Mercy Franciscan at St Raphael Inc: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- Mercy Franciscan at St Raphael Inc (EIN 20-2934871)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-10
- IRS object ID
- 201523149349301732
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-10T10:02:04-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 202934871 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mercy Franciscan at St Raphael Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MERC | BusinessNameControlTxt |
| Phone | 5139815600 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 High Street | AddressLine1Txt |
| City | Hamilton | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45011 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Todd Lupton | PersonNm |
| Person Title | Market CFO | PersonTitleTxt |
| Signature | 2015-10-30 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Brian Forschner | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 High Street | AddressLine1Txt |
| City | Hamilton | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45011 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,128,296 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2005 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | MERCY FRANCISCAN AT ST. RAPHAEL, INC. PROVIDES PEOPLE LIVING IN BUTLER COUNTY COMMUNITIES WITH SUPPORT SERVICES AND STANDS READY WITH EMERGENCY SUPPLIES OF FOOD, CLOTHING, AND TEMPORARY SHELTER. AN OUTREACH NURSING PROGRAM PROVIDES MEDICAL CARE, SCREENINGS AND PRESCRIPTION ASSISTANCE TO THE UNINSURED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 10 | TotalEmployeeCnt |
| Total Volunteers | 56 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,052,359 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,127,117 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,023 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,179 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $1,053,382 | PYTotalRevenueAmt |
| CY Total Revenue | $1,128,296 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $377,212 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $482,871 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $470,244 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $551,840 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $366,508 | PYOtherExpensesAmt |
| CY Other Expenses | $362,528 | CYOtherExpensesAmt |
| PY Total Expenses | $1,213,964 | PYTotalExpensesAmt |
| CY Total Expenses | $1,397,239 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$160,582 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$268,943 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $992,411 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,017,590 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $27,929 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $302,825 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $964,482 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $714,765 | NetAssetsOrFundBalancesEOYAmt |
| Mission | MERCY FRANCISCAN AT ST. RAPHAEL, INC. EXTENDS THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,248,392 | ExpenseAmt |
| Grant | $482,871 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | MERCY FRANCISCAN AT ST. RAPHAEL, INC. PROVIDES PEOPLE LIVING IN THE CITY OF HAMILTON AND SURROUNDING BUTLER COUNTY COMMUNITIES WITH SUPPORT SERVICES IN TIMES OF CRISIS. WHEN INDIVIDUALS AND FAMILIES SUFFER SETBACKS FROM JOB LOSS OR HOMELESSNESS, ST. RAPHAEL STANDS READY WITH EMERGENCY SUPPLIES OF FOOD, CLOTHING AND TEMPORARY SHELTER. AN OUTREACH NURSING PROGRAM PROVIDES MEDICAL CARE, SCREENINGS AND PRESCRIPTION ASSISTANCE TO PEOPLE IN THE COMMUNITY WHO ARE UNINSURED. WE ALSO PROVIDE DAILY FREE LUNCHES FOR THE NEEDY AND SUPPLY DAILY SNACKS TO DISADVANTAGED CHILDREN AT A LOCAL COMMUNITY CARE CENTER. | Desc |
| Total Program Service Expenses | $1,248,392 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | 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 | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | 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 | Yes (true) | 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 | false | 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 | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 10 | 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 |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | 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 | Yes (true) | 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 (13 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 | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| JOHN LANGENDERFER | ||||||||
| CHAIRMAN | 0.50 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KIMBERLY MAUER | ||||||||
| TRUSTEE | 0.50 | 3.50 | Yes (X) | $0 | $0 | $0 | ||
| JILL GORLEY | ||||||||
| TRUSTEE | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DEBORAH HAUENSTEIN | ||||||||
| TRUSTEE | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| TRINA TURNER | ||||||||
| TRUSTEE | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DOUGLAS LUTZ | ||||||||
| TRUSTEE | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Sr KAREN HARTMAN SFP | ||||||||
| TRUSTEE | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| SR CHERYL ERB RSM | ||||||||
| TRUSTEE | 0.50 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ANTHONY J ARETZ PHD | ||||||||
| TRUSTEE | 0.50 | 3.50 | Yes (X) | $0 | $0 | $0 | ||
| DAVID NOWISKI | ||||||||
| Market CFO | 0.50 | 56.00 | Yes (X) | $0 | $629,201 | $79,123 | ||
| PATRICK KOWALSKI | ||||||||
| Market CFO | 0.30 | 42.70 | Yes (X) | $0 | $328,421 | $55,833 | ||
| TERRY PERDUE | ||||||||
| EXECUTIVE DIRECTOR SOCIAL SERVICES | 40.00 | 0 | Yes (X) | $67,987 | $0 | $26,114 | ||
| DEBORAH BLOOMFIELD | ||||||||
| FORMER OFFICER | 0.00 | 50.00 | $0 | $702,053 | $143,556 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $67,987 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,659,675 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $304,626 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $115,781 | FederatedCampaignsAmt |
| Related Organizations | $531,509 | RelatedOrganizationsAmt |
| All Other Contributions | $479,827 | AllOtherContributionsAmt |
| Noncash Contributions | $212,363 | NoncashContributionsAmt |
| Total Contributions | $1,127,117 | TotalContributionsAmt |
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 | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,179 | TotalRevenueColumnAmt |
| Exclusion | $1,179 | 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 | $1,128,296 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,179 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $482,871 | TotalAmt |
| Program Services | $482,871 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $444,448 | TotalAmt |
| Program Services | $377,781 | ProgramServicesAmt |
| Management And General | $66,667 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,908 | TotalAmt |
| Program Services | $13,522 | ProgramServicesAmt |
| Management And General | $2,386 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,867 | TotalAmt |
| Program Services | $51,737 | ProgramServicesAmt |
| Management And General | $9,130 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,617 | TotalAmt |
| Program Services | $26,024 | ProgramServicesAmt |
| Management And General | $4,593 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,755 | TotalAmt |
| Management And General | $13,755 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $159,309 | TotalAmt |
| Program Services | $135,412 | ProgramServicesAmt |
| Management And General | $23,897 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,002 | TotalAmt |
| Program Services | $25,502 | ProgramServicesAmt |
| Management And General | $4,500 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,072 | TotalAmt |
| Program Services | $78,261 | ProgramServicesAmt |
| Management And General | $13,811 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $560 | TotalAmt |
| Program Services | $476 | ProgramServicesAmt |
| Management And General | $84 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,109 | TotalAmt |
| Program Services | $45,993 | ProgramServicesAmt |
| Management And General | $8,116 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,415 | TotalAmt |
| Program Services | $3,753 | ProgramServicesAmt |
| Management And General | $662 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Membership Dues | $5,748 | $4,886 | $862 |
| Miscellaneous | $2,558 | $2,174 | $384 |
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 | $1,397,239 | TotalAmt |
| Program Services | $1,248,392 | ProgramServicesAmt |
| Management And General | $148,847 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $421,456 | BOYAmt |
| EOY | $536,188 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,426 | BOYAmt |
| EOY | $30,083 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,553,774 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,102,455 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $504,529 | BOYAmt |
| EOY | $451,319 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $992,411 | BOYAmt |
| EOY | $1,017,590 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,929 | BOYAmt |
| EOY | $302,825 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,929 | BOYAmt |
| EOY | $302,825 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $863,452 | BOYAmt |
| EOY | $547,118 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,030 | BOYAmt |
| EOY | $167,647 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $964,482 | BOYAmt |
| EOY | $714,765 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $992,411 | BOYAmt |
| EOY | $1,017,590 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$268,943 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $19,226 | 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 | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $890,984 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $865,008 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $915,733 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,052,359 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,127,117 | CurrentTaxYearAmt |
| Total | $4,851,201 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $890,984 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $865,008 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $915,733 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,052,359 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,127,117 | CurrentTaxYearAmt |
| Total | $4,851,201 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $4,851,201 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,495 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,814 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,114 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,023 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,179 | CurrentTaxYearAmt |
