MERCY HOSPITAL: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: MERCY HOSPITAL (EIN 45-0226553)
Tax period: 2018-07-01 to 2019-06-30
Filed: 2020-07-14
IRS object ID: 202021969349302367
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 H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-07-14T11:01:03-05:00	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	450226553	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Mercy Hospital of Valley City	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MERC	BusinessNameControlTxt
Phone	7018456489	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	570 Chautauqua Blvd	AddressLine1Txt
City	Valley City	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58072	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	KEITH HEUSER	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Signature	2020-07-14	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	3128997000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	CHI Mercy 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	570 Chautauqua Blvd	AddressLine1Txt
City	Valley City	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58072	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$13,803,017	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.mercyhospitalvalleycity.org/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1928	FormationYr
Legal Domicile State	ND	LegalDomicileStateCd
Activity Or Mission	MERCY HOSPITAL OF VALLEY CITY IS A CRITICAL ACCESS HOSPITAL SERVING A LARGE GEOGRAPHICAL AREA. COMMUNITY BENEFITS INCLUDE: UNCOMPENSATED CARE, MEDICAL EDUCATION AND AWARENESS, SUPPORT SERVICES, AND COMMUNITY OUTREACH.	ActivityOrMissionDesc
Voting Members Governing Body	8	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	101	TotalEmployeeCnt
Total Volunteers	97	TotalVolunteersCnt
Total Gross UBI	$2,616	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$1,616	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$481,084	PYContributionsGrantsAmt
CY Contributions Grants	$171,359	CYContributionsGrantsAmt
PY Program Service Revenue	$13,554,958	PYProgramServiceRevenueAmt
CY Program Service Revenue	$12,883,778	CYProgramServiceRevenueAmt
PY Investment Income	$1,306,590	PYInvestmentIncomeAmt
CY Investment Income	$715,023	CYInvestmentIncomeAmt
PY Other Revenue	$30,137	PYOtherRevenueAmt
CY Other Revenue	$32,857	CYOtherRevenueAmt
PY Total Revenue	$15,372,769	PYTotalRevenueAmt
CY Total Revenue	$13,803,017	CYTotalRevenueAmt
PY Grants And Similar Paid	$245,014	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,159	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$4,599,559	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$4,585,341	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$8,098,167	PYOtherExpensesAmt
CY Other Expenses	$7,735,599	CYOtherExpensesAmt
PY Total Expenses	$12,942,740	PYTotalExpensesAmt
CY Total Expenses	$12,322,099	CYTotalExpensesAmt
PY Revenues Less Expenses	$2,430,029	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$1,480,918	CYRevenuesLessExpensesAmt
Total Assets BOY	$30,399,579	TotalAssetsBOYAmt
Total Assets EOY	$33,197,052	TotalAssetsEOYAmt
Total Liabilities BOY	$1,477,553	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$2,623,792	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$28,922,026	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$30,573,260	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. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$11,559,722	ExpenseAmt
Grant	$1,159	GrantAmt
Revenue	$12,883,778	RevenueAmt
Desc	SEE SCHEDULE H	Desc
Total Program Service Expenses	$11,559,722	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	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	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	false	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	false	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	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	101	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
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	8	GoverningBodyVotingMembersCnt
Independent Voting Member	6	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	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	ND	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BETHANY SMITH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7018456583	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	570 Chautauqua Blvd	AddressLine1Txt
City	Valley City	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58072	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (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
KEITH HEUSER
Board Member/President	1.0	40.0	Yes (X)	Yes (X)	$0	$239,238	$33,892
SR STELLA OLSON
CHAIR	1.0	3.0	Yes (X)	Yes (X)	$0	$0	$0
Casey Stoudt
VICE CHAIR	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
Betty Tykwinski
Board Member	1.0	0	Yes (X)		$0	$0	$0
CRAIG CHRISTIANSON
BOARD MEMBER	1.0	0	Yes (X)		$0	$0	$0
FREDRICK MITZEL MD
BOARD MEMBER	1.0	0	Yes (X)		$0	$0	$0
TIM OST
BOARD MEMBER	1.0	1.0	Yes (X)		$0	$0	$0
Joshua Senger
Treasurer/VP, Finance	12.0	36.0		Yes (X)	$0	$125,275	$34,439
CAMILLE SETTELMEYER
VP OF CLINICAL SERVICES - PART YEAR	40.0	0		Yes (X)	$106,239	$13,219	$10,021
LISA URBATSCH
BOARD SECRETARY	40.0	1.0		Yes (X)	$43,113	$0	$19,539
CLARK KRUTA
CRNA	40.0	0			$209,161	$0	$36,694	Yes (X)
AMY NOESKE
PHARMACY MANAGER	40.0	0.0			$106,273	$0	$31,048	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$464,786	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,766,592	TotReportableCompRltdOrgAmt
Total Other Compensation	$206,060	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	3	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	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	Address Line2ContractorAddress/USAddress/AddressLine2Txt
NATIONAL MEDICAL RESOURCES INC
2792 E Broadway Ave	Bismarck	ND	58501	ER Physician Coverage	$875,141
MEDEFIS INC
2121 N 117TH AVE	OMAHA	NE	68164	VENDOR STAFFING	$264,485	STE 200
INTERSTAFF INC
PO BOX 4652	HOUSTON	TX	772104652	CONTRACT NURSING LABOR	$213,528	DEPT 980
DMS HEALTH TECHNOLOGIES INC
2101 N University DR	Fargo	ND	58102	Imaging Services	$160,487

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	$0	FundraisingAmt
