STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

ALEGENT HEALTH MERCY HOSPITAL: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
ALEGENT HEALTH MERCY HOSPITAL (EIN 42-0782518)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-13
IRS object ID
202211339349306826
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 ReturnHeader

FieldValueIRS element (for citing)
Return2022-05-13T14:19:12-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN470617373PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1COMMONSPIRIT HEALTHBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1198 INVERNESS DRIVE WESTAddressLine1Txt
CityENGLEWOODCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80112ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN420782518EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ALEGENT HEALTH-MERCY HOSPITAL CORNINGBusinessNameLine1Txt
Business Name Line2IABusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlALEGBusinessNameControlTxt
Phone4023434323PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1603 ROSARY DRIVEAddressLine1Txt
CityCORNINGCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50841ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJEANETTE WOJTALEWICZPersonNm
Person TitleCFOPersonTitleTxt
Phone4023434323PhoneNum
Signature2022-05-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJEANETTEPersonFirstNm
Person LastWOJTALEWICZPersonLastNm

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonHEATHER ADKINSPreparerPersonNm
PTINP01725376PTIN
Phone3032989100PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerEJ KUIPERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line112809 WEST DODGE ROADAddressLine1Txt
CityOMAHACityNm
State AbbreviationNEStateAbbreviationCd
ZIP68154ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$19,211,164GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CHIHEALTH.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1953FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionTHE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee158TotalEmployeeCnt
Total Volunteers35TotalVolunteersCnt
Total Gross UBI$2,747TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$952,583PYContributionsGrantsAmt
CY Contributions Grants$198,622CYContributionsGrantsAmt
PY Program Service Revenue$18,381,551PYProgramServiceRevenueAmt
CY Program Service Revenue$18,495,213CYProgramServiceRevenueAmt
PY Investment Income$207,040PYInvestmentIncomeAmt
CY Investment Income$364,185CYInvestmentIncomeAmt
PY Other Revenue$151,590PYOtherRevenueAmt
CY Other Revenue$144,917CYOtherRevenueAmt
PY Total Revenue$19,692,764PYTotalRevenueAmt
CY Total Revenue$19,202,937CYTotalRevenueAmt
PY Grants And Similar Paid$7,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$7,500CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,518,459PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,765,646CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$10,213,171PYOtherExpensesAmt
CY Other Expenses$10,618,546CYOtherExpensesAmt
PY Total Expenses$18,738,630PYTotalExpensesAmt
CY Total Expenses$19,391,692CYTotalExpensesAmt
PY Revenues Less Expenses$954,134PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$188,755CYRevenuesLessExpensesAmt
Total Assets BOY$35,243,438TotalAssetsBOYAmt
Total Assets EOY$33,702,092TotalAssetsEOYAmt
Total Liabilities BOY$12,692,306TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,065,521TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$22,551,132NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$25,636,571NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAS 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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,465,008ExpenseAmt
Grant$610GrantAmt
Revenue$1,505,061RevenueAmt
DescALEGENT HEALTH MERCY HOSPITAL, CORNING SUPPORTS THE MISSION BY CONTINUALLY MAKING SERVICES MORE CONVENIENT AND ACCESSIBLE WHILE MAINTAINING A LEVEL OF EFFICIENCY. THE HOSPITAL OFFERS THE FOLLOWING SERVICES TO OUR PATIENTS: 24-HOUR EMERGENCY CARE WITH HELIPORT ACCOMMODATIONS, DIAGNOSTIC IMAGING SERVICES, CARDIOVASCULAR SERVICES, CHEMOTHERAPY AND ELECTROENCEPHALOGRAMS (EEGS) PHYSICAL THERAPY.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,123,800ExpenseAmt
Grant$1,384GrantAmt
Revenue$3,412,735RevenueAmt
DescALEGENT HEALTH MERCY HOSPITAL, CORNING PROVIDES SEVERAL SPECIALTY CLINICS EACH WEEK THROUGH VISITING SPECIALISTS IN THE FOLLOWING AREAS: AUDIOLOGY, EAR, NOSE AND THROAT, CARDIOVASCULAR SERVICES, DERMATOLOGY, GASTROENTEROLOGY, GENERAL SURGERY/WOUND CARE, GYNECOLOGY/OBSTETRICS, ONCOLOGY, OPTHALMOLOGY, ORTHOPEDIC SURGERY, PODIATRY, UROLOGY, SPEECH AND OCCUPATIONAL THERAPY AND PSYCHIATRY.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$869,852ExpenseAmt
Grant$3,019GrantAmt
Revenue$7,443,261RevenueAmt
DescALEGENT HEALTH MERCY HOSPITAL, CORNING STRIVES TO IMPROVE THE HEALTH STATUS OF CHILDREN, TEENS, ADULTS, SENIOR CITIZENS, FRIENDS AND NEIGHBORS IN THIS RURAL COMMUNITY. THE HOSPITAL IS PROUD TO OFFER HEALTHCARE SERVICES CLOSE TO HOME WITHIN THE COMMUNITY. ALEGENT HEALTH MERCY HOSPITAL, CORNING PROVIDES A VARIETY OF DIAGNOSTIC SERVICES TO THE COMMUNITY, SUCH AS CT SCANS, MRI AND NUCLEAR MEDICINE IN ADDITION TO GENERAL RADIOLOGY, MAMMOGRAPHY, SURGICAL RADIOGRAPHY AND ULTRASOUND.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$15,031,275ExpenseAmt
Grant$2,487GrantAmt
Revenue$6,132,356RevenueAmt
DescOTHER PROGRAM SERVICESDesc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$15,031,275TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$2,487TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$6,132,356TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$18,489,935TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee158EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJEANETTE WOJTALEWICZPersonNm
Phone4023434323PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line112809 WEST DODGE ROADAddressLine1Txt
CityOMAHACityNm
State AbbreviationNEStateAbbreviationCd
ZIP68154ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
ANTHONY JONES
BOARD MEMBER1.0059.00Yes (X)$0$2,948,442$27,283
CLIFF ROBERTSON MD
BOARD MEMBER/CEO, CHI HEALTH5.0045.00Yes (X)$0$2,330,702$46,702Yes (X)
JOHN PETERSDORF
BOARD MEMBER1.0049.00Yes (X)$0$1,060,100$793,557
JEANETTE WOJTALEWICZ
BOARD MEMBER/CFO/INTERIM CEO, CHI HEALTH5.0045.00Yes (X)$0$986,312$50,266Yes (X)
CARY WARD MD
FORMER OFFICER5.0045.00$0$642,515$41,571Yes (X)
STEVE HOUSTON
FORMER KEY EMPLOYEE5.0045.00$0$433,805$41,724Yes (X)
JOHN SAFRANEK MD
PHYSICIAN60.000.00$313,053$0$47,280Yes (X)
BETHEL KOPP MD
PHYSICIAN60.000.00$315,869$0$28,299Yes (X)
HEATHER MORGAN MD
BOARD MEMBER1.0059.00Yes (X)$0$293,208$48,743
CAROLINE AMAO MD
PHYSICIAN60.000.00$264,508$0$35,276Yes (X)
DEBRA GOLDSMITH
PRESIDENT, REGIONAL HOSPITAL15.0035.00$0$234,088$48,985Yes (X)
NICK OTOOL
INTERIM CFO, CHI HEALTH5.0045.00$0$212,548$40,111Yes (X)
JASON KRUGER MD
BOARD MEMBER1.0059.00Yes (X)$0$143,420$41,585
AMY WETZEL
PHARMACY SUPERVISOR60.000.00$156,335$0$19,912Yes (X)
LISA WOLFE
FORMER PRESIDENT, MERCY HOSPITAL CORNING50.000.00$126,494$0$42,223Yes (X)
PAISLEE DALTON
NURSE PRACTITIONER60.000.00$140,778$0$24,933Yes (X)
KURT SARGENT
PRESIDENT, MERCY HOSPITAL CORNING50.000.00$0$137,152$22,022Yes (X)
JENNIFER BEATY MD
BOARD MEMBER1.0011.00Yes (X)$0$0$0
FR JAMES CLIFTON SJ
SECRETARY1.0011.00Yes (X)$0$0$0Yes (X)
RICHARD HERINK
BOARD MEMBER1.0011.00Yes (X)$0$0$0
SUSANNE L HRUZA MD
BOARD MEMBER1.0011.00Yes (X)$0$0$0
ROBERT LANIK
TREASURER1.0011.00Yes (X)$0$0$0Yes (X)
THOMAS MURRAY PHD
BOARD MEMBER1.0011.00Yes (X)$0$0$0
BARRY SANDSTROM
BOARD MEMBER1.0011.00Yes (X)$0$0$0
SISTER MAURITA SOUKUP
BOARD CHAIR1.0012.00Yes (X)$0$0$0Yes (X)
BILL YATES
BOARD MEMBER1.0011.00Yes (X)$0$0$0
NADINE HEIMANN OSF
BOARD MEMBER1.0011.00Yes (X)$0$0$0
MARDELL WILSON EDD
BOARD MEMBER1.0011.00Yes (X)$0$0$0
KENT BARNEY
BOARD MEMBER1.0011.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,317,037TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$9,422,292TotReportableCompRltdOrgAmt
Total Other Compensation$1,400,472TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K14IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
DOCS EMERGENCY MEDICINE INC
800 W FRONTIER LANEOLATHEKS66061STAFFING SERVICES$393,440
REHABVISIONS
11623 ARBOR STOMAHANE68144THERAPY SERVICES$390,047
PSYCHIATRIC MEDICAL CARE LLC
4322 HARDING PIKENASHVILLETN37205MEDICAL SERVICES$300,304
ACUTE CARE INC
1609 N ANKENY BLVD STE 200ANKENYIA50023STAFFING SERVICES$211,745
RINGGOLD COUNTY HOSPITAL
504 N CLEVELAND STMOUNT AYRIA50854PHYSICIAN SERVICES$183,228
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Related Organizations$36,333RelatedOrganizationsAmt
Government Grants$162,289GovernmentGrantsAmt
Total Contributions$198,622TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
NET PATIENT SERVICES900099$17,345,468$17,345,468$0$0
PHARMACY SERVICES446110$924,347$924,347$0$0
PATIENT SERVICES900099$139,522$139,522$0$0
EMERGENCY MEDICAL SERV621910$43,094$43,094$0$0
MEDICAL SERVICES621300$42,782$40,982$1,800$0
FieldValueIRS element (for citing)
Total Program Service Revenue$18,495,213TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$58,770TotalRevenueColumnAmt
Unrelated Business Revenue$947UnrelatedBusinessRevenueAmt
Exclusion$57,823ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$12,420RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,169RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$11,251RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,251TotalRevenueColumnAmt
Exclusion$11,251ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$302,615SecuritiesAmt
Other$2,800OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$302,615SecuritiesAmt
Other$2,800OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$305,415TotalRevenueColumnAmt
Exclusion$305,415ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$8,942GrossSalesOfInventoryAmt
Cost Of Goods Sold$7,058CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,884TotalRevenueColumnAmt
Exclusion$1,884ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
CAFETERIA722100$48,155$0$0$48,155
SERVICES SOLD900099$39,161$0$0$39,161
CARE MGMT-INTERCOMPANY900099$32,908$0$0$32,908

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,558TotalRevenueColumnAmt
Exclusion$11,558ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$131,782OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,202,937TotalRevenueColumnAmt
Related Or Exempt Func Income$18,493,413RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$2,747UnrelatedBusinessRevenueAmt
Exclusion$508,155ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$6,000TotalAmt
Program Services$6,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$1,500TotalAmt
Program Services$1,500ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$60,129TotalAmt
Program Services$60,129ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,820,978TotalAmt
Program Services$6,477,729ProgramServicesAmt
Management And General$343,249ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$330,775TotalAmt
Program Services$313,962ProgramServicesAmt
Management And General$16,813ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,072,889TotalAmt
Program Services$1,018,713ProgramServicesAmt
Management And General$54,176ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$480,875TotalAmt
Program Services$456,831ProgramServicesAmt
Management And General$24,044ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$3,097TotalAmt
Program Services$3,097ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,906,743TotalAmt
Program Services$4,661,406ProgramServicesAmt
Management And General$245,337ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$41,204TotalAmt
Program Services$39,143ProgramServicesAmt
Management And General$2,061ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$331,474TotalAmt
Program Services$316,011ProgramServicesAmt
Management And General$15,463ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$629,006TotalAmt
Program Services$597,556ProgramServicesAmt
Management And General$31,450ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$380,251TotalAmt
Program Services$361,238ProgramServicesAmt
Management And General$19,013ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$21,275TotalAmt
Program Services$20,211ProgramServicesAmt
Management And General$1,064ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$68TotalAmt
Program Services$68ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$453,908TotalAmt
Program Services$431,212ProgramServicesAmt
Management And General$22,696ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$743,976TotalAmt
Program Services$706,778ProgramServicesAmt
Management And General$37,198ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$71,210TotalAmt
Program Services$67,650ProgramServicesAmt
Management And General$3,560ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
INTRACOMPANY ALLOCATION$1,396,046$1,326,244$69,802$0
MEDICAL SUPPLIES$1,286,216$1,286,216$0$0
REPAIRS AND MAINTENANCE$296,979$284,224$12,755$0
UNRELATED BUSINESS TAXE$2,000$2,000$0$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$55,093TotalAmt
Program Services$52,017ProgramServicesAmt
Management And General$3,076ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$19,391,692TotalAmt
Program Services$18,489,935ProgramServicesAmt
Management And General$901,757ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$404BOYAmt
EOY$406EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$439,628BOYAmt
EOY$280,080EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,220,618BOYAmt
EOY$1,722,230EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$379,006BOYAmt
EOY$313,322EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,727,105LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$12,168,487LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,935,834BOYAmt
EOY$5,558,618EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$3,808,906BOYAmt
EOY$4,802,800EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$22,459,042BOYAmt
EOY$21,024,636EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$35,243,438BOYAmt
EOY$33,702,092EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,485,575BOYAmt
EOY$5,227,008EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$3,427,222BOYAmt
EOY$765,471EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,779,509BOYAmt
EOY$2,073,042EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,692,306BOYAmt
EOY$8,065,521EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$22,551,132BOYAmt
EOY$25,636,571EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$22,551,132BOYAmt
EOY$25,636,571EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$35,243,438BOYAmt
EOY$33,702,092EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$188,755ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$634,523NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments-$180,567PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$2,820,238OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$3,097GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$3,097TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $576 CATHOLIC HEALTH ASSOCIATION - $306 IOWA HOSPITAL ASSOCATION - $2,215ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$327,835BeginningYearBalanceAmt
Contributions$8,204ContributionsAmt
Other Expenditures$609OtherExpendituresAmt
End Year Balance$335,430EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$322,727BeginningYearBalanceAmt
Contributions$11,643ContributionsAmt
Other Expenditures$6,535OtherExpendituresAmt
End Year Balance$327,835EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$370,899BeginningYearBalanceAmt
Contributions$90,737ContributionsAmt
Other Expenditures$138,909OtherExpendituresAmt
End Year Balance$322,727EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$484,283BeginningYearBalanceAmt
Contributions$39,329ContributionsAmt
Other Expenditures$152,713OtherExpendituresAmt
End Year Balance$370,899EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$460,904BeginningYearBalanceAmt
Contributions$32,131ContributionsAmt
Other Expenditures$8,752OtherExpendituresAmt
End Year Balance$484,283EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$58,867OtherCostOrOtherBasisAmt
Book Value$58,867BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,272,809OtherCostOrOtherBasisAmt
Depreciation$4,942,920DepreciationAmt
Book Value$3,329,889BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,873,108OtherCostOrOtherBasisAmt
Depreciation$6,888,851DepreciationAmt
Book Value$1,984,257BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$522,321OtherCostOrOtherBasisAmt
Depreciation$336,716DepreciationAmt
Book Value$185,605BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,558,618TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescCSH OPERATING INVESTMENT POOLDesc
Book Value$4,802,800BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$4,802,800TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
INTERCOMPANY RECEIVABLES$18,951,260
RIGHT-OF-USE OPERATING LEASE$2,073,376
FieldValueIRS element (for citing)
Total Book Value Other Assets$21,024,636TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
OPERATING LEASE LIABILITY$2,072,892
ONPLAN SERVICE FEE LIABILITY$150
FieldValueIRS element (for citing)
Total Liability$2,073,042TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:ENDOWMENT FUNDS ARE INTENDED TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF MERCY HEALTH CARE FOUNDATION AND ALEGENT HEALTH MERCY HOSPITAL, CORNING, IA.
PART X, LINE 2:ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA'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

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served1452PersonsServedCnt
Total Community Benefit Expns$192,371TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$192,371NetCommunityBenefitExpnsAmt
Total Expense0.00990TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served3250PersonsServedCnt
Total Community Benefit Expns$1,879,921TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,558,535DirectOffsettingRevenueAmt
Net Community Benefit Expns$321,386NetCommunityBenefitExpnsAmt
Total Expense0.01660TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served4702PersonsServedCnt
Total Community Benefit Expns$2,072,292TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,558,535DirectOffsettingRevenueAmt
Net Community Benefit Expns$513,757NetCommunityBenefitExpnsAmt
Total Expense0.02650TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs12ActivitiesOrProgramsCnt
Persons Served430PersonsServedCnt
Total Community Benefit Expns$58,211TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$58,211NetCommunityBenefitExpnsAmt
Total Expense0.00300TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served22PersonsServedCnt
Total Community Benefit Expns$17,239TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,239NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$2,747,136TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,259,071DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,488,065NetCommunityBenefitExpnsAmt
Total Expense0.07670TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$916TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$916NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served88PersonsServedCnt
Total Community Benefit Expns$10,920TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,920NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs20ActivitiesOrProgramsCnt
Persons Served540PersonsServedCnt
Total Community Benefit Expns$2,834,422TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,259,071DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,575,351NetCommunityBenefitExpnsAmt
Total Expense0.08120TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs20ActivitiesOrProgramsCnt
Persons Served5242PersonsServedCnt
Total Community Benefit Expns$4,906,714TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,817,606DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,089,108NetCommunityBenefitExpnsAmt
Total Expense0.10770TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served310PersonsServedCnt
Total Community Benefit Expns$2,436TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,436NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served310PersonsServedCnt
Total Community Benefit Expns$2,436TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,436NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$549,412BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$8,158,514ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$8,835,727CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$677,213MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost Accounting SystemYes (X)CostAccountingSystemInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ALEGENT HEALTH MERCY HOSPITAL CORNINGBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1603 ROSARY DRIVEAddressLine1Txt
CityCORNINGCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50841ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.CHIHEALTH.COMWebsiteAddressTxt
State License02017011StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Facility Reporting GroupAFacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1FACILITY REPORTING GROUP - ABusinessNameLine1Txt
FieldValueIRS element (for citing)
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTPS://WWW.CHIHEALTH.COM/CHNAOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTPS://WWW.CHIHEALTH.COM/CHNAStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCEFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCEFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCEFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, SECTION BFACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:- FACILITY 1: ALEGENT HEALTH MERCY HOSPITAL, CORNING
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5:MERCY CORNING LEVERAGED BEHAVIORAL HEALTH COALITION OF ADAMS AND TAYLOR COUNTY IN ORDER TO CONVENE THE MOST RELEVANT STAKEHOLDERS FROM ACROSS SECTORS, AS WELL AS PUBLIC HEALTH. THE FOLLOWING AGENCIES WERE REPRESENTED AT THE NOVEMBER 1, 2018 MEETING WHERE A COMPREHENSIVE REVIEW OF SECONDARY DATA WAS CONDUCTED, ALONG WITH A DISCUSSION AND PRIORITIZATION OF TOP HEALTH NEEDS. THE FOLLOWING STAKEHOLDERS PROVIDE IMPORTANT PERSPECTIVES RELATED TO THE AGING, LOW-INCOME, UNINSURED, AT-RISK AND VULNERABLE POPULATIONS, AS WELL AS THOSE AFFECTED BY VIOLENCE.CHNA PARTICIPATION THROUGH BEHAVIORAL HEALTH COALITION OF ADAMS AND TAYLOR COUNTY (BHCATC) MEETING ON NOVEMBER 1, 2018:-BHCATC COALITION LEADER, DEB SCHRADER -TAYLOR COUNTY PUBLIC HEALTH -IOWA DEPARTMENT OF PUBLIC HEALTH (IDPH) -TOBACCO PREVENTION & PAGE COUNTY PUBLIC HEALTH -1ST FIVE -QUAD COUNTIES EARLY CHILDHOOD IOWA (SERVING ADAMS, TAYLOR, UNION, AND RINGGOLD COUNTIES) -IMAGINE THE POSSIBILITIES -IOWA STATE UNIVERSITY EXTENSION -MATURA (DESIGNATED COMMUNITY ACTION AGENCY FOR ADAMS, TAYLOR, AND FOUR SURROUNDING COUNTIES) -CRISIS INTERVENTION & ADVOCACY -ADAMS COUNTY EMERGENCY MANAGEMENT -SOUTHWEST VALLEY SCHOOLS (CORNING, IA) -CROSSROADS MENTAL HEALTH -NEBRASKA AIDS PROJECT -CORNING FIRE DEPARTMENT -CHI HEALTH MERCY CORNING HOSPITAL
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B:TAYLOR COUNTY PUBLIC HEALTH (SERVES ADAMS AND TAYLOR COUNTY)
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11:THE MOST RECENT CHNA AND CORRESPONDING IMPLEMENTATION PLAN WAS COMPLETED IN THE TAX REPORTING YEAR 2019. THE FOLLOWING OUTLINES THE CURRENT IMPLEMENTATION PLAN PRIORITIES AND STRATEGIES. THIS PLAN WAS POSTED PUBLICLY ON WWW.CHIHEALTH.COM/CHNA.THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS BY REVIEWING SECONDARY DATA ON A RANGE OF COMMUNITY HEALTH INDICATORS. KEY INFORMANTS REPRESENTING THE FOLLOWING STAKEHOLDER GROUPS: HEALTHCARE, PUBLIC HEALTH, AGING, LOW-INCOME, UNINSURED, AT-RISK AND VULNERABLE POPULATIONS, AS WELL AS THOSE AFFECTED BY VIOLENCE, VALIDATED THE DATA AND PRIORITIZED THE FOLLOWING TOP HEALTH NEEDS.TOP HEALTH NEEDS (FROM 2018 CHNA):1. ACCESS TO CARE2. BEHAVIORAL HEALTH3. CANCER4. CHRONIC DISEASE5. MATERNAL AND CHILD HEALTH6. SEXUALLY TRANSMITTED INFECTIONS7. SOCIAL DETERMINANTS OF HEALTH8. VIOLENCE AND INJURYIN ACKNOWLEDGING THE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS, CHI HEALTH MERCY CORNING PRIORITIZED SOCIAL DETERMINANTS OF HEALTH IN ORDER TO MOST EFFECTIVELY FOCUS RESOURCES AND MEANINGFULLY IMPACT THE SELECTED HEALTH ISSUES. THE HOSPITAL TOOK INTO CONSIDERATION EXISTING PARTNERSHIPS, AVAILABLE RESOURCES, THE HOSPITAL'S LEVEL OF EXPERTISE, EXISTING INITIATIVES (OR LACK THEREOF), POTENTIAL FOR IMPACT, AND THE COMMUNITY'S INTEREST IN THE HOSPITAL ENGAGING IN THAT AREA IN ORDER TO SELECT THE PRIORITIES. HAVING BASIC AND SOCIAL NEEDS IS A CRITICAL COMPONENT OF A PERSON'S HEALTH AND UNMET SOCIAL DETERMINANTS ARE OFTEN KEY DRIVERS OF OTHER HEALTH NEEDS. THEREFORE, THE HOSPITAL SEEKS TO INDIRECTLY ADDRESS THE FOLLOWING HEALTH NEEDS BY ADDRESSING SOCIAL NEEDS AS A ROOT CAUSES OF POOR HEALTH OUTCOMES.FOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEED:PRIORITY HEALTH NEED #1: SOCIAL DETERMINANTS OF HEALTHTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN 2019-2021:*PROVIDE LEADERSHIP TO THE BHCATC AND COLLABORATE WITH KEY PARTNERS TO: -IDENTIFY DRIVERS OF BEHAVIORAL HEALTH AND SUBSTANCE USE ISSUES, SUCH AS POVERTY, SOCIAL DISCONNECTEDNESS, AND TRANSPORTATION, (COLLECTIVELY REFERRED TO AS SOCIAL DETERMINANTS OF HEALTH) AND WORK TO IDENTIFY STRATEGIES TO ADDRESS THESE DRIVERS IN PARTNERSHIP WITH COALITION PARTICIPANTS -SUPPORT EVIDENCE-BASED PROGRAMS AND TRAININGS (SUCH AS TRAUMA-INFORMED CARE, CAPTURING KIDS HEARTS) FOR HEALTH AND HUMAN SERVICES PROVIDERS TO ADDRESS CRISIS AND SUPPORT PARENTS AND FAMILIES DEVELOP STRONG POSITIVE CONNECTIONS FOR RESILIENCE AND LONG-TERM HEALTH -EXPLORE THE OPPORTUNITY TO EXPAND HOME VISITING AND GROUP PARENT EDUCATION SERVICES AND DEVELOP AN ACTION PLAN WITH RELEVANT ACTIONS AND MEASURES OF SUCCESS. -SUPPORT TRAINING AND PROGRAMMING RELATED TO TRAUMA-INFORMED CARE AND OTHER EVIDENCE-BASED PROGRAMMING TO ADDRESS SOCIAL AND EMOTIONAL WELLNESS FOR IMPROVED RESILIENCE AND CAPACITY TO SELF-SUSTAIN, AND DEVELOP AN ACTION PLAN WITH RELEVANT ACTIONS AND MEASURES OF SUCCESS*ADDRESS FOOD INSECURITY THROUGH THE FOLLOWING ACTIVITIES: -PROVIDE SUPPORT TO THE CORNING FEED THE PACK PROGRAM A BACK PACK FOOD PROGRAM FOR CHILDREN ELIGIBLE TO RECEIVE OUT OF SCHOOL MEALS (BREAKFAST AND LUNCH) FOR HOLIDAY AND SCHOOL BREAK DAYS AND IDENTIFY OPPORTUNITIES TO IMPROVE FAMILY CAPACITY FOR PLANNING AND PREPARING HEALTHY FOOD FOR CHILDREN -IDENTIFY ROOT CAUSES OF FOOD INSECURITY IN THE COMMUNITY (ESPECIALLY AMONG CHILDREN) AND DETERMINE STRATEGIES TO ADDRESS AND MEASURES FOR SUCCESSTHE HOSPITAL WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS FOR THE FOLLOWING REASONS: ACCESS: IN ADDITION TO THE RATIONALE STATED ABOVE, THE HOSPITAL STAFFS AMBULANCE SERVICES TO COVER BOTH ADAMS AND TAYLOR COUNTY THROUGH AN EXISTING AGREEMENT WITH BOTH COUNTIES' BOARDS OF HEALTH.BEHAVIORAL HEALTH: THE PRIMARY WORK OF THE STRATEGY ABOVE, WRITTEN TO ADDRESS SOCIAL DETERMINANTS OF HEALTH, WILL BE HAPPENING THROUGH ON-GOING SUPPORT OF THE BEHAVIORAL HEALTH COALITION OF ADAMS AND TAYLOR COUNTIES (BHCATC). THE BHCATC'S IS FOCUSED ON IMPROVING BEHAVIORAL HEALTH THROUGH A COMBINATION OF ADDRESSING IMMEDIATE BEHAVIORAL HEALTH NEEDS, WHILE ALSO IDENTIFYING AND ADDRESSING SOCIAL DETERMINANTS OF HEALTH.CANCER: CHI HEALTH WILL CONTINUE TO PERFORM EXISTING CANCER OUTREACH THROUGHOUT THE COMMUNITY AND FINANCIALLY SUPPORT COMMUNITY PARTNERS SUCH AS THE AMERICAN CANCER SOCIETY, THE NEBRASKA CANCER COALITION AND PROJECT PINK'D. ADDITIONALLY, CHI HEALTH CLINICS ARE WORKING TO INCREASE UTILIZATION OF HPV VACCINATION TO PREVENT CERVICAL CANCER.CHRONIC DISEASE: IN ADDITION TO THE RATIONALE STATED ABOVE, THE HOSPITAL HAS EXISTING PROGRAMMING AROUND EDUCATING AND SUPPORTING THOSE DIAGNOSED WITH PRE-DIABETES, PROVIDING HEART HEALTHY COOKING CLASSES, AND OPERATING THE COMMUNITY'S ONLY WELLNESS CENTER TO PROVIDE A STATE OF THE ART GYM AND RECREATIONAL FACILITY FOR COMMUNITY MEMBERS.MATERNAL & CHILD HEALTH: IN ADDITION TO THE RATIONAL STATED ABOVE, THE HOSPITAL'S WORK TO ADDRESS BEHAVIORAL HEALTH IS AT LEAST IN PART FOCUSED ON HOME VISITING PROGRAMS THAT SUPPORT FAMILIES DURING THE BIRTH TO FIVE YEARS TO ADDRESS PARENTING CHALLENGES FOR THOSE PARENTS AT RISK FOR SUBSTANCE ABUSE AND/OR OTHER POOR HEALTH OUTCOMES.SEXUALLY TRANSMITTED INFECTIONS: THIS NOT AN AREA THAT CHI HEALTH PRIORITIZED. HOWEVER, AS MENTIONED IN THE CANCER SECTION ABOVE, CHI HEALTH CLINICS ARE FOCUSING ON HPV VACCINATION FOR THE PREVENTION OF CERVICAL CANCER.VIOLENCE & INJURY: IMPORTANTLY, CHI HEALTH IS WORKING AT THE SYSTEM LEVEL TO ENSURE SEXUAL ASSAULT NURSE EXAMINERS (SANE) ARE AVAILABLE 24/7 AT TERTIARY HOSPITALS IN OMAHA, LINCOLN, KEARNEY, AND GRAND ISLAND, AS WELL AS TELE-HEALTH AVAILABILITY TO CRITICAL ACCESS HOSPITALS LIKE MERCY CORNING, AND TO IMPROVE TRAUMA- INFORMED CARE AMONG EMERGENCY CARE, WOMEN'S HEALTH, CASE MANAGERS, AND CLINIC PROVIDERS, WHILE ALSO SEEKING SYSTEM-LEVEL STRATEGIES TO ADDRESS HUMAN TRAFFICKING.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13H: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.
FieldValueIRS element (for citing)
Facility4FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - MERCY HOSPITAL SKILLED NURSING FACILITY
603 ROSARY DRIVECORNINGIA50841SKILLED NURSING FACILITY
2 - CHI HEALTH CORNING RURAL HEALTH CLINIC
601 ROSARY DRIVECORNINGIA50841RURAL HEALTH CLINIC
3 - CHI HEALTH LENOX RURAL HEALTH CLINIC
810 1/2 E VAN BUREN STLENOXIA50851RURAL HEALTH CLINIC
4 - CHI HEALTH BEDFORD RURAL HEALTH CLINIC
618 COURT AVEBEDFORDIA50833RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 6A:YES, THE CHI HEALTH SYSTEM PRODUCES AN ANNUAL PUBLIC COMMUNITY BENEFIT REPORT THAT IS MAILED TO A CORE CONSTITUENCY, PLACED IN KEY PLACES THROUGHOUT THE ORGANIZATION AND DISTRIBUTED IN COMMUNITY MEETINGS. IT IS ALSO AVAILABLE ON THE COMPANY'S INTRANET SITE, AND ON ITS PUBLIC WEBSITE AT HTTP://WWW.CHIHEALTH.COM/COMMUNITY-BENEFIT.
PART I, LINE 7:A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING WORKSHEET 2 TO COMPUTE THE COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS.
PART I, LINE 7G:INCLUDED IN SUBSIDIZED HEALTH SERVICES ARE THE FOLLOWING PHYSICIAN CLINICS:-CHI HEALTH CORNING RURAL HEALTH CLINIC-CHI HEALTH BEDFORD RURAL HEALTH CLINIC-CHI HEALTH LENOX RURAL HEALTH CLINICTHE TOTAL EXPENSES ASSOCIATED WITH OPERATING THESE CLINICS WERE $2,747,136. REVENUE OFFSETS WERE $1,259,071. ACCORDINGLY, THE TOTAL SUBSIDIZED COST OF THESE NECESSARY SERVICES WAS $1,488,065. THE CLINICS MEET A COMMUNITY NEED FOR PRIMARY CARE SERVICES OUTSIDE OF THE EMERGENCY ROOM SETTING.
PART II, COMMUNITY BUILDING ACTIVITIES:ALEGENT HEALTH-MERCY HOSPITAL, CORNING HAS A HISTORY OF CENTRALIZED COMMUNITY BENEFIT INVESTMENTS, AS WELL AS HOSPITAL SPECIFIC INVESTMENTS THAT ADDRESS COMMUNITY HEALTH NEEDS WHICH INCLUDE SUPPORT OF LOCAL HEALTH COALITIONS, INVESTMENTS IN PARTNERSHIPS AND PROGRAMS THAT ADDRESS TOP COMMUNITY HEALTH NEEDS, PARTICIPATION IN LOCAL COMMITTEES AND BOARDS TIED TO TOP HEALTH NEEDS, AND INVESTMENTS IN MANY OTHER WAYS AS DESCRIBED IN OTHER AREAS OF THE SCHEDULE H NARRATIVE. BELOW ARE SPECIFIC EXAMPLES OF WORK THAT FALLS WITHIN THE DEFINITION OF COMMUNITY BUILDING ACTIVITIES. THESE ACTIVITIES ARE CRITICAL IN HELPING BUILD SOCIAL, HEALTH, AND ECONOMIC OPPORTUNITIES IN OUR COMMUNITY THAT ULTIMATELY DRIVE HEALTH STATUS AND QUALITY OF LIFE FOR OUR RESIDENTS: - WORKFORCE DEVELOPMENT-THE FOLLOWING ACTIVITIES WORK TO STRENGTHEN THE COMMUNITY'S CAPACITY TO PROMOTE THE HEALTH AND WELL-BEING OF OUR RESIDENTS BY DRIVING ENTRY INTO HEALTHCARE CAREERS: * PRESENTATIONS TO HIGH SCHOOL STUDENTS ABOUT HEALTHCARE CAREERS * STAFF TIME SPENT WITH HIGH SCHOOL SHADOW STUDENTS- COMMUNITY AND ECONOMIC DEVELOPMENT INCLUDING SUPPORT OF LOCAL CHAMBERS OF COMMERCE - PARTICIPATION IN MEALS ON WHEELS PROVIDING DELIVERY OF MEALS TO INDIVIDUALS THAT ARE UNABLE TO PURCHASE AND/OR PREPARE THEIR OWN
PART III, LINE 2:COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 62.37%. 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:ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA 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:ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA 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 CHANGES 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. ALEGENT HEALTH-MERCY HOSPITAL, CORNING IA'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $677,213 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:TO CONDUCT THE CURRENT CHNA, MERCY CORNING'S COMMUNITY BENEFIT ACTION TEAM (CBAT) ENGAGED WITH THE COLLECTIVE IMPACT COALITION, BEHAVIORAL HEALTH COALITION OF ADAMS AND TAYLOR COUNTY (BHCATC), AND TAYLOR COUNTY PUBLIC HEALTH (TCPH) WHICH SERVES BOTH ADAMS AND TAYLOR COUNTIES, ON NOVEMBER 1, 2018. THE BHCATC IS A ROBUST AND ACTIVE COALITION WITH MULTIPLE COMMUNITY STAKEHOLDERS FROM KEY COMMUNITY SERVICES AND AGENCIES THAT SERVE BEHAVIORAL HEALTH NEEDS AS WELL AS OTHER NEEDS ACROSS THE TWO COUNTIES. AT THE NOVEMBER MEETING, MERCY CORNING PRESENTED SECONDARY DATA, AND LED A CONVERSATION TO GAIN INPUT FROM THE GROUP AND PRIORITIZE TOP HEALTH NEEDS.DATA REVIEWED WITH BHATC WAS GATHERED FROM A VARIETY OF SOURCES INCLUDING:-CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) WONDER QUERY SYSTEM-CARES ENGAGEMENT NETWORK AND COMMUNITY COMMONS-COUNTY HEALTH RANKINGS-HEALTHYPEOPLE.GOV U.S. DEPT. OF HEALTH & HUMAN SERVICES - OFFICE OF DISEASE PREVENTION AND HEALTH PROMOTION (BENCHMARKING)-IOWA AGING-IOWA CANCER REGISTRY-KIDS COUNT- IOWA REPORT BY COUNTYUPON COMPLETION OF THE DATA PRESENTATION, THE GROUP HELD A ROBUST DISCUSSION OF THE KEY FINDINGS AND BHCATC MEMBERS WERE ASKED TO CONSIDER THE FACTORS AFFECTING HEALTH (BEHAVIORAL, SOCIOECONOMIC, ENVIRONMENTAL, MEDICAL CARE, AND GENETICS) AND WHICH NEEDS WERE MOST PRESSING IN THE COMMUNITY. AFTER CAPTURING THE GROUP'S DISCUSSION, 19 PARTICIPANTS WERE ASKED TO VOTE FOR THE HEALTH NEED THEY BELIEVED TO BE THE MOST IMPORTANT TO ADDRESS IN ORDER FOR THE COMMUNITY TO REALIZE POSITIVE HEALTH OUTCOMES.FOLLOWING THE NOVEMBER MEETING, THE MERCY CORNING CBAT MET TO VALIDATE THE TOP IDENTIFIED NEEDS, AND BEGIN TO DISCUSS THE STRATEGIC PLANNING PROCESS FOR THE NEXT THREE-YEAR IMPLEMENTATION STRATEGY PLAN (ISP), WHICH WAS RELEASED IN THE FALL OF 2019.
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 HEALTH MERCY CORNING IDENTIFIED ADAMS AND TAYLOR COUNTIES AS THEIR COMMUNITY FOR THE PURPOSE OF THE CHNA. AS A CRITICAL ACCESS HOSPITAL, MERCY CORNING'S PRIMARY SERVICE AREA IS CONSIDERED THE COUNTY IN WHICH THEY ARE LOCATED (ADAMS COUNTY). WHILE MERCY CORNING IS THE ONLY HOSPITAL LOCATED IN ADAMS COUNTY, THEY ALSO SERVE RESIDENTS FROM TAYLOR COUNTY WHERE THERE ARE NO LOCAL HOSPITALS. THEREFORE, BOTH COUNTIES WERE INCLUDED IN THE COMMUNITY DEFINITION.MERCY CORNING IS LOCATED IN CORNING, IOWA WHICH IS SITUATED NEAR THE CENTER OF ADAMS COUNTY, APPROXIMATELY 80 MILES FROM THE METROPOLITAN AREA OF OMAHA, NEBRASKA AND COUNCIL BLUFFS, IOWA AND 95 MILES FROM THE METROPOLITAN AREA OF DES MOINES, IOWA. ADAMS COUNTY IS IMMEDIATELY NORTH OF AND ADJACENT TO TAYLOR COUNTY, WHICH IS AT THE SOUTHERNMOST BORDER OF IOWA TO MISSOURI. BOTH ADAMS AND TAYLOR COUNTIES, AS WELL AS THE SURROUNDING COUNTIES ARE NON-METROPOLITAN AND LOCATED NEAR THE WESTERN BORDER OF IOWA. ADAMS COUNTY HAS ONE SCHOOL DISTRICT AND 4 INCORPORATED TOWNS: CARBON, CORNING, NODAWAY AND PRESCOTT. CORNING IS THE COUNTY SEAT AND THERE ARE ALSO 10 OTHER TOWNSHIPS. BEDFORD IS THE COUNTY SEAT, AND TAYLOR COUNTY HAS 3 PUBLIC SCHOOL DISTRICTS AND EIGHT INCORPORATED CITIES AND SEVENTEEN TOWNSHIPS.POPULATION DATA SHOWS A PRIMARILY NON-HISPANIC WHITE POPULATION, AND A MUCH HIGHER PERCENTAGE OF RESIDENTS OVER 65 YEARS OF AGE IN ADAMS (22.8%) AND TAYLOR (22.4%) COMPARED TO THE STATE OF IOWA (16.7%). ADAMS COUNTY COVERS APPROXIMATELY 423 SQUARE MILES AND TAYLOR COUNTY COVERS 531 SQUARE MILES. BOTH COUNTIES HAVE A VERY LOW POPULATION DENSITY COMPARED TO THE STATE OVERALL, WHICH HIGHLIGHTS THE RURAL NATURE OF THE AREA.POPULATION DEMOGRAPHICS:ADAMS COUNTY:-3,645 TOTAL POPULATION-9.5 POPULATION DENSITY (POPULATION PER SQUARE MILE) -21.2% OF POPULATION IS UNDER THE AGE OF 18-22.8% OF POPULATION IS OVER AGE 65-50.1% OF POPULATION IS FEMALE-0.3% OF POPULATION IS NON-HISPANIC AFRICAN AMERICAN-0.5% OF POPULATION IS AMERICAN INDIAN & ALASKAN NATIVE-0.7% OF POPULATION IS ASIAN-0.0% OF POPULATION IS NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER-1.3% OF POPULATION IS HISPANIC-96.6% OF POPULATION IS NON-HISPANIC WHITE-$49,745 MEDIAN HOUSEHOLD INCOME-2.4 UNEMPLOYMENT RATE-12.3% OF PERSONS LIVING IN POVERTY (125% OF FEDERAL POVERTY LEVEL)-19% OF CHILDREN LIVING IN POVERTY-93.8% HIGH SCHOOL GRADUATION RATE-17.3% OF INDIVIDUALS 25 YEARS OR OLDER HAVE A BACHELOR'S DEGREE OR HIGHER-6.2% ARE UNINSUREDTAYLOR COUNTY:-6,191 TOTAL POPULATION-11.9 POPULATION DENSITY (POPULATION PER SQUARE MILE) -23.2% OF POPULATION IS UNDER THE AGE OF 18-22.4% OF POPULATION IS OVER AGE 65-49.6% OF POPULATION IS FEMALE-0.7% OF POPULATION IS NON-HISPANIC AFRICAN AMERICAN-0.3% OF POPULATION IS AMERICAN INDIAN & ALASKAN NATIVE-0.5% OF POPULATION IS ASIAN-0.0% OF POPULATION IS NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER-8.0% OF POPULATION IS HISPANIC-90.0% OF POPULATION IS NON-HISPANIC WHITE-$46,825 MEDIAN HOUSEHOLD INCOME-2.3 UNEMPLOYMENT RATE-12.3% OF PERSONS LIVING IN POVERTY (125% OF FEDERAL POVERTY LEVEL)-19% OF CHILDREN LIVING IN POVERTY-93.8% HIGH SCHOOL GRADUATION RATE-17.3% OF INDIVIDUALS 25 YEARS OR OLDER HAVE A BACHELOR'S DEGREE OR HIGHER-6.2% ARE UNINSURED
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.CHI HEALTH HAS A HISTORY OF CENTRALIZED COMMUNITY BENEFIT AND HOSPITAL SPECIFIC COMMUNITY BENEFIT INVESTMENTS TO ADDRESS COMMUNITY HEALTH NEEDS OF THE PARTICULAR SERVICE AREA. EXAMPLES OF HOW CHI HEALTH FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY INCLUDE:FINANCIAL ASSISTANCE AND UNPAID COSTS OF MEDICAIDCOMMUNITY HEALTH IMPROVEMENT SERVICES- - COMMUNITY EDUCATION, CLASSES AND PROGRAMS (CPR/FIRST AID, COMMUNITY BEHAVIORAL HEALTH SUPPORT AND EDUCATION, DIABETES, CANCER, PHYSICAL ACTIVITY AND HEALTHY EATING AND COOKING) - SUPPORT GROUPS (CANCER, BEREAVEMENT, YOUTH, ETC.) - COMMUNITY HEALTH EDUCATION/PROMOTION AND SCREENINGS- SCHOOL BASED HEALTHCARE SERVICES- MENTAL HEALTH HOTLINE-STAFF AND OPERATE 717-HOPE MENTAL HEALTH HOTLINE FOR ANYONE IN THE COMMUNITY TO ACCESS. THIS PROGRAM AVERAGES OVER 5,000 PHONE CALLS PER MONTH FROM COMMUNITY MEMBERS IN NEED.- PARISH NURSING PROGRAM AND FAITH COMMUNITY HEALTH NETWORK-THE CHI HEALTH FAITH COMMUNITY HEALTH NETWORK PARTNERS WITH CONGREGATIONS OF ALL FAITHS TO BUILD CAPACITY AND SUPPORT THE GROWTH OF HEALTH MINISTRIES WHICH PROMOTE HEALTH, HEALING AND WHOLENESS IN THE COMMUNITIES SERVED.- 5-4-3-2-1GO!- HEALTHY LIFESTYLE CAMPAIGN FOR KIDS; OPERATED IN SCHOOLS, OUT OF SCHOOL SETTINGS, CLINICS, COMMUNITY SETTINGS IN DOUGLAS, SARPY, CASS, AND COLFAX COUNTIES IN NE. INITIAL WORK COMPLETED BY CHI HEALTH IN FY19 AND FOLLOWING CONTRACTOR DEPARTURE, WORK WAS TRANSITIONED THROUGH A GRANT TO LIVE WELL OMAHA FOR THE BROADER OMAHA COMMUNITY STRATEGY IN DOUGLAS COUNTY AS PART OF A 2-YEAR GRANT. - COUNSELING AND ASSISTANCE IN ENROLLING INDIVIDUALS IN MEANS TESTED INSURANCE PROGRAMS TO IMPROVE ACCESS TO CARE.- SUPPORT TO HEALTH COALITIONS AND INVESTMENTS IN SOCIAL AND ENVIRONMENTAL IMPROVEMENT STRATEGIES. THESE ARE PROGRAMS, ACTIVITIES AND PARTNERSHIPS THAT IMPROVE THE HEALTH OF PERSONS IN THE COMMUNITY BY ADDRESSING THE DETERMINANTS OF HEALTH, WHICH INCLUDES THE SOCIAL, ECONOMIC AND PHYSICAL ENVIRONMENT. SEE SPECIFIC EXAMPLES BY COMMUNITY BELOW:REGIONAL- NEBRASKA APPLESEED TYPICALLY PROVIDES FUNDS TO SUPPORT HUNGER/FOOD ACCESS EFFORTS; THIS INCLUDES SUMMER MEALS PROGRAM OUTREACH, ENRICHMENT PROGRAMMING AT SUMMER MEALS SITES AND SUPPORT TO LAUNCH STATE'S FIRST SNAP EMPLOYMENT & TRAINING (E&T) THIRD PARTY PARTNERSHIP, WHICH PROVIDES JOB TRAINING FOR SNAP RECIPIENTS. IN THIS RECENT YEAR NEBRASKA APPLESEED PROVIDED SNAP OUTREACH TO NEWLY ELIGIBLE INDIVIDUALS THAT WERE EXPERIENCING ECONOMIC HARDSHIP DUE TO COVID19.- FOOD BANK FOR THE HEARTLAND DONATED FUNDS TO HELP SUPPORT THE INCREASED NEED FOR EMERGENCY FOOD BROUGHT ON BY THE PANDEMIC- NEBRASKA EXTENSION-PROVIDED FUNDS TO SUPPORT DOUBLE UP FOOD BUCKS IN OMAHA AND LINCOLN; PROGRAM FOR SNAP RECIPIENTS TO RECEIVE AN ADDITIONAL $1 FOR EVERY $1 THEY SPEND (UP TO $20/DAY) ON FRUITS AND VEGETABLES AT PARTICIPATING SITES; NUTRITION/COOKING EDUCATION IS ALSO PROVIDED AT ALL SITES.CORNING- WELLNESS ACTIVITIES-GROUP EXERCISE CLASSES PROVIDED TO THE COMMUNITY IN CONJUNCTION WITH WELLNESS RELATED NEWSPAPER ARTICLES.- ADAMS/TAYLOR COUNTY FOOD PANTRY DONATED FUNDS TO PROVIDE FRESH FRUITS AND VEGETABLES FOR LOW INCOME FAMILIES IN NEED.HEALTH PROFESSIONAL EDUCATION-- ADMINISTRATION AND STUDENT ONBOARDING COSTS FOR NURSING PRECEPTORSHIPS AND CLINICALS- STAFF TIME FACILITATING THE SMALL-GROUP ETHICS CASE DISCUSSIONS WITH MEDICAL STUDENTS- CLINICAL PASTORAL EDUCATION- ACADEMIC AFFILIATION WITH CREIGHTON UNIVERSITY AND ITS HEALTH PROFESSIONS PROGRAMS, INCLUDING THE SCHOOL OF MEDICINE, COLLEGE OF ARTS & SCIENCES, SCHOOL OF DENTISTRY, SCHOOL OF PHARMACY AND HEALTH PROFESSIONS, COLLEGE OF NURSING.- PHYSICIAN RESIDENCY AND FELLOWSHIP PROGRAMS TRAIN MORE THAN 170 RESIDENTS AND FELLOWS ANNUALLY SUBSIDIZED HEALTH SERVICES - HEALTHCARE SERVICES INCLUDING EMERGENCY CARE AND CLINICAL CARE IN THE RURAL HEALTH SETTINGRESEARCH- - UNFUNDED STAFF SUPPORT OF THE NATIONAL CANCER INSTITUTE COMMUNITY ONCOLOGY RESEARCH PROGRAM (NCORP)- TRAUMA INFORMED CARE-THIS WAS AN IDENTIFIED NEED ON THE COMMUNITY HEALTH IMPROVEMENT PLAN. CHI HEALTH IS PARTNERING TO IMPLEMENT STAFF TRAINING FOR AWARENESS OF TRAUMA AND ITS IMPACT AND COMPLETING A RESEARCH STUDY ON THE EFFECTIVENESS OF THE TRAINING TO HELP BUILD PUBLIC TRAINING AND EDUCATION RESOURCES. FINANCIAL AND IN-KIND CONTRIBUTIONS-- TANZANIA HEALTH MINISTRY-CHI HEALTH IS A MINISTRY PARTNER WITH THE MACHAME LUTHERAN HOSPITAL IN TANZANIA WHICH PROVIDES FULL SERVICE HEALTH CARE IN A DESPERATELY IMPOVERISHED AREA OF THE COUNTRY INCLUDING A FULL SERVICE HOSPITAL, PHARMACY, HOSPICE OUTREACH, CLINICS, CLINICAL OFFICER SCHOOL, AND THE RECENTLY ESTABLISHED SCHOOL OF NURSING. - STAFF SERVICE ON HEALTH RELATED BOARD AND COALITIONS- PARTICIPATION IN AND FUNDING OF MATERNAL HEALTH, SUBSTANCE ABUSE, FOOD ACCESS, VIOLENCE PREVENTION, CANCER AND OTHER COMMUNITY HEALTH COALITIONS.- IN-KIND STAFF TIME ORGANIZING THE DONATION OF ITEMS TO VARIOUS NON-PROFIT GROUPS AND VOLUNTEERING TIME AT FOOD BANK OF THE HEARTLAND- IN-KIND DONATIONS OF SPACE, FOOD AND STAFF TIME PROVIDING STRATEGIC PLANNING, FACILITATION AND CONSULTING SERVICES FOR NOT-FOR-PROFIT ORGANIZATIONS AND COMMUNITY GROUPS- IN-KIND DONATIONS (STAFF TIME, SPACE, ETC.) SUPPORTING GRANTS FOR BEHAVIORAL HEALTH, VIOLENCE PREVENTION, AND COMMUNITY LINK.
PART VI, LINE 6:THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 21 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. 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.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1ADAMS COMMUNITY ECONOMIC DEVELOPMENT CORPBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1710 DAVIS AVEAddressLine1Txt
CityCORNINGCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50841ZIPCd
FieldValueIRS element (for citing)
Recipient EIN421013266RecipientEIN
IRC Section501(C)(6)IRCSectionDesc
Cash Grant$6,000CashGrantAmt
Purpose Of GrantPROGRAM SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org0Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationALEGENT HEALTH-MERCY HOSPITAL, CORNING, IOWA RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. BUSINESS OFFICE STAFF HELP PATIENTS SEEK LOCAL, STATE, AND FEDERAL REIMBURSEMENT AT NO CHARGE WHEN NO OTHER SOURCE OF PAYMENT IS AVAILABLE. THE ORGANIZATION MAKES GRANTS TO OTHER NON-PROFIT ORGANIZATIONS AND THE FUNDS ARE ONLY PROVIDED FOR CHARITABLE PURPOSES.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation Required0SubstantiationRequiredInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ANTHONY JONES
BOARD MEMBER$0$1,172,323$0$1,760,362$0$15,757$0$15,734$0$11,549$0$2,975,725$0$0
CLIFF ROBERTSON MD
BOARD MEMBER/CEO, CHI HEALTH$0$1,011,674$0$921,351$0$397,677$0$16,975$0$29,727$0$2,377,404$0$157,178
JOHN PETERSDORF
BOARD MEMBER$0$509,017$0$445,500$0$105,583$0$729,483$0$64,074$0$1,853,657$0$0
JEANETTE WOJTALEWICZ
BOARD MEMBER/CFO/INTERIM CEO, CHI HE$0$553,985$0$277,663$0$154,664$0$17,649$0$32,617$0$1,036,578$0$49,946
CARY WARD MD
FORMER OFFICER$0$497,053$0$139,634$0$5,828$0$17,150$0$24,421$0$684,086$0$0
STEVE HOUSTON
FORMER KEY EMPLOYEE$0$333,375$0$95,069$0$5,361$0$16,975$0$24,749$0$475,529$0$0
JOHN SAFRANEK MD
PHYSICIAN$310,019$0$0$0$3,034$0$16,317$0$30,963$0$360,333$0$0$0
BETHEL KOPP MD
PHYSICIAN$307,328$0$0$0$8,541$0$16,975$0$11,324$0$344,168$0$0$0
HEATHER MORGAN MD
BOARD MEMBER$0$292,203$0$0$0$1,005$0$17,050$0$31,693$0$341,951$0$0
CAROLINE AMAO MD
PHYSICIAN$262,887$0$0$0$1,621$0$13,254$0$22,022$0$299,784$0$0$0
DEBRA GOLDSMITH
PRESIDENT, REGIONAL HOSPITAL$0$218,630$0$0$0$15,458$0$29,073$0$19,912$0$283,073$0$10,500
NICK OTOOL
INTERIM CFO, CHI HEALTH$0$185,719$0$26,478$0$351$0$11,109$0$29,002$0$252,659$0$0
JASON KRUGER MD
BOARD MEMBER$0$142,625$0$0$0$795$0$13,865$0$27,720$0$185,005$0$0
AMY WETZEL
PHARMACY SUPERVISOR$155,594$0$625$0$116$0$9,318$0$10,594$0$176,247$0$0$0
LISA WOLFE
FORMER PRESIDENT, MERCY HOSPITAL COR$116,827$0$0$0$9,667$0$16,374$0$25,849$0$168,717$0$6,974$0
PAISLEE DALTON
NURSE PRACTITIONER$132,711$0$8,000$0$67$0$8,096$0$16,837$0$165,711$0$0$0
KURT SARGENT
PRESIDENT, MERCY HOSPITAL CORNING$0$126,312$0$5,072$0$5,768$0$10,335$0$11,687$0$159,174$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ADURING THE CALENDAR YEAR 2020, ALEGENT HEALTH-MERCY HOSPITAL, CORNING IA'S PRESIDENT WAS COMPENSATED BY COMMONSPIRIT HEALTH, ALEGENT HEALTH-MERCY HOSPITAL, CORNING IA'S PARENT COMPANY. THE PRESIDENT WAS PROVIDED WITH EMPLOYER-PAID TEMPORARY HOUSING IN CONJUNCTION WITH THE RECRUITMENT AND RELOCATION OF THE INDIVIDUAL TO ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA. THESE BENEFITS ARE PAID AND GROSSED-UP PURSUANT TO A WRITTEN POLICY. COMMONSPIRIT HEALTH'S HUMAN RESOURCES DEPARTMENT OFFERS THIS BENEFIT ONLY IN CIRCUMSTANCES WHERE A SUITABLE CANDIDATE CANNOT BE RECRUITED LOCALLY. ALL SUCH BENEFITS ARE INCLUDED IN THE EMPLOYEE'S FORM W-2.
PART I, LINE 3DURING THE CALENDAR YEAR 2020, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FOR MEMBERS OF MANAGEMENT WHO WERE PAID UNDER CHI HEALTH FOR CALENDAR YEAR 2020, CHI HEALTH COMPLETES A COMPENSATION MARKET STUDY TO DETERMINE SALARY.
PART I, LINE 4BSCHEDULE J, PART I, LINE 4A - SEVERANCE OR CHANGE-OF-CONTROL PAYMENTS: 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. SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: 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. DURING 2020 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: CLIFF ROBERTSON, $186,901; JEANETTE WOJTALEWICZ, $71,692; DEBRA GOLDSMITH, $11,243 AND LISA WOLFE, $7,010. 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: CLIFF ROBERTSON, $195,187 AND JEANETTE WOJTALEWICZ, $77,144.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 1C: PAYMENTS TO VENDORSPAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH (CSH) ARE MADE BY CSH, THEREFORE NO FORM 1099S ARE ISSUED BY ALEGENTHEALTH-MERCY HOSPITAL, CORNING, IA. CSH FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099S ISSUED BY CSH ON BEHALF OF ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA ARE REPORTED TO THE IRS.
FORM 990, PART VI, SECTION A, LINE 6CHI NEBRASKA IS THE SOLE MEMBER OF ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IOWA.
FORM 990, PART VI, SECTION A, LINE 7AACCORDING 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.
FORM 990, PART VI, SECTION A, LINE 7BTHE ORGANIZATION'S CORPORATE MEMBER IS CHI NEBRASKA. PURSUANT TO SECTION 5.4.1 OF THE ORGANIZATION'S BYLAWS, BOTH CHI NEBRASKA AND COMMONSPIRIT HEALTH HAVE RESERVED POWERS AS OUTLINED IN THE COMMONSPIRIT HEALTH GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE HELD BY THE CHI NEBRASKA'S BOARD: *APPROVE MEMBERS OF THE ALEGENT HEALTH- MERCY, CORNING BOARD. *AMENDMENT OF THE CORPORATE DOCUMENTS OF THE ALEGENT HEALTH-MERCY, CORNING. *APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE ALEGENT HEALTH-MERCY, CORNING. *ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR THE ALEGENT HEALTH-MERCY, CORNING. 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 ALEGENT HEALTH-MERCY, CORNING. *REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE ALEGENT HEALTH-MERCY, CORNING. *APPROVAL OF ISSUANCE OF DEBT BY ALEGENT HEALTH-MERCY, CORNING. *APPROVAL OF PARTICIPATION OF ALEGENT HEALTH-MERCY, CORNING IN A JOINT VENTURE. *APPROVAL OF FORMATION OF A NEW CORPORATION BY ALEGENT HEALTH-MERCY, CORNING. *APPROVAL OF A MERGER INVOLVING THE ALEGENT HEALTH-MERCY, CORNING. *APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ALEGENT HEALTH-MERCY, CORNING. *TO REQUIRE THE TRANSFER OF ASSETS BY THE ALEGENT HEALTH-MERCY, CORNING TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH DEBTS. PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, CHI NEBRASKA OR COMMONSPIRIT HEALTH MAY, IN EXERCISE OF THEIR APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND ITS PRESIDENT AND THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE.
FORM 990, PART VI, SECTION B, LINE 11BFOLLOWING THE PREPARATION OF THE FORM 990 BY TAX ANALYSTS OF COMMONSPIRIT HEALTH, A RELATED ORGANIZATION, THE RETURN IS REVIEWED BY THE COMMONSPIRIT HEALTH TAX DIRECTOR AND THE LOCAL CHIEF FINANCIAL OFFICER. ADDITIONALLY, THE BOARD OF DIRECTORS ARE PROVIDED THE FINAL FORM 990 AND RELATED SCHEDULES TO REVIEW AND ARE ABLE TO ASK THE CHIEF FINANCIAL OFFICER AND TAX DIRECTOR QUESTIONS PRIOR TO FILING WITH THE IRS. UPON CHIEF FINANCIAL OFFICER APPROVAL AND SIGNATURE, THE TAX ANALYST FILES THE FINAL FORM 990 AS PRESENTED TO THE BOARD AND FINANCE COMMITTEE, MAKING ANY NONSUBSTANTIVE CHANGES NECESSARY IN ORDER TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
FORM 990, PART VI, SECTION B, LINE 12CTHE 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 - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO.
FORM 990, PART VI, SECTION B, LINE 15BTHE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION WAS PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION THE COMMONSPIRIT HEALTH BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR APPROVING REASONABLE COMPENSATION PACKAGES FOR EACH OFFICER AND CERTAIN KEY EMPLOYEES (INCLUDING THE PRESIDENT/CEO). THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EXECUTIVES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES AN INDEPENDENT CONSULTANT AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF STEWARDSHIP TRUSTEES. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED. FOR MEMBERS OF MANAGEMENT WHO WERE PAID UNDER CHI HEALTH FOR CALENDAR YEAR 2020, CHI HEALTH COMPLETES A COMPENSATION MARKET STUDY TO DETERMINE SALARY.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST FROM THE ADMINISTRATION DEPARTMENT. IN ADDITION, THE ARTICLES OF INCORPORATION ARE AVAILABLE FROM THE IOWA SECRETARY OF STATE AT SOS.IOWA.GOV. 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 IX, LINE 11GPURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,277,862. MANAGEMENT AND GENERAL EXPENSES 119,887. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,397,749. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,150,513. MANAGEMENT AND GENERAL EXPENSES 60,553. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,211,066. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 602,923. MANAGEMENT AND GENERAL EXPENSES 31,733. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 634,656. OTHER FEES: PROGRAM SERVICE EXPENSES 630,108. MANAGEMENT AND GENERAL EXPENSES 33,164. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 663,272.
FORM 990, PART XI, LINE 9:REALLOCATION OF CARES ACT REVENUE 2,820,238.
FORM 990, PART XI, LINE 8PRIOR 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/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
ALEGENT CREIGHTON CLINIC
12809 W DODGE RDOMAHANE68154470765154HOSPITALNE501(C)(3)LINE 3ACH0
ALEGENT CREIGHTON HEALTH
12809 W DODGE RDOMAHANE68154470757164HOSPITALNE501(C)(3)LINE 3CHI NEBRASKA0
ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM
7500 MERCY RDOMAHANE68124470484764HOSPITALNE501(C)(3)LINE 3CHI NEBRASKA0
ALEGENT HEALTH - COMM MEM HOSP OF MO VALLEYIA
631 N 8TH STMISSOURI VALLEYIA51555420776568HOSPITALIA501(C)(3)LINE 3CHI NEBRASKA0
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
6901 N 72ND STOMAHANE68122470376615HOSPITALNE501(C)(3)LINE 3CHI NEBRASKA0
ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER
104 W 17TH STSCHUYLERNE68661470399853HOSPITALNE501(C)(3)LINE 3CHI NEBRASKA0
ALVERNA APARTMENTS
300 SE 8TH AVELITTLE FALLSMN56345411351177LTERM CAREMN501(C)(3)LINE 10CSH0
APPLETREE COURT
601 OAK STBRECKENRIDGEMN56520411850500SENIOR LIVINGMN501(C)(3)LINE 10SFH0
ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION
345 S HALCYON RDARROYO GRANDECA93420203256066FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDH0
BAKERSFIELD MEMORIAL HOSPITAL
420 34TH STREETBAKERSFIELDCA93301951802779HOSPITALCA501(C)(3)LINE 3DCC0
BARROW NEUROLOGICAL FOUNDATION
350 WEST THOMAS ROADPHOENIXAZ85013860174371FUNDRAISING FOUNDATIONAZ501(C)(3)LINE 7DH0
BAYLOR ST LUKE'S HEALTH VENTURES
17200 ST LUKES WAY STE 170THE WOODLANDSTX77384274499340PHYSICIANSTX501(C)(3)LINE 12A, ISLHS0
BAYLOR ST LUKE'S MEDICAL GROUP
6624 FANNIN ST STE 1100HOUSTONTX77030760458535PHYSICIANSTX501(C)(3)LINE 3BSLHV0
BORNEMANN HEALTHCARE CORPORATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112232187242INACTIVEPA501(C)(3)LINE 12A, ICSH0
BRAZOSPORT HEALTH FOUNDATION INC
1 WEST WAY CTLAKE JACKSONTX77566760080110FUNDRAISING FOUNDATIONTX501(C)(3)LINE 12A, ITCHB0
BRAZOSPORT REGIONAL PHYSICIAN SERVICES
100 MEDICAL DRIVELAKE JACKSONTX77566800240261PHYSICIANSTX501(C)(3)LINE 3TCHB0
BURLESON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802742759890HOSPITALTX501(C)(3)LINE 3SJSC0
BURLESON ST JOSEPH MANOR
2801 FRANCISCAN DRIVEBRYANTX77802742913931REHABILITATIONTX501(C)(3)LINE 10SJSC0
CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION
1401 SOUTH GRAND AVENUELOS ANGELESCA90015954000909FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDCC0
CARRINGTON HEALTH CENTER
800 N 4TH STCARRINGTONND58421450227311HOSPITALND501(C)(3)LINE 3CSH0
CATHOLIC HEALTH INITIATIVES - COLORADO
9100 EAST MINERAL CIRCLECENTENNIALCO80112840405257HOSPITALCO501(C)(3)LINE 3CSH0
CATHOLIC HEALTH INITIATIVES - IOWA CORP
1111 6TH AVEDES MOINESIA50314420680448HOSPITALIA501(C)(3)LINE 3CSH0
CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
9100 EAST MINERAL CIRCLECENTENNIALCO80112840902211FUNDRAISING FOUNDATIONCO501(C)(3)LINE 7CHIC0
CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION
1150 KELLY JOHNSON BLVD 204COLORADO SPRINGSCO80920270930004FUNDRAISING FOUNDATIONCO501(C)(3)LINE 12A, ICSH0
CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES
198 INVERNESS DRIVE WESTENGLEWOODCO80112460992796TELEHEALTHCO501(C)(3)LINE 12A, ICHI NS0
CENTENNIAL MEDICAL GROUP INC
2700 STEWART PKWYROSEBURGOR97471263946191SURGERY CENTEROR501(C)(3)LINE 10MMC - ROSEBURG0
CENTRAL CALIFORNIA HEALTH CENTERS
300 OLD RIVER ROAD STE 200BAKERSFIELDCA93311844171789CLINICCA501(C)(3)LINE 3DCC0
CENTRAL KANSAS MEDICAL CENTER
3515 BROADWAYGREAT BENDKS67530480543724INACTIVEKS501(C)(3)LINE 3CSH0
CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PKWY SFARGOND58104271966847SENIOR LIVINGMN501(C)(3)LINE 10CSH0
CHI HEALTH FOUNDATION
12809 W DODGE RDOMAHANE68154470648586FUNDRAISING FOUNDATIONNE501(C)(3)LINE 7ACH0
CHI KENTUCKY INC
3900 OLYMPIC BLVD STE 400ERLANGERKY41018202741651INVESTMENTSKY501(C)(3)LINE 12A, ICSH0
CHI LIVING COMMUNITIES
5942 RENAISSANCE PLACE STE ATOLEDOOH43623341892096SENIOR LIVINGOH501(C)(3)LINE 12A, ISFH-OH0
CHI MEMORIAL HOSPITAL - GEORGIA
100 GROSS CRESCENT CIRCLEFORT OGLETHORPEGA30742822748395HOSPITALGA501(C)(3)LINE 3MHCS0
CHI NATIONAL HOME CARE
198 INVERNESS DRIVE WESTENGLEWOODCO80112451261716HOME HEALTHCO501(C)(3)LINE 10CHI NS0
CHI NATIONAL SERVICES
198 INVERNESS DRIVE WESTENGLEWOODCO80112452532084HOLDING COCO501(C)(3)LINE 12A, ICSH0
CHI NEBRASKA
12809 WEST DODGE ROADOMAHANE68510363233121HOLDING CONE501(C)(3)LINE 12A, ICSH0
CHI ST JOSEPH CHILDREN'S HEALTH
1929 LINCOLN HWY E STE 150LANCASTERPA17602232342997HEALTHCAREPA501(C)(3)LINE 12A, ICSH0
CHI ST JOSEPH'S CHILDREN
1516 5TH ST NWALBUQUERQUENM87102710897107COMMUNITYNM501(C)(3)LINE 12A, ICSH0
CHI ST VINCENT HOSPITAL HOT SPRINGS
300 WERNER STHOT SPRINGSAR71913710236913HOSPITALAR501(C)(3)LINE 3CHISVHS0
CHI ST VINCENT HOT SPRINGS
300 WERNER STHOT SPRINGSAR71913261125064HOLDING COAR501(C)(3)LINE 12A, ISVIMC0
CHI ST VINCENT MEDICAL GROUP HOT SPRINGS
300 WERNER STHOT SPRINGSAR71913261125131PHYSICIANSAR501(C)(3)LINE 3CHISVHS0
COMMONSPIRIT HEALTH
198 INVERNESS DRIVE WESTENGLEWOODCO80112470617373HEALTHCARECO501(C)(3)LINE 12A, I0N/A
COMMONSPIRIT HEALTH FOUNDATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112853374038FUNDRAISING FOUNDATIONCO501(C)(3)LINE 7CSH0
COMMONSPIRIT HEALTH OPERATING INVESTMENT POOL LLC
185 BERRY STREET STE 200SAN FRANCISCOCA94107850919176OPERATING INVESTMENTSDE501(C)(3)LINE 12A, ICSH0
COMMONSPIRIT HEALTH RESEARCH INSTITUTE
198 INVERNESS DRIVE WESTENGLEWOODCO80112271050565RESEARCHCO501(C)(3)LINE 12A, ICSH0
COMMUNITY HOSPITAL OF SAN BERNARDINO
1805 MEDICAL CENTER DRIVESAN BERNARDINOCA92411951643373HOSPITALCA501(C)(3)LINE 3DCC0
COMMUNITY LIMITED CARE DIALYSIS CENTER
625 EDEN PARK DRIVE 7TH FLOORCINCINNATIOH45202237419853HOLDING COOH501(C)(4)GSH0
COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION
631 N 8TH STMISSOURI VALLEYIA51555421294399FUNDRAISING FOUNDATIONIA501(C)(3)LINE 12A, IAH-CMHMV0
CONTINUING CARE HOSPITAL
ONE SAINT JOSEPH DRIVELEXINGTONKY40504611400619HOSPITALKY501(C)(3)LINE 3SJHS0
DIGNITY COMMUNITY CARE
185 BERRY STREET STE 200SAN FRANCISCOCA94107815009488HOSPITALCO501(C)(3)LINE 3CSH0
DIGNITY HEALTH
185 BERRY STREET STE 200SAN FRANCISCOCA94107941196203HOSPITALCA501(C)(3)LINE 3CSH0
DIGNITY HEALTH CONNECTED LIVING
200 MERCY OAKS DRIVEREDDINGCA96003237115371SENIOR CENTER SERVICESCA501(C)(3)LINE 7DH0
DIGNITY HEALTH FOUNDATION
185 BERRY STREET STE 200SAN FRANCISCOCA94107462037641FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDH0
DIGNITY HEALTH FOUNDATION - INLAND EMPIRE
2101 N WATERMAN AVENUESAN BERNARDINOCA92404237440086FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDH0
DIGNITY HEALTH FOUNDATION EAST VALLEY
475 SOUTH DOBSON ROADCHANDLERAZ85224742418514FUNDRAISING FOUNDATIONAZ501(C)(3)LINE 12A, IDH0
DIGNITY HEALTH HPL SELF-INSURANCE TRUST
185 BERRY STREET STE 200SAN FRANCISCOCA94107943006034SELF INSURANCECA501(C)(3)LINE 12A, IDH0
DIGNITY HEALTH INSURANCE NEVADA LTD
185 BERRY STREET STE 200SAN FRANCISCOCA94107813800752SELF INSURANCENV501(C)(3)LINE 12A, IDH0
DIGNITY HEALTH MEDICAL FOUNDATION
3400 DATA DRIVERANCHO CORDOVACA95670680220314MULTI-SPECIALTY OUTPATIENT MEDICAL CLINICCA501(C)(3)LINE 12A, IDCC0
DIGNITY HEALTH WORKERS COMP SELF-INSURANCE TRUST
185 BERRY STREET STE 200SAN FRANCISCOCA94107946612446SELF INSURANCECA501(C)(3)LINE 12A, IDH0
DOMINICAN HEALTH SERVICES
1555 SOQUEL DRIVESANTA CRUZCA95065770056778COMMUNITY HEALTH SYSTEMCA501(C)(3)LINE 12A, IDH0
DOMINICAN HOSPITAL FOUNDATION
1555 SOQUEL DRIVESANTA CRUZCA95065942450442FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDH0
DOMINICAN OAKS CORPORATION
1555 SOQUEL DRIVESANTA CRUZCA95065770127719OPERATION AND MANAGEMENT OF HOUSING COMPLEX TO ELDERLY PERSONSCA501(C)(3)LINE 10DHS0
EAST TEXAS CLINICAL SERVICES
2801 VIA FORTUNA SUITE 500AUSTINTX78746454736213HEALTHCARETX501(C)(3)LINE 12A, ISLHS0
ENUMCLAW REGIONAL HOSPITAL ASSOCIATION
1455 BATTERSBY AVEENUMCLAWWA98022910715805HOSPITALWA501(C)(3)LINE 3FHS0
FLAGET HEALTHCARE INC
4305 NEW SHEPHERDSVILLE RDBARDSTOWNKY40004611345363HOSPITALKY501(C)(3)LINE 3KOH0
FLAGET MEMORIAL HOSPITAL FOUNDATION INC
4305 NEW SHEPHERDSVILLE RDBARDSTOWNKY40004562351341FUNDRAISING FOUNDATIONKY501(C)(3)LINE 12A, IFH0
FRANCISCAN CARE CENTER
4111 N HOLLAND-SYLVANIA RDTOLEDOOH43623341931806HEALTHCAREOH501(C)(3)LINE 10CHILC0
FRANCISCAN FOUNDATION
1717 SOUTH J STTACOMAWA98405911145592FUNDRAISING FOUNDATIONWA501(C)(3)LINE 10FHS0
FRANCISCAN HEALTH SYSTEM
1717 SOUTH J STTACOMAWA98405910564491HOSPITALWA501(C)(3)LINE 3CSH0
FRANCISCAN HEALTH VENTURES
TACOMA FNC CTR BLDG 1145 BROADWAYTACOMAWA98402431882377INACTIVEMO501(C)(3)LINE 10CSH0
FRANCISCAN MEDICAL GROUP
1313 BROADWAY STE 200TACOMAWA98402911939739PHYSICIANSWA501(C)(3)LINE 10FHS0
FRANCISCAN VILLA OF SOUTH MILWAUKEE INC
3601 S CHICAGO AVESOUTH MILWAUKEEWI53172391093829INACTIVEWI501(C)(3)LINE 10CSH0
FRENCH HOSPITAL MEDICAL CENTER FOUNDATION
1911 JOHNSON AVENUESAN LUIS OBISPOCA93401203256125FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDCC0
GARRISON MEMORIAL HOSPITAL
407 THIRD AVENUE SOUTHEASTGARRISONND58540450227752HOSPITALND501(C)(3)LINE 3SAMC0
GLENDALE MEMORIAL HEALTH FOUNDATION
1420 SOUTH CENTRAL AVENUEGLENDALECA91204953625651FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDCC0
GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WESTENGLEWOODCO80112201536108INACTIVECO501(C)(3)LINE 12A, ICSH0
GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE
625 EDEN PARK DRIVE 7TH FLOORCINCINNATIOH45202311778403EDUCATIONOH501(C)(3)LINE 2GSH0
GOOD SAMARITAN FOUNDATION OF CINCINNATI INC
625 EDEN PARK DRIVE 7TH FLOORCINCINNATIOH45202311206047FUNDRAISING FOUNDATIONOH501(C)(3)LINE 12A, IGSH0
GOOD SAMARITAN HOSPITAL
PO BOX 1990KEARNEYNE68848470379755HOSPITALNE501(C)(3)LINE 3CHI NEBRASKA0
GOOD SAMARITAN HOSPITAL FOUNDATION
111 W 31ST STKEARNEYNE68847470659443FUNDRAISING FOUNDATIONNE501(C)(3)LINE 7GSH-KN0
HARRISON MEDICAL CENTER
2520 CHERRY AVEBREMERTONWA98310910565546HOSPITALWA501(C)(3)LINE 3FHS0
HARRISON MEDICAL CENTER FOUNDATION
2520 CHERRY AVEBREMERTONWA98310911197626FUNDRAISING FOUNDATIONWA501(C)(3)LINE 7HMC0
HEALTHCARE AND WELLNESS FOUNDATION
2400 ST FRANCIS DRBRECKENRIDGEMN56520760761782FUNDRAISING FOUNDATIONMN501(C)(3)LINE 12A, ISFMC-MN0
HIGHLINE MEDICAL CENTER
16251 SYLVESTER RD SWBURIENWA98166910712166HOSPITALWA501(C)(3)LINE 3FHS0
HOUSE OF MERCY
1111 6TH AVEDES MOINESIA50314421323808ASSIST LIVINGIA501(C)(3)LINE 7CHI-IA CORP0
JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC
ONE SAINT JOSEPH DRIVELEXINGTONKY40504611029768HOSPITALKY501(C)(3)LINE 3KOH0
KENTUCKYONE HEALTH MEDICAL GROUP INC
100 E LIBERTY ST STE 800LOUISVILLEKY40202611352729PHYSICIANSKY501(C)(3)LINE 10JHSMH0
KENTUCKYONE HEALTH INC
ONE SAINT JOSEPH DRIVELEXINGTONKY40504611029769HEALTHCAREKY501(C)(3)LINE 12A, ICSH0
LAKEWOOD HEALTH CENTER
600 MAIN AVE SBAUDETTEMN56623410758434HOSPITALMN501(C)(3)LINE 3CSH0
LAKEWOOD REGIONAL HEALTHCARE FOUNDATION
600 MAIN AVE SBAUDETTEMN56623411893795FUNDRAISING FOUNDATIONND501(C)(3)LINE 7LHC0
LEGACY FOUNDATION OF KENTUCKIANA INC
1451 HARRODSBURG RD STE D-308LEXINGTONKY40504832170324FUNDRAISING FOUNDATIONKY501(C)(3)LINE 12A, IKOH0
LISBON AREA HEALTH SERVICES
905 MAIN STLISBONND58054820558836HOSPITALND501(C)(3)LINE 3CSH0
LUFKIN VISION ACQUISITIONS
PO BOX 1447LUFKINTX75901820563768PROPERTY MGMTTX501(C)(3)LINE 12A, IMHSET0
MADISON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802742761145HOSPITALTX501(C)(3)LINE 3SJSC0
MADONNA MANOR INC
2344 AMSTERDAM ROADVILLA HILLSKY51017610654635ASSIST LIVINGKY501(C)(3)LINE 10CHILC0
MARIAN REGIONAL MEDICAL CENTER FOUNDATION
1400 E CHURCH STREETSANTA MARIACA93454953818027FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDH0
MARK TWAIN MEDICAL CENTER
768 MOUNTAIN RANCH ROADSAN ANDREASCA95249680127677HOSPITALCA501(C)(3)LINE 3DCC0
MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC
2525 DE SALES AVECHATTANOOGATN37404621839548FUNDRAISING FOUNDATIONTN501(C)(3)LINE 7MHCS0
MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVECHATTANOOGATN37404620532345HOSPITALTN501(C)(3)LINE 3CSH0
MEMORIAL HEALTH PARTNERS FOUNDATION INC
5600 BRAINERD RD STE 500CHATTANOOGATN37411030417049HEALTHCARETN501(C)(3)LINE 10MHCS0
MEMORIAL HEALTH SYSTEM OF EAST TEXAS
PO BOX 1447LUFKINTX75902750755367HOSPITALTX501(C)(3)LINE 3SLHS0
MEMORIAL MEDICAL CENTER - LIVINGSTON
PO BOX 1447LUFKINTX75902760436439HOSPITALTX501(C)(3)LINE 3MHSET0
MEMORIAL MEDICAL CENTER - SAN AUGUSTINE
PO BOX 1447LUFKINTX75902752663904HOSPITALTX501(C)(3)LINE 3MHSET0
MEMORIAL MULTISPECIALTY ASSOCIATES
1201 FRANK AVELUFKINTX95904752721155PHYSICIANSTX501(C)(3)LINE 12A, IMHSET0
MEMORIAL SPECIALTY HOSPITAL
PO BOX 1447LUFKINTX95902752492741INACTIVETX501(C)(3)LINE 3MHSET0
MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVEDES MOINESIA50314426076069AUXILIARYIA501(C)(3)LINE 12A, IMF-DM IA0
MERCY CLINICS INC
1111 6TH AVEDES MOINESIA50314421193699PHYSICIANSIA501(C)(3)LINE 10CHI-IA CORP0
MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVEDES MOINESIA50314421511682EDUCATIONIA501(C)(3)LINE 2CHI-IA CORP0
MERCY FOUNDATION BAKERSFIELD
PO BOX 119BAKERSFIELDCA93302770201321FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDH0
MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVEDES MOINESIA50314237358794FUNDRAISING FOUNDATIONIA501(C)(3)LINE 7CHI-IA CORP0
MERCY FOUNDATION INC
2700 STEWART PKWYROSEBURGOR97471936088946FUNDRAISING FOUNDATIONOR501(C)(3)LINE 7MMC - ROSEBURG0
MERCY HEALTH CARE FOUNDATION
PO BOX 368CORNINGIA50841421461064FUNDRAISING FOUNDATIONIA501(C)(3)LINE 12A, IAHMH-CORNINGYes (1)
MERCY HEALTHCARE FOUNDATION
570 CHAUTAUQUA BLVDVALLEY CITYND58072450435338FUNDRAISING FOUNDATIONND501(C)(3)LINE 12A, IMHVC0
MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DRCOUNCIL BLUFFSIA51503421178204FUNDRAISING FOUNDATIONIA501(C)(3)LINE 12A, IAHBMHS0
MERCY HOSPITAL OF DEVILS LAKE
1031 7TH ST NEDEVILS LAKEND58301450227012HOSPITALND501(C)(3)LINE 3CSH0
MERCY HOSPITAL OF DEVILS LAKE FOUNDATION
1031 7TH ST NEDEVILS LAKEND58301352367360FUNDRAISING FOUNDATIONND501(C)(3)LINE 7MHDL0
MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BLVDVALLEY CITYND58072450226553HOSPITALND501(C)(3)LINE 3CSH0
MERCY MCMAHON TERRACE
3865 J STREETSACRAMENTOCA95816680117340SENIOR CITIZEN'S HOUSING/RETIREMENT COMMUNITIESCA501(C)(3)LINE 10DH0
MERCY MEDICAL CENTER
1301 15TH AVE WESTWILLISTONND58801450231183HOSPITALND501(C)(3)LINE 3CSH0
MERCY MEDICAL CENTER - CENTERVILLE
ONE ST JOSEPHS DRIVECENTERVILLEIA52544420680308HOSPITALIA501(C)(3)LINE 3CHI-IA CORP0
MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER
204 N 4TH AVE ENEWTONIA50314421470935HOSPITALIA501(C)(3)LINE 3CHI-IA CORP0
MERCY MEDICAL CENTER MERCED FOUNDATION
301 E 13TH STREETMERCEDCA95340770035928FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDH0
MERCY MEDICAL CENTER INC
2700 STEWART PKWYROSEBURGOR97471930386868HOSPITALOR501(C)(3)LINE 3CSH0
MERCY MEDICAL FOUNDATION
1301 15TH AVE WESTWILLISTONND58801450381803FUNDRAISING FOUNDATIONND501(C)(3)LINE 12A, IMMC WILLISTON0
NEBRASKA HEART HOSPITAL
7500 S 91ST STLINCOLNNE68526392031968HOSPITALNE501(C)(3)LINE 3CHI NEBRASKA0
NORTHLAND HEALTHCARE ALLIANCE
2223 EAST ROSSER AVENUEBISMARCKND58501911845296MANAGEMENTND501(C)(3)LINE 7SAMC0
NORTHRIDGE HOSPITAL FOUNDATION
18300 ROSCOE BLVDNORTHRIDGECA91328237444901FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDCC0
OAKES COMMUNITY HOSPITAL
1200 N 7TH STOAKESND58474450231675HOSPITALND501(C)(3)LINE 3CSH0
OAKES COMMUNITY HOSPITAL FOUNDATION
1200 N 7TH STOAKESND58474710966606FUNDRAISING FOUNDATIONND501(C)(3)LINE 12A, IOCH0
PACIFIC CENTRAL COAST HEALTH CENTERS
1400 E CHURCH STREETSANTA MARIACA93454770447575CLINICCA501(C)(3)LINE 3DCC0
PINEYWOODS MEDICAL DEVELOPMENT CORP
PO BOX 1447LUFKINTX75902752493116PROPERTY MGMTTX501(C)(3)LINE 12A, IMHSET0
PORT CITY OPERATING COMPANY LLC
3400 DATA DRIVERANCHO CORDOVACA95670465322209HOSPITALCA501(C)(3)LINE 3DH0
PROVIDENCE CARE CENTER
2025 HAYES AVENUESANDUSKYOH44870341658625LTERM CAREOH501(C)(3)LINE 10CHILC0
PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION
5055 PROVIDENCE DRIVESANDUSKYOH44870341896807LIVING COMMOH501(C)(3)LINE 10CHILC0
PUEBLO STEPUP
1925 E ORMAN AVE STE G52PUEBLOCO81004841234295COMMUNITYCO501(C)(3)LINE 7CHIC0
SET OF COLORADO SPRINGS INC
9100 E MINERAL CIRCLECENTENNIALCO80112841183335SENIOR CENTER SERVICESCO501(C)(3)LINE 7CHIC0
SAINT CLARE'S COMMUNITY CARE INC
198 INVERNESS DRIVE WESTENGLEWOODCO80112222876836INACTIVENJ501(C)(3)LINE 10SCHS0
SAINT CLARE'S HEALTH SERVICES INC
198 INVERNESS DRIVE WESTENGLEWOODCO80112223639733INACTIVENJ501(C)(3)LINE 10CSH0
SAINT CLARE'S HOSPITAL INC
198 INVERNESS DRIVE WESTENGLEWOODCO80112223319886INACTIVENJ501(C)(3)LINE 3SCHS0
SAINT ELIZABETH FOUNDATION
555 S 70TH STLINCOLNNE68510470625523FUNDRAISING FOUNDATIONNE501(C)(3)LINE 7SERMC0
SAINT ELIZABETH HEALTH SERVICES
555 S 70TH STLINCOLNNE68510363233120INACTIVENE501(C)(3)LINE 3SERMC0
SAINT ELIZABETH REGIONAL MEDICAL CENTER
555 S 70TH STLINCOLNNE68510470379836HOSPITALNE501(C)(3)LINE 3CHI NEBRASKA0
SAINT FRANCIS MEDICAL CENTER
2620 W FAIDLEYGRAND ISLANDNE68803470376601HOSPITALNE501(C)(3)LINE 3CHI NEBRASKA0
SAINT FRANCIS MEDICAL CENTER FOUNDATION
PO BOX 9804GRAND ISLANDNE68802470630267FUNDRAISING FOUNDATIONNE501(C)(3)LINE 7SFMC-NE0
SAINT FRANCIS MEMORIAL HOSPITAL
900 HYDE STREETSAN FRANCISCOCA94109941156295HOSPITALCA501(C)(3)LINE 3DCC0
SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC
305 ESTILL STBEREAKY40403260152877FUNDRAISING FOUNDATIONKY501(C)(3)LINE 7SJHS0
SAINT JOSEPH HEALTH SYSTEM INC
ONE ST JOSEPHS DRIVELEXINGTONKY40504611334601HOSPITALKY501(C)(3)LINE 3KOH0
SAINT JOSEPH HOSPITAL FOUNDATION INC
701 BOB OLINK DR 200LEXINGTONKY40504611159649FUNDRAISING FOUNDATIONKY501(C)(3)LINE 12A, ISJHS0
SAINT JOSEPH LONDON FOUNDATION INC
1001 SAINT JOSEPH LANELONDONKY40741260438748FUNDRAISING FOUNDATIONKY501(C)(3)LINE 7SJHS0
SAINT JOSEPH MOUNT STERLING FOUNDATION INC
225 FALCON DRMOUNT STERLINGKY40353272884584FUNDRAISING FOUNDATIONKY501(C)(3)LINE 7SJHS0
SAINT JOSEPH'S HOSPITAL FOUNDATION
2500 FAIRWAY STREETDICKINSONND58601363418207FUNDRAISING FOUNDATIONND501(C)(3)LINE 12A, ISJHHC0
SAN GABRIEL VALLEY MEDICAL CENTER FOUNDATION
438 WEST LAS TUNAS DRIVESAN GABRIELCA91776953430341INACTIVECA501(C)(3)LINE 12A, IDH0
SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC
104 W 17TH STSCHUYLERNE68661363630014FUNDRAISING FOUNDATIONNE501(C)(3)LINE 12A, IAHMHS0
SIERRA NEVADA MEMORIAL-MINERS HOSPITAL
155 GLASSON WAYGRASS VALLEYCA95945941439787HOSPITALCA501(C)(3)LINE 3DCC0
SJRMC JOPLIN MISSOURI
198 INVERNESS DRIVE WESTENGLEWOODCO80112440545809HOSPITALMO501(C)(3)LINE 3CSH0
ST FRANCIS FOUNDATION OF SANTA BARBARA
2323 DE LA VINA ST SUITE 104SANTA BARBARACA93105237137119FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDH0
ST FRANCIS HOSPITAL SUPPORT CORPORATION
601 E MICHELTORENA STREETSANTA BARBARACA93103770022302INACTIVECA501(C)(3)LINE 12A, IDH0
ST JOHNS HEALTHCARE FOUNDATION
1600 NORTH ROSE AVENUEOXNARDCA93030202865781FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDH0
ST JOSEPHS FOUNDATION (PHOENIX)
350 WEST THOMAS ROADPHOENIXAZ85013942941245FUNDRAISING FOUNDATIONAZ501(C)(3)LINE 12A, IDH0
ST JOSEPHS FOUNDATION OF SAN JOAQUIN
1800 N CALIFORNIA STREETSTOCKTONCA95204510432777FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDH0
ST MARY MEDICAL CENTER FOUNDATION
1050 LINDEN AVENUELONG BEACHCA90813237153876FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDH0
ST MARY PROFESSIONAL BUILDING INC
1050 LINDEN AVENUELONG BEACHCA90813237373088INACTIVECA501(C)(3)LINE 12A, IDH0
ST MARYS MEDICAL CENTER FOUNDATION
450 STANYAN STREETSAN FRANCISCOCA94117943336143FUNDRAISING FOUNDATIONCA501(C)(3)LINE 12A, IDH0
ST ROSE DOMINICAN HEALTH FOUNDATION
3001 ST ROSE PARKWAYHENDERSONNV89052880349432FUNDRAISING FOUNDATIONNV501(C)(3)LINE 12A, IDH0
ST ALEXIUS MEDICAL CENTER
900 EAST BROADWAY AVENUEBISMARCKND58501450226711HOSPITALND501(C)(3)LINE 3CSH0
ST ANNE OC
1145 BROADWAY PLAZA STE 1200TACOMAWA98402863590968INACTIVEWA501(C)(3)LINE 10FHS0
ST ANTHONY HOSPITAL
2801 ST ANTHONY WAYPENDLETONOR97801930391614HOSPITALOR501(C)(3)LINE 3CSH0
ST ANTHONY HOSPITAL FOUNDATION
2801 ST ANTHONY WAYPENDLETONOR97801930992727FUNDRAISING FOUNDATIONOR501(C)(3)LINE 12A, ISAH0
ST ANTHONY'S HOSPITAL ASSOCIATION
FOUR HOSPITAL DRMORRILTONAR72110710245507HOSPITALAR501(C)(3)LINE 3SVIMC0
ST CATHERINE HOSPITAL
401 EAST SPRUCE STGARDEN CITYKS67846480543721HOSPITALKS501(C)(3)LINE 3CSH0
ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION
401 EAST SPRUCE STGARDEN CITYKS67846200598702FUNDRAISING FOUNDATIONKS501(C)(3)LINE 12A, ISCH0
ST CLARE COMMONS
12469 FIVE POINT ROADTOLEDOOH43551270163752LIVING COMMOH501(C)(3)LINE 10CHILC0
ST DOMINIC OF ONTARIO OREGON
198 INVERNESS DRIVE WESTENGLEWOODCO80112930433692INVESTMENTSOR501(C)(4)CSH0
ST FRANCIS HOME
2400 ST FRANCIS DRBRECKENRIDGEMN56520410729978LTERM CAREMN501(C)(3)LINE 10CSH0
ST FRANCIS LIFE CARE CORPORATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112222536017INACTIVENJ501(C)(3)LINE 8SCHS0
ST FRANCIS MEDICAL CENTER
2400 ST FRANCIS DRBRECKENRIDGEMN56520410695598HOSPITALMN501(C)(3)LINE 3CSH0
ST JOSEPH FOUNDATION OF BRYAN TEXAS
2801 FRANCISCAN DRIVEBRYANTX77802742351158FUNDRAISING FOUNDATIONTX501(C)(3)LINE 12A, ISJSC0
ST JOSEPH MANOR
2801 FRANCISCAN DRIVEBRYANTX77802742847594LTERM CARETX501(C)(3)LINE 10SJSC0
ST JOSEPH MEDICAL CENTER INC
198 INVERNESS DRIVE WESTENGLEWOODCO80112520591461INACTIVEMD501(C)(3)LINE 3CSH0
ST JOSEPH PHYSICIAN ASSOCIATES
2801 FRANCISCAN DRIVEBRYANTX77802203159302PHYSICIANSTX501(C)(3)LINE 3SJSC0
ST JOSEPH PHYSICIAN ENTERPRISE INC
198 INVERNESS DRIVE WESTENGLEWOODCO80112521311775INACTIVEMD501(C)(3)LINE 12A, ISJMC0
ST JOSEPH REGIONAL HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802741282696HOSPITALTX501(C)(3)LINE 3SJSC0
ST JOSEPH REGIONAL HEALTH PARTNERS
2801 FRANCISCAN DRIVEBRYANTX77802454088170HOSPITALTX501(C)(3)LINE 3SJSC0
ST JOSEPH REGIONAL HEALTH PARTNERS ACO
2801 FRANCISCAN DRIVEBRYANTX77802463265423HEALTHCARETX501(C)(3)LINE 10SJSC0
ST JOSEPH SERVICES CORPORATION
2801 FRANCISCAN DRIVEBRYANTX77802742455161MANAGEMENTTX501(C)(3)LINE 12A, ISLHS0
ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVEPARK RAPIDSMN56470410695603HOSPITALMN501(C)(3)LINE 3CSH0
ST JOSEPH'S HOSPITAL AND HEALTH CENTER
2500 FAIRWAY STDICKINSONND58601450226429HOSPITALND501(C)(3)LINE 3CSH0
ST LEONARD
8100 CLYO ROADCENTERVILLEOH45458341940863LIVING COMMOH501(C)(3)LINE 10CHILC0
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC
6624 FANNIN ST STE 2505HOUSTONTX77030273733278HOSPITALTX501(C)(3)LINE 3SLHS0
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND
6624 FANNIN ST STE 2505HOUSTONTX77030261947374HOSPITALTX501(C)(3)LINE 3SLHS0
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS
6624 FANNIN ST STE 2505HOUSTONTX77030260335902HOSPITALTX501(C)(3)LINE 3SLHS0
ST LUKE'S COMMUNITY HEALTH SERVICES
6624 FANNIN ST STE 1100HOUSTONTX77030760536234HOSPITALTX501(C)(3)LINE 3SLHS0
ST LUKE'S FOUNDATION
1213 HERMANN DRIVE STE 855HOUSTONTX77004453811485FUNDRAISING FOUNDATIONTX501(C)(3)LINE 7SLHS0
ST LUKE'S HEALTH SYSTEM CORPORATION
PO BOX 20269HOUSTONTX77225760536232MANAGEMENTTX501(C)(3)LINE 12A, ICSH0
ST LUKE'S HOSPITAL AT THE VINTAGE
6624 FANNIN ST STE 2505HOUSTONTX77030263734606HOSPITALTX501(C)(3)LINE 3SLHS0
ST LUKE'S PROPERTIES CORPORATION
1213 HERMANN DRIVE STE 855HOUSTONTX77004760531716PROPERTY MGMTTX501(C)(3)LINE 12A, ISLHS0
ST LUKE'S SUGAR LAND PROPERTIES CORPORATION
6624 FANNIN ST STE 2505HOUSTONTX77030454120549PROPERTY MGMTTX501(C)(3)LINE 12A, ISLCDC-SL0
ST MARY'S COMMUNITY HOSPITAL
1301 GRUNDMAN BOULEVARDNEBRASKA CITYNE68410470443636HOSPITALNE501(C)(3)LINE 3CHI NEBRASKA0
ST MARY'S HOSPITAL FOUNDATION
1314 3RD AVENEBRASKA CITYNE68410470707604FUNDRAISING FOUNDATIONNE501(C)(3)LINE 7SMCH0
ST VINCENT FOUNDATION
TWO ST VINCENT CIRCLELITTLE ROCKAR72205510169537FUNDRAISING FOUNDATIONAR501(C)(3)LINE 12A, ISVIMC0
ST VINCENT INFIRMARY MEDICAL CENTER
TWO ST VINCENT CIRCLELITTLE ROCKAR72205710236917HOSPITALAR501(C)(3)LINE 3CSH0
ST VINCENT MEDICAL GROUP
TWO ST VINCENT CIRCLELITTLE ROCKAR72205710830696PHYSICIANSAR501(C)(3)LINE 10SVIMC0
SYLVANIA FRANCISCAN HEALTH
198 INVERNESS DRIVE WESTENGLEWOODCO80112341412964HOLDING COOH501(C)(3)LINE 12A, ICSH0
SYLVANIA FRANCISCAN HEALTH FOUNDATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112455357161INACTIVEOH501(C)(3)LINE 12A, ISFH-OH0
THE COMMONS OF PROVIDENCE
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THE COMMUNITY HOSPITAL OF BRAZOSPORT
100 MEDICAL DRIVELAKE JACKSONTX77566741385192HOSPITALTX501(C)(3)LINE 3SLHS0
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH
625 EDEN PARK DRIVE 7TH FLOORCINCINNATIOH45202310537486HOSPITALOH501(C)(3)LINE 3CSH0
THE PHYSICIAN NETWORK
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TRINITY HEALTH FOUNDATION
380 SUMMIT AVENUESTEUBENVILLEOH43952311329423FUNDRAISING FOUNDATIONOH501(C)(3)LINE 12A, ITHS0
TRINITY HEALTH SYSTEM
380 SUMMIT AVENUESTEUBENVILLEOH43952341818681HEALTHCAREOH501(C)(3)LINE 12A, I0N/A
TRINITY HOSPITAL TWIN CITY
819 NORTH FIRST STREETDENNISONOH44621275401105HOSPITALOH501(C)(3)LINE 3THS0
TRI-STATE HEALTH SERVICES INC
ONE ROSS PARK BLVDSTEUBENVILLEOH43952341522484ASSIST LIVINGOH501(C)(3)LINE 7THS0
UNITY FAMILY HEALTHCARE
815 SE 2ND STLITTLE FALLSMN56345410721642HOSPITALMN501(C)(3)LINE 3CSH0
VILLA NAZARETH INC
801 PAGE DRFARGOND58103450226714LTERM CAREND501(C)(3)LINE 10CSH0
VISITING NURSE ASSOCIATION OF ST CLARE'S INC
198 INVERNESS DRIVE WESTENGLEWOODCO80112221768334INACTIVENJ501(C)(3)LINE 10SCHS0
YAVAPAI COMMUNITY HOSPITAL ASSOC
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Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdPredominant Income TypePredominantIncomeTypeTxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCdShare Of Total IncomeShareOfTotalIncomeAmtUBI Code VUBICodeVAmt
AMERICAN MERCY HOME CARE LLC
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ARIZONA CARE NETWORK - NEXT LLC
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BERGAN MERCY SURGERY CENTER LLC
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BERYWOOD OFFICE PROPERTIES LLC
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BIOLIFE DIGNITY HEALTH INTERNATIONAL LTD
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BLUEGRASS REGIONAL IMAGING CENTER
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CBCC OUTSMARTING CANCER LLC
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COLORADO SPRINGS CK LEASING LLC
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DE JV LLC
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DHHP SURGERY CENTERS LLC
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DIGNITY HEALTH AT HOME LLC
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DIGNITY HEALTH SPECIALTY PHARMACY LLC
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PENINSULA RADIATION ONCOLOGY CENTER LLC
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PENRAD IMAGING LLC
1390 KELLY JOHNSON BLVDCOLORADO SPRINGSCO80920841072619MEDICAL IMAGINGCON/AN/A00
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19625 62ND AVE S STE 101KENTWA98032452901632HOLDING COMPANYWAN/AN/A00
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PMC HOSPITAL LLC
3100 MAIN ST STE 500HOUSTONTX77002273280598HOSPITALTXN/AN/A00
PRECISION MEDICINE ALLIANCE LLC
198 INVERNESS DRIVE WESTENGLEWOODCO80112352569159DIAGNOSTIC SERVICESCON/AN/A00
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RBR MANAGEMENT LLC
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REID-ANC HOME CARE SERVICES LLC
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SAINT JOSEPH - SCA HOLDINGS LLC
1451 HARRODSBURG RDLEXINGTONKY40503453801157INACTIVEDEN/AN/A00
SAINT JOSEPH HEALTH ASC LLC
1 SAINT JOSEPH DRIVELEXINGTONKY40504852155230SURGERYKYN/AN/A00
SAINT JOSEPH-ANC HOME CARE SERVICES
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SANTA CRUZ COMPREHENSIVE IMAGING LLC
1661 SOQUEL DRIVE SUITE GSANTA CRUZCA95065010550623IMAGINGCAN/AN/A00
SANTA CRUZ LAND & BUILDING LP
1555 SOQUEL DRIVESANTA CRUZCA95065770285236REAL ESTATECAN/AN/A00
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3003 PAUL SWEET ROADSANTA CRUZCA95065770194916SURGERYCAN/AN/A00
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SOUTHEASTERN HOME CARE LLC
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ST JOSEPH'S SURGERY CENTER LP
15305 DALLAS PARKWAY SUITE 1600 LBADDISONTX75001201019390SURGERYTXN/AN/A00
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ST FRANCIS LAND COMPANY
5390 N ACADEMY BLVD STE 300COLORADO SPRINGSCO80918263134100REAL ESTATECON/AN/A00
ST LUKE'S DIAGNOSTIC CATH LAB LLP
6624 FANNIN ST STE 800HOUSTONTX77030710959365DIAGNOSTIC SERVICESTXN/AN/A00
ST LUKE'S LAKESIDE HOSPITAL LLC
6624 FANNIN STE 2505HOUSTONTX77030300427437HOSPITALTXN/AN/A00
ST LUKE'S THE WOODLANDS SLEEP CENTER LLC
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TEMPLETON SURGERY CENTER LLC
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TIA ARIZONA LLC
3030 N CENTRAL AVENUE SUITE 1402PHOENIXAZ85012863158670CLINICAZN/AN/A00
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Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (62 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
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ALL SAINTS INSURANCE COMPANY SPC LTD
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2801 FRANCISCAN DRIVEBRYANTX77802742466914HEALTHCARETXN/AC0
ALTERNATIVE INSURANCE MANAGEMENT SERVICE INC
198 INVERNESS DRIVE WESTENGLEWOODCO80112841112049MANAGEMENT SERVICESCON/AC0
AMERICAN NURSING CARE INC
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AMERIMED INC
1700 EDISON DRMILFORDOH45150311158699HOME HEALTHOHN/AC0
BC HOLDING COMPANY INC
1850 BLUEGRASS AVELOUISVILLEKY40215311542851INACTIVEKYN/AC0
BRAZOSPORT HEALTH ALLIANCE
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CADUCEUS MEDICAL ASSOCIATES INC
5600 BRAINERD ROAD STE 500CHATTANOOGATN37411621570736HEALTHCARETNN/AC0
CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH
198 INVERNESS DRIVE WESTENGLEWOODCO80112272269511RESEARCHCON/AC0
CHI ST LUKE'S HEALTH - MEMORIAL CONDOMINIUM ASSOCIATION INC
1201 W FRANK AVELUFKINTX75904834184717CONDO ASSOCTXN/AC0
CLEARRIVER HEALTH
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COMCARE SERVICES INC
9100 E MINERAL CIRCLECENTENNIALCO80112840904813INACTIVECON/AC0
CONSOLIDATED HEALTH SERVICES
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DES MOINES MEDICAL CENTER INC
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DIGNITY HEALTH HOLDING CORPORATION
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DIGNITY HEALTH INSURANCE LTD
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FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd