2011-05-09T06:51:55-05:00 2010-06-30 990 2009-07-01 421336618 MERCY MEDICAL CENTER - CLINTON INC MERC 5632445555 1410 NORTH 4TH STREET CLINTON IA 527322940 PAUL MANGIN 5632445555 2011-05-09 2009 2016-02-24 21:20:13Z MERCY MEDICAL CENTER-CLINTON PAUL MANGIN 1410 NORTH 4TH STREET CLINTON IA 527322940 95509049 0 X WWW.MERCYCLINTON.COM X 1989 DE TO PROVIDE QUALITY HEALTH CARE 14 10 1031 320 98056 32645 27177 295748 84117808 91725572 -2001007 1647510 1774783 1529722 83918761 95198552 31883 40922 0 39862283 43509946 0 0 44718215 45349851 84612381 88900719 -693620 6297833 95434554 108532288 30873661 35504022 64560893 73028266 TO PROVIDE QUALITY HEALTHCARE - SEE SCHEDULE H FOR MORE INFORMATION 0 0 73595728 40922 92448758 MERCY MEDICAL CENTER - CLINTON, INC. (THE HOSPITAL), A NOT-FOR-PROFIT CORPORATION, IS THE HUB OF HEALTH CARE IN A FOUR-COUNTY, TWO-STATE AREA LYING IN THE IOWA/ILLINOIS MISSISSIPPI VALLEY. THE HOSPITAL OPERATES 358 LICENSED BEDS, INCLUDING 175 ACUTE CARE BEDS AND 183 LONG-TERM CARE BEDS; LONG-TERM CARE BEDS INCLUDE A 23-BED DEMENTIA CARE UNIT. RECOGNIZING CURRENT AND FUTURE HEALTH CARE NEEDS, THE HOSPITAL IS CONTINUALLY DEVELOPING STATE-OF-THE-ART SERVICES SUCH AS RADIATION ONCOLOGY, RENAL DIALYSIS AND OTHER OUTPATIENT TECHNOLOGY. MERCY MEDICAL CENTER - CLINTON, INC. IS A MEMBER OF TRINITY HEALTH UNDER ITS CORPORATE STRUCTURE. THE MISSION STATEMENT FOR MERCY MEDICAL CENTER-CLINTON IS AS FOLLOWS:OUR MISSION AS MERCY MEDICAL CENTER IS TO WORK TOGETHER AND WITH OTHERS TO CONTINUE THE HEALING MINISTRY OF THE CHURCH, PROMOTING THE WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE BY LIVING THE VALUES OF COMPASSION, RESPECT, CONCERN FOR THOSE WHO ARE POOR, EXCELLENCE AND STEWARDSHIP. 73595728 1 1 0 1 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 1 0 0 1 1 0 0 0 0 0 1 1 0 0 1 174 0 1 1031 1 1 1 0 0 0 0 0 0 0 0 14 10 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 IA X PAUL MANGIN 5632445555 1410 NORTH 4TH STREET CLINTON IA 527322940 VICTORIA ARNDORFER RSM 1.00 X 0 0 0 BRUCE CHRISTENSEN 1.00 X 0 0 0 WILLIAM COTTER 1.00 X 0 0 0 THOMAS FULLERTON 1.00 X 0 0 0 STEPHEN HARRISON MD 1.00 X 10000 0 0 CORITA HEID RSM 1.00 X 0 0 0 JUERGEN HOLL MD 1.00 X 0 0 0 PETER KARADJOFF 1.00 X 0 521282 35686 JAMES OLNEY MD 1.00 X 0 0 0 DOROTHY SCHWENDINGEROSF 1.00 X 0 0 0 CHRISTOPHER VENS 1.00 X 0 0 0 RICHARD J OLSEN 1.00 X 0 0 0 RICHARD WINKEL 1.00 X 0 0 0 LAMETTA WYNN 1.00 X X 0 0 0 KAREN VICKERS 1.00 X X 0 0 0 DONNA OLIVER 50.00 X X 0 541342 45076 SEAN WILLIAMS 50.00 X X 0 0 0 pauL MANGIN 50.00 X 0 215140 44048 MARILYN HEIAR 40.00 X 38829 0 18086 JOSEPH SWEDISH 2.00 X 0 3023292 798303 KEDRICK ADKINS 2.00 X 0 1453695 130171 MICHAEL SLUBOWSKI 2.00 X 0 1617841 154389 J RICHARD O'CONNELL 2.00 X 0 495143 11123 JOAN NOE 50.00 X 0 164683 29555 AMY E BERENTES 50.00 X 0 156355 23578 RODNEY TOKHEIM 50.00 X 0 151953 34368 MOHAMMED IRSHAD MD 50.00 X 650349 0 19391 DOUGLAS T CODY MD 50.00 X 274504 0 25804 JOHN PERUSHEK 50.00 X 125846 0 35521 KENT JORGENSEN 50.00 X 0 122383 31912 WILLIAM EDEN 50.00 X 118145 0 12468 1217673 8463109 1449479 12 0 1 0 CLINTON ER ASSOCIATES PLC 417 BUTTERNUT LANE IOWA CITY IA 52246 ER PHYSICIAN SVCS 1836410 APOGEE MEDICAL MANAGEMENT 2525 E CAMELBACK RD PHOENIX AZ 85016 HOSPITALISTS 895705 AGILITY HEALTH PROFESSIONALS 560 FIFTH STREET NW GRAND RAPIDS MI 49504 REHABILITATION SERVICES 570661 CRESCENT LAUNDRY INC 2422 ROCKINGHAM ROAD DAVENPORT IA 52802 LAUNDRY SERVICES 328703 MEDDATA PO BOX 2065 SEATTLE WA 98111 BILLING SERVICES 236019 16 255704 40044 295748 NET PATIENT SVC REV 900099 91410737 91410737 PHARMACY REVENUE 446110 216779 216779 LABORATORY UBI 621500 98224 98224 PARTNERSHIP UBI 621500 -168 -168 91725572 1614252 1614252 227366 156540 70826 70826 70826 47907 139308 153957 47907 -14649 33258 33258 OTHER REVENUE 900099 1038021 1038021 CAFETERIA 900099 420875 420875 1458896 95198552 92448758 98056 2355990 40922 40922 1446368 1446368 317523 317523 33610210 29843811 3766399 2111401 1891406 219995 3302020 2900168 401852 2722424 2159871 562553 83694 83694 6276 2004 4272 6893639 5947114 946525 291091 24581 266510 12480162 12253917 226245 3380771 3380771 1554113 1539710 14403 226481 201089 25392 15417 13778 1639 769377 769377 8189904 7716810 473094 267358 267358 BAD DEBT 5203689 5203689 CONTRACT LABOR 2413565 878527 1535038 INTERCO. PURCHASED SVCS 2024452 219569 1804883 EQUIPMENT MAINTENANCE 1109916 1092346 17570 UBI TAXES 2725 2725 437221 228464 208757 88900719 73595728 15304991 0 1501619 1954370 8400627 10177799 49797 13872 1334988 1247069 85027 102410 109125042 78560656 34390430 30564386 23693628 38251091 19617337 19360822 1097250 6361101 5763219 95434554 108532288 9487045 13089376 22175 23308 21364441 22391338 30873661 35504022 X 64560893 73028266 64560893 73028266 95434554 108532288 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 21883 1 12778 0 0 34661 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: MERCY MEDICAL CENTER - CLINTON, INC. HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS. THESE ORGANIZATIONS HAVE PROVIDED MERCY MEDICAL CENTER - CLINTON WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. FEDERAL ADVOCACY PRIORITIES FOR FY10 INCLUDED: SECURING COVERAGE AND ACCESS FOR ALL, ACHIEVING BETTER AND MORE EFFICIENT CARE, AND SAFEGUARDING HOSPITAL CAPABILITY TO IMPROVE COMMUNITY AND ECONOMIC HEALTH. 0 1 512212 512212 67844269 46355382 21488887 39807136 32205274 7601862 961425 961425 30564386 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 10186576 F ABSOLUTE RETURN STRATEGY FUNDS 9174246 F 19360822 OTHER RECEIVABLES 138366 INTERCOMPANY ACCOUNTS RECEIVABLE 289131 INTERCOMPANY OTHER LT ASSETS 5316629 INVESTMENT IN AFFILIATES 19093 5763219 INTERCOMPANY ACCOUNTS PAYABLE 882990 ASSET RETIREMENT OBLIGATION (FIN 47) 627025 OTHER LONG-TERM LIABILITIES 16870 DEFERRED COMPENSATION LIABILITIES 67174 INTERCOMPANY NOTES PAYABLE 19700029 OTHER LIABILITIES 1097250 22391338 Part IV, Line 2b: MERCY LIVING CENTER, A LONG TERM CARE FACILITY, HAS TWO CUSTODIAL ACCOUNTS THAT WERE FOR LONG TERM CARE RESIDENTS' PERSONAL USE. Part X: Description of Uncertain Tax Positions Under FIN 48: MERCY MEDICAL CENTER - CLINTON, INC. IS 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. 1 1 X 1 X 1 X 1 1 0 1 1 1 3806 2172618 2172618 0.02600 10607 12374216 12881029 -506813 0.00000 1 14413 14546834 12881029 1665805 0.02600 33 18951 316322 24763 291559 0.00350 2 147 391 391 0.00000 14 7560 1947273 1422659 524614 0.00630 31 73684 73684 0.00090 80 26658 2337670 1447422 890248 0.01070 81 41071 16884504 14328451 2556053 0.03670 1 95 95 0.00000 3 115 1879 1879 0.00000 1 88 15912 15912 0.00020 1 15 49 49 0.00000 1 13 15307 15307 0.00020 1 1 2098 2098 0.00000 6 83 31827 31827 0.00040 14 315 67167 67167 0.00080 0 2034031 528848 33704667 34501281 -796614 X 1 1 CLINTON IMAGING SERVICES LLC MRI SERVICES 0.65000 0.35000 MERCY MEDICAL CENTER - NORTH

1410 N 4TH STREET CLINTON IA 52732

X X X REHAB,LAB, RADIOLOGY MERCY MEDICAL CENTER - SOUTH

638 S BLUFF BLVD CLINTON IA 52732

X REHAB,SKILLED NURSING FACILITY, MERCY MEDICAL CENTER - SOUTH (CONT'D)

638 S BLUFF BLVD CLINTON IA 52732

HOME CARE, HOSPICE MERCY LIVING CENTER - NORTH

600 14TH AVE NORTH CLINTON IA 52732

LONG TERM CARE Part I, Line 6a: MERCY MEDICAL CENTER - CLINTON reports its community benefit information as part of the consolidated community benefit information reported by Trinity Health in its annual report, available at www.trinity-health.org.In addition, MERCY MEDICAL CENTER - CLINTON includes a copy of its most recently filed schedule H on both its own website and trinity health's website. Part I, Line 7: The best available data was used to calculate the cost amounts reported in item 7. For certain categories, primarily total charity care and means-tested government programs, specific cost-to-charge ratios were calculated and applied to those categories. The cost-to-charge ratio was derived from worksheet 2, ratio of patient care cost-to-charges. In other categories, the best available data was derived from the Hospital's cost accounting system.UNREIMBURSED MEDICAIDMERCY MEDICAL CENTER - CLINTON (MMC-CLINTON) HAS REPORTED TOTAL COST OF MEDICAID OF $12,374,216 IN LINE 7B, COLUMN (C). ACTUAL DIRECT OFFSETTING REVENUE WAS $12,881,029, RESULTING IN A NET NEGATIVE COMMUNITY BENEFIT EXPENSE OF -$506,813. THIS NET EXPENSE IS -.61% OF TOTAL EXPENSE.THE TAX REPORTING SOFTWARE DOES NOT PERMIT A NEGATIVE PERCENTAGE TO BE REPORTED IN COLUMN (F). THEREFORE, THE UNREIMBURSED MEDICAID PERCENTAGE IN COLUMN (F) IS SHOWING ZERO PERCENT. Part I, Line 7f: The following number, $5,203,689, represents the amount of bad debt expense included in total functional expenses in Form 990, Part IX, Line 25. Per IRS instructions, this amount was excluded from the denominator when calculating the percent of total expense for Schedule H, Part I, Line 7, column (f). Part III, Line 4: MMC-CLINTON is included in the consolidated financial statements of Trinity Health. The following is the text of the allowance for doubtful accounts footnote from those statements: "Substantially all of the corporation's receivables are related to providing healthcare services to patients. Accounts receivable are reduced by an allowance for amounts that could become uncollectible in the future. The corporation's estimate for its allowance for doubtful accounts is based upon management's assessment of historical and expected net collections by payor."Costing methodology for lines 2 and 3: Amounts are calculated on line 2 using a cost to charge ratio methodology.Any discounts provided or payments made to a particular patient account are applied to that patient account prior to any bad debt write-off and are thus not included in bad debt expense. As a result of the payment and adjustment activity being posted to bad debt accounts, we are able to report bad debt expense net of these transactions.THE AMOUNT ON LINE 3 WAS CALCULATED BASED on the information supplied by A THIRD PARTY VENDOR, H&R, A collection agency WHO USES the FasTag program TO identifY financial assistance based on a proprietary process. FasTag combines account data, external information and the hospital's financial assistance policy to arrive at a discount recommendation for each account. Part III, Line 8: Similar to CHA recommendations, which state that serving Medicare patients is not a differentiating feature of tax-exempt healthcare organizations and that the existing community benefit framework allows community benefit programs that serve the Medicare population to be counted in other community benefit categories, MMC-CLINTON does not believe any Medicare shortfall should be treated as community benefit.Part III, Line 8: Costing methodology for line 6 - Medicare costs were obtained from the filed Medicare cost report. The costs are based on Medicare allowable costs as reported on worksheet B, column 27, which exclude direct medical education costs. Inpatient Medicare costs are calculated based on a combination of allowable cost per day times Medicare days for routine services and cost to charge ratio times Medicare charges for ancillary services. Outpatient Medicare costs are calculated based on cost to charge ratio times Medicare charges by ancillary department. Part III, Line 9b: The organization's collection policy contains the criteria for financial assistance, and contains the following verbiage for arrangements with outside collection agencies: The agreement must define the standards and scope of practices to be used by outside collection agents acting on behalf of the Ministry Organization, all of which must be in compliance with this policy. Part VI, Line 2: NEEDS ASSESSMENT - MERCY MEDICAL CENTER-CLINTON ASSESSES THE HEALTH NEEDS OF THE COMMUNITY THROUGH COMMUNITY NEEDS ASSESSMENTS EVERY THREE YEARS. A COMMUNITY NEEDS ASSESSMENT IS A POINT-IN-TIME EFFORT TO MEASURE THE HEALTH AND WELL BEING OF THE COMMUNITY. IT SERVES AS THE BASIS FOR MERCY MEDICAL CENTER-CLINTON'S STRATEGIC AND SUBSEQUENT ACTION PLANNING TO DEVELOP HEALTH POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS AND COLLABORATE WITH OTHER COMMUNITY HEALTHCARE PROVIDERS. A COMMUNITY NEEDS ASSESSMENT ALSO SERVES AS A BENCHMARK FOR FUTURE ASSESSMENT OF RELATIVE PROGRESS TOWARD ESTABLISHED COMMUNITY HEALTH OBJECTIVES.THE MERCY MEDICAL CENTER-CLINTON COMMUNITY NEEDS ASSESSMENT PROVIDES THE OPPORTUNITY TO:- GAIN INSIGHTS INTO THE NEEDS AND ASSETS OF THE COMMUNITIES SERVED- IDENTIFY AND ADDRESS THE NEEDS OF VULNERABLE POPULATIONS WITHIN THE COMMUNITY- ENHANCE HOSPITAL/COMMUNITY RELATIONSHIPS AND THE OPPORTUNITY FOR COLLABORATIVE COMMUNITY ACTION, INCLUDING INVOLVEMENT WITH COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES, COMMISSIONS, ADVISORY GROUPS AND PANELS- PROVIDE THE INFORMATION REQUIRED FOR COMMUNITY OUTREACH PLANNINGTHE MERCY MEDICAL CENTER-CLINTON COMMUNITY NEEDS ASSESSMENT PROCESS INVOLVES THE GATHERING OF TWO TYPES OF DATA: QUANTITATIVE (DEMOGRAPHICS, HEALTH INDICATORS, ETC.) AND QUALITATIVE (PUBLIC SURVEYS, FORUMS, FOCUS GROUPS). THE DATA HELPS SUPPORT SHORT-TERM AND LONG-TERM DECISIONS ABOUT ALLOCATION OF COMMUNITY HUMAN AND CAPITAL RESOURCES.The Mercy Medical Center-Clinton community health needs assessment is current as of December 2010. The community needs assessment was conducted in collaboration with Genesis VNA, County Health Department, Clinton County Substance Abuse Council, Clinton County Mental Health, Lutheran Social Services of Iowa, RSVP and Generations Agency of Aging, Information Referral & Assistance, Pathways, and The Pregnancy Center. Part VI, Line 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MERCY MEDICAL CENTER-CLINTON IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE- BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITY.IN ACCORDANCE WITH AHA RECOMMENDATIONS, MERCY MEDICAL CENTER-CLINTON HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS:- PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSMERCY MEDICAL CENTER-CLINTON COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. MMC-CLINTON IS ASSISTED IN THIS PROCESS BY R & B SOLUTIONS, AN EXTERNAL VENDOR.FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY HELP THEM OBTAIN AND PAY FOR HEALTHCARE SERVICES. R & B SOLUTIONS HELPS PATIENTS COMPLETE APPLICATIONS AND CONDUCT APPEALS. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE.MERCY MEDICAL CENTER-CLINTON OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH OUR PATIENT HANDBOOKS, MESSAGES ON PATIENT BILLS, AND NOTICES POSTED IN THE REGISTRATION AREA. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO THE DEPARTMENT OF HEALTH AND HUMAN SERVICES AND CONTRACTED COLLECTION AGENCIES. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON THE HOSPITAL WEBSITE. IN ADDITION, INTERPRETERS ARE AVAILABLE TO THOSE NEEDING ASSISTANCE, PRIMARILY IN SPANISH.MERCY MEDICAL CENTER-CLINTON HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MERCY MEDICAL CENTER-CLINTON MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. MERCY MEDICAL CENTER-CLINTON EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, BILLING AND COLLECTIONS) ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES. Part VI, Line 4: COMMUNITY INFORMATION - MERCY MEDICAL CENTER-CLINTON SERVES A 16 ZIP CODE AREA ALONG THE MISSISSIPPI RIVER IN EASTERN IOWA AND WESTERN ILLINOIS. ITS PRIMARY AND SECONDARY SERVICE AREA HAVE A TOTAL POPULATION OF APPROXIMATELY 70,000, WHICH IS PROJECTED TO DECLINE SLIGHTLY BETWEEN 2008 AND 2011. WHILE THE OVERALL POPULATION IS DECLINING, THE NUMBER OF RESIDENTS 65 YEARS OF AGE AND OLDER WILL INCREASE. THE ETHNICITY OF MERCY'S SERVICE AREA IS PRIMARILY WHITE (94.7%), WITH SMALL BLACK AND HISPANIC COMMUNITIES (1.8% EACH).THE MEDICAL CENTER CONSISTS OF AN ACUTE CARE HOSPITAL OF 175 LICENSED BEDS, AND A STRONG CONTINUUM OF SERVICES FOR SENIORS (TWO NURSING HOMES, A DEMENTIA UNIT, TRANSITIONAL CARE BEDS, IRU, HOME CARE AND HOSPICE). Part VI, Line 5: COMMUNITY BUILDING ACTIVITIES - THE COMMUNITY BUILDING PROGRAMS SUPPORTED BY MERCY MEDICAL CENTER ARE INTENDED TO PROMOTE THE OVERALL HEALTH OF OUR COMMUNITY. MANY ARE AIMED AT IMPROVING THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, CHALLENGING FAMILY SITUATIONS, FINANCIAL CHALLENGES, AND ENVIRONMENTAL PROBLEMS. MERCY SUPPORTS THE BIG BROTHER/BIG SISTERS PROGRAM, THE CHAMBER OF COMMERCE, CLINTON REGIONAL DEVELOPMENT CORPORATION, CLINTON ROTARY, AND KIWANIS. MERCY ALSO PROVIDES LEADERSHIP SUPPORT AND PARTICIPATION IN COMMUNITY DEVELOPMENT ACTIVITIES, AND PROVIDES IN-KIND AND FINANCIAL SUPPORT TO UNITED WAY, IN ORDER TO SUPPORT AND ADDRESS THE CHALLENGES IN OUR COMMUNITY AT THE ROOT OF MANY HEALTH PROBLEMS.Major community benefit programs are listed below along with the description of their impact on improving health in the community.-Prenatal education: provides education to low income individuals to promote healthy outcomes for mother and baby.-Ambulance and cab service: provides transportation for additional medical care or transportation home.-Gateway Free Clinic: A medical home for the uninsured. Provides access to care to those who otherwise have no access to a medical home.-Drug Endangered Child Task Force: works on reducing the risk for drug-endangered children born in our facility.Subsidized programs: -Bridgeview Mental Health: MMC-Clinton provides a financial subsidy to the program, which provides mental health services to county funded and other low income and / or uninsured patients in our community. -Specialty Clinic Subsidy: provides GI and ENT services to patients in the community, operating at a loss, due in part to acceptance of Medicaid and charity care patients. -The Pregnancy Center: assists with support for mothers with unwanted pregnancies-Certified Diabetes Center: provides education and medical management for diabetic patients in our community. Part VI, Line 6: OTHER INFORMATION - MERCY MEDICAL CENTER-CLINTON HAS AN OPEN MEDICAL STAFF, AND A BOARD THAT IS REFLECTIVE OF THE DEMOGRAPHICS OF OUR COMMUNITY. A MAJORITY OF BOARD MEMBERS ARE RESIDENTS OF OUR COMMUNITY. AS A SOLE COMMUNITY PROVIDER, MMC-Clinton OFFERs MANY SERVICES TO THE COMMUNITY THAT WOULD OTHERWISE BE UNAVAILABLE. IN ADDITION TO TRADITIONAL ACUTE CARE SERVICES, WE OFFER EMERGENCY SERVICES REGARDLESS OF PAYMENT SOURCE, RADIATION ONCOLOGY, RENAL DIALYSIS, HOSPICE CARE, INPATIENT BEHAVIORAL HEALTH AND INPATIENT REHAB. WE ALSO HAVE A COMMUNITY IRB, WHICH APPROVES ANY MEDICAL RELATED RESEARCH REQUESTS.MERCY MEDICAL CENTER-CLINTON OFFERS MANY OPPORTUNITIES FOR STUDENTS PURSUING MEDICAL RELATED CAREERS TO GAIN CLINICAL EXPERIENCE. THIS INCLUDES, BUT IS NOT LIMITED TO, NURSING, LAB, EEG, RADIOLOGY AND RESPIRATORY THERAPY.LEADERSHIP AND ASSOCIATES ARE ACTIVELY ENGAGED IN ADVOCACY EFFORTS TO IMPROVE MEDICAL ACCESS AND COVERAGE FOR ALL. ADVOCACY EFFORTS ARE TARGETED AT IMPROVING CARE FOR THE UNINSURED AND UNDERINSURED IN OUR COMMUNITY.WE PROMOTE THE HEALTH OF THE COMMUNITIES WE SERVE IN MANY WAYS. FOR EXAMPLE, WE PARTNER WITH THE FREE CLINIC IN OUR COMMUNITY, AND HAVE INITIATED A DIABETIC CLINIC FOR THE UNINSURED. MERCY MEDICAL CENTER ALSO HAS A VERY ACTIVE AND EXPANSIVE VOLUNTEER PROGRAM, WHICH OFFERS OPPORTUNITIES ACROSS THE CONTINUUM, FROM ACUTE CARE TO LONG-TERM CARE AND HOSPICE. Part VI, Line 7: MERCY MEDICAL CENTER - CLINTON is a member organization of Trinity Health, the fourth-largest Catholic health care system in the country. Based in Novi, Michigan, Trinity Health annually requires that all member organizations develop, and are held accountable for achieving, community benefit goals that include developing needed services or expanding access to services for low-income individuals. As a not-for-profit health system, Trinity Health reinvests its profits back into the community through programs to serve the poor and uninsured, manage chronic conditions like diabetes, health education and promotion initiatives, and outreach for the elderly. In fiscal year 2010, this included nearly $456 million in such community benefits. Therefore, Trinity Health takes a systems approach in its community benefit planning and implementation, and is consequently able to ensure that its member hospitals and other entities/affiliates are helping promote and address the health needs of their respective communities.For more information about Trinity Health, visit www.trinity-health.org. 1 CLINTON SUBSTANCE ABUSE COUNCIL INC 215 6TH AVENUE SOUTH CLINTON IA 52732 421349205 501(C)(3) 10000 PROGRAM SUPPORT UNITED WAY OF CLINTON COUNTY IOWA 405 SOUTH 3RD ST CLINTON IA 52732 420698299 501(C)(3) 9000 PROGRAM SUPPORT CLINTON REGIONAL DEVELOPMENT CORPORATION 144 8TH AVENUE SOUTH CLINTON IA 52732 420738495 501(C)(4) 15000 SUPPORT OF QUALITY JOBS PROGRAM 2 1 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: DONATIONS MADE BY MERCY MEDICAL CENTER - CLINTON, INC. 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 PETER KARADJOFF 0 247743 0 224466 0 49073 0 14508 0 21178 0 556968 0 9710 DONNA OLIVER 0 256757 0 242765 0 41820 0 26837 0 18239 0 586418 0 0 pauL MANGIN 0 168155 0 32217 0 14768 0 30140 0 13908 0 259188 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 MICHAEL SLUBOWSKI 0 696108 0 681725 0 240008 0 125922 0 28467 0 1772230 0 94766 J RICHARD O'CONNELL 0 440925 0 0 0 54218 0 11123 0 0 0 506266 0 0 JOAN NOE 0 132706 0 25499 0 6478 0 25637 0 3918 0 194238 0 0 AMY E BERENTES 0 126393 0 24709 0 5253 0 5382 0 18196 0 179933 0 0 RODNEY TOKHEIM 0 121708 0 23933 0 6312 0 14529 0 19839 0 186321 0 0 MOHAMMED IRSHAD MD 580008 0 68875 0 1466 0 18553 0 838 0 669740 0 0 0 DOUGLAS T CODY MD 239319 0 34850 0 335 0 8523 0 17281 0 300308 0 0 0 JOHN PERUSHEK 125176 0 0 0 670 0 13953 0 21568 0 161367 0 0 0 KENT JORGENSEN 0 98269 0 19530 0 4584 0 12082 0 19830 0 154295 0 0 Part I, Line 4a 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 MICHAEL SLUBOWSKI - $55,733 JOSEPH SWEDISH - $493,225 PART I, LINE 4B: 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 DONNA OLIVER - $7,673 MICHAEL SLUBOWSKI - $42,832 JOSEPH SWEDISH - $249,263 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 PETER KARADJOFF - $163,577 DONNA OLIVER - $168,735 MICHAEL SLUBOWSKI - $403,918 JOSEPH SWEDISH - $1,042,563 DOUGLAS CODY FINANCE PURCHASE OF MALPRACTICE TAIL COVERAGE X 34299 2665 0 1 1 MOHAMMED IRSHAD FINANCE PURCHASE OF MALPRACTICE TAIL COVERAGE X 80263 11207 0 1 1 13872 MARY LINCOLN FAMILY MEMBER OF JOAN NOE, KEY EMPLOYEE 92817 EMPLOYMENT ARRANGEMENT 0 BRENDA VENS FAMILY MEMBER OF CHRISTOPHER VENS, BOARD DIRECTOR 78865 EMPLOYMENT ARRANGEMENT 0 JESSICA WINKEL FAMILY MEMBER OF RICHARD WINKEL, BOARD DIRECTOR 33736 EMPLOYMENT ARRANGEMENT 0 CAROLYN LIVINGSTON FAMILY MEMBER OF MARILYN HEIAR, OFFICER 112105 EMPLOYMENT ARRANGEMENT 0 CLINTON IMAGING SERVICES LLC JUERGEN HOLL/BD DIR, HAS 7.5% INDIRECT PRTNRSHP INT IN CLINTON IMAGING SVCS 147658 INPATIENT MRI EXAMS PROVIDED BY CLINTON IMAGING SERVICES FOR WHICH MERCY MEDICAL CENTER-CLINTON PAID $147,658 0 CLINTON IMAGING SERVICES LLC JUERGEN HOLL/BD DIR, HAS 7.5% INDIRECT PRTNRSHP INT IN CLINTON IMAGING SVCS 83187 CLINTON IMAGING SERVICES RENTED SPACE FROM MERCY MEDICAL CENTER-CLINTON 0 CLINTON IMAGING SERVICES LLC JUERGEN HOLL/BD DIR, HAS 7.5% INDIRECT PRTNRSHP INT IN CLINTON IMAGING SVCS 130000 PARTNERSHIP DISTRIBUTIONS FROM CLINTON IMAGING SERVICES (MERCY MEDICAL CENTER-CLINTON HAS A 65% DIRECT PARTNERSHIP INTEREST IN CLINTON IMAGING SERVICES) 0 Form 990, Part VI, Section A, line 2 RICHARD WINKEL, BOARD MEMBER, AND THOMAS FULLERTON, BOARD MEMBER, HAVE A BUSINESS RELATIONSHIP. BRUCE CHRISTENSEN, BOARD MEMBER, AND STEPHEN HARRISON, MD, BOARD MEMBER, HAVE A BUSINESS RELATIONSHIP. Form 990, Part VI, Section A, line 6 THE MEMBERS OF MERCY MEDICAL CENTER - CLINTON, INC. ARE GATEWAY FOUNDATION FOR HEALTH (THE CLASS A MEMBER) AND MERCY HEALTH SERVICES-IOWA CORP. (THE CLASS B MEMBER). SEE LINE 7 FOR ADDITIONAL INFORMATION. Form 990, Part VI, Section A, line 7a THE CLASS B MEMBER, MERCY HEALTH SERVICES-IOWA CORP., ELECTS THE DIRECTORS OF MERCY MEDICAL CENTER-CLINTON, PROVIDED THAT THE DIRECTORS ARE RECOMMENDED BY THE BOARD OF DIRECTORS OF THE CORPORATION. Form 990, Part VI, Section A, line 7b AS CLASS B MEMBER, MERCY HEALTH SERVICES-IOWA CORP. MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MERCY HEALTH SERVICES-IOWA CORP. 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. AS CLASS A MEMBER, GATEWAY FOUNDATION FOR HEALTH MUST APPROVE THE SALE OF SUBSTANTIALLY ALL ASSETS TO, OR MERGER OF MERCY MEDICAL CENTER-CLINTON WITH, AN ENTITY NOT AFFILIATED WITH TRINITY HEALTH CORPORATION. GATEWAY FOUNDATION FOR HEALTH MUST ALSO APPROVE ANY MODIFICATIONS TO GOVERNING DOCUMENTS THAT WOULD CHANGE THE VOTING OR APPROVAL RIGHTS OF THE CLASS A MEMBER. Form 990, Part VI, Section B, line 11 PRIOR TO FILING, THE FORM 990 FOR MERCY MEDICAL CENTER - CLINTON, INC. IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD OF DIRECTORS. 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 MERCY MEDICAL CENTER - CLINTON, INC. 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 MERCY MEDICAL CENTER - CLINTON, WHICH INCLUDES directors, 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 MERCY MEDICAL CENTER - CLINTON'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MERCY MEDICAL CENTER - CLINTON 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 directors OF MERCY MEDICAL CENTER - CLINTON IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO MERCY MEDICAL CENTER - CLINTON. 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 ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE REVIEWED WITH THE BOARD OF directors OF MERCY MEDICAL CENTER - CLINTON 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 MERCY MEDICAL CENTER - CLINTON, INC. 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 MERCY MEDICAL CENTER - CLINTON, INC. 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. IN ADDITION, MERCY MEDICAL CENTER - CLINTON, INC. INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. FORM 990, PART VII, SECTION A, LINE 1: 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 PETER KARADJOFF - 49 HOURS MICHAEL SLUBOWSKI - 53 HOURS JOSEPH SWEDISH - 53 HOURS J. RICHARD O'CONNELL - 53 HOURS FORM 990, PART XI, LINE 2: MERCY MEDICAL CENTER - CLINTON's financial statements were included in the FY10 consolidated financial statements of Trinity Health, which were audited by an independent public accounting firm. FORM 990, PAGE 1, BOX C DOING BUSINESS AS NAMES: MERCY HOME CARE & HOSPICE -CLINTON, MERCY HOME MEDICAL EQUIPMENT, BLUFF TERRACE NURSING HOME, WYNDCREST NURSING HOME, MERCY LIVING CENTER-NORTH, MERCY LIVING CENTER-SOUTH 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 Physicians 363 FREMONT ST BATTLE CREEK MI 49017 264252468 HEALTHCARE SERVICES MI 501(C)(3) 3 Battle Creek Health System Mercy General Health Partners Amicare Homecare 684 HARVEY STREET MUSKEGON MI 49442 383321856 Provide home health care services MI 501(C)(3) 11, TYPE I Trinity Home Health Services Inc Mercy Health Partners 1415 LEAHY STREET MUSKEGON MI 49442 382589966 Healthcare system support MI 501(C)(3) 11, TYPE I Trinity Health-Michigan Mercy Health Services - Iowa Corp 1000 4TH STREET SW MASON CITY IA 50401 311373080 HEALTHCARE SERVICES DE 501(C)(3) 3 Trinity Health-Michigan Mercy Healthcare Foundation 1410 N 4TH ST CLINTON IA 52732 421316126 Fundraising and financial assistance for hospital charitable services IA 501(C)(3) 11, TYPE I Mercy Medical Center-Clinton Mercy Hosp & Health Services of DetroitMarshall Park Health Services Inc 27870 CABOT DRIVE NOVI MI 483772920 381562325 Supports malpractice contingencies of closed hospital MI 501(C)(3) 11, TYPE I Trinity Health-Michigan Mercy Hospital Cadillac Foundation 400 HOBART CADILLAC MI 496012331 203357131 Support the services of related hospital MI 501(C)(3) 11, TYPE I Trinity Health-Michigan Mercy Hospital Gift Shop 2601 ELECTRIC AVE PORT HURON MI 48060 381630480 Volunteer Service Auxiliary MI 501(C)(3) 11, TYPE I Trinity Health-Michigan Mercy Medical Center - Clinton Inc 1410 NORTH 4TH ST CLINTON IA 527322940 421336618 To provide quality health care DE 501(C)(3) 3 Mercy Health Services-Iowa Corp Mercy Medical Center - Sioux City Foundation 801 5TH STREET SIOUX CITY IA 51102 141880022 Support the services of related hospital IA 501(C)(3) 7 Mercy Health Services-Iowa Corp Mercy Medical Center Foundation - North Iowa 1000 4TH STREET SW MASON CITY IA 504012800 421229151 Support the services of related hospital IA 501(C)(3) 11, TYPE III-FI Mercy Health Services-Iowa Corp MERCY MEDICAL CENTER FOUNDATION INC 1512 12TH AVENUE ROAD NAMPA ID 83686 261737256 SUPPORT THE SERVICES OF RELATED HOSPITAL ID 501(C)(3) 7 SAINT ALPHONSUS MEDICAL CENTER-NAMPA Mercy North Homecare and Hospice 7985 MACKINAW TRAIL CADILLAC MI 49601 383313897 Home health and hospice services MI 501(C)(3) 11, TYPE I Trinity Home Health Services Inc Mercy Pavilion of Battle Creek 300 NORTH AVENUE BATTLE CREEK MI 49016 382783350 Provides long-term care for the elderly MI 501(C)(3) 9 Battle Creek Health System MERCY PHYSICIAN GROUP INC 1512 12TH AVENUE ROAD NAMPA ID 83686 208192593 TO PROVIDE QUALITY HEALTH CARE ID 501(C)(3) 9 SAINT ALPHONSUS MEDICAL CENTER-NAMPA Mercy Services for Aging Non-profit Housing Corporation PO BOX 9184 FARMINGTON HILLS MI 483339184 382719605 Provides long-term care for the elderly MI 501(C)(3) 11, TYPE II Trinity Continuing Care Services Inc Midwest Medflight 1300 VICTORS WAY ANN ARBOR MI 48108 382684671 Aeromedical transport MI 501(C)(3) 9 Trinity Health-Michigan Mount Carmel Care Continuum Services Corp 793 WEST STATE STREET COLUMBUS OH 43222 311126211 Cooperative hospital service organization OH 501(C)(3) 3 Mount Carmel Health System Mount Carmel College of Nursing 6150 EAST BROAD STREET COLUMBUS OH 43213 311308555 College of nursing OH 501(C)(3) 2 Mount Carmel Health Mount Carmel Health 6150 EAST BROAD STREET COLUMBUS OH 43213 314379602 HEALTHCARE SERVICES OH 501(C)(3) 3 Mount Carmel Health System Mount Carmel Health Insurance Company 6150 EAST BROAD STREET COLUMBUS OH 43213 251912781 Health Insurance OH 501(C)(4) N/A Mount Carmel Health System Mount Carmel Health Plan Inc 6150 EAST BROAD STREET COLUMBUS OH 43213 311471229 Medicare HMO for seniors OH 501(C)(4) N/A Mount Carmel Health System Mount Carmel Health System 6150 EAST BROAD STREET COLUMBUS OH 43213 311439334 Healthcare system management and support OH 501(C)(3) 11, TYPE I Trinity Health Corporation MOUNT CARMEL HEALTH SYSTEM FOUNDATION 6150 EAST BROAD STREET COLUMBUS OH 43213 311113966 SUPPORT THE SERVICES OF RELATED HOSPITAL OH 501(C)(3) 11, TYPE I MOUNT CARMEL HEALTH SYSTEM Mount Carmel Home Care LLC 1144 DUBLIN ROAD SUITE B COLUMBUS OH 43215 262729300 Provide home health care services OH 501(C)(3) 9 Trinity Home Health Services Inc Mount Carmel New Albany Surgical Hospital 7333 SMITHS MILL RD NEW ALBANY OH 43054 870790288 HEALTHCARE SERVICES OH 501(C)(3) 3 Mount Carmel Health System MRI Mobile Services of West Michigan 1820 - 44TH STREET KENTWOOD MI 49508 383073745 OPERATE MAGNETIC IMAGING RESONANCE (FORMERLY) MI 501(C)(3) 9 Trinity Health-Michigan MUSKEGON COMMUNITY HEALTH PROJECT 565 W WESTERN AVENUE MUSKEGON MI 49440 911932918 FACILITATE AND COORDINATE HEALTHCARE AND RELATED SERVICES MI 501(C)(3) 7 MERCY HEALTH PARTNERS Oakland Mercy Hospital 601 EAST 2ND STREET OAKLAND NE 68045 208072234 HEALTHCARE SERVICES NE 501(C)(3) 3 Mercy Health Services-Iowa Corp Port Huron Mercy Family Care Inc 2601 ELECTRIC AVE PORT HURON MI 48060 201855647 HEALTHCARE SERVICES MI 501(C)(3) 11, TYPE I Trinity Health-Michigan Professional Med Team 965 FORK STREET MUSKEGON MI 494423257 382638284 Medical care, transportation and education MI 501(C)(3) 9 Trinity Health-Michigan Professional Office Corporation 1303 EAST HERNDON AVE FRESNO CA 93720 942839324 HEALTHCARE SERVICES CA 501(C)(3) 11, TYPE I Saint Agnes Medical Center Saint Agnes Medical Center 1303 EAST HERNDON AVE FRESNO CA 93720 941437713 HEALTHCARE SERVICES CA 501(C)(3) 3 Trinity Health Corporation Saint Alphonsus Building Company Inc 1055 NORTH CURTIS RD BOISE ID 83706 820401011 Supports services of related hospital ID 501(C)(3) 11, TYPE I Saint Alphonsus Regional Medical Center Inc Saint Alphonsus Diversified Care Inc 1055 NORTH CURTIS RD BOISE ID 83706 943028978 Supports services of related hospital ID 501(C)(3) 11, TYPE I Saint Alphonsus Regional Medical Center Inc SAINT ALPHONSUS HEALTH SYSTEM INC 1055 N CURTIS ROAD BOISE ID 83706 271929502 HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT ID 501(C)(3) 11, TYPE I TRINITY HEALTH CORPORATION SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY 3325 POCAHONTAS ROAD BAKER CITY OR 97814 271790052 TO PROVIDE QUALITY HEALTH CARE OR 501(C)(3) 3 SAINT ALPHONSUS HEALTH SYSTEM INC SAINT ALPHONSUS MEDICAL CENTER-NAMPA 1512 12TH AVENUE ROAD NAMPA ID 83686 820200896 TO PROVIDE QUALITY HEALTH CARE ID 501(C)(3) 3 SAINT ALPHONSUS HEALTH SYSTEM INC SAINT ALPHONSUS MEDICAL CENTER-ONTARIO 351 SW 9TH STREET ONTARIO OR 97914 271789847 TO PROVIDE QUALITY HEALTH CARE OR 501(C)(3) 3 SAINT ALPHONSUS HEALTH SYSTEM INC Saint Joseph Regional Medical Center - Plymouth Campus Inc 1915 LAKE AVENUE PO BOX 670 PLYMOUTH IN 46563 351142669 Healthcare services IN 501(C)(3) 3 Saint Joseph Regional Medical Center Inc Saint Joseph Regional Medical Center - South Bend Campus Inc PO BOX 1935 SOUTH BEND IN 466341935 350868157 Healthcare services IN 501(C)(3) 3 Saint Joseph Regional Medical Center Inc Saint Joseph Regional Medical Center Inc 801 EAST LASALLE AVE SOUTH BEND IN 46617 351568821 Healthcare system management and support IN 501(C)(3) 11, TYPE I Trinity Health Corporation Saint Joseph's Auxiliary of Marshall County 1915 LAKE AVENUE PLYMOUTH IN 46563 356043563 Hospital Service Auxiliary IN 501(C)(3) 11, TYPE II Saint Joseph Regional Medical Center - Plymouth Campus Inc Saint Joseph's Tower Inc PO BOX 9184 FARMINGTON HILLS MI 483339184 311040468 Provides housing for low income elderly individuals IN 501(C)(3) 9 Trinity Continuing Care Services-Indiana Saint Mary's Amicare Home Healthcare 1430 MONROE NW GRAND RAPIDS MI 48905 383320700 Provide home health care services MI 501(C)(3) 11, TYPE I Trinity Home Health Services Inc Saint Mary's Doran Foundation CO Saint Mary's Health Care 200 JEFFERSON ST SE GRAND RAPIDS MI 49503 381779602 Supports services of related hospital MI 501(C)(3) 7 Trinity Health-Michigan St Alphonsus Regional Medical Center 1055 NORTH CURTIS RD BOISE ID 83706 820200895 Healthcare services ID 501(C)(3) 3 Trinity Health Corporation St John's Health System 27870 CABOT DRIVE NOVI MI 483772920 350877584 HEALTHCARE SERVICES (FORMERLY) IN 501(C)(3) 3 Trinity Health Corporation St Joseph Mercy Oakland Foundation 44405 WOODWARD AVE PONTIAC MI 48341 352356789 Supports services of related hospital MI 501(C)(3) 11, TYPE I Trinity Health-Michigan St Ann's Hospital 500 SOUTH CLEVELAND AVE WESTERVILLE OH 43081 314412701 HEALTHCARE SERVICES OH 501(C)(3) 3 Mount Carmel Health System ST ELIZABETH HEALTH CARE FOUNDATION 3325 POCAHONTAS ROAD BAKER CITY OR 97814 943164869 SUPPORT THE SERVICES OF RELATED HOSPITAL OR 501(C)(3) 7 SAINT ALPHONSUS MEDICAL CENTER-ONTARIO St Joseph's Medical Center Auxiliary 801 E LASALLE AVE PO BOX 1935 SOUTH BEND IN 466341935 356033285 Hospital Service Auxiliary IN 501(C)(4) N/A Saint Joseph Regional Medical Center - South Bend Campus Inc The Foundation of Saint Joseph Regional Medical Center 4215 EDISON LAKES PARKWAY MISHAWAKA IN 46545 351654543 Supports services of related hospital IN 501(C)(3) 11, TYPE I Saint Joseph Regional Medical Center Inc Trinity Continuing Care Services PO BOX 9184 FARMINGTON HILLS MI 483339184 382559656 Management services for Long term care and senior living facilities MI 501(C)(3) 11, TYPE I Trinity Health Corporation Trinity Continuing Care Services - Indiana Inc PO BOX 9184 FARMINGTON HILLS MI 483339184 930907047 Provides long-term care and residential housing IN 501(C)(3) 9 Trinity Continuing Care Services Trinity Health - Michigan 27870 CABOT DRIVE NOVI MI 483772920 382113393 HEALTHCARE SERVICES MI 501(C)(3) 3 Trinity Health Corporation Trinity Health Corporation 27870 CABOT DRIVE NOVI MI 483772920 351443425 Healthcare system management and support IN 501(C)(3) 11, TYPE I N/A Trinity Health International 27870 CABOT DRIVE NOVI MI 483772920 421253527 Healthcare training and support services MI 501(C)(3) 11, TYPE I Trinity Health Corporation Trinity Health Welfare Benefit Trust 27870 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