OAKLAND MERCY HOSPITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- OAKLAND MERCY HOSPITAL (EIN 20-8072234)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-09
- IRS object ID
- 201111299349300606
- Schema version
- 2009v1.7
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-09T14:59:06-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208072234 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OAKLAND MERCY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | OAKL | NameControl |
| Phone | 4026855601 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 EAST 2ND STREET | AddressLine1 |
| City | OAKLAND | City |
| State | NE | State |
| ZIP Code | 68045 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GARY GUETZKO | Name |
| Title | CEO | Title |
| Phone | 4026855601 | Phone |
| Date Signed | 2011-05-09 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | TIMOTHY FISCHER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 EAST 2ND STREET | AddressLine1 |
| City | OAKLAND | City |
| State | NE | State |
| ZIP Code | 68045 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 6025845 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.OAKLANDHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2006 | YearFormation |
| State Legal Domicile | NE | StateLegalDomicile |
| Activity Or Mission Description | HOSPITAL HEALTH CARE SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 9 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 23532 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 30793 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 6310314 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5952723 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 256 | InvestmentIncomePriorYear |
| Investment Income Current Year | 929 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 39869 | OtherRevenuePriorYear |
| Other Revenue Current Year | 39436 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 6373971 | TotalRevenuePriorYear |
| Total Revenue Current Year | 6023881 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 10717 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5560022 | OtherExpensePriorYear |
| Other Expenses Current Year | 5503632 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 5560022 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5514349 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 813949 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 509532 | RevenuesLessExpensesCY |
| Total Assets BOY | 2764967 | TotalAssetsBOY |
| Total Assets EOY | 3597263 | TotalAssetsEOY |
| Total Liabilities BOY | 1180707 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1038673 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1584260 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2558590 | NetAssetsOrFundBalancesEOY |
| Mission Description | HOSPITAL HEALTH CARE SERVICES - SEE SCHEDULE H FOR MORE INFORMATION | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 4972434 | Expense |
| Grants | 10717 | Grants |
| Revenue | 5974227 | Revenue |
| Description | OAKLAND MERCY HOSPITAL (THE HOSPITAL) BECAME PART OF THE TRINITY HEALTH SYSTEM ON DECEMBER 21, 2006 TO PROVIDE QUALITY HEALTH CARE TO THE RESIDENTS OF THE BURT COUNTY AREA AND SURROUNDING COMMUNITIES.THE HOSPITAL HAS 23 ACUTE CARE BEDS AND ALSO OPERATES four AFFILIATED MEDICAL CLINICS IN OAKLAND, LYONS, hooper, AND TEKAMAH, NEBRASKA. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | THE MISSION STATEMENT FOR THE HOSPITAL IS AS FOLLOWS:WE SERVE TOGETHER IN TRINITY HEALTHIN THE SPIRIT OF THE GOSPELTO HEAL BODY, MIND AND SPIRITTO IMPROVE THE HEALTH OF OUR COMMUNITIESAND TO STEWARD THE RESOURCES ENTRUSTED TO US. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 4972434 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 67 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TIMOTHY FISCHER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4026855601 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 EAST 2ND STREET | AddressLine1 |
| City | OAKLAND | City |
| State | NE | State |
| ZIP Code | 68045 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| RANDALL D JOHNSON | ||||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 | ||
| DR KELLY F LECHTENBERG | ||||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | ||
| CLINTON G CARR | ||||||||
| ASST. SEC/TREAS. | 1.00 | X | X | 0 | 0 | 0 | ||
| STEVEN J EAVENSON TATUM LLC | ||||||||
| SEC/TREAS.; MMC-SC INTERIM CFO | 1.00 | X | X | 0 | 283500 | 0 | ||
| TIMOTHY FISCHER | ||||||||
| DIR & CEO/ADMINISTRATOR | 50.00 | X | X | 0 | 104402 | 19861 | ||
| JON K HEIDEMAN | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| JAMES E GROTH | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DR TRACIE MARTIN | ||||||||
| DirectOR; OAKLAND CLINIC PHYSICIAN | 50.00 | X | 0 | 177455 | 17734 | |||
| MARILYN KAPTAIN-DAHLEN | ||||||||
| DIRECTOR; MMC-SC COO | 1.00 | X | 0 | 300423 | 78301 | |||
| ROBERT PEEBLES | ||||||||
| DIRECTOR; MMC-SC CEO | 1.00 | X | 0 | 249658 | 12176 | |||
| BRIAN MONSMA | ||||||||
| DIRECTOR; MMC-SC VP REG. | 1.00 | X | 0 | 183074 | 29889 | |||
| PETER THIELE | ||||||||
| OAKLAND CLINIC PHYSICIAN | 50.00 | 0 | 114299 | 16879 | X | |||
| PAUL DOUGHERTY | ||||||||
| FORMER DIRECTOR | 0.00 | 0 | 397965 | 381341 | X | |||
| GARY GUETZKO | ||||||||
| FORMER DIRECTOR & OFFICER | 0.00 | 0 | 249179 | 48200 | X | |||
| MELVIN GOIN | ||||||||
| FORMER DIRECTOR & OFFICER | 0.00 | 0 | 214531 | 33685 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2274486 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 638066 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| REHABVISIONS | |||||
| 11623 ARBOR ST | OMAHA | NE | 68144 | REHABILITATION SERVICES | 139495 |
| AUREUS NURSING LLC | |||||
| PO BOX 3037 | OMAHA | NE | 68103 | MEDICAL STAFFING | 128596 |
| SHARED IMAGING LLC | |||||
| PO BOX 88544 | MILWAUKEE | WI | 53288 | RADIOLOGY SERVICES | 101775 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| All Other Contributions | 30793 | AllOtherContributions |
| Total Contributions | 30793 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SVC REV | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 5952723 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5952723 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5952723 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 929 | TotalRevenueColumn |
| Exclusion | $929 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 4620 | Real |
| Personal | 836 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1663 | Real |
| Personal | 301 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2957 | Real |
| Personal | 535 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3492 | TotalRevenueColumn |
| Exclusion | $3,492 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| OTHER REVENUE | 900099 | 21504 | 21504 | |
