2013-11-14T17:33:29-06:00 2012-12-31 861065772 Deloitte Tax LLP 1700 Market Street 25th Floor Philadelphia PA 191033984 990 2012-01-01 010211534 Mercy Hospital MERC 2078793000 144 State Street Portland ME 041013795 Michael Hachey 2078793000 2013-11-14 1 William J Homer P00994519 2152462300 2012 2016-02-24 21:20:13Z Eileen Skinner 144 State Street Portland ME 041013795 207556779 0 X www.mercyhospital.com X 1945 ME Mercy Hospital carries out the healing work of Christ by providing clinically excellent, compassionate healthcare for all, with special concern for the poor and disadvantaged. 29 25 2070 461 0 0 1608779 5226026 199595175 200199048 558497 352434 1434405 1276052 203196856 207053560 0 0 0 0 112207570 119455288 0 0 672460 106971762 97722438 219179332 217177726 -15982476 -10124166 197985033 192790632 129071451 131723078 68913582 61067554 Mercy Hospital carries out the healing work of Christ by providing clinically excellent, compassionate healthcare for all, with special concern for the poor and disadvantaged. 0 0 180996831 200199048 Provide access to healthcare for all people through direct patient care at Mercy's various hospital, clinical and physician locations. In providing these services, the organization absorbs significant costs that are not reimbursed through Medicare, Medicaid or other programs. In addition, as part of our mission, we maintain a charity care program with income eligibility thresholds that exceed the State of Maine income eligibility guidelines for free care (the Federal regulations do not mandate a particular eligibility requirement). The Company also provides and sponsors a number of socially responsible activities and events that have a positive impact on the lives of the residents of the Greater Portland Community. 180996831 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 1 0 0 1 161 0 2070 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 29 25 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 ME X X Douglas W Libby 2078793000 144 State Street Portland ME 041013795 Eileen Skinner 37.50 2.50 X X 0 601542 39905 William Demicco MD 37.50 2.50 X 258687 0 31209 Thomas W Yoder Jr 5.00 5.00 X X 0 0 0 Joseph R Foley 5.00 5.00 X X 0 0 0 Karen Hart 5.00 5.00 X X 0 0 0 Sr Barbara Brennan RSM 2.50 2.50 X 0 0 0 Sr Patricia Flynn RSM PhD 2.50 2.50 X 0 0 0 Joseph Gray 2.50 2.50 X 0 0 0 Margaret Hourigan 2.50 2.50 X 0 0 0 Wendy Bush 2.50 2.50 X 0 0 0 Cheryl Libby 2.50 2.50 X 0 0 0 Paul Lones 2.50 2.50 X 0 0 0 Sr Michele Aronica RSM 2.50 2.50 X 0 0 0 Brenda Miley 2.50 2.50 X 0 0 0 Lisa Miller 2.50 2.50 X 0 0 0 Thimi Mina 2.50 2.50 X 0 0 0 Sr Mary Morey RSM 2.50 2.50 X 0 0 0 Mary Louise Norton 2.50 2.50 X 0 0 0 Paul Bloch MD 2.50 2.50 X 0 0 0 Sr Patricia Pora RSM 2.50 2.50 X 0 0 0 Jon Jennings 2.50 2.50 X 0 0 0 David Small 2.50 2.50 X 0 0 0 Sr Kathleen M Smith RSM 2.50 2.50 X 0 0 0 Nelson A Toner Esq 2.50 2.50 X X 0 0 0 Isabella Thurston MD 2.50 2.50 X 0 0 0 Bruce Wagner 2.50 2.50 X 0 0 0 William Schirmer MD 2.50 2.50 X 0 0 0 Daniel P Sheridan PhD 2.50 2.50 X 0 0 0 John Walters 2.50 2.50 X 0 0 0 Greg Otterbein 2.50 2.50 X 0 0 0 Anthony Marple 37.50 2.50 X 0 273571 29751 Michael Hachey 37.50 2.50 X 0 369958 41450 Robert Nutter 37.50 2.50 X 0 324189 39222 Scott Rusk 37.50 2.50 X 0 365423 42117 James Shrum 37.50 2.50 X 0 235694 28599 Gregory Pomeroy 40.00 X 847009 0 37595 Frederick Poulin Jr 40.00 X 538361 0 25384 Gregory Adey 40.00 X 504835 0 35530 Marc Hodroff 40.00 X 508209 0 30419 Craig Brett 40.00 X 508700 0 29748 Edward Ted McCarthy 40.00 0.00 X 144300 0 22331 Daniel Merson DO 40.00 0.00 X 156955 0 24842 3467056 2170377 458102 156 1 1 0 ACCRETIVEHEALTH INC 401 North Michigan Ave Suite 2700 Chicago IL 60611 Revenue Cycle Management 3576329 SYNERNET INC 110 Free Street Portland ME 04101 Transcription; Equip Ser & Maint. 1925563 GENERAL ELECTRIC MED SYSTEM 8200 West Tower Ave Milwaukee WI 53223 Equipment Service & Maint. 1835360 SEABREEZE PROPERTY SERVICES PO Box 617 Portland ME 04102 Grounds Mgmt & Maint. 932517 BCA FINANCIAL SERVICES INC 18001 Old Cutler Road Suite 462 Miami FL 33157 Collections 909901 46 144825 164996 4916205 27551 5226026 Patient Service Revenu 621110 196372221 196372221 All Other Program Serv 621110 3826827 3826827 200199048 219199 219199 252784 0 252784 252784 252784 279259 265152 0 411176 279259 -146024 133235 133235 187458 144825 92043 95415 95415 Cafeteria Income 722210 927853 927853 927853 207053560 200199048 0 1628486 X 2859590 2708031 151559 93960400 88347253 5402853 210294 3445183 3240631 193114 11438 12932078 11104591 1789157 38330 6258037 5792765 450277 14995 184264 12913 171351 348038 348038 119000 119000 25340054 14451832 10626980 261242 596451 2883 582098 11470 40028440 37807779 2109599 111062 7272332 7272332 6256439 5903915 352524 248759 213839 28517 6403 10488 9656 832 2325581 26260 2299321 10545701 8164723 2376238 4740 2969193 2636559 332634 Dues and Subscriptions 1275753 403159 870108 2486 Auxiliary 145042 145042 0 0 Amortization 56903 25000 31903 0 217177726 180996831 35508435 672460 5729864 3117383 29729152 29890429 4672245 4994851 1094317 1025590 194559702 93758392 104510604 100801310 14568913 10583199 4637769 2775087 124167 64167 32918002 39538616 197985033 192790632 19399735 19576196 1890248 972458 73170121 70953524 298118 30530 2384 34580817 39920398 129071451 131723078 X 66899973 56765101 971663 2524411 1041946 1778042 68913582 61067554 197985033 192790632 X -10124166 2145542 132596 X X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 500 0 0 1 102200 0 1 16300 119000 0 Explanation of Lobbying Activities: Part II-B, Line 1: Percentage of dues paid to Maine Hospital Association (MHA) and American Hospital Association (AHA) used by MHA and AHA for lobbying purposes. 1041946 656155 79941 1778042 1052325 1850 -12229 1041946 983424 4188 64713 1052325 873360 31500 78564 983424 1086370 1500 -214510 873360 1.00000 0 0 6220656 6220656 102898808 37768462 65130346 2886912 1140634 1746278 78237161 53943813 24293348 4316165 905483 3410682 100801310 Due from Third-Party Payors 25206827 Other Accounts Receivable 4121792 Unamortized Financing 645422 Other Assets 1479387 Market Value Swap Asset 584188 Insurance Recoveries 7501000 39538616 Market Value Swap Liability 595416 Workers Compensation Reserve 3454000 Accrued Pension Liability 2285447 AR Credit Balances 2169318 Due to Third Party Payors 5519794 Health Claim Reserves 1680000 Due to Related Companies 12579242 Misc. Reserves 10509209 Deferred Compensation 1127972 39920398 Description of Intended Use of Endowment Funds: Part V, Line 4: Endowment funds restricted uses include funding operations, educational programs, hospice and Alzheimer's screening. Gary's House Golf 206228 89825 116403 2633 1000 15751 700 34434 Mercy Golf 59665 26000 33665 1655 0 6381 0 16850 2 66390 29000 37390 0 2360 4244 900 5135 332283 144825 187458 4288 3360 26376 1600 56419 92043 95415 1 1 1 X 1 X 1 1 1 0 0 7108665 7108665 0.03270 30744214 23457238 7286976 0.03360 37852879 23457238 14395641 0.06630 357461 77120 280341 0.00130 357461 77120 280341 0.00130 38210340 23534358 14675982 0.06760 129802 129802 0.00060 129802 129802 0.00060 1 6896005 224136 64671626 84824985 -20153359 X 1 1 1 1 Mercy Hospital

144 State Street Portland ME 04101

X X X Mercy Hospital 1 1 1 200.000000000000 1 250.000000000000 1 X X X X X X 1 1 X X X X 1 0 X 1 X 0 0 Part I, Line 6a: The organization's community benefit activities are included in Catholic Health East's Community Benefit Report (EIN:23-2929748). Part I, Line 7: The method used was a cost-to-charge ratio derived from the most recent Medicare Cost Report data. Part II: Mercy Hospital contracts with Advanced Patient Advocacy, an organization that works with patients who do not have insurance or have minimal health coverage to determine if they qualify for state, federal, or private assistance programs. Advanced Patient Advocacy staff educate patients and their families about coverage options available to help cover the cost of recent medical care, navigate the enrollment process for patients and connect and enroll patients with the program(s) that best meet the patient's unique healthcare needs. Part III, Line 4: Mercy Hospital provides an allowance for doubtful accounts for estimated losses resulting from the unwillingness of patients or third-party payors to make payments for services. The allowance is determined by analyzing historical data and trends. Accounts receivable are written off against the allowance for doubtful accounts when managment determines that recovery is unlikely and refers collection efforts to a third-party collector under contract. Recoveries of bad debt write-offs reduce bad debt expense. The costing methodology used for determining Mercy Hospital's bad debt expense at cost is applying a cost-to-charge ratio on the value of the organization's bad debt expense. To determine the estimated amount of bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy, the calculated percentage of total charity care to total gross patient revenue was applied to the total bad debt expense. The resulting amount was multiplied by the Medicare cost-to-charge ratio. Although our charity care policies and procedures make every effort to identify thoses patients who are eligible for charity care before the billing process begins, often it is not possible to make an appropriate determination until after the billing and collection cycle has commenced. The rationale for including bad debt amounts in community benefits would be to account for those patients who were classified as bad debt expense, but would have qualified for charity care if sufficient information had been availiable to make a determination of their eligibility.Discounts on patient accounts are not considered to be bad debts. Part III, Line 8: The costing methodology to determine Mercy Hospital's Medicare shortfall is calculated by applying a cost-to-charge ratio on the value of gross Medicare revenue to determine an estimate of total revenue received from Medicare and comparing this amount to allowable costs of care. Part III, Line 9b: Mercy Hospital's written charity care policy clearly states that patients who are known to qualify for charity care or financial assistance are covered under Mercy Hospital's charity care policy. The following is taken from Mercy Hospital's charity care policy and outlines specific parameters for collection practices for charity care patients:"H. Hospital Collection EffortsSelf-pay balances may be transferred to professional collection agencies when the accounts complete a patient statement dunning cycle (e.g., approximately 90 days) with no payment from the patient or proof of eligibility for Financial Assistance or other programs. Accounts with applications pending for Financial Assistance or other assistance programs are held until the outcome of the application. A "pending application" is defined as an application that has been fully completed by the patient, received by Mercy's Financial Assistance area, and is in the process of being determined for eligibility.1. It is acceptable (but not preferable) to take an account through the full collection cycle and later reclassify it as Financial Assistance, as long as a consistent process is followed and a legitimate basis is established for the patient's inability to pay.2. In some cases, a patient eligible for Financial Assistance may not have been identified prior to initiating external collection action. Accordingly, each collection agency engaged is aware of the policy on Financial Assistance. This allows the agency to report amounts that they have determined to be uncollectible due to the inability to pay in accordance with the Financial Assistance eligibility guidelines. If a collection agency identifies special circumstances demonstrating a particular patient as being unable (versus unwilling) to pay their bill, per the eligibility criteria of this policy, their liability may be considered Financial Assistance, even if they were originally classified as a Bad Debt.3. Collection agencies shall not, in dealing with uninsured patients at or below the MHSM Financial Assistance guidelines, use or threaten to use wage garnishments or liens on primary residences as a means of collecting on unpaid hospital bills.4. When a patient's financial picture indicates that he/she has the financial resources to pay, a payment plan may be established at the patient's request; therefore, a financial application is not necessary.5. If the patient/responsible party does not cooperate with MHSM, i.e., return of necessary documentation within 60 days of receipt of denial for missing documents (Appendix E), and every attempt to obtain the best resolution of the account has been made; the account may be processed for placement with a MHSM collection agency.I. Collection AgencyIn some cases, a patient eligible for Financial Assistance may not have been identified prior to initiating external collection action. Accordingly, each collection agency engaged is aware of the MHSM policy on Financial Assistance. This allows the agency to report amounts that they have determined to be uncollectible due to the inability to pay in accordance with the Financial Assistance eligibility guidelines. If a collection agency identifies special circumstances demonstrating a particular patient as being unable (versus unwilling) to pay their bill, their liability may be considered Financial Assistance, even if they were originally classified as a Bad Debt. The patient should be reclassified to Financial Assistance." Mercy Hospital Part V, Section B, Line 18e: The organization does not take any of the actions listed on Line 17 with respect to patients eligible for assistance under the organization's FAP. Mercy Hospital Part V, Section B, Line 20d: The hospital discounts charges to patients eligible for financial assistance based on income levels and other factors. In no case is any patient eligible for financial assistance charged an amount greater than charges that would be charged under Medicare. Part VI, Line 2: IntroductionMercy Hospital was founded in 1918 as the Queen's Hospital in response to a devastating flu epidemic. Mercy strives for the highest standards of care for patients' physical, mental, and spiritual needs and has a mission that is grounded in a special commitment to care for the poor and disadvantaged. Mercy continues its long-held tradition of responding to distinct community needs drawing from the Annual Point in Time Survey; the CDC's Behavioral Risk Factor Surveillance System reports; the 2011 Portland Minority Health Assessment; and the annual report of Portland's Public Health Department. Primary data from Mercy Hospital regarding trends associated with Emergency Department (ED) utilization and services for the uninsured and charity care patients were also reviewed to shape planning. Access to comprehensive healthcare services that integrates substance abuse and mental health treatment, supportive housing, and immunizations for marginalized population were identified as gaps in services.Greater Portland InfrastructureIn March 2009, federal stimulus funds were awarded to the Public Health Division to establish the Portland Community Health Center (PCHC). PCHC is a full-service, primary care medical facility serving the greater Portland area. PCHC accepts all private insurance as well as Medicare and Medicaid. There is a sliding fee scale available for patients without insurance. PCHC's focus is on becoming "a medical home" for those in need of consistent care and services. Interpreter services are available for those whose primary language is not English. The new Federally Qualified Health Center is located in the Parkside neighborhood, which is one of the most socioeconomically diverse and densely populated areas of Portland. In 2012, PCHC served nearly 3100 patients with 48% of patients reporting their preferred language to be a language other than English.The Healthcare for the Homeless Clinic, also a Federally Qualified Health Center in Portland, offers adult and adolescent primary care, mental health and substance abuse treatment, medical respite care, dental services, case management, and outreach to the City's most vulnerable populations. Funding comes from Federal Health Resources and Services Administration, other state, federal, and local grants, and MaineCare and Medicare reimbursement. In Fiscal year 2012, the Clinic provided primary care for over 1,395 patients with in excess of 4,624 visits; oral health services to 1,233 patients; substance abuse treatment to 392 with 2,305 visits; and mental health services to 519 patients with 2,643 visits. The percentage of Primary Care patients with their diabetes under control rose from 51% to 57%. The percentage of Primary Care patients with effectively treated hypertension rose from 52% to 54%. Primary Care increased preventative screenings for cervical cancer in female patients 21 to 64 years old from 33% to 42%. Also, the India Street Public Health Clinic offered a variety of programs in 2012 focused on the testing, treatment, management, and immunization of various infectious diseases. In 2012, the HIV Positive Care Program cared for 211 patients; the Immunization Program served 1,801 patients; the HIV/STD Prevention Clinic served 1,270 patients; the Needle Exchange Program served 449 clients with 108,071 needles exchanged. The Portland Community Free Clinic provided primary care for 497 patients without insurance. In 2012, Mercy Health System provided $ 1,884,162.40 worth of Ancillary Services for Programs associated with the City of Portland's Public Health Division.As a Refugee Resettlement Community, the City of Portland is home to people from all over the world, with sixty languages spoken at the local public schools. The Minority Health Program (MHP) serves as a bridge between service providers and the ethnic communities working to eliminate disparities and ensure access to health care and social services. The MHP uses a network of Community Health Outreach Workers (CHOWS), a portion of which are funded by Mercy Health System, in an effort to link community members to primary care services. Mercy Hospital, in partnership with the City of Portland's Minority Health Program hosts an annual health screening event, Exercise for Health and Love and the Latino Soccer Tournament. The Exercise for Health and Love provided Diabetes Education for 839 participants and conducted post-event follow up to connect community members with primary care physicians. In 2012, Mercy Health System provided $ 25,000 for the CHOW Program and additional in-kind support for associated programs. Community Health Outreach Workers provided outreach and services to 89 new clients and 394 existing clients. Surveys were conducted for 22 ethnic stores in five districts and assisted five stores in becoming WIC authorized (The Special Supplemental Nutrition Program for Women, Infants, and Children-WIC). At farmers' markets, over 200 people were reached through outreach using culturally competent materials. The Annual Health, Love, and Exercise event, a partnership between Mercy Health System and Portland's Minority Health Division includes screenings for Cardiovascular Disease and Diabetes. In 2012, 839 participated. Mercy OverviewMercy Hospital is a 230-bed, $200 million net revenue organization with three acute care campuses: Mercy State Street, Mercy Fore River, and Mercy Westbrook, as well as four urgent care facilities: Mercy Windham, Mercy Gorham Crossing, Mercy Westbrook and Mercy Yarmouth. Mercy Hospital provides a wide array of clinically superior services and programs with a breadth and depth that compliments its status as the fifth largest hospital in the state. Mercy has evolved into a health care provider increasingly dedicated to outpatient services, demonstrated by a revenue base that is nearly 70% outpatient services from approximately 60% just four years ago. Mercy's service area includes hospital locations at State Street, Fore River, and Westbrook; Primary and Specialty Practices in Falmouth, W. Falmouth, Fore River, Gorham, Portland, Standish, Westbrook, Windham, and Yarmouth; Women's Health at the Fore River campus and VNA Home Health & Hospice services. Mercy's extensive network of Specialty Provider services includes: Addiction Medicine, Breast Care, Cardiology, Diabetes, Eating Disorders, Foot & Ankle Orthopaedics, Gastroenterology, General Surgery, Hematology/Oncology, Obstetrics/Gynecology, Otolaryngology (ENT), Pain (Medical & Interventional), Pulmonology, Urology/Urogynecology, Wound Healing, Spine Surgery and Thoracic Surgery.All Mercy Primary Care and Specialty Care Practices are accepting new patients regardless of their ability to pay. Substance Abuse and Mental Health ServicesMaine residents show high patterns of ED utilization for a wide range of mental health issues, including senility and organic mental disorders, major depressive disorders, bipolar disorders, schizophrenia, and anxiety disorders. The primary data reviewed showed a significant prevalence of mental illness and substance abuse among frequent users of Emergency Services with 22.67% of visits attributed to mental illness.Mercy's Recovery Center is the State's largest substance abuse treatment service, with 24 inpatient detox beds, a partial hospitalization program (five hours per day, six days per week), an intensive outpatient program (three hours per day, six days per week), level one group therapy sessions offered days and evenings, a family program offered every Saturday, and Mercy Addiction Medicine, a medical office practice with four addictionologists, physician assistants and nurse practitioners. Part VI, Line 2: Integrated Behavioral Health Services Mercy's Patient Centered Medical Home (PCMH) initiative is grounded in highly developed pathways of care and high quality standards of care, our expertise and seamless access between primary, secondary, and tertiary care offerings. At entry, Mercy provides patients with a Health History Assessment. Self-Care Plans for patients may include HbA1C tests for diabetes, Chronic Obstructive Pulmonary Disease (COPD) exacerbation, asthma relief, weight loss, smoking cessation, and appointment maintenance and progress. Our goal in providing PCMH is to implement a person-centric model of care management clearly and consistently. At Mercy, we integrate behavioral health services and techniques in all areas of patient care and develop individual service plans that address substance abuse, basic needs, physical health, mental health, spiritual health, social connectedness, meaningful work, and recreation. An integral goal with PCMH is to implement a person-centric model of case management clearly and consistently. Our goal is to maintain the continuity of the individual/family care coordinator relationship throughout the continuum of services with the support of an interdisciplinary team with a broad array of subject matter expertise. The objectives of care coordination include:Coordinating the mix of services chosen by the individualIdentifying providers preferred by the individualProviding services in the most integrated, least restrictive, and most cost-effective settingMaximizing the likelihood of results desired by the individualMaximizing safety and minimizing riskEliminating barriers to effectiveness in the real worldEngaging and empowering patients/families in improving their health and their health careIn 2012, four Mercy Primary Care Centers will achieve Patient Centered Medical Home designation, which will allow for case management and person-centric care for patients with mental illness and substance abuse concerns regardless of their ability to pay.Supportive Housing - McAuley Residence ExpansionMcAuley Residence is Mercy Hospital's comprehensive program for at-risk women in early recovery, with or without children. The 24-month program serves at-risk women and their children primarily from southern Maine, but some may come from other parts of the state. The program's mission is to provide an empowering environment where a woman can gain stability, build life skills, develop goals, and lead a more meaningful, holistic life. At McAuley Residence, women have access to clinical staff and a diverse group of providers, to help them gain a stable foothold in society. Women who come to the program have been abused at one time, are recovering from addiction, are homeless, have no savings, no job, have not completed their education, have no rental subsidy, have not had recent medical or dental care, and have little knowledge about available resources. In the past 24 years, McAuley Residence has served over 225 women and children. Staff at McAuley Residence serves on the Emergency Shelter Assistance Committee (ESAC) in Portland and the Region One Homeless Committee for the State of Maine, in an effort to leverage resources and participate in the collaborative planning approach to address homelessness. Each year, McAuley Residence turns away hundreds of appropriate referrals due to limited capacity. Responding to an increased need for supportive housing in Southern Maine, Mercy Hospital formed a partnership with Community Housing of Maine, Inc. (CHOM) to expand McAuley Residence, moving from our current location into a larger facility with fifteen apartments dedicated to women in early recovery, who are enrolled in the McAuley Residence program. There are an additional twenty-eight apartments in the new facility for affordable permanent housing for families. CHOM provides the property management and owns the facility, instead of Mercy Health System of Maine. Mercy offers two years of intensive case management, substance abuse counseling, primary care, and safe sober housing for previously homeless women with children. In January of 2013, McAuley Residence moved and expanded from six apartments to fifteen, with many of the new families coming from the local homeless shelters.Increased Immunization Rate for Vulnerable PopulationsThe Cumberland District Public Health Council emerged from the efforts of the statewide Public Health Work Group that divided the state into eight public health districts based on county and/or multi-county lines. The Council was convened in December 2006 following the Public Health Work Group's decision to require district-wide coordinating councils. The Council's mission is to promote the health of all our communities by providing information, coordination, collaboration, and advocacy. The primary focus of the Council thus far has been to ensure that public health services are provided to all towns in the Cumberland Public Health District. On September 17, 2010, the Council adopted Flu/Pneumococcal Vaccine as its "population health priority." This does not mean that other areas are not also being pursued actively by many groups, including the Council, but rather that the Council will map its activities related to this area to determine how -- by working together in a coordinated manner -- the various health related organizations and groups can achieve better outcomes. In particular, the Council is hoping to improve indicators in the capacity to educate, mobilize partnerships, and link people to personal health services. The Cumberland District Public Health Council meets bi-monthly and reviews the reports from their subcommittees, such as the Health Data Committee, Communications, and Healthy Cumberland Committee.Mercy is an active participant on the Cumberland District Public Health Council (CDPHC). Colleen Hilton, CEO of Mercy's VNA Home Health & Hospice, a division of Mercy Health System, has served as chair of CDPHC. VNA is very active in public health in both the Cumberland and York counties and public health districts. The organization annually delivers an array of home health and hospice care services to over 3,000 predominantly elderly clients in their homes, in nursing homes and in assisted living facilities. Through its Health Promotion Department, VNA has an extensive history of providing wellness education across southern Maine. In addition to home health and hospice services, in 2012, VNA conducted over 7200 preventive health screenings for residents in senior housing locations, at senior meal sites and across the community at health fairs, school-based events, and special event.Through local collaboration, formal and informal partnerships, and advocacy, Mercy Hospital/Mercy Health System of Maine will be well positioned to meet the identified needs and improve the overall health and wellbeing of the communities that we serve. Through rational health planning and budgeting, we routinely collaborate with partners to reevaluate current programs, to address identified public health needs, and build a sustainable infrastructure. Part VI, Line 3: The following is taken from our charity care policy and describes how the organization informs and educates patients on charity care: Public Notice of the availability of assistance through this policy is made through each of the following means:1. Posting notices in a visible manner in locations where there is a high volume of inpatient or outpatient admitting/registration, such as emergency departments, billing offices, admitting offices, and hospital outpatient service settings.2. Posting notice of availability of assistance and contact numbers and location on the organization's website.3. Providing uninsured patients the Financial Assistance application upon registration to the hospital. Upon request, a full text copy of the Charity Care policy should be made available. 4. Making available to the public on a reasonable basis: the annual charity care provided; the unreimbursed costs of care provided to the beneficiaries of government programs that serve the poor (being defined as shortfalls between costs and off-setting reimbursement/revenue that the organization experiences in providing care under the Medicaid and local/county indigent programs for care provided to Medicare beneficiaries who are dually eligible for Medicaid). Posted notices (as listed above) shall be in the primary languages(s) of the service area and in a manner consistent with all applicable federal and state laws and regulations. Should any provision of this Policy conflict with the State of Maine requirements surrounding Charity Care, State law shall supersede the conflicting policy provision and the facility shall act in conformance with applicable State law.Mercy Hospital contracts with Advanced Patient Advocacy, an organization that works with patients who do not have insurance or have minimal health coverage to determine if they qualify for state, federal, or private assistance programs. Advanced Patient Advocacy staff educates patients and their families about coverage options available to help cover the cost of recent medical care, navigate the enrollment process for patients, and connect and enroll patients with the program(s) that best meet the patient's unique healthcare needs. Part VI, Line 4: The geographic area served by Mercy Hospital programs is primarily Cumberland and York counties, in south coastal Maine. Two distinct geographic exceptions are the Mercy Recovery Center, Maine's largest addiction treatment facility, which serves patients statewide, and the Northern New England Eating Disorders Program, the only such program located north of Massachusetts. The "community" can be defined as the City of Portland or the larger geographical service area (primarily the two counties, but with a widening catchment area). Portland - Mercy's acute care campuses at Fore River and State Street are located in Portland (Cumberland County), the state's most populous city (pop. 66,214). While population density for the state as a whole is 43 people per square mile, Portland itself is 3,107 people per square mile. Median income is lower in Portland compared to the state of Maine, ($45,153 vs. $47,898). As a designated Refugee Resettlement city, Portland has a more culturally and ethnically diverse population than Maine (16.4% vs. 5.6% non-white, non-Hispanic) and a larger percentage of residents are foreign born (10.7% vs. 3.3%). Portland is home to the largest population of Somali / Sudanese / Rwandan and other pan-African populations in Maine, as well as large populations of Hispanics, Asians, Russians and other ethnic groups. In summary, Portland is more densely populated, poorer and more culturally diverse than the rest of Maine. Portland is also home to a significant population of homeless individuals, drawn to the city by the network of homeless-serving social service agencies, including a dedicated FQHC operated by the City of Portland Public Health Division, located less than a mile from Mercy's State Street campus. This FQHC is strictly for homeless individuals, though Portland Public Health and Mercy Hospital collaborate to provide clinic based services to the poor who are Medicaid (MaineCare) ineligible by subsidizing the Portland Free Clinic with funding and volunteers. A second FQHC, the Portland Community Health Center for MaineCare eligible individuals and children opened in 2009 Mercy Hospital provides the necessary ancillary services and referrals for inpatient admissions from the FQHCs.Mercy's involvement in a wide range of community benefit initiatives to improve the health and lives of individuals and families in the City of Portland is discussed elsewhere in this narrative. Overall Service Area - While the Portland community is a major focus of Mercy healthcare and community involvement, the organization's catchment area (Cumberland and York counties, and wider) also includes more rural areas such as Gorham, Standish and Buxton (designated as "very rural" or "rural"). To facilitate access to primary care - the basic building block of healthcare reform - in these outlying rural areas, Mercy has established primary care practice (PCP) sites in several of them: Windham; Gorham; Standish; Falmouth; Yarmouth; and West Falmouth. These are in addition to PCP sites in Portland and Westbrook." Part VI, Line 5: In addition to the activities listed in Part VI, Line 2, the Hospital maintains an open medical staff and is governed by a board consisting largely of independent members. Part VI, line 7: List of states receiving Catholic Health East's community benefit report: AL, CT, DE, FL, GA, ME, MA, NJ, NY, NC, PA X X 1 1 1 1 0 0 0 1 0 0 0 Eileen Skinner 0 367597 0 96836 0 137109 0 11250 0 28655 0 641447 0 0 William Demicco MD 238000 0 1608 0 19079 0 11869 0 19340 0 289896 0 0 0 Anthony Marple 0 210596 0 25551 0 37424 0 10234 0 19517 0 303322 0 0 Michael Hachey 0 239006 0 80232 0 50720 0 12339 0 29111 0 411408 0 0 Robert Nutter 0 223606 0 70600 0 29983 0 10580 0 28642 0 363411 0 0 Scott Rusk 0 295006 0 31164 0 39253 0 13128 0 28989 0 407540 0 0 James Shrum 0 87692 0 23598 0 124404 0 8800 0 19799 0 264293 0 0 Gregory Pomeroy 500000 0 353764 0 -6755 0 10475 0 27120 0 884604 0 0 0 Frederick Poulin Jr 444808 0 91667 0 1886 0 0 0 25384 0 563745 0 0 0 Gregory Adey 376846 0 108575 0 19414 0 13166 0 22364 0 540365 0 0 0 Marc Hodroff 375308 0 111500 0 21401 0 12265 0 18154 0 538628 0 0 0 Craig Brett 462769 0 43686 0 2245 0 5435 0 24313 0 538448 0 0 0 Edward Ted McCarthy 134517 0 1400 0 8383 0 8700 0 13631 0 166631 0 0 0 Daniel Merson DO 147779 0 13825 0 -4649 0 1164 0 23678 0 181797 0 0 0 Part I, Line 1a As part of the compensation plan, executives receive a discretionary spending account for certain eligible expenses incurred. Payments of these expenses are made on a grossed-up basis. A related organization, Mercy Health System of Maine, provides local housing for one executive. Part I, Line 3 The organization relied on a related organization that used one or more of the methods described below to establish the top management official's compensation: - Compensation committee - Independent compensation consultants - Written employment contract - Compensation survey or study - Approval by the board or compensation committee. Part I, Lines 4a-b Part I, Lines 4a-b: Line 4a: James Shrum received a severance payment in the amount of $102,308. Line 4b: Supplemental Executive Retirement Plan is provided to certain key executive employees. Contributions made to the plan on their behalf are vested and reflected in their compensation at the time of the contribution. Part I, Line 6 An individual listed on Form 990 Part VII Section A received incentive compensation related to the contribution margin associated with office-based services. Under this arrangement, the individual was paid (a) up to 17.5% of the excess of the current year's actual contribution margin over the prior year's contribution margin and (b) up to 17.5% of the excess of the current year's actual contribution margin over the budgeted contribution margin with a combined payment cap not to exceed $120,000. A Maine Health and Higher Educational 010314384 560425G61 2006-12-20 68400000 Construction of Fore River Hospital 0 0 0 B Maine Health and Higher Educational 010314384 560427JA5 2010-06-24 11275000 Refinancing 1998A Bonds 0 0 0 A 1475000 68400000 4710502 496240 195080 62998175 2008 0 0 1 1 B 1455000 11275000 1097744 112393 10064863 2010 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 1 1 0 1 Pallas Capital Corp 2.500000000000 1 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 Schedule K Supplental Information Part III, Line 3a: The Company has entered into various management and service contracts. Collectively, these contracts do not constitute an amount of private business use that exceeds the prescribed percentage. William Demicco MD William Demicco, MD, Board Member 263763 Dr. Demicco is a Mercy Hospital employed Pulmonologist and is paid for his work as a physician. 0 UNUM Joseph R Foley, Board Member 112524 Mercy Hospital purchases employee LTC insurance from UNUM, where Mr. Foley is an executive and an officer. 0 Yvonne Bonney Mina Thimi Mina, Board Member 158004 Mr. Thimi Mina, a Board Member of Mercy Hospital, is married to Ms. Yvonne Bonney Mina, an employee of Mercy Hospital who was paid a salary for her work as a CRNA in 2012. 0 X 9 27551 Cost/Selling Price 0 0 1 0 Method for Determining Number of Contributors: Part I, Column (b): Nine Contributions. Form 990, Part VI, Section A, line 6 Mercy Health System of Maine (MHSM) is the sole member of Mercy Hospital. Form 990, Part VI, Section A, line 7a MHSM is the sole member of Mercy Hospital. MHSM approves all members of the Board of Trustees of Mercy Hospital. Form 990, Part VI, Section A, line 7b MHSM has reserved powers in the following areas: - changes in articles of incorporation; - in all Bylaws Provisions, appoint and remove Trustees; - approve philosophy and mission, strategic plan, operating plan and budget; - significant financial transactions, significant budget variances and - establishment or dissolution of organizational relationships. Form 990, Part VI, Section B, line 11 The Executive Committee of the Board of Directors/Trustees received education about the Form 990 during the October Executive Committee meeting. The Executive Committee discussed significant issues included in the draft Form 990 for MHSM and for Mercy Hospital during this meeting. The Executive Committee endorsed the Finance and Audit Committee's approval of the review process of the Form 990 for MHSM and Mercy Hospital during the October meeting. The Finance and Audit Committee of MHSM received education about the Form 990 at the September Committee meeting and reviewed the Form 990 for MHSM and Mercy Hospital at the September Committee meeting. The Finance Committee approved the review process of the Form 990 for MHSM and Mercy Hospital during the September Finance Committee meeting. Form 990, Part VI, Section B, line 12c Mercy Hospital Attachment A to the Bylaws sets forth the organization's conflict-of-interest policy and processes. Annually, all those serving Mercy Hospital in a fiduciary capacity, including directors, trustees, officers, non-board committee members and key employees receive a copy of the policy and annual disclosure statement to be completed. Disclosures of financial interest or other reportable circumstances as defined in the policy are submitted and reviewed by the organization's Chairman of the Board and Compliance Officer. Summary information is reported to the Governance Committee and entire board. This is available to the board throughout the year as business comes before the board or management for action. The policy contains a continuing affirmative obligation on all affected individuals to disclose compensation or other circumstances throughout the year which may rise to the level of an actual or apparent conflict. The determination of whether a disclosed financial or other interest constitutes a conflict of interest is made by the board or an appropriate committee thereof comprised of dis-interested persons and without the participation of the affected individual except to respond to questions about the disclosure. The policy further addresses the procedure for the board's further consideration of the proposed transaction/matter without the participation of the affected person and the documentation of the proceedings. Lastly, the policy addresses potential disciplinary action for violations of the policy. The policy is available to the public upon request. Form 990, Part VI, Section B, line 15 Mercy Hospital's process for determining compensation includes the following: The board has an independent committee review and approve all elements of remuneration for all disqualified parties, as well as other key management. The board/committee has an established compensation philosophy which details the objectives of market positioning and pay elements. The committee engages with external consultants to provide market data comparing Mercy Hospital roles to similarly sized health systems utilizing both title and job content comparisons. The committee reviews the market analysis, approves any salary adjustments for the executive and employed physician populations, considers both reasonableness and effectiveness of all remunerative programs and establishes the performance expectations which are incorporated into the incentive plan. All of these discussions and decisions are documented through the provision of meeting minutes. Form 990, Part VI, Section C, line 19 Organizational Articles of Incorporation, Corporate Bylaws, governance policies, conflict-of-interest policy and audited financial statements are available upon request. IRS Form 990 is posted on the Mercy Hospital website. Other Fees Form 990, Part IX, line 11g Service contracts: Program service expenses 3,477,389. Management and general expenses 703,935. Fundraising expenses 0. Total expenses 4,181,324. Temp/contract labor: Program service expenses 3,391,641. Management and general expenses 313,240. Fundraising expenses 0. Total expenses 3,704,881. Other: Program service expenses 7,582,802. Management and general expenses 9,609,805. Fundraising expenses 261,242. Total expenses 17,453,849. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Transfers to/from Affliliates 132,596. Form 990, Part XII, line 2a: Financial statements were audited on a consolidated basis. Average hours devoted to related organization(s): Form 990, Part VII, Section A: Individuals compensated by a related organization have responsibilities and perform services for Mercy Hospital and Mercy Health System. The amount of compensation appearing in Columns (E) and (F) reflect the services performed for the entire health system as a whole and not merely a single organization within the health system. Disclosure Statement Related to Form 5471 Filed by Catholic Health East and Saint Michael's Medical Center Under the constructive ownership rule of Internal Revenue Code Sections 318(a) and 958(b), the organization is required to file Form 5471, Information Return of U.S. Persons With Respect to Certain Foreign Corporations, as a Category 4 and/or Category 5 filer with respect to Stella Maris Insurance Company Limited and Chestnut Risk Services, LTD (collectively, the "foreign corporations"). This filing requirement is, or will be, satisfied through the filing of Forms 5471 with respect to the foreign corporations on the organization's behalf by the U.S. organizations identified below. Foreign Corporation: Stella Maris Insurance Company U.S. Organization: Catholic Health East Address: 3805 West Chester Pike, Suite 100, Newtown Square, Pennsylvania 19073 Identifying Number of U.S. Tax Return with Which Form 5471 was filed: 23-2929748 IRS Service Center Where U.S. Return Was Filed: Ogden, UT Foreign Corporation: Chestnut Risk Services, LTD U.S. Organization: Saint Michael's Medical Center Address: 111 Central Avenue, Newark, New Jersey 07102 Identifying Number of U.S. Tax Return with Which Form 5471 was filed: 26-2616046 IRS Service Center Where U.S. Return Was Filed: Ogden, UT Seton Real Estate Holdings 1300 Massachusetts Avenue Troy NY 12180 320393870 Management Real Estate NY Seton Health System Inc Catholic Health East 3805 West Chester Pike Suite 100 Newtown Square PA 19073 232929748 Management Services PA 501(c)(3) Line 11c, III-FI N/A 1 Continuing Care Management Services Network 3805 West Chester Pike Suite 100 Newtown Square PA 19073 352336834 Management & Support Services PA 501(c)(3) Line 11b, II Catholic Health East 1 VNA Home Health & Hospice 50 Foden Road South Portland ME 04106 010246804 Home Health & Hospice ME 501(c)(3) Line 11a, I Mercy Health System of Maine 1 Mercy Health System of Maine 144 State Street Portland MA 04101 010484074 Management & Support Services ME 501(c)(3) Line 11c, III-FI Catholic Health East 1 Sunnyview Hospital & Rehabilitation Center Foundation 1270 Belmont Ave Schenectady NY 12308 222505127 Supporting foundation NY 501(c)(3) Line 11a, I Sunnyview Hospital & Rehabilitation Ctr 1 St Mary's Woodland Village Inc 1300 Massachusetts Avenue Troy NY 12180 141675183 Discontinued Operations NY 501(c)(3) Line 9 Seton Health System Inc 1 Mercy Care for Kids Inc 310 South Manning Blvd Albany NY 12208 141717564 Day care center NY 501(c)(3) Line 9 St Peter's Health Care Services 1 Our Lady of Mercy Life Center 2 Mercycare Lane Guilderland NY 12084 141743506 Nursing Home Facility NY 501(c)(3) Line 3 St Peter's Health Care Services 1 St Peter's Auxiliary 315 South Manning Blvd Albany NY 01228 222843206 Auxiliary NY 501(c)(3) Line 11a, I St Peter's Health Care Services 1 St Peter's Health Care Services 315 South Manning Blvd Albany NY 12208 222702507 Management & Support Services NY 501(c)(3) Line 9 St Peter's Health Partners 1 St Peter's Hospital 315 South Manning Blvd Albany NY 12208 141348692 Hospital NY 501(c)(3) Line 3 St Peter's Health Care Services 1 St Peter's Hospital Foundation Inc 319 South Manning Blvd Suite 309 Albany NY 12208 222262982 Fundraising & Public Relations NY 501(c)(3) Line 7 St Peter's Health Care Services 1 Eddy Licensed Home Care Agency 433 River St Suite 3000 Troy NY 12180 141818568 Home Health NY 501(c)(3) Line 3 LTC(Eddy) Inc 1 The Community Hospice Foundation Inc 295 Valley View Blvd Rensselaer NY 12144 222692940 Fundraising & Public Relations NY 501(c)(3) Line 7 The Community Hospice Inc 1 The Community Hospice Inc 295 Valley View Blvd Rensselaer NY 12144 141608921 Serving seriously ill people & their families NY 501(c)(3) Line 3 St Peter's Health Care Services 1 Villa Mary Immaculate 301 Hackett Blvd Albany NY 12208 141438749 Nursing Home & Physical Rehab NY 501(c)(3) Line 3 St Peter's Hospital 1 Warde Service Corporation Inc 159 Wolf Road 3rd Floor Albany NY 12205 141732097 Supporting & strengthing the ministries of rel. sr. mercy NY 501(c)(3) Line 9 St Peter's Health Care Services 1 Northeast Health Inc 2212 Burdett Ave Troy NY 12180 042450756 Supporting Organization NY 501(c)(3) Line 11b, II St Peter's Health Partners 1 Memorial Hospital Albany NY 600 Northern Blvd Albany NY 12204 141338457 General Hospital NY 501(c)(3) Line 3 Northeast Health Inc 1 Samaritan Hospital of Troy New York 2215 Burdett Ave Troy NY 12180 141338544 General hospital NY 501(c)(3) Line 3 Northeast Health Inc 1 The Northeast Health Foundation Inc 2224 Burdett Ave Troy NY 12180 222743478 Supporting foundation NY 501(c)(3) Line 7 Northeast Health Inc 1 Samaritan Child Care Center Inc 2213 Burdett Ave Troy NY 12180 141710225 Child day care NY 501(c)(3) Line 9 Northeast Health Inc 1 Shaker Properties Inc 2212 Burdett Ave Troy NY 12180 223119822 Real Estate holding NY 501(c)(2) N/A Northeast Health Inc 1 Sunnyview Hospital & Rehabilitation Ctr 1270 Belmont Ave Schenectady NY 12308 141338386 Rehabilitation hospital NY 501(c)(3) Line 3 LTC (Eddy) Inc 1 James A Eddy Memorial Geriatric Center Inc 2256 Burdett Ave Troy NY 12180 222570478 Nursing home NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Capital Region Geriatric Center Inc 421 West Columbia St Cohoes NY 12047 141701597 Nursing Home NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Heritage House Nursing Center Inc 2920 Tibbits Ave Troy NY 12180 141725101 Nursing home NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 The Marjorie Doyle Rockwell Center Inc 421 West Columbia St Cohoes NY 12047 141793885 Adult Home/Alzheimers NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Beverwyck Inc 40 Autumn Drive Slingerlands NY 12159 141717028 Independent/Assisted Living Retirement Community NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Hawthorne Ridge Inc 30 Community Way East Greenbush NY 12061 800102840 Independent/Assisted Living Retirement Community NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Glen Eddy Inc One Glen Eddy Drive Niskayuna NY 12309 141794150 Independent/Assisted Living Community NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Beechwood Inc 2212 Burdett Ave Troy NY 12180 141651563 Real estate holding NY 501(c)(2) N/A LTC (Eddy) Inc 1 Senior Care Connection Inc 504 State St Schenectady NY 12305 141708754 PACE Program NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Home Aid Service of Eastern New York Inc 433 River St Suite 3000 Troy NY 12180 141514867 Home care NY 501(c)(3) Line 9 LTC (Eddy) Inc 1 Seton Health System Inc 1300 Massachusetts Avenue Troy NY 12180 141776186 Hospital NY 501(c)(3) Line 3 St Peter's Health Partners 1 Seton Health at Schuyler Ridge Residential Healthcare 1 Abele Blvd Clifton Park NY 12065 141756230 Skilled Nursing NY 501(c)(3) Line 9 Seton Health System Inc 1 Seton Health Foundation 1300 Massachusetts Avenue Troy NY 12180 222345416 Supporting Organization NY 501(c)(3) Line 11a, I Seton Health System Inc 1 Seton Auxiliary Inc 1300 Massachusetts Avenue Troy NY 12180 141505031 Supporting Organization NY 501(c)(3) Line 9 Seton Health System Inc 1 Seton Licensed Home Care Inc 1300 Massachusetts Avenue Troy NY 12180 141809134 Licensed Home Health Agency NY 501(c)(3) Line 3 Seton Health System Inc 1 Empire Home Infusion Service Inc 10 Blacksmith Drive Malta NY 12020 141795732 Home care NY 501(c)(3) Line 9 Home Aid Service of Eastern New York Inc 1 LTC (Eddy) Inc 2212 Burdett Ave Troy NY 12180 222564710 Elderly health/housing supporting org NY 501(c)(3) Line 11a, I Northeast Health Inc 1 St Peter's Health Partners 315 South Manning Blvd Albany NY 12208 453570715 Management & Support Services NY 501(c)(3) Line 11b, II Catholic Health East 1 St Peter's Health Partners Medical Associates PC 315 South Manning Blvd Albany NY 12208 461177336 Physicians Practice NY 501(c)(3) Line 3 St Peter's Health Partners 1 Providence Place Inc 5 Gamelin Street Holyoke MA 01040 043404084 Retirement Community MA 501(c)(3) Line 9 Sisters of Providence Health System Inc 1 Brightside Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 01040 042182395 Behavioral Care MA 501(c)(3) Line 9 Sisters of Providence Health System Inc 1 Farren Care Center Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 01040 042501711 Long Term Care MA 501(c)(3) Line 3 Sisters of Providence Health System Inc 1 Mercy Hospital Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 01040 043398280 Acute Care MA 501(c)(3) Line 3 Sisters of Providence Health System Inc 1 Mercy Specialist Physicians Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 01040 264033168 Neurosurgery Medical Services MA 501(c)(3) Line 3 Sisters of Providence Health System Inc 1 Sisters of Providence Care Centers Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 01040 222541103 Long Term Care MA 501(c)(3) Line 3 Sisters of Providence Health System Inc 1 Sisters of Providence Health System Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 01040 043398374 Management & Support Services MA 501(c)(3) Line 11a, I Catholic Health East 1 Mercy LIFE Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 01040 453086711 Acute Care MA 501(c)(3) Line 3 Sisters of Providence Health System Inc 1 Pioneer Valley Cardiology Associates Inc c/o SPHS 1221 Main Street Suite 213 Holyoke MA 01040 454208896 Cardiology Services MA 501(c)(3) Line 4 Sisters of Providence Health System Inc 1 Mercy Oncology Services Inc c/o SPHS 1221 Main Street Suite 213 Holyoke MA 01040 454884805 Oncology Medical Services MA 501(c)(3) N/A Sisters of Providence Health System Inc 1 McAuley Center Inc 275 Steele Road West Hartford CT 06117 061058086 Independent Living CT 501(c)(3) Line 9 Mercy Community Health Inc 1 Mercy Community Health Inc 2021 Albany Avenue West Hartford CT 06117 061492707 Management & Support Services CT 501(c)(3) Line 11a, I Catholic Health East 1 Mercy Community HomeCare Services 2021 Albany Avenue West Hartford CT 06117 061488137 In Home Health Care CT 501(c)(3) Line 9 Mercy Community Health Inc 1 Mercy Services 2021 Albany Avenue West Hartford CT 06117 061453323 Support Services CT 501(c)(3) Line 1 Mercy Community Health Inc 1 Mercyknoll Inc 2021 Albany Avenue West Hartford CT 06117 060757380 Skilled Nursing CT 501(c)(3) Line 3 Mercy Community Health Inc 1 Saint Mary Home II Inc 2021 Albany Avenue West Hartford CT 06117 061164104 Elderly Care CT 501(c)(3) Line 3 Mercy Community Health Inc 1 St Mary Home Incorporated 2021 Albany Avenue West Hartford CT 06117 060646843 Skilled Nursing CT 501(c)(3) Line 3 Mercy Community Health Inc 1 Mercy Healthcare Center 114 Wawbeek Avenue Tupper Lake NY 12986 150532211 In Dissolution NY 501(c)(3) Line 3 Catholic Health East 1 Mercy Uihlein Health Corporation 185 Old Military Road Lake Placid NY 12946 161535133 Mgt. & Support Services NY 501(c)(3) Line 11b, II Mercy Healthcare Center 1 Uihlein Mercy Center 185 Old Military Road Tupper Lake NY 12986 150532190 In Dissolution NY 501(c)(3) Line 3 Mercy Healthcare Center 1 St James Mercy Foundation Inc 411 Canisteo Street Hornell NY 14843 161486437 Foundation NY 501(c)(3) Line 7 St James Mercy Health System Inc 1 St James Mercy Health System Inc 411 Canisteo Street Hornell NY 14843 223127184 Management & Support Services NY 501(c)(3) Line 11b, II Catholic Health East 1 St James Mercy Hospital 411 Canisteo Street Hornell NY 14843 160743310 Hospital NY 501(c)(3) Line 3 St James Mercy Health System Inc 1 Maxis Medical Services 100 Lincoln Ave Carbondale PA 18407 232577185 Physician Practices PA 501(c)(3) Line 3 Maxis Health System 1 Marian Community Hospital 100 Lincoln Ave Carbondale PA 18407 240711230 Hospital PA 501(c)(3) Line 3 Maxis Health System 1 Marian Community Hospital Auxiliary 100 Lincoln Ave Carbondale PA 18407 251874733 Fundraising PA 501(c)(3) Line 11b, II Maxis Health System 1 Maxis Foundation 100 Lincoln Ave Carbondale PA 18407 232330090 Fundraising PA 501(c)(3) Line 11b, II Maxis Health System 1 Maxis Health System 100 Lincoln Ave Carbondale PA 18407 911940902 Health Care System PA 501(c)(3) Line 11b, II Maxis Health System 1 Tri-County Human Services Center Inc PO BOX 517 Carbondale PA 18407 231938528 Behavioral Health Organization PA 501(c)(3) Line 7 Maxis Health System 1 Columbus Acquisition Corp 1160 Raymond Boulevard Newark NJ 07102 262616342 Inactive Entity NJ 501(c)(3) Line 9 Saint Michaels Medical Center 1 Saint Michaels Medical Center 111 Central Avenue Newark NJ 07102 262616046 Hospital NJ 501(c)(3) Line 3 Catholic Health East 1 St James Care Inc 1160 Raymond Boulevard Newark NJ 07102 262616230 Inactive Entity NJ 501(c)(3) Line 9 Saint Michaels Medical Center 1 St Michael's Foundation Inc 1160 Raymond Boulevard Newark NJ 07102 223311976 Foundation NJ 501(c)(3) Line 11a, I Saint Michaels Medical Center 1 University Heights Property Company Inc 1160 Raymond Boulevard Newark NJ 07102 223100162 Medical Property Holding Company NJ 501(c)(2) N/A Saint Michaels Medical Center 1 Life St Francis Corporation 601 Hamilton Avenue Trenton NJ 08629 222797282 Health Services NJ 501(c)(3) Line 11a, I St Francis Medical Center Trenton NJ 1 St Francis Medical Center Foundation NJ 601 Hamilton Avenue Trenton NJ 08629 521025476 Foundation NJ 501(c)(3) Line 11a, I St Francis Medical Center Trenton NJ 1 St Francis Medical Center Trenton NJ 601 Hamilton Avenue Trenton NJ 08629 223431049 Hospital NJ 501(c)(3) Line 3 Catholic Health East 1 Langhorne MRI Inc 1201 Langhorne-Newtown Road Langhorne PA 19047 232519529 Inactive Entity PA 501(c)(3) Line 9 St Mary Medical Center 1 Langhorne Physician Services Inc 1201 Langhorne-Newtown Road Langhorne PA 19047 232571699 Physician Services PA 501(c)(3) Line 9: 509(a)(2) St Mary Medical Center 1 LIFE St Mary 1201 Langhorne-Newtown Road Langhorne PA 19047 262976184 Elderly Care PA 501(c)(3) Line 9 St Mary Medical Center 1 St Mary Medical Center 1201 Langhorne-Newtown Road Langhorne PA 19047 231913910 Hospital PA 501(c)(3) Line 3 Catholic Health East 1 St Mary Medical Center Foundation Inc 1201 Langhorne-Newtown Road Langhorne PA 19047 232567468 Foundation PA 501(c)(3) Line 7 St Mary Medical Center 1 East Norriton Physician Services c/o One West Elm Street Conshohocken PA 19428 232515999 Physician Services PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 Mercy Catholic Medical Center of Southeastern Pennsylvania One West Elm Street Conshohocken PA 19428 231352191 Acute Care Hospital PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 Mercy Family Support 1001 Baltimore Pike Suite 301 Springfield PA 19064 232325059 Home Health PA 501(c)(3) Line 9 Mercy Health System of Southeastern Pennsylvania 1 Mercy Health Foundation of Southeastern Pennsylvania c/o One West Elm Street Conshohocken PA 19428 232829864 Fundraising PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania 1 Mercy Health Plan c/o One West Elm Street Conshohocken PA 19428 222483605 Health Plans PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania 1 Mercy Health System of Southeastern Pennsylvania One West Elm Street Conshohocken PA 19428 232212638 Management & Support Services PA 501(c)(3) Line 11b, II Catholic Health East 1 Mercy Home Health 1001 Baltimore Pike Suite 310 Springfield PA 19064 231352099 Home Health PA 501(c)(3) Line 9 Mercy Health System of Southeastern Pennsylvania 1 Mercy Home Health Services 1001 Baltimore Pike Suite 301 Springfield PA 19064 232325058 Home Health PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania 1 Mercy Management of Southeastern Pennsylvania One West Elm Street Conshohocken PA 19428 232627944 Physician Practices PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania 1 Mercy Suburban Hospital One West Elm Street Conshohocken PA 19428 231396763 Acute Care Hospital PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 Nazareth Health Care Foundation 2701 Holme Avenue Philadelphia PA 19152 232300951 Fundraising PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania 1 Nazareth Hospital 2601 Holme Avenue Philadelphia PA 19152 232794121 Acute Care Hospital PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 Nazareth Physician Services Inc 2601 Holme Avenue Philadelphia PA 19152 203261266 Physician Practices PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 NE Physician Services 2601 Holme Avenue Philadelphia PA 19152 232497355 Physician Practices PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 St Agnes Continuing Care Center 1900 S Broad Street Philadelphia PA 19145 232840137 Continuing Care Services PA 501(c)(3) Line 3 Mercy Health System of Southeastern Pennsylvania 1 St Agnes Continuing Care Center Foundation 1900 S Broad Street Philadelphia PA 19145 232415137 Fundraising PA 501(c)(3) Line 11b, II Mercy Health System of Southeastern Pennsylvania 1 Life at Lourdes Inc 1600 Haddon Avenue Camden NJ 08108 261854750 Elderly Care NJ 501(c)(3) Line 3 Our Lady of Lourdes Health Care Services 1 Lourdes Ancillary Services 1600 Haddon Avenue Camden NJ 08103 222568525 Supporting Organization NJ 501(c)(3) Line 11b, II Our Lady of Lourdes Health Care Services 1 Lourdes Dialysis at Innova Inc 1600 Haddon Avenue Camden NJ 08108 263237625 Hospital NJ 501(c)(3) Line 3 Our Lady of Lourdes Health Care Services 1 Lourdes Medical Center Burlington County 218 Sunset Road Willingboro NJ 08046 223612265 Hospital NJ 501(c)(3) Line 3 Our Lady of Lourdes Health Care Services 1 Our Lady of Lourdes Health Care Services 1600 Haddon Avenue Camden NJ 08103 222568528 Management & Support Services NJ 501(c)(3) Line 11b, II Catholic Health East 1 Our Lady of Lourdes Health Foundation Inc 1600 Haddon Avenue Camden NJ 08103 222351960 Foundation NJ 501(c)(3) Line 7 Our Lady of Lourdes Health Care Services 1 Our Lady of Lourdes Medical Center 1600 Haddon Avenue Camden NJ 08103 210635001 Hospital NJ 501(c)(3) Line 3 Our Lady of Lourdes Health Care Services 1 Lourdes Cardiology Services PC 1600 Haddon Avenue Camden NJ 08108 274357794 Cardiology Services NJ 501(c)(3) Line 3 Our Lady of Lourdes Health Care Services 1 Franciscan Eldercare Corporation PO Box 2500 Wilmington DE 19805 223008680 Eldercare DE 501(c)(3) Line 9 St Francis Hospital 1 St Francis Foundation PO Box 2500 Wilmington DE 19805 510374158 Foundation DE 501(c)(3) Line 11b, II St Francis Hospital 1 St Francis Hospital PO Box 2500 Wilmington DE 19805 510064326 Hospital DE 501(c)(3) Line 3 Catholic Health East 1 LIFE at St Francis Healthcare Inc 7th Clayton Streets Wilmington DE 19805 452569214 Elderly Care DE 501(c)(3) Line 3 St Francis Hospital 1 McAuley Ministries McAuley Hall 3333 Fifth Avenue Pittsburgh PA 15213 943436142 Management & Support Services PA 501(c)(3) Line 9 Pittsburgh Mercy Health System 1 Mercy Jeannette Hospital 3805 West Chester Pike Newtown Square PA 19073 251310602 Inactive Entity PA 501(c)(3) Line 9 Pittsburgh Mercy Health System 1 Mercy Life Center Corporation 1200 Reedsdale Street Pittsburgh PA 15233 251604115 Community Treatment PA 501(c)(3) Line 9 Pittsburgh Mercy Health System 1 Pittsburgh Mercy Health System 3333 5th Avenue Pittsburgh PA 15213 251464211 Management & Support Services PA 501(c)(3) Line 11b, II Catholic Health East 1 St Joseph's of the Pines Inc 100 Gossman Drive Suite B Southern Pines NC 28387 560694200 Hospital NC 501(c)(3) Line 3 Catholic Health East 1 Life St Joseph of the Pines Inc 100 Gossman Drive Suite B Southern Pines NC 28387 272159847 Healthcare Services NC 501(c)(3) Line 3 St Joseph's of the Pines Inc 1 Mercy Senior Care Inc 300 Chatillon Road PO Box 866 Rome GA 30162 581366508 Community Outreach GA 501(c)(3) Line 7 Saint Joseph's Health System Inc 1 Saint Joseph's Health System Inc 424 Decatur Street Atlanta GA 30312 581744848 Management & Support Services GA 501(c)(3) Line 11b, II Catholic Health East 1 Saint Joseph's Mercy Care Services Inc 424 Decatur Street Atlanta GA 30312 581752700 Community Outreach GA 501(c)(3) Line 7 Saint Joseph's Health System Inc 1 Saint Joseph's Mercy Foundation Inc 424 Decatur Street Atlanta GA 30312 581448522 Fundraising GA 501(c)(3) Line 11b, II Saint Joseph's Health System Inc 1 Mercy Services Downtown Inc 424 Decatur Street Atlanta GA 30312 272046353 Real Estate Holding Company GA 501(c)(3) Line 11b, II Saint Joseph's Health System Inc 1 St Mary's Health Care System Inc 1230 Baxter Street Athens GA 30606 580566223 Hospital GA 501(c)(3) Line 3 Catholic Health East 1 St Mary's Foundation Inc 1230 Baxter Street Athens GA 30606 582544232 Fundraising GA 501(c)(3) Line 11b, II St Mary's Health Care System Inc 1 St Mary's Highland Hills Inc 1230 Baxter Street Athens GA 30606 020576648 Assisted Living & Retirement Community GA 501(c)(3) Line 3 St Mary's Health Care System Inc 1 St Mary's Medical Group Inc 1230 Baxter Street Athens GA 30606 261858563 Hospital / Physician Services GA 501(c)(3) Line 3 St Mary's Health Care System Inc 1 Good Samaritan Hospital Inc 1201 Siloam Road Greensboro GA 30462 261720984 Hospital GA 501(c)(3) Line 3 Saint Joseph's Health System Inc 1 Mercy Medical Corporation PO Box 1090 101 Villa Drive Daphne AL 36526 636002215 Hospital AL 501(c)(3) Line 3 Catholic Health East 1 Mercy LIFE of Alabama PO Box 1090 101 Villa Drive Daphne AL 36526 273163002 Hospital AL 501(c)(3) Line 3 Mercy Medical Corporation 1 Allegany Franciscan Ministries Inc 33920 US Highway 19 North Suite 269 Palm Harbor FL 34684 581492325 Management & Support Services FL 501(c)(3) Line 11b, II Catholic Health East 1 St Francis Hospital Inc 33920 US Highway 19 North Suite 269 Palm Harbor FL 34684 590624442 Grant-making Organization FL 501(c)(3) Line 11a, I Allegany Franciscan Ministries Inc 1 Holy Cross Hospital Inc 4725 North Federal Highway Ft Lauderdale FL 33308 590791028 Hospital-Healthcare Provider FL 501(c)(3) Line 3 Catholic Health East 1 Holy Cross Long-Term Inc 4725 North Federal Highway Ft Lauderdale FL 33308 650787320 Medical Services FL 501(c)(3) Line 3 Holy Cross Hospital Inc 1 Holy Cross Medical Properties Inc 4725 North Federal Highway Ft Lauderdale FL 33308 650666283 Medical Building Real Estate Management FL 501(c)(2) N/A Holy Cross Hospital Inc 1 SSJ Health Foundation Inc 3663 South Miami Avenue Miami FL 33133 591709438 Fundraising FL 501(c)(3) Line 7 Mercy Hospital Inc 1 Mercy Hospital Inc 3663 South Miami Avenue Miami FL 33133 590791034 Hospital FL 501(c)(3) Line 3 Catholic Health East 1 Mercy Medical Development Inc 3663 South Miami Avenue Miami FL 33133 592789194 Outpatient Services FL 501(c)(3) Line 9 Mercy Hospital Inc 1 Mercy Mission Services Inc 3663 South Miami Avenue Miami FL 33133 650435764 Health Care FL 501(c)(3) Line 11a, I Mercy Hospital Inc 1 Mercy Outpatient Services Inc DBA Sister Emmanuel Hospital 3663 South Miami Avenue Miami FL 33133 510461511 Hospital FL 501(c)(3) Line 3 Mercy Hospital Inc 1 Global Health Ministry 3805 West Chester Pike Suite 100 Newtown Square PA 19073 233068656 Health Care PA 501(c)(3) Line 7 Catholic Health East 1 Intracoastal Health Systems 3805 West Chester Pike Suite 100 Newtown Square PA 19073 650556413 Management & Support Services PA 501(c)(3) Line 11a, I Catholic Health East 1 St Peter's Ambulatory Surgery Center LLC 1375 Washington Avenue Ste 201 Albany NY 12206 460463892 Outpatient Surgery NY N/A Catherine Horan Building Limited Partnership 1221 Main Street Room 108 Holyoke MA 010400000 042723429 Property Management MA N/A Western Massachusetts PETCT Imaging Center LLC 100 Bayview Circle Ste 400 Newport Beach CA 92660 204744663 Outpatient Medical Services DE N/A Central New Jersey Heart Services LLC 29 E 29th Street 2nd Floor Bayonne NJ 07002 208525458 Cardiac Program NJ N/A SMMC MOB II LP 1201 Langhorne-Newtown Road Langhorne PA 19047 364559869 Investment and operation of a medical building PA N/A The Ambulatory Surgery Center at St Mary LLC 1203 Langhorne-Newtown Road Langhorne PA 19047 232871206 Outpatient Surgery PA N/A East Norriton Medical Associates One West Elm Street Conshohocken PA 19428 232319531 Medical Office Building PA N/A East Norriton Medical Associates One West Elm Street Conshohocken PA 19428 232319531 Medical Office Building PA N/A Gateway Health Plan 300 Grant Street Pittsburgh PA 15219 251691945 Medicaid & Medicare/Special Needs Managed Care Organization PA N/A MercyManor Partnership PO Box 10086 Toledo OH 436990086 521931012 Nursing Home PA N/A St Agnes Long Term Intensive Care LLP c/o Mercy Health System One West El Conshohocken PA 19428 200984882 Long Term Intensive Care PA N/A St Agnes Long Term Intensive Care LLP c/o Mercy Health System One West El Conshohocken PA 19428 200984882 Long Term Intensive Care PA N/A Nazareth Medical Office Building Associates LP c/o Nazareth Hospital 2601 Holme Av Philadelphia PA 19152 232388040 Medical Office Building PA N/A Nazareth Medical Office Building Associates LP c/o Nazareth Hospital 2601 Holme Av Philadelphia PA 19152 232388040 Medical Office Building PA N/A SJV Management LLC 200 Century Pkwy Ste 200E Mount Laurel NJ 08054 202273476 Radiology NJ N/A Physicians Outpatient Surgery Center LLC 1000 NE 56th Street Oakland Park FL 33334 352325646 Ambulatory Surgery Center FL N/A Center for Surgery & Digestive Orders 3641 South Miami Avenue Miami FL 33133 510438152 Outpatient Medical Services FL N/A Samaritan Medical Office Building Inc 2212 Burdett Avenue Troy NY 12180 141607244 Real Estate NY N/A C 1 Affiliated Management Services Corporation Inc 1300 Massachusetts Avenue Troy NY 12180 141668024 Real Estate NY N/A C 1 Catherine Horan Building Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 042938160 Building Management MA N/A C 1 Diversified Community Services Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 043128890 Medical Services MA N/A C 1 Mercy Inpatient Medical Associates Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 043029929 Medical Services MA N/A C 1 Providence Home Care Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 043317426 Health Care Services MA N/A C 1 System Coordinated Services Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 042938181 Lab Services MA N/A C 1 Physicians Medical Office Building Condominium Trust 1221 Main Street Room 108 Holyoke MA 010400000 046608649 Property Management MA N/A C 1 SJM Properties Inc 411 Canisteo Street Hornell NY 148482101 161294991 Property Holdings NY N/A C 1 Carbondale Area Physicians' Association PC 100 Lincoln Ave Carbondale PA 18407 232801677 Medical Insurance Contracting PA N/A C 1 Carbondale Area Physicians' PHO Inc 100 Lincoln Ave Carbondale PA 18407 232801676 Inactive PA N/A C 1 Carbondale Physicians' Services Inc 100 Lincoln Ave Carbondale PA 18407 232365077 Pharmacy PA N/A C 1 Chestnut Risk Services Ltd 11 Victoria Street Hamilton BD Insurance BD N/A C 1 LifeCare Physicians PC 601 Hamilton Avenue Trenton NJ 086291986 261649038 Health Care Services NJ N/A C 1 Multicare Plus Inc 601 Hamilton Avenue Trenton NJ 086291986 223435844 Inactive NJ N/A C 1 Langhorne Services II Inc 1201 Langhorne-Newtown Road Langhorne PA 19047 253795549 General Partner of LMOB Partners, II PA N/A C 1 Langhorne Services Inc 1201 Langhorne-Newtown Road Langhorne PA 19047 232625981 General Partner of LMOB Partners, PA N/A C 1 Gateway Health Plan Inc 600 Grant Street Pittsburgh PA 15219 251505506 Health Care PA N/A C 1 Gateway Health Plan Inc of Ohio 600 Grant Street Pittsburgh PA 15219 300282076 Health Care PA N/A C 1 MCMC Eastwick Inc c/o MHS One West Elm Street Conshohocken PA 19428 232184261 Medical Office Buildings PA N/A C 1 Health Management Services Org Inc 500 Grove Street Suite 100 Haddon Heights NJ 08035 223366580 Health Care Billing NJ N/A C 1 Lourdes Medeical Associates PA 500 Grove Street Suite 100 Haddon Heights NJ 08035 223361862 Medical Services NJ N/A C 1 Jeannette Medical Providers 3805 West Chester Pike Newtown Square PA 19073 251787334 Holding Company PA N/A C 1 Jeannette OBGYN Group 1 Inc 3805 West Chester Pike Newtown Square PA 19073 232890748 Holding Company PA N/A C 1 Jeannette Primary Care Group 1 Inc 3805 West Chester Pike Newtown Square PA 19073 232890743 Holding Company PA N/A C 1 Georgia Health Enterprises LLC 1230 Baxter Street Athens GA 30606 541806329 Healthcare GA N/A C 1 St Mary's Highland Hills Village Inc 1660 Jennings Mill Pkly Bogart GA 30622 582276801 Assisted Living GA N/A C 1 GHE Physicians PC 3500 Piedmont Road Atlanta GA 30305 582277939 Practice Management GA N/A C 1 Nursing Network Inc 4725 North Federal Highway Fort Lauderdale Highwa FL 333080000 591145192 Medical Services FL N/A C 1 Mercy Physician Group Inc 3663 South Miami Avenue Miami FL 33133 202970015 Health Care FL N/A C 1 Stella Maris Insurance Company Limited PO Box 69 Grand Cayman Cayman Islands CJ KY1-1102 980078266 Insurance CJ N/A C 1 Catholic Health East Senior Services 3805 West Chester Pike Suite 100 Newtown Square PA 19073 371572595 Senior Services PA N/A C 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 Mercy Health System of Maine P 3214468 Direct costs Catholic Health East P 6621054 Direct costs Visiting Nurse and Hospice Association Q 119594 Direct costs