2012-11-15T08:43:25-06:00 2011-12-31 861065772 Deloitte Tax LLP 1700 Market Street 25th Floor Philadelphia PA 191033984 990 2011-01-01 590791034 Mercy Hospital Inc MERC 3052852904 3663 South Miami Avenue Miami FL 33133 Linda V Wilford 3052852904 2012-11-15 1 William J Homer P00994519 2152462300 2011 2016-02-24 21:20:13Z Linda V Wilford 4725 North Federal Highway Ft Lauderdale FL 333081603 85336184 0 0928 X www.mercymiami.org X 1945 FL Mercy Hospital, Inc. is a member of the Mercy Hospital, Miami Health System. In witness of Jesus' Healing Mission, Mercy Hospital, Miami strives to improve the well-being of those served through a healthcare delivery system designed to promote wellness and cure illness. As a ministry of the Roman Catholic Church and a member of Catholic Health East ("CHE"), we are committed to being a transforming, healing presence within our community. X 6 4 1962 394 4286031 0 8467624 1520999 239588630 74124428 409582 -468024 18174024 9487491 266639860 84664894 56799 12500 0 0 113558141 35889561 0 0 0 186778182 58852396 300393122 94754457 -33753262 -10089563 225827975 24431621 238363700 47138225 -12535725 -22706604 X In witness of Jesus' healing mission, Mercy Hospital strives to improve the well-being of those served through a healthcare delivery system designed to promote wellness and cure illness. As a ministry of the Roman Catholic Church and a member of Catholic Health East, we are committed to being a transforming, healing presence within our community. Adopting the spirit of the Sisters of St. Joseph in "working to achieve unity of neighbor with neighbor and neighbor with God", we attest to the value of human life in all its cycles. This is done through respect for the unborn and recognition of the transcendent meaning of suffering and death by combining professional excellence with a compassionate concern for the whole person. We seek to understand and respond to the needs of our community through collaboration with others that share a common mission and vision. With attention to fiscal responsibility, quality services are made available and accessible to those who need them. 0 1 79336030 12500 74124428 Mercy Hospital is dedicated to providing the highest quality & health care services to Miami and the surrounding 93 communities, including an emergency department that is open 24 hours per day, which provides emergency medical care without regard to the patients' ability to pay. Mercy Hospital's mission includes charity care for those in need, within the limits of the financial resources of the hospital. Other community services include religious services, contributions to charitable organizations, donations to the community, and patient transportation. 79336030 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 1 0 0 0 1 0 0 0 1 0 1 1 1 0 0 1 270 0 1 1962 1 1 1 0 0 0 0 0 0 0 0 0 0 X 6 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 FL X Linda V Wilford 9547763012 3663 South Miami Avenue Miami FL 331334253 X Basil Bernard 1.00 X 0 0 0 John Dasburg 1.00 X 0 0 0 Patrick Dwyer 1.00 X 0 0 0 J Patrick Fitzgerald 1.00 X 0 0 0 Ricardo Girala MD Sch O 1.00 X 107376 0 8035 Jeffrey Horstmyer MD Sch O 1.00 X 78632 0 0 Sister Ann Kuhn SSJ 1.00 X 0 0 0 Leonardo Lopez MD Sch O 1.00 X 5780 0 0 Sister Margaret Mary Lyons SSJ 1.00 X 0 0 0 Marilu Madrigal MD 1.00 X 0 0 0 Rev Monsignor Tomas Marin 1.00 X 0 0 0 Nikki Simon 1.00 X 0 0 0 Sister Jane Stoecker SSJ 1.00 X 0 0 0 Sr Carol E Stovall SSJ Sch O 24.00 X 0 0 0 Ramon Usategui 1.00 X 0 0 0 Sister Elizabeth Worley SSJ 1.00 X 0 0 0 Sister Barbara Cekosh SSJ 1.00 X 0 0 0 Sister Edith Gonzalez Sch O 40.00 X 0 0 0 Patrick K McGrath III 1.00 X 0 0 0 Rolando J De Leon MD 1.00 X 3780 0 0 Dr Manuel P Anton III 40.00 X X 0 474209 14294 John C Johnson Sch O 1.00 X X 0 1767780 33523 Linda Wilford Sch O 16.00 X X 0 517539 164307 Laura Dominguez RN 40.00 X 94945 0 7190 Edward Rundle 40.00 X 95336 0 2392 Mariluz Guzman 40.00 X 186272 0 7315 Martha T Acosta 40.00 X 205409 0 4858 Estrella King-Bryant 40.00 X 189530 0 5675 Gerard J Barrios MD 40.00 X 207256 0 8025 Frances Reese 40.00 X 281550 0 3458 Manuel Mayor MD 40.00 X 188825 0 6086 Carlos Moas MD 0.00 X 18112 0 0 John Matuska 0.00 X 0 637207 12532 1662803 3396735 277690 19 1 1 0 Cardinal Health Florida 2045 Interstate Dr Lakeland FL 33805 Medical 8034898 Neighborhood Health PO Box 025680 Miami FL 33102 Insurance 3796999 Cardinal Health (Allegiance) PO Box 95600 Alburquerque NM 87100 Medical 2407182 Florida's Blood Centers Inc 8669 Commodity Circle Orlando FL 32819 Medical 1384688 Sheridan Healthcorp Inc PO Box 452197 Sunrise FL 333232197 Medical 751205 89 75028 1445971 1520999 Net Patient Revenue 621110 73820158 73820158 Nursing School 611600 242891 242891 Childbirth/Lactation 611600 61379 61379 74124428 203266 203266 8961 0 8961 8961 8961 667806 3484 -667806 -3484 -671290 -671290 Pharmacy 446110 4188722 -97309 4286031 Research Revenue 541700 102657 102657 X-ray MRI Revenue 621500 18282 18282 5168869 5168869 9478530 84664894 79316927 4286031 -459063 12500 12500 672991 305738 367253 28973249 25789616 3183633 3740703 3067376 673327 2502618 2127225 375393 264490 264490 989812 989812 -54159 -54159 559014 559014 783380 232427 550953 3933499 3382809 550690 1111724 1111724 18670 18670 1358516 271703 1086813 157 133 24 4245776 3863656 382120 Medical Supplies 17791091 17791091 Prov. for Bad Debts 10845432 10845432 Professional Fees 10740540 8377621 2362919 Contracted Health Care 1844982 1844982 4419472 311997 4107475 94754457 79336030 15418427 0 1 4708272 7075225 642896 32308340 6890066 0 1251875 1235649 0 141023288 25854141 7530506 13149096 8590241 225827975 24431621 74455628 19418605 120140000 0 43768072 27719620 238363700 47138225 X -12732938 -22706604 197213 0 0 -12535725 -22706604 225827975 24431621 X -10089563 -81316 X X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 1 0 0 0 0 1 12000 0 0 12000 0 Explanation of Lobbying Activities: Part II-B, Line 1: The hospital engaged local lobbyist to lobby on its behalf. According to the contract between the lobbyist and the hospital the lobbyist was to: 1. Provide representation before all relevant state agencies, notably the Agency for Health Care Administration. Representation included a full range of responsibilities including Certificate of Need, Medicaid reimbursement and similar regulatory issues; and, 2. Provide representation before the Florida Legislature on relevant substantive issues as well as appropriations issues. 1 0 Other Receivables 1319809 Investments in Unconsolidated Subsidiaries 1006452 Other Receivables - Life Insurance 161857 Other Receivables - Reverse Split Dollar Insurance 3660123 Workers Compensation Insurance Recoverable 2442000 8590241 Third Party Payable 10829762 Due to Affiliates 352939 Other Liabilities 6790423 Payable to CHE 6069259 Workers Comp - Gross Liability 2442000 Asset Retirement Obligation 983934 Escheat Payable 166602 FICA Taxes Payable 13799 Social Security Tax Withheld 10902 Unemployment Taxes 60000 27719620 1 1 1 X 1 X 1 1 0 1 1 1242585 1242585 0.01480 4904284 4904284 0.05840 860804 860804 0.01030 7007673 7007673 0.08350 401858 401858 0.00480 185775 2259728 -2073953 0.00000 587633 2259728 -1672095 0.00480 7595306 2259728 5335578 0.08830 1 2024842 526459 22514103 21530975 983128 X 1 1 1 Center for Surgery & Digestive Disorders LLC Health Services 0.50000 0.50000 1 1 Mercy Hospital Inc

3663 South Miami Avenue Miami FL 33133

X X X X X Long term care, Hospice, O/P facility Mercy Hospital Inc 1 1 1 200.000000000000 1 200.000000000000 1 X X X X X X X 1 1 X X X X 1 0 1 X X 0 0 Part I, Line 6a: The organization's 2011 community benefit report was included with the community benefit report of Catholic Health East. Part I, Line 7: 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 gross patient charges. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 10845432. Part III, Line 4: The organization writes off patient balances to bad debt expense (deductibles or coinsurance amounts) based on the following procedures: 1. The debt must be related to covered services and derived from deductibles and coinsurance amounts.2. The hospital must be able to establish the reasonable collection efforts were made.3. The debt must actually be uncollectible when claimed as worthless.4. Sound business judgment must be used to establish that there was no likelihood of recovery at any time in the future.Discounts on patient accounts are not included as bad debt expense. Discounts are entered as adjustments to reflect actual expected reimbursements. The organization does not attribute bad debt expenses to patients eligible for charity care. This is evident in the organization's charity policy. Charity care is recorded at cost utilizing the latest cost-to-charge ratio on the most recent audited Medicare cost report.Allowance for Uncollectible Accounts: The Medical Center provides an allowance for doubtful accounts for estimated losses resulting from the unwillingness of patients or third party payors to make payments for services. The allowance is determined by analyzing historical data and trends. Accounts receivable are charged off against the allowance for doubtful accounts when management determines that recovery is unlikely and the Medical Center ceases collection efforts.Charity Care:The Medical Center provides services to patients regardless of ability to pay. In accordance with the Medical Centers policy, a patient is classified as a charity patient based on income eligibility criteria as established by the Federal Poverty Guidelines. Charges for services to patients who meet the Medical Center's guidelines for charity care are not reflected in the accompanying combined financial statements as revenue. The charges associated with these services for charity care provided by the Medical Center approximate $7,595,000 and $16,337,000 in 2011 and 2010, respectively. These amounts do not include the provision for bad debts totaling $10,845,432 and $28,504,000 in 2011 and 2010, respectively, which is reflected separately in the consolidated statements of operations and changes in net assets. Part III, Line 8: The costing methodology or sourced used to determine the amount reported on line 6 is the costing methodology in the Medicare Cost Report which includes routine cost per day apportioned based by Medicare volume (days) and cost-to-charge ratios apportioned based on Medicare charges for ancillary areas.There is no shortfall reported in Part III, line 7. Had there have been a shortfall, none of the shortfall would have been treated as community benefit. Part III, Line 9b: A bad debt does not meet the criteria for Charity Care in that bad debt patients are considered to have the financial capacity and ability to pay, but are unwilling to pay. Unpaid balances are passed to a collection agency after 120 days if there has been no indication of intent to pay. Exceptions to placement with a collection agency include the following: Accounts where there is a pending application for Charity Care or Medicaid, discharged in bankruptcy, granted Charity Care, incarcerated patients, known to be homeless or indigent, and in which a complaint has been filed in a court of law. Mercy Hospital, Inc. Part V, Section B, Line 19d: In addition to Medicare rates the hospital facility used federal poverty guidelines at 200% or below to determine amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care. Part VI, Line 2: In 2011, Mercy Hospital improved the lives of many underserved and uninsured people through healthcare services, health screenings, educational and informational programs and transportation services. These programs were developed to address and improve the overall health and wellness of our community. In addition, our employees, support staff and affiliated physicians volunteered thousands of hours for countless community programs and other charitable organizations. Part VI, Line 3: Charity Care is provided to a patient with a demonstrated inability to pay. A patient is eligible for Charity Care consideration based upon meeting certain income eligibility criteria as established by the Federal Poverty Income Guideline Sliding Scale. When patients arrive at the hospital, those who are uninsured are informed of the hospital's charity care policy through a meeting with a representative. The representative reviews the charity care pamphlet with the patient to determine eligibility for charity care. The patient then completes a statement of financial condition in order to determine to what extent they would qualify for charity care. The hospital's charity care policy is also posted in various areas of the hospital.Mercy Hospital strongly prefers to perform financial screening upon scheduling, admission or registration (discharge processing in the ED) as part of the overall Financial Counseling process. Patients who represent increased financial risk as a result of the amount they are expected to owe "out-of-pocket" should be referred to a Financial Counselor for assistance in applying for alternative payment programs (e.g., Medical Assistance) determining Charity Care eligibility, establishing payment plans or other financing arrangements. Financial Counseling services are to be made available to all elective, urgent and emergent patients. Patients with insurance other than that afforded low-income individuals should not have their patient liability unpaid balance, coinsurance, deductible or non-covered service written-off to Charity Care unless financial hardship can be proven. Part VI, Line 4: In witness of Jesus' healing mission, Mercy Hospital strives to improve the well-being of those served through a health care delivery system designed to promote wellness and cure illness. The majority of the patients Mercy Hospital serves are residents of Miami-Dade Country, Florida. Miami-Dade, the most populous county in Florida, is densely populated, with more than three times the number of person per square mile than Florida's average population density. In 2011 the county's population was 64.5 percent Hispanic; 16 percent White non-Hispanic: 19.3 percent Black non Hispanic: 1.7 Asian & Pacific Islanders; and 1.5 percent all others. The percentage of Hispanics has increased since 2005. The percentage of foreign born persons in Miami-Dade County in 2011 was 51.1 percent, and 71.9 percent of Miami-Dade Country residents had a language other than English spoken at home. In 2011 Miami-Dade County had 14.2 percent of its population in the 65+ age group. 17.2 percent of the county's residents live in poverty and the median household income was $43,605. 77% of Miami-Dade adults aged 25+ had a high school degree, while nationally that percentage is 84.9. The unemployment rate for Miami-Dade County is currently around 10% versus the National rate of 8.2%. Part VI, Line 5: The St. John Bosco Clinic (which was part of Mercy Hospital, Inc.) is a beacon of hope to the under privileged adults and children of Miami-Dade County. The Clinic is a parish-based primary care program staffed by volunteer physicians, support staff and Mercy Hospital employees. It provides free healthcare to children and adults who are not eligible for healthcare programs in the county. Mercy Hospital supports the clinic by providing medical supplies as well as paying the salary of nurse practitioners. Part VI, Line 6: As Miami-Dade County's only Catholic hospital, Mercy Hospital is sponsored by the Sisters of St. Joseph, Florida and is part of Catholic Health East. Since its inception in 1950, Mercy Hospital has maintained its reputation for excellence while following the Catholic tradition of caring for God's people and providing spiritual support.Mercy Hospital provides excellent medical care and cares to the physicial an spiritual needs of the local community through several affiliated organizations. These affiliates include the following:Mercy Hospital Foundation (EIN: 59-1709438)-------------------------------------------Mercy Foundation supports Mercy Hospital and its entities in providing compassionate and quality medical care to the South Florida community. The Foundation is dedicated to meeting the critical needs of the hospital and its medical staff by raising funds for priority projects, capital improvements, outreach programs and charity care.Because Mercy Hospital's capital needs exceed funds available, contributions from grateful patients, generous philanthropists, private foundations and corporations, enhance and expand vital projects that make a difference in the medical care for our community.Mercy Mission Services (EIN: 65-0435764)----------------------------------------Mercy Mission Services support Mercy Hospital in the hospital's provision of healthcare to the community through charity care and community outreach programs. Mercy Medical Development (EIN: 59-2789194)-------------------------------------------Mercy Medical Development supports Mercy Hospital by offering outpatient diagnostic services to the community including outpatient visits for various lab tests, diagnostic imaging, and physical examinations.Mercy Outpatient Services (DBA Sister Emmanual Hospital (EIN: 51-0461511)-------------------------------------------Sister Emmanuel Hospital is a hospital within a hospital providing long-term acute care services by a specified, interdisciplinary treatment team for those with complex medical conditions. The hospital offers a 29-bed, telemetry monitoring, and 6 ventilators. As a long-term care hospital, patients remain in the facility for an average of 25 days. The hospital is committed to "embracing challenges one patient at a time". Part VI, Line 7, List of States Receiving CHE's Community Benefit Report: FL, ME, PA, NY, CT, MA, AL, GA, DE, NC 1 Coconut Grove Arts & Historical 3390 Mary Street 128 Coconut Grove FL 33133 363049954 501(c)(3) 12500 Sponsorship of the Coconut Grove Arts Festival 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The organization grants money to the Coconut Grove Historial Association for their annual Arts Festival in order to provide first aid services to individuals attending the festival. The organization had employees work the booth that provided first-aid in order to make sure funds were indeed spent on first-aid. 1 0 0 0 0 0 0 0 0 Dr Manuel P Anton III 0 172541 0 149547 0 152121 0 4831 0 9463 0 488503 0 0 John C Johnson Sch O 0 600000 0 259875 0 907905 0 11025 0 22498 0 1801303 0 0 Linda Wilford Sch O 0 304065 0 101402 0 112072 0 150736 0 13571 0 681846 0 0 Mariluz Guzman 107035 0 0 0 79237 0 4582 0 2733 0 193587 0 0 0 Martha T Acosta 18720 0 3640 0 183049 0 897 0 3961 0 210267 0 0 0 Estrella King-Bryant 34423 0 0 0 155107 0 1605 0 4070 0 195205 0 0 0 Gerard J Barrios MD 203875 0 0 0 3381 0 0 0 8025 0 215281 0 0 0 Frances Reese 39320 0 4830 0 237400 0 1467 0 1991 0 285008 0 0 0 Manuel Mayor MD 162415 0 0 0 26410 0 0 0 6086 0 194911 0 0 0 Carlos Moas MD 18112 0 0 0 0 0 0 0 0 0 18112 0 0 0 John Matuska 0 0 0 0 0 637207 0 0 0 12532 0 649739 0 0 Part I, Line 3 Part I, Line 3: The organization relied on a related organization that used one or more of the methods described below to establish the top management official's compensation: - Compensation committee - Independent compensation consultant - Written employment contract - Compensation survey or study - Approval by the board or compensation committee. Manuel P Anton Collateral Assignment in executive split dollar plan. X 593100 593100 0 1 1 Edward P Rundle Collateral Assignment in executive split dollar plan. X 224000 224000 0 1 1 817100 Neuroscience Consultants Interested person is business owned by a board member 15500 Dr. Jeffrey Horstmyer, MD was a Mercy Hospital, Inc. board member during part of 2011 and is also a greater than 5% owner of Neuroscience Consultants, a neuroscience medical practice. During 2011 Mercy Hospital paid Neuroscience Consultants $15,500 in physician fees for neuroscience services provided to the hospital. 0 Sleep Services Management Interested person is business owned by former board member 217800 Dr. Carlos Moas, MD is a former board member of Mercy Hospital and has 10% ownership in Sleep Service Management, a sleep lab service. During 2011 Mercy Hospital paid Sleep Services Management $217,800 for sleep lab services provided to the hospital. 0 Hospital Assets 2011-05-01 131202341 Book Value 621372389 Plantation General Hospital LP 3663 South Miami Avenue Miami FL 33133 Corporation 0 1 0 0 Part II, Line 2e: The following individuals were either an officer, director, trustee or key employee of the filing organization and will either become an employee of or an independent contractor for, a successor or transferee organization:Sister Edith GonzalezDr. Manuel P. Anton IIIMariluz GuzmanLaura Dominguez Changes in Program Services Form 990, Part III, line 3 During June 2010, the Board of Trustees of Mercy Hospital voted to sign a non-binding Letter of Intent with the Hospital Corporation of America (HCA) for the sale of certain assets and liabilities of several affiliated organizations to HCA. Under the terms of the Letter of Intent, the affiliated organizations include Mercy Hospital, Sister Emmanuel Hospital, and Mercy Medical Development. In January 2011, Mercy Hospital and HCA signed a definitive agreement for the sale. The transaction was completed on May 1, 2011. Form 990, Part VI, Section A, line 6 Yes, Catholic Health East is the sole member. Form 990, Part VI, Section A, line 7a Yes, Catholic Health East approves the appointment of the members of the governing body. Form 990, Part VI, Section A, line 7b Yes, Catholic Health East has limited reserved powers to approve decisions of the governing body. Form 990, Part VI, Section B, line 11 The organization took steps to educate management, members of the board and members of appropriate subcommittees of the board on the compliance requirements mandated by the Form 990. The form was reviewed by management and then submitted to the board or a subcommittee thereof which reported its findings to the board. Form 990, Part VI, Section B, line 12c Catholic Health East Policy 103 sets forth the organization's conflict-of-interest policy and processes. Annually, all those serving Catholic Health East in a fiduciary capacity, including directors, officers, Sponsors Council representatives, 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 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 appropriate committee thereof comprised of dis-interested persons and without the participation of the affected individual except to respond to questions about the disclosure. The policy further addresses the procedure for the board's further consideration of the proposed transaction/matter without the participation of the affected person and the documentation of the proceedings. Lastly, the policy addresses potential disciplinary action for violations of the policy. The policy is available to the public upon request. Form 990, Part VI, Section B, line 15 Catholic Health East's process for determining compensation includes the following: The board has an independent committee review and approve all elements of remuneration for all disqualified parties, as well as other key management. The board/committee has an established compensation philosophy which details the objectives of market positioning and pay elements. The committee engages with external consultants to provide market data comparing the organization's roles to similarly sized organizations utilizing both title and job content comparisons. The committee reviews the market analysis, approves any salary adjustments for the executive population, considers both reasonableness and effectiveness of all remunerative programs and establishes the detailed performance expectations which are incorporated into the incentive plan. All of these discussions and decisions are documented through the provision of meeting minutes. Form 990, Part VI, Section C, line 19 Organizational articles of incorporation, corporate bylaws, governance policies believed to be of interest to the public, conflict-of-interest policy, audited financial statements, annual community benefit report and IRS Form 990 are available to the public upon request. Form 990, Part VII and Schedule J Compensation paid to Ricardo Girala, MD, Jeffrey Horstmyer, MD and Leonardo Lopez, MD is paid for their postions as physicians at the Hospital and not for their work as trustees. They have not been included as independent during the tax year. Linda V. Wilford's Compensation: The Chief Financial Officer (CFO) compensation is reflective of responsibility over Mercy Hospital, Inc. with joint responsibility over Holy Cross Hospital, Inc. (a related entity owned by CHE). Approximately $104,000 of the total compensation was deferred compensation that vested in 2011. The estimated breakdown for Holy Cross Hospital is Base Compensation $182,439; At-Risk Compensation $60,841; Other Reportable Compensation $67,243; Deferred Compensation $90,442; and Nontaxable Benefits $9,358. The estimated breakdown for Mercy Hospital is Base Compensation $121,626; At-Risk Compensation $40,561; Other Reportable Compensation $44,829; Deferred Compensation $60,294; and Nontaxable Benefits $6,239. Compensation Paid to Sister Edith Gonzalez and Sister Carol E. Stovall, All compensation paid on behalf of the Sisters goes to her religious order. John C. Johnson Compensation: Compensation paid to John C. Johnson by a related organization: The 2011 compensation for John C. Johnson is reflective of his position Executive Vice President Ministry Operations for Catholic Health East. The total amount of Mr. Johnson's compensation is paid out of Catholic Health East and approximately $525,000 of the total compensation was deferred compensation that vested in 2011. Form 990, Part VII Section A: 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. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Donated Services and Use of Facilities -81,316. Total to Form 990, Part XI, Line 5: -81,316. Explanation of financial statements: Form 990, Part XII, Line 2a & 2b: Audited financial statements were completed by independent accountant for CHE, and Mercy Hospital, Inc was part of those audited financial statements. 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 Catholic Health East 3805 West Chester Pike Suite 100 Newtown Square PA 19073 232929748 Management Services PA 501(c)(3) Line 11a, I N/A 1 Continuing Care Management Services Network 3805 West Chester Pike Suite 100 Newtown Square PA 19073 352336834 Management & Support Services PA 501(c)(3) Line 11b, II Catholic Health East 1 Mercy Health System of Maine 144 State Street Portland MA 04101 010484074 Management & Support Services ME 501(c)(3) Line 11c, III-FI Catholic Health East 1 Mercy Hospital 144 State Street Portland MA 04101 010211534 Hospital ME 501(c)(3) Line 3 Mercy Health System of Maine 1 St Peter's Health Partners 315 South Manning Blvd Albany NY 12208 453570715 Management & Support Services NY 501(c)(3) Line 11b, II Catholic Health East 1 St Peter's Health Care Services 315 South Manning Blvd Albany NY 12208 222702507 Management & Support Services NY 501(c)(3) Line 9 St Peter's Health Partners 1 St Peter's Hospital 315 South Manning Blvd Albany NY 12208 141348692 Hospital NY 501(c)(3) Line 3 St Peter's Health Care Services 1 St Peter's Hospital Foundation Inc 319 South Manning Blvd Suite 309 Albany NY 12208 222262982 Fundraising & Public Relations NY 501(c)(3) Line 7 St Peter's Health Care Services 1 Eddy Licensed Home Care Agency 433 River St Suite 3000 Troy NY 12180 141818568 Home Health NY 501(c)(3) Line 3 LTC(Eddy) Inc 1 The Community Hospice Foundation Inc 295 Valley View Blvd Rensselaer NY 12144 222692940 Fundraising & Public Relations NY 501(c)(3) Line 7 The Community Hospice Inc 1 The Community Hospice Inc 295 Valley View Blvd Rensselaer NY 12144 141608921 Serving seriously ill people & their families NY 501(c)(3) Line 3 St Peter's Health Care Services 1 Villa Mary Immaculate 301 Hackett Blvd Albany NY 12208 141438749 Nursing Home & Physical Rehab NY 501(c)(3) Line 3 St Peter's Hospital 1 Warde Service Corporation Inc 159 Wolf Road 3rd Floor Albany NY 12205 141732097 Supporting & strengthing the ministries of rel. sr. mercy NY 501(c)(3) Line 9 St Peter's Health Care Services 1 Mercy Care for Kids Inc 310 South Manning Blvd Albany NY 12208 141717564 Day care center NY 501(c)(3) Line 9 St Peter's Health Care Services 1 Our Lady of Mercy Life Center 2 Mercycare Lane Guilderland NY 12084 141743506 Nursing Home Facility NY 501(c)(3) Line 3 St Peter's Health Care Services 1 St Peter's Auxiliary 315 South Manning Blvd Albany NY 01228 222843206 Auxiliary NY 501(c)(3) Line 11a, I St Peter's Health Care Services 1 Memorial Hospital Albany NY 600 Northern Blvd Albany NY 12204 141338457 General Hospital NY 501(c)(3) Line 3 Northeast Health Inc 1 Beechwood Inc 2212 Burdett Ave Troy NY 12180 141651563 Real estate holding NY 501(c)(2) N/A LTC (Eddy) Inc 1 Beverwyck Inc 40 Autumn Drive Slingerlands NY 12159 141717028 Independent/Assisted Living Retirement Community NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Capital Region Geriatric Center Inc 421 West Columbia St Cohoes NY 12047 141701597 Nursing Home NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Senior Care Connection Inc 504 State St Schenectady NY 12305 141708754 PACE Program NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Glen Eddy Inc One Glen Eddy Drive Niskayuna NY 12309 141794150 Independent/Assisted Living Community NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Hawthorne Ridge Inc 30 Community Way East Greenbush NY 12061 800102840 Independent/Assisted Living Retirement Community NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Heritage House Nursing Center Inc 2920 Tibbits Ave Troy NY 12180 141725101 Nursing home NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Home Aid Service of Eastern New York Inc 433 River St Suite 3000 Troy NY 12180 141514867 Home care NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 James A Eddy Memorial Geriatric Center Inc 2256 Burdett Ave Troy NY 12180 222570478 Nursing home NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 LTC (Eddy) Inc 2212 Burdett Ave Troy NY 12180 222564710 Elderly health/housing supporting org NY 501(c)(3) Line 11a, I Northeast Health Inc 1 The Marjorie Doyle Rockwell Center Inc 421 West Columbia St Cohoes NY 12047 141793885 Adult Home/Alzheimers NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Samaritan Hospital of Troy New York 2215 Burdett Ave Troy NY 12180 141338544 General hospital NY 501(c)(3) Line 3 Northeast Health Inc 1 Shaker Properties Inc 2212 Burdett Ave Troy NY 12180 223119822 Real Estate holding NY 501(c)(2) N/A Northeast Health Inc 1 Sunnyview Hospital & Rehabilitation Ctr 1270 Belmont Ave Schenectady NY 12308 141338386 Rehabilitation hospital NY 501(c)(3) Line 3 LTC (Eddy) Inc 1 Empire Home Infusion Service Inc 10 Blacksmith Drive Malta NY 12020 141795732 Home care NY 501(c)(3) Line 9 Home Aid Service of Eastern New York Inc 1 Samaritan Child Care Center Inc 2213 Burdett Ave Troy NY 12180 141710225 Child day care NY 501(c)(3) Line 9 Northeast Health Inc 1 The Northeast Health Foundation Inc 2224 Burdett Ave Troy NY 12180 222743478 Supporting foundation NY 501(c)(3) Line 7 Northeast Health Inc 1 Northeast Health Inc 2212 Burdett Ave Troy NY 12180 042450756 Supporting Organization NY 501(c)(3) Line 11b, II St Peter's Health Partners 1 Seton Health System Inc 1300 Massachusetts Avenue Troy NY 12180 141776186 Hospital NY 501(c)(3) Line 3 St Peter's Health Partners 1 Seton Auxiliary Inc 1300 Massachusetts Avenue Troy NY 12180 141505031 Supporting Organization NY 501(c)(3) Line 9 Seton Health System Inc 1 Seton Health at Schuyler Ridge Residential Healthcare 1 Abele Blvd Clifton Park NY 12065 141756230 Skilled Nursing NY 501(c)(3) Line 9 Seton Health System Inc 1 Seton Health Foundation 1300 Massachusetts Avenue Troy NY 12180 222345416 Supporting Organization NY 501(c)(3) Line 11a, I Seton Health System Inc 1 Seton Licensed Home Care Inc 1300 Massachusetts Avenue Troy NY 12180 141809134 Licensed Home Health Agency NY 501(c)(3) Line 3 Seton Health System Inc 1 Vincentian Health Services 1300 Massachusetts Avenue Troy NY 12180 141685163 Discontinued Operations NY 501(c)(3) Line 11a, I Seton Health System Inc 1 St Mary's Woodland Village Inc 1300 Massachusetts Avenue Troy NY 12180 141675183 Discontinued Operations NY 501(c)(3) Line 9 Seton Health System Inc 1 Brightside Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 01040 042182395 Behavioral Care MA 501(c)(3) Line 9 Sisters of Providence Health System Inc 1 Farren Care Center Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 01040 042501711 Long Term Care MA 501(c)(3) Line 3 Sisters of Providence Health System Inc 1 Mercy Hospital Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 01040 043398280 Acute Care MA 501(c)(3) Line 3 Sisters of Providence Health System Inc 1 Mercy Specialist Physicians Inc c/o SPHS 1221 Main Street No 108 Holyoke MA 01040 264033168 Neurosurgery Medical Services MA 501(c)(3) Line 3 Sisters of Providence Health System Inc 1 Sisters of Providence Care Centers Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 01040 222541103 Long Term Care MA 501(c)(3) Line 3 Sisters of Providence Health System Inc 1 Sisters of Providence Health System Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 01040 043398374 Management & Support Services MA 501(c)(3) Line 11a, I Catholic Health East 1 McAuley Center Inc 275 Steele Road West Hartford CT 06117 061058086 Independent Living CT 501(c)(3) Line 9 Mercy Community Health Inc 1 Mercy Community Health Inc 2021 Albany Avenue West Hartford CT 06117 061492707 Management & Support Services CT 501(c)(3) Line 11a, I Catholic Health East 1 Mercy Community HomeCare Services 2021 Albany Avenue West Hartford CT 06117 061488137 In Home Health Care CT 501(c)(3) Line 9 Mercy Community Health Inc 1 Mercy Services 2021 Albany Avenue West Hartford CT 06117 061453323 Support Services CT 501(c)(3) Line 1 Mercy Community Health Inc 1 Mercyknoll Inc 2021 Albany Avenue West Hartford CT 06117 060757380 Skilled Nursing CT 501(c)(3) Line 3 Mercy Community Health Inc 1 Saint Mary Home II Inc 2021 Albany Avenue West Hartford CT 06117 061164104 Elderly Care CT 501(c)(3) Line 3 Mercy Community Health Inc 1 St Mary Home Incorporated 2021 Albany Avenue West Hartford CT 06117 060646843 Skilled Nursing CT 501(c)(3) Line 3 Mercy Community Health Inc 1 Mercy Healthcare Center 114 Wawbeek Avenue Tupper Lake NY 12986 150532211 Hospital NY 501(c)(3) Line 3 Catholic Health East 1 Mercy Uihlein Health Corporation 185 Old Military Road Lake Placid NY 12946 161535133 Hospital NY 501(c)(3) Line 11b, II Mercy Healthcare Center 1 Uihlein Mercy Center 185 Old Military Road Lake Placid NY 12946 150532190 Hospital NY 501(c)(3) Line 3 Mercy Healthcare Center 1 St James Mercy Foundation Inc 411 Canisteo Street Hornell NY 14843 161486437 Foundation NY 501(c)(3) Line 7 St James Mercy Health System Inc 1 St James Mercy Health System Inc 411 Canisteo Street Hornell NY 14843 223127184 Management & Support Services NY 501(c)(3) Line 11b, II Catholic Health East 1 St James Mercy Hospital 411 Canisteo Street Hornell NY 14843 160743310 Hospital NY 501(c)(3) Line 3 St James Mercy Health System Inc 1 Marian Community Hospital 100 Lincoln Avenue Carbondale PA 18407 240711230 Hospital PA 501(c)(3) Line 3 Maxis Health System 1 Marian Community Hospital Auxiliary 100 Lincoln Avenue Carbondale PA 18407 251874733 Fundraising PA 501(c)(3) Line 11b, II Maxis Health System 1 Maxis Foundation 100 Lincoln Avenue Carbondale PA 18407 232330090 Fundraising PA 501(c)(3) Line 11b, II Maxis Health System 1 Maxis Health System 100 Lincoln Avenue Carbondale PA 18407 911940902 Health Care System PA 501(c)(3) Line 11b, II Catholic Health East 1 Maxis Medical Services 100 Lincoln Avenue Carbondale PA 18407 232577185 Physician Practices PA 501(c)(3) Line 3 Maxis Health System 1 Tri-County Human Services Center Inc PO Box 517 Carbondale PA 18407 231938528 Behavioral Health Organization PA 501(c)(3) Line 7 Maxis Health System 1 Columbus Acquisition Corp 1160 Raymond Boulevard Newark NJ 07102 262616342 Inactive Entity NJ 501(c)(3) Line 9 Saint Michaels Medical Center 1 Saint Michaels Medical Center 111 Central Avenue Newark NJ 07102 262616046 Hospital NJ 501(c)(3) Line 3 Catholic Health East 1 St James Care Inc 1160 Raymond Boulevard Newark NJ 07102 262616230 Inactive Entity NJ 501(c)(3) Line 9 Saint Michaels Medical Center 1 St Michaels Medical Center Foundation 1160 Raymond Boulevard Newark NJ 07102 223311976 Foundation NJ 501(c)(3) Line 11a, I Saint Michaels Medical Center 1 University Heights Property Company Inc 1160 Raymond Boulevard Newark NJ 07102 223100162 Medical Property Holding Company NJ 501(c)(2) N/A Saint Michaels Medical Center 1 Life St Francis Corporation 601 Hamilton Avenue Trenton NJ 08629 222797282 Health Services NJ 501(c)(3) Line 11a, I St Francis Medical Center Trenton NJ 1 St Francis Medical Center Foundation NJ 601 Hamilton Avenue Trenton NJ 08629 521025476 Foundation NJ 501(c)(3) Line 11a, I St Francis Medical Center Trenton NJ 1 St Francis Medical Center Trenton NJ 601 Hamilton Avenue Trenton NJ 08629 223431049 Hospital NJ 501(c)(3) Line 3 Catholic Health East 1 Langhorne MRI Inc 1201 Langhorne-Newtown Road Langhorne PA 19047 232519529 Inactive Entity PA 501(c)(3) Line 9 St Mary Medical Center 1 Langhorne Physician Services Inc 1201 Langhorne-Newtown Road Langhorne PA 19047 232571699 Physician Services PA 501(c)(3) Line 9 St Mary Medical Center 1 LIFE St Mary 1201 Langhorne-Newtown Road Langhorne PA 19047 262976184 Elderly Care PA 501(c)(3) Line 9 St Mary Medical Center 1 St Mary Medical Center 1201 Langhorne-Newtown Road Langhorne PA 19047 231913910 Hospital PA 501(c)(3) Line 3 Catholic Health East 1 St Mary Medical Center Foundation Inc 1201 Langhorne-Newtown Road Langhorne PA 19047 232567468 Foundation PA 501(c)(3) Line 7 St Mary Medical Center 1 East Norriton Physician Services c/o One West Elm Street Conshohocken PA 19428 232515999 Physician Services PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 Mercy Catholic Medical Center of Southeastern Pennsylvania One West Elm Street Conshohocken PA 19428 231352191 Acute Care Hospital PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 Mercy Family Support 1001 Baltimore Pike Suite 301 Springfield PA 19064 232325059 Home Health PA 501(c)(3) Line 9 Mercy Health System of Southeastern Pennsylvania 1 Mercy Health Foundation of Southeastern Pennsylvania c/o MHS One West Elm Street Conshohocken PA 19428 232829864 Fundraising PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania 1 Mercy Health Plan c/o One West Elm Street Conshohocken PA 19428 222483605 Health Plans PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania 1 Mercy Health System of Southeastern Pennsylvania One West Elm Street Conshohocken PA 19428 232212638 Management & Support Services PA 501(c)(3) Line 11b, II Catholic Health East 1 Mercy Home Health 1001 Baltimore Pike Suite 310 Springfield PA 19064 231352099 Home Health PA 501(c)(3) Line 9 Mercy Health System of Southeastern Pennsylvania 1 Mercy Home Health Services 1001 Baltimore Pike Suite 301 Springfield PA 19064 232325058 Home Health PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania 1 Mercy Management of Southeastern Pennsylvania One West Elm Street Conshohocken PA 19428 232627944 Physician Practices PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania 1 Mercy Suburban Hospital One West Elm Street Conshohocken PA 19428 231396763 Acute Care Hospital PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 Nazareth Health Care Foundation 2701 Holme Avenue Philadelphia PA 19152 232300951 Fundraising PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania 1 Nazareth Hospital 2601 Holme Avenue Philadelphia PA 19152 232794121 Acute Care Hospital PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 Nazareth Physician Services Inc 2601 Holme Avenue Philadelphia PA 19152 203261266 Physician Practices PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 NE Physician Services 2601 Holme Avenue Philadelphia PA 19152 232497355 Physician Practices PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 St Agnes Continuing Care Center 1900 S Broad Street Philadelphia PA 19145 232840137 Continuing Care Services PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 St Agnes Continuing Care Center Foundation 1900 S Broad Street Philadelphia PA 19145 232415137 Fundraising PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania 1 Life at Lourdes Inc 1600 Haddon Avenue Camden NJ 08108 261854750 Elderly Care NJ 501(c)(3) Line 3 Our Lady of Lourdes Health Care Services 1 Lourdes Ancillary Services 1600 Haddon Avenue Camden NJ 08103 222568525 Supporting Organization NJ 501(c)(3) Line 11b, II Our Lady of Lourdes Health Care Services 1 Lourdes Dialysis at Innova Inc 1600 Haddon Avenue Camden NJ 08108 263237625 Hospital NJ 501(c)(3) Line 3 Our Lady of Lourdes Health Care Services 1 Lourdes Medical Center Burlington County 218 Sunset Road Willingboro NJ 08046 223612265 Hospital NJ 501(c)(3) Line 3 Our Lady of Lourdes Health Care Services 1 Our Lady of Lourdes Health Care Services 1600 Haddon Avenue Camden NJ 08103 222568528 Management & Support Services NJ 501(c)(3) Line 11b, II Catholic Health East 1 Our Lady of Lourdes Health Foundation Inc 1600 Haddon Avenue Camden NJ 08103 222351960 Foundation NJ 501(c)(3) Line 7 Our Lady of Lourdes Health Care Services 1 Our Lady of Lourdes Medical Center 1600 Haddon Avenue Camden NJ 08103 210635001 Hospital NJ 501(c)(3) Line 3 Our Lady of Lourdes Health Care Services 1 Franciscan Eldercare Corporation PO Box 2500 Wilmington DE 19805 223008680 Eldercare DE 501(c)(3) Line 9 St Francis Hospital 1 St Francis Foundation PO Box 2500 Wilmington DE 19805 510374158 Foundation DE 501(c)(3) Line 11b, II St Francis Hospital 1 St Francis Hospital PO Box 2500 Wilmington DE 19805 510064326 Hospital DE 501(c)(3) Line 3 Catholic Health East 1 LIFE at St Francis Healthcare Inc 7th Clayton Streets Wilmington DE 19805 452569214 Elderly Care DE 501(c)(3) Line 3 St Francis Hospital 1 McAuley Ministries McAuley Hall 3333 Fifth Avenue Pittsburgh PA 15213 943436142 Management & Support Services PA 501(c)(3) Line 9 Pittsburgh Mercy Health System 1 Mercy Jeannette Hospital 3805 West Chester Pike Newtown Square PA 19073 251310602 Inactive Entity PA 501(c)(3) Line 9 Pittsburgh Mercy Health System 1 Mercy Life Center Corporation 1200 Reedsdale Street Pittsburgh PA 15233 251604115 Community Treatment PA 501(c)(3) Line 9 Pittsburgh Mercy Health System 1 Pittsburgh Mercy Health System 3333 5th Avenue Pittsburgh PA 15213 251464211 Management & Support Services PA 501(c)(3) Line 11b, II Catholic Health East 1 St Joseph's of the Pines Inc 100 Gossman Drive Suite B Southern Pines NC 28387 560694200 Hospital NC 501(c)(3) Line 3 Catholic Health East 1 Life St Joseph of the Pines Inc 100 Gossman Drive Suite B Southern Pines NC 28387 272159847 Healthcare Services NC 501(c)(3) Line 3 St Joseph's of the Pines Inc 1 Mercy Senior Care Inc 212 West Third Street PO Box 866 Rome GA 30162 581366508 Community Outreach GA 501(c)(3) Line 7 Saint Joseph's Health System Inc 1 Good Samaritan HospitalInc 1201 Siloam Road Greensboro GA 30462 261720984 Hospital GA 501(c)(3) Line 3 Saint Joseph's Health System Inc 1 Saint Joseph's Health System Inc 5673 Peachtree-Dunwoody Road Suite Atlanta GA 30342 581744848 Management & Support Services GA 501(c)(3) Line 11b, II Catholic Health East 1 Saint Joseph's Mercy Care Services Inc 5673 Peachtree-Dunwoody Road Suite Atlanta GA 30342 581752700 Community Outreach GA 501(c)(3) Line 7 Saint Joseph's Health System Inc 1 Saint Joseph's Mercy Foundation Inc 5673 Peachtree-Dunwoody Road Suite Atlanta GA 30342 581448522 Fundraising GA 501(c)(3) Line 11b, II Saint Joseph's Health System Inc 1 Mercy Services Downtown Inc 5673 Peachtree-Dunwoody Road Suite Atlanta GA 30342 272046353 Real Estate Holding Company GA 501(c)(3) Line 11b, II Saint Joseph's Health System Inc 1 St Mary's Health Care System Inc 1230 Baxter Street Athens GA 30606 580566223 Hospital GA 501(c)(3) Line 3 Catholic Health East 1 St Mary's Foundation Inc 1230 Baxter Street Athens GA 30606 582544232 Fundraising GA 501(c)(3) Line 11b, II St Mary's Health Care System Inc 1 St Mary's Highland Hills Inc 1230 Baxter Street Athens GA 30606 020576648 Assisted Living & Retirement Community GA 501(c)(3) Line 3 St Mary's Health Care System Inc 1 St Mary's Medical Group Inc 1230 Baxter Street Athens GA 30606 261858563 Hospital / Physician Services GA 501(c)(3) Line 3 St Mary's Health Care System Inc 1 Mercy Medical Corporation PO Box 1090 101 Villa Drive Daphne AL 36526 636002215 Hospital AL 501(c)(3) Line 3 Catholic Health East 1 Mercy LIFE of Alabama PO Box 1090 101 Villa Drive Daphne AL 36526 273163002 Hospital AL 501(c)(3) Line 3 Mercy Medical Corporation 1 Allegany Franciscan Ministries Inc 33920 US Highway 19 North Suite 269 Palm Harbor FL 34684 581492325 Management & Support Services FL 501(c)(3) Line 11b, II Catholic Health East 1 St Francis Hospital Inc 33920 US Highway 19 North Suite 269 Palm Harbor FL 34684 590624442 Hospital FL 501(c)(3) Line 11a, I Allegany Franciscan Ministries Inc 1 Holy Cross Hospital Inc 4725 North Federal Highway Ft Lauderdale FL 33308 590791028 Hospital FL 501(c)(3) Line 3 Catholic Health East 1 Holy Cross Long-Term Inc 4725 North Federal Highway Ft Lauderdale FL 33308 650787320 Medical Services FL 501(c)(3) Line 3 Holy Cross Hospital Inc 1 Holy Cross Medical Properties Inc 4725 North Federal Highway Ft Lauderdale FL 33308 650666283 Medical Building Real Estate Management FL 501(c)(2) N/A Holy Cross Hospital Inc 1 Mercy Hospital Foundation Inc 3663 South Miami Avenue Miami FL 33133 591709438 Fundraising FL 501(c)(3) Line 7 Mercy Hospital Inc 1 Mercy Medical Development Inc 3663 South Miami Avenue Miami FL 33133 592789194 Outpatient Services FL 501(c)(3) Line 9 Mercy Hospital Inc 1 Mercy Mission Services Inc 3663 South Miami Avenue Miami FL 33133 650435764 Health Care FL 501(c)(3) Line 11a, I Mercy Hospital Inc 1 Mercy Outpatient Services Inc DBA Sister Emmanuel Hospital 3663 South Miami Avenue Miami FL 33133 510461511 Hospital FL 501(c)(3) Line 3 Mercy Hospital Inc 1 Global Health Ministry 3805 West Chester Pike Suite 100 Newtown Square PA 19073 233068656 Health Care PA 501(c)(3) Line 7 Catholic Health East 1 VNA Home Health & Hospice 50 Foden Road South Portland ME 04106 010246804 Home Health & Hospice ME 501(c)(3) Line 11a, I Mercy Health System of Maine 1 Providence Place Inc 5 Gamelin Street Holyoke MA 01040 043404084 Retirement Community MA 501(c)(3) Line 9 Sisters of Providence Health System Inc 1 Intercoastal Health Systems 3805 West Chester Pike Suite 100 Newtown Square PA 19073 650556413 Management & Support Services PA 501(c)(3) Line 11a, I Catholic Health East 1 Sunnyview Hospital & Rehabilitation Center Foundation 1270 Belmont Ave Schenectady NY 12308 222505127 Supporting foundation NY 501(c)(3) Line 11a, I Sunnyview Hospital & Rehabilitation Ctr 1 St Peter's Ambulatory Surgery Center LLC 1375 Washington Avenue Ste 201 Albany NY 12206 460463892 Surgery NY N/A Catherine Horan Building Limited Partnership 1221 Main Street Room 108 Holyoke MA 010400000 042723429 Property Management MA N/A Western Massachusetts PETCT Imaging Center LLC 100 Bayview Circle Ste 400 Newport Beach CA 92660 204744663 Outpatient Medical Services DE N/A Central New Jersey Heart Services LLC 10720 Sikes Places Ste 300 Charlotte NC 28277 208525458 Cardiac Program NJ N/A Langhorne MOB Partners LP 1201 Langhorne-Newtown Road Langhorne PA 19047 232622772 Investment and operation of a medical building PA N/A SMMC MOB II LP 1201 Langhorne-Newtown Road Langhorne PA 19047 364559869 Investment and operation of a medical building PA N/A The Ambulatory Surgery Center at St Mary LLC 1203 Langhorne-Newton Road Langhorne PA 19047 232871206 Outpatient Surgery PA N/A AmeriHealth Mercy Health Plan 200 Stevens Drive Suite 350 Philadelphia PA 19113 232859523 Medicaid Managed Care Organization PA N/A Amerihealth Mercy of Indiana LLC 200 STEVENS DRIVE Suite 350 Philadelphia PA 19113 204948091 PREPAID HEALTH CARE SERVICES IN N/A East Norriton Medical Associates One West Elm Street Conshohocken PA 19428 232319531 Medical Office Building PA N/A East Norriton Medical Associates One West Elm Street Conshohocken PA 19428 232319531 Medical Office Building PA N/A Gateway Health Plan 300 Grant Street Pittsburgh PA 15219 251691945 Medicaid & Medicare/Special Needs Managed Care Organization PA N/A Keystone Mercy Health Plan 100 Stevens Drive Philadelphia PA 19113 232842344 Medicaid Managed Care Organization PA N/A MercyManor Partnership PO Box 10086 Toledo OH 436990086 521931012 Nursing Home PA N/A St Agnes Long Term Intensive Care LLP 1900 S Broad Street Philadelphia PA 19145 200984882 Long Term Intensive Care PA N/A Nazareth Medical Office Building Associates LP c/o Nazareth Hospital 2601 Holme Av Philadelphia PA 19152 232388040 Medical Office Building PA N/A Nazareth Medical Office Building Associates LP c/o Nazareth Hospital 2601 Holme Av Philadelphia PA 19152 232388040 Medical Office Building PA N/A St Agnes Long Term Intensive Care LLP 1900 S Broad Street Philadelphia PA 19145 200984882 Long Term Intensive Care PA N/A SJV Management LLC 200 Century Pkwy Ste 200E Mount Laurel NJ 08054 202273476 Radiology NJ N/A Physicians Outpatient Surgery Center LLC 1000 NE 56th Oakland Park FL 33334 352325646 Ambulatory Surgery Center FL N/A Center for Surgery & Digestive Orders 3641 South Miami Avenue Miami FL 33133 510438152 Outpatient Medical Services FL Mercy Hospital Inc Related 149388 1810759 0 1 0.50000 Samaritan Medical Office Building Inc 2212 Burdett Avenue Troy NY 12180 141607244 Real Estate NY N/A C Affiliated Management Services Corporation Inc 1300 Massachusetts Avenue Troy NY 12180 141668024 Real Estate NY N/A C Catherine Horan Building Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 042938180 Building Management MA N/A C Diversified Community Services Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 043128890 Medical Services MA N/A C Mercy Inpatient Medical Associates Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 043029829 Medical Services MA N/A C Providence Home Care Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 043317426 Health Care Services MA N/A C System Coordinated Services Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 042938181 Lab Services MA N/A C Physicians Medical Office Building Condominium Trust 1221 Main Street Room 108 Holyoke MA 010400000 046608649 Property Management MA N/A C SJM Properties Inc 411 Canisteo Street Hornell NY 148482104 161294991 Property Holdings NY N/A C Carbondale Area Physicians' Association PC 100 Lincoln Ave Carbondale PA 18407 232801677 Medical Insurance Contracting PA N/A C Carbondale Area Physicians' PHO Inc 100 Lincoln Ave Carbondale PA 18407 232801676 Inactive PA N/A C Carbondale Physicians' Services Inc 100 Lincoln Ave Carbondale PA 18407 232365077 Pharmacy PA N/A C Chestnut Risk Services Ltd 11 Victoria Street Hamilton BD Insurance BD N/A C LifeCare Physicians PC 601 Hamilton Avenue trenton NJ 086291986 261649038 Health Care Services NJ N/A C Multicare Plus Inc 601 Hamilton Avenue Trenton NJ 086291986 223435844 Inactive NJ N/A C Langhorne Services II Inc 1201 Langhorne-Newtown Road Langhorne PA 190470000 253795549 General Partner of LMOB Partners, II PA N/A C Langhorne Services Inc 1201 Langhorne-Newtown Road Langhorne PA 190470000 232625981 General Partner of LMOB Partners PA N/A C AMHP Holdings Corp 200 Stevens Drive Philadelphia PA 19113 261144363 Behavorial Health PA N/A C Select Health of South Carolina Inc 4390 Belle Oaks Drive Suite 400 Charleston SC 29405 571032456 Health Maintenance Organization SC N/A C Gateway Health Plan Inc 600 Grant Street Pittsburgh PA 15219 251505506 Health Care PA N/A C Gateway Health Plan Inc of Ohio 600 Grant Street Pittsburgh PA 15219 300282076 Health Care PA N/A C MCMC Eastwick Inc c/o MHS One West Elm Street Conshohocken PA 19428 232184261 Medical Office Buildings PA N/A C Community Behavorial Healthcare Network of PA Inc 8040 Carlson Road Harrisburg PA 17112 251765391 Behavorial Health PA N/A C Health Management Services Org Inc 500 Grove Street Suite 100 Haddon Heights NJ 08035 223366580 Health Care Billing NJ N/A C Jeannette Medical Providers 3805 West Chester Pike Newtown Square PA 19073 251787334 Holding Company PA N/A C Jeannette OBGYN Group 1 Inc 3805 West Chester Pike Newtown Square PA 19073 232890748 Holding Company PA N/A C Jeannette Primary Care Group 1 Inc 3805 West Chester Pike Newtown Square PA 19073 232890743 Holding Company PA N/A C Georgia Health Enterprises LLC 11440 Commerce Park Drive Reston VA 20191 541806329 Healthcare VA N/A C St Mary's Highland Hills Village Inc 1660 Jennings Mill Pkly Bogart GA 30622 582276801 Assisted Living GA N/A C GHE Physicians PC 3500 Piedmont Road Atlanta GA 30305 582277939 Practice Management GA N/A C Nursing Network Inc 4725 North Federal Highway Fort Lauderdale Highwa FL 333080000 591145192 Medical Services FL N/A C Mercy Physician Group Inc 3663 South Miami Avenue Miami FL 33133 202970015 Health Care FL Mercy Hospital Inc C 1.00000 Stella Maris Insurance Company Limited PO Box 69 Grand Cayman Cayman Islands CJ KY1-1102 980078266 Insurance CJ N/A C Catholic Health East Senior Services 3805 West Chester Pike Suite 100 Newtown Square PA 19073 371572595 Senior Services PA N/A C 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 Mercy Hospital Foundation C 75028 Fair Market Value Catholic Health East O 8550676 Fair Market Value Mercy Medical Development N 613246 Fair Market Value Mercy Mission Services N 89754 Fair Market Value Holy Cross Hospital N 168838 Fair Market Value Holy Cross Hospital P 92060 Fair Market Value Holy Cross Hospital O 4479747 Fair Market Value Mercy Medical Development R 890348 Fair Market Value Mercy Medical Development P 3955185 Fair Market Value Center for Surgery & Digestive Disorders A 423831 Fair Market Value Mercy Hospital Foundation B 343557 Fair Market Value Mercy Outpatient Services (DBA Sister Emmanual Hospital) O 1330837 Fair Market Value