CHI LISBON HEALTH: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: CHI LISBON HEALTH (EIN 82-0558836)
Tax period: 2017-07-01 to 2018-06-30
Filed: 2019-05-10
IRS object ID: 201921309349300212
Schema version: 2017v2.2
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2019-05-10T07:30:11-05:00	ReturnTs
Tax Period End	2018-06-30	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	CATHOLIC HEALTH INITIATIVES	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	2017-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	820558836	EIN

Business Name BusinessName

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

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Peggy Reinke	PersonNm
Person Title	President	PersonTitleTxt
Signature	2019-05-10	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

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

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2019-02-21 02:37:17Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

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

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Peggy Reinke	BusinessNameLine1Txt

US Address USAddress

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

Field	Value	IRS element (for citing)
Gross Receipts	$11,536,736	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.lisbonhospital.com	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2002	FormationYr
Legal Domicile State	ND	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE HIGH QUALITY HEALTH CARE WITHIN IDEALS OF COMPASSION AND CONCERN, TO BE COMMITTED TO MAINTAIN OUR PRESENCE INTO THE FUTURE BY SERVING OUR CUSTOMERS, TO ASSURE CONTINUITY OF TOTAL CARE. THE ORGANIZATION WAS, FOR THE YEAR ENDED 6/30/18, AFFILIATED WITH CATHOLIC HEALTH INITIATIVES ("CHI"). FOLLOWING THE CLOSE OF THE 6/30/2018 TAX YEAR, ON 2/1/19, IN CONNECTION WITH THE ALIGNMENT OF THE CATHOLIC MINISTRIES OF CHI AND DIGNITY HEALTH, CHI CHANGED ITS NAME TO COMMONSPIRIT HEALTH.	ActivityOrMissionDesc
Voting Members Governing Body	7	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	99	TotalEmployeeCnt
Total Volunteers	10	TotalVolunteersCnt
Total Gross UBI	$636	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$70,551	PYContributionsGrantsAmt
CY Contributions Grants	$160,258	CYContributionsGrantsAmt
PY Program Service Revenue	$11,192,592	PYProgramServiceRevenueAmt
CY Program Service Revenue	$11,063,823	CYProgramServiceRevenueAmt
PY Investment Income	$204,026	PYInvestmentIncomeAmt
CY Investment Income	$219,475	CYInvestmentIncomeAmt
PY Other Revenue	$99,701	PYOtherRevenueAmt
CY Other Revenue	$84,702	CYOtherRevenueAmt
PY Total Revenue	$11,566,870	PYTotalRevenueAmt
CY Total Revenue	$11,528,258	CYTotalRevenueAmt
PY Grants And Similar Paid	$146,097	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$221,363	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$4,110,907	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$4,513,633	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$6,411,273	PYOtherExpensesAmt
CY Other Expenses	$6,268,051	CYOtherExpensesAmt
PY Total Expenses	$10,668,277	PYTotalExpensesAmt
CY Total Expenses	$11,003,047	CYTotalExpensesAmt
PY Revenues Less Expenses	$898,593	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$525,211	CYRevenuesLessExpensesAmt
Total Assets BOY	$13,868,119	TotalAssetsBOYAmt
Total Assets EOY	$14,764,361	TotalAssetsEOYAmt
Total Liabilities BOY	$3,687,036	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$4,143,647	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$10,181,083	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$10,620,714	NetAssetsOrFundBalancesEOYAmt
Mission	SEE SCHEDULE O	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$9,900,648	ExpenseAmt
Grant	$221,363	GrantAmt
Revenue	$11,063,823	RevenueAmt
Desc	SEE SCHEDULE H	Desc
Total Program Service Expenses	$9,900,648	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (true)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	99	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	Yes (true)	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	7	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	false	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

Field	Value	IRS element (for citing)
Phone	7012378022	PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
NEIL OLERUD
Vice Chair	1.0	0	Yes (X)	Yes (X)	$0	$0	$0
PEGGY REINKE
PRESIDENT	40.0	0.0	Yes (X)	Yes (X)	$0	$225,247	$14,179
BRIAN SHELTON
CHAIR	1.0	0	Yes (X)	Yes (X)	$0	$0	$0
Sister Donna Welder
Secretary	1.0	0	Yes (X)	Yes (X)	$0	$0	$0
JEFFREY DROP
Board Member/CHI SVP Division Officer	1.0	59.0	Yes (X)		$0	$1,429,849	$33,844
Jason Enger
BOARD MEMBER	1.0	0	Yes (X)		$0	$0	$0
RYAN ZERFACE
BOARD MEMBER	1.0	0	Yes (X)		$0	$0	$0
AMBER STOWMAN
Division Director of Finance	40.0	0.0		Yes (X)	$0	$124,833	$32,277
OSCAR FERNANDEZ
PHYSICIAN	40.0	0			$177,171	$0	$32,099	Yes (X)
JILL MCRITCHIE
MANAGER PHARMACY	40.0	0			$140,199	$0	$29,112	Yes (X)
KEVIN JACOBSON
Nurse Practitioner	40.0	0			$132,172	$0	$23,178	Yes (X)
Julie A Mallett
VP PATIENT CARE SERVICES	40.0	0			$118,996	$0	$8,606	Yes (X)
REBECCA THOMPSON
VP OPERATIONAL FINANCE (THROUGH 7/31/14)	0.0	60.0			$0	$189,843	$33,684		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$568,538	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,969,772	TotReportableCompRltdOrgAmt
Total Other Compensation	$206,979	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	4	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
NORIDIAN ADMINISTRATIVE SVCS
900 40th St S	Fargo	ND	58103	Services & Solutions	$889,640
NATIONAL MEDICAL RESOURCES INC
2900 E BROADWAY AVE SUITE 1	BISMARCK	ND	58501	EMERGENCY ROOM COVERAGE	$478,242
MOBILITYPLUS REHABILITATION
26295 CRYSTAL RD	PELICAN RAPIDS	MN	56572	PHYSICAL/OCCUPATIONAL THERAPY SERVICES	$269,573
Rudolf Loperena MD
PO BOX 71	LISBON	ND	58054	ER PHYSICIAN COVERAGE	$250,039
NISC NATL INFO SOLUTIONS COOP
3201 NYGREN DRIVE	MANDAN	ND	58554	IT SERVICES	$186,782

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	6	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$0	FederatedCampaignsAmt
Membership Dues	$0	MembershipDuesAmt
Fundraising	$45,203	FundraisingAmt
Related Organizations	$0	RelatedOrganizationsAmt
Government Grants	$60,658	GovernmentGrantsAmt
All Other Contributions	$54,397	AllOtherContributionsAmt
Noncash Contributions	$10,393	NoncashContributionsAmt
Total Contributions	$160,258	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Patient Services	900099	$11,063,823	$11,063,823	$0	$0
		$0	$0	$0	$0
		$0	$0	$0	$0
		$0	$0	$0	$0
		$0	$0	$0	$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

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

Field	Value	IRS element (for citing)
Total Program Service Revenue	$11,063,823	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$99,413	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$636	UnrelatedBusinessRevenueAmt
Exclusion	$98,777	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	$68,995	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	$68,995	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$68,995	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$68,995	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$120,062	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	$120,062	SecuritiesAmt
Other	$0	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$120,062	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$120,062	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$11,222	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$45,203	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$6,165	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,057	TotalRevenueColumnAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$5,057	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$11,955	GamingGrossIncomeAmt
Gaming Direct Expenses	$2,313	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$9,642	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$9,642	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
Medical Records Revenue/Transcription	541200	$516	$0	$0	$516
Cafeteria	722100	$342	$0	$0	$342
Other Miscellaneous Revenue	900099	$150	$0	$0	$150

Miscellaneous Revenue MiscellaneousRevenueGrp

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)
Other Revenue Total	$1,008	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,528,258	TotalRevenueColumnAmt
Related Or Exempt Func Income	$11,063,823	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$636	UnrelatedBusinessRevenueAmt
Exclusion	$303,541	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	$2,903	TotalAmt
Program Services	$2,903	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$218,460	TotalAmt
Program Services	$218,460	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$3,557,537	TotalAmt
Program Services	$3,251,991	ProgramServicesAmt
Management And General	$305,546	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$176,602	TotalAmt
Program Services	$161,434	ProgramServicesAmt
Management And General	$15,168	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$523,486	TotalAmt
Program Services	$478,526	ProgramServicesAmt
Management And General	$44,960	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$256,008	TotalAmt
Program Services	$234,020	ProgramServicesAmt
Management And General	$21,988	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$12,757	TotalAmt
Management And General	$12,757	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$2,741	TotalAmt
Management And General	$2,741	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,878,943	TotalAmt
Program Services	$2,339,257	ProgramServicesAmt
Management And General	$539,686	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$12,482	TotalAmt
Management And General	$12,482	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$234,673	TotalAmt
Program Services	$186,865	ProgramServicesAmt
Management And General	$47,808	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$916,381	TotalAmt
Program Services	$870,562	ProgramServicesAmt
Management And General	$45,819	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$219,794	TotalAmt
Program Services	$200,916	ProgramServicesAmt
Management And General	$18,878	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$4,888	TotalAmt
Program Services	$2,446	ProgramServicesAmt
Management And General	$2,442	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$144	TotalAmt
Program Services	$16	ProgramServicesAmt
Management And General	$128	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$10,953	TotalAmt
Program Services	$10,953	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$324,012	TotalAmt
Program Services	$324,012	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$568,200	TotalAmt
Program Services	$568,200	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$563,038	$563,038
Bad debts	$338,213	$338,213
Repairs and maintenance	$126,234	$125,020	$1,214
Dues & subscriptions	$43,302	$23,816	$19,486

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$11,296	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$11,296	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$11,003,047	TotalAmt
Program Services	$9,900,648	ProgramServicesAmt
Management And General	$1,102,399	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$570	BOYAmt
EOY	$510	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$2,956,833	BOYAmt
EOY	$3,096,686	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,759,019	BOYAmt
EOY	$1,724,685	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$1,893	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$168,512	BOYAmt
EOY	$230,200	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

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

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$8,001,598	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$4,777,557	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$3,591,601	BOYAmt
EOY	$3,224,041	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$2,851,506	BOYAmt
EOY	$3,057,636	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,526,384	BOYAmt
EOY	$3,418,802	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$13,868,119	BOYAmt
EOY	$14,764,361	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$902,787	BOYAmt
EOY	$596,733	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	$0	BOYAmt
EOY	$15,000	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)
BOY	$0	BOYAmt
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	$2,784,249	BOYAmt
EOY	$3,531,914	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$3,687,036	BOYAmt
EOY	$4,143,647	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$10,137,501	BOYAmt
EOY	$10,490,245	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$40,082	BOYAmt
EOY	$126,969	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$10,181,083	BOYAmt
EOY	$10,620,714	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$13,868,119	BOYAmt
EOY	$14,764,361	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$525,211	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$22,504	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$108,084	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

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	$2,741	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$2,741	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 $417 CATHOLIC HEALTH ASSOCIATION $365 NORTH DAKOTA HOSPITAL ASSOCIATION - $1,959
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 $417 CATHOLIC HEALTH ASSOCIATION $365 NORTH DAKOTA HOSPITAL ASSOCIATION - $1,959

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,500	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$3,500	EndYearBalanceAmt

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

Land LandGrp

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

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,273,849	OtherCostOrOtherBasisAmt
Depreciation	$1,126,955	DepreciationAmt
Book Value	$146,894	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

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

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,396,788	OtherCostOrOtherBasisAmt
Depreciation	$3,513,907	DepreciationAmt
Book Value	$2,882,881	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$227,658	OtherCostOrOtherBasisAmt
Depreciation	$136,695	DepreciationAmt
Book Value	$90,963	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$3,224,041	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	CHI OIP	Desc
Book Value	$3,057,636	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$3,057,636	TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
EQUITY IN CENTRAL MINNESOTA DIAGNOSTIC IMAGING	$139,134
INTERCOMPANY RECEIVABLES	$3,279,668

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$3,418,802	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
Intercompany Payables	$3,419,607
CHI Debt Management Program	$112,307

Field	Value	IRS element (for citing)
Total Liability	$3,531,914	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

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

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

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

LISBON AREA HEALTH SERVICES' FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI'S FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2018, READS AS FOLLOWS: "CHI IS A TAX-EXEMPT COLORADO CORPORATION AND HAS BEEN GRANTED AN EXEMPTION FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CHI OWNS CERTAIN TAXABLE SUBSIDIARIES AND ENGAGES IN CERTAIN ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE AND THEREFORE SUBJECT TO INCOME TAX. MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS."

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	GALA	Event1Nm
Gross Receipts Event1	$56,425	GrossReceiptsEvent1Amt
Charitable Contri Event1	$45,203	CharitableContriEvent1Amt
Gross Revenue Event1	$11,222	GrossRevenueEvent1Amt
Food And Beverage Event1	$4,824	FoodAndBeverageEvent1Amt
Entertainment Event1	$199	EntertainmentEvent1Amt
Other Direct Expenses Event1	$1,142	OtherDirectExpensesEvent1Amt
Gross Revenue Event2	$0	GrossRevenueEvent2Amt
Gross Revenue Other Events	$0	GrossRevenueOtherEventsAmt
Gross Receipts Total	$56,425	GrossReceiptsTotalAmt
Charitable Contributions Tot	$45,203	CharitableContributionsTotAmt
Gross Revenue Total Events	$11,222	GrossRevenueTotalEventsAmt
Food And Beverage Total Events	$4,824	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$199	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$1,142	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$6,165	DirectExpenseSummaryEventsAmt
Net Income Summary	$5,057	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

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

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	109	PersonsServedCnt
Total Community Benefit Expns	$90,592	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$90,592	NetCommunityBenefitExpnsAmt
Total Expense	0.0085	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

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

Unreimbursed Costs UnreimbursedCostsGrp

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

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	109	PersonsServedCnt
Total Community Benefit Expns	$90,592	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$90,592	NetCommunityBenefitExpnsAmt
Total Expense	0.0085	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	5	ActivitiesOrProgramsCnt
Persons Served	253	PersonsServedCnt
Total Community Benefit Expns	$15,518	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$15,518	NetCommunityBenefitExpnsAmt
Total Expense	0.0015	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	4	PersonsServedCnt
Total Community Benefit Expns	$23,715	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$23,715	NetCommunityBenefitExpnsAmt
Total Expense	0.0022	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	164	PersonsServedCnt
Total Community Benefit Expns	$29,107	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,200	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$20,907	NetCommunityBenefitExpnsAmt
Total Expense	0.0020	TotalExpensePct

Research ResearchGrp

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

Cash And In Kind Contributions CashAndInKindContributionsGrp

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

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Persons Served	421	PersonsServedCnt
Total Community Benefit Expns	$68,340	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,200	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$60,140	NetCommunityBenefitExpnsAmt
Total Expense	0.0056	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Persons Served	530	PersonsServedCnt
Total Community Benefit Expns	$158,932	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,200	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$150,732	NetCommunityBenefitExpnsAmt
Total Expense	0.0141	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

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

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	150	PersonsServedCnt
Total Community Benefit Expns	$1,543	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,543	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	150	PersonsServedCnt
Total Community Benefit Expns	$300	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$300	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

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

Leadership Development LeadershipDevelopmentGrp

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

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$4,769	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,769	NetCommunityBenefitExpnsAmt
Total Expense	0.0004	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

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

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	48	PersonsServedCnt
Total Community Benefit Expns	$10,111	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,111	NetCommunityBenefitExpnsAmt
Total Expense	0.0009	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

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

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	10	ActivitiesOrProgramsCnt
Persons Served	348	PersonsServedCnt
Total Community Benefit Expns	$16,723	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$16,723	NetCommunityBenefitExpnsAmt
Total Expense	0.0016	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$338,213	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$5,209,679	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$5,241,548	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$31,869	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

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

US Address USAddress

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

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

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	http://www.lisbonhospital.com/chna-report.htm	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	false	StrategyPostedWebsiteInd
Strategy Attached	Yes (true)	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	300.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.0	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	The significant health needs are included in a prioritized description of the significant health needs of the community, along with a description of the process and criteria used in identifying certain health needs as significant and prioritizing those significant heath needs, and are identified through the CHNA.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Lisbon Area Health Services. To help determine future decisions and strategic planning, LAHS conducted a community health needs assessment survey. This was done through a joint effort of LAHS and Sargent County District Health Unit and Ransom County Public Health Department. Community health data was used and solicited input from community members by interviews and a public survey. The survey was distributed throughout Ransom and Sargent County as an on line survey through Survey Monkey. Additional information was collected through key informant interviews of locally identified community leaders. One-on-one interviews with key informants were conducted in person or via phone in Ransom and Sargent counties. Representatives from CHI Lisbon Health conducted the interviews. The individuals selected for interview included those persons who had special knowledge of public health as well as broad interests of the community that CHI Lisbon Health serves. This included individuals from Ransom and Sargent Public Health, area law enforcement, City Mayor, senior service coordinator for the counties, School superintendent and presidents of local community service groups of Civic and Commerce and Kiwanis. These interviews took place from Jan 2016-Mar 2016. Topics covered during these interviews included but not limited to, the most troubling health problems in our communities, issues of concern to the general public officials and the programs already in place to address some of the items identified.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - Lisbon Area Health Services. Lisbon Area Health Services (LAHS) conducted a community health needs assessment survey through a joint effort of LAHS and Sargent County District Health Unit and Ransom County Public Health Department.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Lisbon Area Health Services. Prioritized List of Significant Health Needs Identified in CHNA The process used to identify priorities was the discussion and debate method. Preliminary areas of need were identified by the hospital internal assessment team and local public health departments. Discussion was held with external entities, leadership and LAHS Board of Directors. Priorities were selected based on burden, urgency of need and estimated feasibility and effectiveness of possible interventions. Significant health Needs to be Addressed The first significant health need identified was obesity, poor nutrition and inactivity. The objective in addressing this need is to decrease adult obesity by 3% in each county while increasing education and available information regarding obesity and healthy nutrition. Furthermore, exercise opportunities will be increased. LAHS has applied for a $110,000 grant through the Mission and Ministry fund .The goal of the grant is to hire a coordinator to collaborate with local organizations. These include but are not limited to, public health, clinics, schools NDSU extension office and weight loss groups such as weight watchers. These groups will provide education on nutrition and healthy choices. In addition, LAHS is looking for a funding source to collaborate with local community members to implement a walking path. The second significant health need identified was violence prevention. The objective of addressing this need is to reduce reported incidents 20% by 2018. LAHS has collaborated with local law enforcement, social services, county extension, schools and the local domestic violence prevention coalition. The purpose of the coalition is to provide a forum for networking of local agencies. Additionally, the coalition will provide guidance regarding education in the community. LAHS has received a Violence Prevention grant to collaborate with Abuse Resource Network to provide education in the community. Two specific curriculums have been chosen. The first curriculum, Within My Reach focuses on education potential victims and community members about intimate partner violence. The second curriculum, Futures Without Violence focuses on training professionals to incorporate intimate partner violence prevention efforts into their existing work. The third significant health need identified was mental health and caring for patients with addictions and mental health needs. LAHS has collaborated with local law enforcement, ambulance staff, state and city attorneys, South East Human Service Center and Prairie St. Johns. State legislatures will be invited to the group at a later time. The focus of the group is to address obstacles which prevent patients with mental health and addiction concerns from getting help they require. One major obstacle is transportation for persons who need to be transferred to another facility. Due to lack of resources, LAHS will be investigating the feasibility of contracting with Secure Transport for transportation needs. Another obstacle faced by these patients is the wait time for an available bed at a treatment facility. At times these patients may be in the ED for upwards of eight hours waiting for placement. Due to the amount of time in the ED waiting, LAHS will explore the possibility of a "safe room" for these patients. LAHS staff will receive "Handle With Care" training. LAHS will also explore Global Crises Intervention to help care for patients with addictions and mental health concerns. Lack of mental services locally has also been identified as a concern. LAHS will explore contracting with a local counselor to provide services in our facility. Finally, LAHS will continue to use tele psych in the ED setting and pursue this service in an outpatient arena. Significant Health Needs Not Addressed Three areas of identified need are as follows. The first area identified was the cost of health care. This includes cost of services and insurance which include cost of health, dental and vision insurance. LAHS has a Charity Care Program for persons in need to apply for. LAHS is a part of Catholic Health Initiatives, a nonprofit organization with a longstanding commitment to assist those who seek our care, regardless of ability to pay. If a patient is unable to pay for all or part of the care they receive at our hospital, they may be eligible for free or discounted services. Complete explanation and information can be found at www.lisbonhospital.com. The second area identified was the access and cost of child care and infant care. This is an area identified as high need. This will be shared with both counties through Economic Development for their information and planning purposes. This would be out of scope of the mission of LAHS. The third area also identified as high need was bullying. Currently, the Lisbon School system has a bullying program in place to address this topic with school age children. Bullying takes place in a variety of places such as the work place .With the focus on Mental Health concerns, it is felt that an indirect impact may occur to this area of need.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - Lisbon Area Health Services. The patient must have a minimum account balance of thirty-five dollars ($35.00) with the CHI Hospital Organization. Multiple account balances may be combined to reach this amount. Patients/Guarantors with balances below thirty-five dollars ($35) may contact a financial counselor to make monthly installment payment arrangements. The patient must submit a completed Financial Assistance application. Patient Cooperation Standards - A patient must exhaust all other payment options, including private coverage, federal, state and local medical assistance programs, and other forms of assistance provided by third-parties prior to being approved. An applicant for Financial Assistance is responsible for applying to public programs for available coverage. He or she is also expected to pursue public or private health insurance payment options for care provided by a CHI Hospital Organization within a Hospital Facility. A patient's and, if applicable, any Guarantor's cooperation in applying for applicable programs and identifiable funding sources, including COBRA coverage (a federal law allowing for a time-limited extension of employee healthcare benefits), shall be required. If a Hospital Facility determines that COBRA coverage is potentially available, and that a patient is not a Medicare or Medicaid beneficiary, the patient or Guarantor shall provide the Hospital Facility with information necessary to determine the monthly COBRA premium for such patient, and shall cooperate with Hospital Facility staff to determine whether he or she qualifies for Hospital Facility COBRA premium assistance, which may be offered for a limited time to assist in securing insurance coverage. A Hospital Facility shall make affirmative efforts to help a patient or patient's Guarantor apply for public and private programs.

Field	Value	IRS element (for citing)
Facility	0	FacilityNum

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c Financial Eligibility	Unless eligible for Presumptive Financial Assistance, the following eligibility criteria must be met in order for a patient to qualify for Financial Assistance: * The patient must have a minimum account balance of thirty-five dollars ($35.00) with the CHI Hospital Organization. Multiple account balances may be combined to reach this amount. Patients/Guarantors with balances below thirty-five dollars ($35) may contact a financial counselor to make monthly installment payment arrangements. * The patient's Family Income must be at or below 300% of the FPG. * The patient must comply with Patient Cooperation Standards as described [in the FAP]. * The patient must submit a completed Financial Assistance application. For patients and Guarantors who are unable to provide required documentation, a Hospital Facility may grant Presumptive Financial Assistance based on information obtained from other resources. In particular, presumptive eligibility may be determined on the basis of individual life circumstances that may include: * Recipient of state-funded prescription programs; * Homeless or one who received care from a homeless clinic; * Participation in Women, Infants and Children programs (WIC); * Food stamp eligibility; * Subsidized school lunch program eligibility; * Eligibility for other state or local assistance programs (e.g., Medicaid spend-down); * Low income/subsidized housing is provided as a valid address; or * Patient is deceased with no known estate.
Schedule H, Part VI Schedule H Part II and Part VI, Lines 2, 4, and 5	ORGANIZATION'S MISSION, VISION, AND TAX-EXEMPT PURPOSE The mission of CHI Lisbon Health and Catholic Health Initiatives is "to nurture the healing ministry of the Church, supported by education and research. Fidelity to the Gospel urges us to emphasize human dignity and social justice as we create healthier communities." Our Vision is to live up to our name as one CHI: Catholic: Living our Mission and Core Values. Health: Improving the health of the people and communities we serve. Initiatives: Pioneering models and systems of care to enhance care delivery Primary tax-exempt purpose: to provide healthcare to the residents of the surrounding communities regardless of their ability to pay. The goal of CHI Lisbon Health is to provide high quality healthcare to meet the needs of the communities we serve. We are committed to maintain our presence into the future by serving our customers with dedicated skilled staff. As a provider of a community based, family oriented healthcare, CHI Lisbon Health believes it can best maintain this level of service through a customer focus, where we continually strive to understand and exceed the expectations of our customers. CHI Lisbon Health originally known as Community Memorial Hospital opened its doors on February 1, 1952. Lutheran Hospitals & Homes Society (LHHS) of Fargo worked on this project with the local Community Memorial Hospital Association and assumed operations of the hospital. In 1967 an addition was added to the northeast portion of the hospital, which became a 20-bed nursing home wing. It was determined that additional space was needed and another addition was made to the south of the existing structure. This was completed in 1976 and became the new hospital wing. The previous hospital wing was converted to 25 nursing home beds. By 1996 a remodeling project had been completed and a clinic was moved into the facility. At this time the facility's name changed to Lisbon Medical Center. CHI Lisbon Health changed to Critical Access Hospital status effective January 1, 2001. The facility was acquired by Catholic Health Initiatives on October 1, 2002. Shortly thereafter, clinic services were discontinued. On October 15, 2013 CHI Lisbon Health re-opened the clinic within the facility to better serve their community. This clinic is staffed with a Family Nurse Practitioner Certified and a Family Practice Physician. The clinic saw 1,846 patients in FY18. The Clinic is open Monday-Friday. CHI Lisbon Health is served by physicians and allied professional staff from CHI Lisbon Health Clinic, Family Medical Clinic, Essentia Health-Lisbon and Sanford Health Clinic-Lisbon. In addition to LAHS, Lisbon has 3 other clinics, two home care agencies, two hospice agencies and two long term care facilities (LTC) as well as a LTC facility in Enderlin and one in Forman. There is one assisted living facility and two facilities that offer basic care. Lisbon is located in southeast ND which is one hour away from Fargo. Its economy is based on agriculture, manufacturing, and retail trades. Lisbon Public School System offers curriculum for students K-12 and offer a variety of sports, music and drama. The Historical Opera House hosts several cultural events throughout the year. The scenic theatre offers a variety of selections for diverse ages. The park board maintains 2 city parks, swimming pool, ball diamond, and tennis court. The surrounding areas provide recreational areas such as water sports, hunting, golf and camping. Medical need and care come first at CHI Lisbon Health. CHI Lisbon Health will provide medically necessary health care services to all persons who are in need, regardless of age, race, religion, national origin, gender, handicap, sexual orientation or ability to pay. CHI Lisbon Health has a Board of Directors whose membership includes 7 representatives from Lisbon and the immediate surrounding area. This includes one representative from our founding order, the Sisters of the Presentation of the Blessed Virgin Mary. CHI Lisbon Health also has a Quality Committee, Patient Family Advisory Council and a Foundation Board/Advisory Council of 7. COMMUNITY BENEFIT APPROACH A community health needs assessment is a systematic process involving community input to identify community health needs, prioritize needs and act on unfulfilled needs. The implementation will be CHI Lisbon Health's plan to address community health needs also known as the community benefit plan. The purpose for conducting a community health needs assessment is to describe the health of the local population, identify community needs, and identify action needed to address the future delivery of health care in Ransom and Sargent counties. A health needs assessment benefits the local community by: 1) opening the discussion between community members about the future of health care in the community, 2) organizing information to help guide, inform and educate, 3) collecting input from the local community including providers. CHI Lisbon Health is a 25-bed critical access hospital in Lisbon, North Dakota. CHI Lisbon Health is a state-designated Level V Trauma Center, a Stroke Ready Hospital and employs approximately 80 people. CHI Lisbon Health is the only hospital in Ransom and Sargent counties and serves 10,659 people throughout 1720.87 square miles. Lisbon is in the Health Professional Shortage Areas (HPSAs), the Medically Underserved Areas / Populations, as well as a shortage area for mental health services. HPSA's are designated by Health Resources and Service Administration (HRSA); Dept of Health & Human Services and the Center for Rural Health - UND as having shortages of primary medical care, dental or mental health providers and may be geographic (a county or service area), demographic (low income population) or institutional (comprehensive health center, federally qualified health center or other public facility). Medically Underserved Areas/Populations are areas or populations designated by HRSA as having too few primary care providers, high infant mortality, high poverty and/or high elderly population. Access to an adequate supply of health care providers is a concern in both North Dakota and nationally. COMMUNITY ASSESSMENT, PROCESS AND SUMMARY To help determine future decisions and strategic planning, CHI Lisbon Health conducted a Community Health Needs Assessment survey May 1, 2015 thru June 30, 2015. This was done through a joint effort of CHI Lisbon Health, Sargent County District Health Unit and Ransom County Public Health Department. Community health data was used and input was solicited from community members by interviews and a public survey. The survey was widely distributed throughout Ransom and Sargent counties on line through Survey Monkey. Additional information was collected through key informant interviews of locally identified community leaders. A needs assessment was previously conducted in the community when Open Door was new to the area. They contacted businesses for work for their clients with developmental disabilities. CHI Lisbon Health continues to donate to the non-profit with an hourly stipend, supervision and training in the dietary department. Open Door is a non-profit organization. UNCOMPENSATED CARE FOR THE POOR CHI Lisbon Health provides care to everyone, regardless of his or her ability to pay. Benefits are provided to individuals who cannot afford health care because they have inadequate resources and/or are uninsured or underinsured. Charity care is free or discounted health-related service provided to individuals who cannot afford to pay for medically necessary health care. Eligibility is based on household income. 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. Financial Assistance applications may be obtained from CHI Lisbon Health or on the website: http://www.lisbonhospital.com/patientsvisitors_financialassistance.htm
Schedule H, Part VI Schedule H Part II and Part VI, Lines 2, 4, and 5	QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT: JULY 1, 2017 THROUGH JUNE 30, 2018 COMMUNITY BENEFIT PROVIDED TO THE POOR: COST OF FINANCIAL ASSISTANCE PROVIDED ESTIMATED NUMBER OF PEOPLE SERVED: 109 COMMUNITY BENEFIT COST: $90,592 COMMUNITY BENEFIT OPERATIONS ESTIMATED NUMBER OF PEOPLE SERVED: 94 COMMUNITY BENEFIT COST: $8,813 COMMUNITY BUILDING ACTIVITIES ESTIMATED NUMBER OF PEOPLE SERVED: 48 COMMUNITY BENEFIT COST: $10,171 COMMUNITY BENEFIT PROVIDED TO THE BROADER COMMUNITY: COMMUNITY BENEFIT OPERATIONS ESTIMATED NUMBER OF PEOPLE SERVED: 0 COMMUNITY BENEFIT COST: $889 COMMUNITY BUILDING ACTIVITIES ESTIMATED NUMBER OF PEOPLE SERVED: 300 COMMUNITY BENEFIT COST: $6,552 COMMUNITY HEALTH IMPROVEMENT SERVICES ESTIMATED NUMBER OF PEOPLE SERVED: 323 COMMUNITY BENEFIT COST: $26,723 HEALTH PROFESSIONS EDUCATION ESTIMATED NUMBER OF PEOPLE SERVED: 4 COMMUNITY BENEFIT COST: $23,715 GRAND COST OF COMMUNITY BENEFIT ESTIMATED NUMBER OF PEOPLE SERVED: 878 COMMUNITY BENEFIT COST: $167,455 HUMAN INVESTMENT AND STATISTICS NUMBER OF ACTIVITIES: 19 STAFF HOURS: 1,699 VOLUNTEER HOURS: 21 QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT: Community Benefit is the name given to the programs we created 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 Lisbon. Provide resources to meet those needs. Create collaboration between community organizations that focus on health and well being. COMMUNITY OUTREACH CHI Lisbon Health and CHI's Fargo Division international sister-to-sister hospital program of the new Indigenous People's Hospital opened on May 18, 2012 in Nueva Vizcaya, Philippines. The hospital, located in a remote region of the country, provides care to impoverished tribal people. The new clinic and hospital was immediately busy and had provided care to more than 600 people the day they opened. CHI Lisbon Health supports this hospital with a monetary donation. The Open Door Project provides an opportunity for the developmentally disabled to develop new daily living skills working side by side with the CHI Lisbon Health dietary department. Training and supervision is provided for the tasks they do daily. * COMMUNITY OUTREACH FOR THE BROADER COMMUNITY CHI Lisbon Health is dedicated to caring for the broader community, a strong tradition that is vital and necessary to maintain progress in rural areas with limited resources. CHI Lisbon Health provides and supports various services and programs that benefit the community for which there is no reimbursement or reimbursement is not adequate to cover the hospital's cost. In-kind services include hours spent by staff as part of their work assignment while on health care organization work time, overhead expenses of space provided to non-profit community groups (for meetings) and donation of food, equipment and supplies. Some organizations include the Economic and Community Development, Emergency Disaster, Ministerial Association, Lisbon Civic and Commerce, and Kiwanis. Ransom County Cares is a non-profit group organized to support the citizens of Ransom County who have been diagnosed and are undergoing treatment for cancer. Due to the need to travel out of town for treatment, financial assistance is provided to help defray the costs of expenses not covered/reimbursed by insurance. CHI Lisbon Health provided support thru facility fundraisers (i.e. bake sales) as well as participated in their annual community event. CHI Lisbon Health team raised a total of $2,569. * COLLABORATIVE EFFORTS TO IMPROVE COMMUNITY HEALTH These activities are carried out to improve community health. They extend beyond patient care activities. They include services directed to individuals and to a larger population. Community health improvement services do not generate inpatient or outpatient bills, although they may involve a nominal patient fee and/or a sliding scale fee. The programs in CBISA and summarized in this report not only benefit and serve the community as a whole, but also greatly reduce the burdens on our local health department, a government funded health care system. CHI Lisbon Health supports the Abuse Resource Network by providing after hours call service. CHI Lisbon Health provides staff to present community education through different venues. * HEALTH PROFESSIONS EDUCATION Helping prepare future health care professionals is a distinguishing characteristic of non-profit health care and constitutes a significant community benefit. Radiology, Pharmacy, and Nursing students have the advantage of spending time with the professionals for on the job mentoring. COMMUNITY BUILDING ACTIVITIES Community building activities include programs that address underlying causes of health problems in order to improve health status and quality of life. They focus on the root causes of health problems, such as poverty, homelessness and environmental problems. These activities support community assets by offering the expertise and resources of the health care organization. Community building activities include cash, in-kind donations and budgeted expenditures for the development of community health programs and partnerships. CHI Lisbon Health employees participate in community coalitions and other collaborative efforts with organizations in Sargent, and Ransom Counties to address health and safety issues. The vision brings people together and forms the foundation of both short and long term strategies to meet identified needs and problems. It develops a common thread encompassing a diverse array of viewpoints, opinions, facts and trends. CHI Lisbon Health employees to belong to organizations that work together to promote healthy communities. Membership is with: Kiwanis, Emergency Planning Committee, Students and Violence Prevention Coalition. Economic development is important to CHI Lisbon Health to assist small business development in neighborhoods with vulnerable populations and creating new employment opportunities in areas with high rates of joblessness. Lisbon Civic and Commerce Organization promotes community and civic events including economic development. * COMMUNITY BENEFIT OPERATIONS: Community benefit operations include costs associated with dedicated staff who work with charity care and with planning and operating community benefit programs. There are expenses involved for the community benefit tracking and reporting. Looking towards the future, CHI Lisbon Health will continue to thrive because of the support from our patients, our physicians, and the area communities. CHI Lisbon Health looks forward to providing care that the community members have come to trust and expect for many years to come.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	338213
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 6/30/2018 WAS COMPUTED USING THE FOLLOWING FORMULA: OPERATING EXPENSE (BEFORE RESTRUCTURING, IMPAIRMENT AND OTHER LOSSES) DIVIDED BY GROSS PATIENT REVENUE. $10,456,353/$18,773,272=55.7%. WORKSHEET 2 WAS NOT USED TO DERIVE THE COST-TO-CHARGE RATIO.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Costing methodology for amounts reported on line 2 is determined using the organization's cost/charge ratio of 55.7%. When discounts are extended to self-pay patients, these patient account discounts are recorded as a reduction in revenue, not as bad debt expense.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	Lisbon Area Health Services does not believe that any portion of bad debt expense could reasonably be attributed to patients who qualify for financial assistance since amounts due from those individuals' accounts will be reclassified from bad debt expense to charity care within 30 days following the date that the patient is determined to qualify for charity care.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Lisbon Area Health Services does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of Catholic Health Initiatives. The consolidated footnote reads as follows: "The provision for bad debts is based upon management's assessment of historical and expected net collections, taking into consideration historical business and economic conditions, trends in health care coverage, and other collection indicators. Management routinely assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category. The results of these reviews are used to modify, as necessary, the provision for bad debts and to establish appropriate allowances for uncollectible net patient accounts receivable. After satisfaction of amounts due from insurance, CHI follows established guidelines for placing certain balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by each facility. The provision for bad debts is presented on the consolidated statements of operations as a deduction from patient services revenues (net of contractual allowances and discounts) since CHI accepts and treats substantially all patients without regard to the ability to pay."
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	Lisbon Area Health Services is designated as a Critical Access Hospital (CAH). CAHs are rural community hospitals that are certified to receive cost-based reimbursement from Medicare. The reimbursement that CAHs receive is intended to improve their financial performance and thereby reduce hospital closures. CAHs are certified under a different set of Medicare Conditions of Participation (CoP). Shortfalls are created when a facility receives payments that are less than the costs of caring for program beneficiaries. Although not presented on the Medicare cost report, in order to facilitate a more accurate understanding of the "true" cost of services (for "shortfall" purposes) the CHI Workbook allows a health care facility not to offset costs that Medicare considers to be non-allowable, but for which the facility can legitimately argue are related to the care of the facility's patients. In addition, although not reportable on the Medicare cost report, the CHI workbook includes the cost of services that are paid via a set fee-schedule rather than being reimbursed based on costs (e.g. outpatient clinical laboratory). Finally, the CHI Workbook allows a facility to include other health care services performed by a separate facility (such as a physician practice) that are maintained on separate books and records (as opposed to the main facility's books and records which has its costs of service included within a cost report). True costs of Medicare computed using this methodology: Total Medicare Revenue: $5,209,679 Total Medicare costs: $5,241,548 Surplus or Shortfall $(31,869) Lisbon Area Health Services believes that excluding Medicare losses from community benefit makes the overall community benefit report more credible for these reasons: Unlike subsidized areas such as burn units or behavioral-health services, Medicare is not a differentiating feature of tax-exempt health care organizations. In fact, for-profit hospitals focus on attracting patients with Medicare coverage, especially in the case of well-paid services that include cardiac and orthopedics. Significant effort and resources are devoted to ensuring that hospitals are reimbursed appropriately by the Medicare program. The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency, carefully studies Medicare payment and the access to care that Medicare beneficiaries receive. The commission recommends payment adjustments to Congress accordingly. Though Medicare losses are not included by Catholic hospitals as community benefit, the Catholic Health Association guidelines allow hospitals to count as community benefit some programs that specifically serve the Medicare population. For instance, if hospitals operate programs for patients with Medicare benefits that respond to identified community needs, generate losses for the hospital, and meet other criteria, these programs can be included in the CHA framework in Category C as "subsidized health services." Medicare losses are different from Medicaid losses, which are counted in the CHA community benefit framework, because Medicaid reimbursements generally do not receive the level of attention paid to Medicare reimbursement. Medicaid payment is largely driven by what states can afford to pay, and is typically substantially less than what Medicare pays.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	The organization's billing and collections policy applies to all individuals presenting for emergency or other medically necessary care. The policy contains provisions for collecting amounts due from those patients who the organization knows to qualify for financial assistance either through the traditional financial assistance application process or through presumptive eligibility processes. Before engaging in extraordinary collection actions (ECAs) to obtain payment for EMCare, Hospital Facilities must make reasonable efforts through its billing and collections processes, pursuant to Treas. Reg. §1.501(r)-6(c), to determine whether an individual is eligible for Financial Assistance. In no event will an ECA be initiated prior to 120 days from the date the Facility provides the first post-discharge billing statement (i.e., during the Notification Period) unless all reasonable efforts have been made. Hospital Facilities will not refer accounts for collection where the patient has initially applied for Financial Assistance, and the Hospital Facility has not yet made reasonable efforts with respect to the account. For patients and Guarantors who are unable to provide required documentation, a Hospital Facility may grant Presumptive Financial Assistance based on information obtained from other resources. Patients who qualify for Medicaid are presumed to qualify for full charity write off. Any charges for days or services written off (excluding Medicaid denials related to timeliness of billing, insufficient medical record documentation, missing invoices, authorization, or eligibility issues) as a result of a Medicaid are booked as charity. Some Medicaid plans offer coverage for a limited or restricted list of services. If a patient is eligible for Medicaid, any charges for days or services not covered by the patient's coverage may be written off to charity without a completed application. This does not include any Share of Cost (SOC) or other patient cost-sharing amounts such as deductibles or copayments, as such costs are determined by the state to be an amount that the patient must pay before the patient is eligible for Medicaid. Health and Human Services (HSS) uses the term "Spend Down" instead of Share of Cost. All collection activities conducted by the Facility, a Designated Supplier, or its third-party collection agents will be in conformance with all federal and state laws governing debt collection practices. All third-party agreements governing collection and recovery activities must include a provision requiring compliance with the hospital facilities' financial assistance and billing and collections policy and indemnification for failures as a result of its noncompliance. This includes, but is not limited to, agreements between third parties who subsequently sell or refer debt of the Hospital Facility.
Schedule H, Part V, Section B, Line 16a FAP website	- Lisbon Area Health Services: Line 16a URL: http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm;
Schedule H, Part V, Section B, Line 16b FAP Application website	- Lisbon Area Health Services: Line 16b URL: http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- Lisbon Area Health Services: Line 16c URL: http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm;
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Notification about the availability of Financial Assistance from CHI Hospital Organizations shall be disseminated by various means, which may include, but not be limited to: * Conspicuous publication of notices in patient bills; * Notices posted in emergency rooms, urgent care centers, admitting/registration departments, business offices, and at other public places as a Hospital Facility may elect; and * Publication of a summary of this Policy on the Hospital Facility's website, www.catholichealth.net, and at other places within the communities served by the Hospital Facility as it may elect. Such notices and summary information shall include a contact number and shall be provided in English, Spanish, and other primary languages spoken by the population served by an individual Hospital Facility, as applicable. Referral of patients for Financial Assistance may be made by any member of the CHI Hospital Organization non-medical or medical staff, including physicians, nurses, financial counselors, social workers, case managers, chaplains, and religious sponsors. A request for assistance may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws. In addition, Hospital registration clerks are trained to provide consultation to those who have no insurance or potentially inadequate insurance concerning their financial options including application for Medicaid and for assistance under the Financial Assistance Policy. Counselors assist Medicare eligible patients in enrollment by providing referrals to the appropriate government agencies. Once it is determined that the patient does not qualify for any third party funding, the patient is verbally notified about the existence of Financial Assistance Application and additional screening takes place by a Hospital employee to determine if the patient is eligible for charity service prior to discharge. Upon registration (and once all EMTALA requirements are met), patients who are identified as uninsured (and not covered by Medicare or Medicaid) are provided with a packet of information that addresses the Financial Assistance Policy, the plain language summary of that policy, and an application for assistance. Hospital registration clerks read the organization's medical assistance policy to those who appear to be incapable of reading, and provide translators for non-English-speaking individuals. Patients that have been discharged prior to charity screening, such as emergency room patients, receive a written notification of possible eligibility for services. If the patient is determined not to be eligible for government assistance, he/she may notify the hospital that they seek charity assistance. The appropriate charity form is sent to the patient/guarantor for completion and then returned to the hospital for evaluation and qualification. Once determination of eligibility is made, the patient is sent a notice informing him/her if they qualify for full, partial, or no charity care services. Hospital Facilities must make reasonable efforts through its billing and collections processes, pursuant to Treas. Reg. §1.501(r)-6(c), to determine whether any individual is eligible for Financial Assistance.
Schedule H, Part VI, Line 6 Affiliated health care system	The organization was, for the year ended 6/30/18, affiliated with Catholic Health Initiatives ("CHI"). Following the close of the 6/30/2018 tax year, on 2/1/19, in connection with the alignment of the Catholic ministries of CHI and Dignity Health, CHI changed its name to CommonSpirit Health. The narrative below reflects the activities of the organization's affiliate, CHI, as of and for the year ended 6/30/18: CHI, a nonprofit, faith-based health system formed in 1996 through the consolidation of four Catholic health systems, expresses its mission each day by creating and nurturing healthy communities in the hundreds of sites across the nation where we provide care. One of the nation's largest nonprofit health systems, Englewood, Colorado-based CHI serves as the Parent company of the system. It operates in 18 states and comprises 100 hospitals, including two academic health centers, major teaching hospitals as well as 29 critical-access facilities; community health-services organizations; accredited nursing colleges; home-health agencies; living communities; and other facilities and services that span the inpatient and outpatient continuum of care. In fiscal year 2018, CHI provided more than $1.1 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 $2.0 billion with the inclusion of the unpaid costs of Medicare. The health system, which generated operating revenues of $14.98 billion in fiscal year 2018, has total assets of approximately $20.6 billion. CHI provides strategic planning and management services as well as centralized "share services" for the MBOs. 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 MBOs. The cost savings achieved through CHI's centralization enable MBOS 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 I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
Charity Care	109	$0	$216,960	Book	REDUCTION OR WRITE OFF OF PATIENT SERVICES
Employee Assistance	3	$1,500	$0	N/A	(See Statement)

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule I, Part III CHARITY CARE

LISBON AREA HEALTH SERVICES RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. BUSINESS OFFICE STAFF HELPS PATIENTS SEEK LOCAL, STATE, AND FEDERAL REIMBURSEMENT AT NO CHARGE WHEN NO OTHER SOURCE OF PAYMENT IS AVAILABLE. FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS WITH DEMONSTRATED INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES. THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS ACCOUNTS RECEIVABLE.

Schedule I, Part III, Column (f) DESCRIPTION OF NON-CASH ASSISTANCE

EMPLOYEE ASSISTANCE: CHI Lisbon Health Employee Assistance Fund exists as a program for employees of CHI Lisbon Health. The fund reinforces CHI Lisbon Health's mission and values. Funds are available to employees facing personal tragedy or significant hardship. The program provides employees who are experiencing financial difficulties help with basic needs such as food, shelter, utilities and emergency travel. The fund will be available for current employees only. The maximum amount requested and/or awarded may not exceed $500 in a 12-month period. If an employee receives a partial gift, the employee may reapply for additional assistance in the year should the need arise. All applications/nominations will be reviewed by the MBO Executive Leadership Committee, however, it is not a guarantee of an award. The MBO Executive Leadership Committee decides who will receive an award by consensus. Once the Committee's decision is made, the applicant will be notified of the decision and supporting reasons.

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
PEGGY REINKE
PRESIDENT	$0	$171,281	$0	$29,729	$0	$24,237	$0	$2,466	$0	$11,713	$0	$239,426	$0	$0
JEFFREY DROP
Board Member/CHI SVP Division Officer	$0	$634,544	$0	$675,860	$0	$119,445	$0	$15,900	$0	$17,944	$0	$1,463,693	$0	$0
REBECCA THOMPSON
VP OPERATIONAL FINANCE (THROUGH 7/31/14)	$0	$150,260	$0	$15,093	$0	$24,490	$0	$18,548	$0	$15,136	$0	$223,527	$0	$9,902
AMBER STOWMAN
Division Director of Finance	$0	$105,416	$0	$14,187	$0	$5,230	$0	$8,859	$0	$23,418	$0	$157,110	$0	$0
OSCAR FERNANDEZ
PHYSICIAN	$153,975	$0	$9,790	$0	$13,406	$0	$12,283	$0	$19,816	$0	$209,270	$0	$0	$0
JILL MCRITCHIE
MANAGER PHARMACY	$127,282	$0	$12,319	$0	$598	$0	$8,339	$0	$20,773	$0	$169,311	$0	$0	$0
KEVIN JACOBSON
Nurse Practitioner	$130,485	$0	$0	$0	$1,687	$0	$8,019	$0	$15,159	$0	$155,350	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 4a SEVERANCE OR CHANGE-OF-CONTROL PAYMENTS	POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR CATHOLIC HEALTH INITIATIVES (CHI) 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. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2017 CALENDAR YEAR.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY 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 2017 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. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THAT PLAN: JEFFREY DROP PEGGY ANN REINKE REBECCA THOMPSON DURING 2017 THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: REBECCA THOMPSON - $7,624 DURING 2017 THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI FROM THE DEFERRED COMPENSATION PLAN: REBECCA THOMPSON - $9,903 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 2017 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 2017, the following contributions and associated gains or losses that would have been made by CHI to the deferred compensation plan were paid in cash: JEFFREY DROP - $94,433 PEGGY ANN REINKE - $8,609

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

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

Field	Value	IRS element (for citing)
Relationship Description	Substantial contributor	RelationshipDescriptionTxt
Transaction	$250,039	TransactionAmt
Transaction	Independent contractor arrangement - ER Physician Coverage	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part III, Line 1 ORGANIZATION'S MISSION	THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. FIDELITY TO THE GOSPEL URGES THE CORPORATION TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT CREATES HEALTHIER COMMUNITIES. THE CORPORATION, SPONSORED BY A LAY-RELIGIOUS PARTNERSHIP, CALLS OTHER CATHOLIC SPONSORS AND SYSTEMS TO UNITE TO ENSURE THE FUTURE OF CATHOLIC HEALTH CARE. 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.
Form 990, Part V, Line 1a number reported in Box 3 of Form 1096	PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF CATHOLIC HEALTH INITIATIVES (CHI) ARE MADE BY CHI. THEREFORE NO FORM 1099S ARE ISSUED BY THE ORGANIZATION. CHI FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099S ISSUED BY CHI ON BEHALF OF THE ORGANIZATION ARE REPORTED TO THE IRS.
Form 990, Part VI, Line 14 DOCUMENT RETENTION AND DESTRUCTION POLICY	THE ORGANIZATION HAS A DOCUMENT RETENTION AND DESTRUCTION POLICY THAT IT FOLLOWS; HOWEVER, THE POLICY HAD NOT BEEN FORMALLY ADOPTED BY THE ORGANIZATION'S GOVERNING BODY AT YEAR-END.
Form 990, Part VI, Line 15a PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL	THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION IS PAID BY CATHOLIC HEALTH INITIATIVES ("CHI"), A RELATED ORGANIZATION. CHI HAS A DEFINED COMPENSATION PHILOSOPHY. BOTH THE EXECUTIVE AND NON-EXECUTIVE COMPENSATION STRUCTURES AND RANGES ARE REVIEWED ANNUALLY IN COMPARISON TO MARKET DATA. CHI USES THE KORN FERRY HAY GROUP 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 IS REVIEWED ANNUALLY. THE KORN FERRY HAY GROUP REVIEWS BOTH CASH AND TOTAL COMPENSATION FOR OVERALL REASONABLENESS, FOR ADHERENCE TO CHI'S COMPENSATION PHILOSOPHY, AND FOR COMPARABILITY TO THE NOT-FOR-PROFIT HEALTHCARE MARKET. THIS INDEPENDENT REVIEW IS DELIVERED BY KORN FERRY HAY GROUP TO THE HR COMMITTEE OF THE CHI BOARD OF STEWARDSHIP TRUSTEES ANNUALLY AT THEIR SEPTEMBER MEETING AND MINUTES ARE SHARED WITH THE FULL BOARD AT THE DECEMBER MEETING. THE LAST REVIEW WAS SEPTEMBER 11, 2017. IN ADDITION, KORN FERRY HAY GROUP 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 HAVE BEEN REVIEWED ANNUALLY SINCE AND REVISED BASED ON MARKET DATA, WHERE APPLICABLE.
Form 990, Part VI, Line 15b PROCESS USED TO ESTABLISH COMPENSATION OF OTHER EMPLOYEES	DURING THE TAX YEAR ENDED 6/30/2018, NO OFFICERS, DIRECTORS OR TRUSTEES RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THEREFORE, THESE QUESTIONS ARE MORE APPROPRIATELY ANSWERED AS N/A.
Form 990, Part VI, Line 12c Conflict of Interest Policy	THE BOARD CHAIR OR DESIGNEE SHALL MAKE SUCH 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 WILL ASSUME THE CHAIR'S ROLE OUTLINED IN THE COI POLICY. BASED ON REVIEW AND EVALUATION OF THE RELEVANT FACTS AND CIRCUMSTANCES, THE BOARD CHAIR WILL MAKE 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, WILL BE MADE. THE BOARD CHAIR SHALL THEN MAKE AN APPROPRIATE REPORT TO THE EXECUTIVE COMMITTEE OF THE BOARD CONCERNING SUCH 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 WITHIN THE COI POLICY, THE MATTER SHALL BE SUBMITTED TO THE BOARD'S EXECUTIVE COMMITTEE, WHICH SHALL MAKE A FINAL DETERMINATION AS TO THE MATTER PRESENTED. SUCH DETERMINATION, INCLUDING RELEVANT FACTS AND CIRCUMSTANCES, WILL BE REFLECTED IN THE EXECUTIVE COMMITTEE MINUTES AND WILL BE REPORTED TO THE BOARD. THE BOARD SHALL CAREFULLY SCRUTINIZE 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 CORPORATE OFFICER EITHER: * HAS A MATERIAL FINANCIAL INTEREST; OR * IS A TRUSTEE OR CORPORATE OFFICER OF THE OTHER PARTY (OTHER THAN A CHI-AFFILIATED ORGANIZATION). THE BOARD MUST APPROVE THE TRANSACTION BY A MAJORITY OF THE TRUSTEES ON THE BOARD, WITHOUT COUNTING THE VOTE OF ANY INDIVIDUAL WHO HAS AN INTEREST IN THE TRANSACTION. 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 SHALL ACT NO MORE OR LESS FAVORABLY THAN IT WOULD IN REVIEWING TRANSACTIONS WITH UNRELATED THIRD PARTIES. THE TRANSACTION WILL NOT BE APPROVED UNLESS THE BOARD DETERMINES THAT THE TRANSACTION IS FAIR TO CHI OR THE CHI ENTITY. THE BOARD SHALL CAREFULLY REVIEW AND SCRUTINIZE 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.). BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES, THE BOARD SHALL TAKE WHATEVER ACTION IS DEEMED APPROPRIATE WITH RESPECT TO THE TRUSTEE OR CORPORATE OFFICER UNDER THE CIRCUMSTANCES, INCLUDING POSSIBLE DISCIPLINARY OR CORRECTIVE ACTION, IN ORDER TO BEST PROTECT THE INTERESTS OF CHI OR THE CHI ENTITY. THE BOARD SHOULD CONSULT WITH THE GENERAL COUNSEL OF CHI OR HIS OR HER DESIGNEE WHEN CONSIDERING DISCIPLINARY OR CORRECTIVE ACTION. WHEN ANY CONFLICT OF INTEREST IS CONSIDERED BY THE BOARD, THE TRUSTEE OR CORPORATE OFFICER, AS APPROPRIATE, MUST DISCLOSE ALL OF THE MATERIAL FACTS TO THE BOARD. THE TRUSTEE SHALL NOT VOTE AND THE TRUSTEE OR CORPORATE OFFICER SHALL NOT USE HIS OR HER PERSONAL INFLUENCE ON THE 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 OF SIGNIFICANT IMPORTANCE. THE TRUSTEE OR CORPORATE OFFICER SHALL BE EXCUSED FROM THE MEETING DURING DISCUSSION AND VOTE ON THE CONFLICT OF INTEREST. MINUTES OF THE BOARD SHALL REFLECT THE FOLLOWING: 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. IF THE BOARD REASONABLY BELIEVES THAT A TRUSTEE OR CORPORATE OFFICER HAS FAILED TO DISCLOSE EITHER AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, OR ALL MATERIAL FACTS SURROUNDING AN ACTUAL OR POSSIBLE CONFLICT AS REQUIRED BY THE COI POLICY, THE TRUSTEE OR CORPORATE OFFICER WILL BE GIVEN AN OPPORTUNITY TO EXPLAIN SUCH ALLEGED FAILURE TO DISCLOSE. AFTER HEARING THE RESPONSE OF THE TRUSTEE OR CORPORATE OFFICER, THE BOARD WILL CONDUCT SUCH ADDITIONAL INVESTIGATION AS MAY BE APPROPRIATE. IF THE BOARD DETERMINES THAT THE TRUSTEE OR CORPORATE OFFICER HAS IN FACT FAILED TO DISCLOSE AS REQUIRED BY THE COI POLICY, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION. ALL DETERMINATIONS OF CONFLICTS OF INTEREST ARE REPORTED AS REQUIRED BY LAW, REGULATIONS, AND CHI POLICY.
Form 990, Part VI, Line 1a Delegate broad authority to a committee	Pursuant to Section 8.6 of the Bylaws of Lisbon Area Health Services, the Executive Committee is composed of the board chair, the board vice chair, the President and CEO, each of whom shall serve as an ex officio voting member of the Executive Committee, and two voting members appointed by the Board of Directors. Each individual appointed to the Executive Committee shall serve for a term of one year or until his or her successor is duly appointed by the Board of Directors. The Executive Committee shall consist of only directors of the Corporation. Pursuant to Section 8.1 of the Corporation's bylaws, committees, such as the executive committee, that are granted the authority to act on behalf of the board of directors may include only directors of the corporation. Further, pursuant to Section 8.6 of the Corporation's bylaws, the executive committee has and may exercise such powers as may be delegated to it by the board of directors. The Executive Committee also possesses the power to transact routine business of the corporation in the interim period between regularly scheduled meetings of the board of directors.
Form 990, Part VI, Line 6 Classes of members or stockholders	According to the bylaws of Lisbon Area Health Services the entity's sole member is Catholic Health Initiatives, 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 Catholic Health Initiatives (CHI). 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 CHI Board directly or through powers delegated to the CHI Chief Executive Officer: * Substantial change in the mission or philosophy of the Lisbon Area Health Services * Amendment of the corporate documents of Lisbon Area Health Services * Approve members of the Lisbon Area Health Servicesboard * Removal of a member of the governing body of the Lisbon Area Health Services * Approval of issuance of debt by Lisbon Area Health Services * Approval of participation of Lisbon Area Health Servicesin a joint venture * Approval of formation of a new corporation by Lisbon Area Health Services * Approval of a merger involving Lisbon Area Health Services * Approval of the sale of all or substantially all of the assets of Lisbon Area Health Services * To require the transfer of assets by Lisbon Area Health Services to CHI to accomplish CHI's goals and objectives, and to satisfy CHI debts. * Adoption of long range and strategic plans for Lisbon Area Health Services Pursuant to Article V Section 5.5.2 of the organization's bylaws, CHI may, in exercise of its approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and the President and Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate. (CHCF Reserved Rights) Except as otherwise provided in the Corporation's Articles of Incorporation or the laws of the State of organization, Catholic Health Care Federation ("CHCF") shall have such rights as are reserved to the Corporate Member, acting in its capacity as the membership body of CHCF, under the Governance Matrix.
Form 990, Part VI, Line 11b Review of form 990 by governing body	Once the return is prepared, the return is presented to the board at a board meeting or an electronic copy of the return is sent to each board member by email for their review, etc. Subsequent to providing the return to the board, the tax department files the return with the appropriate federal and state agencies, making any non-substantive changes necessary to effect e-filing. Any such changes are not re-submitted to the board.
Form 990, Part VI, Line 12c Conflict of interest policy	CATHOLIC HEALTH INITIATIVES ("CHI") HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO MAINTAIN THE INTEGRITY OF ALL OF ITS ACTIVITIES. THE POLICY APPLIES TO CHI BOARD OF STEWARDSHIP TRUSTEES AND MEMBERS OF ITS COMMITTEES; ALL CHI ENTITY BOARD AND BOARD COMMITTEE MEMBERS; ALL CHI EMPLOYEES; AND ALL CHI RESEARCH PERSONNEL (BOTH EMPLOYED AND NON-EMPLOYED). DISCLOSURE, REVIEW AND MANAGEMENT OF PERCEIVED, POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON MUST 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 WHERE THE PERSON MAY BE IN DOUBT, A FULL DISCLOSURE SHOULD BE MADE TO PERMIT AN IMPARTIAL AND OBJECTIVE DETERMINATION. IN ADDITION TO THE GENERAL ONGOING OBLIGATION, THERE ARE INITIAL DISCLOSURE OBLIGATIONS. AT THE TIME OF INITIAL APPOINTMENT, A COPY OF THE POLICY SHALL BE DISTRIBUTED TO THE BOARD OR COMMITTEE MEMBER ALONG WITH A CONFLICT OF INTEREST DISCLOSURE. THE BOARD OR COMMITTEE MEMBER WILL COMPLETE AND SUBMIT THE DISCLOSURE. THE COMPLETED DISCLOSURE SHALL BE MAINTAINED IN CONFIDENCE AND ACCESS SHALL BE LIMITED TO PERSONS WHO HAVE A REASONABLE NEED TO KNOW THE CONTENTS. AT THE TIME OF HIRING, A COPY OF THE POLICY SHALL BE DISTRIBUTED TO ALL EMPLOYEES. IN ADDITION, A CONFLICT OF INTEREST DISCLOSURE WILL BE PROVIDED. THE EMPLOYEE MUST COMPLETE AND SUBMIT A CONFLICT OF INTEREST DISCLOSURE. THE COMPLETED DISCLOSURE SHALL BE MAINTAINED IN CONFIDENCE AND ACCESS SHALL BE LIMITED TO PERSONS WHO HAVE A REASONABLE NEED TO KNOW THE CONTENTS. IN ADDITION TO THE GENERAL ONGOING AND INITIAL DISCLOSURE OBLIGATIONS, THERE IS AN ANNUAL DISCLOSURE OBLIGATION. ON AN ANNUAL BASIS, THE FOLLOWING PERSONS MUST COMPLETE A NEW CONFLICT OF INTEREST DISCLOSURE: * BOARD AND BOARD COMMITTEE MEMBERS; * EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE; * RESEARCHERS * SUPPLY CHAIN EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE AND THOSE EMPLOYEES INVOLVED IN CONTRACTING REGARDLESS OF EMPLOYMENT LEVEL; * OTHER EMPLOYEES AS DEEMED APPLICABLE BY CHI LEADERSHIP DISCLOSURES OF PERCEIVED, POTENTIAL OR ACTUAL CONFLICTS INVOLVING FINANCIAL INTERESTS ARE FORWARDED TO THE CONFLICTS OF INTEREST REVIEW COMMITTEE ("C-CIRC"), NATIONAL OR REGIONAL LEGAL SERVICES, NATIONAL, ENTITY, OR RESEARCH CORPORATE RESPONSIBILITY PROGRAM, OR THE EXECUTIVE COMMITTEE OF THE BOARD OR BOARD CHAIR, FOR REVIEW DEPENDING ON THE POSITION OF THE PERSON INVOLVED. AMONG THE FACTORS THAT SHOULD BE CONSIDERED IN DETERMINING WHETHER A CONFLICT EXISTS ARE THE NATURE AND MAGNITUDE OF THE OPPORTUNITY, TRANSACTION OR ARRANGEMENT, THE DEGREE TO WHICH IT IS RELATED TO CHI'S BUSINESS, WHETHER THE PERSON WITH THE CONFLICT IS THE ULTIMATE DECISION-MAKER OR HOLDS SIGNIFICANT INFLUENCE OVER THE ULTIMATE DECISION-MAKER (I.E., DEGREE OF INDEPENDENCE OF THE DECISION-MAKING PROCESS), THE UNIQUE NATURE OF THE OPPORTUNITY, TRANSACTION OR ARRANGEMENT, THE EXISTENCE OF OTHER VIABLE ALTERNATIVES AND THE QUALITY OF THOSE ALTERNATIVES, AND WHAT IS CUSTOMARY AND REASONABLE IN THE HEALTH CARE OR RESEARCH INDUSTRY. WHEN A PERSON HAS, OR IS CONSIDERING INITIATING, A BUSINESS INTEREST OR RELATIONSHIP OUTSIDE OF CHI BUT IS UNCERTAIN WHETHER THE INTEREST CONSTITUTES A CONFLICT OF INTEREST REQUIRING DISCLOSURE UNDER THIS POLICY, THE PERSON SHOULD CONSULT WITH LOCAL CORPORATE RESPONSIBILITY PROGRAM (CRP) STAFF OR CHI LEGAL SERVICES GROUP (LSG) STAFF, AS APPROPRIATE. AS APPROPRIATE, A COI MANAGEMENT PLAN WILL BE DEVELOPED. WITH RESPECT TO THOSE AUDIENCES FOR WHICH THE C-CIRC HAS REVIEW RESPONSIBILITY, THE C-CIRC WILL FACILITATE DEVELOPMENT OF ANY SUCH COI MANAGEMENT PLAN IN COLLABORATION WITH LOCAL CRP STAFF OR CHI LSG STAFF, AS APPROPRIATE. THIS PLAN WILL INCLUDE DOCUMENTATION OF THE C-CIRC'S DETERMINATIONS AND RECOMMENDATIONS. AS NECESSARY, REPORTS TO AN APPROPRIATE GOVERNMENTAL AGENCY OR SPONSOR WILL BE MADE ACCORDING TO THE RELEVANT APPENDICES TO THIS POLICY TO PROVIDE REQUIRED INFORMATION REGARDING HOW THE CONFLICT OF INTEREST WILL BE MANAGED, REDUCED, OR ELIMINATED. DESIGNATED CHI ENTITY STAFF ARE RESPONSIBLE FOR MONITORING THE COI MANAGEMENT PLAN AND FOR DOCUMENTING MONITORING ACTIVITIES. AT ITS SOLE DISCRETION, A CHI 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. THE C-CIRC WILL DETERMINE WHETHER A DISCLOSED OR OTHERWISE IDENTIFIED INTEREST IS A CONFLICT OF INTEREST. IF THE C-CIRC DETERMINES THAT A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS THAT DOES NOT CURRENTLY HAVE APPROPRIATE CONTROLS TO ADDRESS THE CONFLICT OF INTEREST, IT MAY RECOMMEND THAT THE DISCLOSING PERSON BE ALLOWED TO PARTICIPATE IN THE ACTIVITY OR TRANSACTION SUBJECT TO RESTRICTIONS AS OUTLINED IN A WRITTEN COI MANAGEMENT PLAN. ALL DETERMINATIONS OF CONFLICTS OF INTEREST WILL BE REPORTED AS REQUIRED BY LAW, REGULATIONS, AND CHI POLICY. IF A PERSON, OTHER THAN A BOARD OR BOARD COMMITTEE MEMBER OR CORPORATE OFFICER, REQUIRED TO COMPLETE A COI DISCLOSURE 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 FOLLOWING STEPS SHOULD BE FOLLOWED. WITHIN A REASONABLE PERIOD OF TIME AFTER RECEIVING NOTICE OF THE C-CIRC'S DECISION, THE PERSON MUST PRESENT THE MATTER TO THE PERSON'S IMMEDIATE DIRECT MANAGER OR SUPERVISOR (OR IN THE CASE OF A RESEARCHER, TO [FILL IN THE TITLE OR POSITION TO WHOM RESEARCHERS REPORT]) AND REQUEST RECONSIDERATION, SUBMITTING AT THAT TIME ANY NEW OR ADDITIONAL INFORMATION THAT MAY SUPPORT OR RECOMMEND RECONSIDERATION. IF THE PERSON'S MANAGER INDIVIDUALLY OR IN CONSULTATION WITH THE MANAGER'S VICE PRESIDENT (OR HIGHER IF THE MANAGER IS A VICE PRESIDENT) FINDS THAT NEW INFORMATION SUPPORTING RECONSIDERATION HAS BEEN PRESENTED, THE MANAGER WILL CONTACT LOCAL OR NATIONAL CRP STAFF, AS APPROPRIATE, AND REQUEST THAT THE MATTER BE RE-PRESENTED TO THE C-CIRC. THE C-CIRC WILL BE RECONVENED FOR THIS PURPOSE AND, FOLLOWING SUCH RECONSIDERATION, ISSUE A FINAL DETERMINATION. THIS APPEALS PROCESS IS INTENDED TO BE NARROWLY APPLIED, AS PERSONS SEEKING CONFLICT OF INTEREST EXEMPTIONS OR EXCEPTIONS ARE EXPECTED TO OFFER ALL AVAILABLE INFORMATION SUPPORTING AN EXEMPTION OR EXCEPTION AT THE TIME THE MATTER IS FIRST PRESENTED TO THE C-CIRC. MANAGEMENT OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST OF BOARD OR BOARD COMMITTEE MEMBERS AND CORPORATE OFFICERS WILL BE DETERMINED BY THE APPROPRIATE BOARD, AS REFLECTED IN THE POLICY. REVIEWS AND DETERMINATIONS INVOLVING BOARD AND BOARD COMMITTEE MEMBERS AND CORPORATE OFFICERS WILL BE THE RESPONSIBILITY OF THE BOARD, BOARD EXECUTIVE COMMITTEE, OR BOARD CHAIR, WITH GUIDANCE FROM THE LEGAL SERVICES GROUP (LSG). EACH TRUSTEE AND CORPORATE OFFICER MUST PROMPTLY AND FULLY REPORT TO THE BOARD CHAIR SITUATIONS THAT MAY CREATE A CONFLICT OF INTEREST WHEN HE OR SHE BECOMES AWARE OF SUCH SITUATIONS. IN ANY SITUATION WHEN A TRUSTEE OR CORPORATE OFFICER IS IN DOUBT, FULL DISCLOSURE SHOULD BE MADE TO PERMIT AN IMPARTIAL AND OBJECTIVE DETERMINATION. A WRITTEN RECORD OF THE DISCLOSURE WILL BE MADE. IN ADDITION TO THE ONGOING DISCLOSURE OBLIGATION, ALL TRUSTEES AND CORPORATE OFFICERS SHALL COMPLETE A COI DISCLOSURE QUESTIONNAIRE ON AN ANNUAL BASIS. A COPY OF THE COI POLICY SHALL BE AVAILABLE TO TRUSTEES AND CORPORATE OFFICERS. DEFINITIONS OF TERMS USED IN THE DISCLOSURE QUESTIONNAIRE/FORM SHALL ALSO BE INCLUDED. EACH TRUSTEE AND CORPORATE OFFICER MUST PROMPTLY COMPLETE THE COI DISCLOSURE. COI DISCLOSURES THAT INVOLVE NO DISCLOSURES OF CONFLICTS OF INTEREST WILL NOT REQUIRE REVIEW. DISCLOSURES OF PERCEIVED, POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ON THE COI QUESTIONNAIRE INVOLVING FINANCIAL INTERESTS WILL BE REVIEWED BY NATIONAL OR REGIONAL LSG.
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 Catholic Health Initiatives' consolidated audited financial statements that are available at www.catholichealthinitiatives.org. In addition, the governing documents are available from the North Dakota Secretary of State.
Form 990, Part IX, Line 11g Other Fees	Other Fees for Services - Total Expense: 1075325, Program Service Expense: 708158, Management and General Expenses: 367167, Fundraising Expenses: 0; Consulting - Total Expense: 9370, Program Service Expense: 0, Management and General Expenses: 9370, Fundraising Expenses: 0; Contract Services - Total Expense: 967534, Program Service Expense: 967534, Management and General Expenses: 0, Fundraising Expenses: 0; Contract Labor - Total Expense: 174117, Program Service Expense: 174117, Management and General Expenses: 0, Fundraising Expenses: 0; Purchased Services - Total Expense: 652597, Program Service Expense: 489448, Management and General Expenses: 163149, Fundraising Expenses: 0;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Capital Resource Pool Contribution - -108084;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (186 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	HEALTHCARE	NE	501(c)(3)	3	ACH	Yes (true)
ALEGENT CREIGHTON HEALTH
12809 W DODGE RD	OMAHA	NE	68154	470757164	HEALTHCARE	NE	501(c)(3)	3	CHI NEBRASKA	Yes (true)
ALEGENT CREIGHTON HEALTH FOUNDATION
12809 W DODGE RD	OMAHA	NE	68154	470648586	FUNDRAISING	NE	501(c)(3)	7	ACH	Yes (true)
ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM
7500 MERCY RD	OMAHA	NE	68124	470484764	HEALTHCARE	NE	501(c)(3)	3	CHI NEBRASKA	Yes (true)
ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA
631 N 8TH ST	MISSOURI VALLEY	IA	51555	420776568	HEALTHCARE	IA	501(c)(3)	3	CHI NEBRASKA	Yes (true)
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
6901 N 72ND ST	OMAHA	NE	68122	470376615	HEALTHCARE	NE	501(c)(3)	3	CHI NEBRASKA	Yes (true)
ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER
104 W 17TH ST	SCHUYLER	NE	68661	470399853	HEALTHCARE	NE	501(c)(3)	3	CHI NEBRASKA	Yes (true)
ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA
PO BOX 368	CORNING	IA	50841	420782518	HEALTHCARE	IA	501(c)(3)	3	CHI NEBRASKA	Yes (true)
ALVERNA APARTMENTS
300 SE 8TH AVE	LITTLE FALLS	MN	56345	411351177	LTERM CARE	MN	501(c)(3)	10	CHI	Yes (true)
APPLETREE COURT
601 OAK ST	BRECKENRIDGE	MN	56520	411850500	SENIOR LIVING	MN	501(c)(3)	10	SFH	Yes (true)
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	Yes (true)
BAYLOR ST LUKE'S MEDICAL GROUP
6624 FANNIN ST STE 1100	HOUSTON	TX	77030	760458535	PHYSICIANS	TX	501(c)(3)	3	SLHS	Yes (true)
BELLEVILLE ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	274005511	HEALTHCARE	TX	501(c)(3)	3	SHSC	Yes (true)
BISHOP DRUMM RETIREMENT CENTER
5837 Winwood Dr	Johnston	IA	50131	420725196	LTERM CARE	IA	501(c)(3)	10	CHI-IA CORP	Yes (true)
BORNEMANN HEALTHCARE CORPORATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	232187242	HEALTHCARE	CO	501(c)(3)	Type I	CHI	Yes (true)
BRAZOSPORT HEALTH FOUNDATION INC
1 West Way Ct	LAKE JACKSON	TX	77566	760080110	FUNDRAISING	TX	501(c)(3)	Type I	BRHS	Yes (true)
BRAZOSPORT REGIONAL PHYSICIAN SERVICES
100 MEDICAL DRIVE	LAKE JACKSON	TX	77566	800240261	HEALTHCARE	TX	501(c)(3)	3	BRHS	Yes (true)
BURLESON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742759890	HEALTHCARE	TX	501(c)(3)	3	SJSC	Yes (true)
BURLESON ST JOSEPH MANOR
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742913931	HEALTHCARE	TX	501(c)(3)	10	SJSC	Yes (true)
CARRINGTON HEALTH CENTER
800 N 4TH ST	CARRINGTON	ND	58421	450227311	HEALTHCARE	ND	501(c)(3)	3	CHI	Yes (true)
CATHOLIC HEALTH INITIATIVES - COLORADO
9100 East Mineral Circle	Centennial	CO	80112	840405257	HEALTHCARE	CO	501(c)(3)	3	CHI	Yes (true)
CATHOLIC HEALTH INITIATIVES - IOWA CORP
1111 6TH AVE	DES MOINES	IA	50314	420680448	HEALTHCARE	IA	501(c)(3)	3	CHI	Yes (true)
CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
1150 Kelly Johnson Blvd 204	COLORADO SPRINGS	CO	80920	840902211	FUNDRAISING	CO	501(c)(3)	7	CHIC	Yes (true)
CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION
1150 Kelly Johnson Blvd 204	COLORADO SPRINGS	CO	80920	270930004	FUNDRAISING	CO	501(c)(3)	Type I	CHI	Yes (true)
CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	460992796	HEALTHCARE	CO	501(c)(3)	Type I	CHINS	Yes (true)
CENTENNIAL MEDICAL GROUP INC
2700 STEWART PKWY	ROSEBURG	OR	97471	263946191	PHYSICIANS	OR	501(c)(3)	10	MMC	Yes (true)
CENTRAL KANSAS MEDICAL CENTER
3515 BROADWAY	GREAT BEND	KS	67530	480543724	SURGERY CENTER	KS	501(c)(3)	3	CHI	Yes (true)
CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PKWY S	FARGO	ND	58104	271966847	HEALTHCARE	ND	501(c)(3)	10	CHI	Yes (true)
CHI INSTITUTE FOR RESEARCH AND INNOVATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	271050565	HEALTHCARE	CO	501(c)(3)	Type I	CHI	Yes (true)
CHI KENTUCKY INC
3900 OLYMPIC BLVD STE 400	ERLANGER	KY	41018	202741651	HEALTHCARE	KY	501(c)(3)	Type I	CHI	Yes (true)
CHI LIVING COMMUNITIES
5942 RENAISSANCE PLACE STE A	TOLEDO	OH	43623	341892096	HEALTHCARE	OH	501(c)(3)	Type II	SFH	Yes (true)
CHI Memorial Hospital - Georgia
100 GROSS CRESCENT CIRCLE	FORT OGLETHORPE	GA	30742	822748395	HEALTHCARE	GA	501(c)(3)	3	MHCS	Yes (true)
CHI NATIONAL HOME CARE
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	451261716	HEALTHCARE	CO	501(c)(3)	10	CHI NS	Yes (true)
CHI NATIONAL SERVICES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	452532084	HEALTHCARE	CO	501(c)(3)	Type I	CHI	Yes (true)
CHI NEBRASKA
12809 West Dodge Road	Omaha	NE	68510	363233121	HEALTHCARE	NE	501(c)(3)	Type I	CHI	Yes (true)
CHI ST JOSEPH CHILDREN'S HEALTH
1929 LINCOLN HWY E STE 150	LANCASTER	PA	17602	232342997	HEALTHCARE	PA	501(c)(3)	Type I	CHI	Yes (true)
CHI ST JOSEPH'S CHILDREN
1516 5TH ST NW	ALBUQUERQUE	NM	87102	710897107	COMMUNITY	NM	501(c)(3)	Type I	CHI	Yes (true)
CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER
6624 FANNIN ST 1100	HOUSTON	TX	77030	741161938	HEALTHCARE	TX	501(c)(3)	3	SLHS	Yes (true)
CHI ST VINCENT HOSPITAL HOT SPRINGS
300 WERNER ST	HOT SPRINGS	AR	71913	710236913	HEALTHCARE	AR	501(c)(3)	3	CHISVHS	Yes (true)
CHI ST VINCENT HOT SPRINGS
300 WERNER ST	HOT SPRINGS	AR	71913	261125064	HOLDING CO	AR	501(c)(3)	Type II	SVIMC	Yes (true)
CHI ST VINCENT MEDICAL GROUP HOT SPRINGS
300 WERNER ST	HOT SPRINGS	AR	71913	261125131	HEALTHCARE	AR	501(c)(3)	3	CHISVHS	Yes (true)
COMMONSPIRIT HEALTH
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	470617373	HEALTHCARE	CO	501(c)(3)	Type I	NA	Yes (true)
COMMUNITY LIMITED CARE DIALYSIS CENTER
619 OAK ST ACCOUNTING-3 W	CINCINNATI	OH	45206	237419853	HOLDING CO	OH	501(c)(4)		GSH	Yes (true)
COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION
631 N 8TH ST	MISSOURI VALLEY	IA	51555	421294399	FUNDRAISING	IA	501(c)(3)	Type I	AH-CMHMV	Yes (true)
CONTINUING CARE HOSPITAL
One Saint Joseph Drive	LEXINGTON	KY	40504	611400619	LT ACH	KY	501(c)(3)	3	SJHS	Yes (true)
East Texas Clinical Services
2801 VIA FORTUNA SUITE 500	AUSTIN	TX	78746	454736213	HEALTHCARE	TX	501(c)(3)	Type I	MHSET	Yes (true)
ENUMCLAW REGIONAL HOSPITAL ASSOCIATION
1455 BATTERSBY AVE	ENUMCLAW	WA	98022	910715805	HEALTHCARE	WA	501(c)(3)	3	FHS	Yes (true)
FLAGET HEALTHCARE INC
4305 NEW SHEPHERDSVILLE RD	BARDSTOWN	KY	40004	611345363	HEALTHCARE	KY	501(c)(3)	3	KOH	Yes (true)
FLAGET MEMORIAL HOSPITAL FOUNDATION INC
4305 NEW SHEPHERDSVILLE RD	BARDSTOWN	KY	40004	562351341	FUNDRAISING	KY	501(c)(3)	Type I	FH	Yes (true)
FRANCISCAN CARE CENTER
4111 N HOLLAND-SYLVANIA RD	TOLEDO	OH	43623	341931806	HEALTHCARE	OH	501(c)(3)	10	FLC	Yes (true)
FRANCISCAN FOUNDATION
1717 SOUTH J ST	TACOMA	WA	98405	911145592	FUNDRAISING	WA	501(c)(3)	10	FHS	Yes (true)
FRANCISCAN HEALTH SYSTEM
1717 SOUTH J ST	TACOMA	WA	98405	910564491	HEALTHCARE	WA	501(c)(3)	3	CHI	Yes (true)
FRANCISCAN HEALTH VENTURES FKA SJMGROUP
TACOMA FNC CTR BLDG 1145 BROADWAY	TACOMA	WA	98402	431882377	PHYSICIANS	WA	501(c)(3)	10	CHI	Yes (true)
FRANCISCAN MEDICAL GROUP
1313 BROADWAY STE 200	TACOMA	WA	98402	911939739	HEALTHCARE	WA	501(c)(3)	10	FHS	Yes (true)
FRANCISCAN VILLA OF SOUTH MILWAUKEE INC
3601 S CHICAGO AVE	SOUTH MILWAUKEE	WI	53172	391093829	HEALTHCARE	WI	501(c)(3)	10	CHI	Yes (true)
GARRISON MEMORIAL HOSPITAL
407 THIRD AVENUE SOUTHEAST	GARRISON	ND	58540	450227752	HEALTHCARE	ND	501(c)(3)	3	SAMC	Yes (true)
GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	201536108	MINISTRIES	CO	501(c)(3)	Type I	CHI	Yes (true)
GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE
619 OAK ST ACCOUNTING-3 W	CINCINNATI	OH	45206	311778403	EDUCATION	OH	501(c)(3)	2	GSH	Yes (true)
GOOD SAMARITAN FOUNDATION OF CINCINNATI INC
619 OAK ST ACCOUNTING-3 W	CINCINNATI	OH	45206	311206047	FUNDRAISING	OH	501(c)(3)	Type I	GSH	Yes (true)
GOOD SAMARITAN HOSPITAL
110 N MAIN ST STE 500	DAYTON	OH	45402	310536981	HEALTHCARE	OH	501(c)(3)	3	SHP	Yes (true)
GOOD SAMARITAN HOSPITAL
PO BOX 1990	KEARNEY	NE	68848	470379755	HEALTHCARE	NE	501(c)(3)	3	CHI NEBRASKA	Yes (true)
GOOD SAMARITAN HOSPITAL FOUNDATION
111 W 31ST ST	KEARNEY	NE	68847	470659443	FUNDRAISING	NE	501(c)(3)	7	GSH	Yes (true)
GOOD SAMARITAN HOSPITAL FOUNDATION - DAYTON
110 N MAIN ST STE 500	DAYTON	OH	45402	237296923	FUNDRAISING	OH	501(c)(3)	7	SHP	Yes (true)
HARRISON MEDICAL CENTER
2520 CHERRY AVE	BREMERTON	WA	98310	910565546	HEALTHCARE	WA	501(c)(3)	3	FHS	Yes (true)
HARRISON MEDICAL CENTER FOUNDATION
2520 CHERRY AVE	BREMERTON	WA	98310	911197626	FUNDRAISING	WA	501(c)(3)	7	HMC	Yes (true)
HEALTHCARE AND WELLNESS FOUNDATION
2400 ST FRANCIS DR	BRECKENRIDGE	MN	56520	760761782	FUNDRAISING	MN	501(c)(3)	Type I	SFMC	Yes (true)
HIGHLINE MEDICAL CENTER
16251 SYLVESTER RD SW	BURIEN	WA	98166	910712166	HEALTHCARE	WA	501(c)(3)	3	FHS	Yes (true)
HOUSE OF MERCY
1111 6TH AVE	DES MOINES	IA	50314	421323808	SHELTER	IA	501(c)(3)	7	CHI-IA CORP	Yes (true)
JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC
250 E Liberty St Ste 500	LOUISVILLE	KY	40202	611029768	HEALTHCARE	KY	501(c)(3)	3	KOH	Yes (true)
KENTUCKYONE HEALTH MEDICAL GROUP INC
100 E Liberty St Ste 800	LOUISVILLE	KY	40202	611352729	HEALTHCARE	KY	501(c)(3)	10	JHSMH	Yes (true)
KENTUCKYONE HEALTH INC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	611029769	HEALTHCARE	KY	501(c)(3)	Type II	CHI	Yes (true)
LAKEWOOD HEALTH CENTER
600 MAIN AVE S	BAUDETTE	MN	56623	410758434	HEALTHCARE	MN	501(c)(3)	3	CHI	Yes (true)
LAKEWOOD REGIONAL HEALTHCARE FOUNDATION
600 MAIN AVE S	BAUDETTE	MN	56623	411893795	FUNDRAISING	MN	501(c)(3)	7	LHC	Yes (true)
LINUS OAKES INC
2700 STEWART PKWY	ROSEBURG	OR	97471	930821381	SENIOR LIVING	OR	501(c)(3)	10	MMC	Yes (true)
LISBON AREA HEALTH SERVICES
905 MAIN ST	LISBON	ND	58054	820558836	HEALTHCARE	ND	501(c)(3)	3	CHI	Yes (true)
LUFKIN VISION ACQUISITIONS
PO BOX 1447	LUFKIN	TX	75901	820563768	PROPERTY MGMT	TX	501(c)(3)	Type I	MHSET	Yes (true)
MADISON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742761145	HEALTHCARE	TX	501(c)(3)	3	SJSC	Yes (true)
MADONNA MANOR INC
2344 AMSTERDAM ROAD	VILLA HILLS	KY	51017	610654635	LIVING ASSIST	KY	501(c)(3)	10	FLC	Yes (true)
MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC
2525 DE SALES AVE	CHATTANOOGA	TN	37404	621839548	FUNDRAISING	TN	501(c)(3)	7	MHCS	Yes (true)
MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVE	CHATTANOOGA	TN	37404	620532345	HEALTHCARE	TN	501(c)(3)	3	CHI	Yes (true)
MEMORIAL HEALTH PARTNERS FOUNDATION INC
5600 BRAINERD RD STE 500	CHATTANOOGA	TN	37411	030417049	HEALTHCARE	TN	501(c)(3)	10	MHCS	Yes (true)
MEMORIAL HEALTH SYSTEM OF EAST TEXAS
PO BOX 1447	LUFKIN	TX	75902	750755367	HEALTHCARE	TX	501(c)(3)	3	CHI	Yes (true)
MEMORIAL MEDICAL CENTER - LIVINGSTON
PO BOX 1447	LUFKIN	TX	75902	760436439	HEALTHCARE	TX	501(c)(3)	3	MHSET	Yes (true)
MEMORIAL MEDICAL CENTER - SAN AUGUSTINE
PO BOX 1447	LUFKIN	TX	75902	752663904	HEALTHCARE	TX	501(c)(3)	3	MHSET	Yes (true)
MEMORIAL MULTISPECIALTY ASSOCIATES
1201 FRANK AVE	LUFKIN	TX	95904	752721155	PHYSICIANS	TX	501(c)(3)	Type I	MHSET	Yes (true)
MEMORIAL SPECIALTY HOSPITAL
PO BOX 1447	LUFKIN	TX	95902	752492741	HEALTHCARE	TX	501(c)(3)	3	MHSET	Yes (true)
MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVE	DES MOINES	IA	50314	426076069	AUXILIARY	IA	501(c)(3)	Type I	MF-DM IA	Yes (true)
MERCY CLINICS INC
1111 6TH AVE	DES MOINES	IA	50314	421193699	PHYSICIANS	IA	501(c)(3)	10	CHI-IA CORP	Yes (true)
MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVE	DES MOINES	IA	50314	421511682	EDUCATION	IA	501(c)(3)	2	CHI-IA CORP	Yes (true)
MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVE	DES MOINES	IA	50314	237358794	FUNDRAISING	IA	501(c)(3)	7	CHI-IA CORP	Yes (true)
MERCY FOUNDATION INC
2700 STEWART PKWY	ROSEBURG	OR	97471	936088946	FUNDRAISING	OR	501(c)(3)	7	MMC	Yes (true)
MERCY HEALTH CARE FOUNDATION
PO BOX 368	CORNING	IA	50841	421461064	FUNDRAISING	IA	501(c)(3)	Type I	AHMH-Corning	Yes (true)
MERCY HEALTHCARE FOUNDATION
570 CHAUTAUQUA BLVD	VALLEY CITY	ND	58072	450435338	FUNDRAISING	ND	501(c)(3)	Type I	MHVC	Yes (true)
MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DR	COUNCIL BLUFFS	IA	51503	421178204	FUNDRAISING	IA	501(c)(3)	Type I	AHBMHS	Yes (true)
MERCY HOSPITAL OF DEVILS LAKE
1031 7TH ST NE	DEVILS LAKE	ND	58301	450227012	HEALTHCARE	ND	501(c)(3)	3	CHI	Yes (true)
MERCY HOSPITAL OF DEVILS LAKE FOUNDATION
1031 7TH ST NE	DEVILS LAKE	ND	58301	352367360	FUNDRAISING	ND	501(c)(3)	7	MHDL	Yes (true)
MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BLVD	VALLEY CITY	ND	58072	450226553	HEALTHCARE	ND	501(c)(3)	3	CHI	Yes (true)
MERCY MEDICAL CENTER
1301 15TH AVE WEST	WILLISTON	ND	58801	450231183	HEALTHCARE	ND	501(c)(3)	3	CHI	Yes (true)
MERCY MEDICAL CENTER - CENTERVILLE
ONE ST JOSEPHS DRIVE	CENTERVILLE	IA	52544	420680308	HEALTHCARE	IA	501(c)(3)	3	CHI-IA CORP	Yes (true)
MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER
204 N 4th Ave E	Newton	IA	50314	421470935	PHYSICIANS	IA	501(c)(3)	3	CHI-IA CORP	Yes (true)
MERCY MEDICAL CENTER INC
2700 STEWART PKWY	ROSEBURG	OR	97471	930386868	HEALTHCARE	OR	501(c)(3)	3	CHI	Yes (true)
MERCY MEDICAL FOUNDATION
1301 15TH AVE WEST	WILLISTON	ND	58801	450381803	FUNDRAISING	ND	501(c)(3)	Type I	MMC	Yes (true)
NEBRASKA HEART HOSPITAL
7500 S 91ST ST	LINCOLN	NE	68526	392031968	HEALTHCARE	NE	501(c)(3)	3	CHI NEBRASKA	Yes (true)
North Central Health Care Alliance dba PrimeCare Health Group
401 N 9th St	BISMARCK	ND	585014507	450439894	HEALTHCARE	ND	501(c)(3)	7	NHCA	Yes (true)
OAKES COMMUNITY HOSPITAL
1200 N 7TH ST	OAKES	ND	58474	450231675	HEALTHCARE	ND	501(c)(3)	3	CHI	Yes (true)
OAKES COMMUNITY HOSPITAL FOUNDATION
1200 N 7TH ST	OAKES	ND	58474	710966606	FUNDRAISING	ND	501(c)(3)	Type I	OCH	Yes (true)
PINEYWOODS MEDICAL DEVELOPMENT CORP
PO BOX 1447	LUFKIN	TX	75902	752493116	PROPERTY MGMT	TX	501(c)(3)	Type I	MHSET	Yes (true)
PROVIDENCE CARE CENTER
2025 HAYES AVENUE	SANDUSKY	OH	44870	341658625	HEALTHCARE	OH	501(c)(3)	10	FLC	Yes (true)
PROVIDENCE CARE CENTERS
2025 HAYES AVENUE	SANDUSKY	OH	44870	341826099	HOLDING CO	OH	501(c)(3)	Type II	FLC	Yes (true)
PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION
5055 PROVIDENCE DRIVE	SANDUSKY	OH	44870	341896807	LIVING COMM	OH	501(c)(3)	10	FLC	Yes (true)
PUEBLO STEPUP
1925 E ORMAN AVE STE G52	PUEBLO	CO	81004	841234295	COMMUNITY	CO	501(c)(3)	7	CHIC	Yes (true)
REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE
16251 Sylvester Road SW	Burien	WA	98166	911170040	HEALTHCARE	WA	501(c)(3)	3	FHS	Yes (true)
SET OF COLORADO SPRINGS INC
9100 E Mineral Circle	Centennial	CO	80112	841183335	LTERM CARE	CO	501(c)(3)	7	CHIC	Yes (true)
SAINT CLARE'S COMMUNITY CARE INC
25 POCONO RD	DENVILLE	NJ	07834	222876836	HEALTHCARE	NJ	501(c)(3)	10	SCHS	Yes (true)
SAINT CLARE'S FOUNDATION INC
25 POCONO RD	DENVILLE	NJ	07834	222502997	FUNDRAISING	NJ	501(c)(3)	7	SCHS	Yes (true)
SAINT CLARE'S HEALTH SERVICES INC
25 POCONO RD	DENVILLE	NJ	07834	223639733	MANAGEMENT	NJ	501(c)(3)	10	CHI	Yes (true)
SAINT CLARE'S HOSPITAL INC
25 POCONO RD	DENVILLE	NJ	07834	223319886	HEALTHCARE	NJ	501(c)(3)	3	SCHS	Yes (true)
SAINT ELIZABETH FOUNDATION
555 S 70TH ST	LINCOLN	NE	68510	470625523	FUNDRAISING	NE	501(c)(3)	7	SERMC	Yes (true)
SAINT ELIZABETH HEALTH SERVICES
555 S 70TH ST	LINCOLN	NE	68510	363233120	HEALTHCARE	NE	501(c)(3)	3	SERMC	Yes (true)
SAINT ELIZABETH REGIONAL MEDICAL CENTER
555 S 70TH ST	LINCOLN	NE	68510	470379836	HEALTHCARE	NE	501(c)(3)	3	CHI NEBRASKA	Yes (true)
SAINT FRANCIS MEDICAL CENTER
2620 W FAIDLEY	GRAND ISLAND	NE	68803	470376601	HEALTHCARE	NE	501(c)(3)	3	CHI NEBRASKA	Yes (true)
SAINT FRANCIS MEDICAL CENTER FOUNDATION
PO BOX 9804	GRAND ISLAND	NE	68802	470630267	FUNDRAISING	NE	501(c)(3)	7	SFMC	Yes (true)
SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC
305 ESTILL ST	BEREA	KY	40403	260152877	FUNDRAISING	KY	501(c)(3)	7	SJHS	Yes (true)
SAINT JOSEPH HEALTH SYSTEM INC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	611334601	HEALTHCARE	KY	501(c)(3)	3	KOH	Yes (true)
SAINT JOSEPH HOSPITAL FOUNDATION INC
701 Bob Olink Dr 200	LEXINGTON	KY	40504	611159649	FUNDRAISING	KY	501(c)(3)	Type I	SJHS	Yes (true)
SAINT JOSEPH LONDON FOUNDATION INC
1001 SAINT JOSEPH LANE	LONDON	KY	40741	260438748	FUNDRAISING	KY	501(c)(3)	7	SJHS	Yes (true)
SAINT JOSEPH MOUNT STERLING FOUNDATION INC
225 FALCON DR	MOUNT STERLING	KY	40353	272884584	FUNDRAISING	KY	501(c)(3)	7	SJHS	Yes (true)
SAINT JOSEPH'S HOSPITAL FOUNDATION
2500 Fairway Street	DICKINSON	ND	58601	363418207	FUNDRAISING	ND	501(c)(3)	Type I	SJHHC	Yes (true)
SAMARITAN BEHAVIORAL HEALTH INC
110 N MAIN ST STE 500	DAYTON	OH	45402	020633634	HEALTHCARE	OH	501(c)(3)	7	SHP	Yes (true)
SAMARITAN HEALTH PARTNERS
110 N MAIN ST STE 500	DAYTON	OH	45402	311107411	HEALTHCARE	OH	501(c)(3)	Type I	CHI	Yes (true)
SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC
104 W 17TH ST	SCHUYLER	NE	68661	363630014	FUNDRAISING	NE	501(c)(3)	Type I	AHMHS	Yes (true)
SJRMC JOPLIN MISSOURI
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	440545809	HEALTHCARE	CO	501(c)(3)	3	CHI	Yes (true)
ST ALEXIUS MEDICAL CENTER
900 EAST BROADWAY AVENUE	BISMARCK	ND	58501	450226711	HEALTHCARE	ND	501(c)(3)	3	CHI	Yes (true)
ST ANTHONY HOSPITAL
2801 St Anthony Way	PENDLETON	OR	97801	930391614	HEALTHCARE	OR	501(c)(3)	3	CHI	Yes (true)
ST ANTHONY HOSPITAL FOUNDATION
2801 St Anthony Way	PENDLETON	OR	97801	930992727	FUNDRAISING	OR	501(c)(3)	Type I	SAH	Yes (true)
ST ANTHONY'S HOSPITAL ASSOCIATION
FOUR HOSPITAL DR	MORRILTON	AR	72110	710245507	HEALTHCARE	AR	501(c)(3)	3	SVIMC	Yes (true)
ST CATHERINE HOSPITAL
401 EAST SPRUCE ST	GARDEN CITY	KS	67846	480543721	HEALTHCARE	KS	501(c)(3)	3	CHI	Yes (true)
ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION
401 EAST SPRUCE ST	GARDEN CITY	KS	67846	200598702	FUNDRAISING	KS	501(c)(3)	Type I	SCH	Yes (true)
ST CLARE COMMONS
12469 Five Point Road	TOLEDO	OH	43551	270163752	LIVING COMM	OH	501(c)(3)	10	FLC	Yes (true)
ST DOMINIC OF ONTARIO OREGON
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	930433692	HEALTHCARE	CO	501(c)(4)		CHI	Yes (true)
ST FRANCIS HOME
2400 ST FRANCIS DR	BRECKENRIDGE	MN	56520	410729978	LTERM CARE	MN	501(c)(3)	10	CHI	Yes (true)
ST FRANCIS LIFE CARE CORPORATION
19 POCONO RD	DENVILLE	NJ	07834	222536017	ELDERLY CARE	NJ	501(c)(3)	10	SCHS	Yes (true)
ST FRANCIS MEDICAL CENTER
2400 ST FRANCIS DR	BRECKENRIDGE	MN	56520	410695598	HEALTHCARE	MN	501(c)(3)	3	CHI	Yes (true)
ST JOSEPH FOUNDATION OF BRYAN TEXAS
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742351158	FUNDRAISING	TX	501(c)(3)	Type II	SJSC	Yes (true)
ST JOSEPH MANOR
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742847594	HEALTHCARE	TX	501(c)(3)	10	SJSC	Yes (true)
ST JOSEPH MEDICAL CENTER INC
201 INTERNATIONAL CIRCLE STE 212	HUNT VALLEY	MD	21030	520591461	HEALTHCARE	MD	501(c)(3)	3	CHI	Yes (true)
ST JOSEPH PHYSICIAN ASSOCIATES
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	203159302	HEALTHCARE	TX	501(c)(3)	3	SJSC	Yes (true)
ST JOSEPH PHYSICIAN ENTERPRISE INC
201 INTERNATIONAL CIRCLE STE 212	HUNT VALLEY	MD	21030	521311775	PHYSICIANS	MD	501(c)(3)	Type I	SJMC	Yes (true)
ST JOSEPH REGIONAL HEALTH CENTER
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	741282696	HEALTHCARE	TX	501(c)(3)	3	SJSC	Yes (true)
ST JOSEPH REGIONAL HEALTH PARTNERS
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	454088170	HEALTHCARE	TX	501(c)(3)	3	SJSC	Yes (true)
ST JOSEPH REGIONAL HEALTH PARTNERS ACO
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	463265423	HEALTHCARE	TX	501(c)(3)	10	SJSC	Yes (true)
ST JOSEPH SERVICES CORPORATION
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742455161	MANAGEMENT	TX	501(c)(3)	Type I	SFH	Yes (true)
ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVE	PARK RAPIDS	MN	56470	410695603	HEALTHCARE	MN	501(c)(3)	3	CHI	Yes (true)
ST JOSEPH'S HOSPITAL AND HEALTH CENTER
2500 Fairway St	DICKINSON	ND	58601	450226429	HEALTHCARE	ND	501(c)(3)	3	CHI	Yes (true)
ST LEONARD
8100 CLYO ROAD	CENTERVILLE	OH	45458	341940863	LIVING COMM	OH	501(c)(3)	10	FLC	Yes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	273733278	HEALTHCARE	TX	501(c)(3)	3	SLCDC	Yes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	261947374	HEALTHCARE	TX	501(c)(3)	3	SLHS	Yes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	260335902	HEALTHCARE	TX	501(c)(3)	3	SLCDC	Yes (true)
ST LUKE'S COMMUNITY HEALTH SERVICES
6624 FANNIN ST STE 1100	HOUSTON	TX	77030	760536234	HEALTHCARE	TX	501(c)(3)	3	SLHS	Yes (true)
ST LUKE'S FOUNDATION
1213 HERMANN DRIVE STE 855	HOUSTON	TX	77004	453811485	FUNDRAISING	TX	501(c)(3)	7	SLHS	Yes (true)
ST LUKE'S HEALTH SYSTEM CORPORATION
PO Box 20269	HOUSTON	TX	77225	760536232	MANAGEMENT	TX	501(c)(3)	Type I	CHI	Yes (true)
ST LUKE'S HOSPITAL AT THE VINTAGE
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	263734606	HEALTHCARE	TX	501(c)(3)	3	SLHS	Yes (true)
ST LUKE'S MEDICAL TOWER CORPORATION
6624 FANNIN ST STE 1100	HOUSTON	TX	77030	760531713	PROPERTY MGMT	TX	501(c)(3)	Type I	CHI-SLH	Yes (true)
ST LUKE'S PROPERTIES CORPORATION
1213 Hermann Drive Ste 855	HOUSTON	TX	77004	760531716	PROPERTY MGMT	TX	501(c)(3)	Type I	SLHS	Yes (true)
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	Yes (true)
ST MARY'S COMMUNITY HOSPITAL
1301 Grundman Boulevard	NEBRASKA CITY	NE	68410	470443636	HEALTHCARE	NE	501(c)(3)	3	CHI NEBRASKA	Yes (true)
ST MARY'S HOSPITAL FOUNDATION
1314 3RD AVE	NEBRASKA CITY	NE	68410	470707604	FUNDRAISING	NE	501(c)(3)	7	SMCH	Yes (true)
ST VINCENT FOUNDATION
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	510169537	FUNDRAISING	AR	501(c)(3)	Type I	SVIMC	Yes (true)
ST VINCENT INFIRMARY MEDICAL CENTER
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	710236917	HEALTHCARE	AR	501(c)(3)	3	CHI	Yes (true)
ST VINCENT MEDICAL GROUP
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	710830696	HEALTHCARE	AR	501(c)(3)	10	SVIMC	Yes (true)
SYLVANIA FRANCISCAN HEALTH
1715 INDIAN WOOD CIR 200	MAUMEE	OH	43537	341412964	HEALTHCARE	OH	501(c)(3)	Type I	CHI	Yes (true)
SYLVANIA FRANCISCAN HEALTH FOUNDATION
1715 INDIAN WOOD CIR 200	MAUMEE	OH	43537	455357161	FUNDRAISING	OH	501(c)(3)	Type I	FLC	Yes (true)
THE COMMONS OF PROVIDENCE
5000 PROVIDENCE DRIVE	SANDUSKY	OH	44870	341826097	ASSIST LIVING	OH	501(c)(3)	10	FLC	Yes (true)
THE COMMUNITY HOSPITAL OF BRAZOSPORT
100 MEDICAL DRIVE	LAKE JACKSON	TX	77566	741385192	HEALTHCARE	TX	501(c)(3)	3	SLHS	Yes (true)
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH
619 OAK ST ACCOUNTING-3 W	CINCINNATI	OH	45206	310537486	HEALTHCARE	OH	501(c)(3)	3	CHI	Yes (true)
THE HEART INSTITUTE OF DAYTON
110 N MAIN ST STE 500	DAYTON	OH	45402	300502367	HEALTHCARE	OH	501(c)(3)	10	CHS	Yes (true)
THE PHYSICIAN NETWORK
2000 Q ST STE 500	LINCOLN	NE	68503	470780857	PHYSICIANS	NE	501(c)(3)	Type I	CHI NEBRASKA	Yes (true)
TOTAL HEALTHCARE
9100 E Mineral Circle	Centennial	CO	80112	840927232	HEALTHCARE	CO	501(c)(3)	3	CHIC	Yes (true)
TRINITY HEALTH FOUNDATION
380 SUMMIT AVENUE	STEUBENVILLE	OH	43952	311329423	FUNDRAISING	OH	501(c)(3)	Type I	THS	Yes (true)
TRINITY HEALTH SYSTEM
380 SUMMIT AVENUE	STEUBENVILLE	OH	43952	341818681	HEALTHCARE	OH	501(c)(3)	Type I	SFH	Yes (true)
TRINITY HEALTH SYSTEM GROUP
380 SUMMIT AVENUE	STEUBENVILLE	OH	43952	300752920	HEALTHCARE	OH	501(c)(3)	Type II	THS	Yes (true)
TRINITY HOSPITAL TWIN CITY
819 NORTH FIRST STREET	DENNISON	OH	44621	275401105	HEALTHCARE	OH	501(c)(3)	3	SFH	Yes (true)
TRI-STATE HEALTH SERVICES INC
ONE ROSS PARK BLVD	STEUBENVILLE	OH	43952	341522484	ASSIST LIVING	OH	501(c)(3)	7	THS	Yes (true)
UNITY FAMILY HEALTHCARE
815 SE 2ND ST	LITTLE FALLS	MN	56345	410721642	HEALTHCARE	MN	501(c)(3)	3	CHI	Yes (true)
VILLA NAZARETH INC
801 PAGE DR	FARGO	ND	58103	450226714	LTERM CARE	ND	501(c)(3)	10	CHI	Yes (true)
VISITING NURSE ASSOCIATION OF ST CLARE'S INC
191 WOODPORT RD	SPARTA	NJ	07871	221768334	HOME HEALTH	NJ	501(c)(3)	10	SCHS	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (38 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct	UBI Code VUBICodeVAmt
Audubon Land Company LLC
630 Southpointe Court 200	COLORADO SPRINGS	CO	80906	841513085	Real Estate	CO	CHIC	Related	$298,037	$20,270,617	false	false	0.73
AVON EMERGENCY AND URGENT CARE CENTER LLC
9100 E Mineral Circle	Centennial	CO	80112	811727282	HEALTHCARE SRVC	CO	CHIC	Related	-$757,555	$6,191,153	false	Yes (true)	0.77
BAYLOR CHI ST LUKES HEALTH SERVICES LLC
6624 Fannin St Ste 1100	HOUSTON	TX	77030	472079184	HEALTHCARE SRVC	TX	SLHS	Related	$0	$3,250,000	false	Yes (true)	0.65
BERGAN MERCY SURGERY CENTER LLC
7710 Mercy Rd Ste 200	OMAHA	NE	68124	208671994	AMBUL SURG CTR	NE	ACH	Related	$1,187,048	$2,549,504	false	false	0.53
BERYWOOD OFFICE PROPERTIES LLC
2501 Citico Avenue	CHATTANOGA	TN	37404	621875199	PHYS OFFICE	TN	MHCS	Related	$133,390	$918,922	false	Yes (true)	0.63
BLUEGRASS REGIONAL IMAGING CENTER
1218 SOUTH BROADWAY STE 310	LEXINGTON	KY	40504	611386736	DIAGNOSTIC IMAGING	KY	SJHS	Related	$122,291	$3,216,558	false	false	0.65
CATHOLIC HEALTH INITIATIVES PHYSICIAN SERVICES LLC
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	462945938	PRACTICE MGMT SRVC	CO	CHI	Related	$1,263,355	-$272,620	false	Yes (true)	1
CENTRAL NEBRASKA REHABILITATION SERVICES LLC
3004 W FAIDLEY AVENUE	GRAND ISLAND	NE	68803	810653461	Physical Therapy	NE	SFMC	Related	$3,422,589	$3,722,591	false	false	0.51
CENTURA-SCA HOLDINGS LLC
569 BROOK VILLAGE STE 901	BIRMINGHAM	AL	35209	474823023	OP SURGERY CENTER	AL	CHIC	Related	$1,734,228	$2,020,115	false	Yes (true)	0.65
CHI OPERATING INVESTMENT PROGRAM LP
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	470727942	INVESTMENTS	CO	CHI	Unrelated	$468,697,209	$6,697,320,773	false	Yes (true)	1	$1,194,677
CHICAMSURG Surgery Centers LLC
1A Burton Hills Blvd	Nashville	TN	37215	465683027	SURGERY CENTER	TN	CHIC	Related	$76,843	$134,172	false	false	0.51
CHICLARKIN VENTURES LLC
9100 E Mineral Circle	Centennial	CO	80112	474210888	URGENT CARE	CO	CHIC	Related	$167,285	$7,823,355	false	Yes (true)	0.87
Colorado Springs CK Leasing LLC
630 Southpointe Court 200	COLORADO SPRINGS	CO	80906	262982714	REAL ESTATE	CO	CHIC	Related	$668,738	-$132,333	false	Yes (true)	0.52
FRANCISCAN SPECIALTY CARE LLC
680 SOUTH FOURTH STREET	LOUISVILLE	KY	40202	813725123	HEALTHCARE SRVC	KY	FHS	Related	$0	$101,598	false	Yes (true)	0.51
HC SL VINTAGE I LLC
18000 W SARAH LANE STE 250	BROOKFIELD	WI	53045	270453767	PROPERTY HOLDING	WI	SL HOSP-VINTAGE	Related	$1,686,676	$52,912,453	false	false	0.51
HEALTHCARE SUPPORT SERVICES LLC
PO BOX 9804	GRAND ISLAND	NE	68802	721546196	LAUNDRY	NE	na	Related	$376,035	$4,358,356	false	false	1
Heartland Oncology LLC
2337 E Crawford St	Salina	KS	67401	464265403	ONCOLOGY	KS	SCH	Related	-$403,368	$850,579	false	false	0.51
LAKESIDE AMBULATORY SURGICAL CENTER LLC
17031 LAKESIDE HILLS DR	OMAHA	NE	68130	204267902	AMBUL SURG CTR	NE	ACH	Related	$3,108,510	$2,029,071	false	false	0.6
LAKESIDE ENDOSCOPY CENTER LLC
17001 LAKESIDE HILLS PLZ STE 201	OMAHA	NE	68130	205544496	ENDOSCOPY SRVC	NE	ACH	Related	$699,620	$777,431	false	false	0.51
LINCOLN CK LEASING LLC
555 SOUTH 70TH STREET	Lincoln	NE	68510	262496856	Real Estate	NE	SERMC	Related	$812,108	$301,911	false	false	0.54
Mercy Rehabilitation Hospital LLC
680 SOUTH FOURTH STREET	LOUISVILLE	KY	40202	814437201	HEALTHCARE SRVC	KY	CHI IA	Related	$0	$1,138,872	false	false	0.51
NEBRASKA SPINE HOSPITAL LLC
6901 N 72ND ST STE 20300	OMAHA	NE	68122	270263191	SPINE HOSPITAL	NE	ACH	Related	$11,039,563	$19,771,159	false	false	0.51
NORTH RIVER SURGERY CENTER LLC
2209 WILDWOOD AVE	SHERWOOD	AR	72120	710799771	AMBUL SURG CTR	AR	SVIMC	Related	$279,520	$1,700,868	false	false	0.67
ORTHOCOLORADO LLC
11650 WEST 2ND PLACE	LAKEWOOD	CO	80228	371577105	ORTHO HOSPITAL	CO	CHIC	Related	$15,065,598	$3,364,245	false	false	0.6
Pasadena Urgency Center LLC
4600 E SAM HOUSTON PKWY SOUTH	PASADENA	TX	77505	812482854	URGENT CARE	TX	SLHS	Related	-$1,031,166	$1,686,969	false	false	0.57
PENINSULA RADIATION ONCOLOGY LLC
314 MLK JR WAY STE 11	TACOMA	WA	98405	870808610	HEALTHCARE SRVC	WA	FHS	Related	$377,689	$1,738,875	false	false	0.6
Penrad Imaging LLC
1390 Kelly Johnson Blvd	COLORADO SPRINGS	CO	80920	841072619	Medical Imaging	CO	CHIC	Related	-$2,396,662	$1,744,893	false	false	0.7
PMC HOSPITAL LLC
3100 MAIN ST STE 500	HOUSTON	TX	77002	273280598	HOSPITAL	TX	SL CDC-PMC	Related	$3,630,803	$64,361,393	false	Yes (true)	0.51
Pueblo Ambulatory Surgery Center LLC
25 Montebello Rd	Pueblo	CO	81003	621488737	SURGERY CENTER	CO	CHIC	Related	-$74,501	$210,538	false	false	0.51
Saint JOSEPH - PAML LLC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	452116736	MGMT SVCS	KY	SJHS	Related	-$19,517	$1,393,440	false	Yes (true)	0.63
SAINT JOSEPH - SCA HOLDINGS LLC
1451 Harrodsburg RD	LEXINGTON	KY	40503	453801157	OP SURGERY	KY	SJHS	Related	$0	$0	false	Yes (true)	0.51
SAINT JOSEPH-ANC HOME CARE SERVICES
1700 EDISON DR	MILFORD	OH	45150	263330545	HOME HEALTH	OH	CHINHC	Related	$4,139,859	$13,245,757	false	false	1
ST FRANCIS LAND COMPANY
5390 N ACADEMY BLVD STE 300	COLORADO SPRINGS	CO	80918	263134100	REAL ESTATE	CO	CHIC	Related	$151,050	$13,285,935	false	false	0.59
ST LUKE'S DIAGNOSTIC CATH LAB LLP
6624 FANNIN ST STE 800	HOUSTON	TX	77030	710959365	DIAGNOSTICS	TX	SLHS HOLDINGS	Related	$469,596	$609,938	false	Yes (true)	0.45
ST LUKE'S LAKESIDE HOSPITAL LLC
6624 FANNIN STE 2505	HOUSTON	TX	77030	300427437	HOSPITAL	TX	SL CDC-W	Related	$1,269,122	$36,450,234	false	Yes (true)	0.51
ST LUKE'S THE WOODLANDS SLEEP CENTER LLC
6624 FANNIN STE 800	HOUSTON	TX	77030	462795726	DIAGNOSTICS	TX	SLHSH	Related	-$76,895	$1,135,073	false	Yes (true)	0.51
SURGERY CENTER OF LEXINGTON LLC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	621179539	SURGERY CENTER	KY	SJHS	Related	-$108,052	$0	false	Yes (true)	0.51
THREE SPRING IMAGING LLC
1 Mercado St STE 200A	DURANGO	CO	81301	813571570	HEALTHCARE SRVC	CO	CHIC	Related	$76,753	$84,093	false	Yes (true)	0.51

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (62 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	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	CHI Nebraska	C Corporation	$9,217,638	$22,568,323	1	Yes (true)
All Saints Insurance Company SPC Ltd
				980556913	Insurance		CHI	C Corporation	$0	$0	1	Yes (true)	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	SJSC	C Corporation	$236,684	$699,916	1	Yes (true)
Alternative Insurance Management Service Inc
3900 OLYMPIC BLVD STE 400	Erlanger	KY	41018	841112049	Management Services	KY	CHI	C Corporation	$5,601	$6,045,874	1	Yes (true)
AMERICAN NURSING CARE Inc
1700 EDISON DR	MILFORD	OH	45150	311085414	HOME HEALTH	OH	CHS	C Corporation	$91,529,470	$56,968,045	1	Yes (true)
AMERIMED INC
1700 EDISON DR	MILFORD	OH	45150	311158699	HOME HEALTH	OH	ANC	C Corporation	$21,023,902	$15,079,827	1	Yes (true)
BC HOLDING COMPANY INC
1850 BLUEGRASS AVE	LOUISVILLE	KY	40215	311542851	Fitness Club	KY	JHSMH	C Corporation	$0	$0	1	Yes (true)
BrazoSport Health Alliance
1 WEST WAY COURT	LAKE JACKSON	TX	77566	760518376	Health Care	TX	BRHS	C Corporation	$134,400	$35,529	1	Yes (true)
Caduceus Medical Associates INC
5600 Brainerd Road Ste 500	Chattanooga	TN	37411	621570736	Healthcare	TN	MHCS	C Corporation	$0	$1,008	1	Yes (true)
Captive Management Initiatives Ltd
				980663022	Captive Management		CHI	C Corporation	$3,500	$176,569	1	Yes (true)	PO BOX 10073 APO	Georgetown	GRAND CAYMAN	CJ	KY11001	CJ
Carmona-DeSoto Building Horizontal Property Regime Inc
300 Werner St	Hot Springs	AR	71913	710771076	Healthcare	AR	CHI-SVHS	C Corporation	$0	$0	1	Yes (true)
Catholic Health Initiatives Center for Translational Research
198 INVERNESS DRIVE WEST	Englewood	CO	80112	272269511	Research	CO	CIRI	C Corporation	$497,688	$1,989,262	1	Yes (true)
CHI St Luke's Health Baylor College of Medicine Medical Center Condominium
6624 Fannin STE 1100	Houston	TX	77030	465079545	Condo Assoc	TX	CHI-SLHBCM	C Corporation	$0	$0	1	Yes (true)							Assoc
ClearRiver Health
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464495960	Insurance	CO	PHPSI	C Corporation	$80,448	$5,368,013	1	Yes (true)
Comcare Services Inc
5570 DTC Parkway	Englewood	CO	80111	840904813	Inactive	CO	CHIC	C Corporation	$0	$0	1	Yes (true)
CONSOLIDATED HEALTH SERVICES
1700 EDISON DR	MILFORD	OH	45150	311378212	HOME HEALTH	OH	CHI	C Corporation	$1,295,835	$52,264,929	1	Yes (true)
Des Moines Medical Center Inc
1111 6TH AVE	Des Moines	IA	50314	420837382	Real Estate	IA	CHI-IA Corp	C Corporation	$71,628	$1,079,124	0.93	Yes (true)
Diversified Health Resources Inc
100 MEDICAL DRIVE	LAKE JACKSON	TX	77566	760222679	Health Care	TX	BRHS	C Corporation	$22,442	$182,538	1	Yes (true)
First Initiatives Insurance LTD
				980203038	Insurance		CHI	C Corporation	$0	$0	1	Yes (true)	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	FHS	C Corporation	$3,755,671	$1,106,230	1	Yes (true)							e
Franciscan Services Inc
198 INVERNESS DRIVE WEST	Englewood	CO	80112	232487967	Healthcare	CO	CHI	C Corporation	$0	$15,522,048	1	Yes (true)
Good Samaritan Outreach Services
PO Box 1990	Kearney	NE	68848	470659440	Medical Clinic	NE	CHI Nebraska	C Corporation	$260,344	$212,541	1	Yes (true)
HarvestPlains Health of Iowa
32129 Weyerhaeuser Way S STE 201	FEDERAL WAY	WA	98001	473451750	Insurance	WA	QCHPS	C Corporation	$45,119	$3,244,070	1	Yes (true)
Health Systems Enterprises Inc
PO BOX 1990	Kearney	NE	68848	470664558	MGMT	NE	GSH	C Corporation	$150,551	$1,318,274	1	Yes (true)
Healthcare MGMT Services Organization INC
1149 MARKET ST	Tacoma	WA	98402	911865474	Health Org.	WA	FHS	C Corporation	$0	$0	1	Yes (true)
HeartlandPlains Health
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464368223	Insurance	CO	PHPSI	C Corporation	$5,739,433	$5,513,263	1	Yes (true)
Highline Medical Group
1717 S J Street	Tacoma	WA	98405	911407026	Medical Services	WA	HMC	C Corporation	$0	$0	1	Yes (true)
Medical Office Building Horizontal Property Regime Inc
300 Werner St	Hot Springs	AR	71913	710720429	Real Estate	AR	CHI-SVHS	C Corporation	$177,558	$81,158	0.77	Yes (true)
Medquest
1301 15TH AVENUE WEST	Williston	ND	58801	450392137	Sale of DME	ND	MMC Williston	C Corporation	$561,543	$852,276	1	Yes (true)
Memorial CV Service Line Management Company LLC
1201 W Frank Ave	Lufkin	TX	75904	463622849	Heath Care	TX	MHSET	C Corporation	$0	$0	1	Yes (true)
Mercy Park Apartments LTD
1111 6th AVE	Des Moines	IA	50314	421202422	Housing	IA	CHI-IA Corp	C Corporation	$951,900	$0	1	Yes (true)
Mercy Services Corp
2700 STEWART PARKWAY	Roseburg	OR	97471	930824308	Retail Sales	OR	MMC	C Corporation	$34,601	$126,694	1	Yes (true)
MHI Clinical Services
1201 W Frank Ave	Lufkin	TX	75904	461967952	Healthcare	TX	MHSET	C Corporation	$11,048,138	$1,739,550	1	Yes (true)
Mountain Management Services Inc
6028 Shallowford Rd	Chattanooga	TN	37421	621570739	MGMT SVC ORG	TN	MHCS	C Corporation	$13,439,403	$3,317,936	1	Yes (true)
PATIENT TRANSPORT SERVICES INC
1700 EDISON DR	MILFORD	OH	45150	311100798	HOME HEALTH	OH	ANC	C Corporation	$10,173,794	$6,744,244	1	Yes (true)
QCA Health Plan Inc
12615 Chenal Parkway STE 300	Little Rock	AR	72211	710794605	Insurance	AR	QCHI	C Corporation	$193,555,136	$75,365,153	1	Yes (true)
QualChoice Advantage
32129 WEYERHAEUSER WAY S STE 201	FEDERAL WAY	WA	98001	473433912	Insurance	WA	QCPS	C Corporation	$11,810,605	$6,432,511	1	Yes (true)
QualChoice Health Plan Services Inc (fka CollabHealth Plan Services Inc)
198 INVERNESS DRIVE WEST	Englewood	CO	80112	461224037	Admin Services	CO	QCHI	C Corporation	$63,300,575	$219,676,343	1	Yes (true)
QualChoice Health Inc (fka CollabHealth Managed Solutions Inc)
198 INVERNESS DRIVE WEST	Englewood	CO	80112	461222808	Holding Co	CO	CHI	C Corporation	$308,157	$1,222,966	1	Yes (true)
QualChoice Holdings Inc
198 INVERNESS DRIVE WEST	Englewood	CO	80112	274075520	Holding Co	CO	PHPS	C Corporation	$0	$9,944	1	Yes (true)
QualChoice Life and Health Insurance Company Inc
12615 Chenal Parkway STE 300	Little Rock	AR	72211	710386640	Insurance	AR	QCH	C Corporation	$111,184,831	$54,451,054	1	Yes (true)
QualChoice of Nebraska
2401 S 73rd St	Omaha	NE	68124	810738827	Insurance	NE	QCH	C Corporation	$0	$0	1	Yes (true)
RiverLink Health
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464380824	Insurance	CO	PHPS	C Corporation	$9,198,897	$6,690,368	1	Yes (true)
RiverLink Health of Kentucky Inc
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464828332	Insurance	CO	PHPS	C Corporation	$8,666,516	$6,927,980	1	Yes (true)
Ross Park Pharmacy Inc
380 SUMMIT AVE	STEUBENVILLE	OH	43952	341832654	Pharmacy	OH	THS	C Corporation	$1,513,328	$2,686,059	1	Yes (true)
Saint Clare's Primary Care Inc
198 INVERNESS DRIVE WEST	Englewood	CO	80112	222441202	Billing Services	CO	SCCC	C Corporation	$0	$0	1	Yes (true)
SAMARITAN FAMILY CARE INC
40 W FOURTH ST STE 1700	Dayton	OH	45402	311299450	Healthcare	OH	SHP	C Corporation	$29,440,066	$8,967,737	1	Yes (true)
SJH Services Corporation
198 INVERNESS DRIVE WEST	Englewood	CO	80112	232307408	Healthcare	CO	FSI	C Corporation	$0	$1,598,610	1	Yes (true)
SJL PHYSICIAN MANAGEMENT SERVICES INC
424 LEWIS HARGETT CR STE 160	Lexington	KY	40503	270164198	Mgmt	KY	SJHS	C Corporation	$0	$0	1	Yes (true)
SoundPath Health Inc
32129 Weyerhaeuser Way S STE 201	Federal Way	WA	98001	421720801	Insurance	WA	PHPS	C Corporation	$181,743,407	$66,769,322	1	Yes (true)
St Alexius Health Services Inc
900 East Broadway Avenue	Bismarck	ND	58501	450402812	Healthcare	ND	SAMC	C Corporation	$0	$0	1	Yes (true)
St Anthony Development Company
1415 Southgate	Pendleton	OR	97801	931216943	Athletic Club	OR	SAH	C Corporation	$1,609,675	$2,187,406	1	Yes (true)
St Joseph Development Company Inc
1717 SOUTH J ST	Tacoma	WA	98405	911480569	Rental	WA	FSI	C Corporation	$4,387,694	$34,715,309	1	Yes (true)
St Luke's Episcopal Hospital Physician Hospital Organization Inc
6720 Bertner MC4-262	Houston	TX	77030	760377932	PHO	TX	CHI-SLH	C Corporation	$0	$0	1	Yes (true)
St Luke's Health System Holdings Inc
6624 Fannin STE 800	Houston	TX	77030	760637138	Holding Co	TX	SLHS	C Corporation	$3,074,493	$39,559,748	1	Yes (true)
St Vincent Community Health Services Inc
TWO ST VINCENT CIRCLE	Little Rock	AR	72205	710710785	Healthcare	AR	SVIMC	C Corporation	$4,768,531	$29,679,087	1	Yes (true)
StableView Health Inc
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464373713	Insurance	CO	PHPS	C Corporation	$62,195	$5,180,266	1	Yes (true)
STE Holdings
12809 West Dodge Rd	Omaha	NE	68154	822383629	Holding Co	NE	SERMC	C Corporation	$334,599	$2,195,538	1	Yes (true)
Sugar Land Doctor Group
1317 Lake Point Parkway	Sugar Land	TX	77478	454270163	Medical Clinic	TX	SLCDC-SL	C Corporation	$0	$0	1	Yes (true)
The Texas Heart Institute at St Luke's Episcopal Hospital Denton A Cooley B
6624 Fannin STE 1100	Houston	TX	77030	900064009	Condo Assoc	TX	CHI-SLH	C Corporation	$0	$0	1	Yes (true)							uilding Comdominium Association
Towson Management Inc
7601 OSLER DR	Towson	MD	21204	521710750	Mgmt Services	MD	FSI	C Corporation	$0	$0	1	Yes (true)
TRINITY MANAGEMENT SERVICES ORGANIZATION
380 SUMMIT AVE	STEUBENVILLE	OH	43952	341471026	Mgmt Services	OH	THS	C Corporation	$13,543,963	$184,008	1	Yes (true)

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