MERCY HEALTH - TIFFIN HOSPITAL LLC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HEALTH - TIFFIN HOSPITAL LLC (EIN 34-4431174)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-14
- IRS object ID
- 201223199349304637
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-14T15:00:56-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 440160260 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 312 WALNUT STREET SUITE 300 | AddressLine1 |
| City | CINCINNATI | City |
| State | OH | State |
| ZIP Code | 45202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 344431174 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL OF TIFFIN OHIO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MERC | NameControl |
| Phone | 4194473130 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 45 ST LAWRENCE DRIVE | AddressLine1 |
| City | Tiffin | City |
| State | OH | State |
| ZIP Code | 44883 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROBERT MOON | Name |
| Title | REGIONAL CFO | Title |
| Date Signed | 2012-11-05 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| PTIN | P00961884 | PTIN |
| Phone | 5136218300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Name Of Principal Officer Business NameOfPrincipalOfficerBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DALE THORNTON CEO | BusinessNameLine1 |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 45 ST LAWRENCE DRIVE | AddressLine1 |
| City | TIFFIN | City |
| State | OH | State |
| ZIP Code | 44833 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 59092548 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MERCYWEB.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1970 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES, WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 694 | TotalNbrEmployees |
| Total Nbr Volunteers | 152 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 112447 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 122681 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 55935932 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 58086336 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2077183 | InvestmentIncomePriorYear |
| Investment Income Current Year | 532050 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 295267 | OtherRevenuePriorYear |
| Other Revenue Current Year | 341983 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 58420829 | TotalRevenuePriorYear |
| Total Revenue Current Year | 59083050 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 22076095 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 23597821 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 32557316 | OtherExpensePriorYear |
| Other Expenses Current Year | 30460290 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 54633411 | TotalExpensesPriorYear |
| Total Expenses Current Year | 54058111 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3787418 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5024939 | RevenuesLessExpensesCY |
| Total Assets BOY | 116898676 | TotalAssetsBOY |
| Total Assets EOY | 115749053 | TotalAssetsEOY |
| Total Liabilities BOY | 50244962 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 49662866 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 66653714 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 66086187 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES, WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. MERCY HOSPITAL TIFFIN IS THE ONLY FULL-SERVICE COMMUNITY HOSPITAL BASED IN TIFFIN AND SERVING THE TRI-COUNTY AREA. IT IS ALSO THE ONLY FAITH-BASED HOSPITAL IN ITS PRIMARY, SECONDARY, AND TERTIARY SERVICE AREA. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 42461953 | Expense |
| Grants | 0 | Grants |
| Revenue | 57769958 | Revenue |
| Description | THE PRIMARY EXEMPT PURPOSE OF MERCY HOSPITAL OF TIFFIN OHIO IS TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. MERCY HOSPITAL OF TIFFIN OHIO ACCOMPLISHES THIS PURPOSE BY DEMONSTRATING BEHAVIORS REFLECTING OUR CORE VALUES OF COMPASSION, EXCELLENCE, HUMAN DIGNITY, JUSTICE, SACREDNESS OF LIFE AND SERVICE. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 602779 | Expense |
| Grants | 0 | Grants |
| Revenue | 201495 | Revenue |
| Description | UROLOGY SERVICES: EMPLOYED PHYSICIAN OFFICE WHICH IS THE SOLE PROVIDER OF COMPREHENSIVE UROLOGY HEALTHCARE (OP, IP AND PROCEDURAL) TO THE ADULT POPULATION OF THE COMMUNITY, REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THESE SERVICES. SERVED 1,679 PEOPLE. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 567878 | Expense |
| Grants | 0 | Grants |
| Revenue | 114883 | Revenue |
| Description | CARDIOLOGY SERVICES: EMPLOYED PHYSICIAN OFFICE WHICH IS SOLE PROVIDER OF COMPREHENSIVE CARDIOLOGY HEALTHCARE (OP, IP AND PROCEDURAL) TO THE ADULT POPULATION OF THE COMMUNITY, REGARDLESS OF PATIENT'S ABILITY TO PAY FOR THOSE SERVICES. SERVED 1,252 PEOPLE. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 43632610 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | true | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 694 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JULIE ALFORD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4194557052 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 45 ST LAWRENCE DRIVE | AddressLine1 |
| City | TIFFIN | City |
| State | OH | State |
| ZIP Code | 44883 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (29 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| CHRIS ENGLISH | |||||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | |||
| DALE THORNTON | |||||||||
| PRESIDENT & CEO, MHT & RURAL DIVISION | 53.00 | X | X | 358258 | 0 | 85818 | |||
| JERRY BUPP | |||||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | |||
| KRIS KLEPPER | |||||||||
| VICE CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | |||
| STEVEN L MICKUS | |||||||||
| TRUSTEE, SVP, DIVISIONAL CEO, CHO COO | 0.50 | X | X | 0 | 1393505 | 322574 | |||
| ANDREA PRICE | |||||||||
| PRESIDENT & CEO, MHP-NORTHERN REGION | 0.50 | X | 0 | 692861 | 164756 | ||||
| BRIAN SMITH | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| JEANNINE CURNS | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| JOHN M STARCHER JR | |||||||||
| TRUSTEE, CHP SVP & DIVISIONAL CEO | 0.50 | X | 0 | 906582 | 167409 | ||||
| JUDY CLEM | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| LEE MARTIN | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| SR NOEL FREY RSM | |||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||||
| WADE YOUNG MD | |||||||||
| TRUSTEE | 1.00 | X | 3820 | 0 | 0 | ||||
| ROBERT MOON | |||||||||
| CFO, MHP - NORTHERN REGION | 0.50 | X | 0 | 376867 | 99135 | ||||
| TODD WARNER | |||||||||
| CFO, MHP - NORTHERN REGION | 0.50 | X | 0 | 255850 | 58604 | ||||
| BARRY HUDGIN | |||||||||
| SVP & GENERAL COUNSEL | 1.00 | 0 | 291826 | 38509 | X | ||||
| CAROL WHITTAKER | |||||||||
| SVP & QUALITY OFFICER | 0.50 | 0 | 404570 | 187826 | X | ||||
| GARY GEORGE | |||||||||
| SVP, HUMAN RESOURCES | 1.00 | 0 | 346485 | 118311 | X | ||||
| H TERRENCE SMITH | |||||||||
| SVP - MERCY MEDICAL PARTNERS | 1.00 | 0 | 432002 | 100039 | X | ||||
| IMRAN ANDRABI MD | |||||||||
| SVP & CHIEF PHYSICIAN EXECUTIVE OFFICER | 1.00 | 0 | 540003 | 78135 | X | ||||
| JOSEPH GLASS | |||||||||
| VICE PRESIDENT - REVENUE CYCLE | 1.00 | 0 | 280812 | 45744 | X | ||||
| THOMAS ARQUILLA | |||||||||
| SVP, BUSINESS DEVELOPMENT/STRATEGY | 1.00 | 0 | 219208 | 32080 | X | ||||
| AJITKUMAR DESAI MD | |||||||||
| PHYSICIAN | 55.00 | 429535 | 0 | 250 | X | ||||
| CHRISTIAN MEADE MD | |||||||||
| PHYSICIAN | 55.00 | 142635 | 0 | 0 | X | ||||
| ROBERT CECCHINO MD | |||||||||
| PHYSICIAN | 55.00 | 277731 | 0 | 250 | X | ||||
| STEVEN BRUHL MD | |||||||||
| PHYSICIAN | 55.00 | 181305 | 0 | 0 | X | ||||
| STEVEN WAGNER MD | |||||||||
| PHYSICIAN | 55.00 | 224507 | 0 | 0 | X | ||||
| DAVID AROSE | |||||||||
| FORMER KEY EMPLOYEE | 0.00 | 0 | 261788 | 25358 | X | ||||
| JIM ALBIN | |||||||||
| FORMER KEY EMPLOYEE | 0.00 | 0 | 144065 | 12187 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1617791 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 6546424 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1536985 | TotalOtherCompensation |
| Number Individuals GT100 K | 13 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Federated Campaigns | 33780 | FederatedCampaigns |
| Related Organizations | 50000 | RelatedOrganizations |
| Government Grants | 25891 | GovernmentGrants |
| All Other Contributions | 13010 | AllOtherContributions |
| Total Contributions | 122681 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE REV | 621990 | 57448268 | 57448268 |
| JOINT VENTURE | 900099 | 223527 | 223527 |
| PHARMACY | 621990 | 3183 | 3183 |
| CLINICS | 621990 | 137011 | 137011 |
| RADIOLOGY | 621990 | 11093 | 11093 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 263254 | TotalRevenueColumn |
| Related Or Exempt Function Income | 263254 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 58086336 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 541548 | TotalRevenueColumn |
| Exclusion | $541,548 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 23548 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 23548 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 23548 | TotalRevenueColumn |
| Related Or Exempt Function Income | 23548 | RelatedOrExemptFunctionIncome |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 9498 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | -9498 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -9498 | TotalRevenueColumn |
| Exclusion | -$9,498 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| CAFETERIA | 624210 | 236710 | $236,710 |
| 5% EMPLOYEE SALARY INCREASE PER CONTRACT W/TASA | 900099 | 68845 | $68,845 |
| MEDICAL RECORD | 561000 | 12880 | $12,880 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 318435 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 59083050 | TotalRevenueColumn |
| Related Or Exempt Function Income | 58109884 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $850,485 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 447896 | Total |
| Program Services | 392832 | ProgramServices |
| Management And General | 55064 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18007167 | Total |
| Program Services | 15793374 | ProgramServices |
| Management And General | 2213793 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 711310 | Total |
| Program Services | 711310 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3195612 | Total |
| Program Services | 3182714 | ProgramServices |
| Management And General | 12898 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1235836 | Total |
| Program Services | 1235836 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 377731 | Total |
| Program Services | 41657 | ProgramServices |
| Management And General | 336074 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49095 | Total |
| Management And General | 49095 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4835 | Total |
| Management And General | 4835 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11767432 | Total |
| Program Services | 5207655 | ProgramServices |
| Management And General | 6559777 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 245304 | Total |
| Management And General | 245304 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7646 | Total |
| Program Services | 7646 | ProgramServices |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1673663 | Total |
| Program Services | 1401250 | ProgramServices |
| Management And General | 272413 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 229783 | Total |
| Program Services | 160349 | ProgramServices |
| Management And General | 69434 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2402636 | Total |
| Program Services | 2402636 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4319254 | Total |
| Program Services | 4319254 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 334810 | Total |
| Program Services | 334810 | ProgramServices |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| STATE & CORP ASSESSMENTS | 952692 | 407634 | 545058 |
| DUES AND MEMBERSHIPS | 105091 | 43335 | 61756 |
| MEDICAL SUPPLIES | 7990318 | 7990318 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54058111 | Total |
| Program Services | 43632610 | ProgramServices |
| Management And General | 10425501 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Joint Costs TotalJointCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5761818 | BOY |
| EOY | 2368758 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7738360 | BOY |
| EOY | 8838675 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 823047 | BOY |
| EOY | 860365 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 432986 | BOY |
| EOY | 383235 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 88728787 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 27053241 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65078029 | BOY |
| EOY | 61675546 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33842839 | BOY |
| EOY | 40944444 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3221597 | BOY |
| EOY | 678030 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116898676 | BOY |
| EOY | 115749053 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3847486 | BOY |
| EOY | 3710755 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63400 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46334076 | BOY |
| EOY | 45952111 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50244962 | BOY |
| EOY | 49662866 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66633510 | BOY |
| EOY | 66054193 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20204 | BOY |
| EOY | 31994 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66653714 | BOY |
| EOY | 66086187 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116898676 | BOY |
| EOY | 115749053 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 5024939 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -5592466 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | true | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $3,110 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 3110 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of the activities reported on Lines 1a through 1i | Identifier |
| Return Reference | Schedule C, Part II-B, Line 1 | ReturnReference |
| Explanation | 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. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2920320 | OtherCostOrOtherBasis |
| Book Value | 2920320 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 56963107 | OtherCostOrOtherBasis |
| Depreciation | 8215289 | Depreciation |
| Book Value | 48747818 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4070579 | OtherCostOrOtherBasis |
| Depreciation | 962748 | Depreciation |
| Book Value | 3107831 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 24544094 | OtherCostOrOtherBasis |
| Depreciation | 17622676 | Depreciation |
| Book Value | 6921418 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 230687 | OtherCostOrOtherBasis |
| Depreciation | 252528 | Depreciation |
| Book Value | -21841 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 61675546 | TotalOfBookValueLandBuildings |
Financial Derivatives FinancialDerivatives
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
Closely Held Equity Interests CloselyHeldEquityInterests
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CATHOLIC HEALTH PARTNERS-INVESTMENT MANAGEMENT PROGRAM | Description |
| Book Value | 40944444 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 40944444 | TotalOfBookValueSecurities |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| PENSION-DEFINED CONTRIBUTION PLAN | $260,000 |
| OTHER LONG TERM LIABILITIES | $3,193,695 |
| ACCOUNTS PAYABLE INTERCOMPANY | $285,392 |
| LOAN PAYABLE TO AFFILIATE | $42,213,024 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 45952111 | TotalOfAmounts |
| Total Revenue | 61473533 | TotalRevenue |
| Total Expenses | 56460384 | TotalExpenses |
| Excess Or Deficit For Year | 5013149 | ExcessOrDeficitForYear |
| Other | $0 | OtherAmount |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 5013149 | ExcessOrDeficitPerFS |
| Other Revenues | 0 | OtherRevenues |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 0 | RevenueSubtotal |
| Other Revenues Not Included | 0 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 0 | TotalRevenuePerForm990 |
| Other Expenses Included | 0 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 0 | ExpensesSubtotal |
| Other Expenses Not Included | 0 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 0 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FIN 48 (ASC 740) footnote | Identifier |
| Return Reference | Schedule D, Part X, Line 2 | ReturnReference |
| Explanation | 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. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4200 | PersonsServed |
| Total Community Benefit Expense | 2191726 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 257647 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1934079 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03580 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 10356 | PersonsServed |
| Total Community Benefit Expense | 5668437 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3530744 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2137693 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03950 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 14556 | PersonsServed |
| Total Community Benefit Expense | 7860163 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3788391 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4071772 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07530 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1764 | PersonsServed |
| Total Community Benefit Expense | 244873 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 120 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 244753 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00450 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 339 | PersonsServed |
| Total Community Benefit Expense | 104777 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 104777 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00190 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 8298 | PersonsServed |
| Total Community Benefit Expense | 5511346 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3137154 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2374192 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04390 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 646 | PersonsServed |
| Total Community Benefit Expense | 64982 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 64982 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 11047 | PersonsServed |
| Total Community Benefit Expense | 5925978 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3137274 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2788704 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05150 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 25603 | PersonsServed |
| Total Community Benefit Expense | 13786141 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6925665 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6860476 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12680 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 3063 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 3063 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 12 | PersonsServed |
| Total Community Building Expense | 259400 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 259400 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00480 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 12 | PersonsServed |
| Total Community Building Expense | 262463 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 262463 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00490 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $2,402,273 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 12348651 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 15250051 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -2901400 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TIFFIN AMBULATORY SURGICAL ASSOCIATION LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | AMBULATORY SURGERY | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.51 | OrganizationProfitOrOwnership |
| Officers Etc Profit Or Ownership | 0 | OfficersEtcProfitOrOwnership |
| Physicans Profit Or Ownership | 0.49 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY TIFFIN HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 45 ST LAWRENCE DRIVE | AddressLine1 |
| City | TIFFIN | City |
| State | OH | State |
| ZIP Code | 44883 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 12 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (12 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| MERCY COMMUNITY LAB | ||||
| 437 W MARKET ST | TIFFIN | OH | 44883 | COMMUNITY LAB |
| MERCY CANCER CENTER AT TIFFIN | ||||
| 40 FAIR LANE | TIFFIN | OH | 44883 | RADIATION THERAPY AND ONCOLOGY INFUSION SERVICES |
| MERCY HOME CARE | ||||
| 435 W MARKET ST | TIFFIN | OH | 44883 | HOME CARE |
| MERCY TIFFIN HOSPITAL SPECIALTY CLINICS | ||||
| 27 ST LAWRENCE DRIVE SUITE 201 | TIFFIN | OH | 44883 | OUTPATIENT CLINICS |
| MERCY UROLOGY SPECIALISTS | ||||
| 27 ST LAWRENCE DRIVE SUITE 204 | TIFFIN | OH | 44883 | PHYSICIANS OFFICES - UROLOGY |
| MCCAULEY HEALTH SERVICES | ||||
| 437 W MARKET ST | TIFFIN | OH | 44883 | FAMILY CARE |
| MERCY SURGICAL SPECIALISTS | ||||
| 27 ST LAWRENCE DRIVE SUITE 203 | TIFFIN | OH | 44883 | PHYSICIAN OFFICES - SURGERY |
| TIFFIN AMBULATORY SURGERY ASSOCIATES | ||||
| 45 ST LAWRENCE DRIVE | TIFFIN | OH | 44833 | AMBULATORY SURGERY CENTER |
| OPTIMA REHABILITATION SERVICES | ||||
| 45 ST LAWRENCE DR SUITE 204 | TIFFIN | OH | 44883 | PHYSICIAL THERAPY, SPEECH, OCCUPATIONAL THERAPY, AQUATIC THERAPY |
| SENECA DIALYSIS | ||||
| 65 SAINT FRANCIS | TIFFIN | OH | 44883 | DIALYSIS CLINIC |
| MERCY PEDIATRICS | ||||
| 433 W MARKET STREET | TIFFIN | OH | 44883 | PHYSICIAN OFFICES - PEDIATRICS |
| MERCY OBGYN ASSOCIATES | ||||
| 2495 W MARKET STREET | TIFFIN | OH | 44883 | PHYSICIAN OFFICES - OB/GYN |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Community benefit report prepared by related organization | Schedule H, Part I, Line 6a | MERCY HEALTH PARTNERS |
| Costing Methodology used to calculate financial assistance | Schedule H, Part I, Line 7 | COST OF CHARITY CARE WAS CALCULATED WITH A COST TO CHARGE RATIO USING WORKSHEET 2. THE COST RELATED TO MEDICAID PATIENTS WAS ALSO DETERMINED USING THE COST TO CHARGE RATIO USING THE HOSPITAL COST ACCOUNTING SYSTEM AND INCLUDED 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 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 |
| Subsidized Health Services | Schedule H, Part I, Line 7g | $3,381,200 OF COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WAS INCLUDED AS SUBSIDIZED HEALTH SERVICES. |
| Community Building Activities | Schedule H, Part II | MERCY TIFFIN HOSPITAL CONDUCTS COMMUNITY HEALTH EDUCATION AND SUPPORT GROUPS, HEALTH FAIRS, AND SCREENINGS FOR THE COMMUNITY. THE HOSPITAL SUPPORTS HEALTH MINISTRIES PROGRAMS FOR CHURCHES IN THE AREA. MERCY TIFFIN HOSPITAL PROVIDES A MERCY EXPRESS VAN SERVICE TO TRANSPORT PATIENTS TO NEEDED HEALTH CARE SERVICES. THE HOSPITAL PROVIDES HEALTH INFORMATION TO THE COMMUNITY THROUGH A TELEPHONE INFORMATION PROGRAM, AND PROVIDES CLINICS TO INCREASE ACCESS TO PRIMARY CARE AND SPECIALTY CARE, INCLUDING WOMEN'S HEALTH. |
| 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 CHARITY CARE OR FINANCIAL ASSISTANCE ARE NOT SENT TO A COLLECTION AGENCY. THE ORGANIZATION REPEATEDLY OFFERS PATIENTS ACCESS TO FINANCIAL HELP DURING THEIR HOSPITAL STAY AND AFTER, AS WELL AS WITH EACH BILLING NOTICE. BILLS 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 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 TIFFIN HOSPITAL - THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY 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 TIFFIN HOSPITAL ASSESSES AND CONTINUALLY RESPONDS TO CHANGING COMMUNITY NEEDS THROUGH THE SERVICES OFFERED. THE HOSPITAL CONDUCTS A COMMUNITY NEEDS ASSESSMENT EVERY 3 YEARS AND UPDATES ARE PROVIDED BETWEEN ASSESSMENTS. MERCY TIFFIN HOSPITAL INCORPORATES PLANNING FOR COMMUNITY BENEFITS AS PART OF ITS ANNUAL BUSINESS AND STRATEGIC PLANNING PROCESSES. THE HOSPITAL RECOGNIZES THAT 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, AND ETHNICITY, SOCIOECONOMIC DATA INCLUDING INCOME, EDUCATION, AND HEALTH INSURANCE RATES, PRIMARY CARE AND CHRONIC DISEASE NEEDS OF UNINSURED PERSONS, AND DATA ON HEALTH DISPARITIES IN HEALTH OUTCOMES AMONG MINORITY GROUPS. MERCY TIFFIN HOSPITAL HAS A DEDICATED STAFF TO ASSIST IN THE COMMUNITY BENEFIT EFFORT. THE HOSPITAL'S COMMUNITY BENEFITS COMMITTEE MEETS QUARTERLY TO PROVIDE OVERSIGHT TO THE ORGANIZATION'S COMMUNITY BENEFITS PROGRAM. MERCY TIFFIN HOSPITAL WORKS CLOSELY WITH HEALTH AND HUMAN SERVICE ORGANIZATIONS IN THE AREA, PARTNERING WITH SOME TO PROVIDE SERVICES AND TO AVOID DUPLICATION. |
| Patient education of eligibility for assistance. | Schedule H, Part VI, Line 3 | MERCY TIFFIN HOSPITAL POSTS ITS CHARITY CARE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSIONS AREAS, EMERGENCY DEPARTMENTS AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. THE HOSPITAL PROVIDES A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO PATIENTS AS PART OF THE INTAKE PROCESS AND WITH DISCHARGE MATERIALS. ADDITIONALLY, A COPY OF THE POLICY OR A SUMMARY ALONG WITH FINANCIAL ASSISTANCE CONTACT INFORMATION IS INCLUDED IN PATIENT BILLS. MERCY TIFFIN HOSPITAL DISCUSSES WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSISTS THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. THE MERCY TIFFIN HOSPITAL ELIGIBILITY LINK PROGRAM (HELP) IS A FREE REFERRAL SERVICE PROVIDED BY MERCY TIFFIN HOSPITAL. THE PURPOSE OF HELP IS TO ASSIST PATIENTS IN OBTAINING MEDICAL BENEFITS THROUGH FEDERAL, STATE, AND HOSPITAL PROGRAMS. HELP REPRESENTATIVES WILL PROVIDE THE FOLLOWING SERVICES AT NO COST TO THE PATIENT: * EXPLORE ELIGIBILITY UNDER PUBLIC ASSISTANCE PROGRAMS * FILE APPLICATIONS ON PATIENT'S BEHALF * SCHEDULE AND ATTEND APPOINTMENTS * PROVIDE TRANSPORTATION WHEN NECESSARY * PROVIDE MEDICAL DOCUMENTATION TO SOCIAL SECURITY ADMINISTRATION FOR DISABILITY CLAIMS. THROUGH HELP, PATIENTS AND THEIR COUNSELORS LOOK AT WHAT OPTIONS ARE AVAILABLE. MERCY TIFFIN HOSPITAL UNDERSTANDS THAT NOT EVERYONE CAN PAY FOR HEALTHCARE SERVICES. HELP IS HERE TO OFFER OPTIONS AND ASSISTANCE FOR THOSE WHO ARE UNINSURED OR UNDERINSURED. HELP IS AN EXTENSION OF THE HOSPITAL'S MISSION TO IMPROVE THE HEALTH OF OUR COMMUNITY WITH EMPHASIS ON THE POOR AND UNDERSERVED. MEETING THE NEEDS OF THOSE WITH LIMITED RESOURCES HAS ALWAYS BEEN THE HEART OF OUR MISSION. IN 2011, HELP MANAGED 4,394 PATIENT REFERRALS. MERCY TIFFIN HOSPITAL IS PROUD TO MAKE OUR FINANCIAL ASSISTANCE INFORMATION AVAILABLE TO THE PUBLIC THROUGH OUR WEBSITE, WHICH CAN BE FOUND AT WWW.MERCYWEB.ORG. |
| Community information. | Schedule H, Part VI, Line 4 | MERCY TIFFIN HOSPITAL SERVES A FOUR-COUNTY GEOGRAPHIC AREA FEATURING THE FOLLOWING COUNTIES: SANDUSKY, SENECA, WOOD, AND WYANDOT IN OHIO. THE POPULATION OF MERCY TIFFIN HOSPITAL'S PRIMARY SERVICE AREA IS APPROXIMATELY 56,000 AND IS OLDER, POORER AND HAS WORSE HEALTH STATISTICS THAN STATE AND NATIONAL AVERAGES. OUR COMMUNITY IS CHANGING AND WE ALSO SERVE A GROWING UNINSURED AND UNDERINSURED POPULATION. MERCY TIFFIN HOSPITAL IS THE ONLY HOSPITAL IN THE COMMUNITY, AND IT IS A NOT-FOR-PROFIT HOSPITAL. TIFFIN IS NOT FEDERALLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA OR POPULATION. THE DEMOGRAPHIC AREA SERVED BY MERCY TIFFIN HOSPITAL SERVES THE FOLLOWING ETHNIC AND CULTURAL GROUPS: CAUCASIAN (91.6%), HISPANIC/LATINO (4.3%), BLACK (2.1%), TWO OR MORE RACES (1.2%), ASIAN (.5%), AMERICAN INDIAN/ALASKA NATIVE (.3%), 11.1% OF RESIDENTS ARE IN HOUSEHOLDS BELOW THE FEDERAL POVERTY GUIDELINES. 18.4% OF FAMILIES ARE ON MEDICAID OR OTHER ASSISTANCE. IN THE COMMUNITY SERVED BY MERCY TIFFIN HOSPITAL HEART DISEASE, CANCER, AND STROKE ARE THE MAJOR HEALTH PROBLEMS AND/OR LEADING CAUSES OF DEATH. EACH OF THESE ARE PREVENTABLE THROUGH PROPER CARE AND MAINTAINING CONTROL OF THE ILLNESS/DISEASE AS WELL AS LEADING HEALTHIER LIVES. THE SMOKING RATE IS 19% OF THE POPULATION. MERCY TIFFIN HOSPITAL WORKS CLOSELY WITH LOCAL COMMUNITY AGENCIES AND HEALTH DEPARTMENTS TO ADDRESS THESE PROBLEMS AND MINIMIZE THE EFFECTS ON THOSE WHO SUFFER. IN 2011, MERCY TIFFIN HOSPITAL HAD 2,303 ADMISSIONS, 87,876 OUTPATIENT VISITS, AND 17,704 EMERGENCY ROOM VISITS. |
| Promotion of community health | Schedule H, Part VI, Line 5 | MERCY TIFFIN HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO PROVIDING EMERGENCY SERVICES, MERCY TIFFIN HOSPITAL ALSO PROVIDES MINOR EMERGENCY AND URGENT CARE SERVICES TO ALL REGARDLESS OF ABILITY TO PAY. THE HOSPITAL OPERATES RURAL HEALTH CLINICS, PSYCHIATRIC, SKILLED NURSING, RENAL DIALYSIS, NEWBORN NURSERY, WOUND CARE, AND DIABETES MANAGEMENT DEPARTMENTS. MERCY TIFFIN HOSPITAL HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA (WITH CERTAIN LIMITED EXCEPTIONS INVOLVING TRADITIONALLY EXCLUSIVE HOSPITAL-BASED SERVICES). THE MAJORITY OF THE GOVERNING BODY CONSISTS OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY SERVED BY THE HOSPITAL. MERCY TIFFIN HOSPITAL PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. MERCY TIFFIN HOSPITAL'S EMERGENCY DEPARTMENT TREATS AN INCREASING NUMBER OF PATIENTS WHO USE THE FACILITY FOR PRIMARY CARE NEEDS. PATIENT DEMOGRAPHICS REFLECT THE CHANGING COMMUNITY. AS IN OTHER COMMUNITIES, SOME AREA PHYSICIANS PLACE LIMITS ON THEIR ACCEPTANCE OF MEDICAID PATIENTS. IN ADDITION, SOME PRIMARY CARE PHYSICIANS REFER PATIENTS WITH AFTER-HOURS NEEDS DIRECTLY TO AREA EMERGENCY ROOMS. |
| Affiliated health care system | Schedule H, Part VI, Line 6 | MERCY TIFFIN HOSPITAL IS A MEMBER OF MERCY HEALTH PARTNERS-NORTHERN REGION AND IS AFFILIATED WITH ST. VINCENT MERCY MEDICAL CENTER, ST. CHARLES MERCY HOSPITAL, MERCY ST. ANNE HOSPITAL, AND MERCY HOSPITAL WILLARD. ALL ARE OHIO NON-PROFIT CORPORATIONS. THE HOSPITAL IS SPONSORED BY THE SISTERS OF MERCY AND SISTERS OF CHARITY OF MONTREAL (GREY NUNS) AND HAS BEEN AN INTEGRAL PART OF THE COMMUNITY SINCE 1913. MERCY TIFFIN HOSPITAL IS AN ACUTE CARE HOSPITAL WITH APPROXIMATELY 120 LICENSED BEDS. MERCY HEALTH PARTNERS-NORTHERN REGION COMMUNITY BENEFIT FOR 2011 PER THE AUDIT FOOTNOTE IS AS FOLLOWS: TOTAL 2011 COMMUNITY BENEFIT: $79.1 MILLION BENEFITS TO THE BROADER COMMUNITY: $19.0 MILLION UNREIMBURSED CARE FOR THOSE WHO ARE POOR AND QUALIFY FOR MEDICAID: $18.0 MILLION COST OF CARE FOR THOSE WHO COULD NOT AFFORD TO PAY: $27.0 MILLION SUPPORT FOR OTHER PROGRAMS FOR THOSE WHO ARE POOR: $15.1 MILLION COMMUNITY BENEFIT AS PERCENT OF TOTAL EXPENSE: 10.0 PERCENT MERCY TIFFIN HOSPITAL IS 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 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 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (19 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AJITKUMAR DESAI MD | |||||||||||||
| 422677 | 0 | 0 | 0 | 6858 | 0 | 0 | 0 | 250 | 0 | 429785 | 0 | 0 | 0 |
| ANDREA PRICE | |||||||||||||
| 0 | 508553 | 0 | 174752 | 0 | 9556 | 0 | 133810 | 0 | 30946 | 0 | 857617 | 0 | 0 |
| BARRY HUDGIN | |||||||||||||
| 0 | 233525 | 0 | 48616 | 0 | 9685 | 0 | 29225 | 0 | 9284 | 0 | 330335 | 0 | 0 |
| CAROL WHITTAKER | |||||||||||||
| 0 | 324182 | 0 | 65686 | 0 | 14702 | 0 | 172875 | 0 | 14951 | 0 | 592396 | 0 | 0 |
| DALE THORNTON | |||||||||||||
| 262153 | 0 | 70441 | 0 | 25664 | 0 | 80083 | 0 | 5735 | 0 | 444076 | 0 | 0 | 0 |
| DAVID AROSE | |||||||||||||
| 0 | 211381 | 0 | 47769 | 0 | 2638 | 0 | 15206 | 0 | 10152 | 0 | 287146 | 0 | 0 |
| GARY GEORGE | |||||||||||||
| 0 | 263407 | 0 | 71249 | 0 | 11829 | 0 | 107989 | 0 | 10322 | 0 | 464796 | 0 | 0 |
| H TERRENCE SMITH | |||||||||||||
| 0 | 200629 | 0 | 84100 | 0 | 147273 | 0 | 74692 | 0 | 25347 | 0 | 532041 | 0 | 0 |
| IMRAN ANDRABI MD | |||||||||||||
| 0 | 415318 | 0 | 115415 | 0 | 9270 | 0 | 54337 | 0 | 23798 | 0 | 618138 | 0 | 0 |
| JIM ALBIN | |||||||||||||
| 0 | 0 | 0 | 0 | 0 | 144065 | 0 | 12187 | 0 | 0 | 0 | 156252 | 0 | 0 |
| JOHN M STARCHER JR | |||||||||||||
| 0 | 554955 | 0 | 211413 | 0 | 140214 | 0 | 140693 | 0 | 26716 | 0 | 1073991 | 0 | 0 |
| JOSEPH GLASS | |||||||||||||
| 0 | 213439 | 0 | 59448 | 0 | 7925 | 0 | 23647 | 0 | 22097 | 0 | 326556 | 0 | 0 |
| ROBERT CECCHINO MD | |||||||||||||
| 274167 | 0 | 0 | 0 | 3564 | 0 | 0 | 0 | 250 | 0 | 277981 | 0 | 0 | 0 |
| ROBERT MOON | |||||||||||||
| 0 | 374752 | 0 | 0 | 0 | 2115 | 0 | 72189 | 0 | 26946 | 0 | 476002 | 0 | 0 |
| STEVEN BRUHL MD | |||||||||||||
| 141184 | 0 | 40000 | 0 | 121 | 0 | 0 | 0 | 0 | 0 | 181305 | 0 | 0 | 0 |
| STEVEN L MICKUS | |||||||||||||
| 0 | 835062 | 0 | 338741 | 0 | 219702 | 0 | 296067 | 0 | 26507 | 0 | 1716079 | 0 | 0 |
| STEVEN WAGNER MD | |||||||||||||
| 162983 | 0 | 61524 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 224507 | 0 | 0 | 0 |
| THOMAS ARQUILLA | |||||||||||||
| 0 | 193307 | 0 | 20000 | 0 | 5901 | 0 | 20868 | 0 | 11212 | 0 | 251288 | 0 | 0 |
| TODD WARNER | |||||||||||||
| 0 | 193493 | 0 | 54454 | 0 | 7903 | 0 | 37112 | 0 | 21492 | 0 | 314454 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Arrangement used to establish the top management official's compensation | Schedule J, Part I, Line 3 | THE COMPENSATION OF DALE THORNTON, PRESIDENT AND CEO OF MERCY HOSPITAL TIFFIN, IS DETERMINED BY MERCY HEALTH PARTNERS - NORTHERN REGION (MHP), A RELATED TAX-EXEMPT ORGANIZATION. MHP UTILIZES AN INDEPENDENT COMPENSATION CONSULTANT, A COMPENSATION SURVEY, AND APPROVAL BY BOARD OR COMPENSATION COMMITTEE WHEN DETERMINING MR. THORNTON'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: H. TERRENCE SMITH $117,577. |
| Supplemental nonqualified retirement plan | Schedule J, Part I, Line 4b | THE MERCY HEALTH PARTNERS (MHP) - NORTHERN REGION NONQUALIFIED SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN IS FOR CERTAIN HIGHLY COMPENSATED INDIVIDUALS AS DETERMINED BY THE BOARD OF TRUSTEES' EXECUTIVE EVALUATION AND COMPENSATION COMMITTEE TO PROVIDE A BENEFIT TO REPLACE THE BENEFIT THESE PARTICIPANTS WOULD HAVE RECEIVED UNDER THE FORMULA OF THE APPLICABLE QUALIFIED PLAN PRIOR TO ITS AMENDMENT TO COMPLY WITH THE OMNIBUS BUDGET RECONCILIATION ACT OF 1993, AND PROVIDING A DEFERRED COMPENSATION PLAN OF 5% OF ANNUAL BASE SALARY TO RETAIN EXECUTIVES. PARTICIPANTS VEST IN THIS PLAN AND RECEIVE A BENEFIT UNDER THIS PLAN ONCE THEY HAVE SATISFIED BOTH OF THESE TWO CONDITIONS: (1) MEET THE VESTING REQUIREMENTS OF THE APPLICABLE QUALIFIED PLAN, AND (2) COMPLETE A 24-MONTH POST-EMPLOYMENT NON-COMPETE REQUIREMENT. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO SERP PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: DALE THORNTON $11,851; JIM ALBIN $144,065; GARY GEORGE $0; IMRAN ANDRABI, MD $0; H. TERRENCE SMITH $0; CAROL WHITTAKER $0. |
| THE CHP SERP PLAN | PART I, LINE 4B | THE CATHOLIC HEALTH PARTNERS (CHP) SERP PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATE. IT PROVIDES ANNUAL CREDITS OF A SPECIFIED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST 50%, 75%, AND 100% IN THEIR ACCOUNTS AFTER 5, 6, AND 7 YEARS OF SERVICE, RESPECTIVELY, VESTING OCCURS EARLIER FOR DEATH OR TOTAL DISABILITY OR REACHING AGE 60 WHILE EMPLOYED, OR INVOLUNTARY TERMINATION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHANGE IN CONTROL OF THE ORGANIZATION OR DUE TO POSITION ELIMINATION, PAYMENTS DURING EMPLOYMENT ARE MADE FOR REQUIRED TAX WITHHOLDINGS. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS AFTER TERMINATION OF EMPLOYMENT. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO SERP PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: JOHN M. STARCHER, JR. $118,835; STEVEN L. MICKUS $184,461; ANDREA PRICE $0. |
| THE CHP EXECUTIVE RETENTION PLAN | PART I, LINE 4B | THE CATHOLIC HEALTH PARTNERS (CHP) EXECUTIVE RETENTION PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES EMPLOYMENT CONTINUATION INCENTIVES 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 AND CEASE TO RECEIVE CREDITS AFTER 5 YEARS OF PLAN PARTICIPATION PROVIDED THEY REMAIN EMPLOYED. VESTING AND CESSATION OF CREDITS OCCUR EARLIER FOR DEATH OR TOTAL DISABILITY WHILE EMPLOYED, INVOLUNTARY TERMINATION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHANGE IN CONTROL OF THE ORGANIZATION, OR, FOR CERTAIN PARTICIPANTS, UPON BEING OFFERED A SPECIFIED PROMOTION. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS UPON VESTING. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO RETENTION PLAN PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: JOHN M. STARCHER, JR. $0; STEVEN L. MICKUS $0; ROBERT MOON $0. |
| Non-fixed payments | Schedule J, Part I, Line 7 | THE ORGANIZATION PROVIDES ANNUAL INCENTIVE COMPENSATION FOR LISTED INDIVIDUALS. THE ORGANIZATION'S BOARD OF TRUSTEES ESTABLISHES OBJECTIVE THRESHOLDS FOR QUALITY, COMMUNITY BENEFIT, AND FINANCIAL PERFORMANCE WHICH MUST BE ACHIEVED FOR INCENTIVES TO BE AWARDED. THE BOARD ALSO ESTABLISHES THRESHOLD, TARGET AND MAXIMUM LEVELS FOR INCENTIVE AWARDS. WITHIN THESE ESTABLISHED PARAMETERS, THE CEO RECOMMENDS INCENTIVE AWARDS FOR LISTED INDIVIDUALS TO THE BOARD'S EXECUTIVE EVALUATION AND COMPENSATION COMMITTEE. THE BOARD COMMITTEE REVIEWS AND APPROVES OR MODIFIES THE CEO'S RECOMMENDATIONS. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 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 HEALTH PARTNERS NORTHERN REGION IS THE MEMBER OF MERCY HOSPITAL OF TIFFIN, OHIO. |
| 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 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 AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. A COPY OF THE FORM 990 IS THEN REVIEWED BY MANAGEMENT. UPON REVIEW, THE FORM 990 IS THEN FORWARDED TO THE GOVERNING BODY AND BOARD FOR REVIEW, THEN TO THE AUDIT & CORPORATE RESPONSIBILITY COMMITTEE FOR APPROVAL. ADDITIONALLY, THE COMPENSATION COMMITTEE REVIEWS ALL COMPENSATION RELATED SCHEDULES AND DISCLOSURES. BOTH THE AUDIT & CORPORATE RESPONSIBILITY COMMITTEE AND THE COMPENSATION COMMITTEE ARE INDEPENDENT OF THE FILING ORGANIZATION. ONCE THE FORM 990 IS REVIEWED BY ALL APPLICABLE PARTIES, A COPY OF THE FINAL VERSION IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING. |
| Conflict of interest policy | Form 990, Part VI, Section B, Line 12c | ANNUALLY, ALL BOARD MEMBERS COMPLETE AND SIGN A CONFLICT OF INTEREST STATEMENT. THIS IS REVIEWED BY THE REGIONAL AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE. TO REINFORCE THE CONFLICT OF INTEREST POLICY AT EACH BOARD MEETING, THE CHAIRMAN MAKES A STATEMENT AND ASKS EVERYONE WHO MAY HAVE A CONFLICT OF INTEREST FOR ANY ITEM TO EXCUSE THEMSELVES. |
| Governing documents, conflict of interest policy and financial statements available to the public | Form 990, Part VI, Section C, Line 19 | THE SYSTEM WIDE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE POSTED ON THE CATHOLIC HEALTH PARTNER'S WEBSITE. |
| Average number of hours devoted per week to related organization | Form 990, Part VII, Section A, Column B | DALE THORNTON - 2 STEVEN L. MICKUS - 57.4 ANDREA PRICE - 56.5 JOHN M. STARCHER, JR. - 58.8 SR. NOEL FREY, RSM - 1 ROBERT MOON - 58.5 TODD WARNER - 58.5 BARRY HUDGIN - 55 CAROL WHITTAKER - 54.5 GARY GEORGE - 54 H. TERRENCE SMITH - 54 IMRAN ANDRABI, MD - 56 JOSEPH GLASS - 54 THOMAS ARQUILLA - 54 |
| Other changes in net assets or fund balances | Form 990, Part XI, Line 5 | NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - -1439944; PENSION ADJUSTMENT CHANGE IN PLAN - -4002224; MEDICAL RETIREE - 91924; DISTRIBUTIONS TO PARTNERS - -50453; ADJUST MINORITY INTEREST ELIMINATION - -191769; |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (100 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 | 501(C)(3) | 11 - Type III - FI | CATHOLIC HEALTH PARTNERS | false |
| MERCY HEALTH PARTNERS OF SOUTHWEST OHIO FOUNDATION | ||||||||||
| 4600 MCAULEY PLACE | CINCINNATI | OH | 45242 | 311217563 | FOUNDATION | OH | 501(C)(3) | 7 | MERCY HEALTH PARTNERS OF SOUTHWEST OHIO | false |
| MERCY HOSPITALS WEST | ||||||||||
| 2446 KIPLING AVENUE | CINCINNATI | OH | 45239 | 311091597 | HOSPITAL | OH | 501(C)(3) | 3 | MERCY HEALTH PARTNERS OF SOUTHWEST OHIO | false |
| MERCY HOSPITAL ANDERSON | ||||||||||
| 7500 STATE ROAD | CINCINNATI | OH | 45255 | 310537085 | HOSPITAL | OH | 501(C)(3) | 3 | MERCY HEALTH PARTNERS OF SOUTHWEST OHIO | false |
| THE SISTERS OF MERCY OF HAMILTON OHIO | ||||||||||
| 3000 MACK ROAD | FAIRFIELD | OH | 45014 | 310538532 | HOSPITAL | OH | 501(C)(3) | 3 | MERCY HEALTH PARTNERS OF SOUTHWEST OHIO | false |
| THE SISTERS OF MERCY OF CLERMONT COUNTY OHIO | ||||||||||
| 3000 HOSPITAL DRIVE | BATAVIA | OH | 45103 | 310830955 | HOSPITAL | OH | 501(C)(3) | 3 | MERCY HEALTH PARTNERS OF SOUTHWEST OHIO | false |
| MERCY FRANCISCAN SENIOR HEALTH AND HOUSING SERVICES INC | ||||||||||
| 7010 ROWAN HILLS DR | CINCINNATI | OH | 45227 | 311308729 | RETIREMENT HOME | OH | 501(C)(3) | 9 | MERCY HEALTH PARTNERS OF SOUTHWEST OHIO | false |
| MERCY SACRED HEART INC | ||||||||||
| 2120 PAYNE STREET | LOUISVILLE | KY | 40206 | 611318326 | RETIREMENT HOME | KY | 501(C)(3) | 9 | MERCY HEALTH PARTNERS OF SOUTHWEST OHIO | false |
| MERCY LONG TERM CARE INITIATIVE | ||||||||||
| 4915 CHARLESTOWN RD | NEW ALBANY | IN | 47150 | 311332491 | RETIREMENT HOME | IN | 501(C)(3) | 9 | MERCY HEALTH PARTNERS OF SOUTHWEST OHIO | false |
| MERCY FRANCISCAN SOCIAL MINISTRIES INC | ||||||||||
| 1800 LOGAN STREET | CINCINNATI | OH | 45210 | 311222942 | LOW INCOME HOUSING | OH | 501(C)(3) | 7 | MERCY HEALTH PARTNERS OF SOUTHWEST OHIO | false |
| MERCY FRANCISCAN AT ST RAPHAEL INC | ||||||||||
| 610 HIGH STREET | HAMILTON | OH | 45011 | 202934871 | SERVICES TO THE POOR | OH | 501(C)(3) | 7 | MERCY HEALTH PARTNERS OF SOUTHWEST OHIO | false |
| COMMUNITY MERCY HEALTH SYSTEM | ||||||||||
| ONE S LIMESTONE ST | SPRINGFIELD | OH | 45502 | 300272454 | REGIONAL PARENT | OH | 501(C)(3) | 11 - Type III - FI | CATHOLIC HEALTH PARTNERS | false |
| COMMUNITY MERCY HEALTH PARTNERS | ||||||||||
| ONE S LIMESTONE ST | SPRINGFIELD | OH | 45502 | 310785684 | HOSPITAL | OH | 501(C)(3) | 3 | COMMUNITY MERCY HEALTH SYSTEM | false |
| THE COMMUNITY MERCY FOUNDATION | ||||||||||
| 1343 N FOUNTAIN BLVD | SPRINGFIELD | OH | 45504 | 311443778 | FOUNDATION | OH | 501(C)(3) | 7 | COMMUNITY MERCY HEALTH SYSTEM | false |
| C H HEALTH SERVICES COMPANY | ||||||||||
| ONE S LIMESTONE ST | SPRINGFIELD | OH | 45502 | 311181984 | HOSPITAL | OH | 501(C)(3) | 3 | COMMUNITY MERCY HEALTH SYSTEM | false |
| CLARKE & CHAMPAIGN COUNTIES HEALTH INFORMATION EXCHANGE | ||||||||||
| 1150 E HOME ROAD | SPRINGFIELD | OH | 45503 | 260698515 | MEDICAL INFORMATION EXCHANGE | OH | 501(C)(3) | 9 | COMMUNITY MERCY HEALTH SYSTEM | false |
| THE WALLACE S MURRAY AND FRANCES RABBITTS MURRAY MEMORIAL TRUST | ||||||||||
| ONE S LIMESTONE ST | SPRINGFIELD | OH | 45502 | 346827136 | INDIGENT MEDICAL CARE | OH | 501(C)(3) | 11 - Type I | NA | false |
| MERCY HEALTH SYSTEM - NORTHERN REGION | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341344482 | REGIONAL PARENT | OH | 501(C)(3) | 11 - Type III - FI | CATHOLIC HEALTH PARTNERS | false |
| MERCY PROPERTY HOLDINGS | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 300699825 | TITLE HOLDING COMPANY | OH | 501(C)(2) | N/A | MERCY HEALTH SYSTEM - NORTHERN REGION | false |
| ST CHARLES MERCY HOSPITAL OF OREGON OHIO | ||||||||||
| 2600 NAVARRE AVENUE | OREGON | OH | 43616 | 344445373 | HOSPITAL | OH | 501(C)(3) | 3 | MERCY HEALTH SYSTEM - NORTHERN REGION | false |
| ST CHARLES MERCY HEALTH FOUNDATION | ||||||||||
| 2600 NAVARRE AVENUE | OREGON | OH | 43616 | 341414900 | FOUNDATION | OH | 501(C)(3) | 11 - Type III - FI | ST CHARLES MERCY HOSPITAL OF OREGON OHIO | false |
| RIVERSIDE MERCY HOSPITAL | ||||||||||
| 3404 W SYLVANIA AVE | TOLEDO | OH | 43623 | 311556401 | HOSPITAL | OH | 501(C)(3) | 3 | MERCY HEALTH SYSTEM - NORTHERN REGION | false |
| MERCY HOME CARE INC | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341587572 | HOME HEALTHCARE | OH | 501(C)(3) | 9 | MERCY HEALTH SYSTEM - NORTHERN REGION | false |
| MERCY COLLEGE OF OHIO | ||||||||||
| 2221 MADISON AVENUE | TOLEDO | OH | 43604 | 341726619 | MEDICAL COLLEGE | OH | 501(C)(3) | 2 | MERCY HEALTH SYSTEM - NORTHERN REGION | false |
| MERCY COLLEGE OF OHIO FOUNDATION INC | ||||||||||
| 2221 MADISON AVENUE | TOLEDO | OH | 43604 | 141963204 | FOUNDATION | OH | 501(C)(3) | 11 - Type I | MERCY COLLEGE OF OHIO | false |
| MERCY HOSPITAL OF TIFFIN OHIO | ||||||||||
| 45 ST LAWRENCE DRIVE | TIFFIN | OH | 44883 | 344431174 | HOSPITAL | OH | 501(C)(3) | 3 | MERCY HEALTH SYSTEM - NORTHERN REGION | false |
| MERCY TIFFIN HEALTH FOUNDATION | ||||||||||
| 45 ST LAWRENCE DRIVE | TIFFIN | OH | 44883 | 341499894 | FOUNDATION | OH | 501(C)(3) | 11 - Type III - FI | MERCY HOSPITAL OF TIFFIN OHIO | false |
| THE SISTERS OF MERCY OF WILLARD OHIO | ||||||||||
| 110 EAST HOWARD ST | WILLARD | OH | 44890 | 341577110 | HOSPITAL | OH | 501(C)(3) | 3 | MERCY HEALTH SYSTEM - NORTHERN REGION | false |
| MERCY HOSPITAL OF WILLARD FOUNDATION | ||||||||||
| 110 EAST HOWARD ST | WILLARD | OH | 44890 | 113742347 | FOUNDATION | OH | 501(C)(3) | 11 - Type III - FI | THE SISTERS OF MERCY OF WILLARD OHIO | false |
| ST VINCENT MERCY MEDICAL CENTER | ||||||||||
| 2213 CHERRY STREET | TOLEDO | OH | 43608 | 344428250 | HOSPITAL | OH | 501(C)(3) | 3 | MERCY HEALTH SYSTEM - NORTHERN REGION | false |
| ST VINCENT MERCY MEDICAL CENTER FOUNDATION | ||||||||||
| 2213 CHERRY STREET | TOLEDO | OH | 43608 | 237393213 | FOUNDATION | OH | 501(C)(3) | 11 - Type III - FI | ST VINCENT MERCY MEDICAL CENTER | false |
| LIFESTAR AMBULANCE INC | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341354653 | MEDICAL TRANSPORTATION | OH | 501(C)(3) | 11 - Type II | MERCY HEALTH SYSTEM - NORTHERN REGION | false |
| RSM MEDICAL FOUNDATION | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43624 | 341693671 | HOSPITAL | OH | 501(C)(3) | 3 | MERCY HEALTH SYSTEM - NORTHERN REGION | false |
| ST MARGUERITE D'YOUVILLE FOUNDATION II | ||||||||||
| 2213 CHERRY STREET | TOLEDO | OH | 43608 | 134350655 | FOUNDATION | OH | 501(C)(3) | 11 - Type II | CATHOLIC HEALTH PARTNERS | false |
| SIMON OUTREACH SERVICES | ||||||||||
| 2600 NAVARRE AVENUE | OREGON | OH | 43616 | 341383325 | MEDICAL OFFICE RENTAL | OH | 501(C)(3) | 11 - Type II | ST CHARLES MERCY HOSPITAL OF OREGON OHIO | false |
| FARLEY HEALTHCARE CORPORATION | ||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341363204 | HEALTH SERVICES | OH | 501(C)(3) | 9 | MERCY HEALTH SYSTEM - NORTHERN REGION | false |
| ST RITA'S MEDICAL CENTER | ||||||||||
| 730 W MARKET STREET | LIMA | OH | 45801 | 341105619 | HOSPITAL | OH | 501(C)(3) | 3 | CATHOLIC HEALTH PARTNERS | false |
| SRHC FOUNDATION | ||||||||||
| 730 W MARKET STREET | LIMA | OH | 45801 | 341368429 | FOUNDATION | OH | 501(C)(3) | 11 - Type III - FI | ST RITA'S MEDICAL CENTER | false |
| NEW VISION MEDICAL LABORATORIES INC | ||||||||||
| 750 W HIGH ST STE 400 | LIMA | OH | 45801 | 341937267 | MEDICAL LAB SERVICES | OH | 501(C)(3) | 11 - Type III - FI | ST RITA'S MEDICAL CENTER | false |
| HUMILITY OF MARY HEALTH PARTNERS | ||||||||||
| 1044 BELMONT AVENUE | YOUNGSTOWN | OH | 44501 | 340505560 | HOSPITAL | OH | 501(C)(3) | 3 | CATHOLIC HEALTH PARTNERS | false |
| THE ASSUMPTION VILLAGE | ||||||||||
| 9800 N MARKET STREET | NORTH LIMA | OH | 44452 | 341013695 | NURSING HOME | OH | 501(C)(3) | 9 | HUMILITY OF MARY HEALTH PARTNERS | false |
| HOSPICE OF THE VALLEY | ||||||||||
| 5190 MARKET STREET | YOUNGSTOWN | OH | 44512 | 341288745 | HOSPICE SERVICES | OH | 501(C)(3) | 9 | HUMILITY OF MARY HEALTH PARTNERS | false |
| HUMILITY OF MARY DEVELOPMENT FOUNDATION | ||||||||||
| 1044 BELMONT AVENUE | YOUNGSTOWN | OH | 44501 | 341826978 | FOUNDATION | OH | 501(C)(3) | 11 - Type III - FI | HUMILITY OF MARY HEALTH PARTNERS | false |
| HUMILITY HOUSE | ||||||||||
| 755 OHLTOWN ROAD | AUSTINTOWN | OH | 44515 | 341894783 | NURSING HOME | OH | 501(C)(3) | 9 | HUMILITY OF MARY HEALTH PARTNERS | false |
| LAUREL LAKE RETIREMENT COMMUNITY INC | ||||||||||
| 200 LAUREL LAKE DRIVE | HUDSON | OH | 44236 | 341481142 | NURSING HOME | OH | 501(C)(3) | 9 | HUMILITY OF MARY HEALTH PARTNERS | false |
| LAUREL LAKE RETIREMENT COMMUNITY FOUNDATION INC | ||||||||||
| 200 LAUREL LAKE DRIVE | HUDSON | OH | 44236 | 341779303 | FOUNDATION | OH | 501(C)(3) | 7 | LAUREL LAKE RETIREMENT COMMUNITY INC | false |
| ST JOSEPH HEALTH CENTER AUXILIARY | ||||||||||
| 677 EASTLAND SE | WARREN | OH | 44484 | 346556121 | FUNDRAISING | OH | 501(C)(3) | 9 | HUMILITY OF MARY HEALTH PARTNERS | false |
| MERCY HEALTH PARTNERS - LOURDES INC | ||||||||||
| 1530 LONE OAK ROAD | PADUCAH | KY | 42003 | 610600313 | HOSPITAL | KY | 501(C)(3) | 3 | CATHOLIC HEALTH PARTNERS | false |
| LOURDES FOUNDATION INC | ||||||||||
| 1530 LONE OAK ROAD | PADUCAH | KY | 42003 | 611258960 | FOUNDATION | KY | 501(C)(3) | 7 | MERCY HEALTH PARTNERS - LOURDES INC | false |
| LOURDES HOSPITAL AUXILIARY GIFT SHOP | ||||||||||
| 1530 LONE OAK ROAD | PADUCAH | KY | 42003 | 610927805 | FUNDRAISING | KY | 501(C)(3) | 11 - Type III - FI | LOURDES FOUNDATION INC | false |
| MARCUM AND WALLACE MEMORIAL HOSPITAL INC | ||||||||||
| 60 MERCY COURT | IRVINE | KY | 40336 | 610927491 | HOSPITAL | KY | 501(C)(3) | 3 | MERCY HEALTH PARTNERS - LOURDES INC | false |
| MARCUM AND WALLACE HOSPITAL FOUNDATION INC | ||||||||||
| 60 MERCY COURT | IRVINE | KY | 40336 | 320026557 | FOUNDATION | KY | 501(C)(3) | 11 - Type III - FI | MARCUM AND WALLACE MEMORIAL HOSPITAL INC | false |
| MERCY HEALTH PARTNERS INC | ||||||||||
| 900 EAST OAK HILL AVE | KNOXVILLE | TN | 37917 | 731627534 | REGIONAL PARENT | TN | 501(C)(3) | 11 - Type I | CATHOLIC HEALTH PARTNERS | false |
| MERCY HEALTH SYSTEM INC | ||||||||||
| 900 EAST OAK HILL AVE | KNOXVILLE | TN | 37917 | 620480068 | HOSPITAL | TN | 501(C)(3) | 3 | MERCY HEALTH PARTNERS INC | false |
| ST MARY'S MEDICAL CENTER OF CAMPBELL COUNTY INC | ||||||||||
| 923 EAST CENTRAL AVE | LAFOLLETTE | TN | 37766 | 621817376 | HOSPITAL | TN | 501(C)(3) | 3 | MERCY HEALTH PARTNERS INC | false |
| MERCY HEALTH PARTNERS FOUNDATION INC | ||||||||||
| 900 EAST OAK HILL AVE | KNOXVILLE | TN | 37917 | 621247676 | FOUNDATION | TN | 501(C)(3) | 7 | MERCY HEALTH PARTNERS INC | false |
| JEFFERSON MEMORIAL HOSPITAL INC | ||||||||||
| 110 HOSPITAL DRIVE | JEFFERSON CITY | TN | 37760 | 621660663 | HOSPITAL | TN | 501(C)(3) | 3 | MERCY HEALTH PARTNERS INC | false |
| JEFFERSON MEMORIAL FOUNDATION INC | ||||||||||
| 110 HOSPITAL DRIVE | JEFFERSON CITY | TN | 37760 | 621660666 | FOUNDATION | TN | 501(C)(3) | 11 - Type III - FI | JEFFERSON MEMORIAL HOSPITAL INC | false |
| ST MARY'S MEDICAL CENTER OF SCOTT COUNTY INC | ||||||||||
| 18797 ALBERTA STREET | ONEIDA | TN | 37841 | 261535503 | HOSPITAL | TN | 501(C)(3) | 3 | MERCY HEALTH PARTNERS INC | false |
| THE BAPTIST HEALTH SYSTEM FOUNDATION INC | ||||||||||
| 101 BLOUNT AVE BOX 1788 | KNOXVILLE | TN | 37920 | 581565290 | FOUNDATION | TN | 501(C)(3) | 7 | MERCY HEALTH PARTNERS INC | false |
| BAPTIST HOSPITAL OF EAST TENNESSEE INC | ||||||||||
| 137 BLOUNT AVE | KNOXVILLE | TN | 37920 | 620506166 | HOSPITAL | TN | 501(C)(3) | 3 | MERCY HEALTH PARTNERS INC | false |
| BAPTIST HOSPITAL OF COCKE COUNTY INC | ||||||||||
| 435 SECOND STREET | NEWPORT | TN | 37821 | 621133149 | HOSPITAL | TN | 501(C)(3) | 3 | MERCY HEALTH PARTNERS INC | false |
| MERCY HEALTH AND REHABILITATION CENTER INC | ||||||||||
| 3916 BOYDS BRIDGE PIKE | KNOXVILLE | TN | 37917 | 621592992 | REHAB CENTER | TN | 501(C)(3) | 9 | MERCY HEALTH PARTNERS INC | false |
| MERCY HEALTH PARTNERS - NORTHEAST REGION INC | ||||||||||
| 746 JEFFERSON AVENUE | SCRANTON | PA | 18510 | 232813196 | REGIONAL PARENT | PA | 501(C)(3) | 11 - Type III - FI | CATHOLIC HEALTH PARTNERS | false |
| MERCY HEALTHCARE FOUNDATION | ||||||||||
| 746 JEFFERSON AVENUE | SCRANTON | PA | 18510 | 232972928 | FOUNDATION | PA | 501(C)(3) | 11 - Type III - FI | MERCY HEALTH PARTNERS - NORTHEAST REGION INC | false |
| MERCY HOSPITAL SCRANTON PA | ||||||||||
| 746 JEFFERSON AVENUE | SCRANTON | PA | 18510 | 240795456 | HOSPITAL | PA | 501(C)(3) | 3 | MERCY HEALTH PARTNERS - NORTHEAST REGION INC | false |
| MERCY COMMUNITY CARE CORPORATION | ||||||||||
| 746 JEFFERSON AVENUE | SCRANTON | PA | 18510 | 232310566 | MEDICAL CARE | PA | 501(C)(3) | 9 | MERCY HEALTH PARTNERS - NORTHEAST REGION INC | false |
| MERCY MED-CARE INC | ||||||||||
| 746 JEFFERSON AVENUE | SCRANTON | PA | 18510 | 232261991 | HOSPITAL | PA | 501(C)(3) | 3 | MERCY HEALTH PARTNERS - NORTHEAST REGION INC | false |
| MERCY HOSPITAL NANTICOKE | ||||||||||
| 128 W WASHINGTON ST | NANTICOKE | PA | 18634 | 232604818 | HOSPITAL | PA | 501(C)(3) | 3 | MERCY HEALTH PARTNERS - NORTHEAST REGION INC | false |
| MERCY HOSPITAL OF WILKES-BARRE | ||||||||||
| 746 JEFFERSON AVENUE | SCRANTON | PA | 18510 | 240795625 | HOSPITAL | PA | 501(C)(3) | 3 | MERCY HEALTH PARTNERS - NORTHEAST REGION INC | false |
| MERCY HEALTH CARE CENTER | ||||||||||
| 746 JEFFERSON AVENUE | SCRANTON | PA | 18510 | 232322809 | HOSPITAL | PA | 501(C)(3) | 3 | MERCY HEALTH PARTNERS - NORTHEAST REGION INC | false |
| MERCY TYLER HEALTH SYSTEMS | ||||||||||
| 880 SR 6W | TUNKHANNOCK | PA | 18657 | 232772476 | SUPPORTING ORG | PA | 501(C)(3) | 11 - Type II | MERCY HEALTH PARTNERS - NORTHEAST REGION INC | false |
| MERCY TYLER HOSPITAL | ||||||||||
| 880 SR 6W | TUNKHANNOCK | PA | 18657 | 240779665 | HOSPITAL | PA | 501(C)(3) | 3 | MERCY TYLER HEALTH SYSTEMS | false |
| MERCY TYLER HOME HEALTH SERVICES | ||||||||||
| 880 SR 6W | TUNKHANNOCK | PA | 18657 | 232723529 | IN-HOME MEDICAL CARE | PA | 501(C)(3) | 9 | MERCY TYLER HEALTH SYSTEMS | false |
| SIENA SPRINGS | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 311052772 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| SIENA SPRINGS II | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 311591780 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| CHARLES MEADOW CORPORATION | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 341552671 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| CHARLES CREST CORPORATION | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 341399869 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| CHARLES CREST II CORPORATION | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 341714407 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| ST THERESA VILLAGE INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 311411529 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| SACRED HEART VILLAGE INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 311411531 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| SACRED HEART VILLAGE II INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 611339396 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| SACRED HEART VILLAGE III INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 611367719 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| MCAULEY MANOR INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 311548500 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| DUBLIN MANOR INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 020655254 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| MERCY MANOR INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 611344092 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| ST MARY'S VILLA INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 311548512 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| RIVERVIEW ST MARY'S INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 621782683 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
| ST MARY'S VILLA AT RIVERVIEW II INC | ||||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 311723287 | HUD HOUSING PROJECT | OH | 501(C)(3) | 9 | CATHOLIC HEALTH PARTNERS | false |
Form990 Schedule R Part III Form990ScheduleRPartIII (16 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NWO INTEGRATED LABORATORIES MERCY LLC | |||||||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43624 | 341898285 | LABORATORY SERVICES | OH | NA | N/A | |||||
| TIFFIN AMBULATORY SURGICAL ASSOCIATES | |||||||||||||
| 45 ST LAWRENCE DRIVE | TIFFIN | OH | 44833 | 371567866 | AMBULATORY SURGERY CENTER | OH | MERCY HOSPITAL OF TIFFIN OHIO | RELATED | 397670 | 949453 | false | false | 0.51 |
| MERCY HOSPITAL OF DEFIANCE LLC | |||||||||||||
| 1404 E SECOND ST | DEFIANCE | OH | 43512 | 020701635 | HOSPITAL | OH | NA | N/A | |||||
| WEST CENTRAL OHIO REGIONAL HEALTHCARE ALLIANCE | |||||||||||||
| FORT AMANDA ROAD | LIMA | OH | 45804 | 341817078 | REG HOSPITALS | OH | NA | N/A | |||||
| WEST CENTRAL OHIO SURGERY & ENDO CENTER | |||||||||||||
| 770 W HIGH ST SUITE 100 | LIMA | OH | 45801 | 341868154 | AMBULATORY SURGERY CENTER | OH | NA | N/A | |||||
| NEW VISION MEDICAL LAB LLC | |||||||||||||
| 750 W HIGH STREET | LIMA | OH | 45801 | 341913433 | LAB SERVICES | OH | NA | N/A | |||||
| WEST CENTRAL OHIO GROUP LTD | |||||||||||||
| 801 MEDICAL DRIVE | LIMA | OH | 45804 | 341848147 | ORTHOPEDIC HOSPITAL | OH | NA | N/A | |||||
| KIDNEY SERVICES OF WEST CENTRAL OHIO | |||||||||||||
| 750 W HIGH STREET SUITE 100 | LIMA | OH | 45801 | 061644264 | DIALYSIS CENTER | OH | NA | N/A | |||||
| ST ELIZABETH CARDIAC CATH LAB LLC | |||||||||||||
| 1044 BELMONT AVE | YOUNGSTOWN | OH | 44501 | 300023795 | CARDIAC CATH LAB | OH | NA | N/A | |||||
| ST ELIZABETH SOUTHWOODS IMAGING | |||||||||||||
| 250 DEBARTOLO PLACE BLDG B | YOUNGSTOWN | OH | 44512 | 261626482 | DIAGNOSTIC IMAGING | OH | NA | N/A | |||||
| UROLOGIC ONCOLOGY OF MAHONING VALLEY LLC | |||||||||||||
| 1044 BELMONT AVE | YOUNGSTOWN | OH | 44501 | 262989686 | RADIATION THERAPY | OH | NA | N/A | |||||
| HMHPUSP SURGERY CENTERS LLC | |||||||||||||
| 15305 DALLAS PKWY STE 1600 | ADDISON | TX | 75001 | 271953122 | SURGERY CENTER | TX | NA | N/A | |||||
| OSC-HMHP LLC | |||||||||||||
| 6505 MARKET ST BLDG B STE 101 | BOARDMAN | OH | 44512 | 010724836 | ORTHOPEDIC SURGERY CENTER | OH | NA | N/A | |||||
| LOURDES AMBULATORY SURGERY CENTER | |||||||||||||
| 225 MEDICAL CENTER DRIVE | PADUCAH | KY | 42003 | 611258960 | SURGERY CENTER | KY | NA | N/A | |||||
| EAST TENNESSEE DIAGNOSTIC CENTER LLC | |||||||||||||
| 1450 DOWELL SPRINGS BLVD SUITE 250 | KNOXVILLE | TN | 37909 | 204773300 | DIAGNOSTIC SERVICES | TN | NA | N/A | |||||
| ST MARY''S AMBULATORY SURGERY CENTER LLC | |||||||||||||
| 1515 ST MARYS ST | KNOXVILLE | TN | 37917 | 621757542 | SURGERY CENTER | TN | NA | N/A | |||||
Form990 Schedule R Part IV Form990ScheduleRPartIV (23 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Legal Domicile StateLegalDomicileState |
|---|---|---|---|---|---|---|---|---|---|
| CHP INSURANCE LTD | |||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 980621978 | INSURANCE | CJ | NA | C CORPORATION | |
| SISTERS OF MERCY WORKERS COMPENSATION SELF-INSURANCE TRUST | |||||||||
| 615 ELSINORE PLACE | CINCINNATI | OH | 45202 | 310990309 | WORKERS COMPENSATION TRUST | NA | TRUST | MA | |
| MHSWO HEALTH VENTURES INC | |||||||||
| 1 S LIMESTONE ST | SPRINGFIELD | OH | 45502 | 311072139 | PHYSICIAN PRACTICES | NA | C CORPORATION | OH | |
| NORTHPARKE MEDICAL COMMONS CONDO ASSN | |||||||||
| 333 N LIMESTONE ST | SPRINGFIELD | OH | 45503 | 311391230 | REAL PROPERTY MGMNT | NA | C CORPORATION | OH | |
| MERCY HEALTH AFFILIATES INC | |||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341372633 | PHYSICIAN SERVICES | NA | C CORPORATION | OH | |
| PHYSICIAN'S HEALTH COLLABORATIVE | |||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 203986844 | MEDICAL & HOSPITAL SERVICES | NA | C CORPORATION | OH | |
| NORTHSIDE CORPORATION | |||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341318438 | RESIDENT RENTALS | NA | C CORPORATION | OH | |
| MERCY WORK SOLUTIONS | |||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 300066340 | WORKERS COMPENSATION | NA | C CORPORATION | OH | |
| MERCY HEALTH SYSTEM PHO | |||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341778321 | MEDICAL SERVICES | NA | C CORPORATION | OH | |
| PHYSICIAN MANAGED CARE INC | |||||||||
| 2200 JEFFERSON AVENUE | TOLEDO | OH | 43604 | 341565320 | HEALTH SERVICES | NA | C CORPORATION | OH | |
| MCAULEY MANAGEMENT SERVICES INC | |||||||||
| 730 W MARKET STREET | LIMA | OH | 45801 | 341379037 | PROPERTY RENTAL | NA | C CORPORATION | OH | |
| LIMA MEDICAL SUPPLIES INC | |||||||||
| 730 W MARKET STREET | LIMA | OH | 45801 | 340944477 | MEDICAL EQUIPMENT | NA | C CORPORATION | OH | |
| COMMUNITY HEALTH PARTNERS ENTERPRISES INC | |||||||||
| 3700 KOLBE ROAD | LORAIN | OH | 44053 | 341455525 | HOLDING COMPANY | NA | C CORPORATION | OH | |
| COMMUNITY HEALTH PARTNERS PHYSICIANS INC | |||||||||
| 3700 KOLBE ROAD | LORAIN | OH | 44053 | 341803352 | PHYSICIAN PRACTICES | NA | C CORPORATION | OH | |
| AMC PHYSICIANS INC | |||||||||
| 200 W LORAIN STREET | OBERLIN | OH | 44074 | 371439554 | PHYSICIAN SERVICES | NA | C CORPORATION | OH | |
| MERCY HEALTH VENTURES INC | |||||||||
| 4600 MCAULEY PLACE | CINCINNATI | OH | 45242 | 311185477 | DIVERSIFIED ACTIVITIES | NA | C CORPORATION | OH | |
| MERCY FRANCISCAN AT WINTON WOODS I INC | |||||||||
| 10290 MILL ROAD | CINCINNATI | OH | 45231 | 311658668 | LOW-INCOME HOUSING | NA | C CORPORATION | OH | |
| MERCY HEALTH MANAGEMENT INC | |||||||||
| 1530 LONE OAK ROAD | PADUCAH | KY | 42003 | 611086762 | MEDICAL OFFICES | NA | C CORPORATION | KY | |
| HEALTH DYNAMICS INC | |||||||||
| 900 E OAK HILL AVENUE | KNOXVILLE | TN | 37917 | 621247729 | MEDICAL EQUIPMENT SALES | NA | C CORPORATION | TN | |
| HEALTH VENTURES INC & SUBSIDIARIES | |||||||||
| P O BOX 1788 | KNOXVILLE | TN | 37901 | 621175587 | MEDICAL SERVICES | NA | C CORPORATION | TN | |
| ANNE KILCAWLEY CHRISTMAN FOUNDATION | |||||||||
| 100 FEDERAL PLAZEA EAST | YOUNGSTOWN | OH | 44503 | 356735706 | BENEFICIAL TRUST | NA | TRUST | OH | |
| RALPH EWE TRUST | |||||||||
| 270 PARK AVENUE | NEW YORK | NY | 10017 | 346866422 | BENEFICIAL TRUST | NA | TRUST | NY | |
| ELIZABETH HINES CATES TRUST | |||||||||
| 1900 E 9TH STREET | CLEVELAND | OH | 44114 | 346515678 | BENEFICIAL TRUST | NA | TRUST | OH | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |