MOB IV LIMITED PARTNERSHIP 3100 EASTON SQUARE PL SUITE 300 COLUMBUS,OH43219 42-1544707	MEDICAL OFFICE BUILDING RENTAL	OH	N/A				No		Yes
(24) MEDWORKS LLC 375 EAST CEDAR STREET NEWINGTON,CT06111 06-1490483	REHABILITATION SERVICES	CT	N/A				No			No
(25) MERCY HEART CTR OP SERVICES LLC 1000 4TH STREET SW MASON CITY,IA50401 13-4237594	CARDIOVASCULAR SERVICES	IA	N/A				No			No
(26) MERCY REHABILITATION HOSPITAL LLC 330 SEVEN SPRINGS WAY BRENTWOOD,TN37027 81-4437201	HEALTH CARE SERVICES	IA	N/A				No			No
(27) MERCYMANOR PARTNERSHIP PO BOX 10086 TOLEDO,OH43699 52-1931012	NURSING HOME	PA	N/A				No		Yes
(28) MERCYUSP HEALTH VENTURES LLC 14201 DALLAS PARKWAY DALLAS,TX75254 47-1290300	OUTPATIENT SURGERY	IA	N/A				No			No
(29) MERCYONE - HFH HOME MEDICAL SHOP LLC 1000 4TH STREET SW MASON CITY,IA50401 85-4007472	MEDICAL EQUIPMENT SALES	IA	N/A				No			No
(30) MERCYONE - KRHC HOME MEDICAL SHOP LLC 1515 S PHILLIPS STREET SUITE 1 ALGONA,IA50511 92-3276114	MEDICAL EQUIPMENT SALES	IA	N/A				No			No
(31) NAUGATUCK VALLEY MRI LLC 385 MAIN STREET SOUTH SOUTHBURY,CT06488 06-1239526	IMAGING CENTER	CT	N/A				No			No
(32) NAZARETH MEDICAL OFFICE BUILDING ASSOCIATES LP 2601 HOLME AVE PHILADELPHIA,PA19152 23-2388040	MEDICAL OFFICE BUILDING	PA	N/A				No		Yes
(33) NUCO HEALTH LLC 18000 W 9 MILE FLOOR 10 SOUTHFIELD,MI48075 46-0951661	REVENUE CYCLE MANAGEMENT	DE	N/A				No			No
(34) PHYSICIANS OUTPATIENT SURGERY CENTER LLC 1000 NE 56TH STREET OAKLAND PARK,FL33334 35-2325646	AMBULATORY SURGERY CENTER	FL	N/A				No		Yes
(35) PREMIER HEALTH HOLDINGS LLC 10319 JEFFERSON HIGHWAY BATON ROUGE,LA70809 47-2665226	URGENT CARE CENTERS	DE	N/A				No			No
(36) PRIMARY CARE PHYSICIAN CENTER LLC 2160 SOUTH FIRST AVENUE MAYWOOD,IL60153 36-4038505	OFFICE BUILDING RENTAL	IL	N/A				No		Yes
(37) RAPIDES AFTER HOURS CLINIC LLC 10319 JEFFERSON HIGHWAY BATON ROUGE,LA70809 45-1772383	URGENT CARE CENTER	LA	N/A				No		Yes
(38) SAINT AGNESDIGNITYUSP SURGERY CENTERS LLC 14201 DALLAS PARKWAY DALLAS,TX75254 84-3522377	OUTPATIENT SURGERY	CA	N/A				No			No
(39) SAINT AGNESUSP SURGERY CENTERS LLC 14201 DALLAS PARKWAY DALLAS,TX75254 36-4896811	MEDICAL SERVICES	CA	N/A				No			No
(40) SAINT ALPHONSUS CALDWELL CANCER CENTER LLC 3123 MEDICAL DR CALDWELL,ID83605 82-0526861	HEALTH CARE SERVICES	ID	N/A				No		Yes
(41) SIXTY FOURTH STREET LLC 2373 64TH ST STE 2200 BYRON CENTER,MI49315 20-2443646	PROVIDE OUTPATIENT SURGICAL CARE	MI	N/A				No			No
(42) SJLS LLC 920 WINTER ST WALTHAM,MA02451 20-1796650	HEALTH CARE SERVICES	NY	N/A				No			No
(43) SMMC MOB II LP 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 36-4559869	INVESTMENT AND OPERATION OF A MEDICAL BUILDING	PA	N/A				No			No
(44) ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP 3100 EASTON SQUARE PLACE SUITE 300 COLUMBUS,OH43219 31-1603660	MEDICAL OFFICE BUILDING RENTAL	OH	N/A				No		Yes
(45) ST JOSEPH'S IMAGING ASSOCIATES PLLC 104 UNION AVE SUITE 905 SYRACUSE,NY13203 16-1104293	HEALTH CARE SERVICES	NY	N/A				No		Yes
(46) ST MARY REHABILITATION HOSPITAL LLP 330 SEVEN SPRINGS WAY BRENTWOOD,TN37027 27-3938747	HEALTH CARE SERVICES	DE	N/A				No			No
(47) ST PETER'S AMBULATORY SURGERY CENTER LLC 1375 WASHINGTON AVE 201 ALBANY,NY12206 46-0463892	OUTPATIENT SURGERY	NY	N/A				No		Yes
(48) TAYLOR STATION SURGICAL CENTER 3100 EASTON SQUARE PL SUITE 300 COLUMBUS,OH43219 31-1459910	OUTPATIENT SURGERY	OH	N/A				No			No
(49) TEN MILE SURGERY CENTER LLC 875 S VANGUARD WAY STE 120 MERIDIAN,ID83642 84-5119941	OUTPATIENT SURGERY	ID	N/A				No			No
(50) THE AMBULATORY SURGERY CENTER AT ST MARY LLC 1203 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 27-2871206	OUTPATIENT SURGERY	PA	N/A				No		Yes
(51) THPH URGENT CARE LLC 20555 VICTOR PARKWAY LIVONIA,MI48152 85-2464958	URGENT CARE CENTERS	DE	N/A				No			No
(52) WEST LAKES SURGERY CENTER LLC 12499 UNIVERSITY AVENUE SUITE 100 CLIVE,IA50325 20-5345295	OUTPATIENT SURGERY	IA	N/A				No			No
(53) WOODLAND IMAGING CENTER LLC 5301 E HURON RIVER DR ANN ARBOR,MI48106 76-0820959	RADIOLOGY/ IMAGING	MI	N/A				No			No
(54) WOODLAND PARTNERS REAL ESTATE LLC 129 WOODLAND STREET HARTFORD,CT06105 83-3371094	REAL ESTATE	CT	N/A				No			No

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) CATHERINE HORAN BUILDING CORPORATION 114 WOODLAND STREET HARTFORD,CT06105 04-2938160	BUILDING MANAGEMENT	MA	N/A	C				Yes
(2) CENTRAL VALLEY HEALTH PLAN INC 1303 E HERNDON AVE FRESNO,CA93720 61-1846844	HEALTH INSURANCE	CA	N/A	C				Yes
(3) DES MOINES MEDICAL CENTER INC 1111 6TH AVENUE DES MOINES,IA50314 42-0837382	REAL ESTATE	IA	N/A	C				Yes
(4) FHS SERVICES INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT,NY13214 27-2995699	MEDICAL SERVICES	NY	N/A	C				Yes
(5) FRANCISCAN ASSOCIATES INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT,NY13214 20-2991688	MEDICAL SERVICES	NY	N/A	C				Yes
(6) FRANCISCAN HEALTH SUPPORT INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT,NY13214 16-1236354	MEDICAL SERVICES	NY	N/A	C				Yes
(7) FRANCISCAN MANAGEMENT SERVICES INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT,NY13214 16-1351193	MANAGEMENT SERVICES	NY	N/A	C				Yes
(8) FRANKLIN MEDICAL GROUP PC 114 WOODLAND STREET HARTFORD,CT06105 06-1470493	PHYSICIAN OFFICE	CT	N/A	C				Yes
(9) GENESIS HEART INSTITUTE OWNER'S ASSOCIATION INC 1227 E RUSHOLME STREET DAVENPORT,IA52803 86-3949369	PROPERTY MANAGEMENT	IA	N/A	C				Yes
(10) GENVENTURES INC 1227 E RUSHOLME STREET DAVENPORT,IA52803 42-1269171	SUPPORT SERVICES/PROPERTY MANAGEMENT	IA	N/A	C				Yes
(11) HACKLEY HEALTH VENTURES INC 318 RIVER RIDGE DR NW SUITE 100 WALKER,MI49544 38-2589959	OTHER MEDICAL SERVICES	MI	N/A	C				Yes
(12) HACKLEY PROFESSIONAL PHARMACY INC 318 RIVER RIDGE DR NW SUITE 100 WALKER,MI49544 38-2447870	PHARMACY	MI	N/A	C				Yes
(13) HEALTH CARE MANAGEMENT ADMINISTRATORS INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT,NY13214 16-1450960	HEALTH CARE MANAGEMENT	NY	N/A	C				Yes
(14) HURON ARBOR CORPORATION 5301 EAST HURON RIVER DR ANN ARBOR,MI48106 38-2475644	OFFICE RENTAL	MI	N/A	C				Yes
(15) IHA AFFILIATION CORPORATION 24 FRANK LLOYD WRIGHT DR LOBBY J ANN ARBOR,MI48106 38-3188895	MEDICAL MANAGEMENT	MI	N/A	C				Yes
(16) LANGHORNE SERVICES II INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 26-3795549	GENERAL PARTNER OF LMOB PARTNERS, II	PA	N/A	C				Yes
(17) LANGHORNE SERVICES INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE,PA19047 23-2625981	GENERAL PARTNER OF LMOB PARTNERS	PA	N/A	C				Yes
(18) MACNEAL HEALTH PROVIDERS INC 2160 SOUTH FIRST AVENUE MAYWOOD,IL60153 36-3361297	MEDICAL SERVICES	IL	N/A	C				Yes
(19) MARYLAND CARE GROUP INC 1500 FOREST GLEN RD SILVER SPRING,MD20910 52-1815313	HEALTH CARE HOLDING	MD	N/A	C				Yes
(20) MAXIS HEALTH TRENTON INC 20555 VICTOR PKWY LIVONIA,MI48152 88-4267557	PROPERTY HOLDINGS	NJ	N/A	C				Yes
(21) MCMC EASTWICK INC 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE,PA19073 23-2184261	MEDICAL OFFICE BUILDINGS	PA	N/A	C				Yes
(22) MEDNOW INC 4300 E FLAMINGO AVE NAMPA,ID83687 82-0389927	MEDICAL SERVICES	ID	N/A	C				Yes
(23) MERCY INPATIENT MEDICAL ASSOCIATES INC 114 WOODLAND STREET HARTFORD,CT06105 04-3029929	MEDICAL SERVICES	MA	N/A	C				Yes
(24) MERCY MEDICAL SERVICES 801 5TH STREET SIOUX CITY,IA51101 42-1283849	PRIMARY CARE PHYSICIANS	IA	N/A	C				Yes
(25) MISERICORDIA ASSURANCE COMPANY LTD PO BOX 1051 GRAND CAYMAN GRAND CAYMAN CJ 98-0457943	SELF-INSURANCE	CJ	N/A	C				Yes
(26) MOB 1 OWNERS' ASSOCIATION 1227 E RUSHOLME STREET DAVENPORT,IA52803 27-0865075	PROPERTY MANAGEMENT	IA	N/A	C				Yes
(27) MOUNT CARMEL HEALTHPROVIDERS INC 3100 EASTON SQUARE PL STE 300 COLUMBUS,OH43219 31-1382442	MEDICAL SERVICES	OH	N/A	C				Yes
(28) NURSING NETWORK INC 4725 NORTH FEDERAL HIGHWAY FORT LAUDERDALE,FL33308 59-1145192	MEDICAL SERVICES	FL	N/A	C				Yes
(29) SAINT ALPHONSUS HEALTH ALLIANCE INC 1055 NORTH CURTIS ROAD BOISE,ID83706 82-0524649	ACCOUNTABLE CARE ORGANIZATION	ID	N/A	C				Yes
(30) SAINT FRANCIS BEHAVIORAL HEALTH GROUP PC 114 WOODLAND STREET HARTFORD,CT06105 06-1384686	MEDICAL SERVICES	CT	N/A	C				Yes
(31) SAINT FRANCIS CARE MEDICAL GROUP PC 114 WOODLAND STREET HARTFORD,CT06105 06-1432373	MEDICAL SERVICES	CT	N/A	C				Yes
(32) SAINT JOSEPH'S MCAULEY PARK I LLC 424 DECATUR ST ATLANTA,GA30312 88-0592157	PROPERTY MANAGEMENT	GA	N/A	C				Yes
(33) SAMARITAN MEDICAL OFFICE BUILDING INC 2212 BURDETT AVENUE TROY,NY12180 14-1607244	REAL ESTATE	NY	N/A	C				Yes
(34) SCOVILL STREET MEDICAL BUILDING ASSOCIATION INC 114 WOODLAND STREET HARTFORD,CT06105 06-1232868	PROPERTY MANAGEMENT	CT	N/A	C				Yes
(35) SJM PROPERTIES INC 20555 VICTOR PARKWAY LIVONIA,MI48152 16-1294991	PROPERTY HOLDINGS	NY	N/A	C				Yes
(36) SJPE PRACTICE MANAGEMENT SERVICES INC 301 PROSPECT AVE SYRACUSE,NY13203 45-4164964	MANAGEMENT SERVICES	NY	N/A	C				Yes
(37) SJRMC HOLDINGS INC 5215 HOLY CROSS PARKWAY MISHAWAKA,IN46545 47-4763735	PROPERTY HOLDINGS	IN	N/A	C				Yes
(38) ST ELIZABETH HEALTH SUPPORT SERVICES INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT,NY13214 16-1540486	MEDICAL SERVICES	NY	N/A	C				Yes
(39) SYNANON INC 1309 SHELDON ROAD GRAND HAVEN,MI49417 38-2715568	URGENT CARE	MI	N/A	C				Yes
(40) SYSTEM COORDINATED SERVICES INC 114 WOODLAND STREET HARTFORD,CT06105 04-2938161	LAB SERVICES	MA	N/A	C				Yes
(41) THRE SERVICES LLC 20555 VICTOR PARKWAY LIVONIA,MI48152 45-2603654	REAL ESTATE BROKERAGE SERVICES	MI	N/A	C				Yes
(42) TRINITY ASSURANCE LTD GOV SQ BLDG 4 34 LIME TREE BAY GRAND CAYMAN CJ 98-0453602	SELF-INSURANCE	CJ	N/A	C				Yes
(43) TRINITY HEALTH ACO INC 20555 VICTOR PARKWAY LIVONIA,MI48152 47-3794666	ACCOUNTABLE CARE ORGANIZATION	DE	N/A	C				Yes
(44) TRINITY HEALTH EMPLOYEE BENEFIT TRUST 20555 VICTOR PARKWAY LIVONIA,MI48152 38-3410377	GRANTOR TRUST	MI	N/A	T				Yes
(45) TRINITY SENIOR SERVICES MANAGEMENT INC PO BOX 530009 LIVONIA,MI48152 37-1572595	SENIOR SERVICES	PA	N/A	C				Yes

Schedule R (Form 990) 2023

Page 3

Part V

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) MERCY HEALTH SERVICES-IOWA CORP	B	390,396	PER BOOKS
(2) MERCY HEALTH SERVICES-IOWA CORP	C	413,138	PER BOOKS

Schedule R (Form 990) 2023

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) 2023

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) 2023

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,437,936	1,396,026
9	Program service revenue (Part VIII, line 2g) .........	0	0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	251,910	267,748
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	30,085	-25,878
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,719,931	1,637,896
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,450,210	390,396
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	164,500	171,020
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 173,648
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	250,628	204,998
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,865,338	766,414
19	Revenue less expenses. Subtract line 18 from line 12.......	-145,407	871,482
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	6,889,536	8,422,426
21	Total liabilities (Part X, line 26).............	24,216	24,217
22	Net assets or fund balances. Subtract line 21 from line 20.....	6,865,320	8,398,209

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 530,059 including grants of $ 390,396 ) (Revenue $ )
	THE DUBUQUE MERCY HEALTH FOUNDATION (THE FOUNDATION) PROVIDES PHILANTHROPIC SUPPORT TO MERCYONE DUBUQUE MEDICAL CENTER THROUGH CONTRIBUTIONS FROM LOCAL BUSINESSES, CORPORATIONS, EMPLOYEES, PHYSICIANS AND INDIVIDUALS. THE FOUNDATION IS GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS WHO ENSURE FISCAL RESPONSIBILITY WHILE OVERSEEING THE PROVISION OF FUNDS FOR MUCH NEEDED EQUIPMENT, PROGRAMS AND SERVICES. THE FOUNDATION CONTINUED RAISING MONEY FOR THE BRAIN HEALTH PROGRAM AND UNRESTRICTED MERCYONE FUND.PLEASE VISIT THE WEBSITE FOR ADDITIONAL INFORMATION:WWW.MERCYONE.ORG/DUBUQUE/GIVING/MERCYONE-DUBUQUE-FOUNDATION

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses530,059

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) KAY TAKES...................................................................... DIR; PRESIDENT EASTERN IOWA REGION	1.00 ................. 54.00	X		0	691,689	62,623
(2) KIM DUWE...................................................................... REGIONAL VP FINANCE THROUGH 12/23	1.00 ................. 49.00		X	0	304,199	52,715
(3) DAVID MOORE...................................................................... DIRECTOR; EXECUTIVE DIRECTOR	30.00 ................. 10.00	X	X	0	103,995	33,631
(4) TODD GEISLER...................................................................... DIRECTOR; CHAIR	1.00 ................. 0.00	X	X	0	0	0
(5) NICOLE GANTZ...................................................................... DIRECTOR; VICE CHAIR	1.00 ................. 0.00	X	X	0	0	0
(6) NICK HEIAR...................................................................... DIRECTOR; TREASURER	1.00 ................. 0.00	X	X	0	0	0
(7) DEB MUELLER...................................................................... DIRECTOR; SECRETARY	1.00 ................. 0.00	X	X	0	0	0
(8) ALEX DIXON...................................................................... DIRECTOR THROUGH 1/24	1.00 ................. 0.00	X		0	0	0
(9) JAMES HERRIG...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(10) STACEY HINES...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(11) ZACH KEELING...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(12) NIKKI KIEFER...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(13) MIKE MORONEY...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0
(14) TOM RAUEN...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)						(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE SUPPORT FOR THE PROGRAMS OF MERCYONE DUBUQUE MEDICAL CENTER
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	28
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	0

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	0	1,099,883	148,969

(A) Name and business address	(B) Description of services	(C) Compensation





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 0

1a	Federated campaigns..		1a	5,300
b	Membership dues..		1b
c	Fundraising events..		1c	206,670
d	Related organizations		1d	413,138
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	770,918

g	Noncash contributions included in lines 1a - 1f:$		1g	55,508

h Total. Add lines 1a-1f.......		1,396,026

		Business Code
2a
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....

3 Investment income (including dividends, interest, and othersimilar amounts) ......			241,938			241,938
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a
b	Less: rental expenses	6b
c	Rental income or (loss)	6c
d	Net rental income or (loss).......
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	25,810
b	Less: cost or other basis and sales expenses	7b	0
c	Gain or (loss)	7c	25,810
d	Net gain or (loss).........			25,810			25,810
8a	Gross income from fundraising events (not including $ 206,670of contributions reported on line 1c). See Part IV, line 18 ....
			8a	21,995
b	Less: direct expenses ...		8b	75,427
c	Net income or (loss) from fundraising events..			-53,432			-53,432
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	54,569
b	Less: direct expenses ...		9b	27,015
c	Net income or (loss) from gaming activities..			27,554			27,554
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			1,637,896	0	0	241,870

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	390,396	390,396
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	137,626	27,525	41,288	68,813
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	33,394	6,679	10,018	16,697
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)
12	Advertising and promotion ....
13	Office expenses .......	57,006	28,503	11,401	17,102
14	Information technology ......
15	Royalties ..
16	Occupancy ...........
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..
23	Insurance ...
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	INTERCO. PURCHASED SVCS	147,992	76,956		71,036
b
c
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	766,414	530,059	62,707	173,648
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 ........			1
2	Savings and temporary cash investments .........		529,353	2	1,546,869
3	Pledges and grants receivable, net ......		1,531,969	3	1,531,970
4	Accounts receivable, net .............			4
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				6
7	Notes and loans receivable, net ...........			7
8	Inventories for sale or use ............			8
9	Prepaid expenses and deferred charges ......			9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation	10b		10c
11	Investments—publicly traded securities .			11
12	Investments—other securities. See Part IV, line 11 .....		4,828,214	12	5,343,587
13	Investments—program-related. See Part IV, line 11 ..			13
14	Intangible assets ...............			14
15	Other assets. See Part IV, line 11 ...........			15
16	Total assets. Add lines 1 through 15 (must equal line 33)...		6,889,536	16	8,422,426

17	Accounts payable and accrued expenses .....	24,216	17	24,217
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D		25
26	Total liabilities. Add lines 17 through 25..	24,216	26	24,217

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	462,102	27	1,485,531
28	Net assets with donor restrictions ...........	6,403,218	28	6,912,678
	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 ...........	6,865,320	32	8,398,209
33	Total liabilities and net assets/fund balances ........	6,889,536	33	8,422,426