GOTTLIEB MEMORIAL HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- GOTTLIEB MEMORIAL HOSPITAL (EIN 36-2379649)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-12
- IRS object ID
- 201441329349301924
- Schema version
- 2012v2.1
- 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 C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-12T11:00:42-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362379649 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOTTLIEB MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GOTT | NameControl |
| Phone | 7084504966 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 W NORTH AVE | AddressLine1 |
| City | MELROSE PARK | City |
| State | IL | State |
| ZIP Code | 60160 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | AJAY SIAL | Name |
| Title | TREASURER | Title |
| Phone | 7084504966 | Phone |
| Date Signed | 2014-05-12 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LARRY GOLDBERG | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 W NORTH AVE | AddressLine1 |
| City | MELROSE PARK | City |
| State | IL | State |
| ZIP Code | 60160 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 142552757 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.GOTTLIEBHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1956 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | HEALTH CARE SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1364 | TotalNbrEmployees |
| Total Nbr Volunteers | 217 | TotalNbrVolunteers |
| Total Gross UBI | 259326 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 462838 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 393764 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 129880571 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 137656182 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 737218 | InvestmentIncomePriorYear |
| Investment Income Current Year | 87240 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1599005 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4078632 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 132679632 | TotalRevenuePriorYear |
| Total Revenue Current Year | 142215818 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 22187 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 67365807 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 69239429 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 65986470 | OtherExpensePriorYear |
| Other Expenses Current Year | 67399230 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 133352277 | TotalExpensesPriorYear |
| Total Expenses Current Year | 136660846 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -672645 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5554972 | RevenuesLessExpensesCY |
| Total Assets BOY | 152695436 | TotalAssetsBOY |
| Total Assets EOY | 156352866 | TotalAssetsEOY |
| Total Liabilities BOY | 78193014 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 72369899 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 74502422 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 83982967 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | HEALTH CARE SERVICES - SEE SCHEDULE H FOR MORE INFORMATION | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 117779838 | Expense |
| Grants | 22187 | Grants |
| Revenue | 140742455 | Revenue |
| Description | GOTTLIEB MEMORIAL HOSPITAL (GOTTLIEB) IS AN ACUTE CARE NOT-FOR-PROFIT HOSPITAL WITH 255 LICENSED BEDS. OPERATING IN THE WESTERN SUBURBS OF ILLINOIS, GOTTLIEB PROVIDES VITAL HEALTH CARE SERVICES 24 HOURS A DAY, SEVEN DAYS A WEEK, TO PATIENTS IN VARIOUS SETTINGS, INCLUDING CARDIOVASCULAR/THORACIC, OBSTETRICS, ORTHOPAEDICS, MEDICAL IMAGING, GASTROENTEROLOGY, UROLOGY, HOME CARE AND HOSPICE SERVICES, TRANSITIONAL CARE, AND ADULT DAY CARE SERVICES.DURING FISCAL YEAR 2013, GOTTLIEB PROVIDED OVER 48,000 DAYS OF HEALTHCARE SERVICES AND OVER 82,000 OUTPATIENT VISITS TO THE COMMUNITY. GOTTLIEB MEMORIAL HOSPITAL IS DEDICATED TO PROVIDING SUPERIOR HEALTHCARE TO IMPROVE THE OVERALL HEALTH OF ALL WE SERVE. INDIVIDUALS WITHIN OUR COMMUNITY ARE PROVIDED ACCESS TO MEDICALLY NECESSARY CARE REGARDLESS OF THEIR ABILITY TO PAY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | THE MISSION STATEMENT OF GOTTLIEB MEMORIAL HOSPITAL IS AS FOLLOWS:WE, CHE TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 117779838 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 89 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1364 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| States Where Copy Of Return Is Filed | NC | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AJAY SIAL SR VP & CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7082164252 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2160 SOUTH FIRST AVE | AddressLine1 |
| City | MAYWOOD | City |
| State | IL | State |
| ZIP Code | 60153 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (40 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|---|
| LARRY GOLDBERG | ||||||||||
| DIR; PRES THRU 6/13; CEO AS OF 6/13 | 10.00 | 35.00 | X | X | 0 | 1106137 | 103495 | |||
| SR JOAN MARIE STEADMAN CSC | ||||||||||
| DIRECTOR; CHAIR AS OF 7/12 | 2.00 | X | X | 0 | 0 | 0 | ||||
| ROBERT FLANIGAN MD | ||||||||||
| DIRECTOR; LUMC PHYSICIAN | 2.00 | 43.00 | X | 0 | 353766 | 25967 | ||||
| RICHARD GAMELLI MD | ||||||||||
| DIRECTOR; LUMC PHYSICIAN | 2.00 | 43.00 | X | 0 | 424205 | 22010 | ||||
| P TERRENCE O'ROURKE | ||||||||||
| DIRECTOR; TRINITY EVP CLINICAL TRANS | 2.00 | 48.00 | X | 0 | 964005 | 56964 | ||||
| ROBERT SULO MD | ||||||||||
| DIRECTOR; LUMC PHYSICIAN | 2.00 | 43.00 | X | 0 | 337625 | 41736 | ||||
| DAVID WILBER MD | ||||||||||
| DIRECTOR; DIR CARDIOVASCULAR INST | 2.00 | 43.00 | X | 0 | 614807 | 23644 | ||||
| NANCY KNOWLES | ||||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||||
| HENRY LANG | ||||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||||
| WILLIAM REICHERT | ||||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||||
| MARC SCHWARTZ | ||||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||||
| JACK WEINBERG | ||||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||||
| JOY CUNNINGHAM | ||||||||||
| DIRECTOR AS OF 1/13 | 2.00 | X | 0 | 0 | 0 | |||||
| LORI HEALEY | ||||||||||
| DIRECTOR AS OF 1/13 | 2.00 | X | 0 | 0 | 0 | |||||
| ROBERT HOMBACH | ||||||||||
| DIRECTOR AS OF 1/13 | 2.00 | X | 0 | 0 | 0 | |||||
| STEPHEN RAY MITCHELL MD | ||||||||||
| DIRECTOR AS OF 1/13 | 2.00 | X | 0 | 0 | 0 | |||||
| LORI PRICE | ||||||||||
| PRESIDENT AS OF 6/13 | 35.00 | 10.00 | X | 0 | 276673 | 53524 | ||||
| AJAY SIAL | ||||||||||
| TREASURER; LUMC SR VP & CFO | 2.00 | 43.00 | X | 0 | 455517 | 28604 | ||||
| ELLYN CHIN | ||||||||||
| ASST TREAS THROUGH 6/13, GMH VP FIN | 35.00 | 10.00 | X | 268412 | 0 | 84389 | ||||
| DANIEL ISACKSEN | ||||||||||
| ASST TREAS AS OF 6/13; LUMC VP FIN | 10.00 | 35.00 | X | 0 | 0 | 0 | ||||
| JILL RAPPIS | ||||||||||
| SECRETARY; LUMC VP GEN CNSL | 2.00 | 43.00 | X | 0 | 327754 | 69848 | ||||
| DONNA HALINSKI | ||||||||||
| ASST SECR THROUGH 12/12; VP CLIN AFFRS | 2.00 | 43.00 | X | 0 | 281171 | 128437 | ||||
| MARIA PEKAR | ||||||||||
| ASST SEC - 12/12;LUMC ASSOC GEN CNSL | 2.00 | 43.00 | X | 0 | 200089 | 65521 | ||||
| DAVID HECHT MD | ||||||||||
| SVP - CLINICAL AFFAIRS AS OF 6/13 | 10.00 | 35.00 | X | 0 | 348704 | 24152 | ||||
| KENNETH FISHBAIN | ||||||||||
| COO | 35.00 | 10.00 | 357533 | 0 | 90727 | X | ||||
| ALAN GOLDBERG | ||||||||||
| VP OF ADMIN SERVICES | 45.00 | 173649 | 0 | 84018 | X | |||||
| JOSEPH SWEDISH | ||||||||||
| TRINITY PRES & CEO THROUGH 3/13 | 2.00 | 53.00 | 0 | 3233500 | 601476 | X | ||||
| KEDRICK ADKINS | ||||||||||
| TRINITY PRES,INTEG SYS THROUGH 6/13 | 2.00 | 53.00 | 0 | 1821619 | 126167 | X | ||||
| J RICHARD O'CONNELL | ||||||||||
| EVP & PRES, TRINITY HEALTH DIV | 2.00 | 53.00 | 0 | 1036410 | 130423 | X | ||||
| SILIA MIGLIO | ||||||||||
| CORPORATE CONTROLLER | 40.00 | 163332 | 0 | 27738 | X | |||||
| MAURITA ADLER | ||||||||||
| CHIEF INFORMATION OFFICER | 40.00 | 156732 | 0 | 60158 | X | |||||
| MARY MORROW | ||||||||||
| VP NURSING | 40.00 | 150610 | 0 | 36618 | X | |||||
| ELIZABETH MCLAIN | ||||||||||
| RN WEEKENDER II | 40.00 | 150306 | 0 | 19824 | X | |||||
| JOHN ASTREIDES | ||||||||||
| DIRECTOR OF INFORMATION SVCS | 40.00 | 148040 | 0 | 35500 | X | |||||
| PAUL WHELTON | ||||||||||
| FORMER OFFICER | 0.00 | 0 | 928851 | 15049 | X | |||||
| DANIEL HALE | ||||||||||
| FORMER OFFICER | 0.00 | 50.00 | 0 | 856049 | 63490 | X | ||||
| BENJAMIN CARTER | ||||||||||
| FORMER OFFICER | 0.00 | 50.00 | 0 | 799303 | 112810 | X | ||||
| TOM HONAN NAVIGANT | ||||||||||
| FORMER OFFICER | 0.00 | 0 | 427675 | 0 | X | |||||
| PATRICIA CASSIDY | ||||||||||
| FORMER OFFICER | 0.00 | 0 | 416736 | 51223 | X | |||||
| MICHAEL MURPHY | ||||||||||
| FORMER KEY EMPLOYEE | 0.00 | 0 | 180882 | 16630 | X | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1568614 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 15391478 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 2200142 | TotalOtherCompensation |
| Number Individuals GT100 K | 64 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| WALSH CONSTRUCTION | |||||
| 929 W ADAMS STREET | CHICAGO | IL | 60607 | CONSTRUCTION SERVICES | 2474174 |
| GEORGE SOLLITT CONSTRUCTION COMPANY | |||||
| 790 N CENTRAL AVE | WOODDALE | IL | 60191 | CONSTRUCTION SERVICES | 1883646 |
| SODEXO INC & AFFILIATES | |||||
| 4880 PAYSPHERE CIRCLE | CHICAGO | IL | 60674 | MANAGEMENT SERVICES | 1744897 |
| HEALTHCARE ASSOCIATES | |||||
| 1151 E WARRENVILLE RD | NAPERVILLE | IL | 60563 | BANKING SERVICES | 1115231 |
| EPIC SYSTEMS CORPORATION | |||||
| PO BOX 88314 | MILWAUKEE | WI | 53288 | INFO TECHNOLOGY SERVICES | 840654 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 47 | NumberOfContractorsGT100K |
| Fundraising Events | 9710 | FundraisingEvents |
| Related Organizations | 12400 | RelatedOrganizations |
| All Other Contributions | 371654 | AllOtherContributions |
| Total Contributions | 393764 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT SVC REV | 900099 | 131944178 | 131944178 | |
| LABORATORY REV | 621500 | 5712004 | 5452678 | 259326 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 137656182 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 103875 | TotalRevenueColumn |
| Exclusion | $103,875 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 312156 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 312156 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 312156 | TotalRevenueColumn |
| Exclusion | $312,156 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 173979 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 190614 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 173979 | Securities |
| Other | -190614 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -16635 | TotalRevenueColumn |
| Exclusion | -$16,635 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 57490 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 9710 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 78622 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -21132 | TotalRevenueColumn |
| Exclusion | -$21,132 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 111387 | GrossSalesOfInventory |
| Cost Of Goods Sold | 67703 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 43684 | TotalRevenueColumn |
| Exclusion | $43,684 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| MEDICARE/MEDICAID HIT | 900099 | 2398001 | 2398001 | |
| CAFETERIA REVENUE | 722210 | 398325 | $398,325 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 947598 | TotalRevenueColumn |
| Related Or Exempt Function Income | 947598 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3743924 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 142215818 | TotalRevenueColumn |
| Related Or Exempt Function Income | 140742455 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 259326 | UnrelatedBusinessRevenue |
| Exclusion | $820,273 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22187 | Total |
| Program Services | 22187 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1055712 | Total |
| Management And General | 1055712 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54516231 | Total |
| Program Services | 49055932 | ProgramServices |
| Management And General | 5460299 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1528760 | Total |
| Program Services | 1522362 | ProgramServices |
| Management And General | 6398 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8043393 | Total |
| Program Services | 7196829 | ProgramServices |
| Management And General | 846564 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4095333 | Total |
| Program Services | 3632077 | ProgramServices |
| Management And General | 463256 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10 | Total |
| Management And General | 10 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53040 | Total |
| Management And General | 53040 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10418956 | Total |
| Program Services | 4642221 | ProgramServices |
| Management And General | 5776735 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 301738 | Total |
| Management And General | 301738 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3319045 | Total |
| Program Services | 2352551 | ProgramServices |
| Management And General | 966494 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 946857 | Total |
| Program Services | 189574 | ProgramServices |
| Management And General | 757283 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2637774 | Total |
| Program Services | 2525505 | ProgramServices |
| Management And General | 112269 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61633 | Total |
| Program Services | 51370 | ProgramServices |
| Management And General | 10263 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109261 | Total |
| Program Services | 39284 | ProgramServices |
| Management And General | 69977 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 197457 | Total |
| Program Services | 197457 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7666645 | Total |
| Program Services | 7666645 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1248279 | Total |
| Program Services | 1248279 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 20345812 | 20345812 | |
| BAD DEBT | 10568538 | 10568538 | |
| HOSPITAL PROVIDER TAX | 3347112 | 3347112 | |
| CONTRACT LABOR | 1692354 | 1302851 | 389503 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4484719 | Total |
| Program Services | 1873252 | ProgramServices |
| Management And General | 2611467 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 136660846 | Total |
| Program Services | 117779838 | ProgramServices |
| Management And General | 18881008 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10803190 | BOY |
| EOY | 3637966 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63107 | BOY |
| EOY | 163113 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16889292 | BOY |
| EOY | 29321574 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 315171 | BOY |
| EOY | 292258 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2874627 | BOY |
| EOY | 2939000 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 415505 | BOY |
| EOY | 154452 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 92802735 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 14487129 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 82915083 | BOY |
| EOY | 78315606 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5298857 | BOY |
| EOY | 764791 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8645504 | BOY |
| EOY | 734800 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24475100 | BOY |
| EOY | 40029306 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 152695436 | BOY |
| EOY | 156352866 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61487039 | BOY |
| EOY | 40107675 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 48778 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5554180 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11151795 | BOY |
| EOY | 32213446 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78193014 | BOY |
| EOY | 72369899 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74502422 | BOY |
| EOY | 83882967 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 100000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74502422 | BOY |
| EOY | 83982967 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 152695436 | BOY |
| EOY | 156352866 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 5554972 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 241829 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 3683744 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $30,142 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 30142 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | GOTTLIEB MEMORIAL HOSPITAL HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED GOTTLIEB MEMORIAL HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. GOTTLIEB MEMORIAL HOSPITAL MADE NO CONTRIBUTIONS TO ANY LEGISLATORS OR CANDIDATES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12500000 | OtherCostOrOtherBasis |
| Book Value | 12500000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 54464529 | OtherCostOrOtherBasis |
| Depreciation | 6873042 | Depreciation |
| Book Value | 47591487 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 25209188 | OtherCostOrOtherBasis |
| Depreciation | 7614087 | Depreciation |
| Book Value | 17595101 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 629018 | OtherCostOrOtherBasis |
| Book Value | 629018 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 78315606 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| NET DEFERRED TAX ASSET | 146000 |
| INTERCOMPANY RECEIVABLES | 33523189 |
| MISCELLANEOUS RECEIVABLES | 1470146 |
| INVESTMENT IN UNCONSOLIDATED AFFILIATES | 101500 |
| OTHER LONG TERM ASSETS | 4788471 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 40029306 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| INTERCOMPANY PAYABLES | $14,046,488 |
| LONG-TERM ASSET RETIREMENT OBLIGATION (FIN 47) | $452,234 |
| OTHER CURRENT LIABILITIES | $1,033,390 |
| OTHER LONG-TERM LIABILITIES | $14,003,685 |
| INTERCOMPANY NOTES PAYABLE | $2,677,649 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 32213446 | TotalOfAmounts |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | EMERALD BALL | NameOfEvent1 |
| Gross Receipts Event1 | 67200 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 9710 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 57490 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 78622 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 67200 | GrossReceiptsTotal |
| Charitable Contributions Total | 9710 | CharitableContributionsTotal |
| Gross Revenue Total Events | 57490 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 78622 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 78622 | DirectExpenseSummaryEvents |
| Net Income Summary | -21132 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 600.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 1613 | PersonsServed |
| Total Community Benefit Expense | 3777028 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3777028 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03000 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15980698 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17576394 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -1595696 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 1613 | PersonsServed |
| Total Community Benefit Expense | 19757726 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17576394 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2181332 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03000 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 2913 | PersonsServed |
| Total Community Benefit Expense | 187675 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 187675 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 6 | PersonsServed |
| Total Community Benefit Expense | 38141 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 38141 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 3600 | PersonsServed |
| Total Community Benefit Expense | 1180 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1180 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 6519 | PersonsServed |
| Total Community Benefit Expense | 226996 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 226996 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 8132 | PersonsServed |
| Total Community Benefit Expense | 19984722 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17576394 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2408328 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03180 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 60 | PersonsServed |
| Total Community Building Expense | 947 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 947 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 60 | PersonsServed |
| Total Community Building Expense | 947 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 947 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $1,909,599 | BadDebtExpenseAmount |
| Amount Attributable To | 782936 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 47896556 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 49409139 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1512583 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOTTLIEB MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 W NORTH AVE | AddressLine1 |
| City | MELROSE PARK | City |
| State | IL | State |
| ZIP Code | 60160 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.GOTTLIEBHOSPITAL.ORG | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | INCLUDING OUTPATIENT SERVICES | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOTTLIEB MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 600.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| State Regulation | X | StateRegulation |
| Other Factors | X | OtherFactors |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| GOTTLIEB HOME HEALTH & HOSPICE | ||||
| 905 W NORTH AVE | MELROSE PARK | IL | 60160 | HOME HEALTH AND HOSPICE PROGRAM |
| GOTTLIEB ADULT DAY CARE CENTER | ||||
| 555 W NORTH AVE | MELROSE PARK | IL | 60160 | ADULT DAY CARE CENTER |
Form990 Schedule H Part VI Form990ScheduleHPartVI (20 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. | ||
| PART I, LINE 6A: GOTTLIEB MEMORIAL HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF ILLINOIS. GOTTLIEB MEMORIAL HOSPITAL ALSO REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH IN ITS ANNUAL REPORT, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.IN ADDITION, GOTTLIEB MEMORIAL HOSPITAL WILL INCLUDE A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. | ||
| PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. | ||
| PART I, L7 COL(F): THE FOLLOWING NUMBER, $10,568,538, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). | ||
| PART II: COMMUNITY BUILDING ACTIVITIES - GOTTLIEB MEMORIAL HOSPITAL (GMH) PROVIDED COMMUNITY BUILDING ACTIVITIES IN FISCAL YEAR 2013 TO SUPPORT AND PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES. GMH STAFF HOSTED QUARTERLY MEETINGS OF A NURSING HOME COLLABORATIVE TO DEVELOP COMMUNITY RELATIONSHIPS AND IMPROVE PATIENT CARE TRANSITIONS WITHIN THE SERVICE AREA. | ||
| PART III, LINE 4: GOTTLIEB MEMORIAL HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 17 OF THOSE STATEMENTS: "THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY MINISTRY ORGANIZATION AND FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE."PART III, LINE 2: METHODOLOGY USED FOR LINE 2: BAD DEBT EXPENSE REPORTED ON LINE 2 IS SHOWN AT COST AND WAS CALCULATED USING A COST TO CHARGE RATIO METHODOLOGY.ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.PART III, LINE 3: GOTTLIEB MEMORIAL HOSPITAL USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR CHARITY: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FY13 WAS THE FIRST YEAR GOTTLIEB MEMORIAL HOSPITAL UTILIZED THE PREDICTIVE MODEL WITH RESULTS USED FOR ANALYSIS ONLY. STARTING IN FY14, GOTTLIEB MEMORIAL HOSPITAL IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. | ||
| PART III, LINE 8: GOTTLIEB MEMORIAL HOSPITAL DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CHA RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. | ||
| PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S COLLECTION POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. | ||
| PART V, SECTION B, LINE 3: GMH ( A MEMBER OF LOYOLA UNIVERSITY HEALTH SYSTEM - LUHS) REACHED OUT TO ITS COMMUNITY THROUGH FOUR METHODS OF COLLECTING INPUT IN THE DEVELOPMENT OF ITS CHNA IN AN EFFORT TO BETTER UNDERSTAND HOW LUHS CAN IMPROVE THE WAYS IT SERVES ITS COMMUNITY. THESE INCLUDED 1) HEALTH SERVICES INVENTORY, 2) COMMUNITY SURVEY, 3) PROVIDER AND FAITH LEADER SURVEY AND PHYSICIAN FOCUS GROUPS AND 4) THREE COMMUNITY CONVERSATIONS REGARDING YOUTH NEEDS CONDUCTED BY UNITED WAY OF METROPOLITAN CHICAGO AND DUPAGE/WEST COOK. IN ADDITION, DATA WAS USED FROM THE NATIONAL RESEARCH CORPORATION CONSUMER HEALTH REPORT FOR THE MARKET AREA.A THIRTY-EIGHT QUESTION COMMUNITY SURVEY WAS DEVELOPED THROUGH THE INPUT OF THE LOYOLA UNIVERSITY HEALTH SYSTEM (LUHS), ILLINOIS PUBLIC HEALTH INSTITUTE (IPHI), ACTING AS CONSULTANT TO THE PROCESS, AND THE CHNA STEERING COMMITTEE, COMPOSED OF COMMUNITY ORGANIZATIONS AND LOCAL PUBLIC HEALTH DEPARTMENTS. THE SURVEY WAS ADMINISTERED IN BOTH ENGLISH AND SPANISH AT 10 SITES DURING A THREE WEEK PERIOD. THE SITES INCLUDED WEST COOK YMCA, CORAZON/CICERO YOUTH TASK FORCE, PCC COMMUNITY WELLNESS CENTER, INFANT WELFARE-OAK PARK, WEST SUBURBAN PADS, CATHOLIC CHARITIES, AGING CARE CONNECTIONS, GOTTLIEB ADULT DAY CARE AND PROVISO PANTRY. A NINE-QUESTION PROVIDER SURVEY WAS ALSO DEVELOPED BY LUHS, IPHI AND THE STEERING COMMITTEE THAT WAS SENT TO HEALTH CARE PROVIDERS, SOCIAL SERVICE PROVIDERS AND COMMUNITY BASED ORGANIZATIONS SERVING IN THE CHNA AREA. | GOTTLIEB MEMORIAL HOSPITAL | |
| PART V, SECTION B, LINE 4: OTHER HOSPITALS THAT PARTICIPATED IN THE CHNA INCLUDE LOYOLA UNIVERSITY MEDICAL CENTER, RML SPECIALTY HOSPITAL AND RIVEREDGE HOSPITAL. | GOTTLIEB MEMORIAL HOSPITAL | |
| PART V, SECTION B, LINE 5C: COPIES OF THE CHNA WERE EMAILED TO ALL STEERING COMMITTEE MEMBERS AS WELL AS AREA SCHOOL PRINCIPALS, LOCAL ELECTED OFFICIALS AND LEADERS OF LOCAL COMMUNITY ORGANIZATIONS.HTTP://WWW.GOTTLIEBHOSPITAL.ORG/SITES/DEFAULT/FILES/CHNA-REPORT.PDF | GOTTLIEB MEMORIAL HOSPITAL | |
| PART V, SECTION B, LINE 7: FOLLOWING THE DATA COLLECTION AND PRESENTATION OF FINDINGS, LUHS AND THE STEERING COMMITTEE WORKED TO IDENTIFY PRIORITY HEALTH ISSUES FOR THE LOCAL COMMUNITY. THROUGH A PRIORITIZATION PROCESS, COMMITTEE MEMBERS DETERMINED THE TOP PRIORITIES BASED ON CRITERIA INCLUDING: SIZE OF THE ISSUE, SERIOUSNESS OF NOT ADDRESSING THE ISSUE, AVAILABLE RESOURCES TO ADDRESS THE ISSUE AND POTENTIAL TO IMPACT THE ISSUE. THE INITIAL PRIORITIZATION PROCESS YIELDED 10 TOP ISSUES INCLUDING ACCESS TO CARE, COORDINATION OF CARE, DENTAL HEALTH, DIABETES, HEART DISEASE, JOBS, LACK OF HEALTH EDUCATION, LOSS OF SERVICES, MENTAL HEALTH AND OBESITY. IT BECAME CLEAR THAT SEVERAL ISSUES WERE INTERRELATED OR COULD SERVE AS STRATEGIES TO ADDRESS OVERARCHING ISSUES. BASED ON THIS, THE STEERING COMMITTEE DECIDED TO COMBINE ISSUES AND TO FOCUS ON TWO PRIORITIES: OBESITY AND ACCESS TO CARE. THE SIZE AND NATURE OF THESE PRIORITIES REQUIRE THE ENGAGEMENT OF NOT JUST LUHS BUT MANY COMMUNITY AND GOVERNMENTAL RESOURCES TO WORK TOGETHER TO ADDRESS THESE SOCIETAL ISSUES. | GOTTLIEB MEMORIAL HOSPITAL | |
| PART V, SECTION B, LINE 12H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTHCARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. | GOTTLIEB MEMORIAL HOSPITAL | |
| PART V, SECTION B, LINE 20D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME BETWEEN 201% AND 600% OF THE FPG RECEIVE A PERCENTAGE DISCOUNT OFF OF HOSPITAL CHARGES FOR MEDICALLY NECESSARY SERVICES, BASED UPON A SLIDING SCALE. | GOTTLIEB MEMORIAL HOSPITAL | |
| PART VI, LINE 2: NEEDS ASSESSMENT - GOTTLIEB MEMORIAL HOSPITAL, THROUGH LOYOLA UNIVERSITY HEALTH SYSTEM, PERFORMS AN ONGOING EVALUATION OF THE NEEDS OF THE MEDICALLY UNDERSERVED POPULATION WITHIN THE COMMUNITY THAT SURROUNDS THE MAIN CAMPUS. GMH SEEKS NEW OPPORTUNITIES TO BETTER SERVE THESE POPULATIONS AS THEIR NEEDS CHANGE AND AS ADVANCES ARE MADE IN MEDICAL CARE. THE NEEDS EVALUATION IS PERFORMED PERIODICALLY THROUGH VARIOUS METHODS, INCLUDING POPULATION PROJECTIONS BY ZIP CODE FOR GMH'S SERVICE AREAS, INVOLVING IDENTIFICATION OF THE NUMBER OF PATIENTS SERVED INCLUDING THEIR AGE, RACE AND GENDER. THE DATA IS USED TO DETERMINE THE COMMUNITY NEEDS AND TO EVALUATE BOTH EXISTING AND FUTURE PROGRAMS THAT WILL BEST SERVE THIS POPULATION AND ENABLE THEM TO RECEIVE THE HEALTH THEY NEED. | ||
| PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - GMH IS COMMITTED TO:PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES; - CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES;- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE; AND - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITY.GMH HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: - PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSGMH PROVIDES EFFECTIVE COMMUNICATION WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING HEALTHCARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE.GMH OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH A NUMBER OF MEANS, INCLUDING THE HOSPITAL'S WEBSITE. GMH HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. GMH MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. GMH EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, AND BILLING AND COLLECTIONS) ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES. | ||
| PART VI, LINE 4: COMMUNITY INFORMATION - OPERATING IN THE WESTERN SUBURBS OF CHICAGO, GMH IS AN ACUTE CARE, 255-LICENSED BED, NOT-FOR-PROFIT HOSPITAL; WITH A PROFESSIONAL OFFICE BUILDING, ADULT DAY CARE, GOTTLIEB CENTER FOR FITNESS, MARJORIE G. WEINBERG CANCER CARE CENTER AND THE LOYOLA METABOLIC SURGERY AND BARIATRIC CARE CENTER ON ITS CAMPUS. GMH PROVIDES VITAL HEALTH CARE SERVICES TO PATIENTS IN VARIOUS CLINICAL AREAS, INCLUDING GENERAL MEDICINE, OBSTETRICS/GYNECOLOGY, CARDIOVASCULAR SERVICES, ORTHOPEDICS, NEUROSCIENCES, SPINE CARE, ONCOLOGY, AND ADULT CARE SERVICE. THE AFFILIATION WITH LOYOLA UNIVERSITY HEALTH SYSTEM AND LOYOLA UNIVERSITY MEDICAL CENTER BRINGS A HIGH-QUALITY, FULL-SERVICE COMMUNITY-BASED INSTITUTION TOGETHER WITH A WORLD-CLASS TEACHING HOSPITAL AND MEDICAL SCHOOL. BOTH ORGANIZATIONS ARE NOT-FOR-PROFIT HEALTHCARE INSTITUTIONS AND BRING DIFFERENT STRENGTHS TO THIS RELATIONSHIP. THE COMMUNITIES SERVED BY THESE INSTITUTIONS BENEFIT FROM THE AFFILIATION BY ENHANCED HEALTHCARE PROVIDED LOCALLY AND THE IMPROVED FINANCIAL POSITIONS OF BOTH ORGANIZATIONS. GMH'S TOTAL SERVICE AREA, WHICH INCLUDES THE WESTERN SECTION OF CHICAGO, WESTERN COOK COUNTY AND THE EASTERN PART OF DUPAGE COUNTY, COVERS A POPULATION OF ABOUT ONE MILLION PEOPLE CHARACTERIZED BY A WIDE DEMOGRAPHIC MIX OF AGE, RACE AND ECONOMIC DIVERSITY. GMH'S PRIMARY SERVICE AREA, WHICH INCLUDES FOUR ACUTE CARE HOSPITALS, CONSISTS OF THE WEST SUBURBAN TOWNS INCLUDING AREAS FEDERALLY-DESIGNATED AS MEDICALLY UNDERSERVED. THE AREA HAS A WIDE RANGE OF SOCIOECONOMIC STATUS, UNEMPLOYMENT AND HEALTH STATUS. SPECIFICALLY, THE AREA HAS THE FOLLOWING CHARACTERISTICS: - 12 PERCENT OF THE POPULATION IS AGE 65 OR OLDER.- AVERAGE HOUSEHOLD INCOME IS $65,744 WITH 18.2 PERCENT OF HOUSEHOLDS OVER $100,000 AND 26.3 PERCENT UNDER $25,000.- HISPANICS ARE AMONG THE FASTEST-GROWING GROUP MAKING UP 34.3 PERCENT OF THE POPULATION. | ||
| PART VI, LINE 5: OTHER INFORMATION - IN FURTHERANCE OF LOYOLA UNIVERSITY HEALTH SYSTEM'S JESUIT' TRADITION OF TEACHING, GMH SUPPORTS HOSPITAL-BASED EDUCATION AND TRAINING OF FUTURE PROFESSIONALS. GMH PROVIDED HOME AND HOSPICE CARE TRAINING FOR STUDENT NURSES, SUPPLIED PRECEPTORS FOR PHARMACY STUDENTS, PROVIDED CLINICAL SUPERVISION OF PHYSICAL AND SPEECH THERAPY STUDENTS AND TRAINED MEDICAL STUDENTS TO EVALUATE PATIENTS' NEEDS THROUGH OUTREACH IN THE COMMUNITY. GMH ALSO PROVIDES SUBSIDIZED HEALTH PROGRAMS IN RESPONSE TO A COMMUNITY NEED THAT OPERATE AT A FINANCIAL LOSS. THESE INCLUDE CLINICAL SERVICES, AS WELL AS COMMUNITY HEALTH AND EDUCATION PROGRAMS. SPECIFICALLY, GMH PROVIDED PRE-SCHOOL HEARING AND SPEECH SCREENINGS, AND ADMINISTERED 150 FREE VACCINATIONS AT ITS FLU SHOT FAIR. GMH ALSO MAINTAINS A HEALTH INFORMATION RESOURCE CENTER TO GIVE PATIENTS, FAMILIES, THE GENERAL PUBLIC, EMPLOYEES AND OTHERS EASY ACCESS TO HEALTH INFORMATION. FURTHERMORE, GMH OFFERS OLDER ADULTS AN AARP SAFE DRIVING PROGRAM.GMH SUPPORTS OTHER NOT-FOR-PROFIT COMMUNITY ORGANIZATIONS THROUGH CASH AND IN-KIND CHARITABLE CONTRIBUTIONS. THIS CONTRIBUTION IN FY 2013 INCLUDED A SPONSORSHIP OF HISPANOCARE, A NOT-FOR-PROFIT ORGANIZATION WITH A MISSION TO PROVIDE QUALITY, COST-EFFECTIVE HEALTHCARE TO CHICAGO'S LATINO COMMUNITY IN A CULTURALLY SENSITIVE MANNER. HISPANOCARE COORDINATES COMMUNITY HEALTH FAIRS WHERE PREVENTIVE SERVICES AND SCREENINGS ARE OFFERED FREE OF CHARGE. IT EDUCATES THE LATINO COMMUNITY ABOUT GENERAL HEALTH, ILLNESS PREVENTION AND OTHER RELATED TOPICS THROUGH SPANISH RADIO TALK SHOWS, NEWSPAPER COLUMNS AND A MEMBER NEWSLETTER. HISPANOCARE ALSO ANNUALLY PROVIDES SEVERAL COLLEGE-LEVEL SCHOLARSHIPS TO STUDENTS ENROLLED IN HEALTHCARE-RELATED STUDIES. IN ADDITION, GMH AWARDED A GRANT TO A LOCAL ELEMENTARY SCHOOL IN THE 2013 FISCAL YEAR IN CONJUNCTION WITH THE PROJECT FIT AMERICA PROGRAM. THE GRANT WILL PAY FOR A SEVEN-STATION EXERCISE CIRCUIT INSTALLED ON THE SCHOOL GROUNDS AND A HEALTH-AND-FITNESS CLASSROOM COMPONENT, ALL DESIGNED TO HELP IMPROVE STUDENTS' FITNESS LEVELS AND MOTIVATE THEM TO ADOPT HEALTHY LIFESTYLES. SINCE THE PROGRAM WAS INITIATED, GMH HAS PROVIDED SPONSORSHIP GRANTS TO 15 SCHOOLS IN THIS HIGHLY EFFECTIVE NATIONAL PROGRAM. | ||
| PART VI, LINE 6: GOTTLIEB MEMORIAL HOSPITAL IS A MEMBER OF CHE TRINITY HEALTH, THE SECOND-LARGEST CATHOLIC HEALTH CARE SYSTEM IN THE COUNTRY. CHE TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEFINE - AND ACHIEVE - COMMUNITY BENEFIT GOALS THAT INCLUDE IMPLEMENTING NEEDED SERVICES OR EXPANDING ACCESS TO SERVICES FOR LOW-INCOME INDIVIDUALS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, CHE TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITY THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND UNINSURED, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND REACHING OUT TO UNDERSERVED POPULATIONS. OVERALL, THE ORGANIZATION INVESTS MORE THAN $800 MILLION IN SUCH COMMUNITY BENEFITS AND WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING EACH COMMUNITY'S SPECIFIC NEEDS. FOR MORE INFORMATION ABOUT CHE TRINITY HEALTH, VISIT WWW.NEWHEALTHMINISTRY.ORG. | ||
| IL | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HISPANOCARE | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 836 W WELLINGTON | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60657 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 363606486 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 22187 | AmountOfCashGrant |
| Purpose Of Grant | GENERAL SUPPORT | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: DONATIONS MADE BY GOTTLIEB MEMORIAL HOSPITAL TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (29 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LARRY GOLDBERG | ||||||||||||||
| DIR; PRES THRU 6/13; CEO AS OF 6/13 | 0 | 733169 | 0 | 204410 | 0 | 168558 | 0 | 89568 | 0 | 13927 | 0 | 1209632 | 0 | 0 |
| ROBERT FLANIGAN MD | ||||||||||||||
| DIRECTOR; LUMC PHYSICIAN | 0 | 310584 | 0 | 36263 | 0 | 6919 | 0 | 22531 | 0 | 3436 | 0 | 379733 | 0 | 0 |
| RICHARD GAMELLI MD | ||||||||||||||
| DIRECTOR; LUMC PHYSICIAN | 0 | 184889 | 0 | 239316 | 0 | 0 | 0 | 21399 | 0 | 611 | 0 | 446215 | 0 | 0 |
| P TERRENCE O'ROURKE | ||||||||||||||
| DIRECTOR; TRINITY EVP CLINICAL TRANS | 0 | 548590 | 0 | 254064 | 0 | 161351 | 0 | 24584 | 0 | 32380 | 0 | 1020969 | 0 | 0 |
| ROBERT SULO MD | ||||||||||||||
| DIRECTOR; LUMC PHYSICIAN | 0 | 334109 | 0 | 0 | 0 | 3516 | 0 | 21399 | 0 | 20337 | 0 | 379361 | 0 | 0 |
| DAVID WILBER MD | ||||||||||||||
| DIRECTOR; DIR CARDIOVASCULAR INST | 0 | 538889 | 0 | 68750 | 0 | 7168 | 0 | 21401 | 0 | 2243 | 0 | 638451 | 0 | 0 |
| LORI PRICE | ||||||||||||||
| PRESIDENT AS OF 6/13 | 0 | 247226 | 0 | 29094 | 0 | 353 | 0 | 34259 | 0 | 19265 | 0 | 330197 | 0 | 0 |
| AJAY SIAL | ||||||||||||||
| TREASURER; LUMC SR VP & CFO | 0 | 345749 | 0 | 65000 | 0 | 44768 | 0 | 15341 | 0 | 13263 | 0 | 484121 | 0 | 0 |
| ELLYN CHIN | ||||||||||||||
| ASST TREAS THROUGH 6/13, GMH VP FIN | 242562 | 0 | 25000 | 0 | 850 | 0 | 53775 | 0 | 30614 | 0 | 352801 | 0 | 0 | 0 |
| JILL RAPPIS | ||||||||||||||
| SECRETARY; LUMC VP GEN CNSL | 0 | 311012 | 0 | 15500 | 0 | 1242 | 0 | 61134 | 0 | 8714 | 0 | 397602 | 0 | 0 |
| DONNA HALINSKI | ||||||||||||||
| ASST SECR THROUGH 12/12; VP CLIN AFF | 0 | 241994 | 0 | 38025 | 0 | 1152 | 0 | 114967 | 0 | 13470 | 0 | 409608 | 0 | 0 |
| MARIA PEKAR | ||||||||||||||
| ASST SEC - 12/12;LUMC ASSOC GEN CNSL | 0 | 189160 | 0 | 10000 | 0 | 929 | 0 | 45012 | 0 | 20509 | 0 | 265610 | 0 | 0 |
| DAVID HECHT MD | ||||||||||||||
| SVP - CLINICAL AFFAIRS AS OF 6/13 | 0 | 306289 | 0 | 38418 | 0 | 3997 | 0 | 22303 | 0 | 1849 | 0 | 372856 | 0 | 0 |
| KENNETH FISHBAIN | ||||||||||||||
| COO | 321823 | 0 | 32500 | 0 | 3210 | 0 | 79558 | 0 | 11169 | 0 | 448260 | 0 | 0 | 0 |
| ALAN GOLDBERG | ||||||||||||||
| VP OF ADMIN SERVICES | 155216 | 0 | 16200 | 0 | 2233 | 0 | 54440 | 0 | 29578 | 0 | 257667 | 0 | 0 | 0 |
| JOSEPH SWEDISH | ||||||||||||||
| TRINITY PRES & CEO THROUGH 3/13 | 0 | 1402192 | 0 | 786411 | 0 | 1044897 | 0 | 572762 | 0 | 28714 | 0 | 3834976 | 0 | 520902 |
| KEDRICK ADKINS | ||||||||||||||
| TRINITY PRES,INTEG SYS THROUGH 6/13 | 0 | 784856 | 0 | 366716 | 0 | 670047 | 0 | 112792 | 0 | 13375 | 0 | 1947786 | 0 | 265335 |
| J RICHARD O'CONNELL | ||||||||||||||
| EVP & PRES, TRINITY HEALTH DIV | 0 | 607209 | 0 | 284428 | 0 | 144773 | 0 | 97104 | 0 | 33319 | 0 | 1166833 | 0 | 0 |
| SILIA MIGLIO | ||||||||||||||
| CORPORATE CONTROLLER | 162972 | 0 | 0 | 0 | 360 | 0 | 23883 | 0 | 3855 | 0 | 191070 | 0 | 0 | 0 |
| MAURITA ADLER | ||||||||||||||
| CHIEF INFORMATION OFFICER | 155153 | 0 | 0 | 0 | 1579 | 0 | 32635 | 0 | 27523 | 0 | 216890 | 0 | 0 | 0 |
| MARY MORROW | ||||||||||||||
| VP NURSING | 149155 | 0 | 0 | 0 | 1455 | 0 | 15544 | 0 | 21074 | 0 | 187228 | 0 | 0 | 0 |
| ELIZABETH MCLAIN | ||||||||||||||
| RN WEEKENDER II | 150205 | 0 | 0 | 0 | 101 | 0 | 9998 | 0 | 9826 | 0 | 170130 | 0 | 0 | 0 |
| JOHN ASTREIDES | ||||||||||||||
| DIRECTOR OF INFORMATION SVCS | 147262 | 0 | 0 | 0 | 778 | 0 | 25504 | 0 | 9996 | 0 | 183540 | 0 | 0 | 0 |
| PAUL WHELTON | ||||||||||||||
| FORMER OFFICER | 0 | 0 | 0 | 0 | 0 | 928851 | 0 | 0 | 0 | 15049 | 0 | 943900 | 0 | 929989 |
| DANIEL HALE | ||||||||||||||
| FORMER OFFICER | 0 | 527004 | 0 | 213622 | 0 | 115423 | 0 | 42104 | 0 | 21386 | 0 | 919539 | 0 | 24468 |
| BENJAMIN CARTER | ||||||||||||||
| FORMER OFFICER | 0 | 523380 | 0 | 202878 | 0 | 73045 | 0 | 80824 | 0 | 31986 | 0 | 912113 | 0 | 0 |
| TOM HONAN NAVIGANT | ||||||||||||||
| FORMER OFFICER | 0 | 427675 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 427675 | 0 | 0 |
| PATRICIA CASSIDY | ||||||||||||||
| FORMER OFFICER | 0 | 146895 | 0 | 0 | 0 | 269841 | 0 | 46283 | 0 | 4940 | 0 | 467959 | 0 | 60502 |
| MICHAEL MURPHY | ||||||||||||||
| FORMER KEY EMPLOYEE | 0 | 139488 | 0 | 0 | 0 | 41394 | 0 | 4650 | 0 | 11980 | 0 | 197512 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 3 | GOTTLIEB MEMORIAL HOSPITAL IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. GOTTLIEB MEMORIAL HOSPITAL'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF GOTTLIEB MEMORIAL HOSPITAL'S PRESIDENT: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE | |
| PART I, LINES 4A-B | THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2012. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III): PATRICIA CASSIDY - $60,502 PAUL WHELTON - $929,989 PART I, LINE 4B: THE FOLLOWING ARE PARTICIPANTS IN THE TRINITY HEALTH CASH BALANCE RESTORATION AND RETENTION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETENTION BENEFITS PLUS RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($250,000 FOR 2012). THE FOLLOWING ACCRUALS FOR 2012 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $100,292 BENJAMIN CARTER - $60,824 LARRY GOLDBERG - $77,068 J. RICHARD O'CONNELL - $77,104 JOSEPH SWEDISH - $543,977 THE FOLLOWING IS A PARTICIPANT IN THE LOYOLA UNIVERSITY MEDICAL CENTER RETIREMENT RESTORATION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($250,000 FOR 2012). THE FOLLOWING TAXABLE AMOUNT FOR 2012 FOR THIS PLAN IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: PATRICIA CASSIDY - $205,638 PART II: THE FOLLOWING INDIVIDUALS ARE VESTED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING VESTED SERP AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KEDRICK ADKINS - $185,540 JOSEPH SWEDISH - $530,000 COLUMN F OF SCHEDULE J INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. | |
| PART III | PART II: TOM HONAN - THE AMOUNT LISTED IN COLUMN B(I) OF SCHEDULE J, PART II REPRESENTS THE AMOUNT PAID BY LOYOLA UNIVERSITY MEDICAL CENTER IN CALENDAR 2012 TO NAVIGANT FOR MR. HONAN'S SERVICES AS INTERIM CFO. GOTTLIEB MEMORIAL HOSPITAL DOES NOT KNOW HOW MUCH MR. HONAN RECEIVED AS WAGES FROM NAVIGANT IN CALENDAR 2012. | SUPPLEMENTAL INFORMATION |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | LOYOLA UNIVERSITY MEDICAL CENTER AND GOTTLIEB MEMORIAL HOSPITAL CONTRACTED WITH NAVIGANT FOR THE PROVISION OF INTERIM CFO SERVICES. SEE SCHEDULE J, PART III FOR ADDITIONAL INFORMATION. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF GOTTLIEB MEMORIAL HOSPITAL IS LOYOLA UNIVERSITY HEALTH SYSTEM. SEE LINE 7 FOR ADDITIONAL INFORMATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | LOYOLA UNIVERSITY HEALTH SYSTEM IS THE SOLE MEMBER OF GOTTLIEB MEMORIAL HOSPITAL. LOYOLA UNIVERSITY HEALTH SYSTEM HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF GOTTLIEB MEMORIAL HOSPITAL. | |
| FORM 990, PART VI, SECTION A, LINE 7B | AS SOLE MEMBER, LOYOLA UNIVERSITY HEALTH SYSTEM MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. LOYOLA UNIVERSITY HEALTH SYSTEM MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY THE TRINITY SYSTEM OFFICE TAX DEPARTMENT, BASED ON INFORMATION PROVIDED BY A MULTI-DISCIPLINARY TEAM OF LOYOLA AND GOTTLIEB STAFF. A DETAILED SUMMARY OF THE DRAFT FORM 990 IS PRESENTED TO THE ORGANIZATION'S BOARD FINANCE & PLANNING COMMITTEE AND THE ORGANIZATION'S OFFICERS ARE PROVIDED A COPY OF THE ORGANIZATION'S DRAFT FORM 990 (INCLUDING ALL KEY REQUIRED SCHEDULES). THE COMPLETE FORM 990 IS PROVIDED TO THE GOTTLIEB MEMORIAL HOSPITAL BOARD IN ELECTRONIC FORM, PRIOR TO FINALIZING AND FILING THE FORM. | |
| FORM 990, PART VI, SECTION B, LINE 12C | GOTTLIEB MEMORIAL HOSPITAL HAS ADOPTED A CONFLICT OF INTEREST POLICY WHICH CONTAINS THE ELEMENTS IN THE MODEL CONFLICT OF INTEREST POLICY ISSUED BY THE IRS. IT APPLIES TO ALL "INTERESTED PERSONS" OF GOTTLIEB MEMORIAL HOSPITAL, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS AND EXECUTIVES, AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. INTERESTED PERSONS ARE REQUIRED TO ACT AT ALL TIMES IN A MANNER CONSISTENT WITH GOTTLIEB MEMORIAL HOSPITAL'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO GOTTLIEB MEMORIAL HOSPITAL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF GOTTLIEB MEMORIAL HOSPITAL IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO GOTTLIEB MEMORIAL HOSPITAL. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE REVIEWED WITH THE BOARD OF DIRECTORS OF GOTTLIEB MEMORIAL HOSPITAL ON AN ANNUAL BASIS. | |
| FORM 990, PART VI, SECTION B, LINE 15 | TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF GOTTLIEB MEMORIAL HOSPITAL ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOTTLIEB MEMORIAL HOSPITAL IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE ANNUAL REPORT (WHICH INCLUDES COMMUNITY BENEFIT MINISTRY INFORMATION) AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, GOTTLIEB MEMORIAL HOSPITAL WILL BE INCLUDING A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. | |
| FORM 990, PART XI, LINE 9: | CHANGE IN DEFERRED RETIREMENT COST 3,683,744. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2 | GOTTLIEB MEMORIAL HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY13 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (242 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP | |||||||||||
| 245 STATE ST SE | GRAND RAPIDS | MI | 49503 | 272491974 | HEALTHCARE SERVICES | MI | 501(C)(3) | LINE 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| AMICARE HOSPICE SERVICES INC | |||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 382949053 | PROVIDE HOSPICE SERVICES | MI | 501(C)(3) | LINE 9 | TRINITY HOME HEALTH SERVICES INC | 0 | |
| AUXILIARY OF HOLY ROSARY HOSPITAL | |||||||||||
| 351 SW 9TH STREET | ONTARIO | OR | 97914 | 943059469 | SUPPORTS SERVICES OF RELATED HOSPITAL | OR | 501(C)(3) | LINE 9 | SAINT ALPHONSUS MEDICAL CENTER-ONTARIO | 0 | |
| BAUM HARMON MERCY HOSPITAL | |||||||||||
| 255 NORTH WELCH AVENUE | PRIMGHAR | IA | 51245 | 421500277 | ACUTE/AMBULATORY HEALTHCARE SERVICES | IA | 501(C)(3) | LINE 3 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION | |||||||||||
| 255 NORTH WELCH AVENUE | PRIMGHAR | IA | 51245 | 262973307 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | LINE 11A, I | BAUM HARMON MERCY HOSPITAL | 0 | |
| CATHERINE MCAULEY HEALTH SERVICES CORP | |||||||||||
| PO BOX 995 | ANN ARBOR | MI | 48106 | 382507173 | FURTHER TRINITY HEALTH ACTIVITIES, ORGANIZE AND DEVELOP MEDICAL SERVICES | MI | 501(C)(3) | LINE 11B, II | TRINITY HEALTH-MICHIGAN | 0 | |
| CHE TRINITY INC | |||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 900931907 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | IN | 501(C)(3) | LINE 11B, II | 0 | N/A | |
| COMMUNITY HEALTH PARTNERS OF SOUTH BEND | |||||||||||
| PO BOX 3998 | SOUTH BEND | IN | 46619 | 263051440 | HEALTHCARE SERVICES | IN | 501(C)(3) | LINE 3 | SAINT JOSEPH REGIONAL MEDICAL CENTER INC | 0 | |
| CRANBROOK HOSPICE CARE | |||||||||||
| 1111 W LONG LAKE RD STE 102 | TROY | MI | 48098 | 383320699 | PROVIDE HOSPICE HEALTH SERVICES | MI | 501(C)(3) | LINE 11A, I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| DILEY RIDGE MEDICAL CENTER | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 342032340 | HOSPITAL CAMPUS IN FAIRFIELD COUNTY OHIO | OH | 501(C)(3) | LINE 3 | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| DUBUQUE MERCY HEALTH FOUNDATION INC | |||||||||||
| 250 MERCY DRIVE | DUBUQUE | IA | 52001 | 262227941 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | LINE 11A, I | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| DYERSVILLE HEALTH FOUNDATION INC | |||||||||||
| 1111 3RD STREET SW | DYERSVILLE | IA | 52040 | 205383271 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | LINE 11A, I | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION | |||||||||||
| 701 W NORTH AVE | MELROSE PARK | IL | 60160 | 363332852 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IL | 501(C)(3) | LINE 9 | GOTTLIEB MEMORIAL HOSPITAL | 1 | |
| GOTTLIEB MEMORIAL FOUNDATION | |||||||||||
| 701 W NORTH AVE | MELROSE PARK | IL | 60160 | 743260011 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IL | 501(C)(3) | LINE 11C, III-FI | 0 | N/A | |
| GOTTLIEB MEMORIAL HOSPITAL | |||||||||||
| 701 W NORTH AVE | MELROSE PARK | IL | 60160 | 362379649 | HEALTHCARE SERVICES | IL | 501(C)(3) | LINE 3 | LOYOLA UNIVERSITY HEALTH SYSTEM | 1 | |
| HACKLEY HOSPITAL | |||||||||||
| 1700 CLINTON ST PO BOX 3302 | MUSKEGON | MI | 494433302 | 381358196 | HEALTHCARE SERVICES | MI | 501(C)(3) | LINE 3 | MERCY HEALTH PARTNERS | 0 | |
| HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST | |||||||||||
| PO BOX 3302 | MUSKEGON | MI | 494433302 | 382299878 | SELF INSURANCE FOR GENERAL AND MALPRACTICE LIABILITY | MI | 501(C)(3) | LINE 11C, III-FI | MERCY HEALTH PARTNERS | 0 | |
| HACKLEY LIFE COUNSELING | |||||||||||
| 1352 TERRACE ST | MUSKEGON | MI | 494423545 | 381386362 | COUNSELING, EDUCATION, AND SUPPORT | MI | 501(C)(3) | LINE 9 | MERCY HEALTH PARTNERS | 0 | |
| HACKLEY VISITING NURSE SERVICES AND HOSPICE INC | |||||||||||
| 888 TERRACE ST | MUSKEGON | MI | 49440 | 381359598 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | LINE 7 | MERCY HEALTH PARTNERS | 0 | |
| HOLY CROSS CARENET INC | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 48333 | 521945054 | LONG-TERM CARE AND REHABILITATION FOR THE ELDERLY | MD | 501(C)(3) | LINE 9 | TRINITY CONTINUING CARE SERVICES | 0 | |
| HOLY CROSS HEALTH FOUNDATION INC | |||||||||||
| 11801 TECH ROAD | SILVER SPRING | MD | 20904 | 208428450 | CHARITABLE FUNDRAISING | MD | 501(C)(3) | LINE 11A, I | HOLY CROSS HEALTH INC | 0 | |
| HOLY CROSS HEALTH INC | |||||||||||
| 1500 FOREST GLEN RD | SILVER SPRING | MD | 209101484 | 520738041 | HEALTHCARE SERVICES | MD | 501(C)(3) | LINE 3 | TRINITY HEALTH CORPORATION | 0 | |
| HOLY CROSS MEDICAL CENTER | |||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 951985442 | HEALTHCARE SERVICES (FORMERLY) | CA | 501(C)(3) | LINE 3 | TRINITY HEALTH CORPORATION | 0 | |
| HOSPICE OF NORTH IOWA | |||||||||||
| 232 SECOND STREET SE | MASON CITY | IA | 504016208 | 421173708 | HOSPICE HEALTH CARE SERVICES | IA | 501(C)(3) | LINE 7 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| HOSPICE OF SIOUXLAND | |||||||||||
| 4300 HAMILTON BLVD | SIOUX CITY | IA | 51104 | 383320710 | HOSPICE SERVICES | IA | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| HOSPICE OF WASHTENAW II | |||||||||||
| 806 AIRPORT BLVD | ANN ARBOR | MI | 48108 | 383320707 | HOSPICE HEALTH CARE SERVICES | MI | 501(C)(3) | LINE 11A, I | TRINITY HEALTH-MICHIGAN | 0 | |
| IHA HEALTH SERVICES CORPORATION | |||||||||||
| 24 FRANK LLOYD WRIGHT DR LOBBY J | ANN ARBOR | MI | 48106 | 383316559 | PROVIDES OFFICE-BASED MEDICAL CARE | MI | 501(C)(3) | LINE 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| LAKESHORE COMMUNITY HOSPITAL INC | |||||||||||
| 72 S STATE STREET | SHELBY | MI | 494551228 | 382549295 | ACUTE HEALTHCARE SERVICES | MI | 501(C)(3) | LINE 3 | MERCY HEALTH PARTNERS | 0 | |
| LOYOLA UNIVERSITY HEALTH SYSTEM | |||||||||||
| 2160 SOUTH FIRST AVENUE | MAYWOOD | IL | 60153 | 363342448 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | IL | 501(C)(3) | LINE 11B, II | TRINITY HEALTH CORPORATION | 0 | |
| LOYOLA UNIVERSITY MEDICAL CENTER | |||||||||||
| 2160 SOUTH FIRST AVENUE | MAYWOOD | IL | 60153 | 364015560 | HEALTHCARE SERVICES | IL | 501(C)(3) | LINE 3 | LOYOLA UNIVERSITY HEALTH SYSTEM | 0 | |
| MARIAN HOME HEALTHCARE | |||||||||||
| 801 5TH STREET | SIOUX CITY | IA | 51101 | 383320705 | PROVIDE HOME HEALTH CARE SERVICES | IA | 501(C)(3) | LINE 11A, I | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| MARYCREST HEIGHTS | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 48333 | 270291722 | PROVIDES HOUSING FOR ELDERLY INDIVIDUALS | MI | 501(C)(3) | LINE 11A, I | TRINITY CONTINUING CARE SERVICES | 0 | |
| MCAULEY CLINIC CORPORATION | |||||||||||
| PO BOX 992 | ANN ARBOR | MI | 48106 | 382561013 | HEALTHCARE SERVICES (FORMERLY) | MI | 501(C)(3) | LINE 3 | CATHERINE MCAULEY HEALTH SERVICES CORP | 0 | |
| MERCY AMICARE HOME HEALTHCARE OAKLAND | |||||||||||
| 1111 W LONG LAKE RD STE 102 | TROY | MI | 48098 | 383320698 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | LINE 11A, I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MERCY AMICARE HOME HEALTHCARE PORT HURON | |||||||||||
| 505 HURON AVENUE | PORT HURON | MI | 48060 | 383320701 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | LINE 11A, I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MERCY FOUNDATION INC | |||||||||||
| 2525 SOUTH MICHIGAN AVENUE | CHICAGO | IL | 60616 | 363227350 | SUPPORTS THE SERVICES OF RELATED HEALTH CARE SYSTEM | IL | 501(C)(3) | LINE 11A, I | MERCY HEALTH SYSTEM OF CHICAGO | 0 | |
| MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE | |||||||||||
| 684 HARVEY STREET | MUSKEGON | MI | 49442 | 383321856 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | LINE 11A, I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MERCY HEALTH NETWORK | |||||||||||
| 1111 6TH AVENUE | DES MOINES | IA | 50314 | 421478417 | HEALTHCARE MANAGEMENT | DE | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| MERCY HEALTH PARTNERS | |||||||||||
| 1415 LEAHY STREET | MUSKEGON | MI | 49442 | 382589966 | HEALTHCARE SYSTEM SUPPORT | MI | 501(C)(3) | LINE 3 | TRINITY HEALTH-MICHIGAN | 0 | |
| MERCY HEALTH SERVICES - IOWA CORP | |||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 50401 | 311373080 | HEALTHCARE SERVICES | DE | 501(C)(3) | LINE 3 | TRINITY HEALTH-MICHIGAN | 0 | |
| MERCY HEALTH SYSTEM OF CHICAGO | |||||||||||
| 2525 SOUTH MICHIGAN AVENUE | CHICAGO | IL | 60616 | 363163327 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | IL | 501(C)(3) | LINE 11A, I | TRINITY HEALTH CORPORATION | 0 | |
| MERCY HEALTH SYSTEM OF CHICAGO LIABILITY SELF INSURANCE TRUST | |||||||||||
| BK OF AMERICA 231 S LASALLE | CHICAGO | IL | 60697 | 912092113 | SELF INSURANCE FOR PROFESSIONAL AND COMPREHENSIVE LIABILITY | IL | 501(C)(3) | LINE 11C, III-FI | MERCY HEALTH SYSTEM OF CHICAGO | 0 | |
| MERCY HEALTHCARE FOUNDATION | |||||||||||
| 1410 N 4TH ST | CLINTON | IA | 52732 | 421316126 | FUNDRAISING AND FINANCIAL ASSISTANCE FOR HOSPITAL CHARITABLE SERVICES | IA | 501(C)(3) | LINE 11C, III-FI | 0 | N/A | |
| MERCY HOSPITAL AND MEDICAL CENTER | |||||||||||
| 2525 SOUTH MICHIGAN AVENUE | CHICAGO | IL | 60616 | 362170152 | HEALTHCARE SERVICES | IL | 501(C)(3) | LINE 3 | MERCY HEALTH SYSTEM OF CHICAGO | 0 | |
| MERCY HOSPITAL CADILLAC FOUNDATION | |||||||||||
| 400 HOBART | CADILLAC | MI | 496012331 | 203357131 | SUPPORT THE SERVICES OF RELATED HOSPITAL | MI | 501(C)(3) | LINE 11A, I | TRINITY HEALTH-MICHIGAN | 0 | |
| MERCY HOSPITAL GIFT SHOP | |||||||||||
| 2601 ELECTRIC AVE | PORT HURON | MI | 48060 | 381630480 | VOLUNTEER SERVICE AUXILIARY | MI | 501(C)(3) | LINE 11A, I | TRINITY HEALTH-MICHIGAN | 0 | |
| MERCY MEDICAL CENTER - CLINTON INC | |||||||||||
| 1410 NORTH 4TH ST | CLINTON | IA | 527322940 | 421336618 | TO PROVIDE QUALITY HEALTH CARE | DE | 501(C)(3) | LINE 3 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION | |||||||||||
| 801 5TH STREET | SIOUX CITY | IA | 51102 | 141880022 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | LINE 7 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA | |||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 504012800 | 421229151 | SUPPORT THE SERVICES OF RELATED HOSPITAL | IA | 501(C)(3) | LINE 11C, III-FI | 0 | N/A | |
| MERCY NORTH HOMECARE AND HOSPICE | |||||||||||
| 7985 MACKINAW TRAIL | CADILLAC | MI | 49601 | 383313897 | HOME HEALTH AND HOSPICE SERVICES | MI | 501(C)(3) | LINE 11A, I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MERCY PHYSICIAN GROUP INC | |||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 208192593 | TO PROVIDE QUALITY HEALTH CARE | ID | 501(C)(3) | LINE 9 | SAINT ALPHONSUS MEDICAL CENTER-NAMPA | 0 | |
| MERCY SERVICES FOR AGING NON-PROFIT HOUSING CORPORATION | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 382719605 | PROVIDES LONG-TERM CARE FOR THE ELDERLY | MI | 501(C)(3) | LINE 11B, II | TRINITY CONTINUING CARE SERVICES | 0 | |
| MIDWEST MEDFLIGHT | |||||||||||
| 1300 VICTORS WAY | ANN ARBOR | MI | 48108 | 382684671 | AEROMEDICAL TRANSPORT | MI | 501(C)(3) | LINE 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| MISSION HEALTH CORPORATION | |||||||||||
| 37595 SEVEN MILE ROAD | LIVONIA | MI | 48152 | 383181557 | FACILITY USED FOR AMBULATORY CARE | DE | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| MOUNT CARMEL COLLEGE OF NURSING | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311308555 | COLLEGE OF NURSING | OH | 501(C)(3) | LINE 2 | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL HEALTH INSURANCE COMPANY | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 251912781 | HEALTH INSURANCE | OH | 501(C)(4) | N/A | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL HEALTH PLAN INC | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311471229 | MEDICARE HMO FOR SENIORS | OH | 501(C)(4) | N/A | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL HEALTH SYSTEM | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311439334 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | OH | 501(C)(3) | LINE 3 | TRINITY HEALTH CORPORATION | 0 | |
| MOUNT CARMEL HEALTH SYSTEM FOUNDATION | |||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311113966 | SUPPORT THE SERVICES OF RELATED HOSPITAL | OH | 501(C)(3) | LINE 11A, I | MOUNT CARMEL HEALTH SYSTEM | 0 | |
| MOUNT CARMEL HOME CARE LLC | |||||||||||
| 1144 DUBLIN ROAD SUITE B | COLUMBUS | OH | 43215 | 262729300 | PROVIDE HOME HEALTH CARE SERVICES | OH | 501(C)(3) | LINE 9 | TRINITY HOME HEALTH SERVICES INC | 0 | |
| MRI MOBILE SERVICES OF WEST MICHIGAN | |||||||||||
| 1820 - 44TH STREET | KENTWOOD | MI | 49508 | 383073745 | OPERATE MAGNETIC IMAGING RESONANCE (FORMERLY) | MI | 501(C)(3) | LINE 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| MUSKEGON COMMUNITY HEALTH PROJECT | |||||||||||
| 565 W WESTERN AVENUE | MUSKEGON | MI | 49440 | 911932918 | FACILITATE AND COORDINATE HEALTHCARE AND RELATED SERVICES | MI | 501(C)(3) | LINE 7 | MERCY HEALTH PARTNERS | 0 | |
| OAKLAND MERCY HOSPITAL | |||||||||||
| 601 EAST 2ND STREET | OAKLAND | NE | 68045 | 208072234 | HEALTHCARE SERVICES | NE | 501(C)(3) | LINE 3 | MERCY HEALTH SERVICES-IOWA CORP | 0 | |
| OAKLAND MERCY HOSPITAL FOUNDATION | |||||||||||
| 601 E 2ND STREET | OAKLAND | NE | 68045 | 311678345 | SUPPORTS SERVICES OF RELATED HOSPITAL | NE | 501(C)(3) | LINE 11C, III-FI | 0 | N/A | |
| OSUMOUNT CARMEL HEALTH ALLIANCE | |||||||||||
| 793 WEST STATE STREET | COLUMBUS | OH | 43222 | 311654603 | COOPERATIVE HEALTH CARE DELIVERY SYSTEM | OH | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| PORT HURON MERCY FAMILY CARE INC | |||||||||||
| 2601 ELECTRIC AVE | PORT HURON | MI | 48060 | 201855647 | HEALTHCARE SERVICES | MI | 501(C)(3) | LINE 11A, I | TRINITY HEALTH-MICHIGAN | 0 | |
| PROFESSIONAL MED TEAM | |||||||||||
| 965 FORK STREET | MUSKEGON | MI | 494423257 | 382638284 | MEDICAL CARE, TRANSPORTATION AND EDUCATION | MI | 501(C)(3) | LINE 9 | TRINITY HEALTH-MICHIGAN | 0 | |
| PROFESSIONAL OFFICE CORPORATION | |||||||||||
| 1303 EAST HERNDON AVE | FRESNO | CA | 93720 | 942839324 | HEALTHCARE SERVICES | CA | 501(C)(3) | LINE 11A, I | SAINT AGNES MEDICAL CENTER | 0 | |
| SAINT AGNES MEDICAL CENTER | |||||||||||
| 1303 EAST HERNDON AVE | FRESNO | CA | 93720 | 941437713 | HEALTHCARE SERVICES | CA | 501(C)(3) | LINE 3 | TRINITY HEALTH CORPORATION | 0 | |
| SAINT ALPHONSUS BUILDING COMPANY INC | |||||||||||
| 1055 NORTH CURTIS RD | BOISE | ID | 83706 | 820401011 | SUPPORTS SERVICES OF RELATED HOSPITAL | ID | 501(C)(3) | LINE 11A, I | SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC | 0 | |
| SAINT ALPHONSUS DIVERSIFIED CARE INC | |||||||||||
| 1055 NORTH CURTIS RD | BOISE | ID | 83706 | 943028978 | SUPPORTS SERVICES OF RELATED HOSPITAL | ID | 501(C)(3) | LINE 11A, I | SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC | 0 | |
| SAINT ALPHONSUS FOUNDATION-BAKER CITY INC | |||||||||||
| 3325 POCAHONTAS ROAD | BAKER CITY | OR | 97814 | 943164869 | SUPPORT THE SERVICES OF RELATED HOSPITAL | OR | 501(C)(3) | LINE 7 | SAINT ALPHONSUS MEDICAL CENTER - BAKER CITY | 0 | |
| SAINT ALPHONSUS FOUNDATION-ONTARIO INC | |||||||||||
| 351 SW 9TH STREET | ONTARIO | OR | 97914 | 202683560 | SUPPORT THE SERVICES OF RELATED HOSPITAL | OR | 501(C)(3) | LINE 11A, I | SAINT ALPHONSUS MEDICAL CENTER-ONTARIO | 0 | |
| SAINT ALPHONSUS HEALTH SYSTEM INC | |||||||||||
| 1055 N CURTIS ROAD | BOISE | ID | 83706 | 271929502 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | ID | 501(C)(3) | LINE 11A, I | TRINITY HEALTH CORPORATION | 0 | |
| SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY INC | |||||||||||
| 3325 POCAHONTAS ROAD | BAKER CITY | OR | 97814 | 271790052 | TO PROVIDE QUALITY HEALTH CARE | OR | 501(C)(3) | LINE 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | 0 | |
| SAINT ALPHONSUS MEDICAL CENTER-NAMPA INC | |||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 820200896 | TO PROVIDE QUALITY HEALTH CARE | ID | 501(C)(3) | LINE 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | 0 | |
| SAINT ALPHONSUS MEDICAL CENTER-NAMPA HEALTH FOUNDATION INC | |||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 261737256 | SUPPORT THE SERVICES OF RELATED HOSPITAL | ID | 501(C)(3) | LINE 7 | SAINT ALPHONSUS MEDICAL CENTER-NAMPA | 0 | |
| SAINT ALPHONSUS MEDICAL CENTER-ONTARIO INC | |||||||||||
| 351 SW 9TH STREET | ONTARIO | OR | 97914 | 271789847 | TO PROVIDE QUALITY HEALTH CARE | OR | 501(C)(3) | LINE 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | 0 | |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER | |||||||||||
| 1055 NORTH CURTIS RD | BOISE | ID | 83706 | 820200895 | HEALTHCARE SERVICES | ID | 501(C)(3) | LINE 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | 0 | |
| SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC | |||||||||||
| 1915 LAKE AVENUE PO BOX 670 | PLYMOUTH | IN | 46563 | 351142669 | HEALTHCARE SERVICES | IN | 501(C)(3) | LINE 3 | SAINT JOSEPH REGIONAL MEDICAL CENTER INC | 0 | |
| SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC | |||||||||||
| PO BOX 1935 | SOUTH BEND | IN | 466341935 | 350868157 | HEALTHCARE SERVICES | IN | 501(C)(3) | LINE 3 | SAINT JOSEPH REGIONAL MEDICAL CENTER INC | 0 | |
| SAINT JOSEPH REGIONAL MEDICAL CENTER MISHAWAKA AUXILIARY INC | |||||||||||
| 5215 HOLY CROSS PARKWAY | MISHAWAKA | IN | 46545 | 356033285 | HOSPITAL SERVICE AUXILIARY | IN | 501(C)(4) | N/A | SAINT JOSEPH REGIONAL MEDICAL CENTER-S BEND | 0 | |
| SAINT JOSEPH REGIONAL MEDICAL CENTER PLYMOUTH AUXILIARY INC | |||||||||||
| 1915 LAKE AVENUE | PLYMOUTH | IN | 46563 | 356043563 | HOSPITAL SERVICE AUXILIARY | IN | 501(C)(3) | LINE 11B, II | SAINT JOSEPH REGIONAL MEDICAL CENTER-PLYMOUTH | 0 | |
| SAINT JOSEPH REGIONAL MEDICAL CENTER INC | |||||||||||
| 801 EAST LASALLE AVE | SOUTH BEND | IN | 46617 | 351568821 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | IN | 501(C)(3) | LINE 11A, I | TRINITY HEALTH CORPORATION | 0 | |
| SAINT JOSEPH'S TOWER INC | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 311040468 | PROVIDES HOUSING FOR LOW INCOME ELDERLY INDIVIDUALS | IN | 501(C)(3) | LINE 9 | TRINITY CONTINUING CARE SERVICES-INDIANA | 0 | |
| SAINT MARY'S AMICARE HOME HEALTHCARE | |||||||||||
| 1430 MONROE NW | GRAND RAPIDS | MI | 49505 | 383320700 | PROVIDE HOME HEALTH CARE SERVICES | MI | 501(C)(3) | LINE 11A, I | TRINITY HOME HEALTH SERVICES INC | 0 | |
| SAINT MARY'S FOUNDATION | |||||||||||
| 200 JEFFERSON ST SE | GRAND RAPIDS | MI | 49503 | 381779602 | SUPPORTS SERVICES OF RELATED HOSPITAL | MI | 501(C)(3) | LINE 7 | TRINITY HEALTH-MICHIGAN | 0 | |
| ST JOSEPH MERCY OAKLAND FOUNDATION | |||||||||||
| 44405 WOODWARD AVE | PONTIAC | MI | 48341 | 352356789 | SUPPORTS SERVICES OF RELATED HOSPITAL | MI | 501(C)(3) | LINE 11A, I | TRINITY HEALTH-MICHIGAN | 0 | |
| THE FOUNDATION OF SAINT JOSEPH REGIONAL MEDICAL CENTER | |||||||||||
| 4215 EDISON LAKES PARKWAY | MISHAWAKA | IN | 46545 | 351654543 | SUPPORTS SERVICES OF RELATED HOSPITAL | IN | 501(C)(3) | LINE 11A, I | SAINT JOSEPH REGIONAL MEDICAL CENTER INC | 0 | |
| TRI-HOSPITAL EMERGENCY MEDICAL SERVICES | |||||||||||
| 309 GRAND RIVER | PORT HURON | MI | 48060 | 382485700 | PROVIDE EMERGENCY AMBULANCE SERVICES | MI | 501(C)(3) | LINE 11D, III-O | 0 | N/A | |
| TRI-HOSPITAL MRI CENTER | |||||||||||
| 4190 24TH AVENUE | FORT GRATIOT | MI | 48054 | 382884297 | MRI SERVICES | MI | 501(C)(3) | LINE 3 | TRINITY HEALTH-MICHIGAN | 0 | |
| TRINITY CONTINUING CARE SERVICES | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 382559656 | MANAGEMENT SERVICES FOR LONG TERM CARE AND SENIOR LIVING FACILITIES | MI | 501(C)(3) | LINE 11A, I | TRINITY HEALTH CORPORATION | 0 | |
| TRINITY CONTINUING CARE SERVICES - INDIANA INC | |||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 930907047 | PROVIDES LONG-TERM CARE AND RESIDENTIAL HOUSING | IN | 501(C)(3) | LINE 9 | TRINITY CONTINUING CARE SERVICES | 0 | |
| TRINITY HEALTH - MICHIGAN | |||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 382113393 | HEALTHCARE SERVICES | MI | 501(C)(3) | LINE 3 | TRINITY HEALTH CORPORATION | 0 | |
| TRINITY HEALTH CORPORATION | |||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 351443425 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | IN | 501(C)(3) | LINE 11B, II | CHE TRINITY INC | 0 | |
| TRINITY HEALTH INTERNATIONAL | |||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 421253527 | HEALTHCARE TRAINING AND SUPPORT SERVICES | MI | 501(C)(3) | LINE 11A, I | TRINITY HEALTH CORPORATION | 0 | |
| TRINITY HEALTH WELFARE BENEFIT TRUST | |||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 208151733 | RETIREE MEDICAL AND RETIREE LIFE INSURANCE COVERAGE | MI | 501(C)(9) | N/A | TRINITY HEALTH CORPORATION | 0 | |
| TRINITY HOME HEALTH SERVICES INC | |||||||||||
| 17410 COLLEGE PARKWAY | LIVONIA | MI | 48152 | 382621935 | HOME HEALTH CARE SYSTEM MANAGEMENT SERVICES | MI | 501(C)(3) | LINE 11A, I | TRINITY HEALTH CORPORATION | 0 | |
| CONTINUING CARE MANAGEMENT SERVICES NETWORK | |||||||||||
| 3805 WEST CHESTER PIKE SUITE 100 | NEWTOWN SQUARE | PA | 19073 | 352336834 | MANAGEMENT & SUPPORT SERVICES | PA | 501(C)(3) | LINE 11B, II | CATHOLIC HEALTH EAST | 0 | |
| VNA HOME HEALTH & HOSPICE | |||||||||||
| 50 FODEN ROAD | SOUTH PORTLAND | ME | 04106 | 010246804 | HOME HEALTH & HOSPICE | ME | 501(C)(3) | LINE 11A, I | MERCY HEALTH SYSTEM OF MAINE | 0 | |
| MERCY HOSPITAL | |||||||||||
| 144 STATE STREET | PORTLAND | MA | 04101 | 010211534 | HOSPITAL | ME | 501(C)(3) | LINE 3 | MERCY HEALTH SYSTEM OF MAINE | 0 | |
| MERCY HEALTH SYSTEM OF MAINE | |||||||||||
| 144 STATE STREET | PORTLAND | MA | 04101 | 010484074 | MANAGEMENT & SUPPORT SERVICES | ME | 501(C)(3) | LINE 11C, III-FI | CATHOLIC HEALTH EAST | 0 | |
| SUNNYVIEW HOSPITAL & REHABILITATION CENTER FOUNDATION | |||||||||||
| 1270 BELMONT AVE | SCHENECTADY | NY | 12308 | 222505127 | SUPPORTING FOUNDATION | NY | 501(C)(3) | LINE 11A, I | SUNNYVIEW HOSPITAL & REHABILITATION CTR | 0 | |
| ST MARY'S WOODLAND VILLAGE INC | |||||||||||
| 1300 MASSACHUSETTS AVENUE | TROY | NY | 12180 | 141675183 | DISCONTINUED OPERATIONS | NY | 501(C)(3) | LINE 9 | SETON HEALTH SYSTEM INC | 0 | |
| MERCY CARE FOR KIDS INC | |||||||||||
| 310 SOUTH MANNING BLVD | ALBANY | NY | 12208 | 141717564 | DAY CARE CENTER | NY | 501(C)(3) | LINE 9 | ST PETER'S HEALTH CARE SERVICES | 0 | |
| OUR LADY OF MERCY LIFE CENTER | |||||||||||
| 2 MERCYCARE LANE | GUILDERLAND | NY | 12084 | 141743506 | NURSING HOME FACILITY | NY | 501(C)(3) | LINE 3 | ST PETER'S HEALTH CARE SERVICES | 0 | |
| ST PETER'S AUXILIARY | |||||||||||
| 315 SOUTH MANNING BLVD | ALBANY | NY | 01228 | 222843206 | AUXILIARY | NY | 501(C)(3) | LINE 11A, I | ST PETER'S HEALTH CARE SERVICES | 0 | |
| ST PETER'S HEALTH CARE SERVICES | |||||||||||
| 315 SOUTH MANNING BLVD | ALBANY | NY | 12208 | 222702507 | MANAGEMENT & SUPPORT SERVICES | NY | 501(C)(3) | LINE 9 | ST PETER'S HEALTH PARTNERS | 0 | |
| ST PETER'S HOSPITAL | |||||||||||
| 315 SOUTH MANNING BLVD | ALBANY | NY | 12208 | 141348692 | HOSPITAL | NY | 501(C)(3) | LINE 3 | ST PETER'S HEALTH CARE SERVICES | 0 | |
| ST PETER'S HOSPITAL FOUNDATION INC | |||||||||||
| 319 SOUTH MANNING BLVD SUITE 309 | ALBANY | NY | 12208 | 222262982 | FUNDRAISING & PUBLIC RELATIONS | NY | 501(C)(3) | LINE 7 | ST PETER'S HEALTH CARE SERVICES | 0 | |
| EDDY LICENSED HOME CARE AGENCY | |||||||||||
| 433 RIVER ST SUITE 3000 | TROY | NY | 12180 | 141818568 | HOME HEALTH | NY | 501(C)(3) | LINE 3 | LTC(EDDY) INC | 0 | |
| THE COMMUNITY HOSPICE FOUNDATION INC | |||||||||||
| 295 VALLEY VIEW BLVD | RENSSELAER | NY | 12144 | 222692940 | FUNDRAISING & PUBLIC RELATIONS | NY | 501(C)(3) | LINE 7 | THE COMMUNITY HOSPICE INC | 0 | |
| THE COMMUNITY HOSPICE INC | |||||||||||
| 295 VALLEY VIEW BLVD | RENSSELAER | NY | 12144 | 141608921 | SERVING SERIOUSLY ILL PEOPLE & THEIR FAMILIES | NY | 501(C)(3) | LINE 3 | ST PETER'S HEALTH CARE SERVICES | 0 | |
| VILLA MARY IMMACULATE | |||||||||||
| 301 HACKETT BLVD | ALBANY | NY | 12208 | 141438749 | NURSING HOME & PHYSICAL REHAB | NY | 501(C)(3) | LINE 3 | ST PETER'S HOSPITAL | 0 | |
| WARDE SERVICE CORPORATION INC | |||||||||||
| 159 WOLF ROAD 3RD FLOOR | ALBANY | NY | 12205 | 141732097 | SUPPORTING & STRENGTHING THE MINISTRIES OF REL. SR. MERCY | NY | 501(C)(3) | LINE 9 | ST PETER'S HEALTH CARE SERVICES | 0 | |
| NORTHEAST HEALTH INC | |||||||||||
| 2212 BURDETT AVE | TROY | NY | 12180 | 042450756 | SUPPORTING ORGANIZATION | NY | 501(C)(3) | LINE 11B, II | ST PETER'S HEALTH PARTNERS | 0 | |
| MEMORIAL HOSPITAL ALBANY NY | |||||||||||
| 600 NORTHERN BLVD | ALBANY | NY | 12204 | 141338457 | GENERAL HOSPITAL | NY | 501(C)(3) | LINE 3 | NORTHEAST HEALTH INC | 0 | |
| SAMARITAN HOSPITAL OF TROY NEW YORK | |||||||||||
| 2215 BURDETT AVE | TROY | NY | 12180 | 141338544 | GENERAL HOSPITAL | NY | 501(C)(3) | LINE 3 | NORTHEAST HEALTH INC | 0 | |
| THE NORTHEAST HEALTH FOUNDATION INC | |||||||||||
| 2224 BURDETT AVE | TROY | NY | 12180 | 222743478 | SUPPORTING FOUNDATION | NY | 501(C)(3) | LINE 7 | NORTHEAST HEALTH INC | 0 | |
| SAMARITAN CHILD CARE CENTER INC | |||||||||||
| 2213 BURDETT AVE | TROY | NY | 12180 | 141710225 | CHILD DAY CARE | NY | 501(C)(3) | LINE 9 | NORTHEAST HEALTH INC | 0 | |
| SHAKER PROPERTIES INC | |||||||||||
| 2212 BURDETT AVE | TROY | NY | 12180 | 223119822 | REAL ESTATE HOLDING | NY | 501(C)(2) | N/A | NORTHEAST HEALTH INC | 0 | |
| SUNNYVIEW HOSPITAL & REHABILITATION CTR | |||||||||||
| 1270 BELMONT AVE | SCHENECTADY | NY | 12308 | 141338386 | REHABILITATION HOSPITAL | NY | 501(C)(3) | LINE 3 | LTC (EDDY) INC | 0 | |
| JAMES A EDDY MEMORIAL GERIATRIC CENTER INC | |||||||||||
| 2256 BURDETT AVE | TROY | NY | 12180 | 222570478 | NURSING HOME | NY | 501(C)(3) | LINE 9 | LTC (EDDY) INC | 0 | |
| CAPITAL REGION GERIATRIC CENTER INC | |||||||||||
| 421 WEST COLUMBIA ST | COHOES | NY | 12047 | 141701597 | NURSING HOME | NY | 501(C)(3) | LINE 9 | LTC (EDDY) INC | 0 | |
| HERITAGE HOUSE NURSING CENTER INC | |||||||||||
| 2920 TIBBITS AVE | TROY | NY | 12180 | 141725101 | NURSING HOME | NY | 501(C)(3) | LINE 9 | LTC (EDDY) INC | 0 | |
| THE MARJORIE DOYLE ROCKWELL CENTER INC | |||||||||||
| 421 WEST COLUMBIA ST | COHOES | NY | 12047 | 141793885 | ADULT HOME/ALZHEIMERS | NY | 501(C)(3) | LINE 9 | LTC (EDDY) INC | 0 | |
| BEVERWYCK INC | |||||||||||
| 40 AUTUMN DRIVE | SLINGERLANDS | NY | 12159 | 141717028 | INDEPENDENT/ASSISTED LIVING RETIREMENT COMMUNITY | NY | 501(C)(3) | LINE 9 | LTC (EDDY) INC | 0 | |
| HAWTHORNE RIDGE INC | |||||||||||
| 30 COMMUNITY WAY | EAST GREENBUSH | NY | 12061 | 800102840 | INDEPENDENT/ASSISTED LIVING RETIREMENT COMMUNITY | NY | 501(C)(3) | LINE 9 | LTC (EDDY) INC | 0 | |
| GLEN EDDY INC | |||||||||||
| ONE GLEN EDDY DRIVE | NISKAYUNA | NY | 12309 | 141794150 | INDEPENDENT/ASSISTED LIVING COMMUNITY | NY | 501(C)(3) | LINE 9 | LTC (EDDY) INC | 0 | |
| BEECHWOOD INC | |||||||||||
| 2212 BURDETT AVE | TROY | NY | 12180 | 141651563 | REAL ESTATE HOLDING | NY | 501(C)(2) | N/A | LTC (EDDY) INC | 0 | |
| SENIOR CARE CONNECTION INC | |||||||||||
| 504 STATE ST | SCHENECTADY | NY | 12305 | 141708754 | PACE PROGRAM | NY | 501(C)(3) | LINE 9 | LTC (EDDY) INC | 0 | |
| HOME AID SERVICE OF EASTERN NEW YORK INC | |||||||||||
| 433 RIVER ST SUITE 3000 | TROY | NY | 12180 | 141514867 | HOME CARE | NY | 501(C)(3) | LINE 9 | LTC (EDDY) INC | 0 | |
| SETON HEALTH SYSTEM INC | |||||||||||
| 1300 MASSACHUSETTS AVENUE | TROY | NY | 12180 | 141776186 | HOSPITAL | NY | 501(C)(3) | LINE 3 | ST PETER'S HEALTH PARTNERS | 0 | |
| SETON HEALTH AT SCHUYLER RIDGE RESIDENTIAL HEALTHCARE | |||||||||||
| 1 ABELE BLVD | CLIFTON PARK | NY | 12065 | 141756230 | SKILLED NURSING | NY | 501(C)(3) | LINE 9 | SETON HEALTH SYSTEM INC | 0 | |
| SETON HEALTH FOUNDATION | |||||||||||
| 1300 MASSACHUSETTS AVENUE | TROY | NY | 12180 | 222345416 | SUPPORTING ORGANIZATION | NY | 501(C)(3) | LINE 11A, I | SETON HEALTH SYSTEM INC | 0 | |
| SETON AUXILIARY INC | |||||||||||
| 1300 MASSACHUSETTS AVENUE | TROY | NY | 12180 | 141505031 | SUPPORTING ORGANIZATION | NY | 501(C)(3) | LINE 9 | SETON HEALTH SYSTEM INC | 0 | |
| SETON LICENSED HOME CARE INC | |||||||||||
| 1300 MASSACHUSETTS AVENUE | TROY | NY | 12180 | 141809134 | LICENSED HOME HEALTH AGENCY | NY | 501(C)(3) | LINE 3 | SETON HEALTH SYSTEM INC | 0 | |
| EMPIRE HOME INFUSION SERVICE INC | |||||||||||
| 10 BLACKSMITH DRIVE | MALTA | NY | 12020 | 141795732 | HOME CARE | NY | 501(C)(3) | LINE 9 | HOME AID SERVICE OF EASTERN NEW YORK INC | 0 | |
| LTC (EDDY) INC | |||||||||||
| 2212 BURDETT AVE | TROY | NY | 12180 | 222564710 | ELDERLY HEALTH/HOUSING SUPPORTING ORG | NY | 501(C)(3) | LINE 11A, I | NORTHEAST HEALTH INC | 0 | |
| ST PETER'S HEALTH PARTNERS | |||||||||||
| 315 SOUTH MANNING BLVD | ALBANY | NY | 12208 | 453570715 | MANAGEMENT & SUPPORT SERVICES | NY | 501(C)(3) | LINE 11B, II | CATHOLIC HEALTH EAST | 0 | |
| ST PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES PC | |||||||||||
| 315 SOUTH MANNING BLVD | ALBANY | NY | 12208 | 461177336 | PHYSICIANS PRACTICE | NY | 501(C)(3) | LINE 3 | ST PETER'S HEALTH PARTNERS | 0 | |
| PROVIDENCE PLACE INC | |||||||||||
| 5 GAMELIN STREET | HOLYOKE | MA | 01040 | 043404084 | RETIREMENT COMMUNITY | MA | 501(C)(3) | LINE 9 | SISTERS OF PROVIDENCE HEALTH SYSTEM INC | 0 | |
| BRIGHTSIDE INC | |||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 108 | HOLYOKE | MA | 01040 | 042182395 | BEHAVIORAL CARE | MA | 501(C)(3) | LINE 9 | SISTERS OF PROVIDENCE HEALTH SYSTEM INC | 0 | |
| FARREN CARE CENTER INC | |||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 108 | HOLYOKE | MA | 01040 | 042501711 | LONG TERM CARE | MA | 501(C)(3) | LINE 3 | SISTERS OF PROVIDENCE HEALTH SYSTEM INC | 0 | |
| MERCY HOSPITAL INC | |||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 108 | HOLYOKE | MA | 01040 | 043398280 | ACUTE CARE | MA | 501(C)(3) | LINE 3 | SISTERS OF PROVIDENCE HEALTH SYSTEM INC | 0 | |
| MERCY SPECIALIST PHYSICIANS INC | |||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 108 | HOLYOKE | MA | 01040 | 264033168 | NEUROSURGERY MEDICAL SERVICES | MA | 501(C)(3) | LINE 3 | SISTERS OF PROVIDENCE HEALTH SYSTEM INC | 0 | |
| SISTERS OF PROVIDENCE CARE CENTERS INC | |||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 108 | HOLYOKE | MA | 01040 | 222541103 | LONG TERM CARE | MA | 501(C)(3) | LINE 3 | SISTERS OF PROVIDENCE HEALTH SYSTEM INC | 0 | |
| SISTERS OF PROVIDENCE HEALTH SYSTEM INC | |||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 108 | HOLYOKE | MA | 01040 | 043398374 | MANAGEMENT & SUPPORT SERVICES | MA | 501(C)(3) | LINE 11A, I | CATHOLIC HEALTH EAST | 0 | |
| MERCY LIFE INC | |||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 108 | HOLYOKE | MA | 01040 | 453086711 | ACUTE CARE | MA | 501(C)(3) | LINE 3 | SISTERS OF PROVIDENCE HEALTH SYSTEM INC | 0 | |
| PIONEER VALLEY CARDIOLOGY ASSOCIATES INC | |||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 213 | HOLYOKE | MA | 01040 | 454208896 | CARDIOLOGY SERVICES | MA | 501(C)(3) | LINE 4 | SISTERS OF PROVIDENCE HEALTH SYSTEM INC | 0 | |
| MERCY ONCOLOGY SERVICES INC | |||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 213 | HOLYOKE | MA | 01040 | 454884805 | ONCOLOGY MEDICAL SERVICES | MA | 501(C)(3) | N/A | SISTERS OF PROVIDENCE HEALTH SYSTEM INC | 0 | |
| MCAULEY CENTER INC | |||||||||||
| 275 STEELE ROAD | WEST HARTFORD | CT | 06117 | 061058086 | INDEPENDENT LIVING | CT | 501(C)(3) | LINE 9 | MERCY COMMUNITY HEALTH INC | 0 | |
| MERCY COMMUNITY HEALTH INC | |||||||||||
| 2021 ALBANY AVENUE | WEST HARTFORD | CT | 06117 | 061492707 | MANAGEMENT & SUPPORT SERVICES | CT | 501(C)(3) | LINE 11A, I | CATHOLIC HEALTH EAST | 0 | |
| MERCY COMMUNITY HOMECARE SERVICES | |||||||||||
| 2021 ALBANY AVENUE | WEST HARTFORD | CT | 06117 | 061488137 | IN HOME HEALTH CARE | CT | 501(C)(3) | LINE 9 | MERCY COMMUNITY HEALTH INC | 0 | |
| MERCY SERVICES | |||||||||||
| 2021 ALBANY AVENUE | WEST HARTFORD | CT | 06117 | 061453323 | SUPPORT SERVICES | CT | 501(C)(3) | LINE 1 | MERCY COMMUNITY HEALTH INC | 0 | |
| MERCYKNOLL INC | |||||||||||
| 2021 ALBANY AVENUE | WEST HARTFORD | CT | 06117 | 060757380 | SKILLED NURSING | CT | 501(C)(3) | LINE 3 | MERCY COMMUNITY HEALTH INC | 0 | |
| SAINT MARY HOME II INC | |||||||||||
| 2021 ALBANY AVENUE | WEST HARTFORD | CT | 06117 | 061164104 | ELDERLY CARE | CT | 501(C)(3) | LINE 3 | MERCY COMMUNITY HEALTH INC | 0 | |
| ST MARY HOME INCORPORATED | |||||||||||
| 2021 ALBANY AVENUE | WEST HARTFORD | CT | 06117 | 060646843 | SKILLED NURSING | CT | 501(C)(3) | LINE 3 | MERCY COMMUNITY HEALTH INC | 0 | |
| MERCY HEALTHCARE CENTER | |||||||||||
| 114 WAWBEEK AVENUE | TUPPER LAKE | NY | 12986 | 150532211 | IN DISSOLUTION | NY | 501(C)(3) | LINE 3 | CATHOLIC HEALTH EAST | 0 | |
| MERCY UIHLEIN HEALTH CORPORATION | |||||||||||
| 185 OLD MILITARY ROAD | LAKE PLACID | NY | 12946 | 161535133 | MGT. & SUPPORT SERVICES | NY | 501(C)(3) | LINE 11B, II | MERCY HEALTHCARE CENTER | 0 | |
| UIHLEIN MERCY CENTER | |||||||||||
| 185 OLD MILITARY ROAD | TUPPER LAKE | NY | 12986 | 150532190 | IN DISSOLUTION | NY | 501(C)(3) | LINE 3 | MERCY HEALTHCARE CENTER | 0 | |
| ST JAMES MERCY FOUNDATION INC | |||||||||||
| 411 CANISTEO STREET | HORNELL | NY | 14843 | 161486437 | FOUNDATION | NY | 501(C)(3) | LINE 7 | ST JAMES MERCY HEALTH SYSTEM INC | 0 | |
| ST JAMES MERCY HEALTH SYSTEM INC | |||||||||||
| 411 CANISTEO STREET | HORNELL | NY | 14843 | 223127184 | MANAGEMENT & SUPPORT SERVICES | NY | 501(C)(3) | LINE 11B, II | CATHOLIC HEALTH EAST | 0 | |
| ST JAMES MERCY HOSPITAL | |||||||||||
| 411 CANISTEO STREET | HORNELL | NY | 14843 | 160743310 | HOSPITAL | NY | 501(C)(3) | LINE 3 | ST JAMES MERCY HEALTH SYSTEM INC | 0 | |
| MAXIS MEDICAL SERVICES | |||||||||||
| 100 LINCOLN AVE | CARBONDALE | PA | 18407 | 232577185 | PHYSICIAN PRACTICES | PA | 501(C)(3) | LINE 3 | MAXIS HEALTH SYSTEM | 0 | |
| MARIAN COMMUNITY HOSPITAL | |||||||||||
| 100 LINCOLN AVE | CARBONDALE | PA | 18407 | 240711230 | HOSPITAL | PA | 501(C)(3) | LINE 3 | MAXIS HEALTH SYSTEM | 0 | |
| MARIAN COMMUNITY HOSPITAL AUXILIARY | |||||||||||
| 100 LINCOLN AVE | CARBONDALE | PA | 18407 | 251874733 | FUNDRAISING | PA | 501(C)(3) | LINE 11B, II | MAXIS HEALTH SYSTEM | 0 | |
| MAXIS FOUNDATION | |||||||||||
| 100 LINCOLN AVE | CARBONDALE | PA | 18407 | 232330090 | FUNDRAISING | PA | 501(C)(3) | LINE 11B, II | MAXIS HEALTH SYSTEM | 0 | |
| MAXIS HEALTH SYSTEM | |||||||||||
| 100 LINCOLN AVE | CARBONDALE | PA | 18407 | 911940902 | HEALTH CARE SYSTEM | PA | 501(C)(3) | LINE 11B, II | MAXIS HEALTH SYSTEM | 0 | |
| TRI-COUNTY HUMAN SERVICES CENTER INC | |||||||||||
| PO BOX 517 | CARBONDALE | PA | 18407 | 231938528 | BEHAVIORAL HEALTH ORGANIZATION | PA | 501(C)(3) | LINE 7 | MAXIS HEALTH SYSTEM | 0 | |
| COLUMBUS ACQUISITION CORP | |||||||||||
| 1160 RAYMOND BOULEVARD | NEWARK | NJ | 07102 | 262616342 | INACTIVE ENTITY | NJ | 501(C)(3) | LINE 9 | SAINT MICHAELS MEDICAL CENTER | 0 | |
| SAINT MICHAELS MEDICAL CENTER | |||||||||||
| 111 CENTRAL AVENUE | NEWARK | NJ | 07102 | 262616046 | HOSPITAL | NJ | 501(C)(3) | LINE 3 | CATHOLIC HEALTH EAST | 0 | |
| ST JAMES CARE INC | |||||||||||
| 1160 RAYMOND BOULEVARD | NEWARK | NJ | 07102 | 262616230 | INACTIVE ENTITY | NJ | 501(C)(3) | LINE 9 | SAINT MICHAELS MEDICAL CENTER | 0 | |
| ST MICHAEL'S FOUNDATION INC | |||||||||||
| 1160 RAYMOND BOULEVARD | NEWARK | NJ | 07102 | 223311976 | FOUNDATION | NJ | 501(C)(3) | LINE 11A, I | SAINT MICHAELS MEDICAL CENTER | 0 | |
| UNIVERSITY HEIGHTS PROPERTY COMPANY INC | |||||||||||
| 1160 RAYMOND BOULEVARD | NEWARK | NJ | 07102 | 223100162 | MEDICAL PROPERTY HOLDING COMPANY | NJ | 501(C)(2) | N/A | SAINT MICHAELS MEDICAL CENTER | 0 | |
| LIFE ST FRANCIS CORPORATION | |||||||||||
| 601 HAMILTON AVENUE | TRENTON | NJ | 08629 | 222797282 | HEALTH SERVICES | NJ | 501(C)(3) | LINE 11A, I | ST FRANCIS MEDICAL CENTER TRENTON NJ | 0 | |
| ST FRANCIS MEDICAL CENTER FOUNDATION NJ | |||||||||||
| 601 HAMILTON AVENUE | TRENTON | NJ | 08629 | 521025476 | FOUNDATION | NJ | 501(C)(3) | LINE 11A, I | ST FRANCIS MEDICAL CENTER TRENTON NJ | 0 | |
| ST FRANCIS MEDICAL CENTER TRENTON NJ | |||||||||||
| 601 HAMILTON AVENUE | TRENTON | NJ | 08629 | 223431049 | HOSPITAL | NJ | 501(C)(3) | LINE 3 | CATHOLIC HEALTH EAST | 0 | |
| LANGHORNE MRI INC | |||||||||||
| 1201 LANGHORNE-NEWTOWN ROAD | LANGHORNE | PA | 19047 | 232519529 | INACTIVE ENTITY | PA | 501(C)(3) | LINE 9 | ST MARY MEDICAL CENTER | 0 | |
| LANGHORNE PHYSICIAN SERVICES INC | |||||||||||
| 1201 LANGHORNE-NEWTOWN ROAD | LANGHORNE | PA | 19047 | 232571699 | PHYSICIAN SERVICES | PA | 501(C)(3) | LINE 9: 509(A)(2) | ST MARY MEDICAL CENTER | 0 | |
| LIFE ST MARY | |||||||||||
| 1201 LANGHORNE-NEWTOWN ROAD | LANGHORNE | PA | 19047 | 262976184 | ELDERLY CARE | PA | 501(C)(3) | LINE 9 | ST MARY MEDICAL CENTER | 0 | |
| ST MARY MEDICAL CENTER | |||||||||||
| 1201 LANGHORNE-NEWTOWN ROAD | LANGHORNE | PA | 19047 | 231913910 | HOSPITAL | PA | 501(C)(3) | LINE 3 | CATHOLIC HEALTH EAST | 0 | |
| ST MARY MEDICAL CENTER FOUNDATION INC | |||||||||||
| 1201 LANGHORNE-NEWTOWN ROAD | LANGHORNE | PA | 19047 | 232567468 | FOUNDATION | PA | 501(C)(3) | LINE 7 | ST MARY MEDICAL CENTER | 0 | |
| EAST NORRITON PHYSICIAN SERVICES | |||||||||||
| C/O ONE WEST ELM STREET | CONSHOHOCKEN | PA | 19428 | 232515999 | PHYSICIAN SERVICES | PA | 501(C)(3) | LINE 3 | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PENNSYLVANIA | |||||||||||
| ONE WEST ELM STREET | CONSHOHOCKEN | PA | 19428 | 231352191 | ACUTE CARE HOSPITAL | PA | 501(C)(3) | LINE 3 | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| MERCY FAMILY SUPPORT | |||||||||||
| 1001 BALTIMORE PIKE SUITE 301 | SPRINGFIELD | PA | 19064 | 232325059 | HOME HEALTH | PA | 501(C)(3) | LINE 9 | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| MERCY HEALTH FOUNDATION OF SOUTHEASTERN PENNSYLVANIA | |||||||||||
| C/O ONE WEST ELM STREET | CONSHOHOCKEN | PA | 19428 | 232829864 | FUNDRAISING | PA | 501(C)(3) | LINE 11B, II | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| MERCY HEALTH PLAN | |||||||||||
| C/O ONE WEST ELM STREET | CONSHOHOCKEN | PA | 19428 | 222483605 | HEALTH PLANS | PA | 501(C)(3) | LINE 11B, II | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | |||||||||||
| ONE WEST ELM STREET | CONSHOHOCKEN | PA | 19428 | 232212638 | MANAGEMENT & SUPPORT SERVICES | PA | 501(C)(3) | LINE 11B, II | CATHOLIC HEALTH EAST | 0 | |
| MERCY HOME HEALTH | |||||||||||
| 1001 BALTIMORE PIKE SUITE 310 | SPRINGFIELD | PA | 19064 | 231352099 | HOME HEALTH | PA | 501(C)(3) | LINE 9 | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| MERCY HOME HEALTH SERVICES | |||||||||||
| 1001 BALTIMORE PIKE SUITE 301 | SPRINGFIELD | PA | 19064 | 232325058 | HOME HEALTH | PA | 501(C)(3) | LINE 11B, II | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA | |||||||||||
| ONE WEST ELM STREET | CONSHOHOCKEN | PA | 19428 | 232627944 | PHYSICIAN PRACTICES | PA | 501(C)(3) | LINE 11B, II | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| MERCY SUBURBAN HOSPITAL | |||||||||||
| ONE WEST ELM STREET | CONSHOHOCKEN | PA | 19428 | 231396763 | ACUTE CARE HOSPITAL | PA | 501(C)(3) | LINE 3 | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| NAZARETH HEALTH CARE FOUNDATION | |||||||||||
| 2701 HOLME AVENUE | PHILADELPHIA | PA | 19152 | 232300951 | FUNDRAISING | PA | 501(C)(3) | LINE 11B, II | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| NAZARETH HOSPITAL | |||||||||||
| 2601 HOLME AVENUE | PHILADELPHIA | PA | 19152 | 232794121 | ACUTE CARE HOSPITAL | PA | 501(C)(3) | LINE 3 | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| NAZARETH PHYSICIAN SERVICES INC | |||||||||||
| 2601 HOLME AVENUE | PHILADELPHIA | PA | 19152 | 203261266 | PHYSICIAN PRACTICES | PA | 501(C)(3) | LINE 3 | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| NE PHYSICIAN SERVICES | |||||||||||
| 2601 HOLME AVENUE | PHILADELPHIA | PA | 19152 | 232497355 | PHYSICIAN PRACTICES | PA | 501(C)(3) | LINE 3 | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| ST AGNES CONTINUING CARE CENTER | |||||||||||
| 1900 S BROAD STREET | PHILADELPHIA | PA | 19145 | 232840137 | CONTINUING CARE SERVICES | PA | 501(C)(3) | LINE 3 | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| ST AGNES CONTINUING CARE CENTER FOUNDATION | |||||||||||
| 1900 S BROAD STREET | PHILADELPHIA | PA | 19145 | 232415137 | FUNDRAISING | PA | 501(C)(3) | LINE 11B, II | MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA | 0 | |
| LIFE AT LOURDES INC | |||||||||||
| 1600 HADDON AVENUE | CAMDEN | NJ | 08108 | 261854750 | ELDERLY CARE | NJ | 501(C)(3) | LINE 3 | OUR LADY OF LOURDES HEALTH CARE SERVICES | 0 | |
| LOURDES ANCILLARY SERVICES | |||||||||||
| 1600 HADDON AVENUE | CAMDEN | NJ | 08103 | 222568525 | SUPPORTING ORGANIZATION | NJ | 501(C)(3) | LINE 11B, II | OUR LADY OF LOURDES HEALTH CARE SERVICES | 0 | |
| LOURDES DIALYSIS AT INNOVA INC | |||||||||||
| 1600 HADDON AVENUE | CAMDEN | NJ | 08108 | 263237625 | HOSPITAL | NJ | 501(C)(3) | LINE 3 | OUR LADY OF LOURDES HEALTH CARE SERVICES | 0 | |
| LOURDES MEDICAL CENTER BURLINGTON COUNTY | |||||||||||
| 218 SUNSET ROAD | WILLINGBORO | NJ | 08046 | 223612265 | HOSPITAL | NJ | 501(C)(3) | LINE 3 | OUR LADY OF LOURDES HEALTH CARE SERVICES | 0 | |
| OUR LADY OF LOURDES HEALTH CARE SERVICES | |||||||||||
| 1600 HADDON AVENUE | CAMDEN | NJ | 08103 | 222568528 | MANAGEMENT & SUPPORT SERVICES | NJ | 501(C)(3) | LINE 11B, II | CATHOLIC HEALTH EAST | 0 | |
| OUR LADY OF LOURDES HEALTH FOUNDATION INC | |||||||||||
| 1600 HADDON AVENUE | CAMDEN | NJ | 08103 | 222351960 | FOUNDATION | NJ | 501(C)(3) | LINE 7 | OUR LADY OF LOURDES HEALTH CARE SERVICES | 0 | |
| OUR LADY OF LOURDES MEDICAL CENTER | |||||||||||
| 1600 HADDON AVENUE | CAMDEN | NJ | 08103 | 210635001 | HOSPITAL | NJ | 501(C)(3) | LINE 3 | OUR LADY OF LOURDES HEALTH CARE SERVICES | 0 | |
| LOURDES CARDIOLOGY SERVICES PC | |||||||||||
| 1600 HADDON AVENUE | CAMDEN | NJ | 08108 | 274357794 | CARDIOLOGY SERVICES | NJ | 501(C)(3) | LINE 3 | OUR LADY OF LOURDES HEALTH CARE SERVICES | 0 | |
| FRANCISCAN ELDERCARE CORPORATION | |||||||||||
| PO BOX 2500 | WILMINGTON | DE | 19805 | 223008680 | ELDERCARE | DE | 501(C)(3) | LINE 9 | ST FRANCIS HOSPITAL | 0 | |
| ST FRANCIS FOUNDATION | |||||||||||
| PO BOX 2500 | WILMINGTON | DE | 19805 | 510374158 | FOUNDATION | DE | 501(C)(3) | LINE 11B, II | ST FRANCIS HOSPITAL | 0 | |
| ST FRANCIS HOSPITAL | |||||||||||
| PO BOX 2500 | WILMINGTON | DE | 19805 | 510064326 | HOSPITAL | DE | 501(C)(3) | LINE 3 | CATHOLIC HEALTH EAST | 0 | |
| LIFE AT ST FRANCIS HEALTHCARE INC | |||||||||||
| 7TH CLAYTON STREETS | WILMINGTON | DE | 19805 | 452569214 | ELDERLY CARE | DE | 501(C)(3) | LINE 3 | ST FRANCIS HOSPITAL | 0 | |
| MCAULEY MINISTRIES | |||||||||||
| MCAULEY HALL 3333 FIFTH AVENUE | PITTSBURGH | PA | 15213 | 943436142 | MANAGEMENT & SUPPORT SERVICES | PA | 501(C)(3) | LINE 9 | PITTSBURGH MERCY HEALTH SYSTEM | 0 | |
| MERCY JEANNETTE HOSPITAL | |||||||||||
| 3805 WEST CHESTER PIKE | NEWTOWN SQUARE | PA | 19073 | 251310602 | INACTIVE ENTITY | PA | 501(C)(3) | LINE 9 | PITTSBURGH MERCY HEALTH SYSTEM | 0 | |
| MERCY LIFE CENTER CORPORATION | |||||||||||
| 1200 REEDSDALE STREET | PITTSBURGH | PA | 15233 | 251604115 | COMMUNITY TREATMENT | PA | 501(C)(3) | LINE 9 | PITTSBURGH MERCY HEALTH SYSTEM | 0 | |
| PITTSBURGH MERCY HEALTH SYSTEM | |||||||||||
| 3333 5TH AVENUE | PITTSBURGH | PA | 15213 | 251464211 | MANAGEMENT & SUPPORT SERVICES | PA | 501(C)(3) | LINE 11B, II | CATHOLIC HEALTH EAST | 0 | |
| ST JOSEPH'S OF THE PINES INC | |||||||||||
| 100 GOSSMAN DRIVE SUITE B | SOUTHERN PINES | NC | 28387 | 560694200 | HOSPITAL | NC | 501(C)(3) | LINE 3 | CATHOLIC HEALTH EAST | 0 | |
| LIFE ST JOSEPH OF THE PINES INC | |||||||||||
| 100 GOSSMAN DRIVE SUITE B | SOUTHERN PINES | NC | 28387 | 272159847 | HEALTHCARE SERVICES | NC | 501(C)(3) | LINE 3 | ST JOSEPH'S OF THE PINES INC | 0 | |
| MERCY SENIOR CARE INC | |||||||||||
| 300 CHATILLON ROAD PO BOX 866 | ROME | GA | 30162 | 581366508 | COMMUNITY OUTREACH | GA | 501(C)(3) | LINE 7 | SAINT JOSEPH'S HEALTH SYSTEM INC | 0 | |
| SAINT JOSEPH'S HEALTH SYSTEM INC | |||||||||||
| 424 DECATUR STREET | ATLANTA | GA | 30312 | 581744848 | MANAGEMENT & SUPPORT SERVICES | GA | 501(C)(3) | LINE 11B, II | CATHOLIC HEALTH EAST | 0 | |
| SAINT JOSEPH'S MERCY CARE SERVICES INC | |||||||||||
| 424 DECATUR STREET | ATLANTA | GA | 30312 | 581752700 | COMMUNITY OUTREACH | GA | 501(C)(3) | LINE 7 | SAINT JOSEPH'S HEALTH SYSTEM INC | 0 | |
| SAINT JOSEPH'S MERCY FOUNDATION INC | |||||||||||
| 424 DECATUR STREET | ATLANTA | GA | 30312 | 581448522 | FUNDRAISING | GA | 501(C)(3) | LINE 11B, II | SAINT JOSEPH'S HEALTH SYSTEM INC | 0 | |
| MERCY SERVICES DOWNTOWN INC | |||||||||||
| 424 DECATUR STREET | ATLANTA | GA | 30312 | 272046353 | REAL ESTATE HOLDING COMPANY | GA | 501(C)(3) | LINE 11B, II | SAINT JOSEPH'S HEALTH SYSTEM INC | 0 | |
| ST MARY'S HEALTH CARE SYSTEM INC | |||||||||||
| 1230 BAXTER STREET | ATHENS | GA | 30606 | 580566223 | HOSPITAL | GA | 501(C)(3) | LINE 3 | CATHOLIC HEALTH EAST | 0 | |
| ST MARY'S FOUNDATION INC | |||||||||||
| 1230 BAXTER STREET | ATHENS | GA | 30606 | 582544232 | FUNDRAISING | GA | 501(C)(3) | LINE 11B, II | ST MARY'S HEALTH CARE SYSTEM INC | 0 | |
| ST MARY'S HIGHLAND HILLS INC | |||||||||||
| 1230 BAXTER STREET | ATHENS | GA | 30606 | 020576648 | ASSISTED LIVING & RETIREMENT COMMUNITY | GA | 501(C)(3) | LINE 3 | ST MARY'S HEALTH CARE SYSTEM INC | 0 | |
| ST MARY'S MEDICAL GROUP INC | |||||||||||
| 1230 BAXTER STREET | ATHENS | GA | 30606 | 261858563 | HOSPITAL / PHYSICIAN SERVICES | GA | 501(C)(3) | LINE 3 | ST MARY'S HEALTH CARE SYSTEM INC | 0 | |
| GOOD SAMARITAN HOSPITAL INC | |||||||||||
| 1201 SILOAM ROAD | GREENSBORO | GA | 30462 | 261720984 | HOSPITAL | GA | 501(C)(3) | LINE 3 | SAINT JOSEPH'S HEALTH SYSTEM INC | 0 | |
| MERCY MEDICAL CORPORATION | |||||||||||
| PO BOX 1090 101 VILLA DRIVE | DAPHNE | AL | 36526 | 636002215 | HOSPITAL | AL | 501(C)(3) | LINE 3 | CATHOLIC HEALTH EAST | 0 | |
| MERCY LIFE OF ALABAMA | |||||||||||
| PO BOX 1090 101 VILLA DRIVE | DAPHNE | AL | 36526 | 273163002 | HOSPITAL | AL | 501(C)(3) | LINE 3 | MERCY MEDICAL CORPORATION | 0 | |
| ALLEGANY FRANCISCAN MINISTRIES INC | |||||||||||
| 33920 US HIGHWAY 19 NORTH SUITE 269 | PALM HARBOR | FL | 34684 | 581492325 | MANAGEMENT & SUPPORT SERVICES | FL | 501(C)(3) | LINE 11B, II | CATHOLIC HEALTH EAST | 0 | |
| ST FRANCIS HOSPITAL INC | |||||||||||
| 33920 US HIGHWAY 19 NORTH SUITE 269 | PALM HARBOR | FL | 34684 | 590624442 | GRANT-MAKING ORGANIZATION | FL | 501(C)(3) | LINE 11A, I | ALLEGANY FRANCISCAN MINISTRIES INC | 0 | |
| HOLY CROSS HOSPITAL INC | |||||||||||
| 4725 NORTH FEDERAL HIGHWAY | FT LAUDERDALE | FL | 33308 | 590791028 | HOSPITAL-HEALTHCARE PROVIDER | FL | 501(C)(3) | LINE 3 | CATHOLIC HEALTH EAST | 0 | |
| HOLY CROSS LONG-TERM INC | |||||||||||
| 4725 NORTH FEDERAL HIGHWAY | FT LAUDERDALE | FL | 33308 | 650787320 | MEDICAL SERVICES | FL | 501(C)(3) | LINE 3 | HOLY CROSS HOSPITAL INC | 0 | |
| HOLY CROSS MEDICAL PROPERTIES INC | |||||||||||
| 4725 NORTH FEDERAL HIGHWAY | FT LAUDERDALE | FL | 33308 | 650666283 | MEDICAL BUILDING REAL ESTATE MANAGEMENT | FL | 501(C)(2) | N/A | HOLY CROSS HOSPITAL INC | 0 | |
| SSJ HEALTH FOUNDATION INC | |||||||||||
| 3663 SOUTH MIAMI AVENUE | MIAMI | FL | 33133 | 591709438 | FUNDRAISING | FL | 501(C)(3) | LINE 7 | MERCY HOSPITAL INC | 0 | |
| MERCY HOSPITAL INC | |||||||||||
| 3663 SOUTH MIAMI AVENUE | MIAMI | FL | 33133 | 590791034 | HOSPITAL | FL | 501(C)(3) | LINE 3 | CATHOLIC HEALTH EAST | 0 | |
| MERCY MEDICAL DEVELOPMENT INC | |||||||||||
| 3663 SOUTH MIAMI AVENUE | MIAMI | FL | 33133 | 592789194 | OUTPATIENT SERVICES | FL | 501(C)(3) | LINE 9 | MERCY HOSPITAL INC | 0 | |
| MERCY MISSION SERVICES INC | |||||||||||
| 3663 SOUTH MIAMI AVENUE | MIAMI | FL | 33133 | 650435764 | HEALTH CARE | FL | 501(C)(3) | LINE 11A, I | MERCY HOSPITAL INC | 0 | |
| MERCY OUTPATIENT SERVICES INC DBA SISTER EMMANUEL HOSPITAL | |||||||||||
| 3663 SOUTH MIAMI AVENUE | MIAMI | FL | 33133 | 510461511 | HOSPITAL | FL | 501(C)(3) | LINE 3 | MERCY HOSPITAL INC | 0 | |
| GLOBAL HEALTH MINISTRY | |||||||||||
| 3805 WEST CHESTER PIKE SUITE 100 | NEWTOWN SQUARE | PA | 19073 | 233068656 | HEALTH CARE | PA | 501(C)(3) | LINE 7 | CATHOLIC HEALTH EAST | 0 | |
| INTRACOASTAL HEALTH SYSTEMS | |||||||||||
| 3805 WEST CHESTER PIKE SUITE 100 | NEWTOWN SQUARE | PA | 19073 | 650556413 | MANAGEMENT & SUPPORT SERVICES | PA | 501(C)(3) | LINE 11A, I | CATHOLIC HEALTH EAST | 0 | |
| CATHOLIC HEALTH EAST | |||||||||||
| 3805 WEST CHESTER PIKE SUITE 100 | NEWTOWN SQUARE | PA | 19073 | 232929748 | MANAGEMENT SERVICES | PA | 501(C)(3) | LINE 11C, III-FI | CHE TRINITY INC | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (44 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|
| ADVENT REHABILITATION LLC | |||||||
| 607 DEWEY AVENUE SUITE 300 | GRAND RAPIDS | MI | 49504 | 383306673 | REHABILITATION THERAPY SERVICES | MI | N/A |
| BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP | |||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311608125 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A |
| CENTER FOR DIGESTIVE CARE LLC | |||||||
| 5300 ELLIOTT DRIVE | YPSILANTI | MI | 48197 | 030447062 | PROVIDE GASTROINTESTINAL SERVICES | MI | N/A |
| CENTRAL OHIO SLEEP MEDICINE LTD | |||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311701029 | SLEEP MEDICINE SERVICES | OH | N/A |
| CLINTON IMAGING SERVICES LLC | |||||||
| 615 VALLEY VIEW DR STE 202 | MOLINE | IL | 61265 | 412044739 | MRI DIAGNOSTIC SERVICES | IA | N/A |
| FOREST PARK IMAGING LLC | |||||||
| 1000 4TH STREET SW | MASON CITY | IA | 50401 | 134365966 | X-RAY AND MAMMOGRAPHY SERVICES | IA | N/A |
| FRANCES WARDE MEDICAL LABORATORY | |||||||
| 300 WEST TEXTILE ROAD | ANN ARBOR | MI | 48104 | 382648446 | LABORATORY | MI | N/A |
| FRESNO IMAGING CENTER | |||||||
| 1303 E HERNDON AVE | FRESNO | CA | 93720 | 770363563 | DIAGNOSTIC IMAGING | CA | N/A |
| HAWARDEN REGIONAL HEALTH CLINICS LLC | |||||||
| 1122 AVENUE L | HAWARDEN | IA | 51023 | 201444339 | MEDICAL CLINIC | IA | N/A |
| IDAHO GYNONCOLOGY SERVICES LLC | |||||||
| 1055 N CURTIS RD | BOISE | ID | 83706 | 202975807 | PROVIDE GYN ONCOLOGY SERVICES | ID | N/A |
| INTERMOUNTAIN MEDICAL IMAGING LLC | |||||||
| 877 WEST MAIN ST STE 603 | BOISE | ID | 83702 | 820514422 | PROVIDE IMAGING SERVICES | ID | N/A |
| LOYOLA AMBULATORY SURGERY CENTER | |||||||
| 3000 RIVERCHASE GALLERIA STE 500 | BIRMINGHAM | AL | 35244 | 364119522 | SURGICAL SERVICES | IL | N/A |
| MAGNETIC RESONANCE SERVICES PARTNERSHIP | |||||||
| 1416 SIXTH STREET SW | MASON CITY | IA | 50401 | 421328388 | MRI SERVICES | IA | N/A |
| MASON CITY AMBULATORY SURGERY CENTER LLC | |||||||
| 990 4TH STREET SW | MASON CITY | IA | 50401 | 201960348 | SURGERY-SAME DAY | IA | N/A |
| MCE MOB IV LIMITED PARTNERSHIP | |||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 421544707 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A |
| MCMC POB III LIMITED PARTNERSHIP | |||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311392994 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A |
| MEDILUCENT MOB I | |||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 204911370 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A |
| MERCY ADVANCED MRI LLC | |||||||
| 2525 SOUTH MICHIGAN AVE | CHICAGO | IL | 60616 | 262116721 | SUBLEASE MRI EQUIPMENT | IL | N/A |
| MERCY HEART & VASCULAR LLC | |||||||
| 2525 SOUTH MICHIGAN AVE | CHICAGO | IL | 60616 | 205272726 | SUBLEASE CT EQUIPMENT | IL | N/A |
| MERCY HEART CTR OP SERVICES LLC | |||||||
| 1000 4TH STREET SW | MASON CITY | IA | 50401 | 134237594 | CARDIOVASCULAR SERVICES | IA | N/A |
| MICHIANA HEALTH INFORMATION NETWORK LLC | |||||||
| 215 WEST MADISON STREET | SOUTH BEND | IN | 46601 | 352050128 | COMMUNITY BASED CLINICAL INFO SYS & DATA DEPOSITORY | IN | N/A |
| MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP | |||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311369473 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A |
| NEWCO AMBULATORY SURGERY CTR LLP | |||||||
| 4190 24TH AVENUE | FORT GRATIOT | MI | 48059 | 300136708 | OUTPATIENT SURGERY CENTER | MI | N/A |
| SARMED OUTPATIENT PHARMACY LLC | |||||||
| 999 N CURTIS RD STE 102 | BOISE | ID | 83706 | 510483218 | PHARMACY | ID | N/A |
| SIXTY FOURTH STREET LLC | |||||||
| 2373 64TH ST STE 2200 | BYRON CENTER | MI | 49315 | 202443646 | PROVIDE OUTPATIENT SURGICAL CARE | MI | N/A |
| ST ALPHONSUS CALDWELL CANCER CTR LLC | |||||||
| 3123 MEDICAL DR | CALDWELL | ID | 83605 | 820526861 | RADIATION ONCOLOGY | ID | N/A |
| ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP | |||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311603660 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A |
| TAMARACK MEDICAL CLINIC LLC | |||||||
| 402 OLD STATE HWY | CASCADE | ID | 83611 | 201637921 | OUTPATIENT MEDICAL SERVICES | ID | N/A |
| WESTAR MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP | |||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311784409 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A |
| WOODLAND IMAGING CENTER LLC | |||||||
| 5301 E HURON RIVER DR | ANN ARBOR | MI | 48106 | 760820959 | RADIOLOGY/IMAGING | MI | N/A |
| ST PETER'S AMBULATORY SURGERY CENTER LLC | |||||||
| 1375 WASHINGTON AVENUE STE 201 | ALBANY | NY | 12206 | 460463892 | OUTPATIENT SURGERY | NY | N/A |
| CATHERINE HORAN BUILDING LIMITED PARTNERSHIP | |||||||
| 1221 MAIN STREET ROOM 108 | HOLYOKE | MA | 010400000 | 042723429 | PROPERTY MANAGEMENT | MA | N/A |
| WESTERN MASSACHUSETTS PETCT IMAGING CENTER LLC | |||||||
| 100 BAYVIEW CIRCLE STE 400 | NEWPORT BEACH | CA | 92660 | 204744663 | OUTPATIENT MEDICAL SERVICES | DE | N/A |
| CENTRAL NEW JERSEY HEART SERVICES LLC | |||||||
| 29 E 29TH STREET 2ND FLOOR | BAYONNE | NJ | 07002 | 208525458 | CARDIAC PROGRAM | NJ | N/A |
| SMMC MOB II LP | |||||||
| 1201 LANGHORNE-NEWTOWN ROAD | LANGHORNE | PA | 19047 | 364559869 | INVESTMENT AND OPERATION OF A MEDICAL BUILDING | PA | N/A |
| THE AMBULATORY SURGERY CENTER AT ST MARY LLC | |||||||
| 1203 LANGHORNE-NEWTOWN ROAD | LANGHORNE | PA | 19047 | 232871206 | OUTPATIENT SURGERY | PA | N/A |
| EAST NORRITON MEDICAL ASSOCIATES | |||||||
| ONE WEST ELM STREET | CONSHOHOCKEN | PA | 19428 | 232319531 | MEDICAL OFFICE BUILDING | PA | N/A |
| GATEWAY HEALTH PLAN | |||||||
| 300 GRANT STREET | PITTSBURGH | PA | 15219 | 251691945 | MEDICAID & MEDICARE/SPECIAL NEEDS MANAGED CARE ORGANIZATION | PA | N/A |
| MERCYMANOR PARTNERSHIP | |||||||
| PO BOX 10086 | TOLEDO | OH | 436990086 | 521931012 | NURSING HOME | PA | N/A |
| ST AGNES LONG TERM INTENSIVE CARE LLP | |||||||
| C/O MHS ONE WEST ELM ST STE 100 | CONSHOHOCKEN | PA | 19428 | 200984882 | LONG TERM INTENSIVE CARE | PA | N/A |
| NAZARETH MEDICAL OFFICE BUILDING ASSOCIATES LP | |||||||
| C/O NAZARETH HOSP 2601 HOLME AVE | PHILADELPHIA | PA | 19152 | 232388040 | MEDICAL OFFICE BUILDING | PA | N/A |
| SJV MANAGEMENT LLC | |||||||
| 200 CENTURY PKWY STE 200E | MOUNT LAUREL | NJ | 08054 | 202273476 | RADIOLOGY | NJ | N/A |
| PHYSICIANS OUTPATIENT SURGERY CENTER LLC | |||||||
| 1000 NE 56TH STREET | OAKLAND PARK | FL | 33334 | 352325646 | AMBULATORY SURGERY CENTER | FL | N/A |
| CENTER FOR SURGERY & DIGESTIVE ORDERS | |||||||
| 3641 SOUTH MIAMI AVENUE | MIAMI | FL | 33133 | 510438152 | OUTPATIENT MEDICAL SERVICES | FL | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (61 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Province Or StateAddressForeign/ProvinceOrState | Postal CodeAddressForeign/PostalCode |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY HEALTH VENTURES INC | |||||||||||||||
| 565 W WESTERN AVE | MUSKEGON | MI | 49440 | 383522260 | SOFTWARE MARKETING | MI | N/A | C | 0 | ||||||
| GOTTLIEB MANAGEMENT SERVICES INC | |||||||||||||||
| 701 W NORTH AVE | MELROSE PARK | IL | 60160 | 363330529 | MANAGEMENT SERVICES | IL | N/A | C | 0 | ||||||
| HACKLEY HEALTH MANAGEMENT CENTER | |||||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382961814 | WEIGHT MANAGEMENT | MI | N/A | C | 0 | ||||||
| HACKLEY HEALTH VENTURES INC | |||||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382589959 | OTHER MEDICAL SERVICES | MI | N/A | C | 0 | ||||||
| HACKLEY HEALTHCARE EQUIPMENT | |||||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382578569 | HOME MEDICAL EQUIPMENT | MI | N/A | C | 0 | ||||||
| HACKLEY PROFESSIONAL CENTER | |||||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 383024797 | REAL ESTATE RENTAL | MI | N/A | C | 0 | ||||||
| HACKLEY PROFESSIONAL PHARMACY | |||||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382447870 | PHARMACY | MI | N/A | C | 0 | ||||||
| HEF INC | |||||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 383086401 | OFFICE STAFFING | MI | N/A | C | 0 | ||||||
| HOLY CROSS PRIVATE HOME SERVICES CORP | |||||||||||||||
| 11801 TECH ROAD | SILVER SPRING | MD | 20904 | 521986562 | HOME CARE SERVICES | MD | N/A | C | 0 | ||||||
| HPC CO-OWNERS ASSOCIATION | |||||||||||||||
| 1700 CLINTON | MUSKEGON | MI | 49442 | 270734448 | CONDOMINIUM ASSOCIATION | MI | N/A | C | 0 | ||||||
| HURON ARBOR CORPORATION | |||||||||||||||
| 5301 EAST HURON RIVER DR PO BOX 992 | ANN ARBOR | MI | 48106 | 382475644 | PROVIDES OFFICE RENTAL SPACE | MI | N/A | C | 0 | ||||||
| IHA AFFILIATION CORPORATION | |||||||||||||||
| 24 FRANK LLOYD WRIGHT DR LOBBY J | ANN ARBOR | MI | 48106 | 383188895 | MEDICAL MANAGEMENT | MI | N/A | C | 0 | ||||||
| MARYLAND CARE GROUP INC | |||||||||||||||
| 11801 TECH ROAD | SILVER SPRING | MD | 20904 | 521815313 | HEALTHCARE HOLDING | MD | N/A | C | 0 | ||||||
| MEDNOW INC | |||||||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 820389927 | OUTPATIENT PHARMACY | ID | N/A | C | 0 | ||||||
| MERCY MEDICAL SERVICES | |||||||||||||||
| 801 5TH STREET | SIOUX CITY | IA | 51101 | 421283849 | PRIMARY CARE PHYSICIANS | IA | N/A | C | 0 | ||||||
| MERCY SERVICES CORPORATION | |||||||||||||||
| 2525 SOUTH MICHIGAN AVENUE | CHICAGO | IL | 60616 | 363227348 | DORMANT | IL | N/A | C | 0 | ||||||
| MICHIGAN ATHLETIC CLUB | |||||||||||||||
| 2500 BURTON | GRAND RAPIDS | MI | 49546 | 382647304 | ATHLETIC CLUB | MI | N/A | C | 0 | ||||||
| MOUNT CARMEL HEALTH PROVIDERS INC | |||||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311382442 | MEDICAL SERVICES | OH | N/A | C | 0 | ||||||
| NORTH IOWA MERCY MEDICAL SERVICES INC | |||||||||||||||
| 1000 4TH ST SW | MASON CITY | IA | 50401 | 421382308 | MEDICAL SERVICES | IA | N/A | C | 0 | ||||||
| PRIORITY PLUS OF CALIFORNIA | |||||||||||||||
| PO BOX 27230 | FRESNO | CA | 93729 | 770395267 | FORMERLY HLTH MGMT NOW DISCONTINUED OPERATIONS | CA | N/A | C | 0 | ||||||
| SAINT ALPHONSUS PHYSICIANS PA | |||||||||||||||
| 1055 NORTH CURTIS ROAD | BOISE | ID | 837061370 | 331078261 | PHYSICIANS | ID | N/A | C | 0 | ||||||
| SAINT MARY'S HEALTH MANAGEMENT COMPANY | |||||||||||||||
| 1640 EAST PARIS SE | GRAND RAPIDS | MI | 49546 | 383450733 | ATHLETIC CLUB | MI | N/A | C | 0 | ||||||
| SURGERY CENTER FINANCING CORPORATION | |||||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311531102 | FINANCE, INSURANCE AND REAL ESTATE | OH | N/A | C | 0 | ||||||
| THRE SERVICES LLC | |||||||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 452603654 | REAL ESTATE BROKERAGE SERVICES | MI | N/A | C | 0 | ||||||
| TRINITY HEALTH EMPLOYEE BENEFIT TRUST | |||||||||||||||
| 20555 VICTOR PARKWAY | LIVONIA | MI | 48152 | 383410377 | GRANTOR TRUST | MI | N/A | T | 0 | ||||||
| VENZKE INSURANCE COMPANY LTD | |||||||||||||||
| 980453602 | PROVISION OF INSURANCE COVERAGE | N/A | C | 0 | PO BOX 1051 GRAND CAYMAN | GRAND CAYMAN | CJ | CJ | |||||||
| WEST SHORE PROFESSIONAL BUILDING CONDOMINIUM | |||||||||||||||
| 1820 44TH STREET SE | KENTWOOD | MI | 49508 | 382700166 | CONDOMINIUM ASSOCIATION | MI | N/A | C | 0 | ||||||
| WESTSHORE HEALTH NETWORK | |||||||||||||||
| 1820 44TH STREET | KENTWOOD | MI | 49508 | 383280200 | PHYSICIAN HOSPITAL ORGANIZATION | MI | N/A | C | 0 | ||||||
| WORKPLACE HEALTH OF GRAND HAVEN | |||||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 383112035 | OCCUPATIONAL HEALTH | MI | N/A | C | 0 | ||||||
| SAMARITAN MEDICAL OFFICE BUILDING INC | |||||||||||||||
| 2212 BURDETT AVENUE | TROY | NY | 12180 | 141607244 | REAL ESTATE | NY | N/A | C | 0 | ||||||
| AFFILIATED MANAGEMENT SERVICES CORPORATION INC | |||||||||||||||
| 1300 MASSACHUSETTS AVENUE | TROY | NY | 12180 | 141668024 | REAL ESTATE | NY | N/A | C | 0 | ||||||
| CATHERINE HORAN BUILDING INC | |||||||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 108 | HOLYOKE | MA | 010400000 | 042938160 | BUILDING MANAGEMENT | MA | N/A | C | 0 | ||||||
| DIVERSIFIED COMMUNITY SERVICES INC | |||||||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 108 | HOLYOKE | MA | 010400000 | 043128890 | MEDICAL SERVICES | MA | N/A | C | 0 | ||||||
| MERCY INPATIENT MEDICAL ASSOCIATES INC | |||||||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 108 | HOLYOKE | MA | 010400000 | 043029929 | MEDICAL SERVICES | MA | N/A | C | 0 | ||||||
| PROVIDENCE HOME CARE INC | |||||||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 108 | HOLYOKE | MA | 010400000 | 043317426 | HEALTH CARE SERVICES | MA | N/A | C | 0 | ||||||
| SYSTEM COORDINATED SERVICES INC | |||||||||||||||
| C/O SPHS 1221 MAIN STREET SUITE 108 | HOLYOKE | MA | 010400000 | 042938181 | LAB SERVICES | MA | N/A | C | 0 | ||||||
| PHYSICIANS MEDICAL OFFICE BUILDING CONDOMINIUM TRUST | |||||||||||||||
| 1221 MAIN STREET ROOM 108 | HOLYOKE | MA | 010400000 | 046608649 | PROPERTY MANAGEMENT | MA | N/A | C | 0 | ||||||
| SJM PROPERTIES INC | |||||||||||||||
| 411 CANISTEO STREET | HORNELL | NY | 148482101 | 161294991 | PROPERTY HOLDINGS | NY | N/A | C | 0 | ||||||
| CARBONDALE AREA PHYSICIANS' ASSOCIATION PC | |||||||||||||||
| 100 LINCOLN AVE | CARBONDALE | PA | 18407 | 232801677 | MEDICAL INSURANCE CONTRACTING | PA | N/A | C | 0 | ||||||
| CARBONDALE AREA PHYSICIANS' PHO INC | |||||||||||||||
| 100 LINCOLN AVE | CARBONDALE | PA | 18407 | 232801676 | INACTIVE | PA | N/A | C | 0 | ||||||
| CARBONDALE PHYSICIANS' SERVICES INC | |||||||||||||||
| 100 LINCOLN AVE | CARBONDALE | PA | 18407 | 232365077 | PHARMACY | PA | N/A | C | 0 | ||||||
| CHESTNUT RISK SERVICES LTD | |||||||||||||||
| INSURANCE | N/A | C | 0 | 11 VICTORIA STREET | HAMILTON | BD | BD | ||||||||
| LIFECARE PHYSICIANS PC | |||||||||||||||
| 601 HAMILTON AVENUE | TRENTON | NJ | 086291986 | 261649038 | HEALTH CARE SERVICES | NJ | N/A | C | 0 | ||||||
| MULTICARE PLUS INC | |||||||||||||||
| 601 HAMILTON AVENUE | TRENTON | NJ | 086291986 | 223435844 | INACTIVE | NJ | N/A | C | 0 | ||||||
| LANGHORNE SERVICES II INC | |||||||||||||||
| 1201 LANGHORNE-NEWTOWN ROAD | LANGHORNE | PA | 19047 | 253795549 | GENERAL PARTNER OF LMOB PARTNERS, II | PA | N/A | C | 0 | ||||||
| LANGHORNE SERVICES INC | |||||||||||||||
| 1201 LANGHORNE-NEWTOWN ROAD | LANGHORNE | PA | 19047 | 232625981 | GENERAL PARTNER OF LMOB PARTNERS, | PA | N/A | C | 0 | ||||||
| GATEWAY HEALTH PLAN INC | |||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 251505506 | HEALTH CARE | PA | N/A | C | 0 | ||||||
| GATEWAY HEALTH PLAN INC OF OHIO | |||||||||||||||
| 600 GRANT STREET | PITTSBURGH | PA | 15219 | 300282076 | HEALTH CARE | PA | N/A | C | 0 | ||||||
| MCMC EASTWICK INC | |||||||||||||||
| C/O MHS ONE WEST ELM STREET | CONSHOHOCKEN | PA | 19428 | 232184261 | MEDICAL OFFICE BUILDINGS | PA | N/A | C | 0 | ||||||
| HEALTH MANAGEMENT SERVICES ORG INC | |||||||||||||||
| 500 GROVE STREET SUITE 100 | HADDON HEIGHTS | NJ | 08035 | 223366580 | HEALTH CARE BILLING | NJ | N/A | C | 0 | ||||||
| LOURDES MEDEICAL ASSOCIATES PA | |||||||||||||||
| 500 GROVE STREET SUITE 100 | HADDON HEIGHTS | NJ | 08035 | 223361862 | MEDICAL SERVICES | NJ | N/A | C | 0 | ||||||
| JEANNETTE MEDICAL PROVIDERS | |||||||||||||||
| 3805 WEST CHESTER PIKE | NEWTOWN SQUARE | PA | 19073 | 251787334 | HOLDING COMPANY | PA | N/A | C | 0 | ||||||
| JEANNETTE OBGYN GROUP 1 INC | |||||||||||||||
| 3805 WEST CHESTER PIKE | NEWTOWN SQUARE | PA | 19073 | 232890748 | HOLDING COMPANY | PA | N/A | C | 0 | ||||||
| JEANNETTE PRIMARY CARE GROUP 1 INC | |||||||||||||||
| 3805 WEST CHESTER PIKE | NEWTOWN SQUARE | PA | 19073 | 232890743 | HOLDING COMPANY | PA | N/A | C | 0 | ||||||
| GEORGIA HEALTH ENTERPRISES LLC | |||||||||||||||
| 1230 BAXTER STREET | ATHENS | GA | 30606 | 541806329 | HEALTHCARE | GA | N/A | C | 0 | ||||||
| ST MARY'S HIGHLAND HILLS VILLAGE INC | |||||||||||||||
| 1660 JENNINGS MILL PKLY | BOGART | GA | 30622 | 582276801 | ASSISTED LIVING | GA | N/A | C | 0 | ||||||
| GHE PHYSICIANS PC | |||||||||||||||
| 3500 PIEDMONT ROAD | ATLANTA | GA | 30305 | 582277939 | PRACTICE MANAGEMENT | GA | N/A | C | 0 | ||||||
| NURSING NETWORK INC | |||||||||||||||
| 4725 NORTH FEDERAL HIGHWAY | FORT LAUDERDALE HIGHWA | FL | 333080000 | 591145192 | MEDICAL SERVICES | FL | N/A | C | 0 | ||||||
| MERCY PHYSICIAN GROUP INC | |||||||||||||||
| 3663 SOUTH MIAMI AVENUE | MIAMI | FL | 33133 | 202970015 | HEALTH CARE | FL | N/A | C | 0 | ||||||
| STELLA MARIS INSURANCE COMPANY LIMITED | |||||||||||||||
| 980078266 | INSURANCE | N/A | C | 0 | PO BOX 69 | GRAND CAYMAN | CJ | CJ | CAYMAN ISLANDS | KY1-1102 | |||||
| CATHOLIC HEALTH EAST SENIOR SERVICES | |||||||||||||||
| 3805 WEST CHESTER PIKE SUITE 100 | NEWTOWN SQUARE | PA | 19073 | 371572595 | SENIOR SERVICES | PA | N/A | C | 0 | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| GOTTLIEB COMMUNITY HEALTH SERVICES | ||
| L | 71160 | PER BOOKS |
| LOYOLA UNIVERSITY MEDICAL CENTER | ||
| M | 232669 | PER BOOKS |
| TRINITY HEALTH CORPORATION | ||
| M | 1304005 | PER BOOKS |
| TRINITY HEALTH CORPORATION | ||
| P | 4578714 | PER BOOKS |
| TRINITY HEALTH CORPORATION | ||
| Q | 320275 | PER BOOKS |