2016-11-14T08:32:51-06:00 2015-12-31 381357951 PLANTE & MORAN PLLC 65 EAST STATE ST STE 600 COLUMBUS OH 43215 990 2015-01-01 352408321 MERCY DEVELOPMENT FOUNDATION MERC 3304891000 1320 MERCY DRIVE NW CANTON OH 44708 THOMAS TURNER PRESIDENT 3304891007 2016-11-10 1 BERNIE OSTROWSKI P00366367 6148493000 2015 2017-02-10 21:41:12Z THOMAS TURNER 1320 MERCY DRIVE NW CANTON OH 44708 1491535 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. 36 30 0 115 0 0 1047861 1491295 0 0 123 240 0 0 1047984 1491535 0 0 0 0 328167 330718 0 0 0 107588 116799 435755 447517 612229 1044018 465954 1416209 82782 165319 383172 1250890 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 447517 SCHEDULE OTHE MERCY DEVELOPMENT FOUNDATION EXISTS SOLELY TO BENEFIT THE PATIENTS, PROGRAMS, AND SERVICES OF MERCY MEDICAL CENTER, A MINISTRY OF THE SISTERS OF CHARITY HEALTH SYSTEM, THROUGH PHILANTHROPY. FOUNDATION ACTIVITIES FOR 2015 INCLUDE:*STARK COUNTY DENTAL SOCIETY DONATED $100,000 THAT IS TO BE USED FOR HEALTH TREATMENT, EDUCATION AND SCHOLARSHIPS. A DESIGNATED FUND WAS ESTABLISHED TO HONOR THE DONOR'S PHILANTHROPIC SUPPORT OF MERCY DENTAL SERVICES.*ESTATE PLANNING SEMINARS AND PLANNED GIVING EDUCATIONAL OPPORTUNITIES FOR EMPLOYEES, VOLUNTEERS AND THE GREATER COMMUNITY.*CORPORATE, FOUNDATION AND GOVERNMENT GRANT SEEKING ACTIVITIES.*ANNUAL CAMPAIGN OF CARING APPEAL.*MERCY HOSPICE MEMORIALS AND TRIBUTES.*MAJOR DONOR CAMPAIGN STARTED FOR THE FACILITY TRANSFORMATION PROJECT-PHASE I:RENOVATION OF 5B.*2ND CENTURY CAPITAL CAMPAIGN FOR THE EXPANSION AND RENOVATION OF THE HOSPITAL'S EMERGENCY DEPARTMENT RECORDED CONTINUED DONATIONS AND CONCLUDED THE CAMPAIGN WITH FULFILLING THE MATCHING GRANT FROM THE SISTERS OF CHARITY FOUNDATION OF CANTON. THE MATCHING 3-TO-1 CHALLENGE GRANT AWARDED $1 FOR EVERY NEW $3 RAISED, UP TO $250,000.*DONOR APPRECIATION ACTIVITIES INCLUDING PAST PRESIDENTS OF MERCY SERVICE LEAGUE LUNCHEON, FRANK DALE-SONG OF THE ANGELS-RECEPTION AND AN EVENT AT BLOSSOM MUSIC CENTER.*BI-MONTHLY FOUNDATION BOARD MEETINGS AND STRATEGIC PLANNING RETREAT HELD.*DONOR CULTIVATION AND STEWARDSHIP ACTIVITIES INCLUDING OUR FOUNDERS DAY MASS AND RECEPTION.*SPECIAL EVENT FUNDRAISING AND SUPPORT OF THE MERCY SERVICE LEAGUE AUXILIARY. 447517 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 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 0 0 0 0 0 X 36 30 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 F TURNER PRESIDENT 10.00 30.00 X X 0 251244 42934 TERRY MOORE BOARD 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 FLEINER SECRETARY 2.00 0.00 X X 0 0 0 DAVID STEWART TREASURER 2.00 38.00 X X 0 378298 39260 LEE ANN THORN 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 THOMAS E CECCONI BOARD MEMBER 2.00 38.00 X 0 577904 59064 RICHARD E CROASDAILE JR BOARD MEMBER 1.00 0.00 X 0 0 0 CHRISTOPHER A DILORETO BOARD MEMBER 1.00 0.00 X 0 0 0 DENNIS FULMER 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 MEL HERNCANE BOARD MEMBER 1.00 0.00 X 0 0 0 FRANK KAEBERLEIN MD BOARD MEMBER 1.00 4.00 X 0 22548 0 TERRENCE KESSLER BOARD MEMBER 1.00 39.00 X 0 651367 45060 JAMES F KING MD BOARD MEMBER 1.00 0.00 X 0 0 0 MSGR JAMES KOLP BOARD MEMBER 1.00 0.00 X 0 0 0 JUDITH E LANCASTER BOARD MEMBER 1.00 0.00 X 0 0 0 JACK LIBERATOR BOARD MEMBER 1.00 0.00 X 0 0 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 STEVEN A MAXIM BOARD MEMBER 1.00 0.00 X 0 0 0 MICHAEL A MCCANN BOARD MEMBER 1.00 0.00 X 0 0 0 JENNIFER MEIER BOARD MEMBER 1.00 0.00 X 0 0 0 THOMAS M PAUMIER DDS BOARD MEMBER 1.00 0.00 X 0 0 0 JOHN M PRELAC BOARD MEMBER 1.00 0.00 X 0 0 0 WILLIAM RACINE BOARD MEMBER 1.00 0.00 X 0 0 0 WILLIAM P SCHWEIZER BOARD MEMBER 1.00 0.00 X 0 0 0 RANDY SNOW BOARD MEMBER 1.00 0.00 X 0 0 0 KATHLEEN STONEMAN BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID THOMSON BOARD MEMBER 1.00 0.00 X 0 0 0 CHRISTINA WALKER BOARD MEMBER 2.00 38.00 X 0 206284 31685 TOM WHEATON BOARD MEMBER 1.00 0.00 X 0 0 0 FONDA WILLIAMS BOARD MEMBER 1.00 0.00 X 0 0 0 0 2087645 218003 0 0 1 0 0 168805 1322490 34003 1491295 240 240 1491535 0 0 240 53229 53229 206981 206981 53864 53864 16644 16644 1600 1600 27081 27081 21104 21104 13323 13323 6539 6539 108 108 4034 4034 1036 1036 166 166 POSTAGE 28941 28941 PROGRAM EXP(ETHICS/FOUN 6638 6638 DUES & MEMBERSHIPS 4541 4541 CREDIT CARD FEES 1286 1286 402 402 447517 447517 0 0 152552 275866 500000 3324 166 3324 3158 310078 637185 465954 1416209 9600 82782 155719 82782 165319 X 42187 498680 30907 215094 310078 537116 383172 1250890 465954 1416209 X 1044018 -32388 -143912 X X 0 1 X 1 0 X X 1 MERCY MEDICAL CTR 341893439 3 1 170765 0 1 170765 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 310078 232642 -3289 2315 537116 139742 143424 27245 333 310078 134966 4776 139742 0 0 3324 166 3158 3158 DENTAL ENDOWMENT FUND 537116 STARK DENTAL CHARITABLE FUND 100069 637185 DUE TO MERCY MEDICAL CENTER 155719 155719 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, 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO DECEMBER 31, 2012. 0 1 0 0 0 0 0 0 0 THOMAS F TURNER PRESIDENT 0 203509 0 43118 0 4617 0 13089 0 29845 0 294178 0 0 DAVID STEWART TREASURER 0 311012 0 65137 0 2149 0 27060 0 12200 0 417558 0 0 THOMAS E CECCONI BOARD MEMBER 0 442491 0 119947 0 15466 0 45060 0 14004 0 636968 0 0 TERRENCE KESSLER BOARD MEMBER 0 644509 0 0 0 6858 0 45060 0 0 0 696427 0 0 CHRISTINA WALKER BOARD MEMBER 0 200889 0 0 0 5395 0 19485 0 12200 0 237969 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 SUPPLEMENTAL EXECUTIVE RETIREMENT PAYMENTS (SERP) OF $18,000 WERE MADE BY THE RELATED ORGANIZATION TO THOMAS CECCONI AND TERRENCE KESSLER. 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. X 612 35014 SELLING PRICE 0 1 1 PART I, COLUMN (B): NUMBER OF CONTRIBUTIONS REPRESENTS NUMBER OF SHARES OF STOCK DONATED. PART I, LINE 32B: THE FOUNDATION USES THE SISTERS OF CHARITY OF ST. AUGUSTINE HEALTH SYSTEM INC (SCHS) TO PROCESS THE SALE OF DONATED STOCK. SCHS IS A RELATED ORGANIZATION. 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 11 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 -170,765. INVESTMENT INCOME-ENDOWMENT & STARK DENTAL FUND 26,853. 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 11A 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 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 FOUNDATION SC 501 (C) 3 11A PROVIDENCE HOSPITALS 1 REGINIA HEALTH CENTER 5232 BROADVIEW ROAD RICHFIELD OH 44286 341722394 RETIREMENT COMMUNITY OH 501 (C) 3 9 SCHS 1 ST VINCENT CHARITY MEDICAL CENTER 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 FOUNDATION OH 501 (C) 3 11A ST VINCENT CHARITY MEDICAL CENTER 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 11A SCHS 1 HEALTHY LEARNERS 2749 LAUREL STREET COLUMBIA SC 29204 571127197 CHARITABLE ORGANIZATION SC 501 (C) 3 11A SCHS 1 JOSEPH'S HOME 2412 COMMUNITY COLLEGE AVENUE CLEVELAND OH 44115 340901676 TRANSITIONAL HOME OH 501 (C) 3 9 SCHS 1 SISTERS OF CHARITY FOUNDATION OF CLEVELAND 1228 EUCLID AVE HALLE BLDG CLEVELAND OH 44115 341832698 CHARITABLE FOUNDATION OH 501 (C) 3 11A SCHS 1 SISTERS OF CHARITY FOUNDATION OF CANTON 400 MARKET AVE N STE 300 CANTON OH 44702 341832697 CHARITABLE FOUNDATION OH 501 (C) 3 11A SCHS 1 EARLY CHILDHOOD RESOURCE CENTER 1718 CLEVELAND AVE NW CANTON OH 44703 340714462 CHARITABLE ORGANIZATION OH 501 (C) 3 11A SISTERS OF CHARITY FOUNDATION OF CANTON 1 SISTERS OF CHARITY FOUNDATION OF SC 2711 MIDDLEBURG DRIVE COLUMBIA SC 29204 570708391 CHARITABLE FOUNDATION OH 501 (C) 3 11A 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 11A 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 168805 BOOK MERCY MEDICAL CENTER B 170765 BOOK