2012-11-15T13:50:09-06:00 2011-12-31 861065772 Deloitte Tax LLP 1700 Market Street 25th Floor Philadelphia PA 191033984 990 2011-01-01 590791028 Holy Cross Hospital Inc HOLY 9542676869 4725 North Federal Highway Ft Lauderdale FL 333084603 Linda V Wilford 9547763012 2012-11-15 1 William J Homer P00994519 2152462300 2011 2016-02-24 21:20:13Z Patrick A Taylor 4725 North Federal Highway Ft Lauderdale FL 333084603 529068394 0 0928 X WWW.HOLY-CROSS.COM X 1952 FL Holy Cross Hospital provides quality patient care in Broward County. Holy Cross Hospital, Inc. serves the healthcare needs of persons of all faiths and cultures by providing quality health care with christ-like compassion. The organization is a member Catholic Health East ("CHE"). 16 14 3521 791 803926 193366 3943573 11301406 414699818 443870695 5433749 55714 10962221 10070203 435039361 465298018 0 0 0 0 197616527 212940301 0 0 682661 219801404 235475120 417417931 448415421 17621430 16882597 412961127 440593577 269127945 309882275 143833182 130711302 X The mission of Holy Cross Hospital, a member of Catholic Health East and sponsored by the Sisters of Mercy, is to serve the healthcare needs of persons of all faiths and cultures by providing quality health care with Christ-like compassion. We uphold the ethical and moral teachings of the Catholic Church in all policies and practices. We espouse the core values of reverence for each person, community, justice, commitment to those who are poor, stewardship, courage and integrity. 0 0 397264919 449329999 Holy Cross Hospital provides health care and hospital services to the community of Broward County. Health care is provided at no charge or at amounts less than the established rates to patients who qualify under the charity policy. Additionally, the hospital provides health education, health screenings and various other programs designed to better the health of the community it services. During the year, there were 88,902 days of inpatient care provided, 162,810 outpatient registrations and 49,280 emergency room visits. 397264919 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 468 0 1 3521 1 1 1 0 0 0 0 0 0 0 0 0 X 16 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 FL X Marlene Berger 9542676869 4725 N Federal Highway Ft Lauderdale FL 333084603 Raul Tapia MD 40.00 X 539141 0 13034 Patrick A Taylor MD 40.00 X X 0 918628 40341 Sr Patricia M Hespelein RSM 1.00 X 0 0 0 Sr Susan Welsh RSM Sch O 1.00 X 0 0 0 Sr Fidelis McDonough RSM 1.00 X 0 0 0 Keith Koenig 1.00 X 0 0 0 Jonathan Levine MD 1.00 X 0 0 0 Rev Msgr Tomas M Martin 1.00 X 0 0 0 Michaelle Valbrun-Pope 1.00 X 0 0 0 Ray Rodriguez 1.00 X 0 0 0 Joseph Catania 1.00 X 0 0 0 Sr Nancy Hoff RSM 1.00 X 0 0 0 Sr Marjorie Bosse RSM 1.00 X 0 0 0 Andrea J Bradley 40.00 X 247132 0 46795 Mark R Dissette 40.00 X 300851 0 123040 Luisa Gutman 40.00 X 346042 0 70918 Sister Rita Levasseur Sch O 40.00 X 0 0 0 Linda V Wilford Sch O 40.00 X 517539 0 164307 Aryendra Laljie 40.00 X 245214 0 36890 James Desmarteau 40.00 X 214800 0 40294 Kenneth Homer MD 40.00 X 281040 0 4584 Martin W Roche MD 40.00 X 1499864 0 15276 W Porter McRoberts MD 40.00 X 1247145 0 14642 Jonathan C Levy MD 40.00 X 1180752 0 26012 Charles Russo MD 40.00 X 905619 0 15240 Joshua M Purow MD 40.00 X 827468 0 14612 8352607 918628 625985 259 0 1 0 Lauderdale Critical Care Services 6278 N Fed Hwy Ft Lauderdale FL 333081916 Physicians Services 1675805 Arellano Construction Co 7051 SW 12 Street Miami FL 33134 Architectural/Construction Services 1108153 HC Acute Dialysis Services LLC 7061 Cypress Road Plantation FL 333172243 Physicians Services 1025316 Buchanan Ingersoll Rooney 301 Grant Street Pittsburgh PA 152191410 Legal Services 771133 Zachariah P Zachariah MD 4725 N Federal Hwy Ft Lauderdale FL 333084603 Physicians Services 724599 54 11301406 2662 11301406 Patient Revenue 621110 442610022 442610022 Rental - Affiliates 531120 1241308 1241308 Reference Lab 621500 19365 19365 443870695 -1272487 -1272487 1532031 0 1532031 1532031 1532031 65098577 63770376 1328201 1328201 1328201 Billing & Mgmt. Fees 900099 2343529 15586 2327943 Cafeteria 722210 1303607 1303607 Wellness Center 713940 985865 216890 768975 3905171 3905171 8538172 465298018 449276998 803926 3915688 3469571 552175 2917396 180504648 166658019 13530948 315681 1376353 1183663 185808 6882 16608069 14282940 2242089 83040 10981660 9445806 1480946 54908 1043421 1043421 37044702 22937440 13943988 163274 3689358 27161 3662197 3171419 2799038 372064 317 5848282 780795 5064744 2743 412260 311586 98516 2158 4744675 4104144 640531 18804102 16265548 2538554 12333785 12333785 Supplies 80856227 80180314 675913 0 Bad Debts 34932531 34932531 0 0 Leases/Rental 9075250 8183221 892029 0 Equipment Maintenance & 7245031 6808707 436119 205 16274077 15478046 742578 53453 448415421 397264919 50467841 682661 -1 2 21024978 21551361 4127348 4851811 51827600 54606352 71547 63890 9381862 8878849 6350648 7510594 472332132 255436001 209079093 216896131 76894928 83554707 34203124 42679880 412961127 440593577 30112216 31733283 116461966 113659156 122553763 164489836 269127945 309882275 X 130182530 110973762 11709900 17796788 1940752 1940752 143833182 130711302 412961127 440593577 X 16882597 -30004477 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 3479916 3479916 276397175 116329899 160067276 185680878 139106102 46574776 6774163 6774163 216896131 Assets Held for Sales 18384000 Malpractice Ins Recoverable-ASU 1020-24 11030000 Property Held in Investments 6574793 Malpractice Capital Contribution 2032701 WC Ins Recoverable-ASU 2010-24 1558000 Pledge Receivable - one year or less 814462 Investment In Unconsolidated SubSidiary 774251 Posted Collateral Swaps 217634 Other 1294039 42679880 Accrued Pension Expense 68938814 Loss Contingency - Malpractice 19839000 Liabilities Related to Assets Held for Sale 18850000 Malpractice Gross Liability-ASU 2010-24 11030000 Malpractice Insurance-Current 5092000 Deferred Employee Comp 5028747 Est Third Party Settlements 2399415 Loss Contingency - W/C 1756847 WC Gross Liability-ASU 2010-24 1558000 AT Credit Balances 8594719 CHE Bond Series - 1198 &2010 4310751 Current Health Care Claims Reserve 2911640 Deferred Compensation 457 Plan - Physicians 2517984 Executive Benefit Plan 2258530 Charitable Gift Annuity 1283472 LT Swap Program CHE - Market Valuation Adjustment 1272159 Current Portion Lease Payable 1136080 Fixed Asset Retirement Obligation 840670 Patient Refund Clearing 808985 Current Workers Compensation Reserve 798455 Joint Venture Minority Interest 776921 Current Portion - CHE Long Term Debt 750000 Real Estate Taxes 307619 Deferred Home Health Revenue 216879 Security Deposit Payable 124854 Accounting and Audit Fees Accrual 118340 Deferred Revenue Grant 117759 Federal and State Taxes Reserve 96765 Other 754431 164489836 465298018 448415421 16882597 -286478 -29717999 -30004477 -13121880 457062529 3057383 3057383 454005146 11292872 11292872 465298018 446658898 0 446658898 1756523 1756523 448415421 Part XI, Line 8 - Other Adjustments: Investment Income -4,117,613. Release from Restrictions -797,279. Pension Adjustment -26,600,673. Loss on Discontinued Operations -1,484,948. Annuity Expense and Payouts 2,374,814. Bad Debt Expense 58,739. Other Adjustment 848,961. Total to Schedule D, Part XI, Line 8: -29,717,999. Part XII, Line 2d - Other Adjustments: Net Assets released from restrictions 3,057,383. Part XII, Line 4b - Other Adjustments: Cash Contribution 11,237,158. Investments returns, net 28,171. Gain In Disposal of Assets 27,543. Part XIII, Line 4b - Other Adjustments: Expense offset for Discontinued Operation 1,756,523. 1 1 1 X 1 X 1 1 1 0 1 1 3597280 3597280 0.00870 15686458 5821536 9864922 0.02390 19283738 5821536 13462202 0.03260 1268952 94059 1174893 0.00280 291785 291785 0.00070 2332149 2332149 0.00560 256248 256248 0.00060 4149134 94059 4055075 0.00970 23432872 5915595 17517277 0.04230 94059 -94059 0.00000 94059 -94059 1 7887765 1904986 122916367 141300639 -18384272 X 1 1 1 Physicians Outpatient Surgery Center LLC Outpatient multi-specialty ambulatory surgery services 0.73000 0.27000 1 1 Holy Cross Hospital Inc

4725 N Fesderal Hwy Ft Lauderdale FL 333084603

X X X Holy Cross Hospital Inc 1 1 1 200.000000000000 1 400.000000000000 1 X X X X X 1 1 X X X 1 0 1 X 0 0 1 Physicians Outpatient Surgery Center LL

1000 North East 56th Street Oakland Park FL 33334

Ambulatory Surgery Center Part I, Line 6a: Holy Cross Hospital issues its own community benefit report in addition to a related organization, Catholic Health East, issuing a consolidated report. Part I, Line 7: Costing methodology used is cost-to-charge ratio derived from worksheet 2, ratio of patient care cost-to-charge ratio. Part I, L7 Col(f): The bad debt expense included on Form 990. part IX. line 25, column A, but subtracted for purposes of calculating the percentage in this column is $34,932,531 Part II: Holy Cross Hospital's Community Outreach Department is the sponsor of the National School Lunch Program and Summer Food Service Program. Responsibilities include: application, planning, coordination, implementation, monitoring, etc. of all aspects of the programs in targeted lower-income (and Title I) parochial and private schools. As a result of these programs, the overall health of students has improved due to increased access to nutritious, quality food provided in portion controlled servings. This program has also provided economic relief for the families whose children receive free or reduced rate lunches/snacks. Part III, Line 4: The figures were calculated based on the cost-to-charge ratio. The cost-to-charge ratio was derived as defined in the Form 990 Schedule H instructions and using the worksheets provided for in the Form 990 Schedule H. The cost-to-charge ratio derived from above was applied to total bad debt write-offs to calculate the costs for line 2. The organization derives the cost-to-charge ratio by using Worksheet 2 - Ratio of Patient Care Costs to Charges. Worksheet 2 computes the adjusted patient care costs by taking Total Operating Expenses and subtracting non-patient care activities, Medicaid provider taxes, total community benefit expense and Bad Debt expense. We then divide the adjusted patient care costs by gross patient charges.While we make all reasonable efforts to identify patients eligible for charity care prior to billing, such pre-billing identification is not always possible. This arises largely with patients treated in our Emergency Department ("ED") on an outpatient basis. Frequently, these patients do not complete an application for financial assistance, therefore making a definitive determination difficult. The estimated amount of bad debt for patients who qualify for financial assistance is calculated for line 3 based on a review of charity write-offs and estimating the amount of that cost that could be bad debt using the cost-to-charge ratio as described above. Per the organization's audited financial statements in regards to determining bad debt: "The Company provides an allowance for uncollectible accounts for estimated losses resulting from the unwillingness of patients and other third party payors to make payments for services. The allowance is determined by analyzing historical data and trends. Accounts receivable are charged off against the allowance for uncollectible accounts when management determines that recovery is unlikely and the Company ceases collection efforts." Part III, Line 8: None of the shortfall is treated as community benefit. Part III, Line 9b: Collection efforts are placed on hold for patients that are known to qualify for charity care or financial assistance. Holy Cross Hospital, Inc. Part V, Section B, Line 13g: The Funding Assistance program is referenced on the hospital billing statements, and on signage at each point of patient registration and the emergency discharge office. Holy Cross Hospital, Inc. Part V, Section B, Line 19d: The hospital use the appropriate Medicaid payment rate for inpatients or outpatients. Part VI, Line 2: Holy Cross Hospital, Inc. actively conducts a Community Needs Assessment every (3) years which is inclusive of primary and secondary research methodologies - focus groups, key informant interviews, studies, findings, and a group process (including community members). In addition, local data including information from the health data warehouse, and the Quality of Life Assessments provided by the Broward Regional Health Planning Council are assessed as part of an ongoing and continuous environmental scan. During the months of March - June, 2010 Holy Cross conducted its Needs Assessment. In addition to the resulting Needs Assessment product, the Community Health Improvement Plan 2011-2013 was also developed. Part VI, Line 3: Holy Cross Hospital's Admissions Clerks and Patient Financial Services Department are knowledgeable of federal, state, and local programs and assist patients in applying for these benefits. In addition, Financial Assistance applications for the hospital's charity care program are readily available for hospital and medical group patients. Signs informing patients of the program's availability are posted at the Admissions desk in the hospital. In addition, patients may glean information and applications on-line, via the in-house Medicaid application agency, from their Case Manager, Medical Group Office manager, or admissions clerk. Part VI, Line 4: The primary service area (PSA) from which 77% of Holy Cross's inpatient admissions and 80% of outpatient visits emanate consists of 24 zip codes (9) different cities. The secondary service area (SSA) consists of 42 zip codes and represents approximately 13% of the inpatient and 11% of the outpatient visits. The PSA and SSA populations are significantly older than that of the U.S. (median age of 40.0 and 40.6 vs. 36.3). Approximately 45% of the PSA population is over the age of 45. Part VI, Line 5: Holy Cross Hospital has a very active and dynamic Community Outreach ("CO") Department. Through this department, a majority of the community based services are performed. The CO Department facilitates access to healthcare to populations in need by identifying, advocating, educating, procuring and providing health related resources and disease prevention to better serve and improve the health of lower income, minority, and underserved populations. 2011 Year in review: Our works embody the physical, mental, emotional, and spiritual health of all age individuals- from newborn babies to the end of life. Our target audiences, though differing in age, always include the poor, disenfranchised, and those who lack access to healthcare services because they are uninsured, underinsured or undocumented.The work we do here today in our own backyard is not so different than the work that began in 1846 in Pittsburgh when, under the auspices of the Sisters of Mercy, a new hospital was opened. Although the hospital had no written mission statement, there was the acknowledged commitment "that care be provided to persons of every class, condition and religious persuasion and that assistance would be offered to the poor and destitue to the utmost limit of the mean of the institution. This statement was printed in the local newspaper of the time and continues to be the essence of our mission today.In 2011, 165 years later, 13 staff members and 2 loyal volunteers that comprise the CO team continue this "unspoken and unwritten mission statement." Last year, we served more than 35,000 members of our "more needy socioeconomic community." Children and seniors represented almost three-quarters of this number and were provided with health education, necessary vaccines, navigation, resources, counseling and screening services.In addition, CO coordinates Thanksgiving Baskets, Angel Tree gifts and Back to School Backpack distributions for more than 900 associates and their children.The programs we deliver make a huge difference in the lives of the community we serve. They include teaching a preschool child good dental hygiene; decreasing the obesity epidemic; assisting seniors to maintain their health and independence; early diagnosis of life threatening diseases and linkages into health care...we connect people.All of us at Holy Cross Hospital have a commitment to service- something that makes us difference and unique.The Parish Nurse Starquest Program:Outreach to the Isolated and Underserved The Parish Nursing Program promotes senior independence while caring for individual health needs. The program's intention is to promote health and well-being to individuals with decreased access to socialization, peer interaction, and family relationships by providing myriad services to parishioners at three targeted churches. This program was expanded in 2011 by adding a second Parish Nurse to serve our faith communities. A special emphasis and focus will be placed on chronic disease management. Programming includes health education, counseling and support, healthcare management, health assessment, observation and referrals into care, loss and bereavement support groups, and Starquest Transport. By the Numbers: 5,084 Seniors Served2,988 at the Parish49 Education Groups for 1,021 Individuals72 Support Groups for 582 Individuals270 Hospital Visits174 Home Visits142 Nursing Home Visits 877 senior riders provided with 375 transports via the Starquest Transport ProgramThe Holy Cross Goodstart Program:Impacting the Community by Bringing Children and Seniors Together In its twentieth year of programming, the Holy Cross Goodstart Program has coordinated and presented innovative health education classes for licensed child daycare centers and homes in the community surrounding Holy Cross. Classes, seminars and children's learning activities are structured to meet the special educational needs of caregivers, pre-kindergarten children and their parents.In addition to providing health education classes for socio-economically challenged daycare centers and preschools, the program acknowledges the impactful role seniors play in the lives of children. Once a month, a group of special grandparents meet at Holy Cross for four hours to learn about different children's health-related topics. Topics include nutrition, emotions, heart health, stranger safety, and dental health and hygiene. These grandparents, who volunteer at local daycare centers in Broward County, return to the classroom empowered and filled with new information and skills to interact with small children. The program also provides a great social setting and an opportunity for these grandparents to share information and learn from each other.Goodstart by the Numbers 194 Children's Learning Activities for 2,584 Preschool Children8 Health classes and a Book Club started for (30) youth at the Jan Moran Collier City Library 10 (4-hour) Caregiver Workshops for 1,650 and (9) Goodstart Grandparent Workshops for 190 SeniorsThe Holy Cross School Health Program:Benefits for our Uninsured Youth The Community Outreach Team School Health program provides health screenings (vision, hearing and scoliosis), immunizations, health room observations, and health education to all Broward Elementary Parochial Schools. The department also serves as a resource to all Miami-Dade Parochial Elementary Schools. Health education classes expanded to include boys and girls at the Broward Regional Juvenile Detention Center on a routine basis. Class subjects include health, hygiene, maturity, effective parenting, abuse, substance use, and abuse and violence. In 2011, classes regarding health, healthy relationships, goal setting and coping strategies were provided to students at an alternative middle school.Youth Services by the Numbers 6,916 Screenings: 500 Referrals for Follow Up 150 Clinic Visits1,200 Immunization Compliance Reviews904 Immunizations for 361 children98 Health classes to 1,575 Students12 Health & CPR classes to 282 School Staff Members46 Parent/Teacher Conferences36 Classroom Observations Nutritional Assistance:Meeting the Basic Needs of the CommunityFrom school children to seniors, we worked with people from all walks of life who, for multiple reasons, found themselves in need of nutritional assistance. The Community Outreach Department continues to be an authorized host provider of the National School Lunch Program (NSLP) and a technical assistance resource to independent parochial school NSLP providers. The goal is for every qualified parochial school to seek and glean independent NSLP sponsorship; two former HCH sponsored schools achieved this goal in 2011.Hunger Initiatives by the Numbers The National School Lunch Program (66,833 meals served) Year-round hospital-wide food drive donated to local Food Pantry Contributions (more than 200 tons of canned and dried goods donated) Collier City Kids Health Programming Monthly Meal (240 meals served) Goodstart Senior Grandparent Program Monthly Meal (190 meals served) Goodstart Caregiver Monthly Program (1,650 meals served) Publix Gift Cards for Associates and Community (25,000) Thanksgiving Donations to Associates and Community (25,000 pounds) HIV/AIDS Family Meal Program Donations (1,500 meals) HIV/AIDS Homeless HIV+ Backpack Program (1,845 meals)Growing Healthy Kids:A Multifaceted Approach to Encourage Healthy EatingThe Growing Healthy Kids Program enhances classroom learning by experiential learning outside of the classroom, including on-site school vegetable gardens. We have found that students are more enthusiastic about eating vegetables when they have a hand in their growth.30 Broward, Miami-Dade and Monroe County Parochial Elementary Schools are participating in the Growing Healthy Kids Program, while 9,323 students are participating in nutrition activities on a routine basis in their classrooms. And more than 175 edible gardens have been planted on school sites and are tended to by students, teachers and parent volunteers. A Pilates program was started in 2011 for middle school girls at one parochial elementary school. The goal of the program is to focus on the benefits of fitness in addition to building good eating habits and self-esteem.Growing Healthy Kids Services by the Numbers 23 Broward, Miami-Dade and Monroe County Parochial Elementary Schools provided with services9,547 students are participating in nutrition activities on a routine basis in their classrooms 737 nutrition lessons and activities have been taught to students177 edible gardens have been planted on school sites and are tended to by students and adult Champions 105 trainings to 102 teachers and 41 food service workers12 community programs incepted each with a garden and involving 300 community members HIV/AIDS Testing Outreach Program:Rapid Attention to Enhance CareHoly Cross provides HIV rapid testing inclusive of pre- and post-test counseling and linkage to care. The goal of the program is to make individuals aware of their status and, if positive, link them to care and treatment. Test sites are located throughout the community at targeted locations in addition to on-site at the Community Outreach office. The program was one of (6) nationwide chosen to participate in a Rapid HCV pilot project that was most successful.HIV Care by the Numbers 8,871 client contacts made by outreach coordinators3,633 Tests Provided in 201137 Persons Identified as Positive and Referred/Case Managed into Medical Care 25% of Those Tested Were Homeless 321 homeless HIV positive individuals provided with 615 weekend food backpacksCommunity Building: Helping the Homeless in Our Community Through Community Outreach's efforts, the number of homeless individuals served increased by 82%. From incepting partnerships for our mobile health program; administration to flu shots;summer book driver; and a nutrition show for sheltered homeless families Holy Cross Hospital makes every attempt to respond to the needs.Helping the Homeless by the Numbers2,234 clients seen on board our Mobile Health program1,650 on board our Mobile Health Unit in targeted communities908 served through HIV programming servicesHoly Cross Hospital Response to Outstanding Community Needs and Community BenefitIn 2011, Holy Cross Hospital provided $11.7 million in care for the disadvantaged, community benefits and education and $3.6 million in net cost of hospital patient care services, including charity care, public programs and other programs.Community Outreach provided 36,528 individuals with direct services, health screenings, and health education. In addition to providing services to lower income minority communities, priority populations targeted for programs included the homeless, uninsured and underinsured and seniors. Homeless Outreach Programming has expanded this year and 25% of Community Outreach's ETI program participants were homeless. Efforts by all programs included participation in the community's Point In Time Survey; provision of health screenings and health education and the provision of weekend food backpacks to HIV positive homeless individuals. A children's EXTREME health show was sponsored by the Department for more than 100 sheltered homeless families and was met with great success.Community Building efforts were concentrated in large part to the homeless and in building a partners for Breast Health program (PIBH). This included outreaching to targeted lower income communities lacking health insurance and access to preventive and well care. Women over 40 years of age, lacking health insurance and meeting at least 200% FPL are targeted to provide clinical breast health exam and screening mammogram services. Men with breast symptoms and/or women under the age of 40 but having symptoms or a strong family history of breast cancer are also eligible for program participation. The outcomes of these efforts have included early diagnosis and intervention of breast cancer. Continuation of this and other programs, such as the sponsorship of the National School Lunch Program to targeted parochial schools provides local families with access to improved health and wellness; care and treatment and nutritious, portion controlled lunches at low or no cost. The Community Outreach Department provided 66,833 hot lunches this year to 955 unduplicated students.The Mercy Family Life Center, a medical group facility providing primary care to homeless, uninsured, underinsured and refugees has provided essential direct care services to hundreds of patients. For many families fleeing from the despair and destruction caused by the earthquake in Haiti, it is a true blessing. The Center plays an instrumental role in facilitating the care and treatment of our chronic disease management of under and uninsured individuals. In addition to providing services in the clinic setting, doctors also go aboard the mobile Health unit and see clients "in the field". Part VI, Line 6: Catholic Health East (CHE) is a multi-institutional Catholic health system, which is co-sponsored by nine religious congregations and Hope Ministries, a Public Juridic Person within CHE. Based in Newtown Square, Pennsylvania, the System provides the means to ensure the continuation of the Catholic identity and operational strength of the sponsors' health ministries, which are located within 11 eastern states from Maine to Florida. The System includes 35 acute care hospitals, one long-term acute care hospital, 24 freestanding and hospital-based long-term care facilities, 7 assisted-living facilities, four continuing care retirement communities, eight behavioral health and rehabilitation facilities, 27 home health/hospice agencies, and numerous ambulatory and community-based health services. Catholic Health East facilities employ approximately 55,000 full-time employees as partners in ministry. Part VI, Line 7, List of State Receiving Community Benefit Report: AL,CT,DE,FL,GA,ME,MA,NJ,NC,PA X X X X 0 0 0 0 0 0 0 0 0 Raul Tapia MD 410600 0 128541 0 0 0 0 0 13034 0 552175 0 0 0 Patrick A Taylor MD 0 440500 0 200427 0 277701 0 11025 0 29316 0 958969 0 0 Andrea J Bradley 199018 0 42303 0 5811 0 39572 0 7223 0 293927 0 0 0 Mark R Dissette 233528 0 60803 0 6520 0 96990 0 26050 0 423891 0 0 0 Luisa Gutman 245212 0 64050 0 36780 0 50543 0 20375 0 416960 0 0 0 Linda V Wilford Sch O 304065 0 101402 0 112072 0 150736 0 13571 0 681846 0 0 0 Aryendra Laljie 202666 0 40359 0 2189 0 10906 0 25984 0 282104 0 0 0 James Desmarteau 196846 0 12293 0 5661 0 28000 0 12294 0 255094 0 0 0 Kenneth Homer MD 280791 0 0 0 249 0 3500 0 1084 0 285624 0 0 0 Martin W Roche MD 643999 0 853705 0 2160 0 0 0 15276 0 1515140 0 0 0 W Porter McRoberts MD 296419 0 949468 0 1258 0 0 0 14642 0 1261787 0 0 0 Jonathan C Levy MD 502148 0 677542 0 1062 0 0 0 26012 0 1206764 0 0 0 Charles Russo MD 755297 0 146916 0 3406 0 0 0 15240 0 920859 0 0 0 Joshua M Purow MD 653280 0 173546 0 642 0 0 0 14612 0 842080 0 0 0 City of Miami Florida Health Facilities Authority 592252396 59341PAP3 2003-11-25 32624712 Capital Expenditure 0 0 0 City of Tampa Florida 591101138 875231JR4 2010-04-07 26829425 Partial Refunding 1998 City of Tampa, Florida 0 0 0 4585000 32624712 2223876 497679 29903157 2004 0 0 1 1 3870000 26829425 377525 26451900 2010 1 0 1 1 0 0 1 1 0 1 0 0 0 1 Citibank Financial Products Inc 30.000000000000 1 0 0 0 1 0 0 0 0 X Schedule K Supplental Information Part III, Line 3a: Part III, Line 3a: The organization 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. Form 990, Part VI, Section A, line 6 Catholic Health East is the sole member. Form 990, Part VI, Section A, line 7a Yes, Catholic Health East approves the appointment of the members of the governing body. Form 990, Part VI, Section A, line 7b Catholic Health East has limited reserved power to approve decisions of the governing body. Form 990, Part VI, Section B, line 11 The organization took steps to educate management, members of the board and members of appropriate subcommittees of the board on the compliance requirements mandated by the Form 990. The form was reviewed by management and then submitted to a subcommitte thereof which reported its findings to the board. Form 990, Part VI, Section B, line 12c Catholic Health East's Policy 103 sets forth the organization's conflict of interest policy and processes. Annually, all those serving CHE in a fiduciary capacity, including directors, officers, Sponsors Council representatives, 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 CEO and Board Chair. Summary information is reported to the entire board and 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 on the CHE web site. Form 990, Part VI, Section B, line 15 The organization adopted Catholic Health East's process for determining compensation which 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 the organization's 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 population, considers both reasonableness and effectiveness of all remunerative programs and establishes the detailed 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 believed to be of interest to the public, conflict of interest policy, audited financial statements; annual community benefit report and IRS Form 990 are available to the public through the organization's web site. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -286,478. Investment Income -4,117,613. Release from Restrictions -797,279. Pension Adjustment -26,600,673. Loss on Discontinued Operations -1,484,948. Annuity Expense and Payouts 2,374,814. Bad Debt Expense 58,739. Other Adjustment 848,961. Total to Form 990, Part XI, Line 5: -30,004,477. Explanation of financial statements: Form 990, Part XII, Line 2a & 2b: Financial statements were issued on a consolidated and separate basis. Form 990 Part VII and Schedule J: Linda V. Wilford's Compensation: The Chief Financial Officer (CFO) compensation is reflective of responsibility over Holy Cross Hospital, Inc. with joint responsibility over Mercy Hospital, Inc. (a related entity owned by CHE). Approximately $104,000 of the total compensation was deferred compensation that vested in 2011. The estimated breakdown for Holy Cross Hospital is Base Compensation $182,439; At Risk Compensation $60,841; Other Reportable Compensation $67,243; Deferred Compensation $90,442; and Nontaxable Benefits $9,358. The estimated breakdown for Mercy Hospital is Base Compensation $121,626; At Risk Compensation $40,561; Other Reportable Compensation $44,829; Deferred Compensation $60,294; and Nontaxable Benefits $6,239. Compensation Paid to Sister Susan Welsh and Sister Rita Levasseur: All compensation paid on behalf of the Sisters goes to their religious order. 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 Catholic Health East 3805 West Chester Pike Suite 100 Newtown Square PA 19073 232929748 Management Services PA 501(c)(3) Line 11a, I 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 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 Mercy Hospital 144 State Street Portland MA 04101 010211534 Hospital ME 501(c)(3) Line 3 Mercy Health System of Maine 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 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 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 Memorial Hospital Albany NY 600 Northern Blvd Albany NY 12204 141338457 General Hospital NY 501(c)(3) Line 3 Northeast Health Inc 1 Beechwood Inc 2212 Burdett Ave Troy NY 12180 141651563 Real estate holding NY 501(c)(2) N/A 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 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 Senior Care Connection Inc 504 State St Schenectady NY 12305 141708754 PACE Program 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 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 Heritage House Nursing Center Inc 2920 Tibbits Ave Troy NY 12180 141725101 Nursing home 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 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 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 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 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 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 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 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 The Northeast Health Foundation Inc 2224 Burdett Ave Troy NY 12180 222743478 Supporting foundation NY 501(c)(3) Line 7 Northeast Health Inc 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 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 Auxiliary Inc 1300 Massachusetts Avenue Troy NY 12180 141505031 Supporting Organization NY 501(c)(3) Line 9 Seton Health System Inc 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 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 Vincentian Health Services 1300 Massachusetts Avenue Troy NY 12180 141685163 Discontinued Operations NY 501(c)(3) Line 11a, I Seton Health System Inc 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 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 No 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 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 Hospital NY 501(c)(3) Line 3 Catholic Health East 1 Mercy Uihlein Health Corporation 185 Old Military Road Lake Placid NY 12946 161535133 Hospital NY 501(c)(3) Line 11b, II Mercy Healthcare Center 1 Uihlein Mercy Center 185 Old Military Road Lake Placid NY 12946 150532190 Hospital 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 Marian Community Hospital 100 Lincoln Avenue Carbondale PA 18407 240711230 Hospital PA 501(c)(3) Line 3 Maxis Health System 1 Marian Community Hospital Auxiliary 100 Lincoln Avenue Carbondale PA 18407 251874733 Fundraising PA 501(c)(3) Line 11b, II Maxis Health System 1 Maxis Foundation 100 Lincoln Avenue Carbondale PA 18407 232330090 Fundraising PA 501(c)(3) Line 11b, II Maxis Health System 1 Maxis Health System 100 Lincoln Avenue Carbondale PA 18407 911940902 Health Care System PA 501(c)(3) Line 11b, II Catholic Health East 1 Maxis Medical Services 100 Lincoln Avenue Carbondale PA 18407 232577185 Physician Practices PA 501(c)(3) Line 3 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 Michaels Medical Center Foundation 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 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 MHS 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 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 212 West Third Street PO Box 866 Rome GA 30162 581366508 Community Outreach GA 501(c)(3) Line 7 Saint Joseph's Health System Inc 1 Good Samaritan HospitalInc 1201 Siloam Road Greensboro GA 30462 261720984 Hospital GA 501(c)(3) Line 3 Saint Joseph's Health System Inc 1 Saint Joseph's Health System Inc 5673 Peachtree-Dunwoody Road Suite Atlanta GA 30342 581744848 Management & Support Services GA 501(c)(3) Line 11b, II Catholic Health East 1 Saint Joseph's Mercy Care Services Inc 5673 Peachtree-Dunwoody Road Suite Atlanta GA 30342 581752700 Community Outreach GA 501(c)(3) Line 7 Saint Joseph's Health System Inc 1 Saint Joseph's Mercy Foundation Inc 5673 Peachtree-Dunwoody Road Suite Atlanta GA 30342 581448522 Fundraising GA 501(c)(3) Line 11b, II Saint Joseph's Health System Inc 1 Mercy Services Downtown Inc 5673 Peachtree-Dunwoody Road Suite Atlanta GA 30342 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 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 Hospital FL 501(c)(3) Line 11a, I Allegany Franciscan Ministries Inc 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 Mercy Hospital 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 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 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 Intercoastal 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 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 Peter's Ambulatory Surgery Center LLC 1375 Washington Avenue Ste 201 Albany NY 12206 460463892 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 10720 Sikes Places Ste 300 Charlotte NC 28277 208525458 Cardiac Program NJ N/A Langhorne MOB Partners LP 1201 Langhorne-Newtown Road Langhorne PA 19047 232622772 Investment and operation of a medical building PA 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-Newton Road Langhorne PA 19047 232871206 Outpatient Surgery PA N/A AmeriHealth Mercy Health Plan 200 Stevens Drive Suite 350 Philadelphia PA 19113 232859523 Medicaid Managed Care Organization PA N/A Amerihealth Mercy of Indiana LLC 200 STEVENS DRIVE Suite 350 Philadelphia PA 19113 204948091 PREPAID HEALTH CARE SERVICES IN 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 Keystone Mercy Health Plan 100 Stevens Drive Philadelphia PA 19113 232842344 Medicaid 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 1900 S Broad Street Philadelphia PA 19145 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 St Agnes Long Term Intensive Care LLP 1900 S Broad Street Philadelphia PA 19145 200984882 Long Term Intensive Care 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 Oakland Park FL 33334 352325646 Ambulatory Surgery Center FL Holy Cross Hospital Inc Related 889565 2373699 0 1 0.73000 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 Affiliated Management Services Corporation Inc 1300 Massachusetts Avenue Troy NY 12180 141668024 Real Estate NY N/A C Catherine Horan Building Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 042938180 Building Management MA N/A C Diversified Community Services Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 043128890 Medical Services MA N/A C Mercy Inpatient Medical Associates Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 043029829 Medical Services MA N/A C Providence Home Care Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 043317426 Health Care Services MA N/A C System Coordinated Services Inc c/o SPHS 1221 Main Street Suite 108 Holyoke MA 010400000 042938181 Lab Services MA N/A C Physicians Medical Office Building Condominium Trust 1221 Main Street Room 108 Holyoke MA 010400000 046608649 Property Management MA N/A C SJM Properties Inc 411 Canisteo Street Hornell NY 148482104 161294991 Property Holdings NY N/A C Carbondale Area Physicians' Association PC 100 Lincoln Ave Carbondale PA 18407 232801677 Medical Insurance Contracting PA N/A C Carbondale Area Physicians' PHO Inc 100 Lincoln Ave Carbondale PA 18407 232801676 Inactive PA N/A C Carbondale Physicians' Services Inc 100 Lincoln Ave Carbondale PA 18407 232365077 Pharmacy PA N/A C Chestnut Risk Services Ltd 11 Victoria Street Hamilton BD Insurance BD N/A C LifeCare Physicians PC 601 Hamilton Avenue trenton NJ 086291986 261649038 Health Care Services NJ N/A C Multicare Plus Inc 601 Hamilton Avenue Trenton NJ 086291986 223435844 Inactive NJ N/A C Langhorne Services II Inc 1201 Langhorne-Newtown Road Langhorne PA 190470000 253795549 General Partner of LMOB Partners, II PA N/A C Langhorne Services Inc 1201 Langhorne-Newtown Road Langhorne PA 190470000 232625981 General Partner of LMOB Partners PA N/A C AMHP Holdings Corp 200 Stevens Drive Philadelphia PA 19113 261144363 Behavorial Health PA N/A C Select Health of South Carolina Inc 4390 Belle Oaks Drive Suite 400 Charleston SC 29405 571032456 Health Maintenance Organization SC N/A C Gateway Health Plan Inc 600 Grant Street Pittsburgh PA 15219 251505506 Health Care PA N/A C Gateway Health Plan Inc of Ohio 600 Grant Street Pittsburgh PA 15219 300282076 Health Care PA N/A C MCMC Eastwick Inc c/o MHS One West Elm Street Conshohocken PA 19428 232184261 Medical Office Buildings PA N/A C Community Behavorial Healthcare Network of PA Inc 8040 Carlson Road Harrisburg PA 17112 251765391 Behavorial Health PA N/A C Health Management Services Org Inc 500 Grove Street Suite 100 Haddon Heights NJ 08035 223366580 Health Care Billing NJ N/A C Jeannette Medical Providers 3805 West Chester Pike Newtown Square PA 19073 251787334 Holding Company PA N/A C Jeannette OBGYN Group 1 Inc 3805 West Chester Pike Newtown Square PA 19073 232890748 Holding Company PA N/A C Jeannette Primary Care Group 1 Inc 3805 West Chester Pike Newtown Square PA 19073 232890743 Holding Company PA N/A C Georgia Health Enterprises LLC 11440 Commerce Park Drive Reston VA 20191 541806329 Healthcare VA N/A C St Mary's Highland Hills Village Inc 1660 Jennings Mill Pkly Bogart GA 30622 582276801 Assisted Living GA N/A C GHE Physicians PC 3500 Piedmont Road Atlanta GA 30305 582277939 Practice Management GA N/A C Nursing Network Inc 4725 North Federal Highway Fort Lauderdale Highwa FL 333080000 591145192 Medical Services FL Holy Cross Hospital Inc C 14280 236460 1.00000 Mercy Physician Group Inc 3663 South Miami Avenue Miami FL 33133 202970015 Health Care FL N/A C Stella Maris Insurance Company Limited PO Box 69 Grand Cayman Cayman Islands CJ KY1-1102 980078266 Insurance CJ N/A C Catholic Health East Senior Services 3805 West Chester Pike Suite 100 Newtown Square PA 19073 371572595 Senior Services PA N/A C 0 0 1 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 Catholic Health East B 123236 Actual Cost Catholic Health East C 20000 Actual Cost Physician Outpatient Surgery Center I 1414429 Actual Cost Mercy Hospital K 168838 Actual Cost Catholic Health East K 3943993 Actual Cost Catholic Health East K 2306959 Actual Cost Catholic Health East K 4732248 Actual Cost Physician Outpatient Surgery Center I 512373 Actual Cost Mercy Hospital O 92060 Actual Cost Mercy Hospital P 4479747 Actual Cost Catholic Health East O 894448 Actual Cost Catholic Health East O 5591535 Actual Cost Catholic Health East O 631444 Actual Cost Catholic Health East O 6736459 Actual Cost Catholic Health East O 2965254 Actual Cost Catholic Health East O 12532130 Actual Cost Catholic Health East O 179640964 Actual Cost Catholic Health East O 189914316 Actual Cost Catholic Health East O 8117772 Actual Cost The organization timely filed a request for an additional three month extension to November 15, 2012, but the IRS approval letter for the "Application for Extension of Time to File an Exempt Organization Return" had the extended due date to file as August 15, 2012. The August 15, 2012, date appears to be an IRS error.