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ST ANN'S HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ST ANN'S HOSPITAL (EIN 31-4412701)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-08
IRS object ID
201241299349301024
Schema version
2010v3.4
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-08T10:31:47-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN314412701EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST ANN'S HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTANNameControl
Phone6145464300Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 SOUTH CLEVELAND AVENUEAddressLine1
CityWESTERVILLECity
StateOHState
ZIP Code430818971ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJACQUELINE PRIMEAUName
TitleSVP & CFOTitle
Phone6155464300Phone
Date Signed2012-05-08DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCLAUS VON ZYCHLINNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line16150 EAST BROAD STAddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code43213ZIPCode
FieldValueIRS element (for citing)
Gross Receipts286874091GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.MOUNTCARMELHEALTH.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1955YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionHEALTH CARE AND RELATED ACTIVITIESActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members2NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers375TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year9058ContributionsGrantsPriorYear
Contributions Grants Current Year10000ContributionsGrantsCurrentYear
Program Service Revenue Prior Year247623902ProgramServiceRevenuePriorYear
Program Service Revenue CY276485112ProgramServiceRevenueCY
Investment Income Prior Year1711InvestmentIncomePriorYear
Investment Income Current Year200InvestmentIncomeCurrentYear
Other Revenue Prior Year1610869OtherRevenuePriorYear
Other Revenue Current Year10378779OtherRevenueCurrentYear
Total Revenue Prior Year249245540TotalRevenuePriorYear
Total Revenue Current Year286874091TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year12400GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY9856GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year100864232SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year221702528OtherExpensePriorYear
Other Expenses Current Year147018057OtherExpensesCurrentYear
Total Expenses Prior Year221714928TotalExpensesPriorYear
Total Expenses Current Year247892145TotalExpensesCurrentYear
Revenues Less Expenses Prior Year27530612RevenuesLessExpensesPriorYear
Revenues Less Expenses CY38981946RevenuesLessExpensesCY
Total Assets BOY113220117TotalAssetsBOY
Total Assets EOY117967323TotalAssetsEOY
Total Liabilities BOY9824362TotalLiabilitiesBOY
Total Liabilities EOY13789216TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY103395755NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY104178107NetAssetsOrFundBalancesEOY
Mission DescriptionHEALTH CARE AND RELATED ACTIVITIES - SEE SCHEDULE H FOR MORE INFORMATIONMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense234387530Expense
Grants9856Grants
Revenue282340955Revenue
DescriptionST ANN'S HOSPITAL, A MEMBER OF MOUNT CARMEL HEALTH SYSTEM AND TRINITY HEALTH, IS LOCATED IN WESTERVILLE, OHIO AND SERVES THE GREATER COLUMBUS, OHIO AREA. DURING THE FISCAL YEAR ENDED JUNE 30, 2011, ST ANN'S HOSPITAL PROVIDED OVER 71,000 PATIENT DAYS OF HEALTH CARE SERVICES. THE MISSION STATEMENT FOR SAINT ANN'S HOSPITAL IS AS FOLLOWS: WE SERVE TOGETHER IN TRINITY HEALTH IN THE SPIRIT OF THE GOSPEL TO HEAL BODY, MIND AND SPIRIT TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND TO STEWARD THE RESOURCES ENTRUSTED TO US.Description
Total Program Service Expense234387530TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members2NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JACQUELINE PRIMEAUBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6145464300TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16150 EAST BROAD STREETAddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code43213ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
JANET MEEKS
COO & V. CHAIR50.00XX036470781974
BARRY FAGAN MD
TRUSTEE2.00X000
SR BARBARA HAHL CSC
SEC/TREAS5.00XX007673
STEVEN TUTTLE MD
TRUSTEE2.00X000
CLAUS VON ZYCHLIN
PRESIDENT, CHAIR & CEO8.00XX0729816103949
JACQUELINE PRIMEAU
SVP & CFO8.00X041253335393
RONALD WHITESIDE
EXEC VP & SYSTEM COO7.00X0446715205163
KEDRICK ADKINS
TRINITY PRES INTEGRATED SVCS2.0001160870198248X
JOSEPH SWEDISH
TRINITY HEALTH PRES & CEO2.0002853932791453X
MICHAEL SLUBOWSKI
TRIN PRES HLTH&HOSP NTWKS TIL 12/102.0001153164271732X
TAMMY WEIDNER
VP PATIENT CARE SERVICES50.00021094657280X
JOHN HEISLER
SVP HUMAN AFFAIRS7.00029952939854X
HUGH JONES
SVP STRATEGY & SYSTEM DEV7.00027200133639X
J RICHARD OCONNELL
TRINITY EVP, COO-HOSP NTWKS2.000761373137960X
MICHAEL MURPHY
TRINITY EVP, HEALTH NTWKS2.00053982368542X
PHILLIP SHUBERT MD
DIRECTOR, PERINATOLOGY50.00048604341512X
JOSEPH KINGTON
OBGYN PHYSICIAN50.00035855450294X
MICHAEL HANINGER
OBGYN PHYSICIAN50.00027208538835X
CHRIS LANG
PERINATOLOGIST50.00022199320410X
SIMEON HODGES III
MEDICAL PHYSICIST50.00016901026257X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs10713094TotalReportableCompFrmRltdOrgs
Total Other Compensation2210168TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MESSER CONSTRUCTION
5158 FISHWICK DRCINCINNATIOH45216CONSTRUCTION SERVICES2317381
MEDONE HOSPITAL PHYSICIANS INC
3525 OLENTANGY RIVER RDCOLUMBUSOH43214MEDICAL STAFFING SERVICES1010000
ELFORD INC
1220 DUBLIN RDCOLUMBUSOH43215CONSTRUCTION SERVICES977418
HHA SERVICES INC
22622 HARPER AVENUEST CLAIR SHORESMI48080DIETARY SERVICES680027
BRICKMAN GROUP LTD
3630 SOLUTIONS CENTERCHICAGOIL60677LANDSCAPING SERVICES545029
FieldValueIRS element (for citing)
Number Of Contractors GT100 K19NumberOfContractorsGT100K
All Other Contributions10000AllOtherContributions
Total Contributions10000TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SVC REVDescription
Business Code900099BusinessCode
Total Revenue Column276485112TotalRevenueColumn
Related Or Exempt Function Income276485112RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue276485112TotalProgramServiceRevenue

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real3269179Real
Personal218607Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real3269179Real
Personal218607Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column3487786TotalRevenueColumn
Exclusion$3,487,786ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other200Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other200Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column200TotalRevenueColumn
Exclusion$200ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
OTHER REVENUE90009958558435855843
CAFETERIA9000991035150$1,035,150
FieldValueIRS element (for citing)
Total Other Revenue6890993TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column286874091TotalRevenueColumn
Related Or Exempt Function Income282340955RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$4,523,136ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total9856Total
Program Services9856ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total80598833Total
Program Services75448782ProgramServices
Management And General5150051ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total6351985Total
Program Services5946110ProgramServices
Management And General405875ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8414511Total
Program Services7876846ProgramServices
Management And General537665ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total5498903Total
Program Services5147538ProgramServices
Management And General351365ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total113853Total
Program Services113853ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total11186186Total
Program Services8775801ProgramServices
Management And General2410385ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2413579Total
Program Services1274292ProgramServices
Management And General1139287ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total53766Total
Program Services53766ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6666090Total
Program Services6347492ProgramServices
Management And General318598ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total56051Total
Program Services40703ProgramServices
Management And General15348ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total23085Total
Program Services17167ProgramServices
Management And General5918ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total5010729Total
Program Services5010729ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total12182802Total
Program Services11296058ProgramServices
Management And General886744ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2175415Total
Program Services2175415ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES3870813837855012853126
CORPORATE ALLOCATION3852907638529076
BAD DEBT2213227522132275
EQUIPMENT MAINTENANCE37120473393352318695

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total4054965Total
Program Services2943407ProgramServices
Management And General1111558ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total247892145Total
Program Services234387530ProgramServices
Management And General13504615ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY13092BOY
EOY16262EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY28924696BOY
EOY30951755EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2923184BOY
EOY3649502EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY41990BOY
EOY176320EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis208870862LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec128138372LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY80464831BOY
EOY80732490EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY852324BOY
EOY2440994EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY113220117BOY
EOY117967323EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9336083BOY
EOY10666082EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY1000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY488279BOY
EOY3122134EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY9824362BOY
EOY13789216EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY103395755BOY
EOY104178107EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY103395755BOY
EOY104178107EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY113220117BOY
EOY117967323EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses38981946ReconcilationRevenueExpenses
Reconcilation Other Changes-38199594ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$5,759GrantsOtherOrganizationsAmount
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB5759TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF OTHER LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1I:ReturnReference
ExplanationSAINT ANN'S HOSPITAL HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED SAINT ANN'S HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. SAINT ANN'S HOSPITAL MADE NO CONTRIBUTIONS TO ANY LEGISLATORS OR CANDIDATES.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1780423OtherCostOrOtherBasis
Book Value1780423BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis126973913OtherCostOrOtherBasis
Depreciation72938659Depreciation
Book Value54035254BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis72715462OtherCostOrOtherBasis
Depreciation55199713Depreciation
Book Value17515749BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7401064OtherCostOrOtherBasis
Book Value7401064BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings80732490TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
OTHER CURRENT LIABILITIES$735,033
ASSET RETIREMENT OBLIGATION (FIN 47)$12,408
INTERCOMPANY ACCOUNTS PAYABLE$919,554
OTHER LONG TERM LIABILITIES$1,455,139
FieldValueIRS element (for citing)
Total Of Amounts3122134TotalOfAmounts

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served7638PersonsServed
Total Community Benefit Expense10142676TotalCommunityBenefitExpense
Direct Offsetting Revenue4132062DirectOffsettingRevenue
Net Community Benefit Expense6010614NetCommunityBenefitExpense
Percent Of Total Expense0.02660PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs19NumberOfActivitiesOrPrograms
Persons Served30031PersonsServed
Total Community Benefit Expense26608550TotalCommunityBenefitExpense
Direct Offsetting Revenue18203426DirectOffsettingRevenue
Net Community Benefit Expense8405124NetCommunityBenefitExpense
Percent Of Total Expense0.03720PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs20NumberOfActivitiesOrPrograms
Persons Served37669PersonsServed
Total Community Benefit Expense36751226TotalCommunityBenefitExpense
Direct Offsetting Revenue22335488DirectOffsettingRevenue
Net Community Benefit Expense14415738NetCommunityBenefitExpense
Percent Of Total Expense0.06380PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs20NumberOfActivitiesOrPrograms
Persons Served37669PersonsServed
Total Community Benefit Expense36751226TotalCommunityBenefitExpense
Direct Offsetting Revenue22335488DirectOffsettingRevenue
Net Community Benefit Expense14415738NetCommunityBenefitExpense
Percent Of Total Expense0.06380PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$7,039,192BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare50220643AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare47090344CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall3130299MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1MOUNT CARMEL ST ANN'SBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1500 SOUTH CLEVELAND AVENUEAddressLine1
CityWESTERVILLECity
StateOHState
ZIP Code43081ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NOT REQUIREDBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities3NumberOfOtherFacilities

Other Facilities OtherFacilities (3 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
MOUNT CARMEL ST ANN'S WOMEN'S HLTH CTR
477 COOPER ROADWESTERVILLEOH43081WOMEN'S HEALTH CENTER
WESTAR HEALTH CENTER
444 N CLEVELAND AVEWESTERVILLEOH43082URGENT CARE, REHAB, IMAGING
MOUNT CARMEL ST ANN'S CANCER CENTER
495 COOPER ROADWESTERVILLEOH43081OUTPATIENT CANCER CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanation
PART I, LINE 6A: ST. ANN'S HOSPITAL REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH IN ITS ANNUAL REPORT, AVAILABLE AT WWW.TRINITY-HEALTH.ORG. IN ADDITION, ST. ANN'S HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON TRINITY HEALTH'S WEBSITE AS WELL AS MOUNT CARMEL HEALTH SYSTEM'S WEBSITE (WWW.MOUNTCARMELHEALTH.COM).
PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM.
PART I, L7 COL(F): THE FOLLOWING NUMBER, $22,132,275, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F).
PART III, LINE 4: ST. ANN'S HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM THOSE STATEMENTS: "SUBSTANTIALLY ALL OF THE CORPORATION'S RECEIVABLES ARE RELATED TO PROVIDING HEALTHCARE SERVICES TO PATIENTS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE. THE CORPORATION'S ESTIMATE FOR ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS BY PAYOR."COSTING METHODOLOGY FOR LINES 2 AND 3: AMOUNTS ARE CALCULATED ON LINE 2 USING A COST TO CHARGE RATIO METHODOLOGY.ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.THE ORGANIZATION IDENTIFIES MANY CHARITY PATIENTS AT THE TIME OF SERVICE AND INCLUDES A CHARITY APPLICATION WITH EVERY STATEMENT PER OHIO LAW. THE AMOUNT ON LINE 3 WAS OBTAINED BY REVIEWING ACCOUNTS ASSIGNED TO BAD DEBT AND EXAMINING THE AMOUNT OF CHARITY FOR WHICH ST. ANN'S HOSPITAL HAS BEEN ABLE TO IDENTIFY AND OBTAIN APPLICATIONS. THIS ALSO INCLUDES ACCOUNTS THAT QUALIFY FOR HCAP, OHIO'S PROGRAM FOR THE INDIGENT POPULATION.
PART III, LINE 8: ST. ANN'S HOSPITAL DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CHA RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT.
PART III, LINE 9B: THE ORGANIZATION'S COLLECTION POLICY CONTAINS THE CRITERIA FOR FINANCIAL ASSISTANCE, AND CONTAINS THE FOLLOWING VERBIAGE FOR ARRANGEMENTS WITH OUTSIDE COLLECTION AGENCIES: THE AGREEMENT MUST DEFINE THE STANDARDS AND SCOPE OF PRACTICES TO BE USED BY OUTSIDE COLLECTION AGENTS ACTING ON BEHALF OF THE MINISTRY ORGANIZATION, ALL OF WHICH MUST BE IN COMPLIANCE WITH THIS POLICY.
PART VI, LINE 2: NEEDS ASSESSMENT - MOUNT CARMEL HEALTH SYSTEM, WHICH INCLUDES ST. ANN'S HOSPITAL, IS COMMITTED TO HELPING ASSESS AND ADDRESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH ITS OWN PROGRAMS AND SERVICES, AND IN PARTNERSHIP WITH OTHERS.MOUNT CARMEL HEALTH SYSTEM ASSESSES THE HEALTH NEEDS OF THE COMMUNITY THROUGH COMMUNITY HEALTH NEEDS ASSESSMENTS EVERY THREE (3) YEARS. A COMMUNITY HEALTH NEEDS ASSESSMENT IS A POINT-IN-TIME EFFORT TO MEASURE THE HEALTH AND WELL BEING OF THE COMMUNITY. IT SERVES AS THE BASIS FOR MOUNT CARMEL'S STRATEGIC AND SUBSEQUENT ACTION PLANNING TO DEVELOP HEALTH POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS AND COLLABORATE WITH OTHER COMMUNITY HEALTHCARE PROVIDERS. A COMMUNITY HEALTH NEEDS ASSESSMENT ALSO SERVES AS A BENCHMARK FOR FUTURE ASSESSMENT OF RELATIVE PROGRESS TOWARD ESTABLISHED COMMUNITY HEALTH OBJECTIVES.MOUNT CARMEL'S COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES THE OPPORTUNITY TO:- GAIN INSIGHTS INTO THE NEEDS AND ASSETS OF THE COMMUNITIES SERVED- IDENTIFY AND ADDRESS THE NEEDS OF VULNERABLE POPULATIONS WITHIN THE COMMUNITY- ENHANCE HOSPITAL/COMMUNITY RELATIONSHIPS AND THE OPPORTUNITY FOR COLLABORATIVE COMMUNITY ACTION, INCLUDING INVOLVEMENT WITH COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES, COMMISSIONS, ADVISORY GROUPS AND PANELS- PROVIDE THE INFORMATION REQUIRED FOR COMMUNITY OUTREACH PLANNINGMOUNT CARMEL'S COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS INVOLVES THE GATHERING OF TWO TYPES OF DATA: QUANTITATIVE (DEMOGRAPHICS, HEALTH INDICATORS, ETC.) AND QUALITATIVE (PUBLIC SURVEYS, FORUMS, FOCUS GROUPS). WHILE MOUNT CARMEL CONDUCTS SOME OF ITS OWN ORIGINAL RESEARCH IN COMPLETING THE COMMUNITY NEEDS ASSESSMENT, IT ALSO RELIES UPON THE AVAILABILITY OF DATA COLLECTED BY OTHERS WHENEVER POSSIBLE TO AVOID UNNECESSARY DUPLICATION. THE DATA HELP SUPPORT SHORT-TERM AND LONG-TERM DECISIONS ABOUT ALLOCATION OF COMMUNITY HUMAN AND CAPITAL RESOURCES.MOUNT CARMEL'S MOST RECENT COMMUNITY NEEDS ASSESSMENT WAS RELEASED IN JANUARY 2007. BESIDES ITS BOARD OF TRUSTEES, MOUNT CARMEL SHARES THE FINDINGS OF ITS COMMUNITY NEEDS ASSESSMENTS WITH OTHER NON-PROFIT ORGANIZATIONS AND GOVERNMENT OFFICIALS/ENTITIES AND SEEKS TO FORM COLLABORATIVE PARTNERSHIPS WITH THEM WHEN POSSIBLE TO AVOID UNNECESSARY DUPLICATION OF EFFORTS IN ADDRESSING IDENTIFIED COMMUNITY HEALTH NEEDS.MOUNT CARMEL IS IN THE PROCESS OF CONDUCTING A NEW SURVEY WHICH WILL BE COMPLETED IN 2012.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - ST. ANN'S IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES.- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE- BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITY.IN ACCORDANCE WITH THE AMERICAN HOSPITAL ASSOCIATION (AHA) RECOMMENDATIONS, MOUNT CARMEL HEALTH SYSTEM HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS:- PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSMOUNT CARMEL HEALTH SYSTEM IS COMMITTED TO EFFECTIVELY COMMUNICATING WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ABOUT MOUNT CARMEL'S PATIENT FINANCIAL ASSISTANCE PROGRAM AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. THIS INFORMATION IS COMMUNICATED THROUGH PATIENT FINANCIAL SERVICES ASSOCIATES IN PATIENT REGISTRATION, CUSTOMER SERVICE, AND BILLING AND COLLECTIONS - ALL OF WHOM RECEIVE TRAINING REGARDING FEDERAL, STATE AND LOCAL PUBLIC FINANCIAL ASSISTANCE PROGRAMS AND MOUNT CARMEL'S PATIENT FINANCIAL ASSISTANCE PROGRAM. IN ADDITION, THE EXTERNAL COLLECTION AGENCIES AND EXTERNAL MEDICAID ELIGIBILITY VERIFICATION VENDOR WITH WHOM MOUNT CARMEL WORKS ALSO RECEIVE TRAINING REGARDING THESE PROGRAMS. ALL MOUNT CARMEL PATIENT FINANCIAL STATEMENTS INCLUDE A FINANCIAL ASSISTANCE APPLICATION AND PHONE NUMBER FOR PATIENTS TO CALL WITH QUESTIONS.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND WHICH MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTHCARE SERVICES. MOUNT CARMEL HEALTH SYSTEM UTILIZES BOTH INTERNAL RESOURCES AND AN EXTERNAL VENDOR TO ASSIST PATIENTS IN APPLYING FOR MEDICAID. INPATIENTS, EMERGENCY DEPARTMENT PATIENTS, CLINIC PATIENTS, AND PATIENTS RECEIVING HIGH-COST OUTPATIENT SERVICES ARE SCREENED TO DETERMINE WHETHER THEY QUALIFY FOR FEDERAL, STATE OR LOCAL PUBLIC FINANCIAL ASSISTANCE PROGRAMS OR MOUNT CARMEL'S PATIENT FINANCIAL ASSISTANCE PROGRAM. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE.MOUNT CARMEL HEALTH SYSTEM OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED FINANCIAL MEANS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS LIKE MEDICAID OR OTHER PUBLIC ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS COMMUNICATED VIA SIGNS THAT ARE PROMINENTLY DISPLAYED IN ALL PATIENT REGISTRATION AREAS. BROCHURES PLACED IN PATIENT REGISTRATION AREAS EDUCATE PATIENTS IN GREATER DETAIL ABOUT THE AVAILABILITY OF FEDERAL, STATE AND LOCAL ASSISTANCE PROGRAMS AS WELL AS MOUNT CARMEL'S PATIENT FINANCIAL ASSISTANCE PROGRAM.SUMMARIES OF FEDERAL, STATE AND LOCAL PUBLIC FINANCIAL ASSISTANCE PROGRAMS AND MOUNT CARMEL'S OWN PATIENT FINANCIAL ASSISTANCE PROGRAM ALSO ARE MADE AVAILABLE THROUGH MOUNT CARMEL SERVICES THAT DIRECTLY INTERACT WITH THE COMMUNITY, INCLUDING MOUNT CARMEL COMMUNITY OUTREACH AND MOUNT CARMEL HEALTH STATIONS CLINICS; OTHER ORGANIZATIONS THAT SERVE THE UNINSURED AND UNDERINSURED SUCH AS ACCESS HEALTH COLUMBUS; SOCIAL SERVICES AGENCIES LIKE CATHOLIC SOCIAL SERVICES AND HOMELESS SHELTERS; AND FEDERALLY QUALIFIED HEALTH CENTERS LIKE HEART OF OHIO FAMILY HEALTH CENTERS AND LOWER LIGHTS CHRISTIAN HEALTH CENTER. INFORMATION REGARDING PATIENT FINANCIAL ASSISTANCE PROGRAMS ALSO IS AVAILABLE ON MOUNT CARMEL'S WEBSITE.IN ADDITION TO ENGLISH, PATIENT FINANCIAL ASSISTANCE INFORMATION IS ALSO AVAILABLE IN SPANISH AND SOMALI FOR THOSE WITH LIMITED ENGLISH PROFICIENCY, REFLECTING OTHER PREDOMINANT LANGUAGES SPOKEN IN THE COMMUNITIES SERVED BY MOUNT CARMEL. MOUNT CARMEL ALSO HAS INTERPRETING SERVICES AVAILABLE FOR LIMITED ENGLISH PROFICIENCY PATIENTS WHO SPEAK OTHER LANGUAGES.MOUNT CARMEL HEALTH SYSTEM HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MOUNT CARMEL HEALTH SYSTEM MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. MOUNT CARMEL HEALTH SYSTEM EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION, CUSTOMER SERVICE, BILLING AND COLLECTIONS) ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES.
PART VI, LINE 4: COMMUNITY INFORMATION - MOUNT CARMEL HEALTH SYSTEM, WHICH INCLUDES ST. ANN'S, PREDOMINATELY SERVES CENTRAL OHIO, WHICH INCLUDES FRANKLIN AND FIVE CONTIGUOUS COUNTIES (DELAWARE, FAIRFIELD, LICKING, MADISON AND PICKAWAY). THIS REGION IS HOME TO NEARLY 1.7 MILLION RESIDENTS. AMONG CENTRAL OHIO HOUSEHOLDS, 20% HAVE A HOUSEHOLD INCOME OF LESS THAN $25,000, AND ANOTHER 26% HAVE A HOUSEHOLD INCOME OF BETWEEN $25,000 AND $50,000.OVER THE NEXT FIVE YEARS, CENTRAL OHIO'S POPULATION IS EXPECTED TO EXPERIENCE A HIGH GROWTH RATE (18%) IN ADULTS AGE 55 AND OLDER AND A SLIGHT DECLINE IN ADULTS BETWEEN THE AGES OF 18 AND 34. IN 2009, APPROXIMATELY 33% OF THE POPULATION OVER AGE 25 HELD A BACHELOR'S OR HIGHER DEGREE, FIVE AND A HALF PERCENTAGE POINTS HIGHER THAN THE NATIONAL AVERAGE.CENTRAL OHIO FEATURES A DIVERSE EMPLOYER BASE, INCLUDING MANUFACTURING, TRADE, EDUCATION, SERVICE, FINANCE AND AGRICULTURE. THE OCTOBER 2010 UNEMPLOYMENT RATE WAS 8.4%, A DECLINE OF 0.4 PERCENTAGE POINTS OVER NOVEMBER 2009.ACCORDING TO THE 2008-2009 OHIO FAMILY HEALTH SURVEY, 138,625 ADULTS IN FRANKLIN COUNTY BETWEEN THE AGES OF 18-64, OR ABOUT 19% OF THAT POPULATION, DO NOT HAVE HEALTH INSURANCE. THIS NUMBER IS SLIGHTLY HIGHER THAN THE STATEWIDE PERCENTAGE OF 17% UNINSURED ADULTS IN THAT AGE GROUP.
PART VI, LINE 6: OTHER INFORMATION - IN FISCAL YEAR 2010- 2011, MOUNT CARMEL HEALTH SYSTEM, INCLUDING ST. ANN'S, PROVIDED EDUCATIONAL ACTIVITIES FOR COMMUNITY MEMBERS IN AREAS INCLUDING WELLNESS, DIABETES EDUCATION AND SUPPORT. (THE OUTREACH VAN GOES TO SEVERAL LOCATIONS TO SERVE THE UNINSURED SOMALI POPULATION IN WESTERVILLE.) MOUNT CARMEL HAS A NUMBER OF CANCER FOCUSED PROGRAMS BECAUSE CANCER IS THE NUMBER ONE CAUSE OF DEATH IN FRANKLIN COUNTY AND THE AGE ADJUSTED DEATH RATE IS GREATER IN FRANKLIN COUNTY THAN THE RATE FOR THE STATE OF OHIO. MOUNT CARMEL ALSO PROVIDED MEETING SPACE FOR NUMEROUS SUPPORT GROUPS FOR INDIVIDUALS FACING EMOTIONAL AND PHYSICAL HEALTH CHALLENGES, SUCH AS GRIEF, PROSTATE CANCER, ALZHEIMER'S DISEASE, BREAST CANCER AND PULMONARY ILLNESSES. MCSA'S PROVIDES THE FOLLOWING COMMUNITY PROGRAMS FOR THE WESTERVILLE AREA: -WESTERVILLE AREA RESOURCE MINISTRY (WARM) AND MOUNT CARMEL ST. ANN'S, AND WESTERVILLE CITY SCHOOLS WORK TOGETHER TO BRING THE FIRST EVER SUMMER LUNCH CLUB PROGRAM TO WESTERVILLE AREA CHILDREN WHO TYPICALLY RECEIVE FREE OR REDUCED LUNCHES DURING THE SCHOOL YEAR. THE GOAL WAS TO SERVE 50 LUNCHES PER DAY TO CHILDREN IN THE WESTERVILLE RIDGEWOOD PARK AREA. HOWEVER, THREE WEEKS INTO THE PROGRAM, THEY WERE ALREADY SERVING OVER 100 PER DAY. LUNCH IS PROVIDED FROM 1145AM-1230PM MONDAY THROUGH FRIDAY AND FROM 1200PM-100PM. ORGANIZED LEARNING AND RECREATIONAL ACTIVITIES ARE PROVIDED FOR THE CHILDREN WHO ATTEND. -GRIEF AND LOSS PROGRAMS ARE PRESENTED BY MOUNT CARMEL HOSPICE AND PALLIATIVE CARE STAFF TO PROVIDE CARE AND SUPPORT TO INDIVIDUALS AND FAMILIES DURING THE GRIEVING PROCESS.-INSTRUCTIONS ON CAR SEAT USE AND PROVIDE INFANT CAR SEATS FOR AT RISK OR LOW INCOME FAMILIES. THE CAR SEATS ARE AVAILABLE WHEN FAMILIES ARE LEAVING THE HOSPITAL WITH THEIR NEWBORNS. -INFANT LOSS PROGRAM PROVIDES COMFORT AND EDUCATION IN THE GRIEVING PROCESS FOR INDIVIDUALS, COUPLES AND FAMILY MEMBERS WHO HAVE EXPERIENCED PREGNANCY LOSS THROUGH MISCARRIAGE, STILLBIRTH OR ECTOPIC PREGNANCY, OR WHO HAVE LOST A NEWBORN OR INFANT. -PHARMACEUTICAL ASSISTANCE PROGRAM PROVIDES MEDICATIONS TO INDIGENT AND POOR PATIENTS.-CLASSES AND RESOURCES AVAILABLE TO THE PUBLIC INCLUDE YOGA, GUIDED IMAGERY, CANCER SUPPORT, AND DIABETES MANAGEMENT TRAINING SESSIONS.ONE HUNDRED PERCENT OF MOUNT CARMEL'S SURPLUS REVENUE IS INVESTED BACK INTO SUPPORTING THE ORGANIZATION'S HEALTH CARE MINISTRY. MOUNT CARMEL HEALTH SYSTEM IS GOVERNED BY A 15-MEMBER BOARD OF TRUSTEES, WITH A MAJORITY OF THE SEATS ALLOCATED TO COMMUNITY REPRESENTATIVES AND LEADERS. OUR GOVERNANCE STRUCTURE ENSURES THAT THE COMMUNITY AND ITS INTERESTS ARE STRONGLY REPRESENTED IN IMPORTANT DECISION-MAKING. IN ADDITION, TWO SEATS ON MOUNT CARMEL'S BOARD ARE ALLOCATED TO WOMEN RELIGIOUS, WHO HELP ENSURE THAT THE ORGANIZATION REMAINS TRUE TO ITS CHARITABLE MISSION.MOUNT CARMEL HEALTH SYSTEM, INCLUDING ST. ANN'S, MAINTAINS AN OPEN MEDICAL STAFF - MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS. MOUNT CARMEL ST. ANN'S ACTIVELY RECRUITS, INCLUDING EMPLOYING WHEN NECESSARY, PHYSICIANS TO SERVE IN UNDER-SERVED AREAS OF THE COMMUNITY.MOUNT CARMEL ST. ANN'S ALSO OPERATES A GRADUATE MEDICAL EDUCATION PROGRAM THAT TRAINS PHYSICIANS IN FAMILY PRACTICE, INTERNAL MEDICINE, OBSTETRICS & GYNECOLOGY, GENERAL SURGERY, ORTHOPEDIC SURGERY AND TRANSITIONAL YEAR (FOR PHYSICIANS WHO WANT TO PURSUE SUB-SPECIALTY TRAINING).COMMUNITY BUILDING ACTIVITIES - MOUNT CARMEL HEALTH SYSTEM CONTRIBUTED TO THE ECONOMIC AND CIVIC HEALTH OF THE SURROUNDING COMMUNITY BY SERVING IN AND CONTRIBUTING TO THE EFFORTS OF SEVERAL CHAMBERS OF COMMERCE AND OTHER CIVIC ORGANIZATIONS, BOTH IN THE CITY OF COLUMBUS AND IN SURROUNDING SUBURBS. MOUNT CARMEL ST. ANN'S (MCSA) HAS FORMED COMMUNITY PARTNERSHIPS WITH A NUMBER OF ORGANIZATIONS TO FEED THE HUNGRY, PROVIDE LUNCHES FOR SCHOOL CHILDREN IN THE SUMMER, PROVIDE HOUSING ASSISTANCE, AND MCSA'S LEADERS HAVE IDENTIFIED COMMUNITY NEEDS THROUGH THEIR SERVICE ON VARIOUS COMMUNITY BOARDS AND ADVISORY GROUPS. THEY HAVE ALSO LENT THEIR EXPERTISE TO THESE GROUPS AND HAVE BEEN ABLE TO ADVOCATE ON ISSUES SURROUNDING HEALTH IN THE WESTERVILLE AREA.SYSTEM WIDE SENIOR LEADERSHIP MEMBERS SERVE ON A NUMBER OF BOARDS FOR COMMUNITY AGENCIES SUCH AS THE WESTSIDE HEALTH ADVISORY BOARD, FRANKLINTON AREA COMMISSION, HILLTOP BUSINESS ASSOCIATION, THE NEW ALBANY CHAMBER OF COMMERCE, AND THE LIFELINE OF OHIO (LOOP) BOARD, THE AMERICAN HEART ASSOCIATION, YMCA, UNITED WAY, COLUMBUS PARTNERSHIP, HEART OF OHIO FEDERAL QUALIFIED HEALTH CENTER, ACCESS HEALTH COLUMBUS, CATHOLIC SOCIAL SERVICES, FRANKLINTON DEVELOPMENT ASSOCIATION, AFFORDABLE HOUSING TRUST, LIFELINE OF OHIO, CENTRAL OHIO TRAUMA SYSTEM ACCESS, SIMON KENTON COUNCIL OF THE BOY SCOUTS OF AMERICA BOARD, WALK WITH A DOC,WESTERVILLE AREA CHAMBER OF COMMERCE, OHIO STATE UNIVERSITY HONORS COLLEGE ADVISORY COUNCIL AND EYE CENTER OF COLUMBUS.DURING 2010-2011, MOUNT CARMEL COLLABORATED WITH THE LOCAL RED CROSS TO DONATE EMPLOYEE TIME AND SPACE WITHIN OUR FACILITIES FOR BLOOD DONATIONS. WE WILL CONTINUE THIS COLLABORATION NEXT YEAR BECAUSE OF THE NEED ANNOUNCED IN AN AUGUST 17, 2010 NEWS RELEASE FROM THE AMERICAN RED CROSS OF CENTRAL OHIO. THE ORGANIZATION IS 1,000 DONATIONS SHORT OF THE TARGET FOR THIS AREA. ST. ANN'S ALSO PROVIDED MEETING SPACE FOR NUMEROUS SUPPORT GROUPS FOR INDIVIDUALS FACING EMOTIONAL AND PHYSICAL HEALTH CHALLENGES, SUCH AS GRIEF, PROSTATE CANCER, ALZHEIMER'S DISEASE, BREAST CANCER AND PULMONARY ILLNESSES.ST. ANN'S ALSO CONTRIBUTED TO THE ECONOMIC AND CIVIC HEALTH OF THE SURROUNDING COMMUNITY BY SERVING IN AND CONTRIBUTING TO THE EFFORTS OF THE CHAMBER OF COMMERCE AND OTHER CIVIC ORGANIZATIONS, BOTH IN THE CITY OF WESTERVILLE AND IN SURROUNDING SUBURBS. ST. ANN'S COLLABORATES WITH THE WESTERVILLE COMMUNITY IN MANY OF THEIR SOCIAL ACTIVITIES, AND PROVIDES A HEALTH NURSE FOR OTTERBEIN COLLEGE. ST. ANN'S ASSOCIATES SERVE ON SEVERAL BOARDS AND COMMITTEES IN THE COMMUNITY, AND ARE HELPING THE MAYOR'S OFFICE IN THEIR EFFORTS TO COMBINE A MEDICAL CLINIC WITH THEIR OUTREACH PROGRAM. AS IN PAST YEARS, MOUNT CARMEL HEALTH SYSTEM, INCLUDING ST. ANN'S, MADE FINANCIAL CONTRIBUTIONS TO A VARIETY OF NON-PROFIT SOCIAL SERVICES AGENCIES/ORGANIZATIONS IN FY11, INCLUDING THOSE THAT HELP ADDRESS HEALTH, EMERGENCY HOUSING AND SHELTER AND HUNGER.
PART VI, LINE 7: ST. ANN'S HOSPITAL IS A MEMBER ORGANIZATION OF TRINITY HEALTH WHICH IS ONE OF THE LARGEST CATHOLIC HEALTH CARE SYSTEMS IN THE COUNTRY. BASED IN NOVI, MICHIGAN, TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEVELOP, AND ARE HELD ACCOUNTABLE FOR ACHIEVING, COMMUNITY BENEFIT GOALS THAT INCLUDE DEVELOPING NEEDED SERVICES OR EXPANDING ACCESS TO SERVICES FOR LOW-INCOME INDIVIDUALS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITY THROUGH PROGRAMS TO SERVE THE POOR AND UNINSURED, MANAGE CHRONIC CONDITIONS LIKE DIABETES, HEALTH EDUCATION AND PROMOTION INITIATIVES, AND OUTREACH FOR THE ELDERLY. IN FISCAL YEAR 2011, THIS INCLUDED NEARLY $453 MILLION IN SUCH COMMUNITY BENEFITS. THEREFORE, TRINITY HEALTH TAKES A SYSTEMS APPROACH IN ITS COMMUNITY BENEFIT PLANNING AND IMPLEMENTATION, AND IS CONSEQUENTLY ABLE TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ARE HELPING PROMOTE AND ADDRESS THE HEALTH NEEDS OF THEIR RESPECTIVE COMMUNITIES.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000
Total Nbr Of501 C3 And Govt Grants0TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: DONATIONS MADE BY ST. ANN'S HOSPITAL TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE AND ARE CONSIDERED UNRESTRICTED WITH REGARD TO THE USE OF THE FUNDS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JANET MEEKS
029957006225402883063744018230044668100
CLAUS VON ZYCHLIN
04732590163784092773078441025508083376500
JACQUELINE PRIMEAU
03529170578130180302629609097044792600
RONALD WHITESIDE
0364897076374054440186369018794065187800
KEDRICK ADKINS
07173560326029011748501844610137870135911800
JOSEPH SWEDISH
01240774064516109679970763945027508036453850690161
MICHAEL SLUBOWSKI
070100802915610160595024692502480701424896042832
TAMMY WEIDNER
02015650506404317043452013828026822600
JOHN HEISLER
024459305265102285022844017010033938300
HUGH JONES
02246330468820486017882015757030564000
J RICHARD OCONNELL
0533392011379401141870116680021280089933300
MICHAEL MURPHY
03431840686180128021047238021304060836500
PHILLIP SHUBERT MD
046122100024822027504014008052755500
JOSEPH KINGTON
03542020004352036314013980040884800
MICHAEL HANINGER
0271087000998027333011502031092000
CHRIS LANG
0216695000529808041012369024240300
SIMEON HODGES III
016674001500212007572018685019526700

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationTHE FOLLOWING ARE PARTICIPANTS IN THE TRINITY HEALTH PENSION RESTORATION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($245,000 FOR 2010).THE FOLLOWING ACCRUALS FOR 2010 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS $113,498 MICHAEL MURPHY $26,316 J. RICHARD O'CONNELL $83,058 MICHAEL SLUBOWSKI $136,445 JOSEPH SWEDISH $223,342 CLAUS VON ZYCHLIN $55,997 PART I, LINE 4B: THE FOLLOWING ARE PARTICIPANTS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING SERP ACCRUALS FOR 2010 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS $49,977 JANET MEEKS $39,260 MICHAEL SLUBOWSKI $77,185 JOSEPH SWEDISH $511,613 RONALD WHITESIDE $141,850Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DIAGNOSTIC PATHOLOGY ASSOCIATES (DPA)BusinessNameLine1
FieldValueIRS element (for citing)
RelationshipSTEVEN TUTTLE, ST ANN'S HOSP. TRUSTEE, IS A BOARD MEMBER OF DPARelationship
Amount Of Transaction190442AmountOfTransaction
Description Of TransactionST. ANN'S HOSPITAL PROVIDES LAB SERVICES TO DPADescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3MOUNT CARMEL ST. ANN'S HOSPITAL CONTRACTS WITH HHA, INC. TO MANAGE THE DIETARY, ENVIRONMENTAL SERVICES, AND FACILITIES DEPARTMENTS; AND SOYRING CONSULTING FOR DEPARTMENT DIRECTORS FOR SURGICAL SERVICES.
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF ST. ANN'S HOSPITAL IS MOUNT CARMEL HEALTH SYSTEM. SEE LINE 7 FOR ADDITIONAL INFORMATION.
FORM 990, PART VI, SECTION A, LINE 7AMOUNT CARMEL HEALTH SYSTEM HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF TRUSTEES OF ST. ANN'S HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7BAS SOLE MEMBER, MOUNT CARMEL HEALTH SYSTEM MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MOUNT CARMEL HEALTH SYSTEM MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS.
FORM 990, PART VI, SECTION B, LINE 11PRIOR TO FILING, THE FORM 990 FOR ST. ANN'S HOSPITAL IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE FINANCE COMMITTEE AS WELL AS THE BOARD OF TRUSTEES. THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE.
ST. ANN'S HOSPITAL HAS ADOPTED A CONFLICT OF INTEREST POLICY WHICH CONTAINS THE ELEMENTS IN THE MODEL CONFLICT OF INTEREST POLICY ISSUED BY THE IRS. IT APPLIES TO ALL "INTERESTED PERSONS" OF ST. ANN'S HOSPITAL, WHICH INCLUDES TRUSTEES, PRINCIPAL OFFICERS AND EXECUTIVES, AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. INTERESTED PERSONS ARE REQUIRED TO ACT AT ALL TIMES IN A MANNER CONSISTENT WITH ST. ANN'S HOSPITAL'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO ST. ANN'S HOSPITAL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE BOARD OF TRUSTEES OF ST. ANN'S HOSPITAL IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO ST. ANN'S HOSPITAL. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE REVIEWED WITH THE BOARD OF TRUSTEES OF ST. ANN'S HOSPITAL ON AN ANNUAL BASIS.FORM 990, PART VI, SECTION B, LINE 12C
TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF ST. ANN'S HOSPITAL ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS.FORM 990, PART VI, SECTION B, LINE 15
ST. ANN'S HOSPITAL IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE ANNUAL REPORT (WHICH INCLUDES COMMUNITY BENEFIT MINISTRY INFORMATION) AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, ST. ANN'S HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON TRINITY HEALTH'S WEBSITE AS WELL AS MOUNT CARMEL HEALTH SYSTEM'S WEBSITE (WWW.MOUNTCARMELHEALTH.COM).FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:EQUITY TRANSFERS TO AFFILIATES -38,199,594. TOTAL TO FORM 990, PART XI, LINE 5: -38,199,594.FORM 990, PART XI, LINE 5:
ST. ANN'S HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY11 CONSOLIDATED FINANCIAL STATEMENTS OF MOUNT CARMEL HEALTH SYSTEM, AS WELL AS THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. BOTH SETS OF CONSOLIDATED FINANCIAL STATEMENTS WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM.FORM 990, PART XII, LINE 2:
ESTIMATE OF THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS:THE HOURS LISTED IN COLUMN B OF PART VII, SECTION A, LINE 1 REFLECT ONLY THE INDIVIDUALS' AVERAGE WEEKLY HOURS SPENT DIRECTLY ON THE ACTIVITIES OF THE REPORTING ORGANIZATION. IN ADDITION, THESE ARE THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: KEDRICK ADKINS - 53 HOURS SR. BARBARA HAHL - 50 HOURS JOHN HEISLER - 45 HOURS HUGH JONES - 45 HOURS MICHAEL MURPHY - 53 HOURS J. RICHARD O'CONNELL - 53 HOURS JACQUELINE PRIMEAU - 56 HOURS MICHAEL SLUBOWSKI - 53 HOURS JOSEPH SWEDISH - 53 HOURS CLAUS VON ZYCHLIN - 56 HOURS RONALD WHITESIDE - 52 HOURSFORM 990, PART VII, SECTION A, LINE 1 , COLUMN B:
TRUSTEES:SR. BARBARA HAHL IS A MEMBER OF THE CONGREGATION OF THE SISTERS OF THE HOLY CROSS. HAVING TAKEN A VOW OF POVERTY, SR. BARBARA DID NOT RECEIVE COMPENSATION FOR THE SERVICES SHE PROVIDED TO MOUNT CARMEL HEALTH SYSTEM EXCEPT FOR INSURANCE BENEFITS ($4,547) AND THE USE OF A LEASED CAR ($3,126). INSTEAD, A TOTAL OF $267,077 WAS PAID BY MOUNT CARMEL HEALTH SYSTEM DIRECTLY TO THE SISTERS OF THE HOLY CROSS FOR SR. BARBARA'S SERVICES.FORM 990, PART VII, SECTION A, LINE 1:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (93 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP
245 STATE ST SEGRAND RAPIDSMI49503272491974HEALTHCARE SERVICESMI501(C)(3)9TRINITY HEALTH-MICHIGAN0
AMICARE HOSPICE SERVICES INC
27870 CABOT DRIVENOVIMI483772920382949053PROVIDE HOSPICE SERVICESMI501(C)(3)11, TYPE ITRINITY HOME HEALTH SERVICES INC0
AUXILIARY OF HOLY ROSARY HOSPITAL
351 SW 9TH STREETONTARIOOR97914943059469SUPPORTS SERVICES OF RELATED HOSPITALOR501(C)(3)9SAINT ALPHONSUS MEDICAL CENTER-ONTARIO0
BATTLE CREEK HEALTH SYSTEM
300 NORTH AVENUEBATTLE CREEKMI49016382776791HEALTHCARE SERVICESMI501(C)(3)3TRINITY HEALTH - MICHIGAN0
BATTLE CREEK HEALTH SYSTEM AUXILIARY
300 NORTH AVENUEBATTLE CREEKMI49016383355520SUPPORT OF TAX EXEMPT HEALTH ORGANIZATIONMI501(C)(3)11, TYPE IBATTLE CREEK HEALTH SYSTEM0
BAUM HARMON MERCY HOSPITAL
255 NORTH WELCH AVENUEPRIMGHARIA51245421500277ACUTE/AMBULATORY HEALTHCARE SERVICESIA501(C)(3)3MERCY HEALTH SERVICES-IOWA CORP0
BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION
255 NORTH WELCH AVENUEPRIMGHARIA51245262973307SUPPORT THE SERVICES OF RELATED HOSPITALIA501(C)(3)11, TYPE IBAUM HARMON MERCY HOSPITAL0
CAPITAL PARK FAMILY HEALTH CENTER INC
6150 EAST BROAD STREETCOLUMBUSOH43213311387838OPERATION OF A FEDERALLY QUALIFIED HEALTH CENTER (FORMERLY)OH501(C)(3)3MOUNT CARMEL HEALTH SYSTEM0
CATHERINE MCAULEY HEALTH SERVICES CORP
PO BOX 995ANN ARBORMI48106382507173FURTHER TRINITY HEALTH ACTIVITIES, ORGANIZE AND DEVELOP MEDICAL SERVICESMI501(C)(3)11, TYPE IITRINITY HEALTH-MICHIGAN0
COMMUNITY HEALTH PARTNERS OF SOUTH BEND
PO BOX 3998SOUTH BENDIN46619263051440HEALTHCARE SERVICESIN501(C)(3)3SAINT JOSEPH REGIONAL MEDICAL CENTER INC0
CRANBROOK HOSPICE CARE
281 ENTERPRISE COURTBLOOMFIELD HILLSMI48302383320699PROVIDE HOSPICE HEALTH SERVICESMI501(C)(3)11, TYPE ITRINITY HOME HEALTH SERVICES INC0
DILEY RIDGE MEDICAL CENTER
6150 EAST BROAD STREETCOLUMBUSOH43213342032340HOSPITAL CAMPUS IN FAIRFIELD COUNTY OHIOOH501(C)(3)3MOUNT CARMEL HEALTH SYSTEM0
DUBUQUE MERCY HEALTH FOUNDATION INC
250 MERCY DRIVEDUBUQUEIA52001262227941SUPPORT THE SERVICES OF RELATED HOSPITALIA501(C)(3)11, TYPE IMERCY HEALTH SERVICES-IOWA CORP0
DYERSVILLE HEALTH FOUNDATION INC
1111 3RD STREET SWDYERSVILLEIA52040205383271SUPPORT THE SERVICES OF RELATED HOSPITALIA501(C)(3)11, TYPE IMERCY HEALTH SERVICES-IOWA CORP0
HACKLEY HOSPITAL
1700 CLINTON ST PO BOX 3302MUSKEGONMI494433302381358196HEALTHCARE SERVICESMI501(C)(3)3MERCY HEALTH PARTNERS0
HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST
PO BOX 3302MUSKEGONMI494433302382299878SELF INSURANCE FOR GENERAL AND MALPRACTICE LIABILITYMI501(C)(3)11, TYPE III-FIMERCY HEALTH PARTNERS0
HACKLEY LIFE COUNSELING
1352 TERRACE STMUSKEGONMI494423545381386362COUNSELING, EDUCATION, AND SUPPORTMI501(C)(3)9MERCY HEALTH PARTNERS0
HACKLEY VISITING NURSE SERVICES AND HOSPICE INC
888 TERRACE STMUSKEGONMI49440381359598PROVIDE HOME HEALTH CARE SERVICESMI501(C)(3)7MERCY HEALTH PARTNERS0
HOLY CROSS CARENET INC
PO BOX 9184FARMINGTON HILLSMI48333521945054LONG-TERM CARE AND REHABILITATION FOR THE ELDERLYMD501(C)(3)9TRINITY CONTINUING CARE SERVICES0
HOLY CROSS HOSPITAL FOUNDATION INC
11801 TECH ROADSILVER SPRINGMD20904208428450CHARITABLE FUNDRAISINGMD501(C)(3)11, TYPE IHOLY CROSS HOSPITAL OF SILVER SPRING INC0
HOLY CROSS HOSPITAL OF SILVER SPRING INC
1500 FOREST GLEN RDSILVER SPRINGMD209101484520738041HEALTHCARE SERVICESMD501(C)(3)3TRINITY HEALTH CORPORATION0
HOLY CROSS MEDICAL CENTER
27870 CABOT DRIVENOVIMI483772920951985442HEALTHCARE SERVICES (FORMERLY)CA501(C)(3)3TRINITY HEALTH CORPORATION0
HOLY ROSARY MEDICAL CENTER FOUNDATION
351 SW 9TH STREETONTARIOOR97914202683560SUPPORT THE SERVICES OF RELATED HOSPITALOR501(C)(3)11, TYPE ISAINT ALPHONSUS MEDICAL CENTER-ONTARIO0
HOSPICE OF NORTH IOWA
232 SECOND STREET SEMASON CITYIA504016208421173708HOSPICE HEALTH CARE SERVICESIA501(C)(3)7MERCY HEALTH SERVICES-IOWA CORP0
HOSPICE OF WASHTENAW II
806 AIRPORT BLVDANN ARBORMI48108383320707HOSPICE HEALTH CARE SERVICESMI501(C)(3)11, TYPE ITRINITY HEALTH-MICHIGAN0
HPCN
1675 LEAHY STREETMUSKEGONMI49442300207909HEALTHCARE SERVICESMI501(C)(3)11, TYPE IIMERCY HEALTH PARTNERS0
IHA HEALTH SERVICES CORPORATION
24 FRANK LLOYD WRIGHT DR LOBBY JANN ARBORMI48106383316559PROVIDES OFFICE-BASED MEDICAL CAREMI501(C)(3)9TRINITY HEALTH-MICHIGAN0
LAKESHORE COMMUNITY HOSPITAL INC
72 S STATE STREETSHELBYMI494551228382549295ACUTE HEALTHCARE SERVICESMI501(C)(3)3MERCY HEALTH PARTNERS0
LIFESPAN INC
166 EAST GOODALE AVEBATTLE CREEKMI490372728383298476PROVIDE HOSPICE HEALTH SERVICESMI501(C)(3)9BATTLE CREEK HEALTH SYSTEM0
MARIAN HOME HEALTHCARE
801 5TH STREETSIOUX CITYIA51101383320705PROVIDE HOME HEALTH CARE SERVICESIA501(C)(3)11, TYPE IMERCY HEALTH SERVICES-IOWA CORP0
MCAULEY CLINIC CORPORATION
PO BOX 992ANN ARBORMI48106382561013HEALTHCARE SERVICES (FORMERLY)MI501(C)(3)3CATHERINE MCAULEY HEALTH SERVICES CORP0
MERCY AMICARE HOME HEALTHCARE OAKLAND
281 ENTERPRISE COURTBLOOMFIELD HILLSMI483020312383320698PROVIDE HOME HEALTH CARE SERVICESMI501(C)(3)11, TYPE ITRINITY HOME HEALTH SERVICES INC0
MERCY AMICARE HOME HEALTHCARE PORT HURON
505 HURON AVENUEPORT HURONMI48060383320701PROVIDE HOME HEALTH CARE SERVICESMI501(C)(3)11, TYPE ITRINITY HOME HEALTH SERVICES INC0
MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE
684 HARVEY STREETMUSKEGONMI49442383321856PROVIDE HOME HEALTH CARE SERVICESMI501(C)(3)11, TYPE ITRINITY HOME HEALTH SERVICES INC0
MERCY HEALTH PARTNERS
1415 LEAHY STREETMUSKEGONMI49442382589966HEALTHCARE SYSTEM SUPPORTMI501(C)(3)11, TYPE ITRINITY HEALTH-MICHIGAN0
MERCY HEALTH SERVICES - IOWA CORP
1000 4TH STREET SWMASON CITYIA50401311373080HEALTHCARE SERVICESDE501(C)(3)3TRINITY HEALTH-MICHIGAN0
MERCY HEALTHCARE FOUNDATION
1410 N 4TH STCLINTONIA52732421316126FUNDRAISING AND FINANCIAL ASSISTANCE FOR HOSPITAL CHARITABLE SERVICESIA501(C)(3)11, TYPE IMERCY MEDICAL CENTER-CLINTON0
MERCY HOSP & HEALTH SERVICES OF DETROITMARSHALL PARK HEALTH SERVICES INC
27870 CABOT DRIVENOVIMI483772920381562325SUPPORTS MALPRACTICE CONTINGENCIES OF CLOSED HOSPITALMI501(C)(3)11, TYPE ITRINITY HEALTH-MICHIGAN0
MERCY HOSPITAL CADILLAC FOUNDATION
400 HOBARTCADILLACMI496012331203357131SUPPORT THE SERVICES OF RELATED HOSPITALMI501(C)(3)11, TYPE ITRINITY HEALTH-MICHIGAN0
MERCY HOSPITAL GIFT SHOP
2601 ELECTRIC AVEPORT HURONMI48060381630480VOLUNTEER SERVICE AUXILIARYMI501(C)(3)11, TYPE ITRINITY HEALTH-MICHIGAN0
MERCY MEDICAL CENTER - CLINTON INC
1410 NORTH 4TH STCLINTONIA527322940421336618TO PROVIDE QUALITY HEALTH CAREDE501(C)(3)3MERCY HEALTH SERVICES-IOWA CORP0
MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION
801 5TH STREETSIOUX CITYIA51102141880022SUPPORT THE SERVICES OF RELATED HOSPITALIA501(C)(3)7MERCY HEALTH SERVICES-IOWA CORP0
MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA
1000 4TH STREET SWMASON CITYIA504012800421229151SUPPORT THE SERVICES OF RELATED HOSPITALIA501(C)(3)11, TYPE III-FIMERCY HEALTH SERVICES-IOWA CORP0
MERCY MEDICAL CENTER FOUNDATION INC
1512 12TH AVENUE ROADNAMPAID83686261737256SUPPORT THE SERVICES OF RELATED HOSPITALID501(C)(3)7SAINT ALPHONSUS MEDICAL CENTER-NAMPA0
MERCY NORTH HOMECARE AND HOSPICE
7985 MACKINAW TRAILCADILLACMI49601383313897HOME HEALTH AND HOSPICE SERVICESMI501(C)(3)11, TYPE ITRINITY HOME HEALTH SERVICES INC0
MERCY PAVILION OF BATTLE CREEK
300 NORTH AVENUEBATTLE CREEKMI49016382783350PROVIDES LONG-TERM CARE FOR THE ELDERLYMI501(C)(3)9BATTLE CREEK HEALTH SYSTEM0
MERCY PHYSICIAN GROUP INC
1512 12TH AVENUE ROADNAMPAID83686208192593TO PROVIDE QUALITY HEALTH CAREID501(C)(3)9SAINT ALPHONSUS MEDICAL CENTER-NAMPA0
MERCY SERVICES FOR AGING NON-PROFIT HOUSING CORPORATION
PO BOX 9184FARMINGTON HILLSMI483339184382719605PROVIDES LONG-TERM CARE FOR THE ELDERLYMI501(C)(3)11, TYPE IITRINITY CONTINUING CARE SERVICES INC0
MIDWEST MEDFLIGHT
1300 VICTORS WAYANN ARBORMI48108382684671AEROMEDICAL TRANSPORTMI501(C)(3)9TRINITY HEALTH-MICHIGAN0
MOUNT CARMEL CARE CONTINUUM SERVICES CORP
793 WEST STATE STREETCOLUMBUSOH43222311126211COOPERATIVE HOSPITAL SERVICE ORGANIZATIONOH501(C)(3)3MOUNT CARMEL HEALTH SYSTEM0
MOUNT CARMEL COLLEGE OF NURSING
6150 EAST BROAD STREETCOLUMBUSOH43213311308555COLLEGE OF NURSINGOH501(C)(3)2MOUNT CARMEL HEALTH0
MOUNT CARMEL HEALTH
6150 EAST BROAD STREETCOLUMBUSOH43213314379602HEALTHCARE SERVICESOH501(C)(3)3MOUNT CARMEL HEALTH SYSTEM0
MOUNT CARMEL HEALTH INSURANCE COMPANY
6150 EAST BROAD STREETCOLUMBUSOH43213251912781HEALTH INSURANCEOH501(C)(4)N/AMOUNT CARMEL HEALTH SYSTEM0
MOUNT CARMEL HEALTH PLAN INC
6150 EAST BROAD STREETCOLUMBUSOH43213311471229MEDICARE HMO FOR SENIORSOH501(C)(4)N/AMOUNT CARMEL HEALTH SYSTEM0
MOUNT CARMEL HEALTH SYSTEM
6150 EAST BROAD STREETCOLUMBUSOH43213311439334HEALTHCARE SYSTEM MANAGEMENT AND SUPPORTOH501(C)(3)11, TYPE ITRINITY HEALTH CORPORATION0
MOUNT CARMEL HEALTH SYSTEM FOUNDATION
6150 EAST BROAD STREETCOLUMBUSOH43213311113966SUPPORT THE SERVICES OF RELATED HOSPITALOH501(C)(3)11, TYPE IMOUNT CARMEL HEALTH SYSTEM0
MOUNT CARMEL HOME CARE LLC
1144 DUBLIN ROAD SUITE BCOLUMBUSOH43215262729300PROVIDE HOME HEALTH CARE SERVICESOH501(C)(3)9TRINITY HOME HEALTH SERVICES INC0
MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL
7333 SMITHS MILL RDNEW ALBANYOH43054870790288HEALTHCARE SERVICESOH501(C)(3)3MOUNT CARMEL HEALTH SYSTEM0
MRI MOBILE SERVICES OF WEST MICHIGAN
1820 - 44TH STREETKENTWOODMI49508383073745OPERATE MAGNETIC IMAGING RESONANCE (FORMERLY)MI501(C)(3)9TRINITY HEALTH-MICHIGAN0
MUSKEGON COMMUNITY HEALTH PROJECT
565 W WESTERN AVENUEMUSKEGONMI49440911932918FACILITATE AND COORDINATE HEALTHCARE AND RELATED SERVICESMI501(C)(3)7MERCY HEALTH PARTNERS0
OAKLAND MERCY HOSPITAL
601 EAST 2ND STREETOAKLANDNE68045208072234HEALTHCARE SERVICESNE501(C)(3)3MERCY HEALTH SERVICES-IOWA CORP0
OAKLAND MERCY HOSPITAL FOUNDATION
601 E 2ND STREETOAKLANDNE68045311678345SUPPORTS SERVICES OF RELATED HOSPITALNE501(C)(3)11, TYPE III-FIOAKLAND MERCY HOSPITAL0
PORT HURON MERCY FAMILY CARE INC
2601 ELECTRIC AVEPORT HURONMI48060201855647HEALTHCARE SERVICESMI501(C)(3)11, TYPE ITRINITY HEALTH-MICHIGAN0
PROFESSIONAL MED TEAM
965 FORK STREETMUSKEGONMI494423257382638284MEDICAL CARE, TRANSPORTATION AND EDUCATIONMI501(C)(3)9TRINITY HEALTH-MICHIGAN0
PROFESSIONAL OFFICE CORPORATION
1303 EAST HERNDON AVEFRESNOCA93720942839324HEALTHCARE SERVICESCA501(C)(3)11, TYPE ISAINT AGNES MEDICAL CENTER0
SAINT AGNES MEDICAL CENTER
1303 EAST HERNDON AVEFRESNOCA93720941437713HEALTHCARE SERVICESCA501(C)(3)3TRINITY HEALTH CORPORATION0
SAINT ALPHONSUS BUILDING COMPANY INC
1055 NORTH CURTIS RDBOISEID83706820401011SUPPORTS SERVICES OF RELATED HOSPITALID501(C)(3)11, TYPE ISAINT ALPHONSUS REGIONAL MEDICAL CENTER INC0
SAINT ALPHONSUS DIVERSIFIED CARE INC
1055 NORTH CURTIS RDBOISEID83706943028978SUPPORTS SERVICES OF RELATED HOSPITALID501(C)(3)11, TYPE ISAINT ALPHONSUS REGIONAL MEDICAL CENTER INC0
SAINT ALPHONSUS HEALTH SYSTEM INC
1055 N CURTIS ROADBOISEID83706271929502HEALTHCARE SYSTEM MANAGEMENT AND SUPPORTID501(C)(3)11, TYPE ITRINITY HEALTH CORPORATION0
SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY
3325 POCAHONTAS ROADBAKER CITYOR97814271790052TO PROVIDE QUALITY HEALTH CAREOR501(C)(3)3SAINT ALPHONSUS HEALTH SYSTEM INC0
SAINT ALPHONSUS MEDICAL CENTER-NAMPA
1512 12TH AVENUE ROADNAMPAID83686820200896TO PROVIDE QUALITY HEALTH CAREID501(C)(3)3SAINT ALPHONSUS HEALTH SYSTEM INC0
SAINT ALPHONSUS MEDICAL CENTER-ONTARIO
351 SW 9TH STREETONTARIOOR97914271789847TO PROVIDE QUALITY HEALTH CAREOR501(C)(3)3SAINT ALPHONSUS HEALTH SYSTEM INC0
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
1055 NORTH CURTIS RDBOISEID83706820200895HEALTHCARE SERVICESID501(C)(3)3SAINT ALPHONSUS HEALTH SYSTEM INC0
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC
1915 LAKE AVENUE PO BOX 670PLYMOUTHIN46563351142669HEALTHCARE SERVICESIN501(C)(3)3SAINT JOSEPH REGIONAL MEDICAL CENTER INC0
SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC
PO BOX 1935SOUTH BENDIN466341935350868157HEALTHCARE SERVICESIN501(C)(3)3SAINT JOSEPH REGIONAL MEDICAL CENTER INC0
SAINT JOSEPH REGIONAL MEDICAL CENTER INC
801 EAST LASALLE AVESOUTH BENDIN46617351568821HEALTHCARE SYSTEM MANAGEMENT AND SUPPORTIN501(C)(3)11, TYPE ITRINITY HEALTH CORPORATION0
SAINT JOSEPH'S AUXILIARY OF MARSHALL COUNTY
1915 LAKE AVENUEPLYMOUTHIN46563356043563HOSPITAL SERVICE AUXILIARYIN501(C)(3)11, TYPE IISAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC0
SAINT JOSEPH'S TOWER INC
PO BOX 9184FARMINGTON HILLSMI483339184311040468PROVIDES HOUSING FOR LOW INCOME ELDERLY INDIVIDUALSIN501(C)(3)9TRINITY CONTINUING CARE SERVICES-INDIANA0
SAINT MARY'S AMICARE HOME HEALTHCARE
1430 MONROE NWGRAND RAPIDSMI49505383320700PROVIDE HOME HEALTH CARE SERVICESMI501(C)(3)11, TYPE ITRINITY HOME HEALTH SERVICES INC0
SAINT MARY'S DORAN FOUNDATION CO SAINT MARY'S HEALTH CARE
200 JEFFERSON ST SEGRAND RAPIDSMI49503381779602SUPPORTS SERVICES OF RELATED HOSPITALMI501(C)(3)7TRINITY HEALTH-MICHIGAN0
ST JOHN'S HEALTH SYSTEM
27870 CABOT DRIVENOVIMI483772920350877584HEALTHCARE SERVICES (FORMERLY)IN501(C)(3)3TRINITY HEALTH CORPORATION0
ST JOSEPH MERCY OAKLAND FOUNDATION
44405 WOODWARD AVEPONTIACMI48341352356789SUPPORTS SERVICES OF RELATED HOSPITALMI501(C)(3)11, TYPE ITRINITY HEALTH-MICHIGAN0
ST ANN'S HOSPITAL
500 SOUTH CLEVELAND AVEWESTERVILLEOH43081314412701HEALTHCARE SERVICESOH501(C)(3)3MOUNT CARMEL HEALTH SYSTEM0
ST ELIZABETH HEALTH CARE FOUNDATION
3325 POCAHONTAS ROADBAKER CITYOR97814943164869SUPPORT THE SERVICES OF RELATED HOSPITALOR501(C)(3)7SAINT ALPHONSUS MEDICAL CENTER - BAKER CITY0
ST JOSEPH'S MEDICAL CENTER AUXILIARY
801 E LASALLE AVE PO BOX 1935SOUTH BENDIN466341935356033285HOSPITAL SERVICE AUXILIARYIN501(C)(4)N/ASAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC0
THE FOUNDATION OF SAINT JOSEPH REGIONAL MEDICAL CENTER
4215 EDISON LAKES PARKWAYMISHAWAKAIN46545351654543SUPPORTS SERVICES OF RELATED HOSPITALIN501(C)(3)11, TYPE ISAINT JOSEPH REGIONAL MEDICAL CENTER INC0
TRINITY CONTINUING CARE SERVICES
PO BOX 9184FARMINGTON HILLSMI483339184382559656MANAGEMENT SERVICES FOR LONG TERM CARE AND SENIOR LIVING FACILITIESMI501(C)(3)11, TYPE ITRINITY HEALTH CORPORATION0
TRINITY CONTINUING CARE SERVICES - INDIANA INC
PO BOX 9184FARMINGTON HILLSMI483339184930907047PROVIDES LONG-TERM CARE AND RESIDENTIAL HOUSINGIN501(C)(3)9TRINITY CONTINUING CARE SERVICES0
TRINITY HEALTH - MICHIGAN
27870 CABOT DRIVENOVIMI483772920382113393HEALTHCARE SERVICESMI501(C)(3)3TRINITY HEALTH CORPORATION0
TRINITY HEALTH CORPORATION
27870 CABOT DRIVENOVIMI483772920351443425HEALTHCARE SYSTEM MANAGEMENT AND SUPPORTIN501(C)(3)11, TYPE I0N/A
TRINITY HEALTH INTERNATIONAL
27870 CABOT DRIVENOVIMI483772920421253527HEALTHCARE TRAINING AND SUPPORT SERVICESMI501(C)(3)11, TYPE ITRINITY HEALTH CORPORATION0
TRINITY HEALTH WELFARE BENEFIT TRUST
27870 CABOT DRIVENOVIMI483772920208151733RETIREE MEDICAL AND RETIREE LIFE INSURANCE COVERAGEMI501(C)(9)N/ATRINITY HEALTH CORPORATION0
TRINITY HOME HEALTH SERVICES INC
17410 COLLEGE PARKWAYLIVONIAMI48152382621935HOME HEALTH CARE SYSTEM MANAGEMENT SERVICESMI501(C)(3)11, TYPE ITRINITY HEALTH CORPORATION0

Form990 Schedule R Part III Form990ScheduleRPartIII (31 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
ADVANCED IMAGING SERVICES OF BATTLE CREEK
5352 BECKLEY ROAD STE ABATTLE CREEKMI49015204594297RADIOLOGY/IMAGINGMIN/AN/A000.00000
ADVENT REHABILITATION LLC
607 DEWEY AVENUE SUITE 300GRAND RAPIDSMI49504383306673REHABILITATION THERAPY SERVICESMIN/AN/A000.00000
BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222311608125MEDICAL OFFICE BUILDING RENTALOHN/AN/A000.00000
CENTER FOR DIGESTIVE CARE LLC
5300 ELLIOTT DRIVEYPSILANTIMI48197030447062PROVIDE GASTROINTESTINAL SERVICESMIN/AN/A000.00000
CENTRAL OHIO SLEEP MEDICINE LTD
5955 EAST BROAD STCOLUMBUSOH43213311701029SLEEP MEDICINE SERVICESOHN/AN/A000.00000
CLINTON IMAGING SERVICES LLC
615 VALLEY VIEW DR STE 202MOLINEIL61265412044739MRI DIAGNOSTIC SERVICESIAN/AN/A000.00000
FOREST PARK IMAGING LLC
1000 4TH STREET SWMASON CITYIA50401134365966X-RAY AND MAMMOGRAPHY SERVICESIAN/AN/A000.00000
FRANCES WARDE MEDICAL LABORATORY
300 WEST TEXTILE ROADANN ARBORMI48104382648446LABORATORYMIN/AN/A000.00000
FRESNO IMAGING CENTER
1303 E HERNDON AVEFRESNOCA93720770363563DIAGNOSTIC IMAGINGCAN/AN/A000.00000
HAWARDEN COMMUNITY CLINIC LLC
1122 AVENUE LHAWARDENIA51023201444339MEDICAL CLINICIAN/AN/A000.00000
IDAHO GYNONCOLOGY SERVICES LLC
1055 N CURTIS RDBOISEID83706202975807PROVIDE GYN ONCOLOGY SERVICESIDN/AN/A000.00000
INTERMOUNTAIN MEDICAL IMAGING LLC
877 WEST MAIN ST STE 603BOISEID83702820514422PROVIDE IMAGING SERVICESIDN/AN/A000.00000
MAGNETIC RESONANCE SERVICES PARTNERSHIP
1416 SIXTH STREET SWMASON CITYIA50401421328388MRI SERVICESIAN/AN/A000.00000
MASON CITY AMBULATORY SURGERY CENTER LLC
990 4TH STREET SWMASON CITYIA50401201960348SURGERY-SAME DAYIAN/AN/A000.00000
MCE MOB IV LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222421544707MEDICAL OFFICE BUILDING RENTALOHN/AN/A000.00000
MCMC POB III LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222311392994MEDICAL OFFICE BUILDING RENTALOHN/AN/A000.00000
MEDILUCENT MOB I
793 W STATE STREETCOLUMBUSOH43222204911370MEDICAL OFFICE BUILDING RENTALOHN/AN/A000.00000
MERCY HEART CTR OP SERVICES LLC
1000 4TH STREET SWMASON CITYIA50401134237594CARDIOVASCULAR SERVICESIAN/AN/A000.00000
MERCY OUTPATIENT SURGERY CENTER LLC
1512 12TH AVENUE ROADNAMPAID83686841380439OUTPATIENT SURGERYIDN/AN/A000.00000
MICHIANA HEALTH INFORMATION NETWORK LLC
215 WEST MADISON STREETSOUTH BENDIN46601352050128COMMUNITY BASED CLINICAL INFORMATION SYSTEM AND DATA DEPOSITORYINN/AN/A000.00000
MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222311369473MEDICAL OFFICE BUILDING RENTALOHN/AN/A000.00000
NEWCO AMBULATORY SURGERY CTR LLP
4190 24TH AVENUEFORT GRATIOTMI48059300136708OUTPATIENT SURGERY CENTERMIN/AN/A000.00000
RIVERVIEW MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222311531135MEDICAL OFFICE BUILDING RENTALOHN/AN/A000.00000
ROSENBERG & BRUNO PROPERTIES LLC (FKA BSV MEDICAL OFFICE BUILDING II LLC)
855 M STREET TENTH FLOORFRESNOCA93721202673839MEDICAL OFFICE BUILDING RENTALCAN/AN/A000.00000
SARMED OUTPATIENT PHARMACY LLC
999 N CURTIS RD STE 102BOISEID83706510483218PHARMACYIDN/AN/A000.00000
SIXTY FOURTH STREET LLC
2373 64TH ST STE 2200BYRON CENTERMI49315202443646PROVIDE OUTPATIENT SURGICAL CAREMIN/AN/A000.00000
ST ALPHONSUS CALDWELL CANCER CTR LLC
3123 MEDICAL DRCALDWELLID83605820526861RADIATION ONCOLOGYIDN/AN/A000.00000
ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222311603660MEDICAL OFFICE BUILDING RENTALOHN/AN/A000.00000
TAMARACK MEDICAL CLINIC LLC
610 VILLAGE DRIVEDONNELLYID83615201637921OUTPATIENT MEDICAL SERVICESIDN/AN/A000.00000
WESTAR MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP
793 W STATE STREETCOLUMBUSOH43222311784409MEDICAL OFFICE BUILDING RENTALOHN/AN/A000.00000
WOODLAND IMAGING CENTER LLC
5301 E HURON RIVER DRANN ARBORMI48106760820959RADIOLOGY/IMAGINGMIN/AN/A000.00000

Form990 Schedule R Part IV Form990ScheduleRPartIV (32 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
COMMUNITY HEALTH VENTURES INC
565 W WESTERN AVEMUSKEGONMI49440383522260SOFTWARE MARKETINGMIN/AC
HACKLEY HEALTH MANAGEMENT CENTER
1415 LEAHY STMUSKEGONMI49442382961814WEIGHT MANAGEMENTMIN/AC
HACKLEY HEALTH VENTURES INC
1415 LEAHY STMUSKEGONMI49442382589959OTHER MEDICAL SERVICESMIN/AC
HACKLEY HEALTHCARE EQUIPMENT
1415 LEAHY STMUSKEGONMI49442382578569HOME MEDICAL EQUIPMENTMIN/AC
HACKLEY PROFESSIONAL CENTER
1415 LEAHY STMUSKEGONMI49442383024797REAL ESTATE RENTALMIN/AC
HACKLEY PROFESSIONAL PHARMACY
1415 LEAHY STMUSKEGONMI49442382447870PHARMACYMIN/AC
HEF INC
1415 LEAHY STMUSKEGONMI49442383086401OFFICE STAFFINGMIN/AC
HOLY CROSS PRIVATE HOME SERVICES CORP
11801 TECH ROADSILVER SPRINGMD20904521986562HOME CARE SERVICESMDN/AC
HPC CO-OWNERS ASSOCIATION
1700 CLINTONMUSKEGONMI49442270734448CONDOMINIUM ASSOCIATIONMIN/AC
HURON ARBOR CORPORATION
5301 EAST HURON RIVER DR PO BOX 992ANN ARBORMI48106382475644PROVIDES OFFICE RENTAL SPACEMIN/AC
INTEGRATED HEALTH ASSOCIATES INC
24 FRANK LLOYD WRIGHT DR LOBBY JANN ARBORMI48106383126920MEDICAL MANAGEMENTMIN/AC
IHA AFFILIATION CORPORATION
24 FRANK LLOYD WRIGHT DR LOBBY JANN ARBORMI48106383188895MEDICAL MANAGEMENTMIN/AC
IHA HEALTH SERVICES CORPORATION
24 FRANK LLOYD WRIGHT DR LOBBY JANN ARBORMI48106383316559MEDICAL SERVICESMIN/AC
MARYLAND CARE GROUP INC
11801 TECH ROADSILVER SPRINGMD20904521815313HEALTHCARE HOLDINGMDN/AC
MEDNOW INC
1512 12TH AVENUE ROADNAMPAID83686820389927OUTPATIENT PHARMACYIDN/AC
MERCY COMMUNITY PHYSICIANS
363 FREMONT STREETBATTLE CREEKMI49017264252468HEALTHCARE SERVICESMIN/AC
MERCY MEDICAL SERVICES
801 5TH STREETSIOUX CITYIA51101421283849PRIMARY CARE PHYSICIANSIAN/AC
MICHIGAN PHYSICIAN SERVICES
44405 WOODWARD AVENUE H-5PONTIACMI48341383293125PHYSICIAN SERVICESMIN/AC
MICHIGAN ATHLETIC CLUB
2500 BURTONGRAND RAPIDSMI49546382647304ATHLETIC CLUBMIN/AC
MOUNT CARMEL BEHAVIORAL HEALTHCARE SERVICES INC
6150 EAST BROAD STREETCOLUMBUSOH43213310971510BEHAVIORAL HEALTHCARE SERVICESOHN/AC
MOUNT CARMEL HEALTH HORIZONS CORP
6150 EAST BROAD STREETCOLUMBUSOH43213311177652MEDICAL SERVICES/RENTOHN/AC
MOUNT CARMEL HEALTH PROVIDERS INC
6150 EAST BROAD STREETCOLUMBUSOH43213311382442MEDICAL SERVICESOHN/AC
NORTH IOWA MERCY MEDICAL SERVICES INC
1000 4TH ST SWMASON CITYIA50401421382308MEDICAL SERVICESIAN/AC
PRIMARY CARE NETWORK OF OHIO INC
6150 EAST BROAD STREETCOLUMBUSOH43213311422486HEALTH MANAGEMENT SERVICESOHN/AC
PRIORITY PLUS OF CALIFORNIA
PO BOX 27230FRESNOCA93729770395267FORMERLY HEALTH MANAGEMENT NOW DISCONTINUED SUBSTANTIALLY ALL OPERATIONSCAN/AC
SAINT ALPHONSUS PHYSICIANS PA
1055 NORTH CURTIS ROADBOISEID837061370331078261PHYSICIANSIDN/AC
SAINT MARY'S HEALTH MANAGEMENT COMPANY
1640 EAST PARIS SEGRAND RAPIDSMI49546383450733ATHLETIC CLUBMIN/AC
SURGERY CENTER FINANCING CORPORATION
6150 EAST BROAD STREETCOLUMBUSOH43213311531102FINANCE, INSURANCE AND REAL ESTATEOHN/AC
TRINITY HEALTH EMPLOYEE BENEFIT TRUST
27870 CABOT DRIVENOVIMI483772920383410377GRANTOR TRUSTMIN/AT
VENZKE INSURANCE COMPANY LTD
980453602PROVISION OF INSURANCE COVERAGEN/ACPO BOX 1051 GRAND CAYMANGRAND CAYMANCJCJ
WESTSHORE HEALTH NETWORK
1820 44TH STREETKENTWOODMI49508383280200PHYSICIAN HOSPITAL ORGANIZATIONMIN/AC
WORKPLACE HEALTH OF GRAND HAVEN
1415 LEAHY STMUSKEGONMI49442383112035OCCUPATIONAL HEALTHMIN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MOUNT CARMEL HEALTH SYSTEM
B38199594PER BOOKS
MOUNT CARMEL HEALTH PROVIDERS
L123420PER BOOKS
MOUNT CARMEL HEALTH PLAN
K12403261PER BOOKS
MOUNT CARMEL HEALTH SYSTEM
Q38529076PER BOOKS
TRINITY HEALTH CORPORATION
Q5010729PER BOOKS
MOUNT CARMEL INSURANCE COMPANY
K369680PER BOOKS