HEALTHSPAN PARTNERS: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- HEALTHSPAN PARTNERS (EIN 46-3055925)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-13
- IRS object ID
- 201513179349301696
- Schema version
- 2014v5.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-13T09:01:04-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 440160260 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 312 Walnut Street Suite 3000 | AddressLine1Txt |
| City | Cincinnati | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 463055925 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HealthSpan Partners | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HEAL | BusinessNameControlTxt |
| Phone | 5136392800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 Elsinore Place | AddressLine1Txt |
| City | Cincinnati | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45202 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | David Nowiski | PersonNm |
| Person Title | Chief Financial Officer | PersonTitleTxt |
| Signature | 2015-10-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Aaron Hershberger | PreparerPersonNm |
| PTIN | P00961884 | PTIN |
| Phone | 5136218300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kenneth C Page | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 Elsinore Place | AddressLine1Txt |
| City | Cincinnati | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $69,973,126 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | The promotion of health in a charitable manner by providing compassionate, high quality affordable healthcare to improve the health of the communities it serves, with emphasis on caring for the poor and underserved. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 246 | TotalEmployeeCnt |
| Total Volunteers | 8 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $22,638,445 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $69,745,110 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $228,016 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $22,638,445 | PYTotalRevenueAmt |
| CY Total Revenue | $69,973,126 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,266,167 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $59,353,245 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,586,434 | PYOtherExpensesAmt |
| CY Other Expenses | $19,313,351 | CYOtherExpensesAmt |
| PY Total Expenses | $17,852,601 | PYTotalExpensesAmt |
| CY Total Expenses | $78,666,596 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,785,844 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$8,693,470 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $274,858,870 | TotalAssetsBOYAmt |
| Total Assets EOY | $263,595,845 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $310,073,026 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $325,023,473 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$35,214,156 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$61,427,628 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The specific purpose for which the corporation is organized is to engage in the delivery, and in activities that further or are in any way related to or associated with the delivery, of health care and related services of every kind, nature and description deemed appropriate by the corporation, provided that the corporation shall do so on a non-discriminatory basis that promotes health for the benefit of the community in a manner consistent with Code Section 501(c)(3). | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $66,819,202 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $69,745,110 | RevenueAmt |
| Desc | THE PROMOTION OF HEALTH IN A CHARITABLE MANNER BY PROVIDING COMPASSIONATE, HIGH QUALITY AFFORDABLE HEALTHCARE TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES, WITH EMPHASIS ON CARING FOR THE POOR AND UNDERSERVED. | Desc |
| Total Program Service Expenses | $66,819,202 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (true) | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 3007 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 246 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Travis Crum | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5136392800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 Elsinore Place | AddressLine1Txt |
| City | Cincinnati | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45202 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 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 |
|---|---|---|---|---|---|---|---|---|---|
| CATHLEEN P ELDRIDGE | |||||||||
| BOARD CHAIR | 1.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JAMES PATTON CPA | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| EVAN M BENJAMIN MD | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SR GERALDINE HOYLER CSC | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID LEACH MD | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JOEL A LEVINE JD | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| LEONARD M RANDOLPH JR MD | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $460,084 | $22,704 | |||
| KATHERINE W VESTAL PHD | |||||||||
| BOARD VICE CHAIR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| GLORIA YSASI-DIAZ | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Lawrence Grypp | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Catherine JACobson | |||||||||
| TRUSTEE | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DONALD KLINE | |||||||||
| Treasurer (End 2/14) | 50.00 | 0.00 | Yes (X) | $0 | $584,485 | $182,537 | |||
| DAVID NOWISKI | |||||||||
| HealthSpan Partners CFO, Treasurer | 25.00 | 31.50 | Yes (X) | $0 | $629,201 | $79,123 | |||
| JANE CROWLEY | |||||||||
| Mercy EVP, President and CEO | 2.00 | 50.00 | Yes (X) | $0 | $1,225,763 | $166,229 | |||
| JUDY SISSON | |||||||||
| SECRETARY | 1.00 | 51.00 | Yes (X) | $0 | $204,780 | $22,771 | |||
| KENNETH C PAGE | |||||||||
| PRESIDENT and CEO (End 11/14) | 25.00 | 25.00 | Yes (X) | $0 | $610,076 | $108,036 | |||
| DANIEL J HOUNCHELL | |||||||||
| COO | 25.00 | 25.00 | $0 | $251,698 | $26,679 | Yes (X) | |||
| NABIL CHEHADE MD | |||||||||
| President, HealthSpan Physicians LLC | 50.00 | 0 | $487,036 | $0 | $130,700 | Yes (X) | |||
| REBECCA HOLLAND | |||||||||
| VICE PRESIDENT AND ASSOCIATE GENERAL COUNSEL | 50.00 | 0 | $161,799 | $0 | $14,459 | Yes (X) | |||
| VENKAT RAPURI | |||||||||
| Physician | 50.00 | 0 | $530,093 | $0 | $65,343 | Yes (X) | |||
| CHARLES WEHBE | |||||||||
| Physician | 50.00 | 0 | $512,796 | $0 | $49,552 | Yes (X) | |||
| JAIME SABOGAL | |||||||||
| Physician | 50.00 | 0 | $458,795 | $0 | $32,004 | Yes (X) | |||
| LORRAINE DOYLE | |||||||||
| PHYSICIAN | 50.00 | 0 | $456,151 | $0 | $27,261 | Yes (X) | |||
| JOHN WOOD | |||||||||
| PHYSICIAN | 50.00 | 0 | $453,221 | $0 | $64,089 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,059,891 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,966,087 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $991,487 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 162 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| University Hospitals of Cleveland | ||||||
| PO Box 74689 | Cleveland | OH | 44194 | Medical Services | $36,304,763 | |
| UH AHUJA Medical Center | ||||||
| University Hospitals | Detroit | MI | 48278 | Medical Services | $15,351,032 | Dept 781966 |
| Metrohealth System | ||||||
| PO Box 73122 | Cleveland | OH | 44193 | Medical Services | $12,413,477 | |
| Cleveland Clinic Foundation | ||||||
| 9500 Euclid Avenue | Cleveland | OH | 44195 | Medical Services | $7,698,654 | |
| Akron General Medical Center | ||||||
| Dept 781642 PO Box 78000 | Detroit | MI | 48278 | Medical Services | $7,151,947 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 120 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Member Revenue | 621400 | $2,617,932 | $2,617,932 |
| Other Operating Revenue | 621400 | -$56,028 | -$56,028 |
| Administrative Fee | 621400 | $3,515,020 | $3,515,020 |
| Physician Services | 621110 | $63,668,186 | $63,668,186 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $69,745,110 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $228,016 | TotalRevenueColumnAmt |
| Exclusion | $228,016 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $69,973,126 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $69,745,110 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $228,016 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $793,892 | TotalAmt |
| Program Services | $674,808 | ProgramServicesAmt |
| Management And General | $119,084 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,607,265 | TotalAmt |
| Program Services | $41,316,175 | ProgramServicesAmt |
| Management And General | $7,291,090 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,739,322 | TotalAmt |
| Program Services | $6,578,424 | ProgramServicesAmt |
| Management And General | $1,160,898 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,212,766 | TotalAmt |
| Program Services | $1,880,851 | ProgramServicesAmt |
| Management And General | $331,915 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $434,560 | TotalAmt |
| Management And General | $434,560 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,422,260 | TotalAmt |
| Program Services | $5,849,094 | ProgramServicesAmt |
| Management And General | $573,166 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,699 | TotalAmt |
| Program Services | $11,644 | ProgramServicesAmt |
| Management And General | $2,055 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,739 | TotalAmt |
| Program Services | $12,528 | ProgramServicesAmt |
| Management And General | $2,211 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,479 | TotalAmt |
| Program Services | $245,207 | ProgramServicesAmt |
| Management And General | $43,272 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,962,304 | TotalAmt |
| Program Services | $6,767,958 | ProgramServicesAmt |
| Management And General | $1,194,346 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,845,655 | TotalAmt |
| Program Services | $2,418,807 | ProgramServicesAmt |
| Management And General | $426,848 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,455,378 | TotalAmt |
| Program Services | $1,237,071 | ProgramServicesAmt |
| Management And General | $218,307 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Claims Expense | -$454,673 | -$454,673 | |
| Dues/Subscriptions & Memberships | $186,941 | $158,900 | $28,041 |
| Education | $115,721 | $98,363 | $17,358 |
| Miscellaneous | $28,288 | $24,045 | $4,243 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,666,596 | TotalAmt |
| Program Services | $66,819,202 | ProgramServicesAmt |
| Management And General | $11,847,394 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,688 | BOYAmt |
| EOY | $240,767 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,799 | BOYAmt |
| EOY | $170,592 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,000 | BOYAmt |
| EOY | $75,000 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $274,621,383 | BOYAmt |
| EOY | $263,109,486 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $274,858,870 | BOYAmt |
| EOY | $263,595,845 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,097,781 | BOYAmt |
| EOY | $11,485,924 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $304,975,245 | BOYAmt |
| EOY | $313,537,549 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $310,073,026 | BOYAmt |
| EOY | $325,023,473 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$35,214,156 | BOYAmt |
| EOY | -$61,427,628 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$35,214,156 | BOYAmt |
| EOY | -$61,427,628 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $274,858,870 | BOYAmt |
| EOY | $263,595,845 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$8,693,470 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$17,520,002 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (2 entries)
| EINEIN | Organization TypeOrganizationTypeDesc | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| Mercy Health | ||||
| 311161086 | 3 | false | $0 | $0 |
| HealthSpan Integrated Care | ||||
| 340922268 | 9 | Yes (true) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 2 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | Yes (true) | MajorityDirTrstSupportedOrgInd |
Schedule D IRS990ScheduleD
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Investment in Summa Health | $258,200,600 |
| Goodwill Unamortized Debt Issuance | |
| Other Intangible Assets | |
| Notes Receivable Physician Loans | $4,908,886 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $263,109,486 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Note Payable to Mercy Health | $313,537,549 |
| Other Long-Term Liabilities |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $313,537,549 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | The company completed an analysis of its tax positions in accordance with applicable accountng guidance at December 31, 2014, and determined that no amounts were required to be recognized in the consolidated financial statements at December 31, 2014. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LEONARD M RANDOLPH JR MD | ||||||||||||||
| TRUSTEE | $0 | $12,115 | $0 | $39,695 | $0 | $408,274 | $0 | $2,284 | $0 | $20,420 | $0 | $482,788 | $0 | $0 |
| DONALD KLINE | ||||||||||||||
| Treasurer (End 2/14) | $0 | $454,574 | $0 | $124,179 | $0 | $5,732 | $0 | $157,149 | $0 | $25,388 | $0 | $767,022 | $0 | $0 |
| DAVID NOWISKI | ||||||||||||||
| HealthSpan Partners CFO, Treasurer | $0 | $359,553 | $0 | $84,531 | $0 | $185,117 | $0 | $53,998 | $0 | $25,125 | $0 | $708,324 | $0 | $107,822 |
| JANE CROWLEY | ||||||||||||||
| Mercy EVP, President and CEO | $0 | $803,071 | $0 | $256,443 | $0 | $166,249 | $0 | $140,172 | $0 | $26,057 | $0 | $1,391,992 | $0 | $0 |
| JUDY SISSON | ||||||||||||||
| SECRETARY | $0 | $151,579 | $0 | $33,733 | $0 | $19,468 | $0 | $14,360 | $0 | $8,411 | $0 | $227,551 | $0 | $0 |
| KENNETH C PAGE | ||||||||||||||
| PRESIDENT and CEO (End 11/14) | $0 | $334,919 | $0 | $74,523 | $0 | $200,634 | $0 | $78,410 | $0 | $29,626 | $0 | $718,112 | $0 | $0 |
| DANIEL J HOUNCHELL | ||||||||||||||
| COO | $0 | $208,395 | $0 | $35,138 | $0 | $8,165 | $0 | $23,895 | $0 | $2,784 | $0 | $278,377 | $0 | $0 |
| NABIL CHEHADE MD | ||||||||||||||
| President, HealthSpan Physicians LLC | $430,755 | $0 | $35,979 | $0 | $20,302 | $0 | $106,200 | $0 | $24,500 | $0 | $617,736 | $0 | $0 | $0 |
| REBECCA HOLLAND | ||||||||||||||
| VICE PRESIDENT AND ASSOCIATE GENERAL COUNSEL | $97,756 | $0 | $63,000 | $0 | $1,043 | $0 | $5,048 | $0 | $9,411 | $0 | $176,258 | $0 | $0 | $0 |
| VENKAT RAPURI | ||||||||||||||
| Physician | $492,516 | $0 | $0 | $0 | $37,577 | $0 | $41,338 | $0 | $24,005 | $0 | $595,436 | $0 | $0 | $0 |
| CHARLES WEHBE | ||||||||||||||
| Physician | $476,726 | $0 | $0 | $0 | $36,070 | $0 | $40,375 | $0 | $9,177 | $0 | $562,348 | $0 | $0 | $0 |
| JAIME SABOGAL | ||||||||||||||
| Physician | $396,048 | $0 | $0 | $0 | $62,747 | $0 | $15,600 | $0 | $16,404 | $0 | $490,799 | $0 | $0 | $0 |
| LORRAINE DOYLE | ||||||||||||||
| PHYSICIAN | $395,509 | $0 | $0 | $0 | $60,642 | $0 | $15,600 | $0 | $11,661 | $0 | $483,412 | $0 | $0 | $0 |
| JOHN WOOD | ||||||||||||||
| PHYSICIAN | $414,530 | $0 | $0 | $0 | $38,691 | $0 | $37,597 | $0 | $26,492 | $0 | $517,310 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 4b Terms and Conditions of the Mercy Health Executive Retention Plan | The Mercy Health executive retention plan is a deferred compensation plan which provides employment continuation incentives to persons selected by the Board of Trustees or its delegate. It provides annual credits of a specified percentage of compensation and annual interest credits. Participants vest and cease to receive credits after 5 years of plan participation provided they remain employed. Vesting and cessation of credits occur earlier for death or total disability while employed, involuntary termination of employment within 24 months after a change in control of the organization, or, for certain participants, upon being offered a specified promotion. Payment of the vested account balance in a lump sum occurs upon vesting. Amounts includable as taxable compensation for listed individuals due to retention plan participation in the reporting year were as follows: Kenneth C. Page $106,162; David Nowiski $151,655; Jane Crowley $0; Donald Kline $0. |
| Schedule J, Part I, Line 4b Terms and Conditions of the HealthSpan System SERP | The HealthSpan System SERP is a non-qualified deferred compensation plan which provides supplemental retirement benefits to persons selected by the Board of Trustees or its delegate. The plan provides for annual credits of a specified percentage of an eligible participants base salary paid in a plan year and interest credits. Plan participants vest in plan credits after completing a three year class vesting schedule or earlier for death or total disability or reaching age 60 while employed, or due to involuntary separation of employment other than for cause. Payments during employment are made for required tax withholding and reduce the participants account balance. Distribution of the vested account balance in a lump sum occurs after termination of employment. Amounts includible as taxable compensation for listed individuals due to SERP participation in the reporting year were as follows: Nabil Chehade $0; Lorraine Doyle $20,839; Rebecca Holland $0; Venkat Rapuri $0; Jaime Sabogal $20,884; Charles Wehbe $0; John Wood $0. |
| Schedule J, Part I, Line 4b Terms and conditions of the Mercy Health System SERP | The Mercy Health System SERP is a non-qualified deferred compensation plan which provides supplemental retirement benefits to persons selected by the Board of Trustees or its delegate. The plan provides for annual credits of a specified percentage of an eligible participants base salary paid in a plan year and interest credits. Plan participants vest in plan credits after completing a three year class vesting schedule or earlier for death or total disability or reaching age 60 while employed, or due to involuntary separation of employment other than for cause. Payments during employment are made for required tax withholding and reduce the participants account balance. Distribution of the vested account balance in a lump sum occurs after termination of employment. Amounts includible as taxable compensation for listed individuals due to SERP participation in the reporting year were as follows: Daniel Hounchell $0; David Nowiski $0; Kenneth C. Page $34,869; Donald Kline $0. |
| Schedule J, Part I, Line 4b Terms and conditions of the Cincinnati Market SERP | The Cincinnati Market SERP is a deferred compensation plan which provides employment continuation incentives to all executive council members. It provides annual credits of a specified percentage of compensation. A benefit is calculated for any individual whose compensation is limited in the qualified cash balance plan due to income which exceeds the IRS maximum. The benefit is based upon Form W-2 compensation and is equal to the amount excluded from the qualified plan. Participants must complete a two tiered vesting provision. participants must be vested under the base qualified plan and must count 24 months after termination during which they do not compete with Mercy Health Cincinnati LLC. Amounts includable as taxable compensation for listed individuals due to executive benefit plan participation in the reporting year were as follows: Leonard M Randolph, Jr. MD $0; Kenneth C. Page $0. |
| Schedule J, Part I, Line 4b Terms and conditions of the Youngstown Market SERP | The Youngstown Market SERP Plan is a deferred compensation plan which provides supplemental retirement benefits to persons selected by the Mercy Health Youngstown LLC Board of trustees or its delegate. The Plan provides annual credits of a specified percentage of compensation and annual interest credits. Participants vest 100% in their accounts after three years of service, except for participants who had attained at least ten years of service at plan inception, who had immediate vesting. Vesting occurs earlier upon death or total disability. Payments are made during employment for required tax withholding. The vested account balance is paid as a lump sum after termination of employment. Amounts includible as taxable compensation for listed individuals due to SERP participation in the reporting year are as follows: Donald Kline $0. |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | The compensation of Kenneth C. Page and Jane Crowley, President and CEO, is determined by a related tax-exempt Section 501(c)(3) organization. The determination of their compensation includes a review and approval by independent persons, comparability data, and contemporaneous substantiation of the decision. |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | Severance Benefits consisting of continuation of base salary and insurance benefits were provided to listed individuals for specified periods. The listed individuals executed releases and waivers of claims in exchange for the severance benefits. Salary continuation amounts provided during the reporting year to listed individuals were as follows: Leonard M. Randolph, Jr. MD $380,630. |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | The Mercy Health SERP plan is a deferred compensation plan which provides supplemental retirement benefits to persons selected by the Board of Trustees or its delegate. It provides annual credits of a specified percentage of compensation and annual interest credits. Participants vest 50%, 75%, and 100% in their accounts after 5, 6, and 7 years of service, respectively. Vesting occurs earlier for death or total disability or reaching age 60 while employed, or involuntary termination of employment within 24 months after a change in control of the organization or due to position elimination. Payments during employment are made for required tax withholding. Payment of the vested account balance in a lump sum occurs after termination of employment. Amounts includable as taxable compensation for listed individuals due to SERP participation in the reporting year were as follows: Jane Crowley $159,922. |
| Schedule J, Part I, Line 7 Non-fixed payments | The organization provides annual incentive compensation for listed individuals. The organization's Board of Trustees establishes objective thresholds for quality, community benefit, and financial performance which must be achieved for incentives to be awarded. The Board also establishes threshold, target and maximum levels for incentive awards. The Board may authorize modified incentive awards when appropriate in its judgment. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (6 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan From OrganizationLoanFromOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| NABIL CHEHADE MD | |||||||
| EMPLOYMENT | RECRUITMENT AGREEMENT | Yes (X) | $50,000 | $24,932 | false | false | Yes (true) |
| Evelyn Doyle | |||||||
| Employment | Recruitment Agreement | Yes (X) | $50,000 | $29,132 | false | false | Yes (true) |
| Venkat Rapuri | |||||||
| Employment | Recruitment Agreement | Yes (X) | $50,000 | $29,132 | false | false | Yes (true) |
| Jaime Sabogal | |||||||
| Employment | Recruitment Agreement | Yes (X) | $50,000 | $29,132 | false | false | Yes (true) |
| Charles Wehbe | |||||||
| Employment | Recruitment Agreement | Yes (X) | $50,000 | $29,132 | false | false | Yes (true) |
| John Wood | |||||||
| Employment | Recruitment Agreement | Yes (X) | $50,000 | $29,132 | false | false | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $170,592 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 2 Family/business relationships amongst interested persons | Michael Connelly, David Nowiski, Judy Sisson, Kenneth Page, Daniel Hounchell, Cathleen Eldridge, James Patton, Evan Benjamin, Sr. Geraldine Hoyler, David Leach, Joel Levine, Katherine Vestal - Business relationship, The organization's trustees and officers served together on the boards of other organizations within the Mercy Health System ("the System"), as well as joint ventures in which the System had an ownership interest. See Schedule R for a listing of such entities. - Business relationship |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The Form 990 is reviewed by an independent accounting firm and management. Upon review, a copy of the Form 990 is then forwarded to the Audit & Corporate Responsibility Committee for approval. Additionally, the compensation committee reviews all compensation related schedules and disclosures. Both committees are independent of the filing organization. Once the Form 990 is reviewed by all applicable parties a copy of the final version is provided to all members of the governing body prior to filing. |
| Form 990, Part VI, Line 12c Conflict of interest policy | All board members, committee members and members of management are required to complete an annual conflict of interest disclosure. Prior to the start of all board and committee meetings members are asked to disclose any potential conflicts of interest. |
| Form 990, Part VI, Line 19 Required documents available to the public | Governing documents are maintained on the Ohio Secretary of State website and are available upon request. Audited consolidated financial statements are issued annually and are available upon request. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Goodwill Impairment - -8920000; Equity Transfer - -5000000; Intercompany Loan - -3600002; |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHSPAN PHYSICIANS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 ELSINORE PLACE | AddressLine1Txt |
| City | CINCINNATI | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320417416 | EIN |
| Primary Activities | PHYSICIAN PRACTICE | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Total Income | $66,458,105 | TotalIncomeAmt |
| End Of Year Assets | $10,517,032 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHSPAN PARTNERS | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (37 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| MERCY HEALTH | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 311161086 | HEALTHCARE SYSTEM PARENT | OH | 501(c)(3 | 3 | NA | false |
| MERCY HEALTH FOUNDATION | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 201072726 | FUNDRAISING | OH | 501(c)(3 | 7 | MERCY HEALTH | false |
| MERCY HEALTH RETIREMENT TRUST | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 316046304 | RETIREMENT TRUST | OH | 501(c)(3 | 7 | MERCY HEALTH | false |
| COMMUNITY HEALTH PARTNERS PHYSICIANS OFFICE BUILDINGS | ||||||||||
| 3700 KOLBE ROAD | LORAIN | OH | 44053 | 341268828 | MEDICAL OFFICE RENTAL | OH | 501(c)(3 | 9 | MERCY HEALTH - REGIONAL MEDICAL CENTER LLC | false |
| ALLEN MEDICAL CENTER MEDICAL OFFICE BUILDING | ||||||||||
| 200 WEST LORAIN ST | OBERLIN | OH | 44074 | 364504991 | MEDICAL OFFICE RENTAL | OH | 501(c)(3 | Type II | MERCY HEALTH - ALLEN HOSPITAL LLC | false |
| MERCY FRANCISCAN SENIOR HEALTH AND HOUSING SERVICES INC | ||||||||||
| 7010 ROWAN HILLS DR | CINCINNATI | OH | 45227 | 311308729 | RETIREMENT HOME | OH | 501(c)(3 | 9 | MERCY HEALTH CINCINNATI LLC | false |
| MERCY SACRED HEART INC | ||||||||||
| 2120 PAYNE STREET | LOUISVILLE | KY | 40206 | 611318326 | RETIREMENT HOME | KY | 501(c)(3 | 9 | MERCY HEALTH CINCINNATI LLC | false |
| MERCY LONG TERM CARE INITIATIVE | ||||||||||
| 4915 CHARLESTOWN RD | NEW ALBANY | IN | 47150 | 311332491 | RETIREMENT HOME | IN | 501(c)(3 | 9 | MERCY HEALTH CINCINNATI LLC | false |
| MERCY FRANCISCAN SOCIAL MINISTRIES INC | ||||||||||
| 1800 LOGAN STREET | CINCINNATI | OH | 45210 | 311222942 | LOW INCOME HOUSING | OH | 501(c)(3 | 7 | MERCY HEALTH CINCINNATI LLC | false |
| MERCY FRANCISCAN AT ST RAPHAEL INC | ||||||||||
| 610 HIGH STREET | HAMILTON | OH | 45011 | 202934871 | SOCIAL SERVICES | OH | 501(c)(3 | 7 | MERCY HEALTH CINCINNATI LLC | false |
| COMMUNITY MERCY HEALTH SYSTEM | ||||||||||
| ONE S LIMESTONE ST | SPRINGFIELD | OH | 45502 | 300272454 | MARKET PARENT | OH | 501(c)(3 | Type I | MERCY HEALTH | false |
| COMMUNITY MERCY HEALTH PARTNERS | ||||||||||
| ONE S LIMESTONE ST | SPRINGFIELD | OH | 45502 | 310785684 | HOSPITAL | OH | 501(c)(3 | 3 | COMMUNITY MERCY HEALTH SYSTEM | false |
| C H HEALTH SERVICES COMPANY | ||||||||||
| ONE S LIMESTONE ST | SPRINGFIELD | OH | 45502 | 311181984 | HOSPITAL | OH | 501(c)(3 | 3 | COMMUNITY MERCY HEALTH SYSTEM | false |
| CLARKE & CHAMPAIGN COUNTIES HEALTH INFORMATION EXCHANGE | ||||||||||
| 1150 E HOME ROAD | SPRINGFIELD | OH | 45503 | 260698515 | MEDICAL INFORMATION EXCHANGE | OH | 501(c)(3 | 9 | COMMUNITY MERCY HEALTH SYSTEM | false |
| THE WALLACE S MURRAY AND FRANCES RABBITTS MURRAY MEMORIAL TRUST | ||||||||||
| ONE S LIMESTONE ST | SPRINGFIELD | OH | 45502 | 346827136 | INDIGENT MEDICAL CARE | OH | 501(c)(3 | Type I | NA | false |
| MERCY PROPERTY HOLDINGS | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 300699825 | TITLE HOLDING COMPANY | OH | 501(c)(2 | MERCY HEALTH NORTH LLC | false | |
| MERCY HOME CARE INC | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341587572 | HOME HEALTHCARE | OH | 501(c)(3 | 9 | MERCY HEALTH NORTH LLC | false |
| MERCY COLLEGE OF OHIO | ||||||||||
| 2221 MADISON AVENUE | TOLEDO | OH | 43604 | 341726619 | MEDICAL COLLEGE | OH | 501(c)(3 | 2 | MERCY HEALTH NORTH LLC | false |
| MERCY COLLEGE OF OHIO FOUNDATION INC | ||||||||||
| 2221 MADISON AVENUE | TOLEDO | OH | 43604 | 141963204 | FOUNDATION | OH | 501(c)(3 | Type I | MERCY COLLEGE OF OHIO | false |
| LIFESTAR AMBULANCE INC | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341354653 | MEDICAL TRANSPORTATION | OH | 501(c)(3 | Type II | MERCY HEALTH NORTH LLC | false |
| RSM MEDICAL FOUNDATION | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43624 | 341693671 | HOSPITAL | OH | 501(c)(3 | 3 | MERCY HEALTH NORTH LLC | false |
| SIMON OUTREACH SERVICES | ||||||||||
| 2600 NAVARRE AVENUE | OREGON | OH | 43616 | 341383325 | MEDICAL OFFICE RENTAL | OH | 501(c)(3 | Type II | MERCY HEALTH - ST CHARLES HOSPITAL LLC | false |
| FARLEY HEALTHCARE CORPORATION | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341363204 | HEALTH SERVICES | OH | 501(c)(3 | 9 | MERCY HEALTH NORTH LLC | false |
| NEW VISION MEDICAL LABORATORIES INC | ||||||||||
| 750 W HIGH ST STE 400 | LIMA | OH | 45801 | 341937267 | MEDICAL LAB SERVICES | OH | 501(c)(3 | Type II | ST RITA'S MEDICAL CENTER LLC | false |
| THE ASSUMPTION VILLAGE | ||||||||||
| 9800 N MARKET STREET | NORTH LIMA | OH | 44452 | 341013695 | NURSING HOME | OH | 501(c)(3 | 9 | MERCY HEALTH YOUNGSTOWN LLC | false |
| HOSPICE OF THE VALLEY | ||||||||||
| 5190 MARKET STREET | YOUNGSTOWN | OH | 44512 | 341288745 | HOSPICE SERVICES | OH | 501(c)(3 | 9 | MERCY HEALTH YOUNGSTOWN LLC | false |
| HUMILITY HOUSE | ||||||||||
| 755 OHLTOWN ROAD | AUSTINTOWN | OH | 44515 | 341894783 | NURSING HOME | OH | 501(c)(3 | 9 | MERCY HEALTH YOUNGSTOWN LLC | false |
| ST JOSEPH HEALTH CENTER AUXILIARY | ||||||||||
| 677 EASTLAND SE | WARREN | OH | 44484 | 346556121 | FUNDRAISING | OH | 501(c)(3 | 9 | MERCY HEALTH YOUNGSTOWN LLC | false |
| MERCY HEALTH PARTNERS - LOURDES INC | ||||||||||
| 1530 LONE OAK ROAD | PADUCAH | KY | 42003 | 610600313 | HOSPITAL | KY | 501(c)(3 | 3 | MERCY HEALTH | false |
| LOURDES HOSPITAL AUXILIARY GIFT SHOP | ||||||||||
| 1530 LONE OAK ROAD | PADUCAH | KY | 42003 | 610927805 | FUNDRAISING | KY | 501(c)(3 | Type I | MERCY HEALTH FOUNDATION | false |
| MARCUM AND WALLACE MEMORIAL HOSPITAL INC | ||||||||||
| 60 MERCY COURT | IRVINE | KY | 40336 | 610927491 | HOSPITAL | KY | 501(c)(3 | 3 | MERCY HEALTH PARTNERS - LOURDES INC | false |
| MERCY HEALTH PARTNERS INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 731627534 | MARKET PARENT | TN | 501(c)(3 | Type I | MERCY HEALTH | false |
| MERCY HEALTH PARTNERS - NORTHEAST REGION INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 232813196 | MARKET PARENT | PA | 501(c)(3 | Type I | MERCY HEALTH | false |
| MERCY HOSPITAL OF WILKES-BARRE | ||||||||||
| 746 JEFFERSON AVENUE | SCRANTON | PA | 18510 | 240795625 | HOSPITAL | PA | 501(c)(3 | 3 | MERCY HEALTH PARTNERS - NORTHEAST REGION INC | false |
| MERCY HEALTH CARE CENTER | ||||||||||
| 746 JEFFERSON AVENUE | SCRANTON | PA | 18510 | 232322809 | HOSPITAL | PA | 501(c)(3 | 3 | MERCY HEALTH PARTNERS - NORTHEAST REGION INC | false |
| HEALTHSPAN PARTNERS | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 463055925 | MARKET PARENT | OH | 501(c)(3 | Type II | MERCY HEALTH | false |
| HEALTHSPAN INTEGRATED CARE | ||||||||||
| 1001 LAKESIDE AVE SUITE 1200 | CLEVELAND | OH | 44114 | 340922268 | HMO | OH | 501(c)(3 | 9 | HEALTHSPAN PARTNERS | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt |
|---|---|---|---|---|---|---|---|---|
| NWO Integrated Laboratories Mercy LLC | ||||||||
| 2200 Jefferson Avenue | Toledo | OH | 43624 | 341898285 | Laboratory services | OH | NA | N/A |
| Tiffin Ambulatory Surgical Associates | ||||||||
| 45 St Lawrence Drive | Tiffin | OH | 44833 | 371567866 | Ambulatory Surgery Center | OH | NA | N/A |
| New Vision Medical Lab LLC | ||||||||
| 750 W High Street | Lima | OH | 45801 | 341913433 | Lab Services | OH | NA | N/A |
| West Central Ohio Group Ltd | ||||||||
| 801 Medical Drive | Lima | OH | 45804 | 341848147 | Orthopedic Hospital | OH | NA | N/A |
| Kidney Services of West Central Ohio | ||||||||
| 750 W High Street Suite 100 | Lima | OH | 45801 | 061644264 | Dialysis Center | OH | NA | N/A |
| West Central Ohio Regional Healthcare Alliance Ltd | ||||||||
| 2615 Fort Amanda Road | Lima | OH | 45805 | 341817078 | Healthcare quality | OH | NA | N/A |
| Urologic Oncology of Mahoning Valley LLC | ||||||||
| 1044 Belmont Ave | Youngstown | OH | 44501 | 262989686 | Radiation Therapy | OH | NA | N/A |
| HMHPUSP Surgery Centers LLC | ||||||||
| 15305 Dallas Pkwy Ste 1600 | Addison | TX | 75001 | 271953122 | Surgery Center | TX | NA | N/A |
| OSC-HMHP LLC | ||||||||
| 6505 Market St Bldg B Ste 101 | Boardman | OH | 44512 | 010724836 | Orthopedic Surgery Center | OH | NA | N/A |
| Lourdes Ambulatory Surgery Center | ||||||||
| 225 Medical Center Drive | Paducah | KY | 42003 | 611258960 | Surgery Center | KY | NA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|
| CHP INSURANCE LTD | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 980621978 | INSURANCE | CJ | NA | C Corporation | Yes (true) | |
| NORTHPARKE MEDICAL COMMONS CONDO ASSN | ||||||||||
| 333 N LIMESTONE ST | SPRINGFIELD | OH | 45503 | 311391230 | REAL PROPERTY MGMNT | NA | C Corporation | Yes (true) | OH | |
| NORTHSIDE CORPORATION | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341318438 | RESIDENT RENTALS | NA | C Corporation | Yes (true) | OH | |
| MERCY WORK SOLUTIONS | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 300066340 | WORKERS COMPENSATION | NA | C Corporation | Yes (true) | OH | |
| MERCY HEALTH SYSTEM PHO | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341778321 | MEDICAL SERVICES | NA | C Corporation | Yes (true) | OH | |
| MCAULEY MANAGEMENT SERVICES INC | ||||||||||
| 730 W MARKET STREET | LIMA | OH | 45801 | 341379037 | PROPERTY RENTAL | NA | C Corporation | Yes (true) | OH | |
| LIMA MEDICAL SUPPLIES INC | ||||||||||
| 730 W MARKET STREET | LIMA | OH | 45801 | 340944477 | MEDICAL EQUIPMENT | NA | C Corporation | Yes (true) | OH | |
| COMMUNITY HEALTH PARTNERS ENTERPRISES INC | ||||||||||
| 3700 KOLBE ROAD | LORAIN | OH | 44053 | 341455525 | HOLDING COMPANY | NA | C Corporation | Yes (true) | OH | |
| AMC PHYSICIANS INC | ||||||||||
| 200 W LORAIN STREET | OBERLIN | OH | 44074 | 371439554 | PHYSICIAN SERVICES | NA | C Corporation | Yes (true) | OH | |
| MERCY HEALTH VENTURES INC | ||||||||||
| 4600 MCAULEY PLACE | CINCINNATI | OH | 45242 | 311185477 | DIVERSIFIED ACTIVITIES | NA | C Corporation | Yes (true) | OH | |
| MERCY FRANCISCAN AT WINTON WOODS I INC | ||||||||||
| 10290 MILL ROAD | CINCINNATI | OH | 45231 | 311658668 | LOW-INCOME HOUSING | NA | C Corporation | Yes (true) | OH | |
| HEALTH DYNAMICS INC | ||||||||||
| 900 E OAK HILL AVENUE | KNOXVILLE | TN | 37917 | 621247729 | MEDICAL EQUIPMENT SALES | NA | C Corporation | Yes (true) | TN | |
| HEALTH VENTURES INC & SUBSIDIARIES | ||||||||||
| P O BOX 1788 | KNOXVILLE | TN | 37901 | 621175587 | MEDICAL SERVICES | NA | C Corporation | Yes (true) | TN | |
| ANNE KILCAWLEY CHRISTMAN FOUNDATION | ||||||||||
| 100 FEDERAL PLAZA EAST | YOUNGSTOWN | OH | 44503 | 356735706 | BENEFICIAL TRUST | NA | Trust | Yes (true) | OH | |
| RALPH EWE TRUST | ||||||||||
| 270 PARK AVENUE | NEW YORK | NY | 10017 | 346866422 | BENEFICIAL TRUST | NA | Trust | Yes (true) | NY | |
| ELIZABETH HINES CATES TRUST | ||||||||||
| PNC 1900 E 9TH ST | CLEVELAND | OH | 44114 | 346515678 | BENEFICIAL TRUST | NA | Trust | Yes (true) | OH | |
| WILLIS PARK TRUST | ||||||||||
| PNC 1900 E 9TH ST | CLEVELAND | OH | 44114 | 346519904 | BENEFICIAL TRUST | NA | Trust | Yes (true) | OH | |
| ERMA GIBSON BALDWIN TRUST | ||||||||||
| PNC 1900 E 9TH ST | CLEVELAND | OH | 44114 | 346515566 | BENEFICIAL TRUST | NA | Trust | Yes (true) | OH | |
| HEALTHSPAN INC | ||||||||||
| 225 PICTORIA DR | CINCINNATI | OH | 45246 | 311431434 | INSURANCE | NA | C Corporation | Yes (true) | OH | |
| HEALTHSPAN SOLUTIONS INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 300810766 | CONSULTING | NA | C Corporation | Yes (true) | OH | |