GOTTLIEB MEMORIAL HOSPITAL: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: GOTTLIEB MEMORIAL HOSPITAL (EIN 36-2379649)
Tax period: 2015-07-01 to 2016-06-30
Filed: 2017-05-11
IRS object ID: 201711319349300021
Schema version: 2015v3.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-05-11T07:47:30-05:00	ReturnTs
Tax Period End	2016-06-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	362379649	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GOTTLIEB MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	GOTT	BusinessNameControlTxt
Phone	7082169000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	701 W NORTH AVE	AddressLine1Txt
City	MELROSE PARK	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60160	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	BLAINE PETERSEN	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	7082169000	PhoneNum
Signature	2017-05-11	SignatureDt

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	LARRY GOLDBERG	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	701 W NORTH AVE	AddressLine1Txt
City	MELROSE PARK	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60160	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$147,474,680	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.GOTTLIEBHOSPITAL.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1956	FormationYr
Legal Domicile State	IL	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE HEALTHCARE AND HOSPITAL SERVICES	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	1216	TotalEmployeeCnt
Total Volunteers	94	TotalVolunteersCnt
Total Gross UBI	$65,490	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$8,037	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$255,872	PYContributionsGrantsAmt
CY Contributions Grants	$152,900	CYContributionsGrantsAmt
PY Program Service Revenue	$121,443,729	PYProgramServiceRevenueAmt
CY Program Service Revenue	$124,752,095	CYProgramServiceRevenueAmt
PY Investment Income	$405,404	PYInvestmentIncomeAmt
CY Investment Income	-$108,248	CYInvestmentIncomeAmt
PY Other Revenue	$7,520,082	PYOtherRevenueAmt
CY Other Revenue	$21,136,008	CYOtherRevenueAmt
PY Total Revenue	$129,625,087	PYTotalRevenueAmt
CY Total Revenue	$145,932,755	CYTotalRevenueAmt
PY Grants And Similar Paid	$2,000	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$3,655	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$62,876,102	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$58,672,452	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$69,508,410	PYOtherExpensesAmt
CY Other Expenses	$79,645,322	CYOtherExpensesAmt
PY Total Expenses	$132,386,512	PYTotalExpensesAmt
CY Total Expenses	$138,321,429	CYTotalExpensesAmt
PY Revenues Less Expenses	-$2,761,425	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$7,611,326	CYRevenuesLessExpensesAmt
Total Assets BOY	$183,090,757	TotalAssetsBOYAmt
Total Assets EOY	$181,036,359	TotalAssetsEOYAmt
Total Liabilities BOY	$103,613,235	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$107,879,910	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$79,477,522	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$73,156,449	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	WE, LOYOLA UNIVERSITY HEALTH SYSTEM AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES.GOTTLIEB MEMORIAL HOSPITAL IS A MEMBER OF LOYOLA UNIVERSITY HEALTH SYSTEM AND TRINITY HEALTH.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$121,755,018	ExpenseAmt
Grant	$3,655	GrantAmt
Revenue	$144,428,049	RevenueAmt
Desc	FOUNDED IN 1961, GOTTLIEB MEMORIAL HOSPITAL (GMH), LOCATED IN MELROSE PARK, ILLINOIS, IS A 254 BED ACUTE CARE NOT-FOR-PROFIT, COMMUNITY HOSPITAL THAT OFFERS EMERGENCY, INPATIENT AND OUTPATIENT MEDICAL SERVICES. GMH, WHICH IS PART OF LOYOLA UNIVERSITY HEALTH SYSTEM, PROVIDES VITAL HEALTH CARE SERVICES 24 HOURS A DAY, SEVEN DAYS A WEEK, TO PATIENTS IN VARIOUS SETTINGS INCLUDING CARDIOVASCULAR /THORACIC, OBSTETRICS, ORTHOPAEDICS, MEDICAL IMAGING, GASTROENTEROLOGY, UROLOGY, HOME CARE AND HOSPICE, TRANSITIONAL CARE, AND ADULT DAY CARE SERVICES. THE HOSPITAL CAMPUS INCLUDES AN EMERGENCY DEPT. AND LEVEL II TRAUMA CENTER WITH HELIPORT, WOUND CARE AND HYPERBARIC MEDICINE CENTER, SLEEP LAB AND DIAGNOSTIC CENTER, BIRTH CENTER, AND THE MARJORIE G. WEINBERG CANCER CENTER.DURING FISCAL YEAR 2016, GMH PROVIDED OVER 39,000 DAYS OF HEALTHCARE SERVICES AND OVER 64,000 OUTPATIENT VISITS TO THE COMMUNITY.PLEASE VISIT SCHEDULE H AND OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES, RECOGNITIONS AND AWARDS: HTTP://WWW.GOTTLIEBHOSPITAL.ORG/	Desc
Total Program Service Expenses	$121,755,018	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	183	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1216	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	0	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	IL	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NC	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BLAINE PETERSEN	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7082164253	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2160 SOUTH FIRST AVENUE	AddressLine1Txt
City	MAYWOOD	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	601533328	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (37 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
LARRY GOLDBERG
DIRECTOR; CEO	10.00	45.00	Yes (X)	Yes (X)	$0	$1,276,989	$36,662
MARC SCHWARTZ
DIRECTOR; CHAIR	2.00	3.00	Yes (X)	Yes (X)	$0	$0	$0
JOY CUNNINGHAM
DIRECTOR	2.00	3.00	Yes (X)		$0	$0	$0
ROBERT FLANIGAN MD
DIRECTOR; LUMC PHYSICIAN	2.00	48.00	Yes (X)		$0	$446,265	$21,306
LORI HEALEY
DIRECTOR	2.00	3.00	Yes (X)		$0	$0	$0
ROBERT HOMBACH
DIRECTOR THROUGH 12/15	2.00	3.00	Yes (X)		$0	$0	$0
HENRY LANG
DIRECTOR THROUGH 12/15	2.00	3.00	Yes (X)		$0	$0	$0
STEPHEN RAY MITCHELL MD
DIRECTOR	2.00	3.00	Yes (X)		$0	$0	$0
REV JOHN J O'CALLAGHAN SJ
DIRECTOR	2.00	3.00	Yes (X)		$0	$0	$0
P TERRENCE O'ROURKE MD
DIR THR 12/15; CONSULTANT	2.00	15.00	Yes (X)		$0	$485,001	$11,062
SR JOAN STEADMAN CSC
DIRECTOR	2.00	3.00	Yes (X)		$0	$0	$0
JACK WEINBERG
DIRECTOR	2.00	3.00	Yes (X)		$0	$0	$0
DAVID WILBER MD
DIRECTOR THR 12/15; DIR CARDIO INST	2.00	48.00	Yes (X)		$0	$668,626	$17,925
STEVE BERGFELD
DIRECTOR	2.00	3.00	Yes (X)		$0	$0	$0
KEITH VESELIK MD
DIRECTOR; MEDICAL DIRECTOR	2.00	48.00	Yes (X)		$0	$408,635	$31,541
SALLY JEFFCOAT
DIRECTOR AS OF 1/16;EVP WEST/MIDWEST	2.00	53.00	Yes (X)		$0	$1,465,283	$40,351
OMAR DUQUE
DIRECTOR AS OF 1/16	2.00	3.00	Yes (X)		$0	$0	$0
RONALD POTKUL MD
DIRECTOR AS OF 1/16; PHYSICIAN	2.00	48.00	Yes (X)		$0	$777,654	$21,868
BRIAN PROCTOR MD
DIRECTOR AS OF 1/16; GMH COMM. CHR.	8.00	3.00	Yes (X)		$23,237	$0	$0
LORI PRICE
PRESIDENT	48.00	2.00		Yes (X)	$0	$576,051	$54,097
AJAY SIAL
TREAS THROUGH 11/15; LUMC SVP & CFO	10.00	40.00		Yes (X)	$0	$595,544	$34,843
BLAINE PETERSEN
TREASURER AS OF 3/16; LUMC SVP & CFO	10.00	40.00		Yes (X)	$0	$544,869	$32,592
DANIEL ISACKSEN
ASST TREASURER; LUMC SVP FINANCE	10.00	40.00		Yes (X)	$0	$346,690	$30,384
JILL RAPPIS
SECRETARY; LUMC VP GEN CNSL	2.00	48.00		Yes (X)	$0	$433,566	$50,806
MARIA PEKAR
ASST SECRETARY; LUMC ASSOC. GEN CNSL	2.00	48.00		Yes (X)	$0	$260,513	$54,709
DAVID HECHT MD MS MBA
EVP, CLINICAL AFFAIRS	15.00	40.00			$0	$772,129	$21,635	Yes (X)
ALAN GOLDBERG
VP, ADMIN SERVICES	50.00	0.00			$181,196	$0	$45,630	Yes (X)
LAURA CONCANNON
CHIEF MEDICAL OFFICER	50.00	0.00			$288,778	$0	$29,592		Yes (X)
GINGER HOOK
VP CHIEF NURSE EXECUTIVE	50.00	0.00			$214,896	$0	$25,944		Yes (X)
ELIZABETH MCLAIN
CRITICAL CARE RN	50.00	0.00			$149,124	$0	$16,985		Yes (X)
SANDRA SWANSON
ADMIN DIR PERIOP/PERINATAL SVCS	50.00	0.00			$187,214	$0	$31,573		Yes (X)
EWA BOGACZ
CRITICAL CARE RN	50.00	0.00			$145,127	$0	$12,846		Yes (X)
DANIEL HALE
FORMER OFFICER	0.00	0.00			$0	$774,683	$555,873			Yes (X)
BENJAMIN CARTER
FORMER OFFICER; EVP, CFO	0.00	55.00			$0	$1,510,330	$47,466			Yes (X)
KEDRICK ADKINS
FORMER KEY EMPLOYEE	0.00	0.00			$0	$768,621	$141			Yes (X)
RICHARD O'CONNELL
FORMER KEY EMPLOYEE; EVP EAST GROUP	0.00	55.00			$0	$1,558,150	$47,546			Yes (X)
DONNA HALINSKI
FORMER OFFICER; VP CLINICAL AFFRS	0.00	50.00			$0	$302,095	$42,021			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,189,572	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$13,971,694	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,315,398	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	60	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
GEORGE SOLLITT CONSTRUCTION CO
790 N CENTRAL AVE	WOODDALE	IL	60191	CONSTRUCTION SERVICES	$6,314,501
SODEXO INC & AFFILIATES
4880 PAYSPHERE CIRCLE	CHICAGO	IL	60674	MANAGEMENT SERVICES	$1,540,008
WALSH CONSTRUCTION
929 W ADAMS	CHICAGO	IL	60607	CONSTRUCTION SERVICES	$1,444,274
MIDWEST ANES HBRJ LLC
40 SHUMAN BLVD	NAPERVILLE	IL	60563	MEDICAL SERVICES	$847,583
HEALTHCARE ASSOCIATES
1151 E WARRENVILLE RD	NAPERVILLE	IL	60563	BANKING SERVICES	$788,510

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	31	CntrctRcvdGreaterThan100KCnt
Fundraising	$27,005	FundraisingAmt
Government Grants	$4,024	GovernmentGrantsAmt
All Other Contributions	$121,871	AllOtherContributionsAmt
Total Contributions	$152,900	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE	622110	$120,751,542	$120,751,542
LABORATORY REVENUE	621500	$4,000,553	$3,935,063	$65,490

Field	Value	IRS element (for citing)
Total Program Service Revenue	$124,752,095	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$216,306	TotalRevenueColumnAmt
Exclusion	$216,306	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$2,127,739	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,079,586	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$1,048,153	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,048,153	TotalRevenueColumnAmt
Exclusion	$1,048,153	ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$249,686	SecuritiesAmt
Other	$74,868	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$249,686	SecuritiesAmt
Other	-$74,868	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$324,554	TotalRevenueColumnAmt
Exclusion	-$324,554	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$58,590	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$27,005	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$75,066	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$16,476	TotalRevenueColumnAmt
Exclusion	-$16,476	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$106,166	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$62,719	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$43,447	TotalRevenueColumnAmt
Exclusion	$43,447	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
PENSION CURTAILMENT INCOME	622110	$1,552,716	$1,552,716
GOV'T SUBSIDY - EHR	622110	$1,109,023	$1,109,023
CAFETERIA REVENUE	722210	$319,440		$319,440

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$17,079,705	TotalRevenueColumnAmt
Related Or Exempt Func Income	$17,079,705	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$20,060,884	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$145,932,755	TotalRevenueColumnAmt
Related Or Exempt Func Income	$144,428,049	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$65,490	UnrelatedBusinessRevenueAmt
Exclusion	$1,286,316	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$3,655	TotalAmt
Program Services	$3,655	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$856,974	TotalAmt
Management And General	$856,974	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$46,513,170	TotalAmt
Program Services	$44,906,436	ProgramServicesAmt
Management And General	$1,606,734	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,527,495	TotalAmt
Program Services	$2,447,389	ProgramServicesAmt
Management And General	$80,106	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$5,232,199	TotalAmt
Program Services	$5,018,985	ProgramServicesAmt
Management And General	$213,214	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,542,614	TotalAmt
Program Services	$3,365,449	ProgramServicesAmt
Management And General	$177,165	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$23,640	TotalAmt
Management And General	$23,640	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$16,177	TotalAmt
Management And General	$16,177	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$23,632	TotalAmt
Management And General	$23,632	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$9,535,746	TotalAmt
Program Services	$8,721,360	ProgramServicesAmt
Management And General	$814,386	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$174,890	TotalAmt
Management And General	$174,890	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,753,945	TotalAmt
Program Services	$2,299,474	ProgramServicesAmt
Management And General	$454,471	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$987,092	TotalAmt
Program Services	$278,738	ProgramServicesAmt
Management And General	$708,354	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$3,190,584	TotalAmt
Program Services	$2,861,774	ProgramServicesAmt
Management And General	$328,810	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$32,591	TotalAmt
Program Services	$19,541	ProgramServicesAmt
Management And General	$13,050	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$63,677	TotalAmt
Program Services	$54,600	ProgramServicesAmt
Management And General	$9,077	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$555,692	TotalAmt
Program Services	$555,692	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$8,768,868	TotalAmt
Program Services	$8,768,868	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$3,260,891	TotalAmt
Program Services	$3,260,891	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$19,057,505	$19,057,505
BAD DEBT	$9,756,780	$9,756,780
HOSPITAL PROVIDER TAX	$5,107,249	$5,107,249
CONTRACT LABOR	$3,045,630	$2,376,533	$669,097

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$13,290,733	TotalAmt
Program Services	$2,894,099	ProgramServicesAmt
Management And General	$10,396,634	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$138,321,429	TotalAmt
Program Services	$121,755,018	ProgramServicesAmt
Management And General	$16,566,411	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$4,482,026	BOYAmt
EOY	$2,545,612	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,366,394	BOYAmt
EOY	$383,541	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$3,500,000	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$25,296,987	BOYAmt
EOY	$14,985,619	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$286,815	BOYAmt
EOY	$123,353	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$3,176,000	BOYAmt
EOY	$2,816,000	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$445,390	BOYAmt
EOY	$235,862	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$125,071,229	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$38,506,619	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$81,103,400	BOYAmt
EOY	$86,564,610	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$7,597,371	BOYAmt
EOY	$8,564,682	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$7,566,760	BOYAmt
EOY	$8,189,458	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$48,269,614	BOYAmt
EOY	$56,627,622	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$183,090,757	BOYAmt
EOY	$181,036,359	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$33,204,216	BOYAmt
EOY	$42,859,016	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$70,409,019	BOYAmt
EOY	$65,020,894	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$103,613,235	BOYAmt
EOY	$107,879,910	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$74,674,246	BOYAmt
EOY	$72,836,092	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,803,276	BOYAmt
EOY	$320,357	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$79,477,522	BOYAmt
EOY	$73,156,449	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$183,090,757	BOYAmt
EOY	$181,036,359	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$7,611,326	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$440,319	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$13,492,080	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (1)	GrantsOtherOrganizationsInd
Grants Other Organizations	$1,545	GrantsOtherOrganizationsAmt
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	0	OtherActivitiesInd
Total Lobbying Expenditures	$1,545	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	GOTTLIEB MEMORIAL HOSPITAL 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 GOTTLIEB MEMORIAL HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$12,500,000	OtherCostOrOtherBasisAmt
Book Value	$12,500,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$67,089,064	OtherCostOrOtherBasisAmt
Depreciation	$18,762,639	DepreciationAmt
Book Value	$48,326,425	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$41,871,311	OtherCostOrOtherBasisAmt
Depreciation	$19,743,980	DepreciationAmt
Book Value	$22,127,331	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,610,854	OtherCostOrOtherBasisAmt
Book Value	$3,610,854	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$86,564,610	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDesc	Book ValueBookValueAmt
INTERCOMPANY RECEIVABLES	$55,874,685
MISCELLANEOUS RECEIVABLES	$521,697
INVESTMENT IN UNCONSOLIDATED AFFILIATES	$88,000
OTHER CURRENT ASSETS	$123,384
OTHER ASSETS	$19,856

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$56,627,622	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
INTERCOMPANY PAYABLES	$43,522,261
LONG-TERM ASSET RETIREMENT OBLIGATION (FIN 47)	$485,325
OTHER CURRENT LIABILITIES	$191,014
OTHER LONG-TERM LIABILITIES	$1,304,717
INTERCOMPANY NOTES PAYABLE	$16,798,968
DEFERRED COMPENSATION LIABILITY	$40,960
INTERCOMPANY OTHER LIABILITIES	$2,677,649

Field	Value	IRS element (for citing)
Total Liability	$65,020,894	TotalLiabilityAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	EMERALD BALL	Event1Nm
Gross Receipts Event1	$85,595	GrossReceiptsEvent1Amt
Charitable Contri Event1	$27,005	CharitableContriEvent1Amt
Gross Revenue Event1	$58,590	GrossRevenueEvent1Amt
Food And Beverage Event1	$56,826	FoodAndBeverageEvent1Amt
Entertainment Event1	$13,380	EntertainmentEvent1Amt
Other Direct Expenses Event1	$4,860	OtherDirectExpensesEvent1Amt
Gross Receipts Total	$85,595	GrossReceiptsTotalAmt
Charitable Contributions Tot	$27,005	CharitableContributionsTotAmt
Gross Revenue Total Events	$58,590	GrossRevenueTotalEventsAmt
Food And Beverage Total Events	$56,826	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$13,380	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$4,860	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$75,066	DirectExpenseSummaryEventsAmt
Net Income Summary	-$16,476	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,651	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,651	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,206,185	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,284,821	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,921,364	NetCommunityBenefitExpnsAmt
Total Expense	0.06160	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,207,836	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,284,821	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,923,015	NetCommunityBenefitExpnsAmt
Total Expense	0.06160	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	1833	PersonsServedCnt
Total Community Benefit Expns	$72,201	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$72,201	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	11	PersonsServedCnt
Total Community Benefit Expns	$301,738	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$72,674	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$229,064	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	410	PersonsServedCnt
Total Community Benefit Expns	$48,411	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$48,411	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	12	ActivitiesOrProgramsCnt
Persons Served	2254	PersonsServedCnt
Total Community Benefit Expns	$422,350	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$72,674	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$349,676	NetCommunityBenefitExpnsAmt
Total Expense	0.00280	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	12	ActivitiesOrProgramsCnt
Persons Served	2254	PersonsServedCnt
Total Community Benefit Expns	$24,630,186	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,357,495	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,272,691	NetCommunityBenefitExpnsAmt
Total Expense	0.06440	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$9,756,780	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$41,097,883	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$39,539,307	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$1,558,576	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GOTTLIEB MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	701 W NORTH AVE	AddressLine1Txt
City	MELROSE PARK	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60160	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.GOTTLIEBHOSPITAL.ORG	WebsiteAddressTxt
State License	0005793	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	INCLUDING OUTPATIENT SERVICES	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	GOTTLIEB MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE SCHEDULE H, PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE SCHEDULE H, PART V, SECTION C	StrategyWebsiteURLTxt
Strategy Attached	0	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
GOTTLIEB MEMORIAL HOSPITAL	PART V, SECTION B, LINE 5: BEGINNING IN MARCH 2015, GOTTLIEB MEMORIAL HOSPITAL (GMH), A MEMBER OF LOYOLA UNIVERSITY HEALTH SYSTEM (LUHS), PARTICIPATED IN A COLLABORATIVE OF HOSPITALS IN CHICAGO AND SUBURBAN COOK COUNTY TO CONDUCT THEIR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). KNOWN AS THE HEALTH IMPACT COLLABORATIVE OF COOK COUNTY (HICC), HOSPITALS, COMMUNITY ORGANIZATIONS AND PUBLIC HEALTH DEPARTMENTS COLLABORATIVELY GATHERED DATA AND INPUT THROUGH A COMMUNITY SURVEY AND A SERIES OF FOCUS GROUPS. THE ILLINOIS PUBLIC HEALTH INSTITUTE (IPHI) SERVED AS THE PROCESS FACILITATOR AND BACKBONE ORGANIZATION FOR THE COLLABORATIVE CHNA AND IMPLEMENTATION PLANNING PROCESS. IPHI AND PARTNERS WORKED TOGETHER TO DESIGN A SHARED LEADERSHIP MODEL AND COLLABORATIVE INFRASTRUCTURE TO SUPPORT COMMUNITY-ENGAGED PLANNING, PARTNERSHIPS, AND STRATEGIC ALIGNMENT OF IMPLEMENTATION, WHICH WILL FACILITATE MORE EFFECTIVE AND SUSTAINABLE COMMUNITY HEALTH IMPROVEMENT IN THE FUTURE. THE COLLABORATIVE DIVIDED COOK COUNTY INTO THREE REGIONS, OF WHICH THE GMH CHNA (WEST SUBURBAN COOK COUNTY) WAS INCLUDED WITHIN THE CENTRAL REGION. SEVEN NONPROFIT HOSPITALS, ONE PUBLIC HOSPITAL, THREE HEALTH DEPARTMENTS, AND APPROXIMATELY 30 COMMUNITY STAKEHOLDERS PARTNERED ON THE CHNA FOR THE CENTRAL REGION. HEALTH DEPARTMENTS WERE KEY PARTNERS IN LEADING THE COLLABORATIVE AND CONDUCTING THE CHNA. THE PARTICIPATING HEALTH DEPARTMENTS IN THE CENTRAL REGION WERE THE CHICAGO DEPARTMENT OF PUBLIC HEALTH, COOK COUNTY DEPARTMENT OF PUBLIC HEALTH, AND OAK PARK DEPARTMENT OF PUBLIC HEALTH. THE HICC IS FOCUSED ON COMMUNITY-ENGAGED ASSESSMENT, PLANNING, AND IMPLEMENTATION. STAKEHOLDERS AND COMMUNITY PARTNERS WERE INVOLVED IN MULTIPLE WAYS THROUGHOUT THE ASSESSMENT PROCESS, BOTH IN TERMS OF COMMUNITY INPUT DATA AND AS DECISION-MAKING PARTNERS. AVENUES FOR ENGAGEMENT IN THE CENTRAL REGION CHNA INCLUDED: STAKEHOLDER ADVISORY TEAM, HOSPITALS' COMMUNITY ADVISORY GROUPS, DATA COLLECTION (COMMUNITY INPUT THROUGH SURVEY AND FOCUS GROUPS), AND ACTION PLANNING FOR STRATEGIC PRIORITIES (STARTED IN SUMMER 2016). BETWEEN MARCH AND MAY 2016, IPHI WORKED WITH THE PARTICIPATING HOSPITALS AND HEALTH DEPARTMENTS IN THE CENTRAL REGION OF COOK COUNTY (I.E., CENTRAL LEADERSHIP TEAM) TO IDENTIFY AND INVITE COMMUNITY STAKEHOLDERS TO PARTICIPATE AS MEMBERS OF THE STAKEHOLDER ADVISORY TEAM. THE STAKEHOLDER ADVISORY TEAM MEMBERS BROUGHT DIVERSE PERSPECTIVES AND EXPERTISE, AND REPRESENTED POPULATIONS AFFECTED BY HEALTH INEQUITIES INCLUDING DIVERSE RACIAL AND ETHNIC GROUPS, IMMIGRANTS AND REFUGEES, OLDER ADULTS, YOUTH, HOMELESS INDIVIDUALS, UNEMPLOYED, UNINSURED, AND VETERANS. THE CENTRAL STAKEHOLDER ADVISORY TEAM INCLUDED REPRESENTATIVES OF DIVERSE COMMUNITY ORGANIZATIONS FROM ACROSS THE WEST SIDE OF CHICAGO AND WEST COOK SUBURBS. THE ORGANIZATIONS REPRESENTED ON THE CENTRAL STAKEHOLDER ADVISORY TEAM INCLUDED: AGE OPTIONS, AGING CARE CONNECTIONS, AMERICAN CANCER SOCIETY, CASA CENTRAL, CATHOLIC CHARITIES, CHICAGO POLICE DEPARTMENT - 14TH DISTRICT, CHICAGO PUBLIC SCHOOLS, COMMUNITYHEALTH, DIABETES EMPOWERMENT CENTER, HEALTHCARE ALTERNATIVES SYSTEMS, HOUSING FORWARD, INFANT WELFARE-OAK PARK/THE CHILDREN'S CLINIC, INTERFAITH LEADERSHIP PROJECT, LOYOLA UNIVERSITY STRITCH SCHOOL OF MEDICINE, METROPOLITAN PLANNING COUNCIL, MILE SQUARE HEALTH CENTER, PCC WELLNESS, PROVISO LEYDEN COUNCIL FOR COMMUNITY ACTION (PLCC), PROVISO TOWNSHIP MENTAL HEALTH COMMISSION, RESPIRATORY HEALTH ASSOCIATION, SAINT ANTHONY'S HOSPITAL, WEST 40 INTERMEDIATE SERVICE CENTER, WEST COOK YMCA, WEST HUMBOLDT PARK DEVELOPMENT COUNCIL, WEST SIDE HEALTH AUTHORITY, AND WICKER PARK BUCKTOWN CHAMBER OF COMMERCE. MEMBERS OF THE STAKEHOLDER ADVISORY TEAM WERE VERY IMPORTANT PARTNERS IN THE CHNA AND IMPLEMENTATION PLANNING PROCESS AND CONTRIBUTED IN SOME OF THE FOLLOWING WAYS: PARTICIPATED IN A SERIES OF 8-10 MEETINGS BETWEEN MAY 2015 AND AUGUST 2016; PROVIDED INPUT ON ASSESSMENT DESIGN, INCLUDING DATA INDICATORS, SURVEYS, FOCUS GROUPS, AND ASSET MAPPING; FACILITATED THE PARTICIPATION OF COMMUNITY MEMBERS TO PROVIDE INPUT THROUGH SURVEYS AND FOCUS GROUPS; REVIEWED ASSESSMENT DATA, ASSISTED WITH DEVELOPING FINDINGS, AND IDENTIFIED PRIORITY STRATEGIC ISSUES; AND JOINED AN ACTION TEAM TO HELP SHAPE IMPLEMENTATION STRATEGIES. THE HICC ORGANIZED 23 FOCUS GROUPS THROUGHOUT CHICAGO AND SUBURBAN COOK COUNTY BETWEEN OCTOBER 2015 AND MARCH 2016, INCLUDING SEVEN FOCUS GROUPS IN THE CENTRAL REGION. THE GOAL OF THE FOCUS GROUPS WAS TO UNDERSTAND THE NEEDS, ASSETS, AND POTENTIAL RESOURCES IN VARIOUS COMMUNITIES OF CHICAGO AND SUBURBAN COOK COUNTY AND TO GATHER IDEAS ABOUT HOW HOSPITALS CAN PARTNER WITH COMMUNITIES TO IMPROVE HEALTH. THE FOCUS GROUP FINDINGS WERE AN INTEGRAL COMPONENT OF DATA IN THE CHNA, AND THE HOSPITALS AND THEIR PARTNERS IN THE HICC FOCUSED ON HEARING FROM COMMUNITY REPRESENTATIVES WHO HAVE DIRECT KNOWLEDGE AND EXPERIENCE RELATED TO THE HEALTH INEQUITIES IN OUR REGION. MEMBERS OF THE REGIONAL LEADERSHIP TEAM AND STAKEHOLDER ADVISORY TEAM HOSTED THE FOCUS GROUPS AND RECRUITED FOCUS GROUP PARTICIPANTS, WITH AN INTENTIONAL APPROACH TO INCLUDE A DIVERSE RANGE OF COMMUNITIES AND SERVICE PROVIDERS. RECRUITERS SPECIFICALLY SOUGHT OUT PARTICIPANTS WHO BELONG TO OR INTERACT WITH POPULATIONS SUCH AS RACIAL OR ETHNIC MINORITIES, IMMIGRANTS, LIMITED ENGLISH SPEAKERS, LOW-INCOME COMMUNITIES, FAMILIES WITH CHILDREN, FORMERLY INCARCERATED INDIVIDUALS, VETERANS, SENIORS, AND YOUNG ADULTS. HOST ORGANIZATIONS INCLUDED: CASA CENTRAL, CATHOLIC CHARITIES, HOUSING FORWARD, NATIONAL ALLIANCE FOR THE EMPOWERMENT OF THE FORMERLY INCARCERATED (NAEFI), NORWEGIAN AMERICAN HOSPITAL, PRESENCE SAINT MARY AND ELIZABETH CENTER, AND QUINN COMMUNITY CENTER. ADDITIONALLY, BY LEVERAGING ITS PARTNERS AND NETWORKS, THE COLLABORATIVE COLLECTED APPROXIMATELY 5,200 RESIDENT SURVEYS BETWEEN OCTOBER 2015 AND JANUARY 2016, INCLUDING 1,200 IN THE CENTRAL REGION. THE SURVEY WAS AVAILABLE ON PAPER AND ONLINE AND WAS DISSEMINATED IN FIVE LANGUAGES - ENGLISH, SPANISH, POLISH, KOREAN, AND ARABIC.
GOTTLIEB MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6A: OTHER HOSPITALS THAT PARTICIPATED IN THE CHNA INCLUDED LOYOLA UNIVERSITY MEDICAL CENTER (LUMC), NORWEGIAN AMERICAN HOSPITAL, PRESENCE SAINT MARY AND ELIZABETH MEDICAL CENTER, RML SPECIALTY HOSPITALS, RUSH (INCLUDING RUSH UNIVERSITY MEDICAL CENTER AND RUSH OAK PARK), AND STROGER HOSPITAL OF COOK COUNTY.
GOTTLIEB MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6B: ORGANIZATIONS, OTHER THAN HOSPITAL FACILITIES, THAT PARTICIPATED IN THE CHNA INCLUDE AGE OPTIONS, AGING CARE CONNECTIONS, AMERICAN CANCER SOCIETY, CASA CENTRAL, CATHOLIC CHARITIES, CHICAGO POLICE DEPARTMENT - 14TH DISTRICT, CHICAGO PUBLIC SCHOOLS, COMMUNITYHEALTH, DIABETES EMPOWERMENT CENTER, HEALTHCARE ALTERNATIVES SYSTEMS, HOUSING FORWARD, INFANT WELFARE-OAK PARK/THE CHILDREN'S CLINIC, INTERFAITH LEADERSHIP PROJECT, LOYOLA UNIVERSITY STRITCH SCHOOL OF MEDICINE, METROPOLITAN PLANNING COUNCIL, MILE SQUARE HEALTH CENTER, PCC WELLNESS, PROVISO LEYDEN COUNCIL FOR COMMUNITY ACTION (PLCC), PROVISO TOWNSHIP MENTAL HEALTH COMMISSION, RESPIRATORY HEALTH ASSOCIATION, SAINT ANTHONY'S HOSPITAL, WEST 40 INTERMEDIATE SERVICE CENTER, WEST COOK YMCA, WEST HUMBOLDT PARK DEVELOPMENT COUNCIL, WEST SIDE HEALTH AUTHORITY, WICKER PARK BUCKTOWN CHAMBER OF COMMERCE.
GOTTLIEB MEMORIAL HOSPITAL	PART V, SECTION B, LINE 7D: IN ADDITION TO MAKING THE CHNA AVAILABLE AT THE HOSPITAL AND ON THE WEBSITE, COPIES OF THE CHNA WERE EMAILED TO ALL STEERING COMMITTEE MEMBERS.
GOTTLIEB MEMORIAL HOSPITAL	PART V, SECTION B, LINE 11: BASED ON THE DATA AND FEEDBACK GATHERED THROUGH THE CHNA PROCESS, THE HICC CAME TO A CONSENSUS ON FOUR FOCUS AREAS THAT TOUCH AND CUT ACROSS THE THREE REGIONS IN COOK COUNTY: 1) IMPROVING SOCIAL, ECONOMIC, AND STRUCTURAL DETERMINANTS OF HEALTH, WHILE REDUCING SOCIAL AND ECONOMIC INEQUITIES; 2) IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE; 3) PREVENTING AND REDUCING CHRONIC DISEASE, WITH A FOCUS ON RISK FACTORS - NUTRITION, PHYSICAL ACTIVITY AND TOBACCO; AND 4) INCREASING ACCESS TO CARE AND COMMUNITY SERVICES. THE RECOMMENDATION OF THE COLLABORATIVE IS THAT ALL PARTICIPATING HOSPITALS INCLUDE FOCUS AREA #1 AS A PRIORITY WITHIN THEIR SPECIFIC CHNA AREA. AFTER REVIEW AND CONSULTATION WITH ITS COMMUNITY PARTNERS, GMH IS COMMITTED TO WORKING TO DEVELOP STRATEGIES AND PROGRAMS THAT WILL ADDRESS FOCUS SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH, CHRONIC DISEASE PREVENTION, AND ACCESS TO CARE. THROUGH COLLABORATION WITH ITS COMMUNITY PARTNERS AS WELL AS OTHER HEALTH PROVIDERS, GMH WILL SUPPORT INITIATIVES THAT ADDRESS THE UNDERLYING ISSUES THAT CUT ACROSS THESE FOCUS AREAS. THESE INITIATIVES INCLUDE OFFERING A DEDICATED SPECIALTY CARE CLINIC FOR THE OVERWEIGHT OR OBESE CHILDREN, OFFERING A PEDIATRIC WEIGHT MANAGEMENT PROGRAM FOR DISADVANTAGED CHILDREN, AND CONDUCTING VARIOUS HEALTH SCREENINGS AND COMMUNITY COALITION OUTREACH ACTIVITIES.GMH ACKNOWLEDGES THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH IT DEEMED MOST PRESSING, UNDER-ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. GMH WILL NOT ALLOCATE SIGNIFICANT RESOURCES TO ADDRESS MENTAL AND BEHAVIORAL HEALTH ISSUES. GMH WILL CONTINUE TO WORK WITH AREA PROVIDERS AND SUPPORT INITIATIVES BY THE HICC AS APPROPRIATE TO GMH'S MISSION AND RESOURCES.
GOTTLIEB MEMORIAL HOSPITAL	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 HEALTHCARE 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.
GOTTLIEB MEMORIAL HOSPITAL	PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE.
GOTTLIEB MEMORIAL HOSPITAL - PART V, SECTION B, LINE 7A:	HTTP://WWW.GOTTLIEBHOSPITAL.ORG/GOTTLIEB-MEMORIAL-HOSPITAL-COMMUNITY-BENEFITS
GOTTLIEB MEMORIAL HOSPITAL - 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 THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.RG/ABOUT-LOYOLA/COMMUNITY-BENEFITS
GOTTLIEB MEMORIAL HOSPITAL - PART V, SECTION B, LINE 10A:	HTTPS://WWW.LOYOLAMEDICINE.ORG/ABOUT-LOYOLA/COMMUNITY-BENEFITS
GOTTLIEB MEMORIAL HOSPITAL - PART V, SECTION B, LINE 16A:	HTTPS://WWW.LOYOLAMEDICINE.ORG/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE-AND-CHARITY-CARE-POLICY
GOTTLIEB MEMORIAL HOSPITAL - PART V, SECTION B, LINE 16B:	HTTPS://WWW.LOYOLAMEDICINE.ORG/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE-AND-CHARITY-CARE-POLICY
GOTTLIEB MEMORIAL HOSPITAL - PART V, SECTION B, LINE 16C:	HTTPS://WWW.LOYOLAMEDICINE.ORG/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE-AND-CHARITY-CARE-POLICY

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - GOTTLIEB HOME HEALTH & HOSPICE
905 W NORTH AVE	MELROSE PARK	IL	60160	HOME HEALTH AND HOSPICE PROGRAM
2 - GOTTLIEB ADULT DAY CARE CENTER
555 W NORTH AVE	MELROSE PARK	IL	60160	ADULT DAY CARE CENTER

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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:	GOTTLIEB MEMORIAL HOSPITAL (GMH) PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF ILLINOIS. IN ADDITION, GMH 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.GOTTLIEB MEMORIAL HOSPITAL 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, $9,756,780, 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 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:	GMH USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR CHARITY: (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, GOTTLIEB MEMORIAL HOSPITAL IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, GMH IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL.
PART III, LINE 4:	GMH IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 15 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:	GMH 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 HEALTHCARE 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 - GMH 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.
PART VI, LINE 3:	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - GMH IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE 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, GMH 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 OBLIGATIONSGMH 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 HEALTHCARE 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.GMH 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 SPANISH AND POLISH, REFLECTING OTHER LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. GMH HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. GMH 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 - BASED IN THE WESTERN SUBURBS OF CHICAGO, GMH IS A COMMUNITY-BASED HOSPITAL LOCATED ON A 36-ACRE CAMPUS. THE HOSPITAL CAMPUS IS LOCATED IN MELROSE PARK, 14 MILES WEST OF CHICAGO'S LOOP AREA. THE HEART OF THE CAMPUS IS THE GOTTLIEB MEMORIAL HOSPITAL, A 254 LICENSED-BED FACILITY. BESIDES THE HOSPITAL, THE FOLLOWING CLINICAL SERVICES AND FACILITIES ARE LOCATED ON THE CAMPUS: LEVEL 2 TRAUMA CENTER, THE MARJORIE WEINBERG CANCER CENTER, THE WOUND CARE AND HYPERBARIC MEDICINE CENTER, SLEEP LAB AND DIAGNOSTIC CENTER, ADULT DAY CENTER, A MEDICAL OFFICE BUILDING AND THE GOTTLIEB CENTER FOR FITNESS. GMH'S CLINICAL STRENGTHS INCLUDE PRIMARY CARE, GENERAL MEDICINE, OBSTETRICS & GYNECOLOGY, CARDIOVASCULAR SERVICES, ORTHOPEDICS, NEUROSCIENCES, AND ONCOLOGY. THE CHNA SERVICE AREA IS CENTERED AROUND THE TWO CAMPUSES OF LUMC (MAYWOOD) AND GMH (MELROSE PARK) IN THE WESTERN SUBURBS OF CHICAGO. THE CHNA AREA IS COMPOSED OF A DIVERSE POPULATION OF ABOUT 540,000. HISPANICS MAKE UP THE LARGEST RACE/ETHNIC GROUPS WITH 41.1% OF THE POPULATION. WHITE NON-HISPANIC IS THE SECOND LARGEST GROUP WITH 33.7% AND AFRICAN-AMERICANS REPRESENT 21.5% OF THE CHNA POPULATION. AN INVENTORY OF HOSPITALS FOR THE CHNA SERVICE AREA INCLUDED A TOTAL OF 12 FACILITIES. GMH'S PRIMARY SERVICE AREA HAS A DIVERSE POPULATION OF OVER 388,000. OVER 14% OF THE POPULATION IS AGE 65 OR OLDER. THE AVERAGE HOUSEHOLD INCOME IS $77,861, WITH 24.4% OF HOUSEHOLDS OVER $100,000 AND 21.2% UNDER $25,000. HISPANICS ARE AMONG THE FASTEST-GROWING DEMOGRAPHIC MAKING UP 31% OF THE POPULATION.GMH SERVED 11.1% OF THE 43,895 DISCHARGED INPATIENTS FROM THIS PRIMARY SERVICE AREA IN FY16. MORE THAN 23,939 EMERGENCY DEPARTMENT VISITS WERE SEEN AT GMH WITH MORE THAN 535 TRAUMA PATIENTS TREATED. THE EMERGENCY DEPARTMENT IS A LEVEL II TRAUMA CENTER RECOGNIZED BY THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH AS AN EMERGENCY DEPARTMENT APPROVED FOR PEDIATRICS (EDAP). THROUGH GMH, PRE-HOSPITAL TRAINING IS PROVIDED IN THE EDUCATION AND TRAINING OF EMERGENCY MEDICAL TECHNICIANS (EMTS) AND PARAMEDICS IN NEIGHBORING COMMUNITIES.
PART VI, LINE 5:	OTHER INFORMATION - IN FURTHERANCE OF LUHS' TRADITION OF TEACHING, GMH SUPPORTS HOSPITAL-BASED EDUCATION AND TRAINING OF FUTURE PROFESSIONALS. GMH PROVIDED CLINICAL SUPERVISION OF PHYSICAL, SPEECH AND RESPIRATORY THERAPY STUDENTS.IN FY16, GMH PROMOTED THE HEALTH OF THE COMMUNITY THROUGH VARIOUS INITIATIVES, INCLUDING SUPPORT FOR COMMUNITY HEALTH AND SCREENING SERVICES AND A TRANSPORTATION VAN SERVICE FOR THOSE WITH NO MEANS OF TRANSPORT TO HOSPITAL DIAGNOSTIC TESTING OR ANCILLARY SERVICES. IN ADDITION, GMH PROVIDED SPACE TO A NOT-FOR-PROFIT ORGANIZATION FOR CONDUCTING A CHILDREN'S EXERCISE AND NUTRITION 8-WEEK PROGRAM, OFFERED FREE TO THE COMMUNITY AS PART OF GMH'S INITIATIVE TO ADDRESS CHILDHOOD OBESITY. GMH ALSO WORKED WITH A COMMITTEE OF AREA PROVIDERS AND AGENCIES TO HELP CONNECT SENIORS AND OTHERS WITH HEALTHCARE RESOURCES. GMH OFFERED SUPPORT GROUPS AND FREE COMMUNITY PRESENTATIONS WITH EXPERT SPEAKERS ON CARING FOR AGING FAMILY MEMBERS.ANOTHER EXAMPLE OF HOW GMH PROMOTED COMMUNITY HEALTH RELATED TO RAISING AWARENESS AND PROVIDING INFORMATION TO THE COMMUNITY FOR HEALTH-RELATED CONDITIONS: GMH AND ITS STAFF ALLERGIST JOSEPH LEIJA, MD, PROVIDED GMH'S DAILY ALLERGY COUNT (FROM APRIL THROUGH OCTOBER) FOR THE ENTIRE CHICAGOLAND. THE COUNT IS PROVIDED, AT NO COST, TO NEWS OUTLETS AND ALL CHICAGO METEOROLOGISTS. THE COUNT ALSO IS AVAILABLE ON GMH'S WEB SITE, VIA TWITTER AND BY A TELEPHONE HOTLINE EACH WEEKDAY MORNING DURING ALLERGY SEASON. IT IS A RELIED-UPON RESOURCE BY PEOPLE IN THE CHICAGO AREA WHO NEED TO DETERMINE WHETHER TO TAKE ALLERGY MEDICATION BEFORE STEPPING OUT THE DOOR IN THE MORNING.GMH CONTINUED TO ACTIVELY SUPPORT PROVISO PARTNERS FOR HEALTH (PP4H), A MULTI-SECTOR, COMMUNITY DRIVEN COALITION OF MORE THAN 25 LOCAL COMMUNITY GROUPS AND ORGANIZATIONS FOCUSED ON CREATING ENVIRONMENTS THAT PROMOTE HEALTHY LIFESTYLES. GMH LEADERS ACTIVELY PARTICIPATED ON PLANNING COMMITTEES TO IDENTIFY AND IMPLEMENT STRATEGIES TO IMPROVE CHILDHOOD NUTRITION, ACCESS TO HEALTHY FOOD, TOBACCO-FREE LIVING, AND THE BUILT ENVIRONMENT TO SUPPORT HEALTH AND WELLBEING. IN 2016, LUHS/PP4H WAS AMONG SIX COLLABORATIONS RECEIVING THE FIRST TRANSFORMING COMMUNITIES INITIATIVE GRANTS SPONSORED BY TRINITY HEALTH. AS PART OF THIS AWARD LUHS/PP4H IS ELIGIBLE TO RECEIVE UP TO $500,000 A YEAR FOR FIVE YEARS TO BE DIRECTED TOWARDS THE IMPLEMENTATION OF A SERIES OF PRE-SELECTED, PRO-HEALTH POLICY, SYSTEM, AND ENVIRONMENTAL (PSE) INTERVENTIONS. INTERVENTIONS INCLUDE: TOBACCO 21, COMPLETE STREETS, IMPLEMENTATION OF NUTRITION STANDARDS IN EARLY CHILDHOOD SETTINGS, BREASTFEEDING POLICY ENHANCEMENT, SCHOOL BOARD POLICY TO ENHANCE PHYSICAL ACTIVITY IN SCHOOLS, AND FOOD & BEVERAGE STANDARDS/COMPETITIVE FOODS POLICIES.IN FY16, GMH (AS PART OF LUHS) THROUGH ITS COMMUNITY COALITION PP4H, SUPPORTED EFFORTS ON THE STATE AND LOCAL LEVELS TO ADOPT TOBACCO 21 POLICIES. TOBACCO 21 ADVOCATES INCREASING THE LEGAL AGE TO PURCHASE TOBACCO PRODUCTS FROM 18 TO 21. LUHS JOINED THE TOBACCO 21 EFFORT IN ILLINOIS AND COORDINATED WITH COMMUNITY PARTNERS AND OTHERS FOR ADVOCACY OF STATE-WIDE LEGISLATION RESTRICTING SALE TO MINORS OF CIGARETTE PRODUCTS. OTHER STATEWIDE ORGANIZATIONS LUHS PARTNERED WITH INCLUDED THE ILLINOIS HOSPITAL ASSOCIATION, RESPIRATORY HEALTH ASSOCIATION, AMERICAN HEART ASSOCIATION, AMERICAN LUNG ASSOCIATION, AMERICAN CANCER ASSOCIATION, AND TOBACCO FREE KIDS. INITIATIVES INCLUDED A CAMPAIGN THAT ENCOURAGED LUHS EMPLOYEES AND THE PUBLIC TO WRITE THEIR REPRESENTATIVE IN SUPPORT OF THE LEGISLATION AS WELL AS MEETINGS WITH LAWMAKERS.
PART VI, LINE 6:	GMH 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 2016, GOALS INCLUDED 1) PARTNERING WITH COMMUNITY ORGANIZATIONS IN INSURANCE ENROLLMENT ACTIVITIES TARGETED AT UNINSURED INDIVIDUALS TO IMPROVE ACCESS TO HEALTHCARE, 2) PARTICIPATING IN LOCAL ADVOCACY EFFORTS AIMED AT CURBING TOBACCO USE AND PREVENTING OBESITY, AND 3) DEVELOPING A STRATEGY WITH MULTI-DISCIPLINARY TEAMS TO OPTIMIZE CARE FOR VULNERABLE PERSONS, WITH PARTICULAR FOCUS ON THOSE WHO ARE DUALLY ENROLLED IN MEDICAID AND MEDICARE. TRINITY HEALTH APPRECIATES 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 PROGRAMS FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL CHANGES THAT SPECIFICALLY IMPACT COMMUNITY IDENTIFIED AREAS OF NEED AND THAT WILL REDUCE OBESITY AND TOBACCO USE.AS A SYSTEM, TRINITY HEALTH SUPPORTED PROGRAMS AND ORGANIZATIONS WHO ADDRESS THESE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE GRANTING SEVEN DACA "DREAMERS" LOW INTEREST LOANS, ENABLING RECIPIENTS TO ATTEND MEDICAL SCHOOL AT STRITCH SCHOOL OF MEDICINE, AND PROVIDING A GRANT TO THE U.S. SOCCER FOUNDATION TO FUND ITS SOCCER FOR SUCCESS PROGRAM IN NINE COMMUNITIES, OFFERING STUDENTS IN UNDERSERVED AREAS THE OPPORTUNITY TO SAFELY AND COST-EFFECTIVELY ENGAGE IN A HEALTHY AND ACTIVE LIFESTYLE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO OUR COMMUNITIES THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND UNINSURED, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND REACHING OUT TO UNDERSERVED POPULATIONS. ANNUALLY, THE ORGANIZATION INVESTS NEARLY $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	IL

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (25 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
LARRY GOLDBERG
DIRECTOR; CEO	$0	$824,937	$0	$248,072	$0	$203,980	$0	$17,379	$0	$19,283	$0	$1,313,651	$0	$0
ROBERT FLANIGAN MD
DIRECTOR; LUMC PHYSICIAN	$0	$395,990	$0	$40,375	$0	$9,900	$0	$19,875	$0	$1,431	$0	$467,571	$0	$0
P TERRENCE O'ROURKE MD
DIR THR 12/15; CONSULTANT	$0	$153,089	$0	$156,533	$0	$175,379	$0	$11,031	$0	$31	$0	$496,063	$0	$0
DAVID WILBER MD
DIRECTOR THR 12/15; DIR CARDIO INST	$0	$596,139	$0	$58,888	$0	$13,599	$0	$15,830	$0	$2,095	$0	$686,551	$0	$0
KEITH VESELIK MD
DIRECTOR; MEDICAL DIRECTOR	$0	$374,259	$0	$30,600	$0	$3,776	$0	$10,950	$0	$20,591	$0	$440,176	$0	$0
SALLY JEFFCOAT
DIRECTOR AS OF 1/16;EVP WEST/MIDWEST	$0	$789,885	$0	$352,425	$0	$322,973	$0	$11,925	$0	$28,426	$0	$1,505,634	$0	$29,838
RONALD POTKUL MD
DIRECTOR AS OF 1/16; PHYSICIAN	$0	$699,488	$0	$68,638	$0	$9,528	$0	$19,875	$0	$1,993	$0	$799,522	$0	$0
LORI PRICE
PRESIDENT	$0	$335,340	$0	$150,662	$0	$90,049	$0	$29,608	$0	$24,489	$0	$630,148	$0	$0
AJAY SIAL
TREAS THROUGH 11/15; LUMC SVP & CFO	$0	$505,942	$0	$88,318	$0	$1,284	$0	$11,925	$0	$22,918	$0	$630,387	$0	$0
BLAINE PETERSEN
TREASURER AS OF 3/16; LUMC SVP & CFO	$0	$428,231	$0	$114,596	$0	$2,042	$0	$11,925	$0	$20,667	$0	$577,461	$0	$0
DANIEL ISACKSEN
ASST TREASURER; LUMC SVP FINANCE	$0	$315,432	$0	$30,913	$0	$345	$0	$7,950	$0	$22,434	$0	$377,074	$0	$0
JILL RAPPIS
SECRETARY; LUMC VP GEN CNSL	$0	$337,674	$0	$92,758	$0	$3,134	$0	$41,370	$0	$9,436	$0	$484,372	$0	$0
MARIA PEKAR
ASST SECRETARY; LUMC ASSOC. GEN CNSL	$0	$245,478	$0	$13,888	$0	$1,147	$0	$33,414	$0	$21,295	$0	$315,222	$0	$0
DAVID HECHT MD MS MBA
EVP, CLINICAL AFFAIRS	$0	$569,034	$0	$194,815	$0	$8,280	$0	$19,875	$0	$1,760	$0	$793,764	$0	$0
ALAN GOLDBERG
VP, ADMIN SERVICES	$171,493	$0	$8,625	$0	$1,078	$0	$19,122	$0	$26,508	$0	$226,826	$0	$0	$0
LAURA CONCANNON
CHIEF MEDICAL OFFICER	$270,583	$0	$17,756	$0	$439	$0	$11,386	$0	$18,206	$0	$318,370	$0	$0	$0
GINGER HOOK
VP CHIEF NURSE EXECUTIVE	$184,650	$0	$30,000	$0	$246	$0	$14,106	$0	$11,838	$0	$240,840	$0	$0	$0
ELIZABETH MCLAIN
CRITICAL CARE RN	$146,617	$0	$2,434	$0	$73	$0	$8,240	$0	$8,745	$0	$166,109	$0	$0	$0
SANDRA SWANSON
ADMIN DIR PERIOP/PERINATAL SVCS	$186,162	$0	$0	$0	$1,052	$0	$13,730	$0	$17,843	$0	$218,787	$0	$0	$0
EWA BOGACZ
CRITICAL CARE RN	$145,091	$0	$0	$0	$36	$0	$4,234	$0	$8,612	$0	$157,973	$0	$0	$0
DANIEL HALE
FORMER OFFICER	$0	$18,441	$0	$116,681	$0	$639,561	$0	$549,305	$0	$6,568	$0	$1,330,556	$0	$0
BENJAMIN CARTER
FORMER OFFICER; EVP, CFO	$0	$798,221	$0	$356,711	$0	$355,398	$0	$11,925	$0	$35,541	$0	$1,557,796	$0	$129,972
KEDRICK ADKINS
FORMER KEY EMPLOYEE	$0	$0	$0	$0	$0	$768,621	$0	$0	$0	$141	$0	$768,762	$0	$767,689
RICHARD O'CONNELL
FORMER KEY EMPLOYEE; EVP EAST GROUP	$0	$859,386	$0	$383,634	$0	$315,130	$0	$11,925	$0	$35,621	$0	$1,605,696	$0	$39,142
DONNA HALINSKI
FORMER OFFICER; VP CLINICAL AFFRS	$0	$273,851	$0	$26,869	$0	$1,375	$0	$19,875	$0	$22,146	$0	$344,116	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART I, LINE 3

GOTTLIEB MEMORIAL HOSPITAL IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. GOTTLIEB MEMORIAL HOSPITAL'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 OF GOTTLIEB MEMORIAL HOSPITAL'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, LINES 4A-B

THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2015. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KEDRICK ADKINS - $532,835 DANIEL HALE - $504,808 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES THE FOLLOWING SEVERANCE AMOUNT, WHICH WAS UNPAID AS OF 12/31/15: DANIEL HALE - $545,199 ($525,006 PAID IN 2016 AND $20,193 TO BE PAID IN 2017) THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2015. 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 2015, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2015. THE FOLLOWING PAYOUTS FOR 2015 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KEDRICK ADKINS - $235,854 BENJAMIN CARTER - $194,694 LARRY GOLDBERG - $185,868 DANIEL HALE - $129,855 SALLY JEFFCOAT - $158,659 RICHARD O'CONNELL - $207,673 TERRENCE O'ROURKE, MD - $168,151 LORI PRICE - $75,233 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. 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 2015). THE FOLLOWING PAYOUTS FOR 2015 FOR THIS PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: BENJAMIN CARTER - $135,796 SALLY JEFFCOAT - $29,838 RICHARD O'CONNELL - $39,142 COLUMN (F) OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2	HENRY LANG, DIRECTOR, AND JACK WEINBERG, DIRECTOR, HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF GOTTLIEB MEMORIAL HOSPITAL (GMH) IS LOYOLA UNIVERSITY HEALTH SYSTEM. SEE LINE 7 FOR ADDITIONAL INFORMATION.
FORM 990, PART VI, SECTION A, LINE 7A	LOYOLA UNIVERSITY HEALTH SYSTEM IS THE SOLE MEMBER OF GMH. LOYOLA UNIVERSITY HEALTH SYSTEM HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF GMH.
FORM 990, PART VI, SECTION A, LINE 7B	AS SOLE MEMBER, LOYOLA UNIVERSITY HEALTH SYSTEM MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. LOYOLA UNIVERSITY 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 11	PRIOR TO FILING, THE FORM 990 FOR GMH IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD OF DIRECTORS. 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	GMH 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 GMH, 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 GMH 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 GMH (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO GMH OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF GMH (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 GMH. 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 GMH IS ESTABLISHED AND PAID BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING 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 CEO AND CFO OF GMH 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 HEALTHCARE 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	GMH 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, GMH INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. GMH'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:	CHANGE IN DEFERRED RETIREMENT COSTS -13,590,689. EQUITY TRANSFERS FROM AFFILIATES 98,609.
FORM 990, PART XII, LINE 2	GMH'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY16 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (240 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Direct Controlling NADirectControllingNACd
ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP
245 STATE ST SE	GRAND RAPIDS	MI	49503	272491974	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 9	TRINITY HEALTH-MICHIGAN	Yes (1)
ALBANY MEMORIAL HOSPITAL
600 NORTHERN BLVD	ALBANY	NY	12204	141338457	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes (1)
ALLEGANY FRANCISCAN MINISTRIES INC
33920 US HIGHWAY 19 NORTH SUITE 269	PALM HARBOR	FL	34684	581492325	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	FL	501(C)(3)	LINE 11A, I	TRINITY HEALTH CORPORATION	Yes (1)
AMICARE HOSPICE SERVICES INC
20555 VICTOR PARKWAY	LIVONIA	MI	48152	382949053	HOSPICE SERVICES	MI	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES	Yes (1)
ASYLUM HILL FAMILY MEDICINE CENTER INC
114 WOODLAND STREET	HARTFORD	CT	06105	061450170	HEALTHCARE SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH - NEW ENGLAND INC	Yes (1)
BAUM HARMON MERCY HOSPITAL
255 NORTH WELCH AVENUE	PRIMGHAR	IA	51245	421500277	HEALTHCARE AND HOSPITAL SERVICES	IA	501(C)(3)	LINE 3	MERCY HEALTH SERVICES-IOWA CORP	Yes (1)
BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION
255 NORTH WELCH AVENUE	PRIMGHAR	IA	51245	262973307	FOUNDATION	IA	501(C)(3)	LINE 11A, I	BAUM HARMON MERCY HOSPITAL	Yes (1)
BEECHWOOD INC
2212 BURDETT AVE	TROY	NY	12180	141651563	TITLE HOLDING COMPANY	NY	501(C)(2)	N/A	LTC (EDDY) INC	Yes (1)
BEVERWYCK INC
40 AUTUMN DRIVE	SLINGERLANDS	NY	12159	141717028	SENIOR LIVING COMMUNITY	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes (1)
BRIGHTSIDE INC
C/O SPHS 1221 MAIN STREET SUITE 213	HOLYOKE	MA	01040	042182395	HEALTHCARE SERVICES	MA	501(C)(3)	LINE 9	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes (1)
CAPITAL REGION GERIATRIC CENTER INC
421 WEST COLUMBIA ST	COHOES	NY	12047	141701597	LONG TERM CARE	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes (1)
CATHERINE MCAULEY HEALTH SERVICES CORP
PO BOX 995	ANN ARBOR	MI	48106	382507173	HEALTHCARE SERVICES (INACTIVE)	MI	501(C)(3)	LINE 3	TRINITY HEALTH-MICHIGAN	Yes (1)
CATHOLIC HEALTH MINISTRIES
20555 VICTOR PARKWAY	LIVONIA	MI	48152		GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM		501(C)(3)	LINE 1		0	VT	N/A
COLUMBUS ACQUISITION CORP
111 CENTRAL AVENUE	NEWARK	NJ	07102	262616342	INACTIVE ENTITY	NJ	501(C)(3)	LINE 9	SAINT MICHAEL'S MEDICAL CENTER	Yes (1)
COMMUNITY HEALTH PARTNERS OF SOUTH BEND
PO BOX 3998	SOUTH BEND	IN	46619	263051440	HEALTHCARE SERVICES	IN	501(C)(3)	LINE 3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	Yes (1)
CRANBROOK HOSPICE CARE
1111 W LONG LAKE RD STE 102	TROY	MI	48098	383320699	HOSPICE SERVICES	MI	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES	Yes (1)
DILEY RIDGE MEDICAL CENTER
6150 EAST BROAD STREET	COLUMBUS	OH	43213	342032340	HEALTHCARE AND HOSPITAL SERVICES	OH	501(C)(3)	LINE 3	MOUNT CARMEL HEALTH SYSTEM	Yes (1)
DUBUQUE MERCY HEALTH FOUNDATION INC
250 MERCY DRIVE	DUBUQUE	IA	52001	262227941	FOUNDATION	IA	501(C)(3)	LINE 11A, I	MERCY HEALTH SERVICES-IOWA CORP	Yes (1)
DYERSVILLE HEALTH FOUNDATION INC
1111 3RD STREET SW	DYERSVILLE	IA	52040	205383271	FOUNDATION	IA	501(C)(3)	LINE 11A, I	MERCY HEALTH SERVICES-IOWA CORP	Yes (1)
EAST NORRITON PHYSICIANS SERVICES
ONE WEST ELM STREET SUITE 100	CONSHOHOCKEN	PA	19428	232515999	HEALTHCARE SERVICES	PA	501(C)(3)	LINE 3	MERCY PHYSICIAN NETWORK	Yes (1)
EDDY LICENSED HOME CARE AGENCY INC
433 RIVER ST SUITE 3000	TROY	NY	12180	141818568	HOME HEALTH SERVICES	NY	501(C)(3)	LINE 3	LTC (EDDY) INC	Yes (1)
EMBRACING AGE INC
333 BUTTERNUT DRIVE SUITE 100	DEWITT	NY	13214	461051881	PACE PROGRAM	NY	501(C)(3)	LINE 9	ST JOSEPH'S HEALTH INC	Yes (1)
EMPIRE HOME INFUSION SERVICE INC
10 BLACKSMITH DRIVE	MALTA	NY	12020	141795732	HOME HEALTH SERVICES	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes (1)
FARREN CARE CENTER INC
C/O SPHS 1221 MAIN STREET SUITE 213	HOLYOKE	MA	01040	042501711	LONG TERM CARE	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes (1)
FRANCISCAN ELDERCARE CORPORATION
PO BOX 2500	WILMINGTON	DE	19805	223008680	LONG TERM CARE (INACTIVE)	DE	501(C)(3)	LINE 9	ST FRANCIS HOSPITAL	Yes (1)
GLEN EDDY INC
ONE GLEN EDDY DRIVE	NISKAYUNA	NY	12309	141794150	SENIOR LIVING COMMUNITY	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes (1)
GLOBAL HEALTH MINISTRY
20555 VICTOR PARKWAY	LIVONIA	MI	48152	421253527	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH CORPORATION	Yes (1)
GOOD SAMARITAN HOSPITAL INC
5401 LAKE OCONEE PARKWAY	GREENSBORO	GA	30642	261720984	HEALTHCARE AND HOSPITAL SERVICES	GA	501(C)(3)	LINE 3	ST MARY'S HEALTH CARE SYSTEM INC	Yes (1)
GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION
701 W NORTH AVE	MELROSE PARK	IL	60160	363332852	COMMUNITY OUTREACH	IL	501(C)(3)	LINE 9	GOTTLIEB MEMORIAL HOSPITAL	Yes (1)
GOTTLIEB MEMORIAL FOUNDATION
701 W NORTH AVE	MELROSE PARK	IL	60160	743260011	FOUNDATION	IL	501(C)(3)	LINE 11C, III-FI		0		N/A
GOTTLIEB MEMORIAL HOSPITAL
701 W NORTH AVE	MELROSE PARK	IL	60160	362379649	HEALTHCARE AND HOSPITAL SERVICES	IL	501(C)(3)	LINE 3	LOYOLA UNIVERSITY HEALTH SYSTEM	0
GRAND RAPIDS MEDICAL EDUCATION PARTNERS INC
945 OTTAWA AVE NW	GRAND RAPIDS	MI	49503	237270669	MEDICAL EDUCATION TRAINING PROGRAMS	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN	Yes (1)
HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST
PO BOX 3302	MUSKEGON	MI	49443	382299878	SELF INSURANCE	MI	501(C)(3)	LINE 11B, II	MERCY HEALTH PARTNERS	Yes (1)
HACKLEY LIFE COUNSELING
125 E SOUTHERN AVENUE	MUSKEGON	MI	49442	381386362	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 9	MERCY HEALTH PARTNERS	Yes (1)
HAWTHORNE RIDGE INC
30 COMMUNITY WAY	EAST GREENBUSH	NY	12061	800102840	SENIOR LIVING COMMUNITY	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes (1)
HERITAGE HOUSE NURSING CENTER INC
2920 TIBBITS AVE	TROY	NY	12180	141725101	LONG TERM CARE	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes (1)
HOLY CROSS CARENET INC
PO BOX 9184	FARMINGTON HILLS	MI	48152	521945054	LONG TERM CARE	MD	501(C)(3)	LINE 9	HOLY CROSS HEALTH INC	Yes (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	Yes (1)
HOLY CROSS HEALTH INC
1500 FOREST GLEN RD	SILVER SPRING	MD	20910	520738041	HEALTHCARE AND HOSPITAL SERVICES	MD	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes (1)
HOLY CROSS HOSPITAL INC
4725 NORTH FEDERAL HIGHWAY	FT LAUDERDALE	FL	33308	590791028	HEALTHCARE AND HOSPITAL SERVICES	FL	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes (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	Yes (1)
HOLY CROSS OUTPATIENT SERVICES INC
4725 NORTH FEDERAL HIGHWAY	FT LAUDERDALE	FL	33308	465421068	HEALTHCARE SERVICES	FL	501(C)(3)	LINE 9	HOLY CROSS HOSPITAL INC	Yes (1)
HOLY CROSS PRIMARY CARE INC
4725 NORTH FEDERAL HIGHWAY	FT LAUDERDALE	FL	33308	812531495	HEALTHCARE SERVICES	FL	501(C)(3)	LINE 9	HOLY CROSS HOSPITAL INC	Yes (1)
HOME & COMMUNITY HEALTH SERVICES INC
201 CHESTNUT HILL ROAD	STAFFORD SPRINGS	CT	06076	810723591	HOME HEALTH SERVICES	CT	501(C)(3)	LINE 9	TRINITY HEALTH - NEW ENGLAND INC	Yes (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 9	LTC (EDDY) INC	Yes (1)
HOSPICE OF NORTH IOWA
232 SECOND STREET SE	MASON CITY	IA	50401	421173708	HOSPICE SERVICES	IA	501(C)(3)	LINE 9	MERCY HEALTH SERVICES-IOWA CORP	Yes (1)
HOSPICE OF SIOUXLAND
4300 HAMILTON BLVD	SIOUX CITY	IA	51104	383320710	HOSPICE SERVICES	IA	501(C)(3)	LINE 11A, I		0		N/A
HOSPICE OF WASHTENAW II
806 AIRPORT BLVD	ANN ARBOR	MI	48108	383320707	HOSPICE SERVICES (INACTIVE)	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN	Yes (1)
IHA HEALTH SERVICES CORPORATION
24 FRANK LLOYD WRIGHT DR LOBBY J	ANN ARBOR	MI	48106	383316559	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 9	TRINITY HEALTH-MICHIGAN	Yes (1)
JOHNSON HEALTH CARE INC
201 CHESTNUT HILL ROAD	STAFFORD SPRINGS	CT	06076	810709903	HEALTHCARE SERVICES	CT	501(C)(3)	LINE 9	TRINITY HEALTH - NEW ENGLAND INC	Yes (1)
JOHNSON MEMORIAL HOSPITAL INC
201 CHESTNUT HILL ROAD	STAFFORD SPRINGS	CT	06076	475676956	HEALTHCARE AND HOSPITAL SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH - NEW ENGLAND INC	Yes (1)
JOHNSON MEMORIAL MEDICAL CENTER INC
201 CHESTNUT HILL ROAD	STAFFORD SPRINGS	CT	06076	810696923	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	CT	501(C)(3)	LINE 11B, II	TRINITY HEALTH - NEW ENGLAND INC	Yes (1)
LANGHORNE MRI INC
1201 LANGHORNE-NEWTOWN ROAD	LANGHORNE	PA	19047	232519529	HEALTHCARE SERVICES (INACTIVE)	PA	501(C)(3)	LINE 9	ST MARY MEDICAL CENTER	Yes (1)
LANGHORNE PHYSICIAN SERVICES INC
1201 LANGHORNE-NEWTOWN ROAD	LANGHORNE	PA	19047	232571699	HEALTHCARE SERVICES	PA	501(C)(3)	LINE 9	ST MARY MEDICAL CENTER	Yes (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	Yes (1)
LIFE AT ST FRANCIS HEALTHCARE INC
7TH CLAYTON STREETS	WILMINGTON	DE	19805	452569214	PACE PROGRAM	DE	501(C)(3)	LINE 9	ST FRANCIS HOSPITAL	Yes (1)
LIFE ST FRANCIS CORPORATION
1435 LIBERTY STREET	HAMILTON	NJ	08629	222797282	PACE PROGRAM	NJ	501(C)(3)	LINE 9	ST FRANCIS MEDICAL CENTER TRENTON NJ	Yes (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	Yes (1)
LIFE ST MARY
1201 LANGHORNE-NEWTOWN ROAD	LANGHORNE	PA	19047	262976184	PACE PROGRAM	PA	501(C)(3)	LINE 9	ST MARY MEDICAL CENTER	Yes (1)
LOURDES ANCILLARY SERVICES
1600 HADDON AVENUE	CAMDEN	NJ	08103	222568525	VOLUNTEER SERVICE AUXILIARY	NJ	501(C)(3)	LINE 11B, II	OUR LADY OF LOURDES HEALTH CARE SERVICES	Yes (1)
LOURDES CARDIOLOGY SERVICES PC
1600 HADDON AVENUE	CAMDEN	NJ	08103	274357794	HEALTHCARE SERVICES	NJ	501(C)(3)	LINE 3	OUR LADY OF LOURDES HEALTH CARE SERVICES	Yes (1)
LOURDES MEDICAL CENTER OF BURLINGTON COUNTY
218 SUNSET ROAD	WILLINGBORO	NJ	08046	223612265	HEALTHCARE AND HOSPITAL SERVICES	NJ	501(C)(3)	LINE 3	OUR LADY OF LOURDES HEALTH CARE SERVICES	Yes (1)
LOYOLA MEDICINE TRANSPORT LLC
905 W NORTH AVE	MELROSE PARK	IL	60160	474147171	TRANSPORATION SERVICES	IL	501(C)(3)	LINE 9	LOYOLA UNIVERSITY MEDICAL CENTER	Yes (1)
LOYOLA UNIVERSITY HEALTH SYSTEM
2160 SOUTH FIRST AVENUE	MAYWOOD	IL	60153	363342448	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IL	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes (1)
LOYOLA UNIVERSITY MEDICAL CENTER
2160 SOUTH FIRST AVENUE	MAYWOOD	IL	60153	364015560	HEALTHCARE AND HOSPITAL SERVICES	IL	501(C)(3)	LINE 3	LOYOLA UNIVERSITY HEALTH SYSTEM	Yes (1)
LTC (EDDY) INC
2212 BURDETT AVE	TROY	NY	12180	222564710	MANAGEMENT SERVICES FOR LONG TERM CARE	NY	501(C)(3)	LINE 11B, II	ST PETER'S HEALTH PARTNERS	Yes (1)
MARIAN COMMUNITY HOSPITAL
3805 WEST CHESTER PIKE STE 100	NEWTOWN SQUARE	PA	19073	240711230	HEALTHCARE SERVICES (INACTIVE)	PA	501(C)(3)	LINE 9	MAXIS HEALTH SYSTEM	Yes (1)
MARIAN HOME HEALTHCARE
801 5TH STREET	SIOUX CITY	IA	51101	383320705	HOME HEALTH SERVICES (INACTIVE)	IA	501(C)(3)	LINE 11A, I	MERCY HEALTH SERVICES-IOWA CORP	Yes (1)
MARYCREST HEIGHTS
PO BOX 9184	FARMINGTON HILLS	MI	48333	270291722	SENIOR LIVING COMMUNITY	MI	501(C)(3)	LINE 9	TRINITY CONTINUING CARE SERVICES	Yes (1)
MAXIS HEALTH SYSTEM
3805 WEST CHESTER PIKE STE 100	NEWTOWN SQUARE	PA	19073	911940902	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT (INACTIVE)	PA	501(C)(3)	LINE 11A, I	TRINITY HEALTH CORPORATION	Yes (1)
MCAULEY CENTER INC
275 STEELE ROAD	WEST HARTFORD	CT	06117	061058086	SENIOR LIVING COMMUNITY	CT	501(C)(3)	LINE 9	MERCY COMMUNITY HEALTH INC	Yes (1)
MCAULEY CLINIC CORPORATION
PO BOX 992	ANN ARBOR	MI	48106	382561013	HEALTHCARE SERVICES (INACTIVE)	MI	501(C)(3)	LINE 3	CATHERINE MCAULEY HEALTH SERVICES CORP	Yes (1)
MCAULEY MINISTRIES
3333 FIFTH AVENUE	PITTSBURGH	PA	15213	943436142	GRANT MAKING	PA	501(C)(3)	LINE 11B, II	PITTSBURGH MERCY HEALTH SYSTEM	Yes (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 9	TRINITY HOME HEALTH SERVICES	Yes (1)
MERCY AMICARE HOME HEALTHCARE PORT HURON
17410 COLLEGE PARKWAY STE 150	LIVONIA	MI	48152	383320701	HOME HEALTH SERVICES	MI	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES	Yes (1)
MERCY CARE FOUNDATION
424 DECATUR STREET	ATLANTA	GA	30312	581448522	FOUNDATION	GA	501(C)(3)	LINE 7	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes (1)
MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PENNSYLVANIA
ONE WEST ELM STREET SUITE 100	CONSHOHOCKEN	PA	19428	231352191	HEALTHCARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes (1)
MERCY COMMUNITY HEALTH INC
2021 ALBANY AVENUE	WEST HARTFORD	CT	06117	061492707	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	CT	501(C)(3)	LINE 11B, II	TRINITY CONTINUING CARE SERVICES	Yes (1)
MERCY FAMILY SUPPORT
1001 BALTIMORE PIKE SUITE 310	SPRINGFIELD	PA	19064	232325059	HOME HEALTH SERVICES	PA	501(C)(3)	LINE 9	MERCY HOME HEALTH SERVICES	Yes (1)
MERCY FOUNDATION INC
2525 SOUTH MICHIGAN AVENUE	CHICAGO	IL	60616	363227350	FOUNDATION	IL	501(C)(3)	LINE 7	MERCY HEALTH SYSTEM OF CHICAGO	Yes (1)
MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE
888 TERRACE STREET	MUSKEGON	MI	49440	383321856	HOSPICE & HOME HEALTH SERVICES	MI	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES	Yes (1)
MERCY HEALTH FOUNDATION OF SOUTHEASTERN PENNSYLVANIA
ONE WEST ELM STREET SUITE 100	CONSHOHOCKEN	PA	19428	232829864	FOUNDATION	PA	501(C)(3)	LINE 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes (1)
MERCY HEALTH NETWORK INC
1111 6TH AVENUE	DES MOINES	IA	50314	421478417	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	DE	501(C)(3)	LINE 11B, II		0		N/A
MERCY HEALTH PARTNERS
1500 E SHERMAN BLVD	MUSKEGON	MI	49444	382589966	HEALTHCARE AND HOSPITAL SERVICES	MI	501(C)(3)	LINE 3	TRINITY HEALTH-MICHIGAN	Yes (1)
MERCY HEALTH PLAN
ONE WEST ELM STREET SUITE 100	CONSHOHOCKEN	PA	19428	222483605	MEDICAID MANAGED CARE PLAN	PA	501(C)(3)	LINE 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes (1)
MERCY HEALTH SERVICES - IOWA CORP
1000 4TH STREET SW	MASON CITY	IA	50401	311373080	HEALTHCARE AND HOSPITAL SERVICES	DE	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes (1)
MERCY HEALTH SYSTEM OF CHICAGO
2525 SOUTH MICHIGAN AVENUE	CHICAGO	IL	60616	363163327	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IL	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes (1)
MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA
ONE WEST ELM STREET SUITE 100	CONSHOHOCKEN	PA	19428	232212638	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	PA	501(C)(3)	LINE 11C, III-FI	TRINITY HEALTH CORPORATION	Yes (1)
MERCY HEALTHCARE CENTER
114 WAWBEEK AVENUE	TUPPER LAKE	NY	12986	150532211	HEALTHCARE AND HOSPITAL SERVICES (INACTIVE)	NY	501(C)(3)	LINE 3	MERCY UIHLEIN HEALTH CORPORATION	Yes (1)
MERCY HEALTHCARE FOUNDATION-CLINTON
1410 N 4TH ST	CLINTON	IA	52732	421316126	FOUNDATION	IA	501(C)(3)	LINE 7		0		N/A
MERCY HOME HEALTH
1001 BALTIMORE PIKE SUITE 310	SPRINGFIELD	PA	19064	231352099	HOME HEALTH SERVICES	PA	501(C)(3)	LINE 9	MERCY HOME HEALTH SERVICES	Yes (1)
MERCY HOME HEALTH SERVICES
1001 BALTIMORE PIKE SUITE 310	SPRINGFIELD	PA	19064	232325058	MANAGEMENT SERVICES FOR HOME HEALTH	PA	501(C)(3)	LINE 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes (1)
MERCY HOSPITAL AND MEDICAL CENTER
2525 SOUTH MICHIGAN AVENUE	CHICAGO	IL	60616	362170152	HEALTHCARE AND HOSPITAL SERVICES	IL	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF CHICAGO	Yes (1)
MERCY HOSPITAL CADILLAC FOUNDATION
1820 44TH ST SE	KENTWOOD	MI	49508	203357131	FOUNDATION	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN	Yes (1)
MERCY HOSPITAL GIFT SHOP
2601 ELECTRIC AVE	PORT HURON	MI	48060	381630480	VOLUNTEER SERVICE AUXILIARY	MI	501(C)(3)	LINE 9	TRINITY HEALTH-MICHIGAN	Yes (1)
MERCY HOSPITAL INC
C/O SPHS 1221 MAIN STREET SUITE 213	HOLYOKE	MA	01040	043398280	HEALTHCARE AND HOSPITAL SERVICES	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes (1)
MERCY HOSPITAL INC
4725 NORTH FEDERAL HIGHWAY	FT LAUDERDALE	FL	33308	590791034	HEALTHCARE SERVICES (INACTIVE)	FL	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes (1)
MERCY LIFE CENTER CORPORATION
1200 REEDSDALE STREET	PITTSBURGH	PA	15233	251604115	COMMUNITY OUTREACH	PA	501(C)(3)	LINE 9	PITTSBURGH MERCY HEALTH SYSTEM	Yes (1)
MERCY LIFE OF ALABAMA
PO BOX 7957	MOBILE	AL	36670	273163002	PACE PROGRAM	AL	501(C)(3)	LINE 3	TRINITY HEALTH PACE	Yes (1)
MERCY LIFE INC
C/O SPHS 1221 MAIN STREET SUITE 213	HOLYOKE	MA	01040	453086711	PACE PROGRAM	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE CARE CENTERS INC	Yes (1)
MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
ONE WEST ELM STREET SUITE 100	CONSHOHOCKEN	PA	19428	232627944	HEALTHCARE SERVICES	PA	501(C)(3)	LINE 3	MERCY PHYSICIAN NETWORK	Yes (1)
MERCY MEDICAL CENTER - CLINTON INC
1410 NORTH 4TH ST	CLINTON	IA	52732	421336618	HEALTHCARE AND HOSPITAL SERVICES	DE	501(C)(3)	LINE 3	MERCY HEALTH SERVICES-IOWA CORP	Yes (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	Yes (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	Yes (1)
MERCY MEDICAL CORPORATION
PO BOX 7957	MOBILE	AL	36670	636002215	HOSPICE & HOME HEALTH SERVICES	AL	501(C)(3)	LINE 9	TRINITY HEALTH CORPORATION	Yes (1)
MERCY MEDICAL GROUP
C/O SPHS 1221 MAIN STREET SUITE 213	HOLYOKE	MA	01040	454884805	HEALTHCARE SERVICES	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes (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 11B, II	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes (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	Yes (1)
MERCY SERVICES DOWNTOWN INC
424 DECATUR STREET	ATLANTA	GA	30312	272046353	TITLE HOLDING COMPANY	GA	501(C)(3)	LINE 11B, II	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes (1)
MERCY SERVICES FOR AGING NON-PROFIT HOUSING CORPORATION
PO BOX 9184	FARMINGTON HILLS	MI	48333	382719605	LONG TERM CARE	MI	501(C)(3)	LINE 9	TRINITY CONTINUING CARE SERVICES	Yes (1)
MERCY SPECIALIST PHYSICIANS INC
C/O SPHS 1221 MAIN STREET SUITE 213	HOLYOKE	MA	01040	264033168	HEALTHCARE SERVICES	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes (1)
MERCY SUBURBAN HOSPITAL
ONE WEST ELM STREET SUITE 100	CONSHOHOCKEN	PA	19428	231396763	HEALTHCARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes (1)
MERCY UIHLEIN HEALTH CORPORATION
3805 WEST CHESTER PIKE SUITE 100	NEWTOWN SQUARE	NY	19073	161535133	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT (INACTIVE)	NY	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes (1)
MISSION HEALTH CORPORATION
37595 SEVEN MILE ROAD	LIVONIA	MI	48152	383181557	BUILDING MANAGEMENT SERVICES	DE	501(C)(3)	LINE 11A, I		0		N/A
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	Yes (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	Yes (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	Yes (1)
MOUNT CARMEL HEALTH SYSTEM
6150 EAST BROAD STREET	COLUMBUS	OH	43213	311439334	HEALTHCARE AND HOSPITAL SERVICES	OH	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes (1)
MOUNT CARMEL HEALTH SYSTEM FOUNDATION
6150 EAST BROAD STREET	COLUMBUS	OH	43213	311113966	FOUNDATION	OH	501(C)(3)	LINE 11A, I	MOUNT CARMEL HEALTH SYSTEM	Yes (1)
MOUNT CARMEL HOME CARE LLC
501 WEST SCHROCK ROAD	WESTERVILLE	OH	43081	262729300	HOME HEALTH SERVICES	OH	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES	Yes (1)
MOUNT SINAI HOSPITAL FOUNDATION INC
500 BLUE HILLS AVENUE	HARTFORD	CT	06112	222584082	FOUNDATION	CT	501(C)(3)	LINE 11C, III-FI		0		N/A
MOUNT SINAI REHABILITATION HOSPITAL INC
114 WOODLAND STREET	HARTFORD	CT	06105	061422973	HEALTHCARE AND HOSPITAL SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH - NEW ENGLAND INC	Yes (1)
MRI MOBILE SERVICES OF WEST MICHIGAN
1820 44TH STREET	KENTWOOD	MI	49508	383073745	HEALTHCARE SERVICES (INACTIVE)	MI	501(C)(3)	LINE 9	TRINITY HEALTH-MICHIGAN	Yes (1)
MUSKEGON COMMUNITY HEALTH PROJECT
565 W WESTERN AVENUE	MUSKEGON	MI	49440	911932918	COMMUNITY OUTREACH	MI	501(C)(3)	LINE 7	MERCY HEALTH PARTNERS	Yes (1)
NAZARETH HEALTH CARE FOUNDATION
2701 HOLME AVENUE	PHILADELPHIA	PA	19152	232300951	FOUNDATION	PA	501(C)(3)	LINE 11A, I	NAZARETH HOSPITAL	Yes (1)
NAZARETH HOSPITAL
2601 HOLME AVENUE	PHILADELPHIA	PA	19152	232794121	HEALTHCARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes (1)
NAZARETH PHYSICIAN SERVICES INC
ONE WEST ELM STREET SUITE 100	CONSHOHOCKEN	PA	19428	203261266	HEALTHCARE SERVICES	PA	501(C)(3)	LINE 3	MERCY PHYSICIAN NETWORK	Yes (1)
NE PHYSICIAN SERVICES INC
ONE WEST ELM STREET SUITE 100	CONSHOHOCKEN	PA	19428	232497355	HEALTHCARE SERVICES (INACTIVE)	PA	501(C)(3)	LINE 3	MERCY PHYSICIAN NETWORK	Yes (1)
NORTHEAST HEALTH INC
2212 BURDETT AVE	TROY	NY	12180	042450756	HEALTHCARE SYSTEM SUPPORT	NY	501(C)(3)	LINE 11B, II	ST PETER'S HEALTH PARTNERS	Yes (1)
OAKLAND MERCY HOSPITAL
601 EAST 2ND STREET	OAKLAND	NE	68045	208072234	HEALTHCARE AND HOSPITAL SERVICES	NE	501(C)(3)	LINE 3	MERCY HEALTH SERVICES-IOWA CORP	Yes (1)
OAKLAND MERCY HOSPITAL FOUNDATION
601 E 2ND STREET	OAKLAND	NE	68045	311678345	FOUNDATION	NE	501(C)(3)	LINE 11C, III-FI		0		N/A
ONE THOUSAND CORPORATION
1000 ASYLUM AVENUE	HARTFORD	CT	06105	060922325	BUILDING MANAGEMENT SERVICES	CT	501(C)(2)	N/A	SAINT FRANCIS HOSPITAL AND MEDICAL CENTER	Yes (1)
OSUMOUNT CARMEL HEALTH ALLIANCE
6150 EAST BROAD STREET	COLUMBUS	OH	43213	311654603	COOPERATIVE HEALTHCARE DELIVERY SYSTEM	OH	501(C)(3)	LINE 11A, I		0		N/A
OUR LADY OF LOURDES HEALTH CARE SERVICES
1600 HADDON AVENUE	CAMDEN	NJ	08103	222568528	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	NJ	501(C)(3)	LINE 11B, II	MAXIS HEALTH SYSTEM	Yes (1)
OUR LADY OF LOURDES HEALTH FOUNDATION INC
1600 HADDON AVENUE	CAMDEN	NJ	08103	222351960	FOUNDATION	NJ	501(C)(3)	LINE 7	OUR LADY OF LOURDES HEALTH CARE SERVICES	Yes (1)
OUR LADY OF LOURDES MEDICAL CENTER
1600 HADDON AVENUE	CAMDEN	NJ	08103	210635001	HEALTHCARE AND HOSPITAL SERVICES	NJ	501(C)(3)	LINE 3	OUR LADY OF LOURDES HEALTH CARE SERVICES	Yes (1)
OUR LADY OF MERCY LIFE CENTER
2 MERCYCARE LANE	GUILDERLAND	NY	12084	141743506	LONG TERM CARE	NY	501(C)(3)	LINE 3	ST PETER'S HOSPITAL	Yes (1)
PIONEER VALLEY CARDIOLOGY ASSOCIATES INC
C/O SPHS 1221 MAIN STREET SUITE 213	HOLYOKE	MA	01040	454208896	HEALTHCARE SERVICES	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes (1)
PITTSBURGH MERCY HEALTH SYSTEM
3333 5TH AVENUE	PITTSBURGH	PA	15213	251464211	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	PA	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes (1)
PORT HURON MERCY FAMILY CARE INC
2601 ELECTRIC AVE	PORT HURON	MI	48060	201855647	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN	Yes (1)
PROBILITY THERAPY SERVICES
2058 S STATE STREET	ANN ARBOR	MI	48104	202020239	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 9	TRINITY HEALTH-MICHIGAN	Yes (1)
PROFESSIONAL MED TEAM
965 FORK STREET	MUSKEGON	MI	49442	382638284	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 9	MERCY HEALTH PARTNERS	Yes (1)
SAINT AGNES MEDICAL CENTER
1303 EAST HERNDON AVE	FRESNO	CA	93720	941437713	HEALTHCARE AND HOSPITAL SERVICES	CA	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes (1)
SAINT AGNES MEDICAL FOUNDATION (FKA PROFESSIONAL OFFICE CORPORATION)
1303 EAST HERNDON AVE	FRESNO	CA	93720	942839324	HEALTHCARE SERVICES	CA	501(C)(3)	LINE 11A, I	SAINT AGNES MEDICAL CENTER	Yes (1)
SAINT ALPHONSUS BUILDING COMPANY INC
1055 NORTH CURTIS RD	BOISE	ID	83706	820401011	BUILDING MANAGEMENT SERVICES	ID	501(C)(3)	LINE 9	SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC	Yes (1)
SAINT ALPHONSUS DIVERSIFIED CARE INC
1055 NORTH CURTIS RD	BOISE	ID	83706	943028978	HEALTHCARE SYSTEM SUPPORT	ID	501(C)(3)	LINE 11A, I	SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC	Yes (1)
SAINT ALPHONSUS FOUNDATION-BAKER CITY INC
3325 POCAHONTAS ROAD	BAKER CITY	OR	97814	943164869	FOUNDATION	OR	501(C)(3)	LINE 7	SAINT ALPHONSUS MEDICAL CENTER - BAKER CITY	Yes (1)
SAINT ALPHONSUS FOUNDATION-ONTARIO INC
351 SW 9TH STREET	ONTARIO	OR	97914	202683560	FOUNDATION	OR	501(C)(3)	LINE 7	SAINT ALPHONSUS MEDICAL CENTER-ONTARIO	Yes (1)
SAINT ALPHONSUS HEALTH SYSTEM INC
1055 N CURTIS ROAD	BOISE	ID	83706	271929502	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	ID	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes (1)
SAINT ALPHONSUS MEDICAL CENTER ONTARIO VOLUNTEERS
351 SW 9TH STREET	ONTARIO	OR	97914	943059469	VOLUNTEER SERVICE AUXILIARY	OR	501(C)(3)	LINE 9	SAINT ALPHONSUS MEDICAL CENTER-ONTARIO	Yes (1)
SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY INC
3325 POCAHONTAS ROAD	BAKER CITY	OR	97814	271790052	HEALTHCARE AND HOSPITAL SERVICES	OR	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC	Yes (1)
SAINT ALPHONSUS MEDICAL CENTER-NAMPA HEALTH FOUNDATION INC
1512 12TH AVENUE ROAD	NAMPA	ID	83686	261737256	FOUNDATION	ID	501(C)(3)	LINE 7	SAINT ALPHONSUS MEDICAL CENTER-NAMPA	Yes (1)
SAINT ALPHONSUS MEDICAL CENTER-NAMPA INC
1512 12TH AVENUE ROAD	NAMPA	ID	83686	820200896	HEALTHCARE AND HOSPITAL SERVICES	ID	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC	Yes (1)
SAINT ALPHONSUS MEDICAL CENTER-ONTARIO INC
351 SW 9TH STREET	ONTARIO	OR	97914	271789847	HEALTHCARE AND HOSPITAL SERVICES	OR	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC	Yes (1)
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
1055 NORTH CURTIS RD	BOISE	ID	83706	820200895	HEALTHCARE AND HOSPITAL SERVICES	ID	501(C)(3)	LINE 3	SAINT ALPHONSUS HEALTH SYSTEM INC	Yes (1)
SAINT FRANCIS EMERGENCY MEDICAL GROUP INC
114 WOODLAND STREET	HARTFORD	CT	06105	451994612	HEALTHCARE SERVICES	CT	501(C)(3)	LINE 11B, II	SAINT FRANCIS MEDICAL GROUP INC	Yes (1)
SAINT FRANCIS FOUNDATION INC
114 WOODLAND STREET	HARTFORD	CT	06105	061008255	FOUNDATION	CT	501(C)(3)	LINE 11B, II	TRINITY HEALTH - NEW ENGLAND INC	Yes (1)
SAINT FRANCIS HOSPITAL AND MEDICAL CENTER
114 WOODLAND STREET	HARTFORD	CT	06105	060646813	HEALTHCARE AND HOSPITAL SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH - NEW ENGLAND INC	Yes (1)
SAINT FRANCIS MEDICAL GROUP INC
114 WOODLAND STREET	HARTFORD	CT	06105	061450168	HEALTHCARE SERVICES	CT	501(C)(3)	LINE 3	TRINITY HEALTH - NEW ENGLAND INC	Yes (1)
SAINT JAMES CARE INC
111 CENTRAL AVENUE	NEWARK	NJ	07102	262616230	INACTIVE ENTITY	NJ	501(C)(3)	LINE 9	SAINT MICHAEL'S MEDICAL CENTER	Yes (1)
SAINT JOSEPH PACE INC
20555 VICTOR PARKWAY	LIVONIA	MI	48152	473129127	PACE PROGRAM	IN	501(C)(3)	LINE 7	TRINITY HEALTH PACE	Yes (1)
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC
PO BOX 670	PLYMOUTH	IN	46563	351142669	HEALTHCARE AND HOSPITAL SERVICES	IN	501(C)(3)	LINE 3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	Yes (1)
SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC
5215 HOLY CROSS PARKWAY	MISHAWAKA	IN	46545	350868157	HEALTHCARE AND HOSPITAL SERVICES	IN	501(C)(3)	LINE 3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	Yes (1)
SAINT JOSEPH REGIONAL MEDICAL CENTER MISHAWAKA AUXILIARY INC
5215 HOLY CROSS PARKWAY	MISHAWAKA	IN	46545	356033285	VOLUNTEER SERVICE AUXILIARY	IN	501(C)(4)	N/A	SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC	Yes (1)
SAINT JOSEPH REGIONAL MEDICAL CENTER PLYMOUTH AUXILIARY INC
1915 LAKE AVENUE	PLYMOUTH	IN	46563	356043563	VOLUNTEER SERVICE AUXILIARY	IN	501(C)(3)	LINE 11B, II	SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC	Yes (1)
SAINT JOSEPH REGIONAL MEDICAL CENTER INC
5215 HOLY CROSS PARKWAY	MISHAWAKA	IN	46545	351568821	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IN	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes (1)
SAINT JOSEPH'S HEALTH SYSTEM INC
424 DECATUR STREET	ATLANTA	GA	30312	581744848	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	GA	501(C)(3)	LINE 11C, III-FI	TRINITY HEALTH CORPORATION	Yes (1)
SAINT JOSEPH'S MERCY CARE SERVICES INC
424 DECATUR STREET	ATLANTA	GA	30312	581752700	HEALTHCARE SERVICES	GA	501(C)(3)	LINE 7	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes (1)
SAINT JOSEPH'S TOWER INC
PO BOX 9184	FARMINGTON HILLS	MI	48333	311040468	SENIOR LIVING COMMUNITY	IN	501(C)(3)	LINE 9	TRINITY CONTINUING CARE SERVICES - INDIANA INC	Yes (1)
SAINT MARY'S AMICARE HOME HEALTHCARE
1430 MONROE NW STE 120	GRAND RAPIDS	MI	49505	383320700	HOME HEALTH SERVICES	MI	501(C)(3)	LINE 9	TRINITY HOME HEALTH SERVICES	Yes (1)
SAINT MARY'S FOUNDATION
200 JEFFERSON ST SE	GRAND RAPIDS	MI	49503	381779602	FOUNDATION	MI	501(C)(3)	LINE 7	TRINITY HEALTH-MICHIGAN	Yes (1)
SAINT MICHAEL'S MEDICAL CENTER
111 CENTRAL AVENUE	NEWARK	NJ	07102	262616046	HEALTHCARE AND HOSPITAL SERVICES	NJ	501(C)(3)	LINE 3	MAXIS HEALTH SYSTEM	Yes (1)
SAMARITAN CHILD CARE CENTER INC
2213 BURDETT AVE	TROY	NY	12180	141710225	CHILD CARE	NY	501(C)(3)	LINE 9	ST PETER'S HEALTH PARTNERS	Yes (1)
SAMARITAN HOSPITAL
2215 BURDETT AVE	TROY	NY	12180	141338544	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes (1)
SENIOR CARE CONNECTION INC
504 STATE ST	SCHENECTADY	NY	12305	141708754	PACE PROGRAM	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes (1)
SETON AUXILIARY INC
1300 MASSACHUSETTS AVENUE	TROY	NY	12180	141505031	VOLUNTEER SERVICE AUXILIARY	NY	501(C)(3)	LINE 9	SETON HEALTH SYSTEM INC	Yes (1)
SETON HEALTH AT SCHUYLER RIDGE RESIDENTIAL HEALTHCARE
1 ABELE BLVD	CLIFTON PARK	NY	12065	141756230	LONG TERM CARE	NY	501(C)(3)	LINE 9	SETON HEALTH SYSTEM INC	Yes (1)
SETON HEALTH FOUNDATION INC
1300 MASSACHUSETTS AVENUE	TROY	NY	12180	222345416	FOUNDATION	NY	501(C)(3)	LINE 11A, I	SETON HEALTH SYSTEM INC	Yes (1)
SETON HEALTH SYSTEM INC
1300 MASSACHUSETTS AVENUE	TROY	NY	12180	141776186	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes (1)
SISTERS OF PROVIDENCE CARE CENTERS INC
C/O SPHS 1221 MAIN STREET SUITE 213	HOLYOKE	MA	01040	222541103	LONG TERM CARE	MA	501(C)(3)	LINE 3	SISTERS OF PROVIDENCE HEALTH SYSTEM INC	Yes (1)
SISTERS OF PROVIDENCE HEALTH SYSTEM INC
C/O SPHS 1221 MAIN STREET SUITE 213	HOLYOKE	MA	01040	043398374	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	MA	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes (1)
SJ MANAGEMENT COMPANY OF SYRACUSE INC
301 PROSPECT AVENUE	SYRACUSE	NY	13203	271763712	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	NY	501(C)(3)	LINE 11C, III-FI	ST JOSEPH'S HOSPITAL HEALTH CENTER	Yes (1)
SJHSJOC HOLDINGS INC
424 DECATUR STREET	ATLANTA	GA	30312	472299757	HEALTHCARE SYSTEM SUPPORT	GA	501(C)(3)	LINE 11B, II	SAINT JOSEPH'S HEALTH SYSTEM INC	Yes (1)
ST AGNES CONTINUING CARE CENTER
ONE WEST ELM STREET SUITE 100	CONSHOHOCKEN	PA	19428	232840137	PACE PROGRAM	PA	501(C)(3)	LINE 3	MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA	Yes (1)
ST AGNES CONTINUING CARE CENTER FOUNDATION
ONE WEST ELM STREET SUITE 100	CONSHOHOCKEN	PA	19428	232415137	FOUNDATION	PA	501(C)(3)	LINE 11A, I	ST AGNES CONTINUING CARE CENTER	Yes (1)
ST FRANCIS FOUNDATION
PO BOX 2500	WILMINGTON	DE	19805	510374158	FOUNDATION	DE	501(C)(3)	LINE 11A, I	ST FRANCIS HOSPITAL	Yes (1)
ST FRANCIS HOSPITAL INC
PO BOX 2500	WILMINGTON	DE	19805	510064326	HEALTHCARE AND HOSPITAL SERVICES	DE	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes (1)
ST FRANCIS MEDICAL CENTER FOUNDATION INC
601 HAMILTON AVENUE	TRENTON	NJ	08629	521025476	FOUNDATION	NJ	501(C)(3)	LINE 7	ST FRANCIS MEDICAL CENTER TRENTON NJ	Yes (1)
ST FRANCIS MEDICAL CENTER TRENTON NJ
601 HAMILTON AVENUE	TRENTON	NJ	08629	223431049	HEALTHCARE AND HOSPITAL SERVICES	NJ	501(C)(3)	LINE 3	MAXIS HEALTH SYSTEM	Yes (1)
ST JAMES MERCY HEALTH SYSTEM INC
411 CANISTEO STREET	HORNELL	NY	14843	223127184	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	NY	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes (1)
ST JAMES MERCY HOSPITAL
411 CANISTEO STREET	HORNELL	NY	14843	160743310	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST JAMES MERCY HEALTH SYSTEM INC	Yes (1)
ST JOSEPH MERCY OAKLAND FOUNDATION
44405 WOODWARD AVE	PONTIAC	MI	48341	352356789	FOUNDATION	MI	501(C)(3)	LINE 11A, I	TRINITY HEALTH-MICHIGAN	Yes (1)
ST JOSEPH OF THE PINES INC
100 GOSSMAN DRIVE	SOUTHERN PINES	NC	28387	560694200	LONG TERM CARE	NC	501(C)(3)	LINE 3	TRINITY CONTINUING CARE SERVICES	Yes (1)
ST JOSEPH'S COLLEGE OF NURSING AT ST JOSEPH'S HOSPITAL HEALTH CENTER
206 PROSPECT AVENUE	SYRACUSE	NY	13203	202497520	COLLEGE OF NURSING	NY	501(C)(3)	LINE 2	ST JOSEPH'S HOSPITAL HEALTH CENTER	Yes (1)
ST JOSEPH'S HEALTH CENTER PROPERTIES INC
301 PROSPECT AVENUE	SYRACUSE	NY	13203	237219294	BUILDING MANAGEMENT SERVICES	NY	501(C)(3)	LINE 11B, II	ST JOSEPH'S HEALTH INC	Yes (1)
ST JOSEPH'S HEALTH INC
301 PROSPECT AVENUE	SYRACUSE	NY	13203	474754987	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	NY	501(C)(3)	LINE 11A, I	TRINITY HEALTH CORPORATION	Yes (1)
ST JOSEPH'S HOSPITAL HEALTH CENTER
301 PROSPECT AVENUE	SYRACUSE	NY	13203	150532254	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST JOSEPH'S HEALTH INC	Yes (1)
ST JOSEPH'S HOSPITAL HEALTH CENTER FOUNDATION INC
301 PROSPECT AVENUE	SYRACUSE	NY	13203	222149775	FOUNDATION	NY	501(C)(3)	LINE 11A, I	ST JOSEPH'S HEALTH INC	Yes (1)
ST JOSEPH'S MEDICAL PC
301 PROSPECT AVENUE	SYRACUSE	NY	13203	273899821	HEALTHCARE SERVICES	NY	501(C)(3)	LINE 11A, I	ST JOSEPH'S HOSPITAL HEALTH CENTER	Yes (1)
ST JOSEPH'S PHYSICIAN HEALTH PC
301 PROSPECT AVENUE	SYRACUSE	NY	13203	161516863	HEALTHCARE SERVICES	NY	501(C)(3)	LINE 11A, I	ST JOSEPH'S HOSPITAL HEALTH CENTER	Yes (1)
ST MARY BUILDING AND DEVELOPMENT COMPANY
1201 LANGHORNE-NEWTOWN ROAD	LANGHORNE	PA	19047	461827502	TITLE HOLDING COMPANY	PA	501(C)(2)	N/A	ST MARY MEDICAL CENTER	Yes (1)
ST MARY EMERGENCY MEDICAL SERVICES
1201 LANGHORNE-NEWTOWN ROAD	LANGHORNE	PA	19047	465354512	HEALTHCARE SERVICES	PA	501(C)(3)	LINE 9	ST MARY MEDICAL CENTER	Yes (1)
ST MARY HOME INCORPORATED
2021 ALBANY AVENUE	WEST HARTFORD	CT	06117	060646843	LONG TERM CARE	CT	501(C)(3)	LINE 3	MERCY COMMUNITY HEALTH INC	Yes (1)
ST MARY MEDICAL CENTER
1201 LANGHORNE-NEWTOWN ROAD	LANGHORNE	PA	19047	231913910	HEALTHCARE AND HOSPITAL SERVICES	PA	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes (1)
ST MARY MEDICAL CENTER FOUNDATION INC
1201 LANGHORNE-NEWTOWN ROAD	LANGHORNE	PA	19047	232567468	FOUNDATION	PA	501(C)(3)	LINE 7	ST MARY MEDICAL CENTER	Yes (1)
ST MARY'S FOUNDATION INC
1230 BAXTER STREET	ATHENS	GA	30606	582544232	FOUNDATION	GA	501(C)(3)	LINE 11A, I	ST MARY'S HEALTH CARE SYSTEM INC	Yes (1)
ST MARY'S HEALTH CARE SYSTEM INC
1230 BAXTER STREET	ATHENS	GA	30606	580566223	HEALTHCARE AND HOSPITAL SERVICES	GA	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes (1)
ST MARY'S HIGHLAND HILLS INC
1230 BAXTER STREET	ATHENS	GA	30606	020576648	SENIOR LIVING COMMUNITY	GA	501(C)(3)	LINE 3	ST MARY'S HEALTH CARE SYSTEM INC	Yes (1)
ST MARY'S MEDICAL GROUP INC
1230 BAXTER STREET	ATHENS	GA	30606	261858563	HEALTHCARE SERVICES	GA	501(C)(3)	LINE 3	ST MARY'S HEALTH CARE SYSTEM INC	Yes (1)
ST MARY'S SACRED HEART HOSPITAL INC
367 CLEAR CREEK PARKWAY	LAVONIA	GA	30553	473752176	HEALTHCARE AND HOSPITAL SERVICES	GA	501(C)(3)	LINE 3	ST MARY'S HEALTH CARE SYSTEM INC	Yes (1)
ST MICHAEL'S FOUNDATION INC
111 CENTRAL AVENUE	NEWARK	NJ	07102	223311976	FOUNDATION	NJ	501(C)(3)	LINE 11A, I	SAINT MICHAEL'S MEDICAL CENTER	Yes (1)
ST PETER'S HEALTH CARE SERVICES
315 SOUTH MANNING BLVD	ALBANY	NY	12208	222702507	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	NY	501(C)(3)	LINE 9	ST PETER'S HEALTH PARTNERS	Yes (1)
ST PETER'S HEALTH PARTNERS
315 SOUTH MANNING BLVD	ALBANY	NY	12208	453570715	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	NY	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes (1)
ST PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES PC
315 SOUTH MANNING BLVD	ALBANY	NY	12208	461177336	HEALTHCARE SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes (1)
ST PETER'S HOSPITAL
315 SOUTH MANNING BLVD	ALBANY	NY	12208	141348692	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes (1)
ST PETER'S HOSPITAL FOUNDATION INC
319 SOUTH MANNING BLVD	ALBANY	NY	12208	222262982	FOUNDATION	NY	501(C)(3)	LINE 7	ST PETER'S HEALTH PARTNERS	Yes (1)
SUNNYVIEW HOSPITAL & REHABILITATION CENTER
1270 BELMONT AVE	SCHENECTADY	NY	12308	141338386	HEALTHCARE AND HOSPITAL SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes (1)
SUNNYVIEW HOSPITAL & REHABILITATION CENTER FOUNDATION INC
1270 BELMONT AVE	SCHENECTADY	NY	12308	222505127	FOUNDATION	NY	501(C)(3)	LINE 11A, I	SUNNYVIEW HOSPITAL & REHABILITATION CENTER	Yes (1)
THE COMMUNITY HOSPICE FOUNDATION INC
295 VALLEY VIEW BLVD	RENSSELAER	NY	12144	222692940	FOUNDATION	NY	501(C)(3)	LINE 7	THE COMMUNITY HOSPICE INC	Yes (1)
THE COMMUNITY HOSPICE INC
295 VALLEY VIEW BLVD	RENSSELAER	NY	12144	141608921	HOSPICE SERVICES	NY	501(C)(3)	LINE 3	ST PETER'S HEALTH PARTNERS	Yes (1)
THE FOUNDATION OF SAINT JOSEPH REGIONAL MEDICAL CENTER
707 EAST CEDAR STREET	SOUTH BEND	IN	46617	351654543	FOUNDATION	IN	501(C)(3)	LINE 7	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	Yes (1)
THE JAMES A EDDY MEMORIAL GERIATRIC CENTER INC
2256 BURDETT AVE	TROY	NY	12180	222570478	LONG TERM CARE	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes (1)
THE MARJORIE DOYLE ROCKWELL CENTER INC
421 WEST COLUMBIA ST	COHOES	NY	12047	141793885	LONG TERM CARE	NY	501(C)(3)	LINE 9	LTC (EDDY) INC	Yes (1)
THE NORTHEAST HEALTH FOUNDATION INC
2224 BURDETT AVE	TROY	NY	12180	222743478	FOUNDATION	NY	501(C)(3)	LINE 7	ST PETER'S HEALTH PARTNERS	Yes (1)
THE WOMEN'S AUXILIARY OF SAINT FRANCIS HOSPITAL AND MEDICAL CENTER INC
114 WOODLAND STREET	HARTFORD	CT	06105	060660403	VOLUNTEER SERVICE AUXILIARY	CT	501(C)(3)	LINE 11A, I		0		N/A
TRI-HOSPITAL EMERGENCY MEDICAL SERVICES
309 GRAND RIVER	PORT HURON	MI	48060	382485700	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 11D, III-O		0		N/A
TRI-HOSPITAL MRI CENTER
4190 24TH AVENUE	FORT GRATIOT	MI	48054	382884297	HEALTHCARE SERVICES	MI	501(C)(3)	LINE 3	TRINITY HEALTH-MICHIGAN	Yes (1)
TRINITY CONTINUING CARE SERVICES
PO BOX 9184	FARMINGTON HILLS	MI	48333	382559656	LONG TERM CARE	MI	501(C)(3)	LINE 9	TRINITY HEALTH CORPORATION	Yes (1)
TRINITY CONTINUING CARE SERVICES - INDIANA INC
PO BOX 9184	FARMINGTON HILLS	MI	48333	930907047	LONG TERM CARE	IN	501(C)(3)	LINE 9	TRINITY CONTINUING CARE SERVICES	Yes (1)
TRINITY HEALTH - MICHIGAN
20555 VICTOR PARKWAY	LIVONIA	MI	48152	382113393	HEALTHCARE AND HOSPITAL SERVICES	MI	501(C)(3)	LINE 3	TRINITY HEALTH CORPORATION	Yes (1)
TRINITY HEALTH - NEW ENGLAND INC (FKA SAINT FRANCIS CARE INC)
114 WOODLAND STREET	HARTFORD	CT	06105	061491191	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	CT	501(C)(3)	LINE 11A, I	TRINITY HEALTH CORPORATION	Yes (1)
TRINITY HEALTH CORPORATION
20555 VICTOR PARKWAY	LIVONIA	MI	48152	351443425	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IN	501(C)(3)	LINE 11B, II	CATHOLIC HEALTH MINISTRIES	Yes (1)
TRINITY HEALTH LIFE PENNSYLVANIA INC
3805 WEST CHESTER PIKE SUITE 100	NEWTOWN SQUARE	PA	19073	475244984	PACE PROGRAM	PA	501(C)(3)	LINE 9	TRINITY HEALTH PACE	Yes (1)
TRINITY HEALTH PACE
20555 VICTOR PARKWAY	LIVONIA	MI	48152	473073124	PACE PROGRAM	MI	501(C)(3)	LINE 11B, II	TRINITY HEALTH CORPORATION	Yes (1)
TRINITY HEALTH WELFARE BENEFIT TRUST
20555 VICTOR PARKWAY	LIVONIA	MI	48152	208151733	RETIREE MEDICAL AND RETIREE LIFE INSURANCE	MI	501(C)(9)	N/A	TRINITY HEALTH CORPORATION	Yes (1)
TRINITY HOME HEALTH SERVICES
17410 COLLEGE PARKWAY STE 150	LIVONIA	MI	48152	382621935	MANAGEMENT SERVICES FOR HOME HEALTH SYSTEM	MI	501(C)(3)	LINE 9	TRINITY HEALTH CORPORATION	Yes (1)
UIHLEIN MERCY CENTER
3805 WEST CHESTER PIKE SUITE 100	NEWTOWN SQUARE	PA	19073	150532190	HEALTHCARE SERVICES (INACTIVE)	NY	501(C)(3)	LINE 3	MERCY UIHLEIN HEALTH CORPORATION	Yes (1)
UNIVERSITY HEIGHTS PROPERTY COMPANY INC
111 CENTRAL AVENUE	NEWARK	NJ	07102	223100162	TITLE HOLDING COMPANY	NJ	501(C)(2)	N/A	SAINT MICHAEL'S MEDICAL CENTER	Yes (1)
VILLA MARY IMMACULATE
301 HACKETT BLVD	ALBANY	NY	12208	141438749	LONG TERM CARE	NY	501(C)(3)	LINE 3	ST PETER'S HOSPITAL	Yes (1)
WESTSHORE HEALTH NETWORK
1820 44TH STREET	KENTWOOD	MI	49508	383280200	HEALTH NETWORK	MI	501(C)(4)	N/A	MERCY HEALTH PARTNERS	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (49 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd
ADVENT REHABILITATION LLC
607 DEWEY AVENUE SUITE 300	GRAND RAPIDS	MI	49504	383306673	REHABILITATION THERAPY SERVICES	MI	N/A
BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP
793 W STATE STREET	COLUMBUS	OH	43222	311608125	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
CATHERINE HORAN BUILDING ASSOCIATES LP
1221 MAIN STREET SUITE 105	HOLYOKE	MA	01040	042723429	PROPERTY MANAGEMENT	MA	N/A
CENTENNIAL SURGUNIT LLC
502 CENTENNIAL BLVD SUITE 1	VOORHEES	NJ	08043	223580847	HEALTHCARE SERVICES	NJ	N/A
CENTER FOR DIGESTIVE CARE LLC
5300 ELLIOTT DRIVE	YPSILANTI	MI	48197	030447062	PROVIDE GASTROINTESTINAL SERVICES	MI	N/A
CENTRAL NEW JERSEY HEART SERVICES LLC
PO BOX 148	BAYONNE	NJ	07002	208525458	CARDIAC PROGRAM	NJ	N/A
CLINTON IMAGING SERVICES LLC
615 VALLEY VIEW DR STE 202	MOLINE	IL	61265	412044739	MRI DIAGNOSTIC SERVICES	IA	N/A
EAST NORRITON MEDICAL ASSOCIATES
ONE WEST ELM STREET	CONSHOHOCKEN	PA	19428	232319531	MEDICAL OFFICE BUILDING	PA	N/A
FOREST PARK IMAGING LLC
1000 4TH STREET SW	MASON CITY	IA	50401	134365966	X-RAY AND MAMMOGRAPHY SERVICES	IA	N/A
FRANCES WARDE MEDICAL LABORATORY
300 WEST TEXTILE ROAD	ANN ARBOR	MI	48104	382648446	LABORATORY	MI	N/A
FRESNO IMAGING CENTER
1303 E HERNDON AVE	FRESNO	CA	93720	770363563	FORMERLY DIAGNOSTIC IMAGING, IN DISSOLUTION	CA	N/A
GATEWAY HEALTH PLAN LP
444 LIBERTY AVE	PITTSBURGH	PA	15222	251691945	MEDICAID & MEDICARE/SPECIAL NEEDS MANAGED CARE ORGANIZATION	PA	N/A
GREATER HARTFORD LITHOTRIPSY LLC
144 WOODLAND ST	HARTFORD	CT	06105	061578891	LITHOTRIPSY SERVICES	CT	N/A
HAWARDEN REGIONAL HEALTH CLINICS LLC
1122 AVENUE L	HAWARDEN	IA	51023	201444339	MEDICAL CLINIC	IA	N/A
IDAHO ASC HOLDINGS LLC
1055 N CURTIS ROAD	BOISE	ID	83706	364729605	HOLDING COMPANY FOR AMBULATORY SURGERY	ID	N/A
INNOVATIVE HEALTH ALLIANCE OF NEW YORK LLC
14 COLUMBIA CIRCLE DRIVE	ALBANY	NY	12203	465676066	ACCOUNTABLE CARE ORGANIZATION	NY	N/A
LOYOLA AMBULATORY SURGERY CENTER AT OAKBROOK LP
569 BROOKWOOD VILLAGE SUITE 901	BIRMINGHAM	AL	35209	364119522	SURGICAL SERVICES	IL	N/A
MAGNETIC RESONANCE SERVICES PARTNERSHIP
1416 SIXTH STREET SW	MASON CITY	IA	50401	421328388	MRI SERVICES	IA	N/A
MASON CITY AMBULATORY SURGERY CENTER LLC
990 4TH STREET SW	MASON CITY	IA	50401	201960348	SURGERY-SAME DAY	IA	N/A
MCE MOB IV LIMITED PARTNERSHIP
793 W STATE STREET	COLUMBUS	OH	43222	421544707	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
MCMC POB III LIMITED PARTNERSHIP
793 W STATE STREET	COLUMBUS	OH	43222	311392994	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
MDRMRI TECHNICAL SERVICES LLC
5640 EAST TAFT ROAD 3770	SYRACUSE	NY	13220	161590982	MRI SERVICES	NY	N/A
MEDILUCENT MOB I
793 W STATE STREET	COLUMBUS	OH	43222	204911370	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
MEDWORKS LLC
375 EAST CEDAR STREET	NEWINGTON	CT	06111	061490483	REHABILITATION SERVICES	CT	N/A
MERCY ADVANCED MRI LLC
2525 SOUTH MICHIGAN AVE	CHICAGO	IL	60616	262116721	SUBLEASE MRI EQUIPMENT	IL	N/A
MERCY HEART CTR OP SERVICES LLC
1000 4TH STREET SW	MASON CITY	IA	50401	134237594	CARDIOVASCULAR SERVICES	IA	N/A
MERCYMANOR PARTNERSHIP
PO BOX 10086	TOLEDO	OH	43699	521931012	NURSING HOME	PA	N/A
MERCYUSP HEALTH VENTURES LLC
15305 DALLAS PARKWAY STE 1600 LB 28	ADDISON	TX	75001	471290300	OUTPATIENT SURGERY	IA	N/A
MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP
793 W STATE STREET	COLUMBUS	OH	43222	311369473	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
NAZARETH MEDICAL OFFICE BUILDING ASSOCIATES LP
C/O NAZARETH HOSP 2601 HOLME AVE	PHILADELPHIA	PA	19152	232388040	MEDICAL OFFICE BUILDING	PA	N/A
NEWCO AMBULATORY SURGERY CTR LLP
4190 24TH AVENUE	FORT GRATIOT	MI	48059	300136708	OUTPATIENT SURGERY CENTER	MI	N/A
PHYSICIANS OUTPATIENT SURGERY CENTER LLC
1000 NE 56TH STREET	OAKLAND PARK	FL	33334	352325646	AMBULATORY SURGERY CENTER	FL	N/A
RADISSON SJH PROPERTIES LLC
5000 CAMPUSWOOD DRIVE SUITE 100	EAST SYRACUSE	NY	13057	461892799	MEDICAL OFFICE BUILDING	NY	N/A
SARMED OUTPATIENT PHARMACY LLC
999 N CURTIS RD STE 102	BOISE	ID	83706	510483218	PHARMACY	ID	N/A
SIXTY FOURTH STREET LLC
2373 64TH ST STE 2200	BYRON CENTER	MI	49315	202443646	PROVIDE OUTPATIENT SURGICAL CARE	MI	N/A
SJLS LLC
7650 SE 27TH ST STE 200	MERCER ISLAND	WA	98040	201796650	DIALYSIS SERVICES	NY	N/A
SJV MANAGEMENT LLC
200 CENTURY PKWY STE 200E	MOUNT LAUREL	NJ	08054	202273476	RADIOLOGY	NJ	N/A
SMMC MOB II LP
1201 LANGHORNE-NEWTOWN ROAD	LANGHORNE	PA	19047	364559869	INVESTMENT AND OPERATION OF A MEDICAL BUILDING	PA	N/A
ST AGNES LONG-TERM INTENSIVE CARE LLP
C/O MHS ONE WEST ELM ST STE 100	CONSHOHOCKEN	PA	19428	200984882	LONG TERM INTENSIVE CARE	PA	N/A
ST ALPHONSUS CALDWELL CANCER CTR LLC
3123 MEDICAL DR	CALDWELL	ID	83605	820526861	HEALTH CARE SERVICES	ID	N/A
ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP
793 W STATE STREET	COLUMBUS	OH	43222	311603660	MEDICAL OFFICE BUILDING RENTAL	OH	N/A
ST JOSEPH'S IMAGING ASSOCIATES PLLC
104 UNION AVE SUITE 905	SYRACUSE	NY	13203	161104293	RADIOLOGY SERVICES	NY	N/A
ST MARY REHABILITATION HOSPITAL LLP
680 SOUTH FORTH STREET	LOUISVILLE	KY	40202	273938747	HEALTHCARE SERVICES	DE	N/A
ST PETER'S AMBULATORY SURGERY CENTER LLC
1375 WASHINGTON AVENUE STE 201	ALBANY	NY	12206	460463892	OUTPATIENT SURGERY	NY	N/A
TAMARACK MEDICAL CLINIC LLC
402 LAKE CASCADE PARKWAY	CASCADE	ID	83611	201637921	OUTPATIENT MEDICAL SERVICES	ID	N/A
THE AMBULATORY SURGERY CENTER AT ST MARY LLC
1203 LANGHORNE-NEWTOWN ROAD	LANGHORNE	PA	19047	232871206	OUTPATIENT SURGERY	PA	N/A
TOTAL LAUNDRY COLLABORATIVE LLC
114 WOODLAND STREET	HARTFORD	CT	06105	208335788	LAUNDRY SERVICES	CT	N/A
TRINITY HEALTH PARTNERS LLC
20555 VICTOR PARKWAY	LIVONIA	MI	48152	472798085	POPULATION HEALTH MANAGEMENT	DE	N/A
WOODLAND IMAGING CENTER LLC
5301 E HURON RIVER DR	ANN ARBOR	MI	48106	760820959	RADIOLOGY/ IMAGING	MI	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (56 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
AFFILIATED MANAGEMENT SERVICES CORPORATION INC
1300 MASSACHUSETTS AVENUE	TROY	NY	12180	141668024	REAL ESTATE	NY	N/A	C	Yes (1)
CARBONDALE PHYSICIANS' SERVICES INC
100 LINCOLN AVE	CARBONDALE	PA	18407	232365077	PHARMACY	PA	N/A	C	Yes (1)
CATHERINE HORAN BUILDING CORP
1233 MAIN STREET	HOLYOKE	MA	01040	042938160	BUILDING MANAGEMENT	MA	N/A	C	Yes (1)
CHESTNUT RISK SERVICES LTD
					INSURANCE		N/A	C	Yes (1)	11 VICTORIA STREET	HAMILTON	BD	BD
DIVERSIFIED COMMUNITY SERVICES INC
1233 MAIN STREET	HOLYOKE	MA	01040	043128890	MEDICAL SERVICES	MA	N/A	C	Yes (1)
FHS SERVICES INC
333 BUTTERNUT DRIVE SUITE 100	DEWITT	NY	13214	272995699	MEDICAL SERVICES	NY	N/A	C	Yes (1)
FRANCISCAN ASSOCIATES INC
333 BUTTERNUT DRIVE SUITE 100	DEWITT	NY	13214	202991688	MEDICAL SERVICES	NY	N/A	C	Yes (1)
FRANCISCAN HEALTH SUPPORT INC
333 BUTTERNUT DRIVE SUITE 100	DEWITT	NY	13214	161236354	MEDICAL SERVICES	NY	N/A	C	Yes (1)
FRANCISCAN MANAGEMENT SERVICES INC
333 BUTTERNUT DRIVE SUITE 100	DEWITT	NY	13214	161351193	MANAGEMENT SERVICES	NY	N/A	C	Yes (1)
GOTTLIEB MANAGEMENT SERVICES INC
701 W NORTH AVE	MELROSE PARK	IL	60160	363330529	MANAGEMENT SERVICES	IL	N/A	C	Yes (1)
HEF INC
1820 44TH STREET SE	KENTWOOD	MI	49508	383086401	OFFICE STAFFING	MI	N/A	C	Yes (1)
HACKLEY HEALTH MANAGEMENT INC
1820 44TH STREET SE	KENTWOOD	MI	49508	382961814	WEIGHT MANAGEMENT	MI	N/A	C	Yes (1)
HACKLEY HEALTH VENTURES INC
1820 44TH STREET SE	KENTWOOD	MI	49508	382589959	OTHER MEDICAL SERVICES	MI	N/A	C	Yes (1)
HACKLEY HEALTHCARE EQUIPMENT CORP
1820 44TH STREET SE	KENTWOOD	MI	49508	382578569	HOME MEDICAL EQUIPMENT	MI	N/A	C	Yes (1)
HACKLEY PROFESSIONAL CENTER INC
1820 44TH STREET SE	KENTWOOD	MI	49508	383024797	REAL ESTATE RENTAL	MI	N/A	C	Yes (1)
HACKLEY PROFESSIONAL PHARMACY INC
1820 44TH STREET SE	KENTWOOD	MI	49508	382447870	PHARMACY	MI	N/A	C	Yes (1)
HEALTH CARE MANAGEMENT ADMINISTRATORS INC
333 BUTTERNUT DRIVE SUITE 100	DEWITT	NY	13214	161450960	HEALTHCARE MANAGEMENT	NY	N/A	C	Yes (1)
HEALTH MANAGEMENT SERVICES ORG INC
500 GROVE STREET SUITE 100	HADDON HEIGHTS	NJ	08035	223366580	MEDICAL ADMINISTRATION	NJ	N/A	C	Yes (1)
HOLY CROSS PRIVATE HOME SERVICES CORP
1500 FOREST GLEN RD	SILVER SPRING	MD	20910	521986562	HOME CARE SERVICES	MD	N/A	C	Yes (1)
HPC CO-OWNERS ASSOCIATION
1700 CLINTON	MUSKEGON	MI	49442	270734448	CONDOMINIUM ASSOCIATION	MI	N/A	C	Yes (1)
HURON ARBOR CORPORATION
5301 EAST HURON RIVER DR	YPSILANTI	MI	48197	382475644	PROVIDES OFFICE RENTAL SPACE	MI	N/A	C	Yes (1)
IHA AFFILIATION CORPORATION
24 FRANK LLOYD WRIGHT DR LOBBY J	ANN ARBOR	MI	48106	383188895	MEDICAL MANAGEMENT	MI	N/A	C	Yes (1)
LANGHORNE SERVICES II INC
1201 LANGHORNE-NEWTOWN ROAD	LANGHORNE	PA	19047	253795549	GENERAL PARTNER OF LMOB PARTNERS, II	PA	N/A	C	Yes (1)
LANGHORNE SERVICES INC
1201 LANGHORNE-NEWTOWN ROAD	LANGHORNE	PA	19047	232625981	GENERAL PARTNER OF LMOB PARTNERS	PA	N/A	C	Yes (1)
LIFECARE PHYSICIANS PC
601 HAMILTON AVENUE	TRENTON	NJ	08629	261649038	HEALTH CARE SERVICES	NJ	N/A	C	Yes (1)
LOURDES MEDICAL ASSOCIATES PA
500 GROVE STREET SUITE 100	HADDON HEIGHTS	NJ	08035	223361862	MEDICAL SERVICES	NJ	N/A	C	Yes (1)
LOURDES URGENT CARE SERVICES PC
1600 HADDON AVENUE	CAMDEN	NJ	08103	464188202	URGENT CARE CENTER	NJ	N/A	C	Yes (1)
MARYLAND CARE GROUP INC
1500 FOREST GLEN RD	SILVER SPRING	MD	20910	521815313	HEALTHCARE HOLDING	MD	N/A	C	Yes (1)
MCMC EASTWICK INC
C/O MHS ONE WEST ELM STREET STE 100	CONSHOHOCKEN	PA	19428	232184261	MEDICAL OFFICE BUILDINGS	PA	N/A	C	Yes (1)
MEDNOW INC
1512 12TH AVENUE ROAD	NAMPA	ID	83686	820389927	MEDICAL SERVICES	ID	N/A	C	Yes (1)
MERCY INPATIENT MEDICAL ASSOCIATES INC
1233 MAIN STREET	HOLYOKE	MA	01040	043029929	MEDICAL SERVICES	MA	N/A	C	Yes (1)
MERCY MEDICAL SERVICES
801 5TH STREET	SIOUX CITY	IA	51101	421283849	PRIMARY CARE PHYSICIANS	IA	N/A	C	Yes (1)
MERCY SERVICES CORPORATION
2525 SOUTH MICHIGAN AVENUE	CHICAGO	IL	60616	363227348	DORMANT	IL	N/A	C	Yes (1)
MOUNT CARMEL HEALTH PROVIDERS INC
6150 EAST BROAD STREET	COLUMBUS	OH	43213	311382442	MEDICAL SERVICES	OH	N/A	C	Yes (1)
NURSING NETWORK INC
4725 NORTH FEDERAL HIGHWAY	FORT LAUDERDALE	FL	33308	591145192	MEDICAL SERVICES	FL	N/A	C	Yes (1)
PHYSICIANS MEDICAL OFFICE BUILDING CONDOMINIUM TRUST
1221 MAIN STREET SUITE 108	HOLYOKE	MA	01040	046608649	PROPERTY MANAGEMENT	MA	N/A	C	Yes (1)
PRIORITY PLUS OF CALIFORNIA
PO BOX 27230	FRESNO	CA	93729	770395267	FORMERLY HLTH MGMT NOW DISCONTINUED OPERATIONS	CA	N/A	C	Yes (1)
PROVIDENCE HOME CARE INC
1233 MAIN STREET	HOLYOKE	MA	01040	043317426	HEALTH CARE SERVICES	MA	N/A	C	Yes (1)
SAINT ALPHONSUS HEALTH ALLIANCE INC
1055 NORTH CURTIS ROAD	BOISE	ID	83706	820524649	ACCOUNTABLE CARE ORGANIZATION	ID	N/A	C	Yes (1)
SAINT ALPHONSUS PHYSICIANS PA
1055 NORTH CURTIS ROAD	BOISE	ID	83706	331078261	HEALTH CARE SERVICES (INACTIVE)	ID	N/A	C	Yes (1)
SAINT FRANCIS BEHAVIORAL HEALTH GROUP PC
114 WOODLAND STREET	HARTFORD	CT	06105	061384686	MEDICAL SERVICES	CT	N/A	C	Yes (1)
SAINT FRANCIS CARE MEDICAL GROUP PC
114 WOODLAND STREET	HARTFORD	CT	06105	061432373	MEDICAL SERVICES	CT	N/A	C	Yes (1)
SAMARITAN MEDICAL OFFICE BUILDING INC
2212 BURDETT AVENUE	TROY	NY	12180	141607244	REAL ESTATE	NY	N/A	C	Yes (1)
SJM PROPERTIES INC
411 CANISTEO STREET	HORNELL	NY	14843	161294991	PROPERTY HOLDINGS	NY	N/A	C	Yes (1)
SJPE PRACTICE MANAGEMENT SERVICES INC
301 PROSPECT AVE	SYRACUSE	NY	13203	454164964	MANAGEMENT SERVICES	NY	N/A	C	Yes (1)
SJRMC HOLDINGS INC
5215 HOLY CROSS PARKWAY	MISHAWAKA	IN	46545	474763735	PROPERTY HOLDINGS	IN	N/A	C	Yes (1)
ST ELIZABETH HEALTH SUPPORT SERVICES INC
2209 GENESEE STREET	UTICA	NY	13501	161540486	MEDICAL SERVICES	NY	N/A	C	Yes (1)
ST MARY'S HIGHLAND HILLS VILLAGE INC
1230 BAXTER STREET	ATHENS	GA	30606	582276801	ASSISTED LIVING	GA	N/A	C	Yes (1)
SYSTEM COORDINATED SERVICES INC
1233 MAIN STREET	HOLYOKE	MA	01040	042938161	LAB SERVICES	MA	N/A	C	Yes (1)
THRE SERVICES LLC
20555 VICTOR PARKWAY	LIVONIA	MI	48152	452603654	REAL ESTATE BROKERAGE SERVICES	MI	N/A	C	Yes (1)
TRINITY ASSURANCE LTD
				980453602	PROVISION OF INSURANCE COVERAGE		N/A	C	Yes (1)	PO BOX 1051 GRAND CAYMAN	GRAND CAYMAN	CJ	CJ
TRINITY HEALTH ACO INC
20555 VICTOR PARKWAY	LIVONIA	MI	48152	473794666	ACCOUNTABLE CARE ORGANIZATION	DE	N/A	C	Yes (1)
TRINITY HEALTH EMPLOYEE BENEFIT TRUST
20555 VICTOR PARKWAY	LIVONIA	MI	48152	383410377	GRANTOR TRUST	MI	N/A	T	Yes (1)
TRINITY SENIOR SERVICES MANAGEMENT INC
PO BOX 9184	FARMINGTON HILLS	MI	48333	371572595	SENIOR SERVICES	PA	N/A	C	Yes (1)
WEST SHORE PROFESSIONAL BUILDING CONDOMINIUM
1820 44TH STREET SE	KENTWOOD	MI	49508	382700166	CONDOMINIUM ASSOCIATION	MI	N/A	C	Yes (1)
WORKPLACE HEALTH OF GRAND HAVEN INC
1820 44TH STREET SE	KENTWOOD	MI	49508	383112035	OCCUPATIONAL HEALTH	MI	N/A	C	Yes (1)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	0	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (10 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
LOYOLA UNIVERSITY MEDICAL CENTER
Q	$583,917	PER BOOKS
LOYOLA UNIVERSITY MEDICAL CENTER
M	$963,851	PER BOOKS
TRINITY HOME HEALTH SERVICES
L	$207,031	PER BOOKS
TRINITY HEALTH CORPORATION
C	$98,609	PER BOOKS
TRINITY HEALTH CORPORATION
M	$1,338,549	PER BOOKS
TRINITY HEALTH CORPORATION
P	$5,591,882	PER BOOKS
TRINITY HEALTH CORPORATION
Q	$1,262,422	PER BOOKS
TRINITY HEALTH CORPORATION
R	$617,787	PER BOOKS
TRINITY CONTINUING CARE SERVICES
M	$330,532	PER BOOKS
LOYOLA UNIVERSITY HEALTH SYSTEM
S	$1,620,000	PER BOOKS