MEMORIAL MEDICAL CENTER-SAN AUGUSTINE: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- MEMORIAL MEDICAL CENTER-SAN AUGUSTINE (EIN 75-2663904)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-10
- IRS object ID
- 201921309349304727
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-10T22:02:22-05:00 | 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 | 752663904 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Memorial Medical Center - San Augustine | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MEMO | BusinessNameControlTxt |
| Phone | 9366348111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 1447 | AddressLine1Txt |
| City | LUFKIN | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75902 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Duane C Miller | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2019-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANGELA NOEL | PreparerPersonNm |
| PTIN | P01051055 | PTIN |
| Phone | 7208741500 | 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 ST LUKE'S HEALTH MEMORIAL SAN AUGUSTINE | BusinessNameLine1Txt |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DARLENE WILLIAMS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 1447 | AddressLine1Txt |
| City | LUFKIN | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75902 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,834,406 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://www.chistlukeshealthmemorial.org/centers/san-augustine/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION IS TO SUPPORT, MANAGE, AND FURNISH FACILITIES TO PROVIDE QUALITY CRITICAL ACCESS TO HEALTHCARE SERVICES FOR THE CITIZENS OF SAN AUGUSTINE AND SURROUNDING COUNTIES AND TO FACILITATE AND ENCOURAGE EDUCATION AND TRAINING ACTIVITIES TO PROMOTE THE HEALTH AND WELFARE OF THOSE CITIZENS. 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 | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 56 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $244 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,390,536 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,823,148 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,924 | PYInvestmentIncomeAmt |
| CY Investment Income | $964 | CYInvestmentIncomeAmt |
| PY Other Revenue | $16,102 | PYOtherRevenueAmt |
| CY Other Revenue | $10,294 | CYOtherRevenueAmt |
| PY Total Revenue | $6,408,562 | PYTotalRevenueAmt |
| CY Total Revenue | $7,834,406 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,230,972 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,174,403 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,383,385 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,252,688 | PYOtherExpensesAmt |
| CY Other Expenses | $3,018,663 | CYOtherExpensesAmt |
| PY Total Expenses | $6,427,091 | PYTotalExpensesAmt |
| CY Total Expenses | $7,633,020 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$18,529 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $201,386 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,141,517 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,720,937 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,755,808 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,133,842 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$5,614,291 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$5,412,905 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION IS TO SUPPORT, MANAGE AND FURNISH FACILITIES TO PROVIDE QUALITY CRITICAL ACCESS HEALTHCARE SERVICES FOR THE CITIZENS OF SAN AUGUSTINE AND SURROUNDING COUNTIES AND TO FACILITATE AND ENCOURAGE EDUCATION AND TRAINING ACTIVITIES TO PROMOTE THE HEALTH AND WELFARE OF THOSE CITIZENS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $6,731,975 | ExpenseAmt |
| Grant | $1,230,972 | GrantAmt |
| Revenue | $7,824,050 | RevenueAmt |
| Desc | HOSPITAL SERVICES PROVIDED TO PATIENTS IN SAN AUGUSTINE AND SURROUNDING AREA, INCLUDING 211 ADMISSIONS, 8,728 OUTPATIENT VISITS, 5,324 EMERGENCY ROOM VISITS AND 575 PATIENT DAYS. | Desc |
| Total Program Service Expenses | $6,731,975 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | 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 | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | 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 | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | 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 | 56 | 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 | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 | false | 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 | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | 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 | Duane Miller | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9366397130 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 W FRANK AVENUE | AddressLine1Txt |
| City | LUFKIN | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75904 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 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 |
|---|---|---|---|---|---|---|---|---|---|
| CARL RAY POLK | |||||||||
| CHAIRMAN | 1.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MONTE BOSTWICK | |||||||||
| MARKET CEO | 1.0 | 52.0 | Yes (X) | Yes (X) | $0 | $410,065 | $52,887 | ||
| MIKE ARNOLD M D | |||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $24,810 | $0 | |||
| RAVINDER BACHIREDDY M D | |||||||||
| DIRECTOR | 1.0 | 2.0 | Yes (X) | $0 | $161,023 | $0 | |||
| MARLO BRAWNER MD | |||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| JUDY B COCHRAN | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| Michael Covert | |||||||||
| Pres & CEO CHI St. Luke's Health System (partial year) | 1.0 | 59.0 | Yes (X) | $0 | $2,147,178 | $42,502 | |||
| TREY DENMAN | |||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| CORKY EVANS | |||||||||
| DIRECTOR | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| JULE FENLEY | |||||||||
| DIRECTOR | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| GEORGE FIDONE M D | |||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| JOHN F GLICK | |||||||||
| Director | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | |||
| DEMETRESS HARRELL | |||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| M HUNT HUBER M D | |||||||||
| DIRECTOR | 1.0 | 2.0 | Yes (X) | $0 | $396,646 | $0 | |||
| T DOUGLAS LAWSON | |||||||||
| Pres & CEO CHI St. Luke's Health System (Beginning March 2018) | 1.0 | 59.0 | Yes (X) | $0 | $0 | $0 | |||
| CHERIPARAMBIL MANI MD | |||||||||
| Director | 1.0 | 2.0 | Yes (X) | $0 | $42,204 | $0 | |||
| BEN R OGLETREE JR | |||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| JANE AINSWORTH | |||||||||
| DIRECTOR | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| STEPHEN RALEY | |||||||||
| DIRECTOR | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| Duane Miller | |||||||||
| CFO | 5.0 | 35.0 | Yes (X) | $0 | $132,392 | $9,565 | |||
| DARLENE WILLIAMS | |||||||||
| ADMINISTRATOR, CNE | 13.0 | 27.0 | Yes (X) | $155,077 | $0 | $23,073 | |||
| Ashley London | |||||||||
| Director of Operations | 40.0 | 0 | $113,751 | $0 | $12,564 | Yes (X) | |||
| William Skinner | |||||||||
| RN | 40.0 | 0 | $109,770 | $0 | $8,851 | Yes (X) | |||
| GARY N LOOPER | |||||||||
| Former Director | 0.0 | 40.0 | $0 | $122,955 | $14,357 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $378,598 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,437,273 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $163,799 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Texas EM-1 Medical Services | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7032 COLLECTION CENTER DR | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60693 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | ER PHYSICIANS | ServicesDesc |
| Compensation | $407,979 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $7,823,148 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,823,148 | RelatedOrExemptFuncIncomeAmt |
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 | $7,823,148 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $364 | TotalRevenueColumnAmt |
| Exclusion | $364 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $600 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $600 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $600 | TotalRevenueColumnAmt |
| Exclusion | $600 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA SERVICES | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $9,148 | TotalRevenueColumnAmt |
| Exclusion | $9,148 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,146 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $902 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $244 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $10,294 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,834,406 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,824,050 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $244 | UnrelatedBusinessRevenueAmt |
| Exclusion | $10,112 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,230,972 | TotalAmt |
| Program Services | $1,230,972 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,077 | TotalAmt |
| Management And General | $155,077 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,437,387 | TotalAmt |
| Program Services | $2,421,798 | ProgramServicesAmt |
| Management And General | $15,589 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,626 | TotalAmt |
| Program Services | $32,329 | ProgramServicesAmt |
| Management And General | $2,297 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $573,033 | TotalAmt |
| Program Services | $532,596 | ProgramServicesAmt |
| Management And General | $40,437 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,262 | TotalAmt |
| Program Services | $171,253 | ProgramServicesAmt |
| Management And General | $12,009 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,903 | TotalAmt |
| Management And General | $12,903 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,764 | TotalAmt |
| Management And General | $13,764 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245 | TotalAmt |
| Management And General | $245 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,046,996 | TotalAmt |
| Program Services | $935,653 | ProgramServicesAmt |
| Management And General | $111,343 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,960 | TotalAmt |
| Management And General | $3,960 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $313,609 | TotalAmt |
| Program Services | $300,607 | ProgramServicesAmt |
| Management And General | $13,002 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,382 | TotalAmt |
| Program Services | $130,382 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,330 | TotalAmt |
| Program Services | $1,035 | ProgramServicesAmt |
| Management And General | $295 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $257,473 | TotalAmt |
| Program Services | $257,473 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,665 | TotalAmt |
| Program Services | $37,665 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Patient Care Supplies | $554,315 | $554,315 | |
| Home Office Cost Allocation | $483,468 | $483,468 | |
| Repairs & Maintenance | $113,509 | $103,118 | $10,391 |
| Rents & Leases - Equipment | $4,641 | $4,641 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,403 | TotalAmt |
| Program Services | $18,138 | ProgramServicesAmt |
| Management And General | $26,265 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,633,020 | TotalAmt |
| Program Services | $6,731,975 | ProgramServicesAmt |
| Management And General | $901,045 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,420 | BOYAmt |
| EOY | $7,832 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $324,877 | BOYAmt |
| EOY | $532,448 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,788 | BOYAmt |
| EOY | $97,458 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,128 | BOYAmt |
| EOY | $34,040 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,092,405 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,618,607 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $678,557 | BOYAmt |
| EOY | $473,798 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,747 | BOYAmt |
| EOY | $575,361 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,141,517 | BOYAmt |
| EOY | $1,720,937 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $420,486 | BOYAmt |
| EOY | $458,507 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,335,322 | BOYAmt |
| EOY | $6,675,335 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,755,808 | BOYAmt |
| EOY | $7,133,842 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$5,614,291 | BOYAmt |
| EOY | -$5,412,905 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$5,614,291 | BOYAmt |
| EOY | -$5,412,905 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,141,517 | BOYAmt |
| EOY | $1,720,937 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $201,386 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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 | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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 | $245 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $245 | 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 - 245 |
| 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 - 245 |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $98,481 | OtherCostOrOtherBasisAmt |
| Depreciation | $31,898 | DepreciationAmt |
| Book Value | $66,583 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,993,924 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,586,709 | DepreciationAmt |
| Book Value | $407,215 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $473,798 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATE | $394,006 |
| Estimated Third Party Settlements | $181,355 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $575,361 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED THIRD PARTY SETTLEMENTS | |
| DUE TO AFFILIATES | $6,675,335 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,675,335 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | MEMORIAL MEDICAL CENTER - SAN AUGUSTINE'S 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." | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $342,333 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $342,333 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0536 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $935,610 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $935,610 | DirectOffsettingRevenueAmt |
| 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 | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,277,943 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $935,610 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $342,333 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0536 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | 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) |
|---|---|---|
| Total Community Benefit Expns | $5,969 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,969 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0009 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $5,969 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,969 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0009 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,283,912 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $935,610 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $348,302 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0545 | 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) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | 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) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | 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) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | 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 | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $329,070 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,672,785 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,963,125 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$290,340 | 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 | MMC - SAN AUGUSTINE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 511 E HOSPITAL ST | AddressLine1Txt |
| City | SAN AUGUSTINE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75972 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https://www.chistlukeshealthmemorial.org/ | WebsiteAddressTxt |
| State License | 000072 | 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 | MMC - SAN AUGUSTINE | 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 | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.chistlukeshealthmemorial.org/about/health-needs-assessment | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | false | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (true) | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.0 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.chistlukeshealthmemorial.org/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.chistlukeshealthmemorial.org/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.chistlukeshealthmemorial.org/ | 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 | false | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - MMC - SAN AUGUSTINE. The CHI St. Luke's Health Healthy Communities Department, located in Houston, TX, collaborated with Saurage Marketing Research, Inc., selected Memorial staff, and community organizations to conduct the Memorial CHNA. A survey, prepared by Saurage Marketing Research, Inc. in March 2016, was distributed via email and telephone to residents residing within the Memorial service area. Telephone interviews were also performed with Memorial employed physicians and focus groups including Memorial staff and community members were held. Survey, interview and focus group results were analyzed in April in order to report to the hospital leadership and the larger community as part of the CHNA. These results will be prioritized by Memorial executive leadership and the Mission Integration Department will work with hospital and community leaders to create the Community Health Improvement Plan and Implementation Strategy by November. The names, titles, organizations, and roles of those involved in the CHNA were as follows: -VALERIE MATTICE AUSBORN, PROJECT COORDINATOR CHI ST. LUKE'S HEALTH SYSTEM, OVERALL CHNA PROJECT MANAGEMENT -JAY GILCHRIST VICE PRESIDENT CHI ST. LUKE'S MEMORIAL, MISSION, CHNA PROJECT, MANAGEMENT -MIKE SULLIVAN, PHD DIRECTOR CHI ST. LUKE'S HEALTH SYSTEM, HEALTHY COMMUNITIES, TECHNICAL ASSISTANCE -JANICE LAMY VICE PRESIDENT CHI ST. LUKE'S HEALTH SYSTEM, MARKETING & COMMUNICATION, TECHNICAL ASSISTANCE -YANA OGLETREE DIRECTOR CHI ST. LUKE'S MEMORIAL, MARKETING & COMMUNICATION TECHNICAL ASSISTANCE -SUSAN SAURAGE PRESIDENT SAURAGE MARKETING RESEARCH INC. QUALITATIVE DATA ANALYSIS -Vickie Cooper Dietary Manager CHI St. Luke's Health, Focus Group Staff Participant -Janice Napier Nurse Practitioner CHI St. Luke's Health, Focus Group Staff Participant -Norrell Thomas Advisory Board, CHI St. Luke's Health Memorial-San Augustine Focus Group Participant Community Stakeholders: -David Parks - Director Boys & Girls Club San Augustine -Virginia Liepman - Superintendent San Augustine School District -Samye Johnson -San Augustine County Judge-Executive -Leasa Dunn - San Augustine High School Principal -Sandy Jenkins - County Extension Agent -Shane Bridges - County Extension Agent/LVN -LaTasha Byrd - San Augustine Chamber of Commerce |
| Schedule H, Part V, Section B, Line 6a Facility , 1 | Facility , 1 - MMC - SAN AUGUSTINE. A comprehensive Community Health Needs Assessment (CHNA) was conducted for CHI St. Luke's Health-Memorial from March-May 2016. CHI St. Luke's Health-Memorial includes four hospital facilities: (1) MEMORIAL MEDICAL CENTER OF EAST TEXAS (LUFKIN), (2) MEMORIAL MEDICAL CENTER - LIVINGSTON, (3) MEMORIAL MEDICAL CENTER - SAN AUGUSTINE, AND (4) MEMORIAL SPECIALTY HOSPITAL. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - MMC - SAN AUGUSTINE. The Memorial Health System of East Texas (MHSET) prioritized eight needs that were identified in the 2017-19 Community Health Needs Assessment. Executive leadership studied the triennial assessment during the beginning of the year, and they developed Implementation Strategies in the following categories: Access to Care, Providers; Awareness and Communication of Resources; Education; and Special Programs and Improvements. Those strategies are as follows. 1. ACCESS TO CARE Increase access to care for the very old and very young; and people who are transient, homeless, indigent, disabled and low-income. 2. PROVIDERS Increase local providers through a mission-focused market plan. 3. AWARENESS & COMMUNICATION OF RESOURCES Make people more aware of available health services, education and support. 4. EDUCATION Raise the importance of the prevention of disease through healthy living, exercise and nutrition. 5-8 -- SPECIAL PROGRAMS & IMPROVEMENTS 5. Identify lower cost sources for meds, healthy foods and medical care. 6. Minimize use of ER for primary and routine care. 7. Explore partnership with churches already credible and involved in the community 8. Develop a partnership between Memorial Clinics and the Direct Practice Improvement Project. Focus on preventing polypharmacy, and on a stronger social services component The CHI St. Luke's Health Memorial executive team developed objectives to target activities and services to directly address these seven priorities. The objectives were identified by studying the prioritized health needs within the context of the hospital's strategic plan and the availability of finite resources. To develop the strategies an additional round of community partner meetings was held, and the Healthy Communities Council, in consultation with CHI St. Luke's Health Texas Division Healthy Communities Team, made recommendations to the Executive Team. The Executive Team took the suggestions flowing from the new 2017-19 Community Health Needs Assessment and developed strategies for the Memorial Healthy Communities Team. An Action Plan flow chart was created to track progress, and to keep executive and departmental leadership advised and ensure their collaboration. Use of the Community Benefit Inventory for Social Accountability (CBISA) software was inaugurated to begin to track staff involvement in community health improvement and general community building. Sound progress was made on each priority, as identified in this evaluative summary of the implementation strategies carried out for each objective. 1. ACCESS TO CARE Increase access to care for the very old and very young; and people who are transient, homeless, indigent, disabled and low-income. Objective A: Provide additional resources (education series, brochures, etc. in English and Spanish) and services. - Memorial Health System of East Texas' Cancer Committee is evaluating the possibility of offering lung cancer screenings at each of its facilities. - Each MHSET County participates in the Texas Adult Potentially Preventable Hospitalization Initiative to improve care and reduce costs. Major foci in our service areas are Dehydration, Bacterial Pneumonia & UTI. - MHSET collaborates with Express Lab to offer very affordable lab testing at all of the system's facilities. Discounted screenings include glucose testing and PSAs. - MHSET offers the Lifeline home alert system, at a discounted rate. - Memorial-San Augustine utilizes a Medicaid staff member, employed by Memorial-Lufkin, who works to connect indigent and disabled patients to available payer sources. - Memorial-San Augustine funds an Indigent Intake Coordinator. The hospital pays this employees salary and provides office space. - Memorial-San Augustine provides two midlevel practitioners to see patients in the jail population. - Women's Services and our BCCS grant program provides free and discounted exams and follow-up in San Augustine. 2. PROVIDERS Increase local providers through a mission-focused market plan. Objective A: Focus on primary and specialty physicians according to recruitment needs discerned by market study. - The hospital is actively recruiting primary care and specialist physicians, based on a recently conducted Medical Staff Development Plan, via its MMA affiliation. Hiring efforts were begun for FYI 17 focus areas including infectious disease, obstetrics, pediatrics, and internal medicine. New San Augustine medical staffers were added in Radiology. - MHSET collaborates with a recruitment firm to actively recruit primary care and specialist physicians, based on a recently conducted Medical Staff Development Plan, via its MMA affiliation. Due to the difficulty of recruiting physicians to Memorial-San Augustine, recruitment at this facility is ongoing. - The hospital is a clinical rotation site for area nursing, laboratory, physical therapy, pharmacy, nurse practitioner, medical student and physician assistant programs. - MHSET and its hospitals participate in Education Affiliation Agreements with over 30 universities, colleges and medical institutions that prepare students for careers in nursing, allied therapies and administration. 3. AWARENESS & COMMUNICATION OF RESOURCES Make people more aware of available health services, education and support. Objective A: Increase information on web page and social media about services & educational opportunities. - CHI St. Luke's Health Memorial has improved and expanded its public web site to make it more user friendly and add resources for social services, as well as medical services, physician location, scheduling, billing and financial help, and contact information. An events/special events section was created to inform the public about learning activities about health issues. The social media presence was enhanced, with helpful and educational information available on Facebook, Twitter, LinkedIn, Instagram and YouTube. Objective B: Create a brochure about available health and social services in the community 4. EDUCATION Raise the importance of the prevention of disease through healthy living, exercise and nutrition. Objective A: Coordinated patient education programs for general healthy living, and for specific diseases and health care problems, including prevention, understanding and living with diabetes, heart disease, obesity, cancer, stroke, drug use, depression and stress. - MHSET participates in the city wide, smoke free initiative in Lufkin. In addition, all of Memorial Health System of East Texas' campuses are all smoke free. - Memorial-San Augustine participates in MHSET's initiative to provide nutritional articles on a monthly basis to various news sources, including the Lufkin Daily News, the Polk County Enterprise paper and the San Augustine Tribune and East Texas Magazines. - Memorial-San Augustine provides financial support and volunteers to organizations, such as the American Cancer Society, that strive to improve unhealthy lifestyles in the community. - The ministry sponsored a Health and Wellness Fairs in San Augustine and Broaddus, plus a Shelby County Health and Fitness Fair. The hospital partnered with First United Methodist Church on a Get Fit San Augustine effort. - MHSET produces a monthly cooking show, Memorial Cooking Innovations, a 30 minute program featuring a registered dietitian and a certified chef. The show features diabetic friendly foods that are delicious and easy to prepare and is broadcast on the local government access television channels daily, in 62 cities across the United States, and online any time at http://www.Memorialhealth.us/cooking. - Memorial-San Augustine sponsors Go Pink Night, a Local Rodeo event. The hospital, as sponsors of the night, emphasizes a theme: Have a Mammography--Save Lives; The sponsors and many of the participants in the rodeo wear pink because it is a breast cancer awareness night. - Memorial-San Augustine actively participates in Mammography Month. The hospital runs an educational media campaign on understanding the signs and symptoms of breast cancer and encourages women to get mammograms. A free gift is offered to those scheduling a mammogram at one of MHSET's facilities. - Currently, MHSET conducts Women's Power Lunches at the Lufkin and Livingston facilities. Memorial-San Augustine is in the process of evaluating a similar event. - The hospital organizes and provides space for diabetes support groups. - The hospital offers CPR classes at a reduced rate. - MHSET participates in the monthly Speakers' Bureau at each of its facilities. At this event, MHSET physicians speak to civic clubs on a variety of health topics. - The East Texas Heart and Vascular Initiative public education forums are held at industries, schools, assisted living centers, retirement centers, and civic clubs. Memorial-San Augustine has duplicated these efforts at its facility. |
| Schedule H, Part V, Section B, Line 11 Facility , 2 | Facility , 2 - MMC - SAN AUGUSTINE. - Memorial-San Augustine serves as a clinical resource for allied health academic institutions. This includes a relationship with Panola County Junior College in Carthage, TX. - MHSET has increased postings on its online patient library that serves as a medical resource for surgical procedures, illnesses, etc. - MHSET and its hospitals participate in Education Affiliation Agreements with over 30 universities, colleges and medical institutions that prepare students for careers in nursing, allied therapies and administration. Objective B: Develop a "Healthy Spirit" community education module collaboratively with Mission staff, clinicians and local churches - Research, drafting, and networking for this module was initiated in FY 2017. 5-8 -- SPECIAL PROGRAMS & IMPROVEMENTS 5. Identify lower cost sources for meds, healthy foods and medical care. Objective A: Increase use of online programs like Partnership for Prescription Assistance, Texas Health Information and Advocacy Program, MD Save, etc. - MHSET is linked with the Partnership for Prescription Assistance and other national and state programs to assist with medical costs. - The ministry continues the MD Save program, which obtains discounts on specific radiology and cardiology diagnostic tests and certain procedures. - In partnership with Angelina County and Cities Health District, our ministry helps to provide assistance for enrolling in the ACA exchanges, Medicaid, CHIP and other programs. ACCHD provides services in San Augustine County to help people to find a medical home and manage chronic disease. They provide hands-on assistance with applications, eligibility screening and documentation, as well as resources for healthy food and housing. - MHSET provides leadership to various boards that seek to improve the mental health continuum of care in the community. For example, Darlene Williams serves on the Rural East Texas Health Network Board (Memorial-San Augustine was a founding member) and is also president of local advisory board for RETHN. 6. Minimize use of ER for primary and routine care. Objective A: Consider community clinic hours in the new Children's Services facility. - Conversations were begun in FY17 about the ministry's participation in the new facility's services. 7. Explore partnership with churches already credible and involved in the community. Objective A: Convene a "Healthy Spirit" group among local leaders - Research, drafting, and networking for this module was initiated in FY 2017. 8. Develop a partnership between Memorial Clinics and the Direct Practice Improvement Project. Focus on preventing polypharmacy, and on a stronger social services component Objective A: Work with Memorial Clinics staff to coordinate projects and services. - The Direct Practice Improvement Project was inaugurated in FY17, with emphases on preventing polypharmacy and building stronger social services. - Memorial-San Augustine participates with Lufkin personnel in outreach in public schools, such as infection and behavior related activities. - MHSET provides Women's Special Services that offers mammograms, GYN exams and pap smears and GYN educational services to the uninsured population in the community. Memorial-San Augustine performs mammograms as a part of these services. - MHSET provides bacterial pneumonia and flu vaccinations at all of its facilities. - Memorial-San Augustine is working with the county judge, the San Augustine County Coalition and the Deep East Texas Council of Governments to address transportation issues in San Augustine County. - The hospital district solely provides funding for the ambulance and transport services at Memorial-San Augustine. - MHSET has been a partner with San Augustine County, Stephen F. Austin State University, and various community organizations in the planning of a coordinated Children's Services Center in downtown San Augustine. - Memorial-San Augustine works with the San Augustine County coalition and the SFA School of Social Work to develop and find resources available in the community. The hospital is collaborating on the Children's Service Center community project. - MHSET and Memorial-San Augustine staff have been involved in the planning of a local Meals on Wheels program. |
| Schedule H, Part V, Section B, Line 13 Facility , 1 | Facility , 1 - Memorial Medical Center of San Augustine. The patient must have a minimum account balance of thirty-five dollars ($35.00) with the CHI Hospital Organization. Multiple account balances may be combined to reach this amount. Patients/Guarantors with balances below thirty-five dollars ($35) may contact a financial counselor to make monthly installment payment arrangements. The patient must submit a completed Financial Assistance application. Patient Cooperation Standards - A patient must exhaust all other payment options, including private coverage, federal, state and local medical assistance programs, and other forms of assistance provided by third-parties prior to being approved. An applicant for Financial Assistance is responsible for applying to public programs for available coverage. He or she is also expected to pursue public or private health insurance payment options for care provided by a CHI Hospital Organization within a Hospital Facility. A patient's and, if applicable, any Guarantor's cooperation in applying for applicable programs and identifiable funding sources, including COBRA coverage (a federal law allowing for a time-limited extension of employee healthcare benefits), shall be required. If a Hospital Facility determines that COBRA coverage is potentially available, and that a patient is not a Medicare or Medicaid beneficiary, the patient or Guarantor shall provide the Hospital Facility with information necessary to determine the monthly COBRA premium for such patient, and shall cooperate with Hospital Facility staff to determine whether he or she qualifies for Hospital Facility COBRA premium assistance, which may be offered for a limited time to assist in securing insurance coverage. A Hospital Facility shall make affirmative efforts to help a patient or patient's Guarantor apply for public and private programs. |
| Schedule H, Part V, Section B, Line 24 Facility , 1 | Facility , 1 - MMC - SAN AUGUSTINE. ALL PATIENTS ARE EQUALLY CHARGED. PATIENTS WHO FILE AN APPLICATION FOR FINANCIAL ASSISTANCE ARE NOT BILLED UNLESS IT IS LATER DETERMINED THAT THEY DO NOT QUALIFY FOR ASSISTANCE. |
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Supplemental Information Detail SupplementalInformationDetail (17 entries)
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| Schedule H, Part I, Line 3c Financial Assistance 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 I, Line 6a Community benefit report prepared by related organization | MEMORIAL HEALTH SYSTEM OF EAST TEXAS |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | THE HOSPITAL USED A COST-TO-CHARGE RATIO TO CALCULATE AMOUNTS REPORTED IN THIS TABLE. THIS COST-TO-CHARGE RATIO WAS DEVELOPED USING THE FORMAT SHOWN IN IRS WKST 2 -"RATIO OF PATIENT CARE COST-TO-CHARGES: IN ACCORDANCE WITH THE INSTRUCTIONS, EXPENSES REPORTED ON PART IX, LINE 25, COLUMN A IN THE AMOUNT OF $6,401,804 WERE REDUCED BY $5,969 IN COMMUNITY BENEFITS AND $10,050 IN REVENUE FROM NON PATIENT SERVICES. THE REMAINING EXPENSES OF $6,385,785 WERE USED IN THE CALCULATION OF OF THE COST-TO- CHARGE RATIO. BAD DEBTS EXPENSE WAS NOT INCLUDED ON PART IX, LINE 25, COLUMN A OF FORM 990. |
| 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 27.81%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | MEMORIAL MEDICAL CENTER SAN AUGUSTINE DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM, BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | MEMORIAL MEDICAL CENTER SAN AUGUSTINE 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 ALLOWANCES 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 PATIENT 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 IN THE CONSOLIDATED STATEMENT OF OPERATIONS AS A DEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) SINCE CHI ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | USING ESSENTIALLY THE SAME MEDICARE COST REPORT PRINCIPLES AS TO THE ALLOCATION OF GENERAL SERVICES COSTS AND "APPORTIONMENT" METHODS, THE "CHI WORKBOOK" CALCULATES A PAYERS' GROSS ALLOWABLE COSTS BY SERVICE (SO AS TO FACILITATE A CORRESPONDING COMPARISON BETWEEN GROSS ALLOWABLE COSTS AND ULTIMATE PAYMENTS RECEIVED). THE TERM "GROSS ALLOWABLE COSTS" MEANS COSTS BEFORE ANY DEDUCTIBLES OR CO-INSURANCE ARE SUBTRACTED.MEMORIAL MEDICAL CENTER SAN AUGUSTINE 'S ULTIMATE REIMBURSEMENT WILL BE REDUCED BY ANY APPLICABLE COPAYMENT/ DEDUCTIBLE. WHERE MEDICARE IS THE SECONDARY INSURER, AMOUNTS DUE FROM THE INSURED'S PRIMARY PAYER WERE NOT SUBTRACTED FROM MEDICARE ALLOWABLE COSTS BECAUSE THE AMOUNTS ARE TYPICALLY IMMATERIAL. ALTHOUGH NOT PRESENTED ON THE MEDICARE COST REPORT, IN ORDER TO FACILITATE A MORE ACCURATE UNDERSTANDING OF THE "TRUE" COST OF SERVICES (FOR "SHORTFALL" PURPOSES) THE CHI WORKBOOK ALLOWS A HEALTH CARE FACILITY NOT TO OFFSET COSTS THAT MEDICARE CONSIDERS TO BE NON-ALLOWABLE, BUT FOR WHICH THE FACILITY CAN LEGITIMATELY ARGUE ARE RELATED TO THE CARE OF THE FACILITY'S PATIENTS. IN ADDITION, ALTHOUGH NOT REPORTABLE ON THE MEDICARE COST REPORT, THE CHI WORKBOOK INCLUDES THE COST OF SERVICES THAT ARE PAID VIA A SET FEE-SCHEDULE RATHER THAN BEING REIMBURSED BASED ON COSTS (E.G. OUTPATIENT CLINICAL LABORATORY). FINALLY, THE CHI WORKBOOK ALLOWS A FACILITY TO INCLUDE OTHER HEALTH CARE SERVICES PERFORMED BY A SEPARATE FACILITY (SUCH AS A PHYSICIAN PRACTICE) THAT ARE MAINTAINED ON SEPARATE BOOKS AND RECORDS (AS OPPOSED TO THE MAIN FACILITY'S BOOKS AND RECORDS WHICH HAS ITS COSTS OF SERVICE INCLUDED WITHIN A COST REPORT). TRUE COSTS OF MEDICARE COMPUTED USING THIS METHODOLOGY: TOTAL MEDICARE REVENUE: $3,672,785 TOTAL MEDICARE COSTS: $3,963,125 SURPLUS OR SHORTFALL: ($290,340) MEMORIAL MEDICAL CENTER SAN AUGUSTINE BELIEVES THAT EXCLUDING MEDICARE LOSSES FROM COMMUNITY BENEFIT MAKES THE OVERALL COMMUNITY BENEFIT REPORT MORE CREDIBLE FOR THESE REASONS: UNLIKE SUBSIDIZED AREAS SUCH AS BURN UNITS OR BEHAVIORAL-HEALTH SERVICES, MEDICARE IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS. IN FACT, FOR-PROFIT HOSPITALS FOCUS ON ATTRACTING PATIENTS WITH MEDICARE COVERAGE, ESPECIALLY IN THE CASE OF WELL-PAID SERVICES THAT INCLUDE CARDIAC AND ORTHOPEDICS. SIGNIFICANT EFFORT AND RESOURCES ARE DEVOTED TO ENSURING THAT HOSPITALS ARE REIMBURSED APPROPRIATELY BY THE MEDICARE PROGRAM. THE MEDICARE PAYMENT ADVISORY COMMISSION (MEDPAC), AN INDEPENDENT CONGRESSIONAL AGENCY, CAREFULLY STUDIES MEDICARE PAYMENT AND THE ACCESS TO CARE THAT MEDICARE BENEFICIARIES RECEIVE. THE COMMISSION RECOMMENDS PAYMENT ADJUSTMENTS TO CONGRESS ACCORDINGLY. THOUGH MEDICARE LOSSES ARE NOT INCLUDED BY CATHOLIC HOSPITALS AS COMMUNITY BENEFIT, THE CATHOLIC HEALTH ASSOCIATION GUIDELINES ALLOW HOSPITALS TO COUNT AS COMMUNITY BENEFIT SOME PROGRAMS THAT SPECIFICALLY SERVE THE MEDICARE POPULATION. FOR INSTANCE, IF HOSPITALS OPERATE PROGRAMS FOR PATIENTS WITH MEDICARE BENEFITS THAT RESPOND TO IDENTIFIED COMMUNITY NEEDS, GENERATE LOSSES FOR THE HOSPITAL, AND MEET OTHER CRITERIA, THESE PROGRAMS CAN BE INCLUDED IN THE CHA FRAMEWORK IN CATEGORY C AS ''SUBSIDIZED HEALTH SERVICES''. MEDICARE LOSSES ARE DIFFERENT FROM MEDICAID LOSSES, WHICH ARE COUNTED IN THE CHA COMMUNITY BENEFIT FRAMEWORK, BECAUSE MEDICAID REIMBURSEMENTS GENERALLY DO NOT RECEIVE THE LEVEL OF ATTENTION PAID TO MEDICARE REIMBURSEMENT. MEDICAID PAYMENT IS LARGELY DRIVEN BY WHAT STATES CAN AFFORD TO PAY, AND IS TYPICALLY SUBSTANTIALLY LESS THAN WHAT MEDICARE PAYS. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY APPLIES TO ALL INDIVIDUALS PRESENTING FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE POLICY CONTAINS PROVISIONS FOR COLLECTING AMOUNTS DUE FROM THOSE PATIENTS WHO THE ORGANIZATION KNOWS TO QUALIFY FOR FINANCIAL ASSISTANCE EITHER THROUGH THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS OR THROUGH PRESUMPTIVE ELIGIBILITY PROCESSES. BEFORE ENGAGING IN EXTRAORDINARY COLLECTION ACTIONS (ECAS) TO OBTAIN PAYMENT FOR EMCARE, HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. §1.501(R)-6(C), TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. IN NO EVENT WILL AN ECA BE INITIATED PRIOR TO 120 DAYS FROM THE DATE THE FACILITY PROVIDES THE FIRST POST-DISCHARGE BILLING STATEMENT (I.E., DURING THE NOTIFICATION PERIOD) UNLESS ALL REASONABLE EFFORTS HAVE BEEN MADE. HOSPITAL FACILITIES WILL NOT REFER ACCOUNTS FOR COLLECTION WHERE THE PATIENT HAS INITIALLY APPLIED FOR FINANCIAL ASSISTANCE, AND THE HOSPITAL FACILITY HAS NOT YET MADE REASONABLE EFFORTS WITH RESPECT TO THE ACCOUNT. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. PATIENTS WHO QUALIFY FOR MEDICAID ARE PRESUMED TO QUALIFY FOR FULL CHARITY WRITE OFF. ANY CHARGES FOR DAYS OR SERVICES WRITTEN OFF (EXCLUDING MEDICAID DENIALS RELATED TO TIMELINESS OF BILLING, INSUFFICIENT MEDICAL RECORD DOCUMENTATION, MISSING INVOICES, AUTHORIZATION, OR ELIGIBILITY ISSUES) AS A RESULT OF A MEDICAID ARE BOOKED AS CHARITY. SOME MEDICAID PLANS OFFER COVERAGE FOR A LIMITED OR RESTRICTED LIST OF SERVICES. IF A PATIENT IS ELIGIBLE FOR MEDICAID, ANY CHARGES FOR DAYS OR SERVICES NOT COVERED BY THE PATIENT'S COVERAGE MAY BE WRITTEN OFF TO CHARITY WITHOUT A COMPLETED APPLICATION. THIS DOES NOT INCLUDE ANY SHARE OF COST (SOC) OR OTHER PATIENT COST-SHARING AMOUNTS SUCH AS DEDUCTIBLES OR COPAYMENTS, AS SUCH COSTS ARE DETERMINED BY THE STATE TO BE AN AMOUNT THAT THE PATIENT MUST PAY BEFORE THE PATIENT IS ELIGIBLE FOR MEDICAID. HEALTH AND HUMAN SERVICES (HSS) USES THE TERM "SPEND DOWN" INSTEAD OF SHARE OF COST. ALL COLLECTION ACTIVITIES CONDUCTED BY THE FACILITY, A DESIGNATED SUPPLIER, OR ITS THIRD-PARTY COLLECTION AGENTS WILL BE IN CONFORMANCE WITH ALL FEDERAL AND STATE LAWS GOVERNING DEBT COLLECTION PRACTICES. ALL THIRD-PARTY AGREEMENTS GOVERNING COLLECTION AND RECOVERY ACTIVITIES MUST INCLUDE A PROVISION REQUIRING COMPLIANCE WITH THE HOSPITAL FACILITIES' FINANCIAL ASSISTANCE AND BILLING AND COLLECTIONS POLICY AND INDEMNIFICATION FOR FAILURES AS A RESULT OF ITS NONCOMPLIANCE. THIS INCLUDES, BUT IS NOT LIMITED TO, AGREEMENTS BETWEEN THIRD PARTIES WHO SUBSEQUENTLY SELL OR REFER DEBT OF THE HOSPITAL FACILITY. |
| Schedule H, Part V, Section B, Line 16a FAP website | - MMC - SAN AUGUSTINE: Line 16a URL: https://www.chistlukeshealthmemorial.org/; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - MMC - SAN AUGUSTINE: Line 16b URL: https://www.chistlukeshealthmemorial.org/; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - MMC - SAN AUGUSTINE: Line 16c URL: https://www.chistlukeshealthmemorial.org/; |
| Schedule H, Part VI, Line 2 Needs assessment | IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT REQUIRED BY LAW, OUR PHYSICIANS HAVE NUMEROUS COMMITTEES AT THE HOSPITAL, IN PART TO KEEP US INFORMED ABOUT COMMUNITY MEDICAL NEEDS. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM CHI HOSPITAL ORGANIZATIONS SHALL BE DISSEMINATED BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT NOT BE LIMITED TO: * CONSPICUOUS PUBLICATION OF NOTICES IN PATIENT BILLS; * NOTICES POSTED IN EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING/REGISTRATION DEPARTMENTS, BUSINESS OFFICES, AND AT OTHER PUBLIC PLACES AS A HOSPITAL FACILITY MAY ELECT; AND * PUBLICATION OF A SUMMARY OF THIS POLICY ON THE HOSPITAL FACILITY'S WEBSITE, WWW.CATHOLICHEALTH.NET, AND AT OTHER PLACES WITHIN THE COMMUNITIES SERVED BY THE HOSPITAL FACILITY AS IT MAY ELECT. SUCH NOTICES AND SUMMARY INFORMATION SHALL INCLUDE A CONTACT NUMBER AND SHALL BE PROVIDED IN ENGLISH, SPANISH, AND OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY AN INDIVIDUAL HOSPITAL FACILITY, AS APPLICABLE. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE CHI HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. IN ADDITION, HOSPITAL REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES. ONCE IT IS DETERMINED THAT THE PATIENT DOES NOT QUALIFY FOR ANY THIRD PARTY FUNDING, THE PATIENT IS VERBALLY NOTIFIED ABOUT THE EXISTENCE OF FINANCIAL ASSISTANCE APPLICATION AND ADDITIONAL SCREENING TAKES PLACE BY A HOSPITAL EMPLOYEE TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR CHARITY SERVICE PRIOR TO DISCHARGE. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY OF THAT POLICY, AND AN APPLICATION FOR ASSISTANCE. HOSPITAL REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON-ENGLISH-SPEAKING INDIVIDUALS. PATIENTS THAT HAVE BEEN DISCHARGED PRIOR TO CHARITY SCREENING, SUCH AS EMERGENCY ROOM PATIENTS, RECEIVE A WRITTEN NOTIFICATION OF POSSIBLE ELIGIBILITY FOR SERVICES. IF THE PATIENT IS DETERMINED NOT TO BE ELIGIBLE FOR GOVERNMENT ASSISTANCE, HE/SHE MAY NOTIFY THE HOSPITAL THAT THEY SEEK CHARITY ASSISTANCE. THE APPROPRIATE CHARITY FORM IS SENT TO THE PATIENT/GUARANTOR FOR COMPLETION AND THEN RETURNED TO THE HOSPITAL FOR EVALUATION AND QUALIFICATION. ONCE DETERMINATION OF ELIGIBILITY IS MADE, THE PATIENT IS SENT A NOTICE INFORMING HIM/HER IF THEY QUALIFY FOR FULL, PARTIAL, OR NO CHARITY CARE SERVICES. HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. §1.501(R)-6(C), TO DETERMINE WHETHER ANY INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. |
| Schedule H, Part VI, Line 4 Community information | SAN AUGUSTINE COUNTY WITH AN APPROXIMATE POPULATION OF 8,258 AS OF 2017, IS CONSIDERED A RURAL COUNTY. IT IS A FEDERALLY DESIGNATED MEDICALLY UNDER SERVED AREA; HEALTH PROFESSIONAL SHORTAGE AREA AND MENTAL HEALTH PROFESSIONAL SHORTAGE AREA PER A RECENT HRSA SHORTAGE AREA REVIEW AND PER THE 2000 TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER'S RURAL HEALTH STUDY, WE ARE ALSO A FRONTIER AREA. AS OF 2017, THE POPULATION'S AVERAGE INCOME IS $32,394; 21.6% OF COMMUNITY RESIDENTS WITH INCOME BELOW THE FEDERAL POVERTY GUIDELINE. IN 2016 WE HAD AN AVERAGE UNEMPLOYMENT RATE OF 19.1%. APPROXIMATELY 18.4% OF OUR PATIENT BASE IS UNINSURED, APPROXIMATELY 15% OF OUR PATIENT BASE IS MEDICAID RECIPIENTS, AND APPROXIMATELY 53% OF OUR PATIENT BASE IS MEDICARE RECIPIENTS. THE HOSPITAL IS THE ONLY HEALTH CARE FACILITY IN SAN AUGUSTINE COUNTY, AND IS THEREFORE THE ONLY HOSPITAL WHICH DIRECTLY SERVES OUR COMMUNITY. WE ARE A MEDICARE DESIGNATED CRITICAL ACCESS FACILITY. THE CITY OF SAN AUGUSTINE IS THE COUNTY SEAT AND THE HOSPITAL SERVES AS THE MEDICAL HUB OF SAN AUGUSTINE COUNTY. WE HAVE MISSION DELORES VISITOR CENTER AND RV PARK LOCATED ONE MILE FROM THE HOSPITAL. WE ARE WITHIN 20 MINUTES OF LAKE SAM RAYBURN AND TOLEDO BEND RESERVOIR AND THE BIG THICKET NATIONAL RESERVE. WE ARE A CERTIFIED RETIREMENT COMMUNITY SO THE HOSPITAL SERVES A LARGE POPULATION OF RETIREES, VACATIONERS, HUNTERS AND NATURE LOVERS. |
| Schedule H, Part VI, Line 5 Promotion of community health | THE ORGANIZATION'S HOSPITAL FACILITY(IES) PROMOTE HEALTH FOR THE BENEFIT OF THE COMMUNITY. MEDICAL STAFF PRIVILEGES IN THE HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, CONSISTENT WITH THE SIZE AND NATURE OF ITS FACILITIES. THE ORGANIZATION'S HOSPITAL FACILITY(IES) HAVE AN OPEN MEDICAL STAFF. ITS BOARD OF TRUSTEES IS COMPOSED OF PROMINENT CITIZENS IN THE COMMUNITY. EXCESS FUNDS ARE GENERALLY APPLIED TO EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, IMPROVEMENT IN PATIENT CARE, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH. THE FACILITY(IES) TREAT PERSONS PAYING THEIR BILLS WITH THE AID OF PUBLIC PROGRAMS LIKE MEDICARE AND MEDICAID. ALL PATIENTS PRESENTING AT THE HOSPITAL FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ARE TREATED REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH TREATMENT. |
| Schedule H, Part VI, Line 6 Affiliated health care system | THE ORGANIZATION 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 | TX |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | Financial Assistance | GrantTypeTxt |
| Recipient | 1212 | RecipientCnt |
| Cash Grant | $0 | CashGrantAmt |
| Non Cash Assistance | $1,230,972 | NonCashAssistanceAmt |
| Valuation Method Used | Book | ValuationMethodUsedDesc |
| Non Cash Assistance | Financial Assistance | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. | FormAndLineReferenceDesc |
| Explanation | Grants are made directly to patient accounts based on the financial assistance policy. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MONTE BOSTWICK | ||||||||||||||
| MARKET CEO | $0 | $361,992 | $0 | $25,000 | $0 | $23,073 | $0 | $27,776 | $0 | $25,111 | $0 | $462,952 | $0 | $0 |
| GARY N LOOPER | ||||||||||||||
| Former Director | $0 | $120,812 | $0 | $0 | $0 | $2,143 | $0 | $2,648 | $0 | $11,709 | $0 | $137,312 | $0 | $0 |
| RAVINDER BACHIREDDY M D | ||||||||||||||
| DIRECTOR | $0 | $161,023 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $161,023 | $0 | $0 |
| Michael Covert | ||||||||||||||
| Pres & CEO CHI St. Luke's Health System (partial year) | $0 | $1,146,287 | $0 | $794,040 | $0 | $206,851 | $0 | $15,375 | $0 | $27,127 | $0 | $2,189,680 | $0 | $0 |
| M HUNT HUBER M D | ||||||||||||||
| DIRECTOR | $0 | $396,646 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $396,646 | $0 | $0 |
| DARLENE WILLIAMS | ||||||||||||||
| ADMINISTRATOR, CNE | $151,716 | $0 | $2,500 | $0 | $861 | $0 | $4,747 | $0 | $18,326 | $0 | $178,150 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 4a Post-Termination 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. |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | WITH THE APPROVAL OF A COMPENSATION COMMITTEE, THE CEO OF MEMORIAL HEALTH SYSTEM OF EAST TEXAS (THE MEMBER) DETERMINES THE SALARY OF THE ADMINISTRATOR. |
| 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: MICHAEL COVERT MONTE J. BOSTWICK DURING 2017 THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: MONTE J. BOSTWICK - $18,326 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: MICHAEL COVERT - $184,783 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part V, Line 1a FORM 1096 | MEMORIAL HEALTH SYSTEM OF EAST TEXAS (MHSET) PAYS THE HOSPITAL'S BILLS FOR SERVICES THAT WOULD REQUIRE THE PREPARATION OF FORMS 1099 AND THE RELATED FORM 1096, AND REPORTS SUCH PAYMENTS UNDER ITS FEDERAL IDENTIFICATION NUMBER (75-0755367). THE HOSPITAL REIMBURSES MHSET FOR SUCH PAYMENTS. |
| 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 2 Family/business relationships amongst interested persons | CORKY EVANS AND JUDY COCHRAN - Business relationship |
| Form 990, Part VI, Line 6 Classes of members or stockholders | MEMORIAL HEALTH SYSTEM OF EAST TEXAS IS THE SOLE CORPORATE MEMBER. CATHOLIC HEALTH INITIATIVES (CHI) IS THE SOLE CORPORATE MEMBER OF MEMORIAL HEALTH SYSTEM OF EAST TEXAS. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | THE BOARD OF DIRECTORS OF THE MEMBER (MEMORIAL HEALTH SYSTEM OF EAST TEXAS) ALSO SERVE AS MEMBERS OF THE BOARD OF DIRECTORS OF MMC-SAN AUGUSTINE. THE MANAGEMENT OF OF MHSET PROVIDES OVERSITE OF FINANCIAL AND CLINICAL OPERATIONS. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | THE MEMBER (MEMORIAL HEALTH SYSTEM OF EAST TEXAS) APPROVES THE INDIVIDUALS SELECTED TO THE BOARD OF DIRECTORS OF MMC-SAN AUGUSTINE AND HAS FINAL APPROVAL OF ALL ACTIONS OF THE BOARD OF DIRECTORS. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE BOARD OF DIRECTORS, BY RESOLUTION, APPOINTS A SPECIAL COMMITTEE TO REVIEW THE FORMS 990 AND 990T PRIOR TO FILING. ONCE THE RETURNS ARE COMPLETED, THEY ARE PROVIDED TO THIS COMMITTEE FOR THEIR REVIEW AND APPROVAL FOR FILING. EMPLOYEES OF THE CORPORATION RESPONSIBLE FOR THE PREPARATION AND REVIEW OF THE RETURNS ARE AVAILABLE TO RESPOND TO QUESTIONS OR PROVIDE BACKGROUND AS NEEDED. ONCE THE DIRECTORS RESPONSIBLE FOR REVIEWING THE RETURNS ARE SATISFIED THEY ARE COMPLETE, THE RETURNS ARE APPROVED TO BE FILED. SUBSEQUENT TO PRESENTATION TO THE BOARD'S COMMITTEE, THE TAX DEPARTMENT FILES THE RETURNS WITH THE IRS, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE COMMITTEE. AFTER FILING, THE RETURNS ARE MADE AVAILABLE TO ALL DIRECTORS FOR THEIR REVIEW. |
| Form 990, Part VI, Line 12c Conflict of interest policy | 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. (CONTINUED ON SCHEDULE O) |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | THE SALARY OF THE ADMINISTRATOR OF THE CORPORATION IS SET BY THE CHIEF EXECUTIVE OFFICER OF MEMORIAL HEALTH SYSTEM OF EAST TEXAS. THIS PROCESS IS PERFORMED ANNUALLY. |
| 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, AT SUCH TIMES THAT ARE SCHEDULED WITH THE CHIEF FINANCIAL OFFICER OF MEMORIAL HEALTH SYSTEM OF EAST TEXAS. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT www.catholichealthinitiatives.org. |
| Form 990, Part VIII, Line 2a PATIENT SERVICE REVENUE | PATIENT SERVICE REVENUE WAS DETERMINED AS FOLLOWS: GROSS CHARGES TO PATIENTS - $ 22,962,537 LESS: MEDICARE CONTRACTUAL ADJUSTMENTS - ($5,304,518) MEDICAID CONTRACTUAL ADJUSTMENTS - $209,351 MANAGED CARE ADJUSTMENTS - ($6,407,860) UNCOLLECTIBLE ACCOUNTS - ($1,183,279) OTHER DISCOUNTS - ($2,453,083) NET PATIENT SERVICE REVENUE - $7,812,422 |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | - Total Revenue: 1146, Related or Exempt Function Revenue: 902, Unrelated Business Revenue: 244, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
| Form 990, Part IX, Line 11g Other Fees | Outside Services - ED Physicians - Total Expense: 371565, Program Service Expense: 371565, Management and General Expenses: , Fundraising Expenses: ; Outside Services - Biomed - Total Expense: 314559, Program Service Expense: 314559, Management and General Expenses: , Fundraising Expenses: ; Outside Services - Other - Total Expense: 360872, Program Service Expense: 249529, Management and General Expenses: 111343, Fundraising Expenses: ; |
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 | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | 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 |