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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.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
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) 16,935,739       Capital and program support
(2) Bon Secours - Richmond Health System Inc
8580 Magellan Pkwy
Bld 4
Richmond,VA23227
52-1988421 501(C)(3) 4,947,757       Capital and program support
(3) St Francis Hospital Inc
one st francis dr
Greenville,SC29601
58-2504530 501(C)(3) 1,262,590       Capital and program support
(4) Community Mercy Health Partners
100 Medical Center Dr
SPRINGFIELD,OH45503
31-0785684 501(C)(3) 1,004,707       Capital and program support
(5) Harness Health Partners LLC
1701 Mercy Health Pl
Cincinnati,OH45237
87-0923810   28,868       Program Support
(6) Bon Secours Baltimore Community Works Inc
26 N Fulton Ave
Baltimore,MD21223
52-1732800 501(C)(3) 79,440       Program Support
(7) Unity Properties Inc
26 N Fulton Ave
Baltimore,MD21223
52-1857768 501(C)(3) 99,421       Program Support
(8) Mercy Franciscan Senior Health and Housing LLC
2950 W Park Dr
Cincinnati,OH45238
31-1308729 501(C)(3) 224,702       Program Support
(9) Mercy College of Ohio
2221 Madison Ave
Toledo,OH43604
34-1726619 501(C)(3) 170,256       Program Support
(10) St Francis Physicians Services
One St Francis Drive
Greenville,SC29601
13-4290167 501(C)(3) 338,850       Program Support
(11) Bon Secours Ambulatory Services SF LLC
One St Francis Drive
Greenville,SC29601
80-0520229   23,291       Program Support
(12) ABILITY CENTER OF GREATER TOLEDO
5605 MONROE ST
SYLVANIA,OH43560
34-4428597 501(C)(3) 25,000       Program Support
(13) ACADEMY FOR URBAN SCHOLARS YOUNGSTOWN
2780 AIRPORT DR
COLUMBUS,OH43219
45-5564652 501(C)(3) 51,133       Program Support
(14) ACADEMY OF MUSIC
4101 GROVE AVE
Richmond,VA23221
64-1949644 501(C)(3) 20,840       Program Support
(15) ALLIANCE FOR HOPE INTL
101 West Broadway
San Diego,CA92101
11-3692035 501(C)(3) 20,464       Program Support
(16) AMER SOC FOR METABOLIC & BARIATRIC SURGERY
14407 SW 2ND Pl
NEWBERRY,FL32669
52-1203109 501(C)(3) 5,760       Program Support
(17) AREA AGENCY ON AGING 11 INC
330 5TH ST N
ST PETERSBURG,FL33701
31-1710636 501(C)(3) 12,000       Program Support
(18) BON SECOURS CHARITY HEALTH SYS
22 Van Duzer Pl
Warwick,NY10990
06-1381994 501(C)(3) 100,000       Program Support
(19) BOYS & GIRLS CLUB OF GREATER CINCINNATI
600 DALTON AVE
CINCINNATI,OH45203
31-0536965 501(C)(3) 6,500       Program Support
(20) CATHOLIC CHARITIES DIOCESE OF TOLEDO
1933 SPIELBUSCH AVE
TOLDEO,OH43604
59-0875805 501(C)(3) 15,000       Program Support
(21) CATHOLIC CHARITIES REGIONAL AGENCY
319O W RAYEN AVE
YOUNGSTOWN,OH44502
34-0714330 501(C)(3) 39,865       Program Support
(22) CATHOLIC DIOCESE OF RICHMOND
7900 CAROUSEL LN
Henrico,VA23228
54-0505947 501(C)(3) 36,000       Program Support
(23) CENTRAL CATHOLIC HIGH SCHOOL
2550 CHERRYS T
TOLEDO,OH43608
34-4428211 501(C)(3) 326,345       Program Support
(24) CHAMPAIGN TRANSIT SYSTEM
1512 S US HIGHWAY 68
URBANA,OH43078
34-6400283 115 Government 11,797       Program Support
(25) CHERRY STREET MISSION MINISTRIES
1501 Monroe St
TOLEDO,OH43604
34-1133369 501(C)(3) 25,000       Program Support
(26) CHESTERFIELD COUNTY PUBLIC SCHOOLS
9900 KRAUSE RD
CHESTERFIELD,VA23882
54-6001210 115 Government 80,518       Program Support
(27) COMMONWEALTH CATHOLIC CHARITIES
1601 ROLLING HILLS DR
Richmond,VA23229
54-0404877 501(C)(3) 90,000       Program Support
(28) COMMUNITY FOUNDATION OF MAHONING VALLEY
201 E COMMERCE ST
YOUNGSTOWN,OH44503
34-1904353 501(C)(3) 39,500       Program Support
(29) Headwaters at Incarnate World Inc
4503 BROADWAY
SAN ANTONIO,TX78209
46-5515608 501(C)(3) 165,663       Program Support
(30) COUNTY OF CLARK OH-MENTAL HEALTH & RECOVER BOARD CLARK GREEN & MADISON
529 E HOME RD
SPRINGFIELD,OH45503
31-6000132 501(C)(3) 21,766       Program Support
(31) COURAGEOUS COMMUNITY SERVICES
12701 WATERVILLE SWANTON RD
WHITEHOUSE,OH43571
34-1750892 501(C)(3) 10,000       Program Support
(32) DIABETES YOUTH SERVICES
2100 WEST CENTRAL AVE
Toledo,OH43606
34-1967194 501(C)(3) 15,000       Program Support
(33) FAMILY AND COMMUNITY SERVICES INC
705 Oakwood St
Ravenna,OH44266
34-1902451 501(C)(3) 5,000       Program Support
(34) FLYING HIGH INC
6 FEDERAL PLAZA
YOUNGSTOWN,OH44503
34-1749183 501(C)(3) 13,303       Program Support
(35) FRIENDS OF LUCAS COUNTY CHILDREN SERVICES
705 Adams St
TOLEDO,OH43604
01-0557195 501(C)(3) 25,000       Program Support
(36) GALA OF HOPE FOUNDATION INC
3500 Pentagon Blvd
Beavercreek,OH45431
46-4277044 501(C)(3) 5,000       Program Support
(37) GLOBAL SMILE FOUNDATION
106 ACCESS RD
NORWOOD,MA02062
26-2668127 501(C)(3) 75,000       Program Support
(38) HISPANIC CHAMBER CINCINNATI
2637 ERIE AVE
CINCINNATI,OH45208
31-1458839 501(C)(3) 5,000       Program Support
(39) HISTORIC SOUTH INITIATIVE FOR HISPANICS
PO BOX 1008
TOLEDO,OH43697
47-1691856 501(C)(3) 25,000       Program Support
(40) HOPE HOUSE VISITATION CENTER INC
660 W EARLE AVE
YOUNGSTOWN,OH44511
34-1906321 501(C)(3) 10,000       Program Support
(41) OH Superintendents of County Boards of Developmental Disabilities
4791 Woodride Dr
YOUNGSTOWN,OH44515
31-1319905 501(C)(3) 13,004       Program Support
(42) INSPIRING MINDS YOUNGSTOWN
PO BOX 8512
Warren,OH44484
26-1429323 501(C)(3) 27,000       Program Support
(43) JENNIFER WAKEFIELD AND LUCAS COUNTY SPC
536 LAWSON ST
OREGON,OH43616
27-0860163 501(C)(3) 38,290       Program Support
(44) JUNIOR ACHIEVEMENT OF NORTHWESTERN OHIO
1645 INDIAN WOOD CIR
MAUMEE,OH43537
34-4430363 501(C)(3) 50,000       Program Support
(45) JUNIOR CIVIC LEAGUE
PO BOX 243
YOUNGSTOWN,OH44501
34-1214986 501(C)(3) 35,000       Program Support
(46) KING'S DAUGHTERS MEDICAL CENTER
2201 LEXINGTON AVE
ASHLAND,KY41101
61-0444716 501(C)(3) 233,776       Program Support
(47) LITTLE FORK SW OHIO REG FAMILY ADVOCACY CENTER
2908 Victoria Ave
Cincinnati,OH45208
82-1519377 501(C)(3) 25,000       Program Support
(48) LIVEWELL GREENVILLE
PO BOX 2284
Greenville,SC29602
81-1376760 501(C)(3) 149,408       Program Support
(49) LOCAL INITIATIVES SUPPORT CORPORATION
28 Liberty St
New York,NY10005
13-3030229 501(C)(3) 75,000       Program Support
(50) LOURDES UNIVERSITY
6832 Convent Blvd
Sylvania,OH45360
34-1226547 501(C)(3) 10,000       Program Support
(51) United Way of Youngstown and the Mahoning Valley
255 Watt St
Youngstown,OH44505
34-0714598 501(C)(3) 5,000       Program Support
(52) MAREDA Center
223 Page St
TOLEDO,OH43620
83-1794238 501(C)(3) 20,000       Program Support
(53) MAUMEE VALLEY HABITAT FOR HUMANITY
1310 CONANT ST
MAUMEE,OH43537
34-1584723 501(C)(3) 50,000       Program Support
(54) MAYERSON JCC
8485 RIDGE RD
CINCINNATI,OH45236
31-0536986 501(C)(3) 25,000       Program Support
(55) MERCY NEIGHBORHOOD MINISTRIES
1602 MADISON RD 2ND FL
CINCINNATI,OH45206
31-1376693 501(C)(3) 125,640       Program Support
(56) MERCY VOLUNTEER CORPS
1012 N BETHLEHEM PKE
LOWER GWYNEDD,PA19002
52-1837856 501(C)(3) 60,000       Program Support
(57) MERIDIAN HEALTHCARE
8255 SOUTH AVE
YOUNGSTOWN,OH44512
34-1138485 501(C)(3) 66,046       Program Support
(58) METROPARKS TOLEDIO FOUNDATION
5100 W CENTRAL AVE
TOLEDO,OH43615
23-7425773 501(C)(3) 200,000       Program Support
(59) MULTIFAITH COUNCIL OF NW OHIO
3009 Gunckel Blvd
Toledo,OH43606
51-0507680 501(C)(3) 5,500       Program Support
(60) NEIL KENNEDY RECOVERY CLINIC
2151 Rush Boulevard
YOUNGSTOWN,OH44507
34-0685251 501(C)(3) 33,969       Program Support
(61) NORTHEAST OHIO ADOPTION SERVICES
5000 E Market St
Warren,OH44484
34-1255887 501(C)(3) 5,000       Program Support
(62) NORTHEAST OHIO MEDICAL UNIVERSITY
PO BOX 95
ROOTSTOWN,OH44272
34-1131512 501(C)(3) 246,851       Program Support
(63) OHIO HIGH SCHOOL ATHLETIC ASSOCIATION
4080 ROSELEA PL
COLUMBUS,OH43214
31-4355728 501(C)(3) 31,500       Program Support
(64) PERRYSBURG HEIGHTS COMM ASSOC
12282 Jefferson St
Perrysburg,OH43551
31-1329031 501(C)(3) 5,000       Program Support
(65) PRODUCE PERKS
3600 PARK 42 DRIVE
CINCINNATI,OH45241
47-5000763 501(C)(3) 118,770       Program Support
(66) RICHMOND JEWISH FOUNDATION
5403 MONUMENT AVE
Richmond,VA23226
54-1623966 501(C)(3) 10,000       Program Support
(67) SIGHT FOR ALL UNITED
2747 BELMONT AVE
YOUNGSTOWN,OH44505
81-1468439 501(C)(3) 6,000       Program Support
(68) SISTERS ACADEMY OF BALTIMORE
139 FIRST AVE
BALTIMORE,MD21227
34-1975939 501(C)(3) 25,000       Program Support
(69) SISTERS IN SHELTER
76 E MARKET ST
TIFFIN,OH44883
46-3859361 501(C)(3) 20,000       Program Support
(70) SISTERS OF ST FRANCIS OF TIFFIN
200 St Francis Ave
TIFFIN,OH44883
34-4428986 501(C)(3) 26,500       Program Support
(71) SISTERS OF THE HUMILITY OF MARY Charitable Trust
PO Box 914
VillA Maria,PA16155
25-6307483 501(C)(3) 5,000       Program Support
(72) SOMPLACE SAFE INC
1370 TOD AVE NW
WARREN,OH44485
34-1255329 501(C)(3) 40,000       Program Support
(73) ST FRANCIS DE SALES HIGH SCHOOL Foundation Inc
2323 W Bancroft St
Toledo,OH43607
34-1696266 501(C)(3) 26,900       Program Support
(74) ST FRANCIS SENIOR MINISTRIES
182 ST FRANCIS AVE
TIFFIN,OH44883
83-2533222 501(C)(3) 20,000       Program Support
(75) TIFFIN COMMUNITY FOUNDATION
31 S WASHINGTON ST
TIFFIN,OH44883
34-1405286 501(C)(3) 5,000       Program Support
(76) TLC HOMELESSNESS BOARD
1946 N 13TH ST
TOLEDO,OH43604
72-1604255 501(C)(3) 20,000       Program Support
(77) TOLEDO COMMUNITY SERVICE CTR
669 INDIANA AVE
TOLEDO,OH43604
34-1556086 501(C)(3) 12,000       Program Support
(78) TRAUMATIC BRAIN INJURY RESOURCE
7430 W CENTRAL AVE
TOLEDO,OH43617
47-1421039 501(C)(3) 25,000       Program Support
(79) UMFS
3900 W BROAD ST
Richmond,VA23230
54-0505969 501(C)(3) 92,033       Program Support
(80) YMCA OF YOUNGSTOWN
17 N Champion St
Youngstown,OH44503
47-5303771 501(C)(3) 5,000       Program Support
(81) YOUNGSTOWN AREA JEWISH FEDERATION
505 GYPSY LN
YOUNGSTOWN,OH44504
34-0714442 501(C)(3) 30,000       Program Support
(82) YOUNGSTOWN NEIGHBORHOOD DEV CORP
820 Canfield Road
YOUNGSTOWN,OH44511
26-4117989 501(C)(3) 107,221       Program Support
(83) CATHOLIC MEDICAL MISSION
100 WALL ST
NEW YORK,NY10005
13-5602319 501(C)(3) 901,989       Program Support
(84) 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 ................. Graphic Arrow
82
3
Enter total number of other organizations listed in the line 1 table ........................ . Graphic Arrow
2
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021

Schedule I (Form 990) 2021
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) Medical Support 1118 95,853      
(2) Transportation 1545 64,808      
(3) Scholarships 49 61,205      
(4) Patient Therapy 236 41,403      
(5) Medical Screenings 208 12,846      
(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
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) 2021



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Software ID: 21014044
Software Version: 2021v4.2