2017-11-14T09:05:29-06:00 2016-12-31 381357951 PLANTE & MORAN PLLC 65 EAST STATE ST STE 600 COLUMBUS OH 43215 990 2016-01-01 352408321 MERCY DEVELOPMENT FOUNDATION MERC 3304891000 1320 MERCY DRIVE NW CANTON OH 44708 THOMAS TURNER PRESIDENT 3304891007 2017-11-13 1 BERNIE OSTROWSKI P00366367 6148493000 2017-11-13 67.59.56.30 2017-11-13 14:33:56 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 62F685DCD8B327ED37C30025DF4E68B78D3FE745 2016 2021-01-29 14:40:06Z THOMAS TURNER 1320 MERCY DRIVE NW CANTON OH 44708 987922 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 33 0 86 0 0 1491295 973911 0 0 240 2008 0 2404 1491535 978323 0 0 0 0 330718 358640 0 0 9599 116799 168427 447517 527067 1044018 451256 1416209 1922105 165319 224547 1250890 1697558 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 517468 SCHEDULE OIN 2016, MERCY DEVELOPMENT FOUNDATION SOLICITED 7,433 GIFTS FROM 1,579 INDIVIDUALS, BUSINESSES, CORPORATIONS,ORGANIZATIONS, FOUNDATIONS, AND GOVERNMENT AGENCIES. THESE DOLLARS SUPPORTD THE 5B ORTHO RENOVATION CAPITAL PROJECT, THE AREA OF GREATEST NEED, DENTAL SERVICES AND MISSION AND MINISTRY OUTREACH PROGRAMS. THROUGH THE FOUNDATION'S EFFORTS, GRANTS TOTALING $696,018 WERE DIRECTLY RECEIVED BY MERCY MEDICAL CENTER. THESE DOLLARS SUPPORTED THE HAVEN (HEALING AFTER VIOLENT ENCOUNTERS NETWORK), PATIENT TRANSPORT PROGRAMS, EMS OUTREACH PROGRAMS AND WOMEN'S CANCER SERVICES.THE MERCY DEVELOPMENT FOUNDATION (MDF) SERVES IN AN ADVISORY ROLE TO THE MERCY SERVICE LEAGUE WHICH IS A SEPARATE 501(C)(3). IN 2016, THE MERCY SERVICE LEAGUE PRESENTED A DONATION IN THE AMOUNT OF $205,000 DEDICATED TO THE MERCY TRANSFORMATION PROJECT OF OUR ORTHOPEDIC FLOOR. THE STAFF OF THE FOUNDATION WORKED WITH THE WOMEN OF THE SERVICE LEAGUE ON THE HARVEST BALL (BLACK AND WHITE GALA), SOUPER BOWL FUNDRAISER AND THE KICK OFF EVENT FOR THE WINE WOMEN AND SHOES FUNDRAISER THAT IS SCHEDULED FOR 2017.SPECIFIC 2016 PROGRAM SERVICES ACCOMPLISHMENTS INCLUDED:*FORE MERCY SAKE - MERCY DEVELOPMENT FOUNDATION OFFERS 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. VASCO ASPHALT WAS THE PROJECT'S SPONSOR. THIS EVENT IS DONE DIRECTLY THROUGH THE MEDICAL CENTER.*RUHLIN SPORTING CLAYS- THIS EVENT WAS NEW FOR MDF IN 2016. IT WAS HELD AT THE PRESTIGIOUS COURSE IN THE MIDWEST - HILL'N DALE CLUB IN MEDINA. THE PROCEEDS FROM THE EVENT BENEFITTED THE MERCY TRANSFORMATION PROJECT. THE RUHLIN COMPANY WAS THE PROJECT'S PRESENTING SPONSOR.*HAUTE ROUTE BIKE CHALLENGE - MERCY EMPLOYEE, CHRIS CHRISTIAN, RAISED PHILANTHROPIC DOLLARS FOR MERCY'S CANCER CENTER BECAUSE CANCER HAS TOUCHED THE LIVES OF SO MANY FAMILY AND FRIENDS. CHRIS PARTICIPATED IN THE HAUTE ROUTE, THE WORLD'S HIGHEST AND MOST STRENUOUS CYCLOSPORTIVE EVENT. THE EVENT IS AN ENDURANCE ROAD AND BIKE CHALLENGE THAT STARTED IN FRANCE AND ENDED IN SWITZERLAND. *2016 CAMPAIGN OF CARING - WE ARE MERCY BECAUSE OF YOU! - 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. *NUMEROUS PHILANTHROPIC AND GOVERNMENT GRANTS*MAJOR GIFT SOLICITATION*PLANNED GIFTS 517468 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 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 38 33 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 234657 47288 Terry Moore chairman 2.00 0.00 X X 0 0 0 doNALD PETERSON III vICE CHAIRMAN 2.00 0.00 X X 0 0 0 mark s fleiner seCRETARY 2.00 0.00 X X 0 0 0 david Stewart tREASURER 2.00 38.00 X X 0 358239 40160 leE ANN THORN aSSISTANT TREASURER 2.00 0.00 X X 0 0 0 sr CAROLyn capuano hm DIRECTOR 1.00 39.00 X 0 0 0 thomAS E CECCONI DIRECTOR 2.00 38.00 X 0 591171 61257 foNDA WILLIAMS DIRECTOR 1.00 0.00 X 0 0 0 richARD E CROASDAILE JR DIRECTOR 1.00 0.00 X 0 0 0 scott fitzpatrick DIRECTOR 1.00 0.00 X 0 0 0 dennis Fulmer DIRECTOR 1.00 0.00 X 0 0 0 linda ganser DIRECTOR 1.00 0.00 X 0 0 0 derek gordon DIRECTOR 1.00 0.00 X 0 0 0 gretchen graham DIRECTOR 1.00 0.00 X 0 0 0 Frank Kaeberlein md DIRECTOR 1.00 4.00 X 0 20990 0 JameS F KING MD DIRECTOR 1.00 0.00 X 0 0 0 MSGR JAMES KOLP DIRECTOR 1.00 0.00 X 0 0 0 JUDITH E LANCASTER DIRECTOR 1.00 0.00 X 0 0 0 JACK LIBERATOR DIRECTOR 1.00 0.00 X 0 0 0 LOUISE MAHONEY DIRECTOR 1.00 0.00 X 0 0 0 ROBERT MAHONEY DIRECTOR 1.00 0.00 X 0 0 0 anna mavrakis DIRECTOR 1.00 0.00 X 0 0 0 steven maxim DIRECTOR 1.00 0.00 X 0 0 0 michael mccann DIRECTOR 1.00 0.00 X 0 0 0 jennifer s meier DIRECTOR 1.00 0.00 X 0 0 0 thomas paumier dds DIRECTOR 1.00 0.00 X 0 0 0 CHRISTOPHER A DILORETO DIRECTOR 1.00 0.00 X 0 0 0 john prelac DIRECTOR 1.00 0.00 X 0 0 0 matt savage DIRECTOR 1.00 0.00 X 0 0 0 KATHLEEN STONEMAN DIRECTOR 1.00 0.00 X 0 0 0 thomas strauss DIRECTOR 1.00 0.00 X 0 0 0 daVID THOMSON DIRECTOR 1.00 0.00 X 0 0 0 CHRISTINA WALKER DIRECTOR 1.00 39.00 X 0 272505 33318 TOM WHEATON DIRECTOR 1.00 0.00 X 0 0 0 JONI LOCKE DIRECTOR 1.00 0.00 X 0 0 0 Bill Racine DIRECTOR 1.00 0.00 X 0 0 0 GEORGE WILLIAMS DDS DIRECTOR 1.00 0.00 X 0 0 0 0 1477562 182023 0 0 1 0 0 19752 112105 842054 5231 973911 2008 2008 12003 19752 9599 2404 2404 978323 0 0 4412 54663 54663 230775 230775 55618 55618 17584 17584 3400 3400 2205 2205 35911 35911 16056 16056 4273 4273 300 300 2293 2293 16832 16832 332 332 Campaign of Caring Wall 36225 36225 Postage 29903 29903 Other 14687 5088 9599 DUES & MEMBERSHIPS 5040 5040 970 970 527067 517468 0 9599 275866 1222348 500000 740 3324 499 3158 2825 637185 696192 1416209 1922105 9600 29987 155719 194560 165319 224547 X 498680 523183 215094 606308 537116 568067 1250890 1697558 1416209 1922105 X 451256 19686 -1687 -22587 X X 0 1 X 1 0 X X 1 Mercy Medical Ctr 341893439 3 1 8685 0 1 8685 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 537116 10967 28116 6696 1436 568067 310078 232642 -3289 2315 537116 139742 143424 27245 333 310078 134966 4776 139742 1.00000 0 0 3324 499 2825 2825 Dental Endowment Fund 568067 STARK DENTAL CHARITABLE FUND 128125 696192 Due to Mercy Medical Center 194560 194560 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, 2016, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. RUHLIN SPORTING CLAYS 31755 19752 12003 1642 3951 3936 70 31755 19752 12003 1642 3951 3936 70 9599 2404 0 1 0 0 0 0 0 0 0 Thomas Turner PRESIDENT 0 206530 0 23372 0 4755 0 16013 0 31275 0 281945 0 0 david Stewart tREASURER 0 321695 0 34447 0 2097 0 27060 0 13100 0 398399 0 0 thomAS E CECCONI DIRECTOR 0 455760 0 113589 0 21822 0 45060 3097 13100 3097 649331 0 0 CHRISTINA WALKER DIRECTOR 0 206992 0 62100 0 3413 0 20218 0 13100 0 305823 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, Line 4b A SUPPLEMENTAL EXECUTIVE RETIREMENT PAYMENT (SERP) OF $18,000 WAS MADE BY THE RELATED ORGANIZATION TO THOMAS CECCONI. Schedule J Part II The Board members' compensation is for adminstrative and physician services for related organizations. They are not compensated as Board members for the Foundation. 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: Asset Transfer TO MERCY MEDICAL CENTER -8,685. Investment Income-EndowmENt & Stark Dental Fund 12,658. Temp Restricted Disbursements -26,562. Prior Period Adjustment 2. 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 Sisters of Charity Providence Hospitals (SCPH) 120 GATEWAY CORPORATION Columbia SC 29203 570314409 Hospital SC 501 (C) 3 3 SCHS 1 Providence Hospitals Development Foundation 2435 FOREST DRIVE Columbia SC 29204 271140183 Charitable organization SC 501 (C) 3 12a SCPH 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 Transitional Home OH 501 (C) 3 10 SCHS 1 Sisters of Charity Foundation of Cleveland 1228 EUCLID AVE HALLE BLDG 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 Assisted Living Facility 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 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 Sisters of Charity Foundation of Canton C 112105 Book