| CAFETERIA REVENUE | 900099 | 14440 | $14,440 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 35944 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6023881 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5974227 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $18,861 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10717 | Total |
| Program Services | 10717 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60084 | Total |
| Program Services | 60084 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17544 | Total |
| Management And General | 17544 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 363887 | Total |
| Program Services | 349787 | ProgramServices |
| Management And General | 14100 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25795 | Total |
| Program Services | 8830 | ProgramServices |
| Management And General | 16965 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 869273 | Total |
| Program Services | 817514 | ProgramServices |
| Management And General | 51759 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 142321 | Total |
| Program Services | 142321 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20914 | Total |
| Program Services | 15340 | ProgramServices |
| Management And General | 5574 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12801 | Total |
| Program Services | 10873 | ProgramServices |
| Management And General | 1928 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 489 | Total |
| Program Services | 489 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 164740 | Total |
| Program Services | 156832 | ProgramServices |
| Management And General | 7908 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13558 | Total |
| Program Services | 13558 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| LBR COSTS PD BY PARENT | 3587569 | 3202549 | 385020 |
| EQUIPMENT MAINTENANCE | 97191 | 71208 | 25983 |
| CONTRACT LABOR | 63660 | 63660 | |
| SubscriptionS & Dues | 20709 | 11475 | 9234 |
| I/C PURCHASED SERVICES | 7881 | 6081 | 1800 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35216 | Total |
| Program Services | 31116 | ProgramServices |
| Management And General | 4100 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5514349 | Total |
| Program Services | 4972434 | ProgramServices |
| Management And General | 541915 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 156430 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100350 | BOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1142777 | BOY |
| EOY | 1727052 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 176360 | BOY |
| EOY | 183774 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41997 | BOY |
| EOY | 40272 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1490159 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 562041 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 918689 | BOY |
| EOY | 928118 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 314236 | BOY |
| EOY | 411538 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70558 | BOY |
| EOY | 150079 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2764967 | BOY |
| EOY | 3597263 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1027926 | BOY |
| EOY | 883099 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 152781 | BOY |
| EOY | 155574 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1180707 | BOY |
| EOY | 1038673 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1483910 | BOY |
| EOY | 2558590 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100350 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1584260 | BOY |
| EOY | 2558590 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2764967 | BOY |
| EOY | 3597263 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $1,116 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 1116 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i: | Identifier |
| Return Reference | Explanation of Other Lobbying Activities: | ReturnReference |
| Explanation | OAKLAND MERCY HOSPITAL HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS. THESE ORGANIZATIONS HAVE PROVIDED THE HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS THAT ARE USED FOR LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 50000 | OtherCostOrOtherBasis |
| Book Value | 50000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 789029 | OtherCostOrOtherBasis |
| Depreciation | 278263 | Depreciation |
| Book Value | 510766 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 434917 | OtherCostOrOtherBasis |
| Depreciation | 228452 | Depreciation |
| Book Value | 206465 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 216213 | OtherCostOrOtherBasis |
| Depreciation | 55326 | Depreciation |
| Book Value | 160887 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 928118 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ASSET RETIREMENT OBLIGATION (FIN 47) | $148,979 |
| oTHER LIABILITIES | $6,595 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 155574 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part X: | Identifier |
| Return Reference | Description of Uncertain Tax Positions Under FIN 48: | ReturnReference |
| Explanation | OAKLAND MERCY HOSPITAL is included in the consolidated financial statements of Trinity Health. Trinity Health's financial statements for the year ended June 30, 2010 did not include a FIN 48 footnote. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 23 | PersonsServed |
| Total Community Benefit Expense | 1302 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1302 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 140 | PersonsServed |
| Total Community Benefit Expense | 314507 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 313046 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1461 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 163 | PersonsServed |
| Total Community Benefit Expense | 315809 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 313046 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2763 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 200 | PersonsServed |
| Total Community Benefit Expense | 1440 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1440 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 1 | PersonsServed |
| Total Community Benefit Expense | 5000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 6 | PersonsServed |
| Total Community Benefit Expense | 7193 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7193 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 207 | PersonsServed |
| Total Community Benefit Expense | 13633 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 13633 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00250 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 370 | PersonsServed |
| Total Community Benefit Expense | 329442 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 313046 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 16396 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00300 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $0 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 3680369 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 3381098 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 299271 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (5 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|
| OAKLAND MERCY HOSPITAL | ||||||||
| 601 EAST 2ND STREET | OAKLAND | NE | 68045 | X | X | X | X | SKILLED NURSING CARE |
| OAKLAND MERCY MEDICAL CLINIC | ||||||||
| 211 N ENGDAHL | OAKLAND | NE | 68045 | OUTPATIENT CLINIC | ||||
| LYONS MERCY MEDICAL CLINIC | ||||||||
| 200 MAIN STREET | LYONS | NE | 68038 | OUTPATIENT CLINIC | ||||
| TEKAMAH MERCY MEDICAL CLINIC | ||||||||
| 1121 S 13TH STREET | TEKAMAH | NE | 68061 | OUTPATIENT CLINIC | ||||
| HOOPER MERCY MEDICAL CLINIC | ||||||||
| 600 E FULTON AVE | HOOPER | NE | 68031 | OUTPATIENT CLINIC | ||||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Annual Community Benefit Expln | Part I, Line 6a: OAKLAND MERCY 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, OAKLAND MERCY HOSPITAL WILL BE INCLUDING A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON TRINITY HEALTH'S WEBSITE AS WELL AS MERCY MEDICAL CENTER - SIOUX CITY'S WEBSITE (WWW.MERCYSIOUXCITY.COM) | AnnualCommunityBenefitExpln |
| Costing Method Used | 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. | CostingMethodUsed |
| Bad Debt Footnote | Part III, Line 4: OAKLAND MERCY 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." | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: 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, OAKLAND MERCY HOSPITAL does not believe any Medicare shortfall should be treated as community benefit.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. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: OAKLAND MERCY HOSPITAL'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. | DebtCollectionPolicy |
| Needs Assessment | Part VI, Line 2: NEEDS ASSESSMENT - OAKLAND MERCY HOSPITAL ASSESSES THE HEALTH NEEDS OF THE COMMUNITY THROUGH COMMUNITY NEEDS ASSESSMENTS EVERY THREE YEARS. A COMMUNITY NEEDS ASSESSMENT IS A POINT-IN-TIME EFFORT TO MEASURE THE HEALTH AND WELL BEING OF THE COMMUNITY. IT SERVES AS THE BASIS FOR OAKLAND MERCY HOSPITAL'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 NEEDS ASSESSMENT ALSO SERVES AS A BENCHMARK FOR FUTURE ASSESSMENT OF RELATIVE PROGRESS TOWARD ESTABLISHED COMMUNITY HEALTH OBJECTIVES.THE OAKLAND MERCY HOSPITAL COMMUNITY 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 PLANNINGTHE OAKLAND MERCY HOSPITAL COMMUNITY NEEDS ASSESSMENT PROCESS INVOLVES THE GATHERING OF TWO TYPES OF DATA: QUANTITATIVE (DEMOGRAPHICS, HEALTH INDICATORS, ETC.) AND QUALITATIVE (PUBLIC SURVEYS, FORUMS, FOCUS GROUPS). THE DATA HELPS SUPPORT SHORT-TERM AND LONG-TERM DECISIONS ABOUT ALLOCATION OF COMMUNITY HUMAN AND CAPITAL RESOURCES.THE OAKLAND MERCY HOSPITAL COMMUNITY NEEDS ASSESSMENT IS CURRENT AS OF AUGUST 2009. THE COMMUNITY NEEDS ASSESSMENT WAS COMPLETED IN COLLABORATION WITH MERCY MEDICAL CENTER-SIOUX CITY; ELKHORN LOGAN VALLEY HEALTH DEPARTMENT AND LOCAL COMMUNITY ORGANIZATIONS. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - OAKLAND MERCY HOSPITAL 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; AND- 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 AHA RECOMMENDATIONS, OAKLAND MERCY HOSPITAL 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 OBLIGATIONSOAKLAND MERCY HOSPITAL COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES 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. PATIENTS ARE NOTIFIED AT THE TIME OF ADMISSION OF OAKLAND MERCY HOSPITAL'S CHARITY CARE POLICY. IN ADDITION, INFORMATION IS MAILED TO PATIENTS WHO ARE IDENTIFIED THROUGH THE BILLING PROCESS AS NOT HAVING INSURANCE.OAKLAND MERCY HOSPITAL OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH MESSAGES INCLUDED ON THE PATIENT BILLS, POSTING NOTICES IN PUBLIC REGISTRATION AREAS, AND INFORMATION MAILED TO PATIENTS WHO ARE IDENTIFIED THROUGH THE BILLING PROCESS AS NOT HAVING INSURANCE. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO THE STATE OF NEBRASKA. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON THE HOSPITAL WEBSITE AND IN THE ADMISSION PACKAGE.OAKLAND MERCY HOSPITAL HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. OAKLAND MERCY HOSPITAL 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. OAKLAND MERCY HOSPITAL EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, 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. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: COMMUNITY INFORMATION - THE Oakland Mercy Hospital primary service area is Burt and the surrounding counties in Northeast Nebraska. The primary hospital is located in Oakland, NE and operates 4 rural health clinics in Oakland, Lyons, Tekamah and Hooper. Oakland Mercy Hospital is an owned facility of Mercy Medical Center - Sioux City and part of the Mercy Siouxland regional network, which also manages the Pender Community Hospital in Thurston County. Oakland Mercy Hospital's service area is considered rural. The median income for a household in the county was $33,954, and the median income for a family was $40,515. Males had a median income of $28,750 versus $20,663 for females. The per capita income for the county was $16,654. About 6.60% of families and 8.90% of the population were below the poverty line, including 11.80% of those under age 18 and 8.30% of those age 65 or over. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: COMMUNITY BUILDING ACTIVITIES- N/A | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: OTHER INFORMATION - OAKLAND MERCY HOSPITAL PROVIDES COMPREHENSIVE MEDICAL CARE FOR THE BURT COUNTY AREA, INCLUDING EMERGENCY AND GENERAL HEALTH SERVICES. OAKLAND MERCY ALSO OFFERS A VARIETY OF SPECIALTY CLINICS AT LEAST ONCE PER MONTH, PROVIDING SPECIALTY CARE FOR ONCOLOGY, ORTHOPEDICS, PODIATRY, UROLOGY, SURGERY, GASTROINTESTINAL, AND OB/GYN.THE HOSPITAL SEES THE IMPORTANCE IN WORKING COLLABORATIVELY TO ASSURE THAT THE NEEDS OF THE BURT COUNTY COMMUNITY ARE MET. THE HOSPITAL BOARD OF 11 MEMBERS INCLUDES FIVE INDIVIDUALS FROM EACH OF THE PRIMARY COMMUNITIES IN OUR SERVICE AREA, OAKLAND AND LYONS, AND SIX APPOINTED MEMBERS.OUR OPEN MEDICAL STAFF PROVIDES SEVERAL DIFFERENT STYLES OF CARE, FROM INTERNISTS TO FAMILY PRACTICE PHYSICIANS AND A WIDE ARRAY OF SPECIALTY PHYSICIANS. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: OAKLAND MERCY HOSPITAL is a member organization of Trinity Health, the fourth-largest Catholic health care system 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 2010, this included nearly $456 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. | AffiliatedHealthCareSystem |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
| No Grant More Than5000 | X | NoGrantMoreThan5000 |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: DONATIONS MADE BY OAKLAND MERCY 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEVEN J EAVENSON (TATUM LLC) | |||||||||||||
| 0 | 283500 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 283500 | 0 | 0 |
| DR TRACIE MARTIN | |||||||||||||
| 0 | 177358 | 0 | 0 | 0 | 97 | 0 | 5065 | 0 | 12669 | 0 | 195189 | 0 | 0 |
| MARILYN KAPTAIN-DAHLEN | |||||||||||||
| 0 | 231316 | 0 | 49875 | 0 | 19232 | 0 | 61235 | 0 | 17066 | 0 | 378724 | 0 | 8429 |
| ROBERT PEEBLES | |||||||||||||
| 0 | 219423 | 0 | 0 | 0 | 30235 | 0 | 12176 | 0 | 0 | 0 | 261834 | 0 | 0 |
| BRIAN MONSMA | |||||||||||||
| 0 | 144145 | 0 | 32496 | 0 | 6433 | 0 | 8321 | 0 | 21568 | 0 | 212963 | 0 | 0 |
| PAUL DOUGHERTY | |||||||||||||
| 0 | 129080 | 0 | 0 | 0 | 268885 | 0 | 365749 | 0 | 15592 | 0 | 779306 | 0 | 0 |
| GARY GUETZKO | |||||||||||||
| 0 | 198532 | 0 | 40516 | 0 | 10131 | 0 | 26366 | 0 | 21834 | 0 | 297379 | 0 | 0 |
| MELVIN GOIN | |||||||||||||
| 0 | 0 | 0 | 0 | 0 | 214531 | 0 | 23181 | 0 | 10504 | 0 | 248216 | 0 | 215481 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part I, Line 4a | THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2009. THIS AMOUNT IS INCLUDED IN COLUMN B(iii): MELVIN GOIN - $212,503 PAUL DOUGHERTY - $208,844 IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES $23,181 OF SEVERANCE FOR MELVIN GOIN WHICH WAS UNPAID AS OF 12/31/09. THE $23,181 WAS PAID AND INCLUDED IN MELVIN GOIN'S TAXABLE INCOME IN 2010. IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES $363,019 OF SEVERANCE FOR PAUL DOUGHERTY WHICH WAS UNPAID AS OF 12/31/09. OF THE $363,019 TOTAL, $344,361 WAS PAID AND INCLUDED IN PAUL DOUGHERTY'S TAXABLE INCOME IN 2010, AND $18,658 WAS PAID AND INCLUDED IN HIS TAXABLE INCOME IN 2011. | |
| Part I, Line 5 | ||
| Part III | PART II: STEVEN EAVENSON - THE AMOUNT LISTED IN COLUMN B(I) OF SCHEDULE J, PART II REPRESENTS THE AMOUNT PAID BY MERCY HEALTH SERVICES - IOWA, CORP. (MHS-IA) IN CALENDAR 2009 TO TATUM, LLC FOR MR. EAVENSON'S SERVICES AS INTERIM CFO FOR MERCY MEDICAL CENTER - SIOUX CITY, A DIVISION OF MHS-IA. MHS-IA DOES NOT KNOW HOW MUCH MR. EAVENSON RECEIVED AS WAGES FROM TATUM, LLC IN CALENDAR 2009. | Supplemental Information |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 3 | STEVEN EAVENSON, BOARD DIRECTOR AND OFFICER (SECRETARY/TREASURER), SERVES AS INTERIM CHIEF FINANCIAL OFFICER FOR MERCY MEDICAL CENTER-SIOUX CITY (A DIVISION OF MERCY HEALTH SERVICES - IOWA, CORP. (MHS-IA), THE SOLE MEMBER OF OAKLAND MERCY HOSPITAL). MR. EAVENSON IS A KEY EMPLOYEE OF TATUM, LLC. COMPENSATION FOR HIS SERVICES WAS PAID BY MERCY MEDICAL CENTER - SIOUX CITY TO TATUM, LLC. SEE SCHEDULE J, PART III FOR ADDITIONAL INFORMATION. | |
| Form 990, Part VI, Section A, line 6 | THE SOLE MEMBER OF OAKLAND MERCY HOSPITAL IS MERCY HEALTH SERVICES-IOWA, CORP. SEE LINE 7 FOR ADDITIONAL INFORMATION. | |
| Form 990, Part VI, Section A, line 7a | MERCY HEALTH SERVICES-IOWA, CORP. HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF OAKLAND MERCY HOSPITAL. | |
| Form 990, Part VI, Section A, line 7b | AS SOLE MEMBER, MERCY HEALTH SERVICES-IOWA, CORP. MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MERCY HEALTH SERVICES-IOWA, CORP. 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 11 | PRIOR TO FILING, THE FORM 990 FOR OAKLAND MERCY HOSPITAL IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD OF DIRECTORS. THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. | |
| Form 990, Part VI, Section B, line 12c | OAKLAND MERCY 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 OAKLAND MERCY HOSPITAL, WHICH INCLUDES directors, 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 OAKLAND MERCY HOSPITAL'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO OAKLAND MERCY 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 directors OF OAKLAND MERCY HOSPITAL IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO OAKLAND MERCY 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 directors OF OAKLAND MERCY HOSPITAL ON AN ANNUAL BASIS. | |
| Form 990, Part VI, Section B, line 15 | 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 DIRECTORS OF OAKLAND MERCY 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 C, line 19 | OAKLAND MERCY 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, OAKLAND MERCY HOSPITAL WILL BE INCLUDING A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON TRINITY HEALTH'S WEBSITE AS WELL AS MERCY MEDICAL CENTER - SIOUX CITY'S WEBSITE (WWW.MERCYSIOUXCITY.COM) | |
| CORE FORM, PART VII, SECTION A, LINE 1, COLUMN B: | 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: STEVEN J. EAVENSON - 49 HOURS GARY GUETZKO - 50 HOURS MARILYN KAPTAIN-DAHLEN - 49 HOURS BRIAN MONSMA - 49 HOURS ROBERT PEEBLES - 49 HOURS | ESTIMATE OF THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: |
| CORE FORM, PART XI, LINE 2: | OAKLAND MERCY HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY10 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| CLR Investments LLC | |||||||||
| 120 W HARRIS ST | CADILLAC | MI | 49601 | 320008631 | Real estate rental & development | MI | 19827 | 175469 | Trinity Health-Michigan |
| Saint Agnes Home Health and Hospice LLC | |||||||||
| 17410 COLLEGE PARKWAY STE 150 | LIVONIA | MI | 48152 | 382621935 | Provide home health services | CA | 9367604 | 1116725 | Trinity Home Health Services Inc |
| Saint Mary's Pharmacy LLC | |||||||||
| 200 JEFFERSON AVE SE | GRAND RAPIDS | MI | 49503 | 383404443 | Pharmacy | MI | 0 | 0 | Trinity Health-Michigan |
| Mount Carmel HealthProviders Two LLC | |||||||||
| 6150 E BROAD STREET | COLUMBUS | OH | 43213 | 201983271 | MEDICAL SERVICES | OH | 0 | 0 | MOUNT CARMEL HEALTH PROVIDERS INC |
| PATHWAY HOSPICE LLC | |||||||||
| 1050 SW 3RD AVE SUITE 1600 | ONTARIO | OR | 97914 | 931310235 | HOSPICE CARE | OR | 1273503 | 1512716 | SAINT ALPHONSUS MEDICAL CENTER-ONTARIO |
| TRINITY HEALTH-WARDE LAB LLC | |||||||||
| 34605 W TWELVE MILE ROAD | FARMINGTON HILLS | MI | 48331 | 272681908 | REAL ESTATE RENTAL | DE | 0 | 0 | TRINITY HEALTH - MICHIGAN |
| MOUNT CARMEL HEALTH PROVIDERS III LLC | |||||||||
| 10 West Broad St Ste 2100 | COLUMBUS | OH | 43215 | 204145781 | MEDICAL SERVICES | OH | 1741059 | 6043 | MOUNT CARMEL HEALTH PROVIDERS INC |
Form990 Schedule R Part II Form990ScheduleRPartII (90 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 | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|
| AMICARE HOSPICE SERVICES INC | ||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 382949053 | PROVIDE HOSPICE SERVICES | MI | 501(C)(3) | 11, TYPE I | TRINITY HOME HEALTH SERVICES INC | |
| AUXILIARY OF HOLY ROSARY HOSPITAL | ||||||||||
| 351 SW 9TH STREET | ONTARIO | OR | 97914 | 943059469 | SUPPORTS SERVICES OF RELATED HOSPITAL | OR | 501(C)(3) | 9 | SAINT ALPHONSUS MEDICAL CENTER-ONTARIO | |
| BATTLE CREEK HEALTH SYSTEM | ||||||||||
| 300 NORTH AVENUE | BATTLE CREEK | MI | 49016 | 382776791 | HEALTHCARE SERVICES | MI | 501(C)(3) | 3 | TRINITY HEALTH - MICHIGAN | |
| BATTLE CREEK HEALTH SYSTEM AUXILIARY | ||||||||||
| 300 NORTH AVENUE | BATTLE CREEK | MI | 49016 | 383355520 | SUPPORT OF TAX EXEMPT HEALTH ORGANIZATION | MI | 501(C)(3) | 11, TYPE I | BATTLE CREEK HEALTH SYSTEM | |
| BAUM HARMON MERCY HOSPITAL | ||||||||||
| 255 NORTH WELCH AVENUE | PRIMGHAR | IA | 51245 | 421500277 | Acute/Ambulatory healthcare services | IA | 501(C)(3) | 3 | Mercy Health Services-Iowa Corp | |
| BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION | ||||||||||
| 255 NORTH WELCH AVENUE | PRIMGHAR | IA | 51245 | 262973307 | Support the services of related hospital | IA | 501(C)(3) | 11, TYPE I | Baum Harmon Mercy Hospital | |
| CAPITAL PARK FAMILY HEALTH CENTER INC | ||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311387838 | Operation of a federally qualified health center (formerly) | OH | 501(C)(3) | 3 | Mount Carmel Health System | |
| CATHERINE MCAULEY HEALTH SERVICES CORP | ||||||||||
| PO BOX 995 | ANN ARBOR | MI | 48106 | 382507173 | Further Trinity Health activities, organize and develop medical services | MI | 501(C)(3) | 11, TYPE II | Trinity Health-Michigan | |
| Cranbrook Hospice Care | ||||||||||
| 281 ENTERPRISE COURT | BLOOMFIELD HILLS | MI | 48302 | 383320699 | Provide hospice health services | MI | 501(C)(3) | 11, TYPE I | Trinity Home Health Services Inc | |
| Diley Ridge Medical Center | ||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 342032340 | Hospital campus in Fairfield County Ohio | OH | 501(C)(3) | 3 | Mount Carmel Health System | |
| Dubuque Mercy Health Foundation Inc | ||||||||||
| 250 MERCY DRIVE | DUBUQUE | IA | 52001 | 262227941 | Support the services of related hospital | IA | 501(C)(3) | 11, TYPE I | Mercy Health Services-Iowa Corp | |
| Dyersville Health Foundation Inc | ||||||||||
| 1111 3RD STREET SW | DYERSVILLE | IA | 52040 | 205383271 | Support the services of related hospital | IA | 501(C)(3) | 11, TYPE I | Mercy Health Services-Iowa Corp | |
| Hackley Hospital | ||||||||||
| 1700 CLINTON ST PO BOX 3302 | MUSKEGON | MI | 494433302 | 381358196 | HEALTHCARE SERVICES | MI | 501(C)(3) | 3 | Mercy Health Partners | |
| Hackley Hospital Self Insurance Professional Liability Trust | ||||||||||
| PO BOX 3302 | MUSKEGON | MI | 494433302 | 382299878 | Self insurance for general and malpractice liability | MI | 501(C)(3) | 11, TYPE III-FI | Mercy Health Partners | |
| Hackley Life Counseling | ||||||||||
| 1352 TERRACE ST | MUSKEGON | MI | 494423545 | 381386362 | Counseling, education, and support | MI | 501(C)(3) | 9 | Mercy Health Partners | |
| Hackley Visiting Nurse Services and Hospice Inc | ||||||||||
| 888 TERRACE ST | MUSKEGON | MI | 49440 | 381359598 | Provide home health care services | MI | 501(C)(3) | 7 | Mercy Health Partners | |
| Holy Cross Carenet Inc | ||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 48333 | 521945054 | Long-term care and rehabilitation for the elderly | MD | 501(C)(3) | 9 | Trinity Continuing Care Services | |
| Holy Cross Hospital Foundation Inc | ||||||||||
| 11801 TECH ROAD | SILVER SPRING | MD | 20904 | 208428450 | Charitable fundraising | MD | 501(C)(3) | 11, TYPE I | Holy Cross Hospital of Silver Spring Inc | |
| Holy Cross Hospital of Silver Spring Inc | ||||||||||
| 1500 FOREST GLEN RD | SILVER SPRING | MD | 209101484 | 520738041 | HEALTHCARE SERVICES | MD | 501(C)(3) | 3 | Trinity Health Corporation | |
| Holy Cross Medical Center | ||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 951985442 | HEALTHCARE SERVICES (FORMERLY) | CA | 501(C)(3) | 3 | Trinity Health Corporation | |
| HOLY ROSARY MEDICAL CENTER FOUNDATION | ||||||||||
| 351 SW 9TH STREET | ONTARIO | OR | 97914 | 202683560 | SUPPORT THE SERVICES OF RELATED HOSPITAL | OR | 501(C)(3) | 11, TYPE I | SAINT ALPHONSUS MEDICAL CENTER-ONTARIO | |
| Hospice of North Iowa | ||||||||||
| 232 SECOND STREET SE | MASON CITY | IA | 504016208 | 421173708 | Hospice health care services | IA | 501(C)(3) | 7 | Mercy Health Services-Iowa Corp | |
| Hospice of Washtenaw II | ||||||||||
| 806 AIRPORT BLVD | ANN ARBOR | MI | 48108 | 383320707 | Hospice health care services | MI | 501(C)(3) | 11, TYPE I | Trinity Health-Michigan | |
| HPCN | ||||||||||
| 1675 LEAHY STREET | MUSKEGON | MI | 49442 | 300207909 | HEALTHCARE SERVICES | MI | 501(C)(3) | 11, TYPE II | Mercy Health Partners | |
| Lakeshore Community Hospital Inc | ||||||||||
| 72 S STATE STREET | SHELBY | MI | 494551228 | 382549295 | Acute healthcare services | MI | 501(C)(3) | 3 | Mercy Health Partners | |
| Lifespan Inc | ||||||||||
| 166 EAST GOODALE AVE | BATTLE CREEK | MI | 490372728 | 383298476 | Provide hospice health services | MI | 501(C)(3) | 9 | Battle Creek Health System | |
| Marian Home Healthcare | ||||||||||
| 801 5TH STREET | SIOUX CITY | IA | 51101 | 383320705 | Provide home health care services | IA | 501(C)(3) | 11, TYPE I | Mercy Health Services-Iowa Corp | |
| McAuley Clinic Corporation | ||||||||||
| PO BOX 992 | ANN ARBOR | MI | 48106 | 382561013 | HEALTHCARE SERVICES (FORMERLY) | MI | 501(C)(3) | 3 | Catherine McAuley Health Services Corp | |
| Mercy Amicare Home Healthcare Oakland | ||||||||||
| 281 ENTERPRISE COURT | BLOOMFIELD HILLS | MI | 483020312 | 383320698 | Provide home health care services | MI | 501(C)(3) | 11, TYPE I | Trinity Home Health Services Inc | |
| Mercy Amicare Home Healthcare Port Huron | ||||||||||
| 2540 16TH STREET | PORT HURON | MI | 48060 | 383320701 | Provide home health care services | MI | 501(C)(3) | 11, TYPE I | Trinity Home Health Services Inc | |
| Mercy Community Physicians | ||||||||||
| 363 FREMONT ST | BATTLE CREEK | MI | 49017 | 264252468 | HEALTHCARE SERVICES | MI | 501(C)(3) | 3 | Battle Creek Health System | |
| Mercy General Health Partners Amicare Homecare | ||||||||||
| 684 HARVEY STREET | MUSKEGON | MI | 49442 | 383321856 | Provide home health care services | MI | 501(C)(3) | 11, TYPE I | Trinity Home Health Services Inc | |
| Mercy Health Partners | ||||||||||
| 1415 LEAHY STREET | MUSKEGON | MI | 49442 | 382589966 | Healthcare system support | MI | 501(C)(3) | 11, TYPE I | Trinity Health-Michigan | |
| Mercy Health Services - Iowa Corp | ||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 50401 | 311373080 | HEALTHCARE SERVICES | DE | 501(C)(3) | 3 | Trinity Health-Michigan | |
| Mercy Healthcare Foundation | ||||||||||
| 1410 N 4TH ST | CLINTON | IA | 52732 | 421316126 | Fundraising and financial assistance for hospital charitable services | IA | 501(C)(3) | 11, TYPE I | Mercy Medical Center-Clinton | |
| Mercy Hosp & Health Services of DetroitMarshall Park Health Services Inc | ||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 381562325 | Supports malpractice contingencies of closed hospital | MI | 501(C)(3) | 11, TYPE I | Trinity Health-Michigan | |
| Mercy Hospital Cadillac Foundation | ||||||||||
| 400 HOBART | CADILLAC | MI | 496012331 | 203357131 | Support the services of related hospital | MI | 501(C)(3) | 11, TYPE I | Trinity Health-Michigan | |
| Mercy Hospital Gift Shop | ||||||||||
| 2601 ELECTRIC AVE | PORT HURON | MI | 48060 | 381630480 | Volunteer Service Auxiliary | MI | 501(C)(3) | 11, TYPE I | Trinity Health-Michigan | |
| Mercy Medical Center - Clinton Inc | ||||||||||
| 1410 NORTH 4TH ST | CLINTON | IA | 527322940 | 421336618 | To provide quality health care | DE | 501(C)(3) | 3 | Mercy Health Services-Iowa Corp | |
| Mercy Medical Center - Sioux City Foundation | ||||||||||
| 801 5TH STREET | SIOUX CITY | IA | 51102 | 141880022 | Support the services of related hospital | IA | 501(C)(3) | 7 | Mercy Health Services-Iowa Corp | |
| Mercy Medical Center Foundation - North Iowa | ||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 504012800 | 421229151 | Support the services of related hospital | IA | 501(C)(3) | 11, TYPE III-FI | Mercy Health Services-Iowa Corp | |
| MERCY MEDICAL CENTER FOUNDATION INC | ||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 261737256 | SUPPORT THE SERVICES OF RELATED HOSPITAL | ID | 501(C)(3) | 7 | SAINT ALPHONSUS MEDICAL CENTER-NAMPA | |
| Mercy North Homecare and Hospice | ||||||||||
| 7985 MACKINAW TRAIL | CADILLAC | MI | 49601 | 383313897 | Home health and hospice services | MI | 501(C)(3) | 11, TYPE I | Trinity Home Health Services Inc | |
| Mercy Pavilion of Battle Creek | ||||||||||
| 300 NORTH AVENUE | BATTLE CREEK | MI | 49016 | 382783350 | Provides long-term care for the elderly | MI | 501(C)(3) | 9 | Battle Creek Health System | |
| MERCY PHYSICIAN GROUP INC | ||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 208192593 | TO PROVIDE QUALITY HEALTH CARE | ID | 501(C)(3) | 9 | SAINT ALPHONSUS MEDICAL CENTER-NAMPA | |
| Mercy Services for Aging Non-profit Housing Corporation | ||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 382719605 | Provides long-term care for the elderly | MI | 501(C)(3) | 11, TYPE II | Trinity Continuing Care Services Inc | |
| Midwest Medflight | ||||||||||
| 1300 VICTORS WAY | ANN ARBOR | MI | 48108 | 382684671 | Aeromedical transport | MI | 501(C)(3) | 9 | Trinity Health-Michigan | |
| Mount Carmel Care Continuum Services Corp | ||||||||||
| 793 WEST STATE STREET | COLUMBUS | OH | 43222 | 311126211 | Cooperative hospital service organization | OH | 501(C)(3) | 3 | Mount Carmel Health System | |
| Mount Carmel College of Nursing | ||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311308555 | College of nursing | OH | 501(C)(3) | 2 | Mount Carmel Health | |
| Mount Carmel Health | ||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 314379602 | HEALTHCARE SERVICES | OH | 501(C)(3) | 3 | Mount Carmel Health System | |
| Mount Carmel Health Insurance Company | ||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 251912781 | Health Insurance | OH | 501(C)(4) | N/A | Mount Carmel Health System | |
| Mount Carmel Health Plan Inc | ||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311471229 | Medicare HMO for seniors | OH | 501(C)(4) | N/A | Mount Carmel Health System | |
| Mount Carmel Health System | ||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311439334 | Healthcare system management and support | OH | 501(C)(3) | 11, TYPE I | Trinity Health Corporation | |
| MOUNT CARMEL HEALTH SYSTEM FOUNDATION | ||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311113966 | SUPPORT THE SERVICES OF RELATED HOSPITAL | OH | 501(C)(3) | 11, TYPE I | MOUNT CARMEL HEALTH SYSTEM | |
| Mount Carmel Home Care LLC | ||||||||||
| 1144 DUBLIN ROAD SUITE B | COLUMBUS | OH | 43215 | 262729300 | Provide home health care services | OH | 501(C)(3) | 9 | Trinity Home Health Services Inc | |
| Mount Carmel New Albany Surgical Hospital | ||||||||||
| 7333 SMITHS MILL RD | NEW ALBANY | OH | 43054 | 870790288 | HEALTHCARE SERVICES | OH | 501(C)(3) | 3 | Mount Carmel Health System | |
| MRI Mobile Services of West Michigan | ||||||||||
| 1820 - 44TH STREET | KENTWOOD | MI | 49508 | 383073745 | OPERATE MAGNETIC IMAGING RESONANCE (FORMERLY) | MI | 501(C)(3) | 9 | Trinity Health-Michigan | |
| MUSKEGON COMMUNITY HEALTH PROJECT | ||||||||||
| 565 W WESTERN AVENUE | MUSKEGON | MI | 49440 | 911932918 | FACILITATE AND COORDINATE HEALTHCARE AND RELATED SERVICES | MI | 501(C)(3) | 7 | MERCY HEALTH PARTNERS | |
| Oakland Mercy Hospital | ||||||||||
| 601 EAST 2ND STREET | OAKLAND | NE | 68045 | 208072234 | HEALTHCARE SERVICES | NE | 501(C)(3) | 3 | Mercy Health Services-Iowa Corp | |
| Port Huron Mercy Family Care Inc | ||||||||||
| 2601 ELECTRIC AVE | PORT HURON | MI | 48060 | 201855647 | HEALTHCARE SERVICES | MI | 501(C)(3) | 11, TYPE I | Trinity Health-Michigan | |
| Professional Med Team | ||||||||||
| 965 FORK STREET | MUSKEGON | MI | 494423257 | 382638284 | Medical care, transportation and education | MI | 501(C)(3) | 9 | Trinity Health-Michigan | |
| Professional Office Corporation | ||||||||||
| 1303 EAST HERNDON AVE | FRESNO | CA | 93720 | 942839324 | HEALTHCARE SERVICES | CA | 501(C)(3) | 11, TYPE I | Saint Agnes Medical Center | |
| Saint Agnes Medical Center | ||||||||||
| 1303 EAST HERNDON AVE | FRESNO | CA | 93720 | 941437713 | HEALTHCARE SERVICES | CA | 501(C)(3) | 3 | Trinity Health Corporation | |
| Saint Alphonsus Building Company Inc | ||||||||||
| 1055 NORTH CURTIS RD | BOISE | ID | 83706 | 820401011 | Supports services of related hospital | ID | 501(C)(3) | 11, TYPE I | Saint Alphonsus Regional Medical Center Inc | |
| Saint Alphonsus Diversified Care Inc | ||||||||||
| 1055 NORTH CURTIS RD | BOISE | ID | 83706 | 943028978 | Supports services of related hospital | ID | 501(C)(3) | 11, TYPE I | Saint Alphonsus Regional Medical Center Inc | |
| SAINT ALPHONSUS HEALTH SYSTEM INC | ||||||||||
| 1055 N CURTIS ROAD | BOISE | ID | 83706 | 271929502 | HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT | ID | 501(C)(3) | 11, TYPE I | TRINITY HEALTH CORPORATION | |
| SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY | ||||||||||
| 3325 POCAHONTAS ROAD | BAKER CITY | OR | 97814 | 271790052 | TO PROVIDE QUALITY HEALTH CARE | OR | 501(C)(3) | 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | |
| SAINT ALPHONSUS MEDICAL CENTER-NAMPA | ||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 820200896 | TO PROVIDE QUALITY HEALTH CARE | ID | 501(C)(3) | 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | |
| SAINT ALPHONSUS MEDICAL CENTER-ONTARIO | ||||||||||
| 351 SW 9TH STREET | ONTARIO | OR | 97914 | 271789847 | TO PROVIDE QUALITY HEALTH CARE | OR | 501(C)(3) | 3 | SAINT ALPHONSUS HEALTH SYSTEM INC | |
| Saint Joseph Regional Medical Center - Plymouth Campus Inc | ||||||||||
| 1915 LAKE AVENUE PO BOX 670 | PLYMOUTH | IN | 46563 | 351142669 | Healthcare services | IN | 501(C)(3) | 3 | Saint Joseph Regional Medical Center Inc | |
| Saint Joseph Regional Medical Center - South Bend Campus Inc | ||||||||||
| PO BOX 1935 | SOUTH BEND | IN | 466341935 | 350868157 | Healthcare services | IN | 501(C)(3) | 3 | Saint Joseph Regional Medical Center Inc | |
| Saint Joseph Regional Medical Center Inc | ||||||||||
| 801 EAST LASALLE AVE | SOUTH BEND | IN | 46617 | 351568821 | Healthcare system management and support | IN | 501(C)(3) | 11, TYPE I | Trinity Health Corporation | |
| Saint Joseph's Auxiliary of Marshall County | ||||||||||
| 1915 LAKE AVENUE | PLYMOUTH | IN | 46563 | 356043563 | Hospital Service Auxiliary | IN | 501(C)(3) | 11, TYPE II | Saint Joseph Regional Medical Center - Plymouth Campus Inc | |
| Saint Joseph's Tower Inc | ||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 311040468 | Provides housing for low income elderly individuals | IN | 501(C)(3) | 9 | Trinity Continuing Care Services-Indiana | |
| Saint Mary's Amicare Home Healthcare | ||||||||||
| 1430 MONROE NW | GRAND RAPIDS | MI | 48905 | 383320700 | Provide home health care services | MI | 501(C)(3) | 11, TYPE I | Trinity Home Health Services Inc | |
| Saint Mary's Doran Foundation CO Saint Mary's Health Care | ||||||||||
| 200 JEFFERSON ST SE | GRAND RAPIDS | MI | 49503 | 381779602 | Supports services of related hospital | MI | 501(C)(3) | 7 | Trinity Health-Michigan | |
| St Alphonsus Regional Medical Center | ||||||||||
| 1055 NORTH CURTIS RD | BOISE | ID | 83706 | 820200895 | Healthcare services | ID | 501(C)(3) | 3 | Trinity Health Corporation | |
| St John's Health System | ||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 350877584 | HEALTHCARE SERVICES (FORMERLY) | IN | 501(C)(3) | 3 | Trinity Health Corporation | |
| St Joseph Mercy Oakland Foundation | ||||||||||
| 44405 WOODWARD AVE | PONTIAC | MI | 48341 | 352356789 | Supports services of related hospital | MI | 501(C)(3) | 11, TYPE I | Trinity Health-Michigan | |
| St Ann's Hospital | ||||||||||
| 500 SOUTH CLEVELAND AVE | WESTERVILLE | OH | 43081 | 314412701 | HEALTHCARE SERVICES | OH | 501(C)(3) | 3 | Mount Carmel Health System | |
| ST ELIZABETH HEALTH CARE FOUNDATION | ||||||||||
| 3325 POCAHONTAS ROAD | BAKER CITY | OR | 97814 | 943164869 | SUPPORT THE SERVICES OF RELATED HOSPITAL | OR | 501(C)(3) | 7 | SAINT ALPHONSUS MEDICAL CENTER-ONTARIO | |
| St Joseph's Medical Center Auxiliary | ||||||||||
| 801 E LASALLE AVE PO BOX 1935 | SOUTH BEND | IN | 466341935 | 356033285 | Hospital Service Auxiliary | IN | 501(C)(4) | N/A | Saint Joseph Regional Medical Center - South Bend Campus Inc | |
| The Foundation of Saint Joseph Regional Medical Center | ||||||||||
| 4215 EDISON LAKES PARKWAY | MISHAWAKA | IN | 46545 | 351654543 | Supports services of related hospital | IN | 501(C)(3) | 11, TYPE I | Saint Joseph Regional Medical Center Inc | |
| Trinity Continuing Care Services | ||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 382559656 | Management services for Long term care and senior living facilities | MI | 501(C)(3) | 11, TYPE I | Trinity Health Corporation | |
| Trinity Continuing Care Services - Indiana Inc | ||||||||||
| PO BOX 9184 | FARMINGTON HILLS | MI | 483339184 | 930907047 | Provides long-term care and residential housing | IN | 501(C)(3) | 9 | Trinity Continuing Care Services | |
| Trinity Health - Michigan | ||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 382113393 | HEALTHCARE SERVICES | MI | 501(C)(3) | 3 | Trinity Health Corporation | |
| Trinity Health Corporation | ||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 351443425 | Healthcare system management and support | IN | 501(C)(3) | 11, TYPE I | N/A | |
| Trinity Health International | ||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 421253527 | Healthcare training and support services | MI | 501(C)(3) | 11, TYPE I | Trinity Health Corporation | |
| Trinity Health Welfare Benefit Trust | ||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 208151733 | Retiree medical and retiree life insurance coverage | MI | 501(C)(9) | N/A | Trinity Health Corporation | |
| Trinity Home Health Services Inc | ||||||||||
| 17410 COLLEGE PARKWAY | LIVONIA | MI | 48152 | 382621935 | Home health care system management services | MI | 501(C)(3) | 11, TYPE I | Trinity Health Corporation | |
Form990 Schedule R Part III Form990ScheduleRPartIII (31 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|
| ADVANCED IMAGING SERVICES OF BATTLE CREEK | ||||||||||
| 5352 BECKLEY ROAD STE A | BATTLE CREEK | MI | 49015 | 204594297 | RADIOLOGY/IMAGING | MI | N/A | N/A | 0 | 0 |
| ADVENT REHABILITATION LLC | ||||||||||
| 560 FIFTH ST NW STE 404 | GRAND RAPIDS | MI | 49504 | 383306673 | REHABILITATION THERAPY SERVICES | MI | N/A | N/A | 0 | 0 |
| BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311608125 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| BSV MEDICAL OFFICE BUILDING II LLC | ||||||||||
| 855 M STREET TENTH FLOOR | FRESNO | CA | 93721 | 202673839 | MEDICAL OFFICE BUILDING RENTAL | CA | N/A | N/A | 0 | 0 |
| CCH LABORATORY | ||||||||||
| 775 SOUTH MAIN STREET | CHELSEA | MI | 48118 | 382910400 | LABORATORY | MI | N/A | N/A | 0 | 0 |
| CENTRAL OHIO SLEEP MEDICINE LTD | ||||||||||
| 5955 EAST BROAD ST | COLUMBUS | OH | 43213 | 311701029 | SLEEP MEDICINE SERVICES | OH | N/A | N/A | 0 | 0 |
| CLINTON IMAGING SERVICES LLC | ||||||||||
| 1410 NORTH 4TH ST | CLINTON | IA | 52732 | 412044739 | MRI DIAGNOSTIC SERVICES | IA | N/A | N/A | 0 | 0 |
| FOREST PARK IMAGING LLC | ||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 50401 | 134365966 | X-RAY AND MAMMOGRAPHY SERVICES | IA | N/A | N/A | 0 | 0 |
| FRANCES WARDE MEDICAL LABORATORY | ||||||||||
| 300 WEST TEXTILE ROAD | ANN ARBOR | MI | 48104 | 382648446 | LABORATORY | MI | N/A | N/A | 0 | 0 |
| FRESNO IMAGING CENTER | ||||||||||
| 1303 E HERNDON AVE | FRESNO | CA | 93720 | 770363563 | DIAGNOSTIC IMAGING | CA | N/A | N/A | 0 | 0 |
| HAWARDEN COMMUNITY CLINIC LLC | ||||||||||
| 1122 AVENUE L | HAWARDEN | IA | 51023 | 201444339 | MEDICAL CLINIC | IA | N/A | N/A | 0 | 0 |
| IDAHO GYNONCOLOGY SERVICES LLC | ||||||||||
| 1055 N CURTIS RD | BOISE | ID | 83706 | 202975807 | PROVIDE GYN ONCOLOGY SERVICES | ID | N/A | N/A | 0 | 0 |
| MAGNETIC RESONANCE SERVICES PARTNERSHIP | ||||||||||
| 1416 SIXTH STREET SW | MASON CITY | IA | 50401 | 421328388 | MRI SERVICES | IA | N/A | N/A | 0 | 0 |
| MASON CITY AMBULATORY SURGERY CENTER LLC | ||||||||||
| 990 4TH STREET SW | MASON CITY | IA | 50401 | 201960348 | SURGERY-SAME DAY | IA | N/A | N/A | 0 | 0 |
| MCE MOB IV LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 421544707 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| MCMC POB III LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311392994 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| MEDILUCENT MOB I | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 204911370 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| MERCY HEART CTR OP SERVICES LLC | ||||||||||
| 1000 4TH STREET SW | MASON CITY | IA | 50401 | 134237594 | CARDIOVASCULAR SERVICES | IA | N/A | N/A | 0 | 0 |
| MERCY OUTPATIENT SURGERY CENTER LLC | ||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 841380439 | OUTPATIENT SURGERY | ID | N/A | N/A | 0 | 0 |
| MICHIANA HEALTH INFORMATION NETWORK LLC | ||||||||||
| 215 WEST MADISON STREET | SOUTH BEND | IN | 46601 | 352050128 | COMMUNITY BASED CLINICAL INFORMATION SYSTEM AND DATA DEPOSITORY | IN | N/A | N/A | 0 | 0 |
| MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311369473 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| NEWCO AMBULATORY SURGERY CTR LLP | ||||||||||
| 4190 24TH AVENUE | FORT GRATIOT | MI | 48059 | 300136708 | OUTPATIENT SURGERY CENTER | MI | N/A | N/A | 0 | 0 |
| PLAZA SURGICAL CENTER | ||||||||||
| PO BOX 27230 | FRESNO | CA | 93729 | 371463357 | AMBULATORY SURGERY | CA | N/A | N/A | 0 | 0 |
| RIVERVIEW MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311531135 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| SARMED OUTPATIENT PHARMACY LLC | ||||||||||
| 999 N CURTIS RD STE 102 | BOISE | ID | 83706 | 510483218 | PHARMACY | ID | N/A | N/A | 0 | 0 |
| SIXTY FOURTH STREET LLC | ||||||||||
| 2373 64TH ST STE 2200 | BYRON CENTER | MI | 49315 | 202443646 | PROVIDE OUTPATIENT SURGICAL CARE | MI | N/A | N/A | 0 | 0 |
| ST ALPHONSUS CALDWELL CANCER CTR LLC | ||||||||||
| 3123 MEDICAL DR | CALDWELL | ID | 83605 | 820526861 | RADIATION ONCOLOGY | ID | N/A | N/A | 0 | 0 |
| ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311603660 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| TAMARACK MEDICAL CLINIC LLC | ||||||||||
| 610 VILLAGE DRIVE | DONNELLY | ID | 83615 | 201637921 | OUTPATIENT MEDICAL SERVICES | ID | N/A | N/A | 0 | 0 |
| WESTAR MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP | ||||||||||
| 793 W STATE STREET | COLUMBUS | OH | 43222 | 311784409 | MEDICAL OFFICE BUILDING RENTAL | OH | N/A | N/A | 0 | 0 |
| WOODLAND IMAGING CENTER LLC | ||||||||||
| 5301 E HURON RIVER DR | ANN ARBOR | MI | 48106 | 760820959 | RADIOLOGY/IMAGING | MI | N/A | N/A | 0 | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (32 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY HEALTH VENTURES INC | ||||||||||||
| 565 W WESTERN AVE | MUSKEGON | MI | 49440 | 383522260 | SOFTWARE MARKETING | MI | N/A | C | ||||
| GENERAL HEALTHCORP VENTURES INC | ||||||||||||
| 1820-44TH STREET | KENTWOOD | MI | 49508 | 382533165 | MEDICAL SERVICES | MI | N/A | C | ||||
| HACKLEY HEALTH MANAGEMENT CENTER | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382961814 | WEIGHT MANAGEMENT | MI | N/A | C | ||||
| HACKLEY HEALTH VENTURES INC | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382589959 | OTHER MEDICAL SERVICES | MI | N/A | C | ||||
| HACKLEY HEALTHCARE EQUIPMENT | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382578569 | HOME MEDICAL EQUIPMENT | MI | N/A | C | ||||
| HACKLEY ORTHOTICS & PROSTHETICS | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382999815 | HEALTHCARE SERVICES | MI | N/A | C | ||||
| HACKLEY PROFESSIONAL CENTER | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 383024797 | REAL ESTATE RENTAL | MI | N/A | C | ||||
| HACKLEY PROFESSIONAL PHARMACY | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 382447870 | PHARMACY | MI | N/A | C | ||||
| HEF INC | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 383086401 | OFFICE STAFFING | MI | N/A | C | ||||
| HOLY CROSS PRIVATE HOME SERVICES CORP | ||||||||||||
| 11801 TECH ROAD | SILVER SPRING | MD | 20904 | 521986562 | HOME CARE SERVICES | MD | N/A | C | ||||
| HURON ARBOR CORPORATION | ||||||||||||
| 5301 EAST HURON RIVER DR PO BOX 992 | ANN ARBOR | MI | 48106 | 382475644 | PROVIDES OFFICE RENTAL SPACE | MI | N/A | C | ||||
| MARYLAND CARE GROUP INC | ||||||||||||
| 11801 TECH ROAD | SILVER SPRING | MD | 20904 | 521815313 | HEALTHCARE HOLDING | MD | N/A | C | ||||
| MEDNOW INC | ||||||||||||
| 1512 12TH AVENUE ROAD | NAMPA | ID | 83686 | 820389927 | OUTPATIENT PHARMACY | ID | N/A | C | ||||
| MERCY MEDICAL SERVICES | ||||||||||||
| 801 5TH STREET | SIOUX CITY | IA | 51101 | 421283849 | PRIMARY CARE PHYSICIANS | IA | N/A | C | ||||
| MICHIGAN PHYSICIAN SERVICES | ||||||||||||
| 44405 WOODWARD AVENUE H-5 | PONTIAC | MI | 48341 | 383293125 | PHYSICIAN SERVICES | MI | N/A | C | ||||
| MICHIGAN ATHLETIC CLUB | ||||||||||||
| 2500 BURTON | GRAND RAPIDS | MI | 49546 | 382647304 | ATHLETIC CLUB | MI | N/A | C | ||||
| MOUNT CARMEL BEHAVIORAL HEALTHCARE SERVICES INC | ||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 310971510 | BEHAVIORAL HEALTHCARE SERVICES | OH | N/A | C | ||||
| MOUNT CARMEL HEALTH HORIZONS CORP | ||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311177652 | MEDICAL SERVICES/RENT | OH | N/A | C | ||||
| MOUNT CARMEL HEALTH PROVIDERS INC | ||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311382442 | MEDICAL SERVICES | OH | N/A | C | ||||
| NORTH IOWA MERCY MEDICAL SERVICES INC | ||||||||||||
| 1000 4TH ST SW | MASON CITY | IA | 50401 | 421382308 | MEDICAL SERVICES | IA | N/A | C | ||||
| PRIMARY CARE NETWORK OF OHIO INC | ||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311422486 | HEALTH MANAGEMENT SERVICES | OH | N/A | C | ||||
| PRIORITY PLUS OF CALIFORNIA | ||||||||||||
| PO BOX 27230 | FRESNO | CA | 93729 | 770395267 | FORMERLY HEALTH MANAGEMENT NOW DISCONTINUED SUBSTANTIALLY ALL OPERATIONS | CA | N/A | C | ||||
| SAINT ALPHONSUS PHYSICIAN SERVICES INC | ||||||||||||
| 1055 NORTH CURTIS ROAD | BOISE | ID | 83706 | 820477852 | PHYSICIAN CLINICS | ID | N/A | C | ||||
| SAINT ALPHONSUS PHYSICIANS PA | ||||||||||||
| 1055 NORTH CURTIS ROAD | BOISE | ID | 837061370 | 331078261 | PHYSICIANS | ID | N/A | C | ||||
| SAINT MARY'S HEALTH MANAGEMENT COMPANY | ||||||||||||
| 1640 EAST PARIS SE | GRAND RAPIDS | MI | 49546 | 383450733 | ATHLETIC CLUB | MI | N/A | C | ||||
| SURGERY CENTER FINANCING CORPORATION | ||||||||||||
| 6150 EAST BROAD STREET | COLUMBUS | OH | 43213 | 311531102 | FINANCE, INSURANCE AND REAL ESTATE | OH | N/A | C | ||||
| TRINITY HEALTH EMPLOYEE BENEFIT TRUST | ||||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 383410377 | GRANTOR TRUST | MI | N/A | T | ||||
| TRINITY HEALTH SELF-INSURANCE PLAN | ||||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 386742154 | GRANTOR TRUST | MI | N/A | T | ||||
| TRINITY HEALTH SELF-INSURED WORKERS' COMPENSATION FUND | ||||||||||||
| 27870 CABOT DRIVE | NOVI | MI | 483772920 | 386742157 | GRANTOR TRUST | MI | N/A | T | ||||
| VENZKE INSURANCE COMPANY LTD | ||||||||||||
| 980453602 | PROVISION OF INSURANCE COVERAGE | N/A | C | PO BOX 1051 GRAND CAYMAN | GRAND CAYMAN | CJ | CJ | |||||
| WESTSHORE HEALTH NETWORK | ||||||||||||
| 1820 44TH STREET | KENTWOOD | MI | 49508 | 383280200 | PHYSICIAN HOSPITAL ORGANIZATION | MI | N/A | C | ||||
| WORKPLACE HEALTH OF GRAND HAVEN | ||||||||||||
| 1415 LEAHY ST | MUSKEGON | MI | 49442 | 383112035 | OCCUPATIONAL HEALTH | MI | N/A | C | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEDICAL SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 489030 | AmountInvolved |