2011-05-04T14:15:46-05:00 2010-06-30 990 2009-07-01 381358196 HACKLEY HOSPITAL HACK 2317284952 1700 CLINTON STREET PO BOX 3302 MUSKEGON MI 494433302 GARY ALLORE 2317284952 2011-05-04 2009 2016-02-24 21:20:13Z HACKLEY CORNERSTONE FOUNDATION GARY ALLORE 1700 CLINTON STREET PO BOX 3302 MUSKEGON MI 494433302 154048317 0 X WWW.MERCY-HEALTHPARTNERS.ORG X 1932 MI TO PROVIDE HEALTHCARE SERVICES 14 9 1498 243 2038605 0 350093 398201 150329055 149865988 -1479958 -119649 771987 886489 149971177 151031029 4800 8865 0 80426032 71847248 0 0 76891539 121332348 157322371 193188461 -7351194 -42157432 77283624 111121536 127619259 146643884 -50335635 -35522348 TO PROVIDE HEALTHCARE SERVICES - SEE SCHEDULE H FOR MORE INFORMATION 0 0 175470965 8865 148598548 HACKLEY HOSPITAL IS A 181-BED, NOT-FOR-PROFIT HOSPITAL LOCATED IN THE CITY OF MUSKEGON, MICHIGAN, WITH A 100-YEAR TRADITION OF PROVIDING QUALITY MEDICAL SERVICES TO THE POPULATION OF WESTERN MICHIGAN.HACKLEY HOSPITAL PROVIDES HEALTH CARE SERVICES REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, OR THE ABILITY TO PAY. ALTHOUGH REIMBURSEMENT OF SERVICES RENDERED IS CRITICAL TO THE OPERATION AND FINANCIAL STABILITY OF HACKLEY HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS HAVE THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THE HOSPITAL'S MISSION, THE COMMUNITY IS PROVIDED THE FOLLOWING:1) FREE OR SUBSIDIZED MEDICAL CARE TO INCOME-ELIGIBLE PATIENTS,2) SUBSIDIZED CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS,3) DONATED COMMUNITY HEALTH ACTIVITIES AND PROGRAMS.SEE SCHEDULE H FOR MORE INFORMATION. Mission: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. 175470965 1 1 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 1 98 0 1 1498 1 1 1 0 0 0 0 0 0 0 0 14 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X GLENN PEULER 6166853574 1820 44TH STREET SE KENTWOOD MI 49508 A SCOTT LACHNIET MD 2.00 X 0 0 0 MICHAEL K OLTHOFF 2.00 X 0 0 0 DANA BRYANT 2.00 X 0 0 0 GREGORY C PITTMAN JD 2.00 X 0 0 0 SR MARY D PALASZEKRSM 2.00 X 0 0 0 ROGER SPOELMAN 20.00 X X 0 885116 88965 SR MYRA BERGMAN RSM 2.00 X 0 0 0 FRANK BEDNAREK 2.00 X 0 0 0 DAVID DORA DO 2.00 X 0 185280 46996 MARK FAZAKERLEY 2.00 X X 0 0 0 T BRUCE FOX 2.00 X 0 0 0 MICHAEL GLUHANICH 2.00 X X 0 0 0 YOUSIF HAMATI MD 2.00 X 0 14400 0 CAMILLE S JOURDEN-MARK 2.00 X 0 0 0 PHILIP MCCORKLE 2.00 X 0 989470 200681 GREGORY LOOMIS 20.00 X 0 359088 49144 GARY ALLORE 20.00 X 0 303730 30144 JEFFREY ALEXANDER 20.00 X 0 285891 27803 JOSEPH SWEDISH 2.00 X 0 3023292 798303 MICHAEL SLUBOWSKI 2.00 X 0 1617841 154389 KEDRICK ADKINS 2.00 X 0 1453695 130171 F REMINGTON SPRAGUE 20.00 X 0 419837 51499 MARY BOYD 20.00 X 0 317053 25378 KIMBERLY MAGUIRE 20.00 X 0 233916 33597 J RICHARD OCONNELL 2.00 X 0 495143 11123 JOHN M RATCHFORD 50.00 X 317532 0 40702 BRUCE OLSON MD 50.00 X 310607 0 39994 CHARLES FELDT 50.00 X 206187 0 31158 JOSEPH RAFFERTY 50.00 X 177921 0 28213 RONI DEVLIN 50.00 X 168166 0 11333 GORDON MUDLER 0.00 X 419776 0 353096 DAVID GINGRAS 0.00 X 258789 0 179327 RON HAASE 0.00 X 150296 0 4486 MARY TOBIN 0.00 X 0 57195 332 2009274 10583752 2336502 35 1 1 0 MCKESSON INFORMATION SOLUTIONS PO BOX 98347 CHICAGO IL 60693 INFORMATION SYSTEMS SERVICES 1476884 PINE REST CHRISTIAN MENTAL HEALTH SVCS PO BOX 165 GRAND RAPIDS MI 49501 HEALTH CARE SERVICES 758695 TOWERS WATSON 1079 SOLUTIONS CTR CHICAGO IL 60677 PENSION SERVICES 653087 SECURITAS SECURITY SERVICES INC PO BOX 403412 ATLANTA GA 30384 SECURITY SERVICES 594855 WEST MI SHARED HOSPITAL LAUNDRY PO BOX 1134 GRAND RAPIDS MI 49501 LAUNDRY SERVICES 461518 23 339943 58258 12025 398201 NET PATIENT SVC REV 900099 147827383 147827383 REFERENCE LAB 621500 2038605 2038605 149865988 1308239 1308239 1115966 122800 1366373 76523 -250407 46277 -204130 -204130 146504 342028 1232364 -342028 -1085860 -1427888 -1427888 CAFETERIA 900099 319454 319454 771165 771165 1090619 151031029 148598548 2038605 -4325 8865 8865 61853 61853 52522701 48191336 4331365 5304622 4867337 437285 10017059 9191605 825454 3941013 3517570 423443 2438 375 2063 25444 25444 6750 6750 10247341 8411295 1836046 3936 3936 23433393 22429050 1004343 5058124 13617 5044507 3801161 3257243 543918 63861 34255 29606 25166 5551 19615 2364992 2364992 6603465 4420107 2183358 2383747 2382296 1451 PENSION PLAN CURTAILMNT 46298335 46298335 BAD DEBT 7678690 7678690 INTERCO PURCHASED SVCS 5144944 4152096 992848 HOSPITAL PROVIDER TAXES 4539958 4539958 UBI TAXES 17704 7704 10000 3632899 3632899 193188461 175470965 17717496 0 4818016 2051937 25721 25897 45000 45000 14714559 14607369 71832 23309 2055194 1911890 1735614 856319 150331436 118808773 28113508 31522663 11610654 33879914 4777325 13654792 169854 156127 9146347 12386319 77283624 111121536 16975008 17054884 15014 110644251 129573986 127619259 146643884 X -52586567 -37856656 777623 698303 1473309 1636005 -50335635 -35522348 77283624 111121536 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 2905 0 0 0 2905 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: HACKLEY HOSPITAL HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO A NATIONAL HEALTH CARE ORGANIZATION, WHERE THE ORGANIZATION HAS PROVIDED HACKLEY HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. 1473309 2600 160096 1636005 1472499 810 1473309 1.00000 1 0 5148000 5148000 75041404 59579365 15462039 63338847 56552974 6785873 6803185 2676434 4126751 31522663 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 7184384 F ABSOLUTE RETURN STRATEGY FUNDS 6470408 F 13654792 OTHER ASSETS 639119 INTERCOMPANY RECEIVABLES 11544326 MISCELLANEOUS RECEIVABLES 202874 12386319 OTHER LONG TERM LIABILITIES 722189 INTERCOMPANY NOTES PAYABLE 98916195 INTERCOMPANY ACCOUNTS PAYABLE 29027652 OTHER CURRENT LIABILITIES 907950 129573986 Part V, Line 4: Description of Intended Use of Endowment Funds: SOME OF HACKLEY HOSPITAL'S ENDOWMENT FUNDS ARE FOR PATIENT RELATED PURPOSES. OTHER HACKLEY ENDOWMENT FUNDS ARE FOR NURSING EDUCATION AND TRAINING. Part X: Description of Uncertain Tax Positions Under FIN 48: HACKLEY 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. 1 1 X 1 X 1 X 1 1 1 0 1 1 1 8472 4073468 25926 4047542 0.02180 1 57908 27088007 20577873 6510134 0.03510 3 3962 2407813 1718739 689074 0.00370 5 70342 33569288 22322538 11246750 0.06060 11 7497 126662 126662 0.00070 2 39 8195 8195 0.00000 1 74 74 0.00000 4 14883 14883 0.00010 18 7536 149814 149814 0.00080 23 77878 33719102 22322538 11396564 0.06140 1 1052 1052 0.00000 1 1052 1052 0 3125033 312503 34575180 48836011 -14260831 X 1 1 MERCY HEALTH PARTNERS HACKLEY CAMPUS

1700 CLINTON AVE MUSKEGON MI 49442

X X X MERCY HEALTH PARTNERS LAKES CAMPUS

6401 PRAIRIE ST NORTON SHORES MI 49444

OUTPATIENT SERVICES, LAB MERCY HEALTH PARTNERS LAKES CAMPUS (CON

6401 PRAIRIE ST NORTON SHORES MI 49444

URGENT CARE, REHAB, IMAGING Part I, Line 6a: HACKLEY 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, HACKLEY HOSPITAL WILL BE INCLUDING a copy of its most recently filed schedule H on both trinity health's WEBSITE AS WELL AS MERCY HEALTH PARTNER'S WEBSITE (WWW.MERCY-HEALTHPARTNERS.ORG). 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, Line 7f: The following number, $7,678,690, 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: HACKLEY 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.A BAD DEBT to Charity Reclass was conducted at two of the Western Michigan Region TRINITY HEALTH ORGANIZATIONS. Based on data returned from Collection Agencies, which was validated through electronic means (iSolutions), amounts that had been written off to Bad Debt were re-classed to Charity due to patient's inability to pay that would meet Presumptive Charity Criteria. Selected returned accounts were cases where there was no payment within 90 days of placement with the agency.As iSolutions data was not available for HACKLEY HOSPITAL, we assume approximately 10% of the amounts written-off to Bad Debt would have qualified for Charity based on similar findings within the region.WHILE CURRENT OPERATIONS ATTEMPT TO IDENTIFY THOSE CASES THAT WILL QUALIFY FOR CHARITY OR UNCOMPENSTATED CARE, IT IS ASSUMED THAT APPROXIMATELY 10% OF THE REMAINING BAD DEBT AMOUNT MAY ALSO QUALIFY AS CHARITY. 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, HACKLEY 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. 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 - HACKLEY HOSPITAL (Mercy Health Partners-Hackley Campus) 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 Mercy Health Partners' 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 Mercy Health Partners 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 Mercy Health Partners 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 Mercy Health Partners community needs assessment is current as of June, 2009. The community needs assessment was conducted with the assistance of outside experts including Peter J. Sartorius, Development and Planning Manager, MCHP; Christine Robere, President, United Way of the Lakeshore; Kenneth Kraus, Health Officer, Muskegon County Public Health; Paula Kelson, Projects Coordinator, Community Mental Health Services of Muskegon County; Jennifer Bailey, Provider Network Manager, Lakeshore Health Network; Joan Vanover, Community Benefit Coordinator, Mercy Health Partners; Helen Sherman, Office Assistant, MCHP; and Gerald L. Adams, Focus Group and Forum Facilitator, Project Consultant. Part VI, Line 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MERCY HEALTH PARTNERS-HACKLEY CAMPUS 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 COMMUNITYIN ACCORDANCE WITH AHA RECOMMENDATIONS, MERCY HEALTH PARTNERS-HACKLEY CAMPUS 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 OBLIGATIONSMERCY HEALTH PARTNERS-HACKLEY CAMPUS EFFECTIVELY COMMUNICATES 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.MERCY HEALTH PARTNERS-HACKLEY CAMPUS OFFERS IN-PERSON SUPPORT WITH FINANCIAL COUNSELORS, CASHIERS AND THE MUSKEGON COMMUNITY HEALTH PROJECT (A PART OF MERCY HEALTH PARTNERS). ANY REGISTRAR CAN MAKE A CONNECTION TO PATIENTS. MERCY HEALTH PARTNERS-HACKLEY CAMPUS PUBLISHES THE PHONE NUMBERS FOR OUR CALL-IN SUPPORT, AND SHARED SERVICES ALSO PROVIDES PHONE SUPPORT. MERCY HEALTH PARTNERS-HACKLEY CAMPUS HAS AN EXTERNAL VENDOR, MEDASSIST, AND WE ALSO WORK WITH DEPARTMENT OF HEALTH SERVICES STAFF.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTHCARE SERVICES. MERCY HEALTH PARTNERS-HACKLEY CAMPUS UTILIZES AN EXTERNAL VENDOR AS AN EXTENSION OF HOSPITAL SERVICES. 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.MERCY HEALTH PARTNERS-HACKLEY CAMPUS 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 THE PUBLICATION OF PATIENT BROCHURES, NOTICES OR MESSAGING INCLUDED ON PATIENT BILLS; POSTING OF NOTICES IN PUBLIC REGISTRATION AREAS, INCLUDING EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS; HOSPITAL PATIENT ACCOUNTING DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES THAT ARE LOCATED ON OUR CAMPUSES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO ACCESS HEALTH, INC., AMERICAN RED CROSS, BENSON DRUGS, CATHOLIC CHARITIES OF WEST MICHIGAN, CITY OF MUSKEGON, CITY OF MUSKEGON HEIGHTS, COMMUNITY ACCESS LINE OF THE LAKESHORE, COMMUNITY MENTAL HEALTH SERVICES OF MUSKEGON COUNTY, COOPERATING CHURCHES, DISABILITY CONNECTION OF WEST MICHIGAN, EVERY WOMAN'S PLACE, GOODWILL INDUSTRIES, HACKLEY COMMUNITY CARE CENTER, HACKLEY PHARMACIES, LIFE COUNSELING, LIONS CLUBS OF MUSKEGON COUNTY, MISSION FOR AREA PEOPLE, MUSKEGON COUNTY PUBLIC HEALTH, MUSKEGON COUNTY DEPT. OF HUMAN SERVICES/FAMILY RESOURCE CENTERS, MUSKEGON FAMILY CARE, MUSKEGON/OCEANA MICHIGAN WORKS!, THE SALVATION ARMY, SENIOR RESOURCES, URBAN LEAGUE, WESTSHORE PHARMACY, AND WEST MICHIGAN THERAPY.INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON THE MERCY HEALTH PARTNERS-HACKLEY CAMPUS' WEBSITE, AS WELL AS IN THE ADMISSION PACKAGE. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN SPANISH, REFLECTING THE OTHER PRIMARY LANGUAGE SPOKEN BY THE POPULATION SERVED BY OUR HOSPITAL.MERCY HEALTH PARTNERS-HACKLEY CAMPUS HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MERCY HEALTH PARTNERS-HACKLEY CAMPUS 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. MERCY HEALTH PARTNERS-HACKLEY CAMPUS 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. MERCY HEALTH PARTNERS-HACKLEY CAMPUS' FRONTLINE REGISTRATION ASSOCIATES, CASHIERS AND THE MUSKEGON COMMUNITY HEALTH PROJECT RECEIVE TRAINING ON MAKING A CONNECTION TO A FINANCIAL COUNSELOR. Part VI, Line 4: COMMUNITY INFORMATION - MERCY HEALTH PARTNERS-HACKLEY CAMPUS' SERVICE AREA INCLUDES MUSKEGON, OCEANA AND NEWAYGO COUNTIES, LOCATED IN CENTRAL WEST MICHIGAN, ON OR NEAR THE SHORELINE OF LAKE MICHIGAN. TOTAL POPULATION OF THE SERVICE AREA IS ABOUT 250,000 AND IS COMPRISED OF BOTH SIGNIFICANT RURAL AND URBAN AREAS. THE RURAL AREA IS CHARACTERIZED BY A CHIEFLY AGRICULTURAL, RECREATION AND TOURISM ECONOMY. THE METROPOLITAN AREA OF ABOUT 120,000 IS CENTERED AROUND THE CITY OF MUSKEGON AND IS LARGELY COMPRISED OF MANUFACTURING AND SERVICE INDUSTRIES. THE POPULATION IS GENERALLY DIVERSE WITH MANY ETHNIC AND RACIAL POPULATION SEGMENTS. THE METROPOLITAN AREA HAS A SIGNIFICANT AFRICAN-AMERICAN POPULATION, WHILE OCEANA COUNTY HAS A HIGHER CONCENTRATION OF HISPANIC RESIDENTS.MUSKEGON COUNTY IS HOME TO THE COUNTY'S MAJOR HOSPITAL SYSTEM, MERCY HEALTH PARTNERS, WHICH RECENTLY MERGED WITH HACKLEY HOSPITAL AND NOW INCLUDES FOUR CAMPUSES, INCLUDING LAKESHORE HOSPITAL IN OCEANA COUNTY.BASED ON THE 2000 CENSUS, THERE WERE 170,200 PEOPLE, 63,330 HOUSEHOLDS, AND 44,267 FAMILIES RESIDING IN THE COUNTY. THE RACIAL MAKEUP WAS APPROXIMATELY 81% CAUCASIAN, 14% BLACK AND LESS THAN 1% EACH FOR NATIVE AMERICAN, ASIAN, AND PACIFIC ISLANDER. THE MEDIAN HOUSEHOLD INCOME WAS $38,008, AND THE MEDIAN INCOME FOR A FAMILY WAS $45,710. ABOUT 9% OF FAMILIES AND 11% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 16% OF THOSE UNDER AGE 18 AND 8% OF THOSE AGES 65 OR OVER.OCEANA COUNTY IS A RURAL COUNTY ROUGHLY 41 MILES NORTH OF MUSKEGON AND 75 MILES NORTHWEST OF GRAND RAPIDS. THE RACIAL MAKEUP ACCORDING TO THE 2000 CENSUS WAS 90% CAUCASIAN, WITH AFRICAN-AMERICAN, ASIAN, AND PACIFIC ISLANDER EACH COMPRISING LESS THAN 1% OF THE TOTAL POPULATION. ROUGHLY 12% OF THE POPULATION WAS HISPANIC OR LATINO, THE HIGHEST PERCENTAGE OF LATINOS OF ANY COUNTY IN MICHIGAN. RECENT ESTIMATES SHOW THE PERCENTAGE OF LATINOS AND AFRICAN-AMERICANS TO BE INCREASING, WHILE THE PERCENTAGE OF NON-HISPANIC WHITES IS DECREASING. THE CENSUS BUREAU ESTIMATES THE 2008 COUNTY POPULATION AT 27,598. THE AVERAGE HOUSEHOLD SIZE WAS 2.67 AND THE AVERAGE FAMILY SIZE WAS 3.09 IN 2000. MEDIAN INCOME WAS $35,307.NEWAYGO COUNTY IS HOME TO GERBER INDUSTRIES AND THE GERBER MEMORIAL HOSPITAL, LOCATED IN FREMONT. THE GEOGRAPHIC PROXIMITY OF THE TWO URBAN CENTERS RESULTS IN SOME COUNTY RESIDENTS TRAVELING TO THE MUSKEGON AREA FOR HEALTHCARE SERVICES WHILE OTHERS USE THE SERVICES AVAILABLE IN GRAND RAPIDS.BASED ON THE 2000 CENSUS, THE RACIAL MAKEUP WAS APPROXIMATELY 95% CAUCASIAN, 1% BLACK, AND LESS THAN 1% EACH FOR NATIVE AMERICAN, ASIAN, AND PACIFIC ISLANDER. THE CENSUS BUREAU ESTIMATES THE 2008 COUNTY POPULATION AT 48,897. THE MEDIAN HOUSEHOLD INCOME WAS $37,130 AND THE MEDIAN INCOME FOR A FAMILY WAS $42,498. ABOUT 9% OF FAMILIES AND 12% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING APPROXIMATELY 15% OF THOSE UNDER AGE 18 AND 9% OF THOSE AGE 65 OR OVER. Part VI, Line 5: COMMUNITY BUILDING ACTIVITIES - Mercy Health Partners-Hackley conducted the following community building program, Muskegon Area Medication Disposal (MAMDP). The program included planning meetings and going into the community to collect the actual medications for disposal. Part VI, Line 6: OTHER INFORMATION - THE MAJORITY OF THE MERCY HEALTH PARTNERS-HACKLEY CAMPUS' GOVERNING BODY IS COMPRISED OF PEOPLE WHO RESIDE IN THE MERCY HEALTH PARTNERS (LAKESHORE CAMPUS, HACKLEY CAMPUS AND MERCY CAMPUS) PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS. SINCE MERCY HEALTH PARTNERS IS THE ONLY HEALTH SYSTEM IN MUSKEGON COUNTY, STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.Surplus funds are allocated to improvements in patient care, medical education and research. HOWEVER FY2010 has AGAIN not been A typical YEAR. The service area has very high rates of uninsured (Muskegon Co. 23.5%; Oceana Co. 27.6%; Newaygo Co. 12.7%), so Mercy Health Partners' focus has been on access to care. Mercy Health Partners' Health Project has been very proactive in working with medical clinics and the two FQHCs. The design of a single enrollment process has proven to make applying for assistance less cumbersome. The new form includes all information essential for determining eligibility for multiple health and human serviceS, thus streamlining the process of assisting patients to receive services. The Wheels of Mercy, a mobile unit, is taken to various areas through the three counties, providing, at the least, blood pressure, diabetes, pulmonary function, vision and cholesterol checks. Enrollment assistance into various programs is also provided. The goal is to alleviate many Emergency Department visits by screening and alerting patients to treatable problems that could escalate into life-threatening situations. Departments are aggressively involved in community programs. for instance, Outreach and Enrollment Specialists conduct health and human service eligibility screens on all uninsured patients at the time of discharge from the hospital or Emergency Department. Included in the screening is eligibility for Medicaid, SCHIP or other available health coverage, Food Assistance Program, Mercy Health Partners financial assistance, et al. Mercy Health Partners participates in the United Way Day of Caring. Also, every year, the Healthy-U event is conducted to educate the community about heart health, and provide workshops and programs at no cost. Support for events, such as the African-American Diabetes Conference, Men's Health Fair and Screening, and the Walk for Diabetes are conducted to raise funds for pharmaceutical products for people who can't afford them. Mercy Health Partners-Hackley Campus conducts extensive community-based screenings at churches and other venues around the community. Physicians volunteer their time in Doc Talks for the community; community services are provided to benefit everyone in the community, such as birthing classes. All of Mercy Health Partners supports the use of facilities by non-profit organizations for meetings and support. A certain percent of earnings from the Sister Simone Fund are redirected back to community groups for projects to improve the health of the community. Medical and administrative staffs sit on community coalitions that target areas of community need, including HIV/AIDS; diabetes; childhood obesity; health disparities, asthma; alcohol, tobacco and substance abuse; and youth risk behaviors. Mercy Health Partners' also gives money to support the Community Access Line of the Lakeshore (CALL 2-1-1) information and referral phone line; Access Health, a "3-share" model community health coverage program; as well as vision services. Mercy Health Partners (all campuses) is involved with "Aligning Forces for Quality: Equity and Language Quality" to meet the Trinity Equity in Care process of determining whether inequities exist in care due to race or ethnicity. A Mercy Health Partners' collaborative has been meeting at the Lakeshore Hospital in Oceana County to build a community consensus around evaluation, planning and deployment of healthcare services to meet the needs of underserved residents of Oceana County. The committee is working on life-long prevention services/lifestyle changes. Mercy Health Partners' Lakeshore Health Network developed a Health Literacy Committee to focus on issues that emerged out of the Community Needs Assessment process. This committee is looking at how we can improve giving patients information they can understand in order to improve their health and compliance with medical protocols.In partnership with Lakeshore Health Network, the Health Project has been in development of the Muskegon Area Medication Disposal Project. A medication take-back project reduces youth access to non-prescribed medications, reduces the number of expired and potentially unsafe medications, assists law enforcement with neighborhood safety for those seeking out drugs in medicine cabinets and reduces the environmental impact on water quality. Part VI, Line 7: HACKLEY 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. 0 X Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: DONATIONS MADE BY HACKLEY 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. X X X X X X 1 1 0 0 0 1 0 0 0 ROGER SPOELMAN 0 406506 0 367171 0 111439 0 67431 0 21534 0 974081 0 37936 DAVID DORA DO 0 180649 0 0 0 4631 0 22323 0 24673 0 232276 0 0 PHILIP MCCORKLE 0 417598 0 404505 0 167367 0 169919 0 30762 0 1190151 0 75751 GREGORY LOOMIS 0 274331 0 54983 0 29774 0 31715 0 17429 0 408232 0 16013 GARY ALLORE 0 240389 0 48380 0 14961 0 11339 0 18805 0 333874 0 0 JEFFREY ALEXANDER 0 227560 0 45424 0 12907 0 14791 0 13012 0 313694 0 0 JOSEPH SWEDISH 0 1214458 0 1607837 0 200997 0 769899 0 28404 0 3821595 0 0 MICHAEL SLUBOWSKI 0 696108 0 681725 0 240008 0 125922 0 28467 0 1772230 0 94766 KEDRICK ADKINS 0 712415 0 611975 0 129305 0 117250 0 12921 0 1583866 0 0 F REMINGTON SPRAGUE 0 317338 0 63017 0 39482 0 36488 0 15011 0 471336 0 22076 MARY BOYD 0 249722 0 50203 0 17128 0 23073 0 2305 0 342431 0 6015 KIMBERLY MAGUIRE 0 188360 0 37674 0 7882 0 18126 0 15471 0 267513 0 153 J RICHARD OCONNELL 0 440925 0 0 0 54218 0 11123 0 0 0 506266 0 0 JOHN M RATCHFORD 310716 0 0 0 6816 0 24251 0 16451 0 358234 0 0 0 BRUCE OLSON MD 243997 0 65660 0 950 0 23580 0 16414 0 350601 0 0 0 CHARLES FELDT 200319 0 5686 0 182 0 10939 0 20219 0 237345 0 0 0 JOSEPH RAFFERTY 171128 0 0 0 6793 0 20116 0 8097 0 206134 0 0 0 RONI DEVLIN 122086 0 45962 0 118 0 5599 0 5734 0 179499 0 0 0 GORDON MUDLER 0 0 0 0 419776 0 345007 0 8089 0 772872 0 414008 0 DAVID GINGRAS 56197 0 31170 0 171422 0 166830 0 12497 0 438116 0 0 0 RON HAASE 0 0 0 0 150296 0 0 0 4486 0 154782 0 145385 0 Part I, Line 4a THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2009. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III): DAVID GINGRAS - $151,850 RON HAASE - $148,846 GORDON MUDLER - $414,008 IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES THE FOLLOWING AMOUNTS WHICH WERE UNPAID AS OF 12/31/09. THESE AMOUNTS WERE PAID AND INCLUDED IN THE INDIVIDUALS' TAXABLE INCOME IN 2010. DAVID GINGRAS - $151,850 GORDON MUDLER - $345,007 PART I, LINE 4B: THE 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 2009). THE FOLLOWING ACCRUALS FOR 2009 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $59,584 PHILIP MCCORKLE - $125,372 MICHAEL SLUBOWSKI - $42,832 ROGER SPOELMAN - $37,116 JOSEPH SWEDISH - $249,263 PART I, LINE 4B: THE FOLLOWING ARE PARTICIPANTS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING SERP ACCRUALS FOR 2009 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $38,675 MICHAEL SLUBOWSKI - $55,733 JOSEPH SWEDISH - $493,225 PART I, LINE 4B: THE FOLLOWING INDIVIDUAL RECEIVED A TAXABLE DISTRIBUTION FROM A 457(F) PLAN DURING CALENDAR 2009. THIS AMOUNT IS INCLUDED IN COLUMN B(III): DAVID GINGRAS - $16,916 PART I, LINE 6: THE FOLLOWING BONUSES REPORTED IN COLUMN B(ii) WERE DETERMINED BASED ON THE NET EARNINGS OF THE PHYSICIAN PRACTICE DEPARTMENTS FOR WHICH EACH INDIVIDUAL WORKS, AS WELL AS THEIR PRODUCTIVITY. BRUCE OLSON - $65,660 RONI DEVLIN - $45,962 Part II, Column B (ii): The following individuals received amounts in 2009 from a long-term incentive plan (LTIP). Participants in the LTIP (CEOs and certain Trinity executives) were eligible to receive a payment under the plan only if certain patient loyalty improvement targets were achieved by the end of a three-year period (FY07 through FY09). The following LTIP amounts are included in Schedule J, Part II, Column B(ii): KEDRICK ADKINS - $337,826 PHILIP MCCORKLE - $275,409 MICHAEL SLUBOWSKI - $403,918 ROGER SPOELMAN - $248,854 JOSEPH SWEDISH - $1,042,563 NICHOLS MICHAEL OLTHOFF, TRUSTEE, IS ALSO A BOARD MEMBER OF NICHOLS 156746 PURCHASE OF CLEANING EQUIPMENT AND SUPPLIES FROM NICHOLS 0 BLUE CROSS BLUE SHIELD OF MICHIGAN F. REMINGTON SPRAGUE, KEY EMPLOYEE, IS TRUSTEE OF BLUE CROSS BLUE SHIELD-MI 30933131 NET REVENUE FROM PROVISION OF MEDICAL SERVICES 0 0 0 0 PAMELA ALEXANDER FAMILY MEMBER OF JEFFREY ALEXANDER, KEY EMPLOYEE 61853 EMPLOYMENT ARRANGEMENT 0 0 Form 990, Part I, Item C Doing Business As MERCY HEALTH PARTNERS-WORK PLACE HEALTH MERCY HEALTH PARTNERS, HACKLEY CAMPUS Form 990, Part VI, Section A, line 6 THE SOLE MEMBER OF HACKLEY HOSPITAL IS MERCY HEALTH PARTNERS. SEE LINE 7 FOR ADDITIONAL INFORMATION. Form 990, Part VI, Section A, line 7a MERCY HEALTH PARTNERS IS THE SOLE MEMBER OF HACKLEY HOSPITAL. MERCY HEALTH PARTNERS HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF TRUSTEES OF HACKLEY HOSPITAL. Form 990, Part VI, Section A, line 7b AS SOLE MEMBER, MERCY HEALTH PARTNERS MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MERCY HEALTH PARTNERS 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 HACKLEY HOSPITAL IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY 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. Form 990, Part VI, Section B, line 12c HACKLEY 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 HACKLEY 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 HACKLEY HOSPITAL'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO HACKLEY 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 HACKLEY HOSPITAL IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO HACKLEY 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 HACKLEY 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 KEY MANAGEMENT OFFICIALS OF HACKLEY 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 HACKLEY 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, HACKLEY HOSPITAL WILL BE INCLUDING A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON TRINITY HEALTH'S WEBSITE as well as Mercy Health Partner's website (www.meRCY-healthpartners.org). FORM 990, PART VII, SECTION A: Trustees: Sr. MYRA BERGMAN, RSM is a member of the RELIGIOUS SISTERS OF MERCY. Having taken a vow of poverty, Sr. MYRA did not receive compensation for the services she provided AS VICE PRESIDENT, MISSION SERVICES FOR SAINT MARY'S HEALTH CARE (A DIVISION OF TRINITY HEALTH - MICHIGAN). Instead, a total of $185,761 was paid by TRINITY HEALTH - MICHIGAN directly to the SISTERS OF MERCY for Sr. MYRA's services. CORE FORM, PART VII, SECTION A, COLUMN B: 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 JEFFREY ALEXANDER - 30 HOURS GARY ALLORE - 30 HOURS MARY BOYD - 30 HOURS DAVID DORA, DO - 48 HOURS GREGORY LOOMIS - 30 HOURS KIMBERLY MAGUIRE - 30 HOURS PHILIP MCCORKLE - 48 HOURS J. RICHARD O'CONNELL - 53 HOURS MICHAEL SLUBOWSKI - 53 HOURS ROGER SPOELMAN - 30 HOURS F. REMINGTON SPRAGUE - 30 HOURS JOSEPH SWEDISH - 53 HOURS CORE FORM, PART XI, LINE 2: HACKLEY HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY10 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. 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 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 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 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 PO BOX 1051 GRAND CAYMAN GRAND CAYMAN CJ 980453602 PROVISION OF INSURANCE COVERAGE CJ N/A C 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 0 0 1 0 1 0 0 0 0 1 1 1 0 0 1 1 1 1 TRINITY HEALTH - MICHIGAN L 1101537 TRINITY HEALTH CORPORATION E 61900000 TRINITY HEALTH CORPORATION C 18000000 TRINITY HEALTH CORPORATION L 2017584 TRINITY HEALTH CORPORATION Q 2126396 MERCY HEALTH PARTNERS J 142819 MERCY HEALTH PARTNERS K 214157 MERCY HEALTH PARTNERS L 7091729 MERCY HEALTH PARTNERS O 6641932 MERCY HEALTH PARTNERS Q 877359 LAKESHORE COMMUNITY HOSPITAL INC K 230151 LAKESHORE COMMUNITY HOSPITAL INC P 78106 HACKLEY VISITING NURSE SERVICES AND HOSPICE INC C 2713577 HACKLEY LIFE COUNSELING R 68861 HACKLEY PROFESSIONAL CENTER J 232898