STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

JEFFERSON MEMORIAL HOSPITAL INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
JEFFERSON MEMORIAL HOSPITAL INC (EIN 62-1660663)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-12
IRS object ID
201313169349304606
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-12T14:00:35-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN621660663EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1JEFFERSON MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlJEFFNameControl
Phone5136392800Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1615 Elsinore PlaceAddressLine1
CityCincinnatiCity
StateOHState
ZIP Code45202ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDAVID NOWISKIName
TitleTREASURERTitle
Date Signed2013-11-12DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Terminated ReturnXTerminatedReturn

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1DAVID NOWISKIBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1615 Elsinore PlaceAddressLine1
CityCincinnatiCity
StateOHState
ZIP Code45202ZIPCode
FieldValueIRS element (for citing)
Gross Receipts40863GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileTNStateLegalDomicile
Activity Or Mission DescriptionTHE PRIMARY EXEMPT PURPOSE OF JEFFERSON MEMORIAL HOSPITAL IS TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED.ActivityOrMissionDescription
Termination Or ContractionXTerminationOrContraction
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year20000ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year30159745ProgramServiceRevenuePriorYear
Program Service Revenue CY37751ProgramServiceRevenueCY
Investment Income Prior Year73239InvestmentIncomePriorYear
Investment Income Current Year-75987InvestmentIncomeCurrentYear
Other Revenue Prior Year173613OtherRevenuePriorYear
Other Revenue Current Year16OtherRevenueCurrentYear
Total Revenue Prior Year30426597TotalRevenuePriorYear
Total Revenue Current Year-38220TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year10681283SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year15274909OtherExpensePriorYear
Other Expenses Current Year137985OtherExpensesCurrentYear
Total Expenses Prior Year25956192TotalExpensesPriorYear
Total Expenses Current Year137985TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4470405RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-176205RevenuesLessExpensesCY
Total Assets BOY45524604TotalAssetsBOY
Total Assets EOY0TotalAssetsEOY
Total Liabilities BOY5582296TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY39942308NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY0NetAssetsOrFundBalancesEOY
Mission DescriptionTHE PRIMARY EXEMPT PURPOSE OF JEFFERSON MEMORIAL HOSPITAL IS TO EXTEND THE HEALING MINISTRY OF JESUS BY IMROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense93830Expense
Grants0Grants
Revenue37751Revenue
DescriptionTHE OPERATING ASSETS OF JEFFERSON MEMORIAL HOSPITAL, INC. WERE SOLD TO HEALTH MANAGEMENT ASSOCIATES, INC. EFFECTIVE OCTOBER 1, 2011. ACCORDINGLY, ALL HOSPITAL OPERATIONS CEASED EFFECTIVE THAT DATE. ALL REMAINING ASSETS AND LIABILITIES WERE MERGED INTO MERCY HEALTH PARTNERS, INC. ON DECEMBER 31, 2012.Description
Total Program Service Expense93830TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedtrueTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1TRAVIS CRUMBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5136392800TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1615 Elsinore PlaceAddressLine1
CityCincinnatiCity
StateOHState
ZIP Code45202ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationFormerFormer
DAVID NOWISKI
CHP VP FINANCE, TREASURER0.1051.70XX045413683333
JOHN M STARCHER JR
CHP SVP, DIVISIONAL CEO, BOARD MEMBER0.1059.20XX087529226045
MICHAEL BEZNEY
CHP GENERAL COUNSEL, CHAIR & PRESIDENT0.1052.70XX0738716111134
YEMI ADEYANJU
CHP ASSOC GENERAL COUNSEL, SECRETARY0.1049.70XX015791218201
JANICE K VAN DYNE
FORMER KEY EMPLOYEE0.0050.00051116738486X
JERRY SANDERS
FORMER KEY EMPLOYEE0.000.000212383353X
PATRICIA A MCDANIEL
FORMER KEY EMPLOYEE0.0055.00023005419379X
ROBERT MOON
FORMER OFFICER0.0050.00063723844598X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3816898TotalReportableCompFrmRltdOrgs
Total Other Compensation341529TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE6219903775137751
0
0
0
0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue37751TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3096TotalRevenueColumn
Exclusion$3,096ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities79083Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-79083Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-79083TotalRevenueColumn
Exclusion-$79,083ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
OTHER16$16
0
0

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue16TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column-38220TotalRevenueColumn
Related Or Exempt Function Income37751RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$75,971ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1033Total
Program Services702ProgramServices
Management And General331ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total127798Total
Program Services86903ProgramServices
Management And General40895ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total9154Total
Program Services6225ProgramServices
Management And General2929ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total137985Total
