2011-05-11T11:26:32-05:00 2010-06-30 990 2009-07-01 311439334 MOUNT CARMEL HEALTH SYSTEM MOUN 6145464300 6150 EAST BROAD STREET COLUMBUS OH 432131574 JACQUELINE PRIMEAU 6145464300 2011-05-11 2009 2016-02-24 21:20:13Z JACQUELINE PRIMEAU 6150 EAST BROAD STREET COLUMBUS OH 432131574 199662168 0 0928 X www.mountcarmelhealth.com X 1995 OH HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT 14 8 9178 10 3457664 -76819 0 171562880 173499288 -18483486 11257861 14548732 13495028 167628126 198252177 620335 733277 0 68000622 68353761 0 0 124308671 126879059 192929628 195966097 -25301502 2286080 571601737 656577204 428148581 421842032 143453156 234735172 MOUNT CARMEL HEALTH SYSTEM'S PURPOSE IS TO GOVERN, MANAGE AND PROVIDE ADMINISTRATIVE SERVICES TO ITS SUBSIDIARIES. THE ADMINISTRATIVE SERVICES PROVIDED BY MOUNT CARMEL HEALTH SYSTEM FOR THE SUBSIDIARIES ALLOW FOR ECONOMIES OF SCALE THAT PERMIT THE SUBSIDIARIES TO PROVIDE HEALTHCARE SERVICES TO PATIENTS AT A REASONABLE COST. 0 0 189294367 733277 177868555 MOUNT CARMEL HEALTH SYSTEM, AN OHIO NOT-FOR-PROFIT CORPORATION, OWNS AND OPERATES Five HOSPITALS IN THE COLUMBUS, OHIO AREA CONTAINING 1,196 BEDS AND VARIOUS OTHER ACUTE AND NONACUTE HEALTH SERVICE PROVIDERS AS WELL AS A LICENSED HEALTH MAINTENANCE ORGANIZATION. THE HEALTH SYSTEM PROVIDES SERVICES TO PATIENTS WHO RESIDE IN CENTRAL OHIO. OHIO NOT-FOR-PROFIT MEMBER ORGANIZATIONS INCLUDE MOUNT CARMEL HEALTH, SAINT ANN'S HOSPITAL, MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL, DILEY RIDGE MEDICAL CENTER, MOUNT CARMEL CARE CONTINUUM SERVICES CORPORATION, MOUNT CARMEL COLLEGE OF NURSING, MOUNT CARMEL HEALTH SYSTEM FOUNDATION AND MOUNT CARMEL HEALTH PLAN, INC. OHIO FOR-PROFIT MEMBER ORGANIZATIONS INCLUDE MOUNT CARMEL HEALTH HORIZONS CORPORATION, MOUNT CARMEL HEALTH PROVIDERS, INC., PRIMARY CARE NETWORK OF OHIO INC., AND MOUNT CARMEL BEHAVIORAL HEALTHCARE SERVICES.MOUNT CARMEL HEALTH SYSTEM IS A MEMBER OF TRINITY HEALTH.FOR MORE INFORMATION ON SPECIFIC SERVICES PROVIDED, PLEASE SEE MOUNT CARMEL HEALTH SYSTEM'S WEBSITE AT WWW.MOUNTCARMELHEALTH.COM. MISSIONTHE MISSION STATEMENT FOR MOUNT CARMEL HEALTH SYSTEM IS AS FOLLOWS:WE SERVE TOGETHER IN TRINITY HEALTHIN THE SPIRIT OF THE GOSPELTO HEAL BODY, MIND AND SPIRITTO IMPROVE THE HEALTH OF OUR COMMUNITIESAND TO STEWARD THE RESOURCES ENTRUSTED TO US. 189294367 1 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 1 1107 0 1 9178 1 1 1 0 0 0 0 0 0 0 0 0 14 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X JACQUELINE PRIMEAU 6145464300 6150 EAST BROAD STREET COLUMBUS OH 43213 STAMPP CORBIN 2.00 X X 0 0 0 MICHAEL FLOWERS 2.00 X X 0 0 0 HERB GLIMCHER 2.00 X 0 0 0 MATTHEW HABASH 2.00 X X 0 0 0 CHARLES HICKEY MD 2.00 X 0 0 0 SR RUTH M NICKERSON CSC 2.00 X X 0 0 0 DAVID STEWART MD 2.00 X 0 0 0 M ROSITA SCHILLER RSM 2.00 X 0 0 0 MICHAEL SLUBOWSKI 2.00 X 0 1617841 154389 CLAUS VON ZYCHLIN 20.00 X X 0 1007069 70248 MICHAEL GONSIOROWSKI 2.00 X 0 0 0 MICHAEL CURTIN 2.00 X 0 0 0 PHILLIP SHUBERT MD 2.00 X 499409 0 37627 SUSAN TOMASKY 2.00 X 0 0 0 J RICHARD OCONNELL 2.00 X 0 495143 11123 CARL BERASI DO 2.00 X 0 0 0 John Perez 2.00 X 0 0 0 JACQUELINE PRIMEAU 20.00 X 0 491642 32586 RONALD WHITESIDE 20.00 X 0 453976 269271 ALAN PAPA 2.00 X 0 301100 38337 CYNTHIA SHEETS 50.00 X 0 390748 54761 PAULA AUTRY 2.00 X 0 353408 31691 JANET MEEKS 2.00 X 0 376393 100757 JOHN HEISLER 20.00 X 0 299295 43505 HUGH JONES 20.00 X 0 286450 32785 DAVID DRYDEN 50.00 X 166688 0 30043 JOSEPH SWEDISH 2.00 X 0 3023292 798303 KEDRICK ADKINS 2.00 X 0 1453695 130171 RICHARD STRECK 50.00 X 0 469042 43231 MICHELE HELBIG 50.00 X 222267 0 48011 LYNDON CHRISTMAN 50.00 X 220035 0 15036 MARY ANN WOLF 50.00 X 211499 0 43537 DENNIS F RUPPEL 50.00 X 207114 0 40246 1527012 11019094 2025658 263 0 1 0 BVK DIRECT 250 WEST COVENTRY CT STE 300 MILWAUKEE WI 53217 MARKETING & ADVERTISING 1830090 dawson healthcare 3650 OLENTANGY RIVER ROAD COLUMBUS OH 43214 TEMPORARY SERVICES 1216247 ESCRIPTION INC PO BOX 845912 KANSAS CITY MO 64141 TRANSCRIPTION SERVICES 929574 DELOITTE CONSULTING PO BOX 7247-6446 PHILADELPHIA PA 19170 ACCOUNTING AND CONSULTING 693975 NEXTGEN HEALTHCARE INFORMATION PO BOX 809390 CHICAGO IL 60680 MAINTENANCE SERVICES 603978 58 SUBSIDIARY FEES 900099 171990155 171990155 GIFT SHOPS 453220 1410315 1410315 CAFETERIA REVENUE 900099 98818 98818 173499288 12100254 12100254 4158964 4158964 4158964 4158964 567598 1053433 356558 -1053433 211040 -842393 -842393 MANAGEMENT FEES 561499 3361973 2816802 545171 PROFESSIONAL FEES 900099 1590670 457474 1133196 4383421 2604124 1779297 9336064 198252177 177868555 3457664 16925958 733277 733277 5199108 5199108 165912 165912 49028329 48609040 419289 2946758 2946758 7044981 6961603 83378 3968673 3968673 15734 15734 1107499 1107499 10800 10800 8735659 8628136 107523 3771047 3766941 4106 9552311 9487277 65034 39508894 39507394 1500 2519672 2083369 436303 362683 354546 8137 234866 234866 18377589 18116323 261266 879064 879064 INTERCO. PURCHASED SERV 20569703 20569703 EQUIPMENT MAINTENANCE 10866664 10790995 75669 CONTRACT LABOR 4807094 4807094 SUBSCRIPTIONS AND DUES 1569509 1568134 1375 UBI TAXES 309190 309190 3681081 3672039 9042 195966097 189294367 6671730 0 18886 19206 24916573 20153908 12181063 28691399 13030471 954957 4955337 2602479 218124754 128510289 96326844 89614465 175643089 254090226 145451734 128693109 1151934 99077740 130605521 571601737 656577204 46496776 48897995 53000 381651805 372891037 428148581 421842032 X 143453156 234735172 143453156 234735172 571601737 656577204 X 0 1 1 X 1 1 X X X 0 0 0 MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL 870790288 3 0 1 1 0 MOUNT CARMEL HEALTH 314379602 3 0 1 1 0 ST ANN'S HOSPITAL 314412701 3 0 1 1 0 TRINITY HEALTH CORPORATION 351443425 11 1 1 1 8605113 DILEY RIDGE MEDICAL CENTER 342032340 3 0 1 1 0 5 8605113 0 1 0 0 0 1 10087 1 74456 0 0 84543 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: MOUNT CARMEL HEALTH SYSTEM HAS MADE GRANTS TO OTHER ORGANIZATIONS IN THE FORM OF MEMBERSHIP DUES PAID TO A NATIONAL HEALTH CARE ORGANIZATION. THIS ORGANIZATION HAS PROVIDED MOUNT CARMEL HEALTH SYSTEM WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. IN ADDITION, PAYMENTS WERE MADE TO LOBBYING FIRMS TO ASSIST WITH FEDERAL EARMARK REQUESTS AND STATE LEGISLATIVE ADVOCACY. MOUNT CARMEL HEALTH SYSTEM MADE NO CONTRIBUTIONS TO ANY LEGISLATORS OR CANDIDATES. 32473597 32473597 71565358 32300179 39265179 106676070 96210110 10465960 6432769 976960 7409729 89614465 ABSOLUTE RETURN STRATEGY FUNDS 60982029 F COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 67711080 F 128693109 OTHER RECEIVABLES 2254781 INTERCOMPANY ACCOUNTS RECEIVABLES 56203425 INVESTMENT IN AFFILIATES 19712379 INTERCOMPANY OTHER LONG TERM ASSET 52301831 OTHER 133105 130605521 INTERCOMPANY ACCOUNTS PAYABLE 1757850 DEFERRED COMPENSATION LIABILITY 450866 OTHER CURRENT LIABILITIES 286853 OTHER LONG TERM LIABILITIES 2695496 INTERCOMPANY NOTES PAYABLE 365710538 LEASE OBLIGATION 1989434 372891037 Part X: Description of Uncertain Tax Positions Under FIN 48: MOUNT CARMEL HEALTH SYSTEM HAS A SEPARATE CONSOLIDATED AUDIT WHICH INCLUDES ALL WHOLLY OWNED, MAJORITY OWNED, AND CONTROLLED ORGANIZATIONS. MOUNT CARMEL HEALTH SYSTEM'S FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2010 DID NOT INCLUDE A FIN 48 FOOTNOTE. MOUNT CARMEL HEALTH SYSTEM is ALSO included in the consolidated financial statements of Trinity Health. Trinity Health's financial statements for the year ended June 30, 2010 did not include a FIN 48 footnote. 0 CAPITAL PARK FAMILY HEALTH CENTER INC 2150 AGLER RD COLUMBUS OH 43224 383765547 501(C)3 300000 COMMUNITY BENEFIT AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)3 25000 COMMUNITY BENEFIT THE COLUMBUS COALITION AGAINST FAMILY VIOLENCE 655 EAST LIVINGSTON AVENUE COLUMBUS OH 43205 542143915 501(C)3 10000 COMMUNITY BENEFIT ARTHRITIS FOUNDATION INC 3740 RIDGE MILL DRIVE HILLIARD OH 43026 314419290 501(C)3 10000 COMMUNITY BENEFIT COLUMBUS CHAMBER OF COMMERCE 150 SOUTH FRONT ST COLUMBUS OH 43215 314152950 501(C)6 25000 COMMUNITY BENEFIT SOCIETY OF ST VINCENT DEPAUL 197 E GAY STREET COLUMBUS OH 43215 314379603 501(C)3 5500 COMMUNITY BENEFIT WESTERVILLE AREA RESOURCE MINISTRY 175A E BROADWAY WESTERVILLE OH 43081 311640355 501(C)3 5200 COMMUNITY BENEFIT HEALTHY WORTHINGTON COALITION PO BOX 190 WORTHINGTON OH 43085 450532036 501(C)3 6000 COMMUNITY BENEFIT GAHANNA CONVENTION AND VISITORS BUREAU 181 GRANVILLE STREET GAHANNA OH 43230 800322167 501(C)6 25000 COMMUNITY BENEFIT WESTERVILLE SUNRISE ROTARY FOUNDATION P O BOX 1200 WESTERVILLE OH 43086 311481931 501(C)3 17600 COMMUNITY BENEFIT WESTERVILLE PARKS FOUNDATION 350 N CLEVELAND AVE WESTERVILLE OH 43081 311719247 501(C)3 5280 COMMUNITY BENEFIT 9 2 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: DONATIONS MADE BY MOUNT CARMEL HEALTH SYSTEM TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE AND ARE CONSIDERED UNRESTRICTED WITH REGARD TO THE USE OF THE FUNDS. X X X X X X 0 1 0 0 0 0 0 0 0 MICHAEL SLUBOWSKI 0 696108 0 681725 0 240008 0 125922 0 28467 0 1772230 0 94766 CLAUS VON ZYCHLIN 0 466168 0 442450 0 98451 0 42829 0 27419 0 1077317 0 0 PHILLIP SHUBERT MD 435053 0 55991 0 8365 0 21969 0 15658 0 537036 0 0 0 J RICHARD OCONNELL 0 440925 0 0 0 54218 0 11123 0 0 0 506266 0 0 JACQUELINE PRIMEAU 0 343908 0 70753 0 76981 0 22360 0 10226 0 524228 0 60642 RONALD WHITESIDE 0 357508 0 70976 0 25492 0 248590 0 20681 0 723247 0 0 ALAN PAPA 0 236652 0 50930 0 13518 0 14968 0 23369 0 339437 0 0 CYNTHIA SHEETS 0 315525 0 60317 0 14906 0 43977 0 10784 0 445509 0 0 PAULA AUTRY 0 285305 0 54883 0 13220 0 10195 0 21496 0 385099 0 0 JANET MEEKS 0 297542 0 64380 0 14471 0 80824 0 19933 0 477150 0 0 JOHN HEISLER 0 241561 0 44566 0 13168 0 21667 0 21838 0 342800 0 0 HUGH JONES 0 222663 0 46769 0 17018 0 12051 0 20734 0 319235 0 6759 DAVID DRYDEN 145402 0 17412 0 3874 0 8907 0 21136 0 196731 0 0 0 JOSEPH SWEDISH 0 1214458 0 1607837 0 200997 0 769899 0 28404 0 3821595 0 0 KEDRICK ADKINS 0 712415 0 611975 0 129305 0 117250 0 12921 0 1583866 0 0 RICHARD STRECK 0 370385 0 77344 0 21313 0 22030 0 21201 0 512273 0 0 MICHELE HELBIG 185728 0 34934 0 1605 0 34536 0 13475 0 270278 0 0 0 LYNDON CHRISTMAN 192123 0 23823 0 4089 0 14758 0 278 0 235071 0 0 0 MARY ANN WOLF 189668 0 21342 0 489 0 35130 0 8407 0 255036 0 0 0 DENNIS F RUPPEL 206285 0 0 0 829 0 19649 0 20597 0 247360 0 0 0 Part I, Line 4a THE FOLLOWING ARE PARTICIPANTS IN THE TRINITY HEALTH PENSION RESTORATION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($245,000 FOR 2009). THE FOLLOWING ACCRUALS FOR 2009 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS $59,584 MICHAEL SLUBOWSKI $42,832 JOSEPH SWEDISH $249,263 CLAUS VON ZYCHLIN $22,044 PART I, LINE 4B: THE FOLLOWING ARE PARTICIPANTS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING SERP ACCRUALS FOR 2009 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS $38,675 JANET MEEKS $59,610 CYNTHIA SHEETS $16,540 MICHAEL SLUBOWSKI $55,733 JOSEPH SWEDISH $493,225 RONALD WHITESIDE $206,250 Part II, Column B (ii): The following individuals received amounts in 2009 from a long-term incentive plan (LTIP). Participants in the LTIP (CEOs and certain Trinity executives) were eligible to receive a payment under the plan only if certain patient loyalty improvement targets were achieved by the end of a three-year period (FY07 through FY09). The following LTIP amounts are included in Schedule J, Part II, Column B(ii): KEDRICK ADKINS $337,826 MICHAEL SLUBOWSKI $403,918 JOSEPH SWEDISH $1,042,563 CLAUS VON ZYCHLIN $292,000 NEW ALBANY HOSPITAL MANAGEMENT COMPANY II LLC (NAHMC) CARL BERASI, MCHS TRUSTEE, IS A PART OWNER, BD MEMBER & EMPLOYEE OF NAHMC 1823428 NEW ALBANY MANAGEMENT COMPANY II LLC CONTRACTS WITH MOUNT CARMEL HEALTH SYSTEM TO PROVIDE MANAGEMENT SERVICES TO MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL. THESE TRANSACTIONS WERE ALL AT ARMS LENGTH. 0 PNC BANK MICHAEL GONSIOROWSKI, MCHS TRUSTEE, IS REG. PRES. OF PNC'S CNTRL OH REGION 1130772 PNC BANK PROVIDES COMMERCIAL BANKING SERVICES TO MOUNT CARMEL HEALTH SYSTEM. 0 ANGELA SMITH FAMILY MEMBER OF CYNTHIA SHEETS, KEY EMPLOYEE 94129 EMPLOYMENT ARRANGEMENT 0 MICHAEL SLAPER FAMILY MEMBER OF MATTHEW HABASH, OFFICER AND TRUSTEE 71783 EMPLOYMENT ARRANGEMENT 0 Form 990, Part VI, Section A, line 6 THE SOLE MEMBER OF MOUNT CARMEL HEALTH SYSTEM IS TRINITY HEALTH CORPORATION. SEE LINE 7 FOR ADDITIONAL INFORMATION. Form 990, Part VI, Section A, line 7a TRINITY HEALTH CORPORATION IS THE SOLE MEMBER OF MOUNT CARMEL HEALTH SYSTEM. TRINITY HEALTH CORPORATION HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF MOUNT CARMEL HEALTH SYSTEM. Form 990, Part VI, Section A, line 7b AS SOLE MEMBER, TRINITY HEALTH CORPORATION MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. TRINITY HEALTH CORPORATION MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS. Form 990, Part VI, Section B, line 11 PRIOR TO FILING, THE FORM 990 FOR MOUNT CARMEL HEALTH SYSTEM IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE FINANCE COMMITTEE AS WELL AS THE BOARD OF TRUSTEES. THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. Form 990, Part VI, Section B, line 12c MOUNT CARMEL HEALTH SYSTEM HAS ADOPTED A CONFLICT OF INTEREST POLICY WHICH CONTAINS THE ELEMENTS IN THE MODEL CONFLICT OF INTEREST POLICY ISSUED BY THE IRS. IT APPLIES TO ALL "INTERESTED PERSONS" OF MOUNT CARMEL HEALTH SYSTEM, WHICH INCLUDES trustees, PRINCIPAL OFFICERS AND EXECUTIVES, AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. INTERESTED PERSONS ARE REQUIRED TO ACT AT ALL TIMES IN A MANNER CONSISTENT WITH MOUNT CARMEL HEALTH SYSTEM'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MOUNT CARMEL HEALTH SYSTEM OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE BOARD OF trustees OF MOUNT CARMEL HEALTH SYSTEM IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO MOUNT CARMEL HEALTH SYSTEM. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORIGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE REVIEWED WITH THE BOARD OF trustees OF MOUNT CARMEL HEALTH SYSTEM ON AN ANNUAL BASIS. Form 990, Part VI, Section B, line 15 TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF MOUNT CARMEL HEALTH SYSTEM ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. Form 990, Part VI, Section C, line 19 MOUNT CARMEL HEALTH SYSTEM IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE ANNUAL REPORT (WHICH INCLUDES COMMUNITY BENEFIT MINISTRY INFORMATION) AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. FORM 990, PART VII, SECTION A, COLUMN B: ESTIMATE OF THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: THE HOURS LISTED IN COLUMN B OF PART VII, SECTION A, LINE 1 REFLECT ONLY THE INDIVIDUALS' AVERAGE WEEKLY HOURS SPENT DIRECTLY ON THE ACTIVITIES OF THE REPORTING ORGANIZATION. IN ADDITION, THESE ARE THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: KEDRICK ADKINS - 53 HOURS PAULA AUTRY - 53 HOURS JOHN HEISLER - 35 HOURS HUGH JONES - 35 HOURS JANET MEEKS - 53 HOURS J. RICHARD O'CONNELL - 53 HOURS ALAN PAPA - 53 HOURS JACQUELINE PRIMEAU - 35 HOURS PHILLIP SHUBERT, MD - 48 HOURS MICHAEL SLUBOWSKI - 53 HOURS JOSEPH SWEDISH - 53 HOURS CLAUS VON ZYCHLIN - 35 HOURS RONALD WHITESIDE - 35 HOURS FORM 990, PART XI, LINE 2: MOUNT CARMEL HEALTH SYSTEM'S FINANCIAL INFORMATION WAS INCLUDED IN THE FY10 CONSOLIDATED FINANCIAL STATEMENTS OF MOUNT CARMEL HEALTH SYSTEM, AS WELL AS THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. BOTH SETS OF CONSOLIDATED FINANCIAL STATEMENTS WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. CLR Investments LLC 120 W HARRIS ST CADILLAC MI 49601 320008631 Real estate rental & development MI 19827 175469 Trinity Health-Michigan Saint Agnes Home Health and Hospice LLC 17410 COLLEGE PARKWAY STE 150 LIVONIA MI 48152 382621935 Provide home health services CA 9367604 1116725 Trinity Home Health Services Inc Saint Mary's Pharmacy LLC 200 JEFFERSON AVE SE GRAND RAPIDS MI 49503 383404443 Pharmacy MI 0 0 Trinity Health-Michigan Mount Carmel HealthProviders Two LLC 6150 E BROAD STREET COLUMBUS OH 43213 201983271 MEDICAL SERVICES OH 0 0 MOUNT CARMEL HEALTH PROVIDERS INC PATHWAY HOSPICE LLC 1050 SW 3RD AVE SUITE 1600 ONTARIO OR 97914 931310235 HOSPICE CARE OR 1273503 1512716 SAINT ALPHONSUS MEDICAL CENTER-ONTARIO TRINITY HEALTH-WARDE LAB LLC 34605 W TWELVE MILE ROAD FARMINGTON HILLS MI 48331 272681908 REAL ESTATE RENTAL DE 0 0 TRINITY HEALTH - MICHIGAN MOUNT CARMEL HEALTH PROVIDERS III LLC 10 West Broad St Ste 2100 COLUMBUS OH 43215 204145781 MEDICAL SERVICES OH 1741059 6043 MOUNT CARMEL HEALTH PROVIDERS INC AMICARE HOSPICE SERVICES INC 27870 CABOT DRIVE NOVI MI 483772920 382949053 PROVIDE HOSPICE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC AUXILIARY OF HOLY ROSARY HOSPITAL 351 SW 9TH STREET ONTARIO OR 97914 943059469 SUPPORTS SERVICES OF RELATED HOSPITAL OR 501(C)(3) 9 SAINT ALPHONSUS MEDICAL CENTER-ONTARIO BATTLE CREEK HEALTH SYSTEM 300 NORTH AVENUE BATTLE CREEK MI 49016 382776791 HEALTHCARE SERVICES MI 501(C)(3) 3 TRINITY HEALTH - MICHIGAN BATTLE CREEK HEALTH SYSTEM AUXILIARY 300 NORTH AVENUE BATTLE CREEK MI 49016 383355520 SUPPORT OF TAX EXEMPT HEALTH ORGANIZATION MI 501(C)(3) 11, TYPE I BATTLE CREEK HEALTH SYSTEM BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 Acute/Ambulatory healthcare services IA 501(C)(3) 3 Mercy Health Services-Iowa Corp BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 Support the services of related hospital IA 501(C)(3) 11, TYPE I Baum Harmon Mercy Hospital CAPITAL PARK FAMILY HEALTH CENTER INC 6150 EAST BROAD STREET COLUMBUS OH 43213 311387838 Operation of a federally qualified health center (formerly) OH 501(C)(3) 3 Mount Carmel Health System CATHERINE MCAULEY HEALTH SERVICES CORP PO BOX 995 ANN ARBOR MI 48106 382507173 Further Trinity Health activities, organize and develop medical services MI 501(C)(3) 11, TYPE II Trinity Health-Michigan Cranbrook Hospice Care 281 ENTERPRISE COURT BLOOMFIELD HILLS MI 48302 383320699 Provide hospice health services MI 501(C)(3) 11, TYPE I Trinity Home Health Services Inc Diley Ridge Medical Center 6150 EAST BROAD STREET COLUMBUS OH 43213 342032340 Hospital campus in Fairfield County Ohio OH 501(C)(3) 3 Mount Carmel Health System Dubuque Mercy Health Foundation Inc 250 MERCY DRIVE DUBUQUE IA 52001 262227941 Support the services of related hospital IA 501(C)(3) 11, TYPE I Mercy Health Services-Iowa Corp Dyersville Health Foundation Inc 1111 3RD STREET SW DYERSVILLE IA 52040 205383271 Support the services of related hospital IA 501(C)(3) 11, TYPE I Mercy Health Services-Iowa Corp Hackley Hospital 1700 CLINTON ST PO BOX 3302 MUSKEGON MI 494433302 381358196 HEALTHCARE SERVICES MI 501(C)(3) 3 Mercy Health Partners Hackley Hospital Self Insurance Professional Liability Trust PO BOX 3302 MUSKEGON MI 494433302 382299878 Self insurance for general and malpractice liability MI 501(C)(3) 11, TYPE III-FI Mercy Health Partners Hackley Life Counseling 1352 TERRACE ST MUSKEGON MI 494423545 381386362 Counseling, education, and support MI 501(C)(3) 9 Mercy Health Partners Hackley Visiting Nurse Services and Hospice Inc 888 TERRACE ST MUSKEGON MI 49440 381359598 Provide home health care services MI 501(C)(3) 7 Mercy Health Partners Holy Cross Carenet Inc PO BOX 9184 FARMINGTON HILLS MI 48333 521945054 Long-term care and rehabilitation for the elderly MD 501(C)(3) 9 Trinity Continuing Care Services Holy Cross Hospital Foundation Inc 11801 TECH ROAD SILVER SPRING MD 20904 208428450 Charitable fundraising MD 501(C)(3) 11, TYPE I Holy Cross Hospital of Silver Spring Inc Holy Cross Hospital of Silver Spring Inc 1500 FOREST GLEN RD SILVER SPRING MD 209101484 520738041 HEALTHCARE SERVICES MD 501(C)(3) 3 Trinity Health Corporation Holy Cross Medical Center 27870 CABOT DRIVE NOVI MI 483772920 951985442 HEALTHCARE SERVICES (FORMERLY) CA 501(C)(3) 3 Trinity Health Corporation HOLY ROSARY MEDICAL CENTER FOUNDATION 351 SW 9TH STREET ONTARIO OR 97914 202683560 SUPPORT THE SERVICES OF RELATED HOSPITAL OR 501(C)(3) 11, TYPE I SAINT ALPHONSUS MEDICAL CENTER-ONTARIO Hospice of North Iowa 232 SECOND STREET SE MASON CITY IA 504016208 421173708 Hospice health care services IA 501(C)(3) 7 Mercy Health Services-Iowa Corp Hospice of Washtenaw II 806 AIRPORT BLVD ANN ARBOR MI 48108 383320707 Hospice health care services MI 501(C)(3) 11, TYPE I Trinity Health-Michigan HPCN 1675 LEAHY STREET MUSKEGON MI 49442 300207909 HEALTHCARE SERVICES MI 501(C)(3) 11, TYPE II Mercy Health Partners Lakeshore Community Hospital Inc 72 S STATE STREET SHELBY MI 494551228 382549295 Acute healthcare services MI 501(C)(3) 3 Mercy Health Partners Lifespan Inc 166 EAST GOODALE AVE BATTLE CREEK MI 490372728 383298476 Provide hospice health services MI 501(C)(3) 9 Battle Creek Health System Marian Home Healthcare 801 5TH STREET SIOUX CITY IA 51101 383320705 Provide home health care services IA 501(C)(3) 11, TYPE I Mercy Health Services-Iowa Corp McAuley Clinic Corporation PO BOX 992 ANN ARBOR MI 48106 382561013 HEALTHCARE SERVICES (FORMERLY) MI 501(C)(3) 3 Catherine McAuley Health Services Corp Mercy Amicare Home Healthcare Oakland 281 ENTERPRISE COURT BLOOMFIELD HILLS MI 483020312 383320698 Provide home health care services MI 501(C)(3) 11, TYPE I Trinity Home Health Services Inc Mercy Amicare Home Healthcare Port Huron 2540 16TH STREET PORT HURON MI 48060 383320701 Provide home health care services MI 501(C)(3) 11, TYPE I Trinity Home Health Services Inc Mercy Community 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