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
2015
Open to Public
Inspection
Name of the organization
Memorial Health Care System Inc
 
Employer identification number
62-0532345
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
non-cash assistance		 (h) Purpose of grant
or assistance
(1) ACCESS ONE EAPPARTNERSHIP FOR
1800 MCCALLIE AVE
CHATTANOOGA,TN374043025 		62-0911679 501c3 10,000       COMMUNITY SUPPORT
(2) AMER CANCER TNLAMSA V160791
1100 IRELAND WY
BIRMINGHAM,AL352057014 		64-0329009 501c3 6,750       COMMUNITY SUPPORT
(3) AMER HEART ASSNAMER STROKE AS
7272 GREENVILLE AVE
DALLAS,TX75231 		13-5613797 501c3 37,083       COMMUNITY SUPPORT
(4) AMER RED CROSS-ALL CHAP
431 18TH ST NW
WASHINGTON,DC20006 		53-0196605 501c3 25,000       COMMUNITY SUPPORT
(5) BREAST CANCER SUPPORT SERVICES
1400 MCCALLIE AVE
CHATTANOOGA,TN37404 		45-2772331 501c3 5,000       COMMUNITY SUPPORT
(6) CATHOLIC CHARITIES OF EAST TN
859 MCCALLIE AVE
CHATTANOOGA,TN374032621 		62-1377551 501c3 52,500       COMMUNITY SUPPORT
(7) CATOOSA COUNTY AREA CHAMBER
264 CATOOSA CIR
RINGGOLD,GA30736 		58-1721665 501c3 5,000       COMMUNITY SUPPORT
(8) CHATT CHAMBER FDTN
ATTN DIANE PARKS
811 BROAD ST
CHATTANOOGA,TN37402 		62-0154480 501c3 25,000       COMMUNITY SUPPORT
(9) CHATT HAMILTON COUNTY GOVT
921 E 3RD ST
CHATTANOOGA,TN374032102 		62-0000636 govt 40,000       COMMUNITY SUPPORT
(10) CHATTANOOGA AREA FOOD BANK
ATTN MARISA OGLES
2009 CURTAIN POLE RD
CHATTANOOGA,TN37406 		62-0867645 501c3 5,000       COMMUNITY SUPPORT
(11) CHATTANOOGA CATHOLIC SCHOOLS
C/O STS
ATTN KATHLEEN ETHERTON PRESTON
CHATTANOOGA,TN37415 		43-1694323 501c3 10,000       COMMUNITY SUPPORT
(12) CHATTANOOGA COMMUNITY KITCHEN
PO BOX 11203
727 E 11TH ST
CHATTANOOGA,TN37401 		62-1151413 501c3 5,000       COMMUNITY SUPPORT
(13) CHATTANOOGA FC INC
1271 MARKET ST
CHATTANOOGA,TN37402 		27-1880693 501c3 18,000       COMMUNITY SUPPORT
(14) CHOICES PREGNANCY RESOURCE CTR
6232 VANCE RD
CHATTANOOGA,TN37421 		30-0400541 501c3 8,000       COMMUNITY SUPPORT
(15) COMMUNITY FOUNDATION OF GREATE
1270 MARKET ST
CHATTANOOGA,TN37402 		62-6045999 501c3 6,600       COMMUNITY SUPPORT
(16) FAM PROMISE OF GREATER CHATT
1184 BALDWIN ST
CHATTANOOGA,TN37403 		31-1529222 501c3 5,000       COMMUNITY SUPPORT
(17) GOODWILL INDUSTRCHATTANOOGA G
3500 DODDS AVE
CHATTANOOGA,TN37407 		62-0536733 501c3 10,000       COMMUNITY SUPPORT
(18) LA PAZ DE DIOSLA PAZ CHATTANO
1402 BAILEY AVE
CHATTANOOGA,TN37404 		20-1115026 501c3 5,000       COMMUNITY SUPPORT
(19) MEDICAL FDTN OF CHATTANOOGA
1917 E THIRD ST
CHATTANOOGA,TN37404 		58-1696660 501c3 5,000       COMMUNITY SUPPORT
(20) NORTH RIVER YMCA CHAT EPAY HDR
301 W 6TH ST
CHATTANOOGA,TN374021108 		62-0475699 501c3 11,500       COMMUNITY SUPPORT
(21) NORTHSIDE NEIGHBORHOOD HOUSE
211 MINOR ST
PO BOX 4086
CHATTANOOGA,TN37405 		62-0481801 501c3 10,000       COMMUNITY SUPPORT
(22) RICHMONT COMM COUNSELING CTR
1815 MCCALLIE AVE
CHATTANOOGA,TN37404 		62-0789275 501c3 5,000       COMMUNITY SUPPORT
(23) TENNESSEE AQUARIUM
5000 ONE BROAD ST
CHATTATNOOGA,TN37402 		58-1837154 501C3 10,000       COMMUNITY SUPPORT
(24) SOUTHERN ADVENTISTWSMC EPAY
PO BOX 370
COLLEGEDALE,TN37315 		62-0536733 501c3 17,250       COMMUNITY SUPPORT
(25) SUSAN G KOMEN FOR THE CURE-TN
CHATTANOOGA AFFILIATE
PO BOX 11288
CHATTANOOGA,TN37401 		72-5875175 501c3 10,000       COMMUNITY SUPPORT
(26) UNITED STATES SOCCER FEDERATIO
1801 S PRAIRIE AVE
CHICAGO,IL60616 		13-5591991 501C3 25,000       COMMUNITY SUPPORT
(27) UNITED WAY CHATTANGIFTS IN KI
630 MARKET ST
CHATTANOOGA,TN37405 		62-0569562 501c3 20,137       COMMUNITY SUPPORT
(28) UNIVERSITY OF TENNESSEEWUTC
201 ANDY HOLT TOWER
KNOXVILLE,TN379960100 		62-6001636 501c3 62,988       COMMUNITY SUPPORT
(29) URBAN LEAGUE OF GREATER CHATT
730 MLK BLVD
CHATTANOOGA,TN37403 		58-1436933   16,500       COMMUNITY SUPPORT
(30) WALKER COUNTY
PO BOX 436
LAFAYETTE,GA30728 		govt 6,000       COMMUNITY SUPPORT
(31) WELCOME TO CHATTANOOGA
PO BOX 4246
CHATTANOOGA,TN37405 		46-2613489 501c3 10,000       COMMUNITY SUPPORT
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
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015
Page 2

Schedule I (Form 990) 2015
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
non-cash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of non-cash assistance
(1) VIOLENCE PREVENTION PROGRAM 250 32,274      
(2) WE CARE WEEKEND FOR CANCER SURVIVORS AND THEIR FAMILIES 125 31,977      
(3) Scholarships 3 6,000      
(4) MOBILE COACH HEALTH SERVICES 2105 320,481      
(5) LUNG SCREENING 23 1,150      
(6) PATIENT ASSISTANCE-TRANSPORTATION, FOOD, LODGING, ETC 155 61,589      
(7) Ivy School Programs 250 59,303      
(8) CHARITY CARE ASSISTANCE 8432 44,126,327   book FINANCIAL ASSISTANCE
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 III LINE 8: CHARITY CARE ASSISTANCE Memorial Health Care System RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. BUSINESS OFFICE STAFF HELPS PATIENTS SEEK LOCAL, STATE, AND FEDERAL REIMBURSEMENT AT NO CHARGE WHEN NO OTHER SOURCE OF PAYMENT IS AVAILABLE. FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS WITH DEMONSTRATED INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES. THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS ACCOUNTS RECEIVABLE.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. GRANT REQUESTS ARE COORDINATED THROUGH THE MEMORIAL HEALTH CARE SYSTEM FOUNDATION. THE BENEFICIARY OF THE GRANT IS RESPONSIBLE FOR USING THE FUNDS IN ACCORDANCE WITH THE GRANT REQUIREMENTS. ALL GRANT SPENDING IS REVIEWED BY FISCAL SERVICES AND THE FOUNDATION BEFORE GRANT SPENDING IS REIMBURSED THROUGH THE FOUNDATION. PERIODIC REPORTING IS COORDINATED BETWEEN THE BENEFICIARY, FISCAL SERVICES, AND THE FOUNDATION.
Schedule I (Form 990) 2015



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