CHI LISBON HEALTH: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: CHI LISBON HEALTH (EIN 82-0558836)
Tax period: 2018-07-01 to 2019-06-30
Filed: 2020-07-13
IRS object ID: 202021959349301842
Schema version: 2018v3.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-07-13T11:31:07-05:00	ReturnTs
Tax Period End	2019-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	470617373	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CommonSpirit Health	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	198 INVERNESS DRIVE WEST	AddressLine1Txt
City	ENGLEWOOD	CityNm
State Abbreviation	CO	StateAbbreviationCd
ZIP	80112	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	820558836	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Lisbon Area Health Services	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	LISB	BusinessNameControlTxt
Phone	7016835241	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	905 Main Street	AddressLine1Txt
City	Lisbon	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58054	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Keith Heuser	PersonNm
Person Title	President	PersonTitleTxt
Signature	2020-07-13	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MARK STOCKI	PreparerPersonNm
PTIN	P00642127	PTIN
Phone	3032989100	PhoneNum

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-09-22 18:59:49Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	CHI Lisbon Health	BusinessNameLine1Txt

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KEITH HEUSER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	905 Main Street	AddressLine1Txt
City	Lisbon	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58054	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$11,394,765	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.lisbonhospital.com	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2002	FormationYr
Legal Domicile State	ND	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE HIGH QUALITY HEALTH CARE WITHIN IDEALS OF COMPASSION AND CONCERN, TO BE COMMITTED TO MAINTAIN OUR PRESENCE INTO THE FUTURE BY SERVING OUR CUSTOMERS, TO ASSURE CONTINUITY OF TOTAL CARE.	ActivityOrMissionDesc
Voting Members Governing Body	7	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	96	TotalEmployeeCnt
Total Volunteers	10	TotalVolunteersCnt
Total Gross UBI	$411	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$160,258	PYContributionsGrantsAmt
CY Contributions Grants	$125,532	CYContributionsGrantsAmt
PY Program Service Revenue	$11,063,823	PYProgramServiceRevenueAmt
CY Program Service Revenue	$11,064,030	CYProgramServiceRevenueAmt
PY Investment Income	$219,475	PYInvestmentIncomeAmt
CY Investment Income	$108,241	CYInvestmentIncomeAmt
PY Other Revenue	$84,702	PYOtherRevenueAmt
CY Other Revenue	$88,147	CYOtherRevenueAmt
PY Total Revenue	$11,528,258	PYTotalRevenueAmt
CY Total Revenue	$11,385,950	CYTotalRevenueAmt
PY Grants And Similar Paid	$221,363	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$3,544	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$4,513,633	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$4,458,948	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$6,268,051	PYOtherExpensesAmt
CY Other Expenses	$6,554,212	CYOtherExpensesAmt
PY Total Expenses	$11,003,047	PYTotalExpensesAmt
CY Total Expenses	$11,016,704	CYTotalExpensesAmt
PY Revenues Less Expenses	$525,211	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$369,246	CYRevenuesLessExpensesAmt
Total Assets BOY	$14,764,361	TotalAssetsBOYAmt
Total Assets EOY	$15,989,241	TotalAssetsEOYAmt
Total Liabilities BOY	$4,143,647	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$4,988,853	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$10,620,714	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$11,000,388	NetAssetsOrFundBalancesEOYAmt
Mission	As an affiliate of CommonSpirit Health, we make the healing presence of God known in our world by improving the health of the people we serve, especially those who are vulnerable, while we advance social justice for all.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$9,952,810	ExpenseAmt
Grant	$3,544	GrantAmt
Revenue	$11,064,030	RevenueAmt
Desc	SEE SCHEDULE H	Desc
Total Program Service Expenses	$9,952,810	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (true)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	96	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	Yes (true)	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	7	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	false	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Beth Smith	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7012378022	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4784 Amber Valley Parkway	AddressLine1Txt
City	Fargo	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58104	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Jason Enger
Chair	1.0	0	Yes (X)	Yes (X)	$0	$0	$0
PEGGY REINKE
PRESIDENT	1.0	40.0	Yes (X)	Yes (X)	$0	$225,860	$14,575
RYAN ZERFACE
Vice Chair	1.0	0	Yes (X)	Yes (X)	$0	$0	$0
Dr Cameron Schroeder
SECRETARY	1.0	0	Yes (X)	Yes (X)	$0	$0	$0
JEFFREY DROP
Board Member/CHI SVP Division Officer	1.0	50.0	Yes (X)		$0	$1,388,860	$40,427
NEIL OLERUD
Board Member	1.0	0	Yes (X)		$0	$0	$0
Sister Donna Welder
Board Member	1.0	0	Yes (X)		$0	$0	$0
BETH SMITH
VP of Operational Finance/Treasurer	1.0	40.0		Yes (X)	$0	$103,368	$30,577
AMBER STOWMAN
Division Director of Finance	1.0	40.0		Yes (X)	$0	$152,541	$34,812
OSCAR FERNANDEZ
PHYSICIAN	40.0	0			$305,201	$0	$39,803	Yes (X)
Julie A Mallett
VP PATIENT CARE SERVICES	40.0	0			$118,149	$0	$9,362	Yes (X)
JILL MCRITCHIE
MANAGER PHARMACY	40.0	0			$147,051	$0	$25,883	Yes (X)
REBECCA THOMPSON
VP OPERATIONAL FINANCE (THROUGH 7/31/14)	0.0	2.0			$0	$200,513	$35,461		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$570,401	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,071,142	TotReportableCompRltdOrgAmt
Total Other Compensation	$230,900	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	3	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
MOBILITYPLUS REHABILITATION
26295 CRYSTAL RD	PELICAN RAPIDS	MN	56572	PHYSICAL/OCCUPATIONAL THERAPY SERVICES	$390,774
NATIONAL MEDICAL RESOURCES INC
2900 E BROADWAY AVE SUITE 1	BISMARCK	ND	58501	EMERGENCY ROOM COVERAGE	$366,920
Rudolf Loperena MD
PO BOX 71	LISBON	ND	58054	ER PHYSICIAN COVERAGE	$248,960
DMS HEALTH TECHNOLOGIES
1351 PAGE DR SOUTH STE 300	FARGO	ND	58103	NUCLEAR MED, MRI	$146,623

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	4	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Federated Campaigns	$0	FederatedCampaignsAmt
Membership Dues	$0	MembershipDuesAmt
Fundraising	$39,559	FundraisingAmt
Related Organizations	$0	RelatedOrganizationsAmt
Government Grants	$25,615	GovernmentGrantsAmt
All Other Contributions	$60,358	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$125,532	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Net Patient Services	900099	$11,064,030	$11,064,030	$0	$0
		$0	$0	$0	$0
		$0	$0	$0	$0
		$0	$0	$0	$0
		$0	$0	$0	$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$11,064,030	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$73,955	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$411	UnrelatedBusinessRevenueAmt
Exclusion	$73,544	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$72,740	RealAmt
Personal	$0	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$72,740	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$72,740	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$72,740	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$34,286	SecuritiesAmt
Other	$0	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$34,286	SecuritiesAmt
Other	$0	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$34,286	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$34,286	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$7,053	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$39,559	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$6,065	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$988	TotalRevenueColumnAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$988	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$12,785	GamingGrossIncomeAmt
Gaming Direct Expenses	$2,750	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,035	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$10,035	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Other Program Service Revenue	900099	$3,761	$0	$0	$3,761
Cafeteria	722100	$265	$0	$0	$265
Medical Records Revenue/Transcription	541200	$248	$0	$0	$248

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$110	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$110	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$4,384	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,385,950	TotalRevenueColumnAmt
Related Or Exempt Func Income	$11,064,030	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$411	UnrelatedBusinessRevenueAmt
Exclusion	$195,977	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$3,044	TotalAmt
Program Services	$3,044	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$500	TotalAmt
Program Services	$500	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$3,517,192	TotalAmt
Program Services	$3,200,645	ProgramServicesAmt
Management And General	$316,547	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$187,775	TotalAmt
Program Services	$170,875	ProgramServicesAmt
Management And General	$16,900	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$521,119	TotalAmt
Program Services	$474,219	ProgramServicesAmt
Management And General	$46,900	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$232,862	TotalAmt
Program Services	$211,905	ProgramServicesAmt
Management And General	$20,957	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$10,073	TotalAmt
Management And General	$10,073	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$2,558	TotalAmt
Management And General	$2,558	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$3,072,859	TotalAmt
Program Services	$2,588,878	ProgramServicesAmt
Management And General	$483,981	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$17,755	TotalAmt
Management And General	$17,755	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$194,216	TotalAmt
Program Services	$155,373	ProgramServicesAmt
Management And General	$38,843	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$962,337	TotalAmt
Program Services	$914,220	ProgramServicesAmt
Management And General	$48,117	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$226,824	TotalAmt
Program Services	$206,410	ProgramServicesAmt
Management And General	$20,414	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$11,796	TotalAmt
Program Services	$5,898	ProgramServicesAmt
Management And General	$5,898	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$37	TotalAmt
Program Services	$4	ProgramServicesAmt
Management And General	$33	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,561	TotalAmt
Program Services	$1,561	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$584,052	TotalAmt
Program Services	$584,052	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$576,803	TotalAmt
Program Services	$576,803	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$734,541	$734,541
Repairs and maintenance	$110,199	$109,097	$1,102
Dues & subscriptions	$30,482	$14,785	$15,697
Recruitment and relocation	$8,836		$8,836

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$9,283	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$9,283	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$11,016,704	TotalAmt
Program Services	$9,952,810	ProgramServicesAmt
Management And General	$1,063,894	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$510	BOYAmt
EOY	$833	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$3,096,686	BOYAmt
EOY	$3,263,607	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,724,685	BOYAmt
EOY	$1,917,322	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$230,200	BOYAmt
EOY	$186,328	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$11,801	BOYAmt
EOY	$11,565	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$8,482,627	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$5,354,360	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$3,224,041	BOYAmt
EOY	$3,128,267	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$3,057,636	BOYAmt
EOY	$3,236,299	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$3,418,802	BOYAmt
EOY	$4,245,020	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$14,764,361	BOYAmt
EOY	$15,989,241	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$596,733	BOYAmt
EOY	$505,730	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$15,000	BOYAmt
EOY	$143,053	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$3,531,914	BOYAmt
EOY	$4,340,070	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$4,143,647	BOYAmt
EOY	$4,988,853	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$10,490,245	BOYAmt
EOY	$10,874,447	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$126,969	BOYAmt
EOY	$122,441	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,500	BOYAmt
EOY	$3,500	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$10,620,714	BOYAmt
EOY	$11,000,388	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$14,764,361	BOYAmt
EOY	$15,989,241	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$369,246	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$77,484	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$67,056	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$2,558	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$2,558	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	FormAndLineReferenceDesc
Explanation	THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION $434 CATHOLIC HEALTH ASSOCIATION $327 NORTH DAKOTA HOSPITAL ASSOCIATION - $1797	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,500	BeginningYearBalanceAmt
End Year Balance	$3,500	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,500	BeginningYearBalanceAmt
End Year Balance	$3,500	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,500	BeginningYearBalanceAmt
End Year Balance	$3,500	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,500	BeginningYearBalanceAmt
End Year Balance	$3,500	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,500	BeginningYearBalanceAmt
End Year Balance	$3,500	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.0	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	1.0	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.0	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$103,303	OtherCostOrOtherBasisAmt
Book Value	$103,303	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,273,849	OtherCostOrOtherBasisAmt
Depreciation	$1,148,251	DepreciationAmt
Book Value	$125,598	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$0	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,898,584	OtherCostOrOtherBasisAmt
Depreciation	$4,062,976	DepreciationAmt
Book Value	$2,835,608	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$206,891	OtherCostOrOtherBasisAmt
Depreciation	$143,133	DepreciationAmt
Book Value	$63,758	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$3,128,267	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	CHI OPERATING INVESTMENT PROGRAM, LP	Desc
Book Value	$3,236,299	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$3,236,299	TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
EQUITY IN CENTRAL MINNESOTA DIAGNOSTIC IMAGING	$144,115
INTERCOMPANY RECEIVABLES	$4,100,905

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$4,245,020	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Intercompany Payables
CHI Debt Management Program
Current Liabilities	$521
Intercompany Payables	$4,339,549

Field	Value	IRS element (for citing)
Total Liability	$4,340,070	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule D, Part V, Line 4 Intended uses of endowment funds

ENDOWMENT FUNDS ARE HELD TO PROVIDE SUPPORT TO AND FOR THE BENEFIT OF LISBON AREA HEALTH SERVICES.

Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote

Lisbon Area Health Service's financial information is included in the consolidated audited financial statements of CommonSpirit Health, a related organization. CommonSpirit Health's FIN 48 (ASC 740) footnote for the year ended June 30, 2019, reads as follows: "CommonSpirit has established its status as an organization exempt from income taxes under the Internal Revenue Code Section 501(c)(3) and the laws of the states in which it operates, and as such, is generally not subject to federal or state income taxes. However, CommonSpirit's exempt organizations are subject to income taxes on net income derived from a trade or business, regularly carried on, which does not further the organizations' exempt purposes. No significant income tax provision has been recorded in the accompanying consolidated financial statements for net income derived from unrelated trade or business. CommonSpirit's for-profit subsidiaries account for income taxes related to their operations. The for-profit subsidiaries recognize deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of their assets and liabilities, along with net operating loss and tax credit carryovers, for tax positions that meet the more-likely-than-not recognition criteria. Changes in recognition or measurement are reflected in the period in which the change in judgement occurs. Income tax interest and penalties are recorded as income tax expense. For the years ended June 30, 2019 and 2018, CommonSpirit's taxable entities recorded an immaterial amount of interest and penalties as part of the provision for income taxes. CommonSpirit's taxable entities did not have any material unrecognized income tax benefits as of June 30, 2019 and 2018. 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 G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	GALA	Event1Nm
Gross Receipts Event1	$46,612	GrossReceiptsEvent1Amt
Charitable Contri Event1	$39,559	CharitableContriEvent1Amt
Gross Revenue Event1	$7,053	GrossRevenueEvent1Amt
Rent Facility Costs Event1	$850	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$4,219	FoodAndBeverageEvent1Amt
Entertainment Event1	$300	EntertainmentEvent1Amt
Other Direct Expenses Event1	$696	OtherDirectExpensesEvent1Amt
Gross Revenue Event2	$0	GrossRevenueEvent2Amt
Gross Revenue Other Events	$0	GrossRevenueOtherEventsAmt
Gross Receipts Total	$46,612	GrossReceiptsTotalAmt
Charitable Contributions Tot	$39,559	CharitableContributionsTotAmt
Gross Revenue Total Events	$7,053	GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events	$850	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$4,219	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$300	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$696	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$6,065	DirectExpenseSummaryEventsAmt
Net Income Summary	$988	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	300	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	148	PersonsServedCnt
Total Community Benefit Expns	$126,712	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$126,712	NetCommunityBenefitExpnsAmt
Total Expense	0.0115	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	148	PersonsServedCnt
Total Community Benefit Expns	$126,712	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$126,712	NetCommunityBenefitExpnsAmt
Total Expense	0.0115	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	190	PersonsServedCnt
Total Community Benefit Expns	$17,394	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,394	NetCommunityBenefitExpnsAmt
Total Expense	0.0016	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	10	PersonsServedCnt
Total Community Benefit Expns	$13,273	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,273	NetCommunityBenefitExpnsAmt
Total Expense	0.0012	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	182	PersonsServedCnt
Total Community Benefit Expns	$26,576	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,100	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,476	NetCommunityBenefitExpnsAmt
Total Expense	0.0016	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	8	ActivitiesOrProgramsCnt
Persons Served	382	PersonsServedCnt
Total Community Benefit Expns	$57,243	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,100	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$48,143	NetCommunityBenefitExpnsAmt
Total Expense	0.0044	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	8	ActivitiesOrProgramsCnt
Persons Served	530	PersonsServedCnt
Total Community Benefit Expns	$183,955	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,100	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$174,855	NetCommunityBenefitExpnsAmt
Total Expense	0.0159	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	25	PersonsServedCnt
Total Community Benefit Expns	$1,775	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,775	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	200	PersonsServedCnt
Total Community Benefit Expns	$6,502	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,502	NetCommunityBenefitExpnsAmt
Total Expense	0.0006	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$5,040	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,040	NetCommunityBenefitExpnsAmt
Total Expense	0.0005	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	48	PersonsServedCnt
Total Community Benefit Expns	$9,418	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,418	NetCommunityBenefitExpnsAmt
Total Expense	0.0009	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	8	ActivitiesOrProgramsCnt
Persons Served	273	PersonsServedCnt
Total Community Benefit Expns	$22,735	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$22,735	NetCommunityBenefitExpnsAmt
Total Expense	0.0021	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$261,525	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$5,510,842	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$5,557,051	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$46,209	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Lisbon Area Health Services	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	905 Main Street	AddressLine1Txt
City	Lisbon	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58054	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.lisbonhospital.com	WebsiteAddressTxt
State License	5031	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Lisbon Area Health Services	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	18	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	http://www.lisbonhospital.com/chna-report.htm	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	false	StrategyPostedWebsiteInd
Strategy Attached	Yes (true)	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	300.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.0	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	The significant health needs are included in a prioritized description of the significant health needs of the community, along with a description of the process and criteria used in identifying certain health needs as significant and prioritizing those significant heath needs, and are identified through the CHNA.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Lisbon Area Health Services. The Center for Rural Health (CRH) at the University of North Dakota School of Medicine & Health Sciences (UNDSMHS) in partnership with CHI Lisbon Health, facilitated the CHNA process. Community representatives met regularly in-person, by telephone conference, and email. A CHNA liaison was selected locally, who served as the main point of contact between the CRH and Lisbon. A small steering committee was formed, responsible for planning and implementing the process locally. Representatives from the CRH met and corresponded regularly by teleconference and/or via the eToolkit with the CHNA liaison. The community group provided in-depth information and informed the assessment process in community perceptions, community resources, community needs, and ideas for improving the health of the population and healthcare services. Nineteen people, representing a cross section demographically, attended the focus group meeting. Detailed below are the methods undertaken to gather data for this assessment by convening a Community Group, conducting key informant interviews, soliciting feedback about health needs via a survey, and researching secondary data. Community Group A community group consisting of 19 community members convened and met for the first time on September 4, 2018. During this meeting, group members were introduced to the needs assessment process, reviewed basic demographic information about the CHI Lisbon Health service area, and served as a focus group. Focus group topics included community assets and challenges, the general health needs of the community, concerns, and suggestions for improving the community's health. The Community Group met again on November 20, 2018, with 17 community members in attendance. At this second meeting, the Community Group was presented with survey results, findings from 5 key informant interviews and the focus group, and a wide range of secondary data relating to the general health of the population in Ransom County and Sargent County. The group was tasked with identifying and prioritizing the community's health needs. Members of the Community Group represented broad interests of the community served by CHI Lisbon Health. They included representatives from a number of businesses as well as those in emergency services, extension, law enforcement, social services, commerce, education, local government, religion, retired, and CHI Lisbon Health staff. Not all members of the group were present at both meetings. Interviews Representatives from the CRH conducted one-on-one in-person interviews with six key informants on September 4, 2018. Interviews were held with selected members to include individuals from the fire department, public health, education, and two individuals from area businesses. Topics covered during the interviews included the general health of the community, community concerns, delivery of healthcare by local providers, awareness of health services offered locally, barriers to receiving health services, and suggestions for improving collaboration within the community. Survey A survey was distributed to solicit feedback from the community. It was not intended to be a scientific or statistically valid sampling of the population. It was designed to be an additional tool for collecting qualitative data from the community at large - specifically, information related to community-perceived health needs. The community member survey was distributed, electronically and paper copy, to a variety of residents of the CHI Lisbon Health service area. To raise awareness of the assessment process and promote the importance of the process, the web link for completing the survey was shared on the following websites and Facebook pages: Civic and Commerce in Lisbon, Bobcat in Gwinner, CHI Lisbon Health, Ransom County Public Health, Sargent County Health Unit, and all area schools in Lisbon, Gwinner, Milnor, and Enderlin. A total of 120 paper surveys were available for distribution in the service area. They were located at all four clinics in Lisbon (Family Medical Clinic, CHI Clinic, Sanford Clinic, and Essentia Clinic), and Sanford clinics in Enderlin, Gwinner, and Forman. Additional paper surveys were available at RCPH in Lisbon and Sargent County District Health Unit in Forman. To ensure anonymity, a postage paid return envelope to the CRH was provided with each survey. Online surveys were submitted directly to the CRH. The survey was available from August 27 through September 24, 2018. The online version of the survey was publicized with the link or URL disseminated in all press releases. A total of 264 online surveys and 17 paper surveys were completed. In total, paper and online, 281 community member surveys were completed. This equates to a response rate of 17.5% of the Lisbon population, which is better than average (13%) for this type of survey methodology.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - Lisbon Area Health Services. Lisbon Area Health Services (LAHS) conducted a community health needs assessment survey through a joint effort of LAHS and Sargent County District Health Unit and Ransom County Public Health Department.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Lisbon Area Health Services. THE HOSPITAL IS A PART OF THE BROADER COMMUNITY. BY COLLABORATING WITH COMMUNITY MEMBERS AND KEY STAKEHOLDERS IN THE LISBON AREA HEALTH SERVICES SERVICE AREA, THE HOSPITAL IS ADDRESSING THE SIGNIFICANT HEALTH NEEDS. BELOW DESCRIBES THE HOSPITAL ROLE IN THESE EFFORTS. 1. ALCOHOL AND DRUG USE AND ABUSE, INCLUDING PRESCRIPTION DRUG ABUSE. LAHS WILL PARTNER WITH STUDENTS AGAINST DESTRUCTIVE DECISIONS (SADD) CHAPTER, LISBON PUBLIC SCHOOLS, LOCAL PHARMACIES, RANSOM AND SARGENT COUNTY PUBLIC HEALTH, AND POLICE DEPARTMENT FOR EVENTS AND TRAINING. GOAL IS TO INCORPORATE A COUNTY WIDE IMPACT TO ADDRESS ALCOHOL AND DRUG ABUSE. 2. AVAILABILITY OF MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT SERVICES. LAHS WILL COLLABORATE WITH CURRENT SERVICES IN PLACE WITHIN THE COUNTY AND INCORPORATE ADDITIONAL SERVICES SUCH AS OUTPATIENT PSYCHOLOGY AND TELEPSYCH INTO OUR COMMUNITY. GOAL IS TO INCREASE AWARENESS OF THE AVAILABLE PROGRAMS CURRENTLY AVAILABLE AND ACHIEVE MEASURABLE INCREASE IN VOLUMES OF PARTICIPANTS SEEKING OUR COMMUNITIES' MENTAL HEALTH SERVICES. 3. VIOLENCE PREVENTION. LAHS WILL CONTINUE OUR PARTNERSHIPS ESTABLISHED WITH COMMUNITY MEMBERS ON OUR VIOLENCE PREVENTION TRAINERS GROUP AND OUR VIOLENCE PREVENTION COALITION GROUP. LAHS WILL ALSO CONTINUE THE MESSAGE OF CHI VIOLENCE PREVENTION PROGRAM INTO OUR MISSION AND COMMUNITY. THE GOAL IS TO WORK WITH AND IMPLEMENT PROGRAMS TO BE REACHED INTO THE LOCAL SCHOOLS ON CYBER-BULLYING. SIGNIFICANT HEALTH NEEDS NOT ADDRESSED: 1. NEED FOR PREVENTIVE WELLNESS/INCREASED PHYSICAL ACTIVITY. WHILE LAHS DOES PROMOTE PREVENTATIVE WELLNESS AND PHYSICAL ACTIVITY WITH OUR PATIENTS, AT THIS TIME WE CHOSE TO PUT A LARGER FOCUS ON THE CRITICAL NEEDS IDENTIFIED ABOVE. 2. SENIOR LIVING OPTIONS. AT THIS TIME, ADDRESSING OR INCREASING SENIOR LIVING OPTIONS IS OUTSIDE OF THE CAPACITY OF THE SERVICE OF LAHS.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - Lisbon Area Health Services. The patient must have a minimum account balance of thirty-five dollars ($35.00) with the CHI Hospital Organization. Multiple account balances may be combined to reach this amount. Patients/Guarantors with balances below thirty-five dollars ($35) may contact a financial counselor to make monthly installment payment arrangements. The patient must submit a completed Financial Assistance application. Patient Cooperation Standards - A patient must exhaust all other payment options, including private coverage, federal, state and local medical assistance programs, and other forms of assistance provided by third-parties prior to being approved. An applicant for Financial Assistance is responsible for applying to public programs for available coverage. He or she is also expected to pursue public or private health insurance payment options for care provided by a CHI Hospital Organization within a Hospital Facility. A patient's and, if applicable, any Guarantor's cooperation in applying for applicable programs and identifiable funding sources, including COBRA coverage (a federal law allowing for a time-limited extension of employee healthcare benefits), shall be required. If a Hospital Facility determines that COBRA coverage is potentially available, and that a patient is not a Medicare or Medicaid beneficiary, the patient or Guarantor shall provide the Hospital Facility with information necessary to determine the monthly COBRA premium for such patient, and shall cooperate with Hospital Facility staff to determine whether he or she qualifies for Hospital Facility COBRA premium assistance, which may be offered for a limited time to assist in securing insurance coverage. A Hospital Facility shall make affirmative efforts to help a patient or patient's Guarantor apply for public and private programs.

Field	Value	IRS element (for citing)
Facility	0	FacilityNum

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c Financial Eligibility	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.
Schedule H, Part VI Schedule H Part II and Part VI, Lines 2, 4, and 5	ORGANIZATION'S MISSION, VISION, AND TAX-EXEMPT PURPOSE THE MISSION OF CHI LISBON HEALTH IS "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." OUR VISION IS TO LIVE UP TO OUR NAME AS ONE CHI: CATHOLIC: LIVING OUR MISSION AND CORE VALUES HEALTH: IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE INITIATIVES: PIONEERING MODELS AND SYSTEMS OF CARE TO ENHANCE CARE DELIVERY PRIMARY TAX-EXEMPT PURPOSE: TO PROVIDE HEALTHCARE TO THE RESIDENTS OF THE SURROUNDING COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. THE GOAL OF CHI LISBON HEALTH IS TO PROVIDE HIGH QUALITY HEALTHCARE TO MEET THE NEEDS OF THE COMMUNITIES WE SERVE. WE ARE COMMITTED TO MAINTAIN OUR PRESENCE INTO THE FUTURE BY SERVING OUR CUSTOMERS WITH DEDICATED SKILLED STAFF. AS A PROVIDER OF A COMMUNITY BASED, FAMILY ORIENTED HEALTHCARE, CHI LISBON HEALTH BELIEVES IT CAN BEST MAINTAIN THIS LEVEL OF SERVICE THROUGH A CUSTOMER FOCUS, WHERE WE CONTINUALLY STRIVE TO UNDERSTAND AND EXCEED THE EXPECTATIONS OF OUR CUSTOMERS. CHI LISBON HEALTH ORIGINALLY KNOWN AS COMMUNITY MEMORIAL HOSPITAL OPENED ITS DOORS ON FEBRUARY 1, 1952. LUTHERAN HOSPITALS & HOMES SOCIETY (LHHS) OF FARGO WORKED ON THIS PROJECT WITH THE LOCAL COMMUNITY MEMORIAL HOSPITAL ASSOCIATION AND ASSUMED OPERATIONS OF THE HOSPITAL. IN 1967 AN ADDITION WAS ADDED TO THE NORTHEAST PORTION OF THE HOSPITAL, WHICH BECAME A 20-BED NURSING HOME WING. IT WAS DETERMINED THAT ADDITIONAL SPACE WAS NEEDED AND ANOTHER ADDITION WAS MADE TO THE SOUTH OF THE EXISTING STRUCTURE. THIS WAS COMPLETED IN 1976 AND BECAME THE NEW HOSPITAL WING. THE PREVIOUS HOSPITAL WING WAS CONVERTED TO 25 NURSING HOME BEDS. BY 1996 A REMODELING PROJECT HAD BEEN COMPLETED AND A CLINIC WAS MOVED INTO THE FACILITY. AT THIS TIME THE FACILITY'S NAME CHANGED TO LISBON MEDICAL CENTER. CHI LISBON HEALTH CHANGED TO CRITICAL ACCESS HOSPITAL STATUS EFFECTIVE JANUARY 1, 2001. THE FACILITY WAS ACQUIRED BY CATHOLIC HEALTH INITIATIVES ON OCTOBER 1, 2002. SHORTLY THEREAFTER, CLINIC SERVICES WERE DISCONTINUED. ON OCTOBER 15, 2013 CHI LISBON HEALTH RE-OPENED THE CLINIC WITHIN THE FACILITY TO BETTER SERVE THEIR COMMUNITY. THIS CLINIC IS STAFFED WITH A FAMILY NURSE PRACTITIONER CERTIFIED AND A FAMILY PRACTICE PHYSICIAN. THE CLINIC SAW 1,689 PATIENTS IN FY19. THE CLINIC IS OPEN MONDAY - FRIDAY. CHI LISBON HEALTH IS SERVED BY PHYSICIANS AND ALLIED PROFESSIONAL STAFF FROM CHI LISBON HEALTH CLINIC, FAMILY MEDICAL CLINIC, ESSENTIA HEALTH-LISBON AND SANFORD HEALTH CLINIC-LISBON. IN ADDITION TO CHI LISBON HEALTH, FOSTER AND SARGENT COUNTIES COMBINED HAVE 7 OTHER CLINICS, TWO HOME CARE AGENCIES, TWO HOSPICE AGENCIES, ONE ASSISTED LIVING FACILITY, AND 4 LONG TERM CARE FACILITIES (LTC), TWO OF WHICH OFFER BASIC CARE. LISBON IS LOCATED IN SOUTHEAST ND WHICH IS ONE HOUR AWAY FROM FARGO. ITS ECONOMY IS BASED ON AGRICULTURE, MANUFACTURING, AND RETAIL TRADE OPERATIONS. LISBON PUBLIC SCHOOL SYSTEM OFFERS CURRICULUM FOR STUDENTS K-12 AND OFFER A VARIETY OF SPORTS, MUSIC AND DRAMA. THE HISTORICAL OPERA HOUSE HOSTS SEVERAL CULTURAL EVENTS THROUGHOUT THE YEAR. THE SCENIC THEATRE OFFERS A VARIETY OF SELECTIONS FOR DIVERSE AGES. RANSOM AND SARGENT COUNTIES BOTH HAVE A NUMBER OF COMMUNITY ASSETS AND RESOURCES THAT CAN BE UTILIZED TO ADDRESS POPULATION HEALTH IMPROVEMENT. PHYSICAL ASSETS AND FEATURES WITHIN THE COMMUNITIES PROVIDE OUTDOOR AND INDOOR RECREATIONAL ACTIVITIES: CITY PARKS, SWIMMING POOLS, BALL DIAMONDS, TENNIS COURTS, WELLNESS CENTERS. THE SURROUNDING AREAS PROVIDE RECREATIONAL OPPORTUNITIES SUCH AS WATER SPORTS, HUNTING, GOLF, PICNICS, AND CAMPING. MEDICAL NEED AND CARE COME FIRST AT CHI LISBON HEALTH. CHI LISBON HEALTH WILL PROVIDE MEDICALLY NECESSARY HEALTH CARE SERVICES TO ALL PERSONS WHO ARE IN NEED, REGARDLESS OF AGE, RACE, RELIGION, NATIONAL ORIGIN, GENDER, HANDICAP, SEXUAL ORIENTATION OR ABILITY TO PAY. CHI LISBON HEALTH HAS A BOARD OF DIRECTORS WHOSE MEMBERSHIP INCLUDES 7 REPRESENTATIVES FROM LISBON AND THE IMMEDIATE SURROUNDING AREA. THIS INCLUDES ONE REPRESENTATIVE FROM OUR FOUNDING ORDER, THE SISTERS OF THE PRESENTATION OF THE BLESSED VIRGIN MARY. CHI LISBON HEALTH ALSO HAS A QUALITY COMMITTEE, PATIENT FAMILY ADVISORY COUNCIL AND A FOUNDATION BOARD/ADVISORY COUNCIL OF 7. COMMUNITY BENEFIT APPROACH A COMMUNITY HEALTH NEEDS ASSESSMENT IS A SYSTEMATIC PROCESS INVOLVING COMMUNITY INPUT TO IDENTIFY COMMUNITY HEALTH NEEDS, PRIORITIZE NEEDS AND ACT ON UNFULFILLED NEEDS. THE IMPLEMENTATION WILL BE CHI LISBON HEALTH'S PLAN TO ADDRESS COMMUNITY HEALTH NEEDS ALSO KNOWN AS THE COMMUNITY BENEFIT PLAN. THE PURPOSE OF CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT IS TO DESCRIBE THE HEALTH OF THE LOCAL PEOPLE, IDENTIFY AREAS FOR HEALTH IMPROVEMENT, IDENTIFY USE OF LOCAL HEALTHCARE SERVICES, DETERMINE FACTORS THAT CONTRIBUTE TO HEALTH ISSUES, IDENTIFY AND PRIORITIZE COMMUNITY NEEDS, AND HELP HEALTHCARE LEADERS IDENTIFY POTENTIAL ACTIONS TO ADDRESS THE COMMUNITY'S HEALTH NEEDS. A HEALTH NEEDS ASSESSMENT BENEFITS THE LOCAL COMMUNITY BY: 1) COLLECTING TIMELY INPUT FROM THE LOCAL COMMUNITY MEMBERS, PROVIDERS, AND STAFF; 2) PROVIDING AN ANALYSIS OF SECONDARY DATA RELATED TO HEALTH-RELATED BEHAVIORS, CONDITIONS, RISKS, AND OUTCOMES; 3) COMPILING AND ORGANIZING INFORMATION TO GUIDE DECISION MAKING, EDUCATION, AND MARKETING EFFORTS, AND TO FACILITATE THE DEVELOPMENT OF A STRATEGIC PLAN; 4) ENGAGING COMMUNITY MEMBERS ABOUT THE FUTURE OF HEALTHCARE; AND 5) ALLOWING THE COMMUNITY HOSPITAL TO MEET THE FEDERAL REGULATORY REQUIREMENTS OF THE AFFORDABLE CARE ACT, WHICH REQUIRES NOT-FOR-PROFIT HOSPITALS TO COMPLETE A CHNA AT LEAST EVERY 3 YEARS ,AS WELL AS HELPING THE LOCAL PUBLIC HEALTH UNIT MEET ACCREDITATION REQUIREMENTS. CHI LISBON HEALTH IS A 25-BED CRITICAL ACCESS HOSPITAL IN LISBON, NORTH DAKOTA. CHI LISBON HEALTH IS A STATE-DESIGNATED LEVEL V TRAUMA CENTER, A STROKE READY HOSPITAL AND EMPLOYS APPROXIMATELY 76 PEOPLE. CHI LISBON HEALTH IS THE ONLY HOSPITAL IN RANSOM AND SARGENT COUNTIES AND SERVES 9,155 PEOPLE THROUGHOUT 1731 SQUARE MILES. LISBON IS IN THE HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS), THE MEDICALLY UNDERSERVED AREAS / POPULATIONS, AS WELL AS A SHORTAGE AREA FOR MENTAL HEALTH SERVICES. HPSA'S ARE DESIGNATED BY HEALTH RESOURCES AND SERVICE ADMINISTRATION (HRSA); DEPT OF HEALTH & HUMAN SERVICES AND THE CENTER FOR RURAL HEALTH - UND AS HAVING SHORTAGES OF PRIMARY MEDICAL CARE, DENTAL OR MENTAL HEALTH PROVIDERS AND MAY BE GEOGRAPHIC (A COUNTY OR SERVICE AREA), DEMOGRAPHIC (LOW INCOME POPULATION) OR INSTITUTIONAL (COMPREHENSIVE HEALTH CENTER, FEDERALLY QUALIFIED HEALTH CENTER OR OTHER PUBLIC FACILITY). MEDICALLY UNDERSERVED AREAS/POPULATIONS ARE AREAS OR POPULATIONS DESIGNATED BY HRSA AS HAVING TOO FEW PRIMARY CARE PROVIDERS, HIGH INFANT MORTALITY, HIGH POVERTY AND/OR HIGH ELDERLY POPULATION. ACCESS TO AN ADEQUATE SUPPLY OF HEALTH CARE PROVIDERS IS A CONCERN IN BOTH NORTH DAKOTA AND NATIONALLY. COMMUNITY ASSESSMENT, PROCESS AND SUMMARY TO HELP DETERMINE FUTURE DECISIONS AND STRATEGIC PLANNING, CHI LISBON HEALTH CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY AUGUST 27, 2018 THROUGH SEPTEMBER 24, 2018. THE SURVEY WAS WIDELY DISTRIBUTED THROUGHOUT RANSOM AND SARGENT COUNTIES AND WAS MADE AVAILABLE TO RESIDENTS VIA PAPER AND ONLINE. COMMUNICATION OF ITS AVAILABILITY WAS DONE THROUGH MULTIPLE CHANNELS TO PROMOTE THE IMPORTANCE OF THE ASSESSMENT PROCESS AND PARTICIPATION IN IT. IN ADDITION TO THE SURVEY, COMMUNITY HEALTH DATA WAS COLLECTED BY CONDUCTING KEY INFORMANT INTERVIEWS WITH COMMUNITY LEADERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, CONVENING A COMMUNITY FOCUS GROUP COMPRISED OF COMMUNITY LEADERS AND AREA RESIDENTS, AND EXAMINING A WIDE RANGE OF SECONDARY SOURCES OF DATA THAT PROVIDED INFORMATION ON A MULTITUDE OF MEASURES. A NEEDS ASSESSMENT WAS PREVIOUSLY CONDUCTED IN 2016.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING THE ORGANIZATION'S COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. THE COST-TO-CHARGE RATIO FOR THE YEAR ENDED 6/30/2019 WAS COMPUTED USING THE FOLLOWING FORMULA: OPERATING EXPENSE (BEFORE RESTRUCTURING, IMPAIRMENT AND OTHER LOSSES) DIVIDED BY GROSS PATIENT REVENUE. WORKSHEET 2 WAS NOT USED TO DERIVE THE COST-TO-CHARGE RATIO.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Costing methodology for amounts reported on line 2 is determined using the organization's cost/charge ratio of 54.56%. When discounts are extended to self-pay patients, these patient account discounts are recorded as a reduction in revenue, not as bad debt expense.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	Lisbon Area Health Services 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.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Lisbon Area Health Services does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of CommonSpirit Health. The consolidated footnote reads as follows: CommonSpirit relies on the results of detailed reviews of historical write-offs and collections in estimating the collectability of accounts receivable. Updates to the hindsight analysis is performed at least quarterly using primarily a rolling eighteen-month collection history and write-off data. Subsequent changes to estimates of the transaction price are generally recorded as adjustments to net patient revenue in the period of change. Subsequent changes that are determined to be the result of an adverse change in a third-party payor's ability to pay are recorded as bad debt expense in purchased services and other in the accompanying consolidated statements of operations and change in net assets. Bad debt expense for 2019 was not significant.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	Lisbon Area Health Services is designated as a Critical Access Hospital (CAH). CAHs are rural community hospitals that are certified to receive cost-based reimbursement from Medicare. The reimbursement that CAHs receive is intended to improve their financial performance and thereby reduce hospital closures. CAHs are certified under a different set of Medicare Conditions of Participation (CoP). Shortfalls are created when a facility receives payments that are less than the costs of caring for program beneficiaries. Because shortfalls are based on costs, not charges, Lisbon Area Health Services, due to their designation as a CAH, received cost-based reimbursement for Medicare purposes, Lisbon Area Health Services will not typically experience Medicare related shortfalls. Although not presented on the Medicare cost report, in order to facilitate a more accurate understanding of the "true" cost of services (for "shortfall" purposes) the CHI Workbook allows a health care facility not to offset costs that Medicare considers to be non-allowable, but for which the facility can legitimately argue are related to the care of the facility's patients. In addition, although not reportable on the Medicare cost report, the CHI workbook includes the cost of services that are paid via a set fee-schedule rather than being reimbursed based on costs (e.g. outpatient clinical laboratory). Finally, the CHI Workbook allows a facility to include other health care services performed by a separate facility (such as a physician practice) that are maintained on separate books and records (as opposed to the main facility's books and records which has its costs of service included within a cost report). True costs of Medicare computed using this methodology: Total Medicare Revenue: $5,510,842 Total Medicare costs: $5,557,051 Surplus or Shortfall $(46,209) Lisbon Area Health Services believes that excluding Medicare losses from community benefit makes the overall community benefit report more credible for these reasons: Unlike subsidized areas such as burn units or behavioral-health services, Medicare is not a differentiating feature of tax-exempt health care organizations. In fact, for-profit hospitals focus on attracting patients with Medicare coverage, especially in the case of well-paid services that include cardiac and orthopedics. Significant effort and resources are devoted to ensuring that hospitals are reimbursed appropriately by the Medicare program. The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency, carefully studies Medicare payment and the access to care that Medicare beneficiaries receive. The commission recommends payment adjustments to Congress accordingly. Though Medicare losses are not included by Catholic hospitals as community benefit, the Catholic Health Association guidelines allow hospitals to count as community benefit some programs that specifically serve the Medicare population. For instance, if hospitals operate programs for patients with Medicare benefits that respond to identified community needs, generate losses for the hospital, and meet other criteria, these programs can be included in the CHA framework in Category C as "subsidized health services." Medicare losses are different from Medicaid losses, which are counted in the CHA community benefit framework, because Medicaid reimbursements generally do not receive the level of attention paid to Medicare reimbursement. Medicaid payment is largely driven by what states can afford to pay, and is typically substantially less than what Medicare pays.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	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.
Schedule H, Part V, Section B, Line 16a FAP website	- Lisbon Area Health Services: Line 16a URL: http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm;
Schedule H, Part V, Section B, Line 16b FAP Application website	- Lisbon Area Health Services: Line 16b URL: http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- Lisbon Area Health Services: Line 16c URL: http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm;
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	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, www.catholichealth.net, 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.
Schedule H, Part VI, Line 6 Affiliated health care system	The organization is affiliated with CommonSpirit Health. CommonSpirit Health was created by the alignment of Catholic Health Initiatives and Dignity Health as a single ministry in early 2019. CommonSpirit Health, a nonprofit, faith-based health system is committed to building healthier communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen - both inside its hospitals and out in the community. CommonSpirit Health owns and operates health care facilities in 21 states and comprises 142 hospitals, including three academic health centers, major teaching hospitals as well as 31 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 2019, CommonSpirit Health provided more than $2.1 billion in financial assistance and community benefit for programs and services for the poor, free clinics, education and research. Financial assistance and community benefit totaled more than $4.4 billion with the inclusion of the unpaid costs of Medicare. The health system, which generated operating revenues of $20.96 billion in fiscal year 2019, has total assets of approximately $40.6 billion. CommonSpirit Health provides strategic planning and management services as well as centralized "share 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 H, Part VI, Line 7 State filing of community benefit report	ND

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
PEGGY REINKE
PRESIDENT	$0	$175,844	$0	$25,000	$0	$25,016	$0	$2,902	$0	$11,673	$0	$240,435	$0	$0
JEFFREY DROP
Board Member/CHI SVP Division Officer	$0	$716,564	$0	$535,360	$0	$136,936	$0	$22,411	$0	$18,016	$0	$1,429,287	$0	$0
REBECCA THOMPSON
VP OPERATIONAL FINANCE (THROUGH 7/31/14)	$0	$157,054	$0	$20,771	$0	$22,688	$0	$19,290	$0	$16,171	$0	$235,974	$0	$7,382
AMBER STOWMAN
Division Director of Finance	$0	$138,041	$0	$10,733	$0	$3,767	$0	$9,109	$0	$25,703	$0	$187,353	$0	$0
OSCAR FERNANDEZ
PHYSICIAN	$297,143	$0	$2,080	$0	$5,978	$0	$14,070	$0	$25,733	$0	$345,004	$0	$0	$0
JILL MCRITCHIE
MANAGER PHARMACY	$133,970	$0	$11,909	$0	$1,172	$0	$8,794	$0	$17,089	$0	$172,934	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 4a SEVERANCE OR CHANGE-OF-CONTROL PAYMENTS	During the calendar year 2018, post-termination payments were addressed in executive employment agreements for Catholic Health Initiatives and related organizations' employees at the level of Vice President and above, including the MBO CEOs. 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.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	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) WRITTEN EMPLOYMENT CONTRACTS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	DURING 2018 THE FOLLOWING DISTRIBUTIONS WERE MADE BY CommonSpirit Health FROM THE DEFERRED COMPENSATION PLAN: REBECCA THOMPSON - $7,387 Due to the "super" vesting rules under the CHI deferred compensation plan, participants who had met certain requirements such as involuntary termination without cause, age, age and years of service, or more than 5 years of plan participation were eligible to receive their 2018 contributions in cash during the calendar year. These cash payouts are included in the participant's reportable compensation in column (iii) Other Reportable Compensation on Schedule J Part II. During 2018, the following contributions and any associated investment income, gain or loss that would have been made by CHI to the deferred compensation plan were paid in cash: Jeffrey Drop- $110,067 Peggy Reinke- $8,872

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Rudolf Loperena MD	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship Description	Substantial contributor	RelationshipDescriptionTxt
Transaction	$248,960	TransactionAmt
Transaction	Independent contractor arrangement - ER Physician Coverage	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part V, Line 1a number reported in Box 3 of Form 1096	PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF CommonSpirit Health ARE MADE BY CommonSpirit Health. THEREFORE NO FORM 1099S ARE ISSUED BY THE ORGANIZATION. CommonSpirit Health FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099S ISSUED BY CommonSpirit Health ON BEHALF OF THE ORGANIZATION ARE REPORTED TO THE IRS.
Form 990, Part VI, Line 14 DOCUMENT RETENTION AND DESTRUCTION POLICY	THE ORGANIZATION HAS A DOCUMENT RETENTION AND DESTRUCTION POLICY THAT IT FOLLOWS; HOWEVER, THE POLICY HAD NOT BEEN FORMALLY ADOPTED BY THE ORGANIZATION'S GOVERNING BODY AT YEAR-END.
Form 990, Part VI, Line 15a PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL	The organization's top management official's compensation was paid by Catholic Health Initiatives ("CHI"), a related organization. CHI had a defined compensation philosophy. Both the executive and non-executive compensation structures and ranges were reviewed annually in comparison to market data. Catholic Health Initiatives used Korn Ferry as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of the senior most executives was reviewed annually. Korn Ferry reviewed both cash and total compensation for overall reasonableness, for adherence to Catholic Health Initiatives' compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review was delivered by Korn Ferry to the CHI HR committee of the Board of Stewardship Trustees annually at their September meeting and minutes shared with the full board at the December meeting. The last review was September 25, 2018. In addition, Korn Ferry completed a comprehensive review of all positions at the level of vice president and above in the fall of 2014 to determine and validate appropriate compensation levels. These levels were reviewed annually and revised based on market data, where applicable.
Form 990, Part VI, Line 15b PROCESS USED TO ESTABLISH COMPENSATION OF OTHER EMPLOYEES	DURING THE TAX YEAR ENDED 6/30/2019, NO OFFICERS, DIRECTORS OR TRUSTEES RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THEREFORE, THESE QUESTIONS ARE MORE APPROPRIATELY ANSWERED AS N/A.
Form 990, Part VI, Line 12c Conflict of Interest Policy	c) Board evaluation of non-transactional conflicts - I. The board carefully reviews and scrutinizes any non-transactional conflict of interest (e.g., disclosure of nonpublic information, competition with CHI or a CHI entity, failure to disclose a corporate opportunity, excessive gifts or entertainment, etc.). II. In such circumstances, by a majority vote of the disinterested trustees, the board takes whatever action is deemed appropriate with respect to the trustee or corporate officer under the circumstances (including possible disciplinary or corrective action) to best protect the interests of CHI or the CHI entity. The board is encouraged to consult with the general counsel of CHI or his or her designee when considering disciplinary or corrective action. III. The conflicted trustee or corporate officer is not permitted to use his or her personal influence with respect to the conflict matter. However, if requested, such trustee or corporate officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from trustees, as his or her knowledge may be relevant. The trustee or corporate officer is excused from the meeting during discussion and vote on the conflict of interest. d) Record of proceedings - with respect to board member and officer conflicts of interest, minutes of the board are expected to reflect the identity of the individual making the disclosure, the nature of the disclosure, discussion regarding any proposed transaction, the decision made by the board, and that the interested trustee or corporate officer was excused during the discussion, and that the interested trustee abstained from voting. D. Conflicts reporting: All conflicts of interest are reported by CHI as required by law, regulations, and policy.
Form 990, Part VI, Line 1a Delegate broad authority to a committee	Pursuant to Section 8.6 of the Bylaws of Lisbon Area Health Services, the Executive Committee is composed of the board chair, the board vice chair, the President and CEO, each of whom shall serve as an ex officio voting member of the Executive Committee, and two voting members appointed by the Board of Directors. Each individual appointed to the Executive Committee shall serve for a term of one year or until his or her successor is duly appointed by the Board of Directors. The Executive Committee shall consist of only directors of the Corporation. Pursuant to Section 8.1 of the Corporation's bylaws, committees, such as the executive committee, that are granted the authority to act on behalf of the board of directors may include only directors of the corporation. Further, pursuant to Section 8.6 of the Corporation's bylaws, the executive committee has and may exercise such powers as may be delegated to it by the board of directors. The Executive Committee also possesses the power to transact routine business of the corporation in the interim period between regularly scheduled meetings of the board of directors.
Form 990, Part VI, Line 6 Classes of members or stockholders	According to the bylaws of Lisbon Area Health Services the entity's sole member is CommonSpirit Health, a Colorado nonprofit organization.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	According to the organization's bylaws, directors shall be appointed or refused by the corporate member. The corporate member may appoint one or more individuals to the board of directors, and may at any time remove, with or without cause, any member of the board of directors. According to the organization's bylaws, directors of the corporation shall be appointed by the corporate member no later than June 30 of each year. The names and qualifications of each individual accepted by the board of directors shall be submitted to the corporate member, who shall appoint or refuse each nominee in accordance with the corporate member's bylaws and with endorsement of the senior vice president of operations. The corporate member may unilaterally appoint one or more individuals to the board of directors should the board fail to furnish the corporate member with a list of individuals qualified to serve on the board of directors of the corporation. (CHCF Reserved Rights) Except as otherwise provided in the Corporation's Articles of Incorporation or the laws of the State of organization, Catholic Health Care Federation ("CHCF") shall have such rights as are reserved to the Corporate Member, acting in its capacity as the membership body of CHCF, under the Governance Matrix.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	The organization's corporate member is CommonSpirit Health. Pursuant to Section 5.4 of the organization's bylaws, the Corporate Member shall have the specific rights set forth in the governance matrix. Pursuant to the governance matrix the following rights are reserved to the CommonSpirit Health Board directly or through powers delegated to the CommonSpirit Health Chief Executive Officer: * Substantial change in the mission or philosophy of the Lisbon Area Health Services * Amendment of the corporate documents of the Lisbon Area Health Services * Approve members of the Lisbon Area Health Servicesboard * Removal of a member of the governing body of the Lisbon Area Health Services * Approval of issuance of debt by Lisbon Area Health Services * Approval of participation of Lisbon Area Health Services in a joint venture * Approval of formation of a new corporation by Lisbon Area Health Services * Approval of a merger involving the Lisbon Area Health Services * Approval of the sale of all or substantially all of the assets of the Lisbon Area Health Services * To require the transfer of assets by the Lisbon Area Health Services to CommonSpirit Health to accomplish CommonSpirit Health's goals and objectives, and to satisfy CommonSpirit Health debts. * Adoption of long range and strategic plans for Lisbon Area Health Services Pursuant to Section 5.5.2 of the organization's bylaws, CommonSpirit Health may, in exercise of its approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and the President and Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate." (CHCF Reserved Rights) Except as otherwise provided in the Corporation's Articles of Incorporation or the laws of the State of organization, Catholic Health Care Federation ("CHCF") shall have such rights as are reserved to the Corporate Member, acting in its capacity as the membership body of CHCF, under the Governance Matrix.
Form 990, Part VI, Line 11b Review of form 990 by governing body	Once the return is prepared, the return is presented to the board at a board meeting or an electronic copy of the return is sent to each board member by email for their review, etc. Subsequent to providing the return to the board, the tax department files the return with the appropriate federal and state agencies, making any non-substantive changes necessary to effect e-filing. Any such changes are not re-submitted to the board.
Form 990, Part VI, Line 12c Conflict of interest policy	The organization has a conflicts of interest ("COI") policy (the "policy") in place to maintain the integrity of its activities. Through February 7, 2019, conflicts were administered solely through Catholic Health Initiatives' ("CHI") Governance Policy No. 1 (described below). On February 8, 2019, in connection with the alignment of the Catholic Health Ministries of CHI and Dignity Health, the CommonSpirit Health Board of Stewardship Trustees approved CommonSpirit Health Corporate Responsibility Policy No. G-001, a CommonSpirit Health conflicts of interest policy. This policy stipulates that, at minimum, the pre-closing CHI COI policies and pre-closing Dignity Health COI policies identify the individuals that are covered under the new policy. In addition, subject to certain exceptions, pre-closing CHI COI policies shall continue to apply to the CHI entities and the individuals who were subject to the Pre-Closing CHI COI policies; and the Pre-Closing Dignity Health COI policies shall continue to apply to the Dignity Health entities and the individuals who were subject to the Pre-Closing Dignity Health COI policies. Until CommonSpirit Health adopts a single process for identifying and managing conflicts of interest for all system entities, the following individuals shall be subject to the Pre-Closing CHI COI policies from and after the effective date of Corporate Responsibility Policy No. G-001: 1. Members of the CommonSpirit Health Board of Stewardship Trustees and members of the committees of the Board of Stewardship Trustees; 2. Corporate officers of CommonSpirit Health; 3. Members of the Board of Directors of Dignity Health and members of the committees of the Board of Directors of Dignity Health. CHI Governance Policy No. 1: The policy applies to the following persons: members of the CHI board of stewardship trustees and its committees; members of any CHI direct affiliate or subsidiary (each a CHI entity) board and their committees; employees of CHI entities, and all CHI researchers (as defined in the policy). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure review process. A. Disclosure obligations: 1. Ongoing: Each person is required to promptly and fully disclose to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The person must disclose the actual or potential conflict as soon as she/he becomes aware of it. In any situation in which the person is in doubt it is expected that full disclosure be made to permit dan impartial and objective determination as to the existence of a conflict. 2. Periodic written: In addition to the ongoing disclosure obligation, periodic written conflict of interest disclosure forms must be completed as follows: a) Initially: 1) Upon hiring (employees), 2) Appointment (board / committee members), 3) Upon consideration of affiliation with research sponsor (researchers). b) Annually: 1) Board / committee members, 2) Employees at the level vice president or above, 3) Researchers, 4) Supply chain employees at the level of vice president and above and those employees involved in contracting regardless of employment level, 5) Other employees as determined by CommonSpirit Health leadership. 3. Failure to disclose - an individual who fails to disclose a perceived, potential, or actual conflict of interest, or all material facts surrounding an actual or potential conflict or fails to abide by the final decision regarding the conflict may be subject to disciplinary or corrective actions such as termination of employment, removal from a board or committee, loss or restriction of clinical privileges, or restrictions on research activities in accordance with applicable laws, regulations, rules, contracts, and bylaws. B. Conflicts review: 1. No disclosed conflicts: In the absence of perceived, potential or actual conflicts of interest, no follow-up conflicts review is required or performed. 2. Disclosure of perceived, potential or actual conflicts: a) Are initially reviewed by national or regional legal or corporate responsibility team members (depending upon the role of the individual disclosing the actual or potential conflict) to determine whether an actual or potential for a conflict may exist. b) If it is determined that a potential or actual conflict may exist, I. In the case of board or committee members or officers, issues are elevated to the executive committee of the board or board chair. II. In the case of other persons, conflicts issues are elevated to the conflicts of interest review committee ("C-CIRC"). C. Conflicts determination and management: 1. Matters elevated to C-CIRC: a) The C-CIRC determines whether a disclosed or otherwise identified interest is a conflict of interest. If the C-CIRC determines that a COI exists, and adequate controls are not in place to mitigate the conflict, the C-CIRC facilitates development of a COI management plan designed to mitigate the conflict. Designated entity staff are responsible for monitoring the COI management plan and for documenting monitoring activities. Notwithstanding the foregoing, at its sole discretion, an entity may reject a person's request to enter into the relationship in question, or require the relationship be sufficiently altered to avoid a potential conflict of interest. b) Appeal - if a person does not agree with a determination made by the C-CIRC, its interpretation of the COI policy, still seeks an exemption or exception, or seeks further clarification of the C-CIRC 's decision, the individual may appeal the decision through his or her manager for reconsideration by the C-CIRC, and the C-CIRC will review and issue a final determination based upon any new or additional information presented. 2. Matters elevated to the executive committee or board chair: a) Determination of existence of conflict - the board chair or his or her designee performs any further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the board chair, the vice chair assumes the chair's role outlined in the COI policy. Based on review and evaluation of the relevant facts and circumstances, the board chair makes an initial determination as to whether a conflict of interest exists and whether, pursuant to the COI policy, review and approval or other action by the board is required. A written record of the board chair's determination, including relevant facts and circumstances, is made. The board chair then makes an appropriate report to the executive committee of the board concerning the COI review, evaluation and determination. If a difference of opinion exists between the board chair and another trustee as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether board review and approval or other action is required under the COI policy, the matter is submitted to the board's executive committee, which makes a final determination as to the matter presented. That determination, including relevant facts and circumstances, is reflected in the executive committee minutes and is reported to the board. b) Board evaluation of transactions involving an officer / board member conflict of interest - I. The board carefully scrutinizes and must in good faith approve or disapprove any transaction in which CHI or a CHI entity is a party and in which the trustee or a corporate officer either: 1. Has a material financial interest; or 2. Is a trustee or corporate officer of the other party (other than a CHI affiliated organization). II. The board must approve the transaction by a majority of the trustees on the board (not counting any interested trustee). In reviewing such transactions between CHI or CHI entities and vendors or other contractors who are, or are affiliated with, trustees or corporate officers, the board acts no more or less favorably than it would in reviewing transactions with unrelated third parties. The transaction is not approved unless the board determines that the transaction is fair to CHI or the CHI entity. III. A conflicted trustee or corporate officer is not permitted to use his or her personal influence with respect to the approval or disapproval of the conflicted transaction. However, if requested, such trustee or corporate officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from trustees, as his or her knowledge may be relevant. The trustee or corporate officer is excused from the meeting during discussion and vote on the conflict of interest. (Continued below)
Form 990, Part VI, Line 19 Required documents available to the public	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 or www.catholichealthinitiatives.org.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Other Miscellaneous Revenue - Total Revenue: 110, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 110;
Form 990, Part IX, Line 11g Other Fees	Other Fees for Services - Total Expense: 1126039, Program Service Expense: 844529, Management and General Expenses: 281510, Fundraising Expenses: 0; Contract Labor - Total Expense: 986558, Program Service Expense: 986558, Management and General Expenses: 0, Fundraising Expenses: 0; Purchased Services - Total Expense: 734383, Program Service Expense: 550787, Management and General Expenses: 183596, Fundraising Expenses: 0; Contract Services - Total Expense: 207004, Program Service Expense: 207004, Management and General Expenses: 0, Fundraising Expenses: 0; Consulting - Total Expense: 18875, Program Service Expense: 0, Management and General Expenses: 18875, Fundraising Expenses: 0;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Capital Resource Pool Contribution - -67056;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (216 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
ALEGENT CREIGHTON CLINIC
12809 W DODGE RD	OMAHA	NE	68154	470765154	HOSPITAL	NE	501(c)(3)	3	ACH	false
ALEGENT CREIGHTON HEALTH
12809 W DODGE RD	OMAHA	NE	68154	470757164	HOSPITAL	NE	501(c)(3)	3	CHI NEBRASKA	false
ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM
7500 MERCY RD	OMAHA	NE	68124	470484764	HOSPITAL	NE	501(c)(3)	3	CHI NEBRASKA	false
ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA
631 N 8TH ST	MISSOURI VALLEY	IA	51555	420776568	HOSPITAL	IA	501(c)(3)	3	CHI NEBRASKA	false
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
6901 N 72ND ST	OMAHA	NE	68122	470376615	HOSPITAL	NE	501(c)(3)	3	CHI NEBRASKA	false
ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER
104 W 17TH ST	SCHUYLER	NE	68661	470399853	HOSPITAL	NE	501(c)(3)	3	CHI NEBRASKA	false
ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA
PO BOX 368	CORNING	IA	50841	420782518	HOSPITAL	IA	501(c)(3)	3	CHI NEBRASKA	false
ALVERNA APARTMENTS
300 SE 8TH AVE	LITTLE FALLS	MN	56345	411351177	LTERM CARE	MN	501(c)(3)	10	CSH	false
APPLETREE COURT
601 OAK ST	BRECKENRIDGE	MN	56520	411850500	SENIOR LIVING	MN	501(c)(3)	10	SFH	false
Arroyo Grande Community Hospital Foundation
345 S Halcyon Rd	Arroyo Grande	CA	93420	203256066	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DH	false
Bakersfield Memorial Hospital
420 34TH Street	Bakersfield	CA	93301	951802779	HOSPITAL	CA	501(c)(3)	3	DCC	false
Barrow Neurological Foundation
350 West Thomas Road	Phoenix	AZ	85013	860174371	FUNDRAISING	AZ	501(c)(3)	7	DH	false
BAYLOR ST LUKE'S HEALTH VENTURES
17200 ST LUKES WAY STE 170	THE WOODLANDS	TX	77384	274499340	PHYSICIANS	TX	501(c)(3)	Type I	SLCHS	false
BAYLOR ST LUKE'S MEDICAL GROUP
6624 FANNIN ST STE 1100	HOUSTON	TX	77030	760458535	PHYSICIANS	TX	501(c)(3)	3	SLHS	false
BORNEMANN HEALTHCARE CORPORATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	232187242	HEALTHCARE	PA	501(c)(3)	Type I	CSH	false
BRAZOSPORT HEALTH FOUNDATION INC
1 West Way Ct	LAKE JACKSON	TX	77566	760080110	FUNDRAISING FOUNDATION	TX	501(c)(3)	Type I	BRHS	false
BRAZOSPORT REGIONAL PHYSICIAN SERVICES
100 MEDICAL DRIVE	LAKE JACKSON	TX	77566	800240261	PHYSICIANS	TX	501(c)(3)	3	BRHS	false
BURLESON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742759890	HOSPITAL	TX	501(c)(3)	3	SJSC	false
BURLESON ST JOSEPH MANOR
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742913931	HEALTHCARE	TX	501(c)(3)	10	SJSC	false
California Hospital Medical Center Foundation
1401 South Grand Avenue	Los Angeles	CA	90015	954000909	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DCC	false
CARRINGTON HEALTH CENTER
800 N 4TH ST	CARRINGTON	ND	58421	450227311	HOSPITAL	ND	501(c)(3)	3	CSH	false
CATHOLIC HEALTH INITIATIVES - COLORADO
9100 East Mineral Circle	Centennial	CO	80112	840405257	HOSPITAL	CO	501(c)(3)	3	CSH	false
CATHOLIC HEALTH INITIATIVES - IOWA CORP
1111 6TH AVE	DES MOINES	IA	50314	420680448	HOSPITAL	IA	501(c)(3)	3	CSH	false
CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
1150 Kelly Johnson Blvd 204	COLORADO SPRINGS	CO	80920	840902211	FUNDRAISING FOUNDATION	CO	501(c)(3)	7	CHIC	false
CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION
1150 Kelly Johnson Blvd 204	COLORADO SPRINGS	CO	80920	270930004	HEALTHCARE	CO	501(c)(3)	Type I	CSH	false
CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	460992796	PHYSICIANS	CO	501(c)(3)	Type I	CHINS	false
CENTENNIAL MEDICAL GROUP INC
2700 STEWART PKWY	ROSEBURG	OR	97471	263946191	SURGERY CENTER	OR	501(c)(3)	10	MMC	false
CENTRAL KANSAS MEDICAL CENTER
3515 BROADWAY	GREAT BEND	KS	67530	480543724	HOSPITAL	KS	501(c)(3)	3	CSH	false
CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PKWY S	FARGO	ND	58104	271966847	FUNDRAISING FOUNDATION	MN	501(c)(3)	10	CSH	false
CHI HEALTH FOUNDATION
12809 W DODGE RD	OMAHA	NE	68154	470648586	FUNDRAISING FOUNDATION	NE	501(c)(3)	7	ACH	false
CHI INSTITUTE FOR RESEARCH AND INNOVATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	271050565	HEALTHCARE	CO	501(c)(3)	Type I	CSH	false
CHI KENTUCKY INC
3900 OLYMPIC BLVD STE 400	ERLANGER	KY	41018	202741651	HEALTHCARE	KY	501(c)(3)	Type I	CSH	false
CHI LIVING COMMUNITIES
5942 RENAISSANCE PLACE STE A	TOLEDO	OH	43623	341892096	HEALTHCARE	OH	501(c)(3)	Type II	SFH	false
CHI Memorial Hospital - Georgia
100 GROSS CRESCENT CIRCLE	FORT OGLETHORPE	GA	30742	822748395	HOSPITAL	GA	501(c)(3)	3	MHCS	false
CHI NATIONAL HOME CARE
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	451261716	HEALTHCARE	CO	501(c)(3)	10	CHI NS	false
CHI NATIONAL SERVICES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	452532084	HEALTHCARE	CO	501(c)(3)	Type I	CSH	false
CHI NEBRASKA
12809 West Dodge Road	Omaha	NE	68510	363233121	HEALTHCARE	NE	501(c)(3)	Type I	CSH	false
CHI ST JOSEPH CHILDREN'S HEALTH
1929 LINCOLN HWY E STE 150	LANCASTER	PA	17602	232342997	HEALTHCARE	PA	501(c)(3)	Type I	CSH	false
CHI ST JOSEPH'S CHILDREN
1516 5TH ST NW	ALBUQUERQUE	NM	87102	710897107	COMMUNITY	NM	501(c)(3)	Type I	CSH	false
CHI ST VINCENT HOSPITAL HOT SPRINGS
300 WERNER ST	HOT SPRINGS	AR	71913	710236913	HOSPITAL	AR	501(c)(3)	3	CHISVHS	false
CHI ST VINCENT HOT SPRINGS
300 WERNER ST	HOT SPRINGS	AR	71913	261125064	HOLDING CO	AR	501(c)(3)	Type II	SVIMC	false
CHI ST VINCENT MEDICAL GROUP HOT SPRINGS
300 WERNER ST	HOT SPRINGS	AR	71913	261125131	PHYSICIANS	AR	501(c)(3)	3	CHISVHS	false
COMMONSPIRIT HEALTH
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	470617373	HEALTHCARE	CO	501(c)(3)	Type I	NA	false
Community Hospital of San Bernardino
1805 Medical Center Drive	San Bernardino	CA	92411	951643373	HOSPITAL	CA	501(c)(3)	3	DCC	false
COMMUNITY LIMITED CARE DIALYSIS CENTER
619 OAK ST ACCOUNTING-3 W	CINCINNATI	OH	45206	237419853	HOLDING CO	OH	501(c)(4)		GSH	false
COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION
631 N 8TH ST	MISSOURI VALLEY	IA	51555	421294399	FUNDRAISING FOUNDATION	IA	501(c)(3)	Type I	AH-CMHMV	false
CONTINUING CARE HOSPITAL
One Saint Joseph Drive	LEXINGTON	KY	40504	611400619	HOSPITAL	KY	501(c)(3)	3	SJHS	false
Dignity Community Care
185 Berry Street Suite 300	San Francisco	CA	94107	815009488	HOSPITAL	CO	501(c)(3)	3	NA	false
DIGNITY HEALTH
185 BERRY STREET STE 300	SAN FRANCISCO	CA	94107	941196203	HOSPITAL	CA	501(c)(3)	3	CSH	false
Dignity Health Connected Living
200 Mercy Oaks Drive	Redding	CA	96003	237115371	Senior Center Services	CA	501(c)(3)	7	DH	false
Dignity Health Foundation
185 Berry Street	San Francisco	CA	94107	462037641	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DH	false
Dignity Health Foundation - Inland Empire
2101 N Waterman Avenue	San Bernardino	CA	92404	237440086	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DH	false
Dignity Health Foundation East Valley
475 South Dobson Road	Chandler	AZ	85224	742418514	FUNDRAISING FOUNDATION	AZ	501(c)(3)	Type I	DH	false
Dignity Health HPL Self-Insurance Trust
185 Berry Street	San Francisco	CA	94107	943006034	Self Insurance	CA	501(c)(3)	Type I	DH	false
Dignity Health Insurance Nevada Ltd
185 Berry Street	San Francisco	NV	94107	813800752	Self Insurance	NV	501(c)(3)	Type I	DH	false
Dignity Health Medical Foundation
3400 Data Drive	Rancho Cordova	CA	95670	680220314	MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC	CA	501(c)(3)	Type I	DCC	false
Dignity Health Workers Comp Self-Insurance Trust
185 Berry Street	San Francisco	CA	94107	946612446	Self Insurance	CA	501(c)(3)	Type I	DH	false
Dominican Health Services
1555 Soquel Drive	Santa Cruz	CA	95065	770056778	Community Health System	CA	501(c)(3)	Type I	DH	false
Dominican Hospital Foundation
1555 Soquel Drive	Santa Cruz	CA	95065	942450442	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DH	false
Dominican Oaks Corporation
1555 Soquel Drive	Santa Cruz	CA	95065	770127719	Operation and management of housing complex to elderly persons	CA	501(c)(3)	10	DHS	false
East Texas Clinical Services
2801 VIA FORTUNA SUITE 500	AUSTIN	TX	78746	454736213	HEALTHCARE	TX	501(c)(3)	Type I	SLHS	false
ENUMCLAW REGIONAL HOSPITAL ASSOCIATION
1455 BATTERSBY AVE	ENUMCLAW	WA	98022	910715805	HOSPITAL	WA	501(c)(3)	3	FHS	false
FLAGET HEALTHCARE INC
4305 NEW SHEPHERDSVILLE RD	BARDSTOWN	KY	40004	611345363	HOSPITAL	KY	501(c)(3)	3	KOH	false
FLAGET MEMORIAL HOSPITAL FOUNDATION INC
4305 NEW SHEPHERDSVILLE RD	BARDSTOWN	KY	40004	562351341	FUNDRAISING FOUNDATION	KY	501(c)(3)	Type I	FH	false
FRANCISCAN CARE CENTER
4111 N HOLLAND-SYLVANIA RD	TOLEDO	OH	43623	341931806	HEALTHCARE	OH	501(c)(3)	10	FLC	false
FRANCISCAN FOUNDATION
1717 SOUTH J ST	TACOMA	WA	98405	911145592	FUNDRAISING FOUNDATION	WA	501(c)(3)	10	FHS	false
FRANCISCAN HEALTH SYSTEM
1717 SOUTH J ST	TACOMA	WA	98405	910564491	HOSPITAL	WA	501(c)(3)	3	CSH	false
FRANCISCAN HEALTH VENTURES FKA SJMGROUP
TACOMA FNC CTR BLDG 1145 BROADWAY	TACOMA	WA	98402	431882377	PHYSICIANS	MO	501(c)(3)	10	CSH	false
FRANCISCAN MEDICAL GROUP
1313 BROADWAY STE 200	TACOMA	WA	98402	911939739	HEALTHCARE	WA	501(c)(3)	10	FHS	false
FRANCISCAN VILLA OF SOUTH MILWAUKEE INC
3601 S CHICAGO AVE	SOUTH MILWAUKEE	WI	53172	391093829	HEALTHCARE	WI	501(c)(3)	10	CSH	false
French Hospital Medical Center Foundation
1911 Johnson Avenue	San Luis Obispo	CA	93401	203256125	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DCC	false
GARRISON MEMORIAL HOSPITAL
407 THIRD AVENUE SOUTHEAST	GARRISON	ND	58540	450227752	HOSPITAL	ND	501(c)(3)	3	SAMC	false
Glendale Memorial Health Foundation
1420 South Central Avenue	Glendale	CA	91204	953625651	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DCC	false
GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	201536108	MINISTRIES	CO	501(c)(3)	Type I	CSH	false
GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE
619 OAK ST ACCOUNTING-3 W	CINCINNATI	OH	45206	311778403	EDUCATION	OH	501(c)(3)	2	GSH	false
GOOD SAMARITAN FOUNDATION OF CINCINNATI INC
619 OAK ST ACCOUNTING-3 W	CINCINNATI	OH	45206	311206047	FUNDRAISING FOUNDATION	OH	501(c)(3)	Type I	GSH	false
GOOD SAMARITAN HOSPITAL
PO BOX 1990	KEARNEY	NE	68848	470379755	HOSPITAL	NE	501(c)(3)	3	CHI NEBRASKA	false
GOOD SAMARITAN HOSPITAL FOUNDATION
111 W 31ST ST	KEARNEY	NE	68847	470659443	FUNDRAISING FOUNDATION	NE	501(c)(3)	7	GSH	false
HARRISON MEDICAL CENTER
2520 CHERRY AVE	BREMERTON	WA	98310	910565546	HOSPITAL	WA	501(c)(3)	3	FHS	false
HARRISON MEDICAL CENTER FOUNDATION
2520 CHERRY AVE	BREMERTON	WA	98310	911197626	FUNDRAISING FOUNDATION	WA	501(c)(3)	7	HMC	false
HEALTH FOUNDATION OF KENTUCKYONE INC
1451 HARRODSBURG RD STE D-308	LEXINGTON	KY	40504	832170324	FUNDRAISING FOUNDATION	KY	501(c)(3)	Type II	KOH	false
HEALTHCARE AND WELLNESS FOUNDATION
2400 ST FRANCIS DR	BRECKENRIDGE	MN	56520	760761782	FUNDRAISING FOUNDATION	MN	501(c)(3)	Type I	SFMC	false
HIGHLINE MEDICAL CENTER
16251 SYLVESTER RD SW	BURIEN	WA	98166	910712166	HOSPITAL	WA	501(c)(3)	3	FHS	false
HOUSE OF MERCY
1111 6TH AVE	DES MOINES	IA	50314	421323808	SHELTER	IA	501(c)(3)	7	CHI-IA CORP	false
JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC
250 E Liberty St Ste 500	LOUISVILLE	KY	40202	611029768	HOSPITAL	KY	501(c)(3)	3	KOH	false
KENTUCKYONE HEALTH MEDICAL GROUP INC
100 E Liberty St Ste 800	LOUISVILLE	KY	40202	611352729	HEALTHCARE	KY	501(c)(3)	10	JHSMH	false
KENTUCKYONE HEALTH INC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	611029769	HEALTHCARE	KY	501(c)(3)	Type II	CSH	false
LAKEWOOD HEALTH CENTER
600 MAIN AVE S	BAUDETTE	MN	56623	410758434	HOSPITAL	MN	501(c)(3)	3	CSH	false
LAKEWOOD REGIONAL HEALTHCARE FOUNDATION
600 MAIN AVE S	BAUDETTE	MN	56623	411893795	FUNDRAISING FOUNDATION	ND	501(c)(3)	7	LHC	false
LINUS OAKES INC
2700 STEWART PKWY	ROSEBURG	OR	97471	930821381	SENIOR LIVING	OR	501(c)(3)	10	MMC	false
LUFKIN VISION ACQUISITIONS
PO BOX 1447	LUFKIN	TX	75901	820563768	PROPERTY MGMT	TX	501(c)(3)	Type I	MHSET	false
MADISON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742761145	HOSPITAL	TX	501(c)(3)	3	SJSC	false
MADONNA MANOR INC
2344 AMSTERDAM ROAD	VILLA HILLS	KY	51017	610654635	LIVING ASSIST	KY	501(c)(3)	10	FLC	false
Marian Regional Medical Center Foundation
1400 E Church Street	Santa Maria	CA	93454	953818027	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DH	false
Mark Twain Medical Center
768 Mountain Ranch Road	San Andreas	CA	95249	680127677	HOSPITAL	CA	501(c)(3)	3	NA	false
MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC
2525 DE SALES AVE	CHATTANOOGA	TN	37404	621839548	FUNDRAISING FOUNDATION	TN	501(c)(3)	7	MHCS	false
MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVE	CHATTANOOGA	TN	37404	620532345	HOSPITAL	TN	501(c)(3)	3	CSH	false
MEMORIAL HEALTH PARTNERS FOUNDATION INC
5600 BRAINERD RD STE 500	CHATTANOOGA	TN	37411	030417049	HEALTHCARE	TN	501(c)(3)	10	MHCS	false
MEMORIAL HEALTH SYSTEM OF EAST TEXAS
PO BOX 1447	LUFKIN	TX	75902	750755367	HOSPITAL	TX	501(c)(3)	3	SLHS	false
MEMORIAL MEDICAL CENTER - LIVINGSTON
PO BOX 1447	LUFKIN	TX	75902	760436439	HOSPITAL	TX	501(c)(3)	3	MHSET	false
MEMORIAL MEDICAL CENTER - SAN AUGUSTINE
PO BOX 1447	LUFKIN	TX	75902	752663904	HOSPITAL	TX	501(c)(3)	3	MHSET	false
MEMORIAL MULTISPECIALTY ASSOCIATES
1201 FRANK AVE	LUFKIN	TX	95904	752721155	PHYSICIANS	TX	501(c)(3)	Type I	MHSET	false
MEMORIAL SPECIALTY HOSPITAL
PO BOX 1447	LUFKIN	TX	95902	752492741	HOSPITAL	TX	501(c)(3)	3	MHSET	false
MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVE	DES MOINES	IA	50314	426076069	AUXILIARY	IA	501(c)(3)	Type I	MF-DM IA	false
MERCY CLINICS INC
1111 6TH AVE	DES MOINES	IA	50314	421193699	PHYSICIANS	IA	501(c)(3)	10	CHI-IA CORP	false
MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVE	DES MOINES	IA	50314	421511682	EDUCATION	IA	501(c)(3)	2	CHI-IA CORP	false
Mercy Foundation Bakersfield
PO Box 119	Bakersfield	CA	93302	770201321	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DH	false
MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVE	DES MOINES	IA	50314	237358794	FUNDRAISING FOUNDATION	IA	501(c)(3)	7	CHI-IA CORP	false
MERCY FOUNDATION INC
2700 STEWART PKWY	ROSEBURG	OR	97471	936088946	FUNDRAISING FOUNDATION	OR	501(c)(3)	7	MMC	false
MERCY HEALTH CARE FOUNDATION
PO BOX 368	CORNING	IA	50841	421461064	FUNDRAISING FOUNDATION	IA	501(c)(3)	Type I	AHMH-Corning	false
MERCY HEALTHCARE FOUNDATION
570 CHAUTAUQUA BLVD	VALLEY CITY	ND	58072	450435338	FUNDRAISING FOUNDATION	ND	501(c)(3)	Type I	MHVC	false
MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DR	COUNCIL BLUFFS	IA	51503	421178204	FUNDRAISING FOUNDATION	IA	501(c)(3)	Type I	AHBMHS	false
MERCY HOSPITAL OF DEVILS LAKE
1031 7TH ST NE	DEVILS LAKE	ND	58301	450227012	HOSPITAL	ND	501(c)(3)	3	CSH	false
MERCY HOSPITAL OF DEVILS LAKE FOUNDATION
1031 7TH ST NE	DEVILS LAKE	ND	58301	352367360	FUNDRAISING FOUNDATION	ND	501(c)(3)	7	MHDL	false
MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BLVD	VALLEY CITY	ND	58072	450226553	HOSPITAL	ND	501(c)(3)	3	CSH	false
Mercy McMahon Terrace
3865 J Street	Sacramento	CA	95816	680117340	Senior Citizen's Housing/Retirement Communities	CA	501(c)(3)	10	DCC	false
MERCY MEDICAL CENTER
1301 15TH AVE WEST	WILLISTON	ND	58801	450231183	HOSPITAL	ND	501(c)(3)	3	CSH	false
MERCY MEDICAL CENTER - CENTERVILLE
ONE ST JOSEPHS DRIVE	CENTERVILLE	IA	52544	420680308	HOSPITAL	IA	501(c)(3)	3	CHI-IA CORP	false
MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER
204 N 4th Ave E	Newton	IA	50314	421470935	HOSPITAL	IA	501(c)(3)	3	CHI-IA CORP	false
Mercy Medical Center Merced Foundation
301 E 13th Street	Merced	CA	95340	770035928	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DH	false
MERCY MEDICAL CENTER INC
2700 STEWART PKWY	ROSEBURG	OR	97471	930386868	HOSPITAL	OR	501(c)(3)	3	CSH	false
MERCY MEDICAL FOUNDATION
1301 15TH AVE WEST	WILLISTON	ND	58801	450381803	FUNDRAISING FOUNDATION	ND	501(c)(3)	Type I	MMC	false
NEBRASKA HEART HOSPITAL
7500 S 91ST ST	LINCOLN	NE	68526	392031968	HOSPITAL	NE	501(c)(3)	3	CHI NEBRASKA	false
Northland Healthcare Alliance
2223 East Rosser Avenue	Bismarck	ND	58501	911845296	MANAGEMENT	ND	501(c)(3)	7	NCHA	false
Northridge Hospital Foundation
18300 Roscoe Blvd	Northridge	CA	91328	237444901	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DCC	false
OAKES COMMUNITY HOSPITAL
1200 N 7TH ST	OAKES	ND	58474	450231675	HOSPITAL	ND	501(c)(3)	3	CSH	false
OAKES COMMUNITY HOSPITAL FOUNDATION
1200 N 7TH ST	OAKES	ND	58474	710966606	FUNDRAISING FOUNDATION	ND	501(c)(3)	Type I	OCH	false
Pacific Central Coast Health Centers
1400 E Church Street	Santa Maria	CA	93454	770447575	Clinic	CA	501(c)(3)	3	DH	false
PINEYWOODS MEDICAL DEVELOPMENT CORP
PO BOX 1447	LUFKIN	TX	75902	752493116	PROPERTY MGMT	TX	501(c)(3)	Type I	MHSET	false
Port City Operating Company LLC
3400 Data Drive	Rancho Cordova	CA	95670	465322209	HOSPITAL	CA	501(c)(3)	3	DH	false
PROVIDENCE CARE CENTER
2025 HAYES AVENUE	SANDUSKY	OH	44870	341658625	HEALTHCARE	OH	501(c)(3)	10	FLC	false
PROVIDENCE CARE CENTERS
2025 HAYES AVENUE	SANDUSKY	OH	44870	341826099	HOLDING CO	OH	501(c)(3)	Type II	FLC	false
PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION
5055 PROVIDENCE DRIVE	SANDUSKY	OH	44870	341896807	LIVING COMM	OH	501(c)(3)	10	FLC	false
PUEBLO STEPUP
1925 E ORMAN AVE STE G52	PUEBLO	CO	81004	841234295	COMMUNITY	CO	501(c)(3)	7	CHIC	false
REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE
16251 Sylvester Road SW	Burien	WA	98166	911170040	HOSPITAL	WA	501(c)(3)	3	FHS	false
SET OF COLORADO SPRINGS INC
9100 E Mineral Circle	Centennial	CO	80112	841183335	Senior Center Services	CO	501(c)(3)	7	CHIC	false
SAINT CLARE'S COMMUNITY CARE INC
25 POCONO RD	DENVILLE	NJ	07834	222876836	HEALTHCARE	NJ	501(c)(3)	10	SCHS	false
SAINT CLARE'S FOUNDATION INC
25 POCONO RD	DENVILLE	NJ	07834	222502997	FUNDRAISING FOUNDATION	NJ	501(c)(3)	7	SCHS	false
SAINT CLARE'S HEALTH SERVICES INC
25 POCONO RD	DENVILLE	NJ	07834	223639733	MANAGEMENT	NJ	501(c)(3)	10	CSH	false
SAINT CLARE'S HOSPITAL INC
25 POCONO RD	DENVILLE	NJ	07834	223319886	HEALTHCARE	NJ	501(c)(3)	3	SCHS	false
SAINT ELIZABETH FOUNDATION
555 S 70TH ST	LINCOLN	NE	68510	470625523	FUNDRAISING FOUNDATION	NE	501(c)(3)	7	SERMC	false
SAINT ELIZABETH HEALTH SERVICES
555 S 70TH ST	LINCOLN	NE	68510	363233120	HOSPITAL	NE	501(c)(3)	3	SERMC	false
SAINT ELIZABETH REGIONAL MEDICAL CENTER
555 S 70TH ST	LINCOLN	NE	68510	470379836	HOSPITAL	NE	501(c)(3)	3	CHI NEBRASKA	false
SAINT FRANCIS MEDICAL CENTER
2620 W FAIDLEY	GRAND ISLAND	NE	68803	470376601	HOSPITAL	NE	501(c)(3)	3	CHI NEBRASKA	false
SAINT FRANCIS MEDICAL CENTER FOUNDATION
PO BOX 9804	GRAND ISLAND	NE	68802	470630267	FUNDRAISING FOUNDATION	NE	501(c)(3)	7	SFMC	false
Saint Francis Memorial Hospital
900 Hyde Street	San Francisco	CA	94109	941156295	HOSPITAL	CA	501(c)(3)	3	DCC	false
SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC
305 ESTILL ST	BEREA	KY	40403	260152877	FUNDRAISING FOUNDATION	KY	501(c)(3)	7	SJHS	false
SAINT JOSEPH HEALTH SYSTEM INC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	611334601	HOSPITAL	KY	501(c)(3)	3	KOH	false
SAINT JOSEPH HOSPITAL FOUNDATION INC
701 Bob Olink Dr 200	LEXINGTON	KY	40504	611159649	FUNDRAISING FOUNDATION	KY	501(c)(3)	Type I	SJHS	false
SAINT JOSEPH LONDON FOUNDATION INC
1001 SAINT JOSEPH LANE	LONDON	KY	40741	260438748	FUNDRAISING FOUNDATION	KY	501(c)(3)	7	SJHS	false
SAINT JOSEPH MOUNT STERLING FOUNDATION INC
225 FALCON DR	MOUNT STERLING	KY	40353	272884584	FUNDRAISING FOUNDATION	KY	501(c)(3)	7	SJHS	false
SAINT JOSEPH'S HOSPITAL FOUNDATION
2500 Fairway Street	DICKINSON	ND	58601	363418207	FUNDRAISING FOUNDATION	ND	501(c)(3)	Type I	SJHHC	false
San Gabriel Valley Medical Center Foundation
438 West Las Tunas Drive	San Gabriel	CA	91776	953430341	INACTIVE	CA	501(c)(3)	Type I	DH	false
SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC
104 W 17TH ST	SCHUYLER	NE	68661	363630014	FUNDRAISING FOUNDATION	NE	501(c)(3)	Type I	AHMHS	false
Sierra Nevada Memorial-Miners Hospital
155 Glasson Way	Grass Valley	CA	95945	941439787	HOSPITAL	CA	501(c)(3)	3	DCC	false
SJRMC JOPLIN MISSOURI
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	440545809	HOSPITAL	MO	501(c)(3)	3	CSH	false
St Francis Foundation of Santa Barbara
2323 De La Vina St Suite 104	Santa Barbara	CA	93105	237137119	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DH	false
St Francis Hospital Support Corporation
601 E Micheltorena Street	Santa Barbara	CA	93103	770022302	INACTIVE	CA	501(c)(3)	Type I	DH	false
St Johns Healthcare Foundation
1600 North Rose Avenue	Oxnard	CA	93030	202865781	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DH	false
St Josephs Foundation (Phoenix)
350 West Thomas Road	Phoenix	AZ	85013	942941245	FUNDRAISING FOUNDATION	AZ	501(c)(3)	Type I	DH	false
St Josephs Foundation of San Joaquin
1800 N California Street	Stockton	CA	95204	510432777	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DH	false
St Mary Medical Center Foundation
1050 Linden Avenue	Long Beach	CA	90813	237153876	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DH	false
St Mary Professional Building Inc
1050 Linden Avenue	Long Beach	CA	90813	237373088	INACTIVE	CA	501(c)(3)	Type I	DH	false
St Marys Medical Center Foundation
450 Stanyan Street	San Francisco	CA	94117	943336143	FUNDRAISING FOUNDATION	CA	501(c)(3)	Type I	DH	false
St Rose Dominican Health Foundation
3001 St Rose Parkway	Henderson	NV	89052	880349432	FUNDRAISING FOUNDATION	NV	501(c)(3)	Type I	DH	false
ST ALEXIUS MEDICAL CENTER
900 EAST BROADWAY AVENUE	BISMARCK	ND	58501	450226711	HOSPITAL	ND	501(c)(3)	3	CSH	false
ST ANTHONY HOSPITAL
2801 St Anthony Way	PENDLETON	OR	97801	930391614	HOSPITAL	OR	501(c)(3)	3	CSH	false
ST ANTHONY HOSPITAL FOUNDATION
2801 St Anthony Way	PENDLETON	OR	97801	930992727	FUNDRAISING FOUNDATION	OR	501(c)(3)	Type I	SAH	false
ST ANTHONY'S HOSPITAL ASSOCIATION
FOUR HOSPITAL DR	MORRILTON	AR	72110	710245507	HOSPITAL	AR	501(c)(3)	3	SVIMC	false
ST CATHERINE HOSPITAL
401 EAST SPRUCE ST	GARDEN CITY	KS	67846	480543721	HOSPITAL	KS	501(c)(3)	3	CSH	false
ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION
401 EAST SPRUCE ST	GARDEN CITY	KS	67846	200598702	FUNDRAISING FOUNDATION	KS	501(c)(3)	Type I	SCH	false
ST CLARE COMMONS
12469 Five Point Road	TOLEDO	OH	43551	270163752	LIVING COMM	OH	501(c)(3)	10	FLC	false
ST DOMINIC OF ONTARIO OREGON
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	930433692	HEALTHCARE	OR	501(c)(4)		CSH	false
ST FRANCIS HOME
2400 ST FRANCIS DR	BRECKENRIDGE	MN	56520	410729978	LTERM CARE	MN	501(c)(3)	10	CSH	false
ST FRANCIS LIFE CARE CORPORATION
19 POCONO RD	DENVILLE	NJ	07834	222536017	ELDERLY CARE	NJ	501(c)(3)	10	SCHS	false
ST FRANCIS MEDICAL CENTER
2400 ST FRANCIS DR	BRECKENRIDGE	MN	56520	410695598	HOSPITAL	MN	501(c)(3)	3	CSH	false
ST JOSEPH FOUNDATION OF BRYAN TEXAS
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742351158	FUNDRAISING FOUNDATION	TX	501(c)(3)	Type II	SJSC	false
ST JOSEPH MANOR
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742847594	HEALTHCARE	TX	501(c)(3)	10	SJSC	false
ST JOSEPH MEDICAL CENTER INC
201 INTERNATIONAL CIRCLE STE 212	HUNT VALLEY	MD	21030	520591461	HOSPITAL	MD	501(c)(3)	3	CSH	false
ST JOSEPH PHYSICIAN ASSOCIATES
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	203159302	PHYSICIANS	TX	501(c)(3)	3	SJSC	false
ST JOSEPH PHYSICIAN ENTERPRISE INC
201 INTERNATIONAL CIRCLE STE 212	HUNT VALLEY	MD	21030	521311775	PHYSICIANS	MD	501(c)(3)	Type I	SJMC	false
ST JOSEPH REGIONAL HEALTH CENTER
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	741282696	HOSPITAL	TX	501(c)(3)	3	SJSC	false
ST JOSEPH REGIONAL HEALTH PARTNERS
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	454088170	HOSPITAL	TX	501(c)(3)	3	SJSC	false
ST JOSEPH REGIONAL HEALTH PARTNERS ACO
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	463265423	HEALTHCARE	TX	501(c)(3)	10	SJSC	false
ST JOSEPH SERVICES CORPORATION
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742455161	MANAGEMENT	TX	501(c)(3)	Type I	SLHS	false
ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVE	PARK RAPIDS	MN	56470	410695603	HOSPITAL	MN	501(c)(3)	3	CSH	false
ST JOSEPH'S HOSPITAL AND HEALTH CENTER
2500 Fairway St	DICKINSON	ND	58601	450226429	HOSPITAL	ND	501(c)(3)	3	CSH	false
ST LEONARD
8100 CLYO ROAD	CENTERVILLE	OH	45458	341940863	LIVING COMM	OH	501(c)(3)	10	FLC	false
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	273733278	HOSPITAL	TX	501(c)(3)	3	SLHS	false
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	261947374	HOSPITAL	TX	501(c)(3)	3	SLHS	false
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	260335902	HOSPITAL	TX	501(c)(3)	3	SLHS	false
ST LUKE'S COMMUNITY HEALTH SERVICES
6624 FANNIN ST STE 1100	HOUSTON	TX	77030	760536234	HOSPITAL	TX	501(c)(3)	3	SLHS	false
ST LUKE'S FOUNDATION
1213 HERMANN DRIVE STE 855	HOUSTON	TX	77004	453811485	FUNDRAISING FOUNDATION	TX	501(c)(3)	7	SLHS	false
ST LUKE'S HEALTH SYSTEM CORPORATION
PO Box 20269	HOUSTON	TX	77225	760536232	MANAGEMENT	TX	501(c)(3)	Type I	CSH	false
ST LUKE'S HOSPITAL AT THE VINTAGE
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	263734606	HOSPITAL	TX	501(c)(3)	3	SLHS	false
ST LUKE'S PROPERTIES CORPORATION
1213 Hermann Drive Ste 855	HOUSTON	TX	77004	760531716	PROPERTY MGMT	TX	501(c)(3)	Type I	SLHS	false
ST LUKE'S SUGAR LAND PROPERTIES CORPORATION
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	454120549	PROPERTY MGMT	TX	501(c)(3)	Type I	SLCDC-SL	false
ST MARY'S COMMUNITY HOSPITAL
1301 Grundman Boulevard	NEBRASKA CITY	NE	68410	470443636	HOSPITAL	NE	501(c)(3)	3	CHI NEBRASKA	false
ST MARY'S HOSPITAL FOUNDATION
1314 3RD AVE	NEBRASKA CITY	NE	68410	470707604	FUNDRAISING FOUNDATION	NE	501(c)(3)	7	SMCH	false
ST VINCENT FOUNDATION
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	510169537	FUNDRAISING FOUNDATION	AR	501(c)(3)	Type I	SVIMC	false
ST VINCENT INFIRMARY MEDICAL CENTER
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	710236917	HOSPITAL	AR	501(c)(3)	3	CSH	false
ST VINCENT MEDICAL GROUP
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	710830696	HEALTHCARE	AR	501(c)(3)	10	SVIMC	false
SYLVANIA FRANCISCAN HEALTH
1715 INDIAN WOOD CIR 200	MAUMEE	OH	43537	341412964	HEALTHCARE	OH	501(c)(3)	Type I	CSH	false
SYLVANIA FRANCISCAN HEALTH FOUNDATION
1715 INDIAN WOOD CIR 200	MAUMEE	OH	43537	455357161	FUNDRAISING FOUNDATION	OH	501(c)(3)	Type I	FLC	false
THE COMMONS OF PROVIDENCE
5000 PROVIDENCE DRIVE	SANDUSKY	OH	44870	341826097	ASSIST LIVING	OH	501(c)(3)	10	FLC	false
THE COMMUNITY HOSPITAL OF BRAZOSPORT
100 MEDICAL DRIVE	LAKE JACKSON	TX	77566	741385192	HOSPITAL	TX	501(c)(3)	3	SLHS	false
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH
619 OAK ST ACCOUNTING-3 W	CINCINNATI	OH	45206	310537486	HOSPITAL	OH	501(c)(3)	3	CSH	false
THE PHYSICIAN NETWORK
2000 Q ST STE 500	LINCOLN	NE	68503	470780857	PHYSICIANS	NE	501(c)(3)	Type I	CHI NEBRASKA	false
TOTAL HEALTHCARE
9100 E Mineral Circle	Centennial	CO	80112	840927232	HOSPITAL	CO	501(c)(3)	3	CHIC	false
TRINITY HEALTH FOUNDATION
380 SUMMIT AVENUE	STEUBENVILLE	OH	43952	311329423	FUNDRAISING FOUNDATION	OH	501(c)(3)	Type I	THS	false
TRINITY HEALTH SYSTEM
380 SUMMIT AVENUE	STEUBENVILLE	OH	43952	341818681	HEALTHCARE	OH	501(c)(3)	Type I	NA	false
TRINITY HOSPITAL TWIN CITY
819 NORTH FIRST STREET	DENNISON	OH	44621	275401105	HOSPITAL	OH	501(c)(3)	3	SFH	false
TRI-STATE HEALTH SERVICES INC
ONE ROSS PARK BLVD	STEUBENVILLE	OH	43952	341522484	ASSIST LIVING	OH	501(c)(3)	7	THS	false
UNITY FAMILY HEALTHCARE
815 SE 2ND ST	LITTLE FALLS	MN	56345	410721642	HOSPITAL	MN	501(c)(3)	3	CSH	false
VILLA NAZARETH INC
801 PAGE DR	FARGO	ND	58103	450226714	LTERM CARE	ND	501(c)(3)	10	CSH	false
VISITING NURSE ASSOCIATION OF ST CLARE'S INC
191 WOODPORT RD	SPARTA	NJ	07871	221768334	HOME HEALTH	NJ	501(c)(3)	10	SCHS	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (80 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	UBI Code VUBICodeVAmt	Address Line2USAddress/AddressLine2Txt
AGH Phoenix LLC
220 E Las Colinas Blvd Suite 1000	Irving	TX	75039	471584330	Holding Company	AZ	NA	N/A	false	false
American Mercy Home Care LLC
1700 EDISON DR	MILFORD	OH	45150	830486150	HOME HEALTH	OH	NA	N/A	false	false
Arizona Care Network LLC (ACN LLC)
350 W Thomas Rd	Phoenix	AZ	85013	454494682	Care Network	AZ	NA	N/A	false	false
Audubon Land Company LLC
630 Southpointe Court 200	COLORADO SPRINGS	CO	80906	841513085	Real Estate	CO	NA	N/A	false	false
AVON EMERGENCY AND URGENT CARE CENTER LLC
9100 E Mineral Circle	Centennial	CO	80112	811727282	HEALTHCARE SRVC	CO	NA	N/A	false	false
BAYLOR CHI ST LUKES HEALTH SERVICES LLC
6624 Fannin St Ste 1100	HOUSTON	TX	77030	472079184	HEALTHCARE SRVC	TX	NA	N/A	false	false
BERGAN MERCY SURGERY CENTER LLC
7710 Mercy Rd Ste 200	OMAHA	NE	68124	208671994	AMBUL SURG CTR	NE	NA	N/A	false	false
BERYWOOD OFFICE PROPERTIES LLC
2501 Citico Avenue	CHATTANOGA	TN	37404	621875199	PHYS OFFICE	TN	NA	N/A	false	false
BLUEGRASS REGIONAL IMAGING CENTER
1218 SOUTH BROADWAY STE 310	LEXINGTON	KY	40504	611386736	DIAGNOSTIC IMAGING	KY	NA	N/A	false	false
CBCC Outsmarting Cancer LLC
6501 Truxtun Avenue	Bakersfield	CA	93309	461602286	Radiation / Oncology including Cyberknife	CA	NA	N/A	false	false
CENTRAL NEBRASKA REHABILITATION SERVICES LLC
3004 W FAIDLEY AVENUE	GRAND ISLAND	NE	68803	810653461	Physical Therapy	NE	NA	N/A	false	false
CENTURA-SCA HOLDINGS LLC
569 BROOK VILLAGE STE 901	BIRMINGHAM	AL	35209	474823023	OP SURGERY CENTER	AL	NA	N/A	false	false
CHI OPERATING INVESTMENT PROGRAM LP
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	470727942	INVESTMENTS	CO	NA	Excluded	false	false	$115,198	$3,236,299	$411
CHICAMSURG Surgery Centers LLC
1A Burton Hills Blvd	Nashville	TN	37215	465683027	SURGERY CENTER	CO	NA	N/A	false	false
CHICLARKIN VENTURES LLC
9100 E Mineral Circle	Centennial	CO	80112	474210888	URGENT CARE	CO	NA	N/A	false	false
Colorado Springs CK Leasing LLC
630 Southpointe Court 200	COLORADO SPRINGS	CO	80906	262982714	REAL ESTATE	CO	NA	N/A	false	false
Community Mercy Home Care Services of Springfield LLC
1700 EDISON DR	MILFORD	OH	45150	311746556	HOME HEALTH	OH	NA	N/A	false	false
DE JV LLC
8686 New Trails Drive	The Woodlands	TX	77381	320496548	Emergency Care	NV	NA	N/A	false	false
DHHP Surgery Centers LLC
1513 S Grand Avenue Ste 350	Los Angeles	CA	90015	831847466	SURGERY	CA	NA	N/A	false	false
DHRT Holdings LLC
185 Berry Street Suite 300	San Francisco	CA	94107	352484591	Holding Company	DE	NA	N/A	false	false
Dignity- GoHealthUrgent Care Management LLC
5555 Glenridge Connector Suite 700	Atlanta	GA	30342	352548698	Management Services	DE	NA	N/A	false	false
Dignity Health at Home LLC
1700 EDISON DR	MILFORD	OH	45150	824674115	HEALTHCARE SRVC	DE	NA	N/A	false	false
Dignity Health Specialty Pharmacy LLC
185 Berry Street Suite 300	San Francisco	CA	94107	320589462	Specialty Pharmacy Services	DE	NA	N/A	false	false
DIGNITYUSP LAS VEGAS SURGERY CENTERS LLC
15305 Dallas Parkway	Addison	TX	75001	202999237	Surgery	TX	NA	N/A	false	false				Suite 1600 LB 28
DignityUSP NorCal Surgery Centers LLC
15306 Dallas Parkway	Addison	TX	75001	202468509	SURGERY	TX	NA	N/A	false	false				Suite 1600 LB 28
DIGNITYUSP PHOENIX SURGERY CENTERS LLC
15307 Dallas Parkway	Addison	TX	75001	134248908	Surgery	TX	NA	N/A	false	false				Suite 1600 LB 28
DignityUSPJohn Muir East Bay Surg Ctrs LLC
15308 Dallas Parkway	Addison	TX	75001	352584991	SURGERY	TX	NA	N/A	false	false				Suite 1600 LB 28
Dignity-Abrazo Health Network LLC
3030 N Central Avenue Suite 1402	Phoenix	AZ	85012	465477985	Management Services	AZ	NA	N/A	false	false
Dominican Magnetic Resonance Imaging Center
1545 Soquel Drive	Santa Cruz	CA	94065	770095477	Imaging Center	CA	NA	N/A	false	false
Folsom Sierra Endoscopy Center LP
1650 Creekside Drive 1600	Folsom	CA	95630	680482416	Endoscopy	CA	NA	N/A	false	false
Franciscan Medical Pavilion Bonney Lake LLC
6622 Wollochet Dr NW	Gig Harbor	WA	98335	463494108	Real Estate	WA	NA	N/A	false	false
FRANCISCAN SPECIALTY CARE LLC
680 SOUTH FOURTH STREET	LOUISVILLE	KY	40202	813725123	HEALTHCARE SRVC	WA	NA	N/A	false	false
Good Samaritan Home Care Services of Vincenne IN LLC
1700 EDISON DR	MILFORD	OH	45150	201792869	HOME HEALTH	OH	NA	N/A	false	false
HC SL VINTAGE I LLC
18000 W SARAH LANE STE 250	BROOKFIELD	WI	53045	270453767	PROPERTY HOLDING	WI	NA	N/A	false	false
HEALTHCARE SUPPORT SERVICES LLC
PO BOX 9804	GRAND ISLAND	NE	68802	721546196	LAUNDRY	NE	NA	N/A	false	false
Heartland Oncology LLC
2337 E Crawford St	Salina	KS	67401	464265403	ONCOLOGY	KS	NA	N/A	false	false
Highline Physical Therapy Group
181 S 333rd Street STE 250	Federal Way	WA	98003	911431904	Physical Therapy	WA	NA	N/A	false	false
LAKESIDE AMBULATORY SURGICAL CENTER LLC
17031 LAKESIDE HILLS DR	OMAHA	NE	68130	204267902	AMBUL SURG CTR	NE	NA	N/A	false	false
LAKESIDE ENDOSCOPY CENTER LLC
17001 LAKESIDE HILLS PLZ STE 201	OMAHA	NE	68130	205544496	ENDOSCOPY SRVC	NE	NA	N/A	false	false
LINCOLN CK LEASING LLC
555 SOUTH 70TH STREET	Lincoln	NE	68510	262496856	Real Estate	NE	NA	N/A	false	false
Mercy Davis Cancer Center Management Co LLC
2740 M Street	Merced	CA	95340	943358445	Management of Cancer Center	CA	NA	N/A	false	false
Mercy Rehabilitation Hospital LLC
680 SOUTH FOURTH STREET	LOUISVILLE	KY	40202	814437201	HEALTHCARE SRVC	TX	NA	N/A	false	false
Military Road Properties LLC
181 S 333rd Street STE 250	Federal Way	WA	98003	912067879	Real Estate	WA	NA	N/A	false	false
NEBRASKA SPINE HOSPITAL LLC
6901 N 72ND ST STE 20300	OMAHA	NE	68122	270263191	SPINE HOSPITAL	NE	NA	N/A	false	false
NICU Operating CO of Santa Cruz LLC
1555 Soquel Drive	Santa Cruz	CA	95065	460502935	Neonatal Healthcare	CA	NA	N/A	false	false
NORTH RIVER SURGERY CENTER LLC
2209 WILDWOOD AVE	SHERWOOD	AR	72120	710799771	AMBUL SURG CTR	AR	NA	N/A	false	false
NSC Channel Islands LLC
3000 Riverchase Galleria Suite 500	Birmingham	AL	35244	770418197	Ambulatory surgical center	CA	NA	N/A	false	false
OMG Arizona LLC
130 Sutter Street 2nd Flr	San Francisco	CA	94104	471708588	Medical Office	AZ	NA	N/A	false	false
ORTHOCOLORADO LLC
11650 WEST 2ND PLACE	LAKEWOOD	CO	80228	371577105	ORTHO HOSPITAL	CO	NA	N/A	false	false
Park Rapids Area Health Care
600 Pleasant Avenue S	Park Rapids	MN	56470	204926259	HEALTHCARE SRVC	MN	NA	N/A	false	false
Pasadena Urgency Center LLC
4600 E SAM HOUSTON PKWY SOUTH	PASADENA	TX	77505	812482854	URGENT CARE	TX	NA	N/A	false	false
Patient Transport Services of Columbus Inc
1700 EDISON DR	MILFORD	OH	45150	264601285	Ambulance	OH	NA	N/A	false	false
PENINSULA RADIATION ONCOLOGY LLC
314 MLK JR WAY STE 11	TACOMA	WA	98405	870808610	HEALTHCARE SRVC	WA	NA	N/A	false	false
Penrad Imaging LLC
1390 Kelly Johnson Blvd	COLORADO SPRINGS	CO	80920	841072619	Medical Imaging	CO	NA	N/A	false	false
Performance Medical Equipment & Respiratory Svsc LLC
19625 62nd Avenue South STE 101	Kent	WA	98032	452901632	Holding Company	WA	NA	N/A	false	false
Plaza Surgery Center LP
525 E Plaza Drive Suite 100	Santa Maria	CA	93454	770573567	Surgery	CA	NA	N/A	false	false
PMC HOSPITAL LLC
3100 MAIN ST STE 500	HOUSTON	TX	77002	273280598	HOSPITAL	TX	NA	N/A	false	false
Precision Medicine Alliance LLC
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	352569159	Diagnostic Services	CO	NA	N/A	false	false
Pueblo Ambulatory Surgery Center LLC
25 Montebello Rd	Pueblo	CO	81003	621488737	SURGERY CENTER	CO	NA	N/A	false	false
Radiation Oncology Centers of Ventura County
1700 N ROSE AVENUE SUITE 120	OXNARD	CA	93030	770191706	IMAGING	CA	NA	N/A	false	false
RBR Management LLC
91 Corporate Park Drive Suite 120	Henderson	NV	89074	271466450	Ambulance	NV	NA	N/A	false	false
Reid-ANC Home Care Services LLC
1700 EDISON DR	MILFORD	OH	45150	371454747	HOME HEALTH	IN	NA	N/A	false	false
SAINT JOSEPH - SCA HOLDINGS LLC
1451 Harrodsburg RD	LEXINGTON	KY	40503	453801157	OP SURGERY	DE	NA	N/A	false	false
SAINT JOSEPH-ANC HOME CARE SERVICES
1700 EDISON DR	MILFORD	OH	45150	263330545	HOME HEALTH	KY	NA	N/A	false	false
Santa Cruz Comprehensive Imaging LLC
1661 Soquel Drive Suite G	Santa Cruz	CA	95065	010550623	Imaging	CA	NA	N/A	false	false
Santa Cruz Land & Building LP
1555 Soquel Drive	Santa Cruz	CA	95065	770285236	REAL ESTATE	CA	NA	N/A	false	false
Santa Cruz Surgery Center LLC
3003 PAUL SWEET ROAD	SANTA CRUZ	CA	95065	770194916	SURGERY	CA	NA	N/A	false	false
SMI Imaging LLC
6740 E Camelback Road Suite 101	Scottsdale	AZ	85251	264000683	Imaging Center	CA	NA	N/A	false	false
Southeastern Home Care LLC
1700 EDISON DR	MILFORD	OH	45150	271219638	HOME HEALTH	OH	NA	N/A	false	false
St Joseph's Surgery Center LP
15305 Dallas Parkway	Addison	TX	75001	201019390	Surgery	TX	NA	N/A	false	false				Suite 1600 LB 28
St Elizabeth Home Care Services LLC
1700 EDISON DR	MILFORD	OH	45150	261236191	HOME HEALTH	KY	NA	N/A	false	false
ST FRANCIS LAND COMPANY
5390 N ACADEMY BLVD STE 300	COLORADO SPRINGS	CO	80918	263134100	REAL ESTATE	CO	NA	N/A	false	false
ST LUKE'S DIAGNOSTIC CATH LAB LLP
6624 FANNIN ST STE 800	HOUSTON	TX	77030	710959365	DIAGNOSTICS	TX	NA	N/A	false	false
ST LUKE'S LAKESIDE HOSPITAL LLC
6624 FANNIN STE 2505	HOUSTON	TX	77030	300427437	HOSPITAL	TX	NA	N/A	false	false
ST LUKE'S THE WOODLANDS SLEEP CENTER LLC
6624 FANNIN STE 800	HOUSTON	TX	77030	462795726	DIAGNOSTICS	TX	NA	N/A	false	false
Templeton Surgery Center LLC
1310 Las Tablas Road Suite 104	Templeton	CA	94365	202246616	Surgery	CA	NA	N/A	false	false
The Medical Pavilion at St John's
1700 Rose Avenue	Oxnard	CA	93030	770332349	Real Estate	CA	NA	N/A	false	false
THREE SPRING IMAGING LLC
1 Mercado St STE 200A	DURANGO	CO	81301	813571570	HEALTHCARE SRVC	CO	NA	N/A	false	false
Valley Physicians Surgery Center At Northridge LLC
18330 Roscoe Blvd	Northridge	CA	91328	800864336	Surgery	CA	NA	N/A	false	false
WEST LAKES SURGERY CENTER LLC
12499 UNIVERSITY AVENUE STE 100	CLIVE	IA	50325	205345295	HEALTHCARE SRVC	IA	NA	N/A	false	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (92 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line2RelatedOrganizationName/BusinessNameLine2Txt
Alegent HealthCreighton St Joseph Managed Care Services Inc
12809 West Dodge Rd	Omaha	NE	68154	470802396	Managed Care	NE	NA	C Corporation	false
All Saints Insurance Company SPC Ltd
				980556913	Insurance		NA	C Corporation	false	PO BOX 10073 APO	Georgetown	GRAND CAYMAN	CJ	KY11001	CJ
ALLIANCE HEALTH PROVIDERS OF BRAZOS Valley Inc
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742466914	Healthcare	TX	NA	C Corporation	false
Alternative Insurance Management Service Inc
3900 OLYMPIC BLVD STE 400	Erlanger	KY	41018	841112049	Management Services	CO	NA	C Corporation	false
AMERICAN NURSING CARE Inc
1700 EDISON DR	MILFORD	OH	45150	311085414	HOME HEALTH	OH	NA	C Corporation	false
AMERIMED INC
1700 EDISON DR	MILFORD	OH	45150	311158699	HOME HEALTH	OH	NA	C Corporation	false
BC HOLDING COMPANY INC
1850 BLUEGRASS AVE	LOUISVILLE	KY	40215	311542851	Fitness Club	KY	NA	C Corporation	false
BrazoSport Health Alliance
1 WEST WAY COURT	LAKE JACKSON	TX	77566	760518376	Health Care	TX	NA	C Corporation	false
Caduceus Medical Associates INC
5600 Brainerd Road Ste 500	Chattanooga	TN	37411	621570736	Healthcare	TN	NA	C Corporation	false
Captive Management Initiatives Ltd
				980663022	Captive Management		NA	C Corporation	false	PO BOX 10073 APO	Georgetown	GRAND CAYMAN	CJ	KY11001	CJ
Catholic Health Initiatives Center for Translational Research
198 INVERNESS DRIVE WEST	Englewood	CO	80112	272269511	Research	CO	NA	C Corporation	false
CHI St Luke's Health - Memorial Condominium Association Inc
1201 W Frank Ave	Lufkin	TX	75904	834184717	Condo Assoc	TX	NA	C Corporation	false
ClearRiver Health
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464495960	Insurance	TN	NA	C Corporation	false
Coastal Surgical Specialists Inc
921 Oak Park Blvd Suite 101	Pismo Beach	CA	93449	743000596	Healthcare	CA	NA	S Corporation	false
Comcare Services Inc
5570 DTC Parkway	Englewood	CO	80111	840904813	Inactive	CO	NA	C Corporation	false
CONSOLIDATED HEALTH SERVICES
1700 EDISON DR	MILFORD	OH	45150	311378212	HOME HEALTH	OH	NA	C Corporation	false
Des Moines Medical Center Inc
1111 6TH AVE	Des Moines	IA	50314	420837382	Real Estate	IA	NA	C Corporation	false
Dignity Health Holding Corporation
185 Berry Street Suite 300	San Francisco	CA	94107	460675371	Holding Co	NV	NA	C Corporation	false
Dignity Health Insurance Ltd (Cayman Island corporation)
				981065338	Insurance		NA	C Corporation	false	PO Box 1051 KY1-1102	Grand Cayman Islands	GRAND CAYMAN	CJ	KY11001	CJ
Dignity Health Provider Resources Inc
185 Berry Street Suite 300	San Francisco	CA	94107	473366764	Health Plan	CA	NA	C Corporation	false
Diversified Health Resources Inc
100 MEDICAL DRIVE	LAKE JACKSON	TX	77566	760222679	Health Care	TX	NA	C Corporation	false
First Initiatives Insurance LTD
				980203038	Insurance		NA	C Corporation	false	PO BOX 10073 APO	Georgetown	GRAND CAYMAN	CJ	KY11001	CJ
Franciscan City Urgent Care Services PS dba City MD - Franciscan Urgent Car
C/O CPGUSA 1345 AVE OF THE AMERICAS	NEW YORK	NY	10105	812174959	Healthcare	NY	NA	C Corporation	false							e
Franciscan Services Inc
198 INVERNESS DRIVE WEST	Englewood	CO	80112	232487967	Healthcare	CO	NA	C Corporation	false
Good Samaritan Outreach Services
PO Box 1990	Kearney	NE	68848	470659440	Medical Clinic	NE	NA	C Corporation	false
HarvestPlains Health of Iowa
32129 Weyerhaeuser Way S STE 201	FEDERAL WAY	WA	98001	473451750	Insurance	WA	NA	C Corporation	false
Health Services of the Pacific Central Coast Inc
1400 E Church Street	Santa Maria	CA	93454	770074057	Healthcare	CA	NA	C Corporation	false
Health Systems Enterprises Inc
PO BOX 1990	Kearney	NE	68848	470664558	MGMT	NE	NA	C Corporation	false
Healthcare MGMT Services Organization INC
1149 MARKET ST	Tacoma	WA	98402	911865474	Health Org.	WA	NA	C Corporation	false
HeartlandPlains Health
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464368223	Insurance	NE	NA	C Corporation	false
Highline Medical Group
1717 S J Street	Tacoma	WA	98405	911407026	Medical Services	WA	NA	C Corporation	false
Integrated Medical Services
9250 N 3rd Street Suite 4010	Phoenix	AZ	85020	860783428	Multi-specialty physicians group	AZ	NA	C Corporation	false
KOMG-Louisville Region Inc
201 Abraham Flexner Way	Louisville	KY	40202	832481198	Healthcare	KY	NA	C Corporation	false
Management Services Organization of Santa Maria Inc
1400 E Church Street	Santa Maria	CA	93454	770318135	Health Care Mgmt	CA	NA	C Corporation	false
Medical Office Building Horizontal Property Regime Inc
300 Werner St	Hot Springs	AR	71913	710720429	Real Estate	AR	NA	C Corporation	false
Medquest
1301 15TH AVENUE WEST	Williston	ND	58801	450392137	Sale of DME	ND	NA	C Corporation	false
Memorial CV Service Line Management Company LLC
1201 W Frank Ave	Lufkin	TX	75904	463622849	Heath Care	TX	NA	C Corporation	false
Mercy Park Apartments LTD
1111 6th AVE	Des Moines	IA	50314	421202422	Housing	IA	NA	C Corporation	false
Mercy Services Corp
2700 STEWART PARKWAY	Roseburg	OR	97471	930824308	Retail Sales	OR	NA	C Corporation	false
MHI Clinical Services
1201 W Frank Ave	Lufkin	TX	75904	461967952	Healthcare	TX	NA	C Corporation	false
Millenium Surgery Center Inc
9300 Stockdale Hwy 200	Bakersfield	CA	93311	770513445	Healthcare	CA	NA	S Corporation	false
Mountain Management Services Inc
6028 Shallowford Rd	Chattanooga	TN	37421	621570739	MGMT SVC ORG	TN	NA	C Corporation	false
North Central Health Care Alliance
PO Box 5538	Bismark	ND	58506	450439894	Healthcare	ND	NA	C Corporation	false
PATIENT TRANSPORT SERVICES INC
1700 EDISON DR	MILFORD	OH	45150	311100798	HOME HEALTH	OH	NA	C Corporation	false
QCA Health Plan Inc
12615 Chenal Parkway STE 300	Little Rock	AR	72211	710794605	Insurance	AR	NA	C Corporation	false
QualChoice Advantage
32129 WEYERHAEUSER WAY S STE 201	FEDERAL WAY	WA	98001	473433912	Insurance	WA	NA	C Corporation	false
QualChoice Health Plan Services Inc (fka CollabHealth Plan Services Inc)
198 INVERNESS DRIVE WEST	Englewood	CO	80112	461224037	Admin Services	CO	NA	C Corporation	false
QualChoice Health Inc (fka CollabHealth Managed Solutions Inc)
198 INVERNESS DRIVE WEST	Englewood	CO	80112	461222808	Holding Co	CO	NA	C Corporation	false
QualChoice Holdings Inc
198 INVERNESS DRIVE WEST	Englewood	CO	80112	274075520	Holding Co	AR	NA	C Corporation	false
QualChoice Life and Health Insurance Company Inc
12615 Chenal Parkway STE 300	Little Rock	AR	72211	710386640	Insurance	AR	NA	C Corporation	false
QualChoice of Nebraska
2401 S 73rd St	Omaha	NE	68124	810738827	Inactive	NE	NA	C Corporation	false
RiverLink Health
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464380824	Insurance	OH	NA	C Corporation	false
RiverLink Health of Kentucky Inc
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464828332	Insurance	KY	NA	C Corporation	false
Ross Park Pharmacy Inc
380 SUMMIT AVE	STEUBENVILLE	OH	43952	341832654	Pharmacy	OH	NA	C Corporation	false
RUSHWINC Properties Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	753160650	Lease negotiations	GA	NA	C Corporation	false
Saint Clare's Primary Care Inc
198 INVERNESS DRIVE WEST	Englewood	CO	80112	222441202	Billing Services	NJ	NA	C Corporation	false
SJH Services Corporation
198 INVERNESS DRIVE WEST	Englewood	CO	80112	232307408	Healthcare	CO	NA	C Corporation	false
SJL PHYSICIAN MANAGEMENT SERVICES INC
424 LEWIS HARGETT CR STE 160	Lexington	KY	40503	270164198	Mgmt	KY	NA	C Corporation	false
SoundPath Health Inc
32129 Weyerhaeuser Way S STE 201	Federal Way	WA	98001	421720801	Insurance	WA	NA	C Corporation	false
St Mary Health Ventures Inc
1050 Linden Avenue	Long Beach	CA	90813	951912528	Retail Pharmacy	CA	NA	C Corporation	false
St Anthony Development Company
1415 Southgate	Pendleton	OR	97801	931216943	Athletic Club	OR	NA	C Corporation	false
St Joseph Development Company Inc
1717 SOUTH J ST	Tacoma	WA	98405	911480569	Rental	WA	NA	C Corporation	false
St Luke's Health System Holdings Inc
6624 Fannin STE 800	Houston	TX	77030	760637138	Holding Co	TX	NA	C Corporation	false
St Mary's Multi Specialty Clinic
1625 Prater Way Suite 102	Sparks	NV	89434	113763590	Healthcare	NV	NA	C Corporation	false
St Vincent Community Health Services Inc
TWO ST VINCENT CIRCLE	Little Rock	AR	72205	710710785	Healthcare	AR	NA	C Corporation	false
StableView Health Inc
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464373713	Insurance	KY	NA	C Corporation	false
STE Holdings
12809 West Dodge Rd	Omaha	NE	68154	822383629	Holding Co	NE	NA	C Corporation	false
Sugar Land Doctor Group
1317 Lake Point Parkway	Sugar Land	TX	77478	454270163	Medical Clinic	TX	NA	C Corporation	false
Towson Management Inc
7601 OSLER DR	Towson	MD	21204	521710750	Mgmt Services	MD	NA	C Corporation	false
TRINITY MANAGEMENT SERVICES ORGANIZATION
380 SUMMIT AVE	STEUBENVILLE	OH	43952	341471026	Mgmt Services	OH	NA	C Corporation	false
US HealthWorks Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	582420844	Occupational Medical Services	CA	NA	C Corporation	false
US HealthWorks Medical Group of Alaska LLC
25124 Springfield Court Suite 200	Valencia	CA	91355	631219117	Occupational Medical Services	AK	NA	C Corporation	false
US HealthWorks Medical Group of Arizona Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	582625710	Occupational Medical Services	AZ	NA	C Corporation	false
US HealthWorks Medical Group of Florida Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	582654983	Occupational Medical Services	FL	NA	C Corporation	false
US HealthWorks Medical Group of Georgia Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	582625714	Occupational Medical Services	GA	NA	C Corporation	false
US HealthWorks Medical Group of Kentucky Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	473277440	Occupational Medical Services	KY	NA	C Corporation	false
US HealthWorks Medical Group of Maine Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	582654976	Occupational Medical Services	ME	NA	C Corporation	false
US HealthWorks Medical Group of Ohio Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	311540841	Occupational Medical Services	OH	NA	C Corporation	false
US HealthWorks of Colorado Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	811053593	Occupational Medical Services	CO	NA	C Corporation	false
US HealthWorks of Illinois Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	461384805	Occupational Medical Services	IL	NA	C Corporation	false
US HealthWorks of Indiana Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	351991196	Occupational Medical Services	IN	NA	C Corporation	false
US HealthWorks of Kansas City Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	462754415	Occupational Medical Services	KS	NA	C Corporation	false
US HealthWorks of Minnesota Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	452494357	Occupational Medical Services	MN	NA	C Corporation	false
US HealthWorks of New Jersey Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	043323869	Occupational Medical Services	NJ	NA	C Corporation	false
US HealthWorks of North Carolina Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	562029468	Occupational Medical Services	NC	NA	C Corporation	false
US HealthWorks of Pennsylvania Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	582660955	Occupational Medical Services	PA	NA	C Corporation	false
US HealthWorks of Tennessee Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	452697510	Occupational Medical Services	TN	NA	C Corporation	false
US HealthWorks of Washington Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	911173613	Occupational Medical Services	WA	NA	C Corporation	false
US HealthWorks of Wisconsin Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	461384564	Occupational Medical Services	WI	NA	C Corporation	false
USHW Holding Corporation
25124 Springfield Court Suite 200	Valencia	CA	91355	208050895	Occupational Medical Services	DE	NA	C Corporation	false
USHW of California Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	954585828	Occupational Medical Services	CA	NA	C Corporation	false
USHW of Texas Inc
25124 Springfield Court Suite 200	Valencia	CA	91355	742785392	Occupational Medical Services	TX	NA	C Corporation	false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd