2013-11-15T14:30:18-06:00 2012-12-31 861065772 Deloitte Tax LLP 1700 Market Street 25th Floor Philadelphia PA 19103 990 2012-01-01 580566223 St Mary's Health Care System Inc STMA 7063893939 1230 Baxter Street Athens GA 306063791 Donald McKenna 7063893939 2013-11-15 1 William J Homer P00994519 2152462300 2012 2016-02-25 16:41:14Z Donald McKenna 1230 Baxter Street Athens GA 306063791 165398074 0 0938 X www.stmarysathens.com X 1938 GA As a member of Catholic Health East ("CHE") and sponsored by the Sisters of Mercy, the mission of St. Mary's Health Care System is to be a compassionate healing presence in our community, committed to the sacredness of human life and the dignity of each person we serve. 15 12 1488 350 0 0 53065 367681 173560861 162007624 1114423 79697 2093311 2355161 176821660 164810163 447001 637313 0 0 70440529 71880734 0 0 0 98956254 83876576 169843784 156394623 6977876 8415540 190653889 189854354 79378399 74295433 111275490 115558921 As a member of Catholic Health East ("CHE") and sponsored by the Sisters of Mercy, the mission of St. Mary's Health Care System is to be a compassionate healing presence in our community, committed to the sacredness of human life and the dignity of each person we serve. 0 0 109557306 637313 162888368 St. Mary's Health Care System was established to meet the health care needs of the people of Northeast Georgia. The System operates an acute care hospital, home health care agency, hospice, and leases a long-term care facility. Additionally, the System offers many wellness and educational services to the community at low, or in some cases, at no charge. 109557306 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 0 1 113 0 1488 1 0 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X Marty Hutson 7063893939 1230 Baxter Street Athens GA 306063791 Burgess Tim 1.00 0.00 X 0 0 0 Cline Ruth M MD 1.00 0.00 X 0 0 0 Chin Jean MD 1.00 0.00 X 0 0 0 Griffin Dawn 1.00 0.00 X 0 0 0 Hollingworth III Thomas F 1.00 0.00 X 0 0 0 Hooker Robbie P 1.00 0.00 X 0 0 0 Hubrich Leon 1.00 0.00 X 0 0 0 Perno Louis A 1.00 0.00 X 0 0 0 Salamone Father Robert 1.00 0.00 X 0 0 0 Snipes Bobby 1.00 0.00 X 0 0 0 Upchurch Charles L 1.00 0.00 X 0 0 0 Wilbanks Kathy 1.00 0.00 X 0 0 0 Priest Neal MD 2.00 0.00 X 12000 0 0 McKenna Don 40.00 10.00 X X 0 608118 40905 Hutson Martin 40.00 10.00 X X 253139 0 25056 Dugger Brenda 5.00 0.00 X 24283 0 756 Evans Nina 50.00 0.00 X 244493 0 10143 Carter Montez 16.00 34.00 X 272292 0 30805 English Jeffrey 40.00 10.00 X 217610 0 20533 Schuller Karen 40.00 10.00 X 237272 0 10136 Middendorf Bruce 40.00 0.00 X 326082 0 24515 Loome Sister Patricia 40.00 10.00 X 144273 0 7420 Vaughn Kerry 40.00 10.00 X 0 144105 23579 Camp Steven 60.00 0.00 X 206109 0 16419 Dixon-Martin Kelly 40.00 0.00 X 181831 0 9772 Wright Gary 40.00 0.00 X 164406 0 10416 Shutt Robert 35.00 0.00 X 137419 0 16846 Griffiths Catherine 60.00 0.00 X 137778 0 8795 2558987 752223 256096 60 0 1 0 Athens Hospitalist Services PC PO Box 7695 Athens GA 30606 Physicians 2697118 REHABCARE Group Inc PO Box 502096 St Louis MO 631502096 IP Management Services 1667955 Sodexo Inc PO Box 81049 Woburn MA 018131049 Dietary/Housekeeping 1594696 Anesthesia Consult of Athens PO Box 7127 Athens GA 30604 Anesthesiologist 1559218 Healthcare Fiscal Mgmt Inc 10567 165th St W Lakeville MN 55044 Patient Financial Services 1007481 22 338795 28886 367681 Hospital Patient Services 622110 162007624 162007624 162007624 543426 543426 436856 112532 324324 324324 324324 11650 408472 66907 -408472 -55257 -463729 -463729 Fitness Center 622110 560320 560320 Meaningful Use Payments 622110 455293 455293 Recognition of Net Assets 622110 425451 425451 589773 589773 2030837 164810163 162888368 0 1554114 X 637313 637313 2665515 582772 2082743 55660726 43493920 12166806 2304544 1741526 563018 7121503 5381665 1739838 4128446 3119835 1008611 550001 550001 19257217 5705140 13552077 868069 868069 1162084 420074 742010 3433380 1614186 1819194 580678 424389 156289 553313 553313 8412721 4759995 3652726 1582177 1582177 Medical & General Suppl 35068476 34995625 72851 0 Physician Fees 4853116 4853116 0 Maintenance 1355091 291991 1063100 0 6200253 1535759 4664494 156394623 109557306 46837317 0 34797751 28670406 19314696 20702869 3297226 3582226 3096831 2942968 1412581 1393454 200518450 136691192 62494911 63827258 28575447 31080022 0 319434 291415 37345012 37363736 190653889 189854354 27208066 27061490 62722 37334 18328324 17576300 1052353 861121 32726934 28759188 79378399 74295433 X 111928053 116441841 -652563 -882920 0 111275490 115558921 190653889 189854354 X 8415540 2542999 -6675108 X X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2010254 2010254 70284386 40483426 29800960 338653 36472 302181 78180550 62728411 15452139 49704607 33442883 16261724 63827258 Total Due From Other Entities 30798298 Other LT Assets 222078 Investments in Unconsolidated 6181605 LT-swap prgm CHE-Market Valuation 161756 Rounding -1 37363736 3rd Party Payables 3213163 Due to Related Parties 94366 Workers Compensation Reserve 940000 Pension Liability 21557794 LT Swap Prgm CHE-Market Valuation 164865 Worker's Compensation-Gross Liabi 426000 Other Reserves 2363000 28759188 1 1 1 X 1 X 1 1 1 0 1 1 6271913 6271913 0.04010 18851864 12594503 6257361 0.04000 25123777 12594503 12529274 0.08010 106451 106451 0.00070 2415637 2415637 0.01540 335654 335654 0.00210 14610 14610 138201 138201 0.00090 3010553 3010553 0.01910 28134330 12594503 15539827 0.09920 103096 103096 0.00070 103096 103096 0.00070 1 5274818 2865157 63119601 83662584 -20542983 X 1 1 1 1 St Mary's Health Care System Inc

1230 Baxter Street Athens GA 30606

X X X Home Health, Hospice and other OP Centers St Mary's Health Care System Inc 1 1 1 200.000000000000 1 400.000000000000 1 X X X 1 1 X X X X 1 0 X X X X X 1 X 0 0 Part I, Line 6a: Saint Mary's Health Care System's community benefit report is contained in a report prepared by a related organization, Catholic Health East. Part I, Line 7: The cost-to-charge ratio is not computed using Worksheet 2 from the instructions: the cost-to-charge ratio is computed by taking the full amount of expenses from the hospital statement of expenses, subtracting bad debt and then dividing by gross revenue. Part I, Line 7g: St. Mary's Health Care System has a Pediatric Subspecialty Clinic where specialty physicians from outside the local area come and see patients from the local area. The total cost for the Pedicatric Subspecialty Clinic included in Part I, line 7g is $90,525. Part I, L7 Col(f): There was no bad debt expenses included in the expenses on Form 990, Part IX, Line 25. The bad debt expense for 2012 was $5,274,818 and was reported as an offset to revenue. Part II: The director of Security attends and participates in disaster management and emergency preparedness meeting throughout the year. The planning allows collaboration of state and local agencies and organizations in order to prepare for a local or statewide emergency. Planning is a vital step in disaster management and will certainly increase community health in the case of an emergency. St. Mary's provided services and supplies to a local non-profit, Free IT Athens. Free IT Athens is a group of like-minded citizens who realize that computers are a necessary component of everyday life. They believe that everyone deserves access to low-cost computer equipment and computer-related services. The company provides access to information technology resources to Athens-Clarke County residents and organizations. St. Mary's IT staff helped clean old computers that were then donated to the organization which, in turn, donates them to people in need in the community. St Mary's has played a vital role in the establishment of the new Georgia Health Sciences/University of Georgia Medical Partnership. The Chief Medical Officer has served on a committee to help guide the new medical school and establish working relationships with St. Mary's as well as other health care organizations in the community. St. Mary's hosts many volunteers throughout the year including high school and college students as well as community members of all ages. Volunteers work as part of the Auxiliary and serve more than 2,000 each month. The volunteers not only serve the hospital in vital ways, but also receive experiential training in health care in a hospital setting. Increased education and training correlates with increased health status. Several departments within St. Mary's are involved in mentoring students interested in healthcare careers. The Director of Corporate Health Services serves on the Steering Committee/Board of LEAD Athens. LEAD Athens is a leadership development program of Athens-Clarke County leaders to further their understanding of the community. LEAD participants learn about the resources, opportunities and challenges that face our community and come away with insighs on how they can make a difference. The Manager of Physician Relations at St. Mary's serves on the Leadership Oconee Steering Committee. The Leadership Oconee program develops leaders from within Oconee County. The primary purpose is to educate these leaders with a well-rounded approach to all that is available and happening within our county. Members of each class learn about current programs/services available, challenges we still face as a community and how they can contribute to improve as a county. St. Mary's also participates in the Youth Apprenticeship Program (YAP). YAP is a career development program for High School students that helps them to be better equipped for the workplace. St. Mary's is very supportive of our local Chamber of Commerce. The Chief Financial Officer serves on the Athens Area Chamber of Commerce Board of Directors and the Director of Marketing and Public Relations serves on the Oconee County Chamber of Commerce Board of Directors. Additionally, the Vice President of Human Resources serves on the Economic Development Committee of Oconee County Chamber of Commerce. The Manager of Physician Relations serves on the Citizen Advisory Committee of Oconee Parks & Recreation. The Committee of Recreation Affairs in Oconee County, Georgia is determined by the County Board of Commissioners. Members are appointed by the Board of Commissioners for a minimum of 2 years and meet every other month to discuss overall parks and recreation programs and services, both current and long-range planning of those services. St. Mary's continues to play an integral role in the Athens Health Network (additional information below). Part III, Line 2:The figures were calculated based on a cost-to-charge ratio. The cost-to-charge ratio was derived by dividing total operating expenses by total gross patient charges. The cost-to-charge ratio was applied to total bad debt write-offs to calculate the costs for line 2.Part III, Line 3:While we make all reasonable efforts to identify patients eligible for charity care prior to billing, such pre-billing identification is not always possible. This problem arises largely with patients treated in our Emergency Department ("ED") on an outpatient basis. Frequently, these patients do not complete an application for financial assistance therefore making a definitive determination difficult. The estimated amount for patients who likely would qualify for financial assistance is calculated for line 3 based on a review of bad debt write-offs to include only bad debt for uninsured patients, and estimating the amount of that cost that could be charity based on a review of applications for financial assistance. A reasonable estimate based on the percentage of patients whose applications do not meet the criteria for financial assistance is used to estimate the amount that could qualify for financial assistance.Part III, Line 4:For financial reporting, an allowance for doubtful accounts is recorded for estimated losses resulting from the unwillingness of patients to make payments for services. The allowance is determined by analyzing historical data and trends. Accounts receivable are written off against the allowance for doubtful accounts when management determines that recovery is unlikely and collection efforts cease. Part III, Line 8: The amount here is determined by using the actual patient charges, the Medicare cost-to-charge ratios that we are currently being paid on, and the payment-to-charges from the actual remittances. Based on the calculation this shortfall should be viewed as uncompensated care provided to those patients and thus treated entirely as community benefit. Part III, Line 9b: Accounts with applications pending for Charity Care or other assistance programs are held until the outcome of the application. A "pending charity approval" is defined as an application that has been fully completed by the patient, submitted and is in the process of being determined for eligibility. It is acceptable ( but not preferable) to take an account though the full collection cycle and later reclassify it as Charity Care as long as a consistent process is followed and a legitimate basis exists that the patient is unable to pay. For example, with self-pay accounts written off and sent to bad debt, reclassifying the account to Charity Care may be considered on the basis of all of the following factors:1. No Third party coverage or inadequate coverage exists, 2. No payments are recorded on the account, and 3. The patient/guarantor was billed a minimum of 4 times.All self-pay accounts are automatically transferred to a third-party billing agency. The third-party billing agency contacts the account holder to arrange for payment. If the third-party billing agency has an account that has not been paid in full within 120 days, the account is then sent back to St. Mary's Health Care System. Upon receipt of an outstanding account, St. Mary's Health Care System transfers the account to a collection agency. St. Mary's Health Care System, Inc Part V, Section B, Line 18e: The Hospital utilizes general signage, brochure and in-room literature to make all patients aware of the facility's FAP. It also retains a contracted vendor that works with patients to qualify for government programs as well as financial assistance under the Policy. Additionally all of the facility's pre-collection and collection agencies are well aware of the FAP and have been instructed to educate and refer patients to back to the facility for financial counseling and possible assistance. St. Mary's Health Care System, Inc Part V, Section B, Line 20d: The hospital uses the average managed care write-off percentage for self-pay patients. Part VI, Line 7, The list of states in which CHE's community benefit report is filed are: Alabama, Connecticut, Delaware, Florida, Georgia, Maine, Massachusetts, New Jersey, New York, North Carolina and Pennsylvania. Part VI, Line 2: In July of 2010, St. Mary's Health Care System completed a community health needs assessment. The assessment focused on Athens-Clarke County, where the hospital is located. The assessment included several steps including planning, collecting data, prioritizing needs with community leaders, and meeting with a hospital committee to establish which needs the hospital will work to address. Demographic, health status, and economic data was collected from various governmental databases and community organizations. Qualitative data was collected through focused interviews with knowledgeable community members who are stakeholders in the health of the Athens community. After data was collected, a group of community members met to discuss priorities of needs, and finally a committee of hospital leadership met to determine which needs the hospital will work to address through community partnerships and possible increased services. Part VI, Line 3: Information is displayed on the hospital website and at all registration areas about financial assistance policies. All self-pay patients are visited by a financial counselor in the hospital and are screened for eligibility of financial assistance. The screening process includes screening for eligibility for the Charity Care policy as well as government programs. Part VI, Line 4: St. Mary's Health Care System is located in Athens-Clarke County and serves this community as well as Jackson, Madison, Monroe, Oglethorpe, and Oconee Counties. The estimated population of Athens-Clarke County in 2008 was 114,737 people. The 2008 estimated median age was 26.8 years, almost 10 years younger that the Georgia county average. This is due largely to the presence of the University of Georgia which currently enrolls more than 34,000 undergraduate and graduate students in total. Athens-Clarke County is diverse with about 68% of the population being white, 19% African American, and about 8% Latino and 5% other. Athens-Clarke County is very educated, about 40% of residents have a Bachelor's degree or higher, but also a large proportion, 20%, have not completed high school. Athens-Clarke County has a large population living in poverty, about 30%, and more than 32% of the population is without health insurance. The surrounding counties are more rural, slightly less diverse, and have less people living in poverty and without health insurance. However, people in these counties have fewer local resources and may face barriers to receiving care related to distance or transportation. Part VI, Line 5: Many of St. Mary's senior leadership serve on boards of community organizations. Our President, most Vice Presidents and many Directors donate their time and expertise to organizations that strive to improve community or state health. These organizations include Mercy Health Center, Parish Nurses Resource Center, Athens Health Network, Oncology Nursing Society, American Red Cross and Athens Nurses Clinic. St. Mary's is dedicated to serving the community not only within the hospital but also through partnerships in our community.Second, many of the physicians who work for St. Mary's or are associated with our hospital, donate their time and services to the free clinics in Athens, for example Mercy Health Center and Athens Nurses Clinic. The mission of St. Mary's is to serve the community and we encourage all staff to serve the community outside of the hospital.In addition, we maintain a 24-hour emergency room, an open medical staff and board comprised largely of independent members of the community. Part VI, Line 6: St. Mary's Health Care System Inc. operates as one organization to promote the health of the community. All Community Benefits are reported together and there is one needs assessment for St. Mary's Health Care System. 1 St Marys Foundation Inc 1230 Baxter Street Athens GA 30606 582544232 501(c)(3) 274013 FMV General Operation Funding St Joseph Catholic School 134 Prince Ave Athens GA 30601 580864659 501(c)(3) 200000 FMV School Construction Mercy Health Center 767 Oglethorpe Ave Athens GA 30606 582603523 501(c)(3) 27450 Book Medical Treatment of the underserved American Heart Assosciation 1720 Epps Bridge Parkway Suite 108-383 Athens GA 30606 135613797 501(c)(3) 20000 FMV Medical Reseach for Heart Disease Action Inc Athens Full Plate 594 Oconee Street Athens GA 30601 580961506 501(c)(3) 13756 FMV Food Food for the Needy Food Bank of Northeast Georgia PO Box 48857 Athens GA 30604 581938066 501(c)(3) 12904 FMV Food Food for the Needy United Way of Northeast Georgia 1 Huntington Rd Ste 805 Athens GA 30606 586008133 501(c)(3) 15500 FMV Funding for Various Charities University of Georgia - Golf Course 2600 Riverbend Road Athens GA 30602 586001998 501(c)(3) 6000 FMV Sponsorship of Station Classic Golf Tournament UGA Catholic Center 1344 South Lumpkin Athens GA 30605 580903505 501(c)(3) 5625 FMV Sponsorship of 5K run and Golf Tournament Community Connection 1695 Old West Broad St Athens GA 30606 581564825 501(c)(3) 5000 FMV Sponsor of Taste of Athens event 10 0 Schedule I, Part I, Line 2: The type of financial assistance provided by the organization can be broken into two categories, national charities and local not-for-profit entities. The organization does not ask organizations such as the American Cancer Society and the United Way for any documentation as to how the donated funds were used. Smaller donations made to local organizations are usually event specific. A comittee reviews the donations requests and assumes the money provided paid for the program subject to the request. 0 1 0 0 0 0 0 0 0 McKenna Don 0 360506 0 159250 0 88362 0 11250 0 29655 0 649023 0 0 Hutson Martin 201387 0 49717 0 2035 0 10511 0 14545 0 278195 0 0 0 Evans Nina 197121 0 46577 0 795 0 8545 0 1598 0 254636 0 0 0 Carter Montez 215699 0 48509 0 8084 0 11250 0 19555 0 303097 0 0 0 English Jeffrey 176555 0 39733 0 1322 0 7326 0 13207 0 238143 0 0 0 Schuller Karen 189010 0 47377 0 885 0 8511 0 1625 0 247408 0 0 0 Middendorf Bruce 293970 0 30208 0 1904 0 11250 0 13265 0 350597 0 0 0 Loome Sister Patricia 117307 0 26328 0 638 0 0 0 7420 0 151693 0 0 0 Vaughn Kerry 0 134653 0 11116 0 -1664 0 5826 0 17753 0 167684 0 0 Camp Steven 191348 0 0 0 14761 0 5535 0 10884 0 222528 0 0 0 Dixon-Martin Kelly 177622 0 0 0 4209 0 6866 0 2906 0 191603 0 0 0 Wright Gary 142684 0 12445 0 9277 0 0 0 10416 0 174822 0 0 0 Shutt Robert 129940 0 0 0 7479 0 6414 0 10432 0 154265 0 0 0 Part I, Line 3 The organization relied on a related 501(c)(3) organization (Catholic Health East) that used one or more of the methods described below to establish the compensation for the President/CEO: - Compensation committee - Independent compensation consultant - Written employment contract - Compensation survey or study - Approval by the board or compensation committee Part I, Line 4b Part I, Line 4b: Supplemental Executive Retirement Plan is provided to certain key executive employees. Contributions made to the plan on their behalf are vested and reflected in their compensation at the time of the contribution A Dev Auth - Unified Govt of Athens Series 2009 582613761 047059BB5 2009-03-19 16036560 Current Refunding & Swap Termination 0 0 0 A 480000 16036560 296790 15739770 1 0 1 1 A 0 1 0 0 0 0 0 0 0 A 1 Schedule K Supplental Information Schedule K, Part I, Bond Issue: (a) Issurer Name: Dev Auth - Unified Govt of Athens Series 2009 (f) Description of Purpose: Current Refunding & Swap Termaination. Dr Middendorf Officer President of Athens Hospitalist Services 2697118 Dr. Middendorf is the CMO of St Marys Health Care System, and President of Athens Hospitalist Services PC, however he does not receive any compensation from Athens Hospitalist Services, PC. 0 Neal Priest MD - Medical Staff President & Board Member Medical Partner with Athens-Clarke Emergency Specialists PC 226500 Dr. Priest is Medical Staff President and a Board Member of St. Mary's Health Care System and a Medical Partner with Athens-Clarke Emergency Specialists, PC. As a Medical Partner with Athens-Clarke Emergency Specialists, PC Dr. Priest provides physician coverage in the St. Mary's Emergency Department and is compensated for his work by ACES. 1 Form 990, Part VI, Section A, line 6 CHE is the sole member. Form 990, Part VI, Section A, line 7a Yes, CHE approves the appointment of all Board members. Form 990, Part VI, Section A, line 7b CHE has limited reserved powers to approve decisions of the governing body. Form 990, Part VI, Section B, line 11 The organization took steps to educate management, members of the board and members of appropriate subcommittees of the board on the compliance requirements mandated by the Form 990. The form was reviewed by management and then submitted to the board or a subcommittee thereof which reported its findings to the board. Form 990, Part VI, Section B, line 12c The organization has adopted CHE's policy 103, which sets forth the organization's conflict-of-interest policy and processes. Annually, all those serving St. Mary's Health Care System in a fiduciary capacity, including directors, officers and key employees receive a copy of the policy and annual disclosure statement to be completed. Disclosures of financial interest or other reportable circumstances as defined in the policy are submitted and reviewed by the organization's CEO and board's Chair. Summary information is reported to the entire board and available to the board throughout the year as business comes before the board or management for action. The policy contains a continuing affirmative obligation on all affected individuals to disclose compensation or other circumstances throughout the year which may rise to the level of an actual or apparent conflict. The determination of whether a disclosed financial or other interest constitutes a conflict of interest is made by the board or an appropriated committee thereof comprised of dis-interested persons and without the participation of the affected individual except to respond to questions about the disclosure. The policy further addresses the procedure for the board's further consideration of the proposed transaction/matter without the participation of the affected person and the documentation of the proceedings. Lastly, the policy addresses potential disciplinary action for violations of the policy. The policy is available to the public upon request. Form 990, Part VI, Section B, line 15 As indicated on Schedule J, Part III, the compensation for the organization's President/CEO is determined by CHE. For other employees, the organization has adopted CHE's process for determining compensation which includes the following: The board has an independent committee review and approve all elements of remuneration for all disqualified parties, as well as other key management. The board/committee has an established compensation philosophy which details the objectives of market positioning and pay elements. The committee engages with external consultants to provide market data comparing Saint Mary's Health Care System, Inc.'s roles to similarly sized health systems utilizing both title and job content comparisons. The committee reviews the market analysis, approves any salary adjustments for the executive population, considers both reasonableness and effectiveness of all remunerative programs and establishes the detailed performance expectations which are incorporated into the incentive plan. All of these discussions and decisions are documented through the provision of meeting minutes. Form 990, Part VI, Section C, line 19 Organizational Articles of Incorporation, Corporate By-laws, governance policies believed to be of interest to the public, conflict-of-interest policy, annual community benefit report and IRS Form 990 are available upon request. Other Fees Form 990, Part IX, line 11g CHE Allocations: Program service expenses 0. Management and general expenses 5,724,561. Fundraising expenses 0. Total expenses 5,724,561. Purchased Service/Service Contracts: Program service expenses 5,545,732. Management and general expenses 6,140,822. Fundraising expenses 0. Total expenses 11,686,554. Other: Program service expenses 159,408. Management and general expenses 1,686,694. Fundraising expenses 0. Total expenses 1,846,102. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Change in FV of Interest Rate Swaps 239,086. Transfer to CHE (Heritage Fund) -71,275. Tranfer to CHE YE True-up -568,162. Transfer for Good Samaritan Acquisitiion -3,500,000. Release of Net Assets for Depreciation -230,358. Pension Adjustment -2,544,399. Explanation of financial statements: Form 990, Part XII, Line 2a & 2b: While the entity does not have individual audited financial statements, an audit for CHE's consolidated financial statements was performed. Disclosure Statement Related to Form 5471 Filed by Catholic Health East and Saint Michael's Medical Center Under the constructive ownership rule of Internal Revenue Code Sections 318(a) and 958(b), the organization is required to file Form 5471, Information Return of U.S. Persons With Respect to Certain Foreign Corporations, as a Category 4 and/or Category 5 filer with respect to Stella Maris Insurance Company Limited and Chestnut Risk Services, LTD (collectively, the "foreign corporations"). This filing requirement is, or will be, satisfied through the filing of Forms 5471 with respect to the foreign corporations on the organization's behalf by the U.S. organizations identified below. Foreign Corporation: Stella Maris Insurance Company U.S. Organization: Catholic Health East Address: 3805 West Chester Pike, Suite 100, Newtown Square, Pennsylvania 19073 Identifying Number of U.S. Tax Return with Which Form 5471 was filed: 23-2929748 IRS Service Center Where U.S. Return Was Filed: Ogden, UT Foreign Corporation: Chestnut Risk Services, LTD U.S. Organization: Saint Michael's Medical Center Address: 111 Central Avenue, Newark, New Jersey 07102 Identifying Number of U.S. Tax Return with Which Form 5471 was filed: 26-2616046 IRS Service Center Where U.S. Return Was Filed: Ogden, UT Seton Real Estate Holdings 1300 Massachusetts Avenue Troy NY 12180 320393870 Management Real Estate NY Seton Health System Inc Catholic Health East 3805 West Chester Pike Suite 100 Newtown Square PA 19073 232929748 Management Services PA 501(c)(3) Line 11c, III-FI N/A 1 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 1 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 1 Mercy Hospital 144 State Street Portland MA 04101 010211534 Hospital ME 501(c)(3) Line 3 Mercy Health System of Maine 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 Villa Mary Immaculate 301 Hackett Blvd Albany NY 12208 141438749 Nursing Home & Physical Rehab NY 501(c)(3) Line 3 St Peter's Hospital 1 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 1 Northeast Health Inc 2212 Burdett Ave Troy NY 12180 042450756 Supporting Organization NY 501(c)(3) Line 11b, II St Peter's Health Partners 1 Memorial Hospital Albany NY 600 Northern Blvd Albany NY 12204 141338457 General Hospital NY 501(c)(3) Line 3 Northeast Health Inc 1 Samaritan Hospital of Troy New York 2215 Burdett Ave Troy NY 12180 141338544 General hospital NY 501(c)(3) Line 3 Northeast Health Inc 1 The Northeast Health Foundation Inc 2224 Burdett Ave Troy NY 12180 222743478 Supporting foundation NY 501(c)(3) Line 7 Northeast Health Inc 1 Samaritan Child Care Center Inc 2213 Burdett Ave Troy NY 12180 141710225 Child day care NY 501(c)(3) Line 9 Northeast Health Inc 1 Shaker Properties Inc 2212 Burdett Ave Troy NY 12180 223119822 Real Estate holding NY 501(c)(2) N/A Northeast Health Inc 1 Sunnyview Hospital & Rehabilitation Ctr 1270 Belmont Ave Schenectady NY 12308 141338386 Rehabilitation hospital NY 501(c)(3) Line 3 LTC (Eddy) Inc 1 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 1 Capital Region Geriatric Center Inc 421 West Columbia St Cohoes NY 12047 141701597 Nursing Home NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Heritage House Nursing Center Inc 2920 Tibbits Ave Troy NY 12180 141725101 Nursing home NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 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 1 Beverwyck Inc 40 Autumn Drive Slingerlands NY 12159 141717028 Independent/Assisted Living Retirement Community NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 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 1 Glen Eddy Inc One Glen Eddy Drive Niskayuna NY 12309 141794150 Independent/Assisted Living Community NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Beechwood Inc 2212 Burdett Ave Troy NY 12180 141651563 Real estate holding NY 501(c)(2) N/A LTC (Eddy) Inc 1 Senior Care Connection Inc 504 State St Schenectady NY 12305 141708754 PACE Program NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 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 1 Seton Health System Inc 1300 Massachusetts Avenue Troy NY 12180 141776186 Hospital NY 501(c)(3) Line 3 St Peter's Health Partners 1 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 1 Seton Health Foundation 1300 Massachusetts Avenue Troy NY 12180 222345416 Supporting Organization NY 501(c)(3) Line 11a, I Seton Health System Inc 1 Seton Auxiliary Inc 1300 Massachusetts Avenue Troy NY 12180 141505031 Supporting Organization NY 501(c)(3) Line 9 Seton Health System Inc 1 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 1 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 1 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 1 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 1 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 1 Providence Place Inc 5 Gamelin Street Holyoke MA 01040 043404084 Retirement Community MA 501(c)(3) Line 9 Sisters of Providence Health System Inc 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 McAuley Center Inc 275 Steele Road West Hartford CT 06117 061058086 Independent Living CT 501(c)(3) Line 9 Mercy Community Health Inc 1 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 1 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 1 Mercy Services 2021 Albany Avenue West Hartford CT 06117 061453323 Support Services CT 501(c)(3) Line 1 Mercy Community Health Inc 1 Mercyknoll Inc 2021 Albany Avenue West Hartford CT 06117 060757380 Skilled Nursing CT 501(c)(3) Line 3 Mercy Community Health Inc 1 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 1 St Mary Home Incorporated 2021 Albany Avenue West Hartford CT 06117 060646843 Skilled Nursing CT 501(c)(3) Line 3 Mercy Community Health Inc 1 Mercy Healthcare Center 114 Wawbeek Avenue Tupper Lake NY 12986 150532211 In Dissolution NY 501(c)(3) Line 3 Catholic Health East 1 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 1 Uihlein Mercy Center 185 Old Military Road Tupper Lake NY 12986 150532190 In Dissolution NY 501(c)(3) Line 3 Mercy Healthcare Center 1 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 1 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 1 St James Mercy Hospital 411 Canisteo Street Hornell NY 14843 160743310 Hospital NY 501(c)(3) Line 3 St James Mercy Health System Inc 1 Maxis Medical Services 100 Lincoln Ave Carbondale PA 18407 232577185 Physician Practices PA 501(c)(3) Line 3 Maxis Health System 1 Marian Community Hospital 100 Lincoln Ave Carbondale PA 18407 240711230 Hospital PA 501(c)(3) Line 3 Maxis Health System 1 Marian Community Hospital Auxiliary 100 Lincoln Ave Carbondale PA 18407 251874733 Fundraising PA 501(c)(3) Line 11b, II Maxis Health System 1 Maxis Foundation 100 Lincoln Ave Carbondale PA 18407 232330090 Fundraising PA 501(c)(3) Line 11b, II Maxis Health System 1 Maxis Health System 100 Lincoln Ave Carbondale PA 18407 911940902 Health Care System PA 501(c)(3) Line 11b, II Maxis Health System 1 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 1 Columbus Acquisition Corp 1160 Raymond Boulevard Newark NJ 07102 262616342 Inactive Entity NJ 501(c)(3) Line 9 Saint Michaels Medical Center 1 Saint Michaels Medical Center 111 Central Avenue Newark NJ 07102 262616046 Hospital NJ 501(c)(3) Line 3 Catholic Health East 1 St James Care Inc 1160 Raymond Boulevard Newark NJ 07102 262616230 Inactive Entity NJ 501(c)(3) Line 9 Saint Michaels Medical Center 1 St Michael's Foundation Inc 1160 Raymond Boulevard Newark NJ 07102 223311976 Foundation NJ 501(c)(3) Line 11a, I Saint Michaels Medical Center 1 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 1 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 1 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 1 St Francis Medical Center Trenton NJ 601 Hamilton Avenue Trenton NJ 08629 223431049 Hospital NJ 501(c)(3) Line 3 Catholic Health East 1 Langhorne MRI Inc 1201 Langhorne-Newtown Road Langhorne PA 19047 232519529 Inactive Entity PA 501(c)(3) Line 9 St Mary Medical Center 1 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 1 LIFE St Mary 1201 Langhorne-Newtown Road Langhorne PA 19047 262976184 Elderly Care PA 501(c)(3) Line 9 St Mary Medical Center 1 St Mary Medical Center 1201 Langhorne-Newtown Road Langhorne PA 19047 231913910 Hospital PA 501(c)(3) Line 3 Catholic Health East 1 St Mary Medical Center Foundation Inc 1201 Langhorne-Newtown Road Langhorne PA 19047 232567468 Foundation PA 501(c)(3) Line 7 St Mary Medical Center 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 Nazareth Hospital 2601 Holme Avenue Philadelphia PA 19152 232794121 Acute Care Hospital PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 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 1 NE Physician Services 2601 Holme Avenue Philadelphia PA 19152 232497355 Physician Practices PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 Our Lady of Lourdes Health Foundation Inc 1600 Haddon Avenue Camden NJ 08103 222351960 Foundation NJ 501(c)(3) Line 7 Our Lady of Lourdes Health Care Services 1 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 1 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 1 Franciscan Eldercare Corporation PO Box 2500 Wilmington DE 19805 223008680 Eldercare DE 501(c)(3) Line 9 St Francis Hospital 1 St Francis Foundation PO Box 2500 Wilmington DE 19805 510374158 Foundation DE 501(c)(3) Line 11b, II St Francis Hospital 1 St Francis Hospital PO Box 2500 Wilmington DE 19805 510064326 Hospital DE 501(c)(3) Line 3 Catholic Health East 1 LIFE at St Francis Healthcare Inc 7th Clayton Streets Wilmington DE 19805 452569214 Elderly Care DE 501(c)(3) Line 3 St Francis Hospital 1 McAuley Ministries McAuley Hall 3333 Fifth Avenue Pittsburgh PA 15213 943436142 Management & Support Services PA 501(c)(3) Line 9 Pittsburgh Mercy Health System 1 Mercy Jeannette Hospital 3805 West Chester Pike Newtown Square PA 19073 251310602 Inactive Entity PA 501(c)(3) Line 9 Pittsburgh Mercy Health System 1 Mercy Life Center Corporation 1200 Reedsdale Street Pittsburgh PA 15233 251604115 Community Treatment PA 501(c)(3) Line 9 Pittsburgh Mercy Health System 1 Pittsburgh Mercy Health System 3333 5th Avenue Pittsburgh PA 15213 251464211 Management & Support Services PA 501(c)(3) Line 11b, II Catholic Health East 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 Good Samaritan Hospital Inc 1201 Siloam Road Greensboro GA 30462 261720984 Hospital GA 501(c)(3) Line 3 Saint Joseph's Health System Inc 1 Mercy Medical Corporation PO Box 1090 101 Villa Drive Daphne AL 36526 636002215 Hospital AL 501(c)(3) Line 3 Catholic Health East 1 Mercy LIFE of Alabama PO Box 1090 101 Villa Drive Daphne AL 36526 273163002 Hospital AL 501(c)(3) Line 3 Mercy Medical Corporation 1 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 1 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 1 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 1 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 1 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 1 SSJ Health Foundation Inc 3663 South Miami Avenue Miami FL 33133 591709438 Fundraising FL 501(c)(3) Line 7 Mercy Hospital Inc 1 Mercy Hospital Inc 3663 South Miami Avenue Miami FL 33133 590791034 Hospital FL 501(c)(3) Line 3 Catholic Health East 1 Mercy Medical Development Inc 3663 South Miami Avenue Miami FL 33133 592789194 Outpatient Services FL 501(c)(3) Line 9 Mercy Hospital Inc 1 Mercy Mission Services Inc 3663 South Miami Avenue Miami FL 33133 650435764 Health Care FL 501(c)(3) Line 11a, I Mercy Hospital Inc 1 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 1 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 1 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 1 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 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 Mercy Health System One West El Conshohocken PA 19428 200984882 Long Term Intensive Care PA N/A St Agnes Long Term Intensive Care LLP c/o Mercy Health System One West El Conshohocken PA 19428 200984882 Long Term Intensive Care PA N/A Nazareth Medical Office Building Associates LP c/o Nazareth Hospital 2601 Holme Av Philadelphia PA 19152 232388040 Medical Office Building PA N/A Nazareth Medical Office Building Associates LP c/o Nazareth Hospital 2601 Holme Av 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 Samaritan Medical Office Building Inc 2212 Burdett Avenue Troy NY 12180 141607244 Real Estate NY N/A C 1 Affiliated Management Services Corporation Inc 1300 Massachusetts Avenue Troy NY 12180 141668024 Real Estate NY N/A C 1 Catherine Horan Building Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 042938160 Building Management MA N/A C 1 Diversified Community Services Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 043128890 Medical Services MA N/A C 1 Mercy Inpatient Medical Associates Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 043029929 Medical Services MA N/A C 1 Providence Home Care Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 043317426 Health Care Services MA N/A C 1 System Coordinated Services Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 042938181 Lab Services MA N/A C 1 Physicians Medical Office Building Condominium Trust 1221 Main Street Room 108 Holyoke MA 010400000 046608649 Property Management MA N/A C 1 SJM Properties Inc 411 Canisteo Street Hornell NY 148482101 161294991 Property Holdings NY N/A C 1 Carbondale Area Physicians' Association PC 100 Lincoln Ave Carbondale PA 18407 232801677 Medical Insurance Contracting PA N/A C 1 Carbondale Area Physicians' PHO Inc 100 Lincoln Ave Carbondale PA 18407 232801676 Inactive PA N/A C 1 Carbondale Physicians' Services Inc 100 Lincoln Ave Carbondale PA 18407 232365077 Pharmacy PA N/A C 1 Chestnut Risk Services Ltd 11 Victoria Street Hamilton BD Insurance BD N/A C 1 LifeCare Physicians PC 601 Hamilton Avenue Trenton NJ 086291986 261649038 Health Care Services NJ N/A C 1 Multicare Plus Inc 601 Hamilton Avenue Trenton NJ 086291986 223435844 Inactive NJ N/A C 1 Langhorne Services II Inc 1201 Langhorne-Newtown Road Langhorne PA 19047 253795549 General Partner of LMOB Partners, II PA N/A C 1 Langhorne Services Inc 1201 Langhorne-Newtown Road Langhorne PA 19047 232625981 General Partner of LMOB Partners, PA N/A C 1 Gateway Health Plan Inc 600 Grant Street Pittsburgh PA 15219 251505506 Health Care PA N/A C 1 Gateway Health Plan Inc of Ohio 600 Grant Street Pittsburgh PA 15219 300282076 Health Care PA N/A C 1 MCMC Eastwick Inc c/o MHS One West Elm Street Conshohocken PA 19428 232184261 Medical Office Buildings PA N/A C 1 Health Management Services Org Inc 500 Grove Street Suite 100 Haddon Heights NJ 08035 223366580 Health Care Billing NJ N/A C 1 Lourdes Medeical Associates PA 500 Grove Street Suite 100 Haddon Heights NJ 08035 223361862 Medical Services NJ N/A C 1 Jeannette Medical Providers 3805 West Chester Pike Newtown Square PA 19073 251787334 Holding Company PA N/A C 1 Jeannette OBGYN Group 1 Inc 3805 West Chester Pike Newtown Square PA 19073 232890748 Holding Company PA N/A C 1 Jeannette Primary Care Group 1 Inc 3805 West Chester Pike Newtown Square PA 19073 232890743 Holding Company PA N/A C 1 Georgia Health Enterprises LLC 1230 Baxter Street Athens GA 30606 541806329 Healthcare GA St Mary's Health Care System Inc C 1.00000 1 St Mary's Highland Hills Village Inc 1660 Jennings Mill Pkly Bogart GA 30622 582276801 Assisted Living GA St Mary's Health Care System Inc C 6197854 1.00000 1 GHE Physicians PC 3500 Piedmont Road Atlanta GA 30305 582277939 Practice Management GA N/A C 1 Nursing Network Inc 4725 North Federal Highway Fort Lauderdale Highwa FL 333080000 591145192 Medical Services FL N/A C 1 Mercy Physician Group Inc 3663 South Miami Avenue Miami FL 33133 202970015 Health Care FL N/A C 1 Stella Maris Insurance Company Limited PO Box 69 Grand Cayman Cayman Islands CJ KY1-1102 980078266 Insurance CJ N/A C 1 Catholic Health East Senior Services 3805 West Chester Pike Suite 100 Newtown Square PA 19073 371572595 Senior Services PA N/A C 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 St Mary's Highland Hills Inc S 3346000 Fair Market Value St Mary's Highland Hills Inc R 2566279 Fair Market Value St Mary's Medical Group Inc S 7654010 Fair Market Value St Mary's Medical Group Inc R 11791194 Fair Market Value Catholic Health East P 6419016 Fair Market Value St Mary's Foundation Inc S 155823 Fair Market Value St Mary's Foundation Inc R 429836 Fair Market Value Good Samaritan Hospital Inc R 17207333 Fair Market Value Good Samaritan Hospital Inc S 14435310 Fair Market Value St Mary's Foundation Inc C 28886 Fair Market Value