2019-11-14T15:09:43-06:00 2018-12-31 381357951 PLANTE & MORAN PLLC 250 SOUTH HIGH STREET SUITE 100 COLUMBUS OH 43215 990 2018-01-01 352408321 MERCY DEVELOPMENT FOUNDATION MERC 3304891000 1320 MERCY DRIVE NW CANTON OH 44708 THOMAS TURNER PRESIDENT 3304891007 2019-11-13 1 BERNIE OSTROWSKI P00366367 6148493000 2019-11-13 199.33.77.183 2019-11-13 17:10:00 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 88BB8417C17E4C1C3BDD6C18F80F35263914D73F 2018 2020-04-17 16:48:07Z THOMAS TURNER 1320 MERCY DRIVE NW CANTON OH 44708 1131337 0 0928 X WWW.CANTONMERCY.ORG/GIVING X 2011 OH SCHEDULE OMERCY DEVELOPMENT FOUNDATION IS ORGANIZED EXCLUSIVELY FOR THE BENEFIT OF MERCY MEDICAL CENTER, INC., A MINISTRY OF THE SISTERS OF CHARITY HEALTH SYSTEM. ITS PURPOSE IS TO (1) SOLICIT FUNDS AND GIFTS FROM INDIVIDUALS, BUSINESSES, CORPORATIONS, ORGANIZATIONS, FOUNDATIONS AND THE COMMUNITY OR GOVERNMENT AGENCIES, (2) RECEIVE, RECEIPT, RECORD AND ACKNOWLEDGE ALL GIFTS, (3) APPROPRIATELY MANAGE AND INVEST THESE FUNDS, AND (4) DISBURSE THESE FUNDS IN THE BEST INTEREST OF THE HOSPITAL. 38 32 0 123 0 0 1028461 999134 0 0 6163 6101 4167 9649 1038791 1014884 0 0 0 0 320377 331932 0 0 0 116029 130986 436406 462918 602385 551966 1881849 1993786 130204 179832 1751645 1813954 X SCHEDULE OAS A CATHOLIC HEALTHCARE ORGANIZATION, THE MISSION OF MERCY MEDICAL CENTER AND THE DEVELOPMENT FOUNDATION ARE THE SAME: TO CONTINUE CHRIST'S HEALING MINISTRY BY PROVIDING QUALITY, COMPASSIONATE, ACCESSIBLE AND AFFORDABLE CARE TO THE WHOLE PERSON - REGARDLESS OF ABILITY TO PAY. 0 0 383363 SCHEDULE OIN 2018, MERCY DEVELOPMENT FOUNDATION SOLICITED 6,304 GIFTS FROM 1,013 INDIVIDUALS, BUSINESSES, CORPORATIONS,ORGANIZATIONS, FOUNDATIONS, AND GOVERNMENT AGENCIES. THESE DOLLARS SUPPORTD CAPITAL PROJECTS, CANCER CENTER, DENTAL SERVICES AND MISSION AND MINISTRY OUTREACH PROGRAMS AS WELL AS AREAS OF GREATEST NEED. THROUGH THE FOUNDATION'S EFFORTS, GRANTS TOTALING $688,200 WERE DIRECTLY RECEIVED BY MERCY MEDICAL CENTER. THESE DOLLARS SUPPORTED THE HAVEN (HEALING AFTER VIOLENT ENCOUNTERS NETWORK), WOMEN'S CANCER SERVICES, PATIENT TRANSPORT AND SAFETY, CARDIOLGY, AND MASSILLON OFFSITE PROGRAMS. THE MERCY DEVELOPMENT FOUNDATION (MDF) SERVES IN AN ADVISORY ROLE TO THE MERCY SERVICE LEAGUE WHICH IS A SEPARATE 501(C)(3). IN 2018, THE MERCY SERVICE LEAGUE PRESENTED A DONATION OF $140,000 FOR THE MERCY TRANSFORMATION PROJECT OF OUR ORTHOPEDIC AND CARDIAC OBSERVATON FLOOR. THE STAFF OF THE FOUNDATION WORKED WITH THE WOMEN OF THE SERVICE LEAGUE ON THE SECOND WINE WOMEN AND SHOES EVENT HELD IN MAY. THIS EVENT RAISED $255,000 FOR WOMEN'S CANCER SERVICES. SPECIFIC 2018 PROGRAM SERVICES ACCOMPLISHMENTS INCLUDED:*MERCY CHARITY CLAYS EVENT - THIS EVENT WAS HELD IN MAY AT ONE OF THE PRESTIGIOUS COURSES IN THE MIDWEST - HILL'N DALE CLUB IN MEDINA. THE PROCEEDS FROM THIS EVENT BENEFITED THE FOUNDATION AREA OF GREATEST NEED. PNC WAS THE PROJECT'S LEAD SPONSOR.*FORE MERCY SAKE - MERCY DEVELOPMENT FOUNDATION COORDINATES AN ANNUAL GOLF OUTING CALLED FORE MERCY'S SAKE. THE PROCEEDS FROM THIS EVENT BENEFIT MERCY INTERNATIONAL MISSION OUTREACH THAT SUPPORTS AN ANNUAL MEDICAL MISSION TRIP TO AN UNDERDEVELOPED COUNTRY AND MMC AREA OF GREATEST NEED. VASCO ASPHALT WAS THE PROJECT'S LEAD SPONSOR. *2018 CAMPAIGN OF CARING - KEEPERS OF THE MISSION-"110 YEARS STRONG" - THIS EFFORT WAS THE FOUNDATION'S ANNUAL APPEAL TO BOTH HOSPITAL EMPLOYEES AND COMMUNITY DONORS. THE PROCEEDS FROM THE ANNUAL APPEAL BENEFIT THE HOSPITAL'S AREA OF GREATEST NEED.*DONOR CULTIVATION AND STEWARDSHIP ACTIVITES INCLUDING OUR FOUNDERS DAY MASS AND RECEPTION AND A LABORATORY DEDICATION TO DR. SARIKAYA WHO WAS A MAJOR GIFT DONOR IN 2017. IN ADDITION TO THESE EVENTS, THE FOUNDATION HONORED NUMEROUS INDIVIDUALS OF DONOR OR POTENTIAL DONOR STATUS AT A BLOSSOM MUSIC EVENT ON 8/19/18. *NUMEROUS PHILANTHROPIC AND GOVERNMENT GRANTS WERE SOLICITED FOR MERCY MEDICAL CENTER.*MAJOR GIFT SOLICITATION - IN 2018, THE FOUNDATION STAFF RECIEVED GIFTS FROM GEORGE SEANOR, DR. LEONAR KNELL AND MARGARET HOWLEY 383363 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 38 32 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X DAVID STEWART 3304891007 1320 MERCY DRIVE NW CANTON OH 44708 THOMAS TURNER PRESIDENT 10.00 30.00 X X 0 216475 50263 DONALD PETERSON III CHAIRMAN 2.00 0.00 X X 0 0 0 THOMAS PAUMIER DDS VICE CHAIRMAN 2.00 0.00 X X 0 0 0 LEE ANN THORN SECRETARY 2.00 0.00 X X 0 0 0 DAVID STEWART TREASURER 2.00 38.00 X X 0 343238 42052 JOHN PRELAC ASSISTANT TREASURER 2.00 0.00 X X 0 0 0 SR CAROLYN CAPUANO HM BOARD MEMBER 1.00 39.00 X 0 0 0 GREG COLANER BOARD MEMBER 1.00 0.00 X 0 0 0 MARK COTLEUR BOARD MEMBER 1.00 0.00 X 0 0 0 RICHARD CROASDAILE JR BOARD MEMBER 1.00 0.00 X 0 0 0 CHRISTOPHER DILORETO BOARD MEMBER 1.00 0.00 X 0 0 0 SCOTT FITZPATRICK BOARD MEMBER 1.00 0.00 X 0 0 0 DENNIS FULMER BOARD MEMBER 1.00 0.00 X 0 0 0 LINDA GANSER BOARD MEMBER 1.00 0.00 X 0 0 0 DEREK GORDON BOARD MEMBER 1.00 0.00 X 0 0 0 GRETCHEN GRAHAM BOARD MEMBER 1.00 0.00 X 0 0 0 PAUL HILTZ BOARD MEMBER 2.00 38.00 X 15525 78997 10917 JAMES KING MD BOARD MEMBER 1.00 0.00 X 0 0 0 REV MSGR JAMES KOLP BOARD MEMBER 1.00 0.00 X 0 0 0 JUDITH LANCASTER ESQ BOARD MEMBER 1.00 0.00 X 0 0 0 JACK LIBERATOR BOARD MEMBER 1.00 0.00 X 0 0 0 WENDY LICHTENWALTER BOARD MEMBER 1.00 0.00 X 0 0 0 MICHAEL LINZ MD BOARD MEMBER 1.00 5.00 X 0 25255 0 JONI LOCKE BOARD MEMBER 1.00 0.00 X 0 0 0 LOUISE MAHONEY BOARD MEMBER 1.00 0.00 X 0 0 0 ROBERT MAHONEY BOARD MEMBER 1.00 0.00 X 0 0 0 JENNIFER MEIER BOARD MEMBER 1.00 0.00 X 0 0 0 TERRY MOORE ESQ BOARD MEMBER 1.00 0.00 X 0 0 0 WILLIAM RACINE BOARD MEMBER 1.00 0.00 X 0 0 0 AIDA SAFAR MD BOARD MEMBER 1.00 0.00 X 0 0 0 MATT SAVAGE BOARD MEMBER 1.00 0.00 X 0 0 0 THOMAS STRAUSS BOARD MEMBER 1.00 39.00 X 0 1130364 60577 DAVID THOMSON BOARD MEMBER 1.00 0.00 X 0 0 0 JOHN TUCKER ESQ BOARD MEMBER 1.00 0.00 X 0 0 0 MARK WILHELM BOARD MEMBER 1.00 0.00 X 0 0 0 FONDA WILLIAMS BOARD MEMBER 1.00 0.00 X 0 0 0 GEORGE WILLIAMS DDS BOARD MEMBER 1.00 0.00 X 0 0 0 THOMAS E CECCONI FORMER BOARD MEMBER 1.00 39.00 X 0 553604 35650 15525 2347933 199459 0 1 1 0 0 49532 75000 874602 91227 999134 11458 11458 80565 85922 -5357 -5357 -5357 40180 49532 30531 9649 9649 1014884 0 0 15750 55939 55939 204807 204807 53240 41365 11875 17946 14954 2992 2130 2130 7874 7874 19925 19925 19462 19462 5061 5061 751 751 12668 12668 332 332 RECOGNITION SIGNAGE 21840 21840 PROGRAM FUNDING FOR MER 19488 19488 POSTAGE 15619 15619 DUES, BOOKS & OTHER 5253 4778 475 583 583 462918 383363 79555 0 1005422 1108200 3324 1164 2493 2160 873934 883426 1881849 1993786 20001 20000 110203 159832 130204 179832 X 596503 469210 483693 712324 671449 632420 1751645 1813954 1881849 1993786 X 551966 -99038 -3946 -386673 X X 0 1 X 1 0 X X 1 MERCY MEDICAL CTR 341893439 3 1 1003323 0 1 1003323 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 671449 2000 -35365 2500 3163 632421 568067 6000 100197 2815 671449 537116 10967 28116 6696 1436 568067 310078 232642 -3289 2315 537116 139742 143424 27245 333 310078 1.00000 0 0 3324 1164 2160 2160 DENTAL ENDOWMENT FUND 632420 STARK DENTAL CHARITABLE FUND 251006 883426 DUE TO MERCY MEDICAL CENTER 159832 159832 X PART V, LINE 4: THE MERCY GENERAL PRACTICE DENTAL RESIDENCY ENDOWMENT FUND IS A PERMANENT ENDOWMENT FUND OF THE MERCY DEVELOPMENT FOUNDATION. ITS PURPOSE IS TO GENERATE ADDITIONAL INCOME FROM INVESTMENTS DEDICATED TO THE SUPPORT OF THE LONG TERM GROWTH OF THE MERCY GENERAL DENTAL RESIDENCY PROGRAM FOR PERPETUITY. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2018, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. SPORT EVENT -CLAY SHOOTING 56800 28358 28442 1868 7403 5556 1297 GOLF OUTING -FORE MERCY SAKE 32912 21174 11738 777 7480 3159 2991 89712 49532 40180 2645 14883 8715 4288 30531 9649 1 1 0 0 0 0 0 0 0 THOMAS TURNER PRESIDENT 0 211596 0 0 0 4879 0 18026 0 32237 0 266738 0 0 DAVID STEWART TREASURER 0 340068 0 0 0 3170 0 27852 0 14200 0 385290 0 0 THOMAS STRAUSS BOARD MEMBER 0 1108266 0 0 0 22098 0 45852 0 14725 0 1190941 0 0 THOMAS E CECCONI FORMER BOARD MEMBER 0 98392 0 0 0 455212 0 21925 0 13725 0 589254 0 0 PART I, LINE 3 THE PRESIDENT AND TREASURER ARE PAID FROM RELATED ORGANIZATIONS. MERCY MEDICAL CENTER UTILIZES A COMPENSATION COMMITTEE, PERFORMS COMPENSATION SURVEYS AND STUDIES AS WELL AS GETS APPROVAL FROM THE BOARD OF MERCY MEDICAL CENTER. PART I, LINES 4A-B THOMAS CECCONI RECEIVED A TWO YEAR TERMINATION AGREEMENT FOR 2018 & 2019. THE TOTAL AMOUNT OF THIS AGREEMENT IS FOR $980,398. SUPPLEMENTAL EXECUTIVE RETIREMENT PAYMENTS (SERP) WERE MADE BY THE RELATED ORGANIZATION TO THOMAS STRAUSS ($18,500) AND PAUL HILTZ ($6,370). SCHEDULE J PART II THE BOARD MEMBERS' COMPENSATION IS FOR ADMINSTRATIVE AND PHYSICIAN SERVICES FOR THE RELATED ORGANIZATIONS. THEY ARE NOT COMPENSATED AS BOARD MEMBERS FOR THE FOUNDATION. X 2 91227 FAIR MARKET VALUE 0 1 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE CORPORATE MEMBER: MERCY MEDICAL CENTER FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S MEMBER MAY ELECT MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN DECISIONS OF THE GOVERNING BODY, SUCH AS APPROVAL OF BUDGETS, CAPITAL EXPENDITURES, LIQUIDATION, MERGER OR DISSOLUTION OF ASSETS, AND THE MODIFICATION OF THE ARTICLES OF INCORPORATION AND CODE OF REGULATIONS, MUST BE APPROVED BY THE BOARD OF THE MEMBER ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B AFTER FORM 990 IS REVIEWED INTERNALLY, IT IS SUBMITTED FOR REVIEW TO OUR TAX ADVISOR. THEY REVIEW FOR COMPLETENESS AND COMMUNICATE ANY CONCERNS THAT THEY IDENTIFY WITHIN THE DOCUMENTS AND WORKSHEETS OF THE TAX RETURN. ITEMS IDENTIFIED ARE REVIEWED BY STAFF AND ANY NEEDED CORRECTIONS ARE MADE. THE RETURN IS THEN PROVIDED TO THE CFO FOR REVIEW AND APPROVAL. THE RETURN IS MADE AVAILABLE TO THE FULL BOARD THROUGH A WEB PORTAL THAT THEY ACCESS BEFORE IT IS FILED WITH THE IRS. ANY QUESTIONS OR CONCERNS THAT THEY HAVE ARE SENT TO EITHER THE PRESIDENT OR CHIEF FINANCIAL OFFICER OF THE MEDICAL CENTER. FORM 990, PART VI, SECTION B, LINE 12C MERCY DEVELOPMENT FOUNDATION INITITATED OPERATIONS IN 2011. AS AN ORGANIZATION ESTABLISHED EXCLUSIVELY FOR THE SUPPORT AND BENEFIT OF MERCY MEDICAL CENTER, THE FOUNDATION ADHERES TO THE ADMINISTRATIVE POLICIES OF MERCY MEDICAL CENTER, INCLUDING, BUT NOT LIMITED TO: CORPORATE COMPLIANCE POLICIES; DISCLOSURE OF CONFLICTS OF INTEREST; DOCUMENT RETENTION AND DESTRUCTION; HUMAN RESOURCES; AS WELL AS FINANCIAL MANAGEMENT AND REPORTING. FORM 990, PART VI, SECTION B, LINE 15 THE FOUNDATION ADHERES TO THE ADMINISTRATIVE POLICIES AND PROCEDURES OF MERCY MEDICAL CENTER AND FOLLOWS THEIR ANNUAL COMPENSATION REVIEW BY AN EXTERNAL SOURCE WHICH IS THEN REVIEWED BY THE BOARD FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 AND 1023 ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CAPITAL ASSET TRANSFERS TO MERCY MEDICAL CENTER -324,063. INVESTMENT INCOME-ENDOWMENT & STARK DENTAL FUND 53,476. TEMP RESTRICTED DISBURSEMENTS -73,691. DENTAL ENDOWMENT DONATIONS 2,000. CHARITABLE DENTAL FUND DONATIONS (TEMP) 66,000. RESTRICTED DONATIONS 577,865. CASH TRANSFER TO MERCY MEDICAL CTR - DR. SARIAKAYA DONATION -679,260. DENTAL ENDOWMENT DISBURSEMENTS -2,500. CHARITABLE DENTAL FUND DISBURSEMENTS -6,500. FORM 990, PART XII, LINE 2C A RELATED TAX-EXEMPT ORGANIZATION'S BOARD, MERCY MEDICAL CENTER, ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. SISTERS OF CHARITY OF ST AUGUSTINE HEALTH SYSTEM INC 2475 EAST 22ND ST CLEVELAND OH 44115 341379356 CHARITABLE ORGANIZATION OH 501 (C) 3 12A SISTERS OF CHARITY OF ST AUGUSTINEROMAN CATHOLIC CHURCH 1 SISTERS OF CHARITY OF ST AUGUSTINE ROMAN CATHOLIC CHURCH 5232 BROADVIEW ROAD RICHFIELD OH 44286 340714763 RELIGIOUS ORDER OF WOMEN OH 501 (C) 3 1 N/A 0 SCPH LEGACY CORP (PHLC) 2475 EAST 22ND ST CLEVELAND OH 44115 570314409 CHARITABLE ORGANIZATION OH 501 (C) 3 12A SCHS 1 PROVIDENCE HOSPITALS DEVELOPMENT FOUNDATION 2475 EAST 22ND ST CLEVELAND OH 44115 271140183 CHARITABLE ORGANIZATION SC 501 (C) 3 12A PHLC 1 REGINIA HEALTH CENTER 5232 BROADVIEW ROAD RICHFIELD OH 44286 341722394 RETIREMENT COMMUNITY OH 501 (C) 3 10 SCHS 1 ST VINCENT CHARITY MEDICAL CENTER (SVCMC) 2351 EAST 22ND STREET CLEVELAND OH 44115 340714756 HOSPITAL OH 501 (C) 3 3 SCHS 1 ST VINCENT CHARITY DEVELOPMENT FOUNDATION 2351 EAST 22ND STREET CLEVELAND OH 44115 271602445 CHARITABLE ORGANIZATION OH 501 (C) 3 12A SVCMC 1 MERCY MEDICAL CENTER 1320 MERCY DRIVE NW CANTON OH 44708 341893439 HOSPITAL OH 501 (C) 3 3 SCHS 1 ST JOHN HOSPITAL 2475 EAST 22ND ST CLEVELAND OH 44115 340714504 CHARITABLE ORGANIZATION OH 501 (C) 3 12A SCHS 1 HEALTHY LEARNERS 2749 LAUREL STREET COLUMBIA SC 29204 571127197 CHARITABLE ORGANIZATION SC 501 (C) 3 12A SCHS 1 JOSEPH'S HOME 2412 COMMUNITY COLLEGE AVENUE CLEVELAND OH 44115 340901676 CHARITABLE ORGANIZATION OH 501 (C) 3 10 SCHS 1 SISTERS OF CHARITY FOUNDATION OF CLEVELAND 2475 EAST 22ND ST FOURTH FLOOR CLEVELAND OH 44115 341832698 CHARITABLE ORGANIZATION OH 501 (C) 3 12A SCHS 1 SISTERS OF CHARITY FOUNDATION OF CANTON 400 MARKET AVE N STE 300 CANTON OH 44702 341832697 CHARITABLE ORGANIZATION OH 501 (C) 3 12A SCHS 1 EARLY CHILDHOOD RESOURCE CENTER 1718 CLEVELAND AVE NW CANTON OH 44703 340714462 CHARITABLE ORGANIZATION OH 501 (C) 3 12A SISTERS OF CHARITY FOUNDATION OF CANTON 1 SISTERS OF CHARITY FOUNDATION OF SC 2711 MIDDLEBURG DRIVE COLUMBIA SC 29204 570708391 CHARITABLE ORGANIZATION OH 501 (C) 3 12A SCHS 1 SOUTH CAROLINA CENTER FOR FATHERS & FAMILIES 2711 MIDDLEBURG DRIVE COLUMBIA SC 29204 364506347 CHARITABLE ORGANIZATION SC 501 (C) 3 7 SISTERS OF CHARITY FOUNDATION OF SOUTH CAROLINA 1 LIGHT OF HEARTS VILLA 283 UNION ST BEDFORD OH 44146 341619270 CHARITABLE ORGANIZATION OH 501 (C) 3 12A SCHS 1 MERCY PROFESSIONAL CARE CORP 1320 MERCY DRIVE CANTON OH 44708 341873008 PHYSICIAN/MEDICAL SERVICES OH N/A C 1 ST VINCENT MEDICAL GROUP 2475 EAST 22ND STREET CLEVELAND OH 44115 341634990 PHYSICIAN/MEDICAL SERVICES OH N/A C 1 SCHS INSURANCE CO LTD 62 FORUM LANE-3RD FLOOR GRAND CAYMAN CJ KY1-1203 980679825 INSURANCE CJ N/A C 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0