2019-05-10T16:36:44-05:00 2018-06-30 470617373 CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST DENVER CO 80112 990 2017-07-01 470379836 Saint Elizabeth Regional Medical Center SAIN 4022198000 555 South 70th Street Lincoln NE 68510 Jeanette Wojtalewicz CFO CHI Health 2019-05-10 true ANGELA NOEL CPA P01051055 3032989100 2017 2019-02-21 02:37:17Z CHI Health St Elizabeth Cliff Robertson 12809 West Dodge Road Omaaha NE 68154 243521341 false 0928 X www.chihealth.com X 1889 NE Community Service is a core activity for Saint Elizabeth. Essential inpatient and outpatient services are provided as well as specialties in neonatal, burn, cancer, and emergency. 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. 16 10 1421 344 2387371 414042 1311815 1140890 225650129 214811821 21940913 23651860 4078748 3914197 252981605 243518768 19924041 22032147 0 0 67771757 63019637 0 0 0 134365938 130491620 222061736 215543404 30919869 27975364 534556562 577339662 115616076 130673920 418940486 446665742 X THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH, FIDELITY TO THE GOSPEL URGES THE CORPORATION TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT CREATES HEALTHIER COMMUNITIES. THE CORPORATION , SPONSORED BY A LAY-RELIGIOUS PARTNERSHIP, CALLS OTHER CATHOLIC SPONSORS AND SYSTEMS TO UNITE TO ENSURE THE FUTURE OF CATHOLIC HEALTH CARE. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION. false false 15800472 4284467 41773243 At Saint Elizabeth, our team works to provide you and your referring physician with the information needed for fast and effective treatment. We have met the rigorous requirements of accreditation from the American College of Radiology in CT, MRI, Mammography, Nuclear Medicine and PET/CT imaging. 8328973 1201542 11714945 Our emergency room is staffed 24 hours a day by physicians and nurses who are specially trained in emergency care. We have state-of-the-art technology that assists our expert staff in evaluating, diagnosing and treating any type of illness or injury. We have an accredited Stroke Center and a verified Burn Center, which means that our staff is specially trained to be ready at a moment's notice to treat stroke and burn patients as quickly as possible. We are also recognized as one of the nation's top hospitals for quickest response times to heart attacks. Our cardiac procedure and surgery success rates exceed state and national averages. 8042938 2037236 19862906 We are recognized for being one of the nation's top hospitals for quickest response times to heart attacks. Our cardiac procedure and surgery success rates exceed state and national averages. We are committed to offering the highest standards of care and expertise from skilled medical professionals specially trained to care for your heart. Our services include: Diagnostic Tests & Procedures Our cardiac team performs the latest procedures for diagnosis and treatment of heart disease, including diagnostic and interventional cardiac catheterization, electrophysiology, non-invasive diagnostic studies and medical cardiac care. Cardiac Rehabilitation Our cardiac rehabilitation program offers medically-monitored exercise and education tailored to your needs for recovery and prevention of future heart issues. Prevention We offer preventive programs including screening, lifestyle management and a smoking cessation program. We encourage you to reduce our risk of heart disease by developing a heart-healthy lifestyle. 134837930 14508902 141460727 Other programs 134837930 14508902 141460727 167010313 true true false true false false false false true true true false false true true false true false false false false false false false false true true true true true false false false false false false false false false false false false false true true true false false true 0 0 1421 true true true false false false false false true false false false X 16 10 false false false false true true true true true false false true true true true true true true true true false X Jeanette Wojtalewicz 4023434671 12809 West Dodge Road Omaha NE 68154 LARRY BUTLER Treasurer 1.0 11.0 X X 0 0 0 FR JAMES CLIFTON SJ Secretary 1.0 11.0 X X 0 0 0 RICHARD HERINK Board Chair 1.0 11.0 X X 0 0 0 ROBERT LANIK VICE CHAIR 1.0 11.0 X X 0 5552 0 CLIFF ROBERTSON MD Board Member/CEO CHI Health 1.0 59.0 X X 0 1894789 178116 NATHANIEL BRACKETT MD BOARD MEMBER 1.0 59.0 X 0 0 0 GREGORY HEIDRICK MD Board Member 1.0 11.0 X 0 0 0 Sister Nadine Heimann Board Member 1.0 11.0 X 0 0 0 SUSANNE L HRUZA MD BOARD MEMBER 1.0 11.0 X 0 0 0 Anthony Jones Board Member 1.0 59.0 X 0 0 0 AMY L MCGAHA md BOARD MEMBER 1.0 59.0 X 0 281768 18715 Thomas Murray PHD Board Member 1.0 11.0 X 0 0 0 BARRY SANDSTROM Board Member 1.0 11.0 X 0 0 0 SISTER MAURITA SOUKUP BOARD MEMBER 1.0 11.0 X 0 0 0 Bill T Yates BOARD MEMBER 1.0 11.0 X 0 0 0 JASON KRUGER MD BOARD MEMBER 1.0 59.0 X 0 354358 36032 JENNIFER BEATY MD BOARD MEMBER 1.0 11.0 X 0 0 0 KIM MOORE FORMER PRESIDENT 57.0 3.0 X 0 648835 32782 DEREK VANCE PRESIDENT 30.0 30.0 X 0 41254 3247 CARY WARD MD INTERIM PRESIDENT / CHIEF MEDICAL OFFICER 24.0 36.0 X 0 592959 40285 JEANETTE WOJTALEWICZ CFO CHI Health 5.0 55.0 X 0 814598 88953 DONNA HAMMACK CHIEF DEVELOPMENT OFFICER-FOUNDATION 1.0 50.0 X 169802 0 27276 KENT HOXMEIER PERFUSIONIST 10.0 40.0 X 10221 159299 34039 Michele Murphy Supervisor - Pharmacy 50.0 0 X 180667 0 34559 ELIZABETH RAETZ VP NURSING 50.0 0 X 214037 0 8287 CARY REIMERS VP-PATIENT CARE SERVICES 30.0 20.0 X 87959 90675 35476 DAN SCHONLAU VP Operational Finance NHH, St. Elizabeth 25.0 25.0 X 0 202549 36629 MIKE WATTERS VP-SENIOR COUNSEL 3.0 57.0 X 0 340401 41411 STEVE HOUSTON SVP STRATEGY 8.0 52.0 X 0 351874 32789 JOAN NEUHAUS CHI HEALTH SVP COO 15.0 45.0 X 0 772991 29598 NANCY WALLACE SVP HR CHI HEALTH 8.0 52.0 X 0 402179 33496 662686 6954081 711690 35 true true false WELLTOWER INC 4500 DORR STREET TOLEDO OH 43615 REAL ESTATE INVESTMENT SERVICES 1740795 VASCULAR ACCESS PLUS LLC 9375 G CT OMAHA NE 68127 MEDICAL SERVICES 630150 lincoln medical education partnership 4600 Valley Rd 225 Lincoln NE 68510 healthcare education services 614529 BOFI FEDERAL BANK 4350 LA JOLLA VILLAGE DRIVE SUITE 140 SAN DIEGO CA 92122 FINANCIAL SERVICES 562388 NEBRASKA PULMONARY SPECIALTIES 1500 S 48TH ST SUITE 800 Lincoln NE 68506 HEALTHCARE SERVICES 546000 25 X 0 0 0 1140890 0 0 0 1140890 Patient Services 900099 212668555 212668555 0 0 Equity changes of unconsolidated orgs 900099 2088492 2088492 0 0 Pharmacy Services 446110 54774 54774 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214811821 7807757 0 65927 7741830 0 0 0 0 0 0 0 0 569175 0 0 0 569175 0 569175 0 0 569175 15846676 0 0 2573 15846676 -2573 15844103 0 0 15844103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Durable Medical Equipment 446199 1678149 0 1678149 0 Services Sold 900099 614063 0 408279 205784 Cafeteria 722100 372235 0 0 372235 680575 0 235016 445559 3345022 243518768 214811821 2387371 25178686 X 79126 79126 21953021 21953021 48243618 45831437 2412181 2361590 2243510 118080 8927620 8425324 502296 3486809 3312468 174341 7192 7192 33125833 20062455 13063379 0 2254366 2141648 112718 286535 272209 14326 6342274 6025160 317114 64323 61107 3216 16140 15333 807 2646762 2646762 7680039 7296037 384002 559324 531358 27966 Unrelated Business Taxes 184500 184500 Medical Supplies 39561782 39561782 Intercompany Allocations 31116036 31116036 Bad debts 4826779 4826779 1819735 1724797 94938 0 215543404 167010313 48533092 0 1350206 124954 81417766 125299524 0 0 30675416 40301882 0 0 0 0 329555 5899950 6829255 135167 147191 220786711 144761009 79919900 76025702 0 0 319514972 314924230 0 0 0 15643185 13357369 534556562 577339662 10740001 12542813 0 0 0 8684 0 0 0 0 0 0 0 0 0 104876075 118122423 115616076 130673920 X 418940486 446665742 0 0 0 0 418940486 446665742 534556562 577339662 X 27975364 1075874 -1325982 X false true X true false X false false false false false true 7192 false false false 7192 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 - $2,084 CATHOLIC HEALTH ASSOCIATION - $1,828 NEBRASKA HOSPITAL ASSOCIATION - $3,280 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 - $2,084 CATHOLIC HEALTH ASSOCIATION - $1,828 NEBRASKA HOSPITAL ASSOCIATION - $3,280 324502 324502 324502 324502 324502 324502 308194 16308 324502 264590 43603 6174 6173 308194 0.0 1.0 0.0 false true true 179532 179532 117733955 59979647 57754308 1641818 1637733 4085 90881972 77381753 13500219 10349434 5761876 4587558 76025702 CHI OIP 314924230 F 314924230 CHI Debt Management Program 53844966 Intercompany Payables 59498087 Environmental Remdeiation Liability 3496604 Pension Liability 308728 Other Current Liabilities 22345 Other Post Employment Benefits 951693 118122423 X Schedule D, Part V, Line 4 Intended uses of endowment funds THE ENDOWMENT FUNDS ARE USED FOR SCHOLARSHIPS, MAINTENANCE OF THE WALKING PATH ADJACENT TO SAINT ELIZABETH REGIONAL MEDICAL CENTER, AND OTHER GENERAL PURPOSES. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote SAINT ELIZABETH REGIONAL MEDICAL CENTER'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." true true X true X 300 true X true true true false true true 3834 7674639 0 7674639 0.0364 5923 20465826 4983844 15481982 0.0735 0 263385 143061 120324 0.0006 0 9757 28403850 5126905 23276945 0.1105 13 64807 1413822 433928 979894 0.0047 9 1084 1054511 0 1054511 0.0050 0 0 0 0 0 0.0 1 0 13332 2050 11282 0.0001 8 1154 154746 10338 144408 0.0007 31 67045 2636411 446316 2190095 0.0104 31 76802 31040261 5573221 25467040 0.1209 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 0 33 0 33 0.0000 2 42 11813 0 11813 0.0001 0 0 0 0 0 0.0 3 42 11846 0 11846 0.0001 true 4826779 0 56688323 70104042 -13415719 X true true LINCOLN CK LEASING LLC ONCOLOGY EQUIPMENT 0.5376 0.0 0.3226 SUPERIOR MEDICAL IMAGING LLC OUTPATIENT IMAGING CENTER 0.51 0.0 0.49 NEBRASKA SURGERY CENTER LLC AMBULATORY SURGERY CENTER 0.3923 0.0 0.6077 1 1 Saint Elizabeth Regional Medical Center 555 South 70th Street Lincoln NE 68510 http://www.chihealthstelizabeth.com/ 500007 X X X X Saint Elizabeth Regional Medical Center 1 false false true X X X X X X X X 15 true true true true X www.chihealth.com/chna X X true 16 false true false true X 300.0 300.0 X X X X true true X X X true X www.chihealth.com/financial-assistance X www.chihealth.com/financial-assistance X www.chihealth.com/financial-assistance X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Saint Elizabeth Regional Medical Center. Over 100 individuals representing all sectors of health and community participated in a mobilizing for action through planning and partnership (MAPP) process including several leaders from St. Elizabeth. These stakeholders represent low-income, minority populations, medically underserved populations and the aging population. Several specific methods were used to gain community input on the needs assessment and community health improvement plan. The information gathered from the community informed the health need prioritization process and the community health improvement plan. Online Survey: LLCHD disseminated an online survey in both English and Spanish on the City of Lincoln- Lancaster County website and by sending the link via e-mail to community partners. Hard copies were available for those without access to a computer. The survey asked participants about their perceptions of the public health services and about various aspects of their community related to health. Community Focus Groups: These were held in collaboration with the State for Lincoln and Lancaster County residents. In addition to the larger focus group, two smaller focus groups were held with senior citizens at a senior center. The focus group gained input from participants on their perceptions of the local health services and about various aspects of their community related to health. Community Engagement Session: The MAPP process included a brainstorming session in order to gather input about events, trends and factors that shape the background conditions in the community. The issues focused on during the engagement session were the growth of Lincoln's population now and in the future, and the changing city landscape and development. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Saint Elizabeth Regional Medical Center. CHI Health Nebraska Heart Bryan Health Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Saint Elizabeth Regional Medical Center. Lincoln Lancaster County Health Department Other input from community organizations Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - Saint Elizabeth Regional Medical Center. The CHNA was presented to the Community Board for St. Elizabeth and Nebraska Heart Health. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Saint Elizabeth Regional Medical Center. The current applicable CHNA and corresponding implementation plan was completed in in the tax reporting year 2015. The following outlines the current implementation plan priorities and strategies. This plan was posted publicly on www.chihealth.com/chna. This is a joint plan with CHI Health St. Elizabeth and Nebraska Heart Hospital. Therefore, only strategies that are led or co-led by CHI Health St. Elizabeth are reported below. Priority Health Needs and Strategies are numbered to align with the published joint Implementation Plan at www.chihealth.com/chna. For this plan the hospital prioritized all top community health needs identified in the applicable (2015) community health needs assessment in alignment with the Community Health Improvement Plan: Priority Health Need #1: Access to Care To address this need the hospital will implement the following strategies in 2016-2018: -Offer ED Connections Program to improve healthcare access for lowincome, uninsured, mentally ill, or immigrant persons who repeatedly use the Emergency Departments. -Provide financial assistance and support to Clinic with a Heart to improve access to healthcare for uninsured and underinsured populations. Priority Health Need #2: Behavioral Health To address this need the hospital will implement the following strategies in 2016-2018: -Provide a communitybased behavioral health (BH) coalition with hospitals, providers and other key stakeholders focused on improving BH for individuals in the community. -Provide a system flow for behavioral health patients in treatment or seeking treatment through a provider service coordination process. -Provide the use of behavioral health prevention techniques with primary and integrated health clinics, schools, youth and adults in the community. -Provide awareness and use of the Care Transition Model. Priority Health Need #3: Chronic Disease To address this need the hospital will implement the following strategies in 2016-2018: -Provide a Community Asthma Education Initiative for children in Lincoln, Nebraska with diagnosed undermanaged, undiagnosed asthma, or atrisk for asthma. -Provide a Heart Failure Academy (HFA) and other education for individuals with heart failure and their families. -Provide financial assistance and support to Partnership for a Healthy Lincoln (PHL) to decrease obesity, increase fruit and vegetable consumption, and increase physical activity for both adults and youth in Lancaster County. Priority Health Need #4: Injury & Violence To address this need the hospital will implement the following strategies in 2016-2018: -Provide Lancaster County middle schools with Second Step, a violence prevention program. -Provide after school creative programs at the middle school. Specifically, digital storytelling and painting as a means of sharing emotions and then hold community events(s) to showcase creative works and to educate the community on violence prevention. -Create a community culture that supports violence prevention through engaging community organizations in education and programing. -Offers free education about child passenger safety on how to properly restrain their child in a child safety seat. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - Saint Elizabeth Regional Medical Center. 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. 2 Nebraska Surgery Center LLC 625 South 70th Street Lincoln NE 68510 Ambulatory surgical center Superior Medical Imaging LLC 5000 North 26th Street Lincoln NE 68521 Outpatient diagnostic imaging center Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT THE COMMUNITY BENEFIT REPORT IS NOT REQUIRED TO BE FILED WITH THE STATE OF NEBRASKA; HOWEVER, SAINT ELIZABETH REGIONAL MEDICAL CENTER VOLUNTARILY PARTICIPATES WITH THE NEBRASKA HOSPITAL HOSPITAL ASSOCIATION'S ANNUAL COMPILATION OF COMMUNITY BENEFIT REPORTS, WHICH ARE PROVIDED TO FEDERAL AND STATE OFFICIALS, LEGISLATORS, AND OTHER INTERESTED PARTIES. Schedule H, Part I, Line 3c 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 HOW THE ORGANIZATION MADE ITS COMMUNITY BENEFIT REPORT AVAILABLE Yes, the CHI Health system produces an annual public community benefit report that is mailed to a core constituency, placed in key places throughout the organization and distributed in community meetings. It is also available on the company's intranet site, and on its public website at http://www.chihealth.com/community-benefit. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 4826779 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance A cost accounting system was not used to compute amounts in the table; rather costs in the table were computed using Worksheet 2 to compute the cost-to-charge ratio. The cost-to-charge ratio covers all patient segments. Schedule H, Part II Community Building Activities CHI Health has a history of centralized community benefit investments, as well as hospital specific investments that address community health needs which include support of local health coalitions, investments in partnerships and programs that address top community health needs, participation in local committees and boards tied to top health needs, and investments in many other ways as described in other areas of the Schedule H narrative. Below are specific examples of work that falls within the definition of community building activities. These activities are critical in helping build social, health, and economic opportunities in our community that ultimately drive health status and quality of life for our residents: -Workforce development: The following activities work to strengthen the community's capacity to promote the health and well-being of our residents by driving entry into healthcare careers: -Healthcare career exploration camp-day camp funded by CHI Health for students grades 10-12 to give them the opportunity to explore a variety of healthcare professions -Presentations to high school students about healthcare careers -Staff time spent with high school and college shadow students -Summer camp/interns-health occupations summer day camp and intern opportunities funded by St. Elizabeth to give them the opportunity to explore a variety of healthcare professions -Community and economic development including support of local Chambers of Commerce 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 31.11%. 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 Saint Elizabeth Regional Medical Center 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 Saint Elizabeth Regional Medical Center 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. Saint Elizabeth Regional Medical Center'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: $56,688,323 Total Medicare costs: $70,104,042 Surplus (or Shortfall): $(13,415,719) Saint Elizabeth Regional Medical Center 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 - Saint Elizabeth Regional Medical Center: Line 16a URL: www.chihealth.com/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - Saint Elizabeth Regional Medical Center: Line 16b URL: www.chihealth.com/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Saint Elizabeth Regional Medical Center: Line 16c URL: www.chihealth.com/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment The process of identifying the community health needs in Lancaster County served by St. Elizabeth was accomplished by using data and community input through the Mobilizing for Action through Planning and Partnership (MAPP) Process, and support through the Saint Elizabeth Community Benefit Action Team (CBAT). The MAPP process is a community-driven strategic planning approach used to improve community health through applying strategic thinking to prioritize public health issues and identify the resources to address them. The LLHD MAPP process included stakeholders from across the community representing all of the local health service agencies and several community agencies representing the population served in Lancaster County. St. Elizabeth/NHH staff participated on both the Steering Committee and several Work Groups as part of both the assessment and planning process. The MAPP process included several assessments that collected and reviewed both primary and secondary data: -Community Health Status Assessment: This process involved collecting data on core indicators and selecting additional key indicators tailored to the community. -County Health Rankings -Behavioral Risk Factors Surveillance System Data -Youth Risk Behavior System Data - Vital Statistics Data - US Census Bureau - Lincoln Lancaster County Health Department -Community Themes & Strengths Assessment: This assessment involved community dialogue and focus groups; a community survey; key stakeholder interviews; and reporting the results and identified challenges and opportunities. -Forces of Change Assessment/Community Engagement Sessions: This assessment involved a brainstorming session to gather input about events, trends and factors that shape the background conditions in the community. -Following completion of these assessments and community engagement opportunities, the MAPP Steering Committee met to review the data and applied scoring criteria to rank and prioritize the top health needs for Lancaster County. 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 For the purpose of the CHNA and future implementation strategy, St. Elizabeth considers its primary community to be the City of Lincoln and the surrounding County (Lancaster) which includes 75%-90% of the patients served by the hospitals. This was determined by an interdisciplinary team from Saint. Elizabeth [Community Benefit Action Team (CBAT)] and aligns with a shared definition agreed upon with community partners including other local health systems and the health department. Lancaster County includes residents living in the towns of Bennet, Davey, Denton, Firth, Hallam, Hickman, Lincoln, Malcolm, Martell, Panama, Raymond, Roca, Sprague, Walton, and Waverly. Lancaster County covers an area of 839 square miles in southeastern Nebraska with a population density of 360 persons per square mile (2014). Lincoln Lancaster Total Population is 301,795. Under 5 years 20,219 5 - 14 years 39,085 15 - 24 years 56,538 25 - 44 years 79,768 45 - 64 years 69,624 65 - 84 years 31,329 85 and older 5,232 Gender Female: 151,024 Male: 150,771 Race/Ethnicity White, NH: 249,985 African American, NH: 11,080 Native American, NH: 1,769 Asian/Pacific Islander, NH: 12,265 2+ Races, NH: 6,889 Hispanic: 19,807 Minority: 51,810 A review of the socioeconomic factors shows that the City of Lincoln, Lancaster County, and the State of Nebraska overall have a low unemployment rate. Despite this, a notable portion of the population lives in poverty. Poverty estimates for 2013 indicated that 14.0% of the overall population and 16% of children are below the poverty level. In comparison, 12.9%of families in Nebraska had an income level that was below the poverty threshold. Nearly half of students (43.4%) enrolled in the Lincoln Public Schools qualified for free and reduced meals. Median Household Income is $51,916 Percent of Persons in Poverty is 14.0% Percent of Children in Poverty is 16% Unemployment Rate is 2.9% High School Graduation Rate is 86% Some College was 75% Percent of Uninsured adults age 65 and older is 15% Percent of Uninsured Children under 19 years is 5% Schedule H, Part VI, Line 5 Promotion of community health The organization's hospital facility promotes health for the benefit of the community. Medical staff privileges in the hospital are available to all qualified physicians in the area, consistent with the size and nature of its facilities. The organization's hospital facility has 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 treats persons paying their bills with the aid of public programs like Medicare and Medicaid. All patients presenting at the hospital for emergency and other medically necessary care are treated regardless of their ability to pay for such treatment. CHI Health has a history of centralized community benefit and hospital specific community benefit investments to address community health needs of the particular service area. Examples of how CHI Health furthers its exempt purpose by promoting the health of the community include: * Financial Assistance and Unpaid costs of Medicaid * Community health improvement services- - Community education, classes and programs (burn and wound, CPR, car seat safety checks, community behavioral health support and education, diabetes, cancer, physical activity and healthy eating and cooking) - Support groups (cancer, bereavement, youth, etc.) - Community health fairs and screenings - School based healthcare services - Parish Nursing Program and Faith Community Health Network-the CHI Health Faith Community Health Network partners with congregations of all faiths to build capacity and support the growth of Health Ministries which promote health, healing and wholeness in the communities served. - Healthy Families-this program is a free, 8-week health and nutrition program for families with a child between the ages of 4-18 who has been identified in the top 85th percentile of their weight. This program invites the whole family to participate in learning about physical activity, eating healthy, and setting realistic goals as a family. - 5-4-3-2-1Go!-this program is an evidence-based healthy kids countdown message which CHI health supports through technical assistance and resources for parents and schools to teach kids to learn and practice every day to be healthy and active. - Camp Floyd Rogers-CHI Health employee volunteered 144 hours at no cost to serve as camp pharmacist for this overnight summer camp for 102 youth living with Type 1 Diabetes. - Asthma Camp-CHI Health nurse volunteered 120 hours as a residential nurse. - Burn Camp-CHI Health staff participated in 6-day burn camp with 23 attendees. - Telephone Information Service-health information provided, free of charge, via the telephone to callers of the community. - Pharmacy employees volunteered their time as pharmacists at Magis Clinic and Clinic with a Heart to serve the underserved. - NICU Follow-up Clinic- St. Elizabeth participates in a program called "TIPS" partially funded by the State of Nebraska for follow-up with families who have graduated from the NICU. The funding covers nursing hours, but does not cover the neurologist time, etc. The purpose of the clinic is to ID neuro-developmental problems that need further care. There is nowhere else to go in Lincoln for this type of post-NICU care and they are not charging for any of the post services. They meet with families at 3/6/12 and 18 months for in-person follow-up visits. - Counseling and assistance in enrolling individuals in means tested insurance programs to improve access to care. - Transportation to patients who cannot afford transportation to attend to their medical needs. - Support to health coalitions and investments in social and environmental improvement strategies. These are programs, activities and partnerships that improve the health of persons in the community by addressing the determinants of health, which includes the social, economic and physical environment. See specific examples below: + Milkworks- provided community breastfeeding initiatives support for community-based coalitions in outer NE that are established in partnership with their local hospital, and provides breastfeeding support to moms in their area. + Hunger Free Heartland- provided funds to support Breakfast For All Task Force which is a collaboration of NE nonprofits working to align strategies and advocacy efforts to improve child hunger issues including school breakfast and summer meals. + Alzheimer's Association-provided funds to support the ongoing work of the MedicAlert Program. Individuals diagnosed with dementia, and their families, receive bracelets for free containing contact information to assist in reuniting or notifying either party when necessary (ex. wandering, car accident, etc.). 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 IA, NE true LINCOLN CHAMBER OF COMMERCE 1128 LINCOLN MALL STE 100 LINCOLN NE 68508 470221590 501(C)(6) 15000 GENERAL SUPPORT UNITED WAY OF LINCOLN AND LANCASTER COUNTY 238 S 13TH ST LINCOLN NE 68508 470376624 501(C)(3) 13500 GENERAL SUPPORT NATIONAL COUNCIL ON BEHAVIORAL HEALTH 1400 K ST NW STE 400 WASHINGTON DC 20005 237092671 501(C)(3) 11000 GENERAL SUPPORT MADONNA FOUNDATION 5401 SOUTH STREET LINCOLN NE 68506 237159940 501(C)(3) 10000 GENERAL SUPPORT CATHOLIC SOCIAL SERVICES 2241 O ST LINCOLN NE 68510 470751554 501(C)(3) 8000 GENERAL SUPPORT LANCASTER COUNTY MEDICAL SOCIETY 233 S 13TH ST STE 1200 LINCOLN NE 68508 363305032 501(C)(3) 6000 GENERAL SUPPORT 5 1 Financial Assistance 3834 21953021 BOOK REDUCTION OR WRITE-OFF OF PATIENT SERVICES Schedule I, Part III Assistance to Individuals Saint Elizabeth Regional Medical Center RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. BUSINESS OFFICE STAFF HELPS PATIENTS SEEK LOCAL, STATE, AND FEDERAL REIMBURSEMENT AT NO CHARGE WHEN NO OTHER SOURCE OF PAYMENT IS AVAILABLE. FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS WITH DEMONSTRATED INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES. THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS ACCOUNTS RECEIVABLE. Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. GRANTS INCLUDED IN PART II ARE TO COMMUNITY ORGANIZATIONS THAT ENGAGE IN ACTIVITIES THAT BENEFIT THE COMMUNITY AT LARGE. NO CONSIDERATION IS RECEIVED IN EXCHANGE FOR THESE CONTRIBUTIONS, AS THEY ARE CONSIDERED TO BE A GIFT TO BE USED BY THE RECIPIENTS IN ACCORDANCE WITH THEIR CHARITABLE PURPOSES. AS SUCH, USE OF THE FUNDS GIVEN TO THE GRANTEES IS NOT MONITORED BEYOND DISTRIBUTION. GRANTS INCLUDED IN PART III ARE TO INDIVIDUALS NEEDING FINANCIAL ASSISTANCE. PATIENT HARDSHIP CHARGES ARE BILLED DIRECTLY TO SERMC, AND EMPLOYEES ARE REQUIRED TO PROVIDE COPIES OF INVOICES, ETC. FOR EMPLOYEE ASSISTANCE PAYMENT ELIGIBILITY; THESE PROCEDURES ENSURE PROPER USE OF THE FUNDS. true true false false false false false true false CLIFF ROBERTSON MD Board Member/CEO CHI Health 0 876868 0 868956 0 148965 0 152751 0 25365 0 2072905 0 124000 AMY L MCGAHA md BOARD MEMBER 0 281173 0 0 0 595 0 16033 0 2682 0 300483 0 0 JASON KRUGER MD BOARD MEMBER 0 326110 0 27555 0 693 0 15977 0 20055 0 390390 0 0 STEVE HOUSTON SVP STRATEGY 0 311844 0 17966 0 22064 0 16075 0 16714 0 384663 0 0 JOAN NEUHAUS CHI HEALTH SVP COO 0 467801 0 245946 0 59244 0 16075 0 13523 0 802589 0 0 NANCY WALLACE SVP HR CHI HEALTH 0 357611 0 20235 0 24333 0 15931 0 17565 0 435675 0 0 KIM MOORE FORMER PRESIDENT 0 406143 0 24784 0 217908 0 15626 0 17156 0 681617 0 30479 CARY WARD MD INTERIM PRESIDENT / CHIEF MEDICAL OFFICER 0 500133 0 27366 0 65460 0 16075 0 24210 0 633244 0 0 JEANETTE WOJTALEWICZ CFO CHI Health 0 534695 0 212544 0 67359 0 64743 0 24210 0 903551 0 44617 DAN SCHONLAU VP Operational Finance NHH, St. Elizabeth 0 192783 0 6840 0 2926 0 13254 0 23375 0 239178 0 0 MIKE WATTERS VP-SENIOR COUNSEL 0 252820 0 54028 0 33553 0 16161 0 25250 0 381812 0 0 DONNA HAMMACK CHIEF DEVELOPMENT OFFICER-FOUNDATION 163800 0 3737 0 2265 0 10633 0 16643 0 197078 0 0 0 KENT HOXMEIER PERFUSIONIST 10221 153079 0 0 0 6220 10868 0 18644 4527 39733 163826 0 0 Michele Murphy Supervisor - Pharmacy 175033 0 0 0 5634 0 11169 0 23390 0 215226 0 0 0 ELIZABETH RAETZ VP NURSING 19991 0 0 0 194046 0 7099 0 1188 0 222324 0 0 0 CARY REIMERS VP-PATIENT CARE SERVICES 80460 61669 4829 28877 2670 129 10913 0 22231 2332 121103 93007 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) WRITTEN EMPLOYMENT CONTRACTS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. COMPENSATION FOR THE OTHER OFFICERS OF SAINT ELIZABETH REGIONAL MEDICAL CENTER WAS ESTABLISHED BY THE CHI HEALTH CEO AND HUMAN RESOURCES DIRECTOR USING THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION: (1) COMPENSATION SURVEYS OR STUDIES (2) INDEPENDENT COMPENSATION CONSULTANT AND (3) APPROVAL BY THE BOARD COMPENSATION COMMITTEE. Schedule J, Part I, Line 4a Severance or change-of-control payment 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. The following reportable individuals received severance payments from Catholic Health Initiatives or Saint Elizabeth Regional Medical Center during the 2017 calendar year, and these severance payments were included in the individual's W-2 income and reportable compensation on Schedule J: Kim Moore - $146,867 Elizabeth Raetz - $193,020 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: CLIFF ROBERTSON JEANETTE WOJTALEWICZ KIM MOORE CARY WARD JOAN NEUHAUS DEREK VANCE DURING 2017 THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: CLIFF ROBERTSON - $136,676 JEANETTE WOJTALEWICZ - $48,668 DEREK VANCE - $3,000 DURING 2017 THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI FROM THE DEFERRED COMPENSATION PLAN: CLIFF ROBERTSON - $124,018 JEANETTE WOJTALEWICZ - $44,623 KIM MOORE - $30,483 CARY WARD - $42,848 DUE TO THE "SUPER" VESTING RULES UNDER THE CHI DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS AGE, YEARS OF SERVICE OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2017 CONTRIBUTIONS IN CASH. 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 THAT WOULD HAVE BEEN MADE BY CHI TO THE DEFERRED COMPENSATION PLAN WERE PAID IN CASH: KIM MOORE - $31,756 JOAN NEUHAUS - $41,644 Schedule J, Part I, Line 7 Non-fixed payments CATHOLIC HEALTH INITIATIVES (CHI) MAINTAINS A VARIABLE PAY PROGRAM FOR MANAGERS AND ABOVE THAT PUTS A CERTAIN AMOUNT OF COMPENSATION AT RISK. AWARDS OF INCENTIVE COMPENSATION UNDER THE VARIABLE PAY PROGRAM ARE MADE BASED UPON ACHIEVEMENT OF ORGANIZATIONAL OBJECTIVES INCLUDING FINANCIAL OUTCOMES, QUALITY IMPROVEMENT, AND OTHER MEASURES AS DETERMINED ANNUALLY BY THE BOARD OF STEWARDSHIP TRUSTEES. HOWEVER, ELIGIBLE AWARDS PAYABLE UNDER THIS PROGRAM ARE DEPENDENT ON HITTING MINIMUM LEVELS OF OPERATING MARGIN AND CHARITY CARE LEVELS, UNLESS THE HR COMMITTEE OF THE BOARD OF STEWARDSHIP TRUSTEES USES THEIR DISCRETION TO APPROVE AN EXCEPTION. Form 990, Part III, Line 4d Description of other program services (Expenses $ 134,837,930 including grants of $ 14,508,902)(Revenue $ 141,460,727) Other programs Form 990, Part V, Line 1c number reported in Box 3 of Form 1096 PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF CATHOLIC HEALTH INITIATIVES (CHI) ARE MADE BY CHI. THEREFORE NO FORM 1099'S ARE ISSUED BY CHI HEALTH SAINT ELIZABETH. CHI FILES THE FORM 1099'S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099'S ISSUED BY CHI ON BEHALF OF CHI HEALTH SAINT ELIZABETH ARE REPORTED TO THE IRS. Form 990, Part VI, Line 16b JOINT VENTURE POLICY CHI HEALTH SAINT ELIZABETH HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER CHI'S SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS; AND (5) ALL CONTRACTS ENTERED INTO BY THE PARTNERSHIP WITH THE EXEMPT ORGANIZATION MUST BE AT ARM'S-LENGTH, WITH PRICES SET AT FAIR MARKET VALUE. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL. Form 990, Part VI, Line 12c CONFLICT OF INTEREST POLICY The Board Chair or designee shall make such further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the Board Chair, the Vice Chair will assume the Chair's role outlined in the COI Policy. Based on review and evaluation of the relevant facts and circumstances, the Board Chair will make an initial determination as to whether a conflict of interest exists and whether, pursuant to the COI Policy, review and approval or other action by the Board is required. A written record of the Board Chair's determination, including relevant facts and circumstances, will be made. The Board Chair shall then make an appropriate report to the Executive Committee of the Board concerning such review, evaluation and determination. If a difference of opinion exists between the Board Chair and another Trustee as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether Board review and approval or other action is required within the COI Policy, the matter shall be submitted to the Board's Executive Committee, which shall make a final determination as to the matter presented. Such determination, including relevant facts and circumstances, will be reflected in the Executive Committee minutes and will be reported to the Board. The Board shall carefully scrutinize and must in good faith approve or disapprove any transaction in which CHI or a CHI Entity is a party and in which the Trustee or Corporate Officer either: * Has a material financial interest; or * Is a Trustee or Corporate Officer of the other party (other than a CHI-affiliated organization). The Board must approve the transaction by a majority of the Trustees on the Board, without counting the vote of any individual who has an interest in the transaction. In reviewing such transactions between CHI or CHI Entities and vendors or other contractors who are, or are affiliated with, Trustees or Corporate Officers, the Board shall act no more or less favorably than it would in reviewing transactions with unrelated third parties. The transaction will not be approved unless the Board determines that the transaction is fair to CHI or the CHI Entity. The Board shall carefully review and scrutinize any non-transactional conflict of interest (e.g., disclosure of nonpublic information, competition with CHI or a CHI Entity, failure to disclose a corporate opportunity, excessive gifts or entertainment, etc.). By a majority vote of the disinterested Trustees, the Board shall take whatever action is deemed appropriate with respect to the Trustee or Corporate Officer under the circumstances, including possible disciplinary or corrective action, in order to best protect the interests of CHI or the CHI Entity. The Board should consult with the General Counsel of CHI or his or her designee when considering disciplinary or corrective action. When any conflict of interest is considered by the Board, the Trustee or Corporate Officer, as appropriate, must disclose all of the material facts to the Board. The Trustee shall not vote and the Trustee or Corporate Officer shall not use his or her personal influence on the matter. However, if requested, such Trustee or Corporate Officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from Trustees, as his or her knowledge may be of significant importance. The Trustee or Corporate Officer shall be excused from the meeting during discussion and vote on the conflict of interest. Minutes of the Board shall reflect the following: the individual making the disclosure, the nature of the disclosure, discussion regarding any proposed transaction, the decision made by the Board, and that the interested Trustee or Corporate Officer was excused during the discussion, and that the interested Trustee abstained from voting. If the Board reasonably believes that a Trustee or Corporate Officer has failed to disclose either an actual or potential conflict of interest, or all material facts surrounding an actual or possible conflict as required by the COI Policy, the Trustee or Corporate Officer will be given an opportunity to explain such alleged failure to disclose. After hearing the response of the Trustee or Corporate Officer, the Board will conduct such additional investigation as may be appropriate. If the Board determines that the Trustee or Corporate Officer has in fact failed to disclose as required by the COI Policy, the Board shall take appropriate disciplinary or corrective action. All determinations of conflicts of interest are reported as required by law, regulations, and CHI policy. Form 990, Part VI, Line 1a Delegate broad authority to a committee Pursuant to Section 8.1 of the corporation's bylaws, committees, such as the Executive Committee, that are granted authority to act on behalf of the board of directors may include only directors of the corporation. Form 990, Part VI, Line 6 Classes of members or stockholders According to the organization's bylaws of Saint Elizabeth Regional Medical Center, the entity's sole corporate member is CHI Nebraska, a Nebraska non-profit corporation. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body According to the organization's bylaws, directors shall be appointed or refused by the corporate member. The corporate member may appoint one or more individuals to the board of directors, and may at any time remove, with or without cause, any member of the board of directors. According to the organization's bylaws, directors of the corporation shall be appointed by the corporate member no later than June 30 of each year. The names and qualifications of each individual accepted by the board of directors shall be submitted to the corporate member, who shall appoint or refuse each nominee in accordance with the corporate member's bylaws and with endorsement of the senior vice president of operations. The corporate member may unilaterally appoint one or more individuals to the board of directors should the board fail to furnish the corporate member with a list of individuals qualified to serve on the board of directors of the corporation. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The organization's corporate member is CHI Nebraska. Pursuant to Section 5.4.1 of the organization's bylaws, both CHI Nebraska and Catholic Health Initiatives ("CHI") have reserved powers as outlined in the CHI governance matrix. Pursuant to the governance matrix the following rights are held by the CHI Nebraska's Board: * Approve members of the Saint Elizabeth Regional Medical Center board. * Amendment of the corporate documents of the Saint Elizabeth Regional Medical Center. *Approve removal of a member of the governing body of the Saint Elizabeth Regional Medical Center. * Adoption of long range and strategic plans for the Saint Elizabeth Regional Medical Center. The following rights are reserved to the CHI Board directly or through powers delegated to the CHI Chief Executive Officer: * Substantial change in the mission or philosophy of the Saint Elizabeth Regional Medical Center. * Removal of a member of the governing body of the Saint Elizabeth Regional Medical Center. * Approval of issuance of debt by Saint Elizabeth Regional Medical Center. * Approval of participation of Saint Elizabeth Regional Medical Center in a joint venture. *Approval of formation of a new corporation by Saint Elizabeth Regional Medical Center. * Approval of a merger involving the Saint Elizabeth Regional Medical Center. * Approval of the sale of all or substantially all of the assets of the Saint Elizabeth Regional Medical Center. * To require the transfer of assets by the Saint Elizabeth Regional Medical Center to CHI to accomplish CHI's goals and objectives, and to satisfy CHI debts. Pursuant to Section 5.5.2 of the organization's bylaws, CHI Nebraska or CHI may, in exercise of their approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and its President and the Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate. Form 990, Part VI, Line 11b Review of form 990 by governing body FOLLOWING THE PREPARATION OF THE FORM 990 BY TAX ANALYSTS OF CATHOLIC HEALTH INITIATIVES, A RELATED ORGANIZATION, THE RETURN IS REVIEWED BY THE CHI TAX DIRECTOR AND THE LOCAL CHIEF FINANCIAL OFFICER. ADDITIONALLY, THE BOARD OF DIRECTORS ARE PROVIDED THE FINAL FORM 990 AND RELATED SCHEDULES TO REVIEW AND ARE ABLE TO ASK THE CHIEF FINANCIAL OFFICER AND TAX DIRECTOR QUESTIONS PRIOR TO FILING WITH THE IRS. UPON CHIEF FINANCIAL OFFICER APPROVAL AND SIGNATURE, THE TAX ANALYST FILES THE FINAL FORM 990 AS PRESENTED TO THE BOARD AND FINANCE COMMITTEE, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY IN ORDER TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD. Form 990, Part VI, Line 12c Conflict of interest policy Catholic Health Initiatives ("CHI") has a Conflicts of Interest ("COI") policy (the "Policy") in place to maintain the integrity of all of its activities. The Policy applies to CHI Board of Stewardship Trustees and members of its committees; all CHI Entity board and board committee members; all CHI employees; and all CHI research personnel (both employed and non-employed). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure review process. Each Person must promptly and fully disclose to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The Person must disclose the actual or potential conflict as soon as she/he becomes aware of it. In any situation where the Person may be in doubt, a full disclosure should be made to permit an impartial and objective determination. In addition to the general ongoing obligation, there are initial disclosure obligations. At the time of initial appointment, a copy of the Policy shall be distributed to the board or committee member along with a conflict of interest disclosure. The board or committee member will complete and submit the disclosure. The completed disclosure shall be maintained in confidence and access shall be limited to persons who have a reasonable need to know the contents. At the time of hiring, a copy of the Policy shall be distributed to all Employees. In addition, a conflict of interest disclosure will be provided. The Employee must complete and submit a conflict of interest disclosure. The completed disclosure shall be maintained in confidence and access shall be limited to persons who have a reasonable need to know the contents. In addition to the general ongoing and initial disclosure obligations, there is an annual disclosure obligation. On an annual basis, the following Persons must complete a new conflict of interest disclosure: * Board and board committee members; * Employees at the level of vice president and above; * Researchers; * Supply Chain Employees at the level of vice president and above and those employees involved in contracting regardless of employment level; * Other Employees as deemed applicable by CHI Leadership; Disclosures of perceived, potential or actual conflicts involving financial interests are forwarded to the Conflicts of Interest Review Committee ("C-CIRC"), National or Regional Legal Services, National, Entity, or Research Corporate Responsibility Program, or the Executive Committee of the Board or Board Chair, for review depending on the position of the person involved. Among the factors that should be considered in determining whether a conflict exists are the nature and magnitude of the opportunity, transaction or arrangement, the degree to which it is related to CHI's business, whether the Person with the conflict is the ultimate decision-maker or holds significant influence over the ultimate decision-maker (i.e., degree of independence of the decision-making process), the unique nature of the opportunity, transaction or arrangement, the existence of other viable alternatives and the quality of those alternatives, and what is customary and reasonable in the health care or research industry. When a Person has, or is considering initiating, a business interest or relationship outside of CHI but is uncertain whether the interest constitutes a conflict of interest requiring disclosure under this Policy, the Person should consult with local Corporate Responsibility Program (CRP) staff or CHI Legal Services Group (LSG) staff, as appropriate. As appropriate, a COI management plan will be developed. With respect to those audiences for which the C-CIRC has review responsibility, the C-CIRC will facilitate development of any such COI management plan in collaboration with local CRP staff or CHI LSG staff, as appropriate. This plan will include documentation of the C-CIRC's determinations and recommendations. As necessary, reports to an appropriate governmental agency or sponsor will be made according to the relevant appendices to this Policy to provide required information regarding how the conflict of interest will be managed, reduced, or eliminated. Designated CHI Entity staff are responsible for monitoring the COI management plan and for documenting monitoring activities. At its sole discretion, a CHI Entity may reject a Person's request to enter into the relationship in question, or require the relationship be sufficiently altered to avoid a potential conflict of interest. The C-CIRC will determine whether a disclosed or otherwise identified interest is a conflict of interest. If the C-CIRC determines that a potential or actual conflict of interest exists that does not currently have appropriate controls to address the conflict of interest, it may recommend that the disclosing Person be allowed to participate in the activity or transaction subject to restrictions as outlined in a written COI management plan. All determinations of conflicts of interest will be reported as required by law, regulations, and CHI policy. If a Person, other than a board or board committee member or corporate officer, required to complete a COI disclosure does not agree with a determination made by the C-CIRC, its interpretation of the COI Policy, still seeks an exemption or exception, or seeks further clarification of the C-CIRC's decision, the following steps should be followed. Within a reasonable period of time after receiving notice of the C-CIRC's decision, the Person must present the matter to the Person's immediate direct manager or supervisor (or in the case of a Researcher, to [fill in the title or position to whom Researchers report]) and request reconsideration, submitting at that time any new or additional information that may support or recommend reconsideration. If the Person's manager individually or in consultation with the manager's Vice President (or higher if the manager is a Vice President) finds that new information supporting reconsideration has been presented, the manager will contact local or National CRP staff, as appropriate, and request that the matter be re-presented to the C-CIRC. The C-CIRC will be reconvened for this purpose and, following such reconsideration, issue a final determination. This appeals process is intended to be narrowly applied, as Persons seeking conflict of interest exemptions or exceptions are expected to offer all available information supporting an exemption or exception at the time the matter is first presented to the C-CIRC. Management of actual or potential conflicts of interest of board or board committee members and corporate officers will be determined by the appropriate board, as reflected in the Policy. Reviews and determinations involving board and board committee members and corporate officers will be the responsibility of the board, board executive committee, or board chair, with guidance from the Legal Services Group (LSG). Each Trustee and Corporate Officer must promptly and fully report to the Board Chair situations that may create a conflict of interest when he or she becomes aware of such situations. In any situation when a Trustee or Corporate Officer is in doubt, full disclosure should be made to permit an impartial and objective determination. A written record of the disclosure will be made. In addition to the ongoing disclosure obligation, all Trustees and Corporate Officers shall complete a COI disclosure questionnaire on an annual basis. A copy of the COI Policy shall be available to Trustees and Corporate Officers. Definitions of terms used in the disclosure questionnaire/form shall also be included. Each Trustee and Corporate Officer must promptly complete the COI disclosure. COI disclosures that involve no disclosures of conflicts of interest will not require review. Disclosures of perceived, potential or actual conflicts of interest on the COI questionnaire involving financial interests will be reviewed by National or Regional LSG. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION IS PAID BY CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI HAS A DEFINED COMPENSATION PHILOSOPHY. BOTH THE EXECUTIVE AND NON-EXECUTIVE COMPENSATION STRUCTURES AND RANGES ARE REVIEWED ANNUALLY IN COMPARISON TO MARKET DATA. CHI USES THE KORN FERRY HAY GROUP AS THE INDEPENDENT THIRD PARTY TO ASSESS EXECUTIVE COMPENSATION PROGRAMS AND TO ENSURE THE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. COMPENSATION OF THE SENIOR MOST EXECUTIVES IS REVIEWED ANNUALLY. THE KORN FERRY HAY GROUP REVIEWS BOTH CASH AND TOTAL COMPENSATION FOR OVERALL REASONABLENESS, FOR ADHERENCE TO CHI'S COMPENSATION PHILOSOPHY, AND FOR COMPARABILITY TO THE NOT-FOR-PROFIT HEALTHCARE MARKET. THIS INDEPENDENT REVIEW IS DELIVERED BY KORN FERRY HAY GROUP TO THE HR COMMITTEE OF THE CHI BOARD OF STEWARDSHIP TRUSTEES ANNUALLY AT THEIR SEPTEMBER MEETING AND MINUTES ARE SHARED WITH THE FULL BOARD AT THE DECEMBER MEETING. THE LAST REVIEW WAS SEPTEMBER 11, 2017. IN ADDITION, KORN FERRY HAY GROUP COMPLETED A COMPREHENSIVE REVIEW OF ALL POSITIONS AT THE LEVEL OF VICE PRESIDENT AND ABOVE IN THE FALL OF 2014 TO DETERMINE AND VALIDATE APPROPRIATE COMPENSATION LEVELS. THESE LEVELS HAVE BEEN REVIEWED ANNUALLY SINCE AND REVISED BASED ON MARKET DATA, WHERE APPLICABLE. COMPENSATION FOR THE OTHER OFFICERS OF SAINT ELIZABETH REGIONAL MEDICAL CENTER WAS ESTABLISHED BY THE CHI HEALTH CEO AND HUMAN RESOURCES DIRECTOR USING THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION: (1) COMPENSATION SURVEYS OR STUDIES (2) INDEPENDENT COMPENSATION CONSULTANT AND (3) APPROVAL BY THE BOARD COMPENSATION COMMITTEE. Form 990, Part VI, Line 15b Process to establish compensation of other employees See Form 990, Part VI, Line 15a disclosure. Form 990, Part VI, Line 19 Required documents available to the public The Organization's governing documents and conflict of interest policy are available upon request from the administration department. In addition, the Articles of Incorporation are available from the Nebraska Secretary of State website (http://www.sos.ne.gov/business). The organization's financial statements are included in Catholic Health Initiatives' consolidated audited financial statements that are available at www.CatholicHealthInit.org. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Miscellaneous Revenue - Total Revenue: 680575, Related or Exempt Function Revenue: , Unrelated Business Revenue: 235016, Revenue Excluded from Tax Under Sections 512, 513, or 514: 445559; Form 990, Part IX, Line 11g Other Fees Other Fees for Services - Total Expense: 14876838, Program Service Expense: 5457506, Management and General Expenses: 9419332, Fundraising Expenses: 0; Consulting - Total Expense: 82720, Program Service Expense: 66176, Management and General Expenses: 16544, Fundraising Expenses: ; Contract Services - Total Expense: 529205, Program Service Expense: 423364, Management and General Expenses: 105841, Fundraising Expenses: ; Contract Labor - Total Expense: 4179195, Program Service Expense: 3343356, Management and General Expenses: 835839, Fundraising Expenses: ; Purchased Services - Total Expense: 13457876, Program Service Expense: 10772053, Management and General Expenses: 2685823, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Lincoln CK Leasing Non-Controlling Interest - -1326187; Other Changes - 205; ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HEALTHCARE NE 501(c)(3) 3 ACH true ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HEALTHCARE NE 501(c)(3) 3 CHI NEBRASKA true ALEGENT CREIGHTON HEALTH FOUNDATION 12809 W DODGE RD OMAHA NE 68154 470648586 FUNDRAISING NE 501(c)(3) 7 ACH true ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HEALTHCARE NE 501(c)(3) 3 CHI NEBRASKA 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 true ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HEALTHCARE NE 501(c)(3) 3 CHI NEBRASKA true ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HEALTHCARE NE 501(c)(3) 3 CHI NEBRASKA true ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HEALTHCARE IA 501(c)(3) 3 CHI NEBRASKA true ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(c)(3) 10 CHI true APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(c)(3) 10 SFH 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 true BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760458535 PHYSICIANS TX 501(c)(3) 3 SLHS true BELLEVILLE ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 274005511 HEALTHCARE TX 501(c)(3) 3 SHSC true BISHOP DRUMM RETIREMENT CENTER 5837 Winwood Dr Johnston IA 50131 420725196 LTERM CARE IA 501(c)(3) 10 CHI-IA CORP true BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232187242 HEALTHCARE CO 501(c)(3) Type I CHI true BRAZOSPORT HEALTH FOUNDATION INC 1 West Way Ct LAKE JACKSON TX 77566 760080110 FUNDRAISING TX 501(c)(3) Type I BRHS true BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DRIVE LAKE JACKSON TX 77566 800240261 HEALTHCARE TX 501(c)(3) 3 BRHS true BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HEALTHCARE TX 501(c)(3) 3 SJSC true BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 HEALTHCARE TX 501(c)(3) 10 SJSC true CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HEALTHCARE ND 501(c)(3) 3 CHI true CATHOLIC HEALTH INITIATIVES - COLORADO 9100 East Mineral Circle Centennial CO 80112 840405257 HEALTHCARE CO 501(c)(3) 3 CHI true CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVE DES MOINES IA 50314 420680448 HEALTHCARE IA 501(c)(3) 3 CHI true CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 1150 Kelly Johnson Blvd 204 COLORADO SPRINGS CO 80920 840902211 FUNDRAISING CO 501(c)(3) 7 CHIC true CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 1150 Kelly Johnson Blvd 204 COLORADO SPRINGS CO 80920 270930004 FUNDRAISING CO 501(c)(3) Type I CHI true CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 460992796 HEALTHCARE CO 501(c)(3) Type I CHINS true CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG OR 97471 263946191 PHYSICIANS OR 501(c)(3) 10 MMC true CENTRAL KANSAS MEDICAL CENTER 3515 BROADWAY GREAT BEND KS 67530 480543724 SURGERY CENTER KS 501(c)(3) 3 CHI true CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO ND 58104 271966847 HEALTHCARE ND 501(c)(3) 10 CHI true CHI INSTITUTE FOR RESEARCH AND INNOVATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 271050565 HEALTHCARE CO 501(c)(3) Type I CHI true CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER KY 41018 202741651 HEALTHCARE KY 501(c)(3) Type I CHI true CHI LIVING COMMUNITIES 5942 RENAISSANCE PLACE STE A TOLEDO OH 43623 341892096 HEALTHCARE OH 501(c)(3) Type II SFH true CHI Memorial Hospital - Georgia 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 822748395 HEALTHCARE GA 501(c)(3) 3 MHCS true CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 451261716 HEALTHCARE CO 501(c)(3) 10 CHI NS true CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 452532084 HEALTHCARE CO 501(c)(3) Type I CHI true CHI NEBRASKA 12809 West Dodge Road Omaha NE 68510 363233121 HEALTHCARE NE 501(c)(3) Type I CHI 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 true CHI ST JOSEPH'S CHILDREN 1516 5TH ST NW ALBUQUERQUE NM 87102 710897107 COMMUNITY NM 501(c)(3) Type I CHI 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 true CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 710236913 HEALTHCARE AR 501(c)(3) 3 CHISVHS true CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125064 HOLDING CO AR 501(c)(3) Type II SVIMC true CHI ST VINCENT MEDICAL GROUP HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125131 HEALTHCARE AR 501(c)(3) 3 CHISVHS true COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 470617373 HEALTHCARE CO 501(c)(3) Type I NA true COMMUNITY LIMITED CARE DIALYSIS CENTER 619 OAK ST ACCOUNTING-3 W CINCINNATI OH 45206 237419853 HOLDING CO OH 501(c)(4) GSH 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 true CONTINUING CARE HOSPITAL One Saint Joseph Drive LEXINGTON KY 40504 611400619 LT ACH KY 501(c)(3) 3 SJHS true East Texas Clinical Services 2801 VIA FORTUNA SUITE 500 AUSTIN TX 78746 454736213 HEALTHCARE TX 501(c)(3) Type I MHSET true ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1455 BATTERSBY AVE ENUMCLAW WA 98022 910715805 HEALTHCARE WA 501(c)(3) 3 FHS true FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 611345363 HEALTHCARE KY 501(c)(3) 3 KOH true FLAGET MEMORIAL HOSPITAL FOUNDATION INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 562351341 FUNDRAISING KY 501(c)(3) Type I FH true FRANCISCAN CARE CENTER 4111 N HOLLAND-SYLVANIA RD TOLEDO OH 43623 341931806 HEALTHCARE OH 501(c)(3) 10 FLC true FRANCISCAN FOUNDATION 1717 SOUTH J ST TACOMA WA 98405 911145592 FUNDRAISING WA 501(c)(3) 10 FHS true FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA WA 98405 910564491 HEALTHCARE WA 501(c)(3) 3 CHI true FRANCISCAN HEALTH VENTURES FKA SJMGROUP TACOMA FNC CTR BLDG 1145 BROADWAY TACOMA WA 98402 431882377 PHYSICIANS WA 501(c)(3) 10 CHI true FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 200 TACOMA WA 98402 911939739 HEALTHCARE WA 501(c)(3) 10 FHS true FRANCISCAN VILLA OF SOUTH MILWAUKEE INC 3601 S CHICAGO AVE SOUTH MILWAUKEE WI 53172 391093829 HEALTHCARE WI 501(c)(3) 10 CHI true GARRISON MEMORIAL HOSPITAL 407 THIRD AVENUE SOUTHEAST GARRISON ND 58540 450227752 HEALTHCARE ND 501(c)(3) 3 SAMC true GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 201536108 MINISTRIES CO 501(c)(3) Type I CHI 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 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 true GOOD SAMARITAN HOSPITAL 110 N MAIN ST STE 500 DAYTON OH 45402 310536981 HEALTHCARE OH 501(c)(3) 3 SHP true GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY NE 68848 470379755 HEALTHCARE NE 501(c)(3) 3 CHI NEBRASKA true GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST ST KEARNEY NE 68847 470659443 FUNDRAISING NE 501(c)(3) 7 GSH true GOOD SAMARITAN HOSPITAL FOUNDATION - DAYTON 110 N MAIN ST STE 500 DAYTON OH 45402 237296923 FUNDRAISING OH 501(c)(3) 7 SHP true HARRISON MEDICAL CENTER 2520 CHERRY AVE BREMERTON WA 98310 910565546 HEALTHCARE WA 501(c)(3) 3 FHS true HARRISON MEDICAL CENTER FOUNDATION 2520 CHERRY AVE BREMERTON WA 98310 911197626 FUNDRAISING WA 501(c)(3) 7 HMC true HEALTHCARE AND WELLNESS FOUNDATION 2400 ST FRANCIS DR BRECKENRIDGE MN 56520 760761782 FUNDRAISING MN 501(c)(3) Type I SFMC true HIGHLINE MEDICAL CENTER 16251 SYLVESTER RD SW BURIEN WA 98166 910712166 HEALTHCARE WA 501(c)(3) 3 FHS true HOUSE OF MERCY 1111 6TH AVE DES MOINES IA 50314 421323808 SHELTER IA 501(c)(3) 7 CHI-IA CORP 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 true KENTUCKYONE HEALTH MEDICAL GROUP INC 100 E Liberty St Ste 800 LOUISVILLE KY 40202 611352729 HEALTHCARE KY 501(c)(3) 10 JHSMH true KENTUCKYONE HEALTH INC 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 611029769 HEALTHCARE KY 501(c)(3) Type II CHI true LAKEWOOD HEALTH CENTER 600 MAIN AVE S BAUDETTE MN 56623 410758434 HEALTHCARE MN 501(c)(3) 3 CHI true LAKEWOOD REGIONAL HEALTHCARE FOUNDATION 600 MAIN AVE S BAUDETTE MN 56623 411893795 FUNDRAISING MN 501(c)(3) 7 LHC true LINUS OAKES INC 2700 STEWART PKWY ROSEBURG OR 97471 930821381 SENIOR LIVING OR 501(c)(3) 10 MMC true LISBON AREA HEALTH SERVICES 905 MAIN ST LISBON ND 58054 820558836 HEALTHCARE ND 501(c)(3) 3 CHI true LUFKIN VISION ACQUISITIONS PO BOX 1447 LUFKIN TX 75901 820563768 PROPERTY MGMT TX 501(c)(3) Type I MHSET true MADISON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742761145 HEALTHCARE TX 501(c)(3) 3 SJSC true MADONNA MANOR INC 2344 AMSTERDAM ROAD VILLA HILLS KY 51017 610654635 LIVING ASSIST KY 501(c)(3) 10 FLC true MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC 2525 DE SALES AVE CHATTANOOGA TN 37404 621839548 FUNDRAISING TN 501(c)(3) 7 MHCS true MEMORIAL HEALTH CARE SYSTEM INC 2525 DE SALES AVE CHATTANOOGA TN 37404 620532345 HEALTHCARE TN 501(c)(3) 3 CHI true MEMORIAL HEALTH PARTNERS FOUNDATION INC 5600 BRAINERD RD STE 500 CHATTANOOGA TN 37411 030417049 HEALTHCARE TN 501(c)(3) 10 MHCS true MEMORIAL HEALTH SYSTEM OF EAST TEXAS PO BOX 1447 LUFKIN TX 75902 750755367 HEALTHCARE TX 501(c)(3) 3 CHI true MEMORIAL MEDICAL CENTER - LIVINGSTON PO BOX 1447 LUFKIN TX 75902 760436439 HEALTHCARE TX 501(c)(3) 3 MHSET true MEMORIAL MEDICAL CENTER - SAN AUGUSTINE PO BOX 1447 LUFKIN TX 75902 752663904 HEALTHCARE TX 501(c)(3) 3 MHSET true MEMORIAL MULTISPECIALTY ASSOCIATES 1201 FRANK AVE LUFKIN TX 95904 752721155 PHYSICIANS TX 501(c)(3) Type I MHSET true MEMORIAL SPECIALTY HOSPITAL PO BOX 1447 LUFKIN TX 95902 752492741 HEALTHCARE TX 501(c)(3) 3 MHSET true MERCY AUXILIARY OF CENTRAL IOWA 1111 6TH AVE DES MOINES IA 50314 426076069 AUXILIARY IA 501(c)(3) Type I MF-DM IA true MERCY CLINICS INC 1111 6TH AVE DES MOINES IA 50314 421193699 PHYSICIANS IA 501(c)(3) 10 CHI-IA CORP true MERCY COLLEGE OF HEALTH SCIENCES 1111 6TH AVE DES MOINES IA 50314 421511682 EDUCATION IA 501(c)(3) 2 CHI-IA CORP true MERCY FOUNDATION OF DES MOINES IA 1111 6TH AVE DES MOINES IA 50314 237358794 FUNDRAISING IA 501(c)(3) 7 CHI-IA CORP true MERCY FOUNDATION INC 2700 STEWART PKWY ROSEBURG OR 97471 936088946 FUNDRAISING OR 501(c)(3) 7 MMC true MERCY HEALTH CARE FOUNDATION PO BOX 368 CORNING IA 50841 421461064 FUNDRAISING IA 501(c)(3) Type I AHMH-Corning true MERCY HEALTHCARE FOUNDATION 570 CHAUTAUQUA BLVD VALLEY CITY ND 58072 450435338 FUNDRAISING ND 501(c)(3) Type I MHVC true MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS 800 MERCY DR COUNCIL BLUFFS IA 51503 421178204 FUNDRAISING IA 501(c)(3) Type I AHBMHS true MERCY HOSPITAL OF DEVILS LAKE 1031 7TH ST NE DEVILS LAKE ND 58301 450227012 HEALTHCARE ND 501(c)(3) 3 CHI true MERCY HOSPITAL OF DEVILS LAKE FOUNDATION 1031 7TH ST NE DEVILS LAKE ND 58301 352367360 FUNDRAISING ND 501(c)(3) 7 MHDL true MERCY HOSPITAL OF VALLEY CITY 570 CHAUTAUQUA BLVD VALLEY CITY ND 58072 450226553 HEALTHCARE ND 501(c)(3) 3 CHI true MERCY MEDICAL CENTER 1301 15TH AVE WEST WILLISTON ND 58801 450231183 HEALTHCARE ND 501(c)(3) 3 CHI true MERCY MEDICAL CENTER - CENTERVILLE ONE ST JOSEPHS DRIVE CENTERVILLE IA 52544 420680308 HEALTHCARE IA 501(c)(3) 3 CHI-IA CORP true MERCY MEDICAL CENTER 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HEALTHCARE OH 501(c)(3) 10 FLC true PROVIDENCE CARE CENTERS 2025 HAYES AVENUE SANDUSKY OH 44870 341826099 HOLDING CO OH 501(c)(3) Type II FLC true PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION 5055 PROVIDENCE DRIVE SANDUSKY OH 44870 341896807 LIVING COMM OH 501(c)(3) 10 FLC true PUEBLO STEPUP 1925 E ORMAN AVE STE G52 PUEBLO CO 81004 841234295 COMMUNITY CO 501(c)(3) 7 CHIC true REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE 16251 Sylvester Road SW Burien WA 98166 911170040 HEALTHCARE WA 501(c)(3) 3 FHS true SET OF COLORADO SPRINGS INC 9100 E Mineral Circle Centennial CO 80112 841183335 LTERM CARE CO 501(c)(3) 7 CHIC true SAINT CLARE'S COMMUNITY CARE INC 25 POCONO RD DENVILLE NJ 07834 222876836 HEALTHCARE NJ 501(c)(3) 10 SCHS true SAINT CLARE'S FOUNDATION INC 25 POCONO RD DENVILLE NJ 07834 222502997 FUNDRAISING NJ 501(c)(3) 7 SCHS true SAINT CLARE'S HEALTH SERVICES INC 25 POCONO RD DENVILLE NJ 07834 223639733 MANAGEMENT NJ 501(c)(3) 10 CHI true SAINT CLARE'S HOSPITAL INC 25 POCONO RD 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ORGANIZATION 380 SUMMIT AVE STEUBENVILLE OH 43952 341471026 Mgmt Services OH THS C Corporation 13543963 184008 1 true false false true false false false false false false true false false true true true true false false true SAINT ELIZABETH FOUNDATION C 849665 BOOK