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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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Bon Secours Mercy Health Foundation
 
Employer identification number
20-1072726
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) Bon Secours Mercy Health Inc
1701 Mercy Health Pl
Cincinnati,OH45237
52-1301088 501(c)(3) 43,088,260       Associate Hardship Fund
(2) Mercy Health - Regional Medical Center LLC
3700 Kolbe Rd
Lorain,OH44053
34-0714704 501(c)(3) 766,554       Program Support
(3) Mercy Health - St Rita's Medical Center LLC
730 W Market St
Lima,OH45801
34-1105619 501(c)(3) 148,780       Program Support
(4) Mercy Health North LLC
2409 Cherry Street MOB 1
Toledo,OH43608
34-1344482 501(c)(3) 871,763       Program Support
(5) Mercy Health - St Vincent Medical Center LLC
2213 Cherry St
Toledo,OH43608
34-4428250 501(c)(3) 1,790,916       Program Support
(6) Mercy Health Youngstown LLC
1044 Belmont Ave
Youngstown,OH44503
34-0505560 501(c)(3) 2,974,336       Program Support
(7) Mercy Health - Fairfield Hospital LLC
3000 Mack Rd
Fairfield,OH45014
31-0538532 501(c)(3) 50,732       Program Support
(8) Community Mercy Health Partners
One S Limestone St
Springfield,OH45502
31-0785684 501(c)(3) 610,328       Program Support
(9) Mercy Health Cincinnati LLC
1701 Mercy Health Pl
Cincinnati,OH45237
31-1063783 501(c)(3) 52,274       Program Support
(10) Bon Secours St Francis Health System
1 St Francis Dr
Greenvile,SC29601
58-2504528 501(c)(3) 171,637       Program Support
(11) Bon Secours - Richmond Health System
8580 Magellan Parkway
Richmond,VA23227
52-1988421 501(c)(3) 181,218       Program Support
(12) Bon Secours - DEPAUL MEDICAL CENTER LLC
150 KINGSLEY LANE
NORFOLK,VA23505
54-1820093 501(C)(3) 151,403       Program Support
(13) Mercy Health - Lourdes Hospital LLC
1530 Lone Oak Rd
Paducah,KY42003
61-0600313 501(C)(3) 187,648       Hospice & Palliative Care Program Expenses
(14) Mercy Health - Anderson Hospital LLC
7500 State Rd
Cincinnati,OH45255
31-0537085 501(C)(3) 1,310,973       Capital Equipment
(15) Mercy Franciscan Senior Health and Housing Services Inc
7010 Rowan Hills Dr
Cincinnati,OH45227
31-1308729 501(C)(3) 87,563       West Park benevolent care
(16) Jewish Hospital LLC
4777 E Galbraith Rd
Cincinnati,OH45236
27-1408630 501(C)(3) 7,218       Jewish Hospital Outpatient Pharm
(17) ALTEON HEALTH LLC
PO BOX 645849
CINCINNATI,OH45264
45-1589785   11,595       Patient Therapy Program
(18) COVELLI ENTERPRISES
3900 E MARKET ST
WARREN,OH44484
34-1724212   16,728       COVID Frontline Worker Meals
(19) Bon Secours Baltimore Community Works Inc
26 N Fulton Ave
Baltimore,MD21223
52-1732800 501(C)(3) 26,303       Residentail Financial Educ Pilot
(20) LiveWell Greenville
PO BOX 2284
GREENVILLE,SC29602
81-1376760 501(C)(3) 106,024       HPHC Program
(21) Synergy Homecare
439 CONGAREE RD
GREENVILLE,SC29607
45-3641036   23,312       Hospice pt assistance
(22) 1-HEART
2409 Cherry Street
Toledo,OH43608
46-2097242 501(C)(3) 38,268       Program Expenses
(23) Academy of Music
4101 GROVE AVE
Richmond,VA23221
64-1949644 501(C)(3) 17,374       Music Therapy Program
(24) ACTION INC
PO BOX 456
YOUNGSTOWN,OH44501
04-3779171   7,500       Program Support
(25) AREA AGENCY ON AGING of Pasco-Pinellas Inc
330 5TH ST N
ST PETERSBURG,FL33701
31-1710636 501(c)(3) 24,000       Program Support
(26) BABY UNIVERSITY
860 ORCHARD ST
TOLEDO,OH43609
47-4336051 501(C)(3) 15,000       Program Support
(27) BAYCARE HEALTH SYSTEM INC
2985 DREW ST
CLEARWATER,FL33759
59-2796965 501(C)(3) 100,000       Program Support
(28) BIG BROTHERS AND BIG SISTERS 325
207 WEST ELM ST
LIMA,OH45801
37-4014485 501(C)(3) 5,000       Program Support
(29) BON SECOURS CHARITY HEALTH SYSTEMS
255 Lafayette Ave
Suffern,NY10901
91-2135195 501(C)(3) 100,000       Program Support
(30) BON SECOURS - MARIA MANOR Nursing Care Center LLC
10300 Fourth Street N
ST PETERSBURG,FL33716
65-0061820 501(C)(3) 10,000       Program Support
(31) CANCER FAMILY CARE
4790 RED BANK EXPRESSWAY
CINCINNATI,OH45227
31-0805286 501(C)(3) 7,500       Program Support
(32) CENTRAL CATHOLIC HIGH School
2550 CHERRYS T
TOLEDO,OH43608
34-4428211 501(C)(3) 50,000       Program Support
(33) CENTRAL CITY MINISTRIES OF TOLEDO
1933 SPIELBUSCH AVE
TOLEDO,OH43604
34-1622445 501(C)(3) 10,000       Program Support
(34) CHAMBERLAIN COLLEGE OF NURSING
75 REMITTANCE DRIVE
CHICAGO,IL60675
20-2452410 501(C)(3) 10,400       Program Support
(35) CONNECTING KIDS TO MEALS
PO BOX 9363
TOLEDO,OH43697
34-1969461 501(C)(3) 175,000       Program Support
(36) DIABETES YOUTH SERVICES
2100 WEST CENTRAL AVE
TOLEDO,OH43606
34-1967194 501(C)(3) 15,000       Program Support
(37) DISPENSARY OF HOPE
2700 BRICK CHURCH PK
NASHVILLE,TN37207
58-1716804 501(C)(3) 12,500       Program Support
(38) DOROTHY DAY HOUSE OF HOSPITALITY
620 Belmont Ave
YOUNGSTOWN,OH44502
27-1362838 501(C)(3) 5,000       Program Support
(39) DRS PRINTING
320 W ELM ST
WAUSEON,OH43567
81-4200683   148,225       Program Support
(40) FLYING HIGH Inc
6 FEDERAL PLAZA
YOUNGSTOWN,OH44503
34-1749183 501(C)(3) 15,009       Program Support
(41) FOP 40 CHARITIES
255 Gradolph
TOLEDO,OH43612
45-4698319 501(C)(3) 5,000       Program Support
(42) FRIENDS IN SOLIDARITY INC
8808 CAMERON ST
SILVER SPRING,MD20910
47-5649302 501(C)(3) 75,000       Program Support
(43) GALA OF HOPE FOUNDATION INC
3500 Pentagon Blvd
Beavercreek,OH45431
46-4277044 501(C)(3) 5,000       Program Support
(44) GLOBAL SMILE FOUNDATION
101 ACCESS RD
NORWOOD,MA02062
26-2668127 501(C)(3) 50,000       Program Support
(45) HR ST MARY'S MOB SOUTH SPE
PO Box 844225
DALLAS,TX75284
27-4067277   59,649       Program Support
(46) JASMINE ROAD INC
PO Box 25452
GREENVILLE,SC29616
81-4552155 501(C)(3) 100,000       Program Support
(47) The Youngstown Area Jewish Federation
505 Gypsy Ln
YOUNGSTOWN,OH44504
34-0714442 501(C)(3) 20,900       Program Support
(48) KINGS DAUGHTERS Health System
2001 Scioto Trail
Portsmouth,OH45662
27-4553836 501(C)(3) 233,776       Program Support
(49) LOCKER ROOM
223 N DEFIANCE ST
ARCHBOLD,OH43502
34-1896703   11,454       Program Support
(50) LOTUS
PO BOX 8506
PADUCAH,KY42202
61-1107734   25,000       Program Support
(51) The MAREDA Center
223 Page St
TOLEDO,OH43620
83-1794238 501(C)(3) 29,250       Program Support
(52) MEDITATIONS FOR LIVING
12033 LAYTON DR
Richmond,VA23059
41-7544434   8,548       Meditation Therapy
(53) MERCY MCAULEY HIGH SCHOOL
6000 OAKWOOD AVENUE
CINCINNATI,OH45224
37-1867637 501(C)(3) 100,000       Program Support
(54) MERCY NEIGHBORHOOD MINISTRIES
1602 MADISON RD 2ND FL
CINCINNATI,OH45206
31-1376693 501(C)(3) 81,578       Program Support
(55) MERIDIAN HEALTHCARE
8255 SOUTH AVE
YOUNGSTOWN,OH44512
34-1138485 501(C)(3) 44,094       Program Support
(56) METRO AVIATION INC
PO BOX 7008
SHREVEPORT,LA71137
72-0931049   10,400       Program Support
(57) MIDWIVES FOR HAITI
7130 Glen Forest Dr
Richmond,VA23226
27-2368581 501(C)(3) 135,000       Program Support
(58) MINAS FOSTER CLOSET INC
11836 SOUTH AVE
NORTH LIMA,OH44452
83-1749591 501(C)(3) 5,000       Program Support
(59) NEIL KENNEDY RECOVERY CLINIC
2151 Rush Boulevard
YOUNGSTOWN,OH44507
34-0685251 501(C)(3) 33,056       Program Support
(60) NORTH POINT EDUCATION
4918 Milan Rd
Sandusky,OH44870
62-0890165 501(C)(3) 22,879       Program Support
(61) NORTHEAST OHIO MEDICAL UNIVERSITIES
PO BOX 95
ROOTSTOWN,OH44272
34-1131512 501(a) 445,524       Program Support
(62) NORTHWEST OHIO COMMUNITY ACTION COMMISSION
1933 East Second Street
Defiance,OH43512
34-0971599 501(C)(3) 20,000       Program Support
(63) Ohio High School Athletic Association
4080 Roselea Pl
COLUMBUS,OH43214
31-4355728 501(C)(3) 31,500       Program Support
(64) OSAKI TITAN APEX
1303 MARSH LEE
CARROLLTON,TX75006
81-3339602   11,200       Program Support
(65) OUR COMMUNITY KITCHEN INC
551 Mahoning Ave
YOUNGSTOWN,OH44502
47-2979443 501(C)(3) 5,000       Program Support
(66) POSTGRADUATE INSTITUTE FOR MEDICINE
304 Inverness Way S 100
Englewood,CO80112
84-0793663   11,000       Program Support
(67) PREVENTION AWARENESS SUPPORT SERVICES
309 W High St Suite A
LIMA,OH45801
27-1545570 501(C)(3) 21,281       Program Support
(68) PRINCE MANAGEMENT INC
2311 UNDERHILL ROAD
TOLEDO,OH93605
47-4714829   10,822       Program Support
(69) PRO BONO PTNRSHP OF OHIO
255 E 5TH ST
CINCINNATI,OH45202
46-4283169 501(C)(3) 5,000       Program Support
(70) PRODUCE PERKS Midwest Inc
3600 PARK 42 DRIVE
CINCINNATI,OH45241
47-5000763 501(C)(3) 28,758       Program Support
(71) RESCUE MISSION OF MAHONING VALLEY
962 Martin Luther King Jr Blvd
YOUNGSTOWN,OH44510
34-6006424 501(C)(3) 20,500       Program Support
(72) RIVERDALE SENIOR SERVICES
2600 Netherland Ave
BRONX,NY10463
23-7357997 501(C)(3) 100,000       Program Support
(73) SIMULAB CORP
13001 48TH AVENUE S
SEATTLE,WA98168
91-1636072   11,350       Program Support
(74) SISTERS OF ST FRANCIS OF TIFFIN OH
200 St Francis Ave
TIFFIN,OH44883
34-4428986 501(C)(3) 19,000       Program Support
(75) SOMEPLACE SAFE INC
1370 TOD AVE NW
WARREN,OH44485
34-1255329 501(C)(3) 15,000       Program Support
(76) ST MARYS Hospital AUXILIARY
5801 Bremo Road
Richmond,VA23226
54-0742852 501(C)(3) 26,204       Program Support
(77) ST VINCENT DEPAUL
PO BOX 224
YOUNGSTOWN,OH44501
27-0223497 501(C)(3) 5,000       Program Support
(78) STILL HERE YOGA
7736 WHITTINGTON DR
Richmond,VA23235
04-5521848   6,319       Program Support
(79) STIMDESIGNS LLC
32683 Coast Ridge Dr
CarmelByTheSea,CA93923
27-0382596   7,050       Program Support
(80) STUDENTS MOTIVATED BY THE ARTS
25 E Boardman St First Floor
Youngstown,OH44503
46-5074948 501(C)(3) 6,500       Program Support
(81) Philadelphia University
901 Walnut St
Philadelphia,PA19107
23-1352294 501(C)(3) 5,250       Program Support
(82) TOLEDO GROWS
900 Oneida St
TOLEDO,OH43608
34-1350559 501(C)(3) 15,000       Program Support
(83) TRAUMATIC BRAIN INJURY RESOURCE Center
7430 W CENTRAL AVE
TOLEDO,OH43617
47-1421039 501(C)(3) 25,000       Program Support
(84) ATC GLIMCHER
180 EAST BROAD STREET
COLUMBUS,OH43215
46-4674640   10,000       Program Support
(85) United Methodist Family Services of Virginia
3900 W BROAD ST
Richmond,VA23230
54-0505969 501(C)(3) 64,050       Program Support
(86) UNITED WAY OF GREATER CINCINNATI
2400 Reading Rd
CINCINNATI,OH45202
31-0537502 501(C)(3) 5,445       Program Support
(87) UNITED WAY OF GREATER TOLEDO
424 Jackson St
TOLEDO,OH43604
34-4427947 501(C)(3) 12,017       Program Support
(88) Ohio Suicide Prevention Foundation
1225 Dublin Rd 125
Columbus,OH43215
20-3476310 501(C)(3) 38,290       Program Support
(89) WESTERN RESERVE DISTRIBUTING INC
305 LAKE RD
MEDINA,OH44256
82-0563593   7,128       Program Support
(90) YOUNGSTOWN NEIGHBORHOOD DEV CORP
820 Canfield Road
YOUNGSTOWN,OH44511
26-4117989 501(C)(3) 91,000       Program Support
(91) CATHOLIC MEDICAL MISSION BOARD
100 WALL ST
NEW YORK,NY10005
13-5602319 501(C)(3) 206,228       Program Support
(92) CBS PERU (SISTERS OF BON SECOURS)
1525 Marriottsville Rd
Marriottsville,MD21104
52-1263625 501(C)(3) 208,100       Program Support
(93) COMMUNITY COALITION FOR HAITI
PO Box 1222
Vienna,VA22183
65-1163122 501(C)(3) 10,000       Program Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
75
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
18
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2020

Schedule I (Form 990) 2020
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) Charitable Pharmacy 580 32,073      
(2) Medical Bills 1271 73,869      
(3) Transportation 732 43,515      
(4) Scholarships 677 300,862      
(5) Mammogram Screenings 520 55,765      
(6) Patient Massage Therapy 175 26,991      
(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
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Any organization receiving funds over $5,000 must complete an accompanied "Verification of Use of a Grant or Other Assistance from the Bon Secours Mercy Health Foundation" form. Organizations signing the form "Attest that the grant/assistance provided by the Foundation is being used for the purpose intended as stated in the request to the Foundation and that additional documentation to support usage of the grant/assistance as stated will be provided to the Foundation upon request." The Verification from must be submitted within 30 days of receiving the grant or assistance. Second notices are sent if the form is not returned within the allocated time frame. No additional grant or assistance will be provided until the form is signed and returned to the Foundation. To the extent additional information is required, requests will be made to the grantee. When the Foundation supports a Bon Secours Mercy Health initiative, the manager of the initiative is expected to attend a Foundation board meeting annually in-person during the course of the Foundation's support for the initiative. This attendance is to report the current year's status of the initiative and plans for the following year if the Foundation is being asked to continue support or has already made a multi-year commitment.
Schedule I (Form 990) 2020



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Software ID: 20011424
Software Version: 2020v4.0