Related Organizations	$78,666	RelatedOrganizationsAmt
Government Grants	$85,795	GovernmentGrantsAmt
All Other Contributions	$6,898	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$171,359	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	$12,880,008	$12,880,008	$0	$0
Rental Income	900099	$3,770	$3,770	$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	$12,883,778	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$476,388	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$2,616	UnrelatedBusinessRevenueAmt
Exclusion	$473,772	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	$0	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	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

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 Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$238,635	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	$238,635	SecuritiesAmt
Other	$0	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$238,635	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$238,635	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$0	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

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)
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
Cafeteria	722100	$25,107	$0	$0	$25,107
Rehab Services Revenue	621400	$1,481	$0	$0	$1,481
Durable Medical Equipment	446199	$1,076	$0	$0	$1,076

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,193	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$5,193	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$32,857	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$13,803,017	TotalRevenueColumnAmt
Related Or Exempt Func Income	$12,883,778	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$2,616	UnrelatedBusinessRevenueAmt
Exclusion	$745,264	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	$1,159	TotalAmt
Program Services	$1,159	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$121,103	TotalAmt
Management And General	$121,103	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$3,520,869	TotalAmt
Program Services	$3,360,883	ProgramServicesAmt
Management And General	$159,986	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$181,298	TotalAmt
Program Services	$179,523	ProgramServicesAmt
Management And General	$1,775	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$518,066	TotalAmt
Program Services	$491,053	ProgramServicesAmt
Management And General	$27,013	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$244,005	TotalAmt
Program Services	$224,484	ProgramServicesAmt
Management And General	$19,521	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$13,258	TotalAmt
Management And General	$13,258	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$2,293	TotalAmt
Management And General	$2,293	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$3,566,233	TotalAmt
Program Services	$3,211,673	ProgramServicesAmt
Management And General	$354,560	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$13,606	TotalAmt
Management And General	$13,606	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$174,218	TotalAmt
Program Services	$146,343	ProgramServicesAmt
Management And General	$27,875	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,003,751	TotalAmt
Program Services	$1,003,751	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$225,109	TotalAmt
Program Services	$225,109	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$6,457	TotalAmt
Program Services	$6,199	ProgramServicesAmt
Management And General	$258	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$328	TotalAmt
Management And General	$328	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$654,012	TotalAmt
Program Services	$654,012	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$748,268	TotalAmt
Program Services	$733,303	ProgramServicesAmt
Management And General	$14,965	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$25,274	TotalAmt
Program Services	$25,274	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$1,089,292	$1,089,292
Repairs and maintenance	$125,619	$125,619
Dues & subscriptions	$54,316	$54,316
Education	$16,926	$16,080	$846

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$16,639	TotalAmt
Program Services	$11,649	ProgramServicesAmt
Management And General	$4,990	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$12,322,099	TotalAmt
Program Services	$11,559,722	ProgramServicesAmt
Management And General	$762,377	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$626	BOYAmt
EOY	$625	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,984,947	BOYAmt
EOY	$3,301,880	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	$2,025,240	BOYAmt
EOY	$2,119,788	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	$187,805	BOYAmt
EOY	$201,820	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$17,569	BOYAmt
EOY	$0	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$15,388,607	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$11,939,994	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$3,921,661	BOYAmt
EOY	$3,448,613	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	$21,534,697	BOYAmt
EOY	$22,792,395	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	$727,034	BOYAmt
EOY	$1,331,931	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$30,399,579	BOYAmt
EOY	$33,197,052	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$506,656	BOYAmt
EOY	$960,467	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	$7,331	BOYAmt
EOY	$0	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	$963,566	BOYAmt
EOY	$1,663,325	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,477,553	BOYAmt
EOY	$2,623,792	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$28,901,766	BOYAmt
EOY	$30,553,000	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$20,260	BOYAmt
EOY	$20,260	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$28,922,026	BOYAmt
EOY	$30,573,260	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$30,399,579	BOYAmt
EOY	$33,197,052	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$1,480,918	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$547,313	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$376,997	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	$2,293	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$2,293	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	Line 1F: The portion of organization dues that are related to lobbying are as follows: Catholic Health Association - $338 American Hospital Association - $448 North Dakota Health Association $1,507	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$19,382	OtherCostOrOtherBasisAmt
Book Value	$19,382	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,501,040	OtherCostOrOtherBasisAmt
Depreciation	$5,798,204	DepreciationAmt
Book Value	$702,836	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	$8,746,531	OtherCostOrOtherBasisAmt
Depreciation	$6,045,556	DepreciationAmt
Book Value	$2,700,975	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$121,654	OtherCostOrOtherBasisAmt
Depreciation	$96,234	DepreciationAmt
Book Value	$25,420	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$3,448,613	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	CHI OIP	Desc
Book Value	$22,792,395	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$22,792,395	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
Intercompany Payables	$1,662,807
Service Fee Liability	$518

Field	Value	IRS element (for citing)
Total Liability	$1,663,325	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	FormAndLineReferenceDesc
Explanation	Mercy Hospital of Valley City'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".	ExplanationTxt

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	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
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	168	PersonsServedCnt
Total Community Benefit Expns	$181,641	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$181,641	NetCommunityBenefitExpnsAmt
Total Expense	0.0147	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
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	168	PersonsServedCnt
Total Community Benefit Expns	$181,641	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$181,641	NetCommunityBenefitExpnsAmt
Total Expense	0.0147	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	8	ActivitiesOrProgramsCnt
Persons Served	758	PersonsServedCnt
Total Community Benefit Expns	$39,406	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,435	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$33,971	NetCommunityBenefitExpnsAmt
Total Expense	0.0028	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	86	PersonsServedCnt
Total Community Benefit Expns	$10,431	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$180	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,251	NetCommunityBenefitExpnsAmt
Total Expense	0.0008	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	6	PersonsServedCnt
Total Community Benefit Expns	$38	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$38	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	13	ActivitiesOrProgramsCnt
Persons Served	850	PersonsServedCnt
Total Community Benefit Expns	$49,875	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,615	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$44,260	NetCommunityBenefitExpnsAmt
Total Expense	0.0036	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	13	ActivitiesOrProgramsCnt
Persons Served	1018	PersonsServedCnt
Total Community Benefit Expns	$231,516	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,615	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$225,901	NetCommunityBenefitExpnsAmt
Total Expense	0.0183	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$441	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$441	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	20	PersonsServedCnt
Total Community Benefit Expns	$297	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$297	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	13	PersonsServedCnt
Total Community Benefit Expns	$681	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$681	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
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	4	ActivitiesOrProgramsCnt
Persons Served	33	PersonsServedCnt
Total Community Benefit Expns	$1,419	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,419	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$419,628	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$7,076,734	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$7,117,654	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$40,920	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost Accounting System	Yes (X)	CostAccountingSystemInd

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	MERCY HOSPITAL OF VALLEY CITY	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	570 CHAUTAUQUA BLVD	AddressLine1Txt
City	VALLEY CITY	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58072	ZIPCd

Field	Value	IRS element (for citing)
Website Address	http://www.mercyhospitalvalleycity.org/	WebsiteAddressTxt
State License	5050A	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MERCY HOSPITAL OF VALLEY CITY	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	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	HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/COMMUNITY-BENEFITS/	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	HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/FINANCIAL-INFORMATION-DOCUMENTS/	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/FINANCIAL-INFORMATION-DOCUMENTS/	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/FINANCIAL-INFORMATION-DOCUMENTS/	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (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	Significant health needs of the community are identified and prioritized in the most recent CHNA. A more detailed description is provided in Part VI, Line 2 of the Schedule H.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - MERCY HOSPITAL OF VALLEY CITY. To help inform future decisions and strategic planning, CHI Mercy Health, Valley City and City-County Health District conducted a community health needs assessment (CHNA) in 2018. The Center for Rural Health (CRH) at the University of North Dakota School of Medicine & Health Sciences (UNDSMHS) facilitated the assessment process, which solicited input from area community members and healthcare professionals as well as analysis of community health-related data. To gather feedback from the community, residents of the area were given the opportunity to participate in a survey. There were 199 service area residents who completed the survey. Additional information was collected through seven key informant interviews with community members. The input from the residents, who primarily reside in Barnes County, represented the broad interests of the communities in the service area. Together with secondary data gathered from a wide range of sources, the survey presents a snapshot of the health needs and concerns in the community. CRH representatives also participated in a series of meetings that garnered input from the state's health officer, local North Dakota public health unit professionals, and representatives from North Dakota State University.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - MERCY HOSPITAL OF VALLEY CITY. THE CHNA WAS CONDUCTED WITH BOTH MERCY HOSPITAL AND City-County Health District.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - MERCY HOSPITAL OF VALLEY CITY. The following CHNA priority needs will be addressed by CHI Mercy Health in continued collaboration with City-County Health District: - Mental health - Substance Abuse and Misuse - Attract and Retain Young Families Health Need: Mental Health Strategies: 1) Expansion * Explore early intervention opportunity through Nurse Family Partnership. * Work with community partners to achieve necessary mental health training and resources in community. * Provide appropriate CHI Mercy Health staff with training on mental illness, increasing their understanding of how to connect patients to resources. 2) Youth Prevention * Address collaboratively with community partners family education and support resource needs. * Support current mental health and suicide prevention initiatives in local schools. * Utilize current Nurturing Parent program and Healthy Relationships curriculum as means to reach families with mental health education. Health Need: Substance Abuse and Misuse Strategies: 1) Treatment and Recovery Strategies * Contribute to the work of community partners to develop a local addiction recovery program based on housing, employment, peer support and healthy socialization. * Educate hospital staff on substance abuse disorders. 2) Not In My House * Change the norms of underage drinking through education and community engagement. * Reduce the way youth can access alcohol. 3) Licensed Addiction Counselors * Support the work of City-County Health District and South Central Human Service Center to add the services of licensed addiction counselors to the community. Health Need: Attract and Retain Young Families Strategies 1) Promotion * Partner with Valley City - Barnes County Development Corporation in the promotion of Valley City to achieve quality of place, workforce training and education, and building community. * Increase community awareness of hospital services, targeting young families. 2) Engagement * Actively participate in select community wide events with intent of contributing to a family friendly environment. * Partner with school system to identify and serve student and family health needs. The hospital intends to take actions to address the prioritized significant health needs identified through the Community Health Needs Assessment, both through its own programs and services and with community partners. The hospital has chosen not to address the following identified needs specifically within our initiatives. These health concerns are either beyond our capacity, being addressed by other organizations and programs, or are currently addressed through existing hospital programs. For each issue however, we will continue to dialogue with community partners: 1. Physical violence, domestic violence, sexual abuse remains an issue. 2. Not enough jobs with livable wages makes it difficult for new business development in the community and to increase minimum wages and provide benefits. 3. Extra hours for healthcare appointments in the evenings and on the weekends is desired to make care more accessible. 4. Ability to retain primary care providers (MD, DO, NP, PA, nurses) in the community. 5. Not having access to affordable housing has created a barrier to meeting other general needs of the community.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - MERCY HOSPITAL OF VALLEY CITY. 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	1	FacilityNum

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c eligibility criteria for a patient to qualify for Financial Assistance	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, Line 2 Needs assessment (continued)	COMMUNITY OUTREACH FOR THE BROADER COMMUNITY CHI Mercy Health reaches the broader community in many ways and many activities. Through education, programs, fundraisers, babysitting classes, parade floats, community support, health fairs, wellness days, and phone a nurse. CHI Mercy Health believes their advocacy efforts will continue to improve health care access and quality of life for area residents. Funds and in-kind services are donated to individuals and/or the community at large. In-kind services also include hours donated by staff to the community while on health care organization work time such as Barnes County's Relay for Life, Advisory Boards, in-kind printing, Student housing, and meeting rooms for community education. Health Education outreach for the community is reached by articles written for "Your Health" in the weekly newspaper in addition to weekly radio education segments and public service announcements prepared by hospital staff. CHI Mercy Health also mails a quarterly newsletter to all residents of Barnes County with up-to-date healthcare information. COLLABORATIVE EFFORTS TO IMPROVE COMMUNITY HEALTH Collaborative efforts to improve community health has been going strong for several years in Barnes County by providing educational classes to improve health are Cardiac Rehab, community and business CPR classes, Laboratory education to VCSU students, Social & Behavioral Services, Advanced Directive Education and assistance, Educational opportunities encompass a wide span of patient types. Education includes lectures, presentations, and other programs and activities provided to groups without providing clinical or diagnostic services. Cardiac Support Group and Behavioral Services Community Based Clinical Services and Health Care Support Services: are provided to the community such as Cardiac Rehab - Phase III which is outpatient supervised extended exercise for cardiac patients. Hospital nurses also answer calls for the Abused Persons Outreach Center and pages the Outreach Center's on-call staff; Social Service assistance for public programs, co-lead the Barnes County Behavioral Health Coalition, run a Domestic Violence Prevention Team for community outreach and healthy relationship training, as well as environmental improvement activities in the Community Sharps Disposal program. Health Professions Education: CHI Mercy Health places a high priority on providing education and support of individuals pursuing careers in the health care field. CHI Mercy Health has a nurse internship program where individuals are paid to work, one-on-one, alongside a Registered Nurse to obtain clinical experience while in nursing school. We also provided supervision and guidance for the following students -lab student rotation program; pharmacy student onsite; and physical therapy students. We support our local high school health careers job shadow program. We provide interest-free loans to health career students while they are in school. Donations and free teaching space are made to Dakota Nursing Program and we provide both Nursing Scholarships and General Medical Scholarships to local youth pursuing a career in the healthcare field. CHI Mercy Health reaches out to students not only to our local elementary and high school students, but also to Valley City State University, Vocational High School, NDSU, NDSCS, and LRSC. Community-Building Activities Community-building activities include cash, in-kind donations and budgeted expenditures for the development of community health programs and partnerships. CHI Mercy Health is involved in several collaborative efforts to improve our community and is fortunate to have dedicated staff that supports the hospital efforts in community projects: Barnes County Behavioral Health Coalition, Healthy Community Coalition/Community Resource Collaboration; Violence Prevention; also membership in the Valley City Area Chamber of Commerce, North Dakota Winter Show, Rotary, Barnes County Ministerial Association, and ND APIC and Community Health Improvement Advocacy. Community Benefit Operations: Community benefit operations include costs associated with dedicated staff, community health needs and/or assets assessment, and other costs associated with community benefit strategy and operations. Dedicated Staff hours are counted for the work on Charity Care assisting the patients that are underinsured or uninsured. CHI Mercy Health as a nonprofit, tax-exempt facility continues to take the necessary measures to be compliant with new legislation resulting from healthcare reform in determining what to report, how to report, and also implementing strategies in response from the community needs assessment.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	THE ORGANIZATION'S COST ACCOUNTING SYSTEM WAS USED TO REPORT FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS IN PART I, LINE 7. THE ORGANIZATION'S COST ACCOUNTING SYSTEM ADDRESSES ALL OF THE PATIENTS SERVED BY MERCY HOSPITAL OF VALLEY CITY.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	The organization has reported bad debt expense at gross charges written off. The organization's bad debt expense represents amounts billed to patients that was deemed uncollectible and does not include any charges that were ultimately reimbursed or discounted. Patient discounts are recorded in contractual allowance or financial assistance, as appropriate, as an offset to gross revenue and are not included in bad debt expense.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	Mercy Hospital of Valley City 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	Mercy Hospital of Valley City does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of CommonSpirit Health. The 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	Mercy Hospital 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, Mercy Hospital, due to their designation as a CAH, received cost-based reimbursement for Medicare purposes, Mercy Hospital will not typically experience Medicare related shortfalls. Mercy Hospital 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	- MERCY HOSPITAL OF VALLEY CITY: Line 16a URL: HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/FINANCIAL-INFORMATION-DOCUMENTS/;
Schedule H, Part V, Section B, Line 16b FAP Application website	- MERCY HOSPITAL OF VALLEY CITY: Line 16b URL: HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/FINANCIAL-INFORMATION-DOCUMENTS/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- MERCY HOSPITAL OF VALLEY CITY: Line 16c URL: HTTPS://WWW.MERCYHOSPITALVALLEYCITY.ORG/FINANCIAL-INFORMATION-DOCUMENTS/;
Schedule H, Part VI, Line 2 Needs assessment	ORGANIZATION'S MISSION, VISION, AND TAX-EXEMPT PURPOSE CHI Mercy Health was founded to alleviate a shortage of hospital beds in the community and opened on May 15, 1928. As the first Catholic hospital to serve the community, CHI Mercy Health embraced the mission of the founding congregation, The Sisters of Mercy, which joined with other congregations in 1996 to form Catholic Health Initiatives. The Mission of CHI Mercy Health of Valley City and CommonSpirit Health is "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." CommonSpirit Health's Vision is "A Healthier Future for all - inspired by faith, driven by innovation, and powered by our humanity. Our core values "Compassion, Inclusion, Integrity, Excellence, and Collaboration", are the guiding principles that provide focus, direction and accountability. The core values play a vital role in creating identity, spirit and connection with one another in Common Spirit Health. The primary exempt purpose of CHI Mercy Health of Valley City is to provide healthcare services to residents in the community and surrounding area regardless of their ability to pay. At CHI Mercy Health, you'll find dedicated, committed, highly qualified individuals who can meet your routine and not-so-routine health care needs 365 days of the year without the inconvenience of a 60-mile drive. Services available at CHI Mercy Health include: Acute Care & Swing Bed, Ambulatory Care, Cardiac Rehab, Health Education, Trauma 5 Emergency Room, Laboratory, Occupational Therapy, Physical Therapy, Radiology, Respiratory Therapy, Respite Care, Same Day Surgery, Sleep Studies, Social & Behavioral Services, Counseling Services, Spiritual Services, Stress Testing, Mammography, and Pain Management Injections. CHI Mercy Health assists in addressing the physical, spiritual, and emotional needs of Valley City and portions of six surrounding counties. The mission department, spiritual care and the social services department provide assistance for those needing guidance and help. The CHI Mercy Health Board of Directors consists of six members representing a cross section of local residents, women religious, and Commonspirit Health. The board has fiduciary responsibility for the quality, legal compliance and financial/business performance of the hospital as well as for hiring the hospital administrator. They meet four times per year, or more as needed, to assess strategic direction, mission compliance, and monthly performance as compared to established benchmarks. They also routinely evaluate legal compliance, human resources management, medical staff relations, community needs, and new business lines. COMMUNITY ASSESSMENT, PROCESS AND SUMMARY The last Community Health Needs Assessment was conducted in the fall of 2018 and was adopted in April of 2019. A broad representation of the community was included in the Community Health Needs Assessment Coalition. The initiative was facilitated by leaders from City County Health District and CHI Mercy Health. All coalition representatives participated in data review and local CHNA tool content development and date collection. The members then participated in further data review and finally in consensus priority setting. Using data from the initial presentation and CHNA, the Coalition identified priority areas. The process that was used for prioritization included structured brainstorming to create the list of pertinent issues. This was then followed with a multi-voting priority process, whereas the members identified the priorities for the population they represented. The priority areas identified by the Coalition are: Substance Abuse/Addiction (alcohol and drugs) Attracting and retaining young families Availability of substance abuse/treatment services Depression and anxiety The 2019 CHNA and Implementation Strategy Plan can be located on: www.mercyhospitalvalleycity.org Uncompensated Care for the Poor Our best-known, but often least-utilized, Community Benefit program is the financial assistance we provide to patients who cannot afford to pay for their care. Financial Assistance applications may be obtained at CHI Mercy Health or on the website: www.mercyhospitalvalleycity.org. The process is completely confidential and our goal is to award financial assistance rather than turn patients over to collection for healthcare bills. Charity Care is free or discounted health and health-related services provided to person who cannot afford to pay for medically necessary health care. Eligibility is based on household income as well as other assets. Consideration is given to a patient who has significant or catastrophic medical bills and does not meet the income guidelines. Charity Care is given to uninsured, low-income patients who are not expected to pay all or part of a bill, or who are able to pay only a portion using an income-related fee schedule. Community benefit programs for the poor are geared to reducing morbidity and mortality in beneficiaries of Medicaid or state or local indigent programs. QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT: FY19 - July 1, 2018 - June 30, 2019 Community Benefit Provided to the Poor: Financial Assistance -Estimated Number of People Served: 168 -Community Benefit Cost: $181,641 Unpaid cost of Medicaid -Estimated Number of People Served: 0 -Community Benefit Cost: $0.00 Totals for Living in Poverty -Estimated Number of People Served: 168 -Community Benefit Cost: $181,641 Community Benefit Provided to the Broader Community: Community Building Activities -Estimated Number of People Served: 33 -Community Benefit Cost: $1,419 Community Health Improvement Services -Estimated Number of People Served: 758 -Community Benefit Cost: $33,971 Financial and In-kind Contributions -Estimated Number of People Served: 6 -Community Benefit Cost: $38 Health Professions Education -Estimated Number of People Served: 86 -Community Benefit Cost: $10,251 Total Benefit for the Broader Community -Estimated Number of People Served: 883 -Community Benefit Cost: $45,679 Total Cost of Community Benefit -Estimated Number of People Served: 1,051 -Community Benefit Cost: $227,320 The Total Quantifiable Community Benefits costs: $227,320 serving 1,051 people. QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT Community Benefit is the name given to the programs we create in response to health needs in our service areas. An important part of our mission is building healthier communities through programs designed to serve the needs of people who are poor and disadvantaged in our community. This type of Community Benefit has the added, positive side-effect of delivering an improved quality of life for everyone. Community Benefit most often takes place outside the walls of our facilities and involves partner organizations in the community. Our Community Benefit activities are designed to: Identify and increase awareness of health needs in Barnes County. Provide resources to meet those needs. Create collaboration between community organizations that focus on health and well-being. Tackle problems such as poverty, homelessness, or behaviors (such as chronic disease, domestic violence or underage drinking and addiction) that can contribute to poor health. COMMUNITY OUTREACH FOR THE POOR CHI Mercy Health outreach for the poor activities include: Charity Care/Financial Assistance and unpaid cost of Medicaid. In addition, we have assisted in fundraising efforts to provide our sister hospital in the Philippines.
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 4 Community information	Community Benefit is a planned, organized, managed, and measured approach to a health care organization's participation in meeting identified community health needs. It implies collaboration with a "community" to "benefit" its residents- particularly people who are poor, minorities and other underserved groups-by improving health status and quality of life. Community benefits are programs or activities that provide treatment or promote health and healing as a response to identified community needs and meet at least one of these community benefit objectives: Improve access to health care services, enhance health of the community, advance medical or health care knowledge and relieve or reduce the burden of government or other community efforts. CHI Mercy Health is located in Valley City, Barnes County, North Dakota. Barnes County is the primary service area with close to 90% of the patient's visits and almost 72% come from Valley City alone. Service area population was estimated by the US Census Bureau in 2014 to be at 11,144 for Barnes County-which has a total area of 1492 square miles. This data shows there was a .7% increase in population in Barnes County. Children under the age of 18 dipped to 20.4% and someone over 65 years of age rose to 20.2%. The median income for a household has increased to $54,094. The population living below the poverty line decreased from 12% to 9.3% (2013 estimate). The racial makeup of the county was 94.6% white. CHI Mercy Health service area also includes portions of the following counties: Cass, LaMoure, Ransom, Stutsman, Griggs, and Steele, some of these counties is less than tenths of a percent served by CHI Mercy Health. According to 2006 HRSA Department of Health & Human Services, health resources and service administration, and in findings of the 2019 CHI Mercy Health Community Health Needs Assessment, CHI Mercy Health is in a Mental Health Professional Shortage Area. CHI Mercy Health is providing office space for South Central Human Services within the facility to increase access to mental health professionals for the poor and vulnerable in our community.
Schedule H, Part VI, Line 5 Promotion of community health	The organization's hospital facility promote health for the benefit of the community. Medical staff privileges in the hospital are available to all qualified physicians in the area, consistent with the size and nature of its facilities. The organization's hospital facility have an open medical staff. Its board of trustees is composed of prominent citizens in the community. Excess funds are generally applied to expansion and replacement of existing facilities and equipment, amortization of indebtedness, improvement in patient care, and medical training, education, and research. The facility treat persons paying their bills with the aid of public programs like Medicare and Medicaid. All patients presenting at the hospital for emergency and other medically necessary care are treated regardless of their ability to pay for such treatment.
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	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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
KEITH HEUSER
Board Member/President	$0	$192,701	$0	$20,975	$0	$25,562	$0	$15,360	$0	$18,532	$0	$273,130	$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
Joshua Senger
Treasurer/VP, Finance	$0	$110,114	$0	$12,330	$0	$2,831	$0	$8,019	$0	$26,420	$0	$159,714	$0	$0
CLARK KRUTA
CRNA	$207,012	$0	$150	$0	$1,999	$0	$13,092	$0	$23,602	$0	$245,855	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 4a Post-termination 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	During the calendar year 2018, compensation for the top management official was established and paid by Catholic Health Initiatives ("CHI"), a related organization. CHI 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 the 2018 calendar year, Catholic Health Initiatives ("CHI"), a related organization, maintained a supplemental non-qualified deferred compensation plan for MBO CEOs/Presidents and other CHI employees at the level of Senior Vice President and above. 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 Keith Heuser - $9,692
Schedule J, Part I, Line 7 Non-fixed payments	THE ORGANIZATION ACCRUED INCENTIVE BONUSES FOR THE LEADERSHIP TEAM BASED ON BOTH FINANCIAL AND NON-FINANCIAL METRICS. THE LEADERSHIP TEAM CONSISTS OF THE ADMINISTRATOR, CONTROLLER, HR GENERALIST, AND THE VICE ADMINISTRATOR OF CLINICAL SERVICES.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Line 15a PROCESS FOR DETERMINING 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 14 document retention and destruction policy	The document retention and destruction policy is more of an operational policy. These types of policies usually do not go to the board of directors. This has not been adopted by the board of directors.
Form 990, Part VI, Line 12c Conflict of Interest Policy	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. 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 Mercy Hospital of Valley City, the Executive Committee shall consist of only directors of the Corporation. The Executive Committee has the power to transact the routine business of the corporation in the interim periods between regularly scheduled meetings of the Board of Directors, provided that their actions are consistent with any actions or policies of the Board or the Corporate Member. All actions taken are contemporaneously documented and reported to the Board at the earliest meeting.
Form 990, Part VI, Line 6 Classes of members or stockholders	According to the Bylaws of Mercy Hospital of Valley City, the entity's Sole Member is Commonspirit Health, a Colorado Nonprofit Organization.
Form 990, Part VI, 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 Mercy Hospital of Valley City * Amendment of the corporate documents of Mercy Hospital of Valley City * Approve members of Mercy Hospital of Valley City's board * Removal of a member of the governing body of Mercy Hospital of Valley City * Approval of issuance of debt by Mercy Hospital of Valley City * Approval of participation of Mercy Hospital of Valley City in a joint venture * Approval of formation of a new corporation by Mercy Hospital of Valley City * Approval of a merger involving Mercy Hospital of Valley City * Approval of the sale of all or substantially all of the assets of Mercy Hospital of Valley City * To require the transfer of assets by Mercy Hospital of Valley City to Commonspirit Health to accomplish Commonspirit Health's goals and objectives, and to satisfy Commonspirit Health debts. * Adoption of long range and strategic plans for Mercy Hospital of Valley City Pursuant to Section 5.5 of the organization's bylaws, CommonSpirit Health may, in exercise of its approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and the President and Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate." Except as otherwise provided in the Corporation's Articles of Incorporation or the laws of the State of organization, Catholic Health Care Federation ("CHCF") shall have such rights as are reserved to the Corporate Member, acting in its capacity as the membership body of CHCF, under the Governance Matrix.
Form 990, Part VI, 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. SUBSEQUENT TO PROVIDING THE RETURN TO THE BOARD, THE COMMONSPIRIT HEALTH TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NONSUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RESUBMITTED 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 an 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.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	DURING THE TAX YEAR ENDED 6/30/19, ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES WAS REVIEWED AND APPROVED BY THE BOARD UTILIZING COMPARABILITY STUDIES TO DETERMINE COMPENSATION and was contemporaneously documented.
Form 990, Part VI, 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.catholichealthinitiatives.org or www.commonspirithealth.org.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Other Miscellaneous Revenue - Total Revenue: 5193, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 5193;
Form 990, Part IX, Line 11g Other Fees	Contract Labor - Total Expense: 1403013, Program Service Expense: 1262712, Management and General Expenses: 140301, Fundraising Expenses: 0; Other Fees for Services - Total Expense: 989023, Program Service Expense: 892184, Management and General Expenses: 96839, Fundraising Expenses: 0; Purchased Services - Total Expense: 765100, Program Service Expense: 688590, Management and General Expenses: 76510, Fundraising Expenses: 0; Contract Services - Total Expense: 396817, Program Service Expense: 357135, Management and General Expenses: 39682, Fundraising Expenses: 0; Consulting - Total Expense: 12280, Program Service Expense: 11052, Management and General Expenses: 1228, Fundraising Expenses: 0;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Capital Resource Pool Contribution - -298331; Contributions Received - -78666;

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
LISBON AREA HEALTH SERVICES
905 MAIN ST	LISBON	ND	58054	820558836	HOSPITAL	ND	501(c)(3)	3	CSH	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	Yes (true)
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 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	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	N/A	false	false
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	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	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	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	MERCY HEALTHCARE FOUNDATION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	C	TransactionTypeTxt
Involved	$78,666	InvolvedAmt
Method Of Amount Determination	BOOK	MethodOfAmountDeterminationTxt