| Total | $14,625 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $18,561 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $155 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $18,716 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $4,884,542 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $20,204 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.9932 | PublicSupportCY170Pct |
| Public Support PY170 | 0.9931 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part II, Line 10 Other Income | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION - REFUND OF REAL ESTATE TAXES, COLUMN A - 18561.0, COLUMN B - 0.0, COLUMN C - , COLUMN D - , COLUMN E - , COLUMN F - 18561.0; DESCRIPTION - REFUND - REPUBLIC SERVICES, COLUMN A - , COLUMN B - , COLUMN C - 155.0, COLUMN D - , COLUMN E - , COLUMN F - 155.0; | ExplanationTxt |
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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $93,993 | OtherCostOrOtherBasisAmt |
| Book Value | $93,993 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,220,859 | OtherCostOrOtherBasisAmt |
| Depreciation | $868,080 | DepreciationAmt |
| Book Value | $352,779 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $238,922 | OtherCostOrOtherBasisAmt |
| Depreciation | $234,375 | DepreciationAmt |
| Book Value | $4,547 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $451,319 | TotalBookValueLandBuildingsAmt |
| Total Liability | $0 | 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 [MERCY HEALTH AND AFFILIATED ENTITIES] COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AT DECEMBER 31, 2014 AND 2013, AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT DECEMBER 31, 2014 OR 2013. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | DIRECT ASSISTANCE PAYMENTS | GrantTypeTxt |
| Recipient | 10442 | RecipientCnt |
| Cash Grant | $264,492 | CashGrantAmt |
| Non Cash Assistance | $218,379 | NonCashAssistanceAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Non Cash Assistance | Food, Drugs, Medical Supplies, Personal Goods | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds | MERCY HEALTH FOUNDATION PERSONNEL REVIEW THE DOCUMENTATION SUBMITTED FOR THE INTENDED USE OF THE WITHDRAWALS MADE. |
| Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. | MERCY HEALTH FOUNDATION PERSONNEL REVIEW THE DOCUMENTATION SUBMITTED FOR THE INTENDED USE OF THE WITHDRAWALS MADE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DEBORAH BLOOMFIELD | ||||||||||||||
| FORMER OFFICER | $0 | $541,196 | $0 | $157,500 | $0 | $3,357 | $0 | $122,873 | $0 | $20,683 | $0 | $845,609 | $0 | $0 |
| DAVID NOWISKI | ||||||||||||||
| Market CFO | $0 | $359,553 | $0 | $84,531 | $0 | $185,117 | $0 | $53,998 | $0 | $25,125 | $0 | $708,324 | $0 | $107,822 |
| PATRICK KOWALSKI | ||||||||||||||
| Market CFO | $0 | $326,510 | $0 | $0 | $0 | $1,911 | $0 | $31,586 | $0 | $24,247 | $0 | $384,254 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 4b TERMS AND CONDITIONS OF MERCY HEALTH EXECUTIVE RETENTION PLAN 457(F) | 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 includible as taxable compensation for listed individuals due to retention plan participation in the reporting year were as follows: David Nowiski $151,655. |
| 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: David Nowiski $0; Patrick Kowalski $0; Deborah Bloomfield $0. |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | THE COMPENSATION OF THE ORGANIZATION'S EXECUTIVE DIRECTOR, TERRY PERDUE, IS DETERMINED BY MERCY HEALTH CINCINNATI LLC, A RELATED TAX-EXEMPT ORGANIZATION. |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | The Cincinnati Market Executive Benefit Plan 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 includible as taxable compensation for listed individuals due to SERP participation in the reporting year were as follows: Patrick Kowalski $0; Deborah Bloomfield $0. |
| 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. Within these established parameters, the Board determines the CEO's incentive award and incentive awards for other listed individuals are determined by the listed individual's supervisor and disclosed to the Board. The Board may authorize modified incentive awards when appropriate in its judgment. |
Schedule M IRS990ScheduleM
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $17,860 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Market value | MethodOfDeterminingRevenuesTxt |
Food Inventory FoodInventoryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 89 | ContributionCnt |
| Noncash Contributions Rpt F990 | $179,732 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Market value | MethodOfDeterminingRevenuesTxt |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 10 | ContributionCnt |
| Noncash Contributions Rpt F990 | $14,771 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Market value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule M, Part I Explanations of reporting method for number on contributions | Clothing and household goods: The number of contributions, not the number of items received, is reported in Part I, Column (B) of Schedule M. Drugs and medical supplies: The number of contributions, not the number of items received, is reported in Part I, Column (B) of Schedule M. Food inventory: The number of contributions, not the number of items received, is reported in Part I, Column (B) of Schedule M. |
| Schedule M, Part I, Line 5 Number of contributions or items contributed | The number of contributions, not the number of items received, is reported in Part I, Column (B) of Schedule M. |
| Schedule M, Part I, Line 20 Number of contributions or items contributed | The number of contributions, not the number of items received, is reported in Part I, Column (B) of Schedule M. |
| Schedule M, Part I, Line 19 Number of contributions or items contributed | The number of contributions, not the number of items received, is reported in Part I, Column (B) of Schedule M. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15 POLICIES | THE COMPENSATION OF THE CEO OR TOP MANAGEMENT OFFICIAL IS DETERMINED BY MERCY HEALTH CINCINNATI LLC, A RELATED TAX-EXEMPT ORGANIZATION. NO COMPENSATION WAS PAID TO ANY OTHER OFFICER OR KEY EMPLOYEE BY THE FILING ORGANIZATION. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | MERCY HEALTH CINCINNATI LLC IS THE SOLE MEMBER OF MERCY FRANCISCAN AT ST. RAPHAEL, INC. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Mercy Health elects all board members who have full voting rights. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | CERTAIN MATTERS REQUIRE APPROVAL OF THE MERCY HEALTH CORPORATE MEMBER, MERCY HEALTH GOVERNING BODY, OR MERCY HEALTH CEO. THE REGULATIONS OF THE ORGANIZATION DESCRIBE THE LEVEL OF APPROVAL REQUIRED FOR VARIOUS DECISIONS. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The Form 990 is prepared by Mercy Health's Tax Department and reviewed by management. 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 | Each year trustees complete a conflict of interest statement that is subsequently approved by the Mercy health audit & corporate responsibility committee (ACRC). Any conflicts of interest that occur during the year are required to be brought to the attention of the Mercy Health ACRC. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE SYSTEM-WIDE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE POSTED ON THE MERCY HEALTH WEBSITE. |
| Form 990, Part IX, Line 11g Other Fees | Affiliate Assessment - Total Expense: 107538, Program Service Expense: 91407, Management and General Expenses: 16131, Fundraising Expenses: ; Purchased Services - Total Expense: 51771, Program Service Expense: 44005, Management and General Expenses: 7766, Fundraising Expenses: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | INTERCOMPANY ELIMINATION - -11774; NET ASSETS RELEASED FROM RESTRICTION - 31000; |
Schedule R IRS990ScheduleR
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 | false | |
| NORTHPARKE MEDICAL COMMONS CONDO ASSN | ||||||||||
| 333 N LIMESTONE ST | SPRINGFIELD | OH | 45503 | 311391230 | REAL PROPERTY MGMNT | NA | C Corporation | false | OH | |
| NORTHSIDE CORPORATION | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341318438 | RESIDENT RENTALS | NA | C Corporation | false | OH | |
| MERCY WORK SOLUTIONS | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 300066340 | WORKERS COMPENSATION | NA | C Corporation | false | OH | |
| MERCY HEALTH SYSTEM PHO | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341778321 | MEDICAL SERVICES | NA | C Corporation | false | OH | |
| MCAULEY MANAGEMENT SERVICES INC | ||||||||||
| 730 W MARKET STREET | LIMA | OH | 45801 | 341379037 | PROPERTY RENTAL | NA | C Corporation | false | OH | |
| LIMA MEDICAL SUPPLIES INC | ||||||||||
| 730 W MARKET STREET | LIMA | OH | 45801 | 340944477 | MEDICAL EQUIPMENT | NA | C Corporation | false | OH | |
| COMMUNITY HEALTH PARTNERS ENTERPRISES INC | ||||||||||
| 3700 KOLBE ROAD | LORAIN | OH | 44053 | 341455525 | HOLDING COMPANY | NA | C Corporation | false | OH | |
| AMC PHYSICIANS INC | ||||||||||
| 200 W LORAIN STREET | OBERLIN | OH | 44074 | 371439554 | PHYSICIAN SERVICES | NA | C Corporation | false | OH | |
| MERCY HEALTH VENTURES INC | ||||||||||
| 4600 MCAULEY PLACE | CINCINNATI | OH | 45242 | 311185477 | DIVERSIFIED ACTIVITIES | NA | C Corporation | false | OH | |
| MERCY FRANCISCAN AT WINTON WOODS I INC | ||||||||||
| 10290 MILL ROAD | CINCINNATI | OH | 45231 | 311658668 | LOW-INCOME HOUSING | NA | C Corporation | false | OH | |
| HEALTH DYNAMICS INC | ||||||||||
| 900 E OAK HILL AVENUE | KNOXVILLE | TN | 37917 | 621247729 | MEDICAL EQUIPMENT SALES | NA | C Corporation | false | TN | |
| HEALTH VENTURES INC & SUBSIDIARIES | ||||||||||
| P O BOX 1788 | KNOXVILLE | TN | 37901 | 621175587 | MEDICAL SERVICES | NA | C Corporation | false | TN | |
| ANNE KILCAWLEY CHRISTMAN FOUNDATION | ||||||||||
| 100 FEDERAL PLAZA EAST | YOUNGSTOWN | OH | 44503 | 356735706 | BENEFICIAL TRUST | NA | Trust | false | OH | |
| RALPH EWE TRUST | ||||||||||
| 270 PARK AVENUE | NEW YORK | NY | 10017 | 346866422 | BENEFICIAL TRUST | NA | Trust | false | NY | |
| ELIZABETH HINES CATES TRUST | ||||||||||
| PNC 1900 E 9TH ST | CLEVELAND | OH | 44114 | 346515678 | BENEFICIAL TRUST | NA | Trust | false | OH | |
| WILLIS PARK TRUST | ||||||||||
| PNC 1900 E 9TH ST | CLEVELAND | OH | 44114 | 346519904 | BENEFICIAL TRUST | NA | Trust | false | OH | |
| ERMA GIBSON BALDWIN TRUST | ||||||||||
| PNC 1900 E 9TH ST | CLEVELAND | OH | 44114 | 346515566 | BENEFICIAL TRUST | NA | Trust | false | OH | |
| HEALTHSPAN INC | ||||||||||
| 225 PICTORIA DR | CINCINNATI | OH | 45246 | 311431434 | INSURANCE | NA | C Corporation | false | OH | |
| HEALTHSPAN SOLUTIONS INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 300810766 | CONSULTING | NA | C Corporation | false | OH | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |