Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public
Inspection
Name of the organization
ST MARY MEDICAL CENTER
 
Employer identification number
23-1913910
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) A WOMAN'S PLACE
PO BOX 299
DOYLESTOWN,PA18901
23-2034180 501(C)(3) 25,000       ACCESS TO CARE CHILD TRAUMA PROGRAM FOR CHILDREN OF DOMESTIC VIOLENCE
(2) ADVOCATES FOR THE HOMELESS AND THOSE IN NEED
PO BOX 184
FAIRLESS HILLS,PA19030
27-5038755 501(C)(3) 100,000       ENHANCE POPULATION HEALTH THRU EVICTION PREVENTION ASSISTANCE AND EMERGENCY SVCS FOR HOMELESS
(3) BREAST FEEDING RESOURCE CENTER
1355 OLD YORK RD STE 101
ABINGTON,PA19001
23-3049543 501(C)(3) 69,952       ACCESS TO CARE FOR NUTRITION AND LACTATION SERVICES FOR LOW INCOME UNINSURED NEW MOMS
(4) BUCKS COUNTY COMMUNITY WOMENS CENTER INC
712 VETERANS HIGHWAY
BRISTOL,PA19007
27-3405958 501(C)(3) 30,000       ACCESS TO CARE FOR PRENATAL SERVICES FOR LOW INCOME PREGNANT WOMEN
(5) BUCKS COUNTY DRAGON BOAT ASSOCIATION
1455 WRIGHTSTOWN ROAD
UPPER MAKEFIELD,PA18940
46-1214416 501(C)(3) 25,000       ENHANCE POPULATION HEALTH THROUGH SPONSORSHIP OF FOOD PANTRY COMMUNITY EVENT
(6) BUCKS COUNTY HEALTH IMPROVEMENT PARTNERSHIP
41 UNIVERSITY DRIVE SUITE 106
NEWTOWN,PA18940
23-2862339 501(C)(3) 182,650       ACCESS TO CARE FOR LOW INCOME UNINSURED ADULTS IN BUCKS COUNTY
(7) BUCKS COUNTY HOUSING GROUP
626 JACKSONVILLE RD SUITE 140
WARMINSTER,PA18974
23-1878791 501(C)(3) 467,134       SUPPORTIVE HOUSING PROGRAMS AND CASE MGMT SVCS-BUCKS COUNTY HOMELESS
(8) BUCKS COUNTY OPPORTUNITY COUNCIL
100 DOYLE STREET
DOYLESTOWN,PA18901
23-6406222 501(C)(3) 10,000       ENHANCE POPULATION HEALTH THROUGH SUPPORT OF FOOD DISTRIBUTION SYSTEM
(9) CATHOLIC HEALTH CARE SERVICES
222 NORTH 17TH STREET
PHILADELPHIA,PA19103
53-0196617 501(C)(3) 75,000       ACCESS TO CARE FOR LOW INCOME FRAIL SENIORS LIVING IN COMMUNITY WITH LIMITED SUPPORTS
(10) CATHOLIC SOCIAL SERVICES
222 NORTH 17TH STREET
PHILADELPHIA,PA19103
23-1352063 501(C)(3) 50,000       ENHANCE POPULATION HEALTH FOR LOW INCOME IMMIGRANT POPULATION IN BUCKS COUNTY
(11) CHANDLER HALL
99 BARCLAY STREET
NEWTOWN,PA18940
23-2365124 501(C)(3) 10,000       ACCESS TO END OF LIFE CARE THROUGH SPONSORSHIP OF CHANDLER HALL COMMUNITY EVENT
(12) CHILD HOME & COMMUNITY
204 N WEST STREET SUITE 101
DOYLESTOWN,PA18901
23-2131650 501(C)(3) 35,000       ENHANCE POPULATION HEALTH THROUGH PARENTING CLASSES FOR PREGNANT TEENS
(13) CHOICEONE PREGNANCY & SEXUAL HEALTH RESOURCE CENTER INC
2222 TRENTON ROAD
LEVITTOWN,PA19056
22-2408766 501(C)(3) 30,000       ACCESS TO PRENATAL SERVICES FOR LOW INCOME UNINSURED PREGNANT WOMEN
(14) COUNCIL OF SOUTHEASTERN PENNSYLVANIA
252 WEST SWAMP ROAD UNIT 12
DOYLESTOWN,PA18901
23-1972816 501(C)(3) 76,275       ACCESS TO SUBSTANCE ABUSE RECOVERY SERVICES
(15) ERA OF LOWER BUCKS
8525 NEW FALLS ROAD
LEVITTOWN,PA19057
23-7296756 501(C)(3) 11,700       ENHANCE POPULATION HEALTH THROUGH SUPPORT OF FOOD PANTRY
(16) FAMILY SERVICE ASSOCIATION
4 CORNERSTONE DRIVE
LANGHORNE,PA19047
23-1427224 501(C)(3) 311,000       BEHAVIORAL/MENTAL HEALTH CARE-LOW INCOME UNINSURED BUCKS COUNTY ADULTS & CHILDREN
(17) FAMILY YMCA OF LOWER BUCKS
601 S OXFORD VALLEY ROAD
FAIRLESS HILLS,PA19030
23-1433890 501(C)(3) 79,000       ENHANCE POPULATION HEALTH TO PROMOTE HEALTHY LIFESTYLES ADULTS AND CHILDREN
(18) GAUDENZIA FOUNDATION INC
106 WEST MAIN STREET
NORRISTOWN,PA19401
23-2141307 501(C)(3) 50,000       ACCESS TO DETOX AND RECOVERY SERVICES
(19) INTERFAITH HOUSING VISIONS
2 CANALS END ROAD UNIT 201E
BRISTOL,PA19007
23-2501785 501(C)(3) 15,000       ENHANCE POPULATION HEALTH THROUGH HOUSING SUBSIDIES FOR LOW INCOME BUCKS COUNTY RESIDENTS
(20) LITERACY & LIFE INC
PO BOX 55636
TRENTON,NJ08638
27-1727841 501(C)(3) 15,000       HEALTH/FINANCIAL LITERACY PROGRAM-LOW INCOME BUCKS COUNTY FAMILIES
(21) MINDING YOUR MIND
124 SIDLEY AVENUE
ARDMORE,PA19003
81-3488778 501(C)(3) 20,000       ENHANCE POPULATION HEALTHTHROUGH SUICIDE AWARENESS FOR SCHOOL-AGED YOUTH
(22) NOVA
2370 YORK ROAD BUILDING 1
JAMISON,PA18929
23-7438387 501(C)(3) 25,000       ACCESS TO CARE FOR VICTIMS OF ASSAULT
(23) PEACE CENTER
102 WEST MAPLE AVENUE
LANGHORNE,PA19047
23-3047368 501(C)(3) 50,000       SUPPORT OF BEHAVIORAL HEALTH EDUCATION FOR SCHOOL-AGED BUCKS COUNTY YOUTH
(24) PENN STATE UNIVERSITY
110 TECHNOLOGY CENTER BLDG
UNIVERSITY PARK,PA16802
24-6000376 501(C)(3) 16,989       ENHANCE POPULATION HEALTH THROUGH NUTRITION PROGRAM FOR DIABETIC PATIENTS
(25) REV JOHN DAVIDS MENTORING REENTRY PROGRAM OUR LADY OF MT CARMEL PARISH
235 EAST STATE STREET
DOYLESTOWN,PA18901
23-1401553 501(C)(3) 15,000       ENHANCE POPULATION HEALTH BY ADDRESSING SDOH FOR INMATES PENDING RELEASE
(26) THE IVINS HOUSE
80 WEST TRENTON AVENUE
MORRISVILLE,PA19067
11-3677088 501(C)(3) 15,000       ACCESS TO CARE THROUGH TRANSPORTATION FOR MEDICAL RELATED VISITS AND COMPANION CARE
(27) THE WAY HOME INC
600 WOOD STREET
BRISTOL,PA19007
45-3631631 501(C)(3) 36,000       HEALTH-SUPPORTIVE HOUSING PROGRAMS & CASE MGMT SVCS-BUCKS COUNTY HOMELESS
(28) UNITED WAY OF NORTHWESTERN PA
100 DOYLE STREET
DOYLESTOWN,PA18901
14-1338305 501(C)(3) 33,380       ENHANCE POPULATION HEALTH THROUGH SUPPORT OF FOOD INVENTORY SYSTEM
(29) VITA EDUCATION SERVICES
8 EAST COURT STREET
DOYLESTOWN,PA18901
23-1977810 501(C)(3) 100,000       COMMUNITY BUILDING THROUGH ESL PROGRAM FOR LOW INCOME IMMIGRAMT POPULATION
(30) GLOBAL HEALTH MINISTRY
3805 WEST CHESTER PIKE
NEWTOWN SQUARE,PA19073
23-3068656 501(C)(3) 40,000       ACCESS TO CARE THROUGH MISSION TRIPS TO IMPOVERISHED COUNTRIES
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
30
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2016

Schedule I (Form 990) 2016
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1) MEDICATIONS 3891   896,636 COST MEDICATIONS DONATED TO SMMC LOW INCOME PATIENTS BY ST. CLARE PHARMACY
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: DONATIONS MADE BY SMMC TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H.
Schedule I (Form 990) 2016



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