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NEW VISION MEDICAL LABORATORIES INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
NEW VISION MEDICAL LABORATORIES INC (EIN 34-1937267)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-13
IRS object ID
201323179349302532
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)
Timestamp2013-11-13T12:43:58-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN341937267EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NEW VISION MEDICAL LABORATORIES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNEWVNameControl
Phone4192269366Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1750 W High Street Suite 400AddressLine1
CityLimaCity
StateOHState
ZIP Code45801ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTIM RIEGERName
TitleCFOTitle
Date Signed2013-11-11DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1MARK MINICKBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1837 W HIGH STREETAddressLine1
CityLIMACity
StateOHState
ZIP Code45801ZIPCode
FieldValueIRS element (for citing)
Gross Receipts12888521GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2000YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTHE PRIMARY EXEMPT PURPOSE OF NEW VISION MEDICAL LABORATORIES, INC. IS TO PROVIDE LABORATORY SERVICES TO ITS EXEMPT MEMBER PATRON HOSPITALS.ActivityOrMissionDescription
Nbr Voting Members Governing Body4NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees170TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year12634945ProgramServiceRevenuePriorYear
Program Service Revenue CY12888521ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year12634945TotalRevenuePriorYear
Total Revenue Current Year12888521TotalRevenueCurrentYear
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 Year7684998SalariesEtcPriorYear
Salaries Etc Current Year7837927SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4949947OtherExpensePriorYear
Other Expenses Current Year5050594OtherExpensesCurrentYear
Total Expenses Prior Year12634945TotalExpensesPriorYear
Total Expenses Current Year12888521TotalExpensesCurrentYear
Revenues Less Expenses Prior Year0RevenuesLessExpensesPriorYear
Revenues Less Expenses CY0RevenuesLessExpensesCY
Total Assets BOY142419TotalAssetsBOY
Total Assets EOY210965TotalAssetsEOY
Total Liabilities BOY122458TotalLiabilitiesBOY
Total Liabilities EOY191004TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY19961NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY19961NetAssetsOrFundBalancesEOY
Mission DescriptionTHE PRIMARY EXEMPT PURPOSE OF NEW VISION MEDICAL LABORATORIES, INC. IS TO PROVIDE LABORATORY SERVICES TO ITS EXEMPT MEMBER PATRON HOSPITALS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense12869909Expense
Grants0Grants
Revenue12888521Revenue
DescriptionTHE PRIMARY EXEMPT PURPOSE OF NEW VISION MEDICAL LABORATORIES, INC. IS TO PROVIDE LABORATORY SERVICES TO ITS EXEMPT MEMBER PATRON HOSPITALS.Description
Total Program Service Expense12869909TotalProgramServiceExpense
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
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
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 Employees170NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
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
Excess Business HoldingsfalseExcessBusinessHoldings
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members4NbrVotingGoverningBodyMembers
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 MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
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 (5 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
BRIAN SMITH
TRUSTEE, CHP EVP NETWORKS1.0047.50X0512193186636
JOHN MEYER
TRUSTEE, VP CHIEF QUAL. OFFICER-SRMC1.0040.00X0265690182159
MARK J MINICK
TRUSTEE, PRES. & CEO - VWCH1.0040.00X077113715554
MICHAEL HOLLIDAY
TRUSTEE, VP Finance - VWCH1.0040.00X019807711666
SUSAN HYMER
EXECUTIVE DIR, EXEC DIR ANCILLARY SVCS - SRMC40.000157946077510X
FieldValueIRS element (for citing)
Total Reportable Comp From Org157946TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1747097TotalReportableCompFrmRltdOrgs
Total Other Compensation473525TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
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
LABORATORY FEES6215001288852112888521
0
0
0
0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Program Service Revenue12888521TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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)

Total Revenue ColumnTotalRevenueColumn
0
0
0

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column12888521TotalRevenueColumn
Related Or Exempt Function Income12888521RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

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)
Total235456Total
Program Services235456ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7602471Total
Program Services7602471ProgramServices

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)
Total18612Total
Management And General18612ManagementAndGeneral

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)
Total224114Total
Program Services224114ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total365870Total
Program Services365870ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total319248Total
Program Services319248ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1426982Total
Program Services1426982ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total7937Total
Program Services7937ProgramServices

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)
Total6161Total
Program Services6161ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
LAB & MEDICAL SUPPLIES24789482478948
DUES & SUBSCRIPTIONS71207120
TAXES2300723007

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total172595Total
Program Services172595ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total12888521Total
Program Services12869909ProgramServices
Management And General18612ManagementAndGeneral
Fundraising0Fundraising

Total Joint Costs TotalJointCosts

FieldValueIRS element (for citing)
Total0Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY48413BOY
EOY167163EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY94006BOY
EOY43802EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

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

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY
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)
BOY142419BOY
EOY210965EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY122458BOY
EOY191004EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY122458BOY
EOY191004EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY19961BOY
EOY19961EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY19961BOY
EOY19961EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY142419BOY
EOY210965EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses0ReconcilationRevenueExpenses
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)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (2 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
ST RITA'S MEDICAL CENTER
3411056193truetruetrue$0
VAN WERT HOSPITAL
3444295143truetruetrue$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs2TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

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 PaymentfalseSeverancePayment
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 PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 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
BRIAN SMITH
TRUSTEE, CHP EVP NETWORKS0413415000987780151298035338069882900
JOHN MEYER
TRUSTEE, VP CHIEF QUAL. OFFICER-SRMC02143210318180195510148143034016044784900
MARK J MINICK
TRUSTEE, PRES. & CEO - VWCH0420450013387002168170735008204078669100
MICHAEL HOLLIDAY
TRUSTEE, VP FINANCE - VWCH0159208038869000475506911020974300
SUSAN HYMER
EXECUTIVE DIR, EXEC DIR ANCILLARY SVCS - SRMC143249012222024750652800122300235456000

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Arrangement used to establish the top management official's compensationSchedule J, Part I, Line 3THE COMPENSATION OF THE ORGANIZATION'S EXECUTIVE DIRECTOR, SUSAN HYMER, IS DETERMINED BY ST. RITA'S MEDICAL CENTER (SRMC), A RELATED TAX-EXEMPT ORGANIZATION. SRMC UTILIZES THE APPROVAL OF THE BOARD OR COMPENSATION COMMITTEE WHEN DETERMINING MS. HYMER'S COMPENSATION.
Supplemental nonqualified retirement planSchedule J, Part I, Line 4bST. RITA'S MEDICAL CENTER PROVIDES A 457(F) FLEXIBLE BENEFIT ALLOWANCE TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATE. THE PLAN PROVIDES AN ALLOWANCE BASED UPON A SPECIFIED PERCENTAGE OF COMPENSATION, WHICH PARTICIPANTS MAY USE TO ALLOCATE AMONG VARIOUS INSURANCE AND DEFERRED COMPENSATION BENEFIT OPTIONS. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: JOHN MEYER $0.
TERMS AND CONDITIONS OF SRMC EXECUTIVE RETENTION PLANSCHEDULE J, PART I, LINE 4BTHE ST. RITA'S MEDICAL CENTER EXECUTIVE RETENTION PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES EMPLOYMENT CONTINUATION INCENTIVES TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATE. THE PLAN PROVIDES ANNUAL CREDITS OF A SPECIFIED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST AND CEASE TO RECEIVE CREDITS AFTER 5 YEARS OF PLAN PARTICIPATION, PROVIDED THEY REMAIN EMPLOYED. VESTING AND CESSATION OF CREDITS OCCUR EARLIER FOR DEATH OR TOTAL DISABILITY WHILE EMPLOYED, INVOLUNTARY TERMINATION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHANGE IN CONTROL OF THE ORGANIZATION, OR, FOR CERTAIN PARTICIPANTS, UPON BEING OFFERED A SPECIFIED PROMOTION. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS UPON VESTING. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO RETENTION PLAN PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: BRIAN SMITH $0.
TERMS AND CONDITONS OF THE CHP SERP 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: BRIAN SMITH $78,749.
Non-fixed paymentsSchedule J, Part I, Line 7THE ORGANIZATION PROVIDES ANNUAL INCENTIVE COMPENSATION FOR LISTED INDIVIDUALS. THE ORGANIZATION'S BOARD OF TRUSTEES ESTABLISHES OBJECTIVE THRESHOLDS FOR QUALITY, COMMUNITY BENEFIT, AND FINANCIAL PERFORMANCE WHICH MUST BE ACHIEVED FOR INCENTIVES TO BE AWARDED. THE BOARD ALSO ESTABLISHES THRESHOLD, TARGET AND MAXIMUM LEVELS FOR INCENTIVE AWARDS. WITHIN THESE ESTABLISHED PARAMETERS, THE BOARD DETERMINES THE CEO'S INCENTIVE AWARD AND INCENTIVE AWARDS FOR OTHER LISTED INDIVIDUALS ARE DETERMINED BY THE CEO AND DISCLOSED TO THE BOARD. THE BOARD MAY AUTHORIZE MODIFIED INCENTIVE AWARDS WHEN APPROPRIATE IN ITS JUDGEMENT.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Classes of members or stockholdersForm 990, Part VI, Section A, Line 6ST. RITA'S MEDICAL CENTER AND VAN WERT COUNTY HOSPITAL ARE MEMBERS OF NEW VISION MEDICAL LABORATORIES, INC.
Decisions requiring approval by members or stockholdersForm 990, Part VI, Section A, Line 7bUNANIMOUS CONSENT OF ALL MEMBERS IS REQUIRED FOR THE FOLLOWING: ACQUISTION OF ASSETS EXCEEDING $100,000 AND NOT INCLUDED IN AN APPROVED BUDGET, DISPOSITION OF ASSETS EXCEEDING $100,000 IN VALUE, ENTRANCE OF ANY TRANSACTION OUTSIDE THE ORDINARY COURSE OF BUSINESS, BORROWING OR LENDING MONEY EXCEEDING $100,000, MERGING OR CONSOLIDATING WITH OR INTO ANY OTHER ENTITY, ACQUISTION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF ANY OTHER PERSON OR ENTITY, ENTRANCE INTO ANY CONTRACT, LEASE, LICENSE OR AGREEMENT THAT INVOLVES EXPENDITURES OF $100,000 OR MORE, OR AMENDMENT OF ARTICLES OF INCORPORATION OR BYLAWS. ALSO MAKING ANY CHANGE IN GENERAL NATURE OF BUSINESS OR PURPOSE, ENTRANCE INTO A PARTNERSHIP OR JOINT VENTURE AGREEMENT, FILING OR SETTLING A LAWSUIT WHERE THE AMOUNT IN DISPUTE EXCEEDS $100,000, COMPROMISING OR RELEASING ANY DEBT EXCEPT IN THE ORDINARY COURSE OF BUSINESS, HIRING OR DISCHARGING THE ADMINISTRATIVE DIRECTOR, APPROVING THE CAPITAL AND OPERATING BUDGETS, MAKING ANY CHANGE IN THE ANCILLARY PRODUCTS OR SERVICES OFFERED, ESTABLISHING THE BASE LEVELS FOR AND MAKING CHANGES TO THE BASE LEVELS FOR THE QUALITY OF SERVICES PROVIDED, REQUIRING MEMBERS TO CONTRIBUTE ADDITIONAL CAPITAL, APPOINTING OR REMOVING THE MEDICAL DIRECTOR, OR DISSOLVING OR LIQUIDATING THE CORPORATION.
Review of form 990 by governing bodyForm 990, Part VI, Section B, Line 11bTHE FORM 990 IS PREPARED BY THE CHP TAX DEPARTMENT AND REVIEWED BY MANAGEMENT. UPON REVIEW, THE FORM 990 IS THEN FORWARDED TO THE AUDIT & CORPORATE RESPONSIBILITY COMMITTEE FOR APPROVAL. ADDITIONALLY, THE COMPENSATION COMMITTEE REVIEWS ALL COMPENSATION RELATED DISCLOSURES. BOTH THE AUDIT & CORPORATE RESPONSIBILITY COMMITTEE AND THE COMPENSATION COMMITTEE ARE INDEPENDENT OF THE FILING ORGANIZATION. AFTER THE FORM 990 IS REVIEWED AND APPROVED BY ALL APPLICABLE PARTIES A COPY OF THE FINAL VERSION IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING.
Conflict of interest policyForm 990, Part VI, Section B, Line 12cALL BOARD MEMBERS ARE COVERED BY THE CATHOLIC HEALTH PARTNERS (CHP) CONFLICT OF INTEREST POLICY, WHICH REQUIRES DISCLOSURE ON AN ANNUAL BASIS. ALL POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY A CHP CORPORATE COMPLIANCE OFFICER. AT THE BEGINNING OF EACH BOARD MEETING ALL BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST. BOARD MEMBERS WHO ARE DETERMINED TO HAVE A CONFLICT OF INTEREST ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND DECISION-MAKING FOR THE TRANSACTION IN WHICH THE CONFLICT EXISTS.
PROCESS TO DETERMINE COMPENSATION OF TOP MANAGEMENT OFFICIALFORM 990, PART VI, LINE 15ATHE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL IS DETERMINED BY ST. RITA'S MEDICAL CENTER, A RELATED TAX-EXEMPT ORGANIZATION.
PROCESS TO DETERMINE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEESFORM 990, PART VI, LINE 15BTHE COMPENSATION OF ALL OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED BY ST. RITA'S MEDICAL CENTER AND VAN WERT COUNTY HOSPITAL.
Governing documents, conflict of interest policy and financial statements available to the publicForm 990, Part VI, Section C, Line 19THE SYSTEM-WIDE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE POSTED ON THE CATHOLIC HEALTH PARTNERS WEBSITE.

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 EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipLegal Domicile StateLegalDomicileState
CHP INSURANCE LTD
615 ELSINORE PLACECINCINNATIOH45202980621978INSURANCECJNAC CORPORATION000
SISTERS OF MERCY WORKERS COMPENSATION SELF-INSURANCE TRUST
615 ELSINORE PLACECINCINNATIOH45202310990309WORKERS COMPENSATION TRUSTNATRUST000MA
MHSWO HEALTH VENTURES INC
1 S LIMESTONE STSPRINGFIELDOH45502311072139PHYSICIAN PRACTICESNAC CORPORATION000OH
NORTHPARKE MEDICAL COMMONS CONDO ASSN
333 N LIMESTONE STSPRINGFIELDOH45503311391230REAL PROPERTY MGMNTNAC CORPORATION000OH
MERCY HEALTH AFFILIATES INC
2200 JEFFERSON AVENUETOLEDOOH43604341372633PHYSICIAN SERVICESNAC CORPORATION000OH
PHYSICIAN'S HEALTH COLLABORATIVE
2200 JEFFERSON AVENUETOLEDOOH43604203986844MEDICAL & HOSPITAL SERVICESNAC CORPORATION000OH
NORTHSIDE CORPORATION
2200 JEFFERSON AVENUETOLEDOOH43604341318438RESIDENT RENTALSNAC CORPORATION000OH
MERCY WORK SOLUTIONS
2200 JEFFERSON AVENUETOLEDOOH43604300066340WORKERS COMPENSATIONNAC CORPORATION000OH
MERCY HEALTH SYSTEM PHO
2200 JEFFERSON AVENUETOLEDOOH43604341778321MEDICAL SERVICESNAC CORPORATION000OH
PHYSICIAN MANAGED CARE INC
2200 JEFFERSON AVENUETOLEDOOH43604341565320HEALTH SERVICESNAC CORPORATION000OH
MCAULEY MANAGEMENT SERVICES INC
730 W MARKET STREETLIMAOH45801341379037PROPERTY RENTALNAC CORPORATION000OH
LIMA MEDICAL SUPPLIES INC
730 W MARKET STREETLIMAOH45801340944477MEDICAL EQUIPMENTNAC CORPORATION000OH
COMMUNITY HEALTH PARTNERS ENTERPRISES INC
3700 KOLBE ROADLORAINOH44053341455525HOLDING COMPANYNAC CORPORATION000OH
COMMUNITY HEALTH PARTNERS PHYSICIANS INC
3700 KOLBE ROADLORAINOH44053341803352PHYSICIAN PRACTICESNAC CORPORATION000OH
AMC PHYSICIANS INC
200 W LORAIN STREETOBERLINOH44074371439554PHYSICIAN SERVICESNAC CORPORATION000OH
MERCY HEALTH VENTURES INC
4600 MCAULEY PLACECINCINNATIOH45242311185477DIVERSIFIED ACTIVITIESNAC CORPORATION000OH
MERCY FRANCISCAN MEDICAL MANAGEMENT SERVICES
4600 MCAULEY PLACECINCINNATIOH45242311640789DIVERSIFIED ACTIVITIESNAC CORPORATION000OH
MERCY FRANCISCAN AT WINTON WOODS I INC
10290 MILL ROADCINCINNATIOH45231311658668LOW-INCOME HOUSINGNAC CORPORATION000OH
MERCY HEALTH MANAGEMENT INC
1530 LONE OAK ROADPADUCAHKY42003611086762MEDICAL OFFICESNAC CORPORATION000KY
HEALTH DYNAMICS INC
900 E OAK HILL AVENUEKNOXVILLETN37917621247729MEDICAL EQUIPMENT SALESNAC CORPORATION000TN
HEALTH VENTURES INC & SUBSIDIARIES
P O BOX 1788KNOXVILLETN37901621175587MEDICAL SERVICESNAC CORPORATION000TN
ANNE KILCAWLEY CHRISTMAN FOUNDATION
100 FEDERAL PLAZA EASTYOUNGSTOWNOH44503356735706BENEFICIAL TRUSTNATRUST000OH
RALPH EWE TRUST
270 PARK AVENUENEW YORKNY10017346866422BENEFICIAL TRUSTNATRUST000NY
ELIZABETH HINES CATES TRUST
PNC 1900 E 9TH STCLEVELANDOH44114346515678BENEFICIAL TRUSTNATRUST000OH
WILLIS PARK TRUST
PNC 1900 E 9TH STCLEVELANDOH44114346519904BENEFICIAL TRUSTNATRUST000OH
ERMA GIBSON BALDWIN TRUST
PNC 1900 E 9TH STCLEVELANDOH44114346515566BENEFICIAL TRUSTNATRUST000OH
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 OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg