2012-11-13T16:00:57-06:00 2011-12-31 990 2011-01-01 240779665 MERCY TYLER HOSPITAL MERC 5136392800 615 Elsinore Place Cincinnati OH 45202 DAVID NOWISKI 2012-11-12 2011 2016-02-24 21:20:13Z X DAVID NOWISKI 615 ELSINORE PLACE CINCINNATI OH 45202 6035631 false X N/A X 1949 PA MERCY TYLER HOSPITAL EXTENDS THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. X 3 0 278 11 0 0 3827 0 21170262 5925336 19315 0 275593 110295 21468997 6035631 0 0 0 0 11853590 5585554 0 0 0 11620196 3283783 23473786 8869337 -2004789 -2833706 8932965 2336000 7196513 5141000 1736452 -2805000 X MERCY TYLER HOSPITAL EXTENDS THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. false true 7130183 0 5925336 MERCY TYLER HOSPITAL IS THE ONLY ACUTE CARE HOSPITAL IN WYOMING COUNTY. IN ADDITION TO TRADITIONAL HOSPITAL SERVICES, THE HOSPITAL PROVIDES SEVERAL FREE HEALTH EDUCATION PROGRAMS FOR THE COMMUNITY THROUGHOUT THE YEAR. THE HOSPITAL ALSO PROVIDES REGULAR BLOOD PRESSURE SCREENINGS TO THE LOCAL SENIOR CENTER AND SPONSORS A WEEK-LONG HEALTH EDUCATION AND B/P SCREENING AT THE COUNTY FAIR. THE HOSPITAL PROVIDES FREE SPACE TO LOCAL ORGANIZATIONS WHO PROVIDE SUPPORT GROUPS FOR CHRONIC HEALTH ISSUES, SUCH AS SMOKING CESSATION. THE HOSPITAL ALSO PARTNERS WITH OTHER LOCAL AND REGIONAL SOCIAL SERVICE AGENCIES TO MONITOR THE HEALTH STATUS OF THE COMMUNITY AND PARTICIPATES IN PROGRAMS AND EVENTS TO ADDRESS THESE ISSUES. 7130183 true false false true false false false false true false false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false true false true false false false false true 0 0 278 true false false false false false false false false false false X 3 0 false false false false true true true true true false false true true true true true true false false false PA X SCOTT SCHITTER 5136390173 615 ELSINORE PLACE CINCINNATI OH 45202 X BRUCE HERRON 1.00 X X 0 0 0 DAVID NOWISKI 0.10 X X 0 444666 82257 DENISE GIESKI 40.00 X X 87281 0 43746 JOHN M STARCHER JR 0.10 X X 0 906582 167409 KEVIN COOK 1.00 X X 0 538373 50813 MARK T MITCHELL 1.00 X X 0 0 0 MICHAEL BEZNEY 0.10 X X 0 711020 151690 PETE BUTLER 1.00 X X 0 0 0 TOM DAVIS 1.00 X X 0 0 0 CHERYLE A STONE MD 1.00 X 0 0 0 CHRISTOPHER ANDRES MD 1.00 X 0 0 0 JAMES CLEMENTE 1.00 X 0 0 0 JUDY MEAD 1.00 X 0 0 0 PAUL MILNES 1.00 X 0 0 0 SR LUCILLE MARIE BRISLIN 1.00 X 0 0 0 TONI RUARK 1.00 X 0 0 0 STEPHEN H FRANKO III 1.00 X 0 372191 44906 CHARLES J MANCUSO 40.00 X 109383 0 22992 196664 2972832 563813 1 false true false 0 0 NET PATIENT SVC REVENUE 621990 5925336 5925336 0 5925336 0 0 0 0 0 0 0 0 0 0 0 0 OTHER REVENUE 900099 110295 110295 0 110295 6035631 5925336 0 110295 0 0 0 0 131027 104822 26205 0 5454527 4363621 1090906 0 0 0 0 0 3358 3358 0 0 0 981263 785010 196253 0 976038 780830 195208 0 0 604993 483994 120999 633 506 127 0 0 9311 7449 1862 0 261537 209230 52307 208311 166649 41662 DUES AND SUBSCRIPTIONS 45041 36033 9008 STATE ASSESSMENTS 187000 187000 6298 5039 1259 0 8869337 7130183 1739154 0 0 506497 1823000 3060956 90000 244899 114351 0 0 4019325 0 221255 0 0 0 0 765682 423000 8932965 2336000 2261969 1858000 443037 4491507 3283000 7196513 5141000 X 1543625 -2805000 171827 21000 1736452 -2805000 8932965 2336000 X -2833706 -1707746 X false true true X true true X false false false false false true 1552 false false false 1552 false Description of the activities reported on Lines 1a through 1i Schedule C, Part II-B, Line 1 LOBBYING ACTIVITIES PERFORMED INCLUDE BOTH THE USE OF VOLUNTEERS ENCOURAGED TO WRITE LETTERS TO PUBLIC OFFICIALS ON ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE TO PROVIDE HEALTH SERVICES TO THE COMMUNITIES SERVED, AND THE USE OF PAID STAFF MEMBERS AND MANAGEMENT PERSONNEL. PAID MANAGEMENT PERSONNEL REGULARLY ISSUE MAILINGS TO LEGISLATORS ATTEMPTING TO INFLUENCE LEGISLATIVE MATTERS AND REFERENDUM, AND ORGANIZE AND HOST MEETINGS AMONG HOSPITAL EXECUTIVES AND THEIR LEGISLATORS REGARDING ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE PROVIDING HEALTHCARE SERVICES TO ITS PATIENTS AND TO CONTINUE IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. PAID STAFF MEMBERS HAVE, ON LIMITED OCCASIONS, WRITTEN TO LEGISLATORS ON SUCH ISSUES. THE PRIMARY PURPOSE FOR LOBBYING ACTIVITIES IS TO ENHANCE THE ORGANIZATION'S PUBLIC POSITION ON LEGISLATIVE AND REGULATORY ISSUES THAT IMPACT PATIENT CARE THROUGHOUT OUR SYSTEM. THE ORGANIZATION FOCUSES ON PUBLIC POLICY ISSUES THAT EXTEND OUR HEALING MINISTRY TO THOSE WHO ARE POOR AND UNDERSERVED IN THE COMMUNITIES WE SERVE. TO CARRY OUT THESE EFFORTS, THE ORGANIZATION PARTNERS WITH EXPERT CONSULTANTS AND PROFESSIONAL TRADE ASSOCIATIONS TO BUILD AWARENESS AND EXECUTE SPECIFIC STRATEGIES THAT WILL YIELD A FAVORABLE OUTCOME FOR PATIENT CARE IN THE ORGANIZATION'S FACILITIES WHERE THEY ARE TREATED. 22160 22160 0 22112 48 22160 22073 39 22112 24097 122 2146 22073 0 0 0 0 0 0 OTHER ACCOUNTS RECEIVABLE 201000 FUNDS HELD BY TRUSTEES 222000 423000 0 RETIREMENT LIABILITIES 3283000 3283000 6035631 8869337 -2833706 0 0 -2833706 0 0 0 0 0 0 0 0 0 0 0 0 Intended uses of endowment funds Schedule D, Part V, Line 4 THE NURSING TUITION FUND WAS ESTABLISHED IN 1978 IN MEMORY OF ARTHUR & MARY STOCKER. THE MORGAN OPERATING SUITE FUND WAS ESTABLISHED IN 1984. IN BOTH CASES, THE PRINCIPAL IS RESTRICTED BUT THE INTEREST IS TO BE SPENT ON THE FUNDS' PRIMARY PURPOSES-NURSING EDUCATION AND SURGICAL EQUIPMENT. FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 THE COMPANY [CATHOLIC HEALTH PARTNERS AND AFFILIATED ENTITIES] COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AT DECEMBER 31, 2011 AND 2010, AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT DECEMBER 31, 2011 OR 2010. true true X true X true X true true false true true false 890338 0 1586886 1857327 -270441 X true true 1 1 MERCY TYLER HOSPITAL

880 SR 6W TUNKHANNOCK PA 18657

X X X MERCY TYLER HOSPITAL 1 true true 200 true 400 true X X X X true true X X X X X X true false true X false false Community benefit report prepared by related organization Schedule H, Part I, Line 6a CATHOLIC HEALTH PARTNERS COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6B THE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS CONTAINED IN A REPORT PREPARED BY CATHOLIC HEALTH PARTNERS (CHP), A RELATED TAX-EXEMPT ORGANIZATION. A COPY OF THE COMMUNITY BENEFIT REPORT CAN BE FOUND ON CHP'S WEB SITE AT WWW.HEALTH-PARTNERS.ORG. Costing Methodology used to calculate financial assistance Schedule H, Part I, Line 7 COST OF CHARITY CARE AND THE COST RELATED TO MEDICAID PATIENTS WERE DETERMINED USING THE AGGREGATE COST TO CHARGE METHODOLOGY, (TOTAL COST LESS BAD DEBT)/TOTAL REVENUES, REQUIRED BY CATHOLIC HEALTH PARTNERS TO STANDARDIZE OUR CALCULATION OF COMMUNITY BENEFIT AMOUNTS AND INCLUDES BOTH INPATIENTS AND OUTPATIENTS FOR TRADITIONAL MEDICAID AND MEDICAID MANAGED CARE PLANS. FOR SUBSIDIZED SERVICES THE HOSPITAL'S COST ACCOUNTING SYSTEM IS USED TO DETERMINE COST RELATED TO THE SPECIFIC SERVICE EXCLUDING TRADITIONAL MEDICAID AND MEDICAID MANAGED CARE PATIENTS. COSTS FOR CHARITY AND BAD DEBT ACCOUNTS ARE DEDUCTED USING A RATIO OF COST TO CHARGE SPECIFIC TO THAT SUBSIDIZED SERVICE. COSTS FOR OTHER PROGRAMS REFLECT THE DIRECT AND INDIRECT COSTS OF PROVIDING THOSE PROGRAMS. Bad Debt Expense excluded from financial assistance calculation Schedule H, Part I, Line 7, column(f) 0 Bad debt expense - financial statement footnote Schedule H, Part III, Line 4 THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THE HOSPITAL ELECTED TO EARLY ADOPT ASU 2011-07. ACCORDINGLY, BAD DEBT EXPENSE IS REFLECTED AS A DEDUCTION FROM REVENUE RATHER THAN AN OPERATING EXPENSE. THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY DOES NOT PERMIT THE COST OF PATIENTS WHO ARE UNCOOPERATIVE OR UNABLE TO BE LOCATED TO BE RECLASSIFIED FROM BAD DEBT TO FINANCIAL ASSISTANCE. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY REQUIRES AN APPLICATION AND SUPPORTING DOCUMENTATION. THEREFORE, ZERO DOLLARS ARE BEING REPORTED ON PART III, LINE 3 AS AMOUNTS INCLUDED IN BAD DEBT THAT COULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. NET PATIENT ACCOUNTS ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED UPON THE HOSPITAL'S HISTORICAL COLLECTION EXPERIENCE ADJUSTED FOR CURRENT ENVIRONMENTAL RISKS AND TRENDS FOR EACH MAJOR PAYOR SOURCE. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS IN THE PERIOD OF SERVICE BASED ON PAST COLLECTION EXPERIENCE. THE HOSPITAL'S CONCENTRATION OF CREDIT RISK RELATED TO NET PATIENT ACCOUNTS IS LIMITED DUE TO THE DIVERSITY OF PATIENTS AND PAYORS. NET PATIENT ACCOUNTS CONSIST OF AMOUNTS DUE FROM GOVERNMENTAL PROGRAMS (PRIMARILY MEDICARE AND MEDICAID), PRIVATE INSURANCE COMPANIES, MANAGED CARE PROGRAMS AND PATIENTS THEMSELVES. NET PATIENT SERVICE REVENUE FOR SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE IS RECOGNIZED BASED ON CONTRACTUAL RATES FOR SERVICES RENDERED. THE HOSPITAL RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME SERVICES ARE RENDERED EVEN THOUGH IT DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). AMOUNTS RECOGNIZED ARE SUBJECT TO ADJUSTMENT UPON REVIEW BY THIRD-PARTY PAYORS. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE HOSPITAL RECOGNIZES REVENUE WHEN SERVICES ARE PROVIDED. BASED ON HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE HOSPITAL'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR SERVICES PROVIDED. THUS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. Community benefit & methodology for determining medicare costs Schedule H, Part III, Line 8 THE HOSPITAL FOLLOWS THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES POLICY DOCUMENT, COMMUNITY BENEFIT PROGRAM, A REVISED RESOURCE FOR SOCIAL ACCOUNTABILITY ("CHA GUIDELINES") FOR DETERMINING COMMUNITY BENEFIT. THE CHA GUIDELINES RECOMMEND THAT HOSPITALS NOT INCLUDE MEDICARE LOSSES AS COMMUNITY BENEFIT. THE HOSPITAL'S COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE MEDICARE AMOUNTS IN PART III. Collection practices for patients eligible for financial assistance Schedule H, Part III, Line 9b PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT SENT TO A COLLECTION AGENCY. THE ORGANIZATION REPEATEDLY OFFERS PATIENTS ACCESS TO FINANCIAL ASSISTANCE DURING THEIR HOSPITAL STAY AND AFTER, AS WELL AS WITH EACH BILLING NOTICE. PATIENT ACCOUNTS ARE SENT TO A COLLECTION AGENCY AS A LAST RESORT AND ONLY: WHEN PATIENTS HAVE THE ABILITY TO PAY SOME PORTION OF THEIR HEALTHCARE EXPENSES BUT REFUSE TO DO SO; WHEN PATIENTS REFUSE TO WORK WITH THE ORGANIZATION TO DETERMINE IF THEY QUALIFY FOR FREE OR DISCOUNTED CHARITY CARE VIA FEDERAL, STATE, LOCAL OR HOSPITAL ASSISTANCE PROGRAMS; WHEN THE ORGANIZATION IS UNABLE TO LOCATE THE PATIENT OR PERSON RESPONSIBLE FOR THE BILL. Means used to determine amounts billed Schedule H, Part V Section B, Line 19d (1) MERCY TYLER HOSPITAL - THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY CARE OR OTHER MEDICALLY NECESSARY CARE IS BASED UPON FEDERAL POVERTY LEVELS STATED IN THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.; Needs assessment. Schedule H, Part VI, Line 2 MERCY TYLER HOSPITAL (HOSPITAL) ASSESSES AND CONTINUALLY RESPONDS TO CHANGING COMMUNITY NEEDS THROUGH THE SERVICES OFFERED. HOSPITAL INCORPORATES PLANNING FOR COMMUNITY BENEFITS AS PART OF ITS ANNUAL BUSINESS AND STRATEGIC PLANNING PROCESSES. HOSPITAL RECOGNIZES THE HEALTH OF THE COMMUNITY IS INFLUENCED BY SOCIAL, ECONOMIC, AND ENVIRONMENTAL FACTORS NOT JUST BY DISEASE AND ILLNESS. OUR COMMUNITY BENEFIT INCLUDES BOTH QUALITATIVE AND QUANTITATIVE DATA; DEMOGRAPHICS INCLUDING RACE, AGE, ETHNICITY; SOCIOECONOMIC DATA INCLUDING INCOME, EDUCATION, AND HEALTH INSURANCE RATES; PRIMARY CARE AND CHRONIC DISEASE NEEDS OF UNINSURED PERSONS; DATA ON HEALTH DISPARITIES IN HEALTH OUTCOMES AMONG MINORITY GROUPS. Patient education of eligibility for assistance. Schedule H, Part VI, Line 3 MERCY TYLER HOSPITAL PROVIDES BROCHURES AND HAS DISCUSSIONS WITH PATIENTS DURING ADMISSION AND DISCHARGE PROCESSES REGARDING THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS. REPRESENTATIVES ASSIST THE PATIENT WITH QUALIFICATIONS FOR SUCH PROGRAMS, WHERE APPLICABLE. Community information. Schedule H, Part VI, Line 4 MERCY TYLER HOSPITAL IS LOCATED IN WYOMING COUNTY, PENNSYLVANIA. IT IS THE ONLY HOSPITAL IN WYOMING COUNTY, WHICH HAS AN ESTIMATED POPULATION OF 28,000 PEOPLE. THE POPULATION DENSITY IN WYOMING COUNTY IS APPROXIMATELY 71 PEOPLE PER SQUARE MILE. Promotion of community health Schedule H, Part VI, Line 5 THE MAJORITY OF THE BOARD OF DIRECTORS IS COMPRISED OF PEOPLE WHO RESIDE IN MERCY TYLER HOSPITAL'S PRIMARY SERVICE AREA AND ARE NEITHER EMPLOYEES, CONTRACTORS, NOR FAMILY MEMBERS. MEDICAL STAFF PRIVELEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS. Affiliated health care system Schedule H, Part VI, Line 6 PRIOR TO THE SALE ON MAY 1, 2011, TYLER MEMORIAL HOSPITAL WAS AFFILIATED WITH MERCY HEALTH PARTNERS - NORTHEAST REGION (PARENT COMPANY), A PENNSYLVANIA NON-PROFIT CORPORATION, AND IT'S AFFILIATES. PRIOR TO MAY 1, 2011 MERCY TYLER HOSPITAL WAS A MEMBER OF CATHOLIC HEALTH PARTNERS (CHP). CHP IS THE CONTINUATION OF THE HEALTH MINISTRY STARTED MORE THAN 150 YEARS AGO BY OUR CO-SPONSORING CONGREGATIONS: THE SISTERS OF MERCY, REGIONAL COMMUNITY OF CINCINNATI (OH) (NOW THE SISTERS OF MERCY, SOUTH CENTRAL COMMUNITY); THE MID-ATLANTIC COMMUNITY; THE SISTERS OF THE HUMILITY OF MARY; THE FRANCISCAN SISTERS OF THE POOR; AND COVENANT HEALTH SYSTEMS. OUR SYSTEM OF REGIONAL HEALTH CARE PROVIDERS SERVES LOCAL HEALTH NEEDS IN COMMUNITIES IN OHIO AND KENTUCKY. CHP IS FOCUSED ON IMPROVING THE HEALTH OF COMMUNITIES WE SERVE BY PROVIDING INTEGRATED HEALTH SERVICES THROUGH FACILITIES THAT INCLUDE ACUTE CARE HOSPITALS, SENIOR HEALTH AND HOUSING FACILITIES, HOME HEALTH AGENCIES, HOSPICE PROGRAMS, OUTREACH SERVICES AND WELLNESS CENTERS. OUR HOSPITALS INCLUDE CRITICAL ACCESS FACILITIES OFFERING ESSENTIAL HEALTH SERVICES THAT WOULD OTHERWISE NOT EXIST IN THOSE COMMUNITIES. WE CARE FOR EVERYONE WHO COMES TO US, REGARDLESS OF THEIR ABILITY TO PAY. AS WE HAVE DONE FOR DECADES, WE PROVIDE EXTENSIVE SERVICES TO THE BROADER COMMUNITY, WITH EMPHASIS ON SERVICES FOR PERSONS WHO ARE POOR AND UNDER-SERVED. CHP'S HOME OFFICE PROVIDES SERVICES AND SUPPORT TO THE ENTIRE SYSTEM, INCLUDING BUT NOT LIMITED TO: PROVIDING GOVERNANCE, MANAGEMENT OVERSIGHT, STRATEGIC LEADERSHIP, FOCUSING RESOURCES TO ASSURE THE HEALING MISSION, PROVIDING ACCESS TO LOWER COST DEBT FINANCING TO SUPPORT OPERATIONS, IMPROVING CLINICAL OUTCOMES AND REDUCING OPERATING COSTS. SYSTEM-WIDE COMMUNITY BENEFIT FOR 2011 PER THE AUDIT FOOTNOTE IS AS FOLLOWS: TOTAL 2011 COMMUNITY BENEFIT: $ 345.7 MILLION. BENEFITS TO THE BROADER COMMUNITY $ 76.0 MILLION. UNREIMBURSED CARE FOR THOSE WHO ARE POOR AND QUALIFY FOR MEDICAID $ 124.3 MILLION. COST OF CARE FOR THOSE WHO COULD NOT AFFORD TO PAY $ 116.7 MILLION. SUPPORT FOR OTHER PROGRAMS FOR THOSE WHO ARE POOR $ 28.7 MILLION. COMMUNITY BENEFIT AS PERCENT OF TOTAL EXPENSE: 10.0 PERCENT. COMMUNITY BENEFIT REPORT FILING PART VI, LINE 7 THE HOSPITAL IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT IN ANY STATE. true true false false false false false false false DAVID NOWISKI 0 350338 0 81867 0 12461 0 55449 0 26808 0 526923 0 0 JOHN M STARCHER JR 0 554955 0 211413 0 140214 0 140693 0 26716 0 1073991 0 0 KEVIN COOK 0 510384 0 15000 0 12989 0 31670 0 19143 0 589186 0 0 MICHAEL BEZNEY 0 392478 0 148981 0 169561 0 125327 0 26363 0 862710 0 0 STEPHEN H FRANKO III 0 139402 0 0 0 232789 0 39762 0 5144 0 417097 0 0 Arrangement used to establish the top management official's compensation Schedule J, Part I, Line 3 THE COMPENSATION OF THE ORGANIZATION'S CEO IS DETERMINED BY MERCY HEALTH PARTNERS - NORTHEAST REGION (MHP), A RELATED TAX-EXEMPT ORGANIZATION. MHP UTILIZES A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, A COMPENSATION SURVEY AND APPROVAL BY BOARD OR COMPENSATION COMMITTEE WHEN DETERMINING THE CEO'S COMPENSATION. Severance or change-of-control payment Schedule J, Part I, Line 4a SEVERANCE BENEFITS CONSISTING OF CONTINUATION OF BASE SALARY AND INSURANCE BENEFITS WERE PROVIDED TO LISTED INDIVIDUALS FOR SPECIFIED PERIODS. THE LISTED INDIVIDUALS EXECUTED RELEASES AND WAIVERS OF CLAIMS IN EXCHANGE FOR THE SEVERANCE BENEFITS. SALARY CONTINUATION AMOUNTS PROVIDED DURING THE YEAR TO LISTED INDIVIDUALS WERE AS FOLLOWS: STEPHEN H. FRANKO, III: $232,789. Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b THE CHP SERP PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATE. IT PROVIDES ANNUAL CREDITS OF A SPECIFIED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST 50%, 75%, AND 100% IN THEIR ACCOUNTS AFTER 5, 6, AND 7 YEARS OF SERVICE, RESPECTIVELY. VESTING OCCURS EARLIER FOR DEATH OR TOTAL DISABILITY OR REACHING AGE 60 WHILE EMPLOYED, OR INVOLUNTARY TERMINATION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHANGE IN CONTROL OF THE ORGANIZATION OR DUE TO POSITION ELIMINATION. PAYMENTS DURING EMPLOYMENT ARE MADE FOR REQUIRED TAX WITHHOLDINGS. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS AFTER TERMINATION OF EMPLOYMENT. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO SERP PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: JOHN M. STARCHER, JR $118,835; MICHAEL BEZNEY $141,704. THE CHP RETENTION PLAN PART I, LINE 4B THE CHP EXECUTIVE RETENTION PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES EMPLOYMENT CONTINUATION INCENTIVES TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELIGATE. IT PROVIDES ANNUAL CREDITS OF A SPECIFIED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST AND CEASE TO RECEIVE CREDITS AFTER 5 YEARS OF PLAN PARTICIPATION PROVIDED THEY REMAIN EMPLOYED. VESTING AND CESSATION OF CREDITS OCCUR EARLIER FOR DEATH OR TOTAL DISABILITY WHILE EMPLOYED, INVOLUNTARY TERMAINTION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHANGE IN CONTROL OF THE ORGANIZATION, OR, FOR CERTAIN PARTICIPANTS, UPON BEING OFFERED A SPECIFIED PROMOTION. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS UPON VESTING. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO RETENTION PLAN PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: JOHN M. STARCHER JR. $0; MICHAEL BEZNEY $0; DAVID NOWISKI $0. SUBSTANTIALLY ALL OPERATING ASSETS, EXISTING CONTRACTS, AND LEASES. 2011-05-01 4721257 HEALTH SYSTEM PURCHASE ALLOCATION 133893191 COMMUNITY HEALTH SYSTEMS INC 4000 MERIDIAN BLVD FRANKLIN TN 37067 FOR-PROFIT CORP. false true false false Interested person who became an employee or independent contractor of transferee organization Schedule N, Part II, Line 2b OFFICERS AND KEY EMPLOYEES OF THE FILING ORGANIZATION MAY SERVE, AT LEAST TEMPORARILY DURING THE TRANSITION PERIOD, IN SIMILAR ROLES WITHIN THE TRANSFEREE ORGANIZATION. NO ADDITIONAL BENEFIT IS ANTICIPATED TO BE RECEIVED BY THOSE WHO ELECT TO SERVE IN THIS MANNER. Significant changes in program services Form 990, Part III, Line 3 THE OPERATING ASSETS OF MERCY TYLER HOSPITAL WERE SOLD TO COMMUNITY HEALTH SYSTEMS, INC. ON MAY 1, 2011. ACCORDINGLY, ALL HOSPITAL OPERATIONS CEASED EFFECTIVE THAT DATE. CONSOLIDATED AUDITED FINANCIAL STATEMENTS FORM 990, PART IV, LINE 20B THE FILING ORGANIZATION DOES NOT HAVE SEPARATE, INDEPENDENT AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION IS INCLUDED IN CATHOLIC HEALTH PARTNERS' CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH ARE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. CATHOLIC HEALTH PARTNERS' AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE HAS RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. Classes of members or stockholders Form 990, Part VI, Section A, Line 6 MERCY TYLER HEALTH SYSTEMS IS THE SOLE MEMBER OF MERCY TYLER HOSPITAL. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a CATHOLIC HEALTH PARTNERS (CHP) APPROVES MEMBERS THAT ARE APPOINTED TO THE BOARD OF TRUSTEES. ALL MEMBERS OF THE BOARD OF TRUSTEES HAVE FULL VOTING RIGHTS. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b CERTAIN MATTERS REQUIRE APPROVAL OF THE CHP CORPORATE MEMBER, CHP GOVERNING BODY, OR CHP CEO. THE REGULATIONS OF THE ORGANIZATION DESCRIBE THE LEVEL OF APPROVAL REQUIRED FOR VARIOUS DECISIONS. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b THE FORM 990 IS PREPARED BY CHP'S TAX DEPARTMENT. A COPY OF THE FINAL VERSION IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING. Conflict of interest policy Form 990, Part VI, Section B, Line 12c ALL BOARD MEMBERS ARE COVERED BY THE CATHOLIC HEALTH PARTNERS (CHP) CONFLICT OF INTEREST POLICY WHICH REQUIRES DISCLOSURE ON AN ANNUAL BASIS. ALL POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY CHP CORPORATE COMPLIANCE OFFICER. AT THE BEGINNING OF EACH BOARD MEETING ALL BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST. BOARD MEMBERS DETERMINED TO HAVE A CONFLICT OF INTEREST ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND DECISION-MAKING FOR THE TRANSACTION IN WHICH THE CONFLICT EXISTS. CEO COMPENSATION FORM 990, PART VI, LINE 15A THE COMPENSATION OF THE ORGANIZATION'S CEO OR TOP MANAGEMENT OFFICIAL IS DETERMINED BY MERCY HEALTH PARTNERS - NORTHEAST REGION, A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES FORM 990, PART VI, LINE 15B THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED BY MERCY HEALTH PARTNERS - NORTHEAST REGION, A RELATED TAX-EXEMPT ORGANIZATION. Governing documents, conflict of interest policy and financial statements available to the public Form 990, Part VI, Section C, Line 19 MERCY TYLER HOSPITAL'S CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS AND ARTICLES OF INCORPORATION ARE AVAILABLE UPON REQUEST. CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT THE CATHOLIC HEALTH PARTNERS WEB SITE. Average number of hours devoted per week to related organization Form 990, Part VII, Section A, Column B BRUCE HERRON - 2 DAVID NOWISKI - 51.7 DENISE GIESKI - 2 JOHN M. STARCHER, JR. - 59.2 KEVIN COOK - 50 MARK T. MITCHELL - 7 MICHAEL BEZNEY - 52.7 PETE BUTLER - 2 TOM DAVIS - 2 CHERYLE A. STONE, MD - 2 CHRISTOPHER ANDRES, MD - 2 JAMES CLEMENTE - 7 JUDY MEAD - 2 PAUL MILNES - 2 SR LUCILLE MARIE BRISLIN - 2 TONI RUARK - 2 STEPHEN H. FRANKO, III - 48 Other changes in net assets or fund balances Form 990, Part XI, Line 5 EQUITY TRANSFERS - -1707746; CATHOLIC HEALTH PARTNERS 615 ELSINORE PLACE CINCINNATI OH 45202 311161086 HEALTHCARE SYSTEM PARENT OH 501(C)(3) 11 - Type III - FI NA false CATHOLIC HEALTH PARTNERS FOUNDATION 615 ELSINORE PLACE CINCINNATI OH 45202 201072726 FUNDRAISING OH 501(C)(3) 7 CATHOLIC HEALTH PARTNERS false CATHOLIC HEALTHCARE PARTNERS HOUSING DEVELOPMENT 615 ELSINORE PLACE CINCINNATI OH 45202 208943658 HUD PARENT OH 501(C)(3) 9 CATHOLIC HEALTH PARTNERS false CATHOLIC HEALTHCARE PARTNERS RETIREMENT TRUST 615 ELSINORE PLACE CINCINNATI OH 45202 316046304 RETIREMENT TRUST OH 501(C)(3) 8 CATHOLIC HEALTH PARTNERS false COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM 3700 KOLBE ROAD LORAIN OH 44053 270071694 REGIONAL PARENT OH 501(C)(3) 11 - Type II CATHOLIC HEALTH PARTNERS false COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER 3700 KOLBE ROAD LORAIN OH 44053 340714704 HOSPITAL OH 501(C)(3) 3 COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM false ALLEN MEDICAL CENTER 200 WEST LORAIN ST OBERLIN OH 44074 340864230 HOSPITAL OH 501(C)(3) 3 COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM false COMMUNITY HEALTH PARTNERS REGIONAL FOUNDATION 3700 KOLBE ROAD LORAIN OH 44053 341504558 FOUNDATION OH 501(C)(3) 11 - Type III - FI COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER false COMMUNITY HEALTH PARTNERS PHYSICIANS OFFICE BUILDINGS 3700 KOLBE ROAD LORAIN OH 44053 341268828 MEDICAL OFFICE RENTAL OH 501(C)(3) 9 COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER false ALLEN MEDICAL CENTER FOUNDATION 200 WEST LORAIN ST OBERLIN OH 44074 341675592 FOUNDATION OH 501(C)(3) 11 - Type I ALLEN MEDICAL CENTER false ALLEN MEDICAL CENTER MEDICAL OFFICE BUILDING 200 WEST LORAIN ST OBERLIN OH 44074 364504991 MEDICAL OFFICE RENTAL OH 501(C)(3) 11 - Type II ALLEN MEDICAL CENTER false MERCY HEALTH PARTNERS OF SOUTHWEST OHIO 4600 MCAULEY PLACE CINCINNATI OH 45242 311063783 REGIONAL PARENT OH 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