2020-07-13T11:31:36-05:00 2019-06-30 470617373 CommonSpirit Health 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2018-07-01 760436439 Memorial Medical Center - Livingston MEMO 9366348111 P O BOX 1447 LUFKIN TX 75902 Shelli Brooks Vice President of Finance, CFO 2020-07-13 true Angela Noel P01051055 7208741500 2018 2021-01-29 14:40:06Z CHI ST LUKE'S HEALTH MEMORIAL LIVINGSTON Monte Bostwick P O BOX 1447 LUFKIN TX 75902 51351469 false X https://www.chistlukeshealthmemorial.org/centers/livingston X 1994 TX THE ORGANIZATION OPERATES A GENERAL ACUTE CARE HOSPITAL WITH 66 LICENSED BEDS AND PROVIDES SERVICES TO PATIENTS IN POLK AND SURROUNDING COUNTIES. 18 11 321 41 0 0 5000 62362954 51322043 23255 16632 42226 7794 62428435 51351469 15567923 1000 0 17378728 18403387 0 0 21793438 23095073 54740089 41499460 7688346 9852009 59348057 59115361 46958317 36877121 12389740 22238240 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. false false 40262998 1000 51326105 HOSPITAL SERVICES PROVIDED TO PATIENTS IN POLK COUNTY, INCLUDING 1,982 ADMISSIONS, 56,219 OUTPATIENT VISITS, 26,480 EMERGENCY ROOM VISITS AND 6,071 PATIENT DAYS. 40262998 true false false true false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true X 0 0 321 true false false false false false false true false false false false false X 18 11 true false false false true true true true true false false false true true true true true false false false X Shelli Brooks 9366397166 1201 W FRANK AVENUE LUFKIN TX 75904 MONTE BOSTWICK Market CEO 1.0 40.0 X X 0 451617 63481 JULE FENLEY VICE CHAIR 1.0 2.0 X X 0 0 0 CARL RAY POLK CHAIRMAN 1.0 2.0 X X 0 0 0 MIKE ARNOLD M D Director 1.0 2.0 X 0 18846 0 RAVINDER BACHIREDDY M D DIRECTOR 1.0 2.0 X 0 134109 0 MARLO BRAWNER MD Director 1.0 2.0 X 0 0 0 JUDY COCHRAN DIRECTOR 1.0 2.0 X 0 0 0 TREY DENMAN Director 1.0 2.0 X 0 0 0 CORKY EVANS DIRECTOR 1.0 2.0 X 0 0 0 GEORGE FIDONE M D Director 1.0 2.0 X 0 0 0 JOHN F GLICK Director 1.0 4.0 X 0 0 0 DEMETRESS HARRELL Director 1.0 2.0 X 0 0 0 M HUNT HUBER M D DIRECTOR 1.0 2.0 X 0 22243 0 T DOUGLAS LAWSON PHD Pres & CEO CHI St. Luke's Health System 1.0 50.0 X 0 1355710 146269 KURUVILLA MANI CHERIPARAMBIL MD Director 1.0 2.0 X 0 64058 0 BEN OGLETREE DIRECTOR 1.0 2.0 X 0 0 0 STEPHEN RALEY DIRECTOR 1.0 2.0 X 0 0 0 Jane Ainsworth Director 1.0 2.0 X 0 0 0 Mohammed Musa Khan MD Director 1.0 2.0 X 0 140642 0 Duane Miller CFO 1.0 40.0 X 0 228728 18279 TAMANIKA FITE DIRECTOR OF PHARMACY 40.0 0 X 147778 0 15479 Sylvia Tolbert-Ford Director - Perioperative 40.0 0 X 131697 0 10614 Nicholas Fontenot Clinical Pharmacist I 40.0 0 X 123362 0 25929 Robert Davis Market Director of Respiratory 40.0 0 X 124220 0 18777 Joseph Fuselier RN - Clinical Coordinator 40.0 0 X 112941 0 25595 Michael Covert Former Pres & CEO CHI St. Luke's Health System 0.0 50.0 X 0 1280995 18328 639998 3696948 342751 13 true true false Forney Construction 8945 Long Point RD STE 200 Houston TX 77055 General Contractor 927736 Sound Physicians P O Box 742936 Los Angeles CA 900742936 Management of Hospitalists 725424 AMN Healthcare Inc 2735 Collection Center Drive Chicago IL 606932735 Workforce Staffing 716485 Sodexo Services PO BOX 360170 Pittsburg PA 152516170 Environmental 553577 HB Anesthesiology Group PA 7032 Collection Center Drive CHICAGO IL 60693 Anesthesiology 527000 10 5000 5000 NET PATIENT SERVICE REVENUE 900099 51322043 51322043 0 0 0 0 51322043 13198 13198 3732 3732 0 3732 3732 3434 0 3434 3434 3434 Education 611710 3894 3894 Financial Services 541200 105 105 Medical Records Revenue/Transcription 541200 63 63 0 0 0 0 4062 51351469 51326105 0 20364 X 1000 1000 0 0 14122321 13981098 141223 336495 333130 3365 2932032 2873391 58641 1012539 1002413 10126 77260 77260 863 863 9033074 8553512 479562 0 26510 26510 788572 528343 260229 107255 101892 5363 979063 979063 39787 35012 4775 3048840 3048840 443796 443796 Medical Supplies 5626524 5626524 State Provider Tax 1787351 1697983 89368 Repairs and maintenance 1040319 1019513 20806 Dues and Subscriptions 38088 15235 22853 57771 22253 35518 0 41499460 40262998 1236462 0 125260 58132 55467 4514339 8481908 0 0 0 858075 864692 8929 14763 63038576 13476307 51243541 49562269 0 0 2597913 78130 59348057 59115361 3623344 3174282 70000 0 43334973 33632839 46958317 36877121 X 12389740 22238240 12389740 22238240 59348057 59115361 X 9852009 -3509 X false true X true false X false false false false false true 863 false false false 863 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - 863 530000 530000 46744123 6814011 39930112 14518421 6659847 7858574 1246032 2449 1243583 49562269 DUE TO AFFILIATE 33613089 Self- Insurance Reserves and Claims 19750 33632839 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote MEMORIAL MEDICAL CENTER LIVINGSTON'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." true true X true X 300 true X true true true false true true 4612 2024036 2024036 0.0488 6564852 6564852 0 0.0 0 0.0 0 4612 8588888 6564852 2024036 0.0488 0 0.0 0 0.0 0 0.0 0 0.0 20237 20237 0.0005 0 0 20237 0 20237 0.0005 0 4612 8609125 6564852 2044273 0.0493 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 11253548 0 19758796 20143630 -384834 X true true 1 1 MMC - LIVINGSTON 1717 HWY 59 BYPASS LIVINGSTON TX 77351 https://www.chistlukeshealthmemorial.org/ 000466 X X MMC - LIVINGSTON 1 false false true X X X X X X X X X 18 true true false true X https://www.chistlukeshealthmemorial.org/about/health-needs-assessment X true 18 false true false true X 300.0 300.0 X X X X true true X X X true X https://www.chistlukeshealthmemorial.org/patients/financial-assistance X https://www.chistlukeshealthmemorial.org/patients/financial-assistance X https://www.chistlukeshealthmemorial.org/patients/financial-assistance X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - MMC - LIVINGSTON. THE HOSPITAL ORGANIZED A GROUP OF LOCAL AND REGIONAL HEALTH AND HEALTH-RELATED ORGANIZATIONS TO SUPPORT THE REGIONAL ASSESSMENT. REQUESTED PARTNER SUPPORT INCLUDED WORKING WITH THE HOSPITAL TO IDENTIFY AND CONTACT COLLEAGUES AND/OR PARTNERING AGENCIES IN THE SEVEN COUNTIES TO HOST COMMUNITY DISCUSSION GROUPS AND RECRUITMENT OF PARTICIPANTS. COMMUNITY DISCUSSION GROUPS INCLUDED A BROAD CROSS-SECTION OF COMMUNITY MEMBERS, AND THE CHNA ALSO CONDUCTED INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS. THE FOLLOWING ORGANIZATIONS, INCLUDING LOCAL PUBLIC HEALTH AND REPRESENTATIVES OF UNINSURED AND VULNERABLE POPULATIONS, WERE ACTIVE PARTICIPANTS IN AND CONTRIBUTORS TO THE CHNA: ALCOHOL & DRUG ABUSE COUNCIL OF DEEP EAST TEXAS, ANGELINA COUNTY HEALTH SERVICES DISTRICT, ANGELINA HEALTH COALITION, ARMSTRONG MEMORIAL CME CHURCH, BURKE CENTER, INTERAGENCY GROUPS, LUFKIN ISD, RURAL EAST TEXAS HEALTH NETWORK, TEXAS FOREST COUNTRY PARTNERSHIP, THE COALITION, THE SALVATION ARMY (LUFKIN), AND TRINITY MEMORIAL HOSPITAL DISTRICT. THE COMMUNITY DISCUSSION GROUPS WERE FACILITATED BY A TEAM INCLUDING A GROUP MODERATOR AND TWO INDIVIDUALS DOCUMENTING INPUT - ONE CAPTURING "BIG IDEAS" ON A FLIPCHART AND A SECOND CAPTURING MORE DETAILED NOTES ON A LAPTOP COMPUTER. DISCUSSION GROUPS AND/OR INTERVIEWS WERE CONDUCTED IN EACH COUNTY. MEETINGS WERE SCHEDULED WITH COMMUNITY RESIDENTS IN THREE SEPARATE GROUPS: MEMBERS OF THE GENERAL PUBLIC, REPRESENTATIVES FROM HEALTHCARE AND HUMAN SERVICE ORGANIZATIONS, AND KEY COMMUNITY LEADERS. TWENTY DISCUSSION GROUPS/INTERVIEWS WERE HELD ACROSS THE REGION. OVERALL, 197 INDIVIDUALS PARTICIPATED. DATA WERE ANALYZED FOR COMMON THEMES, WHICH PROVIDED CONTEXT TO RELATED SECONDARY DATA. ALL GROUPS AND INTERVIEWS USED THE FOLLOWING QUESTIONS TO GUIDE THE DISCUSSION: DESCRIBE YOUR COMMUNITY; WHAT ARE THE MOST IMPORTANT ISSUES OR PROBLEMS YOUR COMMUNITY IS FACING; WHAT ARE THE KEY RESOURCES IN YOUR COMMUNITY; HOW HAS YOUR COMMUNITY COME TOGETHER IN THE PAST TO ADDRESS IMPORTANT ISSUES; AND WHAT ADVICE WOULD YOU GIVE TO A GROUP WANTING TO ADDRESS ANY ISSUES WE HAVE DISCUSSED TODAY IN ORDER FOR THEM TO BE SUCCESSFUL? Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - MMC - LIVINGSTON. THE CHNA WAS CONDUCTED AMONG THE THREE CHI ST. LUKE'S HEALTH-MEMORIAL HOSPITAL FACILITIES: MEMORIAL MEDICAL CENTER OF EAST TEXAS (LUFKIN), MEMORIAL MEDICAL CENTER - LIVINGSTON, AND MEMORIAL MEDICAL CENTER - SAN AUGUSTINE. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - MEMORIAL MEDICAL CENTER - LIVINGSTON. THE HOSPITAL'S 2019 CHNA IDENTIFIED FOUR SIGNIFICANT HEALTH NEEDS IN COMMON TO THE COMMUNITIES SERVED BY CHI ST. LUKE'S MEMORIAL MEDICAL CENTER OF EAST TEXAS (LUFKIN), MEMORIAL MEDICAL CENTER - LIVINGSTON, AND MEMORIAL MEDICAL CENTER - SAN AUGUSTINE. THE HOSPITAL INTENDS TO TAKE ACTIONS TO HELP ADDRESS EACH OF THESE NEEDS, BOTH ON ITS OWN AND IN COLLABORATION WITH A NUMBER OF COMMUNITY PARTNERS. 1. RESTRICTED TRANSPORTATION TO HEALTH SERVICES. TO INCREASE COMMUNITY (AND PATIENT) AWARENESS OF TRANSPORTATION SERVICES IN THE COMMUNITIES, THE HOSPITAL WILL RESEARCH THE FULL SCOPE OF TRANSPORTATION SERVICES INCLUDING THEIR CURRENT PROMOTION STRATEGY, AND CREATE A PROMOTION PLAN AND MATERIALS TO BETTER EQUIP OUR PATIENTS AND PROVIDERS WITH THE RESOURCES OF LOCAL CARE ETC.) IN ENGLISH AND SPANISH. 2. AWARENESS OF AND ACCESS TO HEALTH CARE RESOURCES. - TO FOCUS ON PREVENTATIVE HEALTH MEASURES THROUGH CHILDREN EDUCATION, THE HOSPITAL WILL EXPLORE PARTNERSHIP WITH LOCAL SCHOOLS, TARGET SCHOOL-AGE CHILDREN AND THEIR PARENTS/ GUARDIANS FOR PRIMARY/SPECIAL EDUCATIONAL EFFORTS, AND REACH OUT TO THE SCHOOL DISTRICTS TO HELP MEET THEIR NEEDS FOR SCHOOL-BASED HEALTH EDUCATION. - TO RAISE COMMUNITY AWARENESS FOR PREVENTATIVE LUNG CANCER MEASURES, THE HOSPITAL WILL INCREASE PHYSICIAN REFERRALS TO ADDITIONAL SERVICES INCLUDING PROMOTION/PARTNERSHIP OF SMOKING CESSATION CLASSES, AND INCREASE INFORMATION ON WEB PAGE/SOCIAL MEDIA OUTLETS ABOUT HEALTH SERVICES AND EDUCATIONAL OPPORTUNITIES IN OUR COMMUNITY INCLUDING OUTREACH. - CHI ST. LUKE'S MEMORIAL HEALTH SYSTEM OF EAST TEXAS (MHSET) HAS BILINGUAL STAFF MEMBERS IN THE EDUCATION CENTER AND IN REGISTRATION AREAS TO HELP WITH COMMUNICATIONS, AND ALSO CONTRACTS WITH A LANGUAGE LINE SERVICE TO ASSIST HOSPITAL AND PHYSICIAN STAFF WITH INTERPRETATION ON MEDICAL ISSUES. - EACH MHSET COUNTY PARTICIPATES IN THE TEXAS ADULT POTENTIALLY PREVENTABLE HOSPITALIZATION INITIATIVE TO IMPROVE CARE AND REDUCE COSTS. MAJOR FOCI IN OUR SERVICE AREAS ARE DEHYDRATION, BACTERIAL PNEUMONIA & UTI. - MEMORIAL-LIVINGSTON EMPLOYS A MEDICAID STAFF MEMBER WHO WORKS TO CONNECT INDIGENT AND DISABLED PATIENTS TO AVAILABLE PAYER SOURCES. THE HOSPITAL CONTRIBUTES HALF OF THE STAFF MEMBER'S SALARY, WHILE THE STATE PAYS THE REMAINING HALF. - MHSET OFFERS MD SAVE, WHICH ENABLES PATIENTS TO OBTAIN A 60% DISCOUNT ON SPECIFIC RADIOLOGY AND CARDIOLOGY DIAGNOSTIC TESTS AND CERTAIN PROCEDURES. - PART OF THE PROCEEDS RAISED THROUGH POWER OF PINK PROVIDES GAS VOUCHERS FOR CANCER TREATMENT AND PRESCRIPTION MEDICATION FOR QUALIFIED PATIENTS. - MHSET'S CANCER CENTER OFFERS LUNG CANCER SCREENINGS AT EACH OF ITS FACILITIES. THE CANTER ALSO OFFERS THE DRUG REPLACEMENT PROGRAM, WHICH OFFERS FREE MEDICATION TO CANCER PATIENTS WHO ARE UNABLE TO PAY. - THE HOSPITAL PARTNERS WITH MEMORIAL HERMANN HOSPITAL IN HOUSTON TO ENHANCE THE CARE OF STROKE PATIENTS IN THE LIVINGSTON ED. THROUGH TELEMEDICINE MEMORIAL-LIVINGSTON AND MEMORIAL HERMAN ARE ELEVATING THE CARE FOR STROKE PATIENTS PRESENTING TO THE LIVINGSTON ED. ADDITIONALLY, THE HOSPITAL IS PART OF THE EAST TEXAS HEART AND VASCULAR INITIATIVE, WHICH HOLDS PUBLIC EDUCATION FORUMS AT INDUSTRIES, SCHOOLS, ASSISTED LIVING CENTERS, RETIREMENT CENTERS, AND CIVIC CLUBS. - MHSET COLLABORATES WITH EXPRESS LAB TO OFFER VERY AFFORDABLE LAB TESTING AT ALL OF THE SYSTEM'S FACILITIES. DISCOUNTED SCREENINGS INCLUDE GLUCOSE TESTING AND PSAS. - MHSET OFFERS THE LIFELINE HOME ALERT SYSTEM, AT A DISCOUNTED RATE. -THE HOSPITAL IS ACTIVELY RECRUITING PRIMARY CARE AND SPECIALIST PHYSICIANS, BASED ON A RECENTLY CONDUCTED MEDICAL STAFF DEVELOPMENT PLAN, VIA ITS MMA AFFILIATION. CURRENT MHSET FOCUS IS ON INFECTIOUS DISEASE, PEDIATRICS AND INTERNAL MEDICINE. NEW LIVINGSTON MEDICAL STAFFERS WERE ADDED IN EMERGENCY, FAMILY PRACTICE, INTERNAL MEDICINE, OB/GYN AND SURGERY. - THE HOSPITAL IS A CLINICAL ROTATION SITE FOR AREA NURSING, LABORATORY, PHYSICAL THERAPY, PHARMACY, NURSE PRACTITIONER, MEDICAL STUDENT AND PHYSICIAN ASSISTANT PROGRAMS. - MHSET AND ITS HOSPITALS PARTICIPATE IN EDUCATION AFFILIATION AGREEMENTS WITH OVER 30 UNIVERSITIES, COLLEGES AND MEDICAL INSTITUTIONS THAT PREPARE STUDENTS FOR CAREERS IN NURSING, ALLIED THERAPIES AND ADMINISTRATION. - CHI ST. LUKE'S HEALTH MEMORIAL HAS IMPROVED AND EXPANDED ITS PUBLIC WEB SITE TO MAKE IT MORE USER FRIENDLY AND ADD RESOURCES FOR SOCIAL SERVICES, AS WELL AS MEDICAL SERVICES, PHYSICIAN LOCATION, SCHEDULING, BILLING AND FINANCIAL HELP, AND CONTACT INFORMATION. AN EVENTS/SPECIAL EVENTS SECTION WAS CREATED TO INFORM THE PUBLIC ABOUT LEARNING ACTIVITIES ABOUT HEALTH ISSUES. THE SOCIAL MEDIA PRESENCE WAS ENHANCED, WITH HELPFUL AND EDUCATIONAL INFORMATION AVAILABLE ON FACEBOOK, TWITTER, LINKEDIN, INSTAGRAM AND YOUTUBE. - MEMORIAL-LIVINGSTON ORGANIZES AND PROVIDES SPACE FOR DIABETES AND CANCER SUPPORT GROUPS. - THE HOSPITAL PROVIDES SPACE FOR WEIGHT WATCHERS MEETINGS IN THE HOSPITAL'S CAFETERIA. - THE MINISTRY'S CLINICAL AND SURGICAL DIRECTORS WORKED WITH DR. BLACKLEDGE AND OTHERS TO DEVELOP A MONTHLY HEALTH TOPIC FOR PRINTED EDUCATIONAL MATTER, A LUNCH AND LEARN, ETC. - MHSET PROVIDES WOMEN'S SPECIAL SERVICES THAT OFFERS MAMMOGRAMS, GYN EXAMS AND PAP SMEARS AND GYN EDUCATIONAL SERVICES TO THE UNINSURED POPULATION IN THE COMMUNITY. - TO SERVE THE AT-RISK MOTHER POPULATION, THE HOSPTAL WILL LAUNCH MATERNAL FETAL MEDICINE SERVICES IN OUR REGION. 3. MENTAL HEALTH NEEDS ACCESS AND RESOURCING. TO HELP INCREASE COMMUNITY AWARENESS OF AVAILABLE RESOURCES, THE HOSPITAL WILL CONTINUE AND EXPAND OUTREACH THROUGH EDUCATIONAL EVENTS AND STRATEGIC PROMOTION. TO HELP INCREASE COMMUNITY ACCESS TO MENTAL HEALTH SERVICES, THE HOSPITAL WILL PARTNER WITH BURKE CENTER MOBILE RESPONSE SERVICES BY INCREASING REACH ACROSS COUNTIES AND EXPLORE INNOVATION OF NEW TREATMENT AND SERVICES THROUGH PHYSICIAN REFERRALS TO BURKE CENTER. 4. SUBSTANCE ABUSE. - TO RAISE THE IMPORTANCE OF PREVENTING SUBSTANCE ABUSE THROUGH HEALTHY LIVING AND COPING STRATEGIES, THE HOSPITAL WILL REFOCUS OUR EDUCATION TOWARD OPIOID ALTERNATIVES, INCREASE HEALTHIER REFERRAL OPTIONS, AND EXPLORE COMMUNITY EDUCATION. THE HOSPITAL WILL INCREASE COLLABORATIVE PARTNERSHIPS, INCLUDING WITH THE ALCOHOL & DRUG ABUSE COUNCIL OF DEEP EAST TEXAS, AND ASSIST WITH GRANTS, RESEARCH AND PROGRAM IMPLEMENTATION. - MEMORIAL-LIVINGSTON PROVIDES FINANCIAL SUPPORT AND VOLUNTEERS TO ORGANIZATIONS THAT OFFER PREVENTION AND TREATMENT FOR ALCOHOL AND DRUG ABUSE, UNDERAGE DRINKING, ETC. THESE ORGANIZATIONS INCLUDE THE ALCOHOL DRUG ABUSE COUNCIL OF DEEP EAST TEXAS AND THE ALZHEIMER'S ASSOCIATION. - MHSET HAS EXPANDED ITS RELATIONSHIP AND INCREASED REFERRALS WITH THE BURKE CENTER AND THE ALCOHOL AND DRUG ABUSE COUNCIL TO IMPROVE CARE AND ACCESS TO CARE FOR MENTAL AND SUBSTANCE ABUSE PATIENTS. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - Memorial Medical Center Livingston. 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. Schedule H, Part V, Section B, Line 24 Facility , 1 Facility , 1 - MMC - LIVINGSTON. ALL PATIENTS ARE EQUALLY CHARGED. PATIENTS WHO FILE AN APPLICATION FOR FINANCIAL ASSISTANCE ARE NOT BILLED UNLESS IT IS LATER DETERMINED THAT THEY DO NOT QUALIFY FOR ASSISTANCE. 0 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 I, Line 6a Community benefit report prepared by related organization MEMORIAL HEALTH SYSTEM OF E. TEXAS Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING THE ORGANIZATION'S COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. THE COST-TO-CHARGE RATIO FOR THE YEAR ENDED 6/30/2019 WAS COMPUTED USING THE FOLLOWING FORMULA: OPERATING EXPENSES (BEFORE RESTRUCTURING, IMPAIRMENT AND OTHER LOSSES) DIVIDED BY GROSS PATIENT REVENUE. BASED ON THAT FORMULA, $41,474,385/ $309,759,843 RESULTS IN A 13.39% COST-TO-CHARGE RATIO. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 13.39%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. Schedule H, Part III, Line 3 Bad Debt Expense Methodology MEMORIAL MEDICAL CENTER LIVINGSTON 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 Memorial Medical Center Livingston 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. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Using essentially the same Medicare cost report principles as to the allocation of general services costs and "apportionment" methods, the "CHI Workbook" calculates a payers' gross allowable costs by service (so as to facilitate a corresponding comparison between gross allowable costs and ultimate payments received). The term "gross allowable costs" means costs before any deductibles or co-insurance are subtracted. Memorial Medical Center Livingston's ultimate reimbursement will be reduced by any applicable copayment/ deductible. Where Medicare is the secondary insurer, amounts due from the insured's primary payer were not subtracted from Medicare allowable costs because the amounts are typically immaterial. Although not presented on the Medicare cost report, in order to facilitate a more accurate understanding of the "true" cost of services (for "shortfall" purposes) the CHI Workbook allows a health care facility not to offset costs that Medicare considers to be non-allowable, but for which the facility can legitimately argue are related to the care of the facility's patients. In addition, although not reportable on the Medicare cost report, the CHI workbook includes the cost of services that are paid via a set fee-schedule rather than being reimbursed based on costs (e.g. outpatient clinical laboratory). Finally, the CHI Workbook allows a facility to include other health care services performed by a separate facility (such as a physician practice) that are maintained on separate books and records (as opposed to the main facility's books and records which has its costs of service included within a cost report). True costs of Medicare computed using this methodology: Total Medicare Revenue: $19,758,796 Total Medicare costs: $20,143,630 Surplus or Shortfall ($384,834) Memorial Medical Center Livingston 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 - MMC - LIVINGSTON: Line 16a URL: https://www.chistlukeshealthmemorial.org/patients/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - MMC - LIVINGSTON: Line 16b URL: https://www.chistlukeshealthmemorial.org/patients/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - MMC - LIVINGSTON: Line 16c URL: https://www.chistlukeshealthmemorial.org/patients/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT REQUIRED BY LAW, THE HOSPITAL HAS A BOARD OF DIRECTORS MADE UP OF COMMUNITY MEMBERS WHO PROVIDE INPUT ABOUT NEEDS IN THE COMMUNITY. OUR PHYSICIANS HAVE NUMEROUS COMMITTEES AT THE HOSPITAL, IN PART TO KEEP US INFORMED ABOUT COMMUNITY MEDICAL NEEDS. 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 BASED ON THE U.S. CENSUS BUREAU'S 2017 ESTIMATE, THE POPULATION OF THE SEVEN-COUNTY ASSESSMENT REGION WAS ESTIMATED AT 228,930 PEOPLE, WHICH REPRESENTED AN INCREASE OF 3,020 PEOPLE OR 1.3% SINCE THE 2010 CENSUS. IN THAT SAME TIME, INDIVIDUAL COUNTY GROWTH VARIED FROM -6.9% FOR SAN AUGUSTINE COUNTY TO +8.3% FOR POLK COUNTY. WITH THE EXCEPTION OF POLK COUNTY, THE REGION SAW VERY SMALL OR EVEN NEGATIVE GROWTH, THE OPPOSITE OF BOTH THE STATE OF TEXAS AND THE UNITED STATES. THE 2018 MEDIAN AGE IN THE CHNA AREA RANGED FROM 52.1 YEARS FOR SABINE COUNTY TO 36.8 YEARS IN ANGELINA COUNTY. THE REGION EXCEEDED THE PROPORTION OF TEXANS IN THE 45 YEARS AND OLDER AGE GROUPS, AND ALL COUNTIES BUT ANGELINA COUNTY HAD HIGHER PROPORTIONS THAN THE NATIONAL RATES. THE POPULATION IS 67.8% WHITE, NOT-HISPANIC; 15.0% BLACK/AFRICAN-AMERICAN, NOT HISPANIC; 15.0% AS HISPANIC, ANY RACE; AND 1.5% AS ALL OTHER RACES, NOT HISPANIC. EDUCATIONAL ATTAINMENT IS LOW IN THIS REGION WITH MORE THAN 20% OF RESIDENTS HAVING LESS THAN A HIGH SCHOOL EDUCATION IN FOUR COUNTIES WITHIN THE REGION - SABINE (41.7%), HOUSTON (26.8%), POLK (22.5%), AND SAN AUGUSTINE (21.7%) COUNTIES. THE REGIONAL UNEMPLOYMENT RATE OF 4.9% WAS HIGHER THAN THE RATE FOR THE ENTIRE STATE AT 3.7% AND NATION AT 3.9%. ALL COUNTIES WITH THE EXCEPTION OF HOUSTON COUNTY (3.2%) WERE ABOVE THE STATE AND NATIONAL RATES, WITH THE HIGHEST IN SABINE COUNTY AT 8.1%. THE POVERTY RATE FOR THE CHNA REGION WAS 19.9%, AND RANGED FROM 18.0% IN POLK COUNTY TO 22.3% IN HOUSTON COUNTY. POLK COUNTY HAS AN APPROXIMATE POPULATION OF 51,353 AS OF 2019 ACCORDING TO THE U.S. CENSUS, IS CONSIDERED A RURAL COUNTY AND ALSO A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA. THE MEDIAN INCOME PER HOUSEHOLD, AS OF 2017, IS $43,267; 18.0% OF PERSONS IN POLK COUNTY ARE BELOW POVERTY LEVEL. APPROXIMATELY 21.9% OF OUR PATIENT BASE IS UNINSURED, APPROXIMATELY 15-16% OF OUR PATIENT BASE IS MEDICAID RECIPIENTS, AND APPROXIMATELY 49-50% OF OUR PATIENT BASE IS MEDICARE RECIPIENTS. THE HOSPITAL IS THE ONLY ACUTE CARE FACILITY IN POLK COUNTY, AND IS THEREFORE THE ONLY HOSPITAL WHICH DIRECTLY SERVES OUR COMMUNITY. WITH THE CITY OF LIVINGSTON BEING THE COUNTY SEAT, WE SERVE AS THE MEDICAL HUB OF POLK COUNTY. WE SERVE AS THE PRIMARY HEALTH CARE FACILITY FOR THE ALABAMA-COUSHATTA TRIBE OF TEXAS WHO RESIDE IN POLK COUNTY. THE HOSPITAL SERVES A LARGE POPULATION OF RETIREES, SNOWBIRDS AND VACATIONERS. IN 2017, THE PERCENT OF THE POPULATION OF 65 YEARS AND OLDER WAS 18.7%. Schedule H, Part VI, Line 5 Promotion of community health THE HOSPITAL PROMOTES 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. ITS BOARD OF TRUSTEES IS COMPOSED OF 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 HOSPITAL TREATS 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. IN ADDITION TO CUSTOMIZED OUTREACH IN EACH INDIVIDUAL COMMUNITY, THE CORPORATE STRUCTURE PROVIDES EACH HOSPITAL IN ANGELINA, POLK AND SAN AUGUSTINE COUNTIES WITH IMPROVED MEDICAL TECHNOLOGY THROUGH A COMMON COMPUTER SYSTEM, COMMUNICATION TO ALL COMMUNITIES THROUGH THE CORPORATE MARKETING DEPARTMENT, AND COORDINATION OF MEDICAL TRAINING FOR ALL CLINICAL EMPLOYEES. - SINCE 2009, ST. LUKE'S MEMORIAL LIVINGSTON HAS PROVIDED THE SEXUAL ASSAULT NURSE EXAMINER PROGRAM FOR SEXUAL ASSAULT VICTIMS IN POLK, SAN JACINTO AND SURROUNDING COUNTIES WITHIN A SPECIALIZED AREA OF THE HOSPITAL TO ACCOMMODATE THE PATIENT IN PRIVACY AND COMFORT. - MHSET BROUGHT THE ANNUAL BREAST CANCER AWARENESS LUNCHEON, POWER OF PINK TO LIVINGSTON IN 2013. THE HOSPITAL WORKS WITH THE AMERICAN CANCER SOCIETY TO SUPPLY VENDORS AND SIGN WOMEN UP TO GET MAMMOGRAMS. IN 2016, THE POWER OF PINK LUNCHEON REACHED NEARLY 500 WOMEN. - MEMORIAL-LIVINGSTON ACTIVELY PARTICIPATES IN MAMMOGRAPHY MONTH. THE HOSPITAL RUNS AN EDUCATIONAL MEDIA CAMPAIGN ON UNDERSTANDING THE SIGNS AND SYMPTOMS OF BREAST CANCER AND ENCOURAGES WOMEN TO GET MAMMOGRAMS. A FREE GIFT IS OFFERED TO THOSE SCHEDULING A MAMMOGRAM AT ONE OF MHSET'S FACILITIES. - MEMORIAL-LIVINGSTON SERVES AS A RESOURCE FOR OTHER HEALTHCARE CARE PROVIDERS, SUCH AS NURSING HOMES, THE REGIONAL ADVISORY COUNCIL, THE EMERGENCY PREPAREDNESS TEAM, THE RURAL EAST TEXAS HEALTH NETWORK AND EMS. - MEMORIAL-LIVINGSTON SERVES AS A CLINICAL RESOURCE FOR ALLIED HEALTH ACADEMIC INSTITUTIONS. THIS INCLUDES CLINICAL ROTATIONS, "MINIINTERNSHIPS," AND SERVING AS A TRAINING SITE FOR SAM HOUSTON STATE UNIVERSITY FOR DIETETIC INTERNS TO COME OBTAIN CLINICAL AND FOOD SERVICE HOURS. - THE MINISTRY ADVOCATES FOR IMPROVED HEALTH AND WELLBEING AMONG STAFF BY OFFERING DISCOUNTED OR FREE SERVICES TO EMPLOYEES. MEMORIAL-LIVINGSTON OPERATES AN EMPLOYEE HEALTH CLINIC. - THE HOSPITAL ENGAGES IN OUTREACH IN PUBLIC SCHOOLS, SUCH AS INFECTION AND BEHAVIOR RELATED ACTIVITIES. - IN COLLABORATION WITH THE LARGER SYSTEM, MEMORIAL-LIVINGSTON SPONSORS COMMUNITY WIDE HEALTH FAIRS AND HEALTH SCREENINGS, INCLUDING THE SENIOR EXPO, WOMEN'S HEALTH EXPO, PHYSICIAN/NEW PRODUCT PRESENTATIONS, AND AREA SCHOOL EVENTS. 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 TX true true false false false false false true false MONTE BOSTWICK Market CEO 0 371336 0 56145 0 24136 0 34884 0 28597 0 515098 0 7636 Michael Covert Former Pres & CEO CHI St. Luke's Health System 0 145959 0 108433 0 1026603 0 15934 0 2394 0 1299323 0 0 T DOUGLAS LAWSON PHD Pres & CEO CHI St. Luke's Health System 0 733582 0 443750 0 178378 0 126625 0 19644 0 1501979 0 0 Duane Miller CFO 0 215140 0 12400 0 1188 0 3004 0 15275 0 247007 0 0 TAMANIKA FITE DIRECTOR OF PHARMACY 145753 0 1852 0 173 0 0 0 15479 0 163257 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation WITH THE APPROVAL OF A COMPENSATION COMMITTEE, THE CEO OF MEMORIAL HEALTH SYSTEM OF EAST TEXAS (THE MEMBER) DETERMINES THE SALARY OF THE CEO/PRESIDENT. Schedule J, Part I, Line 4a Severance or change-of-control payment 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. The following reportable individuals received severance payments from Catholic Health Initiatives (a Related Organization) during the 2018 calendar year, and these severance payments were included in the individual's W-2 income and reportable compensation on Schedule J: Michael Covert - $1,008,106 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. During 2018 the following distributions were made by CHI from the deferred compensation plan: Monte Bostwick - $9,298 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: Michael Covert - $15,395 Schedule J, Part I, Line 7 Non-fixed payments DURING THE 2018 CALENDAR YEAR, CHI MAINTAINED A VARIABLE PAY PROGRAM FOR MANAGERS AND ABOVE THAT PUTS A CERTAIN AMOUNT OF COMPENSATION AT RISK. AWARDS OF INCENTIVE COMPENSATION UNDER THE VARIABLE PAY PROGRAM ARE MADE BASED UPON ACHIEVEMENT OF ORGANIZATIONAL OBJECTIVES INCLUDING FINANCIAL OUTCOMES, QUALITY IMPROVEMENT, AND OTHER MEASURES AS DETERMINED ANNUALLY BY THE HR COMMITTEE OF THE BOARD OF STEWARDSHIP TRUSTEES. HOWEVER, ELIGIBLE AWARDS PAYABLE UNDER THIS PROGRAM ARE DEPENDENT ON REACHING MINIMUM LEVELS OF OPERATING MARGIN AND CHARITY CARE LEVELS, UNLESS THE HR COMMITTEE OF THE BOARD OF STEWARDSHIP TRUSTEES USES ITS DISCRETION TO APPROVE AN EXCEPTION. Form 990, Part V, Line 1a FORM 1096 PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF CATHOLIC HEALTH INITIATIVES (CHI) ARE MADE BY CHI. CHI FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099'S ISSUED BY CHI ON BEHALF OF MEMORIAL MEDICAL CENTER - LIVINGSTON ARE REPORTED TO THE IRS. Form 990, Part VI, Line 12c CONFLICT OF INTEREST POLICY c) Board evaluation of non-transactional conflicts - I. The board carefully reviews and scrutinizes any non-transactional conflict of interest (e.g., disclosure of nonpublic information, competition with CHI or a CHI entity, failure to disclose a corporate opportunity, excessive gifts or entertainment, etc.). II. In such circumstances, by a majority vote of the disinterested trustees, the board takes whatever action is deemed appropriate with respect to the trustee or corporate officer under the circumstances (including possible disciplinary or corrective action) to best protect the interests of CHI or the CHI entity. The board is encouraged to consult with the general counsel of CHI or his or her designee when considering disciplinary or corrective action. III. The conflicted trustee or corporate officer is not permitted to use his or her personal influence with respect to the conflict matter. However, if requested, such trustee or corporate officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from trustees, as his or her knowledge may be relevant. The trustee or corporate officer is excused from the meeting during discussion and vote on the conflict of interest. d) Record of proceedings - with respect to board member and officer conflicts of interest, minutes of the board are expected to reflect the identity of the individual making the disclosure, the nature of the disclosure, discussion regarding any proposed transaction, the decision made by the board, and that the interested trustee or corporate officer was excused during the discussion, and that the interested trustee abstained from voting. D. Conflicts reporting: All conflicts of interest are reported by CHI as required by law, regulations, and policy. Form 990, Part VI, Line 15a Memorial Medical Center - Livingston During the tax year ended 6/30/2019, no officers, directors or trustees received compensation from the organization. Any executive compensation paid to officers, directors or trustees by related organizations was set by the related organization's compensation committee utilizing both an independent consultant and comparability studies to determine compensation. Therefore, these questions are more appropriately answered as N/A. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons CORKY EVANS AND JUDY COCHRAN - Business relationship Form 990, Part VI, Line 6 Classes of members or stockholders MEMORIAL HEALTH SYSTEM OF EAST TEXAS IS THE SOLE CORPORATE MEMBER. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE BOARD OF DIRECTORS OF THE SOLE MEMBER (MEMORIAL HEALTH SYSTEM OF EAST TEXAS) ALSO SERVE AS MEMBERS OF THE BOARD OF DIRECTORS OF MMC- LIVINGSON . THE MANAGEMENT OF MHSET PROVIDES OVERSIGHT OF FINANCIAL AND CLINICAL OPERATIONS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE MEMBER (MEMORIAL HEALTH SYSTEM OF EAST TEXAS) APPROVES THE INDIVIDUALS SELECTED TO THE BOARD OF DIRECTORS OF MMC-LIVINGSTON AND HAS FINAL APPROVAL OF ALL ACTIONS OF THE BOARD OF DIRECTORS. Form 990, Part VI, Line 11b Review of form 990 by governing body THE BOARD OF DIRECTORS, BY RESOLUTION, APPOINTS A SPECIAL COMMITTEE TO REVIEW THE FORMS 990 AND 990T PRIOR TO FILING. ONCE THE RETURNS ARE COMPLETED, THEY ARE PROVIDED TO THIS COMMITTEE FOR THEIR REVIEW AND APPROVAL FOR FILING. EMPLOYEES OF THE CORPORATION RESPONSIBLE FOR THE PREPARATION AND REVIEW OF THE RETURNS ARE AVAILABLE TO RESPOND TO QUESTIONS OR PROVIDE BACKGROUND AS NEEDED. ONCE THE DIRECTORS RESPONSIBLE FOR REVIEWING THE RETURNS ARE SATISFIED THEY ARE COMPLETE, THE RETURNS ARE APPROVED TO BE FILED. SUBSEQUENT TO PRESENTATION TO THE BOARD'S COMMITTEE, THE TAX DEPARTMENT FILES THE RETURNS WITH THE IRS, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE COMMITTEE. AFTER FILING, THE RETURNS ARE MADE AVAILABLE TO ALL DIRECTORS FOR THEIR REVIEW. Form 990, Part VI, Line 12c Conflict of interest policy The organization has a conflicts of interest ("COI") policy (the "policy") in place to maintain the integrity of its activities. Through February 7, 2019, conflicts were administered solely through Catholic Health Initiatives' ("CHI") Governance Policy No. 1 (described below). On February 8, 2019, in connection with the alignment of the Catholic Health Ministries of CHI and Dignity Health, the CommonSpirit Health Board of Stewardship Trustees approved CommonSpirit Health Corporate Responsibility Policy No. G-001, a CommonSpirit Health conflicts of interest policy. This policy stipulates that, at minimum, the pre-closing CHI COI policies and pre-closing Dignity Health COI policies identify the individuals that are covered under the new policy. In addition, subject to certain exceptions, pre-closing CHI COI policies shall continue to apply to the CHI entities and the individuals who were subject to the Pre-Closing CHI COI policies; and the Pre-Closing Dignity Health COI policies shall continue to apply to the Dignity Health entities and the individuals who were subject to the Pre-Closing Dignity Health COI policies. Until CommonSpirit Health adopts a single process for identifying and managing conflicts of interest for all system entities, the following individuals shall be subject to the Pre-Closing CHI COI policies from and after the effective date of Corporate Responsibility Policy No. G-001: 1. Members of the CommonSpirit Health Board of Stewardship Trustees and members of the committees of the Board of Stewardship Trustees; 2. Corporate officers of CommonSpirit Health; 3. Members of the Board of Directors of Dignity Health and members of the committees of the Board of Directors of Dignity Health. CHI Governance Policy No. 1: The policy applies to the following persons: members of the CHI board of stewardship trustees and its committees; members of any CHI direct affiliate or subsidiary (each a CHI entity) board and their committees; employees of CHI entities, and all CHI researchers (as defined in the policy). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure review process. A. Disclosure obligations: 1. Ongoing: Each person is required to promptly and fully disclose to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The person must disclose the actual or potential conflict as soon as she/he becomes aware of it. In any situation in which the person is in doubt it is expected that full disclosure be made to permit dan impartial and objective determination as to the existence of a conflict. 2. Periodic written: In addition to the ongoing disclosure obligation, periodic written conflict of interest disclosure forms must be completed as follows: a) Initially: 1) Upon hiring (employees), 2) Appointment (board / committee members), 3) Upon consideration of affiliation with research sponsor (researchers). b) Annually: 1) Board / committee members, 2) Employees at the level vice president or above, 3) Researchers, 4) Supply chain employees at the level of vice president and above and those employees involved in contracting regardless of employment level, 5) Other employees as determined by CommonSpirit Health leadership. 3. Failure to disclose - an individual who fails to disclose a perceived, potential, or actual conflict of interest, or all material facts surrounding an actual or potential conflict or fails to abide by the final decision regarding the conflict may be subject to disciplinary or corrective actions such as termination of employment, removal from a board or committee, loss or restriction of clinical privileges, or restrictions on research activities in accordance with applicable laws, regulations, rules, contracts, and bylaws. B. Conflicts review: 1. No disclosed conflicts: In the absence of perceived, potential or actual conflicts of interest, no follow-up conflicts review is required or performed. 2. Disclosure of perceived, potential or actual conflicts: a) Are initially reviewed by national or regional legal or corporate responsibility team members (depending upon the role of the individual disclosing the actual or potential conflict) to determine whether an actual or potential for a conflict may exist. b) If it is determined that a potential or actual conflict may exist, I. In the case of board or committee members or officers, issues are elevated to the executive committee of the board or board chair. II. In the case of other persons, conflicts issues are elevated to the conflicts of interest review committee ("C-CIRC"). C. Conflicts determination and management: 1. Matters elevated to C-CIRC: a) The C-CIRC determines whether a disclosed or otherwise identified interest is a conflict of interest. If the C-CIRC determines that a COI exists, and adequate controls are not in place to mitigate the conflict, the C-CIRC facilitates development of a COI management plan designed to mitigate the conflict. Designated entity staff are responsible for monitoring the COI management plan and for documenting monitoring activities. Notwithstanding the foregoing, at its sole discretion, an entity may reject a person's request to enter into the relationship in question, or require the relationship be sufficiently altered to avoid a potential conflict of interest. b) Appeal - if a person does not agree with a determination made by the C-CIRC, its interpretation of the COI policy, still seeks an exemption or exception, or seeks further clarification of the C-CIRC 's decision, the individual may appeal the decision through his or her manager for reconsideration by the C-CIRC, and the C-CIRC will review and issue a final determination based upon any new or additional information presented. 2. Matters elevated to the executive committee or board chair: a) Determination of existence of conflict - the board chair or his or her designee performs any further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the board chair, the vice chair assumes the chair's role outlined in the COI policy. Based on review and evaluation of the relevant facts and circumstances, the board chair makes an initial determination as to whether a conflict of interest exists and whether, pursuant to the COI policy, review and approval or other action by the board is required. A written record of the board chair's determination, including relevant facts and circumstances, is made. The board chair then makes an appropriate report to the executive committee of the board concerning the COI review, evaluation and determination. If a difference of opinion exists between the board chair and another trustee as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether board review and approval or other action is required under the COI policy, the matter is submitted to the board's executive committee, which makes a final determination as to the matter presented. That determination, including relevant facts and circumstances, is reflected in the executive committee minutes and is reported to the board. b) Board evaluation of transactions involving an officer / board member conflict of interest - I. The board carefully scrutinizes and must in good faith approve or disapprove any transaction in which CHI or a CHI entity is a party and in which the trustee or a corporate officer either: 1. Has a material financial interest; or 2. Is a trustee or corporate officer of the other party (other than a CHI affiliated organization). II. The board must approve the transaction by a majority of the trustees on the board (not counting any interested trustee). In reviewing such transactions between CHI or CHI entities and vendors or other contractors who are, or are affiliated with, trustees or corporate officers, the board acts no more or less favorably than it would in reviewing transactions with unrelated third parties. The transaction is not approved unless the board determines that the transaction is fair to CHI or the CHI entity. III. A conflicted trustee or corporate officer is not permitted to use his or her personal influence with respect to the approval or disapproval of the conflicted transaction. However, if requested, such trustee or corporate officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from trustees, as his or her knowledge may be relevant. The trustee or corporate officer is excused from the meeting during discussion and vote on the conflict of interest. (Continued below) Form 990, Part VI, Line 19 Required documents available to the public The organization's financial statements, conflict of interest policy and governing documents are available to the public upon request. The organization's financial statements are included in CommonSpirit Health's consolidated audited financial statements that are available at www.commonspirit.org or www.catholichealthinitiatives.org. Form 990, Part IX, Line 11g Other Fees Purchased Services - Total Expense: 4820245, Program Service Expense: 4579233, Management and General Expenses: 241012, Fundraising Expenses: ; Other Fees for Services - Total Expense: 2170806, Program Service Expense: 2062266, Management and General Expenses: 108540, Fundraising Expenses: ; Contract Labor - Total Expense: 1483855, Program Service Expense: 1409662, Management and General Expenses: 74193, Fundraising Expenses: ; Contract Services - Total Expense: 558168, Program Service Expense: 502351, Management and General Expenses: 55817, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Affiliate Transactions - -3509; 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 - SAN AUGUSTINE PO BOX 1447 LUFKIN TX 75902 752663904 HOSPITAL TX 501(c)(3) 3 MHSET false MEMORIAL MULTISPECIALTY ASSOCIATES 1201 FRANK AVE LUFKIN TX 95904 752721155 PHYSICIANS TX 501(c)(3) Type I MHSET false MEMORIAL SPECIALTY HOSPITAL PO BOX 1447 LUFKIN TX 95902 752492741 HOSPITAL TX 501(c)(3) 3 MHSET false MERCY AUXILIARY OF CENTRAL IOWA 1111 6TH AVE DES MOINES IA 50314 426076069 AUXILIARY IA 501(c)(3) Type I MF-DM IA false MERCY CLINICS INC 1111 6TH AVE DES MOINES IA 50314 421193699 PHYSICIANS IA 501(c)(3) 10 CHI-IA CORP false MERCY COLLEGE OF HEALTH SCIENCES 1111 6TH AVE DES MOINES IA 50314 421511682 EDUCATION IA 501(c)(3) 2 CHI-IA CORP false Mercy Foundation Bakersfield PO Box 119 Bakersfield CA 93302 770201321 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DH false MERCY FOUNDATION OF DES MOINES IA 1111 6TH AVE DES MOINES IA 50314 237358794 FUNDRAISING FOUNDATION IA 501(c)(3) 7 CHI-IA CORP false MERCY FOUNDATION INC 2700 STEWART PKWY ROSEBURG OR 97471 936088946 FUNDRAISING FOUNDATION OR 501(c)(3) 7 MMC false MERCY HEALTH CARE FOUNDATION PO BOX 368 CORNING IA 50841 421461064 FUNDRAISING FOUNDATION IA 501(c)(3) Type I AHMH-Corning false MERCY HEALTHCARE FOUNDATION 570 CHAUTAUQUA BLVD VALLEY CITY ND 58072 450435338 FUNDRAISING FOUNDATION ND 501(c)(3) Type I MHVC false MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS 800 MERCY DR COUNCIL BLUFFS IA 51503 421178204 FUNDRAISING FOUNDATION IA 501(c)(3) Type I AHBMHS false MERCY HOSPITAL OF DEVILS LAKE 1031 7TH ST NE DEVILS LAKE ND 58301 450227012 HOSPITAL ND 501(c)(3) 3 CSH false MERCY HOSPITAL OF DEVILS LAKE FOUNDATION 1031 7TH ST NE DEVILS LAKE ND 58301 352367360 FUNDRAISING FOUNDATION ND 501(c)(3) 7 MHDL false MERCY HOSPITAL OF VALLEY CITY 570 CHAUTAUQUA BLVD VALLEY CITY ND 58072 450226553 HOSPITAL ND 501(c)(3) 3 CSH false Mercy McMahon Terrace 3865 J Street Sacramento CA 95816 680117340 Senior Citizen's Housing/Retirement Communities CA 501(c)(3) 10 DCC false MERCY MEDICAL CENTER 1301 15TH AVE WEST WILLISTON ND 58801 450231183 HOSPITAL ND 501(c)(3) 3 CSH false MERCY MEDICAL CENTER - CENTERVILLE ONE ST JOSEPHS DRIVE CENTERVILLE IA 52544 420680308 HOSPITAL IA 501(c)(3) 3 CHI-IA CORP false MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER 204 N 4th Ave E Newton IA 50314 421470935 HOSPITAL IA 501(c)(3) 3 CHI-IA CORP false Mercy Medical Center Merced Foundation 301 E 13th Street Merced CA 95340 770035928 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DH false MERCY MEDICAL CENTER INC 2700 STEWART PKWY ROSEBURG OR 97471 930386868 HOSPITAL OR 501(c)(3) 3 CSH false MERCY MEDICAL FOUNDATION 1301 15TH AVE WEST WILLISTON ND 58801 450381803 FUNDRAISING FOUNDATION ND 501(c)(3) Type I MMC false NEBRASKA HEART HOSPITAL 7500 S 91ST ST LINCOLN NE 68526 392031968 HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA false Northland Healthcare Alliance 2223 East Rosser Avenue Bismarck ND 58501 911845296 MANAGEMENT ND 501(c)(3) 7 NCHA false Northridge Hospital Foundation 18300 Roscoe Blvd Northridge CA 91328 237444901 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DCC false OAKES COMMUNITY HOSPITAL 1200 N 7TH ST OAKES ND 58474 450231675 HOSPITAL ND 501(c)(3) 3 CSH false OAKES COMMUNITY HOSPITAL FOUNDATION 1200 N 7TH ST OAKES ND 58474 710966606 FUNDRAISING FOUNDATION ND 501(c)(3) Type I OCH false Pacific Central Coast Health Centers 1400 E Church Street Santa Maria CA 93454 770447575 Clinic CA 501(c)(3) 3 DH false PINEYWOODS MEDICAL DEVELOPMENT CORP PO BOX 1447 LUFKIN TX 75902 752493116 PROPERTY MGMT TX 501(c)(3) Type I MHSET false Port City Operating Company LLC 3400 Data Drive Rancho Cordova CA 95670 465322209 HOSPITAL CA 501(c)(3) 3 DH false PROVIDENCE CARE CENTER 2025 HAYES AVENUE SANDUSKY OH 44870 341658625 HEALTHCARE OH 501(c)(3) 10 FLC false PROVIDENCE CARE CENTERS 2025 HAYES AVENUE SANDUSKY OH 44870 341826099 HOLDING CO OH 501(c)(3) Type II FLC false PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION 5055 PROVIDENCE DRIVE SANDUSKY OH 44870 341896807 LIVING COMM OH 501(c)(3) 10 FLC false PUEBLO STEPUP 1925 E ORMAN AVE STE G52 PUEBLO CO 81004 841234295 COMMUNITY CO 501(c)(3) 7 CHIC false REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE 16251 Sylvester Road SW Burien WA 98166 911170040 HOSPITAL WA 501(c)(3) 3 FHS false SET OF COLORADO SPRINGS INC 9100 E Mineral Circle Centennial CO 80112 841183335 Senior Center Services CO 501(c)(3) 7 CHIC false SAINT CLARE'S COMMUNITY CARE INC 25 POCONO RD DENVILLE NJ 07834 222876836 HEALTHCARE NJ 501(c)(3) 10 SCHS false SAINT CLARE'S FOUNDATION INC 25 POCONO RD DENVILLE NJ 07834 222502997 FUNDRAISING FOUNDATION NJ 501(c)(3) 7 SCHS false SAINT CLARE'S HEALTH SERVICES INC 25 POCONO RD DENVILLE NJ 07834 223639733 MANAGEMENT NJ 501(c)(3) 10 CSH false SAINT CLARE'S HOSPITAL INC 25 POCONO RD DENVILLE NJ 07834 223319886 HEALTHCARE NJ 501(c)(3) 3 SCHS false SAINT ELIZABETH FOUNDATION 555 S 70TH ST LINCOLN NE 68510 470625523 FUNDRAISING FOUNDATION NE 501(c)(3) 7 SERMC false SAINT ELIZABETH HEALTH SERVICES 555 S 70TH ST LINCOLN NE 68510 363233120 HOSPITAL NE 501(c)(3) 3 SERMC false SAINT ELIZABETH REGIONAL MEDICAL CENTER 555 S 70TH ST LINCOLN NE 68510 470379836 HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA false SAINT FRANCIS MEDICAL CENTER 2620 W FAIDLEY GRAND ISLAND NE 68803 470376601 HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA false SAINT FRANCIS MEDICAL CENTER FOUNDATION PO BOX 9804 GRAND ISLAND NE 68802 470630267 FUNDRAISING FOUNDATION NE 501(c)(3) 7 SFMC false Saint Francis Memorial Hospital 900 Hyde Street San Francisco CA 94109 941156295 HOSPITAL CA 501(c)(3) 3 DCC false SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC 305 ESTILL ST BEREA KY 40403 260152877 FUNDRAISING FOUNDATION KY 501(c)(3) 7 SJHS false SAINT JOSEPH HEALTH SYSTEM INC 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 611334601 HOSPITAL KY 501(c)(3) 3 KOH false SAINT JOSEPH HOSPITAL FOUNDATION INC 701 Bob Olink Dr 200 LEXINGTON KY 40504 611159649 FUNDRAISING FOUNDATION KY 501(c)(3) Type I SJHS false SAINT JOSEPH LONDON FOUNDATION INC 1001 SAINT JOSEPH LANE LONDON KY 40741 260438748 FUNDRAISING FOUNDATION KY 501(c)(3) 7 SJHS false SAINT JOSEPH MOUNT STERLING FOUNDATION INC 225 FALCON DR MOUNT STERLING KY 40353 272884584 FUNDRAISING FOUNDATION KY 501(c)(3) 7 SJHS false SAINT JOSEPH'S HOSPITAL FOUNDATION 2500 Fairway Street DICKINSON ND 58601 363418207 FUNDRAISING FOUNDATION ND 501(c)(3) Type I SJHHC false San Gabriel Valley Medical Center Foundation 438 West Las Tunas Drive San Gabriel CA 91776 953430341 INACTIVE CA 501(c)(3) Type I DH false SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC 104 W 17TH ST SCHUYLER NE 68661 363630014 FUNDRAISING FOUNDATION NE 501(c)(3) Type I AHMHS false Sierra Nevada Memorial-Miners Hospital 155 Glasson Way Grass Valley CA 95945 941439787 HOSPITAL CA 501(c)(3) 3 DCC false SJRMC JOPLIN MISSOURI 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 440545809 HOSPITAL MO 501(c)(3) 3 CSH false St Francis Foundation of Santa Barbara 2323 De La Vina St Suite 104 Santa Barbara CA 93105 237137119 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DH false St Francis Hospital Support Corporation 601 E Micheltorena Street Santa Barbara CA 93103 770022302 INACTIVE CA 501(c)(3) Type I DH false St Johns Healthcare Foundation 1600 North Rose Avenue Oxnard CA 93030 202865781 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DH false St Josephs Foundation (Phoenix) 350 West Thomas Road Phoenix AZ 85013 942941245 FUNDRAISING FOUNDATION AZ 501(c)(3) Type I DH false St Josephs Foundation of San Joaquin 1800 N California Street Stockton CA 95204 510432777 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DH false St Mary Medical Center Foundation 1050 Linden Avenue Long Beach CA 90813 237153876 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DH false St Mary Professional Building Inc 1050 Linden Avenue Long Beach CA 90813 237373088 INACTIVE CA 501(c)(3) Type I DH false St Marys Medical Center Foundation 450 Stanyan Street San Francisco CA 94117 943336143 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DH false St Rose Dominican Health Foundation 3001 St Rose Parkway Henderson NV 89052 880349432 FUNDRAISING FOUNDATION NV 501(c)(3) Type I DH false ST ALEXIUS MEDICAL CENTER 900 EAST BROADWAY AVENUE BISMARCK ND 58501 450226711 HOSPITAL ND 501(c)(3) 3 CSH false ST ANTHONY HOSPITAL 2801 St Anthony Way PENDLETON OR 97801 930391614 HOSPITAL OR 501(c)(3) 3 CSH false ST ANTHONY HOSPITAL FOUNDATION 2801 St Anthony Way PENDLETON OR 97801 930992727 FUNDRAISING FOUNDATION OR 501(c)(3) Type I SAH false ST ANTHONY'S HOSPITAL ASSOCIATION FOUR HOSPITAL DR MORRILTON AR 72110 710245507 HOSPITAL AR 501(c)(3) 3 SVIMC false ST CATHERINE HOSPITAL 401 EAST SPRUCE ST GARDEN CITY KS 67846 480543721 HOSPITAL KS 501(c)(3) 3 CSH false ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION 401 EAST SPRUCE ST GARDEN CITY KS 67846 200598702 FUNDRAISING FOUNDATION KS 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