MERCY HOSPITAL: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HOSPITAL (EIN 45-0226553)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-11
- IRS object ID
- 202321319349302407
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-11T09:24:22-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 470617373 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMONSPIRIT HEALTH | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 198 INVERNESS DRIVE WEST | AddressLine1Txt |
| City | ENGLEWOOD | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80112 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450226553 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL OF VALLEY CITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MERC | BusinessNameControlTxt |
| Phone | 7018456489 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 570 CHAUTAUQUA BLVD | AddressLine1Txt |
| City | VALLEY CITY | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58072 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NICK O'TOOL | PersonNm |
| Person Title | INTERIM SVP FINANCE | PersonTitleTxt |
| Phone | 7018456489 | PhoneNum |
| Signature | 2023-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | NICK | PersonFirstNm |
| Person Last | OTOOL | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARK STOCKI | PreparerPersonNm |
| PTIN | P00642127 | PTIN |
| Phone | 3032989100 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHI MERCY HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | D RYAN FOWLER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 570 CHAUTAUQUA BLVD | AddressLine1Txt |
| City | VALLEY CITY | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58072 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,959,731 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MERCYHOSPITALVALLEYCITY.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1928 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | MERCY HOSPITAL OF VALLEY CITY IS A CRITICAL ACCESS HOSPITAL SERVING A LARGE GEOGRAPHICAL AREA. COMMUNITY BENEFITS INCLUDE: UNCOMPENSATED CARE, MEDICAL EDUCATION AND AWARENESS, SUPPORT SERVICES, AND COMMUNITY OUTREACH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 96 | TotalEmployeeCnt |
| Total Volunteers | 60 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $588,113 | PYContributionsGrantsAmt |
| CY Contributions Grants | $200,541 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,446,166 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,049,439 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,168,799 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,659,151 | CYInvestmentIncomeAmt |
| PY Other Revenue | $28,788 | PYOtherRevenueAmt |
| CY Other Revenue | $50,600 | CYOtherRevenueAmt |
| PY Total Revenue | $15,231,866 | PYTotalRevenueAmt |
| CY Total Revenue | $14,959,731 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,680 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,272 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,575,460 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,465,158 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,968,618 | PYOtherExpensesAmt |
| CY Other Expenses | $9,283,129 | CYOtherExpensesAmt |
| PY Total Expenses | $11,545,758 | PYTotalExpensesAmt |
| CY Total Expenses | $13,751,559 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,686,108 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,208,172 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $49,620,792 | TotalAssetsBOYAmt |
| Total Assets EOY | $46,786,903 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,581,678 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,312,706 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $42,039,114 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $40,474,197 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $12,833,945 | ExpenseAmt |
| Grant | $3,272 | GrantAmt |
| Revenue | $13,049,439 | RevenueAmt |
| Desc | SEE SCHEDULE H | Desc |
| Total Program Service Expenses | $12,833,945 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 96 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | ND | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BETHANY SMITH | PersonNm |
| Phone | 7018456583 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 570 CHAUTAUQUA BLVD | AddressLine1Txt |
| City | VALLEY CITY | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58072 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| JEANETTE WOJTALEWICZ | |||||||||
| BOARD MEMBER/CSH SVP DIVISION OFFICER (PARTIAL YEA | 1.00 | 49.00 | Yes (X) | $0 | $1,233,421 | $51,903 | |||
| REBECCA THOMPSON | |||||||||
| BOARD MEMBER/INTERIM PRESIDENT | 1.00 | 40.00 | Yes (X) | $0 | $288,444 | $30,144 | Yes (X) | ||
| KEITH HEUSER | |||||||||
| BOARD MEMBER/PRESIDENT (PARTIAL YEAR) | 1.00 | 40.00 | Yes (X) | $0 | $254,282 | $25,714 | Yes (X) | ||
| CLARK KRUTA | |||||||||
| CRNA | 40.00 | 0.00 | $224,297 | $0 | $48,081 | Yes (X) | |||
| JOSHUA SENGER | |||||||||
| FORMER TREASURER/VP, FINANCE | 0.00 | 40.00 | $0 | $156,507 | $40,887 | Yes (X) | |||
| BETH SMITH | |||||||||
| TREASURER/VP, FINANCE | 1.00 | 39.00 | $0 | $145,712 | $37,296 | Yes (X) | |||
| AMY NOESKE | |||||||||
| PHARMACY MANAGER | 40.00 | 0.00 | $123,803 | $0 | $32,450 | Yes (X) | |||
| COLLEEN JONES | |||||||||
| VP, PATIENT CARE SERVICES | 40.00 | 0.00 | $121,842 | $0 | $15,223 | Yes (X) | |||
| ALANA MCCLELLAN | |||||||||
| MANAGER, EMERGENCY SERVICES | 40.00 | 0.00 | $111,637 | $0 | $24,366 | Yes (X) | |||
| CAMILLE SETTELMEYER | |||||||||
| VP OF CLINICAL SERVICES | 0.00 | 40.00 | $0 | $114,378 | $17,751 | Yes (X) | |||
| ROWENA DEPRA | |||||||||
| RN, MEDICAL-SURGICAL | 40.00 | 0.00 | $120,324 | $0 | $8,583 | Yes (X) | |||
| LISA URBATSCH | |||||||||
| BOARD SECRETARY (PARTIAL YEAR) | 40.00 | 0.00 | $45,507 | $2,411 | $25,559 | Yes (X) | |||
| KAYLA BRADEMEYER | |||||||||
| BOARD SECRETARY | 1.00 | 0.00 | $31,853 | $0 | $10,005 | Yes (X) | |||
| FREDRICK MITZEL MD | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| SR STELLA OLSON | |||||||||
| BOARD MEMBER | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| TIM OST | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| CASEY STOUDT | |||||||||
| CHAIR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| PAIGE BJORNSON | |||||||||
| VICE CHAIR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ALAN LAFAVE | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| D RYAN FOWLER | |||||||||
| BOARD MEMBER/PRESIDENT | 40.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| EVERT KUIPER | |||||||||
| BOARD MEMBER/CSH SVP DIVISION OFFICER | 1.00 | 50.00 | Yes (X) | $0 | $0 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $779,263 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,195,155 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $367,962 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NATIONAL MEDICAL RESOURCES INC | |||||
| 2900 E BROADWAY AVE | BISMARCK | ND | 58540 | LOCUM PROVIDERS | $1,022,101 |
| MEDEFIS INC | |||||
| 2121 N 117TH AVE STE 200 | OMAHA | NE | 68164 | VENDOR MANAGEMENT/STAFFING | $418,458 |
| INTERSTAFF INC | |||||
| PO BOX 4652 DEPT 980 | HOUSTON | TX | 772104652 | CONTRACT TRAVELING NURSING LABOR | $156,100 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $133,944 | RelatedOrganizationsAmt |
| Government Grants | $25,057 | GovernmentGrantsAmt |
| All Other Contributions | $41,540 | AllOtherContributionsAmt |
| Total Contributions | $200,541 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICES | 900099 | $13,047,759 | $13,047,759 |
| RENTAL INCOME | 900099 | $1,680 | $1,680 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,049,439 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $272,368 | TotalRevenueColumnAmt |
| Exclusion | $272,368 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,386,783 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,386,783 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,386,783 | TotalRevenueColumnAmt |
| Exclusion | $1,386,783 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| EMPLOYEE RETENTION CRE | 900099 | $28,530 | $28,530 |
| CAFETERIA | 722100 | $12,502 | $12,502 |
| MEDICAL SERVICES | 621300 | $5,615 | $5,615 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,953 | TotalRevenueColumnAmt |
| Exclusion | $3,953 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $50,600 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,959,731 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,049,439 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,709,751 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,272 | TotalAmt |
| Program Services | $3,272 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,201 | TotalAmt |
| Management And General | $91,201 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,570,402 | TotalAmt |
| Program Services | $3,375,927 | ProgramServicesAmt |
| Management And General | $194,475 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,976 | TotalAmt |
| Program Services | $163,160 | ProgramServicesAmt |
| Management And General | $12,816 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $366,436 | TotalAmt |
| Program Services | $365,208 | ProgramServicesAmt |
| Management And General | $1,228 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,143 | TotalAmt |
| Program Services | $240,252 | ProgramServicesAmt |
| Management And General | $20,891 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,054 | TotalAmt |
| Management And General | $13,054 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $974 | TotalAmt |
| Management And General | $974 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,937,757 | TotalAmt |
| Program Services | $4,443,981 | ProgramServicesAmt |
| Management And General | $493,776 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,384 | TotalAmt |
| Management And General | $20,384 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $234,662 | TotalAmt |
| Program Services | $197,116 | ProgramServicesAmt |
| Management And General | $37,546 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $470,531 | TotalAmt |
| Program Services | $470,531 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $201,575 | TotalAmt |
| Program Services | $201,575 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,286 | TotalAmt |
| Program Services | $13,715 | ProgramServicesAmt |
| Management And General | $571 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,353 | TotalAmt |
| Management And General | $1,353 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $837 | TotalAmt |
| Management And General | $837 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $380,460 | TotalAmt |
| Program Services | $380,460 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,218,080 | TotalAmt |
| Program Services | $1,193,718 | ProgramServicesAmt |
| Management And General | $24,362 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,627 | TotalAmt |
| Program Services | $42,627 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,315,802 | $1,315,802 | |
| REPAIRS AND MAINTENANCE | $350,788 | $350,788 | |
| DUES & SUBSCRIPTIONS | $51,491 | $51,491 | |
| EDUCATION | $19,454 | $18,481 | $973 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,014 | TotalAmt |
| Program Services | $5,841 | ProgramServicesAmt |
| Management And General | $3,173 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,751,559 | TotalAmt |
| Program Services | $12,833,945 | ProgramServicesAmt |
| Management And General | $917,614 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $625 | BOYAmt |
| EOY | $499 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,078,841 | BOYAmt |
| EOY | $10,281,552 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,589,987 | BOYAmt |
| EOY | $1,926,519 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $211,112 | BOYAmt |
| EOY | $204,532 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,806 | BOYAmt |
| EOY | $35,712 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,555,064 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,839,368 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,689,082 | BOYAmt |
| EOY | $2,715,696 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,471,200 | BOYAmt |
| EOY | $28,371,841 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,539,139 | BOYAmt |
| EOY | $3,250,552 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,620,792 | BOYAmt |
| EOY | $46,786,903 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,811,387 | BOYAmt |
| EOY | $2,748,968 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,582 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,721,709 | BOYAmt |
| EOY | $3,563,738 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,581,678 | BOYAmt |
| EOY | $6,312,706 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,025,360 | BOYAmt |
| EOY | $40,460,443 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,754 | BOYAmt |
| EOY | $13,754 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,039,114 | BOYAmt |
| EOY | $40,474,197 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,620,792 | BOYAmt |
| EOY | $46,786,903 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,208,172 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,758,399 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$14,690 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $974 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $974 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LINE 1F: THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: CATHOLIC HEALTH ASSOCIATION - $98 AMERICAN HOSPITAL ASSOCIATION - $149 NORTH DAKOTA HEALTH ASSOCIATION - $727 | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $122,801 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$4,281 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $300 | AdministrativeExpensesAmt |
| End Year Balance | $118,220 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $97,450 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $25,351 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $122,801 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $94,878 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $2,885 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $313 | AdministrativeExpensesAmt |
| End Year Balance | $97,450 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $89,600 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $5,579 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $301 | AdministrativeExpensesAmt |
| End Year Balance | $94,878 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $83,074 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $6,733 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $207 | AdministrativeExpensesAmt |
| End Year Balance | $89,600 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.40106 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.59894 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,382 | OtherCostOrOtherBasisAmt |
| Book Value | $19,382 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,955,588 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,104,470 | DepreciationAmt |
| Book Value | $851,118 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,458,440 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,627,898 | DepreciationAmt |
| Book Value | $1,830,542 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $121,654 | OtherCostOrOtherBasisAmt |
| Depreciation | $107,000 | DepreciationAmt |
| Book Value | $14,654 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,715,696 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CSH OPERATING INVESTMENT POOL | Desc |
| Book Value | $28,371,841 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $28,371,841 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTERCOMPANY RECEIVABLES | $3,205,222 |
| INVESTMENT IN UNCONSOLIDATED ORGS | $16,424 |
| RIGHT OF USE ASSETS | $28,906 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,250,552 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY PAYABLES | $3,533,594 |
| LEASE LIABILITIES | $29,781 |
| SERVICE FEE LIABILITY | $363 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,563,738 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | WE HAVE TWO ENDOWMENT FUNDS, ONE IS FOR SCHOLARSHIPS AND THE OTHER ONE IS AN EMPLOYEE ENDOWMENT FUND THAT WAS CREATED FOR REMODEL PURPOSES. THE BALANCE OF THE SCHOLARSHIP FUND IS $37,438, AND THE EMPLOYEE ENDOWMENT FUND IS $80,782. |
| PART X, LINE 2: | MERCY HOSPITAL OF VALLEY CITY'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 169 | PersonsServedCnt |
| Total Community Benefit Expns | $124,668 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $124,668 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00910 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,854 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,854 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 169 | PersonsServedCnt |
| Total Community Benefit Expns | $126,522 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $126,522 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00920 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 15746 | PersonsServedCnt |
| Total Community Benefit Expns | $23,285 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $23,285 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 3 | PersonsServedCnt |
| Total Community Benefit Expns | $319 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $319 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 11000 | PersonsServedCnt |
| Total Community Benefit Expns | $10,300 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 26749 | PersonsServedCnt |
| Total Community Benefit Expns | $33,904 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $33,904 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 26918 | PersonsServedCnt |
| Total Community Benefit Expns | $160,426 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $160,426 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01160 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 1500 | PersonsServedCnt |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 2050 | PersonsServedCnt |
| Total Community Benefit Expns | $320 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $320 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $49 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $49 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 3550 | PersonsServedCnt |
| Total Community Benefit Expns | $369 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $369 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $413,690 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $5,890,059 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,666,372 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $223,687 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL OF VALLEY CITY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 570 CHAUTAUQUA BLVD | AddressLine1Txt |
| City | VALLLEY CITY | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58072 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://WWW.MERCYHOSPITALVALLEYCITY.ORG | WebsiteAddressTxt |
| State License | 5050A | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL OF VALLEY CITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/COMMUNITY-BENEFITS/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/COMMUNITY-BENEFITS/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/FINANCIAL-INFORMATION-DOCUMENTS/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/FINANCIAL-INFORMATION-DOCUMENTS/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/FINANCIAL-INFORMATION-DOCUMENTS/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B, LINE 3E | THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. |
| PART V, SECTION B, LINE 5 | THIS ASSESSMENT EXAMINES HEALTH NEEDS AND CONCERNS IN BARNES COUNTY. IN ADDITION TO VALLEY CITY, LOCATED IN THE COUNTY ARE THE COMMUNITIES OF DAZEY, FINGAL, KATHRYN, LEAL, LITCHVILLE, NOME, ORISKA, PILLSBURY, ROGERS, SANBORN, SIBLEY, TOWER CITY, AND WIMBLEDON.CENTER FOR RURAL HEALTH (CRH), IN PARTNERSHIP WITH CHI MERCY HEALTH AND CITY-COUNTY HEALTH DISTRICT, FACILITATED THE CHNA PROCESS. COMMUNITY REPRESENTATIVES MET REGULARLY IN-PERSON, BY TELEPHONE CONFERENCE, AND EMAIL. A CHNA LIAISON WAS SELECTED LOCALLY, WHO SERVED AS THE MAIN POINT OF CONTACT BETWEEN CRH AND CHI MERCY HEALTH. A SMALL STEERING COMMITTEE WAS FORMED THAT WAS RESPONSIBLE FOR PLANNING AND IMPLEMENTING THE PROCESS LOCALLY. REPRESENTATIVES FROM THE CRH MET AND CORRESPONDED REGULARLY BY TELECONFERENCE AND/OR VIA THE ETOOLKIT WITH THE CHNA LIAISON. THE COMMUNITY GROUP (DESCRIBED IN MORE DETAIL BELOW) PROVIDED IN-DEPTH INFORMATION AND INFORMED THE ASSESSMENT PROCESS IN TERMS OF COMMUNITY PERCEPTIONS, COMMUNITY RESOURCES, COMMUNITY NEEDS, AND IDEAS FOR IMPROVING THE HEALTH OF THE POPULATION, AND HEALTHCARE SERVICES. EIGHT PEOPLE, REPRESENTING A CROSS SECTION DEMOGRAPHICALLY, ATTENDED THE FOCUS GROUP MEETING.AS PART OF THE ASSESSMENT'S OVERALL COLLABORATIVE PROCESS, CRH SPEARHEADED EFFORTS TO COLLECT DATA FOR THE ASSESSMENT IN A VARIETY OF WAYS: -A SURVEY SOLICITED FEEDBACK FROM AREA RESIDENTS; -COMMUNITY LEADERS, REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, TOOK PART IN ONE-ON-ONE KEY INFORMANT INTERVIEWS; -THE COMMUNITY GROUP, COMPRISED OF COMMUNITY LEADERS AND AREA RESIDENTS, WAS CONVENED TO DISCUSS AREA HEALTH NEEDS AND INFORM THE ASSESSMENT PROCESS; AND -A WIDE RANGE OF SECONDARY SOURCES OF DATA WERE EXAMINED, PROVIDING INFORMATION ON A MULTITUDE OF MEASURES, INCLUDING DEMOGRAPHICS, HEALTH CONDITIONS, INDICATORS, OUTCOMES, RATES OF PREVENTIVE MEASURES; RATES OF DISEASE; AND AT-RISK BEHAVIOR.MEMBERS OF THE COMMUNITY GROUP AND KEY INFORMANT INTERVIEWS REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY AND SERVED BY CHI MERCY HEALTH AND CITY-COUNTY HEALTH DISTRICT. THEY INCLUDED REPRESENTATIVES OF THE HEALTH COMMUNITY, BUSINESS COMMUNITY, POLITICAL BODIES, LAW ENFORCEMENT, EDUCATION, FAITH COMMUNITY, AND SOCIAL SERVICE AGENCIES. |
| PART V, SECTION B, LINE 6B | CENTER FOR RURAL HEALTHCITY-COUNTY HEALTH DISTRICTOUR SAVIOR'S LUTHERAN CHURCHSOUTH CENTRAL HUMAN SERVICE CENTER VALLEY CITY STATE UNIVERSITYVALLEY CITY CHAMBER OF COMMERCE |
| PART V, SECTION B, LINE 11 | THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH PRIMARY DATA GATHERED THROUGH A COMMUNITY HEALTH SURVEY AND KEY INFORMANT INTERVIEW, AS WELL AS REVIEW OF SECONDARY DATA. TOP HEALTH NEEDS (FROM 2022 CHNA): 1. AVAILABILITY OF MENTAL HEALTH SERVICES2. NOT ENOUGH JOBS WITH LIVABLE WAGES3. DEPRESSION/ANXIETY YOUTH4. ALCOHOL AND DRUG USE AND ABUSE YOUTH5. AVAILABILITY OF RESOURCES TO HELP THE ELDERLY STAY IN THEIR HOMES6. ALCOHOL USE AND ABUSE ADULTS7. ATTRACTING AND RETAINING YOUNG FAMILIES8. COST OF LONG-TERM/NURSING HOME CARE9. DRUG USE AND ABUSE ADULT10. DEPRESSION/ANXIETY ADULTFOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: HEALTH NEED: AVAILABILITY OF MENTAL HEALTH SERVICESTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023-2025: -VIRTUAL BEHAVIORAL HEALTH SERVICE ASSESSMENTS: PROVIDE A VIRTUAL PROVIDER-PATIENT ASSESSMENT TOOL FOR ASSESSING BEHAVIORAL HEALTH ISSUES -NORTH DAKOTA HOSPITAL ASSOCIATION (NDHA) BEHAVIORAL HEALTH WORKGROUP: PARTICIPATE IN NDHA WORKGROUP TO ADDRESS BEHAVIORAL HEALTH CARE IN ND CAHS -SCREENING PROCESS AT CRITICAL ACCESS HOSPITAL (CAH): EVALUATE SCREENINGS FOR PEOPLE IN CRISIS WHO MAY NEED REFERRAL TO OTHER FACILITIES AND DEFINE PROCESS FOR TRANSPORTING INDIVIDUALS IN NEED OF BEHAVIORAL HEALTH SERVICES -SCREENING AND COMMUNICATION PROCESSES WITH SCHOOLS: ASSIST IN DEVELOPING SCREENING AND COMMUNICATION PROCESSES TO IDENTIFY BEHAVIORAL HEALTH ISSUES IN YOUTH AND COMMUNICATE WITH APPROPRIATE RESOURCES -EDUCATION ON AVAILABLE BEHAVIORAL HEALTH SERVICES: PARTNER WITH CITY-COUNTY HEALTH DISTRICT TO PROVIDE MENTAL HEALTH FIRST AID TRAINING TO EDUCATE THE COMMUNITY AND EMERGENCY ROOM PROVIDERS ON THE CURRENT AVAILABLE TREATMENT OPTIONS AND WORK TOWARDS DEVELOPING AND IMPLEMENTING NEW TREATMENT OPTIONS FOR PEOPLE IN CRISIS AND NORTH DAKOTA VIOLENCE PREVENTION "COACHING BOYS INTO MEN" PROGRAM THAT ADDRESSES MENTAL HEALTH ISSUES TIED TO VIOLENCE IN YOUTH AS YOUNG AS 12PRIORITY HEALTH NEED #2: NOT ENOUGH JOBS WITH LIVABLE WAGESTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023-2025: -GROW YOUR OWN HEALTHCARE WORKFORCE: HOSPITAL WILL CREATE A SHADOW PROGRAM FOR HIGH SCHOOL-AGED YOUTH TO LEARN ABOUT HEALTHCARE OCCUPATIONS, PARTICIPATE IN OR HOST A LOCAL JOB FAIR AND PROVIDE CLASSES TO THE COMMUNITY FOR CERTIFIED NURSING ASSISTANT CERTIFICATION BEYOND EXISTING HIGH SCHOOL PROGRAMS -PARTNER WITH VALLEY CITY ECONOMIC DEVELOPMENT GROUP AND CHAMBER OF COMMERCE: IN SUPPORT OF LOCAL BUSINESSES, BUILD AWARENESS OF JOBS AND THE AVAILABILITY OF COMPETITIVE LIVABLE WAGES AND BENEFITS WITHIN THE COMMUNITY -WORKFORCE HEALTH EDUCATION: INCREASE AWARENESS AMONG EMPLOYERS AND ENCOURAGE EDUCATION IN UNDERSTANDING WORKPLACE MENTAL HEALTH STRUGGLES TO MAINTAIN/RECRUIT WORKFORCEPRIORITY HEALTH NEED #3: HEALTH NEED: DEPRESSION/ANXIETY YOUTHTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023-2025: -EDUCATION FOR FRONTLINE WORKERS: THE HOSPITAL WILL WORK WITH LOCAL SCHOOLS, EMERGENCY SERVICES AND AGENCIES TO PROVIDE BEHAVIORAL HEALTH EDUCATION TO WORKERS WHO ARE DIRECTLY IMPACTED BY YOUTH WITH BEHAVIORAL HEALTH PROBLEMS -EXPLORE EVIDENCE-BASED PREVENTION PROGRAMS: WORK WITH LOCAL AGENCIES TO DEVELOP OR IMPLEMENT A PREVENTION PROGRAM THAT CAN BE USED BY ALL MEMBERS OF THE BEHAVIORAL HEALTH COALITION TO WORK TOWARDS REDUCING THE NUMBER OF YOUTH SUFFERING FROM DEPRESSION AND ANXIETY -SOUTH CENTRAL HUMAN SERVICE CENTER RESOURCES: PARTNER WITH SOUTH CENTRAL HUMAN SERVICE CENTER TO EDUCATE THE COMMUNITY ON THE CURRENT AVAILABLE TREATMENT OPTIONS AND WORK TOWARDS DEVELOPING AND IMPLEMENTING NEW TREATMENT OPTIONSPRIORITY HEALTH NEED #4: HEALTH NEED: ALCOHOL AND DRUG USE AND ABUSE YOUTHTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023-2025: -COMMUNITY HEALTH PARTNERS AT VALLEY CITY SCHOOLS: PROVIDE SCHOOL-BASED HEALTH CARE EDUCATION ABOUT ALCOHOL AND DRUG ABUSE TO CHILDREN AND FAMILIES AND TRAIN STAFF IN IDENTIFYING AND ASSESSING OF YOUTH WHO MAY BE STRUGGLING WITH ADDICTION PROBLEMS -IDENTIFY PREVENTIVE PROGRAMS FOR ALCOHOL AND DRUG ABUSE: WORK WITH LOCAL FAITH LEADERS, SCHOOLS AND PARENT GROUPS TO DEVELOP PEER SUPPORT RESOURCES FOR YOUTH STRUGGLING WITH ADDICTION. -IDENTIFY CURRENT AND NEW TREATMENT RESOURCES: PARTNER WITH SOUTH CENTRAL HUMAN SERVICE CENTER TO EDUCATE THE COMMUNITY ON THE CURRENTLY AVAILABLE TREATMENT OPTIONS AND WORK TOWARDS DEVELOPING AND IMPLEMENTING NEW TREATMENT OPTIONSTHE HOSPITAL HAS CHOSEN NOT TO ADDRESS THE FOLLOWING IDENTIFIED NEEDS SPECIFICALLY WITHIN OUR INITIATIVES. THESE HEALTH CONCERNS ARE EITHER BEYOND ARE CAPACITY, BEING ADDRESSED BY OTHER ORGANIZATIONS AND PROGRAMS, OR ARE CURRENTLY ADDRESSED THROUGH EXISTING HOSPITAL PROGRAMS. FOR EACH ISSUE, HOWEVER, WE WILL CONTINUE TO DIALOGUE WITH COMMUNITY PARTNERS1. AVAILABILITY OF RESOURCES TO HELP THE ELDERLY TO STAY IN THEIR HOMES2. ALCOHOL USE AND ABUSE ADULTS3. ATTRACTING AND RETAINING YOUNG FAMILIES4. COST OF LONG-TERM/NURSING HOME CARE5. DRUG USE AND ABUSE ADULT6. DEPRESSION/ANXIETY ADULTTHE FOLLOWING TOP HEALTH NEEDS WERE IDENTIFIED AND PRIORITIZED AS PART OF THE CHNA AND IMPLEMENTATION STRATEGY PLAN APPROVED IN 2019. ALTHOUGH A MORE RECENT CHNA WAS COMPLETED IN 2022, THE RELATED IMPLEMENTATION PLAN WAS NOT APPROVED UNTIL JULY, 2022. THEREFORE THE WORK DESCRIBED BELOW IS TIED TO THE 2019 ASSESSMENT AND PLANS AND REPRESENTS WORK CARRIED OUT BY THE HOSPITAL DURING FISCAL YEAR 2022.THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH PRIMARY DATA OBTAINED THROUGH THE COMMUNITY HEALTH SURVEY AND KEY INFORMANT SURVEY, AS WELL AS A REVIEW OF SECONDARY DATA ON A VARIETY OF HEALTH INDICATORS.TOP HEALTH NEEDS (FROM 2019 CHNA): 1. SUBSTANCE USE AND ABUSE (ALCOHOL AND DRUGS)2. ATTRACTING AND RETAINING YOUNG FAMILIES3. AVAILABILITY OF SUBSTANCE ABUSE/TREATMENT SERVICES4. DEPRESSION AND ANXIETYPRIORITY HEALTH NEED #1: MENTAL HEALTH (DEPRESSION AND ANXIETY)TO ADDRESS THIS NEED THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES IN 2019-2021: -EXPANSION: EXPLORE EARLY INTERVENTION OPPORTUNITIES THROUGH NURSE FAMILY PARTNERSHIP, WORK WITH COMMUNITY PARTNERS TO ACHIEVE NECESSARY MENTAL HEALTH TRAINING AND RESOURCES IN THE COMMUNITY AND PROVIDE APPROPRIATE CHI MERCY HEALTH STAFF WITH TRAINING ON MENTAL ILLNESS, INCREASING THEIR UNDERSTANDING OF HOW TO CONNECT PATIENTS TO RESOURCES -YOUTH PREVENTION: ADDRESS COLLABORATIVELY WITH COMMUNITY PARTNERS, FAMILY EDUCATION AND SUPPORT RESOURCE NEEDS; SUPPORT CURRENT MENTAL HEALTH AND SUICIDE PREVENTION INITIATIVES IN LOCAL SCHOOLS AND UTILIZE CURRENT NURTURING PARENT PROGRAM AND HEALTHY RELATIONSHIPS CURRICULUM AS MEANS TO REACH FAMILIES WITH MENTAL HEALTH EDUCATIONFY2022 ACTIONS AND IMPACT: THE GOAL OF THE INITIATIVE IS TO ELIMINATE THE STIGMA OF MENTAL HEALTH, FOR PEOPLE TO UNDERSTAND THAT IT IS "OK TO NOT BE OK". THROUGH THE INITIATIVE, YOUTH AND PARENTS WILL GAIN KNOWLEDGE AND THUS MORE CONFIDENCE IN THEIR ABILITY TO DISCUSS THE ISSUE AND SEEK HELP. THE OVERALL OUTCOME IS TO INSTILL CONFIDENCE AND SUPPORT IN YOUTH STRUGGLING WITH MENTAL HEALTH ISSUES TO SHARE THEIR STRUGGLES AND ASK FOR HELP KNOWING THEY ARE NOT ALONE.MEASURES: OUTCOMES FOR ACHIEVEMENT THAT WILL BE EVALUATED INCLUDE THE NUMBER OF MENTAL HEALTH EDUCATION INSTANCES MADE AVAILABLE TO YOUTH AND A KNOWN NUMBER OF SUICIDE ATTEMPTS AND DEATHS BY SUICIDE THROUGH 2021. THE TOTAL NUMBER OF EDUCATION OPPORTUNITIES WAS SET UP AT 2 PER QUARTER, HOWEVER, WITH THE ADVENT OF COVID, THIS ENDED UP BEING A TOTAL OF 7 SESSIONS. THE CURRENT NUMBER ACCORDING TO THE CDC IS 2 DEATHS IN BARNES COUNTY BY SUICIDE BETWEEN 2014 AND 2020. THIS IS A DECREASE FROM 9 BETWEEN 2008 AND 2013.PRIORITY HEALTH NEED #2: SUBSTANCE ABUSE AND MISUSE TREATMENT RECOVERY AND SERVICES TO ADDRESS THIS NEED THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES IN 2019-2021: -TREATMENT AND RECOVERY SERVICES: CONTRIBUTE TO THE WORK OF COMMUNITY PARTNERS TO DEVELOP A LOCAL ADDICTION RECOVERY PROGRAM BASED ON HOUSING, EMPLOYMENT, PEER SUPPORT, AND HEALTHY SOCIALIZATION AND EDUCATE HOSPITAL STAFF ON SUBSTANCE ABUSE DISORDERS. -NOT IN MY HOUSE: CHANGE THE NORMS OF UNDERAGE DRINKING THROUGH EDUCATION AND COMMUNITY ENGAGEMENT AND REDUCE THE WAY YOUTH CAN ACCESS ALCOHOL -LICENSED ADDICTION COUNSELORS: SUPPORT THE WORK OF THE CITY-COUNTY HEALTH DISTRICT AND SOUTH CENTRAL HUMAN SERVICE CENTER TO ADD THE SERVICES OF LICENSED ADDICTION COUNSELORS TO THE COMMUNITY. |
| PART V, SECTION B, LINE 11 CONTINUATION | FY2022 ACTIONS AND IMPACT: THE GOAL OF THE INITIATIVE IS TO MAKE APPROPRIATE RECOVERY RESOURCES AVAILABLE FOR THOSE RETURNING TO OUR COMMUNITY AFTER TREATMENT AND/OR INCARCERATION, IN TURN DECREASING RECIDIVISM RATES AND INCREASING SUCCESSFUL REENTRY. THE OVERALL OUTCOME IS TO DEVELOP AND OFFER A SUPPORT SYSTEM THAT WILL INCREASE SUCCESSFUL REENTRY INTO OUR COMMUNITY.MEASURES: OUTCOMES FOR ACHIEVEMENT WAS UNABLE TO GAIN FOOTING DUE TO COVID RESTRICTIONS PUT IN PLACE PRIOR TO NEW PLANS TAKING SHAPE. -ASSIST IN DEVELOPING A STRONG PEER SUPPORT NETWORK IN VALLEY CITY/BARNES COUNTY -MEET WITH LOCAL DEVELOPMENT GROUP AND PHILANTHROPISTS TO DETERMINE A LOCATION FOR RECOVERY HOUSING IN VALLEY CITY -ASSIST WITH: APPROVING EVIDENCE-BASED GUIDELINES FOR RECOVERY HOUSING, DETERMINATION OF APPROPRIATE LEASING OR RENTAL OF A HOME, AND ASSESSMENT OF STAFFING MODEL AND NEEDS.PRIORITY HEALTH NEED #3: ATTRACT AND RETAIN YOUNG FAMILIES QUALITY OF LIFETO ADDRESS THIS NEED THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES IN 2019-2021: -PROMOTION: PARTNER WITH VALLEY CITY BARNES COUNTY DEVELOPMENT CORPORATION IN THE PROMOTION OF VALLEY CITY TO ACHIEVE QUALITY OF PLACE, WORKFORCE TRAINING AND EDUCATION, AND BUILDING COMMUNITY AND INCREASE COMMUNITY AWARENESS OF HOSPITAL SERVICES, TARGETING YOUNG FAMILIES -ENGAGEMENT: ACTIVELY PARTICIPATE IN SELECT COMMUNITY WIDE EVENTS WITH INTENT OF CONTRIBUTING TO A FAMILY FRIENDLY ENVIRONMENT AND PARTNER WITH SCHOOL SYSTEM TO IDENTIFY AND SERVE STUDENT AND FAMILY HEALTH NEEDSFY2022 ACTIONS AND IMPACT: THE GOAL OF THE INITIATIVE IS TO MAKE VALLEY CITY AND SURROUNDING COMMUNITIES MORE ATTRACTIVE TO YOUNG FAMILIES BY MEETING THEIR QUALITY OF LIFE NEEDS. THE OVERALL OUTCOME IS TO INCREASE THE POPULATION OF YOUNG FAMILIES IN THE COMMUNITY.MEASURES: O BEST PLACES TO RETIRE IN NORTH DAKOTA 2 OF 17O PLACES WITH THE LOWEST COST OF LIVING IN NORTH DAKOTA 6 OF 48O PLACES WITH THE BEST PUBLIC SCHOOLS IN NORTH DAKOTA 6 OF 17O BEST PLACES TO BUY A HOUSE IN NORTH DAKOTA 23 OF 48O MOST DIVERSE PLACES TO LIVE IN NORTH DAKOTA 25 OF 48O BEST PLACES TO LIVE IN NORTH DAKOTA 34 OF 48O BEST PLACES TO RAISE A FAMILY IN NORTH DAKOTA 34 OF 48O BEST PLACES FOR YOUNG PROFESSIONALS IN NORTH DAKOTA 40 OF 48 |
| PART V, SECTION B, LINE 13H | THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS. |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE: -THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.-THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS. -THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION (FAA).FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: -RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS;- HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS OR FREE CARE CLINIC; -PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); -FOOD STAMP ELIGIBILITY; -ELIGIBILITY OR REFERRALS FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID); -LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR -PATIENT IS DECEASED WITH NO KNOWN SPOUSE OR KNOWN ESTATE. |
| PART I, LINE 7: | COMMONSPIRIT HEALTH HOSPITALS USE A COST ACCOUNTING SYSTEM OR AN ADJUSTED COST TO CHARGE RATIO CALCULATED IN A MANNER CONSISTENT WITH WORKSHEET 2 FOR EACH REPORTING FACILITY, TO DERIVE THE REPORTED COSTS OF FINANCIAL ASSISTANCE, MEDICAID AND OTHER MEANS-TESTED PROGRAMS. WORKSHEET 3 OR THE EQUIVALENT IN THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY ("CBISA") SOFTWARE ARE USED TO CALCULATE EXPENSE AND REVENUE, INCLUDING WHERE APPLICABLE MEDICAID PROVIDER FEES AND PAYMENTS FROM UNCOMPENSATED CARE PROGRAMS. ACTUAL OR ESTIMATED COST AND ANY DIRECT OFFSETTING REVENUE IS REPORTED, AND SCHEDULE H WORKSHEETS OR THEIR EQUIVALENTS ARE USED, FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND DONATIONS. |
| PART III, LINE 2: | THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE COST TO CHARGE RATIO TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED.THE FILING ORGANIZATION PROVIDES FREE CARE TO ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL, OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS WHOSE FAMILY INCOME IS ABOVE 201% BUT LOWER THAN 400% OF THE FEDERAL POVERTY LEVEL. THE FILING ORGANIZATION ALSO PROVIDES OPTIONS FOR PROMPT PAY DISCOUNTS, AND INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS AT ALL FACILITIES RECEIVE AN AUTOMATIC UNINSURED DISCOUNT. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE. |
| PART III, LINE 3: | MERCY HOSPITAL OF VALLEY CITY MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. MERCY HOSPITAL OF VALLEY CITY'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. MERCY HOSPITAL OF VALLEY CITY ALSO UTILIZES A PAYMENT ASSISTANCE RANK ORDERING (PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF AN UNINSURED PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL UNINSURED PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE ARE NOT REPORTED AS BAD DEBT. AS SUCH, MERCY HOSPITAL OF VALLEY CITY DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE. |
| PART III, LINE 4: | MERCY HOSPITAL OF VALLEY CITY DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2022, RELATED TO PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE. THE ENTIRE FOOTNOTE CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT CONSOLIDATED FINANCIAL STATEMENTS ON PAGES 12-13."PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION COMMONSPIRIT EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS, AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. NET PATIENT REVENUE IS PRIMARILY COMPRISED OF HOSPITAL AND PHYSICIAN SERVICES." |
| PART III, LINE 8: | COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 13). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES, CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. MERCY HOSPITAL OF VALLEY CITY'S SURPLUS, AS REPORTED ON PART III, SECTION B, LINE 7, OF $223,687 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS. |
| PART III, LINE 9B: | COMMONSPIRIT HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. COMMONSPIRIT HEALTH'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE COMMONSPIRIT HEALTH FACILITY, OR BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH, IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED ASSISTANCE OR FOR ASSISTANCE UNDER COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, COMMONSPIRIT HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, COMMONSPIRIT HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT. |
| PART VI, LINE 2: | BARNES COUNTY BEHAVIORAL HEALTH COALITION, HOSTED BY CHI MERCY HEALTH WITH PARTNERSHIP FROM CITY COUNTY PUBLIC HEALTH, CONSISTS OF A VARIED GROUP OF LEADERS IN BARNES COUNTY. THESE LEADERS INCLUDE CHI MERCY HEALTH, CITY-COUNTY HOME HEALTH, ECONOMIC DEVELOPMENT, LOCAL AND STATE REPRESENTATIVES, STATE AGENCIES, SCHOOLS, BUSINESS OWNERS, LAW ENFORCEMENT, SOCIAL SERVICES, STATES ATTORNEY, DISTRICT 24 REPRESENTATIVES, PHYSICIANS, CLINICS, SCHSC, AND LOCAL BEHAVIORAL HEALTH PROVIDERS. THE COALITION MEET QUARTERLY AND IS OPEN TO ALL WHO WISH TO ATTEND. THE COALITION WORKS ON THE GOALS, CAPTURED FROM THE CHNA, OPIOID GRANT, ALCOHOL PREVENTION GROUP, AND SERVICES AND SUPPORTS NEEDED FOR OUR COMMUNITY MEMBERS. CORE COALITION MEMBERS WERE MEETING MONTHLY BEFORE PANDEMIC TO COMPLETE THE "WORK". |
| PART VI, LINE 3: | INFORMATION ABOUT COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS EACH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES COMMONSPIRIT HEALTH SERVES. THE SIGNAGE INCLUDES NOTIFICATION THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION AND HOW TO REACH STAFF THAT CAN ASSIST WITH ANSWERING QUESTIONS AND GUIDE PATIENTS THROUGH THE APPLICATION PROCESS. INFORMATION CAN ALSO BE FOUND ON THE FACILITY WEBSITES. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED AND A STATEMENT INFORMING PATIENTS HOW TO CONTACT US REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF COMMONSPIRIT HEALTH REQUIRE THEY FOLLOW COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. ALSO, REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE COMMONSPIRIT HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. |
| PART VI, LINE 4: | BARNES COUNTY IS LOCATED IN SOUTHEASTERN NORTH DAKOTA. THE COUNTY SEAT IS VALLEY CITY, WHICH LIES IN THE CENTER OF THE COUNTY. THE STATE CAPITAL, BISMARCK, IS LOCATED TWO HOURS TO THE WEST OF VALLEY CITY. THE 2019 ESTIMATED POPULATION OF BARNES COUNTY WAS 10,415, WHICH IS A 5.9% DECREASE FROM 2010. VALLEY CITY'S ESTIMATED POPULATION IN 2019 WAS 6,323 (A 4.9% DECREASE FROM 2010). RURAL BARNES COUNTY HAS SEVERAL INCORPORATED CITIES, INCLUDING WIMBLEDON, SANBORN, LITCHVILLE, ORISKA, AND DAZEY. BEYOND CITY-COUNTY HEALTH DISTRICT AND CHI MERCY HEALTH, ADDITIONAL AGENCIES WHO PROVIDE HEALTH SERVICES IN BARNES COUNTY INCLUDE ESSENTIA HEALTH VALLEY CITY CLINIC AND SANFORD HEALTH VALLEY CITY CLINIC. IN ADDITION TO SEEKING HEALTHCARE IN BARNES COUNTY, RESIDENTS MOST FREQUENTLY ACCESS HEALTHCARE SERVICES IN CASS COUNTY AND STUTSMAN COUNTY. THE VALLEY CITY AREA HAS A NUMBER OF COMMUNITY ASSETS AND RESOURCES THAT ARE POTENTIALLY AVAILABLE TO ADDRESS SIGNIFICANT HEALTH NEEDS.DEMOGRAPHIC INFORMATIONGENERAL DEMOGRAPHIC AND GEOGRAPHIC DATA ABOUT BARNES COUNTY.FROM 2010 CENSUS/2019 AMERICAN COMMUNITY SURVEY; MORE RECENT ESTIMATES USED WHERE AVAILABLEBARNES COUNTY NORTH DAKOTAPOPULATION (2019)COUNTY - 10,415STATE - 762,062POPULATION CHANGE (2010-2019)COUNTY - 5.9%STATE - 13.3%PEOPLE PER SQUARE MILE (2010)COUNTY - 7.4STATE - 9.7PERSONS 65 YEARS OR OLDER (2019)COUNTY - 23.2%STATE - 15.7%PERSONS UNDER 18 YEARS (2019)COUNTY - 19.6%STATE - 23.6%MEDIAN AGE (2019 EST.) COUNTY - 33.5STATE - 35.1WHITE PERSONS (2019)COUNTY - 94.2% STATE - 86.9%HIGH SCHOOL GRADUATES (2019)COUNTY - 92.3%STATE - 92.6%BACHELOR'S DEGREE OR HIGHER (2019)COUNTY - 29.4%STATE - 30.0%LIVE BELOW POVERTY LINE (2019)COUNTY - 9.9%STATE - 10.6%PERSONS WITHOUT HEALTH INSURANCE, UNDER AGE 65 YEARS (2019)COUNTY - 6.9%STATE - 8.1%HOUSEHOLDS WITH A BROADBAND INTERNET SUBSCRIPTION (2019)COUNTY - 77.0%STATE - 80.7%HEALTH OUTCOMES -LENGTH OF LIFE -QUALITY OF LIFEHEALTH FACTORS -SOCIAL AND ECONOMIC FACTORS -HEALTH BEHAVIOR -EDUCATION -SMOKING -EMPLOYMENT -DIET AND EXERCISE -INCOME -ALCOHOL AND DRUG USE -FAMILY AND SOCIAL SUPPORT -SEXUAL ACTIVITY -COMMUNITY SAFETY -PHYSICAL ENVIRONMENT -AIR AND WATER QUALITY -HOUSING AND TRANSIT -CLINICAL CARE -ACCESS TO CARE -QUALITY OF CARE -AIR AND WATER QUALITY -HOUSING AND TRANSIT |
| PART VI, LINE 5: | FINANCIAL ASSISTANCE: IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY. THIS HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY THAT DESCRIBES THE ASSISTANCE PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A FINANCIAL HARDSHIP TO FULLY PAY THE EXPECTED OUT-OF-POCKET EXPENSES FOR SUCH CARE, AND WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE.USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, THE HOSPITAL REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR THE HOSPITAL TO DELIVER ON ITS MISSION, INCLUDING HELPING TO ENSURE THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTH CARE.OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS INCLUDES GATHERING AND VERIFYING CREDENTIALS, ALLOWING THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND ULTIMATELY MAKING A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS.ROLE OF THE BOARD: THE COMMONSPIRIT HEALTH BOARD AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL, POLICY-BASED ROLES TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REGULAR REPORTS ON ACTIVITIES AND PERFORMANCE. HOSPITAL COMMUNITY BOARDS (OR THEIR DESIGNATED COMMUNITY HEALTH OR COMMUNITY BENEFIT COMMITTEES) ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS CONDUCT AND ADOPT COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES, TAKE ACTIONS TO HELP ADDRESS IDENTIFIED SIGNIFICANT HEALTH NEEDS WITH AN EMPHASIS ON POOR AND VULNERABLE POPULATIONS AND HEALTH EQUITY, AND MONITORING ACTIONS AND PROGRESS TOWARD IDENTIFIED GOALS. |
| PART VI, LINE 6: | THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 21 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. AS OF JUNE 30, 2022, COMMONSPIRIT HEALTH IS COMPRISED OF APPROXIMATELY 2,200 CARE SITES, CONSISTING OF 142 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. IN FISCAL YEAR 2022, COMMONSPIRIT HEALTH PROVIDED MORE THAN $3.16 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $4.89 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $33.9 BILLION IN FISCAL YEAR 2022, HAS TOTAL ASSETS OF APPROXIMATELY $50.31 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | ND |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEANETTE WOJTALEWICZ | ||||||||||||||
| BOARD MEMBER/CSH SVP DIVISION OFFICE | $0 | $646,728 | $0 | $527,651 | $0 | $59,042 | $0 | $17,100 | $0 | $34,803 | $0 | $1,285,324 | $0 | $0 |
| REBECCA THOMPSON | ||||||||||||||
| BOARD MEMBER/INTERIM PRESIDENT | $0 | $190,558 | $0 | $79,419 | $0 | $18,467 | $0 | $13,887 | $0 | $16,257 | $0 | $318,588 | $0 | $8,086 |
| KEITH HEUSER | ||||||||||||||
| BOARD MEMBER/PRESIDENT (PARTIAL YEAR | $0 | $135,111 | $0 | $109,589 | $0 | $9,582 | $0 | $15,018 | $0 | $10,696 | $0 | $279,996 | $0 | $0 |
| CLARK KRUTA | ||||||||||||||
| CRNA | $219,404 | $0 | $675 | $0 | $4,218 | $0 | $15,164 | $0 | $32,917 | $0 | $272,378 | $0 | $0 | $0 |
| JOSHUA SENGER | ||||||||||||||
| FORMER TREASURER/VP, FINANCE | $0 | $123,019 | $0 | $31,889 | $0 | $1,599 | $0 | $9,449 | $0 | $31,438 | $0 | $197,394 | $0 | $0 |
| BETH SMITH | ||||||||||||||
| TREASURER/VP, FINANCE | $0 | $117,148 | $0 | $27,800 | $0 | $764 | $0 | $8,316 | $0 | $28,980 | $0 | $183,008 | $0 | $0 |
| AMY NOESKE | ||||||||||||||
| PHARMACY MANAGER | $109,490 | $0 | $13,181 | $0 | $1,132 | $0 | $6,254 | $0 | $26,196 | $0 | $156,253 | $0 | $0 | $0 |
| CAMILLE SETTELMEYER | ||||||||||||||
| VP OF CLINICAL SERVICES | $0 | $112,024 | $0 | $1,016 | $0 | $1,338 | $0 | $7,343 | $0 | $10,408 | $0 | $132,129 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | DURING THE CALENDAR YEAR 2021, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART 1, LINE 4A: | CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. |
| PART 1, LINE 4B: | DURING THE 2021 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2021 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: REBECCA LYNN THOMPSON, $8,147. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2021 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2021, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: JEANETTE WOJTALEWICZ, $55,430, KEITH HEUSER, $7,539; REBECCA LYNN THOMPSON, $9,008. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1C | PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH ARE MADE BY COMMONSPIRIT HEALTH. THEREFORE, NO FORMS 1099 ARE ISSUED BY MERCY HOSPITAL OF VALLEY CITY. COMMONSPIRIT HEALTH FILES THE FORMS 1099 AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAME WINNINGS. THE FORMS 1099 ISSUED ON BEHALF OF MERCY HOSPITAL OF VALLEY CITY ARE REPORTED TO THE IRS. |
| FORM 990, PART VI, SECTION A, LINE 1A | PURSUANT TO SECTION 8.6 OF THE BYLAWS OF MERCY HOSPITAL OF VALLEY CITY, THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT THE ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIODS BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT THEIR ACTIONS ARE CONSISTENT WITH ANY ACTIONS OR POLICIES OF THE BOARD OR THE CORPORATE MEMBER. ALL ACTIONS TAKEN ARE CONTEMPORANEOUSLY DOCUMENTED AND REPORTED TO THE BOARD AT THE EARLIEST MEETING. |
| FORM 990, PART VI, SECTION A, LINE 6 | ACCORDING TO THE BYLAWS OF MERCY HOSPITAL OF VALLEY CITY, THE ENTITY'S SOLE MEMBER IS COMMONSPIRIT HEALTH, A COLORADO NONPROFIT ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ORGANIZATION'S CORPORATE MEMBER IS COMMONSPIRIT HEALTH. PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE COMMONSPIRIT HEALTH BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE COMMONSPIRIT HEALTH CHIEF EXECUTIVE OFFICER: * SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF MERCY HOSPITAL OF VALLEY CITY * AMENDMENT OF THE CORPORATE DOCUMENTS OF MERCY HOSPITAL OF VALLEY CITY * APPROVE MEMBERS OF MERCY HOSPITAL OF VALLEY CITY'S BOARD * REMOVAL OF A MEMBER OF THE GOVERNING BODY OF MERCY HOSPITAL OF VALLEY CITY * APPROVAL OF ISSUANCE OF DEBT BY MERCY HOSPITAL OF VALLEY CITY * APPROVAL OF PARTICIPATION OF MERCY HOSPITAL OF VALLEY CITY IN A JOINT VENTURE * APPROVAL OF FORMATION OF A NEW CORPORATION BY MERCY HOSPITAL OF VALLEY CITY * APPROVAL OF A MERGER INVOLVING MERCY HOSPITAL OF VALLEY CITY * APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF MERCY HOSPITAL OF VALLEY CITY * TO REQUIRE THE TRANSFER OF ASSETS BY MERCY HOSPITAL OF VALLEY CITY TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH DEBTS. * ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR MERCY HOSPITAL OF VALLEY CITY PURSUANT TO SECTION 5.5 OF THE ORGANIZATION'S BYLAWS, COMMONSPIRIT HEALTH MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE." EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. |
| FORM 990, PART VI, SECTION B, LINE 11B | FOLLOWING THE PREPARATION OF THE FORM 990 BY TAX ANALYSTS OF COMMONSPIRIT HEALTH, A RELATED ORGANIZATION, THE RETURN IS REVIEWED BY THE COMMONSPIRIT HEALTH TAX DIRECTOR AND THE LOCAL VP OF OPERATIONAL FINANCE. ADDITIONALLY, THE BOARD OF DIRECTORS ARE PROVIDED THE FINAL FORM 990 AND RELATED SCHEDULES TO REVIEW VIA EMAIL AND ARE ABLE TO ASK THE VP OF OPERATIONAL FINANCE AND TAX DIRECTOR QUESTIONS PRIOR TO FILING WITH THE IRS. UPON VP OF OPERATIONAL FINANCE APPROVAL AND SIGNATURE, THE TAX ANALYST FILES THE FINAL FORM 990 AS PRESENTED TO THE BOARD, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY IN ORDER TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. |
| FORM 990, PART VI, SECTION B, LINE 15B | THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION WAS PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. THE COMMONSPIRIT HEALTH BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR APPROVING REASONABLE COMPENSATION PACKAGES FOR EACH OFFICER AND CERTAIN KEY EMPLOYEES (INCLUDING THE PRESIDENT/CEO). THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EXECUTIVES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES OUTSIDE LEGAL COUNSEL AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF STEWARDSHIP TRUSTEES. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED. DURING THE TAX YEAR ENDED 6/30/2022, ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES WAS REVIEWED AND APPROVED BY THE BOARD UTILIZING COMPARABILITY STUDIES TO DETERMINE COMPENSATION AND WAS CONTEMPORANEOUSLY DOCUMENTED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRITHEALTH.ORG. |
| FORM 990, PART VI, LINE 14 | THE DOCUMENT RETENTION AND DESTRUCTION POLICY IS MORE OF AN OPERATIONAL POLICY. THESE TYPES OF POLICIES USUALLY DO NOT GO TO THE BOARD OF DIRECTORS. THIS HAS NOT BEEN ADOPTED BY THE BOARD OF DIRECTORS. |
| FORM 990, PART IX, LINE 11G | OTHER FEES: PROGRAM SERVICE EXPENSES 973,082. MANAGEMENT AND GENERAL EXPENSES 108,120. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,081,202. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,726,568. MANAGEMENT AND GENERAL EXPENSES 191,841. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,918,409. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,216,719. MANAGEMENT AND GENERAL EXPENSES 135,191. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,351,910. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 527,612. MANAGEMENT AND GENERAL EXPENSES 58,624. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 586,236. |
| FORM 990, PART XI, LINE 9: | EQUITY CHANGES OF UNCONSOLIDATED ORGS -14,690. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (210 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ALEGENT CREIGHTON CLINIC | |||||||||||
| 12809 W DODGE RD | OMAHA | NE | 68154 | 470765154 | HOSPITAL | NE | 501(C)(3) | LINE 3 | ACH | 0 | |
| ALEGENT CREIGHTON HEALTH | |||||||||||
| 12809 W DODGE RD | OMAHA | NE | 68154 | 470757164 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM | |||||||||||
| 7500 MERCY RD | OMAHA | NE | 68124 | 470484764 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH-COMM MEM HOSPITAL OF MO VALLEY IA | |||||||||||
| 631 N 8TH ST | MISSOURI VALLEY | IA | 51555 | 420776568 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH-IMMANUEL MEDICAL CENTER | |||||||||||
| 6901 N 72ND ST | OMAHA | NE | 68122 | 470376615 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH-MEMORIAL HOSPITAL SCHUYLER | |||||||||||
| 104 W 17TH ST | SCHUYLER | NE | 68661 | 470399853 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH-MERCY HOSPITAL CORNING IOWA | |||||||||||
| PO BOX 368 | CORNING | IA | 50841 | 420782518 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALVERNA APARTMENTS | |||||||||||
| 300 SE 8TH AVE | LITTLE FALLS | MN | 56345 | 411351177 | LTERM CARE | MN | 501(C)(3) | LINE 10 | CSH | 0 | |
| APPLETREE COURT | |||||||||||
| 601 OAK ST | BRECKENRIDGE | MN | 56520 | 411850500 | SENIOR LIVING | MN | 501(C)(3) | LINE 10 | SFH | 0 | |
| ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION | |||||||||||
| 345 S HALCYON RD | ARROYO GRANDE | CA | 93420 | 203256066 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| BAKERSFIELD MEMORIAL HOSPITAL | |||||||||||
| 420 34TH STREET | BAKERSFIELD | CA | 93301 | 951802779 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| BARROW NEUROLOGICAL FOUNDATION | |||||||||||
| 350 WEST THOMAS ROAD | PHOENIX | AZ | 85013 | 860174371 | FUNDRAISING FOUNDATION | AZ | 501(C)(3) | LINE 7 | DH | 0 | |
| BAYLOR ST LUKE'S HEALTH VENTURES | |||||||||||
| 17200 ST LUKES WAY STE 170 | THE WOODLANDS | TX | 77384 | 274499340 | PHYSICIANS | TX | 501(C)(3) | LINE 12A, I | SLHS | 0 | |
| BAYLOR ST LUKE'S MEDICAL GROUP | |||||||||||
| 6624 FANNIN ST STE 1100 | HOUSTON | TX | 77030 | 760458535 | PHYSICIANS | TX | 501(C)(3) | LINE 3 | BSLHV | 0 | |
| BORNEMANN HEALTHCARE CORPORATION | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 232187242 | INACTIVE | PA | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| BRAZOSPORT HEALTH FOUNDATION INC | |||||||||||
| 100 MEDICAL DRIVE | LAKE JACKSON | TX | 77566 | 760080110 | FUNDRAISING FOUNDATION | TX | 501(C)(3) | LINE 12A, I | TCHB | 0 | |
| BRAZOSPORT REGIONAL PHYSICIAN SERVICES | |||||||||||
| 100 MEDICAL DRIVE | LAKE JACKSON | TX | 77566 | 800240261 | PHYSICIANS | TX | 501(C)(3) | LINE 3 | TCHB | 0 | |
| BURLESON ST JOSEPH HEALTH CENTER | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742759890 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLH-CO | 0 | |
| BURLESON ST JOSEPH MANOR | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742913931 | REHABILITATION | TX | 501(C)(3) | LINE 10 | SJSC | 0 | |
| CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION | |||||||||||
| 1401 SOUTH GRAND AVENUE | LOS ANGELES | CA | 90015 | 954000909 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| CARRINGTON HEALTH CENTER | |||||||||||
| 800 N 4TH ST | CARRINGTON | ND | 58421 | 450227311 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| CATHOLIC HEALTH INITIATIVES - COLORADO | |||||||||||
| 9100 EAST MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 840405257 | HOSPITAL | CO | 501(C)(3) | LINE 3 | CSH | 0 | |
| CATHOLIC HEALTH INITIATIVES - IOWA CORP | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 420680448 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CSH | 0 | |
| CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION | |||||||||||
| 9100 EAST MINERAL AVE | CENTENNIAL | CO | 80112 | 840902211 | FUNDRAISING FOUNDATION | CO | 501(C)(3) | LINE 7 | CHIC | 0 | |
| CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION | |||||||||||
| 1150 KELLY JOHNSON BLVD 204 | COLORADO SPRINGS | CO | 80920 | 270930004 | FUNDRAISING FOUNDATION | CO | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 460992796 | TELEHEALTH | CO | 501(C)(3) | LINE 12A, I | CHI NS | 0 | |
| CENTENNIAL MEDICAL GROUP INC | |||||||||||
| 2700 STEWART PKWY | ROSEBURG | OR | 97471 | 263946191 | SURGERY CENTER | OR | 501(C)(3) | LINE 10 | MMC - ROSEBURG | 0 | |
| CENTRAL CALIFORNIA HEALTH CENTERS | |||||||||||
| 300 OLD RIVER ROAD STE 200 | BAKERSFIELD | CA | 93311 | 844171789 | CLINIC | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| CENTRAL KANSAS MEDICAL CENTER | |||||||||||
| 3515 BROADWAY | GREAT BEND | KS | 67530 | 480543724 | INACTIVE | KS | 501(C)(3) | LINE 3 | CSH | 0 | |
| CHI HEALTH CONNECT AT HOME - FARGO | |||||||||||
| 4816 AMBER VALLEY PKWY S | FARGO | ND | 58104 | 271966847 | SENIOR LIVING | MN | 501(C)(3) | LINE 10 | CSH | 0 | |
| CHI HEALTH FOUNDATION | |||||||||||
| 12809 W DODGE RD | OMAHA | NE | 68154 | 470648586 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | ACH | 0 | |
| CHI KENTUCKY INC | |||||||||||
| 3900 OLYMPIC BLVD STE 400 | ERLANGER | KY | 41018 | 202741651 | INVESTMENTS | KY | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI LIVING COMMUNITIES | |||||||||||
| 930 S WYNN ROAD | OREGON | OH | 43616 | 341892096 | SENIOR LIVING | OH | 501(C)(3) | LINE 12A, I | SFH-OH | 0 | |
| CHI MEMORIAL HOSPITAL - GEORGIA | |||||||||||
| 100 GROSS CRESCENT CIRCLE | FORT OGLETHORPE | GA | 30742 | 822748395 | HOSPITAL | GA | 501(C)(3) | LINE 3 | MHCS | 0 | |
| CHI NATIONAL HOME CARE | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 451261716 | HOME HEALTH | CO | 501(C)(3) | LINE 10 | CHI NS | 0 | |
| CHI NATIONAL SERVICES | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 452532084 | HOLDING CO | CO | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI NEBRASKA | |||||||||||
| 12809 WEST DODGE ROAD | OMAHA | NE | 68510 | 363233121 | HOLDING CO | NE | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI ST JOSEPH CHILDREN'S HEALTH | |||||||||||
| 1929 LINCOLN HWY E STE 150 | LANCASTER | PA | 17602 | 232342997 | HEALTHCARE | PA | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI ST JOSEPH'S CHILDREN | |||||||||||
| 1516 5TH ST NW | ALBUQUERQUE | NM | 87102 | 710897107 | COMMUNITY | NM | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI ST VINCENT HOSPITAL HOT SPRINGS | |||||||||||
| 300 WERNER ST | HOT SPRINGS | AR | 71913 | 710236913 | HOSPITAL | AR | 501(C)(3) | LINE 3 | CHI-SVHS | 0 | |
| CHI ST VINCENT HOT SPRINGS | |||||||||||
| 300 WERNER ST | HOT SPRINGS | AR | 71913 | 261125064 | HOLDING CO | AR | 501(C)(3) | LINE 12A, I | SVIMC | 0 | |
| CHI ST VINCENT MEDICAL GROUP HOT SPRINGS | |||||||||||
| 300 WERNER ST | HOT SPRINGS | AR | 71913 | 261125131 | PHYSICIANS | AR | 501(C)(3) | LINE 3 | CHI-SVHS | 0 | |
| COMMONSPIRIT HEALTH | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 470617373 | HEALTHCARE | CO | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| COMMONSPIRIT HEALTH FOUNDATION | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 853374038 | FUNDRAISING FOUNDATION | CO | 501(C)(3) | LINE 7 | CSH | 0 | |
| COMMONSPIRIT HEALTH OPERATING INVESTMENT POOL LLC | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 850919176 | OPERATING INVESTMENTS | DE | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| COMMONSPIRIT HEALTH RESEARCH INSTITUTE | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 271050565 | RESEARCH | CO | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| COMMUNITY HOSPITAL OF SAN BERNARDINO | |||||||||||
| 1805 MEDICAL CENTER DRIVE | SAN BERNARDINO | CA | 92411 | 951643373 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| COMMUNITY LIMITED CARE DIALYSIS CENTER | |||||||||||
| 625 EDEN PARK DRIVE 7TH FLOOR | CINCINNATI | OH | 45202 | 237419853 | HOLDING CO | OH | 501(C)(2) | GSH | 0 | ||
| COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION | |||||||||||
| 631 N 8TH ST | MISSOURI VALLEY | IA | 51555 | 421294399 | FUNDRAISING FOUNDATION | IA | 501(C)(3) | LINE 12A, I | AH-CMHMV | 0 | |
| CONTINUING CARE HOSPITAL | |||||||||||
| ONE SAINT JOSEPH DRIVE | LEXINGTON | KY | 40504 | 611400619 | HOSPITAL | KY | 501(C)(3) | LINE 3 | SJHS | 0 | |
| DIGNITY COMMUNITY CARE | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 815009488 | HOSPITAL | CO | 501(C)(3) | LINE 3 | CSH | 0 | |
| DIGNITY HEALTH | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 941196203 | HOSPITAL | CA | 501(C)(3) | LINE 3 | CSH | 0 | |
| DIGNITY HEALTH CONNECTED LIVING | |||||||||||
| 200 MERCY OAKS DRIVE | REDDING | CA | 96003 | 237115371 | SENIOR CENTER SERVICES | CA | 501(C)(3) | LINE 7 | DH | 0 | |
| DIGNITY HEALTH FOUNDATION | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 462037641 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH FOUNDATION - INLAND EMPIRE | |||||||||||
| 2101 N WATERMAN AVENUE | SAN BERNARDINO | CA | 92404 | 237440086 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH FOUNDATION EAST VALLEY | |||||||||||
| 475 SOUTH DOBSON ROAD | CHANDLER | AZ | 85224 | 742418514 | FUNDRAISING FOUNDATION | AZ | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH MEDICAL FOUNDATION | |||||||||||
| 3400 DATA DRIVE | RANCHO CORDOVA | CA | 95670 | 680220314 | MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| DOMINICAN HEALTH SERVICES | |||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 770056778 | COMMUNITY HEALTH SYSTEM | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DOMINICAN HOSPITAL FOUNDATION | |||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 942450442 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DOMINICAN OAKS CORPORATION | |||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 770127719 | OPERATION AND MANAGEMENT OF HOUSING COMPLEX TO ELDERLY PERSONS | CA | 501(C)(3) | LINE 10 | DHS | 0 | |
| EAST TEXAS CLINICAL SERVICES | |||||||||||
| 101 VISION PARK SUITE 100 | SHENANDOAH | TX | 77384 | 454736213 | HEALTHCARE | TX | 501(C)(3) | LINE 12A, I | SLHS | 0 | |
| ENUMCLAW REGIONAL HOSPITAL ASSOCIATION | |||||||||||
| 1455 BATTERSBY AVE | ENUMCLAW | WA | 98022 | 910715805 | HOSPITAL | WA | 501(C)(3) | LINE 3 | FHS | 0 | |
| FLAGET HEALTHCARE INC | |||||||||||
| 4305 NEW SHEPHERDSVILLE RD | BARDSTOWN | KY | 40004 | 611345363 | HOSPITAL | KY | 501(C)(3) | LINE 3 | KOH | 0 | |
| FLAGET MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 4305 NEW SHEPHERDSVILLE RD | BARDSTOWN | KY | 40004 | 562351341 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 12A, I | FH | 0 | |
| FRANCISCAN CARE CENTER | |||||||||||
| 4111 N HOLLAND-SYLVANIA RD | TOLEDO | OH | 43623 | 341931806 | HEALTHCARE | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| FRANCISCAN FOUNDATION | |||||||||||
| 1717 SOUTH J ST | TACOMA | WA | 98405 | 911145592 | FUNDRAISING FOUNDATION | WA | 501(C)(3) | LINE 10 | FHS | 0 | |
| FRANCISCAN HEALTH SYSTEM | |||||||||||
| 1717 SOUTH J ST | TACOMA | WA | 98405 | 910564491 | HOSPITAL | WA | 501(C)(3) | LINE 3 | CSH | 0 | |
| FRANCISCAN MEDICAL GROUP | |||||||||||
| 1313 BROADWAY STE 200 | TACOMA | WA | 98402 | 911939739 | PHYSICIANS | WA | 501(C)(3) | LINE 10 | FHS | 0 | |
| FRENCH HOSPITAL MEDICAL CENTER FOUNDATION | |||||||||||
| 1911 JOHNSON AVENUE | SAN LUIS OBISPO | CA | 93401 | 203256125 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| GARRISON MEMORIAL HOSPITAL | |||||||||||
| 407 THIRD AVENUE SOUTHEAST | GARRISON | ND | 58540 | 450227752 | HOSPITAL | ND | 501(C)(3) | LINE 3 | SAMC | 0 | |
| GLENDALE MEMORIAL HEALTH FOUNDATION | |||||||||||
| 1420 SOUTH CENTRAL AVENUE | GLENDALE | CA | 91204 | 953625651 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| GLOBAL HEALTH INITIATIVES | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 201536108 | INACTIVE | CO | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE | |||||||||||
| 625 EDEN PARK DRIVE 7TH FLOOR | CINCINNATI | OH | 45202 | 311778403 | EDUCATION | OH | 501(C)(3) | LINE 2 | GSH | 0 | |
| GOOD SAMARITAN HOSPITAL | |||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470379755 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| GOOD SAMARITAN HOSPITAL FOUNDATION | |||||||||||
| 111 W 31ST ST | KEARNEY | NE | 68847 | 470659443 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | GSH-KN | 0 | |
| GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI INC | |||||||||||
| 625 EDEN PARK DRIVE 7TH FLOOR | CINCINNATI | OH | 45202 | 311206047 | FUNDRAISING FOUNDATION | OH | 501(C)(3) | LINE 12A, I | GSH | 0 | |
| HARRISON MEDICAL CENTER | |||||||||||
| 2520 CHERRY AVE | BREMERTON | WA | 98310 | 910565546 | HOSPITAL | WA | 501(C)(3) | LINE 3 | FHS | 0 | |
| HEALTHCARE AND WELLNESS FOUNDATION | |||||||||||
| 2400 ST FRANCIS DR | BRECKENRIDGE | MN | 56520 | 760761782 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | LINE 12A, I | SFMC-MN | 0 | |
| HOUSE OF MERCY | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 421323808 | ASSISTED LIVING | IA | 501(C)(3) | LINE 7 | CHI-IA CORP | 0 | |
| JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC | |||||||||||
| ONE SAINT JOSEPH DRIVE | LEXINGTON | KY | 40504 | 611029768 | HOSPITAL | KY | 501(C)(3) | LINE 3 | KOH | 0 | |
| KENTUCKYONE HEALTH MEDICAL GROUP INC | |||||||||||
| 100 E LIBERTY ST STE 800 | LOUISVILLE | KY | 40202 | 611352729 | PHYSICIANS | KY | 501(C)(3) | LINE 10 | JHSMH | 0 | |
| KENTUCKYONE HEALTH INC | |||||||||||
| ONE SAINT JOSEPH DRIVE | LEXINGTON | KY | 40504 | 611029769 | HEALTHCARE | KY | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| LAKEWOOD HEALTH CENTER | |||||||||||
| 600 MAIN AVE S | BAUDETTE | MN | 56623 | 410758434 | HOSPITAL | MN | 501(C)(3) | LINE 3 | CSH | 0 | |
| LAKEWOOD REGIONAL HEALTHCARE FOUNDATION | |||||||||||
| 600 MAIN AVE S | BAUDETTE | MN | 56623 | 411893795 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 7 | LHC | 0 | |
| LEGACY FOUNDATION OF KENTUCKIANA INC | |||||||||||
| 1451 HARRODSBURG RD STE D-308 | LEXINGTON | KY | 40504 | 832170324 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 12A, I | KOH | 0 | |
| LISBON AREA HEALTH SERVICES | |||||||||||
| 905 MAIN ST | LISBON | ND | 58054 | 820558836 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| LUFKIN VISION ACQUISITIONS | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75901 | 820563768 | PROPERTY MGMT | TX | 501(C)(3) | LINE 12A, I | MHSET | 0 | |
| MADISON ST JOSEPH HEALTH CENTER | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742761145 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLH-CO | 0 | |
| MADONNA MANOR INC | |||||||||||
| 2344 AMSTERDAM ROAD | VILLA HILLS | KY | 51017 | 610654635 | ASSISTED LIVING | KY | 501(C)(3) | LINE 10 | CHILC | 0 | |
| MARIAN REGIONAL MEDICAL CENTER FOUNDATION | |||||||||||
| 1400 E CHURCH STREET | SANTA MARIA | CA | 93454 | 953818027 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| MARK TWAIN MEDICAL CENTER | |||||||||||
| 768 MOUNTAIN RANCH ROAD | SAN ANDREAS | CA | 95249 | 680127677 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC | |||||||||||
| 2525 DE SALES AVE | CHATTANOOGA | TN | 37404 | 621839548 | FUNDRAISING FOUNDATION | TN | 501(C)(3) | LINE 7 | MHCS | 0 | |
| MEMORIAL HEALTH CARE SYSTEM INC | |||||||||||
| 2525 DE SALES AVE | CHATTANOOGA | TN | 37404 | 620532345 | HOSPITAL | TN | 501(C)(3) | LINE 3 | CSH | 0 | |
| MEMORIAL HEALTH PARTNERS FOUNDATION INC | |||||||||||
| 5600 BRAINERD RD STE 500 | CHATTANOOGA | TN | 37411 | 030417049 | HEALTHCARE | TN | 501(C)(3) | LINE 10 | MHCS | 0 | |
| MEMORIAL HEALTH SYSTEM OF EAST TEXAS | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 750755367 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLH-CO | 0 | |
| MEMORIAL MEDICAL CENTER-LIVINGSTON | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 760436439 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLH-CO | 0 | |
| MEMORIAL MEDICAL CENTER-SAN AUGUSTINE | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 752663904 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLH-CO | 0 | |
| MEMORIAL MULTISPECIALTY ASSOCIATES | |||||||||||
| 1201 FRANK AVE | LUFKIN | TX | 75904 | 752721155 | PHYSICIANS | TX | 501(C)(3) | LINE 12A, I | MHSET | 0 | |
| MEMORIAL SPECIALTY HOSPITAL | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 752492741 | INACTIVE | TX | 501(C)(3) | LINE 3 | MHSET | 0 | |
| MERCY AUXILIARY OF CENTRAL IOWA | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 426076069 | AUXILIARY | IA | 501(C)(3) | LINE 12A, I | MF-DM IA | 0 | |
| MERCY CLINICS INC | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 421193699 | PHYSICIANS | IA | 501(C)(3) | LINE 10 | CHI-IA CORP | 0 | |
| MERCY COLLEGE OF HEALTH SCIENCES | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 421511682 | EDUCATION | IA | 501(C)(3) | LINE 2 | CHI-IA CORP | 0 | |
| MERCY FOUNDATION BAKERSFIELD | |||||||||||
| PO BOX 119 | BAKERSFIELD | CA | 93302 | 770201321 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| MERCY FOUNDATION OF DES MOINES IA | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 237358794 | FUNDRAISING FOUNDATION | IA | 501(C)(3) | LINE 7 | CHI-IA CORP | 0 | |
| MERCY FOUNDATION INC | |||||||||||
| 2700 STEWART PKWY | ROSEBURG | OR | 97471 | 936088946 | FUNDRAISING FOUNDATION | OR | 501(C)(3) | LINE 7 | MMC - ROSEBURG | 0 | |
| MERCY HEALTH CARE FOUNDATION | |||||||||||
| PO BOX 368 | CORNING | IA | 50841 | 421461064 | FUNDRAISING FOUNDATION | IA | 501(C)(3) | LINE 12A, I | AHMH-CORNING | 0 | |
| MERCY HEALTHCARE FOUNDATION | |||||||||||
| 570 CHAUTAUQUA BLVD | VALLEY CITY | ND | 58072 | 450435338 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 12A, I | MHVC | Yes (1) | |
| MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS | |||||||||||
| 800 MERCY DR | COUNCIL BLUFFS | IA | 51503 | 421178204 | FUNDRAISING FOUNDATION | IA | 501(C)(3) | LINE 12A, I | AHBMHS | 0 | |
| MERCY HOSPITAL OF DEVILS LAKE | |||||||||||
| 1031 7TH ST NE | DEVILS LAKE | ND | 58301 | 450227012 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| MERCY HOSPITAL OF DEVILS LAKE FOUNDATION | |||||||||||
| 1031 7TH ST NE | DEVILS LAKE | ND | 58301 | 352367360 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 7 | MHDL | 0 | |
| MERCY HOSPITAL OF VALLEY CITY | |||||||||||
| 570 CHAUTAUQUA BLVD | VALLEY CITY | ND | 58072 | 450226553 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| MERCY MCMAHON TERRACE | |||||||||||
| 3865 J STREET | SACRAMENTO | CA | 95816 | 680117340 | SENIOR CITIZEN'S HOUSING/RETIREMENT COMMUNITIES | CA | 501(C)(3) | LINE 10 | DH | 0 | |
| MERCY MEDICAL CENTER | |||||||||||
| 1301 15TH AVE WEST | WILLISTON | ND | 58801 | 450231183 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| MERCY MEDICAL CENTER - CENTERVILLE | |||||||||||
| ONE ST JOSEPHS DRIVE | CENTERVILLE | IA | 52544 | 420680308 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CHI-IA CORP | 0 | |
| MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER | |||||||||||
| 204 N 4TH AVE E | NEWTON | IA | 50314 | 421470935 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CHI-IA CORP | 0 | |
| MERCY MEDICAL CENTER MERCED FOUNDATION | |||||||||||
| 301 E 13TH STREET | MERCED | CA | 95340 | 770035928 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| MERCY MEDICAL CENTER INC | |||||||||||
| 2700 STEWART PKWY | ROSEBURG | OR | 97471 | 930386868 | HOSPITAL | OR | 501(C)(3) | LINE 3 | CSH | 0 | |
| MERCY MEDICAL FOUNDATION | |||||||||||
| 1301 15TH AVE WEST | WILLISTON | ND | 58801 | 450381803 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 12A, I | MMC WILLISTON | 0 | |
| NEBRASKA HEART HOSPITAL | |||||||||||
| 7500 S 91ST ST | LINCOLN | NE | 68526 | 392031968 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| NORTHLAND HEALTHCARE ALLIANCE | |||||||||||
| 2223 EAST ROSSER AVENUE | BISMARCK | ND | 58501 | 911845296 | MANAGEMENT | ND | 501(C)(3) | LINE 7 | SAMC | 0 | |
| NORTHRIDGE HOSPITAL FOUNDATION | |||||||||||
| 18300 ROSCOE BLVD | NORTHRIDGE | CA | 91328 | 237444901 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| OAKES COMMUNITY HOSPITAL | |||||||||||
| 1200 N 7TH ST | OAKES | ND | 58474 | 450231675 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| OAKES COMMUNITY HOSPITAL FOUNDATION | |||||||||||
| 1200 N 7TH ST | OAKES | ND | 58474 | 710966606 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 12A, I | OCH | 0 | |
| PACIFIC CENTRAL COAST HEALTH CENTERS | |||||||||||
| 1400 E CHURCH STREET | SANTA MARIA | CA | 93454 | 770447575 | CLINIC | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| PINEYWOODS MEDICAL DEVELOPMENT CORP | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 752493116 | PROPERTY MGMT | TX | 501(C)(3) | LINE 12A, I | MHSET | 0 | |
| PORT CITY OPERATING COMPANY LLC | |||||||||||
| 3400 DATA DRIVE | RANCHO CORDOVA | CA | 95670 | 465322209 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DH | 0 | |
| PROVIDENCE CARE CENTER | |||||||||||
| 2025 HAYES AVENUE | SANDUSKY | OH | 44870 | 341658625 | LTERM CARE | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION | |||||||||||
| 5055 PROVIDENCE DRIVE | SANDUSKY | OH | 44870 | 341896807 | LIVING COMM | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| SAINT CLARE'S COMMUNITY CARE INC | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 222876836 | INACTIVE | NJ | 501(C)(3) | LINE 12B, II | SCHS | 0 | |
| SAINT CLARE'S HEALTH SERVICES INC | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 223639733 | INACTIVE | NJ | 501(C)(3) | LINE 10 | CSH | 0 | |
| SAINT CLARE'S HOSPITAL INC | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 223319886 | INACTIVE | NJ | 501(C)(3) | LINE 3 | SCHS | 0 | |
| SAINT ELIZABETH FOUNDATION | |||||||||||
| 555 S 70TH ST | LINCOLN | NE | 68510 | 470625523 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | SERMC | 0 | |
| SAINT ELIZABETH HEALTH SERVICES | |||||||||||
| 555 S 70TH ST | LINCOLN | NE | 68510 | 363233120 | INACTIVE | NE | 501(C)(3) | LINE 3 | SERMC | 0 | |
| SAINT ELIZABETH REGIONAL MEDICAL CENTER | |||||||||||
| 555 S 70TH ST | LINCOLN | NE | 68510 | 470379836 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| SAINT FRANCIS MEDICAL CENTER | |||||||||||
| 2620 W FAIDLEY | GRAND ISLAND | NE | 68803 | 470376601 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| SAINT FRANCIS MEDICAL CENTER FOUNDATION | |||||||||||
| PO BOX 9804 | GRAND ISLAND | NE | 68802 | 470630267 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | SFMC-NE | 0 | |
| SAINT FRANCIS MEMORIAL HOSPITAL | |||||||||||
| 900 HYDE STREET | SAN FRANCISCO | CA | 94109 | 941156295 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC | |||||||||||
| 305 ESTILL ST | BEREA | KY | 40403 | 260152877 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 7 | SJHS | 0 | |
| SAINT JOSEPH HEALTH SYSTEM INC | |||||||||||
| ONE ST JOSEPHS DRIVE | LEXINGTON | KY | 40504 | 611334601 | HOSPITAL | KY | 501(C)(3) | LINE 3 | KOH | 0 | |
| SAINT JOSEPH HOSPITAL FOUNDATION INC | |||||||||||
| 701 BOB OLINK DR 200 | LEXINGTON | KY | 40504 | 611159649 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 12A, I | SJHS | 0 | |
| SAINT JOSEPH LONDON FOUNDATION INC | |||||||||||
| 1001 SAINT JOSEPH LANE | LONDON | KY | 40741 | 260438748 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 7 | SJHS | 0 | |
| SAINT JOSEPH MOUNT STERLING FOUNDATION INC | |||||||||||
| 225 FALCON DR | MOUNT STERLING | KY | 40353 | 272884584 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 7 | SJHS | 0 | |
| SAINT JOSEPH'S HOSPITAL FOUNDATION | |||||||||||
| 2500 FAIRWAY STREET | DICKINSON | ND | 58601 | 363418207 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 12A, I | SJHHC | 0 | |
| SAN GABRIEL VALLEY MEDICAL CENTER FOUNDATION | |||||||||||
| 438 WEST LAS TUNAS DRIVE | SAN GABRIEL | CA | 91776 | 953430341 | INACTIVE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 104 W 17TH ST | SCHUYLER | NE | 68661 | 363630014 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 12A, I | AHMHS | 0 | |
| SIERRA NEVADA MEMORIAL-MINERS HOSPITAL | |||||||||||
| 155 GLASSON WAY | GRASS VALLEY | CA | 95945 | 941439787 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| SJRMC JOPLIN MISSOURI | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 440545809 | INACTIVE | MO | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST FRANCIS FOUNDATION OF SANTA BARBARA | |||||||||||
| 2323 DE LA VINA ST SUITE 104 | SANTA BARBARA | CA | 93105 | 237137119 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST FRANCIS HOSPITAL SUPPORT CORPORATION | |||||||||||
| 601 E MICHELTORENA STREET | SANTA BARBARA | CA | 93103 | 770022302 | INACTIVE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST JOHNS HEALTHCARE FOUNDATION | |||||||||||
| 1600 NORTH ROSE AVENUE | OXNARD | CA | 93030 | 202865781 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST JOSEPHS FOUNDATION (PHOENIX) | |||||||||||
| 350 WEST THOMAS ROAD | PHOENIX | AZ | 85013 | 942941245 | FUNDRAISING FOUNDATION | AZ | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST JOSEPHS FOUNDATION OF SAN JOAQUIN | |||||||||||
| 1800 N CALIFORNIA STREET | STOCKTON | CA | 95204 | 510432777 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST MARY MEDICAL CENTER FOUNDATION | |||||||||||
| 1050 LINDEN AVENUE | LONG BEACH | CA | 90813 | 237153876 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST MARY PROFESSIONAL BUILDING INC | |||||||||||
| 1050 LINDEN AVENUE | LONG BEACH | CA | 90813 | 237373088 | INACTIVE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST MARYS MEDICAL CENTER FOUNDATION | |||||||||||
| 450 STANYAN STREET | SAN FRANCISCO | CA | 94117 | 943336143 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST ROSE DOMINICAN HEALTH FOUNDATION | |||||||||||
| 3001 ST ROSE PARKWAY | HENDERSON | NV | 89052 | 880349432 | FUNDRAISING FOUNDATION | NV | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST ALEXIUS MEDICAL CENTER | |||||||||||
| 900 EAST BROADWAY AVENUE | BISMARCK | ND | 58501 | 450226711 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST ANNE OC | |||||||||||
| 1145 BROADWAY PLAZA STE 1200 | TACOMA | WA | 98402 | 863590968 | INACTIVE | WA | 501(C)(3) | LINE 10 | FHS | 0 | |
| ST ANTHONY HOSPITAL | |||||||||||
| 2801 ST ANTHONY WAY | PENDLETON | OR | 97801 | 930391614 | HOSPITAL | OR | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST ANTHONY HOSPITAL FOUNDATION | |||||||||||
| 2801 ST ANTHONY WAY | PENDLETON | OR | 97801 | 930992727 | FUNDRAISING FOUNDATION | OR | 501(C)(3) | LINE 12A, I | SAH | 0 | |
| ST ANTHONY'S HOSPITAL ASSOCIATION | |||||||||||
| FOUR HOSPITAL DR | MORRILTON | AR | 72110 | 710245507 | HOSPITAL | AR | 501(C)(3) | LINE 3 | SVIMC | 0 | |
| ST CATHERINE HOSPITAL | |||||||||||
| 401 EAST SPRUCE ST | GARDEN CITY | KS | 67846 | 480543721 | HOSPITAL | KS | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION | |||||||||||
| 401 EAST SPRUCE ST | GARDEN CITY | KS | 67846 | 200598702 | FUNDRAISING FOUNDATION | KS | 501(C)(3) | LINE 12A, I | SCH | 0 | |
| ST CLARE COMMONS | |||||||||||
| 12469 FIVE POINT ROAD | TOLEDO | OH | 43551 | 270163752 | LIVING COMM | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| ST DOMINIC OF ONTARIO OREGON | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 930433692 | INVESTMENTS | OR | 501(C)(4) | CSH | 0 | ||
| ST FRANCIS HOME | |||||||||||
| 2400 ST FRANCIS DR | BRECKENRIDGE | MN | 56520 | 410729978 | LTERM CARE | MN | 501(C)(3) | LINE 10 | CSH | 0 | |
| ST FRANCIS LIFE CARE CORPORATION | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 222536017 | INACTIVE | NJ | 501(C)(3) | LINE 8 | SCHS | 0 | |
| ST FRANCIS MEDICAL CENTER | |||||||||||
| 2400 ST FRANCIS DR | BRECKENRIDGE | MN | 56520 | 410695598 | HOSPITAL | MN | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST JOSEPH FOUNDATION OF BRYAN TEXAS | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742351158 | FUNDRAISING FOUNDATION | TX | 501(C)(3) | LINE 12A, I | SJSC | 0 | |
| ST JOSEPH MANOR | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742847594 | LTERM CARE | TX | 501(C)(3) | LINE 10 | SJSC | 0 | |
| ST JOSEPH MEDICAL CENTER INC | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 520591461 | INACTIVE | MD | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST JOSEPH PHYSICIAN ASSOCIATES | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 203159302 | PHYSICIANS | TX | 501(C)(3) | LINE 3 | SJSC | 0 | |
| ST JOSEPH PHYSICIAN ENTERPRISE INC | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 521311775 | INACTIVE | MD | 501(C)(3) | LINE 12A, I | SJMC | 0 | |
| ST JOSEPH REGIONAL HEALTH CENTER | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 741282696 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLH-CO | 0 | |
| ST JOSEPH REGIONAL HEALTH PARTNERS | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 454088170 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SJSC | 0 | |
| ST JOSEPH REGIONAL HEALTH PARTNERS ACO | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 463265423 | HEALTHCARE | TX | 501(C)(3) | LINE 10 | SJSC | 0 | |
| ST JOSEPH SERVICES CORPORATION | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742455161 | MANAGEMENT | TX | 501(C)(3) | LINE 12A, I | SLHS | 0 | |
| ST JOSEPH'S AREA HEALTH SERVICES | |||||||||||
| 600 PLEASANT AVE | PARK RAPIDS | MN | 56470 | 410695603 | HOSPITAL | MN | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST JOSEPH'S HOSPITAL AND HEALTH CENTER | |||||||||||
| 2500 FAIRWAY ST | DICKINSON | ND | 58601 | 450226429 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST LEONARD | |||||||||||
| 8100 CLYO ROAD | CENTERVILLE | OH | 45458 | 341940863 | LIVING COMM | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 261947374 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLH-CO | 0 | |
| ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 260335902 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| ST LUKE'S COMMUNITY HEALTH SERVICES | |||||||||||
| 6624 FANNIN ST STE 1100 | HOUSTON | TX | 77030 | 760536234 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLH-CO | 0 | |
| ST LUKE'S FOUNDATION | |||||||||||
| 1213 HERMANN DRIVE STE 855 | HOUSTON | TX | 77004 | 453811485 | FUNDRAISING FOUNDATION | TX | 501(C)(3) | LINE 7 | SLHS | 0 | |
| ST LUKE'S HEALTH CLINICAL OPERATIONS | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 273733278 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| ST LUKE'S HEALTH SYSTEM CORP | |||||||||||
| PO BOX 20269 | HOUSTON | TX | 77225 | 760536232 | MANAGEMENT | TX | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| ST LUKE'S HOSPITAL AT THE VINTAGE | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 263734606 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLH-CO | 0 | |
| ST LUKE'S PROPERTIES CORPORATION | |||||||||||
| 1213 HERMANN DRIVE STE 855 | HOUSTON | TX | 77004 | 760531716 | PROPERTY MGMT | TX | 501(C)(3) | LINE 12A, I | SLHS | 0 | |
| ST LUKE'S SUGAR LAND PROPERTIES CORPORATION | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 454120549 | PROPERTY MGMT | TX | 501(C)(3) | LINE 12A, I | SLCDC-SL | 0 | |
| ST MARY'S COMMUNITY HOSPITAL | |||||||||||
| 1301 GRUNDMAN BOULEVARD | NEBRASKA CITY | NE | 68410 | 470443636 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ST MARY'S HOSPITAL FOUNDATION | |||||||||||
| 1301 GRUNDMAN BLVD | NEBRASKA CITY | NE | 68410 | 470707604 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | SMCH | 0 | |
| ST VINCENT FOUNDATION | |||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 510169537 | FUNDRAISING FOUNDATION | AR | 501(C)(3) | LINE 12A, I | SVIMC | 0 | |
| ST VINCENT INFIRMARY MEDICAL CENTER | |||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 710236917 | HOSPITAL | AR | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST VINCENT MEDICAL GROUP | |||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 710830696 | PHYSICIANS | AR | 501(C)(3) | LINE 10 | SVIMC | 0 | |
| SYLVANIA FRANCISCAN HEALTH | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 341412964 | HOLDING CO | OH | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| SYLVANIA FRANCISCAN HEALTH FOUNDATION | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 455357161 | INACTIVE | OH | 501(C)(3) | LINE 12A, I | SFH-OH | 0 | |
| THE COMMONS OF PROVIDENCE | |||||||||||
| 5000 PROVIDENCE DRIVE | SANDUSKY | OH | 44870 | 341826097 | ASSISTED LIVING | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| THE COMMUNITY HOSPITAL OF BRAZOSPORT | |||||||||||
| 100 MEDICAL DRIVE | LAKE JACKSON | TX | 77566 | 741385192 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLH-CO | 0 | |
| THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH | |||||||||||
| 625 EDEN PARK DRIVE 7TH FLOOR | CINCINNATI | OH | 45202 | 310537486 | HOSPITAL | OH | 501(C)(3) | LINE 3 | CSH | 0 | |
| THE PHYSICIAN NETWORK | |||||||||||
| 2000 Q ST STE 500 | LINCOLN | NE | 68503 | 470780857 | PHYSICIANS | NE | 501(C)(3) | LINE 12A, I | CHI NEBRASKA | 0 | |
| TOTAL HEALTHCARE | |||||||||||
| 9100 E MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 840927232 | INACTIVE | CO | 501(C)(3) | LINE 3 | CHIC | 0 | |
| TRINITY HEALTH FOUNDATION | |||||||||||
| 380 SUMMIT AVENUE | STEUBENVILLE | OH | 43952 | 311329423 | FUNDRAISING FOUNDATION | OH | 501(C)(3) | LINE 12A, I | THS | 0 | |
| TRINITY HEALTH SYSTEM | |||||||||||
| 380 SUMMIT AVENUE | STEUBENVILLE | OH | 43952 | 341818681 | HEALTHCARE | OH | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| TRINITY HOSPITAL TWIN CITY | |||||||||||
| 819 NORTH FIRST STREET | DENNISON | OH | 44621 | 275401105 | HOSPITAL | OH | 501(C)(3) | LINE 3 | THS | 0 | |
| TRI-STATE HEALTH SERVICES INC | |||||||||||
| ONE ROSS PARK BLVD | STEUBENVILLE | OH | 43952 | 341522484 | ASSISTED LIVING | OH | 501(C)(3) | LINE 7 | THS | 0 | |
| UNITY FAMILY HEALTHCARE | |||||||||||
| 815 SE 2ND ST | LITTLE FALLS | MN | 56345 | 410721642 | HOSPITAL | MN | 501(C)(3) | LINE 3 | CSH | 0 | |
| VILLA NAZARETH INC | |||||||||||
| 801 PAGE DR | FARGO | ND | 58103 | 450226714 | LTERM CARE | ND | 501(C)(3) | LINE 10 | CSH | 0 | |
| VISITING NURSE ASSOCIATION OF ST CLARE'S INC | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 221768334 | INACTIVE | NJ | 501(C)(3) | LINE 10 | SCHS | 0 | |
| YAVAPAI COMMUNITY HOSPITAL ASSOCIATION | |||||||||||
| 1003 WILLOW CREEK ROAD | PRESCOTT | AZ | 86301 | 860098923 | HOSPITAL | AZ | 501(C)(3) | LINE 3 | DCC | 0 | |
| YAVAPAI REGIONAL MEDICAL CENTER FOUNDATION | |||||||||||
| 1003 WILLOW CREEK ROAD | PRESCOTT | AZ | 86301 | 861038463 | FUNDRAISING FOUNDATION | AZ | 501(C)(3) | LINE 12A, I | YRMC | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (83 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMERICAN MERCY HOME CARE LLC | ||||||||||||||
| 6281 TRI RIDGE BLVD STE 300 | LOVELAND | OH | 45150 | 830486150 | HOME HEALTH | OH | N/A | N/A | 0 | 0 | ||||
| ARIZONA CARE NETWORK - NEXT LLC | ||||||||||||||
| 4222 E THOMAS RD STE 400 | PHOENIX | AZ | 85018 | 474696671 | CARE NETWORK | AZ | N/A | N/A | 0 | 0 | ||||
| ARIZONA CARE NETWORK LLC (ACN LLC) | ||||||||||||||
| 4222 E THOMAS RD STE 400 | PHOENIX | AZ | 85013 | 454494682 | CARE NETWORK | AZ | N/A | N/A | 0 | 0 | ||||
| ARIZONA DIAGNOSTIC RADIOLOGY GROUP LLC | ||||||||||||||
| 1510 COTNER AVENUE | LOS ANGELES | CA | 90025 | 851067265 | DIAGNOSTIC SERVICES | CA | N/A | N/A | 0 | 0 | ||||
| AUDUBON LAND COMPANY LLC | ||||||||||||||
| 630 SOUTHPOINTE COURT 200 | COLORADO SPRINGS | CO | 80906 | 841513085 | REAL ESTATE | CO | N/A | N/A | 0 | 0 | ||||
| BAYLOR CHI ST LUKES HEALTH SERVICES LLC | ||||||||||||||
| 3100 MAIN STE 566 | HOUSTON | TX | 77002 | 472079184 | HEALTHCARE SRVC | TX | N/A | N/A | 0 | 0 | ||||
| BERGAN MERCY SURGERY CENTER LLC | ||||||||||||||
| 7500 MERCY RD STE 4300 | OMAHA | NE | 68124 | 208671994 | AMBUL SURG CTR | NE | N/A | N/A | 0 | 0 | ||||
| BERYWOOD OFFICE PROPERTIES LLC | ||||||||||||||
| 2501 CITICO AVENUE | CHATTANOGA | TN | 37404 | 621875199 | PHYS OFFICE | TN | N/A | N/A | 0 | 0 | ||||
| BIOLIFE DIGNITY HEALTH INTERNATIONAL LTD | ||||||||||||||
| HEALTH SERVICES | N/A | N/A | 0 | 0 | 709 WING ON PLAZA 62 MODY ROAD TS | HONG KONG | CH | CH | ||||||
| BLUEGRASS REGIONAL IMAGING CENTER | ||||||||||||||
| 1218 SOUTH BROADWAY STE 310 | LEXINGTON | KY | 40504 | 611386736 | DIAGNOSTIC IMAGING | KY | N/A | N/A | 0 | 0 | ||||
| CBCC OUTSMARTING CANCER LLC | ||||||||||||||
| 6501 TRUXTUN AVENUE | BAKERSFIELD | CA | 93309 | 461602286 | RADIATION / ONCOLOGY | CA | N/A | N/A | 0 | 0 | ||||
| CENTRAL NEBRASKA REHABILITATION SVCS LLC | ||||||||||||||
| 3004 W FAIDLEY AVE | GRAND ISLAND | NE | 68803 | 810653461 | PHYSICAL THERAPY | NE | N/A | N/A | 0 | 0 | ||||
| CENTURA SUMMIT ORTHOPEDICS LLC | ||||||||||||||
| 68 SCHOOL RD | FRISCO | CO | 80443 | 871308304 | HEALTHCARE SRVC | CO | N/A | N/A | 0 | 0 | ||||
| CHICAMSURG SURGERY CENTERS LLC | ||||||||||||||
| 1A BURTON HILLS BLVD | NASHVILLE | TN | 37215 | 465683027 | SURGERY CENTER | CO | N/A | N/A | 0 | 0 | ||||
| COLORADO SPRINGS CK LEASING LLC | ||||||||||||||
| 630 SOUTHPOINTE COURT 200 | COLORADO SPRINGS | CO | 80906 | 262982714 | REAL ESTATE | CO | N/A | N/A | 0 | 0 | ||||
| COMMUNITY MERCY HOME CARE OF SPRINGFLD LLC | ||||||||||||||
| 6281 TRI RIDGE BLVD 300 | LOVELAND | OH | 45150 | 311746556 | HOME HEALTH | OH | N/A | N/A | 0 | 0 | ||||
| DE JV LLC | ||||||||||||||
| 8686 NEW TRAILS DRIVE | THE WOODLANDS | TX | 77381 | 320496548 | EMERGENCY CARE | NV | N/A | N/A | 0 | 0 | ||||
| DHHP SURGERY CENTERS LLC | ||||||||||||||
| 1513 S GRAND AVENUE STE 350 | LOS ANGELES | CA | 90015 | 831847466 | SURGERY | DE | N/A | N/A | 0 | 0 | ||||
| DHRT HOLDINGS LLC | ||||||||||||||
| 185 BERRY STREET SUITE 200 | SAN FRANCISCO | CA | 94107 | 352484591 | HOLDING COMPANY | DE | N/A | N/A | 0 | 0 | ||||
| DIGNITY- GOHEALTHURGENT CARE MANAGEMENT LLC | ||||||||||||||
| 5555 GLENRIDGE CONNECTOR SUITE 700 | ATLANTA | GA | 30342 | 352548698 | MANAGEMENT SERVICES | DE | N/A | N/A | 0 | 0 | ||||
| DIGNITY HEALTH AT HOME LLC | ||||||||||||||
| 6281 TRI RIDGE BLVD STE 300 | LOVELAND | OH | 45150 | 824674115 | HEALTHCARE SRVC | DE | N/A | N/A | 0 | 0 | ||||
| DIGNITY HEALTH SPECIALTY PHARMACY LLC | ||||||||||||||
| 185 BERRY STREET SUITE 200 | SAN FRANCISCO | CA | 94107 | 320589462 | SPECIALTY PHARMACY SERVICES | DE | N/A | N/A | 0 | 0 | ||||
| DIGNITY HOME RECOVERY CARE LLC | ||||||||||||||
| 49 MUSIC SQUARE WEST SUITE 401 | NASHVILLE | TN | 37203 | 832832522 | HOME RECOVERY PROGRAM | DE | N/A | N/A | 0 | 0 | ||||
| DIGNITYUSP LAS VEGAS SURGERY CENTERS LLC | ||||||||||||||
| 14201 DALLAS PARKWAY | DALLAS | TX | 75254 | 202999237 | SURGERY | TX | N/A | N/A | 0 | 0 | ||||
| DIGNITYUSP NORCAL SURGERY CENTERS LLC | ||||||||||||||
| 14201 DALLAS PARKWAY | DALLAS | TX | 75254 | 202468509 | SURGERY | TX | N/A | N/A | 0 | 0 | ||||
| DIGNITYUSP PHOENIX SURGERY CENTERS LLC | ||||||||||||||
| 14201 DALLAS PARKWAY | DALLAS | TX | 75254 | 134248908 | SURGERY | TX | N/A | N/A | 0 | 0 | ||||
| DIGNITYUSPJOHN MUIR EAST BAY SURG CTRS LLC | ||||||||||||||
| 14201 DALLAS PARKWAY | DALLAS | TX | 75254 | 352584991 | SURGERY | TX | N/A | N/A | 0 | 0 | ||||
| DIGNITY-ABRAZO HEALTH NETWORK LLC | ||||||||||||||
| 4222 E THOMAS RD STE 400 | PHOENIX | AZ | 85018 | 465477985 | MANAGEMENT SERVICES | AZ | N/A | N/A | 0 | 0 | ||||
| DOMINICAN MAGNETIC RESONANCE IMAGING CENTER | ||||||||||||||
| 1545 SOQUEL DRIVE | SANTA CRUZ | CA | 94065 | 770095477 | IMAGING CENTER | CA | N/A | N/A | 0 | 0 | ||||
| ECCS ACQUISITION COMPANY LLC | ||||||||||||||
| 2940 NORTH CIRCLE DRIVE | COLORADO SPRINGS | CO | 80909 | 352656413 | AMBUL SURG CTR | CO | N/A | N/A | 0 | 0 | ||||
| ENDOSCOPY CENTER OF ARKANSAS | ||||||||||||||
| 1024 NORTH UNIVERSITY AVE | LITTLE ROCK | AR | 72207 | 201337002 | DIAGNOSTIC SERVICES | AR | N/A | N/A | 0 | 0 | ||||
| FOLSOM SIERRA ENDOSCOPY CENTER LP | ||||||||||||||
| 1671 CREEKSIDE DRIVE SUITE 100 | FOLSOM | CA | 95630 | 680482416 | ENDOSCOPY | CA | N/A | N/A | 0 | 0 | ||||
| FRANCISCAN MEDICAL PAVILION BONNEY LAKE LLC | ||||||||||||||
| 6622 WOLLOCHET DR NW | GIG HARBOR | WA | 98335 | 463494108 | REAL ESTATE | WA | N/A | N/A | 0 | 0 | ||||
| FRANCISCAN SPECIALTY CARE LLC | ||||||||||||||
| 330 SEVEN SPRINGS WAY | BRENTWOOD | TN | 37027 | 813725123 | HEALTHCARE SRVC | WA | N/A | N/A | 0 | 0 | ||||
| GOLDEN RIDGE SURGERY CENTER LLC | ||||||||||||||
| 660 GOLDEN RIDGE RD 100 | GOLDEN | CO | 80401 | 841498087 | HEALTHCARE SRVC | CO | N/A | N/A | 0 | 0 | ||||
| GOOD SAMARITAN HOME CARE SVCS OF VINCENNE LLC | ||||||||||||||
| 6281 TRI RIDGE BLVD 300 | LOVELAND | OH | 45150 | 201792869 | HOME HEALTH | OH | N/A | N/A | 0 | 0 | ||||
| HC SL VINTAGE I LLC | ||||||||||||||
| 1400 N WATER ST STE 500 | MILWAUKEE | WI | 53202 | 270453767 | PROPERTY HOLDING | WI | N/A | N/A | 0 | 0 | ||||
| HEALTHCARE SUPPORT SERVICES LLC | ||||||||||||||
| PO BOX 9804 | GRAND ISLAND | NE | 68802 | 721546196 | LAUNDRY | NE | N/A | N/A | 0 | 0 | ||||
| HEARTLAND ONCOLOGY LLC | ||||||||||||||
| 2337 E CRAWFORD ST | SALINA | KS | 67402 | 464265403 | ONCOLOGY | KS | N/A | N/A | 0 | 0 | ||||
| LAKESIDE AMBULATORY SURGICAL CENTER LLC | ||||||||||||||
| 17030 LAKESIDE HILLS PLAZA STE 110 | OMAHA | NE | 68130 | 204267902 | AMBUL SURG CTR | NE | N/A | N/A | 0 | 0 | ||||
| LAKESIDE ENDOSCOPY CENTER LLC | ||||||||||||||
| 17001 LAKESIDE HILLS PLZ STE 201 | OMAHA | NE | 68130 | 205544496 | ENDOSCOPY SRVC | NE | N/A | N/A | 0 | 0 | ||||
| LEXINGTON MBO PARTNERS LTD | ||||||||||||||
| 5050 SOUTH SYRACUSE ST STE 800 | DENVER | CO | 80237 | 651132855 | REAL ESTATE | CO | N/A | N/A | 0 | 0 | ||||
| LINCOLN CK LEASING LLC | ||||||||||||||
| 555 SOUTH 70TH STREET | LINCOLN | NE | 68510 | 262496856 | REAL ESTATE | NE | N/A | N/A | 0 | 0 | ||||
| MEMORIAL MEDICAL PLAZA | ||||||||||||||
| 3838 SAN DIMAS SUITE B 201 | BAKERSFIELD | CA | 93301 | 364510880 | REAL ESTATE | CA | N/A | N/A | 0 | 0 | ||||
| MERCY DAVIS CANCER CENTER MANAGEMENT CO LLC | ||||||||||||||
| 2740 M STREET | MERCED | CA | 95340 | 943358445 | MANAGEMENT OF CANCER CENTER | CA | N/A | N/A | 0 | 0 | ||||
| MERCY REHABILITATION HOSPITAL LLC | ||||||||||||||
| 330 SEVEN SPRINGS WAY | BRENTWOOD | TN | 37027 | 814437201 | HEALTHCARE SRVC | TX | N/A | N/A | 0 | 0 | ||||
| MILITARY ROAD PROPERTIES LLC | ||||||||||||||
| 18229 TERRACE COURT SW | NORMANDY PARK | WA | 98166 | 912067879 | REAL ESTATE | WA | N/A | N/A | 0 | 0 | ||||
| NEBRASKA SPINE HOSPITAL LLC | ||||||||||||||
| 6901 N 72ND ST STE 20300 | OMAHA | NE | 68122 | 270263191 | SPINE HOSPITAL | NE | N/A | N/A | 0 | 0 | ||||
| NICU OPERATING CO OF SANTA CRUZ LLC | ||||||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 460502935 | NEONATAL HEALTHCARE | CA | N/A | N/A | 0 | 0 | ||||
| NORTH RIVER SURGERY CENTER LLC | ||||||||||||||
| 2209 WILDWOOD AVE | SHERWOOD | AR | 72120 | 710799771 | AMBUL SURG CTR | AR | N/A | N/A | 0 | 0 | ||||
| NORTHERN PLAINS LABORATORY LLC | ||||||||||||||
| 401 N 9 STREET | BISMARK | ND | 58501 | 841641341 | DIAGNOSTIC SERVICES | ND | N/A | N/A | 0 | 0 | ||||
| NSC CHANNEL ISLANDS LLC | ||||||||||||||
| 569 BROOKWOOD VILLAGE SUITE 901 | BIRMINGHAM | AL | 35209 | 770409291 | AMBULATORY SURGICAL CENTER | CA | N/A | N/A | 0 | 0 | ||||
| ORTHOCOLORADO LLC | ||||||||||||||
| 11650 WEST 2ND PLACE | LAKEWOOD | CO | 80228 | 371577105 | ORTHO HOSPITAL | CO | N/A | N/A | 0 | 0 | ||||
| PARK RAPIDS AREA HEALTH CARE | ||||||||||||||
| 600 PLEASANT AVENUE S | PARK RAPIDS | MN | 56470 | 204926259 | HEALTHCARE SRVC | MN | N/A | N/A | 0 | 0 | ||||
| PENINSULA RADIATION ONCOLOGY CENTER LLC | ||||||||||||||
| 4230 BRIDGEPORT WAY W STE B | UNIVERSITY PLACE | WA | 98466 | 870808610 | HEALTHCARE SRVC | WA | N/A | N/A | 0 | 0 | ||||
| PENRAD IMAGING LLC | ||||||||||||||
| 1390 KELLY JOHNSON BLVD | COLORADO SPRINGS | CO | 80920 | 841072619 | MEDICAL IMAGING | CO | N/A | N/A | 0 | 0 | ||||
| PERFORMANCE MED EQUIP & RESPIR SVSC LLC | ||||||||||||||
| 19625 62ND AVE SOUTH 101 | KENT | WA | 98032 | 452901632 | HOLDING COMPANY | WA | N/A | N/A | 0 | 0 | ||||
| PLAZA SURGERY CENTER LP | ||||||||||||||
| 525 E PLAZA DRIVE SUITE 100 | SANTA MARIA | CA | 93454 | 770573567 | SURGERY | CA | N/A | N/A | 0 | 0 | ||||
| PMC HOSPITAL LLC | ||||||||||||||
| 3100 MAIN ST STE 500 | HOUSTON | TX | 77002 | 273280598 | HOSPITAL | TX | N/A | N/A | 0 | 0 | ||||
| PRECISION MEDICINE ALLIANCE LLC | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 352569159 | DIAGNOSTIC SERVICES | CO | N/A | N/A | 0 | 0 | ||||
| RADIATION ONCOLOGY CENTERS OF VENTURA COUNTY | ||||||||||||||
| 1700 N ROSE AVENUE SUITE 120 | OXNARD | CA | 93030 | 770191706 | IMAGING | CA | N/A | N/A | 0 | 0 | ||||
| RBR MANAGEMENT LLC | ||||||||||||||
| 91 CORPORATE PARK DRIVE SUITE 120 | HENDERSON | NV | 89074 | 271466450 | AMBULANCE | NV | N/A | N/A | 0 | 0 | ||||
| REID-ANC HOME CARE SERVICES LLC | ||||||||||||||
| 6281 TRI RIDGE BLVD STE 300 | LOVELAND | OH | 45150 | 371454747 | HOME HEALTH | IN | N/A | N/A | 0 | 0 | ||||
| SAINT JOSEPH - SCA HOLDINGS LLC | ||||||||||||||
| 1451 HARRODSBURG RD | LEXINGTON | KY | 40503 | 453801157 | INACTIVE | DE | N/A | N/A | 0 | 0 | ||||
| SAINT JOSEPH HEALTH ASC LLC | ||||||||||||||
| ONE SAINT JOSEPH DRIVE | LEXINGTON | KY | 40504 | 852155230 | SURGERY | KY | N/A | N/A | 0 | 0 | ||||
| SAINT JOSEPH-ANC HOME CARE SERVICES | ||||||||||||||
| 6281 TRI RIDGE BLVD STE 300 | LOVELAND | OH | 45150 | 263330545 | HOME HEALTH | KY | N/A | N/A | 0 | 0 | ||||
| SANTA CRUZ COMPREHENSIVE IMAGING LLC | ||||||||||||||
| 1661 SOQUEL DRIVE SUITE G | SANTA CRUZ | CA | 95065 | 010550623 | IMAGING | CA | N/A | N/A | 0 | 0 | ||||
| SANTA CRUZ LAND & BUILDING LP | ||||||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 770285236 | REAL ESTATE | CA | N/A | N/A | 0 | 0 | ||||
| SANTA CRUZ SURGERY CENTER LLC | ||||||||||||||
| 3003 PAUL SWEET ROAD | SANTA CRUZ | CA | 95065 | 770194916 | SURGERY | CA | N/A | N/A | 0 | 0 | ||||
| SEVEN OAKS SURGERY CENTER LLC | ||||||||||||||
| 1801 ORANGE TREE LANE SUITE 200 | REDLANDS | CA | 92374 | 851559544 | SURGERY | CA | N/A | N/A | 0 | 0 | ||||
| SOUTHEASTERN HOME CARE LLC | ||||||||||||||
| 6281 TRI RIDGE BLVD STE 300 | LOVELAND | OH | 45150 | 271219638 | HOME HEALTH | OH | N/A | N/A | 0 | 0 | ||||
| ST JOSEPH'S SURGERY CENTER LP | ||||||||||||||
| 15305 DALLAS PARKWAY SUITE 1600 LB | ADDISON | TX | 75001 | 201019390 | SURGERY | TX | N/A | N/A | 0 | 0 | ||||
| ST ELIZABETH HOME CARE SERVICES LLC | ||||||||||||||
| 6281 TRI RIDGE BLVD STE 300 | LOVELAND | OH | 45150 | 261236191 | HOME HEALTH | KY | N/A | N/A | 0 | 0 | ||||
| ST FRANCIS LAND COMPANY | ||||||||||||||
| 5390 N ACADEMY BLVD STE 300 | COLORADO SPRINGS | CO | 80918 | 263134100 | REAL ESTATE | CO | N/A | N/A | 0 | 0 | ||||
| ST LUKE'S DIAGNOSTIC CATH LAB LLP | ||||||||||||||
| 6624 FANNIN ST STE 800 | HOUSTON | TX | 77030 | 710959365 | DIAGNOSTIC SERVICES | TX | N/A | N/A | 0 | 0 | ||||
| ST LUKE'S LAKESIDE HOSPITAL LLC | ||||||||||||||
| 6624 FANNIN STE 2505 | HOUSTON | TX | 77030 | 300427437 | HOSPITAL | TX | N/A | N/A | 0 | 0 | ||||
| ST LUKE'S THE WOODLANDS SLEEP CENTER LLC | ||||||||||||||
| 6624 FANNIN STE 800 | HOUSTON | TX | 77030 | 462795726 | DIAGNOSTIC SERVICES | TX | N/A | N/A | 0 | 0 | ||||
| TEMPLETON SURGERY CENTER LLC | ||||||||||||||
| 1310 LAS TABLAS ROAD SUITE 104 | TEMPLETON | CA | 94365 | 202246616 | SURGERY | CA | N/A | N/A | 0 | 0 | ||||
| THE MEDICAL PAVILION AT ST JOHN'S | ||||||||||||||
| 1600 ROSE AVENUE | OXNARD | CA | 93030 | 770332349 | REAL ESTATE | CA | N/A | N/A | 0 | 0 | ||||
| THREE SPRING IMAGING LLC | ||||||||||||||
| 1 MERCADO ST STE 200A | DURANGO | CO | 81301 | 813571570 | HEALTHCARE SRVC | CO | N/A | N/A | 0 | 0 | ||||
| TIA ARIZONA LLC | ||||||||||||||
| 3030 N CENTRAL AVENUE SUITE 1402 | PHOENIX | AZ | 85012 | 863158670 | CLINIC | AZ | N/A | N/A | 0 | 0 | ||||
| VALLEY PHYSICIANS SURGERY CENTER AT NORTHRIDGE LLC | ||||||||||||||
| 18330 ROSCOE BLVD | NORTHRIDGE | CA | 91328 | 800864336 | SURGERY | CA | N/A | N/A | 0 | 0 | ||||
| WEST LAKES SURGERY CENTER LLC | ||||||||||||||
| 12499 UNIVERSITY AVE STE 100 | CLIVE | IA | 50325 | 205345295 | HEALTHCARE SRVC | IA | N/A | N/A | 0 | 0 | ||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (59 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SVCS INC | |||||||||||||
| 12809 WEST DODGE RD | OMAHA | NE | 68154 | 470802396 | MANAGED CARE | NE | N/A | C | 0 | ||||
| ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY INC | |||||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742466914 | HEALTHCARE | TX | N/A | C | 0 | ||||
| ALTERNATIVE INSURANCE MANAGEMENT SERVICE INC | |||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 841112049 | MANAGEMENT SERVICES | CO | N/A | C | 0 | ||||
| AMERICAN NURSING CARE INC | |||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311085414 | HOME HEALTH | OH | N/A | C | 0 | ||||
| AMERIMED INC | |||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311158699 | HOME HEALTH | OH | N/A | C | 0 | ||||
| BC HOLDING COMPANY INC | |||||||||||||
| 1850 BLUEGRASS AVE | LOUISVILLE | KY | 40215 | 311542851 | INACTIVE | KY | N/A | C | 0 | ||||
| BRAZOSPORT HEALTH ALLIANCE | |||||||||||||
| 1 WEST WAY COURT | LAKE JACKSON | TX | 77566 | 760518376 | HEALTHCARE | TX | N/A | C | 0 | ||||
| CADUCEUS MEDICAL ASSOCIATES INC | |||||||||||||
| 5600 BRAINERD ROAD STE 500 | CHATTANOOGA | TN | 37411 | 621570736 | HEALTHCARE | TN | N/A | C | 0 | ||||
| CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH | |||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 272269511 | INACTIVE | CO | N/A | C | 0 | ||||
| CHI ST LUKE'S HEALTH - MEMORIAL CONDOMINIUM ASSOCIATION INC | |||||||||||||
| 1201 W FRANK AVE | LUFKIN | TX | 75904 | 834184717 | CONDO ASSOC | TX | N/A | C | 0 | ||||
| COASTAL SURGICAL SPECIALISTS INC | |||||||||||||
| 921 OAK PARK BLVD SUITE 101 | PISMO BEACH | CA | 93449 | 743000596 | AMBULATORY SURGERY CENTER | CA | N/A | S | 0 | ||||
| COMCARE SERVICES INC | |||||||||||||
| 9100 E MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 840904813 | INACTIVE | CO | N/A | C | 0 | ||||
| CONSOLIDATED HEALTH SERVICES | |||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311378212 | HOME HEALTH | OH | N/A | C | 0 | ||||
| DES MOINES MEDICAL CENTER INC | |||||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 420837382 | REAL ESTATE | IA | N/A | C | 0 | ||||
| DIGNITY HEALTH HOLDING CORPORATION | |||||||||||||
| 185 BERRY STREET SUITE 200 | SAN FRANCISCO | CA | 94107 | 460675371 | HOLDING CO | NV | N/A | C | 0 | ||||
| DIGNITY HEALTH INSURANCE LTD | |||||||||||||
| 981065338 | CAPTIVE INSURANCE | N/A | C | 0 | PO BOX 1051 GRAND CAYMAN ISL | GRAND CAYMAN ISL | CJ | CJ | |||||
| DIGNITY HEALTH PROVIDER RESOURCES INC | |||||||||||||
| 185 BERRY STREET SUITE 200 | SAN FRANCISCO | CA | 94107 | 473366764 | HEALTH PLAN | CA | N/A | C | 0 | ||||
| DIVERSIFIED HEALTH RESOURCES INC | |||||||||||||
| 100 MEDICAL DRIVE | LAKE JACKSON | TX | 77566 | 760222679 | HEALTHCARE | TX | N/A | C | 0 | ||||
| FRANCISCAN CITY URGENT CARE SERVICES PS | |||||||||||||
| C/O CPGUSA 1345 AVE OF THE AMERICAS | NEW YORK | NY | 10105 | 812174959 | INACTIVE | NY | N/A | C | 0 | ||||
| FRANCISCAN SERVICES INC | |||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 232487967 | HOLDING CO | CO | N/A | C | 0 | ||||
| GALLERIA PAVILION OWNERS'ASSOCIATION | |||||||||||||
| 800 N GIBSON RD | HENDERSON | NV | 89011 | 824275367 | REAL ESTATE | NV | N/A | C | 0 | ||||
| GOOD SAMARITAN OUTREACH SERVICES | |||||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470659440 | MEDICAL CLINIC | NE | N/A | C | 0 | ||||
| HARVESTPLAINS HEALTH OF IOWA | |||||||||||||
| 32129 WEYERHAEUSER WAY S STE 201 | FEDERAL WAY | WA | 98001 | 473451750 | INSURANCE | WA | N/A | C | 0 | ||||
| HEALTH SERVICES OF THE PACIFIC CENTRAL COAST INC | |||||||||||||
| 1400 E CHURCH STREET | SANTA MARIA | CA | 93454 | 770074057 | HEALTH SERVICES | CA | N/A | C | 0 | ||||
| HEALTH SYSTEMS ENTERPRISES INC | |||||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470664558 | MGMT | NE | N/A | C | 0 | ||||
| HEALTHCARE MGMT SERVICES ORGANIZATION INC | |||||||||||||
| 1149 MARKET ST | TACOMA | WA | 98402 | 911865474 | INACTIVE | WA | N/A | C | 0 | ||||
| HEARTLANDPLAINS HEALTH | |||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 464368223 | INSURANCE | NE | N/A | C | 0 | ||||
| HIGHLINE MEDICAL GROUP | |||||||||||||
| 1717 S J STREET | TACOMA | WA | 98405 | 911407026 | MEDICAL SERVICES | WA | N/A | C | 0 | ||||
| INTEGRATED MEDICAL SERVICES | |||||||||||||
| 9250 N 3RD STREET SUITE 4010 | PHOENIX | AZ | 85020 | 860783428 | MULTI-SPECIALTY PHYSICIANS GROUP | AZ | N/A | C | 0 | ||||
| MEDICAL OFFICE BUILDING HORIZONTAL PROPERTY REGIME INC | |||||||||||||
| 300 WERNER ST | HOT SPRINGS | AR | 71913 | 710720429 | REAL ESTATE | AR | N/A | C | 0 | ||||
| MEDQUEST | |||||||||||||
| 1301 15TH AVENUE WEST | WILLISTON | ND | 58801 | 450392137 | SALE OF DME | ND | N/A | C | 0 | ||||
| MEMORIAL CV SERVICE LINE MANAGEMENT COMPANY LLC | |||||||||||||
| 1201 W FRANK AVE | LUFKIN | TX | 75904 | 463622849 | INACTIVE | TX | N/A | C | 0 | ||||
| MERCY PARK APARTMENTS LTD | |||||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 421202422 | INACTIVE | IA | N/A | C | 0 | ||||
| MERCY SERVICES CORP | |||||||||||||
| 2700 STEWART PARKWAY | ROSEBURG | OR | 97471 | 930824308 | RETAIL SALES | OR | N/A | C | 0 | ||||
| MHI CLINICAL SERVICES | |||||||||||||
| 1201 W FRANK AVE | LUFKIN | TX | 75904 | 461967952 | HEALTHCARE | TX | N/A | C | 0 | ||||
| MILLENNIUM SURGERY CENTER INC | |||||||||||||
| 9300 STOCKDALE HWY 200 | BAKERSFIELD | CA | 93311 | 770513445 | OUTPAITENT SURGERY SERVICES | CA | N/A | S | 0 | ||||
| MOUNTAIN MANAGEMENT SERVICES INC | |||||||||||||
| 6028 SHALLOWFORD RD | CHATTANOOGA | TN | 37421 | 621570739 | MGMT SVC ORG | TN | N/A | C | 0 | ||||
| NORTH CENTRAL HEALTH CARE ALLIANCE | |||||||||||||
| PO BOX 5538 | BISMARK | ND | 58506 | 450439894 | HEALTHCARE | ND | N/A | C | 0 | ||||
| QUALCHOICE ADVANTAGE | |||||||||||||
| 32129 WEYERHAEUSER WAY S STE 201 | FEDERAL WAY | WA | 98001 | 473433912 | INSURANCE | WA | N/A | C | 0 | ||||
| QUALCHOICE HEALTH PLAN SERVICES INC | |||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 461224037 | ADMIN SERVICES | CO | N/A | C | 0 | ||||
| QUALCHOICE HEALTH INC | |||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 461222808 | HOLDING CO | CO | N/A | C | 0 | ||||
| QUALCHOICE HOLDINGS INC | |||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 274075520 | HOLDING CO | AR | N/A | C | 0 | ||||
| QUALCHOICE OF NEBRASKA | |||||||||||||
| 2401 S 73RD ST | OMAHA | NE | 68124 | 810738827 | INACTIVE | NE | N/A | C | 0 | ||||
| RIVERLINK HEALTH | |||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 464380824 | INSURANCE | OH | N/A | C | 0 | ||||
| RIVERLINK HEALTH OF KENTUCKY INC | |||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 464828332 | INSURANCE | KY | N/A | C | 0 | ||||
| ROSS PARK PHARMACY INC | |||||||||||||
| 380 SUMMIT AVE | STEUBENVILLE | OH | 43952 | 341832654 | PHARMACY | OH | N/A | C | 0 | ||||
| SAINT CLARE'S PRIMARY CARE INC | |||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 222441202 | INACTIVE | NJ | N/A | C | 0 | ||||
| SJH SERVICES CORPORATION | |||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 232307408 | INACTIVE | CO | N/A | C | 0 | ||||
| SJL PHYSICIAN MANAGEMENT SERVICES INC | |||||||||||||
| 424 LEWIS HARGETT CR STE 160 | LEXINGTON | KY | 40503 | 270164198 | INACTIVE | KY | N/A | C | 0 | ||||
| SOUNDPATH HEALTH INC | |||||||||||||
| 32129 WEYERHAEUSER WAY S STE 201 | FEDERAL WAY | WA | 98001 | 421720801 | INSURANCE | WA | N/A | C | 0 | ||||
| ST MARY HEALTH VENTURES INC | |||||||||||||
| 1050 LINDEN AVENUE | LONG BEACH | CA | 90813 | 951912528 | RETAIL PHARMACY | CA | N/A | C | 0 | ||||
| ST ANTHONY DEVELOPMENT COMPANY | |||||||||||||
| 1415 SOUTHGATE | PENDLETON | OR | 97801 | 931216943 | ATHLETIC CLUB | OR | N/A | C | 0 | ||||
| ST JOSEPH DEVELOPMENT COMPANY INC | |||||||||||||
| 1717 SOUTH J ST | TACOMA | WA | 98405 | 911480569 | RENTAL | WA | N/A | C | 0 | ||||
| ST LUKE'S HEALTH SYSTEM HOLDINGS INC | |||||||||||||
| 6624 FANNIN STE 800 | HOUSTON | TX | 77030 | 760637138 | HOLDING CO | TX | N/A | C | 0 | ||||
| ST VINCENT COMMUNITY HEALTH SERVICES INC | |||||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 710710785 | HEALTHCARE | AR | N/A | C | 0 | ||||
| STE HOLDINGS | |||||||||||||
| 12809 WEST DODGE RD | OMAHA | NE | 68154 | 822383629 | HOLDING CO | NE | N/A | C | 0 | ||||
| SUGAR LAND DOCTOR GROUP | |||||||||||||
| 1317 LAKE POINT PARKWAY | SUGAR LAND | TX | 77478 | 454270163 | INACTIVE | TX | N/A | C | 0 | ||||
| TOWSON MANAGEMENT INC | |||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 521710750 | INACTIVE | MD | N/A | C | 0 | ||||
| TRINITY MANAGEMENT SERVICES ORGANIZATION | |||||||||||||
| 380 SUMMIT AVE | STEUBENVILLE | OH | 43952 | 341471026 | MGMT SERVICES | OH | N/A | C | 0 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HEALTHCARE FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $133,794 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |