MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL (EIN 87-0790288)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-05-13
IRS object ID: 201331339349300213
Schema version: 2011v1.5
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule C
Schedule H
Schedule J
Schedule L
Schedule N
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-13T08:44:03-05:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	870790288	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MOUN	NameControl
Phone	6145464000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	7333 SMITHS MILL ROAD	AddressLine1
City	NEW ALBANY	City
State	OH	State
ZIP Code	430549291	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	KEITH COLEMAN	Name
Title	SVP & CFO	Title
Phone	6145464000	Phone
Date Signed	2013-05-13	DateSigned

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Terminated Return	X	TerminatedReturn
Name Of Principal Officer Person	CLAUS VON ZYCHLIN	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	6150 EAST BROAD ST	AddressLine1
City	COLUMBUS	City
State	OH	State
ZIP Code	43213	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	121209605	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.MOUNTCARMELHEALTH.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	2006	YearFormation
State Legal Domicile	OH	StateLegalDomicile
Activity Or Mission Description	SPECIALTY HOSPITAL PROVIDING ORTHOPEDIC, NEUROLOGIC AND MUSCULOSKELETAL CARE	ActivityOrMissionDescription
Nbr Voting Members Governing Body	5	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	2	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Nbr Volunteers	19	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	0	ContributionsGrantsPriorYear
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	112498234	ProgramServiceRevenuePriorYear
Program Service Revenue CY	120512338	ProgramServiceRevenueCY
Investment Income Prior Year	-10487	InvestmentIncomePriorYear
Investment Income Current Year	-243097	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1088551	OtherRevenuePriorYear
Other Revenue Current Year	668792	OtherRevenueCurrentYear
Total Revenue Prior Year	113576298	TotalRevenuePriorYear
Total Revenue Current Year	120938033	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	14387794	SalariesEtcPriorYear
Salaries Etc Current Year	15044205	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	69552450	OtherExpensePriorYear
Other Expenses Current Year	73392263	OtherExpensesCurrentYear
Total Expenses Prior Year	83940244	TotalExpensesPriorYear
Total Expenses Current Year	88436468	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	29636054	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	32501565	RevenuesLessExpensesCY
Total Assets BOY	109371775	TotalAssetsBOY
Total Assets EOY	0	TotalAssetsEOY
Total Liabilities BOY	6691137	TotalLiabilitiesBOY
Total Liabilities EOY	0	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	102680638	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	0	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	SPECIALTY HOSPITAL PROVIDING INPATIENT AND OUTPATIENT ORTHOPEDIC, NEUROLOGIC AND MUSCULOSKELETAL CARE - SEE SCHEDULE H FOR MORE INFORMATION.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	82697329	Expense
Revenue	120739879	Revenue
Description	MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL IS THE NEWEST ADDITION TO THE MOUNT CARMEL HEALTH SYSTEM SINCE ITS PURCHASE ON JANUARY 1, 2007. MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL IS A PLACE WHERE YEARS OF PHYSICIAN EXPERIENCE MEET PERSONAL ATTENTION - WHERE WORLD-CLASS CARE MEETS WORLD-CLASS CARING. AS A SPECIALTY HOSPITAL FOCUSED SOLELY ON INPATIENT AND OUTPATIENT ORTHOPEDIC, NEUROLOGIC AND MUSCULOSKELETAL CARE, IT IS A FACILITY BUILT DIFFERENTLY FROM THE GROUND UP; A PLACE WHERE TECHNOLOGY AND TOUCH PLAY AN EQUAL ROLE IN THE HEALING PROCESS. MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL FEATURES TECHNOLOGICALLY ADVANCED TREATMENTS COMBINED WITH A PURPOSEFUL CARING PHILOSOPHY FOR EACH PATIENT.THE TWO-STORY FACILITY INCLUDES 96,000 SQUARE FEET, FORTY-TWO PATIENT ROOMS AND EIGHT OPERATING ROOMS. APPROXIMATELY EIGHTY PERCENT OF THE PROCEDURES PERFORMED AT MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL ARE DONE ON AN OUTPATIENT BASIS. THE REMAINING TWENTY PERCENT ARE INPATIENT AND ARE PRIMARILY TOTAL JOINT REPLACEMENT AND SPINE PROCEDURES.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Description	MISSIONTHE MISSION STATEMENT FOR THE HOSPITAL IS AS FOLLOWS: WE SERVE TOGETHER IN TRINITY HEALTH IN THE SPIRIT OF THE GOSPEL TO HEAL BODY, MIND AND SPIRIT TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND TO STEWARD THE RESOURCES ENTRUSTED TO US.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	82697329	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	0	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	0	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	1	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	1	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	0	NumberOfEmployees
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	5	NbrVotingGoverningBodyMembers
Number Independent Voting Members	2	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	1	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	CAROLYN WHITE	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	6145464130	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	6150 EAST BROAD STREET	AddressLine1
City	COLUMBUS	City
State	OH	State
ZIP Code	43213	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
CLAUS VON ZYCHLIN
PRES, CEO & VICE CHAIR	8.00	X	X	0	742791	100792
CARL BERASI DO
CHAIR	2.00	X	X	0	0	0
SR BARBARA HAHL CSC
SEC/TREAS	5.00	X	X	0	0	7960
MICHAEL CANNONE DO
TRUSTEE AS OF 1/12	2.00	X		0	800	0
ANANTHA PADMANABHAN MD
TRUSTEE	2.00	X		0	0	0
CHARLES KERR DO
TRUSTEE UNTIL 12/11	2.00	X		0	0	0
JACQUELINE PRIMEAU
SVP & CFO	8.00		X	0	435000	40553
RICHARD D'ENBEAU
PRESIDENT & COO	50.00		X	650000	0	0
RONALD WHITESIDE
EXEC VP & SYSTEM COO	7.00		X	0	1842081	56546
JOHN HEISLER
SVP HUMAN AFFAIRS	7.00			0	413570	36981	X
HUGH JONES
SVP STRATEGY & SYSTEM DEV.	7.00			0	284314	35570	X
JOSEPH SWEDISH
TRINITY HEALTH PRES & CEO	2.00			0	5186660	576202	X
KEDRICK ADKINS
TRINITY PRES INTEGRATED SVCS	2.00			0	1405226	117120	X
J RICHARD O'CONNELL
TRINITY EVP, COO-HOSP NTWKS	2.00			0	943237	118221	X
MICHAEL MURPHY
TRINITY EVP, HEALTH NTWKS UNTIL 4/12	2.00			0	474370	75538	X
ANGELA M GILMORE
DIRECTOR FINANCIAL OPS	50.00			0	127584	28511		X
ELIZABETH PEGAN
RN, ADMIN. SUPERVISOR	50.00			0	123285	27016		X
DONNA M HUTCHINSON
CT/MRI TECH	50.00			0	121785	31633		X
JUDY EDWARDS
STAFF RN-CERT	50.00			0	109874	10654		X
CHRISTINA ROSS
STAFF RN-CERT	50.00			0	100932	22508		X
MICHAEL SLUBOWSKI
FORMER KEY EMPLOYEE	0.00			0	150838	1101			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	650000	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	12462347	TotalReportableCompFrmRltdOrgs
Total Other Compensation	1286906	TotalOtherCompensation
Number Individuals GT100 K	1	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	1	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
MESSER CONSTRUCTION
5158 FISHWICK DRIVE	CINCINNATI	OH	45216	CONSTRUCTION SVCS	3684053
NEW ALBANY HOSPITAL MANAGEMENT COMPANY I
11 SECOND STREET	NEW ALBANY	OH	43054	MANAGEMENT SERVICES	2223168
HHA SERVICES
22622 HARPER AVENUE	ST CLAIR SHORES	MI	48080	MANAGEMENT SERVICES	1689340
LABORATORY CORPORATION OF AMERICA
5200 UPPER METRO PLACE STE 350	DUBLIN	OH	43017	LABORATORY SERVICES	1156282
HEARTLAND REHABILITATION SERVICES INC
3425 EXECUTIVE PARKWAY	TOLEDO	OH	43606	REHABILITATION SERVICES	705247

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	12	NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	NET PATIENT SVC REV	Description
Business Code	621110	BusinessCode
Total Revenue Column	120512338	TotalRevenueColumn
Related Or Exempt Function Income	120512338	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	120512338	TotalProgramServiceRevenue

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	2720	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	0	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	2720	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	2720	TotalRevenueColumn
Exclusion	$2,720	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	28475	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	271572	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	-243097	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-243097	TotalRevenueColumn
Exclusion	-$243,097	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA	900099	438531	$438,531
OTHER REVENUE	900099	227541		227541

Field	Value	IRS element (for citing)
Total Other Revenue	666072	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	120938033	TotalRevenueColumn
Related Or Exempt Function Income	120739879	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$198,154	ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	12277104	Total
Program Services	11239762	ProgramServices
Management And General	1037342	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	713856	Total
Program Services	646657	ProgramServices
Management And General	67199	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1111314	Total
Program Services	1006701	ProgramServices
Management And General	104613	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	941931	Total
Program Services	853263	ProgramServices
Management And General	88668	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	2448310	Total
Program Services	225143	ProgramServices
Management And General	2223167	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	2070839	Total
Program Services	1369610	ProgramServices
Management And General	701229	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	4243	Total
Program Services	3000	ProgramServices
Management And General	1243	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	819916	Total
Program Services	546027	ProgramServices
Management And General	273889	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	26443	Total
Program Services	26443	ProgramServices

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3100742	Total
Program Services	2957870	ProgramServices
Management And General	142872	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	20359	Total
Program Services	6471	ProgramServices
Management And General	13888	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	60625	Total
Program Services	39598	ProgramServices
Management And General	21027	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	1589503	Total
Program Services	1589503	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	6690543	Total
Program Services	6416882	ProgramServices
Management And General	273661	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	115315	Total
Program Services	115315	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	40610218	40111029	499189
CORPORATE ALLOCATION	9323213	9323213
CONTRACT LABOR	3227396	3191880	35516
EQUIPMENT MAINTENANCE	1014753	804546	210207

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	2269845	Total
Program Services	2224416	ProgramServices
Management And General	45429	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	88436468	Total
Program Services	82697329	ProgramServices
Management And General	5739139	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	700	BOY
EOY	0	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
EOY	0	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	12595984	BOY
EOY	0	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	724889	BOY
EOY	0	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	658181	BOY
EOY	0	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	0	LandBuildingsEquipmentBasis

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	56395344	BOY
EOY	0	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	38480389	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	516288	BOY
EOY	0	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	109371775	BOY
EOY	0	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	6592857	BOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	98280	BOY
EOY	0	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	6691137	BOY
EOY	0	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	102680638	BOY
EOY	0	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	102680638	BOY
EOY	0	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	109371775	BOY
EOY	0	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	32501565	ReconcilationRevenueExpenses
Reconcilation Other Changes	-135182203	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	1	GrantsOtherOrganizations
Grants Other Organizations	$3,373	GrantsOtherOrganizationsAmount
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	0	OtherActivities
Total Lobbying Expenditures IIB	3373	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL (MCNASH) HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO STATE AND NATIONAL ORGANIZATIONS, WHERE THE ORGANIZATION HAS PROVIDED MCNASH WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. MCNASH MADE NO CONTRIBUTIONS TO ANY LEGISLATORS OR CANDIDATES.	Explanation

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	0	ExpensesExceededBudget
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	32	PersonsServed
Total Community Benefit Expense	893761	TotalCommunityBenefitExpense
Net Community Benefit Expense	893761	NetCommunityBenefitExpense
Percent Of Total Expense	0.01020	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	380	PersonsServed
Total Community Benefit Expense	2779685	TotalCommunityBenefitExpense
Direct Offsetting Revenue	857492	DirectOffsettingRevenue
Net Community Benefit Expense	1922193	NetCommunityBenefitExpense
Percent Of Total Expense	0.02190	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	412	PersonsServed
Total Community Benefit Expense	3673446	TotalCommunityBenefitExpense
Direct Offsetting Revenue	857492	DirectOffsettingRevenue
Net Community Benefit Expense	2815954	NetCommunityBenefitExpense
Percent Of Total Expense	0.03210	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	412	PersonsServed
Total Community Benefit Expense	3673446	TotalCommunityBenefitExpense
Direct Offsetting Revenue	857492	DirectOffsettingRevenue
Net Community Benefit Expense	2815954	NetCommunityBenefitExpense
Percent Of Total Expense	0.03210	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	75	PersonsServed
Total Community Building Expense	546	TotalCommunityBuildingExpense
Net Community Building Expense	546	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	75	PersonsServed
Total Community Building Expense	546	TotalCommunityBuildingExpense
Net Community Building Expense	546	NetCommunityBuildingExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$255,182	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	19606617	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	22088691	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-2482074	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MOUNT CARMEL NEW ALBANY SURGICAL HOSP	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	7333 SMITHS MILL ROAD	AddressLine1
City	NEW ALBANY	City
State	OH	State
ZIP Code	43054	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Research Facility	X	ResearchFacility

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MOUNT CARMEL NEW ALBANY SURGICAL HOSP	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	400.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Attached To Invoices	X	AttachedToInvoices
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	1	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanation	IdentifierIdentifier
PART I, LINE 6A: MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH IN ITS ANNUAL REPORT, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.IN ADDITION, MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON TRINITY HEALTH'S WEBSITE AS WELL AS MOUNT CARMEL HEALTH SYSTEM'S WEBSITE (WWW.MOUNTCARMELHEALTH.COM).
PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM.
PART I, L7 COL(F): THE FOLLOWING NUMBER, $726,044, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F).
PART II: COMMUNITY BUILDING ACTIVITIES - MOUNT CARMEL HEALTH SYSTEM, WHICH INCLUDES MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL, CONTRIBUTED TO THE ECONOMIC AND CIVIC HEALTH OF THE SURROUNDING COMMUNITY BY SERVING IN AND CONTRIBUTING TO THE EFFORTS OF SEVERAL CHAMBERS OF COMMERCE AND OTHER CIVIC ORGANIZATIONS, BOTH IN THE CITY OF COLUMBUS AND IN SURROUNDING SUBURBS. MOUNT CARMEL NEW ALBANY (MCNA) LEADERS HAVE IDENTIFIED COMMUNITY NEEDS THROUGH THEIR SERVICE ON VARIOUS COMMUNITY BOARDS AND ADVISORY GROUPS. THEY HAVE ALSO LENT THEIR EXPERTISE TO THESE GROUPS AND HAVE BEEN ABLE TO ADVOCATE ON ISSUES SURROUNDING HEALTH IN THE NEW ALBANY AREA. SYSTEM-WIDE SENIOR LEADERSHIP MEMBERS SERVE ON A NUMBER OF BOARDS FOR COMMUNITY AGENCIES SUCH AS THE WESTSIDE HEALTH ADVISORY BOARD, FRANKLINTON AREA COMMISSION, HILLTOP BUSINESS ASSOCIATION, THE NEW ALBANY CHAMBER OF COMMERCE, AND THE LIFELINE OF OHIO (LOOP) BOARD, THE AMERICAN HEART ASSOCIATION, YMCA, UNITED WAY, COLUMBUS PARTNERSHIP, HEART OF OHIO FEDERAL QUALIFIED HEALTH CENTER, ACCESS HEALTH COLUMBUS, CATHOLIC SOCIAL SERVICES, FRANKLINTON DEVELOPMENT ASSOCIATION, AFFORDABLE HOUSING TRUST, LIFELINE OF OHIO, CENTRAL OHIO TRAUMA SYSTEM ACCESS, SIMON KENTON COUNCIL OF THE BOY SCOUTS OF AMERICA BOARD, WALK WITH A DOC, WESTERVILLE AREA CHAMBER OF COMMERCE, OHIO STATE UNIVERSITY HONORS COLLEGE ADVISORY COUNCIL AND EYE CENTER OF COLUMBUS.
PART III, LINE 4: MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM THOSE STATEMENTS: "SUBSTANTIALLY ALL OF THE CORPORATION'S RECEIVABLES ARE RELATED TO PROVIDING HEALTHCARE SERVICES TO PATIENTS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE. THE CORPORATION'S ESTIMATE FOR ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS BY PAYOR."COSTING METHODOLOGY FOR LINES 2 AND 3: AMOUNTS ARE CALCULATED ON LINE 2 USING A COST TO CHARGE RATIO METHODOLOGY. ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.THE ORGANIZATION IDENTIFIES MANY CHARITY PATIENTS AT THE TIME OF SERVICE AND INCLUDES A CHARITY APPLICATION WITH EVERY STATEMENT PER OHIO LAW.
PART III, LINE 8: MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CHA RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT.
PART III, LINE 9B: THE ORGANIZATION'S COLLECTION POLICY CONTAINS THE CRITERIA FOR FINANCIAL ASSISTANCE, AND CONTAINS THE FOLLOWING VERBIAGE FOR ARRANGEMENTS WITH OUTSIDE COLLECTION AGENCIES: THE AGREEMENT MUST DEFINE THE STANDARDS AND SCOPE OF PRACTICES TO BE USED BY OUTSIDE COLLECTION AGENTS ACTING ON BEHALF OF THE MINISTRY ORGANIZATION, ALL OF WHICH MUST BE IN COMPLIANCE WITH THIS POLICY.
PART V, SECTION B, LINE 19D: FOR PATIENTS WITH INCOMES UP TO 200% OF FPL, NOTHING WAS CHARGED. PATIENTS WITH INCOMES AT 201% TO 400% OF FPL RECEIVED A STANDARD DISCOUNT (HIGHER THAN THAT WHICH WOULD BE OFFERED TO A NON FAP ELIGIBLE PATIENT). THESE ARE NOT CORRELATED TO ANY CONTRACTUAL DISCOUNT.	MOUNT CARMEL NEW ALBANY SURGICAL HOSP.
PART V, SECTION B, LINE 20: MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL'S SLIDING SCALE INCLUDES PATIENTS WITH INCOMES UP TO 400% OF THE FPL. THE DISCOUNT AT THIS LEVEL IS 25%.	MOUNT CARMEL NEW ALBANY SURGICAL HOSP.
PART VI, LINE 2: NEEDS ASSESSMENT-MOUNT CARMEL HEALTH SYSTEM, WHICH INCLUDES MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL, IS COMMITTED TO HELPING ASSESS AND ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH ITS OWN PROGRAMS AND SERVICES AND IN PARTNERSHIP WITH OTHERS.MOUNT CARMEL HEALTH SYSTEM ASSESSES THE HEALTH NEEDS OF THE COMMUNITY THROUGH COMMUNITY HEALTH NEEDS ASSESSMENTS EVERY THREE (3) YEARS. A COMMUNITY HEALTH NEEDS ASSESSMENT IS A POINT-IN-TIME EFFORT TO MEASURE THE HEALTH AND WELL BEING OF THE COMMUNITY. IT SERVES AS THE BASIS FOR MOUNT CARMEL'S STRATEGIC AND SUBSEQUENT ACTION PLANNING TO DEVELOP HEALTH POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS AND COLLABORATE WITH OTHER COMMUNITY HEALTH CARE PROVIDERS. A COMMUNITY HEALTH NEEDS ASSESSMENT ALSO SERVES AS A BENCHMARK FOR FUTURE ASSESSMENT OF RELATIVE PROGRESS TOWARD ESTABLISHED COMMUNITY HEALTH OBJECTIVES.MOUNT CARMEL'S COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES THE OPPORTUNITY TO:- GAIN INSIGHTS INTO THE NEEDS AND ASSETS OF THE COMMUNITIES SERVED - IDENTIFY AND ADDRESS THE NEEDS OF VULNERABLE POPULATIONS WITHIN THE COMMUNITY- ENHANCE HOSPITAL/COMMUNITY RELATIONSHIPS AND THE OPPORTUNITY FOR COLLABORATIVE COMMUNITY ACTION,INCLUDING INVOLVEMENT WITH COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES, COMMISSIONS, ADVISORY GROUPS AND PANELS- PROVIDE THE INFORMATION REQUIRED FOR COMMUNITY OUTREACH PLANNINGMOUNT CARMEL'S COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS INVOLVES THE GATHERING OF TWO TYPES OF DATA: QUANTITATIVE (DEMOGRAPHICS, HEALTH INDICATORS, ETC.) AND QUALITATIVE (PUBLIC SURVEYS, FORUMS, FOCUS GROUPS). WHILE MOUNT CARMEL CONDUCTS SOME OF ITS OWN ORIGINAL RESEARCH IN COMPLETING THE COMMUNITY NEEDS ASSESSMENT, IT ALSO RELIES UPON THE AVAILABILITY OF DATA COLLECTED BY OTHERS WHENEVER POSSIBLE TO AVOID UNNECESSARY DUPLICATION. THE DATA HELP SUPPORT SHORT-TERM AND LONG-TERM DECISIONS ABOUT ALLOCATION OF COMMUNITY HUMAN AND CAPITAL RESOURCES. THE ASSESSMENT WAS COMPLETED IN COLLABORATION WITH OTHER HOSPITAL SYSTEMS, PUBLIC HEALTH DEPARTMENTS, OTHER COMMUNITY ORGANIZATIONS AND COMMUNITY ADVISORY BOARDS. DURING THIS PROCESS BOTH QUANTITATIVE AND QUALITATIVE DATA WERE GATHERED REFLECTING PROMINENT AREAS IF CONCERN RELATED TO COMMUNITY HEALTH. THE FULL COMMUNITY HEALTH NEEDS ASSESSMENT DOCUMENT AND 3 YEAR IMPLEMENTATION STRATEGY WILL BE AVAILABLE FOR PUBLIC VIEW ON MOUNT CARMEL'S WEBSITE IN JUNE 2013. BESIDES ITS BOARD OF TRUSTEES, MOUNT CARMEL SHARES THE FINDINGS OF ITS COMMUNITY NEEDS ASSESSMENTS WITH OTHER NON-PROFIT ORGANIZATIONS AND GOVERNMENT OFFICIALS/ENTITIES AND SEEKS TO FORM COLLABORATIVE PARTNERSHIPS TO AVOID UNNECESSARY DUPLICATION OF EFFORTS IN ADDRESSING IDENTIFIED COMMUNITY HEALTH NEEDS.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MOUNT CARMEL HEALTH SYSTEM, INCLUDING MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL, IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES.- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE- BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEEDCARE IN A COMMUNITY.IN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION (AHA) RECOMMENDATIONS, MOUNT CARMEL HEALTH SYSTEM HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS:- PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONS.MOUNT CARMEL HEALTH SYSTEM IS COMMITTED TO EFFECTIVELY COMMUNICATING WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ABOUT MOUNT CARMEL'S PATIENT FINANCIAL ASSISTANCE PROGRAM AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES IS MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. THIS INFORMATION IS COMMUNICATED THROUGH PATIENT FINANCIAL SERVICES ASSOCIATES IN PATIENT REGISTRATION, CUSTOMER SERVICE, AND BILLING AND COLLECTIONS - ALL OF WHOM RECEIVE TRAINING REGARDING FEDERAL, STATE AND LOCAL PUBLIC FINANCIAL ASSISTANCE PROGRAMS AND MOUNT CARMEL'S PATIENT FINANCIAL ASSISTANCE PROGRAM. IN ADDITION, THE EXTERNAL COLLECTION AGENCIES AND EXTERNAL MEDICAID ELIGIBILITY VERIFICATION VENDOR WITH WHOM MOUNT CARMEL WORKS ALSO RECEIVE TRAINING REGARDING THESE PROGRAMS. ALL MOUNT CARMEL PATIENT FINANCIAL STATEMENTS INCLUDE A FINANCIAL ASSISTANCE APPLICATION AND PHONE NUMBER FOR PATIENTS TO CALL WITH QUESTIONS.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND WHICH MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTHCARE SERVICES. MOUNT CARMEL HEALTH SYSTEM UTILIZES BOTH INTERNAL RESOURCES AND AN EXTERNAL VENDOR TO ASSIST PATIENTS IN APPLYING FOR MEDICAID. INPATIENTS, EMERGENCY DEPARTMENT PATIENTS, CLINIC PATIENTS, AND PATIENTS RECEIVING HIGH-COST OUTPATIENT SERVICES ARE SCREENED TO DETERMINE WHETHER THEY QUALIFY FOR FEDERAL, STATE OR LOCAL PUBLIC FINANCIAL ASSISTANCE PROGRAMS OR MOUNT CARMEL'S PATIENT FINANCIAL ASSISTANCE PROGRAM. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE.MOUNT CARMEL HEALTH SYSTEM OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED FINANCIAL MEANS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS LIKE MEDICAID OR OTHER PUBLIC ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS COMMUNICATED VIA SIGNS THAT ARE PROMINENTLY DISPLAYED IN ALL PATIENT REGISTRATION AREAS. BROCHURES PLACED IN PATIENT REGISTRATION AREAS EDUCATE PATIENTS IN GREATER DETAIL ABOUT THE AVAILABILITY OF FEDERAL, STATE AND LOCAL ASSISTANCE PROGRAMS AS WELL AS MOUNT CARMEL'S PATIENT FINANCIAL ASSISTANCE PROGRAM.SUMMARIES OF FEDERAL, STATE AND LOCAL PUBLIC FINANCIAL ASSISTANCE PROGRAMS AND MOUNT CARMEL'S OWN PATIENT FINANCIAL ASSISTANCE PROGRAM ALSO ARE MADE AVAILABLE THROUGH MOUNT CARMEL SERVICES THAT DIRECTLY INTERACT WITH THE COMMUNITY, INCLUDING MOUNT CARMEL COMMUNITY OUTREACH AND MOUNT CARMEL HEALTH STATIONS CLINICS; OTHER ORGANIZATIONS THAT SERVE THE UNINSURED AND UNDERINSURED SUCH AS ACCESS HEALTH COLUMBUS; SOCIAL SERVICES AGENCIES LIKE CATHOLIC SOCIAL SERVICES, HOMELESS SHELTERS, FEDERALLY QUALIFIED HEALTH CENTERS LIKE HEART OF OHIO FAMILY HEALTH CENTERS, AND LOWER LIGHTS CHRISTIAN HEALTH CENTER. INFORMATION REGARDING PATIENT FINANCIAL ASSISTANCE PROGRAMS ALSO IS AVAILABLE ON MOUNT CARMEL'S WEBSITE.IN ADDITION TO ENGLISH, PATIENT FINANCIAL ASSISTANCE INFORMATION IS ALSO AVAILABLE IN SPANISH AND SOMALI FOR THOSE WITH LIMITED ENGLISH PROFICIENCY, REFLECTING OTHER PREDOMINANT LANGUAGES SPOKEN IN THE COMMUNITIES SERVED BY MOUNT CARMEL. MOUNT CARMEL ALSO HAS INTERPRETING SERVICES AVAILABLE FOR LIMITED ENGLISH PROFICIENCY PATIENTS WHO SPEAK OTHER LANGUAGES.MOUNT CARMEL HEALTH SYSTEM HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MOUNT CARMEL HEALTH SYSTEM MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. MOUNT CARMEL HEALTH SYSTEM EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION, CUSTOMER SERVICE, BILLING AND COLLECTIONS) ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES.
PART VI, LINE 4: COMMUNITY INFORMATION - MOUNT CARMEL HEALTH SYSTEM, WHICH INCLUDES NEW ALBANY, PREDOMINATELY SERVES CENTRAL OHIO, WHICH INCLUDES FRANKLIN AND FIVE CONTIGUOUS COUNTIES (DELAWARE, FAIRFIELD, LICKING, MADISON AND PICKAWAY). THIS REGION IS HOME TO NEARLY 1.7 MILLION RESIDENTS. AMONG CENTRAL OHIO HOUSEHOLDS, 20% HAVE A HOUSEHOLD INCOME OF LESS THAN $25,000, AND ANOTHER 26% HAVE A HOUSEHOLD INCOME OF BETWEEN $25,000 AND $50,000. ALTHOUGH NEW ALBANY HAS A MEDIAN HOUSEHOLD INCOME OF $144,581 AND COMMUNITY NEED INDEX OF 1.6 ON A SCALE OF 1 - 5, WITH ONE BEING AN AREA OF LEAST NEED AND 5 BEING AN AREA OF HIGH NEED, 1.5% OF NEW ALBANY RESIDENTS LIVE BELOW THE POVERTY LEVEL. OVER THE NEXT FIVE YEARS, CENTRAL OHIO'S POPULATION IS EXPECTED TO EXPERIENCE A HIGH GROWTH RATE (18%) IN ADULTS AGE 55 AND OLDER AND A SLIGHT DECLINE IN ADULTS BETWEEN THE AGES OF 18 AND 34. IN 2010, APPROXIMATELY 35% OF THE POPULATION OVER AGE 25 HELD A BACHELOR'S OR HIGHER DEGREE, NEARLY 5.6% HIGHER THAN THE NATIONAL AVERAGE. ACCORDING TO THE 2008-2009 OHIO FAMILY HEALTH SURVEY, 138,625 ADULTS IN FRANKLIN COUNTY BETWEEN THE AGES OF 18-64, OR ABOUT 19% OF THAT POPULATION, DO NOT HAVE HEALTH INSURANCE. THIS NUMBER IS SLIGHTLY HIGHER THAN THE STATEWIDE PERCENTAGE OF 17% UNINSURED ADULTS IN THAT AGE GROUP. CENTRAL OHIO FEATURES A DIVERSE EMPLOYER BASE, INCLUDING MANUFACTURING, TRADE, EDUCATION, SERVICE, FINANCE AND AGRICULTURE. THE OHIO UNEMPLOYMENT RATE DECLINED TO 6.9% IN OCTOBER 2012.
PART VI, LINE 5: OTHER INFORMATION - DURING FISCAL YEAR 2012, MOUNT CARMEL NEW ALBANY PROVIDED CARE FOR 17 PATIENTS NEEDING JOINT IMPLANTS. THROUGH MCNA'S OPERATION WALK, PATIENTS WERE PROVIDED WITH FREE CARE WHICH INCLUDED PRE AND POST OP CARE, SURGERY, HOSPITALIZATION, PHYSICAL THERAPY, MEDICATIONS AND ANY SUPPLIES NEEDED FOR THEIR CARE. MOUNT CARMEL NEW ALBANY REACHED BEYOND ITS ZIP CODE TO SUPPLY COLUMBUS AREA HOMELESS WITH SOCKS, FLASHLIGHTS AND FOOD. ONE HUNDRED PERCENT OF MOUNT CARMEL'S SURPLUS REVENUE IS INVESTED BACK INTO SUPPORTING THE ORGANIZATION'S HEALTH CARE MINISTRY. MOUNT CARMEL HEALTH SYSTEM IS GOVERNED BY A 15-MEMBER BOARD OF TRUSTEES, WITH A MAJORITY OF THE SEATS ALLOCATED TO COMMUNITY REPRESENTATIVES AND LEADERS. OUR GOVERNANCE STRUCTURE ENSURES THAT THE COMMUNITY AND ITS INTERESTS ARE STRONGLY REPRESENTED IN IMPORTANT DECISION-MAKING. MOUNT CARMEL HEALTH SYSTEM MAINTAINS AN OPEN MEDICAL STAFF - MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS. MOUNT CARMEL ACTIVELY RECRUITS, AND EMPLOYS DOCTORS TO SERVE IN UNDER-SERVED AREAS OF THE COMMUNITY. MOUNT CARMEL HEALTH SYSTEM ALSO HELPS TRAIN MEDICAL PROFESSIONALS BY OPERATING A GRADUATE MEDICAL EDUCATION PROGRAM THAT TRAINS PHYSICIANS IN FAMILY PRACTICE, INTERNAL MEDICINE, OBSTETRICS & GYNECOLOGY, GENERAL SURGERY, ORTHOPEDIC SURGERY AND TRANSITIONAL YEAR (FOR PHYSICIANS WHO WANT TO PURSUE SUB-SPECIALTY TRAINING.)SYSTEM-WIDE SENIOR LEADERSHIP MEMBERS SERVE ON A NUMBER OF BOARDS FOR COMMUNITY AGENCIES SUCH AS THE WESTSIDE HEALTH ADVISORY BOARD, FRANKLINTON AREA COMMISSION, HILLTOP BUSINESS ASSOCIATION, THE NEW ALBANY CHAMBER OF COMMERCE, AND THE LIFELINE OF OHIO (LOOP) BOARD.
PART VI, LINE 6: MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL IS A MEMBER ORGANIZATION OF TRINITY HEALTH, WHICH IS ONE OF THE LARGEST CATHOLIC HEALTH CARE SYSTEMS IN THE COUNTRY. BASED IN LIVONIA, MICHIGAN, TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEVELOP, AND ARE HELD ACCOUNTABLE FOR ACHIEVING, COMMUNITY BENEFIT GOALS THAT INCLUDE DEVELOPING NEEDED SERVICES OR EXPANDING ACCESS TO SERVICES FOR LOW-INCOME INDIVIDUALS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITY THROUGH PROGRAMS TO SERVE THE POOR AND UNINSURED, MANAGE CHRONIC CONDITIONS LIKE DIABETES, HEALTH EDUCATION AND PROMOTION INITIATIVES, AND OUTREACH FOR THE ELDERLY. IN FISCAL YEAR 2012, THIS INCLUDED OVER $615 MILLION IN SUCH COMMUNITY BENEFITS. THEREFORE, TRINITY HEALTH TAKES A SYSTEMS APPROACH IN ITS COMMUNITY BENEFIT PLANNING AND IMPLEMENTATION, AND IS CONSEQUENTLY ABLE TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ARE HELPING PROMOTE AND ADDRESS THE HEALTH NEEDS OF THEIR RESPECTIVE COMMUNITIES.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CLAUS VON ZYCHLIN
0	482336	0	173932	0	86523	0	72419	0	28373	0	843583	0	0
JACQUELINE PRIMEAU
0	366292	0	65158	0	3550	0	30625	0	9928	0	475553	0	0
RICHARD D'ENBEAU
650000	0	0	0	0	0	0	0	0	0	650000	0	0	0
RONALD WHITESIDE
0	378136	0	94027	0	1369918	0	36370	0	20176	0	1898627	0	555919
JOHN HEISLER
0	297988	0	61070	0	54512	0	20751	0	16230	0	450551	0	0
HUGH JONES
0	232540	0	51014	0	760	0	19514	0	16056	0	319884	0	0
JOSEPH SWEDISH
0	1279458	0	677642	0	3229560	0	548602	0	27600	0	5762862	0	2698342
KEDRICK ADKINS
0	743978	0	316652	0	344596	0	103857	0	13263	0	1522346	0	143708
J RICHARD O'CONNELL
0	571942	0	230946	0	140349	0	85919	0	32302	0	1061458	0	0
MICHAEL MURPHY
0	402598	0	0	0	71772	0	48365	0	27173	0	549908	0	0
ANGELA M GILMORE
0	118000	0	9499	0	85	0	9996	0	18515	0	156095	0	0
ELIZABETH PEGAN
0	120588	0	732	0	1965	0	18769	0	8247	0	150301	0	0
DONNA M HUTCHINSON
0	112177	0	7876	0	1732	0	17799	0	13834	0	153418	0	0
MICHAEL SLUBOWSKI
0	13394	0	0	0	137444	0	500	0	601	0	151939	0	136445

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART I, LINE 3	MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL'S SYSTEM CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL'S SYSTEM CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B	THE FOLLOWING ARE PARTICIPANTS IN THE TRINITY HEALTH PENSION RESTORATION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($245,000 FOR 2011).THE FOLLOWING ACCRUALS FOR 2011 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $91,607 MICHAEL MURPHY - $27,513 J. RICHARD O'CONNELL - $66,279 JOSEPH SWEDISH - $255,902 CLAUS VON ZYCHLIN - $52,433 PART I, LINE 4B: THE FOLLOWING IS A PARTICIPANT IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING SERP ACCRUAL FOR 2011 IS INCLUDED IN COLUMN C OF SCHEDULE J, PART II: JOSEPH SWEDISH - $265,000 PART II: THE FOLLOWING INDIVIDUALS BECAME VESTED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) DURING CALENDAR 2011. AS A RESULT, THE VESTED AMOUNTS WERE INCLUDED IN THEIR 2011 TAXABLE INCOMES. THE FOLLOWING VESTED SERP AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: JOSEPH SWEDISH - $2,740,000 KEDRICK ADKINS - $220,648 RONALD WHITESIDE - $1,364,200 COLUMN F OF SCHEDULE J INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS.
PART III	PART II: RICHARD D'ENBEAU - THE AMOUNT LISTED IN COLUMN B(III) OF SCHEDULE J, PART II REPRESENTS THE AMOUNT PAID BY MOUNT CARMEL HEALTH SYSTEM (MCHS) IN CALENDAR 2011 TO NEW ALBANY MANAGEMENT COMPANY II, LLC FOR MR. D'ENBEAU'S SERVICES, AS WELL AS FOR THE SERVICES OF THREE OTHER INDIVIDUALS. MCHS DOES NOT KNOW THE PORTION OF THE $650,000 THAT WAS FOR MR. D'ENBEAU'S SERVICES VS. THE OTHER THREE INDIVIDUALS. MCHS ALSO DOES NOT KNOW HOW MUCH MR. D'ENBEAU RECEIVED AS WAGES FROM THE MANAGEMENT COMPANY IN CALENDAR 2011. THE $650,000 IS INCLUDED IN THE TOTAL MANAGEMENT FEE REPORTED IN SCHEDULE L, PART IV.	SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
NEW ALBANY HOSPITAL MANAGEMENT COMPANY II LLC (NAHMC)
CARL BERASI, CHAIR, & MICHAEL CANNONE, TRUSTEE, ARE BOTH BD MBRS OF NAHMC	2223168	MANAGEMENT FEES PAID TO NAHMC	0
NEW ALBANY HOSPITAL MANAGEMENT COMPANY II LLC (NAHMC)
CARL BERASI, CHAIR, & MICHAEL CANNONE, TRUSTEE, ARE BOTH BD MBRS OF NAHMC	247098	REVENUE FROM NAHMC	0

Schedule N IRS990ScheduleN

Liquidation Table LiquidationTable

Liquidation Detail LiquidationDetail

Field	Value	IRS element (for citing)
Description Of Asset	MERGER INTO MOUNT CARMEL HEALTH SYSTEM	DescriptionOfAsset
Date Of Distribution	2012-07-01	DateOfDistribution
FMV Of Asset	106951481	FMVOfAsset
Method Of FMV Determination	BOOK VALUE	MethodOfFMVDetermination
EIN	311439334	EIN

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	MOUNT CARMEL HEALTH SYSTEM	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	6150 EAST BROAD STREET	AddressLine1
City	COLUMBUS	City
State	OH	State
ZIP Code	43213	ZIPCode

Field	Value	IRS element (for citing)
IRC Section	501(C)(3)	IRCSection

Field	Value	IRS element (for citing)
Director Of Successor	0	DirectorOfSuccessor
Employee Of Successor	0	EmployeeOfSuccessor
Owner Of Successor	0	OwnerOfSuccessor
Receive Compensation	0	ReceiveCompensation
Assets Distributed	1	AssetsDistributed
Required To Notify AG	1	RequiredToNotifyAG
AG Notified	1	AGNotified
Liabilities Paid	1	LiabilitiesPaid
Bonds Outstanding	0	BondsOutstanding
Bond Liabilities Discharged	0	BondLiabilitiesDischarged

Form990 Schedule N Part III Form990ScheduleNPartIII

Field	Value	IRS element (for citing)
Explanation	PART I, LINE 7C: MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL HAD NO TAX-EXEMPT BOND LIABILITIES TO DISCHARGE OR DEFEASE DURING THE TAX YEAR.	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2	CHARLES KERR, D.O., RICHARD D'ENBEAU, MICHAEL CANNONE, D.O. AND CARL BERASI, D.O. HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 3	MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL RECEIVES MANAGEMENT SERVICES FROM NEW ALBANY MANAGEMENT COMPANY II, LLC. UNDER THE MANAGEMENT SERVICES AGREEMENT, NEW ALBANY MANAGEMENT COMPANY MANAGES THE DAY-TO-DAY OPERATION, MANAGEMENT, AND SUPERVISION OF MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL. INCLUDED IN THE AGREEMENT IS THE PROVISION BY THE MANAGEMENT COMPANY OF A CHIEF OPERATING OFFICER, SENIOR VICE PRESIDENT OF CLINICAL SERVICES, SENIOR FINANCIAL ANALYST, AND CHIEF NURSING OFFICER FOR THE HOSPITAL. SEE SCHEDULE J, PART III AND SCHEDULE L FOR ADDITIONAL INFORMATION.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL IS MOUNT CARMEL HEALTH SYSTEM. SEE LINE 7 FOR ADDITIONAL INFORMATION.
FORM 990, PART VI, SECTION A, LINE 7A	MOUNT CARMEL HEALTH SYSTEM (MCHS) IS THE SOLE MEMBER OF MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL (MCNASH). MCHS HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF MCNASH.
FORM 990, PART VI, SECTION A, LINE 7B	AS SOLE MEMBER, MOUNT CARMEL HEALTH SYSTEM (MCHS) MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MCHS MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS.
FORM 990, PART VI, SECTION B, LINE 11	PRIOR TO FILING, THE FORM 990 FOR MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE FINANCE COMMITTEE AS WELL AS THE BOARD OF TRUSTEES. THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL HAS ADOPTED A CONFLICT OF INTEREST POLICY WHICH CONTAINS THE ELEMENTS IN THE MODEL CONFLICT OF INTEREST POLICY ISSUED BY THE IRS. IT APPLIES TO ALL "INTERESTED PERSONS" OF MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL, WHICH INCLUDES TRUSTEES, PRINCIPAL OFFICERS AND EXECUTIVES, AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. INTERESTED PERSONS ARE REQUIRED TO ACT AT ALL TIMES IN A MANNER CONSISTENT WITH MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE BOARD OF TRUSTEES OF MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE REVIEWED WITH THE BOARD OF TRUSTEES OF MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL ON AN ANNUAL BASIS.
FORM 990, PART VI, SECTION B, LINE 15	TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS.
FORM 990, PART VI, SECTION C, LINE 19	MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE ANNUAL REPORT (WHICH INCLUDES COMMUNITY BENEFIT MINISTRY INFORMATION) AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON TRINITY HEALTH'S WEBSITE AS WELL AS MOUNT CARMEL HEALTH SYSTEM'S WEBSITE (WWW.MOUNTCARMELHEALTH.COM).
FORM 990, PART VII, SECTION A, LINE 1 , COLUMN B:	THE HOURS LISTED IN COLUMN B OF PART VII, SECTION A, LINE 1 REFLECT ONLY THE INDIVIDUALS' AVERAGE WEEKLY HOURS SPENT DIRECTLY ON THE ACTIVITIES OF THE REPORTING ORGANIZATION. IN ADDITION, THESE ARE THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: KEDRICK ADKINS - 53 HOURS SR. BARBARA HAHL, CSC - 50 HOURS JOHN HEISLER - 45 HOURS HUGH JONES - 45 HOURS MICHAEL MURPHY - 53 HOURS J. RICHARD O'CONNELL - 53 HOURS JACQUELINE PRIMEAU - 56 HOURS JOSEPH SWEDISH - 53 HOURS RONALD WHITESIDE - 52 HOURS CLAUS VON ZYCHLIN - 56 HOURS	ESTIMATE OF THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS:
FORM 990, PART XI, LINE 5:	EQUITY TRANSFER: -37,413,934. MERGER OF MOUNT CARMEL NEW ALBANY SURG HOSP INTO MOUNT CARMEL HEALTH SYST: -97,768,269. TOTAL TO FORM 990, PART XI, LINE 5: -135,182,203.	CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2:	MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY12 CONSOLIDATED FINANCIAL STATEMENTS OF MOUNT CARMEL HEALTH SYSTEM, AS WELL AS THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. BOTH SETS OF CONSOLIDATED FINANCIAL STATEMENTS WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM.
FORM 990, PART VII, SECTION A, LINE 1:	SR. BARBARA HAHL IS A MEMBER OF THE CONGREGATION OF THE SISTERS OF THE HOLY CROSS. HAVING TAKEN A VOW OF POVERTY, SR. BARBARA DID NOT RECEIVE COMPENSATION FOR THE SERVICES SHE PROVIDED TO MOUNT CARMEL HEALTH SYSTEM EXCEPT FOR INSURANCE BENEFITS ($4,832) AND THE USE OF A LEASED CAR ($3,128). INSTEAD, A TOTAL OF $244,980 WAS PAID BY MOUNT CARMEL HEALTH SYSTEM DIRECTLY TO THE SISTERS OF THE HOLY CROSS FOR SR. BARBARA'S SERVICES.	TRUSTEES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (96 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP
245 STATE ST SE	GRAND RAPIDS	MI	49503	272491974	HEALTHCARE SERVICES	MI	501(C)(3)	9	TRINITY HEALTH-MICHIGAN	0
AMICARE HOSPICE SERVICES INC
20555 VICTOR PARKWAY	LIVONIA	MI	48152	382949053	PROVIDE HOSPICE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC	0
AUXILIARY OF HOLY ROSARY HOSPITAL
351 SW 9TH STREET	ONTARIO	OR	97914	943059469	SUPPORTS SERVICES OF RELATED HOSPITAL	OR	501(C)(3)	9	SAINT ALPHONSUS MEDICAL CENTER-ONTARIO	0
BAUM HARMON MERCY HOSPITAL
255 NORTH WELCH AVENUE	PRIMGHAR	IA	51245	421500277	ACUTE/AMBULATORY HEALTHCARE SERVICES	IA	501(C)(3)	3	MERCY HEALTH SERVICES-IOWA CORP	0
BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION
255 NORTH WELCH AVENUE	PRIMGHAR	IA	51245	262973307	SUPPORT THE SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	11, TYPE I	BAUM HARMON MERCY HOSPITAL	0
CATHERINE MCAULEY HEALTH SERVICES CORP
PO BOX 995	ANN ARBOR	MI	48106	382507173	FURTHER TRINITY HEALTH ACTIVITIES, ORGANIZE AND DEVELOP MEDICAL SERVICES	MI	501(C)(3)	11, TYPE II	TRINITY HEALTH-MICHIGAN	0
COMMUNITY HEALTH PARTNERS OF SOUTH BEND
PO BOX 3998	SOUTH BEND	IN	46619	263051440	HEALTHCARE SERVICES	IN	501(C)(3)	3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	0
CRANBROOK HOSPICE CARE
281 ENTERPRISE COURT	BLOOMFIELD HILLS	MI	48302	383320699	PROVIDE HOSPICE HEALTH SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC	0
DILEY RIDGE MEDICAL CENTER
6150 EAST BROAD STREET	COLUMBUS	OH	43213	342032340	HOSPITAL CAMPUS IN FAIRFIELD COUNTY OHIO	OH	501(C)(3)	3	MOUNT CARMEL HEALTH SYSTEM	0
DUBUQUE MERCY HEALTH FOUNDATION INC
250 MERCY DRIVE	DUBUQUE	IA	52001	262227941	SUPPORT THE SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	11, TYPE I	MERCY HEALTH SERVICES-IOWA CORP	0
DYERSVILLE HEALTH FOUNDATION INC
1111 3RD STREET SW	DYERSVILLE	IA	52040	205383271	SUPPORT THE SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	11, TYPE I	MERCY HEALTH SERVICES-IOWA CORP	0
GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION
701 W NORTH AVE	MELROSE PARK	IL	60160	363332852	SUPPORT THE SERVICES OF RELATED HOSPITAL	IL	501(C)(3)	9	GOTTLIEB MEMORIAL HOSPITAL	0
GOTTLIEB MEMORIAL FOUNDATION
701 W NORTH AVE	MELROSE PARK	IL	60160	743260011	SUPPORT THE SERVICES OF RELATED HOSPITAL	IL	501(C)(3)	11, TYPE III-FI		0	N/A
GOTTLIEB MEMORIAL HOSPITAL
701 W NORTH AVE	MELROSE PARK	IL	60160	362379649	HEALTHCARE SERVICES	IL	501(C)(3)	3	LOYOLA UNIVERSITY HEALTH SYSTEM	0
HACKLEY HOSPITAL
1700 CLINTON ST PO BOX 3302	MUSKEGON	MI	494433302	381358196	HEALTHCARE SERVICES	MI	501(C)(3)	3	MERCY HEALTH PARTNERS	0
HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST
PO BOX 3302	MUSKEGON	MI	494433302	382299878	SELF INSURANCE FOR GENERAL AND MALPRACTICE LIABILITY	MI	501(C)(3)	11, TYPE III-FI	MERCY HEALTH PARTNERS	0
HACKLEY LIFE COUNSELING
1352 TERRACE ST	MUSKEGON	MI	494423545	381386362	COUNSELING, EDUCATION, AND SUPPORT	MI	501(C)(3)	9	MERCY HEALTH PARTNERS	0
HACKLEY VISITING NURSE SERVICES AND HOSPICE INC
888 TERRACE ST	MUSKEGON	MI	49440	381359598	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	7	MERCY HEALTH PARTNERS	0
HOLY CROSS CARENET INC
PO BOX 9184	FARMINGTON HILLS	MI	48333	521945054	LONG-TERM CARE AND REHABILITATION FOR THE ELDERLY	MD	501(C)(3)	9	TRINITY CONTINUING CARE SERVICES	0
HOLY CROSS HOSPITAL FOUNDATION INC
11801 TECH ROAD	SILVER SPRING	MD	20904	208428450	CHARITABLE FUNDRAISING	MD	501(C)(3)	11, TYPE I	HOLY CROSS HOSPITAL OF SILVER SPRING	0
HOLY CROSS HOSPITAL OF SILVER SPRING INC
1500 FOREST GLEN RD	SILVER SPRING	MD	209101484	520738041	HEALTHCARE SERVICES	MD	501(C)(3)	3	TRINITY HEALTH CORPORATION	0
HOLY CROSS MEDICAL CENTER
20555 VICTOR PARKWAY	LIVONIA	MI	48152	951985442	HEALTHCARE SERVICES (FORMERLY)	CA	501(C)(3)	3	TRINITY HEALTH CORPORATION	0
HOSPICE OF NORTH IOWA
232 SECOND STREET SE	MASON CITY	IA	504016208	421173708	HOSPICE HEALTH CARE SERVICES	IA	501(C)(3)	7	MERCY HEALTH SERVICES-IOWA CORP	0
HOSPICE OF WASHTENAW II
806 AIRPORT BLVD	ANN ARBOR	MI	48108	383320707	HOSPICE HEALTH CARE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH-MICHIGAN	0
HPCN
1675 LEAHY STREET	MUSKEGON	MI	49442	300207909	HEALTHCARE SERVICES	MI	501(C)(3)	11, TYPE II	MERCY HEALTH PARTNERS	0
IHA HEALTH SERVICES CORPORATION
24 FRANK LLOYD WRIGHT DR LOBBY J	ANN ARBOR	MI	48106	383316559	PROVIDES OFFICE-BASED MEDICAL CARE	MI	501(C)(3)	9	TRINITY HEALTH-MICHIGAN	0
LAKESHORE COMMUNITY HOSPITAL INC
72 S STATE STREET	SHELBY	MI	494551228	382549295	ACUTE HEALTHCARE SERVICES	MI	501(C)(3)	3	MERCY HEALTH PARTNERS	0
LOYOLA UNIVERSITY HEALTH SYSTEM
2160 SOUTH FIRST AVENUE	MAYWOOD	IL	60153	363342448	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IL	501(C)(3)	11, TYPE II	TRINITY HEALTH CORPORATION	0
LOYOLA UNIVERSITY MEDICAL CENTER
2160 SOUTH FIRST AVENUE	MAYWOOD	IL	60153	364015560	HEALTHCARE SERVICES	IL	501(C)(3)	3	LOYOLA UNIVERSITY HEALTH SYSTEM	0
MARIAN HOME HEALTHCARE
801 5TH STREET	SIOUX CITY	IA	51101	383320705	PROVIDE HOME HEALTH CARE SERVICES	IA	501(C)(3)	11, TYPE I	MERCY HEALTH SERVICES-IOWA CORP	0
MCAULEY CLINIC CORPORATION
PO BOX 992	ANN ARBOR	MI	48106	382561013	HEALTHCARE SERVICES (FORMERLY)	MI	501(C)(3)	3	CATHERINE MCAULEY HEALTH SERVICES CORP	0
MERCY AMICARE HOME HEALTHCARE OAKLAND
281 ENTERPRISE COURT	BLOOMFIELD HILLS	MI	483020312	383320698	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC	0
MERCY AMICARE HOME HEALTHCARE PORT HURON
505 HURON AVENUE	PORT HURON	MI	48060	383320701	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC	0
MERCY FOUNDATION INC
2525 SOUTH MICHIGAN AVENUE	CHICAGO	IL	60616	363227350	SUPPORTS THE SERVICES OF RELATED HEALTH CARE SYSTEM	IL	501(C)(3)	11, TYPE I	MERCY HEALTH SYSTEM OF CHICAGO	0
MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE
684 HARVEY STREET	MUSKEGON	MI	49442	383321856	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC	0
MERCY HEALTH PARTNERS
1415 LEAHY STREET	MUSKEGON	MI	49442	382589966	HEALTHCARE SYSTEM SUPPORT	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH-MICHIGAN	0
MERCY HEALTH SERVICES - IOWA CORP
1000 4TH STREET SW	MASON CITY	IA	50401	311373080	HEALTHCARE SERVICES	DE	501(C)(3)	3	TRINITY HEALTH-MICHIGAN	0
MERCY HEALTH SYSTEM OF CHICAGO
2525 SOUTH MICHIGAN AVENUE	CHICAGO	IL	60616	363163327	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IL	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION	0
MERCY HEALTH SYSTEM OF CHICAGO LIABILITY SELF INSURANCE TRUST
BK OF AMERICA 231 S LASALLE	CHICAGO	IL	60697	912092113	SELF INSURANCE FOR PROFESSIONAL AND COMPREHENSIVE LIABILITY	IL	501(C)(3)	11, TYPE III-FI	MERCY HEALTH SYSTEM OF CHICAGO	0
MERCY HEALTHCARE FOUNDATION
1410 N 4TH ST	CLINTON	IA	52732	421316126	FUNDRAISING AND FINANCIAL ASSISTANCE FOR HOSPITAL CHARITABLE SERVICES	IA	501(C)(3)	11, TYPE I	MERCY MEDICAL CENTER-CLINTON	0
MERCY HOSPITAL AND MEDICAL CENTER
2525 SOUTH MICHIGAN AVENUE	CHICAGO	IL	60616	362170152	HEALTHCARE SERVICES	IL	501(C)(3)	3	MERCY HEALTH SYSTEM OF CHICAGO	0
MERCY HOSPITAL CADILLAC FOUNDATION
400 HOBART	CADILLAC	MI	496012331	203357131	SUPPORT THE SERVICES OF RELATED HOSPITAL	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH-MICHIGAN	0
MERCY HOSPITAL GIFT SHOP
2601 ELECTRIC AVE	PORT HURON	MI	48060	381630480	VOLUNTEER SERVICE AUXILIARY	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH-MICHIGAN	0
MERCY MEDICAL CENTER - CLINTON INC
1410 NORTH 4TH ST	CLINTON	IA	527322940	421336618	TO PROVIDE QUALITY HEALTH CARE	DE	501(C)(3)	3	MERCY HEALTH SERVICES-IOWA CORP	0
MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION
801 5TH STREET	SIOUX CITY	IA	51102	141880022	SUPPORT THE SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	7	MERCY HEALTH SERVICES-IOWA CORP	0
MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA
1000 4TH STREET SW	MASON CITY	IA	504012800	421229151	SUPPORT THE SERVICES OF RELATED HOSPITAL	IA	501(C)(3)	11, TYPE III-FI	MERCY HEALTH SERVICES-IOWA CORP	0
MERCY NORTH HOMECARE AND HOSPICE
7985 MACKINAW TRAIL	CADILLAC	MI	49601	383313897	HOME HEALTH AND HOSPICE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC	0
MERCY PHYSICIAN GROUP INC
1512 12TH AVENUE ROAD	NAMPA	ID	83686	208192593	TO PROVIDE QUALITY HEALTH CARE	ID	501(C)(3)	9	SAINT ALPHONSUS MEDICAL CENTER-NAMPA	0
MERCY SERVICES FOR AGING NON-PROFIT HOUSING CORPORATION
PO BOX 9184	FARMINGTON HILLS	MI	483339184	382719605	PROVIDES LONG-TERM CARE FOR THE ELDERLY	MI	501(C)(3)	11, TYPE II	TRINITY CONTINUING CARE SERVICES INC	0
MIDWEST MEDFLIGHT
1300 VICTORS WAY	ANN ARBOR	MI	48108	382684671	AEROMEDICAL TRANSPORT	MI	501(C)(3)	9	TRINITY HEALTH-MICHIGAN	0
MOUNT CARMEL CARE CONTINUUM SERVICES CORP
793 WEST STATE STREET	COLUMBUS	OH	43222	311126211	COOPERATIVE HOSPITAL SERVICE ORGANIZATION	OH	501(C)(3)	3	MOUNT CARMEL HEALTH SYSTEM	0
MOUNT CARMEL COLLEGE OF NURSING
6150 EAST BROAD STREET	COLUMBUS	OH	43213	311308555	COLLEGE OF NURSING	OH	501(C)(3)	2	MOUNT CARMEL HEALTH	0
MOUNT CARMEL HEALTH
6150 EAST BROAD STREET	COLUMBUS	OH	43213	314379602	HEALTHCARE SERVICES	OH	501(C)(3)	3	MOUNT CARMEL HEALTH SYSTEM	0
MOUNT CARMEL HEALTH INSURANCE COMPANY
6150 EAST BROAD STREET	COLUMBUS	OH	43213	251912781	HEALTH INSURANCE	OH	501(C)(4)	N/A	MOUNT CARMEL HEALTH SYSTEM	0
MOUNT CARMEL HEALTH PLAN INC
6150 EAST BROAD STREET	COLUMBUS	OH	43213	311471229	MEDICARE HMO FOR SENIORS	OH	501(C)(4)	N/A	MOUNT CARMEL HEALTH SYSTEM	0
MOUNT CARMEL HEALTH SYSTEM
6150 EAST BROAD STREET	COLUMBUS	OH	43213	311439334	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	OH	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION	0
MOUNT CARMEL HEALTH SYSTEM FOUNDATION
6150 EAST BROAD STREET	COLUMBUS	OH	43213	311113966	SUPPORT THE SERVICES OF RELATED HOSPITAL	OH	501(C)(3)	11, TYPE I	MOUNT CARMEL HEALTH SYSTEM	0
MOUNT CARMEL HOME CARE LLC
1144 DUBLIN ROAD SUITE B	COLUMBUS	OH	43215	262729300	PROVIDE HOME HEALTH CARE SERVICES	OH	501(C)(3)	9	TRINITY HOME HEALTH SERVICES INC	0
MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL
7333 SMITHS MILL RD	NEW ALBANY	OH	43054	870790288	HEALTHCARE SERVICES	OH	501(C)(3)	3	MOUNT CARMEL HEALTH SYSTEM	0
MRI MOBILE SERVICES OF WEST MICHIGAN
1820 - 44TH STREET	KENTWOOD	MI	49508	383073745	OPERATE MAGNETIC IMAGING RESONANCE (FORMERLY)	MI	501(C)(3)	9	TRINITY HEALTH-MICHIGAN	0
MUSKEGON COMMUNITY HEALTH PROJECT
565 W WESTERN AVENUE	MUSKEGON	MI	49440	911932918	FACILITATE AND COORDINATE HEALTHCARE AND RELATED SERVICES	MI	501(C)(3)	7	MERCY HEALTH PARTNERS	0
OAKLAND MERCY HOSPITAL
601 EAST 2ND STREET	OAKLAND	NE	68045	208072234	HEALTHCARE SERVICES	NE	501(C)(3)	3	MERCY HEALTH SERVICES-IOWA CORP	0
OAKLAND MERCY HOSPITAL FOUNDATION
601 E 2ND STREET	OAKLAND	NE	68045	311678345	SUPPORTS SERVICES OF RELATED HOSPITAL	NE	501(C)(3)	11, TYPE III-FI	OAKLAND MERCY HOSPITAL	0
PORT HURON MERCY FAMILY CARE INC
2601 ELECTRIC AVE	PORT HURON	MI	48060	201855647	HEALTHCARE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH-MICHIGAN	0
PROFESSIONAL MED TEAM
965 FORK STREET	MUSKEGON	MI	494423257	382638284	MEDICAL CARE, TRANSPORTATION AND EDUCATION	MI	501(C)(3)	9	TRINITY HEALTH-MICHIGAN	0
PROFESSIONAL OFFICE CORPORATION
1303 EAST HERNDON AVE	FRESNO	CA	93720	942839324	HEALTHCARE SERVICES	CA	501(C)(3)	11, TYPE I	SAINT AGNES MEDICAL CENTER	0
SAINT AGNES MEDICAL CENTER
1303 EAST HERNDON AVE	FRESNO	CA	93720	941437713	HEALTHCARE SERVICES	CA	501(C)(3)	3	TRINITY HEALTH CORPORATION	0
SAINT ALPHONSUS BUILDING COMPANY INC
1055 NORTH CURTIS RD	BOISE	ID	83706	820401011	SUPPORTS SERVICES OF RELATED HOSPITAL	ID	501(C)(3)	11, TYPE I	SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC	0
SAINT ALPHONSUS DIVERSIFIED CARE INC
1055 NORTH CURTIS RD	BOISE	ID	83706	943028978	SUPPORTS SERVICES OF RELATED HOSPITAL	ID	501(C)(3)	11, TYPE I	SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC	0
SAINT ALPHONSUS FOUNDATION-BAKER CITY INC
3325 POCAHONTAS ROAD	BAKER CITY	OR	97814	943164869	SUPPORT THE SERVICES OF RELATED HOSPITAL	OR	501(C)(3)	7	SAINT ALPHONSUS MEDICAL CENTER - BAKER CITY	0
SAINT ALPHONSUS FOUNDATION-ONTARIO INC
351 SW 9TH STREET	ONTARIO	OR	97914	202683560	SUPPORT THE SERVICES OF RELATED HOSPITAL	OR	501(C)(3)	11, TYPE I	SAINT ALPHONSUS MEDICAL CENTER-ONTARIO	0
SAINT ALPHONSUS HEALTH SYSTEM INC
1055 N CURTIS ROAD	BOISE	ID	83706	271929502	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	ID	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION	0
SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY
3325 POCAHONTAS ROAD	BAKER CITY	OR	97814	271790052	TO PROVIDE QUALITY HEALTH CARE	OR	501(C)(3)	3	SAINT ALPHONSUS HEALTH SYSTEM INC	0
SAINT ALPHONSUS MEDICAL CENTER-NAMPA
1512 12TH AVENUE ROAD	NAMPA	ID	83686	820200896	TO PROVIDE QUALITY HEALTH CARE	ID	501(C)(3)	3	SAINT ALPHONSUS HEALTH SYSTEM INC	0
SAINT ALPHONSUS MEDICAL CENTER-NAMPA HEALTH FOUNDATION INC
1512 12TH AVENUE ROAD	NAMPA	ID	83686	261737256	SUPPORT THE SERVICES OF RELATED HOSPITAL	ID	501(C)(3)	7	SAINT ALPHONSUS MEDICAL CENTER-NAMPA	0
SAINT ALPHONSUS MEDICAL CENTER-ONTARIO
351 SW 9TH STREET	ONTARIO	OR	97914	271789847	TO PROVIDE QUALITY HEALTH CARE	OR	501(C)(3)	3	SAINT ALPHONSUS HEALTH SYSTEM INC	0
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
1055 NORTH CURTIS RD	BOISE	ID	83706	820200895	HEALTHCARE SERVICES	ID	501(C)(3)	3	SAINT ALPHONSUS HEALTH SYSTEM INC	0
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC
1915 LAKE AVENUE PO BOX 670	PLYMOUTH	IN	46563	351142669	HEALTHCARE SERVICES	IN	501(C)(3)	3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	0
SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC
PO BOX 1935	SOUTH BEND	IN	466341935	350868157	HEALTHCARE SERVICES	IN	501(C)(3)	3	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	0
SAINT JOSEPH REGIONAL MEDICAL CENTER MISHAWAKA AUXILIARY INC
5215 HOLY CROSS PARKWAY	MISHAWAKA	IN	46545	356033285	HOSPITAL SERVICE AUXILIARY	IN	501(C)(4)	N/A	SAINT JOSEPH REGIONAL MEDICAL CENTER-S BEND	0
SAINT JOSEPH REGIONAL MEDICAL CENTER PLYMOUTH AUXILIARY INC
1915 LAKE AVENUE	PLYMOUTH	IN	46563	356043563	HOSPITAL SERVICE AUXILIARY	IN	501(C)(3)	11, TYPE II	SAINT JOSEPH REGIONAL MEDICAL CENTER-PLYMOUTH	0
SAINT JOSEPH REGIONAL MEDICAL CENTER INC
801 EAST LASALLE AVE	SOUTH BEND	IN	46617	351568821	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IN	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION	0
SAINT JOSEPH'S TOWER INC
PO BOX 9184	FARMINGTON HILLS	MI	483339184	311040468	PROVIDES HOUSING FOR LOW INCOME ELDERLY INDIVIDUALS	IN	501(C)(3)	9	TRINITY CONTINUING CARE SERVICES-INDIANA	0
SAINT MARY'S AMICARE HOME HEALTHCARE
1430 MONROE NW	GRAND RAPIDS	MI	49505	383320700	PROVIDE HOME HEALTH CARE SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HOME HEALTH SERVICES INC	0
SAINT MARY'S FOUNDATION (FKA SAINT MARY'S DORAN FOUNDATION)
200 JEFFERSON ST SE	GRAND RAPIDS	MI	49503	381779602	SUPPORTS SERVICES OF RELATED HOSPITAL	MI	501(C)(3)	7	TRINITY HEALTH-MICHIGAN	0
ST JOSEPH MERCY OAKLAND FOUNDATION
44405 WOODWARD AVE	PONTIAC	MI	48341	352356789	SUPPORTS SERVICES OF RELATED HOSPITAL	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH-MICHIGAN	0
ST ANN'S HOSPITAL
500 SOUTH CLEVELAND AVE	WESTERVILLE	OH	43081	314412701	HEALTHCARE SERVICES	OH	501(C)(3)	3	MOUNT CARMEL HEALTH SYSTEM	0
THE FOUNDATION OF SAINT JOSEPH REGIONAL MEDICAL CENTER
4215 EDISON LAKES PARKWAY	MISHAWAKA	IN	46545	351654543	SUPPORTS SERVICES OF RELATED HOSPITAL	IN	501(C)(3)	11, TYPE I	SAINT JOSEPH REGIONAL MEDICAL CENTER INC	0
TRI-HOSPITAL MRI CENTER
4190 24TH AVENUE	FORT GRATIOT	MI	48054	382884297	MRI SERVICES	MI	501(C)(3)	3	TRINITY HEALTH-MICHIGAN	0
TRINITY CONTINUING CARE SERVICES
PO BOX 9184	FARMINGTON HILLS	MI	483339184	382559656	MANAGEMENT SERVICES FOR LONG TERM CARE AND SENIOR LIVING FACILITIES	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION	0
TRINITY CONTINUING CARE SERVICES - INDIANA INC
PO BOX 9184	FARMINGTON HILLS	MI	483339184	930907047	PROVIDES LONG-TERM CARE AND RESIDENTIAL HOUSING	IN	501(C)(3)	9	TRINITY CONTINUING CARE SERVICES	0
TRINITY HEALTH - MICHIGAN
20555 VICTOR PARKWAY	LIVONIA	MI	48152	382113393	HEALTHCARE SERVICES	MI	501(C)(3)	3	TRINITY HEALTH CORPORATION	0
TRINITY HEALTH CORPORATION
20555 VICTOR PARKWAY	LIVONIA	MI	48152	351443425	HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT	IN	501(C)(3)	11, TYPE I		0	N/A
TRINITY HEALTH INTERNATIONAL
20555 VICTOR PARKWAY	LIVONIA	MI	48152	421253527	HEALTHCARE TRAINING AND SUPPORT SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION	0
TRINITY HEALTH WELFARE BENEFIT TRUST
20555 VICTOR PARKWAY	LIVONIA	MI	48152	208151733	RETIREE MEDICAL AND RETIREE LIFE INSURANCE COVERAGE	MI	501(C)(9)	N/A	TRINITY HEALTH CORPORATION	0
TRINITY HOME HEALTH SERVICES INC
17410 COLLEGE PARKWAY	LIVONIA	MI	48152	382621935	HOME HEALTH CARE SYSTEM MANAGEMENT SERVICES	MI	501(C)(3)	11, TYPE I	TRINITY HEALTH CORPORATION	0

Form990 Schedule R Part III Form990ScheduleRPartIII (32 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Predominant Income TypePredominantIncomeType	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner
ADVENT REHABILITATION LLC
607 DEWEY AVENUE SUITE 300	GRAND RAPIDS	MI	49504	383306673	REHABILITATION THERAPY SERVICES	MI	N/A	N/A	0	0
BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP
793 W STATE STREET	COLUMBUS	OH	43222	311608125	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A	0	0
CENTER FOR DIGESTIVE CARE LLC
5300 ELLIOTT DRIVE	YPSILANTI	MI	48197	030447062	PROVIDE GASTROINTESTINAL SERVICES	MI	N/A	N/A	0	0
CENTRAL OHIO SLEEP MEDICINE LTD
6150 EAST BROAD STREET	COLUMBUS	OH	43213	311701029	SLEEP MEDICINE SERVICES	OH	N/A	N/A	0	0
CLINTON IMAGING SERVICES LLC
615 VALLEY VIEW DR STE 202	MOLINE	IL	61265	412044739	MRI DIAGNOSTIC SERVICES	IA	N/A	N/A	0	0
FOREST PARK IMAGING LLC
1000 4TH STREET SW	MASON CITY	IA	50401	134365966	X-RAY AND MAMMOGRAPHY SERVICES	IA	N/A	N/A	0	0
FRANCES WARDE MEDICAL LABORATORY
300 WEST TEXTILE ROAD	ANN ARBOR	MI	48104	382648446	LABORATORY	MI	N/A	N/A	0	0
FRESNO IMAGING CENTER
1303 E HERNDON AVE	FRESNO	CA	93720	770363563	DIAGNOSTIC IMAGING	CA	N/A	N/A	0	0
HAWARDEN REGIONAL HEALTH CLINICS LLC
1122 AVENUE L	HAWARDEN	IA	51023	201444339	MEDICAL CLINIC	IA	N/A	N/A	0	0
IDAHO GYNONCOLOGY SERVICES LLC
1055 N CURTIS RD	BOISE	ID	83706	202975807	PROVIDE GYN ONCOLOGY SERVICES	ID	N/A	N/A	0	0
INTERMOUNTAIN MEDICAL IMAGING LLC
877 WEST MAIN ST STE 603	BOISE	ID	83702	820514422	PROVIDE IMAGING SERVICES	ID	N/A	N/A	0	0
LOYOLA AMBULATORY SURGERY CENTER
1S224 SUMMIT AVE STE 201	OAKBROOK TERRACE	IL	60181	364119522	SURGICAL SERVICES	IL	N/A	N/A	0	0
MAGNETIC RESONANCE SERVICES PARTNERSHIP
1416 SIXTH STREET SW	MASON CITY	IA	50401	421328388	MRI SERVICES	IA	N/A	N/A	0	0
MASON CITY AMBULATORY SURGERY CENTER LLC
990 4TH STREET SW	MASON CITY	IA	50401	201960348	SURGERY-SAME DAY	IA	N/A	N/A	0	0
MCE MOB IV LIMITED PARTNERSHIP
793 W STATE STREET	COLUMBUS	OH	43222	421544707	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A	0	0
MCMC POB III LIMITED PARTNERSHIP
793 W STATE STREET	COLUMBUS	OH	43222	311392994	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A	0	0
MEDILUCENT MOB I
793 W STATE STREET	COLUMBUS	OH	43222	204911370	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A	0	0
MERCY ADVANCED MRI LLC
2525 SOUTH MICHIGAN AVE	CHICAGO	IL	60616	262116721	SUBLEASE MRI EQUIPMENT	IL	N/A	N/A	0	0
MERCY HEART & VASCULAR LLC
2525 SOUTH MICHIGAN AVE	CHICAGO	IL	60616	205272726	SUBLEASE CT EQUIPMENT	IL	N/A	N/A	0	0
MERCY HEART CTR OP SERVICES LLC
1000 4TH STREET SW	MASON CITY	IA	50401	134237594	CARDIOVASCULAR SERVICES	IA	N/A	N/A	0	0
MERCY OUTPATIENT SURGERY CENTER LLC
1512 12TH AVENUE ROAD	NAMPA	ID	83686	841380439	OUTPATIENT SURGERY	ID	N/A	N/A	0	0
MICHIANA HEALTH INFORMATION NETWORK LLC
215 WEST MADISON STREET	SOUTH BEND	IN	46601	352050128	COMMUNITY BASED CLINICAL INFO SYS & DATA DEPOSITORY	IN	N/A	N/A	0	0
MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP
793 W STATE STREET	COLUMBUS	OH	43222	311369473	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A	0	0
NEWCO AMBULATORY SURGERY CTR LLP
4190 24TH AVENUE	FORT GRATIOT	MI	48059	300136708	OUTPATIENT SURGERY CENTER	MI	N/A	N/A	0	0
RIVERVIEW MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP
793 W STATE STREET	COLUMBUS	OH	43222	311531135	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A	0	0
SARMED OUTPATIENT PHARMACY LLC
999 N CURTIS RD STE 102	BOISE	ID	83706	510483218	PHARMACY	ID	N/A	N/A	0	0
SIXTY FOURTH STREET LLC
2373 64TH ST STE 2200	BYRON CENTER	MI	49315	202443646	PROVIDE OUTPATIENT SURGICAL CARE	MI	N/A	N/A	0	0
ST ALPHONSUS CALDWELL CANCER CTR LLC
3123 MEDICAL DR	CALDWELL	ID	83605	820526861	RADIATION ONCOLOGY	ID	N/A	N/A	0	0
ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP
793 W STATE STREET	COLUMBUS	OH	43222	311603660	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A	0	0
TAMARACK MEDICAL CLINIC LLC
610 VILLAGE DRIVE	DONNELLY	ID	83615	201637921	OUTPATIENT MEDICAL SERVICES	ID	N/A	N/A	0	0
WESTAR MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP
793 W STATE STREET	COLUMBUS	OH	43222	311784409	MEDICAL OFFICE BUILDING RENTAL	OH	N/A	N/A	0	0
WOODLAND IMAGING CENTER LLC
5301 E HURON RIVER DR	ANN ARBOR	MI	48106	760820959	RADIOLOGY/IMAGING	MI	N/A	N/A	0	0

Form990 Schedule R Part IV Form990ScheduleRPartIV (30 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Type Of EntityTypeOfEntity	Address Line1AddressForeign/AddressLine1	CityAddressForeign/City	CountryAddressForeign/Country	Legal Domicile Foreign CountryLegalDomicileForeignCountry
COMMUNITY HEALTH VENTURES INC
565 W WESTERN AVE	MUSKEGON	MI	49440	383522260	SOFTWARE MARKETING	MI	N/A	C
GOTTLIEB MANAGEMENT SERVICES INC
701 W NORTH AVE	MELROSE PARK	IL	60160	363330529	MANAGEMENT SERVICES	IL	N/A	C
HACKLEY HEALTH MANAGEMENT CENTER
1415 LEAHY ST	MUSKEGON	MI	49442	382961814	WEIGHT MANAGEMENT	MI	N/A	C
HACKLEY HEALTH VENTURES INC
1415 LEAHY ST	MUSKEGON	MI	49442	382589959	OTHER MEDICAL SERVICES	MI	N/A	C
HACKLEY HEALTHCARE EQUIPMENT
1415 LEAHY ST	MUSKEGON	MI	49442	382578569	HOME MEDICAL EQUIPMENT	MI	N/A	C
HACKLEY PROFESSIONAL CENTER
1415 LEAHY ST	MUSKEGON	MI	49442	383024797	REAL ESTATE RENTAL	MI	N/A	C
HACKLEY PROFESSIONAL PHARMACY
1415 LEAHY ST	MUSKEGON	MI	49442	382447870	PHARMACY	MI	N/A	C
HEF INC
1415 LEAHY ST	MUSKEGON	MI	49442	383086401	OFFICE STAFFING	MI	N/A	C
HOLY CROSS PRIVATE HOME SERVICES CORP
11801 TECH ROAD	SILVER SPRING	MD	20904	521986562	HOME CARE SERVICES	MD	N/A	C
HPC CO-OWNERS ASSOCIATION
1700 CLINTON	MUSKEGON	MI	49442	270734448	CONDOMINIUM ASSOCIATION	MI	N/A	C
HURON ARBOR CORPORATION
5301 EAST HURON RIVER DR PO BOX 992	ANN ARBOR	MI	48106	382475644	PROVIDES OFFICE RENTAL SPACE	MI	N/A	C
IHA AFFILIATION CORPORATION
24 FRANK LLOYD WRIGHT DR LOBBY J	ANN ARBOR	MI	48106	383188895	MEDICAL MANAGEMENT	MI	N/A	C
LOYOLA UNIVERSITY OF CHICAGO INSURANCE CO LTD
					PROVISION OF INSURANCE COVERAGE		N/A	C	23 LIME TREE BAY AVENUE	GRAND CAYMAN	CJ	CJ
MARYLAND CARE GROUP INC
11801 TECH ROAD	SILVER SPRING	MD	20904	521815313	HEALTHCARE HOLDING	MD	N/A	C
MEDNOW INC
1512 12TH AVENUE ROAD	NAMPA	ID	83686	820389927	OUTPATIENT PHARMACY	ID	N/A	C
MERCY MEDICAL SERVICES
801 5TH STREET	SIOUX CITY	IA	51101	421283849	PRIMARY CARE PHYSICIANS	IA	N/A	C
MERCY SERVICES CORPORATION
2525 SOUTH MICHIGAN AVENUE	CHICAGO	IL	60616	363227348	DORMANT	IL	N/A	C
MICHIGAN ATHLETIC CLUB
2500 BURTON	GRAND RAPIDS	MI	49546	382647304	ATHLETIC CLUB	MI	N/A	C
MOUNT CARMEL BEHAVIORAL HEALTHCARE SERVICES INC
6150 EAST BROAD STREET	COLUMBUS	OH	43213	310971510	BEHAVIORAL HEALTHCARE SERVICES	OH	N/A	C
MOUNT CARMEL HEALTH PROVIDERS INC
6150 EAST BROAD STREET	COLUMBUS	OH	43213	311382442	MEDICAL SERVICES	OH	N/A	C
NORTH IOWA MERCY MEDICAL SERVICES INC
1000 4TH ST SW	MASON CITY	IA	50401	421382308	MEDICAL SERVICES	IA	N/A	C
PRIORITY PLUS OF CALIFORNIA
PO BOX 27230	FRESNO	CA	93729	770395267	FORMERLY HLTH MGMT NOW DISCONTINUED OPERATIONS	CA	N/A	C
SAINT ALPHONSUS PHYSICIANS PA
1055 NORTH CURTIS ROAD	BOISE	ID	837061370	331078261	PHYSICIANS	ID	N/A	C
SAINT MARY'S HEALTH MANAGEMENT COMPANY
1640 EAST PARIS SE	GRAND RAPIDS	MI	49546	383450733	ATHLETIC CLUB	MI	N/A	C
SURGERY CENTER FINANCING CORPORATION
6150 EAST BROAD STREET	COLUMBUS	OH	43213	311531102	FINANCE, INSURANCE AND REAL ESTATE	OH	N/A	C
THRE SERVICES LLC
20555 VICTOR PARKWAY	LIVONIA	MI	48152	452603654	REAL ESTATE BROKERAGE SERVICES	MI	N/A	C
TRINITY HEALTH EMPLOYEE BENEFIT TRUST
20555 VICTOR PARKWAY	LIVONIA	MI	48152	383410377	GRANTOR TRUST	MI	N/A	T
VENZKE INSURANCE COMPANY LTD
				980453602	PROVISION OF INSURANCE COVERAGE		N/A	C	PO BOX 1051 GRAND CAYMAN	GRAND CAYMAN	CJ	CJ
WESTSHORE HEALTH NETWORK
1820 44TH STREET	KENTWOOD	MI	49508	383280200	PHYSICIAN HOSPITAL ORGANIZATION	MI	N/A	C
WORKPLACE HEALTH OF GRAND HAVEN
1415 LEAHY ST	MUSKEGON	MI	49442	383112035	OCCUPATIONAL HEALTH	MI	N/A	C

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	0	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
MOUNT CARMEL HEALTH SYSTEM
B	37413934	PER BOOKS
MOUNT CARMEL HEALTH PLAN INC
K	3312868	PER BOOKS
TRINITY HEALTH CORPORATION
Q	1589515	PER BOOKS
MOUNT CARMEL HEALTH SYSTEM
L	9323213	PER BOOKS
MOUNT CARMEL HEALTH INSURANCE COMPANY
K	95220	PER BOOKS