2022-05-13T12:00:19-05:00 2021-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2020-07-01 271966847 CHI HEALTH CONNECT AT HOME - FARGO CHIH 7012378058 4265 45TH ST S STE 200 FARGO ND 58104 NICOLE PEYERL MARKET VP OF OPERATIONS 7012378058 2022-05-13 1 NICOLE PEYERL 999009999 MARK STOCKI P00642127 3032989100 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z X CHI HEALTH AT HOME NICOLE PEYERL 4265 45TH ST S STE 200 FARGO ND 58104 12519554 0 X WWW.CHIHEALTHCONNECTATHOME.COM X 2010 MN THE ORGANIZATION PROVIDES HOME HEALTH AND HOSPICE SERVICES TO PATIENTS LOCATED IN VARIOUS COMMUNITIES IN NORTH DAKOTA AND MINNESOTA. 8 7 156 88 0 0 340386 221870 11004136 12185391 -3257 1873 228777 104116 11570042 12513250 0 1000 0 0 8754051 8920743 0 0 0 2352586 4511058 11106637 13432801 463405 -919551 5444489 3835361 8400152 7334856 -2955663 -3499495 X AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL.TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION. 1 0 12760640 1000 12185391 SEE SCHEDULE O. 12760640 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 156 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 0 0 1 0 ND X MEGAN RATH 7013880274 4265 45TH ST ST SUITE 200 FARGO ND 58104 CLIFF ROBERTSON BRD MBR/CSH SVP OPERATIONS 1.00 50.00 X 0 2330702 46702 JEFFREY DROP BRD MBR/CSH SVP OPERATIONS 1.00 50.00 X 0 1263797 34793 JEANETTE WOJTALEWICZ BOARD MEMBER/CSH SVP OPERATIONS 1.00 50.00 X 0 986312 50266 SUE HEITKAMP PRESIDENT 1.00 40.00 X 9247 131640 40923 MICHELLE COOLEY NURSE PRACT-PALLIATIVE CARE 40.00 0.00 X 128577 0 26556 SANDRA BUCHHOLZ DIRECTOR HOME HEALTH-HOSPICE 40.00 0.00 X 105080 0 1721 KIM HOCKING PHYSICAL THERAPIST 40.00 0.00 X 104475 0 5333 DEANNA KAINZ DIRECTOR OF FINANCE 45.00 0.00 X 104332 0 18040 LISA HANOWSKI DIRECTOR HOME HEALTH-HOSPICE 40.00 0.00 X 103560 0 9333 CHAD PETERSON CHAIR 1.00 0.00 X X 0 0 0 GLENDA REEMTS BOARD MEMBER 1.00 0.00 X 0 0 0 GLORIA DOHMAN BOARD MEMBER 1.00 0.00 X 0 0 0 GRETCHEN DOBERVICH BOARD MEMBER 1.00 0.00 X 0 0 0 LANCE GULLESON BOARD MEMBER 1.00 0.00 X 0 0 0 SR MARY BURGER SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 WENDY MCGINLEY VICE CHAIR 1.00 0.00 X X 0 0 0 555271 4712451 233667 5 0 1 0 ST LUKES HOME 242 W 10TH ST DICKINSON ND 58601 SKILLED NURSING 289408 MEDEFIS INC 2121 N 117TH AVE STE 200 OMAHA ND 68164 VENDOR MANAGEMENT/STAFFING 199931 BETHEL LUTHERAN NURSING & REHAB 1515 2ND AVE W WILLISTON ND 58801 SKILLED NURSING 190424 LUTHERAN HOME OF GOOD SHEPHERD 1226 1ST AVE N NEW ROCKFORD ND 58356 SKILLED NURSING 137872 4 384 64393 157093 221870 PATIENT SERVICES 900099 11972676 11972676 INTERCOMPANY TRANSACTI 900099 212715 212715 12185391 309 309 1564 0 1564 1564 1564 18840 384 6304 12536 12536 SERVICES SOLD 900099 91580 91580 91580 12513250 12185391 0 105989 X 1000 1000 113417 113417 43144 40987 2157 6902885 6659089 243796 212392 202900 9492 1135084 1083600 51484 513821 488130 25691 10681 10146 535 2794986 2654982 140004 57084 54230 2854 234015 222315 11700 8152 7744 408 227992 216592 11400 347731 330345 17386 2067 1964 103 103160 98002 5158 274440 260718 13722 12562 11934 628 13985 13286 699 MEDICAL SUPPLIES 263674 250490 13184 REPAIRS AND MAINTENANCE 57988 55089 2899 RECRUITMENT & RELOCATIO 46845 44503 2342 DUES & SUBSCRIPTIONS 26077 24773 1304 29619 27821 1798 13432801 12760640 672161 0 468306 488732 1536019 1354655 20316 17361 2983 0 1157412 908528 40154 248884 3376711 1725729 5444489 3835361 1422526 1510943 666178 312236 6311448 5511677 8400152 7334856 X -3372725 -3911524 417062 412029 -2955663 -3499495 5444489 3835361 X -919551 375719 X 0 1 X 1 0 X 663247 615866 251271 340386 221870 2092640 9913580 9591605 9581540 11004136 12185391 52276252 363510 382926 108438 101923 91580 1048377 10940337 10590397 9941249 11446445 12498841 55417269 0 0 0 55417269 857 1503 976 890 309 4535 571 571 857 2074 976 890 309 5106 271824 172187 18840 462851 10941194 10592471 10214049 11619522 12517990 55885226 0.99160 0.99120 0.00010 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 47830 47830 0 1109582 860698 248884 248884 INTERCOMPANY RECEIVABLES 1604658 DEPOSITS 2300 ROU 118771 1725729 INTERCOMPANY PAYABLE 1990809 CHI CASH MANAGEMENT 1562144 PAYABLE TO CHI 1853208 LEASE LIABILITIES 105516 5511677 X PART X, LINE 2: CHI HEALTH CONNECT AT HOME'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. BRECKENRIDGE GOLF TOURNAMENT 19224 384 18840 1751 680 3300 573 19224 384 18840 1751 680 3300 573 6304 12536 1 1 0 0 0 0 0 0 0 CLIFF ROBERTSON BRD MBR/CSH SVP OPERATIONS 0 1011674 0 921351 0 397677 0 16975 0 29727 0 2377404 0 157178 JEFFREY DROP BRD MBR/CSH SVP OPERATIONS 0 692085 0 430582 0 141130 0 16844 0 17949 0 1298590 0 0 JEANETTE WOJTALEWICZ BOARD MEMBER/CSH SVP OPERATIONS 0 553985 0 277663 0 154664 0 17649 0 32617 0 1036578 0 49946 SUE HEITKAMP PRESIDENT 2920 119542 6327 0 0 12098 0 16563 10953 13407 20200 161610 0 7382 MICHELLE COOLEY NURSE PRACT-PALLIATIVE CARE 119027 0 2500 0 7050 0 5322 0 21234 0 155133 0 0 0 PART I, LINE 3A: DURING 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. PART I, LINE 4A: FOR REPORTABLE INDIVIDUALS EMPLOYED PRIOR TO 2019, POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. OFFICERS, KEY EMPLOYEES AND CERTAIN HIGHLY COMPENSATED EMPLOYEES WHO BEGAN EMPLOYMENT AFTER NOVEMBER 1ST OF 2019 ARE COVERED BY THE COMMONSPIRIT HEALTH EXECUTIVE SEVERANCE POLICY. THIS POLICY PROVIDES FOR SEVERANCE PAY WHICH VARIES BASED UPON THE EXECUTIVE'S POSITION LEVEL, IN THE EVENT OF A POSITION ELIMINATION OR OTHER QUALIFYING EVENT, IN ACCORDANCE WITH THE GUIDELINES OF THE EXECUTIVE SEVERANCE POLICY. AN EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT SHALL CONTROL WHERE THE SEVERANCE PAY AMOUNTS IN THE POLICY CONFLICT WITH THE EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT. IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT OF CLAIMS. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM CHI HEALTH CONNECT AT HOME -FARGO DURING THE 2020 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): DEANNA KAINZ - $21,751 PART I, LINE 4B: DURING THE 2020 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2020 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: JEANETTE WOJTALEWICZ - $71,692; CLIFF ROBERTSON - $186,901; AND SUE HEITKAMP - $8,910 DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2020 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2020, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: JEFFREY DROP - $113,534; JEANETTE WOJTALEWICZ - $77,144; AND CLIFF ROBERTSON - $195,187 JESSICA BESTE FAMILY MEMBER OF BOARD MEMBER 43144 EMPLOYMENT 0 FORM 990, PART III, LINE 2 TELEHEALTH FOR HOME HEALTH. A GRANT WAS RECEIVED THAT PROVIDED ELECTRONIC TABLETS TO PATIENTS WHO RESIDE IN RURAL COMMUNITIES AND SUFFER FROM CHRONIC DISEASES. THE TABLETS ALLOW OUR HOME HEALTH STAFF TO MONITOR THE PATIENT'S SYMPTOMS REMOTELY. FORM 990, PART III, LINE 4A: IN FISCAL YEAR 2021, CHI HEALTH CONNECT AT HOME-FARGO'S TOTAL COMMUNITY BENEFIT WAS $452,099 SERVING 453 PEOPLE, OF WHICH $393,981 OF UNPAID COSTS SERVING 56 PATIENTS PARTICIPATING IN ND AND MN STATE MEDICAID PROGRAMS. THE DECREASE IN COMMUNITY BENEFIT FROM FY20 WAS, AGAIN THIS FY YEAR, ASSOCIATED WITH THE COVID PANDEMIC AND OUR BEING UNABLE TO HOST NURSING STUDENTS FOR THE FIRST PART OF THE YEAR, UNABLE TO HOLD LIVE EVENTS AND OFFER COMMUNITY EDUCATION. DURING FY21, EBIDA FOR THE YEAR ENDED AT A NEGATIVE $854,615 WHICH WAS $59,199 WORSE THAN BUDGET. CHI HEALTH CONNECT AT HOME-FARGO HAS BEEN IN OPERATION AS A STAND-ALONE HOME HEALTH & HOSPICE BUSINESS FOR 10 AND HALF YEARS, ORIGINALLY STARTING WITH 10 SEPARATE AGENCY LOCATIONS ACROSS ND, MN AND SD. OF THOSE 10, 4 WERE CONSOLIDATED INTO 1, 1 WAS SOLD ALONG WITH THEIR HOSPITAL AND 1 RETURNED TO OPERATE WITH THEIR HOSPITAL. IN 2016, WE ADDED THE BISMARCK HOME HEALTH AND HOSPICE THAT WAS PREVIOUSLY PART OF THE ST. ALEXIUS MEDICAL CENTER, AND IN FY 20, WE CONSOLIDATED OUR ALBANY, MN AGENCY INTO OUR LITTLE FALLS, MN AGENCY. IN OCTOBER OF 2020, WE JOINED THE NATIONAL COMMONSPIRIT HEALTH LINE OF HEALTH AT HOME UNDER A MANAGED SERVICE AGREEMENT. AT THAT TIME, ST JOSEPH'S HOSPICE IN PARK RAPIDS, MN JOINED THE SERVICE LINE, AS WELL UNDER THE MSA, HOWEVER REMAIN A DEPARTMENT OF THEIR HOSPITAL. IN 2019, WE BEGAN TO OFFER SERVICES TO THE FARGO, ND COMMUNITY AS A BRANCH OF THE BRECKENRIDGE OFFICE. WE CURRENTLY HAVE A TOTAL OF 7 AGENCIES, 3 IN MN (BRECKENRIDGE, LITTLE FALLS AND PARK RAPIDS) AND 4 IN ND (DICKINSON, WILLISTON, VALLEY CITY AND BISMARCK). OVERALL, WE SERVE APPROXIMATELY 53 COUNTIES IN ND AND MN. FOR FY21, WE REPORTED COMMUNITY BENEFIT AND SERVED UNDER THE STATE MEDICAID PROGRAMS IN 6 LOCATIONS. COMMUNITY BENEFIT, OFFERED AT ALL LOCATIONS, WAS FOR SERVICES SUCH AS BEREAVEMENT IN THE FORM OF GRIEF SUPPORT GROUPS, COMMUNITY GRIEF EDUCATION EVENTS, MEMORIAL EVENTS FOR HOSPICE AND COMMUNITY BEREAVED, EDUCATION/PRECEPTORSHIP TO NURSING STUDENTS AS WELL AS VARIED TYPES OF COMMUNITY EDUCATION SUCH AS PARTICIPATING IN HEALTH FAIR EVENTS, SPEAKING ENGAGEMENTS, TV NOON SHOWS, ETC. IN FY21, WE WERE ABLE TO DONATE TO THE INDIGENOUS PEOPLE'S HOSPITAL, AN INTERNATIONAL RECIPIENT OF COMMUNITY BENEFIT ACROSS DIVISIONS. WE WERE ABLE TO OFFER COMMUNITY BENEFIT HOURS IN THE FORM OF HOME AND COMMUNITY-BASED PALLIATIVE CARE SERVICES FOR PART OF THE FY, BUT ENDED THIS PROGRAMMING AS WE JOINED THE NATIONAL SERVICE LINE. WE CONTINUE TO BUILD TOWARDS OFFERING PALLIATIVE CARE SERVICES IN THE FUTURE, BUT AS PART OF AN OPERATIONAL SERVICE LINE. OUR BUSINESS OFFERINGS ARE HOME HEALTH AND HOSPICE CARE AND WE CONTINUE TO OPERATE ALMOST ENTIRELY IN RURAL ND AND MN, SERVING PATIENTS WHO LIVE IN SMALL COMMUNITIES AND RESIDE PERHAPS DOZENS OF MILES FROM THE CLOSEST HEALTHCARE FACILITY. OUR RESPONSIBILITY TO THESE SMALL COMMUNITIES AND THEIR CITIZENS IS TO MAKE SURE THEY CAN ACCESS OUR SERVICES AND ARE AWARE OF HOW OUR SERVICES CAN HELP IMPROVE AND MAINTAIN THEIR HEALTH; THIS IS FUNDAMENTAL IN HOW WE CARRY OUT THE MISSION, VISION AND VALUES OF CATHOLIC HEALTH INITIATIVES/COMMONSPIRIT HEALTH WITH OUR WORK. OUR REMOTE AND TELEHEALTH SERVICES, ESPECIALLY DURING THE PANDEMIC, HAVE HELPED US CONTINUE TO PROVIDE AND DEDICATE OUR CARE TO OUR RURAL COMMUNITIES. IN 2019, WE APPLIED, AND WERE GRANTED, AN OTTO BREMER GRANT TO FUND A RURAL TELEHEALTH PROGRAM IN OUR SERVICE AREAS. THE AWARD WAS IN THE AMOUNT OF $72,850 AND WAS DESIGNED TO PROVIDE ELECTRONIC TABLETS TO PATIENTS WHO RESIDE IN OUR RURAL COMMUNITIES AND SUFFER FROM A CHRONIC DISEASE. THE TABLETS ALLOW THE PATIENT TO MONITOR THEIR SYMPTOMS REMOTELY WITH THE ASSIST OF OUR HOME HEALTH STAFF. THE GRANT PROGRAM WAS TO LAUNCH IN FEBRUARY OF 2020, BUT DUE TO THE COVID PANDEMIC, AND OTHER INTERNAL AND EXTERNAL CHALLENGES, WE APPLIED AND WERE GRANTED AN EXTENSION TO RE-LAUNCH THE PROGRAM THROUGH THE END OF 2021. WE RECENTLY SUBMITTED OUR FINAL GRANT REPORT, AND WERE ABLE TO SERVE MORE THAN 148 PATIENTS AND IMPROVED PATIENT OUTCOMES IN AREAS OF AMBULATION, BATHING, MEDICATION MANAGEMENT AND TRANSFERS. WE WERE ALSO ABLE TO ACHIEVE LOWER HOSPITALIZATIONS RATES, AND HIGHER PATIENT EXPERIENCE RATES. ALL FUNDS WERE EXPENDED FOR THE AWARDED GRANT AMOUNT. BASED ON OUTCOMES, AND OUR CONTINUED DEDICATION TO SERVE OUR RURAL COMMUNITIES, WE WILL CONTINUE WITH REMOTE AND TELEHEALTH SERVICES THROUGHOUT OUR LOCATIONS. CHI HEALTH CONNECT AT HOME FARGO IS A NONPROFIT, TAX EXEMPT ORGANIZATION THAT TAKES ALL NECESSARY MEASURES TO BE COMPLIANT WITH ALL LEGISLATION IN HEALTHCARE IN DETERMINING WHAT TO REPORT, HOW TO REPORT, AS WELL AS FOCUSING ON WHAT EACH INDIVIDUAL COMMUNITY MAY NEED. AS WE ARE SPREAD ACROSS SEVERAL COMMUNITIES WITH DIFFERING NEEDS, WE CONTINUE TO EXPLORE WHAT SUPPORT WE ARE OFFERING TO BE SURE WE'RE BEST SERVING THE PATIENTS WHERE WE LIVE. WE WILL CONTINUE OUR EFFORTS TOWARD FINANCIAL STABILITY, POSITIVE MARGINS AND INCREASED CASH FLOW TO INSURE WE CAN KEEP INCREASING COMMUNITY SUPPORT. FORM 990, PART VI, SECTION A, LINE 1 PURSUANT TO SECTION 8.4 OF THE BYLAWS OF CHI CONNECT AT HOME - FARGO, THE STANDING COMMITTEES OF THE BOARD OF DIRECTORS INCLUDES AN EXECUTIVE COMMITTEE AND SUCH OTHER STANDING COMMITTEES AS MAY BE ESTABLISHED BY THE BOARD OF DIRECTORS FROM TIME TO TIME. PURSUANT TO SECTION 8.2 OF THE BYLAWS OF CHI CONNECT AT HOME - FARGO, EACH COMMITTEE SHALL HAVE THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE BUSINESS OF THE CORPORATION TO THE EXTENT PROVIDED IN RESOLUTION ESTABLISHING SUCH COMMITTEE. COMMITTEES ARE SUBJECT AT ALL TIMES TO THE DIRECTION AND CONTROL OF THE BOARD OF DIRECTORS. ANY COMMITTEE COMPOSED OF PERSONS, ONE OR MORE OF WHOM ARE NOT DIRECTORS, SHALL ACT SOLELY IN AN ADVISORY CAPACITY TO THE BOARD. NO COMMITTEE OF THE BOARD SHALL HAVE AUTHORITY TO EXERCISE POWERS RESERVED TO THE CORPORATE MEMBER OR TO EXERCISE POWERS THAT CANNOT BE DELEGATED TO A COMMITTEE UNDER THE LAWS OF THE STATE OF MINNESOTA. FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO THE BYLAWS OF CHI HEALTH CONNECT AT HOME-FARGO, THE ENTITY'S SOLE MEMBER IS COMMONSPIRIT HEALTH, A COLORADO NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE EXECUTIVE VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S CORPORATE MEMBER IS COMMONSPIRIT HEALTH. PURSUANT TO SECTION 5.4.1 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE COMMONSPIRIT HEALTH BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE COMMONSPIRIT HEALTH CHIEF EXECUTIVE OFFICER: *SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF CHI HEALTH CONNECT AT HOME - FARGO; *AMENDMENT OF THE CORPORATE DOCUMENTS OF CHI HEALTH CONNECT AT HOME - FARGO; *APPROVE MEMBERS OF THE CHI HEALTH CONNECT AT HOME - FARGO BOARD; *REMOVAL OF A MEMBER OF THE GOVERNING BODY OF CHI HEALTH CONNECT AT HOME - FARGO; *APPROVAL OF ISSUANCE OF DEBT BY CHI HEALTH CONNECT AT HOME - FARGO; *APPROVAL OF PARTICIPATION OF CHI HEALTH CONNECT AT HOME - FARGO IN A JOINT VENTURE; *APPROVAL OF FORMATION OF A NEW CORPORATION BY CHI HEALTH CONNECT AT HOME - FARGO; *APPROVAL OF A MERGER INVOLVING CHI HEALTH CONNECT AT HOME - FARGO; *APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CHI HEALTH CONNECT AT HOME - FARGO; *TO REQUIRE THE TRANSFER OF ASSETS BY CHI HEALTH CONNECT AT HOME - FARGO TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH'S DEBTS. *ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR CHI HEALTH CONNECT AT HOME - FARGO. PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, COMMONSPIRIT HEALTH MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE EXECUTIVE DIRECTOR OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION B, LINE 11B NO REVIEW WAS OR WILL BE CONDUCTED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. THE POLICY WAS LAST UPDATED DURING THE TAX YEAR ENDED 6/30/2021. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15B MARKET DATA FOR KEY POSITIONS FOR THE ENTITY WAS GATHERED FROM MULTIPLE SALARY SURVEY SOURCES. A REVIEW OF THE DATA AND A RECOMMENDATION WAS MADE BY THE DIRECTOR, HR BUSINESS PRACTICES TO THE DIVISION VICE PRESIDENT OF HUMAN RESOURCES. FINAL APPROVAL OF COMPENSATION WAS OBTAINED BY THE SENIOR VP OF THE FARGO OPERATING DIVISION. THESE DETERMINATIONS ARE REVIEWED BY HUMAN RESOURCES AND BROUGHT TO THE BOARD OF DIRECTORS, WHEREIN THEY HAVE AN OPPORTUNITY FOR QUESTIONS AND/OR TO EXPRESS ANY CONCERNS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG. FORM 990, PART VI, LINE 14: THE DOCUMENT RETENTION AND DESTRUCTION POLICY IS MORE OF AN OPERATIONAL POLICY. THESE TYPES OF POLICIES USUALLY DO NOT GO TO THE BOARD OF DIRECTORS. THIS HAS NOT BEEN ADOPTED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, LINE 15A: THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION WAS PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION THE COMMONSPIRIT HEALTH BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR APPROVING REASONABLE COMPENSATION PACKAGES FOR EACH OFFICER AND CERTAIN KEY EMPLOYEES (INCLUDING THE PRESIDENT/CEO). THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EXECUTIVES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES 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. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,620,083. MANAGEMENT AND GENERAL EXPENSES 137,899. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,757,982. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 30,315. MANAGEMENT AND GENERAL EXPENSES 1,596. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,911. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 4,584. MANAGEMENT AND GENERAL EXPENSES 509. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,093. FORM 990, PART XI, LINE 9: REALLOCATION OF CARES ACT REVENUE 375,719. ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HOSPITAL NE 501(C)(3) LINE 3 ACH 0 ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - COMM MEM HOSP OF MO VALLEYIA 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(C)(3) LINE 10 CSH 0 APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(C)(3) LINE 10 SFH 0 ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION 345 S HALCYON RD ARROYO GRANDE CA 93420 203256066 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 BAKERSFIELD MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD CA 93301 951802779 HOSPITAL CA 501(C)(3) LINE 3 DCC 0 BARROW NEUROLOGICAL FOUNDATION 350 WEST THOMAS ROAD PHOENIX AZ 85013 860174371 FUNDRAISING FOUNDATION AZ 501(C)(3) LINE 7 DH 0 BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS TX 77384 274499340 PHYSICIANS TX 501(C)(3) LINE 12A, I SLHS 0 BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760458535 PHYSICIANS TX 501(C)(3) LINE 3 BSLHV 0 BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232187242 INACTIVE PA 501(C)(3) LINE 12A, I CSH 0 BRAZOSPORT HEALTH FOUNDATION INC 1 WEST WAY CT LAKE JACKSON TX 77566 760080110 FUNDRAISING FOUNDATION TX 501(C)(3) LINE 12A, I TCHB 0 BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DRIVE LAKE JACKSON TX 77566 800240261 PHYSICIANS TX 501(C)(3) LINE 3 TCHB 0 BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HOSPITAL TX 501(C)(3) LINE 3 SJSC 0 BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 REHABILITATION TX 501(C)(3) LINE 10 SJSC 0 CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION 1401 SOUTH GRAND AVENUE LOS ANGELES CA 90015 954000909 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DCC 0 CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HOSPITAL ND 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES - COLORADO 9100 EAST MINERAL CIRCLE CENTENNIAL CO 80112 840405257 HOSPITAL CO 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVE DES MOINES IA 50314 420680448 HOSPITAL IA 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 9100 EAST MINERAL CIRCLE CENTENNIAL CO 80112 840902211 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 7 CHIC 0 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501(C)(3) LINE 12A, I SFH-OH 0 CHI MEMORIAL HOSPITAL - GEORGIA 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 822748395 HOSPITAL GA 501(C)(3) LINE 3 MHCS 0 CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 451261716 HOME HEALTH CO 501(C)(3) LINE 10 CHI NS 0 CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 452532084 HOLDING CO CO 501(C)(3) LINE 12A, I CSH 0 CHI NEBRASKA 12809 WEST DODGE ROAD OMAHA NE 68510 363233121 HOLDING CO NE 501(C)(3) LINE 12A, I CSH 0 CHI ST JOSEPH CHILDREN'S HEALTH 1929 LINCOLN HWY E STE 150 LANCASTER PA 17602 232342997 HEALTHCARE PA 501(C)(3) LINE 12A, I CSH 0 CHI ST JOSEPH'S CHILDREN 1516 5TH ST NW ALBUQUERQUE NM 87102 710897107 COMMUNITY NM 501(C)(3) LINE 12A, I CSH 0 CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 710236913 HOSPITAL AR 501(C)(3) LINE 3 CHISVHS 0 CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125064 HOLDING CO AR 501(C)(3) LINE 12A, I SVIMC 0 CHI ST VINCENT MEDICAL 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TEXAS CLINICAL SERVICES 2801 VIA FORTUNA SUITE 500 AUSTIN TX 78746 454736213 HEALTHCARE TX 501(C)(3) LINE 12A, I SLHS 0 ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1455 BATTERSBY AVE ENUMCLAW WA 98022 910715805 HOSPITAL WA 501(C)(3) LINE 3 FHS 0 FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 611345363 HOSPITAL KY 501(C)(3) LINE 3 KOH 0 FLAGET MEMORIAL HOSPITAL FOUNDATION INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 562351341 FUNDRAISING FOUNDATION KY 501(C)(3) LINE 12A, I FH 0 FRANCISCAN CARE CENTER 4111 N HOLLAND-SYLVANIA RD TOLEDO OH 43623 341931806 HEALTHCARE OH 501(C)(3) LINE 10 CHILC 0 FRANCISCAN FOUNDATION 1717 SOUTH J ST TACOMA WA 98405 911145592 FUNDRAISING FOUNDATION WA 501(C)(3) LINE 10 FHS 0 FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA WA 98405 910564491 HOSPITAL WA 501(C)(3) LINE 3 CSH 0 FRANCISCAN HEALTH VENTURES TACOMA FNC CTR BLDG 1145 BROADWAY TACOMA WA 98402 431882377 INACTIVE MO 501(C)(3) LINE 10 CSH 0 FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 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