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      <Form990PartVIISectionA>
        <NamePerson>Shutt Robert</NamePerson>
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      <Form990PartVIISectionA>
        <NamePerson>Dixon-Martin Kelly</NamePerson>
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      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
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          <AddressUS>
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      <ContractorCompensation>
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        <EligibilityCriteriaExplained>1</EligibilityCriteriaExplained>
        <UsesFPGFree>1</UsesFPGFree>
        <FPGFreePercent>200.000000000000</FPGFreePercent>
        <UsesFPGDiscounted>1</UsesFPGDiscounted>
        <FPGDiscountPercent>400.000000000000</FPGDiscountPercent>
        <ExplainsBasis>1</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <AssetLevel>X</AssetLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <ExplainsApplicationMethod>1</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>1</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>1</ActionsOnNonpayment>
        <CollectionActivities>0</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>1</NondiscrimEmergencyCarePolicy>
        <UsedOtherMethod>X</UsedOtherMethod>
        <AmountsGenerallyBilled>0</AmountsGenerallyBilled>
        <GrossCharges>0</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, Line 6a: Saint Mary's Health Care System's community benefit report is contained in a report prepared by a related organization, Catholic Health East.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, Line 7: The cost to charge ratio is not computed using worksheet 2 from the instructions: the cost to charge ratio is computed by taking the full amount of expenses from the hospital statement of expenses, subtracting bad debt the dividing by gross revenue.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, Line 7g: St. Mary's Health Care System has a Pediatric Subspecialty Clinic where specialty physicians from outside the local area come and see patients from the local area. The total cost for the Pedicatric Sub-specialty Clinic included in Part I, line 7g is $111,696.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, L7 Col(f): The amount of bad debt expense included on Form 990, Part IX, Line 25, column (a), but subtracted for purposes of calculating the percentages on schedule H, part I, line 7 column (f) is $14,555,783.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part II: The director of Security attends and participates in emergency planning meetings throughout the year. The planning allows collaboration of state and local agencies and organizations in order to prepare for a local or statewide emergency. The Emergency Department also participates in quarterly meetings to address emergency service coordination in the Athens-Clarke County area. Planning is a vital step in disaster management and will certainly increase community health in the case of an emergency. St. Mary's provided services and supplies to a local non-profit, Free IT Athens. St. Mary's IT staff helped clean old computers that were then donated to the organization which in turn donates them to people in need in the Athens community. One of St. Mary's staff coordinates the collection and recycling of all types of batteries from St. Mary's employees and family. This service keeps harmful chemicals from entering the environment through landfills.Several St. Mary's staff donated their time to a community wide education initiative called Whatever It Takes (WIT). WIT is working to ensure all students graduate from a post-secondary education. They are taking a very comprehensive approach that includes health for mothers, children and families. St. Mary's staff have helped WIT put together comprehensive and effective health improvement plans. Each year St. Mary's hosts a Clergy Conference for the local clergy who visit and minister to patients in the hospital throughout the year. This conference provides valuable education to these clergy and allows them to better address the emotional and spiritual needs of their parishioners and St. Mary's patients. St. Mary's has played a vital role in the establishment of the new Georgia Health Sciences University/University of Georgia Medical Partnership. The Chief Medical Officer has served on a committee to help guide the new medical school and establish working relationship with St. Mary's as well as other health care organizations in the community. St. Mary's hosts many volunteers throughout the year including high school and college students as well as community members of all ages. Volunteers work as part of the Auxiliary and serve more than 2,000 each month. The volunteers not only serve the hospital in vital ways, but also receive experiential training in health care in a hospital setting. Increased education and training correlates with increased health status. Several departments of St. Mary's are involved in mentoring students interested in healthcare careers. St. Mary's also financially supported the Clarke County Mentor Program which matches students with supportive adults. St. Mary's has played an integral role in the creation and work of the Athens Health Network (additional information below).</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part III, Line 4: The figures were calculated based on the cost-to-charge ratio. The cost-to-charge ratio was derived by dividing total operating expenses (excluding bad debt expense) by total grosspatient charges. The cost-to-charge ratio was applied to total bad debt write-offs to calculate the costs for line 2.While we make all reasonable efforts to identify patients eligible for charity care prior to billing, such pre-billing identification is not always possible. This problem arises largely with patients treated in our Emergency Department ("ED") on an outpatient basis. Frequently, these patients do not complete an application for financial assistance therefore making a definitive determination difficult. The estimated amount for patients who likely would qualify for financial assistance is calculated for line 3 based on a review of bad debt write-offs to include only bad debt for uninsured patients, and estimating the amount of that cost that could be charity based on a review of applications for financial assistance. A reasonable estimate based on the percentage of patients whose applications do not meet the criteria for financial assistance is used to estimate the amount that could qualify for financial assistance. For financial reporting, an allowance for doubtful accounts is recordedfor estimated losses resulting from the unwillingness of patients to make payments for services. The allowance is determined by analyzing historical data and trends. Accounts receivable are written off against the allowance for doubtful accounts when management determines that recovery is unlikely and collection efforts cease.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part III, Line 8: The amount here is determined by using the actual patient charges, the Medicare cost-to-charge ratios that we are currently being paid on, and the payment-to-charges from the actual remittances. Based on the calculation this shortfall should be viewed as uncompensated care provided to those patients and thus treated entirely as community benefit.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part III, Line 9b: Accounts with applications pending for Charity Care or other assistance programs are held until the outcome of the application. A "pending charity approval" is defined as an application that has been fully completed by the patient, submitted and is in the process of being determined for eligiblity. It is acceptable (but not preferable) to take an account though the full collection cycle and later reclassify it as Charity Care as long as a consistent process is followed and a legitimate basis exists that the patient is unable to pay. For example, with self pay accounts written off and sent to bad debt, reclassifying the account to Charity Care may be considered on the basis of all of the following factors:1. No Third party coverage or inadequate coverage exists, 2. No payments are recorded on the account,and 3. The patient/guarantor was billed a minimum of 4 times.All self-pay accounts are automatically transferred to a third party billing agency. The third party billing agency contacts the accountholder to arrange for payment. If the third party billing agency has an account that has not been paid in full within 120 days, the account is then sent back to St. Mary's Health Care System. Upon receipt of an outstanding account, St. Mary's Health Care System transfers the account to a collection agency.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>St. Mary's Health Care System, Inc.</Identifier>
        <Explanation>Part V, Section B, Line 19d: The Hospital uses the average managed care write off percentage for self pay patients.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 7, The list of states in which CHE's community benefit report is filed are: Alabama, Connecticut, Delaware, Florida, Georgia, Maine, Massachusetts, New Jersey, New York, North Carolina and Pennsylvania.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>The partnership St. Mary's has with the Athens Health Network is seen as a very important part of our ministry and commitment to the Athens community. The Athens Health Network was established to address the health care needs of the uninsured and underinsured populations of the Athens community. St. Mary's in partnership with three other institutions, University of Georgia, Athens-Clarke County government, and Athens Regional Medical Center, helped to establish this network and develop it into a 501c3 non-profit. Currently, the Athens Health Network is working to help clinics implement electronic medical records, increase the capacity of the free or reduced cost clinics, and prepare for any changes that will affect our community over the next few years as a result of health care reform. St. Mary's believes that the Athens Health Network is going to greatly impact our community's health and we are eager to be a part of their mission.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 2: St. Mary's Health Care System completed a community health needs assessment in July of 2010 as described in Section B. In addition to the community health needs assessment, St. Mary's is regularly updated on the health status and health care resources of the Athens community through the Athens Health Network of which St. Mary's is a founding member.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 3: Information is displayed on the hospital website and at all registration areas about financial assistance policies. All self-pay patients are visited by a financial counselor in the hospital and are screened for eligibility of financial assistance. The screening process includes screening for eligibility for the Charity Care policy as well as government programs.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 4: St. Mary's Health Care System is located in Athens-Clarke County and serves this community as well as Jackson, Madison, Monroe, Oglethorpe, and Oconee Counties. The estimated population of Athens-Clarke County in 2010 was 116,714 people. The estimated median age is about 27, almost 10 years younger that the Georgia county average. This is due largely to the presence of the University of Georgia which currently enrolls more than 34,000 undergraduate and graduate students in total. Athens-Clarke County is diverse with about 70% of the population being white, 25% African American, and about 10% Latino. Athens-Clarke County is very educated, about 66% of residents have at least some college. However, the high school graduation rate is only 70% which is much lower than the Georgia average of 81%. Athens-Clarke County has a large population living in poverty, including 36% of children, and the median household income is only $34,000, which is $12,000 less than the Georgia average. Finally, 23% of the population under age 65 is without health insurance. The surrounding counties are more rural, slightly less diverse, and have less people living in poverty and without health insurance. However, people in these counties have fewer local resources and may face barriers to receiving care related to distance or transportation.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 5: Many of St. Mary's senior leadership serve on boards of community organizations. Our president, most vice presidents and many directors donate their time and expertise to organizations that strive to improve community or state health. These organizations include Mercy Health Center, Parish Nurses Resource Center, Athens Health Network, Oncology Nursing Society, Athens Technical College's Surgical Tech program, Homeless &amp; Poverty Coalition, and Learning Ally. St. Mary's is dedicated to serving the community not only within the hospital but also through partnerships in our community. Second, some of the physicians who work for St. Mary's or are associated with our hospital, donate their time and services to the free clinics in Athens, for example Mercy Health Center and Athens Nurses Clinic. The mission of St. Mary's is to serve the community and we encourage all staff to serve the community outside of the hospital. St. Mary's also provides corporate donations and sponsorships to many organizations and community events including the American Red Cross, American Heart Association's Heart Walk, Athens Goes Pink Breast Cancer Awareness, Food Bank of Northeast Georgia, and Athens Maternity &amp; Baby Fair.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 6: St. Mary's Health Care System Inc. operates as one organization to promote the health of the community. All Community Benefits are reported together and there is one needs assessment for St. Mary's Health Care System.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <RecordsMaintained>1</RecordsMaintained>
      <RecipientTable>
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          <BusinessNameLine1>American Heart Association</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>1720 Epps Bridge Parkway Suite</AddressLine1>
          <AddressLine2>108-383</AddressLine2>
          <City>Athens</City>
          <State>GA</State>
          <ZIPCode>30606</ZIPCode>
        </AddressUS>
        <EINOfRecipient>135613797</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>20000</AmountOfCashGrant>
        <AmountOfNonCashAssistance>7388</AmountOfNonCashAssistance>
        <MethodOfValuation>FMV</MethodOfValuation>
        <DescriptionOfNonCashAssistance>Volunteer Staff Hours</DescriptionOfNonCashAssistance>
        <PurposeOfGrant>Medical Reseach for Heart Disease</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
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          <BusinessNameLine1>Mercy Health Center</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>767 Oglethorpe Ave</AddressLine1>
          <City>Athens</City>
          <State>GA</State>
          <ZIPCode>30606</ZIPCode>
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        <EINOfRecipient>582603523</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>25000</AmountOfCashGrant>
        <MethodOfValuation>fMV</MethodOfValuation>
        <PurposeOfGrant>Medical treatment of the underserved</PurposeOfGrant>
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      <RecipientTable>
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          <BusinessNameLine1>Athens Health Network</BusinessNameLine1>
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          <AddressLine1>P O Box 48917</AddressLine1>
          <City>Athens</City>
          <State>GA</State>
          <ZIPCode>30604</ZIPCode>
        </AddressUS>
        <EINOfRecipient>275305499</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>15000</AmountOfCashGrant>
        <AmountOfNonCashAssistance>1476</AmountOfNonCashAssistance>
        <MethodOfValuation>FMV</MethodOfValuation>
        <DescriptionOfNonCashAssistance>Volunteer Staff Hours</DescriptionOfNonCashAssistance>
        <PurposeOfGrant>Medical treatment of the underserved NOTE: (IRC SECTION NUMBER APPLIED FOR)</PurposeOfGrant>
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          <AddressLine1>1 Huntington Rd Ste 805</AddressLine1>
          <City>Athens</City>
          <State>GA</State>
          <ZIPCode>30606</ZIPCode>
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        <EINOfRecipient>586008133</EINOfRecipient>
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        <DescriptionOfNonCashAssistance>Volunteer Staff Hours</DescriptionOfNonCashAssistance>
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          <BusinessNameLine1>Action Inc Athens Full Plate</BusinessNameLine1>
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          <AddressLine1>594 Oconee Street</AddressLine1>
          <City>Athens</City>
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          <ZIPCode>30601</ZIPCode>
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        <MethodOfValuation>FMV</MethodOfValuation>
        <DescriptionOfNonCashAssistance>Food</DescriptionOfNonCashAssistance>
        <PurposeOfGrant>Food for the Needy</PurposeOfGrant>
      </RecipientTable>
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          <BusinessNameLine1>Global Health Ministries</BusinessNameLine1>
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          <City>Newton Square</City>
          <State>PA</State>
          <ZIPCode>19073</ZIPCode>
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        <EINOfRecipient>233068656</EINOfRecipient>
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        <AmountOfNonCashAssistance>6044</AmountOfNonCashAssistance>
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        <DescriptionOfNonCashAssistance>Medical Supplies</DescriptionOfNonCashAssistance>
        <PurposeOfGrant>Supplies for Mission Trips</PurposeOfGrant>
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          <BusinessNameLine1>University of Georgia - Golf Course</BusinessNameLine1>
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          <AddressLine1>2600 Riverbend Road</AddressLine1>
          <City>Athens</City>
          <State>GA</State>
          <ZIPCode>30602</ZIPCode>
        </AddressUS>
        <EINOfRecipient>586001998</EINOfRecipient>
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        <MethodOfValuation>fMV</MethodOfValuation>
        <PurposeOfGrant>Sponsorship of Station Classic Golf Tournament</PurposeOfGrant>
      </RecipientTable>
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          <BusinessNameLine1>St Marys Foundation Inc</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>1230 Baxter Street</AddressLine1>
          <City>Athens</City>
          <State>GA</State>
          <ZIPCode>30602</ZIPCode>
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        <EINOfRecipient>582544232</EINOfRecipient>
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        <MethodOfValuation>fMV</MethodOfValuation>
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        <Identifier>Procedure for Monitoring Grants in the U.S.:</Identifier>
        <ReturnReference>Part I, Line 2:</ReturnReference>
        <Explanation>Schedule I, Part I, Line 2: The type of financial assistance provided by the organization can be broken into two categories, national charities and local not-for-profit entities. The organization does not ask organizations such as the American Cancer Society and the United Way for any documentation as to how the donated funds were used. Smaller donations made to local organizations are usually event specific. A comittee reviews the donations requests and assumes the money provided pay for the program subject to the request.</Explanation>
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    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>Dev Auth - Unified Govt of Athens Series 2009</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>582613761</IssuerEIN>
        <CUSIPNumber>047059BB5</CUSIPNumber>
        <DateIssued>2009-03-19</DateIssued>
        <IssuePrice>16036560</IssuePrice>
        <DescriptionOfPurpose>Current Refunding &amp; Swap Termination</DescriptionOfPurpose>
        <Defeased>0</Defeased>
        <OnBehalfOfIssuer>0</OnBehalfOfIssuer>
        <PoolFinancing>0</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <AmountRetired>315000</AmountRetired>
        <TotalProceeds>16036560</TotalProceeds>
        <IssuanceCostsFromProceeds>296790</IssuanceCostsFromProceeds>
        <OtherSpentProceeds>15739770</OtherSpentProceeds>
        <YearOfSubstCompletion>2009</YearOfSubstCompletion>
        <CurrentRefunding>1</CurrentRefunding>
        <AdvanceRefunding>0</AdvanceRefunding>
        <FinalAllocationMade>1</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>1</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>0</Form8038TFiled>
        <VariableRateIssue>0</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>0</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>0</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>0</GrossProceedsInvested>
        <ExceptionToRebate>0</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <FedTaxRequirementsCompliance>X</FedTaxRequirementsCompliance>
      <Form990ScheduleKPartVI>
        <Identifier>Schedule K Supplental Information</Identifier>
        <Explanation>Schedule K, Part I, Bond Issues: (a) Issurer Name: Dev Auth - Unified Govt of Athens Series 2009 (f) Description of Purpose: Current Refunding &amp; Swap Termination</Explanation>
      </Form990ScheduleKPartVI>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Athens Hospitalist Services PC</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>Dr.Middendorf, officer - key employee of Athens Hospitalist Services</Relationship>
        <AmountOfTransaction>2509235</AmountOfTransaction>
        <DescriptionOfTransaction>Physician Services</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section A, line 6</ReturnReference>
        <Explanation>CHE is the sole member</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section A, line 7a</ReturnReference>
        <Explanation>Yes, CHE approves the appointment of all Board members.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section A, line 7b</ReturnReference>
        <Explanation>CHE has limited reserved powers to approve decisions of the governing body.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section B, line 11</ReturnReference>
        <Explanation>The organization took steps to educate management, members of the board and members of appropriate subcommittees of the board on the compliance requirements mandated by the Form 990. The form was reviewed by management and then submitted to the board or a subcommittee thereof which reported its findings to the board.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section B, line 12c</ReturnReference>
        <Explanation>The organization has adopted CHE's policy 103, which sets forth the organization's conflict-of-interest policy and processes. Annually, all those serving St. Mary's Health Care System in a fiduciary capacity, including directors, officers and key employees receive a copy of the policy and annual disclosure statement to be completed. Disclosures of financial interest or other reportable circumstances as defined in the policy are submitted and reviewed by the organization's CEO and board's Chair. Summary information is reported to the entire board and available to the board throughout the year as business comes before the board or management for action. The policy contains a continuing affirmative obligation on all affected individuals to disclose compensation or other circumstances throughout the year which may rise to the level of an actual or apparent conflict. The determination of whether a disclosed financial or other interest constitutes a conflict of interest is made by the board or an appropriated committee thereof comprised of dis-interested persons and without the participation of the affected individual except to respond to questions about the disclosure. The policy further addresses the procedure for the board's further consideration of the proposed transaction/matter without the participation of the affected person and the documentation of the proceedings. Lastly, the policy addresses potential disciplinary action for violations of the policy. The policy is available to the public upon request.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section B, line 15</ReturnReference>
        <Explanation>The organization has adopted CHE's process for determining compensation which includes the following: The board has an independent committee review and approve all elements of remuneration for all disqualified parties, as well as other key management. The board/committee has an established compensation philosophy which details the objectives of market postioning and pay elements. The committee engages with external consultants to provide market data comparing CHE roles to similarly sized health systems utilizing both title and job contenet comparisons. The committee reviews the market analysis, approves any salary adjustments for the executive population, considers both reasonableness and effectiveness of all remunerative programs and establishes the detailed performance expectations which are incorparated into the incentive plan. All of these discussions and decisions are documented through the provision of meeting minutes.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section C, line 19</ReturnReference>
        <Explanation>Organizational Articles of Incorporation, Corporate By-laws, governance policies believed to be of interest to the public, conflict-of-interest policy, annual community benefit report and IRS Form 990 are available upon request.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Changes in Net Assets or Fund Balances:</Identifier>
        <ReturnReference>Form 990, Part XI, line 5:</ReturnReference>
        <Explanation>Net unrealized losses on investments: -948,362. Release of Net Assets for Depreciation -214,087. Pension Adjustment -7,570,555. Contribution to Foundation 288,256. Change in Fair Value of Interest Rate Swaps -234,683. Total to Form 990, Part XI, Line 5: -8,679,431.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Explanation of financial statements:</Identifier>
        <ReturnReference>Form 990, Part XII, Line 2a &amp; 2b:</ReturnReference>
        <Explanation>While the entity does not have individual audited financial statements, an audit for CHE's consolidated financial statements was performed</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VII, Section A:</ReturnReference>
        <Explanation>Individuals compensated by a related organization have responsibilities and perform services for several related organizations including the filing organization. The amount of compensation appearing in Columns(E) and (F) reflect the services performed for this organization and its affiliates.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Explanation>Disclosure Statement Related to Form 5471 Filed by Catholic Health East and Saint Michael's Medical Center Under the constructive ownership rule of Internal Revenue Code Sections 318(a) and 958(b), the organization is required to file Form 5471, Information Return of U.S. Persons With Respect to Certain Foreign Corporations, as a Category 4 and/or Category 5 filer with respect to Stella Maris Insurance Company Limited and Chestnut Risk Services, LTD (collectively, the "foreign corporations"). This filing requirement is, or will be, satisfied through the filing of Forms 5471 with respect to the foreign corporations on the organization's behalf by the U.S. organizations identified below. Foreign Corporation: Stella Maris Insurance Company U.S. Organization: Catholic Health East Address: 3805 West Chester Pike, Suite 100, Newtown Square, Pennsylvania 19073 Identifying Number of U.S. Tax Return with Which Form 5471 was filed: 23-2929748 IRS Service Center Where U.S. Return Was Filed: Ogden, UT Foreign Corporation: Chestnut Risk Services, LTD U.S. Organization: Saint Michael's Medical Center Address: 111 Central Avenue, Newark, New Jersey 07102 Identifying Number of U.S. Tax Return with Which Form 5471 was filed: 26-2616046 IRS Service Center Where U.S. Return Was Filed: Ogden, UT</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
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          <BusinessNameLine1>Catholic Health East</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>3805 West Chester Pike Suite 100</AddressLine1>
          <City>Newtown Square</City>
          <State>PA</State>
          <ZIPCode>19073</ZIPCode>
        </AddressUS>
        <EIN>232929748</EIN>
        <PrimaryActivities>Management Services</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>Line 11a, I</PublicCharityStatus>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <ControlledOrg>1</ControlledOrg>
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          <BusinessNameLine1>Continuing Care Management Services Network</BusinessNameLine1>
        </NameOfDisregardedEntity>
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          <AddressLine1>3805 West Chester Pike Suite 100</AddressLine1>
          <City>Newtown Square</City>
          <State>PA</State>
          <ZIPCode>19073</ZIPCode>
        </AddressUS>
        <EIN>352336834</EIN>
        <PrimaryActivities>Management &amp; Support Services</PrimaryActivities>
        <LegalDomicileState>PA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>Line 11b, II</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Catholic Health East</BusinessNameLine1>
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        <ControlledOrg>1</ControlledOrg>
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          <BusinessNameLine1>Mercy Health System of Maine</BusinessNameLine1>
        </NameOfDisregardedEntity>
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          <AddressLine1>144 State Street</AddressLine1>
          <City>Portland</City>
          <State>MA</State>
          <ZIPCode>04101</ZIPCode>
        </AddressUS>
        <EIN>010484074</EIN>
        <PrimaryActivities>Management &amp; Support Services</PrimaryActivities>
        <LegalDomicileState>ME</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>Line 11c, III-FI</PublicCharityStatus>
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          <BusinessNameLine1>Catholic Health East</BusinessNameLine1>
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          <BusinessNameLine1>Mercy Hospital</BusinessNameLine1>
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          <AddressLine1>144 State Street</AddressLine1>
          <City>Portland</City>
          <State>MA</State>
          <ZIPCode>04101</ZIPCode>
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          <BusinessNameLine1>St Peter's Health Partners</BusinessNameLine1>
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          <City>Albany</City>
          <State>NY</State>
          <ZIPCode>12208</ZIPCode>
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        <PrimaryActivities>Management &amp; Support Services</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>Line 11b, II</PublicCharityStatus>
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          <BusinessNameLine1>St Peter's Health Care Services</BusinessNameLine1>
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          <AddressLine1>315 South Manning Blvd</AddressLine1>
          <City>Albany</City>
          <State>NY</State>
          <ZIPCode>12208</ZIPCode>
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        <PrimaryActivities>Management &amp; Support Services</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>Line 9</PublicCharityStatus>
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          <BusinessNameLine1>St Peter's Health Partners</BusinessNameLine1>
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          <AddressLine1>315 South Manning Blvd</AddressLine1>
          <City>Albany</City>
          <State>NY</State>
          <ZIPCode>12208</ZIPCode>
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        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>Line 3</PublicCharityStatus>
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          <BusinessNameLine1>St Peter's Health Care Services</BusinessNameLine1>
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          <BusinessNameLine1>St Peter's Hospital Foundation Inc</BusinessNameLine1>
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          <AddressLine1>319 South Manning Blvd Suite 309</AddressLine1>
          <City>Albany</City>
          <State>NY</State>
          <ZIPCode>12208</ZIPCode>
        </AddressUS>
        <EIN>222262982</EIN>
        <PrimaryActivities>Fundraising &amp; Public Relations</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>Line 7</PublicCharityStatus>
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          <BusinessNameLine1>St Peter's Health Care Services</BusinessNameLine1>
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        <ControlledOrg>1</ControlledOrg>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>Eddy Licensed Home Care Agency</BusinessNameLine1>
        </NameOfDisregardedEntity>
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          <AddressLine1>433 River St Suite 3000</AddressLine1>
          <City>Troy</City>
          <State>NY</State>
          <ZIPCode>12180</ZIPCode>
        </AddressUS>
        <EIN>141818568</EIN>
        <PrimaryActivities>Home Health</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>Line 3</PublicCharityStatus>
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          <BusinessNameLine1>LTC(Eddy) Inc</BusinessNameLine1>
        </DirectControllingEntityName>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>The Community Hospice Foundation Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
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          <AddressLine1>295 Valley View Blvd</AddressLine1>
          <City>Rensselaer</City>
          <State>NY</State>
          <ZIPCode>12144</ZIPCode>
        </AddressUS>
        <EIN>222692940</EIN>
        <PrimaryActivities>Fundraising &amp; Public Relations</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>Line 7</PublicCharityStatus>
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          <BusinessNameLine1>The Community Hospice Inc</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>1</ControlledOrg>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>The Community Hospice Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
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          <AddressLine1>295 Valley View Blvd</AddressLine1>
          <City>Rensselaer</City>
          <State>NY</State>
          <ZIPCode>12144</ZIPCode>
        </AddressUS>
        <EIN>141608921</EIN>
        <PrimaryActivities>Serving seriously ill people &amp; their families</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>Line 3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>St Peter's Health Care Services</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>1</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Villa Mary Immaculate</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>301 Hackett Blvd</AddressLine1>
          <City>Albany</City>
          <State>NY</State>
          <ZIPCode>12208</ZIPCode>
        </AddressUS>
        <EIN>141438749</EIN>
        <PrimaryActivities>Nursing Home &amp; Physical Rehab</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>Line 3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>St Peter's Hospital</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>1</ControlledOrg>
      </Form990ScheduleRPartII>
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          <BusinessNameLine1>Warde Service Corporation Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>159 Wolf Road 3rd Floor</AddressLine1>
          <City>Albany</City>
          <State>NY</State>
          <ZIPCode>12205</ZIPCode>
        </AddressUS>
        <EIN>141732097</EIN>
        <PrimaryActivities>Supporting &amp; strengthing the ministries of rel. sr. mercy</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>Line 9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>St Peter's Health Care Services</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>1</ControlledOrg>
      </Form990ScheduleRPartII>
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          <BusinessNameLine1>Mercy Care for Kids Inc</BusinessNameLine1>
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          <AddressLine1>310 South Manning Blvd</AddressLine1>
          <City>Albany</City>
          <State>NY</State>
          <ZIPCode>12208</ZIPCode>
        </AddressUS>
        <EIN>141717564</EIN>
        <PrimaryActivities>Day care center</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>Line 9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>St Peter's Health Care Services</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>1</ControlledOrg>
      </Form990ScheduleRPartII>
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          <BusinessNameLine1>Our Lady of Mercy Life Center</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2 Mercycare Lane</AddressLine1>
          <City>Guilderland</City>
          <State>NY</State>
          <ZIPCode>12084</ZIPCode>
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          <BusinessNameLine1>Mercy Hospital Inc</BusinessNameLine1>
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          <BusinessNameLine1>Mercy Outpatient Services Inc DBA Sister Emmanuel Hospital</BusinessNameLine1>
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          <AddressLine1>3663 South Miami Avenue</AddressLine1>
          <City>Miami</City>
          <State>FL</State>
          <ZIPCode>33133</ZIPCode>
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          <BusinessNameLine1>Mercy Hospital Inc</BusinessNameLine1>
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          <BusinessNameLine1>Global Health Ministry</BusinessNameLine1>
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          <AddressLine1>3805 West Chester Pike Suite 100</AddressLine1>
          <City>Newtown Square</City>
          <State>PA</State>
          <ZIPCode>19073</ZIPCode>
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        <PrimaryActivities>Health Care</PrimaryActivities>
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          <BusinessNameLine1>Catholic Health East</BusinessNameLine1>
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          <BusinessNameLine1>VNA Home Health &amp; Hospice</BusinessNameLine1>
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          <AddressLine1>50 Foden Road</AddressLine1>
          <City>South Portland</City>
          <State>ME</State>
          <ZIPCode>04106</ZIPCode>
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        <PrimaryActivities>Home Health &amp; Hospice</PrimaryActivities>
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          <BusinessNameLine1>Mercy Health System of Maine</BusinessNameLine1>
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          <BusinessNameLine1>Providence Place Inc</BusinessNameLine1>
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          <AddressLine1>5 Gamelin Street</AddressLine1>
          <City>Holyoke</City>
          <State>MA</State>
          <ZIPCode>01040</ZIPCode>
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          <BusinessNameLine1>Sisters of Providence Health System Inc</BusinessNameLine1>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>Intercoastal Health Systems</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>3805 West Chester Pike Suite 100</AddressLine1>
          <City>Newtown Square</City>
          <State>PA</State>
          <ZIPCode>19073</ZIPCode>
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        <EIN>650556413</EIN>
        <PrimaryActivities>Management &amp; Support Services</PrimaryActivities>
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        <DirectControllingEntityName>
          <BusinessNameLine1>Catholic Health East</BusinessNameLine1>
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        <ControlledOrg>1</ControlledOrg>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>Sunnyview Hospital &amp; Rehabilitation Center Foundation</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>1270 Belmont Ave</AddressLine1>
          <City>Schenectady</City>
          <State>NY</State>
          <ZIPCode>12308</ZIPCode>
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        <EIN>222505127</EIN>
        <PrimaryActivities>Supporting foundation</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
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          <BusinessNameLine1>Sunnyview Hospital &amp; Rehabilitation Ctr</BusinessNameLine1>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>St Peter's Ambulatory Surgery Center LLC</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>1375 Washington Avenue Ste 201</AddressLine1>
          <City>Albany</City>
          <State>NY</State>
          <ZIPCode>12206</ZIPCode>
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        <EIN>460463892</EIN>
        <PrimaryActivity>Surgery</PrimaryActivity>
        <LegalDomicileState>NY</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Catherine Horan Building Limited Partnership</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>1221 Main Street Room 108</AddressLine1>
          <City>Holyoke</City>
          <State>MA</State>
          <ZIPCode>010400000</ZIPCode>
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        <EIN>042723429</EIN>
        <PrimaryActivity>Property Management</PrimaryActivity>
        <LegalDomicileState>MA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>Western Massachusetts PETCT Imaging Center LLC</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>100 Bayview Circle Ste 400</AddressLine1>
          <City>Newport Beach</City>
          <State>CA</State>
          <ZIPCode>92660</ZIPCode>
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        <EIN>204744663</EIN>
        <PrimaryActivity>Outpatient Medical Services</PrimaryActivity>
        <LegalDomicileState>DE</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Central New Jersey Heart Services LLC</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>10720 Sikes Places Ste 300</AddressLine1>
          <City>Charlotte</City>
          <State>NC</State>
          <ZIPCode>28277</ZIPCode>
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        <EIN>208525458</EIN>
        <PrimaryActivity>Cardiac Program</PrimaryActivity>
        <LegalDomicileState>NJ</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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          <BusinessNameLine1>Langhorne MOB Partners LP</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>1201 Langhorne-Newtown Road</AddressLine1>
          <City>Langhorne</City>
          <State>PA</State>
          <ZIPCode>19047</ZIPCode>
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        <EIN>232622772</EIN>
        <PrimaryActivity>Investment and operation of a medical building</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>SMMC MOB II LP</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>1201 Langhorne-Newtown Road</AddressLine1>
          <City>Langhorne</City>
          <State>PA</State>
          <ZIPCode>19047</ZIPCode>
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        <EIN>364559869</EIN>
        <PrimaryActivity>Investment and operation of a medical building</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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          <BusinessNameLine1>The Ambulatory Surgery Center at St Mary LLC</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>1203 Langhorne-Newton Road</AddressLine1>
          <City>Langhorne</City>
          <State>PA</State>
          <ZIPCode>19047</ZIPCode>
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        <EIN>232871206</EIN>
        <PrimaryActivity>Outpatient Surgery</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>AmeriHealth Mercy Health Plan</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>200 Stevens Drive Suite 350</AddressLine1>
          <City>Philadelphia</City>
          <State>PA</State>
          <ZIPCode>19113</ZIPCode>
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        <EIN>232859523</EIN>
        <PrimaryActivity>Medicaid Managed Care Organization</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Amerihealth Mercy of Indiana LLC</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>200 STEVENS DRIVE Suite 350</AddressLine1>
          <City>Philadelphia</City>
          <State>PA</State>
          <ZIPCode>19113</ZIPCode>
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        <EIN>204948091</EIN>
        <PrimaryActivity>PREPAID HEALTH CARE SERVICES</PrimaryActivity>
        <LegalDomicileState>IN</LegalDomicileState>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>East Norriton Medical Associates</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>One West Elm Street</AddressLine1>
          <City>Conshohocken</City>
          <State>PA</State>
          <ZIPCode>19428</ZIPCode>
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        <EIN>232319531</EIN>
        <PrimaryActivity>Medical Office Building</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>East Norriton Medical Associates</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>One West Elm Street</AddressLine1>
          <City>Conshohocken</City>
          <State>PA</State>
          <ZIPCode>19428</ZIPCode>
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        <EIN>232319531</EIN>
        <PrimaryActivity>Medical Office Building</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Gateway Health Plan</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>300 Grant Street</AddressLine1>
          <City>Pittsburgh</City>
          <State>PA</State>
          <ZIPCode>15219</ZIPCode>
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        <PrimaryActivity>Medicaid &amp; Medicare/Special Needs Managed Care Organization</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Keystone Mercy Health Plan</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>100 Stevens Drive</AddressLine1>
          <City>Philadelphia</City>
          <State>PA</State>
          <ZIPCode>19113</ZIPCode>
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        <PrimaryActivity>Medicaid Managed Care Organization</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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          <BusinessNameLine1>MercyManor Partnership</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>PO Box 10086</AddressLine1>
          <City>Toledo</City>
          <State>OH</State>
          <ZIPCode>436990086</ZIPCode>
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        <EIN>521931012</EIN>
        <PrimaryActivity>Nursing Home</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>St Agnes Long Term Intensive Care LLP</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>1900 S Broad Street</AddressLine1>
          <City>Philadelphia</City>
          <State>PA</State>
          <ZIPCode>19145</ZIPCode>
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        <EIN>200984882</EIN>
        <PrimaryActivity>Long Term Intensive Care</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Nazareth Medical Office Building Associates LP</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>c/o Nazareth Hospital 2601 Holme Av</AddressLine1>
          <City>Philadelphia</City>
          <State>PA</State>
          <ZIPCode>19152</ZIPCode>
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        <PrimaryActivity>Medical Office Building</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>Nazareth Medical Office Building Associates LP</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>c/o Nazareth Hospital 2601 Holme Av</AddressLine1>
          <City>Philadelphia</City>
          <State>PA</State>
          <ZIPCode>19152</ZIPCode>
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        <EIN>232388040</EIN>
        <PrimaryActivity>Medical Office Building</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>St Agnes Long Term Intensive Care LLP</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>1900 S Broad Street</AddressLine1>
          <City>Philadelphia</City>
          <State>PA</State>
          <ZIPCode>19145</ZIPCode>
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        <EIN>200984882</EIN>
        <PrimaryActivity>Long Term Intensive Care</PrimaryActivity>
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          <BusinessNameLine1>SJV Management LLC</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>200 Century Pkwy Ste 200E</AddressLine1>
          <City>Mount Laurel</City>
          <State>NJ</State>
          <ZIPCode>08054</ZIPCode>
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        <LegalDomicileState>NJ</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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          <BusinessNameLine1>Physicians Outpatient Surgery Center LLC</BusinessNameLine1>
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          <AddressLine1>1000 NE 56th</AddressLine1>
          <City>Oakland Park</City>
          <State>FL</State>
          <ZIPCode>33334</ZIPCode>
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        <EIN>352325646</EIN>
        <PrimaryActivity>Ambulatory Surgery Center</PrimaryActivity>
        <LegalDomicileState>FL</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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          <BusinessNameLine1>Center for Surgery &amp; Digestive Orders</BusinessNameLine1>
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          <AddressLine1>3641 South Miami Avenue</AddressLine1>
          <City>Miami</City>
          <State>FL</State>
          <ZIPCode>33133</ZIPCode>
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        <PrimaryActivity>Outpatient Medical Services</PrimaryActivity>
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          <BusinessNameLine1>Samaritan Medical Office Building Inc</BusinessNameLine1>
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          <AddressLine1>2212 Burdett Avenue</AddressLine1>
          <City>Troy</City>
          <State>NY</State>
          <ZIPCode>12180</ZIPCode>
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          <BusinessNameLine1>Affiliated Management Services Corporation Inc</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>1300 Massachusetts Avenue</AddressLine1>
          <City>Troy</City>
          <State>NY</State>
          <ZIPCode>12180</ZIPCode>
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        <PrimaryActivity>Real Estate</PrimaryActivity>
        <LegalDomicileState>NY</LegalDomicileState>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Catherine Horan Building Inc</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>c/o SPHS 1221 Main Street Suite 108</AddressLine1>
          <City>Holyoke</City>
          <State>MA</State>
          <ZIPCode>010400000</ZIPCode>
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        <EIN>042938180</EIN>
        <PrimaryActivity>Building Management</PrimaryActivity>
        <LegalDomicileState>MA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C</TypeOfEntity>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Diversified Community Services Inc</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>c/o SPHS 1221 Main Street Suite 108</AddressLine1>
          <City>Holyoke</City>
          <State>MA</State>
          <ZIPCode>010400000</ZIPCode>
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        <EIN>043128890</EIN>
        <PrimaryActivity>Medical Services</PrimaryActivity>
        <LegalDomicileState>MA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C</TypeOfEntity>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Mercy Inpatient Medical Associates Inc</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>c/o SPHS 1221 Main Street Suite 108</AddressLine1>
          <City>Holyoke</City>
          <State>MA</State>
          <ZIPCode>010400000</ZIPCode>
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        <EIN>043029829</EIN>
        <PrimaryActivity>Medical Services</PrimaryActivity>
        <LegalDomicileState>MA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C</TypeOfEntity>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Providence Home Care Inc</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>c/o SPHS 1221 Main Street Suite 108</AddressLine1>
          <City>Holyoke</City>
          <State>MA</State>
          <ZIPCode>010400000</ZIPCode>
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        <EIN>043317426</EIN>
        <PrimaryActivity>Health Care Services</PrimaryActivity>
        <LegalDomicileState>MA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C</TypeOfEntity>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>System Coordinated Services Inc</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>c/o SPHS 1221 Main Street Suite 108</AddressLine1>
          <City>Holyoke</City>
          <State>MA</State>
          <ZIPCode>010400000</ZIPCode>
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        <EIN>042938181</EIN>
        <PrimaryActivity>Lab Services</PrimaryActivity>
        <LegalDomicileState>MA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C</TypeOfEntity>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Physicians Medical Office Building Condominium Trust</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>1221 Main Street Room 108</AddressLine1>
          <City>Holyoke</City>
          <State>MA</State>
          <ZIPCode>010400000</ZIPCode>
        </AddressUS>
        <EIN>046608649</EIN>
        <PrimaryActivity>Property Management</PrimaryActivity>
        <LegalDomicileState>MA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C</TypeOfEntity>
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      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>SJM Properties Inc</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>411 Canisteo Street</AddressLine1>
          <City>Hornell</City>
          <State>NY</State>
          <ZIPCode>148482104</ZIPCode>
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        <EIN>161294991</EIN>
        <PrimaryActivity>Property Holdings</PrimaryActivity>
        <LegalDomicileState>NY</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C</TypeOfEntity>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Carbondale Area Physicians' Association PC</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>100 Lincoln Ave</AddressLine1>
          <City>Carbondale</City>
          <State>PA</State>
          <ZIPCode>18407</ZIPCode>
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        <EIN>232801677</EIN>
        <PrimaryActivity>Medical Insurance Contracting</PrimaryActivity>
        <LegalDomicileState>PA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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          <City>Hamilton</City>
          <Country>BD</Country>
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          <AddressLine1>600 Grant Street</AddressLine1>
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          <State>VA</State>
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</Return>