Program Services93830ProgramServices
Management And General44155ManagementAndGeneral
Fundraising0Fundraising

Total Joint Costs TotalJointCosts

FieldValueIRS element (for citing)
Total0Total

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY32834862BOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY8182872BOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3447BOY
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis0LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec0LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY81BOY
EOY0EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY4503342BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY45524604BOY
EOY0EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY894837BOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4687459BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5582296BOY
EOY0EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY39942308BOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY39942308BOY
EOY0EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY45524604BOY
EOY0EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-176205ReconcilationRevenueExpenses
Reconciliation Unrealized Invest211740ReconciliationUnrealizedInvest
Reconcilation Other Changes-39977843ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Book Value0BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Book Value0BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Book Value0BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability
Total Of Amounts0TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierFIN 48 (ASC 740) footnoteIdentifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationTHE COMPANY [CATHOLIC HEALTH PARTNERS AND AFFILIATED ENTITIES] COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AT DECEMBER 31, 2012 AND 2011, AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT DECEMBER 31, 2012 OR 2011.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DAVID NOWISKI
CHP VP FINANCE, TREASURER0348377086037019722055987027346053746900
JANICE K VAN DYNE
FORMER KEY EMPLOYEE02523920626970196078020000018486054965300
JERRY SANDERS
FORMER KEY EMPLOYEE02123830000000353021273600
JOHN M STARCHER JR
CHP SVP, DIVISIONAL CEO, BOARD MEMBER01902530275000041003901830107744090133700
MICHAEL BEZNEY
CHP GENERAL COUNSEL, CHAIR & PRESIDENT039843901670740173203083936027198084985000
PATRICIA A MCDANIEL
FORMER KEY EMPLOYEE02057300170000732401062508754024943300
ROBERT MOON
FORMER OFFICER04305690992420107427017500027098068183600
YEMI ADEYANJU
CHP ASSOC GENERAL COUNSEL, SECRETARY0135413021633086601198606215017611300

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Arrangement used to establish the top management official's compensationSchedule J, Part I, Line 3THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS DETERMINED BY CATHOLIC HEALTH PARTNERS (CHP), A RELATED TAX-EXEMPT ORGANIZATION. CHP UTILIZES A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, A COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE WHEN DETERMINING THIS COMPENSATION.
Severance or change-of-control paymentSchedule J, Part I, Line 4aSEVERANCE BENEFITS CONSISTING OF CONTINUATION OF BASE SALARY AND INSURANCE BENEFITS WERE PROVIDED TO LISTED INDIVIDUALS FOR SPECIFIED PERIODS. THE LISTED INDIVIDUALS EXECUTED RELEASES AND WAIVERS OF CLAIMS IN EXCHANGE FOR THE SEVERANCE BENEFITS. SALARY CONTINUATION AMOUNTS PROVIDED DURING THE YEAR TO LISTED INDIVIDUALS WERE AS FOLLOWS: JANICE VAN DYNE $145,288; JERRY SANDERS $212,383.
Supplemental nonqualified retirement planSchedule J, Part I, Line 4bTHE CATHOLIC HEALTH PARTNERS (CHP) SERP PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATE. IT PROVIDES ANNUAL CREDITS OF A SPECIFIED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST 50%, 75%, AND 100% IN THEIR ACCOUNTS AFTER 5, 6, AND 7 YEARS OF SERVICE, RESPECTIVELY, VESTING OCCURS EARLIER FOR DEATH OR TOTAL DISABILITY OR REACHING AGE 60 WHILE EMPLOYED, OR INVOLUNTARY TERMINATION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHANGE IN CONTROL OF THE ORGANIZATION OR DUE TO POSITION ELIMINATION, PAYMENTS DURING EMPLOYMENT ARE MADE FOR REQUIRED TAX WITHHOLDINGS. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS AFTER TERMINATION OF EMPLOYMENT. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO SERP PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: JOHN M. STARCHER, JR. $21,395; MICHAEL BEZNEY $147,814.
THE CHP EXECUTIVE RETENTION PLANSCHEDULE J, PART I, LINE 4BTHE CHP EXECUTIVE RETENTION PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES EMPLOYMENT CONTINUATION INCENTIVES TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELIGATE. IT PROVIDES ANNUAL CREDITS OF A SPECIFIED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST AND CEASE TO RECEIVE CREDITS AFTER 5 YEARS OF PLAN PARTICIPATION PROVIDED THEY REMAIN EMPLOYED. VESTING AND CESSATION OF CREDITS OCCUR EARLIER FOR DEATH OR TOTAL DISABILITY WHILE EMPLOYED, INVOLUNTARY TERMAINTION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHANGE IN CONTROL OF THE ORGANIZATION, OR, FOR CERTAIN PARTICIPANTS, UPON BEING OFFERED A SPECIFIED PROMOTION. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS UPON VESTING. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO RETENTION PLAN PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: JOHN M. STARCHER JR. $383,081; MICHAEL BEZNEY $0; DAVID NOWISKI $0; ROBERT MOON $57,490.

Schedule N IRS990ScheduleN

Liquidation Table LiquidationTable

Liquidation Detail LiquidationDetail

FieldValueIRS element (for citing)
Description Of AssetCASH AND ACCOUNTS RECEIVABLEDescriptionOfAsset
Date Of Distribution2012-12-31DateOfDistribution
FMV Of Asset33918884FMVOfAsset
Method Of FMV DeterminationGAAPMethodOfFMVDetermination
EIN731627534EIN

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MERCY HEALTH PARTNERS INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1615 ELSINORE PLACEAddressLine1
CityCINCINNATICity
StateOHState
ZIP Code45202ZIPCode
FieldValueIRS element (for citing)
IRC Section501(C)(3)IRCSection
FieldValueIRS element (for citing)
Director Of SuccessorfalseDirectorOfSuccessor
Employee Of SuccessorfalseEmployeeOfSuccessor
Owner Of SuccessorfalseOwnerOfSuccessor
Receive CompensationfalseReceiveCompensation
Assets DistributedtrueAssetsDistributed
Required To Notify AGtrueRequiredToNotifyAG
AG NotifiedtrueAGNotified
Liabilities PaidtrueLiabilitiesPaid
Bonds OutstandingfalseBondsOutstanding

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CONSOLIDATED AUDITED FINANCIAL STATEMENTSFORM 990, PART IV, LINE 12BTHE FILING ORGANIZATION DOES NOT HAVE SEPARATE, INDEPENDENT AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION IS INCLUDED IN CATHOLIC HEALTH PARTNERS' CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH ARE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. CATHOLIC HEALTH PARTNERS' AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE HAS RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT.
Classes of members or stockholdersForm 990, Part VI, Section A, Line 6MERCY HEALTH PARTNERS - TENNESSEE IS THE SOLE MEMBER OF THE ORGANIZATION.
Members or stockholders electing members of governing bodyForm 990, Part VI, Section A, Line 7aCATHOLIC HEALTH PARTNERS (CHP) APPROVES MEMBERS THAT ARE APPOINTED TO THE BOARD OF TRUSTEES. ALL MEMBERS OF THE BOARD OF TRUSTEES HAVE FULL VOTING RIGHTS.
Decisions requiring approval by members or stockholdersForm 990, Part VI, Section A, Line 7bCERTAIN MATTERS REQUIRE APPROVAL OF THE CHP CORPORATE MEMBER, CHP GOVERNING BODY, OR CHP CEO. THE REGULATIONS OF THE ORGANIZATION DESCRIBE THE LEVEL OF APPROVAL REQUIRED FOR VARIOUS DECISIONS.
Review of form 990 by governing bodyForm 990, Part VI, Section B, Line 11bTHE FORM 990 IS PREPARED BY CHP'S TAX DEPARTMENT.
Conflict of interest policyForm 990, Part VI, Section B, Line 12cALL DISCLOSED CONFLICTS ARE SUMMARIZED AND PRESENTED TO THE BOARD AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE EACH YEAR ALONG WITH RECOMMENDATIONS TO MANAGE THE CONFLICT. AT EACH BOARD/BOARD COMMITTEE MEETING, MEMBERS ARE REQUESTED TO REVIEW THE AGENDA AND NOTIFY THE CHAIRMAN OF ANY CONFLICT THEY MAY HAVE. INDIVIDUALS HAVE AN ONGOING DUTY TO DISCLOSE ANY POTENTIAL CONFLICT THAT MAY ARISE DURING THE YEAR.
POLICIESFORM 990, PART VI, LINE 15THE COMPENSATION OF THE CEO OR TOP MANAGEMENT OFFICIAL, OFFICERS AND KEY EMPLOYEES IS DETERMINED BY CATHOLIC HEALTH PARTNERS, A RELATED TAX-EXEMPT ORGANIZATION.
Governing documents, conflict of interest policy and financial statements available to the publicForm 990, Part VI, Section C, Line 19GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. THE SYSTEM-WIDE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE ON THE CATHOLIC HEALTH PARTNERS WEBSITE.
Other changes in net assets or fund balancesForm 990 , Part XI, Line 9FUND BALANCE TRANSFER - -39977843;

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (82 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodePrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
CATHOLIC HEALTH PARTNERS
615 ELSINORE PLACECINCINNATIOH45202HEALTHCARE SYSTEM PARENTOH501(C)(3)11 - Type III - FINAfalse
CATHOLIC HEALTH PARTNERS FOUNDATION
615 ELSINORE PLACECINCINNATIOH45202FUNDRAISINGOH501(C)(3)7CATHOLIC HEALTH PARTNERSfalse
CATHOLIC HEALTHCARE PARTNERS HOUSING DEVELOPMENT
615 ELSINORE PLACECINCINNATIOH45202HUD PARENTOH501(C)(3)9CATHOLIC HEALTH PARTNERSfalse
CATHOLIC HEALTHCARE PARTNERS RETIREMENT TRUST
615 ELSINORE PLACECINCINNATIOH45202RETIREMENT TRUSTOH501(C)(3)8CATHOLIC HEALTH PARTNERSfalse
COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM
3700 KOLBE ROADLORAINOH44053REGIONAL PARENTOH501(C)(3)11 - Type IICATHOLIC HEALTH PARTNERSfalse
COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER
3700 KOLBE ROADLORAINOH44053HOSPITALOH501(C)(3)3COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEMfalse
ALLEN MEDICAL CENTER
200 WEST LORAIN STOBERLINOH44074HOSPITALOH501(C)(3)3COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEMfalse
COMMUNITY HEALTH PARTNERS REGIONAL FOUNDATION
3700 KOLBE ROADLORAINOH44053FOUNDATIONOH501(C)(3)11 - Type III - FICOMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTERfalse
COMMUNITY HEALTH PARTNERS PHYSICIANS OFFICE BUILDINGS
3700 KOLBE ROADLORAINOH44053MEDICAL OFFICE RENTALOH501(C)(3)9COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTERfalse
ALLEN MEDICAL CENTER MEDICAL OFFICE BUILDING
200 WEST LORAIN STOBERLINOH44074MEDICAL OFFICE RENTALOH501(C)(3)11 - Type IIALLEN MEDICAL CENTERfalse
MERCY HEALTH PARTNERS OF SOUTHWEST OHIO
4600 MCAULEY PLACECINCINNATIOH45242REGIONAL PARENTOH501(C)(3)11 - Type III - FICATHOLIC HEALTH PARTNERSfalse
MERCY HEALTH PARTNERS OF SOUTHWEST OHIO FOUNDATION
4600 MCAULEY PLACECINCINNATIOH45242FOUNDATIONOH501(C)(3)7MERCY HEALTH PARTNERS OF SOUTHWEST OHIOfalse
MERCY HOSPITALS WEST
2446 KIPLING AVENUECINCINNATIOH45239HOSPITALOH501(C)(3)3MERCY HEALTH PARTNERS OF SOUTHWEST OHIOfalse
MERCY HOSPITAL ANDERSON
7500 STATE ROADCINCINNATIOH45255HOSPITALOH501(C)(3)3MERCY HEALTH PARTNERS OF SOUTHWEST OHIOfalse
THE SISTERS OF MERCY OF HAMILTON OHIO
3000 MACK ROADFAIRFIELDOH45014HOSPITALOH501(C)(3)3MERCY HEALTH PARTNERS OF SOUTHWEST OHIOfalse
THE SISTERS OF MERCY OF CLERMONT COUNTY OHIO
3000 HOSPITAL DRIVEBATAVIAOH45103HOSPITALOH501(C)(3)3MERCY HEALTH PARTNERS OF SOUTHWEST OHIOfalse
MERCY FRANCISCAN SENIOR HEALTH AND HOUSING SERVICES INC
7010 ROWAN HILLS DRCINCINNATIOH45227RETIREMENT HOMEOH501(C)(3)9MERCY HEALTH PARTNERS OF SOUTHWEST OHIOfalse
MERCY SACRED HEART INC
2120 PAYNE STREETLOUISVILLEKY40206RETIREMENT HOMEKY501(C)(3)9MERCY HEALTH PARTNERS OF SOUTHWEST OHIOfalse
MERCY LONG TERM CARE INITIATIVE
4915 CHARLESTOWN RDNEW ALBANYIN47150RETIREMENT HOMEIN501(C)(3)9MERCY HEALTH PARTNERS OF SOUTHWEST OHIOfalse
MERCY FRANCISCAN SOCIAL MINISTRIES INC
1800 LOGAN STREETCINCINNATIOH45210LOW INCOME HOUSINGOH501(C)(3)7MERCY HEALTH PARTNERS OF SOUTHWEST OHIOfalse
MERCY FRANCISCAN AT ST RAPHAEL INC
610 HIGH STREETHAMILTONOH45011SERVICES TO THE POOROH501(C)(3)7MERCY HEALTH PARTNERS OF SOUTHWEST OHIOfalse
COMMUNITY MERCY HEALTH SYSTEM
ONE S LIMESTONE STSPRINGFIELDOH45502REGIONAL PARENTOH501(C)(3)11 - Type III - FICATHOLIC HEALTH PARTNERSfalse
COMMUNITY MERCY HEALTH PARTNERS
ONE S LIMESTONE STSPRINGFIELDOH45502HOSPITALOH501(C)(3)3COMMUNITY MERCY HEALTH SYSTEMfalse
THE COMMUNITY MERCY FOUNDATION
1343 N FOUNTAIN BLVDSPRINGFIELDOH45504FOUNDATIONOH501(C)(3)7COMMUNITY MERCY HEALTH SYSTEMfalse
C H HEALTH SERVICES COMPANY
ONE S LIMESTONE STSPRINGFIELDOH45502HOSPITALOH501(C)(3)3COMMUNITY MERCY HEALTH SYSTEMfalse
CLARKE & CHAMPAIGN COUNTIES HEALTH INFORMATION EXCHANGE
1150 E HOME ROADSPRINGFIELDOH45503MEDICAL INFORMATION EXCHANGEOH501(C)(3)9COMMUNITY MERCY HEALTH SYSTEMfalse
THE WALLACE S MURRAY AND FRANCES RABBITTS MURRAY MEMORIAL TRUST
ONE S LIMESTONE STSPRINGFIELDOH45502INDIGENT MEDICAL CAREOH501(C)(3)11 - Type INAfalse
MERCY HEALTH SYSTEM - NORTHERN REGION
2200 JEFFERSON AVENUETOLEDOOH43604REGIONAL PARENTOH501(C)(3)11 - Type III - FICATHOLIC HEALTH PARTNERSfalse
MERCY PROPERTY HOLDINGS
2200 JEFFERSON AVENUETOLEDOOH43604TITLE HOLDING COMPANYOH501(C)(2)N/AMERCY HEALTH SYSTEM - NORTHERN REGIONfalse
ST CHARLES MERCY HOSPITAL OF OREGON OHIO
2600 NAVARRE AVENUEOREGONOH43616HOSPITALOH501(C)(3)3MERCY HEALTH SYSTEM - NORTHERN REGIONfalse
ST CHARLES MERCY HEALTH FOUNDATION
2600 NAVARRE AVENUEOREGONOH43616FOUNDATIONOH501(C)(3)11 - Type III - FIST CHARLES MERCY HOSPITAL OF OREGON OHIOfalse
RIVERSIDE MERCY HOSPITAL
3404 W SYLVANIA AVETOLEDOOH43623HOSPITALOH501(C)(3)3MERCY HEALTH SYSTEM - NORTHERN REGIONfalse
MERCY HOME CARE INC
2200 JEFFERSON AVENUETOLEDOOH43604HOME HEALTHCAREOH501(C)(3)9MERCY HEALTH SYSTEM - NORTHERN REGIONfalse
MERCY COLLEGE OF OHIO
2221 MADISON AVENUETOLEDOOH43604MEDICAL COLLEGEOH501(C)(3)2MERCY HEALTH SYSTEM - NORTHERN REGIONfalse
MERCY COLLEGE OF OHIO FOUNDATION INC
2221 MADISON AVENUETOLEDOOH43604FOUNDATIONOH501(C)(3)11 - Type IMERCY COLLEGE OF OHIOfalse
MERCY HOSPITAL OF TIFFIN OHIO
45 ST LAWRENCE DRIVETIFFINOH44883HOSPITALOH501(C)(3)3MERCY HEALTH SYSTEM - NORTHERN REGIONfalse
MERCY TIFFIN HEALTH FOUNDATION
45 ST LAWRENCE DRIVETIFFINOH44883FOUNDATIONOH501(C)(3)11 - Type III - FIMERCY HOSPITAL OF TIFFIN OHIOfalse
THE SISTERS OF MERCY OF WILLARD OHIO
110 EAST HOWARD STWILLARDOH44890HOSPITALOH501(C)(3)3MERCY HEALTH SYSTEM - NORTHERN REGIONfalse
MERCY HOSPITAL OF WILLARD FOUNDATION
110 EAST HOWARD STWILLARDOH44890FOUNDATIONOH501(C)(3)11 - Type III - FITHE SISTERS OF MERCY OF WILLARD OHIOfalse
ST VINCENT MERCY MEDICAL CENTER
2213 CHERRY STREETTOLEDOOH43608HOSPITALOH501(C)(3)3MERCY HEALTH SYSTEM - NORTHERN REGIONfalse
ST VINCENT MERCY MEDICAL CENTER FOUNDATION
2213 CHERRY STREETTOLEDOOH43608FOUNDATIONOH501(C)(3)11 - Type III - FIST VINCENT MERCY MEDICAL CENTERfalse
LIFESTAR AMBULANCE INC
2200 JEFFERSON AVENUETOLEDOOH43604MEDICAL TRANSPORTATIONOH501(C)(3)11 - Type IIMERCY HEALTH SYSTEM - NORTHERN REGIONfalse
RSM MEDICAL FOUNDATION
2200 JEFFERSON AVENUETOLEDOOH43624HOSPITALOH501(C)(3)3MERCY HEALTH SYSTEM - NORTHERN REGIONfalse
ST MARGUERITE D'YOUVILLE FOUNDATION II
2213 CHERRY STREETTOLEDOOH43608FOUNDATIONOH501(C)(3)11 - Type IICATHOLIC HEALTH PARTNERSfalse
SIMON OUTREACH SERVICES
2600 NAVARRE AVENUEOREGONOH43616MEDICAL OFFICE RENTALOH501(C)(3)11 - Type IIST CHARLES MERCY HOSPITAL OF OREGON OHIOfalse
FARLEY HEALTHCARE CORPORATION
2200 JEFFERSON AVENUETOLEDOOH43604HEALTH SERVICESOH501(C)(3)9MERCY HEALTH SYSTEM - NORTHERN REGIONfalse
ST RITA'S MEDICAL CENTER
730 W MARKET STREETLIMAOH45801HOSPITALOH501(C)(3)3CATHOLIC HEALTH PARTNERSfalse
SRHC FOUNDATION
730 W MARKET STREETLIMAOH45801FOUNDATIONOH501(C)(3)11 - Type III - FIST RITA'S MEDICAL CENTERfalse
NEW VISION MEDICAL LABORATORIES INC
750 W HIGH ST STE 400LIMAOH45801MEDICAL LAB SERVICESOH501(C)(3)11 - Type III - FIST RITA'S MEDICAL CENTERfalse
HUMILITY OF MARY HEALTH PARTNERS
1044 BELMONT AVENUEYOUNGSTOWNOH44501HOSPITALOH501(C)(3)3CATHOLIC HEALTH PARTNERSfalse
THE ASSUMPTION VILLAGE
9800 N MARKET STREETNORTH LIMAOH44452NURSING HOMEOH501(C)(3)9HUMILITY OF MARY HEALTH PARTNERSfalse
HOSPICE OF THE VALLEY
5190 MARKET STREETYOUNGSTOWNOH44512HOSPICE SERVICESOH501(C)(3)9HUMILITY OF MARY HEALTH PARTNERSfalse
HUMILITY OF MARY DEVELOPMENT FOUNDATION
1044 BELMONT AVENUEYOUNGSTOWNOH44501FOUNDATIONOH501(C)(3)11 - Type III - FIHUMILITY OF MARY HEALTH PARTNERSfalse
HUMILITY HOUSE
755 OHLTOWN ROADAUSTINTOWNOH44515NURSING HOMEOH501(C)(3)9HUMILITY OF MARY HEALTH PARTNERSfalse
LAUREL LAKE RETIREMENT COMMUNITY INC
200 LAUREL LAKE DRIVEHUDSONOH44236NURSING HOMEOH501(C)(3)9HUMILITY OF MARY HEALTH PARTNERSfalse
LAUREL LAKE RETIREMENT COMMUNITY FOUNDATION INC
200 LAUREL LAKE DRIVEHUDSONOH44236FOUNDATIONOH501(C)(3)7LAUREL LAKE RETIREMENT COMMUNITY INCfalse
ST JOSEPH HEALTH CENTER AUXILIARY
677 EASTLAND SEWARRENOH44484FUNDRAISINGOH501(C)(3)9HUMILITY OF MARY HEALTH PARTNERSfalse
MERCY HEALTH PARTNERS - LOURDES INC
1530 LONE OAK ROADPADUCAHKY42003HOSPITALKY501(C)(3)3CATHOLIC HEALTH PARTNERSfalse
LOURDES FOUNDATION INC
1530 LONE OAK ROADPADUCAHKY42003FOUNDATIONKY501(C)(3)7MERCY HEALTH PARTNERS - LOURDES INCfalse
LOURDES HOSPITAL AUXILIARY GIFT SHOP
1530 LONE OAK ROADPADUCAHKY42003FUNDRAISINGKY501(C)(3)11 - Type III - FILOURDES FOUNDATION INCfalse
MARCUM AND WALLACE MEMORIAL HOSPITAL INC
60 MERCY COURTIRVINEKY40336HOSPITALKY501(C)(3)3MERCY HEALTH PARTNERS - LOURDES INCfalse
MARCUM AND WALLACE HOSPITAL FOUNDATION INC
60 MERCY COURTIRVINEKY40336FOUNDATIONKY501(C)(3)11 - Type III - FIMARCUM AND WALLACE MEMORIAL HOSPITAL INCfalse
MERCY HEALTH PARTNERS INC
900 EAST OAK HILL AVEKNOXVILLETN37917REGIONAL PARENTTN501(C)(3)11 - Type ICATHOLIC HEALTH PARTNERSfalse
MERCY HEALTH SYSTEM INC
900 EAST OAK HILL AVEKNOXVILLETN37917HOSPITALTN501(C)(3)3MERCY HEALTH PARTNERS INCfalse
ST MARY'S MEDICAL CENTER OF CAMPBELL COUNTY INC
923 EAST CENTRAL AVELAFOLLETTETN37766HOSPITALTN501(C)(3)3MERCY HEALTH PARTNERS INCfalse
MERCY HEALTH PARTNERS FOUNDATION INC
900 EAST OAK HILL AVEKNOXVILLETN37917FOUNDATIONTN501(C)(3)7MERCY HEALTH PARTNERS INCfalse
JEFFERSON MEMORIAL HOSPITAL INC
110 HOSPITAL DRIVEJEFFERSON CITYTN37760HOSPITALTN501(C)(3)3MERCY HEALTH PARTNERS INCfalse
JEFFERSON MEMORIAL FOUNDATION INC
110 HOSPITAL DRIVEJEFFERSON CITYTN37760FOUNDATIONTN501(C)(3)11 - Type III - FIJEFFERSON MEMORIAL HOSPITAL INCfalse
ST MARY'S MEDICAL CENTER OF SCOTT COUNTY INC
18797 ALBERTA STREETONEIDATN37841HOSPITALTN501(C)(3)3MERCY HEALTH PARTNERS INCfalse
BAPTIST HOSPITAL OF EAST TENNESSEE INC
137 BLOUNT AVEKNOXVILLETN37920HOSPITALTN501(C)(3)3MERCY HEALTH PARTNERS INCfalse
BAPTIST HOSPITAL OF COCKE COUNTY INC
435 SECOND STREETNEWPORTTN37821HOSPITALTN501(C)(3)3MERCY HEALTH PARTNERS INCfalse
MERCY HEALTH PARTNERS - NORTHEAST REGION INC
746 JEFFERSON AVENUESCRANTONPA18510REGIONAL PARENTPA501(C)(3)11 - Type III - FICATHOLIC HEALTH PARTNERSfalse
MERCY HEALTHCARE FOUNDATION
746 JEFFERSON AVENUESCRANTONPA18510FOUNDATIONPA501(C)(3)11 - Type III - FIMERCY HEALTH PARTNERS - NORTHEAST REGION INCfalse
MERCY HOSPITAL SCRANTON PA
746 JEFFERSON AVENUESCRANTONPA18510HOSPITALPA501(C)(3)3MERCY HEALTH PARTNERS - NORTHEAST REGION INCfalse
MERCY COMMUNITY CARE CORPORATION
746 JEFFERSON AVENUESCRANTONPA18510MEDICAL CAREPA501(C)(3)9MERCY HEALTH PARTNERS - NORTHEAST REGION INCfalse
MERCY MED-CARE INC
746 JEFFERSON AVENUESCRANTONPA18510HOSPITALPA501(C)(3)3MERCY HEALTH PARTNERS - NORTHEAST REGION INCfalse
MERCY HOSPITAL NANTICOKE
128 W WASHINGTON STNANTICOKEPA18634HOSPITALPA501(C)(3)3MERCY HEALTH PARTNERS - NORTHEAST REGION INCfalse
MERCY HOSPITAL OF WILKES-BARRE
746 JEFFERSON AVENUESCRANTONPA18510HOSPITALPA501(C)(3)3MERCY HEALTH PARTNERS - NORTHEAST REGION INCfalse
MERCY HEALTH CARE CENTER
746 JEFFERSON AVENUESCRANTONPA18510HOSPITALPA501(C)(3)3MERCY HEALTH PARTNERS - NORTHEAST REGION INCfalse
MERCY TYLER HEALTH SYSTEMS
880 SR 6WTUNKHANNOCKPA18657SUPPORTING ORGPA501(C)(3)11 - Type IIMERCY HEALTH PARTNERS - NORTHEAST REGION INCfalse
MERCY TYLER HOSPITAL
880 SR 6WTUNKHANNOCKPA18657HOSPITALPA501(C)(3)3MERCY TYLER HEALTH SYSTEMSfalse
MERCY TYLER HOME HEALTH SERVICES
880 SR 6WTUNKHANNOCKPA18657IN-HOME MEDICAL CAREPA501(C)(3)9MERCY TYLER HEALTH SYSTEMSfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeType
NWO INTEGRATED LABORATORIES MERCY LLC
2200 JEFFERSON AVENUETOLEDOOH43624341898285LABORATORY SERVICESOHNAN/A
TIFFIN AMBULATORY SURGICAL ASSOCIATES
45 ST LAWRENCE DRIVETIFFINOH44833371567866AMBULATORY SURGERY CENTEROHNAN/A
WEST CENTRAL OHIO SURGERY & ENDO CENTER
770 W HIGH ST SUITE 100LIMAOH45801341868154AMBULATORY SURGERY CENTEROHNAN/A
NEW VISION MEDICAL LAB LLC
750 W HIGH STREETLIMAOH45801341913433LAB SERVICESOHNAN/A
WEST CENTRAL OHIO GROUP LTD
801 MEDICAL DRIVELIMAOH45804341848147ORTHOPEDIC HOSPITALOHNAN/A
KIDNEY SERVICES OF WEST CENTRAL OHIO
750 W HIGH STREET SUITE 100LIMAOH45801061644264DIALYSIS CENTEROHNAN/A
ST ELIZABETH CARDIAC CATH LAB LLC
1044 BELMONT AVEYOUNGSTOWNOH44501300023795CARDIAC CATH LABOHNAN/A
ST ELIZABETH SOUTHWOODS IMAGING
250 DEBARTOLO PLACE BLDG BYOUNGSTOWNOH44512261626482DIAGNOSTIC IMAGINGOHNAN/A
UROLOGIC ONCOLOGY OF MAHONING VALLEY LLC
1044 BELMONT AVEYOUNGSTOWNOH44501262989686RADIATION THERAPYOHNAN/A
HMHPUSP SURGERY CENTERS LLC
15305 DALLAS PKWY STE 1600ADDISONTX75001271953122SURGERY CENTERTXNAN/A
OSC-HMHP LLC
6505 MARKET ST BLDG B STE 101BOARDMANOH44512010724836ORTHOPEDIC SURGERY CENTEROHNAN/A
LOURDES AMBULATORY SURGERY CENTER
225 MEDICAL CENTER DRIVEPADUCAHKY42003611258960SURGERY CENTERKYNAN/A
EAST TENNESSEE DIAGNOSTIC CENTER LLC
1450 DOWELL SPRINGS BLVD SUITE 250KNOXVILLETN37909204773300DIAGNOSTIC SERVICESTNNAN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (26 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile Foreign CountryLegalDomicileForeignCountryBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityLegal Domicile StateLegalDomicileState
CHP INSURANCE LTD
615 ELSINORE PLACECINCINNATIOH45202980621978INSURANCECJNAC CORPORATION
SISTERS OF MERCY WORKERS COMPENSATION SELF-INSURANCE TRUST
615 ELSINORE PLACECINCINNATIOH45202310990309WORKERS COMPENSATION TRUSTNATRUSTMA
MHSWO HEALTH VENTURES INC
1 S LIMESTONE STSPRINGFIELDOH45502311072139PHYSICIAN PRACTICESNAC CORPORATIONOH
NORTHPARKE MEDICAL COMMONS CONDO ASSN
333 N LIMESTONE STSPRINGFIELDOH45503311391230REAL PROPERTY MGMNTNAC CORPORATIONOH
MERCY HEALTH AFFILIATES INC
2200 JEFFERSON AVENUETOLEDOOH43604341372633PHYSICIAN SERVICESNAC CORPORATIONOH
PHYSICIAN'S HEALTH COLLABORATIVE
2200 JEFFERSON AVENUETOLEDOOH43604203986844MEDICAL & HOSPITAL SERVICESNAC CORPORATIONOH
NORTHSIDE CORPORATION
2200 JEFFERSON AVENUETOLEDOOH43604341318438RESIDENT RENTALSNAC CORPORATIONOH
MERCY WORK SOLUTIONS
2200 JEFFERSON AVENUETOLEDOOH43604300066340WORKERS COMPENSATIONNAC CORPORATIONOH
MERCY HEALTH SYSTEM PHO
2200 JEFFERSON AVENUETOLEDOOH43604341778321MEDICAL SERVICESNAC CORPORATIONOH
PHYSICIAN MANAGED CARE INC
2200 JEFFERSON AVENUETOLEDOOH43604341565320HEALTH SERVICESNAC CORPORATIONOH
MCAULEY MANAGEMENT SERVICES INC
730 W MARKET STREETLIMAOH45801341379037PROPERTY RENTALNAC CORPORATIONOH
LIMA MEDICAL SUPPLIES INC
730 W MARKET STREETLIMAOH45801340944477MEDICAL EQUIPMENTNAC CORPORATIONOH
COMMUNITY HEALTH PARTNERS ENTERPRISES INC
3700 KOLBE ROADLORAINOH44053341455525HOLDING COMPANYNAC CORPORATIONOH
COMMUNITY HEALTH PARTNERS PHYSICIANS INC
3700 KOLBE ROADLORAINOH44053341803352PHYSICIAN PRACTICESNAC CORPORATIONOH
AMC PHYSICIANS INC
200 W LORAIN STREETOBERLINOH44074371439554PHYSICIAN SERVICESNAC CORPORATIONOH
MERCY HEALTH VENTURES INC
4600 MCAULEY PLACECINCINNATIOH45242311185477DIVERSIFIED ACTIVITIESNAC CORPORATIONOH
MERCY FRANCISCAN MEDICAL MANAGEMENT SERVICES
4600 MCAULEY PLACECINCINNATIOH45242311640789DIVERSIFIED ACTIVITIESNAC CORPORATIONOH
MERCY FRANCISCAN AT WINTON WOODS I INC
10290 MILL ROADCINCINNATIOH45231311658668LOW-INCOME HOUSINGNAC CORPORATIONOH
MERCY HEALTH MANAGEMENT INC
1530 LONE OAK ROADPADUCAHKY42003611086762MEDICAL OFFICESNAC CORPORATIONKY
HEALTH DYNAMICS INC
900 E OAK HILL AVENUEKNOXVILLETN37917621247729MEDICAL EQUIPMENT SALESNAC CORPORATIONTN
HEALTH VENTURES INC & SUBSIDIARIES
P O BOX 1788KNOXVILLETN37901621175587MEDICAL SERVICESNAC CORPORATIONTN
ANNE KILCAWLEY CHRISTMAN FOUNDATION
100 FEDERAL PLAZA EASTYOUNGSTOWNOH44503356735706BENEFICIAL TRUSTNATRUSTOH
RALPH EWE TRUST
270 PARK AVENUENEW YORKNY10017346866422BENEFICIAL TRUSTNATRUSTNY
ELIZABETH HINES CATES TRUST
PNC 1900 E 9TH STCLEVELANDOH44114346515678BENEFICIAL TRUSTNATRUSTOH
WILLIS PARK TRUST
PNC 1900 E 9TH STCLEVELANDOH44114346519904BENEFICIAL TRUSTNATRUSTOH
ERMA GIBSON BALDWIN TRUST
PNC 1900 E 9TH STCLEVELANDOH44114346515566BENEFICIAL TRUSTNATRUSTOH
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg