CHI LISBON HEALTH: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- CHI LISBON HEALTH (EIN 82-0558836)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-10
- IRS object ID
- 201801309349300920
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-10T16:00:23-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | 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 | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 820558836 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lisbon Area Health Services | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LISB | BusinessNameControlTxt |
| Phone | 7016835241 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 905 Main Street | AddressLine1Txt |
| City | Lisbon | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58054 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Peggy Reinke | PersonNm |
| Person Title | President | PersonTitleTxt |
| Signature | 2018-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Luke Megna | PreparerPersonNm |
| PTIN | P01236643 | PTIN |
| Phone | 3032989100 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHI Lisbon Health | BusinessNameLine1Txt |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Peggy Reinke | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 905 Main Street | AddressLine1Txt |
| City | Lisbon | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58054 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,590,026 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.lisbonhospital.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | To provide high quality health care within ideals of compassion and concern, to be committed to maintain our presence into the future by serving our customers, to assure continuity of total care. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 117 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $330 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $78,916 | PYContributionsGrantsAmt |
| CY Contributions Grants | $70,551 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,410,689 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,192,592 | CYProgramServiceRevenueAmt |
| PY Investment Income | $110,741 | PYInvestmentIncomeAmt |
| CY Investment Income | $204,026 | CYInvestmentIncomeAmt |
| PY Other Revenue | $91,086 | PYOtherRevenueAmt |
| CY Other Revenue | $99,701 | CYOtherRevenueAmt |
| PY Total Revenue | $12,691,432 | PYTotalRevenueAmt |
| CY Total Revenue | $11,566,870 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $126,186 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $146,097 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,655,452 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,110,907 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,064,733 | PYOtherExpensesAmt |
| CY Other Expenses | $6,411,273 | CYOtherExpensesAmt |
| PY Total Expenses | $10,846,371 | PYTotalExpensesAmt |
| CY Total Expenses | $10,668,277 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,845,061 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $898,593 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,247,718 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,868,119 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,077,022 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,687,036 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,170,696 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,181,083 | NetAssetsOrFundBalancesEOYAmt |
| Mission | See Schedule O | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $9,551,065 | ExpenseAmt |
| Grant | $146,097 | GrantAmt |
| Revenue | $11,192,592 | RevenueAmt |
| Desc | SEE SCHEDULE H | Desc |
| Total Program Service Expenses | $9,551,065 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (true) | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 117 | 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 | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Amber Stowman | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7012378022 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4784 Amber Valley Parkway | AddressLine1Txt |
| City | Fargo | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58104 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 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 |
|---|---|---|---|---|---|---|---|---|---|
| PEGGY REINKE | |||||||||
| PRESIDENT | 40.0 | 0.0 | Yes (X) | Yes (X) | $0 | $233,612 | $11,268 | ||
| BRIAN SHELTON | |||||||||
| CHAIR | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| NEIL OLERUD | |||||||||
| Vice Chair | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Sister Donna Welder | |||||||||
| Secretary | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LIZ ANDERSON | |||||||||
| Board member | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| JEFFREY DROP | |||||||||
| Board Member/CHI SVP Division Officer | 1.0 | 59.0 | Yes (X) | $0 | $1,315,324 | $28,212 | |||
| Jason Enger | |||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Dwayne Horgeshimer | |||||||||
| BOARD MEMBER (partial year) | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| AMBER STOWMAN | |||||||||
| Division Director of Finance | 40.0 | 0.0 | Yes (X) | $0 | $120,106 | $24,238 | |||
| OSCAR FERNANDEZ | |||||||||
| PHYSICIAN | 40.0 | 0 | $242,393 | $0 | $29,291 | Yes (X) | |||
| KEVIN JACOBSON | |||||||||
| Nurse Practitioner | 40.0 | 0 | $129,607 | $0 | $18,805 | Yes (X) | |||
| Julie A Mallett | |||||||||
| VP PATIENT CARE SERVICES | 40.0 | 0 | $108,622 | $0 | $7,668 | Yes (X) | |||
| JILL MCRITCHIE | |||||||||
| MANAGER PHARMACY | 40.0 | 0 | $131,763 | $0 | $23,136 | Yes (X) | |||
| BECKI THOMPSON | |||||||||
| VP OPERATIONAL FINANCE (THROUGH 7/31/14) | 0.0 | 60.0 | $0 | $182,976 | $23,314 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $612,385 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,852,018 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $165,932 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NORIDIAN ADMINISTRATIVE SVCS | |||||
| 900 40th St S | Fargo | ND | 58103 | Services & Solutions | $1,608,364 |
| NATIONAL MEDICAL RESOURCES | |||||
| 2900 E BROADWAY AVE SUITE 1 | BISMARCK | ND | 58501 | EMERGENCY ROOM COVERAGE | $405,086 |
| MOBILITY PLUS | |||||
| 26295 CRYSTAL RD | PELICAN RAPIDS | MN | 56572 | PHYSICAL/OCCUPATIONAL THERAPY SERVICES | $276,335 |
| Rudolf LOPERENA MD | |||||
| PO BOX 71 | LISBON | ND | 58054 | ER PHYSICIAN COVERAGE | $254,901 |
| INTERSTAFF INC | |||||
| 16107 Kensington Drive 140 | Sugar Land | TX | 77479 | CONTRACT LABOR | $188,507 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $28,025 | FundraisingAmt |
| Government Grants | $14,988 | GovernmentGrantsAmt |
| All Other Contributions | $27,538 | AllOtherContributionsAmt |
| Total Contributions | $70,551 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient Services | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $11,192,592 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,192,592 | 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 | $11,192,592 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $96,084 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $330 | UnrelatedBusinessRevenueAmt |
| Exclusion | $95,754 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $68,093 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $68,093 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,093 | TotalRevenueColumnAmt |
| Exclusion | $68,093 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $121,036 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $13,094 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $121,036 | SecuritiesAmt |
| Other | -$13,094 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $107,942 | TotalRevenueColumnAmt |
| Exclusion | $107,942 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $28,150 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $28,025 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $9,403 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,747 | TotalRevenueColumnAmt |
| Exclusion | $18,747 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $10,825 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $659 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,166 | TotalRevenueColumnAmt |
| Exclusion | $10,166 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Medical Records Revenue/Transcription | 541200 | $2,216 | $2,216 |
| Cafeteria | 722100 | $177 | $177 |
| Miscellaneous revenue | 900099 | $302 | $302 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,695 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,566,870 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,192,592 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $330 | UnrelatedBusinessRevenueAmt |
| Exclusion | $303,397 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,376 | TotalAmt |
| Program Services | $2,376 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,721 | TotalAmt |
| Program Services | $143,721 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,219,223 | TotalAmt |
| Program Services | $2,942,734 | ProgramServicesAmt |
| Management And General | $276,489 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,730 | TotalAmt |
| Program Services | $152,410 | ProgramServicesAmt |
| Management And General | $14,320 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $492,101 | TotalAmt |
| Program Services | $449,837 | ProgramServicesAmt |
| Management And General | $42,264 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $232,853 | TotalAmt |
| Program Services | $212,854 | ProgramServicesAmt |
| Management And General | $19,999 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,121 | TotalAmt |
| Management And General | $18,121 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,794 | TotalAmt |
| Management And General | $2,794 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,067,974 | TotalAmt |
| Program Services | $2,492,852 | ProgramServicesAmt |
| Management And General | $575,122 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,076 | TotalAmt |
| Management And General | $14,076 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $246,758 | TotalAmt |
| Program Services | $196,488 | ProgramServicesAmt |
| Management And General | $50,270 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $920,246 | TotalAmt |
| Program Services | $874,234 | ProgramServicesAmt |
| Management And General | $46,012 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,626 | TotalAmt |
| Program Services | $198,935 | ProgramServicesAmt |
| Management And General | $18,691 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,731 | TotalAmt |
| Program Services | $3,869 | ProgramServicesAmt |
| Management And General | $3,862 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,027 | TotalAmt |
| Program Services | $112 | ProgramServicesAmt |
| Management And General | $915 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,565 | TotalAmt |
| Program Services | $20,565 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $255,600 | TotalAmt |
| Program Services | $255,600 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $574,515 | TotalAmt |
| Program Services | $574,515 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $562,530 | $562,530 | |
| Bad debts | $275,689 | $275,689 | |
| Repairs and maintenance | $173,074 | $171,409 | $1,665 |
| Dues & subscriptions | $37,223 | $20,335 | $16,888 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,724 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $15,724 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,668,277 | TotalAmt |
| Program Services | $9,551,065 | ProgramServicesAmt |
| Management And General | $1,117,212 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $770 | BOYAmt |
| EOY | $570 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,904,968 | BOYAmt |
| EOY | $2,956,833 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,050,352 | BOYAmt |
| EOY | $1,759,019 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,296 | BOYAmt |
| EOY | $1,893 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $172,868 | BOYAmt |
| EOY | $168,512 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,801 | BOYAmt |
| EOY | $11,801 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,800,958 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,209,357 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,025,244 | BOYAmt |
| EOY | $3,591,601 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,560,799 | BOYAmt |
| EOY | $2,851,506 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,515,620 | BOYAmt |
| EOY | $2,526,384 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,247,718 | BOYAmt |
| EOY | $13,868,119 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,158,960 | BOYAmt |
| EOY | $902,787 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,918,062 | BOYAmt |
| EOY | $2,784,249 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,077,022 | BOYAmt |
| EOY | $3,687,036 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,106,772 | BOYAmt |
| EOY | $10,137,501 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,424 | BOYAmt |
| EOY | $40,082 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,500 | BOYAmt |
| EOY | $3,500 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,170,696 | BOYAmt |
| EOY | $10,181,083 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,247,718 | BOYAmt |
| EOY | $13,868,119 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $898,593 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $111,794 | NetUnrlzdGainsLossesInvstAmt |
| 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 | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (true) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $2,794 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $2,794 | TotalLobbyingExpendituresAmt |
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 $411 CATHOLIC HEALTH ASSOCIATION $329 North Dakota Hospital Association - $2,054 |
| 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 $411 CATHOLIC HEALTH ASSOCIATION $329 North Dakota Hospital Association - $2,054 |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,500 | BeginningYearBalanceAmt |
| End Year Balance | $3,500 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,500 | BeginningYearBalanceAmt |
| End Year Balance | $3,500 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,500 | BeginningYearBalanceAmt |
| End Year Balance | $3,500 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,500 | BeginningYearBalanceAmt |
| Contributions | $0 | ContributionsAmt |
| Investment Earnings Or Losses | $0 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $0 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $3,500 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $0 | BeginningYearBalanceAmt |
| Contributions | $3,500 | ContributionsAmt |
| Investment Earnings Or Losses | $0 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $3,500 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.0 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.0 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.0 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $103,303 | OtherCostOrOtherBasisAmt |
| Book Value | $103,303 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,264,182 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,098,283 | DepreciationAmt |
| Book Value | $165,899 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,260,911 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,987,457 | DepreciationAmt |
| Book Value | $3,273,454 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $172,562 | OtherCostOrOtherBasisAmt |
| Depreciation | $123,617 | DepreciationAmt |
| Book Value | $48,945 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,591,601 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CHI OIP | Desc |
| Book Value | $2,851,506 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $2,851,506 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Equity in Central Minnesota Diagnostic Imaging | $141,293 |
| Intercompany Receivables | $2,385,091 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,526,384 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Intercompany Payables | $2,455,160 |
| CHI Debt Management Program | $329,089 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,784,249 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part V, Line 4 Intended uses of endowment funds | Endowment funds are held to provide support to and for the benefit of Lisbon Area Health Services. |
| Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | Lisbon Area Health Services' financial information is included in the consolidated audited financial statements of Catholic Health Initiatives (CHI), a related organization. CHI's FIN 48 (ASC 740) footnote for the year ended June 30, 2017, reads as follows: "CHI is a tax-exempt Colorado corporation and has been granted an exemption from federal income tax under Section 501(c)(3) of the Internal Revenue Code. CHI owns certain taxable subsidiaries and engages in certain activities that are unrelated to its exempt purpose and therefore subject to income tax. Management reviews its tax positions annually and has determined that there are no material uncertain tax positions that require recognition in the accompanying consolidated financial statements." |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Gala | Event1Nm |
| Gross Receipts Event1 | $56,175 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $28,025 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $28,150 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $990 | NonCashPrizesEvent1Amt |
| Food And Beverage Event1 | $5,826 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $575 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $2,012 | OtherDirectExpensesEvent1Amt |
| Gross Revenue Event2 | $0 | GrossRevenueEvent2Amt |
| Gross Revenue Other Events | $0 | GrossRevenueOtherEventsAmt |
| Gross Receipts Total | $56,175 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $28,025 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $28,150 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $990 | NonCashPrizesTotalEventsAmt |
| Food And Beverage Total Events | $5,826 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $575 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $2,012 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $9,403 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $18,747 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 165 | PersonsServedCnt |
| Total Community Benefit Expns | $87,568 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $87,568 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0084 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 165 | PersonsServedCnt |
| Total Community Benefit Expns | $87,568 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $87,568 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0084 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 100 | PersonsServedCnt |
| Total Community Benefit Expns | $15,542 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,542 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0015 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 51 | PersonsServedCnt |
| Total Community Benefit Expns | $37,854 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $37,854 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0036 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 135 | PersonsServedCnt |
| Total Community Benefit Expns | $28,688 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,750 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $21,938 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0021 | 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 | $1,927 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,927 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0002 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 286 | PersonsServedCnt |
| Total Community Benefit Expns | $84,011 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,750 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $77,261 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0074 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 451 | PersonsServedCnt |
| Total Community Benefit Expns | $171,579 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,750 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $164,829 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0159 | 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) |
|---|---|---|
| Persons Served | 650 | PersonsServedCnt |
| Total Community Benefit Expns | $4,360 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,360 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0004 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 200 | PersonsServedCnt |
| Total Community Benefit Expns | $188 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $188 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,936 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,936 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0008 | 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) |
|---|---|---|
| Persons Served | 48 | PersonsServedCnt |
| Total Community Benefit Expns | $6,928 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,928 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0007 | 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 | 898 | PersonsServedCnt |
| Total Community Benefit Expns | $19,412 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $19,412 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0019 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $275,689 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,608,092 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,625,322 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$17,230 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lisbon Area Health Services | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 905 Main Street | AddressLine1Txt |
| City | Lisbon | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58054 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.lisbonhospital.com | WebsiteAddressTxt |
| State License | 5031 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lisbon Area Health Services | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://www.lisbonhospital.com/chna-report.htm | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | false | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (true) | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.0 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - Lisbon Area Health Services. To help determine future decisions and strategic planning, LAHS conducted a community health needs assessment survey. This was done through a joint effort of LAHS and Sargent County District Health Unit and Ransom County Public Health Department. Community health data was used and solicited input from community members by interviews and a public survey. The survey was distributed throughout Ransom and Sargent County as an on line survey through Survey Monkey. Additional information was collected through key informant interviews of locally identified community leaders. One-on-one interviews with key informants were conducted in person or via phone in Ransom and Sargent counties. Representatives from CHI Lisbon Health conducted the interviews. The individuals selected for interview included those persons who had special knowledge of public health as well as broad interests of the community that CHI Lisbon Health serves. This included individuals from Ransom and Sargent Public Health, area law enforcement, City Mayor, senior service coordinator for the counties, School superintendent and presidents of local community service groups of Civic and Commerce and Kiwanis. These interviews took place from Jan 2016-Mar 2016. Topics covered during these interviews included but not limited to, the most troubling health problems in our communities, issues of concern to the general public officials and the programs already in place to address some of the items identified. |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - Lisbon Area Health Services. Lisbon Area Health Services (LAHS) conducted a community health needs assessment survey through a joint effort of LAHS and Sargent County District Health Unit and Ransom County Public Health Department. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - Lisbon Area Health Services. Prioritized List of Significant Health Needs Identified in CHNA The process used to identify priorities was the discussion and debate method. Preliminary areas of need were identified by the hospital internal assessment team and local public health departments. Discussion was held with external entities, leadership and LAHS Board of Directors. Priorities were selected based on burden, urgency of need and estimated feasibility and effectiveness of possible interventions. Significant health Needs to be Addressed The first significant health need identified was obesity, poor nutrition and inactivity. The objective in addressing this need is to decrease adult obesity by 3% in each county while increasing education and available information regarding obesity and healthy nutrition. Furthermore, exercise opportunities will be increased. LAHS has applied for a $110,000 grant through the Mission and Ministry fund .The goal of the grant is to hire a coordinator to collaborate with local organizations. These include but are not limited to, public health, clinics, schools NDSU extension office and weight loss groups such as weight watchers. These groups will provide education on nutrition and healthy choices. In addition, LAHS is looking for a funding source to collaborate with local community members to implement a walking path. The second significant health need identified was violence prevention. The objective of addressing this need is to reduce reported incidents 20% by 2018. LAHS has collaborated with local law enforcement, social services, county extension, schools and the local domestic violence prevention coalition. The purpose of the coalition is to provide a forum for networking of local agencies. Additionally, the coalition will provide guidance regarding education in the community. LAHS has received a Violence Prevention grant to collaborate with Abuse Resource Network to provide education in the community. Two specific curriculums have been chosen. The first curriculum, Within My Reach focuses on education potential victims and community members about intimate partner violence. The second curriculum, Futures Without Violence focuses on training professionals to incorporate intimate partner violence prevention efforts into their existing work. The third significant health need identified was mental health and caring for patients with addictions and mental health needs. LAHS has collaborated with local law enforcement, ambulance staff, state and city attorneys, South East Human Service Center and Prairie St. Johns. State legislatures will be invited to the group at a later time. The focus of the group is to address obstacles which prevent patients with mental health and addiction concerns from getting help they require. One major obstacle is transportation for persons who need to be transferred to another facility. Due to lack of resources, LAHS will be investigating the feasibility of contracting with Secure Transport for transportation needs. Another obstacle faced by these patients is the wait time for an available bed at a treatment facility. At times these patients may be in the ED for upwards of eight hours waiting for placement. Due to the amount of time in the ED waiting, LAHS will explore the possibility of a "safe room" for these patients. LAHS staff will receive "Handle With Care" training. LAHS will also explore Global Crises Intervention to help care for patients with addictions and mental health concerns. Lack of mental services locally has also been identified as a concern. LAHS will explore contracting with a local counselor to provide services in our facility. Finally, LAHS will continue to use tele psych in the ED setting and pursue this service in an outpatient arena. Significant Health Needs Not Addressed Three areas of identified need are as follows. The first area identified was the cost of health care. This includes cost of services and insurance which include cost of health, dental and vision insurance. LAHS has a Charity Care Program for persons in need to apply for. LAHS is a part of Catholic Health Initiatives, a nonprofit organization with a longstanding commitment to assist those who seek our care, regardless of ability to pay. If a patient is unable to pay for all or part of the care they receive at our hospital, they may be eligible for free or discounted services. Complete explanation and information can be found at www.lisbonhospital.com. The second area identified was the access and cost of child care and infant care. This is an area identified as high need. This will be shared with both counties through Economic Development for their information and planning purposes. This would be out of scope of the mission of LAHS. The third area also identified as high need was bullying. Currently, the Lisbon School system has a bullying program in place to address this topic with school age children. Bullying takes place in a variety of places such as the work place .With the focus on Mental Health concerns, it is felt that an indirect impact may occur to this area of need. |
| Schedule H, Part V, Section B, Line 13 Facility , 1 | Facility , 1 - Lisbon Area Health Services. The patient must have a minimum account balance of thirty-five dollars ($35.00) with the CHI Hospital Organization. Multiple account balances may be combined to reach this amount. Patients/Guarantors with balances below thirty-five dollars ($35) may contact a financial counselor to make monthly installment payment arrangements. The patient must submit a completed Financial Assistance application. Patient Cooperation Standards - A patient must exhaust all other payment options, including private coverage, federal, state and local medical assistance programs, and other forms of assistance provided by third-parties prior to being approved. An applicant for Financial Assistance is responsible for applying to public programs for available coverage. He or she is also expected to pursue public or private health insurance payment options for care provided by a CHI Hospital Organization within a Hospital Facility. A patient's and, if applicable, any Guarantor's cooperation in applying for applicable programs and identifiable funding sources, including COBRA coverage (a federal law allowing for a time-limited extension of employee healthcare benefits), shall be required. If a Hospital Facility determines that COBRA coverage is potentially available, and that a patient is not a Medicare or Medicaid beneficiary, the patient or Guarantor shall provide the Hospital Facility with information necessary to determine the monthly COBRA premium for such patient, and shall cooperate with Hospital Facility staff to determine whether he or she qualifies for Hospital Facility COBRA premium assistance, which may be offered for a limited time to assist in securing insurance coverage. A Hospital Facility shall make affirmative efforts to help a patient or patient's Guarantor apply for public and private programs. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 0 | FacilityNum |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 3c Financial Eligibility | Unless eligible for Presumptive Financial Assistance, the following eligibility criteria must be met in order for a patient to qualify for Financial Assistance: * The patient must have a minimum account balance of thirty-five dollars ($35.00) with the CHI Hospital Organization. Multiple account balances may be combined to reach this amount. Patients/Guarantors with balances below thirty-five dollars ($35) may contact a financial counselor to make monthly installment payment arrangements. * The patient's Family Income must be at or below 300% of the FPG. * The patient must comply with Patient Cooperation Standards as described [in the FAP]. * The patient must submit a completed Financial Assistance application. For patients and Guarantors who are unable to provide required documentation, a Hospital Facility may grant Presumptive Financial Assistance based on information obtained from other resources. In particular, presumptive eligibility may be determined on the basis of individual life circumstances that may include: * Recipient of state-funded prescription programs; * Homeless or one who received care from a homeless clinic; * Participation in Women, Infants and Children programs (WIC); * Food stamp eligibility; * Subsidized school lunch program eligibility; * Eligibility for other state or local assistance programs (e.g., Medicaid spend-down); * Low income/subsidized housing is provided as a valid address; or * Patient is deceased with no known estate. |
| Schedule H, Part VI Schedule H Part II and Part VI, Lines 2, 4, and 5 | ORGANIZATION'S MISSION, VISION, AND TAX-EXEMPT PURPOSE The mission of CHI Lisbon Health and Catholic Health Initiatives is "to nurture the healing ministry of the Church, supported by education and research. Fidelity to the Gospel urges us to emphasize human dignity and social justice as we create healthier communities." Our Vision is to live up to our name as one CHI: Catholic: Living our Mission and Core Values. Health: Improving the health of the people and communities we serve. Initiatives: Pioneering models and systems of care to enhance care delivery Primary tax-exempt purpose: to provide healthcare to the residents of the surrounding communities regardless of their ability to pay. The goal of CHI Lisbon Health is to provide high quality healthcare to meet the needs of the communities we serve. We are committed to maintain our presence into the future by serving our customers with dedicated skilled staff. As a provider of a community based, family oriented healthcare, CHI Lisbon Health believes it can best maintain this level of service through a customer focus, where we continually strive to understand and exceed the expectations of our customers. CHI Lisbon Health originally known as Community Memorial Hospital opened its doors on February 1, 1952. Lutheran Hospitals & Homes Society (LHHS) of Fargo worked on this project with the local Community Memorial Hospital Association and assumed operations of the hospital. In 1967 an addition was added to the northeast portion of the hospital, which became a 20-bed nursing home wing. It was determined that additional space was needed and another addition was made to the south of the existing structure. This was completed in 1976 and became the new hospital wing. The previous hospital wing was converted to 25 nursing home beds. By 1996 a remodeling project had been completed and a clinic was moved into the facility. At this time the facility's name changed to Lisbon Medical Center. CHI Lisbon Health changed to Critical Access Hospital status effective January 1, 2001. The facility was acquired by Catholic Health Initiatives on October 1, 2002. Shortly thereafter, clinic services were discontinued. On October 15, 2013 CHI Lisbon Health re-opened the clinic within the facility to better serve their community. This clinic is staffed with a Family Nurse Practitioner Certified and a Family Practice Physician. The clinic saw 1,570 patients in FY17. The Clinic is open Monday-Friday. CHI Lisbon Health is served by physicians and allied professional staff from CHI Lisbon Health Clinic, Family Medical Clinic, Essentia Health-Lisbon and Sanford Health Clinic-Lisbon. In addition to LAHS, Lisbon has 3 other clinics, two home care agencies, two hospice agencies and two long term care facilities (LTC) as well as a LTC facility in Enderlin and one in Forman. There is one assisted living facilities and two facilities that offer basic care. Lisbon is located in southeast ND which is one hour away from Fargo. Its economy is based on agriculture, manufacturing, and retail trades. Lisbon Public School System offers curriculum for students K-12 and offer a variety of sports, music and drama. The Historical Opera House hosts several cultural events throughout the year. The scenic theatre offers a variety of selections for diverse ages. The park board maintains 2 city parks, swimming pool, ball diamond, and tennis court. The surrounding areas provide recreational areas such as water sports, hunting, golf and camping. Medical need and care come first at CHI Lisbon Health. CHI Lisbon Health will provide medically necessary health care services to all persons who are in need, regardless of age, race, religion, national origin, gender, handicap, sexual orientation or ability to pay. Community benefit programs for the poor are geared to reducing morbidity and mortality in beneficiaries of Medicaid, state or local indigent programs. CHI Lisbon Health has a governing Board of Directors whose membership includes 7 representatives from Lisbon and the immediate surrounding area. This includes one representative from our founding order, the Sisters of the Presentation of the Blessed Virgin Mary. CHI Lisbon Health also has a Quality Committee, Patient Family Advisory Council and a Foundation Board/Advisory Council of 8. COMMUNITY BENEFIT APPROACH A community health needs assessment is a systematic process involving community input to identify community health needs, prioritize needs and act on unfulfilled needs. The implementation will be CHI Lisbon Health's plan to address community health needs also known as the community benefit plan. The purpose for conducting a community health needs assessment is to describe the health of the local population, identify community needs, and identify action needed to address the future delivery of health care in Ransom and Sargent counties. A health needs assessment benefits the local community by: 1) opening the discussion between community members about the future of health care in the community, 2) organizing information to help guide, inform and educate, 3) collecting input from the local community including providers. CHI Lisbon Health is a 25-bed critical access hospital in Lisbon, North Dakota. This is with 12 acute beds and 13 swing beds. It is a state-designated Level V Trauma Center, a Stroke Ready Hospital and employs approximately 80 people. CHI Lisbon Health is the only hospital in Ransom and Sargent counties and serves 10,659 people throughout 1720.87 square miles. Lisbon is in the Health Professional Shortage Areas (HPSAs), the Medically Underserved Areas / Populations, as well as a shortage area for mental health services. HPSA's are designated by Health Resources and Service Administration (HRSA); Dept of Health & Human Services and the Center for Rural Health - UND as having shortages of primary medical care, dental or mental health providers and may be geographic (a county or service area), demographic (low income population) or institutional (comprehensive health center, federally qualified health center or other public facility). Medically Underserved Areas/Populations are areas or populations designated by HRSA as having too few primary care providers, high infant mortality, high poverty and/or high elderly population. Access to an adequate supply of health care providers is a concern in both North Dakota and nationally. COMMUNITY ASSESSMENT, PROCESS AND SUMMARY To help determine future decisions and strategic planning, CHI Lisbon Health conducted a Community Health Needs Assessment survey May 1, 2015 thru June 30, 2015. This was done through a joint effort of CHI Lisbon Health, Sargent County District Health Unit and Ransom County Public Health Department. Community health data was used and input was solicited from community members by interviews and a public survey. The survey was widely distributed throughout Ransom and Sargent counties on line through Survey Monkey. Additional information was collected through key informant interviews of locally identified community leaders. The complete CHNA is on http://www.lisbonhospital.com/documents/CommunityHealthNeedsAssessmentwebsiteBoardApproved.pdf A needs assessment was previously conducted in the community when Open Door was new to the area. They contacted businesses for work for their clients with developmental disabilities. CHI Lisbon Health continues to donate to the non-profit with an hourly stipend, supervision and training in the dietary department. Open Door is a non-profit organization. UNCOMPENSATED CARE FOR THE POOR CHI Lisbon Health provides care to everyone, regardless of his or her ability to pay. Benefits are provided to individuals who cannot afford health care because they have inadequate resources and/or are uninsured or underinsured. Charity care is free or discounted health-related services provided to individuals who cannot afford to pay for medically necessary health care. Eligibility is based on household income as well as other assets. Consideration is given to a patient who has significant or catastrophic medical bills and does not meet the income guidelines. Charity care is given to uninsured, low-income patients who are not expected to pay all or part of a bill, or who are able to pay only a portion using an income-related fee schedule. Community benefit programs for the poor are geared to reducing morbidity and mortality in beneficiaries of Medicaid or state or local indigent programs. Financial Assistance applications may be obtained from CHI Lisbon Health or on the website: http://www.lisbonhospital.com/patientsvisitors_financialassistance.htm |
| Schedule H, Part VI Schedule H Part II and Part VI, Lines 2, 4, and 5 | QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT: July 1, 2016 through June 30, 2017 Community Benefit Provided to the Poor: Cost of financial assistance provided Estimated number of people served: 165 Community benefit cost: $87,568 Community Benefit Operations Estimated number of people served: 100 Community benefit cost: $9,376 Community Building Activities Estimated number of people served: 48 Community benefit cost: $6,928 Financial and In-kind Contributions: Estimated number of people served: 0 Community benefit cost: $1,780 Community Benefit Provided to the Broader Community: Community Benefit Operations Estimated number of people served: 0 Community benefit cost: $6,166 Community Building Activities Estimated number of people served: 850 Community benefit cost: $12,484 Community Health Improvement Services Estimated number of people served: 135 Community benefit cost: $21,938 Financial and In-kind Contributions Estimated number of people served: 0 Community benefit cost: $147 Health Professions Education Estimated number of people served: 51 Community benefit cost: $37,854 Grand Cost of Community Benefit Estimated number of people served: 1,349 Community benefit cost: $184,241 Human Investment and Statistics Number of activities: 20 Staff hours: 2,300.80 Volunteer hours: 12 QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT Community Benefit is the name given to the programs we create in response to health needs in our service areas. An important part of our mission is building healthier communities through programs designed to serve the needs of people who are poor and disadvantaged in our community. This type of Community Benefit has the added, positive side-effect of delivering an improved quality of life for everyone. Community Benefit most often takes place outside the walls of our facilities and involves partner organizations in the community. Our Community Benefit activities are designed to: *Identify and increase awareness of health needs in Lisbon. *Provide resources to meet those needs. *Create collaboration between community organizations that focus on health and well being. * COMMUNITY OUTREACH CHI Lisbon Health and CHI's Fargo Division international sister-to-sister hospital program of the new Indigenous People's Hospital opened on May 18, 2012 in Nueva Vizcaya, Philippines. The hospital, located in a remote region of the country, provides care to impoverished tribal people. The new clinic and hospital was immediately busy and had provided care to more than 600 people the day they opened. CHI Lisbon Health supports this hospital with donated supplies and a monetary donation. The Open Door Project provides an opportunity for the developmentally disabled to develop new daily living skills working side by side with the CHI Lisbon Health dietary department. Training and supervision is provided for the tasks they do daily. * COMMUNITY OUTREACH FOR THE BROADER COMMUNITY CHI Lisbon Health is dedicated to caring for the broader community, a strong tradition that is vital and necessary to maintain progress in rural areas with limited resources. CHI Lisbon Health provides and supports various services and programs that benefit the community for which there is no reimbursement or reimbursement is not adequate to cover the hospital's cost. In-kind services include hours spent by staff as part of their work assignment while on health care organization work time, overhead expenses of space provided to non-profit community groups (for meetings) and donation of food, equipment and supplies. Some organizations include the Economic and Community Development, Emergency Disaster, Ministerial Association, Lisbon Civic and Commerce, and Kiwanis. * COLLABORATIVE EFFORTS TO IMPROVE COMMUNITY HEALTH These activities are carried out to improve community health. They extend beyond patient care activities. They include services directed to individuals and to a larger population. Community health improvement services do not generate inpatient or outpatient bills, although they may involve a nominal patient fee and/or a sliding scale fee. The programs in CBISA and summarized in this report not only benefit and serve the community as a whole, but also greatly reduce the burdens on our local health department, a government funded health care system. Relay for Life is the American Cancer Society's signature activity. It offers everyone in the community an opportunity to participate in the fight against cancer. The funds raised at Relay save lives by funding cutting-edge cancer research, early detection and prevention education, advocacy efforts, and life-affirming patient services. It is because of community involvement that lives are saved, help reaches those battling cancer, and empowers all to fight back against the disease. CHI Lisbon Health sponsored a Relay for Life team and various activities were held to raise $2,375 to the fight against cancer. CHI Lisbon Health supports the Abuse Resource Network by providing after hours call service. CHI Lisbon Health provides staff to present community education through different venues. * HEALTH PROFESSIONS EDUCATION Helping prepare future health care professionals is a distinguishing characteristic of non-profit health care and constitutes a significant community benefit. Radiology, Pharmacy, and Nursing students have the advantage of spending time with the professionals for on the job mentoring. COMMUNITY BUILDING ACTIVITIES Community building activities include programs that address underlying causes of health problems in order to improve health status and quality of life. They focus on the root causes of health problems, such as poverty, homelessness and environmental problems. These activities support community assets by offering the expertise and resources of the health care organization. Community building activities include cash, in-kind donations and budgeted expenditures for the development of community health programs and partnerships. CHI Lisbon Health employees participate in community coalitions and other collaborative efforts with organizations in Sargent, and Ransom Counties to address health and safety issues. The vision brings people together and forms the foundation of both short and long term strategies to meet identified needs and problems. It develops a common thread encompassing a diverse array of viewpoints, opinions, facts and trends. CHI Lisbon Health employees to belong to organizations that work together to promote healthy communities. Membership is with: Kiwanis, Emergency Planning Committee, Students Against Destructive Decisions (SADD), and Violence Prevention Coalition. Economic development is important to CHI Lisbon Health to assist small business development in neighborhoods with vulnerable populations and creating new employment opportunities in areas with high rates of joblessness. Lisbon Civic and Commerce Organization promotes community and civic events including economic development. * COMMUNITY BENEFIT OPERATIONS: Community benefit operations include costs associated with dedicated staff who work with charity care and with planning and operating community benefit programs. There are expenses involved for the community benefit tracking and reporting. Looking towards the future, CHI Lisbon Health will continue to thrive because of the support from our patients, our physicians, and the area communities. CHI Lisbon Health looks forward to providing care that the community members have come to trust and expect for many years to come. |
| Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation | 275689 |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING THE ORGANIZATION'S COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. THE COST-TO-CHARGE RATIO FOR THE YEAR ENDED 6/30/2017 WAS COMPUTED USING THE FOLLOWING FORMULA: OPERATING EXPENSE (BEFORE RESTRUCTURING, IMPAIRMENT AND OTHER LOSSES) DIVIDED BY GROSS PATIENT REVENUE. $10,259,429/$18,142,994=56.5%. WORKSHEET 2 WAS NOT USED TO DERIVE THE COST-TO-CHARGE RATIO. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | Costing methodology for amounts reported on line 2 is determined using the organization's cost/charge ratio of 56.5%. When discounts are extended to self-pay patients, these patient account discounts are recorded as a reduction in revenue, not as bad debt expense. |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | Lisbon Area Health Services does not believe that any portion of bad debt expense could reasonably be attributed to patients who qualify for financial assistance since amounts due from those individuals' accounts will be reclassified from bad debt expense to charity care within 30 days following the date that the patient is determined to qualify for charity care. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | Lisbon Area Health Services does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of Catholic Health Initiatives. The consolidated footnote reads as follows: "The provision for bad debts is based upon management's assessment of historical and expected net collections, taking into consideration historical business and economic conditions, trends in health care coverage, and other collection indicators. Management routinely assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category. The results of these reviews are used to modify, as necessary, the provision for bad debts and to establish appropriate allowances for uncollectible net patient accounts receivable. After satisfaction of amounts due from insurance, CHI follows established guidelines for placing certain balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by each facility. The provision for bad debts is presented on the consolidated statements of operations as a deduction from patient services revenues (net of contractual allowances and discounts) since CHI accepts and treats substantially all patients without regard to the ability to pay." |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | Lisbon Area Health Services is designated as a Critical Access Hospital (CAH). CAHs are rural community hospitals that are certified to receive cost-based reimbursement from Medicare. The reimbursement that CAHs receive is intended to improve their financial performance and thereby reduce hospital closures. CAHs are certified under a different set of Medicare Conditions of Participation (CoP). Shortfalls are created when a facility receives payments that are less than the costs of caring for program beneficiaries. Because shortfalls are based on costs, not charges, Lisbon Area Health Services, due to their designation as a CAH, received cost-based reimbursement for Medicare purposes, Lisbon Area Health Services will not experience Medicare related shortfalls. 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: $7,608,092 Total Medicare costs: $7,625,322 Surplus or Shortfall $(17,230) Lisbon Area Health Services believes that excluding Medicare losses from community benefit makes the overall community benefit report more credible for these reasons: Unlike subsidized areas such as burn units or behavioral-health services, Medicare is not a differentiating feature of tax-exempt health care organizations. In fact, for-profit hospitals focus on attracting patients with Medicare coverage, especially in the case of well-paid services that include cardiac and orthopedics. Significant effort and resources are devoted to ensuring that hospitals are reimbursed appropriately by the Medicare program. The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency, carefully studies Medicare payment and the access to care that Medicare beneficiaries receive. The commission recommends payment adjustments to Congress accordingly. Though Medicare losses are not included by Catholic hospitals as community benefit, the Catholic Health Association guidelines allow hospitals to count as community benefit some programs that specifically serve the Medicare population. For instance, if hospitals operate programs for patients with Medicare benefits that respond to identified community needs, generate losses for the hospital, and meet other criteria, these programs can be included in the CHA framework in Category C as "subsidized health services." Medicare losses are different from Medicaid losses, which are counted in the CHA community benefit framework, because Medicaid reimbursements generally do not receive the level of attention paid to Medicare reimbursement. Medicaid payment is largely driven by what states can afford to pay, and is typically substantially less than what Medicare pays. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | The organization's billing and collections policy applies to all individuals presenting for emergency or other medically necessary care. The policy contains provisions for collecting amounts due from those patients who the organization knows to qualify for financial assistance either through the traditional financial assistance application process or through presumptive eligibility processes. Before engaging in extraordinary collection actions (ECAs) to obtain payment for EMCare, Hospital Facilities must make reasonable efforts through its billing and collections processes, pursuant to Treas. Reg. §1.501(r)-6(c), to determine whether an individual is eligible for Financial Assistance. In no event will an ECA be initiated prior to 120 days from the date the Facility provides the first post-discharge billing statement (i.e., during the Notification Period) unless all reasonable efforts have been made. Hospital Facilities will not refer accounts for collection where the patient has initially applied for Financial Assistance, and the Hospital Facility has not yet made reasonable efforts with respect to the account. For patients and Guarantors who are unable to provide required documentation, a Hospital Facility may grant Presumptive Financial Assistance based on information obtained from other resources. Patients who qualify for Medicaid are presumed to qualify for full charity write off. Any charges for days or services written off (excluding Medicaid denials related to timeliness of billing, insufficient medical record documentation, missing invoices, authorization, or eligibility issues) as a result of a Medicaid are booked as charity. Some Medicaid plans offer coverage for a limited or restricted list of services. If a patient is eligible for Medicaid, any charges for days or services not covered by the patient's coverage may be written off to charity without a completed application. This does not include any Share of Cost (SOC) or other patient cost-sharing amounts such as deductibles or copayments, as such costs are determined by the state to be an amount that the patient must pay before the patient is eligible for Medicaid. Health and Human Services (HSS) uses the term "Spend Down" instead of Share of Cost. All collection activities conducted by the Facility, a Designated Supplier, or its third-party collection agents will be in conformance with all federal and state laws governing debt collection practices. All third-party agreements governing collection and recovery activities must include a provision requiring compliance with the hospital facilities' financial assistance and billing and collections policy and indemnification for failures as a result of its noncompliance. This includes, but is not limited to, agreements between third parties who subsequently sell or refer debt of the Hospital Facility. |
| Schedule H, Part V, Section B, Line 16a FAP website | - Lisbon Area Health Services: Line 16a URL: http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - Lisbon Area Health Services: Line 16b URL: http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - Lisbon Area Health Services: Line 16c URL: http://www.lisbonhospital.com/patientsvisitors_financialassistance_docs.htm; |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | Notification about the availability of Financial Assistance from CHI Hospital Organizations shall be disseminated by various means, which may include, but not be limited to: * Conspicuous publication of notices in patient bills; * Notices posted in emergency rooms, urgent care centers, admitting/registration departments, business offices, and at other public places as a Hospital Facility may elect; and * Publication of a summary of this Policy on the Hospital Facility's website, www.catholichealth.net, and at other places within the communities served by the Hospital Facility as it may elect. Such notices and summary information shall include a contact number and shall be provided in English, Spanish, and other primary languages spoken by the population served by an individual Hospital Facility, as applicable. Referral of patients for Financial Assistance may be made by any member of the CHI Hospital Organization non-medical or medical staff, including physicians, nurses, financial counselors, social workers, case managers, chaplains, and religious sponsors. A request for assistance may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws. In addition, Hospital registration clerks are trained to provide consultation to those who have no insurance or potentially inadequate insurance concerning their financial options including application for Medicaid and for assistance under the Financial Assistance Policy. Counselors assist Medicare eligible patients in enrollment by providing referrals to the appropriate government agencies. Once it is determined that the patient does not qualify for any third party funding, the patient is verbally notified about the existence of Financial Assistance Application and additional screening takes place by a Hospital employee to determine if the patient is eligible for charity service prior to discharge. Upon registration (and once all EMTALA requirements are met), patients who are identified as uninsured (and not covered by Medicare or Medicaid) are provided with a packet of information that addresses the Financial Assistance Policy, the plain language summary of that policy, and an application for assistance. Hospital registration clerks read the organization's medical assistance policy to those who appear to be incapable of reading, and provide translators for non-English-speaking individuals. Patients that have been discharged prior to charity screening, such as emergency room patients, receive a written notification of possible eligibility for services. If the patient is determined not to be eligible for government assistance, he/she may notify the hospital that they seek charity assistance. The appropriate charity form is sent to the patient/guarantor for completion and then returned to the hospital for evaluation and qualification. Once determination of eligibility is made, the patient is sent a notice informing him/her if they qualify for full, partial, or no charity care services. Hospital Facilities must make reasonable efforts through its billing and collections processes, pursuant to Treas. Reg. §1.501(r)-6(c), to determine whether any individual is eligible for Financial Assistance. |
| Schedule H, Part VI, Line 6 Affiliated health care system | The organization is affiliated with Catholic Health Initiatives (CHI). 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 17 states and comprises 101 hospitals, including 4 academic health centers and 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 2017, CHI provided more than $1.2 billion in financial assistance and community benefit - a more than 10% increase over the previous year -- for programs and services for the poor, free clinics, education and research. Financial assistance and community benefit totaled more than $2.1 billion with the inclusion of the unpaid costs of Medicare. The health system, which generated operating revenues of $15.5 billion in fiscal year 2017, has total assets of approximately $21.9 billion. CHI provides strategic planning and management services as well as centralized "share services" for the MBOs. The provision of centralized management and shared services including areas such as accounting, human resources, payroll and supply chain provides economies of scale and purchasing power to the MBOs. The cost savings achieved through CHI's centralization enable MBOS to dedicate additional resources to high-quality health care and community outreach services to the most vulnerable members of our society. |
| Schedule H, Part VI, Line 7 State filing of community benefit report | ND |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Cash GrantCashGrantAmt |
|---|---|---|---|---|---|
| Charity Care | 165 | $143,221 | Book | REDUCTION OR WRITE OFF OF PATIENT SERVICES | |
| Employee Assistance | 1 | N/A | (SEE STATEMENT) | $500 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule I, Part III, Column (f) DESCRIPTION OF NONCASH ASSISTANCE | CHARITY CARE: REDUCTION OR WRITE OFF OF PATIENT SERVICES. |
| Schedule I, Part III CHARITY CARE | LISBON AREA HEALTH SERVICES RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. BUSINESS OFFICE STAFF HELPS PATIENTS SEEK LOCAL, STATE, AND FEDERAL REIMBURSEMENT AT NO CHARGE WHEN NO OTHER SOURCE OF PAYMENT IS AVAILABLE. FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS WITH DEMONSTRATED INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES. THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS ACCOUNTS RECEIVABLE. |
| Schedule I, Part III Employee Assistance Fund | CHI Lisbon Health Employee Assistance Fund exists as a program for employees of CHI Lisbon Health. The fund reinforces CHI Lisbon Health's mission and values. Funds are available to employees facing personal tragedy or significant hardship. The program provides employees who are experiencing financial difficulties help with basic needs such as food, shelter, utilities and emergency travel. The fund will be available for current employees only. The maximum amount requested and/or awarded may not exceed $500 in a 12-month period. If an employee receives a partial gift, the employee may reapply for additional assistance in the year should the need arise. All applications/nominations will be reviewed by the MBO Executive Leadership Committee, however, it is not a guarantee of an award. The MBO Executive Leadership Committee decides who will receive an award by consensus. Once the Committee's decision is made, the applicant will be notified of the decision and supporting reasons. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PEGGY REINKE | ||||||||||||||
| PRESIDENT | $0 | $164,597 | $0 | $19,123 | $0 | $49,892 | $0 | $42 | $0 | $11,226 | $0 | $244,880 | $0 | $26,678 |
| JEFFREY DROP | ||||||||||||||
| Board Member/CHI SVP Division Officer | $0 | $560,895 | $0 | $580,949 | $0 | $173,480 | $0 | $15,900 | $0 | $12,312 | $0 | $1,343,536 | $0 | $61,356 |
| BECKI THOMPSON | ||||||||||||||
| VP OPERATIONAL FINANCE (THROUGH 7/31/14) | $0 | $145,735 | $0 | $16,936 | $0 | $20,305 | $0 | $18,214 | $0 | $5,100 | $0 | $206,290 | $0 | $5,777 |
| OSCAR FERNANDEZ | ||||||||||||||
| PHYSICIAN | $150,337 | $0 | $9,760 | $0 | $82,296 | $0 | $13,536 | $0 | $15,755 | $0 | $271,684 | $0 | $0 | $0 |
| JILL MCRITCHIE | ||||||||||||||
| MANAGER PHARMACY | $123,206 | $0 | $4,904 | $0 | $3,653 | $0 | $7,532 | $0 | $15,604 | $0 | $154,899 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 4a SEVERANCE OR CHANGE-OF-CONTROL PAYMENTS | POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR CATHOLIC HEALTH INITIATIVES (CHI) AND RELATED ORGANIZATIONS' EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE, INCLUDING THE MBO CEOS. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2016 CALENDAR YEAR. |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | Compensation for the top management official was established and paid by Catholic Health Initiatives (CHI), a related organization. CHI used the following to establish the top management official's compensation: (1) Compensation Committee; (2) Independent Compensation Consultant; (3) Written Employment Contracts; (4) Compensation Survey or Study; (5) Approval by the Board or Compensation Committee. |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | During the 2016 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: Peggy Ann Reinke Jeffrey Drop Rebecca L Thompson During 2016 the following contributions were made by CHI to the deferred compensation plan: Rebecca L Thompson - $7,382.00 During 2016 the following distributions were made by CHI from the deferred compensation plan: Peggy Ann Reinke - $26,677.68 Jeffrey Drop - $61,355.56 Rebecca L Thompson - $5,776.57 Due to the "super" vesting rules under the CHI deferred compensation plan, participants who had met certain requirements such as termination, age, years of service or more than 5 years of plan participation were eligible to receive their 2016 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 2016, the following contributions that would have been made by CHI to the deferred compensation plan were paid in cash: Peggy Ann Reinke - $8,336.00 Jeffrey Drop - $87,113.00 |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Oscar Fernandez | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship With Org | Highest compensated employee | RelationshipWithOrgTxt |
| Loan Purpose | Signing bonus | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $10,000 | OriginalPrincipalAmt |
| Balance Due | $1,893 | BalanceDueAmt |
| Default | false | DefaultInd |
| Board Or Committee Approval | Yes (true) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (true) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $1,893 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rudolf Loperena MD | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Substantial contributor | RelationshipDescriptionTxt |
| Transaction | $254,901 | TransactionAmt |
| Transaction | Independent contractor arrangement - ER Physician Coverage | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 1 ORGANIZATION'S MISSION | THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. FIDELITY TO THE GOSPEL URGES THE CORPORATION TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT CREATES HEALTHIER COMMUNITIES. THE CORPORATION, SPONSORED BY A LAY-RELIGIOUS PARTNERSHIP, CALLS OTHER CATHOLIC SPONSORS AND SYSTEMS TO UNITE TO ENSURE THE FUTURE OF CATHOLIC HEALTH CARE. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION. |
| Form 990, Part VI, Line 14 DOCUMENT RETENTION AND DESTRUCTION POLICY | THE ORGANIZATION HAS A DOCUMENT RETENTION AND DESTRUCTION POLICY THAT IT FOLLOWS; HOWEVER, THE POLICY HAD NOT BEEN FORMALLY ADOPTED BY THE ORGANIZATION'S GOVERNING BODY AT YEAR-END. |
| Form 990, Part VI, Line 15a PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL | The organization's top management official's compensation is paid by Catholic Health Initiatives (CHI), a related organization. CHI has a defined compensation philosophy. Both the executive and non-executive compensation structures and ranges are reviewed annually in comparison to market data. CHI uses The Korn Ferry Hay Group as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of the senior most executives is reviewed annually. The Korn Ferry Hay Group reviews both cash and total compensation for overall reasonableness, for adherence to CHI's compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review is delivered by Korn Ferry Hay Group to the HR committee of the CHI Board of Stewardship Trustees annually at their September meeting and minutes are shared with the full board at the December meeting. The last review was September 11, 2017. In addition, Korn Ferry Hay Group completed a comprehensive review of all positions at the level of vice president and above in the fall of 2014 to determine and validate appropriate compensation levels. These levels have been reviewed annually since and revised based on market data, where applicable. |
| Form 990, Part VI, Line 15b PROCESS USED TO ESTABLISH COMPENSATION OF OTHER EMPLOYEES | DURING THE TAX YEAR ENDED 6/30/2017, NO OFFICERS, DIRECTORS OR TRUSTEES RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THEREFORE, THESE QUESTIONS ARE MORE APPROPRIATELY ANSWERED AS N/A. |
| Form 990, Part VI, Line 12c Conflict of Interest Policy | The Board Chair or designee shall make such further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the Board Chair, the Vice Chair will assume the Chair's role outlined in the COI Policy. Based on review and evaluation of the relevant facts and circumstances, the Board Chair will make an initial determination as to whether a conflict of interest exists and whether, pursuant to the COI Policy, review and approval or other action by the Board is required. A written record of the Board Chair's determination, including relevant facts and circumstances, will be made. The Board Chair shall then make an appropriate report to the Executive Committee of the Board concerning such review, evaluation and determination. If a difference of opinion exists between the Board Chair and another Trustee as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether Board review and approval or other action is required within the COI Policy, the matter shall be submitted to the Board's Executive Committee, which shall make a final determination as to the matter presented. Such determination, including relevant facts and circumstances, will be reflected in the Executive Committee minutes and will be reported to the Board. The Board shall carefully scrutinize and must in good faith approve or disapprove any transaction in which CHI or a CHI Entity is a party and in which the Trustee or Corporate Officer either: * Has a material financial interest; or * Is a Trustee or Corporate Officer of the other party (other than a CHI-affiliated organization). The Board must approve the transaction by a majority of the Trustees on the Board, without counting the vote of any individual who has an interest in the transaction. In reviewing such transactions between CHI or CHI Entities and vendors or other contractors who are, or are affiliated with, Trustees or Corporate Officers, the Board shall act no more or less favorably than it would in reviewing transactions with unrelated third parties. The transaction will not be approved unless the Board determines that the transaction is fair to CHI or the CHI Entity. The Board shall carefully review and scrutinize any non-transactional conflict of interest (e.g., disclosure of nonpublic information, competition with CHI or a CHI Entity, failure to disclose a corporate opportunity, excessive gifts or entertainment, etc.). By a majority vote of the disinterested Trustees, the Board shall take whatever action is deemed appropriate with respect to the Trustee or Corporate Officer under the circumstances, including possible disciplinary or corrective action, in order to best protect the interests of CHI or the CHI Entity. The Board should consult with the General Counsel of CHI or his or her designee when considering disciplinary or corrective action. When any conflict of interest is considered by the Board, the Trustee or Corporate Officer, as appropriate, must disclose all of the material facts to the Board. The Trustee shall not vote and the Trustee or Corporate Officer shall not use his or her personal influence on the matter. However, if requested, such Trustee or Corporate Officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from Trustees, as his or her knowledge may be of significant importance. The Trustee or Corporate Officer shall be excused from the meeting during discussion and vote on the conflict of interest. Minutes of the Board shall reflect the following: the individual making the disclosure, the nature of the disclosure, discussion regarding any proposed transaction, the decision made by the Board, and that the interested Trustee or Corporate Officer was excused during the discussion, and that the interested Trustee abstained from voting. If the Board reasonably believes that a Trustee or Corporate Officer has failed to disclose either an actual or potential conflict of interest, or all material facts surrounding an actual or possible conflict as required by the COI Policy, the Trustee or Corporate Officer will be given an opportunity to explain such alleged failure to disclose. After hearing the response of the Trustee or Corporate Officer, the Board will conduct such additional investigation as may be appropriate. If the Board determines that the Trustee or Corporate Officer has in fact failed to disclose as required by the COI Policy, the Board shall take appropriate disciplinary or corrective action. All determinations of conflicts of interest are reported as required by law, regulations, and CHI policy. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | Pursuant to Section 8.6 of the Bylaws of Lisbon Area Health Services, the Executive Committee is composed of the board chair, the board vice chair, the President and CEO, each of whom shall serve as an ex officio voting member of the Executive Committee, and two voting members appointed by the Board of Directors. Each individual appointed to the Executive Committee shall serve for a term of one year or until his or her successor is duly appointed by the Board of Directors. The Executive Committee shall consist of only directors of the Corporation. Pursuant to Section 8.1 of the Corporation's bylaws, committees, such as the executive committee, that are granted the authority to act on behalf of the board of directors may include only directors of the corporation. Further, pursuant to Section 8.6 of the Corporation's bylaws, the executive committee has and may exercise such powers as may be delegated to it by the board of directors. The Executive Committee also possesses the power to transact routine business of the corporation in the interim period between regularly scheduled meetings of the board of directors. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | According to the bylaws of Lisbon Area Health Services the entity's sole member is Catholic Health Initiatives, a Colorado nonprofit organization. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | According to the organization's bylaws, directors shall be appointed or refused by the corporate member. The corporate member may appoint one or more individuals to the board of directors, and may at any time remove, with or without cause, any member of the board of directors. According to the organization's bylaws, directors of the corporation shall be appointed by the corporate member no later than June 30 of each year. The names and qualifications of each individual accepted by the board of directors shall be submitted to the corporate member, who shall appoint or refuse each nominee in accordance with the corporate member's bylaws and with endorsement of the senior vice president of operations. The corporate member may unilaterally appoint one or more individuals to the board of directors should the board fail to furnish the corporate member with a list of individuals qualified to serve on the board of directors of the corporation. (CHCF Reserved Rights) Except as otherwise provided in the Corporation's Articles of Incorporation or the laws of the State of organization, Catholic Health Care Federation ("CHCF") shall have such rights as are reserved to the Corporate Member, acting in its capacity as the membership body of CHCF, under the Governance Matrix. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | The organization's corporate member is Catholic Health Initiatives (CHI). Pursuant to Section 5.4 of the organization's bylaws, the Corporate Member shall have the specific rights set forth in the governance matrix. Pursuant to the governance matrix the following rights are reserved to the CHI Board directly or through powers delegated to the CHI Chief Executive Officer: * Substantial change in the mission or philosophy of the Lisbon Area Health Services * Amendment of the corporate documents of Lisbon Area Health Services * Approve members of the Lisbon Area Health Servicesboard * Removal of a member of the governing body of the Lisbon Area Health Services * Approval of issuance of debt by Lisbon Area Health Services * Approval of participation of Lisbon Area Health Servicesin a joint venture * Approval of formation of a new corporation by Lisbon Area Health Services * Approval of a merger involving Lisbon Area Health Services * Approval of the sale of all or substantially all of the assets of Lisbon Area Health Services * To require the transfer of assets by Lisbon Area Health Services to CHI to accomplish CHI's goals and objectives, and to satisfy CHI debts. * Adoption of long range and strategic plans for Lisbon Area Health Services Pursuant to Article V Section 5.5.2 of the organization's bylaws, CHI may, in exercise of its approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and the President and Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate. (CHCF Reserved Rights) Except as otherwise provided in the Corporation's Articles of Incorporation or the laws of the State of organization, Catholic Health Care Federation ("CHCF") shall have such rights as are reserved to the Corporate Member, acting in its capacity as the membership body of CHCF, under the Governance Matrix. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | Once the return is prepared, the return is presented to the board at a board meeting or an electronic copy of the return is sent to each board member by email for their review, etc. Subsequent to presentation to the board, the tax department files the return with the appropriate federal and state agencies, making any non-substantive changes necessary to effect e-filing. Any such changes are not re-submitted to the board. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Catholic Health Initiatives ("CHI") has a Conflicts of Interest ("COI") policy (the "Policy") in place to maintain the integrity of all of its activities. The Policy applies to CHI Board of Stewardship Trustees and members of its committees; all CHI Entity board and board committee members; all CHI employees; and all CHI research personnel (both employed and non-employed). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure 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; * Employees at the level of manager and above (through 6/21/17). 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. The disclosures will be reviewed by the CHI Senior Vice President, Legal Services, and General Counsel or his or her designee who will report potential conflicts to the applicable Board Chair. (Continued on Schedule O) |
| Form 990, Part VI, Line 19 Required documents available to the public | The organization's financial statements, conflict of interest policy and governing documents are available to the public upon request. The organization's financial statements are included in Catholic Health Initiatives' consolidated audited financial statements that are available at www.catholichealthinitiatives.org. In addition, the governing documents are available from the North Dakota Secretary of State. |
| Form 990, Part IX, Line 11g Other Fees | Clinical Engineering - Total Expense: 88028, Program Service Expense: 88028, Management and General Expenses: , Fundraising Expenses: ; Consulting - Total Expense: 10610, Program Service Expense: , Management and General Expenses: 10610, Fundraising Expenses: ; Contract Nursing - Total Expense: 226566, Program Service Expense: 226566, Management and General Expenses: , Fundraising Expenses: ; Facilities Management - Total Expense: 115600, Program Service Expense: , Management and General Expenses: 115600, Fundraising Expenses: ; Intracompany Allocations - Total Expense: 152114, Program Service Expense: 152114, Management and General Expenses: , Fundraising Expenses: ; RRC Fees - Total Expense: 590376, Program Service Expense: 590376, Management and General Expenses: , Fundraising Expenses: ; LABORATORY FEES - Total Expense: 24329, Program Service Expense: 24329, Management and General Expenses: , Fundraising Expenses: ; VHS - Total Expense: 86773, Program Service Expense: 86773, Management and General Expenses: , Fundraising Expenses: ; Other Fees for Services - Total Expense: 1773578, Program Service Expense: 1324666, Management and General Expenses: 448912, 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) |
| 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 | ||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 420725196 | LTERM CARE | IA | 501(c)(3) | 10 | CHI-IA CORP | Yes (true) |
| BORNEMANN HEALTHCARE CORPORATION | ||||||||||
| 2500 BERNVILLE RD PO BOX 316 | READING | PA | 19603 | 232187242 | HEALTHCARE | PA | 501(c)(3) | Type I | CHI | Yes (true) |
| BRAZOSPORT HEALTH FOUNDATION INC | ||||||||||
| 129 CIRCLE WAY STE 102 | 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 | ||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 470617373 | HEALTHCARE | CO | 501(c)(3) | Type I | NA | Yes (true) |
| CATHOLIC HEALTH INITIATIVES - COLORADO | ||||||||||
| 188 INVERNESS DRIVE WEST STE 500 | ENGLEWOOD | 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 | ||||||||||
| 6385 CORPORATE DR STE 301 | COLORADO SPRINGS | CO | 80919 | 840902211 | FUNDRAISING | CO | 501(c)(3) | 7 | CHIC | Yes (true) |
| CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION | ||||||||||
| 6385 CORPORATE DR | COLORADO SPRINGS | CO | 80919 | 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 | MN | 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 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 | ||||||||||
| 6940 O ST STE 200 | LINCOLN | 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 | ||||||||||
| 1 MERCY LANE STE 201 | HOT SPRINGS | AR | 71913 | 261125131 | HEALTHCARE | AR | 501(c)(3) | 3 | CHISVHS | Yes (true) |
| COMMUNITY LIMITED CARE DIALYSIS CENTER | ||||||||||
| 619 OAK ST ACCOUNTING-3 W | CINCINNATI | OH | 45206 | 237419853 | HOLDING CO | OH | 501(c)(1) | 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 | ||||||||||
| 150 NORTH EAGLE CREEK DR | LEXINGTON | KY | 40509 | 611400619 | LT ACH | KY | 501(c)(3) | 3 | SJHS | Yes (true) |
| COVENANT HOME CARE | ||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 232028429 | HOME HEALTH | PA | 501(c)(3) | Type I | CHI NHC | Yes (true) |
| ENUMCLAW REGIONAL HOSPITAL ASSOCIATION | ||||||||||
| 1450 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 | MO | 501(c)(3) | 10 | CHI | Yes (true) |
| FRANCISCAN LIVING COMMUNITIES | ||||||||||
| 5942 RENAISSANCE PLACE STE A | TOLEDO | OH | 43623 | 341892096 | HEALTHCARE | OH | 501(c)(3) | Type II | SFH | 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 | ||||||||||
| 200 ABRAHAM FLEXNER WAY | LOUISVILLE | KY | 40202 | 611029768 | HEALTHCARE | KY | 501(c)(3) | 3 | KOH | Yes (true) |
| KENTUCKYONE HEALTH MEDICAL GROUP INC | ||||||||||
| 200 ABRAHAM FLEXNER WAY | 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 | ND | 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 | 300417049 | 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 | ||||||||||
| 1111 6TH AVE | DES MOINES | 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) | 8 | 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 | ||||||||||
| 12844 MILITARY RD S | TUKWILA | WA | 98168 | 911170040 | HEALTHCARE | WA | 501(c)(3) | 3 | FHS | Yes (true) |
| SET OF COLORADO SPRINGS INC | ||||||||||
| 2864 S CIRCLE DR STE 450 | COLORADO SPRINGS | CO | 80906 | 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) | 6 | 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) | 2 | 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 | ||||||||||
| ONE SAINT JOSEPH DRIVE | 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 | ||||||||||
| 30 WEST 7TH ST | DICKINSON | ND | 58601 | 363418207 | FUNDRAISING | ND | 501(c)(3) | Type I | SJHHC | Yes (true) |
| SAMARITAN BEHAVIORAL HEALTH INC | ||||||||||
| 601 S EDWIN C MOSES BLVD | DAYTON | OH | 45417 | 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 | MO | 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 | ||||||||||
| 1601 SE COURT AVE | PENDLETON | OR | 97801 | 930391614 | HEALTHCARE | OR | 501(c)(3) | 3 | CHI | Yes (true) |
| ST ANTHONY HOSPITAL FOUNDATION | ||||||||||
| 1601 SE COURT AVE | 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 | ||||||||||
| 5942 RENAISSANCE PLACE STE A | TOLEDO | OH | 43623 | 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 | OR | 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) | 8 | 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 | ||||||||||
| 30 WEST 7TH 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 | ||||||||||
| 6624 FANNIN ST STE 1100 | HOUSTON | TX | 77030 | 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 GROUP | ||||||||||
| 6624 FANNIN ST STE 1100 | HOUSTON | TX | 77030 | 760458535 | PHYSICIANS | 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 | ||||||||||
| 6624 FANNIN ST STE 1100 | HOUSTON | TX | 77030 | 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 | ||||||||||
| 1314 3RD AVE | 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 | ||||||||||
| 188 INVERNESS DRIVE WEST STE 500 | ENGLEWOOD | 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) | 2 | THS | Yes (true) |
| TRINITY HOSPITAL HOLDING COMPANY | ||||||||||
| 380 SUMMIT AVENUE | STEUBENVILLE | OH | 43952 | 341842025 | HEALTHCARE | OH | 501(c)(3) | 3 | 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) | 8 | SCHS | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (44 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 | UBI Code VUBICodeVAmt | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alegent Health Northwest Imaging Center LLC | ||||||||||||||
| 3606 N 156th St | OMAHA | NE | 68116 | 061786985 | OP Diagnostics | NE | ACH | Related | -$7,263 | $485,853 | false | $0 | Yes (true) | 0.51 |
| Audubon Land Company LLC | ||||||||||||||
| 630 Southpointe Court 200 | COLORADO SPRINGS | CO | 80906 | 841513085 | Real Estate | CO | CHIC | Related | $330,065 | $9,984,045 | false | $0 | false | 0.73 |
| AVON EMERGENCY AND URGENT CARE CENTER LLC | ||||||||||||||
| 9100 E Mineral Circle | Centennial | CO | 80112 | 811727282 | HEALTHCARE SRVC | CO | CHIC | Related | -$1,002,190 | $6,646,607 | false | $0 | 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 | $0 | Yes (true) | 0.65 |
| BERGAN MERCY SURGERY CENTER LLC | ||||||||||||||
| 7710 Mercy Rd Ste 200 | OMAHA | NE | 68124 | 208671994 | AMBUL SURG CTR | NE | ACH | Related | $1,308,113 | $2,778,497 | false | $0 | false | 0.51 |
| BERYWOOD OFFICE PROPERTIES LLC | ||||||||||||||
| 2501 Citico Avenue | CHATTANOGA | TN | 37404 | 621875199 | PHYS OFFICE | TN | MHCS | Related | $133,390 | $918,922 | false | $0 | Yes (true) | 0.63 |
| BLUEGRASS REGIONAL IMAGING CENTER | ||||||||||||||
| 1218 SOUTH BROADWAY STE 310 | LEXINGTON | KY | 40504 | 611386736 | DIAGNOSTIC IMAGING | KY | SJHS | Related | $20,471 | $3,315,748 | false | $0 | false | 0.65 |
| CATHOLIC HEALTH INITIATIVES PHYSICIAN SERVICES LLC | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 462945938 | PRACTICE MGMT SRVC | DE | CHI | Related | $118,502 | $43,489,364 | false | $0 | Yes (true) | 0.8 |
| CENTRAL NEBRASKA REHABILITATION SERVICES LLC | ||||||||||||||
| 3004 W FAIDLEY AVENUE | GRAND ISLAND | NE | 68803 | 810653461 | Physical Therapy | NE | SFMC | Related | $3,452,843 | $3,798,424 | false | $0 | false | 0.51 |
| CENTURA-SCA HOLDINGS LLC | ||||||||||||||
| 569 BROOK VILLAGE STE 901 | BIRMINGHAM | AL | 35209 | 474823023 | OP SURGERY CENTER | AL | CHIC | Related | $238,314 | $1,149,906 | false | $0 | Yes (true) | 0.65 |
| CHI OPERATING INVESTMENT PROGRAM LP | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 470727942 | INVESTMENTS | CO | CHI | Unrelated | $460,894,424 | $6,934,279,715 | false | $745,024 | Yes (true) | 1 |
| CHI ST LUKE'S HEALTH EMERGENCY CENTER LLC | ||||||||||||||
| 6624 Fannin St Ste 1100 | HOUSTON | TX | 77030 | 810743412 | URGENT CARE | TX | SLHS | Related | -$2,234,613 | $19,321,224 | false | $0 | Yes (true) | 0.65 |
| CHICAMSURG Surgery Centers LLC | ||||||||||||||
| 1A Burton Hills Blvd | Nashville | TN | 37215 | 465683027 | SURGERY CENTER | CO | CHIC | Related | $38,311 | $123,437 | false | $0 | false | 0.51 |
| CHICLARKIN VENTURES LLC | ||||||||||||||
| 9100 E Mineral Circle | Centennial | CO | 80112 | 474210888 | URGENT CARE | CO | CHIC | Related | -$2,957,202 | $7,086,404 | false | $0 | Yes (true) | 0.87 |
| Colorado Springs CK Leasing LLC | ||||||||||||||
| 630 Southpointe Court 200 | COLORADO SPRINGS | CO | 80906 | 262982714 | REAL ESTATE | CO | CHIC | Related | $506,130 | -$62,688 | false | $0 | Yes (true) | 0.52 |
| HC SL VINTAGE I LLC | ||||||||||||||
| 18000 W SARAH LANE STE 250 | BROOKFIELD | WI | 53045 | 270453767 | PROPERTY HOLDING | WI | SL HOSP-VINTAGE | Related | $1,609,644 | $53,760,469 | false | $0 | false | 0.51 |
| HEALTHCARE SUPPORT SERVICES LLC | ||||||||||||||
| PO BOX 9804 | GRAND ISLAND | NE | 68802 | 721546196 | LAUNDRY | NE | na | Related | $2,752,364 | $3,361,559 | false | $0 | false | 1 |
| Heartland Oncology LLC | ||||||||||||||
| 2337 E Crawford St | Salina | KS | 67401 | 464265403 | ONCOLOGY | KS | SCH | Related | -$457,809 | $1,985,911 | false | $0 | false | 0.51 |
| HIGHLINE IMAGING LLC | ||||||||||||||
| PO BOX 184 | BRUSH PRAIRIE | WA | 98606 | 200460005 | DIAGNOSTIC IMAGING | WA | HMC | Related | $998,974 | $210,552 | false | $0 | false | 0.8 |
| LAKESIDE AMBULATORY SURGICAL CENTER LLC | ||||||||||||||
| 17031 LAKESIDE HILLS DR | OMAHA | NE | 68130 | 204267902 | AMBUL SURG CTR | NE | ACH | Related | $3,231,701 | $934,253 | false | $0 | false | 0.54 |
| LAKESIDE ENDOSCOPY CENTER LLC | ||||||||||||||
| 17001 LAKESIDE HILLS PLZ STE 201 | OMAHA | NE | 68130 | 205544496 | ENDOSCOPY SRVC | NE | ACH | Related | $699,620 | $777,431 | false | $0 | false | 0.51 |
| LINCOLN CK LEASING LLC | ||||||||||||||
| 555 SOUTH 70TH STREET | Lincoln | NE | 68510 | 262496856 | Real Estate | NE | SERMC | Related | $1,040,431 | $650,676 | false | $0 | false | 0.54 |
| NEBRASKA SPINE HOSPITAL LLC | ||||||||||||||
| 6901 N 72ND ST STE 20300 | OMAHA | NE | 68122 | 270263191 | SPINE HOSPITAL | NE | ACH | Related | $14,574,331 | $24,063,010 | false | $0 | false | 0.51 |
| NORTH RIVER SURGERY CENTER LLC | ||||||||||||||
| 2209 WILDWOOD AVE | SHERWOOD | AR | 72120 | 710799771 | AMBUL SURG CTR | AR | SVIMC | Related | $213,304 | $1,526,210 | false | $0 | false | 0.61 |
| ORTHOCOLORADO LLC | ||||||||||||||
| 11650 WEST 2ND PLACE | LAKEWOOD | CO | 80255 | 371577105 | ORTHO HOSPITAL | CO | THC | Related | $15,065,598 | $5,758,345 | false | $0 | false | 0.6 |
| PENINSULA RADIATION ONCOLOGY LLC | ||||||||||||||
| 314 MLK JR WAY STE 11 | TACOMA | WA | 98405 | 870808610 | HEALTHCARE SRVC | WA | FHS | Related | $658,480 | $1,639,249 | false | $0 | false | 0.6 |
| Penrad Imaging | ||||||||||||||
| 1390 Kelly Johnson Blvd | COLORADO SPRINGS | CO | 80920 | 841072619 | Medical Imaging | CO | CHIC | Related | $532,329 | $2,145,214 | false | $0 | false | 0.7 |
| PMC HOSPITAL LLC | ||||||||||||||
| 3100 MAIN ST STE 500 | HOUSTON | TX | 77002 | 273280598 | HOSPITAL | TX | SL CDC-PMC | Related | $3,486,396 | $60,785,684 | false | $0 | Yes (true) | 0.51 |
| PRAIRIE HEALTH VENTURES LLC | ||||||||||||||
| 421 S 9TH ST STE 102 | LINCOLN | NE | 68508 | 204962103 | TECH SRVC | NE | AH-IMC | Related | $1,101,304 | $5,330,749 | false | $0 | Yes (true) | 0.66 |
| Pueblo Ambulatory Surgery Center LLC | ||||||||||||||
| 25 Montebello Rd | Pueblo | CO | 81003 | 621488737 | SURGERY CENTER | CO | CHIC | Related | -$83,926 | $147,188 | false | $0 | false | 0.51 |
| Saint JOSEPH - PAML LLC | ||||||||||||||
| 200 ABRAHAM FLEXNER WAY | LOUISVILLE | KY | 40202 | 452116736 | MGMT SVCS | KY | SJHS | Related | -$382,945 | $203,858 | false | $0 | Yes (true) | 0.63 |
| SAINT JOSEPH - SCA HOLDINGS LLC | ||||||||||||||
| 1451 Harrodsburg RD | LEXINGTON | KY | 40503 | 453801157 | OP SURGERY | DE | SJHS | Related | $0 | $0 | false | $0 | Yes (true) | 0.51 |
| SAINT JOSEPH-ANC HOME CARE SERVICES | ||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 263330545 | HOME HEALTH | KY | JHSMH | Related | $1,820,204 | $8,702,616 | false | $0 | false | 1 |
| SCA Premier Surgery Center of Louisville LLC | ||||||||||||||
| 200 Abraham Flexner Way | LOUISVILLE | KY | 40202 | 721386840 | SURGERY CENTER | KY | JHSMH | Related | -$75,509 | $1,599,003 | false | $0 | false | 0.51 |
| ST FRANCIS LAND COMPANY | ||||||||||||||
| 5390 N ACADEMY BLVD STE 300 | COLORADO SPRINGS | CO | 80918 | 263134100 | REAL ESTATE | CO | CHIC | Related | $245,362 | $13,709,940 | false | $0 | false | 0.59 |
| ST FRANCIS MEDICAL CENTER ASSOCIATES | ||||||||||||||
| 1717 SOUTH J ST | TACOMA | WA | 98405 | 911352698 | MED OFFICE | WA | FHS | Related | $98 | $0 | false | $0 | false | 0.61 |
| ST LUKE'S DIAGNOSTIC CATH LAB LLP | ||||||||||||||
| 6624 FANNIN ST STE 800 | HOUSTON | TX | 77030 | 710959365 | DIAGNOSTICS | TX | SLHS HOLDINGS | Related | $668,977 | $653,674 | false | $0 | false | 0.57 |
| ST LUKE'S LAKESIDE HOSPITAL LLC | ||||||||||||||
| 6624 FANNIN STE 2505 | HOUSTON | TX | 77030 | 300427437 | HOSPITAL | TX | SL CDC-W | Related | $1,519,959 | $35,885,295 | false | $0 | Yes (true) | 0.51 |
| ST LUKE'S THE WOODLANDS SLEEP CENTER LLC | ||||||||||||||
| 6624 FANNIN STE 800 | HOUSTON | TX | 77030 | 462795726 | DIAGNOSTICS | TX | SLHSH | Related | -$97,480 | $1,146,543 | false | $0 | Yes (true) | 0.51 |
| Superior Medical Imaging LLC | ||||||||||||||
| 5000 North 26th ST | LINCOLN | NE | 68521 | 262884555 | OP Diagnostics | NE | SERMC | Related | $9,528 | $402,804 | false | $0 | Yes (true) | 0.51 |
| SURGERY CENTER OF LEXINGTON LLC | ||||||||||||||
| 200 ABRAHAM FLEXNER WAY | LOUISVILLE | KY | 40202 | 621179539 | SURGERY CENTER | KY | SJHS | Related | $55,400 | $3,649,989 | false | $0 | Yes (true) | 0.51 |
| SURGERY CENTER OF LOUISVILLE LLC | ||||||||||||||
| 200 Abraham Flexner Way | LOUISVILLE | KY | 40202 | 621179537 | SURGERY CENTER | KY | JHSMH | Related | $216,645 | $1,681,716 | false | $0 | Yes (true) | 0.51 |
| FRANCISCAN SPECIALTY CARE LLC | ||||||||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 813725123 | HEALTHCARE SRVC | WA | FHS | Related | $0 | $3,878 | false | $0 | Yes (true) | 0.51 |
| THREE SPRING IMAGING LLC | ||||||||||||||
| 1 Mercado St STE 200A | DURANGO | CO | 81301 | 811174301 | HEALTHCARE SRVC | CO | CHIC | Related | $0 | $0 | false | $0 | Yes (true) | 0.51 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (67 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 | $9,007,610 | $6,374,176 | 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 FRACNISCAN DRIVE | BRYAN | TX | 77802 | 742466914 | Healthcare | TX | SJSC | C Corporation | $255,816 | $596,751 | 1 | Yes (true) | |||||||
| Alternative Insurance Management Service Inc | |||||||||||||||||||
| 3900 OLYMPIC BLVD STE 400 | Erlanger | KY | 41018 | 841112049 | Management Services | CO | CHI | C Corporation | $0 | $6,053,478 | 1 | Yes (true) | |||||||
| AMERICAN NURSING CARE Inc | |||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311085414 | HOME HEALTH | OH | CHS | C Corporation | $87,072,744 | $60,223,692 | 1 | Yes (true) | |||||||
| AMERIMED INC | |||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311158699 | HOME HEALTH | OH | ANC | C Corporation | $19,796,409 | $16,432,699 | 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 | $146,745 | $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 | $120,502 | 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 | $593,807 | $1,997,692 | 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 | TN | PHPSI | C Corporation | $4,366,514 | $6,164,262 | 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 | $247,400 | $51,845,030 | 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 | $1,110,463 | 0.93 | Yes (true) | |||||||
| Diversified Health Resources Inc | |||||||||||||||||||
| 100 MEDICAL DRIVE | LAKE JACKSON | TX | 77566 | 760222679 | Health Care | TX | BRHS | C Corporation | $22,921 | $182,538 | 1 | Yes (true) | |||||||
| East Texas Clinical Services Inc | |||||||||||||||||||
| 2801 Via Fortuna 500 | Austin | TX | 78746 | 454736213 | Healthcare | TX | MHSET | C Corporation | $44,581,192 | $35,638,866 | 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 Services Inc | |||||||||||||||||||
| 198 INVERNESS DRIVE WEST | Englewood | CO | 80112 | 232487967 | Healthcare | CO | CHI | C Corporation | $0 | $13,121,352 | 1 | Yes (true) | |||||||
| Good Samaritan Outreach Services | |||||||||||||||||||
| PO Box 1990 | Kearney | NE | 68848 | 470659440 | Medical Clinic | NE | CHI Nebraska | C Corporation | $448,704 | $238,478 | 1 | Yes (true) | |||||||
| HarvestPlains Health of Iowa | |||||||||||||||||||
| 32129 Weyerhaeuser Way S STE 201 | FEDERAL WAY | WA | 98001 | 473451750 | Insurance | WA | QCHPS | C Corporation | $2,707,777 | $3,405,918 | 1 | Yes (true) | |||||||
| Health Systems Enterprises Inc | |||||||||||||||||||
| PO BOX 1990 | Kearney | NE | 68848 | 470664558 | MGMT | NE | GSH | C Corporation | $90,144 | $1,266,555 | 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 | NE | PHPSI | C Corporation | $6,332,841 | $4,591,181 | 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) | |||||||
| Medquest | |||||||||||||||||||
| 1301 15TH AVENUE WEST | Williston | ND | 58801 | 450392137 | Sale of DME | ND | MMC Williston | C Corporation | $476,061 | $1,341,631 | 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 | $1,012,298 | $3,213,761 | 1 | Yes (true) | |||||||
| Mercy Services Corp | |||||||||||||||||||
| 2700 STEWART PARKWAY | Roseburg | OR | 97471 | 930824308 | Retail Sales | OR | MMC | C Corporation | $718,096 | $44,781 | 1 | Yes (true) | |||||||
| MHI Clinical Services | |||||||||||||||||||
| 1201 W Frank Ave | Lufkin | TX | 75904 | 461967952 | Healthcare | TX | MHSET | C Corporation | $8,216,376 | $1,714,060 | 1 | Yes (true) | |||||||
| Mountain Management Services Inc | |||||||||||||||||||
| 6028 Shallowford Rd | Chattanooga | TN | 37421 | 621570739 | MGMT SVC ORG | TN | MHCS | C Corporation | $9,959,066 | $2,332,098 | 1 | Yes (true) | |||||||
| PATIENT TRANSPORT SERVICES INC | |||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311100798 | HOME HEALTH | OH | ANC | C Corporation | $9,129,926 | $6,575,470 | 1 | Yes (true) | |||||||
| PhysicianHealth System Network | |||||||||||||||||||
| 1149 MARKET ST | Tacoma | WA | 98402 | 911746721 | Health Org. | WA | FHS | C Corporation | $0 | $0 | 1 | Yes (true) | |||||||
| QCA Health Plan Inc | |||||||||||||||||||
| 12615 Chenal Parkway STE 300 | Little Rock | AR | 72211 | 710794605 | Insurance | AR | QCHI | C Corporation | $220,347,460 | $75,215,779 | 1 | Yes (true) | |||||||
| QualChoice Advantage | |||||||||||||||||||
| 32129 WEYERHAEUSER WAY S STE 201 | FEDERAL WAY | WA | 98001 | 473433912 | Insurance | WA | QCPS | C Corporation | $12,065,527 | $5,101,872 | 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 | $70,645,496 | $188,158,578 | 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 | $2,722 | -$97,729,832 | 1 | Yes (true) | |||||||
| QualChoice Holdings Inc | |||||||||||||||||||
| 198 INVERNESS DRIVE WEST | Englewood | CO | 80112 | 274075520 | Holding Co | AR | PHPS | C Corporation | $0 | $10,190 | 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 | $133,112,090 | $51,130,374 | 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 | OH | PHPS | C Corporation | $9,313,011 | $5,354,348 | 1 | Yes (true) | |||||||
| RiverLink Health of Kentucky Inc | |||||||||||||||||||
| 198 INVERNESS DRIVE WEST | Englewood | CO | 80112 | 464828332 | Insurance | KY | PHPS | C Corporation | $8,544,070 | $6,502,040 | 1 | Yes (true) | |||||||
| Ross Park Pharmacy Inc | |||||||||||||||||||
| 380 SUMMIT AVE | STEUBENVILLE | OH | 43952 | 341832654 | Pharmacy | OH | THS | C Corporation | $1,100,838 | $1,680,883 | 1 | Yes (true) | |||||||
| Saint Clare's Primary Care Inc | |||||||||||||||||||
| 66 FORD RD | Denville | NJ | 07834 | 222441202 | Billing Services | NJ | SCCC | C Corporation | $0 | $651,958 | 1 | Yes (true) | |||||||
| SAMARITAN FAMILY CARE INC | |||||||||||||||||||
| 40 W FOURTH ST STE 1700 | Dayton | OH | 45402 | 311299450 | Healthcare | OH | SHP | C Corporation | $0 | $0 | 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) | |||||||
| SLMT Parking Inc | |||||||||||||||||||
| 6624 Fannin STE 800 | Houston | TX | 77030 | 760637140 | Parking | TX | SLHS | C Corporation | $1,721,167 | -$1,156,530 | 1 | Yes (true) | |||||||
| SoundPath Health Inc | |||||||||||||||||||
| 32129 Weyerhaeuser Way S STE 201 | Federal Way | WA | 98001 | 421720801 | Insurance | WA | PHPS | C Corporation | $198,821,947 | $55,632,834 | 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 | $1,610,317 | $2,059,282 | 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 6620 Main Condominium Association | |||||||||||||||||||
| 6624 Fannin STE 1100 | Houston | TX | 77030 | 300355517 | Condo Assoc | TX | SLPC | C Corporation | $0 | $0 | 1 | Yes (true) | |||||||
| St Luke's Anesthesiology Associates | |||||||||||||||||||
| 6624 Fannin STE 1100 | Houston | TX | 77030 | 461517163 | Medical Clinic | TX | CHI-SLH | C Corporation | $0 | $0 | 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 | $3,216,555 | $38,523,789 | 1 | Yes (true) | |||||||
| St Luke's Medical Arts Center I Condominium Association | |||||||||||||||||||
| 6624 Fannin STE 1100 | Houston | TX | 77030 | 300355518 | Condo Assoc | TX | SLPC | C Corporation | $0 | $0 | 1 | Yes (true) | |||||||
| St Luke's Medical Tower Condominium Association | |||||||||||||||||||
| 6624 Fannin STE 1100 | Houston | TX | 77030 | 760298751 | Condo Assoc | TX | SLMTC | C Corporation | $0 | $0 | 1 | Yes (true) | |||||||
| St Vincent Community Health Services Inc | |||||||||||||||||||
| TWO ST VINCENT CIRCLE | Little Rock | AR | 72205 | 710710785 | Healthcare | AR | SVIMC | C Corporation | $844,897 | $27,995,529 | 1 | Yes (true) | |||||||
| StableView Health Inc | |||||||||||||||||||
| 198 INVERNESS DRIVE WEST | Englewood | CO | 80112 | 464373713 | Insurance | KY | PHPS | C Corporation | $1,645,346 | $5,436,439 | 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 | $11,470,832 | $192,509 | 1 | Yes (true) | |||||||
| Vintage Doctor Group | |||||||||||||||||||
| 6624 Fannin STE 1100 | Houston | TX | 77030 | Medical Clinic | TX | CHI-SLH | C Corporation | $0 | $0 | 1 | Yes (true) | ||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |