FARREN CARE CENTER INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
FARREN CARE CENTER INC (EIN 04-2501711)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-15
IRS object ID
201243209349302439
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-15T11:36:38-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11700 Market Street 25th FloorAddressLine1
CityPhiladelphiaCity
StatePAState
ZIP Code191033984ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN042501711EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Farren Care Center IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFARRNameControl
Phone4135392689Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1c/o SPHS Finance 1221 Main StreetAddressLine1
Address Line2No 106AddressLine2
CityHolyokeCity
StateMAState
ZIP Code010405396ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameThomas RobertName
TitleSenior Vice President/CFOTitle
Phone4135392917Phone
Date Signed2012-11-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWILLIAM HOMERName
PTINP00994519PTIN
Phone2152462300Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeXAddressChange
Name Of Principal Officer PersonChristopher J McLaughlinNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11233 Main StreetAddressLine1
CityHolyokeCity
StateMAState
ZIP Code010405381ZIPCode
FieldValueIRS element (for citing)
Gross Receipts12756890GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.mercycares.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1990YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionFarren Care Center, Inc., a member of Sisters of Providence Health System, Inc. ("SPHS") is a specialized skilled nursing facility serving residents with both medical and psychiatric illnesses or behavioral disorders. The Sisters of Providence Health System, Inc. is a member of Catholic Health East ("CHE").ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees253TotalNbrEmployees
Total Nbr Volunteers59TotalNbrVolunteers
Total Gross UBI19736TotalGrossUBI
Net Unrelated Business Txbl Income2136NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year16057ContributionsGrantsPriorYear
Contributions Grants Current Year25516ContributionsGrantsCurrentYear
Program Service Revenue Prior Year12181105ProgramServiceRevenuePriorYear
Program Service Revenue CY12353949ProgramServiceRevenueCY
Investment Income Prior Year57642InvestmentIncomePriorYear
Investment Income Current Year60738InvestmentIncomeCurrentYear
Other Revenue Prior Year335692OtherRevenuePriorYear
Other Revenue Current Year316687OtherRevenueCurrentYear
Total Revenue Prior Year12590496TotalRevenuePriorYear
Total Revenue Current Year12756890TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year8126975SalariesEtcPriorYear
Salaries Etc Current Year8074063SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4595757OtherExpensePriorYear
Other Expenses Current Year4782882OtherExpensesCurrentYear
Total Expenses Prior Year12722732TotalExpensesPriorYear
Total Expenses Current Year12856945TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-132236RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-100055RevenuesLessExpensesCY
Total Assets BOY4522157TotalAssetsBOY
Total Assets EOY4151394TotalAssetsEOY
Total Liabilities BOY5649554TotalLiabilitiesBOY
Total Liabilities EOY5589738TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-1127397NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-1438344NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionFarren Care Center, Inc, a member of the Sisters of Providence Health System, Inc. ("SPHS"), is a community of persons committed to being a transforming, healing presence within the communities we serve. We believe in the sacredness of human life, in the innate dignity of each person, and that it is in relationship with one another that all persons realize their fullest potential. In our service, we are sustained by an unwavering trust in God's Providence. Sisters of Providence Health System, Inc. is a member of Catholic Health East ("CHE").MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense11039883Expense
Revenue12353949Revenue
DescriptionFarren Care Center, Inc provided 44,039 days of patient care during the year. This skilled nursing facility combines expert medical and mental health care and long-term rehabilitation services which enable residents to thrive in the least restrictive enviroment possible. Residents participate in one of four specialized programs: a preparation for community re-entry, a comprehensive care program for complex behavioral problems, a therapeutic behavior program offering intensive treatment in a secure unit, and a medical intervention-dementia program for residents with complex medical conditions who require extensive assistance with activities of daily living. Residents' stays will vary from several weeks or months to several years. Residents benefit from a multidisciplinary treatment team, including psychiatric, psychological, behavioral, nursing, social services and pastoral care professionals.Description
Total Program Service Expense11039883TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109624NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees253NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1William KrasinBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4135392689TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1c/o SPHS 1221 Main Street Suite 106AddressLine1
CityHolyokeCity
StateMAState
ZIP Code01040ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
David M Chadbourne MD
Trustee1.00X000
William A Collins
Trustee1.00X000
Rev Msgr C D Connelly
Trustee1.00X000
Philip F Gaziano MD
Trustee1.00X000
Sr Ann M Horgan SP
Trustee1.00X000
Paul Mancinone
Trustee1.00X000
Sr Ruth F McGoldrick SP
Trustee1.00X000
Leda M McKenry PHD
Trustee1.00X000
Mark J Mullan MD
Trustee1.00X000
Sr Joan C Mullen SP
Trustee1.00X000
Shirin Nash MD
Trustee1.00X000
Carla W Newton Esq
Trustee1.00X000
Sr Kathleen M Popko SP
Trustee1.00X000
Rev Karen L Rucks
Trustee1.00X000
John E Sjoberg
Trustee1.00X000
Dean M Whalen Esq
Trustee1.00X000
Joanne M Beauregard
Chair1.00X000X
Kathleen M Kane
Vice Chair1.00X000X
Robert M Sullivan Jr
Secretary1.00X000X
Daniel P Moen
President & CEO50.00X047843930870X
William Bithoney MD
Interim President & CEO50.00X044837839770X
Daniel Keenan
Ast Secty/SVP Gnmt Rel.50.00023209731980X
Sr Kathleen Sullivan
Ast Secty/VP Missions50.00000X
Thomas Robert
Treasurer/SVP & CFO50.00030637622229X
Leonard F Pansa
Sr VP HR & Admin Svcs50.00029497823990X
Christopher McLaughlin
COO/Senior Care50.00023354833552X
James Clifford
Administrator40.00108028016916X
FieldValueIRS element (for citing)
Total Reportable Comp From Org108028TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1993816TotalReportableCompFrmRltdOrgs
Total Other Compensation199307TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Worldwide Staffing
425 Union Street Suite B-1West SpringfieldMA010890000Temp Nursing Staff239023
Preferred Therapy Solutions
850 Silas Deane Highway 2nd FloorWethersfieldCT061090000Physical Therapy187945
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
All Other Contributions25516AllOtherContributions
Total Contributions25516TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionSkilled nursing faciliDescription
Business Code623110BusinessCode
Total Revenue Column12353949TotalRevenueColumn
Related Or Exempt Function Income12353949RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue12353949TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column60738TotalRevenueColumn
Exclusion$60,738ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real229988Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real229988Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column229988TotalRevenueColumn
Exclusion$229,988ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
Cafeteria revenue72221255901$55,901
Catering7223201183811838
Housekeeping56170078987898

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column11062TotalRevenueColumn
Exclusion$11,062ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue86699TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column12756890TotalRevenueColumn
Related Or Exempt Function Income12353949RelatedOrExemptFunctionIncome
Unrelated Business Revenue19736UnrelatedBusinessRevenue
Exclusion$357,689ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6570388Total
Program Services6257081ProgramServices
Management And General313307ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total69360Total
Program Services66053ProgramServices
Management And General3307ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total917993Total
Program Services874219ProgramServices
Management And General43774ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total516322Total
Program Services491701ProgramServices
Management And General24621ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total37628Total
Program Services32567ProgramServices
Management And General5061ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total898896Total
Program Services892938ProgramServices
Management And General5958ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total14684Total
Management And General14684ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total655026Total
Program Services566925ProgramServices
Management And General88101ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total761098Total
Program Services658730ProgramServices
Management And General102368ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total9607Total
Program Services5293ProgramServices
Management And General4314ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total4896Total
Program Services4503ProgramServices
Management And General393ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total132452Total
Management And General132452ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total131474Total
Program Services113791ProgramServices
Management And General17683ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total54715Total
Program Services47356ProgramServices
Management And General7359ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
System assessment1028798010287980
State user fee80240280240200
Medical supplies19463619463600
Bad debt219462194600

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total34624Total
Program Services9742ProgramServices
Management And General24882ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total12856945Total
Program Services11039883ProgramServices
Management And General1817062ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY557496BOY
EOY325097EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY860550BOY
EOY939111EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY14838BOY
EOY11689EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY58221BOY
EOY49045EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis9429107LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8325532LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1148173BOY
EOY1103575EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1679206BOY
EOY1601771EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY203673BOY
EOY121106EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY4522157BOY
EOY4151394EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY905513BOY
EOY979864EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY4321268BOY
EOY4130755EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY89351BOY
EOY90499EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY333422BOY
EOY388620EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5649554BOY
EOY5589738EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-2806603BOY
EOY-3040115EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY65090BOY
EOY75879EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1614116BOY
EOY1525892EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-1127397BOY
EOY-1438344EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4522157BOY
EOY4151394EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-100055ReconcilationRevenueExpenses
Reconcilation Other Changes-210892ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1614116BeginningOfYearBalance
Investment Earnings Or Losses-22325InvestmentEarningsOrLosses
Other Expenditures52560OtherExpenditures
Administrative Expenses13340AdministrativeExpenses
End Of Year Balance1525891EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1487289BeginningOfYearBalance
Investment Earnings Or Losses193607InvestmentEarningsOrLosses
Other Expenditures57594OtherExpenditures
Administrative Expenses9186AdministrativeExpenses
End Of Year Balance1614116EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1248401BeginningOfYearBalance
Investment Earnings Or Losses310081InvestmentEarningsOrLosses
Other Expenditures63312OtherExpenditures
Administrative Expenses7881AdministrativeExpenses
End Of Year Balance1487289EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1834530BeginningOfYearBalance
Investment Earnings Or Losses-504132InvestmentEarningsOrLosses
Other Expenditures67249OtherExpenditures
Administrative Expenses14748AdministrativeExpenses
End Of Year Balance1248401EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis446450OtherCostOrOtherBasis
Book Value446450BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5789901OtherCostOrOtherBasis
Depreciation5548875Depreciation
Book Value241026BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3068151OtherCostOrOtherBasis
Depreciation2702650Depreciation
Book Value365501BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis124605OtherCostOrOtherBasis
Depreciation74007Depreciation
Book Value50598BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1103575TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Current Workers Comp and Health Reserves$149,167
Long-Term Workers Comp Reserve$131,987
Swap Market Valuation$94,592
Other$12,874
FieldValueIRS element (for citing)
Total Of Amounts388620TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part IV, Line 2b:Resident personal needs accounts are administered by the business office of this facility.
Part V, Line 4:Income only of the trust funds shall be used by Farren Care Center, Inc for its general purposes.Description of Intended Use of Endowment Funds:

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Daniel P Moen
0384135040300054004011025019845050930900
William Bithoney MD
0586330424520347293018708021062048814800
Daniel Keenan
01620790692180800016973015007026407700
Thomas Robert
0230056075578074201810504124032860500
Leonard F Pansa
02125530804740195101991404076031896800
Christopher McLaughlin
01665130665020533015351018201026710000

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 1aMonthly dues for SPHS's CEO were paid to the Colony Club.
Part I, Line 3Farren Care Center, Inc. relied on a related organization (Sisters of Providence Health System, Inc.) that used one or more of the methods described below to establish the top management official's compensation: - Compensation committee - Written employment contract - Independent compensation consultant - Compensation survey or study - Approval by the board or compensation committee
Part I, Lines 4a-bWilliam Bithoney M.D. $347,293 Severance
Part I, Lines 4a-bChristopher McLaughlin $10,376; Leonard Pansa $12,797; William Bithoney $16,500; Thomas Robert $7,455; Daniel Keenan $10,200
Part I, Line 6The organization has an incentive pay program of which one criteria is based on the organization's operating results as compared to budget as well as other criteria which includes quality and patient satisfaction.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Mass HEFA 2007C
04245601157586CXY62007-04-193309843Advance refunding000
Mass HEFA 2009
04245601157586EGR62009-03-191935420Current refunding and swap termination000
Mass HEFA 2010
04245601157586ESB82010-04-071821349Current refunding000

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Amount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
17123228889233098438198329937319805120070111
20060193542034654190076620091011
252720182134926371179497820101011

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty1MngmentCntrctBondFinancdPrprty
Engage Bond Counsel Contracts1EngageBondCounselContracts
Any Research Agreements0AnyResearchAgreements
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsBusiness Name Line2NameOfHedgeProvider/BusinessNameLine2Term Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
Merrill Lynch
001Capital21.60000000000000010
(no name)
000001
(no name)
000000

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSchedule K Supplental InformationIdentifier
ExplanationSchedule K, Part III, Column B, 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. Schedule K, Part IV, Column A, Line 5: Proceeds are held in a yield restricted refunding escrow.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 6Yes, Sisters of Providence Health System, Inc. is the sole member.
Form 990, Part VI, Section A, line 7aYes, Sisters of Providence Health System, Inc. approves the appointment of the members of the governing body.
Form 990, Part VI, Section A, line 7bCHE along with Sisters of Providence Health System, Inc. have limited reserved powers to approve decisions of the governing body.
Form 990, Part VI, Section B, line 11The 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 prepared by Deloitte Tax LLP, reviewed by management and then was presented to the Finance Committee, who reviewed the 990 at their meeting on November 6, 2012.
Form 990, Part VI, Section B, line 12cThe organization has adopted CHE's Policy 103, which sets forth the organization's conflict-of-interest policy and processes. Annually, all those serving the organization in a fiduciary capacity, including directors, officers 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's 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 upon request.
Form 990, Part VI, Section B, line 15The organization has adopted CHE'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 program 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 19Organizational 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 upon request.
Form 990, Part VII:Individuals receiving compensation from related organizations have system-wide responsibilities requiring services to be performed for this organization as well as other organizations in the Sisters of Providence Health System, Inc. The hours listed for individuals in Part VII reflect the time the individual spends on this organization and related organizations. Accordingly, compensation listed in this part represents the individual's total compensation for work performed for all organizations comprising the Sisters of Providence Health System, Inc.Avg hours devoted to related org(s) when related comp is reported:
Form 990, Part XI, line 5:Pension adjustment -24,893. Unrealized loss on interest rate swaps -91,669. Restricted Funds Activity 5,577. Net unrealized losses on investments -99,907. Total to Form 990, Part XI, Line 5: -210,892.Changes in Net Assets or Fund Balances:
Form 990, Part XII, Line 2a & 2b:While the entity does not have individual audited financial statements, an audit of SPHS's consolidated financial statements was performed.Explanation of financial statements:
Form 990, Part VII, Section A:All money paid for services performed by Sr. Sullivan goes directly to her religious order on her behalf.
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

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (139 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Catholic Health East
3805 West Chester Pike Suite 100Newtown SquarePA19073232929748Management ServicesPA501(c)(3)Line 11a, IN/A1
Continuing Care Management Services Network
3805 West Chester Pike Suite 100Newtown SquarePA19073352336834Management & Support ServicesPA501(c)(3)Line 11b, II1Catholic Health East
Mercy Health System of Maine
144 State StreetPortlandMA04101010484074Management & Support ServicesME501(c)(3)Line 11c, III-FI1Catholic Health East
Mercy Hospital
144 State StreetPortlandMA04101010211534HospitalME501(c)(3)Line 31Mercy Health System of Maine
St Peter's Health Partners
315 South Manning BlvdAlbanyNY12208453570715Management & Support ServicesNY501(c)(3)Line 11b, II1Catholic Health East
St Peter's Health Care Services
315 South Manning BlvdAlbanyNY12208222702507Management & Support ServicesNY501(c)(3)Line 91St Peter's Health Partners
St Peter's Hospital
315 South Manning BlvdAlbanyNY12208141348692HospitalNY501(c)(3)Line 31St Peter's Health Care Services
St Peter's Hospital Foundation Inc
319 South Manning Blvd Suite 309AlbanyNY12208222262982Fundraising & Public RelationsNY501(c)(3)Line 71St Peter's Health Care Services
Eddy Licensed Home Care Agency
433 River St Suite 3000TroyNY12180141818568Home HealthNY501(c)(3)Line 31LTC(Eddy) Inc
The Community Hospice Foundation Inc
295 Valley View BlvdRensselaerNY12144222692940Fundraising & Public RelationsNY501(c)(3)Line 71The Community Hospice Inc
The Community Hospice Inc
295 Valley View BlvdRensselaerNY12144141608921Serving seriously ill people & their familiesNY501(c)(3)Line 31St Peter's Health Care Services
Villa Mary Immaculate
301 Hackett BlvdAlbanyNY12208141438749Nursing Home & Physical RehabNY501(c)(3)Line 31St Peter's Hospital
Warde Service Corporation Inc
159 Wolf Road 3rd FloorAlbanyNY12205141732097Supporting & strengthing the ministries of rel. sr. mercyNY501(c)(3)Line 91St Peter's Health Care Services
Mercy Care for Kids Inc
310 South Manning BlvdAlbanyNY12208141717564Day care centerNY501(c)(3)Line 91St Peter's Health Care Services
Our Lady of Mercy Life Center
2 Mercycare LaneGuilderlandNY12084141743506Nursing Home FacilityNY501(c)(3)Line 31St Peter's Health Care Services
St Peter's Auxiliary
315 South Manning BlvdAlbanyNY01228222843206AuxiliaryNY501(c)(3)Line 11a, I1St Peter's Health Care Services
Memorial Hospital Albany NY
600 Northern BlvdAlbanyNY12204141338457General HospitalNY501(c)(3)Line 31Northeast Health Inc
Beechwood Inc
2212 Burdett AveTroyNY12180141651563Real estate holdingNY501(c)(2)N/A1LTC (Eddy) Inc
Beverwyck Inc
40 Autumn DriveSlingerlandsNY12159141717028Independent/Assisted Living Retirement CommunityNY501(c)(3)Line 91LTC (Eddy) Inc
Capital Region Geriatric Center Inc
421 West Columbia StCohoesNY12047141701597Nursing HomeNY501(c)(3)Line 91LTC (Eddy) Inc
Senior Care Connection Inc
504 State StSchenectadyNY12305141708754PACE ProgramNY501(c)(3)Line 91LTC (Eddy) Inc
Glen Eddy Inc
One Glen Eddy DriveNiskayunaNY12309141794150Independent/Assisted Living CommunityNY501(c)(3)Line 91LTC (Eddy) Inc
Hawthorne Ridge Inc
30 Community WayEast GreenbushNY12061800102840Independent/Assisted Living Retirement CommunityNY501(c)(3)Line 91LTC (Eddy) Inc
Heritage House Nursing Center Inc
2920 Tibbits AveTroyNY12180141725101Nursing homeNY501(c)(3)Line 91LTC (Eddy) Inc
Home Aid Service of Eastern New York Inc
433 River St Suite 3000TroyNY12180141514867Home careNY501(c)(3)Line 91LTC (Eddy) Inc
James A Eddy Memorial Geriatric Center Inc
2256 Burdett AveTroyNY12180222570478Nursing homeNY501(c)(3)Line 91LTC (Eddy) Inc
LTC (Eddy) Inc
2212 Burdett AveTroyNY12180222564710Elderly health/housing supporting orgNY501(c)(3)Line 11a, I1Northeast Health Inc
The Marjorie Doyle Rockwell Center Inc
421 West Columbia StCohoesNY12047141793885Adult Home/AlzheimersNY501(c)(3)Line 91LTC (Eddy) Inc
Samaritan Hospital of Troy New York
2215 Burdett AveTroyNY12180141338544General hospitalNY501(c)(3)Line 31Northeast Health Inc
Shaker Properties Inc
2212 Burdett AveTroyNY12180223119822Real Estate holdingNY501(c)(2)N/A1Northeast Health Inc
Sunnyview Hospital & Rehabilitation Ctr
1270 Belmont AveSchenectadyNY12308141338386Rehabilitation hospitalNY501(c)(3)Line 31LTC (Eddy) Inc
Empire Home Infusion Service Inc
10 Blacksmith DriveMaltaNY12020141795732Home careNY501(c)(3)Line 91Home Aid Service of Eastern New York Inc
Samaritan Child Care Center Inc
2213 Burdett AveTroyNY12180141710225Child day careNY501(c)(3)Line 91Northeast Health Inc
The Northeast Health Foundation Inc
2224 Burdett AveTroyNY12180222743478Supporting foundationNY501(c)(3)Line 71Northeast Health Inc
Northeast Health Inc
2212 Burdett AveTroyNY12180042450756Supporting OrganizationNY501(c)(3)Line 11b, II1St Peter's Health Partners
Seton Health System Inc
1300 Massachusetts AvenueTroyNY12180141776186HospitalNY501(c)(3)Line 31St Peter's Health Partners
Seton Auxiliary Inc
1300 Massachusetts AvenueTroyNY12180141505031Supporting OrganizationNY501(c)(3)Line 91Seton Health System Inc
Seton Health at Schuyler Ridge Residential Healthcare
1 Abele BlvdClifton ParkNY12065141756230Skilled NursingNY501(c)(3)Line 91Seton Health System Inc
Seton Health Foundation
1300 Massachusetts AvenueTroyNY12180222345416Supporting OrganizationNY501(c)(3)Line 11a, I1Seton Health System Inc
Seton Licensed Home Care Inc
1300 Massachusetts AvenueTroyNY12180141809134Licensed Home Health AgencyNY501(c)(3)Line 31Seton Health System Inc
Vincentian Health Services
1300 Massachusetts AvenueTroyNY12180141685163Discontinued OperationsNY501(c)(3)Line 11a, I1Seton Health System Inc
St Mary's Woodland Village Inc
1300 Massachusetts AvenueTroyNY12180141675183Discontinued OperationsNY501(c)(3)Line 91Seton Health System Inc
Brightside Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040042182395Behavioral CareMA501(c)(3)Line 91Sisters of Providence Health System Inc
Mercy Hospital Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040043398280Acute CareMA501(c)(3)Line 31Sisters of Providence Health System Inc
Mercy Specialist Physicians Inc
c/o SPHS 1221 Main Street No 108HolyokeMA01040264033168Neurosurgery Medical ServicesMA501(c)(3)Line 31Sisters of Providence Health System Inc
Sisters of Providence Care Centers Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040222541103Long Term CareMA501(c)(3)Line 31Sisters of Providence Health System Inc
Sisters of Providence Health System Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040043398374Management & Support ServicesMA501(c)(3)Line 11a, I1Catholic Health East
McAuley Center Inc
275 Steele RoadWest HartfordCT06117061058086Independent LivingCT501(c)(3)Line 91Mercy Community Health Inc
Mercy Community Health Inc
2021 Albany AvenueWest HartfordCT06117061492707Management & Support ServicesCT501(c)(3)Line 11a, I1Catholic Health East
Mercy Community HomeCare Services
2021 Albany AvenueWest HartfordCT06117061488137In Home Health CareCT501(c)(3)Line 91Mercy Community Health Inc
Mercy Services
2021 Albany AvenueWest HartfordCT06117061453323Support ServicesCT501(c)(3)Line 11Mercy Community Health Inc
Mercyknoll Inc
2021 Albany AvenueWest HartfordCT06117060757380Skilled NursingCT501(c)(3)Line 31Mercy Community Health Inc
Saint Mary Home II Inc
2021 Albany AvenueWest HartfordCT06117061164104Elderly CareCT501(c)(3)Line 31Mercy Community Health Inc
St Mary Home Incorporated
2021 Albany AvenueWest HartfordCT06117060646843Skilled NursingCT501(c)(3)Line 31Mercy Community Health Inc
Mercy Healthcare Center
114 Wawbeek AvenueTupper LakeNY12986150532211HospitalNY501(c)(3)Line 31Catholic Health East
Mercy Uihlein Health Corporation
185 Old Military RoadLake PlacidNY12946161535133HospitalNY501(c)(3)Line 11b, II1Mercy Healthcare Center
Uihlein Mercy Center
185 Old Military RoadLake PlacidNY12946150532190HospitalNY501(c)(3)Line 31Mercy Healthcare Center
St James Mercy Foundation Inc
411 Canisteo StreetHornellNY14843161486437FoundationNY501(c)(3)Line 71St James Mercy Health System Inc
St James Mercy Health System Inc
411 Canisteo StreetHornellNY14843223127184Management & Support ServicesNY501(c)(3)Line 11b, II1Catholic Health East
St James Mercy Hospital
411 Canisteo StreetHornellNY14843160743310HospitalNY501(c)(3)Line 31St James Mercy Health System Inc
Marian Community Hospital
100 Lincoln AvenueCarbondalePA18407240711230HospitalPA501(c)(3)Line 31Maxis Health System
Marian Community Hospital Auxiliary
100 Lincoln AvenueCarbondalePA18407251874733FundraisingPA501(c)(3)Line 11b, II1Maxis Health System
Maxis Foundation
100 Lincoln AvenueCarbondalePA18407232330090FundraisingPA501(c)(3)Line 11b, II1Maxis Health System
Maxis Health System
100 Lincoln AvenueCarbondalePA18407911940902Health Care SystemPA501(c)(3)Line 11b, II1Catholic Health East
Maxis Medical Services
100 Lincoln AvenueCarbondalePA18407232577185Physician PracticesPA501(c)(3)Line 31Maxis Health System
Tri-County Human Services Center Inc
PO Box 517CarbondalePA18407231938528Behavioral Health OrganizationPA501(c)(3)Line 71Maxis Health System
Columbus Acquisition Corp
1160 Raymond BoulevardNewarkNJ07102262616342Inactive EntityNJ501(c)(3)Line 91Saint Michaels Medical Center
Saint Michaels Medical Center
111 Central AvenueNewarkNJ07102262616046HospitalNJ501(c)(3)Line 31Catholic Health East
St James Care Inc
1160 Raymond BoulevardNewarkNJ07102262616230Inactive EntityNJ501(c)(3)Line 91Saint Michaels Medical Center
St Michaels Medical Center Foundation
1160 Raymond BoulevardNewarkNJ07102223311976FoundationNJ501(c)(3)Line 11a, I1Saint Michaels Medical Center
University Heights Property Company Inc
1160 Raymond BoulevardNewarkNJ07102223100162Medical Property Holding CompanyNJ501(c)(2)N/A1Saint Michaels Medical Center
Life St Francis Corporation
601 Hamilton AvenueTrentonNJ08629222797282Health ServicesNJ501(c)(3)Line 11a, I1St Francis Medical Center Trenton NJ
St Francis Medical Center Foundation NJ
601 Hamilton AvenueTrentonNJ08629521025476FoundationNJ501(c)(3)Line 11a, I1St Francis Medical Center Trenton NJ
St Francis Medical Center Trenton NJ
601 Hamilton AvenueTrentonNJ08629223431049HospitalNJ501(c)(3)Line 31Catholic Health East
Langhorne MRI Inc
1201 Langhorne-Newtown RoadLanghornePA19047232519529Inactive EntityPA501(c)(3)Line 91St Mary Medical Center
Langhorne Physician Services Inc
1201 Langhorne-Newtown RoadLanghornePA19047232571699Physician ServicesPA501(c)(3)Line 91St Mary Medical Center
LIFE St Mary
1201 Langhorne-Newtown RoadLanghornePA19047262976184Elderly CarePA501(c)(3)Line 91St Mary Medical Center
St Mary Medical Center
1201 Langhorne-Newtown RoadLanghornePA19047231913910HospitalPA501(c)(3)Line 31Catholic Health East
St Mary Medical Center Foundation Inc
1201 Langhorne-Newtown RoadLanghornePA19047232567468FoundationPA501(c)(3)Line 71St Mary Medical Center
East Norriton Physician Services
c/o One West Elm StreetConshohockenPA19428232515999Physician ServicesPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
Mercy Catholic Medical Center of Southeastern Pennsylvania
One West Elm StreetConshohockenPA19428231352191Acute Care HospitalPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
Mercy Family Support
1001 Baltimore Pike Suite 301SpringfieldPA19064232325059Home HealthPA501(c)(3)Line 91Mercy Health System of Southeastern Pennsylvania
Mercy Health Foundation of Southeastern Pennsylvania
c/o MHS One West Elm StreetConshohockenPA19428232829864FundraisingPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Mercy Health Plan
c/o One West Elm StreetConshohockenPA19428222483605Health PlansPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Mercy Health System of Southeastern Pennsylvania
One West Elm StreetConshohockenPA19428232212638Management & Support ServicesPA501(c)(3)Line 11b, II1Catholic Health East
Mercy Home Health
1001 Baltimore Pike Suite 310SpringfieldPA19064231352099Home HealthPA501(c)(3)Line 91Mercy Health System of Southeastern Pennsylvania
Mercy Home Health Services
1001 Baltimore Pike Suite 301SpringfieldPA19064232325058Home HealthPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Mercy Management of Southeastern Pennsylvania
One West Elm StreetConshohockenPA19428232627944Physician PracticesPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Mercy Suburban Hospital
One West Elm StreetConshohockenPA19428231396763Acute Care HospitalPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
Nazareth Health Care Foundation
2701 Holme AvenuePhiladelphiaPA19152232300951FundraisingPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Nazareth Hospital
2601 Holme AvenuePhiladelphiaPA19152232794121Acute Care HospitalPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
Nazareth Physician Services Inc
2601 Holme AvenuePhiladelphiaPA19152203261266Physician PracticesPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
NE Physician Services
2601 Holme AvenuePhiladelphiaPA19152232497355Physician PracticesPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
St Agnes Continuing Care Center
1900 S Broad StreetPhiladelphiaPA19145232840137Continuing Care ServicesPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
St Agnes Continuing Care Center Foundation
1900 S Broad StreetPhiladelphiaPA19145232415137FundraisingPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Life at Lourdes Inc
1600 Haddon AvenueCamdenNJ08108261854750Elderly CareNJ501(c)(3)Line 31Our Lady of Lourdes Health Care Services
Lourdes Ancillary Services
1600 Haddon AvenueCamdenNJ08103222568525Supporting OrganizationNJ501(c)(3)Line 11b, II1Our Lady of Lourdes Health Care Services
Lourdes Dialysis at Innova Inc
1600 Haddon AvenueCamdenNJ08108263237625HospitalNJ501(c)(3)Line 31Our Lady of Lourdes Health Care Services
Lourdes Medical Center Burlington County
218 Sunset RoadWillingboroNJ08046223612265HospitalNJ501(c)(3)Line 31Our Lady of Lourdes Health Care Services
Our Lady of Lourdes Health Care Services
1600 Haddon AvenueCamdenNJ08103222568528Management & Support ServicesNJ501(c)(3)Line 11b, II1Catholic Health East
Our Lady of Lourdes Health Foundation Inc
1600 Haddon AvenueCamdenNJ08103222351960FoundationNJ501(c)(3)Line 71Our Lady of Lourdes Health Care Services
Our Lady of Lourdes Medical Center
1600 Haddon AvenueCamdenNJ08103210635001HospitalNJ501(c)(3)Line 31Our Lady of Lourdes Health Care Services
Franciscan Eldercare Corporation
PO Box 2500WilmingtonDE19805223008680EldercareDE501(c)(3)Line 91St Francis Hospital
St Francis Foundation
PO Box 2500WilmingtonDE19805510374158FoundationDE501(c)(3)Line 11b, II1St Francis Hospital
St Francis Hospital
PO Box 2500WilmingtonDE19805510064326HospitalDE501(c)(3)Line 31Catholic Health East
LIFE at St Francis Healthcare Inc
7th Clayton StreetsWilmingtonDE19805452569214Elderly CareDE501(c)(3)Line 31St Francis Hospital
McAuley Ministries
McAuley Hall 3333 Fifth AvenuePittsburghPA15213943436142Management & Support ServicesPA501(c)(3)Line 91Pittsburgh Mercy Health System
Mercy Jeannette Hospital
3805 West Chester PikeNewtown SquarePA19073251310602Inactive EntityPA501(c)(3)Line 91Pittsburgh Mercy Health System
Mercy Life Center Corporation
1200 Reedsdale StreetPittsburghPA15233251604115Community TreatmentPA501(c)(3)Line 91Pittsburgh Mercy Health System
Pittsburgh Mercy Health System
3333 5th AvenuePittsburghPA15213251464211Management & Support ServicesPA501(c)(3)Line 11b, II1Catholic Health East
St Joseph's of the Pines Inc
100 Gossman Drive Suite BSouthern PinesNC28387560694200HospitalNC501(c)(3)Line 31Catholic Health East
Life St Joseph of the Pines Inc
100 Gossman Drive Suite BSouthern PinesNC28387272159847Healthcare ServicesNC501(c)(3)Line 31St Joseph's of the Pines Inc
Mercy Senior Care Inc
212 West Third Street PO Box 866RomeGA30162581366508Community OutreachGA501(c)(3)Line 71Saint Joseph's Health System Inc
Good Samaritan HospitalInc
1201 Siloam RoadGreensboroGA30462261720984HospitalGA501(c)(3)Line 31Saint Joseph's Health System Inc
Saint Joseph's Health System Inc
5673 Peachtree-Dunwoody Road SuiteAtlantaGA30342581744848Management & Support ServicesGA501(c)(3)Line 11b, II1Catholic Health East
Saint Joseph's Mercy Care Services Inc
5673 Peachtree-Dunwoody Road SuiteAtlantaGA30342581752700Community OutreachGA501(c)(3)Line 71Saint Joseph's Health System Inc
Saint Joseph's Mercy Foundation Inc
5673 Peachtree-Dunwoody Road SuiteAtlantaGA30342581448522FundraisingGA501(c)(3)Line 11b, II1Saint Joseph's Health System Inc
Mercy Services Downtown Inc
5673 Peachtree-Dunwoody Road SuiteAtlantaGA30342272046353Real Estate Holding CompanyGA501(c)(3)Line 11b, II1Saint Joseph's Health System Inc
St Mary's Health Care System Inc
1230 Baxter StreetAthensGA30606580566223HospitalGA501(c)(3)Line 31Catholic Health East
St Mary's Foundation Inc
1230 Baxter StreetAthensGA30606582544232FundraisingGA501(c)(3)Line 11b, II1St Mary's Health Care System Inc
St Mary's Highland Hills Inc
1230 Baxter StreetAthensGA30606020576648Assisted Living & Retirement CommunityGA501(c)(3)Line 31St Mary's Health Care System Inc
St Mary's Medical Group Inc
1230 Baxter StreetAthensGA30606261858563Hospital / Physician ServicesGA501(c)(3)Line 31St Mary's Health Care System Inc
Mercy Medical Corporation
PO Box 1090 101 Villa DriveDaphneAL36526636002215HospitalAL501(c)(3)Line 31Catholic Health East
Mercy LIFE of Alabama
PO Box 1090 101 Villa DriveDaphneAL36526273163002HospitalAL501(c)(3)Line 31Mercy Medical Corporation
Allegany Franciscan Ministries Inc
33920 US Highway 19 North Suite 269Palm HarborFL34684581492325Management & Support ServicesFL501(c)(3)Line 11b, II1Catholic Health East
St Francis Hospital Inc
33920 US Highway 19 North Suite 269Palm HarborFL34684590624442HospitalFL501(c)(3)Line 11a, I1Allegany Franciscan Ministries Inc
Holy Cross Hospital Inc
4725 North Federal HighwayFt LauderdaleFL33308590791028HospitalFL501(c)(3)Line 31Catholic Health East
Holy Cross Long-Term Inc
4725 North Federal HighwayFt LauderdaleFL33308650787320Medical ServicesFL501(c)(3)Line 31Holy Cross Hospital Inc
Holy Cross Medical Properties Inc
4725 North Federal HighwayFt LauderdaleFL33308650666283Medical Building Real Estate ManagementFL501(c)(2)N/A1Holy Cross Hospital Inc
Mercy Hospital Foundation Inc
3663 South Miami AvenueMiamiFL33133591709438FundraisingFL501(c)(3)Line 71Mercy Hospital Inc
Mercy Hospital Inc
3663 South Miami AvenueMiamiFL33133590791034HospitalFL501(c)(3)Line 31Catholic Health East
Mercy Medical Development Inc
3663 South Miami AvenueMiamiFL33133592789194Outpatient ServicesFL501(c)(3)Line 91Mercy Hospital Inc
Mercy Mission Services Inc
3663 South Miami AvenueMiamiFL33133650435764Health CareFL501(c)(3)Line 11a, I1Mercy Hospital Inc
Mercy Outpatient Services Inc DBA Sister Emmanuel Hospital
3663 South Miami AvenueMiamiFL33133510461511HospitalFL501(c)(3)Line 31Mercy Hospital Inc
Global Health Ministry
3805 West Chester Pike Suite 100Newtown SquarePA19073233068656Health CarePA501(c)(3)Line 71Catholic Health East
VNA Home Health & Hospice
50 Foden RoadSouth PortlandME04106010246804Home Health & HospiceME501(c)(3)Line 11a, I1Mercy Health System of Maine
Providence Place Inc
5 Gamelin StreetHolyokeMA01040043404084Retirement CommunityMA501(c)(3)Line 91Sisters of Providence Health System Inc
Intercoastal Health Systems
3805 West Chester Pike Suite 100Newtown SquarePA19073650556413Management & Support ServicesPA501(c)(3)Line 11a, I1Catholic Health East
Sunnyview Hospital & Rehabilitation Center Foundation
1270 Belmont AveSchenectadyNY12308222505127Supporting foundationNY501(c)(3)Line 11a, I1Sunnyview Hospital & Rehabilitation Ctr

Form990 Schedule R Part III Form990ScheduleRPartIII (21 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
St Peter's Ambulatory Surgery Center LLC
1375 Washington Avenue Ste 201AlbanyNY12206460463892SurgeryNYN/A
Catherine Horan Building Limited Partnership
1221 Main Street Room 108HolyokeMA010400000042723429Property ManagementMAN/A
Western Massachusetts PETCT Imaging Center LLC
100 Bayview Circle Ste 400Newport BeachCA92660204744663Outpatient Medical ServicesDEN/A
Central New Jersey Heart Services LLC
10720 Sikes Places Ste 300CharlotteNC28277208525458Cardiac ProgramNJN/A
Langhorne MOB Partners LP
1201 Langhorne-Newtown RoadLanghornePA19047232622772Investment and operation of a medical buildingPAN/A
SMMC MOB II LP
1201 Langhorne-Newtown RoadLanghornePA19047364559869Investment and operation of a medical buildingPAN/A
The Ambulatory Surgery Center at St Mary LLC
1203 Langhorne-Newton RoadLanghornePA19047232871206Outpatient SurgeryPAN/A
AmeriHealth Mercy Health Plan
200 Stevens Drive Suite 350PhiladelphiaPA19113232859523Medicaid Managed Care OrganizationPAN/A
Amerihealth Mercy of Indiana LLC
200 STEVENS DRIVE Suite 350PhiladelphiaPA19113204948091PREPAID HEALTH CARE SERVICESINN/A
East Norriton Medical Associates
One West Elm StreetConshohockenPA19428232319531Medical Office BuildingPAN/A
East Norriton Medical Associates
One West Elm StreetConshohockenPA19428232319531Medical Office BuildingPAN/A
Gateway Health Plan
300 Grant StreetPittsburghPA15219251691945Medicaid & Medicare/Special Needs Managed Care OrganizationPAN/A
Keystone Mercy Health Plan
100 Stevens DrivePhiladelphiaPA19113232842344Medicaid Managed Care OrganizationPAN/A
MercyManor Partnership
PO Box 10086ToledoOH436990086521931012Nursing HomePAN/A
St Agnes Long Term Intensive Care LLP
1900 S Broad StreetPhiladelphiaPA19145200984882Long Term Intensive CarePAN/A
Nazareth Medical Office Building Associates LP
c/o Nazareth Hospital 2601 Holme AvPhiladelphiaPA19152232388040Medical Office BuildingPAN/A
Nazareth Medical Office Building Associates LP
c/o Nazareth Hospital 2601 Holme AvPhiladelphiaPA19152232388040Medical Office BuildingPAN/A
St Agnes Long Term Intensive Care LLP
1900 S Broad StreetPhiladelphiaPA19145200984882Long Term Intensive CarePAN/A
SJV Management LLC
200 Century Pkwy Ste 200EMount LaurelNJ08054202273476RadiologyNJN/A
Physicians Outpatient Surgery Center LLC
1000 NE 56thOakland ParkFL33334352325646Ambulatory Surgery CenterFLN/A
Center for Surgery & Digestive Orders
3641 South Miami AvenueMiamiFL33133510438152Outpatient Medical ServicesFLN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (34 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountryProvince Or StateAddressForeign/ProvinceOrStatePostal CodeAddressForeign/PostalCode
Samaritan Medical Office Building Inc
2212 Burdett AvenueTroyNY12180141607244Real EstateNYN/AC
Affiliated Management Services Corporation Inc
1300 Massachusetts AvenueTroyNY12180141668024Real EstateNYN/AC
Catherine Horan Building Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000042938180Building ManagementMAN/AC
Diversified Community Services Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000043128890Medical ServicesMAN/AC
Mercy Inpatient Medical Associates Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000043029829Medical ServicesMAN/AC
Providence Home Care Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000043317426Health Care ServicesMAN/AC
System Coordinated Services Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000042938181Lab ServicesMAN/AC
Physicians Medical Office Building Condominium Trust
1221 Main Street Room 108HolyokeMA010400000046608649Property ManagementMAN/AC
SJM Properties Inc
411 Canisteo StreetHornellNY148482104161294991Property HoldingsNYN/AC
Carbondale Area Physicians' Association PC
100 Lincoln AveCarbondalePA18407232801677Medical Insurance ContractingPAN/AC
Carbondale Area Physicians' PHO Inc
100 Lincoln AveCarbondalePA18407232801676InactivePAN/AC
Carbondale Physicians' Services Inc
100 Lincoln AveCarbondalePA18407232365077PharmacyPAN/AC
Chestnut Risk Services Ltd
InsuranceN/AC11 Victoria StreetHamiltonBDBD
LifeCare Physicians PC
601 Hamilton AvenuetrentonNJ086291986261649038Health Care ServicesNJN/AC
Multicare Plus Inc
601 Hamilton AvenueTrentonNJ086291986223435844InactiveNJN/AC
Langhorne Services II Inc
1201 Langhorne-Newtown RoadLanghornePA190470000253795549General Partner of LMOB Partners, IIPAN/AC
Langhorne Services Inc
1201 Langhorne-Newtown RoadLanghornePA190470000232625981General Partner of LMOB PartnersPAN/AC
AMHP Holdings Corp
200 Stevens DrivePhiladelphiaPA19113261144363Behavorial HealthPAN/AC
Select Health of South Carolina Inc
4390 Belle Oaks Drive Suite 400CharlestonSC29405571032456Health Maintenance OrganizationSCN/AC
Gateway Health Plan Inc
600 Grant StreetPittsburghPA15219251505506Health CarePAN/AC
Gateway Health Plan Inc of Ohio
600 Grant StreetPittsburghPA15219300282076Health CarePAN/AC
MCMC Eastwick Inc
c/o MHS One West Elm StreetConshohockenPA19428232184261Medical Office BuildingsPAN/AC
Community Behavorial Healthcare Network of PA Inc
8040 Carlson RoadHarrisburgPA17112251765391Behavorial HealthPAN/AC
Health Management Services Org Inc
500 Grove Street Suite 100Haddon HeightsNJ08035223366580Health Care BillingNJN/AC
Jeannette Medical Providers
3805 West Chester PikeNewtown SquarePA19073251787334Holding CompanyPAN/AC
Jeannette OBGYN Group 1 Inc
3805 West Chester PikeNewtown SquarePA19073232890748Holding CompanyPAN/AC
Jeannette Primary Care Group 1 Inc
3805 West Chester PikeNewtown SquarePA19073232890743Holding CompanyPAN/AC
Georgia Health Enterprises LLC
11440 Commerce Park DriveRestonVA20191541806329HealthcareVAN/AC
St Mary's Highland Hills Village Inc
1660 Jennings Mill PklyBogartGA30622582276801Assisted LivingGAN/AC
GHE Physicians PC
3500 Piedmont RoadAtlantaGA30305582277939Practice ManagementGAN/AC
Nursing Network Inc
4725 North Federal HighwayFort Lauderdale HighwaFL333080000591145192Medical ServicesFLN/AC
Mercy Physician Group Inc
3663 South Miami AvenueMiamiFL33133202970015Health CareFLN/AC
Stella Maris Insurance Company Limited
980078266InsuranceN/ACPO Box 69Grand CaymanCJCJCayman IslandsKY1-1102
Catholic Health East Senior Services
3805 West Chester Pike Suite 100Newtown SquarePA19073371572595Senior ServicesPAN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Sisters of Providence Health System IncBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeOTransactionType
Amount Involved1028798AmountInvolved
Method Of Amt DeterminationFair Market ValueMethodOfAmtDetermination

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