LAKEWOOD HEALTH CENTER: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- LAKEWOOD HEALTH CENTER (EIN 41-0758434)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-13
- IRS object ID
- 202201339349302120
- Schema version
- 2020v4.2
- 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 I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-13T11:30:32-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | 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 | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410758434 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEWOOD HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LAKE | BusinessNameControlTxt |
| Phone | 2186342120 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 MAIN AVENUE SOUTH | AddressLine1Txt |
| City | BAUDETTE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56623 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAY ROSS | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2186342120 | PhoneNum |
| Signature | 2022-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JAY | PersonFirstNm |
| Person Last | ROSS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | 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 | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHI LAKEWOOD HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JEFFRY STAMPOHAR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 MAIN AVENUE SOUTH | AddressLine1Txt |
| City | BAUDETTE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56623 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,811,724 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LAKEWOODHEALTHCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1959 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | LAKEWOOD HEALTH CENTER IS A SMALL FACILITY LOCATED IN A RURAL AND ISOLATED SETTING, THE CONTINUUM OF CARE INCLUDES PHYSICIAN CLINIC, ACUTE CARE, RESIDENTIAL CARE, AND LONG TERM CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 196 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $4,967 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,001,007 | PYContributionsGrantsAmt |
| CY Contributions Grants | $569,538 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,644,590 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,179,037 | CYProgramServiceRevenueAmt |
| PY Investment Income | $496,465 | PYInvestmentIncomeAmt |
| CY Investment Income | $625,017 | CYInvestmentIncomeAmt |
| PY Other Revenue | $402,114 | PYOtherRevenueAmt |
| CY Other Revenue | $437,732 | CYOtherRevenueAmt |
| PY Total Revenue | $14,544,176 | PYTotalRevenueAmt |
| CY Total Revenue | $14,811,324 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $54,676 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $48,543 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,240,611 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,483,067 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $116,070 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,381,432 | PYOtherExpensesAmt |
| CY Other Expenses | $8,273,721 | CYOtherExpensesAmt |
| PY Total Expenses | $16,676,719 | PYTotalExpensesAmt |
| CY Total Expenses | $16,805,331 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,132,543 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,994,007 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $20,759,689 | TotalAssetsBOYAmt |
| Total Assets EOY | $20,974,664 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,713,718 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,591,308 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $14,045,971 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $16,383,356 | NetAssetsOrFundBalancesEOYAmt |
| 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,361,722 | ExpenseAmt |
| Grant | $48,543 | GrantAmt |
| Revenue | $13,179,037 | RevenueAmt |
| Desc | SEE SCHEDULE H. | Desc |
| Total Program Service Expenses | $15,361,722 | 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 | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | 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 | Yes (1) | 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 | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 196 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | 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 | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAY ROSS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2186163525 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 MAINE AVENUE SOUTH | AddressLine1Txt |
| City | BAUDETTE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56623 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 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 | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JEFFREY DROP | |||||||||
| BRD MBR/SVP-OPER-CEO (PARTIAL YEAR) | 1.00 | 50.00 | Yes (X) | $0 | $1,263,797 | $34,793 | |||
| DR JUSTIN QUO | |||||||||
| PHYSICIAN/BOARD MEMBER/CHIEF OF STAFF | 50.00 | 1.00 | Yes (X) | $398,553 | $0 | $46,707 | |||
| BENJAMIN KOPPELMAN | |||||||||
| FORMER PRESIDENT | 1.00 | 50.00 | $0 | $310,312 | $46,590 | Yes (X) | |||
| JEFFRY STAMPOHAR | |||||||||
| PRESIDENT | 50.00 | 1.00 | Yes (X) | $176,089 | $0 | $45,281 | Yes (X) | ||
| JAY ROSS | |||||||||
| CFO / TREASURER | 1.00 | 50.00 | $0 | $143,648 | $36,050 | Yes (X) | |||
| BRENT NOBLE | |||||||||
| SUPERVISOR-PHARMACY | 40.00 | 0.00 | $130,714 | $0 | $16,224 | Yes (X) | |||
| ROBERT WOLFE | |||||||||
| PHYSICIAN-EMERGENCY MEDICINE | 20.00 | 0.00 | $142,529 | $0 | $0 | Yes (X) | |||
| SCOTT HARRIS | |||||||||
| PHYSICIAN EMERGENCY MEDICINE | 20.00 | 0.00 | $126,619 | $0 | $0 | Yes (X) | |||
| PATRICIA DAVIDSON | |||||||||
| RN-PATIENT CARE BEDSIDE NON-EXEMPT | 40.00 | 0.00 | $104,851 | $0 | $11,598 | Yes (X) | |||
| WENDI EASTHOUSE | |||||||||
| SUPV-LABORATORY SERVICES NON-EXEMPT | 40.00 | 0.00 | $109,321 | $0 | $6,176 | Yes (X) | |||
| KRISTI BOWMAN | |||||||||
| SECRETARY | 40.00 | 0.00 | $44,050 | $0 | $17,734 | Yes (X) | |||
| BRAD NYLANDER | |||||||||
| BOARD CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| SISTER BERNICE EBNER | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CRYSTAL OLSON | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES AUSTAD | |||||||||
| BOARD MEMBER (PARTIAL YEAR) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,232,726 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,717,757 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $261,153 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | 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 |
|---|---|---|---|---|---|
| KRAUS-ANDERSON CONSTRUCTION CO | |||||
| 501 S 8TH ST | MINNEAPOLIS | MN | 55404 | CONSTRUCTION SERVICES | $698,119 |
| MEDEFIS INC | |||||
| 2121 N 17TH AVE STE 200 | OMAHA | NE | 68164 | VENDOR MANAGEMENT/STAFFING | $322,460 |
| AMN HEALTHCARE | |||||
| 12400 HIGH BLUFF DRIVE | SAN DIEGO | CA | 92130 | HEALTHCARE CONSULTING | $172,124 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $4,325 | RelatedOrganizationsAmt |
| Government Grants | $555,913 | GovernmentGrantsAmt |
| All Other Contributions | $9,300 | AllOtherContributionsAmt |
| Noncash Contributions | $4,325 | NoncashContributionsAmt |
| Total Contributions | $569,538 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| NET PATIENT SERVICES | 900099 | $13,156,794 | $13,156,794 | $0 | $0 |
| MEDICARE/MEDICAID | 900099 | $16,018 | $16,018 | $0 | $0 |
| RENTAL INCOME | 900099 | $6,225 | $6,225 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,179,037 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $95,804 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $1,580 | UnrelatedBusinessRevenueAmt |
| Exclusion | $94,224 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $529,613 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $400 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $529,613 | SecuritiesAmt |
| Other | -$400 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $529,213 | TotalRevenueColumnAmt |
| Exclusion | $529,213 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| 340B CONTRACT REVENUE | 900099 | $309,394 | $0 | $0 | $309,394 |
| SERVICES SOLD | 900099 | $100,872 | $0 | $3,387 | $97,485 |
| CAFETERIA | 722100 | $9,027 | $0 | $0 | $9,027 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,439 | TotalRevenueColumnAmt |
| Exclusion | $18,439 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $437,732 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,811,324 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,179,037 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $4,967 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,057,782 | 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 | $48,543 | TotalAmt |
| Program Services | $48,543 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $646,917 | TotalAmt |
| Program Services | $582,225 | ProgramServicesAmt |
| Management And General | $64,692 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,077,898 | TotalAmt |
| Program Services | $5,470,108 | ProgramServicesAmt |
| Management And General | $541,557 | ManagementAndGeneralAmt |
| Fundraising | $66,233 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,328 | TotalAmt |
| Program Services | $123,595 | ProgramServicesAmt |
| Management And General | $11,994 | ManagementAndGeneralAmt |
| Fundraising | $1,739 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,152,263 | TotalAmt |
| Program Services | $1,037,037 | ProgramServicesAmt |
| Management And General | $103,054 | ManagementAndGeneralAmt |
| Fundraising | $12,172 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $468,661 | TotalAmt |
| Program Services | $421,795 | ProgramServicesAmt |
| Management And General | $42,179 | ManagementAndGeneralAmt |
| Fundraising | $4,687 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,131 | TotalAmt |
| Management And General | $48,131 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,130 | TotalAmt |
| Program Services | $1,130 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,255,452 | TotalAmt |
| Program Services | $3,050,493 | ProgramServicesAmt |
| Management And General | $204,959 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,350 | TotalAmt |
| Program Services | $34,515 | ProgramServicesAmt |
| Management And General | $3,451 | ManagementAndGeneralAmt |
| Fundraising | $384 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $419,087 | TotalAmt |
| Program Services | $377,179 | ProgramServicesAmt |
| Management And General | $37,717 | ManagementAndGeneralAmt |
| Fundraising | $4,191 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $608,916 | TotalAmt |
| Program Services | $548,024 | ProgramServicesAmt |
| Management And General | $54,803 | ManagementAndGeneralAmt |
| Fundraising | $6,089 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $317,894 | TotalAmt |
| Program Services | $286,105 | ProgramServicesAmt |
| Management And General | $28,610 | ManagementAndGeneralAmt |
| Fundraising | $3,179 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,294 | TotalAmt |
| Program Services | $74,964 | ProgramServicesAmt |
| Management And General | $7,497 | ManagementAndGeneralAmt |
| Fundraising | $833 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,575 | TotalAmt |
| Program Services | $5,918 | ProgramServicesAmt |
| Management And General | $591 | ManagementAndGeneralAmt |
| Fundraising | $66 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,476 | TotalAmt |
| Program Services | $2,228 | ProgramServicesAmt |
| Management And General | $223 | ManagementAndGeneralAmt |
| Fundraising | $25 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $713,424 | TotalAmt |
| Program Services | $642,082 | ProgramServicesAmt |
| Management And General | $64,208 | ManagementAndGeneralAmt |
| Fundraising | $7,134 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $906,168 | TotalAmt |
| Program Services | $815,551 | ProgramServicesAmt |
| Management And General | $81,555 | ManagementAndGeneralAmt |
| Fundraising | $9,062 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,552 | TotalAmt |
| Program Services | $24,796 | ProgramServicesAmt |
| Management And General | $2,480 | ManagementAndGeneralAmt |
| Fundraising | $276 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $1,249,612 | $1,249,612 | $0 | $0 |
| REPAIRS AND MAINTENANCE | $240,393 | $228,373 | $12,020 | $0 |
| OTHER TAXES | $234,809 | $223,069 | $11,740 | $0 |
| DUES & SUBSCRIPTIONS | $58,736 | $55,799 | $2,937 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,722 | TotalAmt |
| Program Services | $58,581 | ProgramServicesAmt |
| Management And General | $3,141 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,805,331 | TotalAmt |
| Program Services | $15,361,722 | ProgramServicesAmt |
| Management And General | $1,327,539 | ManagementAndGeneralAmt |
| Fundraising | $116,070 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $930 | BOYAmt |
| EOY | $929 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,731,311 | BOYAmt |
| EOY | $2,890,239 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,042,409 | BOYAmt |
| EOY | $2,044,997 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $212,917 | BOYAmt |
| EOY | $246,597 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,685 | BOYAmt |
| EOY | $91,676 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $24,967,811 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $17,857,362 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,822,767 | BOYAmt |
| EOY | $7,110,449 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,692,302 | BOYAmt |
| EOY | $8,419,455 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $194,368 | BOYAmt |
| EOY | $170,322 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,759,689 | BOYAmt |
| EOY | $20,974,664 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,741,048 | BOYAmt |
| EOY | $4,150,787 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,370,052 | BOYAmt |
| EOY | $138,564 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,804 | BOYAmt |
| EOY | $2,612 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $599,814 | BOYAmt |
| EOY | $299,345 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,713,718 | BOYAmt |
| EOY | $4,591,308 | 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 | $14,044,712 | BOYAmt |
| EOY | $16,381,997 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,259 | BOYAmt |
| EOY | $1,359 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,045,971 | BOYAmt |
| EOY | $16,383,356 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,759,689 | BOYAmt |
| EOY | $20,974,664 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,994,007 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,101,736 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$33,866 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $3,263,522 | 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 | $1,130 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $1,130 | 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 | THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $609 CATHOLIC HEALTH ASSOCIATION - $324 MINNESOTA HOSPITAL ASSOCIATION - $197 | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $103,424 | OtherCostOrOtherBasisAmt |
| Book Value | $103,424 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,624,728 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,813,469 | DepreciationAmt |
| Book Value | $1,811,259 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,444,436 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,800,511 | DepreciationAmt |
| Book Value | $4,643,925 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $795,223 | OtherCostOrOtherBasisAmt |
| Depreciation | $243,382 | DepreciationAmt |
| Book Value | $551,841 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,110,449 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CSH OPERATING INVESTMENT POOL | Desc |
| Book Value | $8,419,455 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $8,419,455 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY PAYABLES | $239,704 |
| CURRENT PORTION OF OPERATING LEASE LIABILITY | $1,474 |
| CURRENT PORTION OF FINANCE LEASE LIABILITY | $21,836 |
| LONG-TERM PORTION OF FINANCE LEASE LIABILITY | $36,331 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $299,345 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | FUNDS ARE HELD ON BEHALF OF RESIDENTS IN LONG TERM CARE. |
| PART X, LINE 2: | LAKEWOOD HEALTH CENTER'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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| 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 | 349 | PersonsServedCnt |
| Total Community Benefit Expns | $176,069 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $176,069 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01050 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1521 | PersonsServedCnt |
| Total Community Benefit Expns | $4,369,871 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,211,675 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,158,196 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06890 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1870 | PersonsServedCnt |
| Total Community Benefit Expns | $4,545,940 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,211,675 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,334,265 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07940 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 236 | PersonsServedCnt |
| Total Community Benefit Expns | $105,618 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $105,618 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00630 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $524,962 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $304,605 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $220,357 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01310 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 89 | PersonsServedCnt |
| Total Community Benefit Expns | $33,548 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $33,548 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Persons Served | 325 | PersonsServedCnt |
| Total Community Benefit Expns | $664,128 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $304,605 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $359,523 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02140 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Persons Served | 2195 | PersonsServedCnt |
| Total Community Benefit Expns | $5,210,068 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,516,280 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,693,788 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10080 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $1,162 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,162 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $1,162 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,162 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $366,341 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $3,432,053 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,420,977 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $11,076 | 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 | LAKEWOOD HEALTH CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 MAIN AVENUE SOUTH | AddressLine1Txt |
| City | BAUDETTE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56623 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://LAKEWOODHEALTHCENTER.ORG/ | WebsiteAddressTxt |
| State License | 375394 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| 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 | LAKEWOOD HEALTH CENTER | 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 | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SCHEDULE H SUPPLEMENTAL INFO | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SCHEDULE H SUPPLEMENTAL INFO | 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 | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 | HTTP://LAKEWOODHEALTHCENTER.ORG/FINANCIAL-ASSISTANCE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://LAKEWOODHEALTHCENTER.ORG/FINANCIAL-ASSISTANCE/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://LAKEWOODHEALTHCENTER.ORG/FINANCIAL-ASSISTANCE/ | 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 |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| LAKEWOOD HEALTH CENTER | PART V, SECTION B, LINE 5: COMMUNITY INPUT WAS GATHERED IN SEVERAL WAYS. PROJECT PARTNERS INCLUDED THE 337 COMMUNITY MEMBERS THAT COMPLETED THE PUBLIC HEALTH SURVEY, AND THE 14 COMMUNITY MEMBERS THAT ATTENDED OUR COMMUNITY FOCUS GROUP. OUR PUBLIC HEALTH DEPARTMENT, WHICH PROVIDES PUBLIC HEALTH FOR THE COUNTY PROVIDED THE SURVEY RESULTS AND ATTENDED THE COMMUNITY FOCUS GROUP MEETING. IN 2017, A HEALTH SURVEY WAS OFFERED TO 1,553 HOUSEHOLDS IN LAKE OF THE WOODS COUNTY THROUGH OUR PUBLIC HEALTH DEPARTMENT. THE SURVEY WAS DEVELOPED WITH ASSISTANCE OF THE MINNESOTA DEPARTMENT OF HEALTH CENTER FOR HEALTH STATISTICS AND INCLUDED QUESTIONS FROM THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS). A FOCUS GROUP WAS CONDUCTED WITH PROVIDERS OF SERVICES FOR OUR AT-RISK POPULATIONS ON APRIL 4, 2019. COMMUNITY REPRESENTATION INCLUDED:MINISTERIAL (FIRST LUTHERAN AND CATHOLIC CHURCHES)EMERGENCY MEDICAL SERVICES (EMT)LAKE OF THE WOODS SOCIAL SERVICESLAKE OF THE WOODS SCHOOL (SUPERINTENDENT, SOCIAL WORKER, HIGH SCHOOL PRINCIPAL)LAKE OF THE WOODS COUNTY COMMISSIONERPARISH NURSE/COMMUNITY MEMBERBAUDETTE CITY COUNCIL MEMBERTHREE PUBLIC HEALTH STAFFCHI LAKEWOOD HEALTH (VICE PRESIDENT OF OPERATIONS AND FOUNDATION/MARKETING LEADER)THE FOURTEEN PROVIDERS PROVIDED THEIR THOUGHTS ON THE GREATEST HEALTH NEEDS OF OUR VULNERABLE POPULATIONS, RESOURCES AND ASSETS AVAILABLE TO RESPOND TO THE NEEDS, AND THE PERCEIVED BARRIERS THAT PREVENT THOSE MOST IN NEED FROM ACCESSING SERVICES. THE FOCUS GROUP PARTICIPANTS BEGAN THE PRIORITIZATION PROCESS BY PERFORMING AN ACTIVITY ON THEIR IDENTIFIED HEALTH NEEDS. A LISTING OF THEIR PRIORITY CONCERNS WAS GIVEN TO THE CHI LAKEWOOD HEALTH SENIOR LEADER TEAM.THE TOP THREE PRIORITIES ESTABLISHED ARE: 1) MENTAL HEALTH; 2) TRANSITIONS OF CARE/PERSONS WITH COMPLEX MEDICAL ISSUES; 3) LOW-INCOME/POVERTY AND IMPLICATIONS THAT RESULTS. COMMUNITY FORUMS ARE HELD WITH THE COMMUNITY EVERY THREE YEARS TO REVIEW PROGRESS ON COMMUNITY GOALS, ASSESS CURRENT NEEDS AND UPDATE ACTION PLANS. CHI LAKEWOOD HEALTH HAS BEEN INVOLVED IN COMMUNITY HEALTH COLLABORATION AND HAS A HISTORY OF SPONSORING COMMUNITY FORUMS TO LOOK AT AREA HEALTH ISSUES, SET PRIORITIES AND PLANS FOR IMPROVEMENT. CHI LAKEWOOD HEALTH CONTINUES A DEEP COMMITMENT AND INVOLVEMENT IN THE COMMUNITY HEALTH ACTIVITIES. |
| LAKEWOOD HEALTH CENTER | PART V, SECTION B, LINE 11: THE FOLLOWING SIGNIFICANT NEEDS WERE IDENTIFIED IN LAKEWOOD HEALTH CENTER'S MOST RECENTLYCONDUCTED CHNA:# 1. MENTAL HEALTH*CHI LAKEWOOD HEALTH WILL EVALUATE AND IMPLEMENT SENIOR LIFE SOLUTIONS, AN OUTPATIENT COUNSELING PROGRAM DESIGNED TO MEET THE MENTAL HEALTH NEEDS OF THOSE WHO ARE 65 AND OLDER. THE PROGRAM WILL PROVIDE ADDITIONAL ACCESS TO MENTAL HEALTH CARE WITHIN OUR COMMUNITY.*CHI LAKEWOOD HEALTH WILL CONTINUE TO COLLABORATE WITH COMMUNITY PARTNERS TO SPONSOR AND PROMOTE MENTAL HEALTH RELATED TRAININGS, WORKSHOPS AND INITIATIVES. IN ADDITION, A MEMBER OF OUR TEAM WILL PARTICIPATE ON THE SUICIDE AWARENESS AND PREVENTION COALITION. THE HOSPITAL WILL ALSO LOOK TO COLLABORATE WITH OUR LOCAL PUBLIC SCHOOL (LOW SCHOOL) TO IDENTIFY OPPORTUNITIES AND NEXT STEPS TO IMPROVE MENTAL HEALTH RESOURCES AND AWARENESS FOR OUR YOUTH.*MAINTAIN CURRENT BEHAVIORAL HEALTH SERVICES AT CHI LAKEWOOD HEALTH AND EXPLORE OPTIONS TO INCREASE PATIENT ACCESS.ANTICIPATED IMPACT: INCREASED ACCESS AND AWARENESS TO REDUCE BARRIERS TO MENTAL HEALTH CARE.#2. TRANSITIONS OF CARE/PERSONS WITH COMPLEX MEDICAL ISSUES*CONTINUE RELATIONSHIP WITH LAND OF THE DANCING SKY AREA AGENCY ON AGING BY SUSTAINING AND GROWING OUR LOCAL MATTER OF BALANCE PROGRAM.*STRATEGIZE AND IMPLEMENT ALTERNATIVE PROVIDER CARE MODELS FOR OUR HOSPITAL AND EMERGENCY DEPARTMENT.*CONTINUE TO COLLABORATE WITH SANFORD HEALTH AND EXPLORE ADDITIONAL OUTREACH SPECIALTY SERVICES.*RECRUIT AND DEVELOP A LIST OF POTENTIAL HEALTH PROVIDERS THAT COULD DELIVER HOMECARE AND/OR HOSPICE WITHIN OUR COMMUNITY.*ENCOURAGE AND PROMOTE PREVENTIVE MEDICINE WITH SCREENINGS, ANNUAL CHECK-UPS AND MEDICARE ANNUAL WELLNESS VISITS.ANTICIPATED IMPACT: INCREASED ACCESS AND IMPROVE PREVENTION AND MANAGEMENT OF COMPLEX MEDICAL ISSUES.#3. LOW-INCOME/POVERTY AND IMPLICATIONS THAT RESULT*PLAY THE ROLE OF INDIRECT STAKEHOLDER THROUGH OUR AREA'S ECONOMIC DEVELOPMENT COMMITTEE TO IDENTIFY PRIORITIES AND ACTION ITEMS THAT ADDRESS OUR UNDER EMPLOYED POPULATION.*CONTINUE TO PARTICIPATE IN RAINY RIVER COMMUNITY COLLEGES COHORT BY PROVIDING ONSITE REGISTERED NURSE PROGRAM, AND CONTINUE TO APPLY FOR THE STUDENT SUMMER HEALTHCARE INTERNSHIP PROGRAM WITH THE MINNESOTA HOSPITAL ASSOCIATION.*CONTINUE TO SUPPORT LOCAL PROGRAMS THAT ADDRESS IMPLICATIONS RESULTING FROM POVERTY WHICH INCLUDES, BUT IS NOT LIMITED TO: LAKE OF THE WOODS SCHOOL BACKPACK PROGRAM, EARLY CHILDHOOD FAMILY INITIATIVE BREAKFAST PROGRAM, SENIOR MEALS AND DOLLARS FOR SCHOLARS.*PROMOTE AND ENCOURAGE EMPLOYEES TO EXPLORE PROFESSIONAL DEVELOPMENT THROUGH THE ORGANIZATION'S LIFELONG LEARNING BENEFITS THAT INCLUDE: EDUCATION ASSISTANCE, ACADEMIC ADVISING, ONLINE AND CALL CENTER SUPPORT THROUGH CATHOLIC HEALTH INITIATIVES' (CHI) EDUCATION PARTNER, EDCOR.*CONTINUE TO ADVOCATE FOR MEMBERS IN OUR COMMUNITY WHO ARE LOW-INCOME AND/OR LIVING IN POVERTY BY PROVIDING FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS WHO DO NOT HAVE THE CAPACITY TO PAY FOR MEDICALLY NECESSARY HEALTH CARE SERVICES, AND WHO OTHERWISE MAY NOT BE ABLE TO RECEIVE THESE SERVICES.ANTICIPATED IMPACT: INCREASED ACCESS TO HEALTH CARE SERVICES AND OPPORTUNITIES THAT PROVIDE ASSISTANCE AND PROMOTE GROWTH.CHI LAKEWOOD HEALTH HAS DEDICATED MOST OF ITS RESOURCES TO ADDRESS THE RESPONSE TO THE ON-GOING CORONAVIRUS PANDEMIC. DUE TO THIS, MANY AREAS OF THE CHNA WERE NOT ABLE TO BE ADDRESSED AS INITIALLY PLANNED, IN ADDITION THE PANDEMIC HAS BROUGHT MANY CHANGES WITH BOTH NEW REGULATIONS AND RECOMMENDATIONS THAT HAVE SIGNIFICANTLY TRANSFORMED THE WAY WE OPERATE. AS WE CONTINUE TO EVOLVE OUR GOAL IS TO FIND ALTERNATIVES TO ADDRESS THE AREAS THAT HAVE BEEN IMPACTED BY THE PANDEMIC AND TO CONSIDER ONGOING SUPPORT AND COLLABORATION FOR THE THREE PRIORITIZED AREAS OF OUR 2019 CHNA. THROUGH THIS APPROACH LAKEWOOD HAS CONTINUED TO SUPPORT AND ADDRESS THE AREAS IN OUR 2019 CHNA AS FOLLOWS:MENTAL HEALTH: LAKEWOOD REMAINS COMMITTED TO EVALUATE AND IMPLEMENT MENTAL HEALTH PROGRAM, SENIOR LIFE SOLUTIONS, AN OUTPATIENT COUNSELING PROGRAM DESIGNED TO MEET THE MENTAL HEALTH NEEDS OF THOSE WHO ARE 65 AND OLDER. ALTHOUGH THE IMPLEMENTATION WAS DELAYED DUE TO COVID LAKEWOOD HAS CONTINUE TO MOVE FORWARD BY ESTABLISHING A RELATIONSHIP WITH THE VENDOR AND COMPLETING A FACILITY SPACE ASSESSMENT TO DETERMINE THE BEST LOCATION FOR THE SERVICES. IN ADDITION TO INCREASING MENTAL HEALTH SERVICES IN OUR COMMUNITY, LAKEWOOD CONTINUES TO COLLABORATE WITH COMMUNITY PARTNERS BY SPONSORING AND PROMOTING MENTAL HEALTH RELATED TRAININGS, WORKSHOPS AND INITIATIVES. AS PART OF THIS, A REPRESENTATIVE FROM LAKEWOOD'S PUBLIC HEALTH DEPARTMENT ATTENDS AND IS A PARTICIPATING COMMITTEE MEMBERS OF THE SUICIDE AWARENESS PREVENTION COALITION. LAKEWOOD ALSO CONTINUES THE SUPPORT OF THIS COMMITTEE AND THEIR MENTAL HEALTH AWARENESS ACTIVITIES THROUGH MONETARY DONATIONS FROM LAKEWOOD REGIONAL HEALTHCARE FOUNDATION.TRANSITIONS OF CARE/PERSONS WITH COMPLEX MEDICAL ISSUES: LAKEWOOD HAS REMAINED COMMITTED TO THE RECRUITMENT OF BOTH A FULL TIME MD AND ADVANCED PRACTICE PRACTITIONERS (APPS) IN OUR RURAL HEALTH CLINIC TO INCREASE ACCESS TO CARE THE COMMUNITY, AND CONTINUES TO WORK COLLABORATIVELY WITH THEIR PHYSICIAN ENTERPRISE RECRUITMENT TEAM TO POST, RECRUIT AND INTERVIEW POTENTIAL CANDIDATES. FOR IMPROVED CONTINUITY IN CARE LAKEWOOD ALSO TRANSITIONED THE EMERGENCY ROOM PROVIDER COVERAGE MODEL. THE NEW MODEL SUPPORTS THREE FULL-TIME APPS. LAKEWOOD HAS CONTINUED ITS LONG STANDING RELATIONSHIP WITH SANFORD HEALTH IN BEMIDJI, MN AND THROUGH THIS COLLABORATIVE OUTREACH SPECIALTY SERVICES ARE PROVIDED SUCH AS: ORTHOPEDICS, CARDIOLOGIST, GENERAL SURGEON AND OBGYN. LAKEWOOD CONTINUES TO PROMOTE AND PRIORITIZE INITIATIVES THAT IMPROVE ACCESS AND IMPROVE PREVENTION AND MANAGEMENT OF THOSE WITH MEDICAL ISSUES, AS PART OF THIS THEY PURCHASED AND INSTALLED A NEW 3D MAMMOGRAPHY UNIT IN JUNE OF 2021 AND PROVIDED HEALTH SCREENINGS THAT SAME MONTH AT NORTH STAR ELECTRIC.LOW INCOME/POVERTY AND IMPLICATIONS THAT RESULT: LAKEWOOD CONTINUES ITS RELATIONSHIP WITH THE ECONOMIC DEVELOPMENT COMMITTEE AND SUPPORTS A ROLE OF INDIRECT STAKEHOLDER, HOWEVER, COVID HAS CONTINUED TO SLOW THESE EFFORTS. LAKEWOOD PROMOTES AND ENCOURAGES EMPLOYEES TO EXPLORE PROFESSIONAL DEVELOPMENT THROUGH THE ORGANIZATION'S LIFELONG LEARNING BENEFITS WHICH SUPPORT: EDUCATION ASSISTANCE, ACADEMIC ADVISING, ONLINE AND CALL CENTER SUPPORT THROUGH COMMONSPIRITS EDUCATION PARTNER, EDCOR. THE HUMAN RESOURCE MANAGER HAS PROMOTED PROFESSIONAL DEVELOPMENT THROUGH EMPLOYEE TOWN HALLS. IN ADDITION LAKEWOOD CONTINUES ITS COHORT WITH RAINY RIVER COMMUNITY COLLEGE TO ASSIST STUDENTS TO COMPLETE AN ASSOCIATE IN SCIENCE DEGREE. THE PROGRAM/INITIATIVE IMPROVES ACCESS TO ADVANCED EDUCATION AND CAREER DEVELOPMENT THROUGH THE USE OF TECHNOLOGY AND CHI LAKEWOOD HEALTH FACILITIES AND PROCTORS. TO IMPROVE ACCESS TO HEALTH SERVICES FOR LOW INCOME POPULATIONS LAKEWOOD HAS PROMOTED THE FINANCIAL ASSISTANCE PROGRAM WITHIN THE COMMUNITY THROUGH SOCIAL MEDIA AND WEBSITE COVERAGE. THE PROGRAM PROVIDES FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS WHO DO NOT HAVE THE CAPACITY TO PAY FOR MEDICALLY NECESSARY HEALTH CARE SERVICES, AND WHO MAY OTHERWISE NOT BE ABLE TO RECEIVE THESE SERVICES. SIGNIFICANT NEEDS THE HOSPITAL DOES NOT INTEND TO ADDRESSALTHOUGH CHI LAKEWOOD HEALTH RECOGNIZED THE IMPORTANCE OF ALL NEEDS IDENTIFIED BY THE COMMUNITY, LAKEWOOD WILL NOT DIRECTLY DESIGN STRATEGIES FOR THE FOLLOWING ISSUES DUE TO LIMITS ON RESOURCES, EXPERTISE OR DUPLICATION OF EFFORT.* TRANSPORTATION - ACCORDING TO OUR 2017 PUBLIC HEALTH SURVEY 2.4% OF OUR SURVEY RESPONDENTS REPLIED THEY DID NOT RECEIVE NEEDED HEALTH CARE DUE TO TRANSPORTATION PROBLEMS.* POOR LIFE CHOICES IN ADULT - ACCORDING TO 2018 DATA FROM THE UNIVERSITY OF WISCONSIN 21% OF LAKE OF THE WOODS COUNTY ADULTS WERE EXCESSIVE DRINKERS AND 15% WERE SMOKERS. |
| PART V, SECTION B, LINE 3E: | THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE CHNA. |
| PART V, SECTION B, LINE 7A: | HTTPS://LAKEWOODHEALTHCENTER.ORG/ABOUT-US/ |
| PART V, SECTION B, LINE 10A: | HTTPS://LAKEWOODHEALTHCENTER.ORG/ABOUT-US/ |
| PART V, SECTION B, LINE 13(H): | THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) 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 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 CHI 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - LAKEWOOD CARE CENTER | ||||
| 600 MAIN AVENUE SOUTH | BAUDETTE | MN | 56623 | LONG TERM CARE FACILITY |
| 2 - LAKEWOOD HEALTHCARE CLINIC | ||||
| 600 MAIN AVENUE SOUTH | BAUDETTE | MN | 56623 | RURAL HEALTH CLINIC |
| 3 - PARKER'S ARC | ||||
| 600 MAIN AVENUE SOUTH | BAUDETTE | MN | 56623 | RESIDENTIAL ASSISTED LIVING |
Supplemental Information Detail SupplementalInformationDetail (14 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 THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. * THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 300% OF THE FPG. *THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED [IN THE FAP]. *THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. 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 CLINIC; *PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); *FOOD STAMP ELIGIBILITY; *SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; *ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID SPEND-DOWN); *LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR *PATIENT IS DECEASED WITH NO KNOWN ESTATE. |
| PART I, LINE 7: | THE APPROACH TAKEN FOR THE COMMUNITY BENEFIT CALCULATION WAS AS FOLLOWS: MEDICAID COMMUNITY BENEFIT WAS CALCULATED BASED UPON USING THE COST TO CHARGE RATIO OF 74.69% TIMES THE CHARGES FOR MEDICAID PATIENTS. THIS RESULTS IN ESTIMATED MEDICAID COSTS OF $4,141,398. ADDITIONALLY, THE MINNESOTA CARE TAX AND MEDICAID SURCHARGE TAX OF $228,473 WAS ALSO INCLUDED AS LINE ITEM COSTS. THIS WAS THEN COMPARED TO PROJECTED REIMBURSEMENT FOR MEDICAID SERVICES OF $3,211,675. THE TOTAL COMMUNITY BENEFIT IS ESTIMATED AT $1,158,196. THE REMAINING COMMUNITY BENEFIT WAS TAKEN BY COMPILING THE COST OF TRADITIONAL CHARITY CARE $176,069; COMMUNITY HEALTH IMPROVEMENT SERVICES $105,618; SUBSIDIZED HEALTH SERVICES $220,357; FINANCIAL AND IN-KIND CONTRIBUTIONS $33,548; AND COMMUNITY BUILDING ACTIVITIES $1,162. THE COST-TO-CHARGE RATIO FOR THE YEAR ENDED 6/30/21 WAS COMPUTED USING THE FOLLOWING FORMULA: TOTAL GROSS CHARGES FOR THE ORGANIZATIONS LESS REVENUE FROM SUBSIDIZED HEALTH SERVICES DIVIDED BY TOTAL OPERATING EXPENSES LESS SUBSIDIZED HEALTH SERVICE EXPENSES AND LESS OTHER COMMUNITY BENEFIT EXPENSES. BASED ON THAT FORMULA THE GROSS CHARGES ARE $20,459,715 DIVIDED BY EXPENSES OF $15,280,700 RESULTS IN A 74.69% COST TO CHARGE RATIO. SUBSIDIZED HEALTH SERVICES WAS CALCULATED USING ESTIMATED NET REVENUE AS COMPARED TO DIRECT COSTS AND OVERHEAD ALLOCATED. OVERHEAD ALLOCATION FOLLOWS THE MEDICARE COST REPORT ASSIGNMENT OF ALLOCATING OVERHEAD TO COST CENTERS. THE MEDICARE COST REPORT IS NOT YET PREPARED AT TIME OF CALCULATION OF THE COMMUNITY BENEFIT FOR FINANCIAL STATEMENT PURPOSES. AS A RESULT, WE UTILIZE AN INTERNAL CALCULATION MODEL TO PROJECT THIS BENEFIT IN JULY. THE COMMUNITY BENEFIT FROM SUBSIDIZED HEALTH SERVICES BELOW WAS $220,357. WORKSHEET 2 WAS NOT USED TO DERIVE THE COST-TO-CHARGE RATIO. |
| PART III, LINE 2: | COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 74.69%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. |
| PART III, LINE 3: | LAKEWOOD HEALTH CENTER DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE. |
| PART III, LINE 4: | LAKEWOOD HEALTH CENTER DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS:COMMONSPIRIT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITE-OFFS AND COLLECTIONS IN ESTIMATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE. UPDATES TO THE HINDSIGHT ANALYSIS IS PERFORMED AT LEAST QUARTERLY USING PRIMARILY A ROLLING EIGHTEEN-MONTH COLLECTION HISTORY AND WRITE-OFF DATA. SUBSEQUENT CHANGES TO ESTIMATES OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT REVENUE IN THE PERIOD OF CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN A THIRD-PARTY PAYOR'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE IN PURCHASED SERVICES AND OTHER IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGE IN NET ASSETS. BAD DEBT EXPENSE FOR 2021 AND 2020 WAS NOT SIGNIFICANT. |
| 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. LAKEWOOD HEALTH CENTER'S SURPLUS, AS REPORTED ON PART III, SECTION B, LINE 7, OF $11,076 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS. |
| PART III, LINE 9B: | THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY APPLIES TO ALL INDIVIDUALS PRESENTING FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE POLICY CONTAINS PROVISIONS FOR COLLECTING AMOUNTS DUE FROM THOSE PATIENTS WHO THE ORGANIZATION KNOWS TO QUALIFY FOR FINANCIAL ASSISTANCE EITHER THROUGH THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS OR THROUGH PRESUMPTIVE ELIGIBILITY PROCESSES. BEFORE ENGAGING IN EXTRAORDINARY COLLECTION ACTIONS (ECAS) TO OBTAIN PAYMENT FOR EMCARE, HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. IN NO EVENT WILL AN ECA BE INITIATED PRIOR TO 120 DAYS FROM THE DATE THE FACILITY PROVIDES THE FIRST POST-DISCHARGE BILLING STATEMENT (I.E., DURING THE NOTIFICATION PERIOD) UNLESS ALL REASONABLE EFFORTS HAVE BEEN MADE.HOSPITAL FACILITIES WILL NOT REFER ACCOUNTS FOR COLLECTION WHERE THE PATIENT HAS INITIALLY APPLIED FOR FINANCIAL ASSISTANCE, AND THE HOSPITAL FACILITY HAS NOT YET MADE REASONABLE EFFORTS WITH RESPECT TO THE ACCOUNT. 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. PATIENTS WHO QUALIFY FOR MEDICAID ARE PRESUMED TO QUALIFY FOR FULL CHARITY WRITE OFF. ANY CHARGES FOR DAYS OR SERVICES WRITTEN OFF (EXCLUDING MEDICAID DENIALS RELATED TO TIMELINESS OF BILLING, INSUFFICIENT MEDICAL RECORD DOCUMENTATION, MISSING INVOICES, AUTHORIZATION, OR ELIGIBILITY ISSUES) AS A RESULT OF A MEDICAID ARE BOOKED AS CHARITY.SOME MEDICAID PLANS OFFER COVERAGE FOR A LIMITED OR RESTRICTED LIST OF SERVICES. IF A PATIENT IS ELIGIBLE FOR MEDICAID, ANY CHARGES FOR DAYS OR SERVICES NOT COVERED BY THE PATIENT'S COVERAGE MAY BE WRITTEN OFF TO CHARITY WITHOUT A COMPLETED APPLICATION. THIS DOES NOT INCLUDE ANY SHARE OF COST (SOC) OR OTHER PATIENT COST-SHARING AMOUNTS SUCH AS DEDUCTIBLES OR COPAYMENTS, AS SUCH COSTS ARE DETERMINED BY THE STATE TO BE AN AMOUNT THAT THE PATIENT MUST PAY BEFORE THE PATIENT IS ELIGIBLE FOR MEDICAID. HEALTH AND HUMAN SERVICES (HSS) USES THE TERM "SPEND DOWN" INSTEAD OF SHARE OF COST.ALL COLLECTION ACTIVITIES CONDUCTED BY THE FACILITY, A DESIGNATED SUPPLIER, OR ITS THIRD-PARTY COLLECTION AGENTS WILL BE IN CONFORMANCE WITH ALL FEDERAL AND STATE LAWS GOVERNING DEBT COLLECTION PRACTICES. ALL THIRD-PARTY AGREEMENTS GOVERNING COLLECTION AND RECOVERY ACTIVITIES MUST INCLUDE A PROVISION REQUIRING COMPLIANCE WITH THE HOSPITAL FACILITIES' FINANCIAL ASSISTANCE AND BILLING AND COLLECTIONS POLICY AND INDEMNIFICATION FOR FAILURES AS A RESULT OF ITS NONCOMPLIANCE. THIS INCLUDES, BUT IS NOT LIMITED TO, AGREEMENTS BETWEEN THIRD PARTIES WHO SUBSEQUENTLY SELL OR REFER DEBT OF THE HOSPITAL FACILITY. |
| PART VI, LINE 2: | COMMUNITY OUTREACH FOR THE POORLAKEWOOD HEALTH CENTER PROVIDES TRADITIONAL CHARITY CARE, AN INTERNAL PROGRAM FOR THE MEDICALLY NEEDY THAT ASSISTS PATIENTS, RESIDENTS OR CLIENTS FINANCIALLY BY FORGIVING OR REDUCING THEIR MEDICAL DEBT AT CHI LAKEWOOD HEALTH. THE BILLING/INSURANCE OFFICE OR THE SOCIAL WORKER IDENTIFIES THOSE INDIVIDUALS OR FAMILIES WITHOUT INSURANCE COVERAGE OR THOSE THAT ARE UNDERINSURED AND PROVIDE APPLICATION ASSISTANCE FOR THIS PROGRAM. COMMUNITY OUTREACH FOR THE BROADER COMMUNITY* LAKEWOOD HEALTH PARTNERED WITH THE LAKE OF THE WOODS SCHOOL TO SCREEN ALL FALL, WINTER AND SPRING SPORTS ATHLETES. THE PROGRAM ALSO EXTENDED TO THE COMMUNITY'S YOUTH HOCKEY PROGRAM. THE SCREENING INVOLVES A 10-MINUTE BASELINE TEST ON EACH ATHLETE LOOKING FOR ANY PHYSICAL OR COGNITIVE SIGNS OF PREVIOUS CONCUSSION. THE ATHLETE'S NORMAL PHYSICAL AND COGNITIVE ABILITIES ARE DOCUMENTED, SHARED WITH THE COACH AND KEPT WITH THE STUDENT'S MEDICAL RECORD. MINNESOTA STATE HIGH SCHOOL LEAGUE ADOPTED NEW RULES (2011) ABOUT WHAT STEPS SHOULD BE TAKEN BEFORE AN ATHLETE WITH A HEAD INJURY CAN RETURN TO PLAY OR PRACTICE AND THIS PROGRAM IS ASSISTING THE ATHLETIC PROGRAMS TO MAINTAIN COMPLIANCE AND SAFETY FOR YOUNG ATHLETES.*CHI LAKEWOOD HEALTH IN CONJUNCTION WITH THE CLINIC DEVELOPED THE DIABETES RESOURCE CENTER TO BRING AWARENESS OF THE CHRONIC DISEASE TO THE PUBLIC AND PROVIDE EDUCATION FOR PEOPLE WITH DIABETES TO HELP THEM UNDERSTAND AND MANAGE THEIR DISEASE. THE PROGRAM IS OFFERED IN CLASS SESSIONS AND ENCOURAGES SELF-MANAGEMENT AND LONG-TERM HEALTH MAINTENANCE. CHI LAKEWOOD HEALTH PROVIDES A DIETITIAN CONSULT AS NEEDED FOR THE PROGRAM. THE DIABETES RESOURCE CENTER STAFF IS AVAILABLE TO MEET WITH INDIVIDUALS TO ASSIST THEM WITH MANAGING THEIR DIABETES. THE DIABETIC RESOURCE CENTER IS STAFFED OUT OF THE CARDIOPULMONARY REHAB DEPARTMENT.THE DIABETES RESOURCE CENTER OFFERED PREVENT T2 PROGRAM. A CDC APPROVED YEAR-LONG PROGRAM WITH WEEKLY MEETINGS FOR THE FIRST 6-MONTHS, THEN ONCE OR TWICE A MONTH FOR THE SECOND 6 MONTHS. THIS IS A PROVEN LIFESTYLE CHANGE PROGRAM TO HELP PARTICIPANTS PREVENT OR DELAY TYPE 2 DIABETES. PARTICIPANTS LEARN TO MANAGE WEIGHT, BECOME MORE PHYSICALLY ACTIVE AND REDUCE STRESS. ALONG THE WAY THEY ALSO RECEIVE SUPPORT FROM OTHERS WHO ARE ON THE SAME JOURNEY.A COMMUNITY SUPPORT GROUP WAS ESTABLISHED FOR THOSE AFFECTED BY DIABETES AND THIS GROUP IS MEETING AT CHI LAKEWOOD HEALTH THREE TO FOUR TIMES A YEAR, SPONSORED BY CHI LAKEWOOD HEALTH.COLLABORATIVE EFFORTS TO IMPROVE COMMUNITY HEALTHCHI LAKEWOOD HEALTH DONATES CASH TO PROGRAMS, PROJECTS AND SPECIAL COMMUNITY EVENTS. THESE ORGANIZATIONS/COMMUNITY GROUPS ARE ALSO NOT FOR PROFIT WHERE COLLABORATION FOR SAFE ENVIRONMENT, SAFE RECREATIONAL OPPORTUNITIES, GROWTH AND DEVELOPMENT OF YOUTH, AND OTHER ACTIVITIES/PROGRAMS THAT ASSIST IN BUILDING THE COMMUNITY AND THE HEALTH OF THE COMMUNITY. THROUGH PARTNERSHIPS WITH LAKEWOOD REGIONAL HEALTHCARE FOUNDATION, CHI LAKEWOOD HEALTH IS ABLE TO INCREASE ITS MONETARY DONATIONS TO LOCAL PROGRAMS AND PROJECTS THAT SUPPORT ITS MISSION. THESE PROGRAMS INCLUDE SENIOR MEALS, SENIOR BOATS, EARLY CHILDHOOD BREAKFAST, CHILDREN'S THEATER, AND LAKE OF THE WOODS SCHOOL HEALTHY CHOICES PROGRAM.CHI LAKEWOOD HEALTH ENCOURAGES EMPLOYEES TO BE INVOLVED IN COMMUNITY ACTIVITIES AND TO VOLUNTEER WHERE ABLE. CHI LAKEWOOD HEALTH ALLOWS USE OF PRINTERS, COPY MACHINES, PAPER, AND DONATION OF SUPPLIES. SOME OF THE PROJECTS INCLUDE THE LOCAL FOOD SHELF, TAKE A KID FISHING PROGRAM, SENIOR FISHING PROGRAM, YOUTH HOCKEY, BAUDETTE AREA MINISTERIUM, HUMANE SOCIETY, POST PROM PARTY, JOB SHADOWING EXPERIENCE, SCHOOL CAREER DAY, SCHOOL BOOSTER CLUB, ROBOTICS, COACHING SPORTS TEAMS AND OTHER SCHOOL PROJECTS. CHI LAKEWOOD HEALTH PARTICIPATES IN FUNDRAISING FOR INTERNATIONAL MISSION PROJECT (ALONG WITH CHI FARGO DIVISION) THE INDIGENOUS PEOPLE'S HOSPITAL IN THE PHILIPPINES WITH INTERNAL FUNDRAISING EVENTS FOR EMPLOYEE PARTICIPATION. THE FUNDS ARE USED TO SHIP MEDICAL SUPPLIES AND EQUIPMENT TO THE PHILIPPINES.CHI LAKEWOOD HEALTH HAS INITIATED A RELATIONSHIP WITH SENIOR LIFE SOLUTIONS TO EXPLORE AND EVALUATE THE PROGRAM AND HOW IT COULD MEET THE MENTAL HEALTH NEEDS IN OUR COMMUNITY. SENIOR LIFE SOLUTIONS IS AN OUTPATIENT THERAPY PROGRAM DESIGNED TO MEET THE NEEDS OF OLDER ADULTS, AGE 65 AND OLDER, STRUGGLING WITH SYMPTOMS OF DEPRESSION AND ANXIETY. THE PROGRAM WILL PROVIDE ADDITIONAL ACCESS TO MENTAL HEALTH CARE WITHIN THE COMMUNITY AND BE OFFERED AT LAKEWOOD ONCE IMPLEMENTED. COMMUNITY BUILDING AND COMMUNITY HEALTH ACTIVITIES1. THE BRINK SENIOR CENTER IS A NON-PROFIT ORGANIZATION THAT PROVIDES NUTRITIOUS MEALS AT NOON, FIVE DAYS A WEEK THROUGH LUTHERAN SOCIAL SERVICE PROGRAM. THEY ALSO PROVIDE MEALS ON WHEELS IN OUR COMMUNITY. THE CENTER ALSO SERVES AS A FORUM FOR INFORMATION RELATED TO HEALTH, SENIOR ISSUES AND ADVOCACY PROGRAMS FOR SENIORS. THE SOCIAL WORKER PARTICIPATES ON THE NUTRITION BOARD AT THE BRINK CENTER AND ASSIST WITH FUNDRAISERS ONCE OR TWICE A YEAR FOR THE NUTRITION PROGRAM. OTHER LAKEWOOD STAFF MEMBERS OCCASIONALLY ASSIST WITH SPECIAL EVENTS OR FUNDRAISERS. CHI LAKEWOOD HEALTH PARTNERED WITH LAKEWOOD REGIONAL HEALTHCARE FOUNDATION TO PROVIDE SUPPORT TO THE SENIOR MEALS PROGRAM IN THE FORM OF A MONETARY DONATION.2. LAKEWOOD SUPPORTS FOUR BLOOD DRIVES IN OUR COMMUNITY. CHI LAKEWOOD HEALTH ENCOURAGES AND SUPPORTS EMPLOYEES TO VOLUNTEER AS BLOOD DONORS AND STAFF FROM ENVIRONMENTAL SERVICES OFFERS ASSISTANCE IN SET UP AND CLEAN UP FOR THE BLOOD DRIVE EVENT. LAKEWOOD HEALTH CENTER LAB AND RADIOLOGY DEPARTMENTS TOOK OVER THE RESPONSIBILITIES IN 2012 AND HAVE HAD SUCCESSFUL BLOOD DRIVES IN OUR COMMUNITY, RECENTLY EXPANDING THIS SERVICE FROM TWO EVENTS TO FOUR EACH YEAR. COMMUNICATIONS/MARKETING STAFF ASSIST WITH PROMOTING THE BLOOD DRIVE.3. THE BAUDETTE COMMUNITY FOUNDATION IS A NON-PROFIT ORGANIZATION SEEKING TO ENHANCE AND IMPROVE AREA RECREATIONAL AND SOCIAL FACILITIES. THE BAUDETTE COMMUNITY FOUNDATION BOARD MEETS MONTHLY AND OVERSEES THE THEATER BUSINESS AND CONTINUES TO WORK TOWARD IMPROVING THE RECREATIONAL FACILITIES. BAUDETTE COMMUNITY FOUNDATION ALSO SERVES AS A FISCAL AGENT FOR THE SENIOR FISHING PROGRAM IN LAKE OF THE WOODS COUNTY. CHI LAKEWOOD HEALTH PROVIDES ONE REPRESENTATIVE ON THE BAUDETTE COMMUNITY FOUNDATION BOARD.4. LAKE OF THE WOODS COUNTY PREVENTION COALITION (ALCOHOL, TOBACCO AND OTHER DRUGS): CHI LAKEWOOD HEALTH CENTER (MISSION LEADER, PUBLIC HEALTH STAFF) ARE MEMBERS OF THE COALITION AND CHI LAKEWOOD HEALTH PROVIDES SPACE FOR MEETINGS AND OCCASIONAL REFRESHMENTS. LAKE OF THE WOODS COUNTY WORKS WITH THE DEPARTMENT OF HUMAN SERVICES/ALCOHOL AND DRUG ABUSE DIVISION BY FOCUSING IN PART - CHANGING THE ENVIRONMENT THE YOUTH LIVE IN. INVESTING IN PREVENTION MEASURES WILL NOT ONLY ENHANCE THE COMMUNITY IT WILL ENHANCE THE LIVES OF OUR YOUTH. THE PREVENTION MEASURES ARE AIMED AT: 1) REDUCING ACCESS AND AVAILABILITY 2) ENFORCEMENT OF EXISTING LAWS AND POLICIES AND 3) CHANGING PUBLIC ATTITUDES AND SOCIAL NORMS.5. SUICIDE AWARENESS AND PREVENTION COALITION: CHI LAKEWOOD HEALTH IS PARTICIPATING IN THIS COALITION PARTNERING WITH LOCAL COUNTY SOCIAL SERVICES, SCHOOL SOCIAL WORK AND ADMINISTRATION, YOUTH GROUP LEADERS, CLERGY, PUBLIC HEALTH. CHI LAKEWOOD HEALTH PARTNERED WITH LAKEWOOD REGIONAL HEALTHCARE FOUNDATION TO PROVIDE A MONETARY DONATION TO SUPPORT THE GROUPS' MEDIA AND EDUCATION CAMPAIGN TO INCREASE AWARENESS IN REGARDS TO ACCESS TO HELP AND LIFE LINES. THIS GROUP HAS PARTNERED WITH THE SCHOOL AND ASSISTED WITH GRANT WRITING TO PROVIDE EDUCATIONAL GUEST SPEAKERS FOR STUDENTS AND THE PUBLIC ON TOPICS OF BULLYING AND SELF-ESTEEM.PART VI, LINE 2 (CONTINUED BELOW) |
| PART VI, LINE 3: | NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM CHI HOSPITAL ORGANIZATIONS SHALL BE DISSEMINATED BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT NOT BE LIMITED TO: *CONSPICUOUS PUBLICATION OF NOTICES IN PATIENT BILLS; *NOTICES POSTED IN EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING/REGISTRATION DEPARTMENTS, BUSINESS OFFICES, AND AT OTHER PUBLIC PLACES AS A HOSPITAL FACILITY MAY ELECT; AND *PUBLICATION OF A SUMMARY OF THIS POLICY ON THE HOSPITAL FACILITY'S WEBSITE AND AT OTHER PLACES WITHIN THE COMMUNITIES SERVED BY THE HOSPITAL FACILITY AS IT MAY ELECT. SUCH NOTICES AND SUMMARY INFORMATION SHALL INCLUDE A CONTACT NUMBER AND SHALL BE PROVIDED IN ENGLISH, SPANISH, AND OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY AN INDIVIDUAL HOSPITAL FACILITY, AS APPLICABLE. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE CHI 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.IN ADDITION, HOSPITAL REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES. ONCE IT IS DETERMINED THAT THE PATIENT DOES NOT QUALIFY FOR ANY THIRD PARTY FUNDING, THE PATIENT IS VERBALLY NOTIFIED ABOUT THE EXISTENCE OF FINANCIAL ASSISTANCE APPLICATION AND ADDITIONAL SCREENING TAKES PLACE BY A HOSPITAL EMPLOYEE TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR CHARITY SERVICE PRIOR TO DISCHARGE. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY OF THAT POLICY, AND AN APPLICATION FOR ASSISTANCE. HOSPITAL REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON-ENGLISH-SPEAKING INDIVIDUALS. PATIENTS THAT HAVE BEEN DISCHARGED PRIOR TO CHARITY SCREENING, SUCH AS EMERGENCY ROOM PATIENTS, RECEIVE A WRITTEN NOTIFICATION OF POSSIBLE ELIGIBILITY FOR SERVICES. IF THE PATIENT IS DETERMINED NOT TO BE ELIGIBLE FOR GOVERNMENT ASSISTANCE, HE/SHE MAY NOTIFY THE HOSPITAL THAT THEY SEEK CHARITY ASSISTANCE. THE APPROPRIATE CHARITY FORM IS SENT TO THE PATIENT/GUARANTOR FOR COMPLETION AND THEN RETURNED TO THE HOSPITAL FOR EVALUATION AND QUALIFICATION. ONCE DETERMINATION OF ELIGIBILITY IS MADE, THE PATIENT IS SENT A NOTICE INFORMING HIM/HER IF THEY QUALIFY FOR FULL, PARTIAL, OR NO CHARITY CARE SERVICES.HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER ANY INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. |
| PART VI, LINE 4: | CHI LAKEWOOD HEALTH IS LOCATED IN BAUDETTE, MINNESOTA, A RURAL AND ISOLATED AREA OF NORTHERN MINNESOTA, SERVING LAKE OF THE WOODS COUNTY AND SURROUNDING COUNTIES OF ROSEAU, KOOCHICHING, BELTRAMI AND ON OCCASION RESIDENTS OF CANADA. TODAY, THE POPULATION OF THE INCORPORATED CITIES IS: BAUDETTE, 1,030 AND WILLIAMS 191. ACCORDING TO MDH, THE 2019 LAKE OF THE WOODS COUNTY POPULATION IS 3,740, A DECREASE OF 4 PEOPLE FROM 2017 DATA. PERSONS 65 YEARS AND OVER MAKE UP 25.4% OF LAKE OF THE WOODS COUNTY POPULATION IN 2019. THE MEDIAN HOUSEHOLD INCOME (2019) WAS $49,967. THERE ARE 3.1 PERSONS PER SQUARE MILE IN LAKE OF THE WOODS COUNTY. |
| PART VI, LINE 5: | THE ORGANIZATION'S HOSPITAL FACILITY(IES) PROMOTE HEALTH FOR THE BENEFIT OF THE COMMUNITY. MEDICAL STAFF PRIVILEGES IN THE HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, CONSISTENT WITH THE SIZE AND NATURE OF ITS FACILITIES. THE ORGANIZATION'S HOSPITAL FACILITY(IES) HAVE AN OPEN MEDICAL STAFF. ITS BOARD OF TRUSTEES IS COMPOSED OF PROMINENT CITIZENS IN THE COMMUNITY. EXCESS FUNDS ARE GENERALLY APPLIED TO EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, IMPROVEMENT IN PATIENT CARE, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH. THE FACILITY(IES) TREAT PERSONS PAYING THEIR BILLS WITH THE AID OF PUBLIC PROGRAMS LIKE MEDICARE AND MEDICAID. ALL PATIENTS PRESENTING AT THE HOSPITAL FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ARE TREATED REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH TREATMENT.THE MISSION OF CHI LAKEWOOD HEALTH AND COMMONSPIRIT HEALTH IS TO 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.CHI LAKEWOOD HEALTH IN BAUDETTE, MINNESOTA, IS A CATHOLIC, NOT-FOR-PROFIT CARE ORGANIZATION, AND SPONSORED BY COMMONSPIRIT HEALTH, THE LARGEST CATHOLIC, NOT-FOR-PROFIT HEALTH CARE SYSTEM IN AMERICA. CHI LAKEWOOD HEALTH IS DEDICATED TO THE HEALTH AND WELLBEING OF THE COMMUNITY AND TO PROVIDING QUALITY, HOLISTIC HEALTH CARE SERVICES AND FACILITIES FOR THE RESIDENTS OF BAUDETTE, LAKE OF THE WOODS COUNTY AND SURROUNDING COMMUNITIES OF THE LAKE OF THE WOODS REGION.CHI LAKEWOOD HEALTH IS LOCATED IN A RURAL AND ISOLATED AREA OF NORTHERN MINNESOTA SERVING LAKE OF THE WOODS COUNTY AND SURROUNDING COUNTIES OF ROSEAU, KOOCHICHING, BELTRAMI AND ON OCCASION RESIDENTS OF CANADA. CHI LAKEWOOD HEALTH IS FEDERALLY DESIGNATED, 15-BED CRITICAL ACCESS HOSPITAL. CHI LAKEWOOD HEALTH OFFERS A CONTINUUM OF CARE INCLUDING LONG TERM CARE, ASSISTED RESIDENTIAL COMMUNITY (BOARD AND LODGING WITH SERVICES), HOSPITAL CARE, PUBLIC HEALTH, RURAL VISITING NURSE PROGRAM, AND A RURAL HEALTH CLINIC.LAKEWOOD CONTINUES TO HAVE OUTREACH SERVICES PROVIDED BY AN ORTHOPEDIC SURGEON, AN ORTHOPEDIC PHYSICIAN'S ASSISTANT, A PODIATRIST, GENERAL SURGEON, AND AN OBGYN ALL FROM SANFORD BEMIDJI. CHI LAKEWOOD CONTINUES TO UTILIZE LOCUM PROVIDERS FOR THE EMERGENCY ROOM AND SOME CLINIC COVERAGE. CHI LAKEWOOD HEALTH CLOSED OB SERVICES IN SEPTEMBER 2009.CHI LAKEWOOD HEALTH SERVES ALL PERSONS IN THE COMMUNITY ON A NONDISCRIMINATORY BASIS AND PARTICIPATES IN MEDICAID, MEDICARE PROGRAMS AND HAS AN ACTIVE CHARITY CARE PROGRAM. THE EMERGENCY ROOM IS AVAILABLE 24 HOURS A DAY, 365 DAYS PER YEAR, AND IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY.HISTORYCHI LAKEWOOD HEALTH OPENED IN MARCH 1950 AS BAUDETTE COMMUNITY HOSPITAL. IT WAS OWNED BY THE COMMUNITY AND OPERATED BY THE SISTERS OF ST. JOSEPH OUT OF CROOKSTON, MINNESOTA. THE HOSPITAL WAS LEASED TO THE SISTERS OF ST. JOSEPH IN 1954 AND IN 1957 THE SISTERS PURCHASED THE HOSPITAL AND CHANGED THE NAME TO "TRINITY HOSPITAL".IN 1982, THE SISTERS ENTERED INTO A MANAGEMENT CONTRACT WITH UNITED HEALTH RESOURCES OF GRAND FORKS, NORTH DAKOTA UNTIL THEY SOLD THE HOSPITAL TO FRANCISCAN SISTERS HEALTH CARE, INCORPORATED IN 1985. DURING THIS TIME, TRINITY HOSPITAL TOOK OVER MANAGEMENT OF THE PIONEER NURSING HOME, THE LONG-TERM TERM CARE FACILITY LOCATED ONE MILE EAST OF THE HOSPITAL. IN 1986, THE HOSPITAL ACQUIRED THE COUNTY-OWNED PUBLIC HEALTH SERVICE. TRINITY HOSPITAL BOUGHT THE PIONEER NURSING HOME IN 1990 AND THE NAME WAS CHANGED TO "LAKEWOOD HEALTH CENTER" TO REFLECT THE COMING TOGETHER OF ACUTE CARE, LONG-TERM CARE (LAKEWOOD CARE CENTER), AND HOME HEALTH/PUBLIC HEALTH (LAKEWOOD NURSING SERVICE) UNDER ONE UMBRELLA.DR. A.A. BRINK OPENED HIS MEDICAL PRACTICE IN 1932 IN THE FIRST NATIONAL BANK BUILDING. WITH THE CONSTRUCTION OF A NEW HOSPITAL IN PROGRESS, DR. BRINK BUILT A NEW CLINIC ON MAIN AVENUE, NOW KNOWN AS THE BRINK SENIOR CENTER, A COMMUNITY CENTER FOR EVENTS AND MEALS. A NEW BAUDETTE MEDICAL CLINIC WAS BUILT NEXT TO THE HOSPITAL IN 1979. THE CLINIC BUILDING WAS ACQUIRED BY LAKEWOOD HEALTH IN 1994 BUT THE CLINIC WAS LEASED AS A SATELLITE CLINIC OF GRAND FORKS CLINIC. IN JULY 2006, THE CLINIC BECAME AN OUTPATIENT DEPARTMENT OF LAKEWOOD HEALTH CENTER.CATHOLIC HEALTH CORPORATION OF OMAHA, NEBRASKA TOOK OVER SPONSORSHIP OF LAKEWOOD HEALTH CENTER IN 1993. TWO YEARS LATER THEY MERGED WITH TWO OTHER LARGE CATHOLIC HEALTH CARE SYSTEMS TO FORM CATHOLIC HEALTH INITIATIVES (CHI) BASED IN ENGLEWOOD, COLORADO. CATHOLIC HEALTH INITIATIVES THEN MERGED WITH DIGNITY HEALTH TO FORM COMMONSPIRIT HEALTH WITH HEADQUARTERS IN CHICAGO, ILLINOIS.LAKEWOOD HEALTH CENTER COMPLETED A BUILDING AND RENOVATION PROJECT IN 2000 THAT RESULTED IN ALL HEALTH CARE SERVICES BEING AVAILABLE ON ONE CAMPUS. LAKE OF THE WOODS COUNTY TRANSFERRED OWNERSHIP OF THE LOCAL EMS AMBULANCE SERVICE TO LAKEWOOD HEALTH AND IS A DEPARTMENT OF THE HEALTH CENTER. LAKEWOOD NURSING SERVICE TRANSFERRED TO CATHOLIC HEALTH INITIATIVES HEALTH CONNECT AT HOME AND THE OPERATION MOVED OFF SITE IN JUNE 2010; THE FINANCIAL OPERATIONS WERE SEPARATED IN DECEMBER OF 2010. CATHOLIC HEALTH INITIATIVES AT HOME DISCONTINUED HOME HEALTH SERVICES IN LAKE OF THE WOODS COUNTY AND PUBLIC HEALTH, SCHOOL NURSING, PARKER'S ARC OPERATIONS TRANSFERRED BACK TO LAKEWOOD HEALTH CENTER BY JULY OF 2012. CHI LAKEWOOD HEALTH IS THE ONLY HOSPITAL, CLINIC AND LICENSED LONG TERM CARE PROVIDER IN LAKE OF THE WOODS COUNTY.CHI LAKEWOOD HEALTH IS COMMITTED TO THE PROMOTION OF HEALTHIER COMMUNITIES. CHI LAKEWOOD HEALTH IS PROUD OF ITS CATHOLIC HERITAGE AND ITS ABILITY TO PROVIDE DIRECT AND INDIRECT SUPPORT TO THE COMMUNITIES IT SERVES.CHI LAKEWOOD HEALTH IS INCLUDED IN THE OFFICIAL CATHOLIC DIRECTORY AS A TAX-EXEMPT HOSPITAL.COMMUNITY BENEFIT APPROACHFINANCE OR ACCOUNTING GATHERS AND TRACKS THE COMMUNITY BENEFIT DATA. THE VP OF FINANCE PROVIDES THE CHARITY CARE AND FINANCIAL DATA FOR INPUT. THE BOARD OF DIRECTORS AND SENIOR LEADERSHIP TEAM ALONG WITH DEPARTMENT HEADS COLLABORATE THROUGHOUT THE YEAR ON HOW TO MAKE A DIFFERENCE IN THE COMMUNITY WE SERVE AND ARE A PART OF. A COST TO CHARGE RATIO IS USED DETERMINED BY A WORKSHEET PROVIDED BY COMMON SPIRIT HEALTH, ENGLEWOOD, COLORADO.CHI LAKEWOOD HEALTH STRIVES TO HAVE COMMUNITY BENEFIT A VISIBLE PART OF WHO WE ARE AND PROVIDES AN ANNUAL REPORT FOR OUR COMMUNITY IN ONE OF OUR NEWSLETTERS PUBLISHED 2 TIMES PER YEAR. COLLABORATING AND COOPERATING WITH OUR COMMUNITY IS "A WAY OF LIFE AND PART OF THE CULTURE FOR CHI LAKEWOOD HEALTH AND ITS EMPLOYEES. WE ARE THANKFUL TO HAVE THE RESOURCES OF TIME, TALENT AND OTHER GIFTS TO SHARE FOR THE GOOD OF OUR COMMUNITY. |
| 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 AS A SINGLE MINISTRY 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 OF OTHER PRIMARILY NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. COMMONSPIRIT HEALTH IS COMPRISED OF MORE THAN 1,500 CARE SITES, CONSISTING OF 140 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 2021, COMMONSPIRIT HEALTH PROVIDED MORE THAN $2.5 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 $5.1 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $33.25 BILLION IN FISCAL YEAR 2021, HAS TOTAL ASSETS OF APPROXIMATELY $54.87 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 | MN |
| PART VI, LINE 2 (CONTINUED): | COMMUNITY BUILDING AND COMMUNITY HEALTH ACTIVITIES6. COMMUNITY GARDENING HAS BEEN A SUCCESSFUL AND SUSTAINABLE PROJECT THAT ORIGINATED FROM LAKEWOOD'S SHIP PUBLIC HEALTH PROGRAM. LAKEWOOD CONTINUES TO PROVIDE THE COMMUNITY GARDEN SPACES AND PREP THE AREAS EACH SEASON. THE GARDENS HAVE ALLOWED COMMUNITY MEMBERS WHO MAY NOT HAVE HAD ACCESS THE ABILITY TO GROW AND HAVE ACCESS TO FRESH FOODS. THE ALSO PROMOTE HEALTH AND WELLBEING AND PHYSICAL ACTIVITY. THROUGH THE SHIP PROGRAM EFFORTS CONTINUED TO TOBACCO EDUCATION. CHI LAKEWOOD HEALTH'S PUBLIC HEALTH SPENT THE YEAR EDUCATING ON THE ADVERSE EFFECTS OF TOBACCO AND E-CIGARETTES. 7. COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGIESTHE PURPOSE OF CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT IS TO DESCRIBE THE HEALTH OF LOCAL PEOPLE, IDENTIFY USE OF LOCAL HEALTH CARE SERVICES, PRIORITIZE COMMUNITY NEEDS AND IDENTIFY ACTION NEEDED TO ADDRESS THE FUTURE DELIVERY OF HEALTH CARE IN THE DEFINED AREA. A HEALTH NEEDS ASSESSMENT BENEFITS THE COMMUNITY BY: 1) COLLECTING TIMELY INPUT FROM THE LOCAL COMMUNITY, PROVIDERS AND STAFF; 2) PROVIDING AN ANALYSIS OF SECONDARY DATA RELATED TO HEALTH CONDITIONS, RISKS AND OUTCOMES; 3) COMPILING AND ORGANIZING INFORMATION TO GUIDE DECISION MAKING, EDUCATION, AND MARKETING EFFORTS, AND TO FACILITATE THE DEVELOPMENT OF A STRATEGIC PLAN; 4) ENGAGING COMMUNITY MEMBERS ABOUT THE FUTURE OF HEALTH CARE COMMUNITY BY: DELIVERY; AND 5) ALLOWING THE CHARITABLE HOSPITAL TO MEET FEDERAL REGULATION REQUIREMENTS OF THE AFFORDABLE CARE ACT, WITH REQUIRED NOT-FOR-PROFIT HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT AT LEAST EVERY THREE YEARS. LAKEWOOD HEALTH CENTER COMPLETED A HEALTH NEEDS ASSESSMENT AND PUBLISHED THE FINDINGS ON THE FACILITY WEBSITE. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED DURING SEPTEMBER 2018-JUNE 2019. THE MOST RECENT COMMUNITY FORUM WAS HELD IN APRIL 2019.8. RAINY RIVER COMMUNITY COLLEGE COHORT: CHI LAKEWOOD HEALTH PARTICIPATES IN A COHORT WITH RAINY RIVER COMMUNITY COLLEGE WHICH OFFERS AREA RESIDENTS AND EMPLOYEES THE OPPORTUNITY TO OBTAIN A REGISTERED NURSE OR LICENSED PRACTICAL NURSE DEGREE BY COMPLETING CLASSES AND COURSEWORK LOCALLY. PARTICIPANTS UTILIZE CHI LAKEWOOD HEALTH'S CONFERENCE ROOM AND TECHNOLOGY TO CONNECT VIA INTERACTIVE TELEVISION (ITV) WITH INSTRUCTORS AND PARTICIPATE IN CLASSES. LAKEWOOD ALSO PROVIDED TWO APPROVED PROCTORS SO THAT STUDENTS COULD COMPLETE EXAMS ONSITE AT LAKEWOOD AS WELL. THE COHORT IS INTENDED TO PROVIDE ACCESS TO ADVANCED EDUCATION AND CAREER DEVELOPMENT. ONCE INDIVIDUALS OBTAIN THEIR DEGREE AND UPON SUCCESSFULLY PASSING THE ACCREDITED BOARD EXAM THEY WILL RECEIVE POSSIBLE JOB PLACEMENT WITHIN THE ORGANIZATION. COMMUNITY HEALTH IMPROVEMENT ADVOCACY AND SUPPORT SERVICES1. MINNESOTA HEALTH CARE PROGRAMS OUTREACH EFFORTS ENHANCED THROUGH MINNESOTA COMMUNITY APPLICATION AGENT (MNCAA) PROGRAM. LEVEL I ORGANIZATIONS ARE REFERRED TO AS A MINNESOTA COMMUNITY APPLICATION AGENT (MNCAA). MNCAA CONTRACTS WITH DHS TO SERVE AS AN APPLICATION SITE FOR THOSE NEEDING ASSISTANCE WITH THE MINNESOTA HEALTH CARE PROGRAMS APPLICATION (HCAPP). EMPLOYEES FROM LAKEWOOD PARTICIPATED IN THIS TRAINING. LEVEL I SITES ARE CONTRACTED TO:A) IDENTIFY THE POTENTIAL HEALTH CARE ENROLLEESB) ASSIST POTENTIALLY ELIGIBLE ENROLLEES WITH THE HCAPPC) ASSIST APPLICANTS WITH OBTAINING DOCUMENTATION NEEDED TO DETERMINE HEALTH CARE ELIGIBILITYD) OFFER USE OF FAX AND COPY SERVICESE) FOLLOW UP AS NEEDED UNTIL AN ELIGIBILITY DETERMINATION IS REACHED |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Purpose Of GrantPurposeOfGrantTxt | Cash GrantCashGrantAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| LAKEWOOD REGIONAL HEALTHCARE FOUNDATION | ||||||||||
| 600 MAIN AVENUE SOUTH | BAUDETTE | MN | 56623 | 411893795 | 501(C)(3) | $20,959 | FMV | IN-KIND DONATION | PROGRAM SUPPORT | |
| LAKE OF THE WOODS INTERNATIONAL ARENA BOARD INC | ||||||||||
| 656 22ND AVENUE NW | BAUDETTE | MN | 56623 | 472602214 | 501(C)(3) | PROGRAM SUPPORT | $25,000 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PROVIDES FINANCIAL ASSISTANCE IN ACCORDANCE WITH THE COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY TO INDIVIDUALS WHO ARE ELIGIBLE FOR FREE OR DISCOUNTED CARE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFREY DROP | ||||||||||||||
| BRD MBR/SVP-OPER-CEO (PARTIAL YEAR) | $0 | $692,085 | $0 | $430,582 | $0 | $141,130 | $0 | $16,844 | $0 | $17,949 | $0 | $1,298,590 | $0 | $0 |
| DR JUSTIN QUO | ||||||||||||||
| PHYSICIAN/BOARD MEMBER/CHIEF OF STAF | $377,992 | $0 | $20,000 | $0 | $561 | $0 | $17,437 | $0 | $29,270 | $0 | $445,260 | $0 | $0 | $0 |
| BENJAMIN KOPPELMAN | ||||||||||||||
| FORMER PRESIDENT | $0 | $264,859 | $0 | $28,040 | $0 | $17,413 | $0 | $17,315 | $0 | $29,275 | $0 | $356,902 | $0 | $0 |
| JEFFRY STAMPOHAR | ||||||||||||||
| PRESIDENT | $156,907 | $0 | $17,000 | $0 | $2,182 | $0 | $18,760 | $0 | $26,521 | $0 | $221,370 | $0 | $0 | $0 |
| JAY ROSS | ||||||||||||||
| CFO / TREASURER | $0 | $137,807 | $0 | $5,536 | $0 | $305 | $0 | $9,586 | $0 | $26,464 | $0 | $179,698 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4A: | FOR REPORTABLE INDIVIDUALS EMPLOYED PRIOR TO 2019, POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. OFFICERS, KEY EMPLOYEES AND CERTAIN HIGHLY COMPENSATED EMPLOYEES WHO BEGAN EMPLOYMENT AFTER NOVEMBER 1ST OF 2019 ARE COVERED BY THE COMMONSPIRIT HEALTH EXECUTIVE SEVERANCE POLICY. THIS POLICY PROVIDES FOR SEVERANCE PAY WHICH VARIES BASED UPON THE EXECUTIVE'S POSITION LEVEL, IN THE EVENT OF A POSITION ELIMINATION OR OTHER QUALIFYING EVENT, IN ACCORDANCE WITH THE GUIDELINES OF THE EXECUTIVE SEVERANCE POLICY. AN EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT SHALL CONTROL WHERE THE SEVERANCE PAY AMOUNTS IN THE POLICY CONFLICT WITH THE EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT. IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT OF CLAIMS. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. |
| PART I, LINE 4B: | DURING THE 2020 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. 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 2020 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 2020, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: JEFFREY DROP - $113,534; BENJAMIN A. KOPPELMAN - $14,462 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | PURSUANT TO SECTION 8.6 OF THE BYLAWS OF LAKEWOOD HEALTH CENTER, THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, THE BOARD VICE CHAIR, THE PRESIDENT AND CEO, EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE, AND TWO VOTING MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. EACH INDIVIDUAL APPOINTED TO THE EXECUTIVE COMMITTEE SHALL SERVE FOR A TERM OF ONE YEAR OR UNTIL HIS OR HER SUCCESSOR IS DULY APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. PURSUANT TO SECTION 8.1 OF THE CORPORATION'S BYLAWS, COMMITTEES, SUCH AS THE EXECUTIVE COMMITTEE, THAT ARE GRANTED THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MAY INCLUDE ONLY DIRECTORS OF THE CORPORATION. FURTHER, PURSUANT TO SECTION 8.6 OF THE CORPORATION'S BYLAWS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 6 | ACCORDING TO THE BYLAWS OF LAKEWOOD HEALTH CENTER, 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 5.4.2 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 THE LAKEWOOD HEALTH CENTER *AMENDMENT OF THE CORPORATE DOCUMENTS OF THE LAKEWOOD HEALTH CENTER *APPROVE MEMBERS OF THE LAKEWOOD HEALTH CENTER BOARD *REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE LAKEWOOD HEALTH CENTER *APPROVAL OF ISSUANCE OF DEBT BY LAKEWOOD HEALTH CENTER *APPROVAL OF PARTICIPATION OF LAKEWOOD HEALTH CENTER IN A JOINT VENTURE *APPROVAL OF FORMATION OF A NEW CORPORATION BY LAKEWOOD HEALTH CENTER *APPROVAL OF A MERGER INVOLVING THE LAKEWOOD HEALTH CENTER *APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE LAKEWOOD HEALTH CENTER *TO REQUIRE THE TRANSFER OF ASSETS BY THE LAKEWOOD HEALTH CENTER 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 LAKEWOOD HEALTH CENTER PURSUANT TO SECTION 5.5.2 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. (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 B, LINE 11B | ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE CHIEF FINANCIAL OFFICER. THE CFO WILL PROVIDE A COPY OF THE RETURN TO THE BOARD EITHER AT A BOARD MEETING OR BY EMAILING A COPY OF THE RETURN TO EACH BOARD MEMBER. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY 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. THE POLICY WAS LAST UPDATED DURING THE TAX YEAR ENDED 6/30/2021. 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 * 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 (WHICH INCLUDES 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). 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 15 | LINE 15A: COMMONSPIRIT HEALTH, CHI LAKEWOOD HEALTH USED GALLAGHER AS THE INDEPENDENT THIRD PARTY TO ASSESS EXECUTIVE COMPENSATION PROGRAMS AND TO ENSURE THE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. COMPENSATION OF THE SENIOR MOST EXECUTIVE WAS REVIEWED ANNUALLY. GALLAGHER REVIEWED BOTH CASH AND TOTAL COMPENSATION FOR OVERALL REASONABLENESS, FOR ADHERENCE TO COMMONSPIRIT HEALTH'S COMPENSATION PHILOSOPHY, AND FOR COMPARABILITY TO THE NOT-FOR-PROFIT HEALTHCARE MARKET. THIS INDEPENDENT REVIEW WAS DELIVERED BY GALLAGHER TO THE CHI LAKEWOOD HEALTH COMMITTEE OF THE BOARD OF STEWARDSHIP TRUSTEES AT THEIR NOVEMBER 2020 MEETING. LINE 15B: ALL EXECUTIVE COMPENSATION PAID TO OFFICERS AND KEY EMPLOYEES WAS SET BY THE BOARD UTILIZING AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THE BOARD OF DIRECTORS OVERSEES THE COMPENSATION SETTING PROCESS AND ENSURES REASONABLENESS AND COMPLIANCE WITH THE ORGANIZATION'S COMPENSATION PHILOSOPHY. |
| 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.COMMONSPIRIT.ORG. |
| FORM 990, PART VI, LINE 14- WRITTEN DOCUMENT RETENTION & DESTRUCTION POLICY | THE ORGANIZATION'S DOCUMENT RETENTION AND DESTRUCTION POLICY HAS NOT YET BEEN FORMALLY ADOPTED BY THE BOARD. HOWEVER, THE ORGANIZATION HAS A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY ADOPTED BY THE BOARD-APPOINTED FINANCE COMMITTEE. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,040,516. MANAGEMENT AND GENERAL EXPENSES 54,764. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,095,280. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 994,109. MANAGEMENT AND GENERAL EXPENSES 52,322. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,046,431. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 759,358. MANAGEMENT AND GENERAL EXPENSES 84,373. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 843,731. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 222,287. MANAGEMENT AND GENERAL EXPENSES 11,699. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 233,986. CONSULTING: PROGRAM SERVICE EXPENSES 34,223. MANAGEMENT AND GENERAL EXPENSES 1,801. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,024. |
| FORM 990, PART XI, LINE 9: | REALLOCATION OF CARES ACT REVENUE 3,263,522. |
| FORM 990, PART XI, LINE 8: | PRIOR PERIOD ADJUSTMENT: CENTRALIZED TRANSACTIONS: TRANSFERS FOR JOURNAL ENTRIES RECORDED CENTRALLY AT COMMONSPIRIT TO STANDARDIZE CONTRACTUAL ALLOWANCE METHODOLOGY ACROSS ALL COMMONSPIRIT AFFILIATES AND SUBSIDIARIES. RECORDED CENTRALLY AT YEAR END AND TRANSFERRED TO FACILITIES IN THE FOLLOWING YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (218 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 HOSP OF MO VALLEYIA | |||||||||||
| 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 | |||||||||||
| 1 WEST WAY CT | 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 | SJSC | 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 CIRCLE | 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 | |||||||||||
| 5942 RENAISSANCE PLACE STE A | TOLEDO | OH | 43623 | 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 | CHISVHS | 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 | CHISVHS | 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)(4) | 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 HPL SELF-INSURANCE TRUST | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 943006034 | SELF INSURANCE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH INSURANCE NEVADA LTD | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 813800752 | SELF INSURANCE | NV | 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 | |
| DIGNITY HEALTH WORKERS COMP SELF-INSURANCE TRUST | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 946612446 | SELF INSURANCE | CA | 501(C)(3) | LINE 12A, I | DH | 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 | |||||||||||
| 2801 VIA FORTUNA SUITE 500 | AUSTIN | TX | 78746 | 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 HEALTH VENTURES | |||||||||||
| TACOMA FNC CTR BLDG 1145 BROADWAY | TACOMA | WA | 98402 | 431882377 | INACTIVE | MO | 501(C)(3) | LINE 10 | CSH | 0 | |
| FRANCISCAN MEDICAL GROUP | |||||||||||
| 1313 BROADWAY STE 200 | TACOMA | WA | 98402 | 911939739 | PHYSICIANS | WA | 501(C)(3) | LINE 10 | FHS | 0 | |
| FRANCISCAN VILLA OF SOUTH MILWAUKEE INC | |||||||||||
| 3601 S CHICAGO AVE | SOUTH MILWAUKEE | WI | 53172 | 391093829 | INACTIVE | WI | 501(C)(3) | LINE 10 | CSH | 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 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 | |
| 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 | |
| HARRISON MEDICAL CENTER | |||||||||||
| 2520 CHERRY AVE | BREMERTON | WA | 98310 | 910565546 | HOSPITAL | WA | 501(C)(3) | LINE 3 | FHS | 0 | |
| HARRISON MEDICAL CENTER FOUNDATION | |||||||||||
| 2520 CHERRY AVE | BREMERTON | WA | 98310 | 911197626 | FUNDRAISING FOUNDATION | WA | 501(C)(3) | LINE 7 | HMC | 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 | |
| HIGHLINE MEDICAL CENTER | |||||||||||
| 16251 SYLVESTER RD SW | BURIEN | WA | 98166 | 910712166 | HOSPITAL | WA | 501(C)(3) | LINE 3 | FHS | 0 | |
| HOUSE OF MERCY | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 421323808 | ASSIST 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 REGIONAL HEALTHCARE FOUNDATION | |||||||||||
| 600 MAIN AVE S | BAUDETTE | MN | 56623 | 411893795 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 7 | LHC | Yes (1) | |
| 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 | SJSC | 0 | |
| MADONNA MANOR INC | |||||||||||
| 2344 AMSTERDAM ROAD | VILLA HILLS | KY | 51017 | 610654635 | ASSIST 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 | SLHS | 0 | |
| MEMORIAL MEDICAL CENTER - LIVINGSTON | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 760436439 | HOSPITAL | TX | 501(C)(3) | LINE 3 | MHSET | 0 | |
| MEMORIAL MEDICAL CENTER - SAN AUGUSTINE | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 752663904 | HOSPITAL | TX | 501(C)(3) | LINE 3 | MHSET | 0 | |
| MEMORIAL MULTISPECIALTY ASSOCIATES | |||||||||||
| 1201 FRANK AVE | LUFKIN | TX | 95904 | 752721155 | PHYSICIANS | TX | 501(C)(3) | LINE 12A, I | MHSET | 0 | |
| MEMORIAL SPECIALTY HOSPITAL | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 95902 | 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 | 0 | |
| 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 | |
| PUEBLO STEPUP | |||||||||||
| 1925 E ORMAN AVE STE G52 | PUEBLO | CO | 81004 | 841234295 | COMMUNITY | CO | 501(C)(3) | LINE 7 | CHIC | 0 | |
| SET OF COLORADO SPRINGS INC | |||||||||||
| 9100 E MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 841183335 | SENIOR CENTER SERVICES | CO | 501(C)(3) | LINE 7 | CHIC | 0 | |
| SAINT CLARE'S COMMUNITY CARE INC | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 222876836 | INACTIVE | NJ | 501(C)(3) | LINE 10 | 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 | HOSPITAL | 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 | SJSC | 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 - PMC | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 273733278 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 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 | SLHS | 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 | SLHS | 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 SYSTEM CORPORATION | |||||||||||
| 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 | SLHS | 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 | |||||||||||
| 1314 3RD AVE | 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 | ASSIST 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 | SLHS | 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 | ASSIST 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 ASSOC | |||||||||||
| 1003 WILLO CREEK ROAD | PRESCOTT | AZ | 86301 | 860098923 | HOSPITAL | AZ | 501(C)(3) | LINE 3 | DCC | 0 | |
| YAVAPAI REGIONAL MEDICAL CENTER FOUNDATION | |||||||||||
| 1003 WILLO 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 | Share Of Total IncomeShareOfTotalIncomeAmt | UBI Code VUBICodeVAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMERICAN MERCY HOME CARE LLC | ||||||||||||||||
| 1700 EDISON DR | MILFORD | 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 | ||||||||||||||||
| 6624 FANNIN ST STE 1100 | HOUSTON | TX | 77030 | 472079184 | HEALTHCARE SRVC | TX | N/A | N/A | 0 | 0 | ||||||
| BERGAN MERCY SURGERY CENTER LLC | ||||||||||||||||
| 7710 MERCY RD STE 200 | 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 REHAB SVCS LLC | ||||||||||||||||
| 3004 W FAIDLEY AVENUE | GRAND ISLAND | NE | 68803 | 810653461 | PHYSICAL THERAPY | NE | N/A | N/A | 0 | 0 | ||||||
| CENTURA-SCA HOLDINGS LLC | ||||||||||||||||
| 569 BROOK VILLAGE STE 901 | BIRMINGHAM | AL | 35209 | 474823023 | OP SURGERY CENTER | AL | N/A | N/A | 0 | 0 | ||||||
| CHI OPERATING INVESTMENT PROGRAM LP | ||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 470727942 | INVESTMENTS | CO | N/A | EXCLUDED | 0 | 0 | $232,347 | $1,580 | ||||
| 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 SERVICES OF SPRINGFIELD LLC | ||||||||||||||||
| 1700 EDISON DR | MILFORD | 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 MGMT LLC | ||||||||||||||||
| 5555 GLENRIDGE CONNECTOR STE 700 | ATLANTA | GA | 30342 | 352548698 | MANAGEMENT SERVICES | DE | N/A | N/A | 0 | 0 | ||||||
| DIGNITY HEALTH AT HOME LLC | ||||||||||||||||
| 1700 EDISON DR | MILFORD | 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 | ||||||||||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 813725123 | HEALTHCARE SRVC | WA | N/A | N/A | 0 | 0 | ||||||
| GOOD SAMARITAN HOME CARE SERVICES OF VINCENNE IN LLC | ||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 201792869 | HOME HEALTH | OH | N/A | N/A | 0 | 0 | ||||||
| HC SL VINTAGE I LLC | ||||||||||||||||
| 18000 W SARAH LANE STE 250 | BROOKFIELD | WI | 53045 | 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 | 67401 | 464265403 | ONCOLOGY | KS | N/A | N/A | 0 | 0 | ||||||
| LAKESIDE AMBULATORY SURGICAL CENTER LLC | ||||||||||||||||
| 17031 LAKESIDE HILLS DR | 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 | ||||||||||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 814437201 | HEALTHCARE SRVC | TX | N/A | N/A | 0 | 0 | ||||||
| MILITARY ROAD PROPERTIES LLC | ||||||||||||||||
| 181 S 333RD STREET STE 250 | FEDERAL WAY | WA | 98003 | 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 | ||||||
| PATIENT TRANSPORT SERVICES OF COLUMBUS INC | ||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 264601285 | AMBULANCE | OH | N/A | N/A | 0 | 0 | ||||||
| PENINSULA RADIATION ONCOLOGY CENTER LLC | ||||||||||||||||
| 314 MLK JR WAY STE 11 | TACOMA | WA | 98405 | 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 S STE 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 | ||||||||||||||||
| 1700 EDISON DR | MILFORD | 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 | ||||||||||||||||
| 1 SAINT JOSEPH DRIVE | LEXINGTON | KY | 40504 | 852155230 | SURGERY | KY | N/A | N/A | 0 | 0 | ||||||
| SAINT JOSEPH-ANC HOME CARE SERVICES | ||||||||||||||||
| 1700 EDISON DR | MILFORD | 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 | ||||||||||||||||
| 1700 EDISON DR | MILFORD | 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 | ||||||||||||||||
| 1700 EDISON DR | MILFORD | 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 | ||||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (62 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 | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SERVICES INC | ||||||||||||||
| 12809 WEST DODGE RD | OMAHA | NE | 68154 | 470802396 | MANAGED CARE | NE | N/A | C | 0 | |||||
| ALL SAINTS INSURANCE COMPANY SPC LTD | ||||||||||||||
| 980556913 | INSURANCE | N/A | C | 0 | PO BOX 10073 APO | GEORGETOWN | GRAND CAYMAN | CJ | CJ | |||||
| 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 | RESEARCH | 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 | |||||
| CLEARRIVER HEALTH | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 464495960 | INSURANCE | TN | 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 ISLANDS | GRAND CAYMAN | 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 SRVS 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 | |||||
| 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 | HEALTHCARE | 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 | |||||
| KOMG-LOUISVILLE REGION INC | ||||||||||||||
| 201 ABRAHAM FLEXNER WAY | LOUISVILLE | KY | 40202 | 832481198 | HEALTHCARE | KY | 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 | HEALTHCARE | 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 | |||||
| PATIENT TRANSPORT SERVICES INC | ||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311100798 | HOME HEALTH | OH | 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 | Yes (1) | 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 | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEWOOD REGIONAL HEALTHCARE FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | B | TransactionTypeTxt |
| Involved | $20,959 | InvolvedAmt |
| Method Of Amount Determination | ACTUAL | MethodOfAmountDeterminationTxt |