2020-07-15T06:26:50-05:00 2019-06-30 990 2018-07-01 311113966 MOUNT CARMEL HEALTH SYSTEM FOUNDATION MOUN 6145464000 6150 EAST BROAD STREET NO WD381N COLUMBUS OH 432131574 DANIEL POWELL INTERIM CFO AND EVP 6145464000 2020-07-15 170.232.229.224 2020-07-15 06:26:41 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 D1F366A5BD87A79DFDC4009DF5A22C938823A153 2018 2021-01-29 14:40:06Z MOUNT CARMEL FOUNDATION LORRAINE LUTTON 6150 EAST BROAD STREET NO WD381N COLUMBUS OH 432131574 11253222 0 0928 X WWW.MOUNTCARMELFOUNDATION.ORG X 1984 OH TO PROVIDE SUPPORT FOR THE PROGRAMS OF MOUNT CARMEL HEALTH SYSTEM AND ITS AFFILIATES. 28 22 0 24 0 0 11308845 3347721 0 0 7791288 7578382 45528 56800 19145661 10982903 4632390 11817978 0 0 1585094 1795810 0 0 1469180 2529804 2547976 8747288 16161764 10398373 -5178861 155429541 150952545 3298489 957072 152131052 149995473 X WE, MOUNT CARMEL AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. MOUNT CARMEL HEALTH SYSTEM FOUNDATION IS A MEMBER OF MOUNT CARMEL AND TRINITY HEALTH. 0 0 13392769 11817978 43492 SINCE 1984, MOUNT CARMEL HEALTH SYSTEM FOUNDATION (MCHS FOUNDATION), LOCATED IN COLUMBUS, OH, HAS SERVED AS THE FUNDRAISING ARM OF MOUNT CARMEL HEALTH SYSTEM AND ITS AFFILIATES. MCHS FOUNDATION IS DEDICATED TO FUNDING THE MISSION-DRIVEN HEALTH AND EDUCATION PROGRAMS AND SERVICES PROVIDED THROUGH THE MOUNT CARMEL HEALTH SYSTEM. MCHS FOUNDATION RAISED $3,347,721 IN FISCAL YEAR 2019 FROM INDIVIDUALS, CORPORATIONS, PRIVATE FOUNDATIONS AND THE FEDERAL AND STATE GOVERNMENT WITH ASSISTANCE FROM DEDICATED VOLUNTEERS AND GENEROUS FRIENDS. DURING FY19, THE FOUNDATION ORGANIZED SEVERAL FUNDRAISING EVENTS INCLUDING THE ANNUAL CHAMPAGNE & DIAMONDS AND THE COLLEGE OF NURSING GOLF INVITATIONAL. THESE CONTRIBUTIONS HELP MOUNT CARMEL HEALTH SYSTEM TO MEET THE VAST MEDICAL, DENTAL AND SOCIAL SERVICE NEEDS OF THE UNINSURED AND UNDERINSURED COMMUNITY AND TO RESPOND TO THE UNMET NEEDS OF OLDER PERSONS IN THE COMMUNITY. PLEASE VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION: WWW.MOUNTCARMELFOUNDATION.ORG 13392769 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 28 22 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X PAUL MORRIS 6145464619 6150 EAST BROAD STREET COLUMBUS OH 43213 X DEANNA STEWART DIRECTOR; PRESIDENT & EXEC DIRECTOR 50.00 0.00 X X 0 299276 74973 EDWARD LAMB DIRECTOR; MOUNT CARMEL PRES & CEO 1.00 54.00 X X 0 1047046 240063 DAVID MONTGOMERY DIRECTOR; CHAIR 1.00 0.00 X X 0 0 0 JOHN TRYDAHL DIRECTOR; VICE CHAIR 1.00 0.00 X X 0 0 0 ROBERT RYAN DIRECTOR; TREASURER; SECRETARY 1.00 0.00 X X 0 0 0 DENNIS ADAMS DIRECTOR 1.00 0.00 X 0 0 0 SHAWN ANDERSON DIRECTOR 1.00 0.00 X 0 0 0 KATIE BALLAY DIRECTOR AS OF 1/19 1.00 0.00 X 0 0 0 JOYCE BRAND DIRECTOR 1.00 0.00 X 0 0 0 JOSHUA CORNA DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL CURTIN DIRECTOR 1.00 0.00 X 0 0 0 JENNIFER DODOVSKI DIRECTOR AS OF 1/19 1.00 0.00 X 0 0 0 ROBERT DUNN DIRECTOR THROUGH 12/18 1.00 0.00 X 0 0 0 KATHY ESPY DIRECTOR; DIR, COMMUNITY ENGAGEMT 1.00 44.00 X 0 109461 14899 KATHRYN GARDNER DIRECTOR 1.00 0.00 X 0 0 0 SCOTT GROTELUESCHEN DIRECTOR 1.00 0.00 X 0 0 0 LISA GUTIERREZ DIRECTOR 1.00 0.00 X 0 0 0 KEVIN HACKETT MD DIRECTOR; PHYSICIAN 1.00 49.00 X 0 737441 45101 MARK HACKMAN MD DIRECTOR; MOUNT CARMEL VP MED AFF 1.00 49.00 X 0 382021 18470 BARBARA HAHL CSC DIRECTOR; SVP MISSION SERVICES 1.00 49.00 X 0 0 7253 RAMON JONES DIRECTOR AS OF 1/19 1.00 0.00 X 0 0 0 JIM KARAM DIRECTOR 1.00 0.00 X 0 0 0 PATRICK KELLEY DIRECTOR 1.00 0.00 X 0 0 0 RICHARD LETTS DIRECTOR 1.00 0.00 X 0 0 0 SU LOK DIRECTOR THROUGH 12/18 1.00 0.00 X 0 0 0 MEAGHAN MCCURDY DIRECTOR 1.00 0.00 X 0 0 0 VERY REV DANIEL MILLISOR DIRECTOR 1.00 0.00 X 0 0 0 TERESA SHERALD DIRECTOR 1.00 0.00 X 0 0 0 PHILLIP SHUBERT MD DIRECTOR; SYSTEM MEDICAL DIRECTOR 1.00 49.00 X 0 554252 43112 NANCY WHETSTONE DIRECTOR 1.00 0.00 X 0 0 0 PAUL MORRIS MOUNT CARMEL EVP & CFO 1.00 49.00 X 0 484097 105075 RENEA DOWDY-WILLIAMS DIRECTOR, DONOR REL & STEWARDSHIP 1.00 44.00 X 0 110954 19038 KIMBERLY KESSLER GRATEFUL PATIENT DIRECTOR 1.00 44.00 X 0 103095 25132 CLAUS VON ZYCHLIN FORMER OFFICER 0.00 0.00 X 0 121204 11830 ROGER SPOELMAN FORMER OFF; LOYOLA INT CEO THR 10/18 0.00 55.00 X 0 1083418 70858 DANIEL POWELL FORMER OFFICER; INT CFO, SMHCS 0.00 50.00 X 0 519423 31491 0 5551688 707295 0 1 1 0 FUND EVALUATION GROUP LLC 201 E 5TH ST STE 1600 CINCINNATI OH 45202 FINANCIAL SERVICES 213154 OHIO STATE UNIVERSITY 1600 CANNON DR COLUMBUS OH 43210 MOMS2B PROGRAM SERVICES 119004 CRISTO REY COLUMBUS HIGH SCHOOL 400 E TOWN ST COLUMBUS OH 43215 WORK STUDY PROGRAM SERVICES 112750 3 705965 849487 1792269 90304 3347721 3786062 3786062 165032 0 165032 165032 165032 3792320 0 3792320 3792320 3792320 118595 705965 270319 -151724 -151724 OTHER RELATED REVENUE 900099 43492 43492 43492 10982903 43492 0 7591690 11817978 11817978 338826 169413 169413 1193894 109889 460998 623007 176321 8005 65723 102593 86769 6966 35887 43916 100854 100854 1357896 849563 15976 492357 31059 10848 5125 15086 44188 12939 31249 909 909 85651 63447 22204 169848 166208 3640 4712 4712 19918 19918 2243 2243 CORPORATE ALLOCATION 255194 255194 MEDICAL SUPPLIES EXP. 215362 208585 6777 I/C PURCHASED SERVICES 96588 96588 SUBSCRIPTIONS AND DUES 27982 14315 13667 135572 118405 1136 16031 16161764 13392769 1299815 1469180 6030305 2916804 2472694 2152968 108361 54623 187138 119125 48269 68013 117398094 118069121 28868220 27225253 503598 465763 155429541 150952545 195072 114210 358418 3103417 484444 3298489 957072 X 133468076 138293092 14647074 7557266 4015902 4145115 152131052 149995473 155429541 150952545 X -5178861 -1209998 4253280 X X 0 1 X 1 1 1 X X 3 MOUNT CARMEL HEALTH SYSTEM 311439334 3 1 11324728 0 DILEY RIDGE MEDICAL CENTER 342032340 3 0 0 0 MOUNT CARMEL COLLEGE OF NURSING 311308555 2 0 426239 0 3 11750967 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 FORM 990, SCHEDULE A, PART IV, SECTIONS A, LINE 1: MOUNT CARMEL HEALTH SYSTEM IS LISTED IN THE GOVERNING DOCUMENTS OF MOUNT CARMEL HEALTH SYSTEM FOUNDATION (MCHS FOUNDATION). MCHS FOUNDATION'S OTHER SUPPORTED ORGANIZATIONS ARE NOT LISTED BY NAME IN THE GOVERNING DOCUMENTS, BUT ARE DESIGNATED BY PURPOSE. THE PURPOSE OF MCHS FOUNDATION AS STATED IN ITS GOVERNING DOCUMENTS IS TO ADVANCE, PROMOTE, SUPPORT, AND CARRY OUT THE PURPOSES OF CATHOLIC HEALTH MINISTRIES AND TRINITY HEALTH. 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 AND TRINITY HEALTH. SUCH ACTIVITIES INCLUDE THE SUPPORT AND ASSISTANCE OF AFFILIATES TO ACCOMPLISH THE FOREGOING PURPOSES. DILEY RIDGE MEDICAL CENTER IS AN AFFILIATE OF TRINITY HEALTH AND QUALIFIES AS A SECTION 509(A)(1)PUBLIC CHARITY BECAUSE IT IS A HOSPITAL AS DESCRIBED UNDER SECTION 170(B)(1)(A)(III). MOUNT CARMEL COLLEGE OF NURSING IS AN AFFILIATE OF TRINITY HEALTH AND QUALIFIES AS A SECTION 509(A)(1) PUBLIC CHARITY BECAUSE IT IS A SCHOOL AS DESCRIBED UNDER SECTION 170(B)(1)(A)(II). BOTH SHARE THE EXEMPT PURPOSES OF MOUNT CARMEL HEALTH SYSTEM FOUNDATION AND TRINITY HEALTH. FORM 990, SCHEDULE A, PART IV, SECTIONS A, LINE 6: MCHS FOUNDATION PROVIDED GRANTS AND MEDICAL EQUIPMENT CONTRIBUTIONS TO UNRELATED CHARITIES AND GOVERNMENTAL ENTITIES THAT CARRY OUT THE CHARITABLE PURPOSES OF ITS SUPPORTED ORGANIZATIONS AND TRINITY HEALTH. FORM 990, SCHEDULE A, PART IV, SECTIONS B, LINE 2: IN ADDITION TO PROVIDING SUPPORT TO ITS PARENT, MOUNT CARMEL HEALTH SYSTEM, MCHS FOUNDATION PROVIDED SUPPORT TO ITS NON-PARENT SUPPORTED ORGANIZATIONS, AS WELL AS TO UNRELATED CHARITIES THAT CARRY OUT THE CHARITABLE PURPOSES OF MOUNT CARMEL HEALTH SYSTEM AND TRINITY HEALTH. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6248246 85426 -3715 -500000 6829957 6037724 193934 16588 6248246 5732036 280331 8410 -16947 6037724 5530038 209371 -7373 5732036 4605748 933267 -9377 -400 5530038 0.37280 0.61990 0.00730 0 0 187138 119125 68013 68013 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 8377001 F EQUITY METHOD INVESTMENTS 13263585 C HEDGE FUNDS 5584667 F 27225253 INTERCOMPANY ACCOUNTS PAYABLE 155208 ANNUITIES PAYABLE 3986 OTHER LONG-TERM LIABILITIES 325250 484444 PART V, LINE 4: THE INTENDED USES OF THE ENDOWMENT FUNDS ARE AS FOLLOWS: HOSPICE/PALLIATIVE, COLLEGE OF NURSING (INCLUDING SCHOLARSHIPS), FACILITIES, GRADUATE MEDICAL EDUCATION, CONTINUING MEDICAL EDUCATION, GENERAL PURPOSE, OPERATIONS, OB/GYN RESIDENCY EDUCATION, INTERN IMPROVEMENT, CHAPLAINCY, MCSA LABOR/DELIVERY STAFF EDUCATION, MCE STAFF EDUCATION, RADIATION ONCOLOGY DEPARTMENTS, WOMEN'S HEALTH, CANCER SERVICES, AND MISSION AND OUTREACH. CHAMPAGNE AND DIAMONDS GALA 591297 515077 76220 20924 109930 19786 4000 31185 CON GOLF INVITATIONAL 118328 91403 26925 20028 1755 9120 1 114935 99485 15450 27150 14593 11848 824560 705965 118595 48074 129958 36134 4000 52153 270319 -151724 1 MOUNT CARMEL HEALTH SYSTEM 6150 E BROAD ST COLUMBUS OH 43213 311439334 501(C)(3) 11324728 FMV EXTERNAL GRANTS RECEIVED AND SUPPORT FOR OUTREACH PROGRAMS FRANKLIN PARK CONSERVARORY 1777 E BROAD STREET COLUMBUS OH 43203 311364884 501(C)(3) 5500 FMV SPONSORSHIP MOUNT CARMEL COLLEGE OF NURSING 6150 E BROAD ST COLUMBUS OH 43213 311308555 501(C)(3) 426239 FMV SCHOLARSHIP FUNDING COLUMBUS SYMPHONY ORCHESTRA 55 E STATE STREET COLUMBUS OH 43215 316402408 501(C)(3) 7000 FMV SPONSORSHIP ST CHARLES PREPARATORY SCHOOL 2010 E BROAD STREET COLUMBUS OH 43209 314379501 501(C)(3) 5000 FMV SPONSORSHIP WELD 752 N STATE STREET 398 WESTERVILLE OH 43082 454542456 501(C)(3) 11650 FMV SPONSORSHIPSPONSORSHIP COLUMBUS URBAN LEAGUE 788 MT VERNON AVE COLUMBUS OH 43203 314379453 501(C)(3) 5000 FMV SPONSORSHIP 7 0 PART I, LINE 2: DONATIONS MADE BY MCHS FOUNDATION TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. 1 1 0 0 0 0 0 0 0 DEANNA STEWART DIRECTOR; PRESIDENT & EXEC DIRECTOR 0 225927 0 40552 0 32797 0 47590 0 27383 0 374249 0 0 EDWARD LAMB DIRECTOR; MOUNT CARMEL PRES & CEO 0 721784 0 297324 0 27938 0 197283 0 42780 0 1287109 0 0 KEVIN HACKETT MD DIRECTOR; PHYSICIAN 0 667510 0 66500 0 3431 0 12375 0 32726 0 782542 0 0 MARK HACKMAN MD DIRECTOR; MOUNT CARMEL VP MED AFF 0 312576 0 53767 0 15678 0 16500 0 1970 0 400491 0 0 PHILLIP SHUBERT MD DIRECTOR; SYSTEM MEDICAL DIRECTOR 0 550363 0 0 0 3889 0 15673 0 27439 0 597364 0 0 PAUL MORRIS MOUNT CARMEL EVP & CFO 0 376105 0 93731 0 14261 0 73016 0 32059 0 589172 0 0 CLAUS VON ZYCHLIN FORMER OFFICER 0 0 0 0 0 121204 0 0 0 11830 0 133034 0 121204 ROGER SPOELMAN FORMER OFF; LOYOLA INT CEO THR 10/18 0 635635 0 262008 0 185775 0 20625 0 50233 0 1154276 0 0 DANIEL POWELL FORMER OFFICER; INT CFO, SMHCS 0 515693 0 0 0 3730 0 12375 0 19116 0 550914 0 0 PART I, LINE 3 MCHS FOUNDATION IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. MCHS FOUNDATION'S PRESIDENT IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, MOUNT CARMEL HEALTH SYSTEM. MOUNT CARMEL HEALTH SYSTEM USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MCHS FOUNDATION'S EXECUTIVE DIRECTOR: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINES 4A-B THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2018. THIS AMOUNT IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: CLAUS VON ZYCHLIN - $121,204 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THIS AMOUNT THAT WAS REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2018. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. BENEFITS FOR PARTICIPANTS VESTED IN A PLAN WERE PAID OUT IN 2018 AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2018 THE FOLLOWING PAYOUTS FOR 2018 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: ROGER SPOELMAN - $148,355 CLAUS VON ZYCHLIN - $106,127 THE FOLLOWING ACCRUALS FOR 2018 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: EDWARD LAMB - $184,908 PAUL MORRIS - $60,641 DEANNA STEWART - $35,422 X 2 6391 MEDIAN VAL-TRAN DATE X 9 1550 DONOR PROVIDED VALUE X MISCELLANEOUS 70 43038 DONOR PROVIDED VALUE X JEWELRY 1 19375 DONOR PROVIDED VALUE X GIFT CERTIFICATE 1 13950 DONOR PROVIDED VALUE X EQUIPMENT 1 6000 DONOR PROVIDED VALUE 0 1 0 FORM 990, PART VI, SECTION A, LINE 2 MOUNT CARMEL HEALTH SYSTEM FOUNDATION (MCHS FOUNDATION) DIRECTORS PATRICK KELLEY AND PHILLIP SHUBERT HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MCHS FOUNDATION IS MOUNT CARMEL HEALTH SYSTEM. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A MOUNT CARMEL HEALTH SYSTEM IS THE SOLE MEMBER OF MCHS FOUNDATION. MOUNT CARMEL HEALTH SYSTEM HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF MCHS FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, MOUNT CARMEL HEALTH SYSTEM MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MOUNT CARMEL HEALTH SYSTEM 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 B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR MCHS 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 MCHS 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 MCHS FOUNDATION, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF MCHS 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 INTERNAL LEGAL COUNSEL AND THE INTEGRITY AND COMPLIANCE OFFICER, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF MCHS FOUNDATION (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MCHS 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 MCHS FOUNDATION (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF MCHS 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 QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF MCHS FOUNDATION IS ESTABLISHED BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING SYSTEM CEO AND CFO 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 SYSTEM CEO AND CFO OF MOUNT CARMEL HEALTH SYSTEM ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FOR OTHER EXECUTIVES WHO ARE NOT PART OF THE REBUTTABLE PRESUMPTION PROCESS, TRINITY HEALTH USES A MARKET ANALYSIS TO DETERMINE THE APPROPRIATENESS OF THE EXECUTIVE'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 MCHS 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. MCHS FOUNDATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A: BARBARA HAHL, CSC IS A MEMBER OF THE CONGREGATION OF THE SISTERS OF THE HOLY CROSS. HAVING TAKEN A VOW OF POVERTY, SISTER BARBARA DID NOT RECEIVE COMPENSATION FOR THE SERVICES SHE PROVIDED TO MOUNT CARMEL HEALTH SYSTEM EXCEPT FOR INSURANCE BENEFITS OF $7,253. INSTEAD, A TOTAL OF $294,285 WAS PAID BY MOUNT CARMEL HEALTH SYSTEM TO THE SISTERS OF THE HOLY CROSS FOR SISTER BARBARA'S SERVICES. FORM 990, PART XI, LINE 9: EQUITY TRANSFER FROM AFFILIATE 4,253,280. FORM 990, PART XII, LINE 2: MCHS FOUNDATION'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY19 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS MI 49503 272491974 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 GRANT MAKING FL 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 061450170 HEALTH CARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 FOUNDATION IA 501(C)(3) LINE 12A, I BAUM HARMON MERCY HOSPITAL 1 BEECHWOOD INC 2212 BURDETT AVE TROY NY 12180 141651563 TITLE HOLDING COMPANY NY 501(C)(2) N/A LTC (EDDY) INC 1 BETHLEHEM HAVEN OF PITTSBURGH 905 WATSON STREET PITTSBURGH PA 15219 251436685 HOMELESS SHELTER PA 501(C)(3) LINE 7 PITTSBURGH MERCY HEALTH SYSTEM INC 1 BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS NY 12159 141717028 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 BRIGHTSIDE INC 114 WOODLAND STREET HARTFORD CT 06105 042182395 HEALTH CARE SERVICES MA 501(C)(3) LINE 10 THE MERCY HOSPITAL INC 1 CAPITAL REGION GERIATRIC CENTER INC 421 WEST COLUMBIA STREET COHOES NY 12047 141701597 LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 CARING PARTNERS HOME HEALTH INC 1200 EARHART RD ANN ARBOR MI 48105 201681131 HOME HEALTH SERVICES MI 501(C)(3) LINE 10 GLACIER HILLS INC 1 CATHERINE MCAULEY HEALTH SERVICES CORP PO BOX 995 ANN ARBOR MI 48106 382507173 HEALTH CARE SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN 1 CATHOLIC HEALTH MINISTRIES 20555 VICTOR PARKWAY LIVONIA MI 48152 GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM VT 501(C)(3) LINE 1 N/A 0 DILEY RIDGE MEDICAL CENTER 6150 EAST BROAD STREET COLUMBUS OH 43213 342032340 HEALTH CARE AND HOSPITAL SERVICES OH 501(C)(3) LINE 3 MOUNT CARMEL HEALTH SYSTEM 1 DUBUQUE MERCY HEALTH FOUNDATION 250 MERCY DRIVE DUBUQUE IA 52001 262227941 FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE IA 52040 205383271 FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 EAST NORRITON PHYSICIANS SERVICES INC ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN PA 19428 232515999 HEALTH CARE SERVICES PA 501(C)(3) LINE 3 MERCY PHYSICIAN NETWORK 1 EDDY LICENSED HOME CARE AGENCY 433 RIVER ST SUITE 3000 TROY NY 12180 141818568 HOME HEALTH SERVICES NY 501(C)(3) LINE 3 LTC (EDDY) INC 1 EMBRACING AGE INC 333 BUTTERNUT DRIVE DEWITT NY 13214 461051881 PACE PROGRAM NY 501(C)(3) LINE 12B, II ST JOSEPH'S HEALTH INC 1 EMPIRE HOME INFUSION SERVICE INC 10 BLACKSMITH DRIVE MALTA NY 12020 141795732 HOME HEALTH SERVICES NY 501(C)(3) LINE 10 HOME AIDE SERVICE OF EASTERN NEW YORK INC 1 FARREN CARE CENTER INC 114 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