2018-05-15T09:21:35-05:00 2017-06-30 990 2016-07-01 271789847 SAINT ALPHONSUS MEDICAL CENTER - ONTARIO INC SAIN 5418817000 351 SW 9TH STREET ONTARIO OR 979142639 B LANNIE CHECKETTS TREASURER 5418817000 2018-05-15 2016 2022-09-23 18:48:47Z SEE SCHEDULE O KENNETH HART 351 SW 9TH STREET ONTARIO OR 979142639 75968030 0 0928 X WWW.SAINTALPHONSUS.ORG/ONTARIO X 2010 OR TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES 18 13 657 75 49041 34802 1210742 880579 69273845 71271501 168055 398425 2876123 2333721 73528765 74884226 39004 20593 0 0 30448194 32307807 0 0 79248 38744227 41974605 69231425 74303005 4297340 581221 73848458 70219345 38366359 32595152 35482099 37624193 X WE, SAINT ALPHONSUS HEALTH SYSTEM AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. SAINT ALPHONSUS MEDICAL CENTER - ONTARIO IS A MEMBER OF SAINT ALPHONSUS HEALTH SYSTEM AND TRINITY HEALTH. 0 0 62689701 20593 73810159 SAINT ALPHONSUS MEDICAL CENTER - ONTARIO (SAMC - ONTARIO) IS A COMMUNITY HOSPITAL LOCATED IN ONTARIO, OREGON. SAMC - ONTARIO IS A 49-BED ACUTE CARE HOSPITAL SERVING ONTARIO AND THE SURROUNDING COMMUNITIES IN EASTERN OREGON AND SOUTHWESTERN IDAHO. THE HOSPITAL OFFERS A FULL RANGE OF SERVICES IN AN INPATIENT AND OUTPATIENT SETTING AS WELL AS 24 HOUR EMERGENCY CARE, SURGICAL SERVICES, CANCER CARE, MATERNITY CARE, NEUROLOGY, ORTHOPEDICS AND CRITICAL CARE, AMONG MANY OTHER SERVICES. SAMC - ONTARIO OFFERS CONVENIENT ACCESS TO HEALTH CARE SERVICES WITH TWO SEPARATE CLINIC LOCATIONS. PLEASE VISIT SCHEDULE H AND THE WEBSITE FOR ADDITIONAL INFORMATION ABOUT SERVICES, RECOGNITIONS AND AWARDS: WWW.SAINTALPHONSUS.ORG/ONTARIO 62689701 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 180 0 1 657 1 1 1 0 0 0 0 0 0 0 0 0 X 18 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OR X STEPHANIE PLISCHKE 2083674504 6301 EMERALD BOISE ID 83706 KENNETH HART TRUSTEE; PRESIDENT AS OF 1/17 50.00 5.00 X X 158739 0 30948 MIKE REULING TRUSTEE; CHAIR THRU 12/16 1.00 4.00 X X 0 0 0 DARREL ANDERSON TRUSTEE; CHAIR AS OF 1/17 1.00 4.00 X X 0 0 0 GARY DYER TRUSTEE; VICE CHAIR AS OF 1/17 1.00 4.00 X X 0 0 0 KENT BAILEY TRUSTEE AS OF 1/17 1.00 4.00 X 0 0 0 MICHAEL FERY TRUSTEE THRU 8/16 1.00 4.00 X 0 0 0 VICKEN GARABEDIAN MD TRUSTEE AS OF 1/17 1.00 4.00 X 0 0 0 LIBBY GOBEN TRUSTEE AS OF 1/17 1.00 4.00 X 0 0 0 RONALD GRAVES TRUSTEE 1.00 4.00 X 0 0 0 STUART HARTLEY TRUSTEE AS OF 1/17 1.00 4.00 X 0 0 0 MICHAEL HOLPER TRUSTEE; TRINITY SVP INTEG/AUDIT SVC 1.00 49.00 X 0 598397 46500 GERALDINE HOYLER CSC TRUSTEE 1.00 4.00 X 0 0 0 GEORGE JUETTEN TRUSTEE 1.00 4.00 X 0 0 0 MAUREEN KIM LYNCH MD TRUSTEE 1.00 4.00 X 0 0 0 KAYE O'RIORDAN TRUSTEE 1.00 4.00 X 0 0 0 STACY PEARSON TRUSTEE AS OF 1/17 1.00 4.00 X 0 0 0 RODNEY REIDER TRUSTEE; SAHS PRESIDENT AND CEO 1.00 54.00 X 0 847648 43323 DON ROUMAGOUX TRUSTEE 1.00 4.00 X 0 0 0 MATTHEW SHIRTCLIFF TRUSTEE THRU 12/16 1.00 4.00 X 0 0 0 SHARLET WAGNER CSC TRUSTEE 1.00 4.00 X 0 0 0 VICTOR YAMAMOTO TRUSTEE THRU 12/16 1.00 4.00 X 0 0 0 STEPHANIE WESTERMEIER SECRETARY; SAHS VP & GENERAL COUNSEL 2.00 48.00 X 0 357460 40044 B LANNIE CHECKETTS TREASURER AS OF 11/16; SAHS CFO 2.00 48.00 X 0 70249 4526 JEAN BASOM REGIONAL DIRECTOR SUPPLY CHAIN 2.00 48.00 X 0 166100 30203 KARL KEELER PRESIDENT THRU 1/17 26.00 29.00 X 0 559560 38589 JAMES LEDERER MD SAHS CMO/CHIEF QUALITY OFFICER 2.00 48.00 X 0 490638 31172 ROBERT MAIRS MD PHYSICIAN 50.00 0.00 X 567118 0 40694 PAMELA BRUCE MD SURGEON 50.00 0.00 X 465932 0 41429 FRANK SPOKAS MD SURGEON 50.00 0.00 X 305221 0 34533 MICHAEL HOILIEN DO PHYSICIAN 50.00 0.00 X 296334 0 25204 JOSH LEAVITT DO PHYSICIAN 50.00 0.00 X 221833 0 31237 SALLY JEFFCOAT FORMER OFFICER; TRINITY HEALTH EVP 0.00 55.00 X 0 1396522 41561 BLAINE PETERSEN FORMER OFFICER; LOYOLA UNIV. CFO 0.00 50.00 X 0 740604 37239 2015177 5227178 517202 26 1 1 0 ANDERSEN CONSTRUCTION COMPANY 6712 N CUTLER CIRCLE PORTLAND OR 97217 CONSTRUCTION SERVICES 3244426 REHABILITATION MGMT ASSOCIATION 901 N CURTIS 204 BOISE ID 83706 REHAB STAFFING 2290964 EMCARE INC 7032 COLLECTION CENTER DR CHICAGO IL 60693 ER ADMINISTRATIVE SERVICES 1114200 COMPHEALTH PO BOX 972651 DALLAS TX 75397 STAFFING SERVICES 957980 JOHN D FOOTE MD PO BOX 469 FRUITLAND ID 83619 PHYSICIAN 612931 16 880579 880579 NET PATIENT SERVICE REVENUE 622110 71271501 71271501 71271501 253344 253344 246353 1031452 -785099 -785099 -785099 197433 0 52352 197433 -52352 145081 145081 2045 0 2045 2045 OTHER RELATED REVENUE 900099 2587699 2538658 49041 CAFETERIA REVENUE 722514 342398 342398 PHARMACY REVENUE 446110 186678 186678 3116775 74884226 73810159 49041 144447 X 18931 18931 1662 1662 25758620 24213103 1545517 1124579 1057104 67475 3640866 3422414 218452 1783742 1641990 141752 17624 17624 397 397 31619 31619 9997697 9311611 663438 22648 335721 5103 297852 32766 645816 520334 115343 10139 3121051 45193 3075858 1172452 1144912 22857 4683 90370 69585 12652 8133 13882 10689 3193 770252 770252 4972573 4205691 766882 421135 113378 307757 MEDICAL SUPPLIES 10645645 10645645 INTERCO. PURCHASED SVCS 6312131 2160088 4152043 BAD DEBT 1913854 1913854 EQUIPMENT MAINTENANCE 1320695 1287436 33259 191691 130726 60086 879 74303005 62689701 11534056 79248 765528 1795746 10858161 11266137 109886 35028 1340550 1576253 154213 96138 52932406 18636677 35357961 34295729 12000191 10194112 11529595 9040061 1732373 1920141 73848458 70219345 14835564 9609925 753562 4312 673377 638073 22103856 22342842 38366359 32595152 X 35482099 37624193 35482099 37624193 73848458 70219345 X 581221 1883662 -322789 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 7025 0 0 0 7025 0 PART II-B, LINE 1: SAINT ALPHONSUS MEDICAL CENTER-ONTARIO (SAMC - ONTARIO) HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED SAMC - ONTARIO WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. 1096460 1096460 30941852 7201352 23740500 18939649 11435325 7504324 1954445 1954445 34295729 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 4039176 F EQUITY METHOD INVESTMENTS 3077468 C HEDGE FUNDS 1923417 F 9040061 OTHER CURRENT LIABILITIES 37296 INTERCOMPANY NOTES PAYABLE 20626902 INTERCOMPANY ACCOUNTS PAYABLE 1370764 ASSET RETIREMENT OBLIGATION(FIN 47) 307880 22342842 1 1 X 1 X 1 X 1 1 0 1 1 1636670 1636670 0.02260 17906738 13962876 3943862 0.05450 19543408 13962876 5580532 0.07710 121286 121286 0.00170 90006 90006 0.00120 19399 50 19349 0.00030 230691 50 230641 0.00320 19774099 13962926 5811173 0.08030 1497 1497 0.00000 2304 2304 0.00000 3801 3801 0.00000 0 1913854 0 15893288 21039789 -5146501 X 1 1 1 1 ST ALPHONSUS MEDICAL CENTER - ONTARIO 351 SW 9TH ST ONTARIO OR 97914 WWW.SAINTALPHONSUS.ORG/ONTARIO LICENSE 14-1470 X X X ST ALPHONSUS MEDICAL CENTER - ONTARIO 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X PART V, SECTION C X 1 16 1 PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X WWW.SAINTALPHONSUS.ORG/FINANCIAL-APPLICATION X WWW.SAINTALPHONSUS.ORG/FINANCIAL-APPLICATION X WWW.SAINTALPHONSUS.ORG/FINANCIAL-APPLICATION X X X X X X 1 X 0 X X X X 1 X 0 0 ST. ALPHONSUS MEDICAL CENTER - ONTARIO PART V, SECTION B, LINE 5: IN 2017, SAINT ALPHONSUS MEDICAL CENTER - ONTARIO (SAMC - ONTARIO) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT TO DETERMINE THE STATE OF THE COMMUNITY IT SERVES. THIS SURVEY WAS CONDUCTED BY SAINT ALPHONSUS HEALTH SYSTEM STAFF DURING THE PERIOD FROM SEPTEMBER OF 2016 THROUGH APRIL OF 2017 AND USED A WIDE VARIETY OF PRIMARY AND SECONDARY SOURCES TO OBTAIN A BROAD OVERVIEW OF INFORMATION. WHEREVER POSSIBLE, COMMUNITY HEALTH INDICATOR DATA WERE COLLECTED TO ALLOW COMPARISONS BETWEEN MALHEUR COUNTY, THE STATE OF OREGON, AND WASHINGTON COUNTY/PAYETTE COUNTY, IDAHO AND THE STATE OF IDAHO, AS WELL AS NATIONAL RATES. PATTERNED OFF OF THE UNITED WAY OF TREASURE VALLEY'S COMMUNITY ASSESSMENT OF 2017, DATA WAS OBTAINED PRIMARILY THROUGH EXTERNAL FOCUS GROUPS TO GATHER QUALITATIVE ASSESSMENT INFORMATION.THE FIRST ROUND OF FOCUS GROUPS WAS CONDUCTED WITH SERVICE PROVIDERS, THOSE ON THE FRONTLINES, INTERACTING WITH THOSE WHO USE SERVICES. THESE TEN FOCUS GROUPS INCLUDED OVER 70 PARTICIPANTS FROM OVER 45 DIFFERENT ORGANIZATIONS THAT PROVIDE SUPPORT SERVICES THROUGHOUT EASTERN TREASURE VALLEY. THE PURPOSE OF THESE FOCUS GROUPS WAS TO ASSESS WHAT HAD CHANGED IN THE AREA SINCE THE LAST ASSESSMENT, BRAINSTORM POTENTIAL SOLUTIONS, DETERMINE WHAT SOLUTIONS COULD BE THE MOST USEFUL, AND MOST IMPORTANTLY, GATHER INSIGHTS FROM DIVERSE MEMBERS OF THE EASTERN TREASURE VALLEY COMMUNITY.FOLLOWING THE SERVICE PROVIDERS, WE WANTED TO GAIN AN UNDERSTANDING OF HOW SERVICES AND SYSTEMS WERE WORKING FOR THOSE UTILIZING THEM. SEVERAL ADDITIONAL FOCUS GROUPS AND SMALLER SCALE CONVERSATIONS WERE UNDERTAKEN WITH COMMUNITY MEMBERS WHO WERE ACTIVELY RECEIVING SERVICES. THESE OPPORTUNITIES PROVIDED SOME NEW AND DIFFERENT INSIGHT FROM WHAT WAS LEARNED WITH THE SERVICE PROVIDERS. LOCATIONS OF THESE FOCUS GROUPS AND SMALLER SCALE CONVERSATIONS INCLUDED HOMELESS SERVICE PROVIDERS AND SHELTER RECIPIENTS, DOMESTIC VIOLENCE SERVICE PROVIDERS AND RECIPIENTS, FOOD DISTRIBUTERS AND RECIPIENTS OF FOOD BOXES, BOYS AND GIRLS CLUB INSTRUCTORS AND TEENAGERS IN THE BOYS AND GIRLS CLUB AND MALHEUR COUNTY DEPARTMENT OF HUMAN SERVICES. FURTHER INPUT WAS GAINED FROM DIVERSE COMMUNITIES THROUGH EUVALCREE (HISPANIC COMMUNITY), REFUGEES AND REFUGEE SERVICE PROVIDERS, LGBT COMMUNITY MEMBERS AND SENIORS. STAFF ALSO CONDUCTED ONE-ON-ONE INTERVIEWS WITH LEADERS WITHIN THE COMMUNITY - FROM THOSE IN CHARGE OF BUSINESSES/ORGANIZATIONS, TO CITY OFFICIALS, EDUCATORS AND STATE LEGISLATORS. THESE CONVERSATIONS ASKED SIMILAR QUESTIONS AS SEEN IN THE FOCUS GROUPS. THE INFORMATION GAINED THROUGH THESE CONVERSATIONS PROVIDES A HUMAN CONTEXT TO THE COMPILED DATA AND WAS UTILIZED TO HELP INFORM THIS CHNA. ST. ALPHONSUS MEDICAL CENTER - ONTARIO PART V, SECTION B, LINE 11: SAMC - ONTARIO ADDRESSED THE IDENTIFIED HEALTH NEEDS IN FY17, AS FOLLOWS: NUTRITION, PHYSICAL ACTIVITY AND WEIGHT STATUS - THE COMMUNITY HAS A PREVALENCE OF OBESITY AND DIABETES, LOW FRUIT AND VEGETABLE CONSUMPTION AS WELL AS A LACK OF AFFORDABLE PHYSICAL FITNESS OPPORTUNITIES. OUR GOAL IS TO IMPROVE PHYSICAL FITNESS OPPORTUNITIES IN THE COMMUNITY THROUGH SUPPORTING AND DEVELOPING OPPORTUNITIES FOR PHYSICAL ACTIVITIES WITHIN THE SCHOOLS AND THE COMMUNITY, INCLUDING INCREASED AWARENESS OF HEALTHY EATING HABITS. THIS WAS DONE BY:- PROVIDING A NUTRITION EDUCATION COMPONENT FOR STUDENTS AND THEIR PARENTS AT LOCAL SCHOOLS THROUGH OUR ATHLETIC TRAINING PROGRAM- CONTINUING THE PROGRAM THAT BEGAN IN 2015 TO PROVIDE PROFESSIONAL ATHLETIC TRAINERS FOR LOCAL HIGH SCHOOLS TO REDUCE STUDENT INJURIES AND CREATE MORE OPPORTUNITIES FOR SCHOOLS TO PROVIDE PHYSICAL ACTIVITIES FOR STUDENTS- CONTINUING TO PROVIDE GONOODLE TO AREA ELEMENTARY SCHOOLS- FINANCIALLY SUPPORTED THE CREATION OF A SPLASH PAD WITHIN THE ONTARIO COMMUNITY PARK SYSTEM TO PROVIDE AN AFFORDABLE PHYSICAL ACTIVITY FOR THE COMMUNITY DURING THE SUMMEREDUCATION - THE EDUCATION LEVEL OF THE COMMUNITY IS LOWER THAN THE AVERAGES FOR BOTH OREGON AND IDAHO, DUE IN PART TO THE DIFFICULTY IN ACCESSING TRAINING AND DEVELOPMENT OPPORTUNITIES AS WELL AS LOW HIGH SCHOOL GRADUATION RATES AND ACCESS TO EDUCATIONAL SUPPORT PROGRAMS.OUR GOAL IS TO IMPROVE LOCAL EDUCATIONAL LEVELS THROUGH IMPROVED GRADUATION RATES AND INCREASED TRAINING AND DEVELOPMENT OPPORTUNITIES BY PROVIDING ENHANCED TRAINING AND DEVELOPMENT OPPORTUNITIES THROUGH EXISTING EDUCATIONAL INSTITUTIONS IN THE COMMUNITY. ACTIONS TAKEN IN FY17 INCLUDE:- CONTINUING THE ONGOING SUPPORT OF THE TREASURE VALLEY TECHNICAL (TVT) PROGRAM BY SERVING AS AN EDUCATION SITE FOR CERTIFIED NURSING ASSISTANT (CNA) STUDENTS, PROVIDING SPEAKERS AND MENTORS TO CLASSES/STUDENTS, ACTING IN AN ADVISORY ROLE FOR TVT BOARD AND CNA PROGRAM, PROVIDING SUPPLIES FOR CNA CLASSES, AND PROVIDING FREE MEDICAL SCREENING TO ALLOW CNA STUDENTS TO BE LICENSED IN THE STATE OF OREGON- CONTINUING TO PROVIDE LEADERSHIP STAFF TO THE MALHEUR COUNTY POVERTY TO PROSPERITY (P2P) ORGANIZATION THAT IS WORKING TO DEVELOP ADDITIONAL EDUCATIONAL PROGRAMS FOR LOCAL HIGH SCHOOL AS WELL AS COMMUNITY COLLEGE STUDENTS AS WELL AS THE UNDEREMPLOYED IN THE COMMUNITY- PARTNERING WITH THE TREASURE VALLEY RELIEF NURSERY WITH NUTRITION CLASSES AS WELL AS FINANCIAL SUPPORT IN ITS EFFORT TO SUPPORT AT RISK FAMILIES WITH PRE-SCHOOL AGE CHILDRENACCESS TO HEALTH SERVICES - ACCESS TO BASIC HEALTH SERVICES IS SEEN AS A BARRIER TO MANY IN THE COMMUNITY CAUSED BY EITHER LACK OF PROVIDERS, LACK OF AFFORDABLE HEALTH INSURANCE AND/OR LACK OF RELIABLE TRANSPORTATION.OUR GOAL IS TO INCREASE HEALTH CARE ACCESS TO THE LOCAL COMMUNITY BY TAKING STEPS TO MAKE ACCESS TO HEALTH CARE SERVICES LESS RESTRICTIVE IN THE LOCAL COMMUNITY. ACTIONS TAKEN BY THE HOSPITAL IN FY17 INCLUDE:- MAINTAINING THE HEALTH RESOURCE CENTER (HRC) WHICH SERVES MEMBERS OF THE COMMUNITY THAT HAVE HEALTH CARE ACCESS ISSUES AS WELL AS ASSISTS THEM WITH GETTING ACCESS TO HEALTH INSURANCE AND OTHER LOCAL MENTAL HEALTH AND SERVICE PROVIDERS- PERFORMING ANNUAL (COMMUNITY AND HOSPITAL BASED) OPEN ENROLLMENT EVENTS FOR OREGON AND IDAHO MEDICAIDSAMC - ONTARIO DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH IT DEEMED MOST PRESSING, UNDER-ADDRESSED, AND WITHIN ITS ABILITY TO INFLUENCE. SAMC - ONTARIO DID NOT TAKE ACTION ON THE FOLLOWING IDENTIFIED NEEDS IN FY17:FINANCIAL STABILITY - WHILE SAMC - ONTARIO IS NOT ABLE TO DIRECTLY ADDRESS THIS COMMUNITY NEED, IT HAS SUPPORTED, THROUGH BOARD MEMBERSHIP, LOCAL EFFORTS SUCH AS MALHEUR COUNTY POVERTY TO PROSPERITY AND THE SNAKE RIVER ECONOMIC DEVELOPMENT ASSOCIATION IN THEIR EFFORTS TO IMPROVE THE ECONOMIC CLIMATE OF THE AREA.INJURY AND VIOLENCE PREVENTION - SAMC - ONTARIO BELIEVES THAT THERE ARE OTHER LOCAL ENTITIES BETTER SUITED TO ADDRESS THE ISSUES OF INJURY AND VIOLENCE PREVENTION. SAMC - ONTARIO LOOKS FORWARD TO ASSISTING THOSE OTHER ENTITIES IN THEIR EFFORTS, AS APPROPRIATE, IN THE FUTURE. ST. ALPHONSUS MEDICAL CENTER - ONTARIO PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. PART V, SECTION B, LINE 7A: WWW.SAINTALPHONSUS.ORG/COMMUNITY-NEEDS-ASSESSMENT PART V, SECTION B, LINE 10A: WWW.SAINTALPHONSUS.ORG/COMMUNITY-NEEDS-ASSESSMENT-IMPLEMENTATION-STRATEGY PART V, SECTION B, LINE 9: AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. 5 1 - ST ALPHONSUS MEDICAL CENTER 1219 SW 4TH AVE ONTARIO OR 97914 WOMEN'S HEALTH 2 - FRUITLAND HEALTH PLAZA 910 NW 16TH STREET FRUITLAND ID 83619 FAMILY MEDICINE 3 - STAARS ONTARIO 898 SW 4TH AVE ONTARIO OR 97914 REHAB AND PHYSICAL THERAPY 4 - NEW PLYMOUTH CLINIC 213 N PLYMOUTH AVE NEW PLYMOUTH ID 83655 FAMILY MEDICINE 5 - ONTARIO PODIATRY 840 SW 4TH AVE ONTARIO OR 97914 PODIATRY PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: SAINT ALPHONSUS MEDICAL CENTER - ONTARIO (SAMC - ONTARIO) PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF OREGON. IN ADDITION, SAMC - ONTARIO REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.SAMC - ONTARIO ALSO INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $1,913,854, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES - AS AN AREA OF DECREASED EDUCATIONAL OPPORTUNITIES, SAMC - ONTARIO PARTNERED WITH OTHER EDUCATIONAL INSTITUTIONS TO INCREASE COMMUNITY HEALTH EDUCATION, SUCCESS IN EDUCATION, AND CONTINUED PHYSICIAN RECRUITMENT IN OUR AREA. THE POVERTY TO PROSPERITY PROGRAM AND THE TREASURE VALLEY TECH PROGRAM, WHERE STUDENTS FROM HIGH SCHOOLS ARE SELECTED TO TAKE CLASSES IN WELDING AND ALLIED HEALTH PRIOR TO GRADUATION, ACTS AS A GATEWAY TO FURTHER EDUCATIONAL OPPORTUNITIES OFFERED AT THE LOCAL COMMUNITY COLLEGE (TREASURE VALLEY COMMUNITY COLLEGE). ACCESS TO EDUCATIONAL OPPORTUNITIES THROUGH TREASURE VALLEY TECH CREATES MORE PROSPECTS FOR HIGH SCHOOL STUDENTS TO PARTICIPATE IN PROGRAMS AIMED AT INCREASING HIGH SCHOOL AND COLLEGE GRADUATION RATES. IN ADDITION, AS A HOSPITAL LOCATED IN A MEDICALLY UNDERSERVED AREA (HPSA SCORE OF 18), THE HOSPITAL ENGAGED IN A NUMBER OF PHYSICIAN RECRUITMENT EFFORTS, INCLUDING RURAL PROVIDER OUTREACH AND UTILIZATION OF PLACEMENT AGENCY SERVICES. PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: SAMC - ONTARIO USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, SAMC - ONTARIO IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, SAMC - ONTARIO IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: SAMC - ONTARIO IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 14 OF THOSE STATEMENTS: "THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY THE HEALTH MINISTRIES AND FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE."PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION. PART III, LINE 8: SAMC - ONTARIO DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S COLLECTION POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - SAMC - ONTARIO ASSESSES THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, THE HOSPITAL MAY USE PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED.WE ALSO UTILIZE THE EXPERTISE OF OUR PUBLIC HEALTH PARTNERS AND THEIR ANALYSIS OF COMMUNITY NEEDS. SAMC - ONTARIO EXAMINED SEVERAL OTHER LOCAL NEEDS ASSESSMENTS AND OBTAINED INPUT FROM ORGANIZATIONS INVOLVED IN THOSE ASSESSMENTS, INCLUDING OUR EXTERNAL REVIEW COMMITTEE (FOUR RIVERS HEALTHY COMMUNITIES OREGON), THE MALHEUR COUNTY HEALTH DEPARTMENT AND THE EASTERN OREGON COORDINATED CARE ORGANIZATION TO IDENTIFY NEEDS BEING ADDRESSED BY OTHER AGENCIES. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - SAMC - ONTARIO IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTH CARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, SAMC - ONTARIO HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: - PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSSAMC - ONTARIO COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. FINANCIAL ASSISTANCE APPLICATIONS WILL BE ACCEPTED UNTIL ONE YEAR AFTER THE FIRST BILLING STATEMENT TO THE PATIENT. SAMC - ONTARIO OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. SAMC - ONTARIO HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. SAMC - ONTARIO MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. PART VI, LINE 4: COMMUNITY INFORMATION - SAMC - ONTARIO IS SITUATED IN MALHEUR COUNTY, OREGON, THE SECOND LARGEST COUNTY IN THE STATE; 9,926 SQUARE MILES IN THE SOUTHEASTERN-MOST CORNER OF THE STATE. BY DEFINITION, MALHEUR COUNTY IS CONSIDERED "FRONTIER" WITH A MERE 3.2 PERSONS PER SQUARE MILE - ALTHOUGH THE POPULATION IS FAIRLY CLUSTERED TOGETHER IN SMALL COMMUNITIES. GEOGRAPHIC ISOLATION RESULTS IN CHALLENGES ACCESSING OREGON SERVICES. WHILE IDAHO IS IN CLOSE PROXIMITY, RESIDENTS OF MALHEUR COUNTY ARE OFTEN UNABLE TO UTILIZE GOVERNMENT SERVICES ACROSS STATE LINES. THE COUNTY HAS A TOTAL OF 31,313 RESIDENTS, OVER HALF OF WHICH LIVE IN THE CITY OF ONTARIO. THE LOCAL ECONOMY IS LARGELY BASED ON AGRICULTURE AND FARMING, AND THE COUNTY IS 94% RANGELAND.MALHEUR COUNTY IS NOTABLE FOR A HIGHER THAN AVERAGE HISPANIC/LATINO POPULATION, MANY OF WHOM ARE SEASONAL, OR MIGRANT, AGRICULTURE WORKERS. THIS IS ALSO EVIDENCED BY A HIGHER THAN AVERAGE PERCENTAGE OF LANGUAGES OTHER THAN ENGLISH SPOKEN AT HOME. MALHEUR COUNTY IS ALSO NOTABLE FOR A POPULATION DENSITY OF 3.2 PERSONS PER SQUARE MILE, WHERE RESIDENTS MUST TRAVEL LONG DISTANCES FOR SERVICES. MALHEUR COUNTY HAS THE LOWEST MEDIAN HOUSEHOLD INCOME AT $35,788, COMPARED TO $50,036 AT A STATE LEVEL AND $53,046 AT THE U.S. LEVEL. THE POVERTY LEVEL, AT 22.7%, IS THE HIGHEST OF THE THREE COUNTIES, AND IS SIGNIFICANTLY ABOVE STATE AND U.S. LEVELS.THE ABILITY TO EARN A LIVABLE WAGE WAS THE HIGHEST RATED BARRIER TO FINANCIAL STABILITY WITH ALMOST EVERY SURVEY RESPONDENT LISTING THIS AS THEIR PRIMARY NEED FOR ACHIEVING FINANCIAL STABILITY. LOW WAGES ALSO CONTRIBUTE TO THE OTHER MOST FREQUENTLY IDENTIFIED BARRIERS AS WELL, WITH INABILITY TO AFFORD TRAINING AND EDUCATION, INCLUDING COLLEGE AND TECHNICAL EDUCATION, AS A KEY THEME. HIGH HOUSING COST BURDENS FURTHER EXACERBATE THE DIFFICULTIES OF THOSE WITH LOW INCOME LEVELS. PART VI, LINE 5: OTHER INFORMATION - SAMC - ONTARIO STRONGLY SUPPORTS HEALTH CARE WORKFORCE DEVELOPMENT EFFORTS, INCLUDING ANNUAL FINANCIAL SUPPORT TO THE TREASURE VALLEY COMMUNITY COLLEGE NURSING PROGRAM. IN ADDITION, SAMC - ONTARIO SERVES AS A KEY CLINICAL TRAINING SITE FOR NURSES AND OTHER ALLIED HEALTH PROFESSIONALS.WE OFFER A VARIETY OF HEALTH EDUCATION AND SCREENING OPPORTUNITIES FREE OF CHARGE INCLUDING CARDIAC & STROKE SCREENINGS, FREE LIPID PROFILES, MAMMOGRAMS, AND MORE. WE USE THESE SCREENINGS AS AN OPPORTUNITY TO CONNECT PARTICIPANTS WITH A PRIMARY CARE PROVIDER FOR FURTHER HEALTH GUIDANCE.IN ADDITION, OUR HEALTH RESOURCE CENTER (HRC) PROVIDES ACCESS TO BASIC HEALTH SERVICES TO THOSE WHO ARE UNINSURED OR UNDER-INSURED, FREE OF CHARGE. PATIENTS WHO WOULD TYPICALLY UTILIZE THE EMERGENCY ROOM FOR CHRONIC MEDICAL CONDITIONS SUCH AS COPD, DIABETES, CHF, PNEUMONIA, AND MILD TO MODERATE MENTAL HEALTH CONCERNS CAN NOW BE MANAGED EFFECTIVELY THROUGH THE HRC AS A WAY TO PROMOTE COMMUNITY HEALTH. SAINT ALPHONSUS HAS ALSO TAKEN THE LEAD IN ESTABLISHING A STATEWIDE TOBACCO 21 COALITION, AND ACTIVELY ENGAGES WITH EXISTING TOBACCO CONTROL COALITIONS.SAINT ALPHONSUS HAS BEEN EXTREMELY ACTIVE IN BOTH GRASSROOTS AND LEGISLATIVE EFFORTS AROUND MEDICAID EXPANSION IN IDAHO AS WELL AS IN COALITION BUILDING AND STRATEGIZING AROUND TOBACCO 21. SAINT ALPHONSUS WAS A LEADING PARTICIPANT IN A LOCAL HOUSING AND HOMELESSNESS ROUNDTABLE AND MAIN ADVOCATE AND FUNDER OF A HOUSING FIRST EFFORT TO PREVENT HOMELESSNESS, IN ALIGNMENT WITH CHNA-FOCUSED SOCIAL DETERMINANTS OF HEALTH WORK. ADDITIONALLY, SAINT ALPHONSUS COLLABORATED WITH COMMUNITY PARTNERS, SERVICE PROVIDERS, LEADERS, AND COMPETITORS TO LEAD AN EFFORT TO PREVENT CHILDHOOD SEXUAL ABUSE. FINALLY, SAINT ALPHONSUS COLLABORATED IN A COMMUNITY ROUNDTABLE ON MENTAL HEALTH, INCLUDING ADVOCACY WORK IN SUPPORTING AND PLANNING A LOCAL CRISIS CENTER. PART VI, LINE 6: SAMC - ONTARIO IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEFINE - AND ACHIEVE - SPECIFIC COMMUNITY HEALTH AND WELL-BEING GOALS. IN FISCAL YEAR 2017, GOALS INCLUDED 1) PARTICIPATING IN LOCAL COALITION AND ADVOCACY EFFORTS AIMED AT CURBING TOBACCO USE AND PREVENTING OBESITY, 2) ASSESSING CAPACITY TO IDENTIFY AND SUPPORT INDIVIDUALS THAT ARE HOUSING INSECURE AND ACKNOWLEDGING OTHER BARRIERS INDIVIDUALS HAVE ACCESSING HEALTH CARE AND 3) EXPANDING ACCESS AND DELIVERY OF DIABETES PREVENTION PROGRAMS. TRINITY HEALTH ACKNOWLEDGES THE IMPACT SOCIAL DETERMINANTS SUCH AS ADEQUATE HOUSING, SAFETY, ACCESS TO FOOD, EDUCATION, INCOME, AND HEALTH COVERAGE HAVE ON THE HEALTH OF THE COMMUNITY. IN FISCAL YEAR 2016, TRINITY HEALTH LAUNCHED THE TRANSFORMING COMMUNITIES INITIATIVE (TCI), AWARDING EIGHT COMMUNITIES FUNDING TO IMPROVE THE HEALTH AND WELL-BEING OF THEIR COMMUNITIES IN PARTNERSHIP WITH THE LOCAL TRINITY HEALTH MEMBER HOSPITAL. THE AWARDED COMMUNITIES FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL CHANGES THAT SPECIFICALLY IMPACT COMMUNITY IDENTIFIED NEEDS AND THAT WILL REDUCE CHILDHOOD OBESITY AND YOUTH TOBACCO USE. IN FISCAL YEAR 2017, TRINITY HEALTH INVESTED $2.7 MILLION IN TCI.AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO OUR COMMUNITIES THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND VULNERABLE, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND DEVELOPING PROGRAMS AND POLICIES TO SPECIFICALLY SUPPORT VULNERABLE POPULATIONS. ANNUALLY, THE ORGANIZATION INVESTS OVER $1.1 BILLION IN SUCH COMMUNITY BENEFITS AND WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING THE SPECIFIC NEEDS OF EACH COMMUNITY.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES OR 0 1 0 0 0 0 0 0 0 KENNETH HART TRUSTEE; PRESIDENT AS OF 1/17 135275 0 19168 0 4296 0 7429 0 23519 0 189687 0 0 0 MICHAEL HOLPER TRUSTEE; TRINITY SVP INTEG/AUDIT SVC 0 392209 0 102488 0 103700 0 19875 0 26625 0 644897 0 0 RODNEY REIDER TRUSTEE; SAHS PRESIDENT AND CEO 0 496314 0 187261 0 164073 0 11925 0 31398 0 890971 0 21009 STEPHANIE WESTERMEIER SECRETARY; SAHS VP & GENERAL COUNSEL 0 294861 0 54750 0 7849 0 15900 0 24144 0 397504 0 0 JEAN BASOM REGIONAL DIRECTOR SUPPLY CHAIN 0 153016 0 11436 0 1648 0 13150 0 17053 0 196303 0 0 KARL KEELER PRESIDENT THRU 1/17 0 321406 0 121808 0 116346 0 11925 0 26664 0 598149 0 18260 JAMES LEDERER MD SAHS CMO/CHIEF QUALITY OFFICER 0 402866 0 85926 0 1846 0 11925 0 19247 0 521810 0 0 ROBERT MAIRS MD PHYSICIAN 540524 0 4411 0 22183 0 16328 0 24366 0 607812 0 0 0 PAMELA BRUCE MD SURGEON 383842 0 0 0 82090 0 11925 0 29504 0 507361 0 0 0 FRANK SPOKAS MD SURGEON 297241 0 6000 0 1980 0 19875 0 14658 0 339754 0 0 0 MICHAEL HOILIEN DO PHYSICIAN 284981 0 9254 0 2099 0 12327 0 12877 0 321538 0 0 0 JOSH LEAVITT DO PHYSICIAN 209362 0 7500 0 4971 0 6790 0 24447 0 253070 0 0 0 SALLY JEFFCOAT FORMER OFFICER; TRINITY HEALTH EVP 0 825512 0 239747 0 331263 0 11925 0 29636 0 1438083 0 85393 BLAINE PETERSEN FORMER OFFICER; LOYOLA UNIV. CFO 0 516855 0 112833 0 110916 0 11925 0 25314 0 777843 0 0 PART I, LINE 3 SAINT ALPHONSUS MEDICAL CENTER - ONTARIO (SAMC - ONTARIO) IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. SAMC - ONTARIO'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION FOR SAMC - ONTARIO'S CEO: - 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, LINE 4B THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2016. 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 2016, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2016. THE FOLLOWING PAYOUTS FOR 2016 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: MICHAEL HOLPER - $88,131 SALLY JEFFCOAT - $205,506 KARL KEELER - $83,673 RODNEY REIDER - $126,168 THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH RESTORATION OR RETENTION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($265,000 FOR 2016). THE FOLLOWING PAYOUTS FOR 2016 FOR THESE PLANS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: SALLY JEFFCOAT - $92,254 KARL KEELER - $18,613 RODNEY REIDER - $21,757 STEPHANIE WESTERMEIER - $5,690 COLUMN (F) OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING INDIVIDUAL IS A PARTICIPANT IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN UNDER 457(F). NO AMOUNTS WERE DEFERRED OR VESTED IN 2016. FRANK SPOKAS, MD FORM 990, PAGE I, DOING BUSINESS AS NAMES: RIVERSIDE ORTHOPEDICS AND SPORTS MEDICINE SAINT ALPHONSUS FRUITLAND HEALTH PLAZA SAINT ALPHONSUS MEDICAL CENTER - ONTARIO SAINT ALPHONSUS MEDICAL GROUP - ONTARIO SAINT ALPHONSUS MEDICAL GROUP RIVERSIDE ORTHOPEDICS FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF SAINT ALPHONSUS MEDICAL CENTER - ONTARIO (SAMC - ONTARIO) IS SAINT ALPHONSUS HEALTH SYSTEM. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A SAINT ALPHONSUS HEALTH SYSTEM IS THE SOLE MEMBER OF SAMC - ONTARIO. SAINT ALPHONSUS HEALTH SYSTEM HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF TRUSTEES OF SAMC - ONTARIO. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, SAINT ALPHONSUS HEALTH SYSTEM MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. SAINT ALPHONSUS 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. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR SAMC - ONTARIO IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE SAINT ALPHONSUS HEALTH SYSTEM PLANNING AND FINANCE COMMITTEE. 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 SAMC - ONTARIO 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 SAMC - ONTARIO, WHICH INCLUDES TRUSTEES, 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 SAMC - ONTARIO 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 TRUSTEES OF SAMC - ONTARIO (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO SAMC - ONTARIO OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF TRUSTEES OF SAMC - ONTARIO (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 SAMC - ONTARIO. 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 SAMC - ONTARIO IS ESTABLISHED BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING CEO AND SYSTEM 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 CEO AND SYSTEM CFO OF SAMC - ONTARIO 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 SAMC - ONTARIO 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. IN ADDITION, SAMC - ONTARIO INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. SAMC - ONTARIO'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G MEDICAL SPECIALIST FEES: PROGRAM SERVICE EXPENSES 4,932,787. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,932,787. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 2,726,889. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,726,889. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 768,017. MANAGEMENT AND GENERAL EXPENSES 609,475. FUNDRAISING EXPENSES 22,496. TOTAL EXPENSES 1,399,988. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 830,404. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 830,404. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 17,702. MANAGEMENT AND GENERAL EXPENSES 48,076. FUNDRAISING EXPENSES 152. TOTAL EXPENSES 65,930. PURCHASED LAUNDRY/LINEN SERVICES: PROGRAM SERVICE EXPENSES 31,358. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,358. RECRUITMENT EXPENSE: PROGRAM SERVICE EXPENSES 182. MANAGEMENT AND GENERAL EXPENSES 5,887. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,069. COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 4,272. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,272. FORM 990, PART XI, LINE 9: EQUITY LOSS IN UNCONSOLIDATED AFFILIATES -1,789. EQUITY TRANSFERS TO AFFILIATES -321,000. FORM 990, PART XII, LINE 2: SAMC - ONTARIO'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY17 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 1221 MAIN STREET SUITE 213 HOLYOKE MA 01040 042182395 HEALTH CARE SERVICES MA 501(C)(3) LINE 10 THE MERCY HOSPITAL INC 1 CAPITAL REGION GERIATRIC CENTER INC 421 WEST COLUMBIA ST 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 COLUMBUS ACQUISITION CORP 111 CENTRAL AVENUE NEWARK NJ 07102 262616342 INACTIVE ENTITY NJ 501(C)(3) LINE 10 SAINT MICHAEL'S MEDICAL CENTER 1 CRANBROOK HOSPICE CARE 1111 W LONG LAKE RD STE 102 TROY MI 48098 383320699 HOSPICE SERVICES MI 501(C)(3) LINE 10 TRINITY HOME HEALTH SERVICES 1 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 SUITE 100 DEWITT NY 13214 461051881 PACE PROGRAM NY 501(C)(3) LINE 10 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 LTC (EDDY) INC 1 FARREN CARE CENTER INC 1221 MAIN STREET SUITE 213 HOLYOKE MA 01040 042501711 LONG TERM CARE MA 501(C)(3) LINE 3 THE MERCY HOSPITAL INC 1 FRANCISCAN ELDERCARE CORPORATION PO BOX 2500 WILMINGTON DE 19805 223008680 LONG TERM CARE (INACTIVE) DE 501(C)(3) LINE 10 ST FRANCIS HOSPITAL 1 GLACIER HILLS FOUNDATION 1200 EARHART RD ANN ARBOR MI 48105 208072723 FOUNDATION MI 501(C)(3) LINE 12A, I GLACIER HILLS INC 1 GLACIER HILLS INC 1200 EARHART RD ANN ARBOR MI 48105 381891500 SENIOR LIVING COMMUNITY MI 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES 1 GLEN EDDY INC 1 GLEN EDDY DRIVE NISKAYUNA NY 12309 141794150 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 GLOBAL HEALTH MINISTRY 20555 VICTOR PARKWAY LIVONIA MI 48152 421253527 HEALTH CARE SERVICES MI 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 GOOD SAMARITAN HOSPITAL INC 5401 LAKE OCONEE PARKWAY GREENSBORO GA 30642 261720984 HEALTH CARE AND HOSPITAL SERVICES GA 501(C)(3) LINE 3 ST MARY'S HEALTH CARE SYSTEM INC 1 GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION 701 W NORTH AVE MELROSE PARK IL 60160 363332852 COMMUNITY OUTREACH IL 501(C)(3) LINE 10 GOTTLIEB MEMORIAL HOSPITAL 1 GOTTLIEB MEMORIAL FOUNDATION 701 W NORTH AVE MELROSE PARK IL 60160 743260011 FOUNDATION IL 501(C)(3) LINE 12C, III-FI N/A 0 GOTTLIEB MEMORIAL HOSPITAL 701 W NORTH AVE MELROSE PARK IL 60160 362379649 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 GRAND RAPIDS MEDICAL EDUCATION PARTNERS INC 945 OTTAWA AVE NW GRAND RAPIDS MI 49503 237270669 MEDICAL EDUCATION TRAINING PROGRAMS MI 501(C)(3) LINE 12A, I TRINITY HEALTH-MICHIGAN 1 HACKLEY LIFE COUNSELING 125 E SOUTHERN AVENUE MUSKEGON MI 49442 381386362 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 MERCY HEALTH PARTNERS 1 HAWTHORNE RIDGE INC 30 COMMUNITY WAY EAST GREENBUSH NY 12061 800102840 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 HEART CENTER OF GREATER WATERBURY INC PO BOX 2153 WATERBURY CT 06722 830416893 MANAGEMENT CT 501(C)(3) LINE 12A, I N/A 0 HERITAGE HOUSE NURSING CENTER INC 2920 TIBBITS AVE TROY NY 12180 141725101 LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 HOLY CROSS CARENET INC PO BOX 9184 FARMINGTON HILLS MI 48152 521945054 LONG TERM CARE MD 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES 1 HOLY CROSS HEALTH FOUNDATION INC 1500 FOREST GLEN RD SILVER SPRING MD 20910 208428450 FOUNDATION MD 501(C)(3) LINE 7 HOLY CROSS HEALTH INC 1 HOLY CROSS HEALTH INC 1500 FOREST GLEN RD SILVER SPRING MD 20910 520738041 HEALTH CARE AND HOSPITAL SERVICES MD 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 1 HOLY CROSS HOSPITAL INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 590791028 HEALTH CARE AND HOSPITAL SERVICES FL 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 1 HOLY CROSS MEDICAL PROPERTIES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 650666283 BUILDING MANAGEMENT SERVICES FL 501(C)(2) N/A HOLY CROSS HOSPITAL INC 1 HOLY CROSS OUTPATIENT SERVICES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 465421068 HEALTH CARE SERVICES FL 501(C)(3) LINE 10 HOLY CROSS HOSPITAL INC 1 HOLY CROSS PRIMARY CARE INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 812531495 HEALTH CARE SERVICES FL 501(C)(3) LINE 10 HOLY CROSS HOSPITAL INC 1 HOME & COMMUNITY HEALTH SERVICES INC 114 WOODLAND STREET HARTFORD CT 06105 810723591 HOME HEALTH SERVICES CT 501(C)(3) LINE 10 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 HOME AIDE SERVICE OF EASTERN NEW YORK INC 433 RIVER ST SUITE 3000 TROY NY 12180 141514867 HOME HEALTH SERVICES NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 HOSPICE OF NORTH IOWA 232 SECOND STREET SE MASON CITY IA 50401 421173708 HOSPICE SERVICES IA 501(C)(3) LINE 10 MERCY HEALTH SERVICES-IOWA CORP 1 HOSPICE OF SIOUXLAND 4300 HAMILTON BLVD SIOUX CITY IA 51104 383320710 HOSPICE SERVICES IA 501(C)(3) LINE 12A, I N/A 0 IHA HEALTH SERVICES CORPORATION 24 FRANK LLOYD WRIGHT DR LOBBY J ANN ARBOR MI 48106 383316559 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN 1 JOHNSON HEALTH CARE INC 114 WOODLAND STREET HARTFORD CT 06105 810709903 HEALTH CARE SERVICES CT 501(C)(3) LINE 10 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 JOHNSON MEMORIAL HOSPITAL INC 114 WOODLAND STREET HARTFORD CT 06105 475676956 HEALTH CARE AND HOSPITAL SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 JOHNSON MEMORIAL MEDICAL CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 810696923 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT CT 501(C)(3) LINE 12B, II TRINITY HEALTH OF NEW ENGLAND CORP INC 1 LANGHORNE MRI INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE PA 19047 232519529 HEALTH CARE SERVICES (INACTIVE) PA 501(C)(3) LINE 10 ST MARY MEDICAL CENTER 1 LANGHORNE PHYSICIAN SERVICES INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE PA 19047 232571699 HEALTH CARE SERVICES PA 501(C)(3) LINE 10 ST MARY MEDICAL CENTER 1 LIFE AT LOURDES INC 2475 MCCLELLAN AVENUE PENNSAUKEN NJ 08109 261854750 PACE PROGRAM NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES 1 LIFE AT ST FRANCIS HEALTHCARE INC 7TH AND CLAYTON STREETS WILMINGTON DE 19805 452569214 PACE PROGRAM DE 501(C)(3) LINE 10 ST FRANCIS HOSPITAL 1 LIFE ST FRANCIS CORPORATION 1435 LIBERTY STREET HAMILTON NJ 08629 222797282 PACE PROGRAM NJ 501(C)(3) LINE 10 ST FRANCIS MEDICAL CENTER TRENTON NJ 1 LIFE ST JOSEPH OF THE PINES INC 100 GOSSMAN DRIVE SOUTHERN PINES NC 28387 272159847 PACE PROGRAM NC 501(C)(3) LINE 3 ST JOSEPH OF THE PINES INC 1 LIFE ST MARY 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE PA 19047 262976184 PACE PROGRAM PA 501(C)(3) LINE 10 ST MARY MEDICAL CENTER 1 LOURDES ANCILLARY SERVICES 1600 HADDON AVENUE CAMDEN NJ 08103 222568525 VOLUNTEER SERVICE AUXILIARY NJ 501(C)(3) LINE 12B, II OUR LADY OF LOURDES HEALTH CARE SERVICES 1 LOURDES CARDIOLOGY SERVICES PC 1600 HADDON AVENUE CAMDEN NJ 08103 274357794 HEALTH CARE SERVICES NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES 1 LOURDES MEDICAL CENTER OF BURLINGTON COUNTY 218 SUNSET ROAD WILLINGBORO NJ 08046 223612265 HEALTH CARE AND HOSPITAL SERVICES NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES 1 LOYOLA MEDICINE TRANSPORT LLC 905 W NORTH AVE MELROSE PARK IL 60160 474147171 TRANSPORATION SERVICES IL 501(C)(3) LINE 10 LOYOLA UNIVERSITY MEDICAL CENTER 1 LOYOLA UNIVERSITY HEALTH SYSTEM 2160 SOUTH FIRST AVENUE MAYWOOD IL 60153 363342448 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT IL 501(C)(3) LINE 12B, II TRINITY HEALTH CORPORATION 1 LOYOLA UNIVERSITY MEDICAL CENTER 2160 SOUTH FIRST AVENUE MAYWOOD IL 60153 364015560 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 LTC (EDDY) INC 2212 BURDETT AVE TROY NY 12180 222564710 MANAGEMENT SERVICES FOR LONG TERM CARE NY 501(C)(3) LINE 12B, II ST PETER'S HEALTH PARTNERS 1 MARIAN COMMUNITY HOSPITAL 3805 WEST CHESTER PIKE STE 100 NEWTOWN SQUARE PA 19073 240711230 HEALTH CARE SERVICES (INACTIVE) PA 501(C)(3) LINE 10 MAXIS HEALTH SYSTEM 1 MARIAN HOME HEALTHCARE 801 5TH STREET SIOUX CITY IA 51101 383320705 HOME HEALTH SERVICES (INACTIVE) IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 MAXIS HEALTH SYSTEM 3805 WEST CHESTER PIKE STE 100 NEWTOWN SQUARE PA 19073 911940902 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT (INACTIVE) PA 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 MCAULEY CENTER INC 275 STEELE ROAD WEST HARTFORD CT 06117 061058086 SENIOR LIVING COMMUNITY CT 501(C)(3) LINE 10 MERCY COMMUNITY HEALTH INC 1 MCAULEY CLINIC CORPORATION PO BOX 992 ANN ARBOR MI 48106 382561013 HEALTH CARE SERVICES (INACTIVE) MI 501(C)(3) LINE 3 CATHERINE MCAULEY HEALTH SERVICES CORP 1 MCAULEY MINISTRIES 3333 FIFTH AVENUE PITTSBURGH PA 15213 943436142 GRANT MAKING PA 501(C)(3) LINE 12B, II PITTSBURGH MERCY HEALTH SYSTEM INC 1 MEMORIAL HOSPITAL ALBANY NY 600 NORTHERN BLVD ALBANY NY 12204 141338457 HEALTH CARE AND HOSPITAL SERVICES NY 501(C)(3) LINE 3 ST PETER'S HEALTH PARTNERS 1 MERCY AMICARE HOME HEALTHCARE OAKLAND 1111 W LONG LAKE RD STE 102 TROY MI 48098 383320698 HOME HEALTH SERVICES MI 501(C)(3) LINE 10 TRINITY HOME HEALTH SERVICES 1 MERCY AMICARE HOME HEALTHCARE PORT HURON 17410 COLLEGE PARKWAY STE 150 LIVONIA MI 48152 383320701 HOME HEALTH SERVICES MI 501(C)(3) LINE 10 TRINITY HOME HEALTH SERVICES 1 MERCY CARE FOUNDATION 424 DECATUR STREET ATLANTA GA 30312 581448522 FOUNDATION GA 501(C)(3) LINE 7 SAINT JOSEPH'S HEALTH SYSTEM INC 1 MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN PA 19428 231352191 HEALTH CARE AND HOSPITAL SERVICES PA 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA 1 MERCY COMMUNITY HEALTH INC 2021 ALBANY AVENUE WEST HARTFORD CT 06117 061492707 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT CT 501(C)(3) LINE 12B, II TRINITY CONTINUING CARE SERVICES 1 MERCY FAMILY SUPPORT 1001 BALTIMORE PIKE SUITE 310 SPRINGFIELD PA 19064 232325059 HOME HEALTH SERVICES PA 501(C)(3) LINE 10 MERCY HOME HEALTH SERVICES 1 MERCY FOUNDATION INC 2525 SOUTH MICHIGAN AVENUE CHICAGO IL 60616 363227350 FOUNDATION IL 501(C)(3) LINE 7 MERCY HEALTH SYSTEM OF CHICAGO 1 MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE 888 TERRACE STREET MUSKEGON MI 49440 383321856 HOSPICE & HOME HEALTH SERVICES MI 501(C)(3) LINE 10 TRINITY HOME HEALTH SERVICES 1 MERCY HEALTH FOUNDATION OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN PA 19428 232829864 FOUNDATION PA 501(C)(3) LINE 12B, II MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA 1 MERCY HEALTH NETWORK INC 1111 6TH AVENUE DES MOINES IA 50314 421478417 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT DE 501(C)(3) LINE 12B, II N/A 0 MERCY HEALTH PARTNERS 1500 E SHERMAN BLVD MUSKEGON MI 49444 382589966 HEALTH CARE AND HOSPITAL SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN 1 MERCY HEALTH PLAN ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN PA 19428 222483605 MEDICAID MANAGED CARE PLAN PA 501(C)(3) LINE 12B, II MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA 1 MERCY HEALTH SERVICES - IOWA CORP 1000 4TH STREET SW MASON CITY IA 50401 311373080 HEALTH CARE AND HOSPITAL SERVICES DE 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 1 MERCY HEALTH SYSTEM OF CHICAGO 2525 SOUTH MICHIGAN AVENUE CHICAGO IL 60616 363163327 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT IL 501(C)(3) LINE 12B, II TRINITY HEALTH CORPORATION 1 MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN PA 19428 232212638 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT PA 501(C)(3) LINE 12C, III-FI TRINITY HEALTH CORPORATION 1 MERCY HEALTHCARE CENTER 114 WAWBEEK AVENUE TUPPER LAKE NY 12986 150532211 HEALTH CARE AND HOSPITAL SERVICES (INACTIVE) NY 501(C)(3) LINE 3 MERCY UIHLEIN HEALTH CORPORATION 1 MERCY HEALTHCARE FOUNDATION - CLINTON 1410 N 4TH ST CLINTON IA 52732 421316126 FOUNDATION IA 501(C)(3) LINE 7 N/A 0 MERCY HOME HEALTH 1001 BALTIMORE PIKE SUITE 310 SPRINGFIELD PA 19064 231352099 HOME HEALTH SERVICES PA 501(C)(3) LINE 10 MERCY HOME HEALTH SERVICES 1 MERCY HOME HEALTH SERVICES 1001 BALTIMORE PIKE SUITE 310 SPRINGFIELD PA 19064 232325058 MANAGEMENT SERVICES FOR HOME HEALTH PA 501(C)(3) LINE 12B, II MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA 1 MERCY HOSPITAL AND MEDICAL CENTER 2525 SOUTH MICHIGAN AVENUE CHICAGO IL 60616 362170152 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF CHICAGO 1 MERCY HOSPITAL CADILLAC FOUNDATION 1820 44TH ST SE KENTWOOD MI 49508 203357131 FOUNDATION MI 501(C)(3) LINE 12A, I TRINITY HEALTH-MICHIGAN 1 MERCY HOSPITAL INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 590791034 HEALTH CARE SERVICES (INACTIVE) FL 501(C)(3) LINE 12B, II TRINITY HEALTH CORPORATION 1 MERCY LIFE CENTER CORPORATION 1200 REEDSDALE STREET PITTSBURGH PA 15233 251604115 COMMUNITY OUTREACH PA 501(C)(3) LINE 10 PITTSBURGH MERCY HEALTH SYSTEM INC 1 MERCY LIFE OF ALABAMA PO BOX 7957 MOBILE AL 36670 273163002 PACE PROGRAM AL 501(C)(3) LINE 3 TRINITY HEALTH PACE 1 MERCY LIFE INC 1221 MAIN STREET SUITE 213 HOLYOKE MA 01040 453086711 PACE PROGRAM MA 501(C)(3) LINE 3 SISTERS OF PROVIDENCE CARE CENTERS INC 1 MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN PA 19428 232627944 HEALTH CARE SERVICES PA 501(C)(3) LINE 3 MERCY PHYSICIAN NETWORK 1 MERCY MEDICAL CENTER - CLINTON INC 1410 NORTH 4TH ST CLINTON IA 52732 421336618 HEALTH CARE AND HOSPITAL SERVICES DE 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION 801 5TH STREET SIOUX CITY IA 51102 141880022 FOUNDATION IA 501(C)(3) LINE 7 MERCY HEALTH SERVICES-IOWA CORP 1 MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA 1000 4TH STREET SW MASON CITY IA 50401 421229151 FOUNDATION IA 501(C)(3) LINE 7 MERCY HEALTH SERVICES-IOWA CORP 1 MERCY MEDICAL CORPORATION PO BOX 7957 MOBILE AL 36670 636002215 PACE PROGRAM AL 501(C)(3) LINE 10 TRINITY HEALTH CORPORATION 1 MERCY MEDICAL GROUP INC 1221 MAIN STREET SUITE 213 HOLYOKE MA 01040 454884805 HEALTH CARE SERVICES MA 501(C)(3) LINE 3 THE MERCY HOSPITAL INC 1 MERCY PHYSICIAN NETWORK ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN PA 19428 461187365 MANAGEMENT SERVICES FOR PHYSICIAN SERVICE ORGANIZATIONS PA 501(C)(3) LINE 12B, II MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA 1 MERCY SENIOR CARE INC 424 DECATUR STREET ATLANTA GA 30312 581366508 COMMUNITY OUTREACH GA 501(C)(3) LINE 7 SAINT JOSEPH'S HEALTH SYSTEM INC 1 MERCY SERVICES DOWNTOWN INC 424 DECATUR STREET ATLANTA GA 30312 272046353 TITLE HOLDING COMPANY GA 501(C)(3) LINE 12B, II SAINT JOSEPH'S HEALTH SYSTEM INC 1 MERCY SERVICES FOR AGING NONPROFIT HOUSING CORPORATION PO BOX 9184 FARMINGTON HILLS MI 48333 382719605 LONG TERM CARE MI 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES 1 MERCY SPECIALIST PHYSICIANS INC 1221 MAIN STREET SUITE 213 HOLYOKE MA 01040 264033168 HEALTH CARE SERVICES MA 501(C)(3) LINE 3 THE MERCY HOSPITAL INC 1 MERCY SUBURBAN HOSPITAL ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN PA 19428 231396763 HEALTH CARE AND HOSPITAL SERVICES PA 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA 1 MERCY UIHLEIN HEALTH CORPORATION 3805 WEST CHESTER PIKE SUITE 100 NEWTOWN SQUARE NY 19073 161535133 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT (INACTIVE) NY 501(C)(3) LINE 12B, II TRINITY HEALTH CORPORATION 1 MISSION HEALTH CORPORATION 37595 SEVEN MILE ROAD LIVONIA MI 48152 383181557 BUILDING MANAGEMENT SERVICES DE 501(C)(3) LINE 12A, I N/A 0 MOUNT CARMEL COLLEGE OF NURSING 6150 EAST BROAD STREET COLUMBUS OH 43213 311308555 COLLEGE OF NURSING OH 501(C)(3) LINE 2 MOUNT CARMEL HEALTH SYSTEM 1 MOUNT CARMEL HEALTH INSURANCE COMPANY 6150 EAST BROAD STREET COLUMBUS OH 43213 251912781 HEALTH INSURANCE OH 501(C)(4) N/A MOUNT CARMEL HEALTH SYSTEM 1 MOUNT CARMEL HEALTH PLAN INC 6150 EAST BROAD STREET COLUMBUS OH 43213 311471229 MEDICARE HMO OH 501(C)(4) N/A MOUNT CARMEL HEALTH SYSTEM 1 MOUNT CARMEL HEALTH SYSTEM 6150 EAST 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