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MERCY MEDICAL CENTER-CENTERVILLE: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
MERCY MEDICAL CENTER-CENTERVILLE (EIN 42-0680308)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-11
IRS object ID
201841319349301934
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 ReturnHeader

FieldValueIRS element (for citing)
Return2018-05-11T11:02:27-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN470617373PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Catholic Health InitiativesBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1198 Inverness Drive WestAddressLine1Txt
CityEnglewoodCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80112ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN420680308EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mercy Medical Center - CentervilleBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMERCBusinessNameControlTxt
Phone5154373413PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 St Josephs DriveAddressLine1Txt
CityCentervilleCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52544ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRandall L RubinPersonNm
Person TitleSVP, CFOPersonTitleTxt
Signature2018-05-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMark StockiPreparerPersonNm
PTINP00642127PTIN
Phone3032989100PhoneNum
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Clinton ChristiansonBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 St Josephs DriveAddressLine1Txt
CityCentervilleCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52544ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$31,440,257GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.mercycenterville.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1965FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionMercy Medical Center-Centerville is a not-for-profit Catholic health organization creating healthier communities by operating a 25-bed acute care hospital and a 20-bed skilled nursing facility.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee269TotalEmployeeCnt
Total Volunteers8TotalVolunteersCnt
Total Gross UBI$3,133TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$1,911NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$760,664PYContributionsGrantsAmt
CY Contributions Grants$609,688CYContributionsGrantsAmt
PY Program Service Revenue$25,765,355PYProgramServiceRevenueAmt
CY Program Service Revenue$29,102,779CYProgramServiceRevenueAmt
PY Investment Income$1,093,469PYInvestmentIncomeAmt
CY Investment Income$1,443,276CYInvestmentIncomeAmt
PY Other Revenue$269,244PYOtherRevenueAmt
CY Other Revenue$284,514CYOtherRevenueAmt
PY Total Revenue$27,888,732PYTotalRevenueAmt
CY Total Revenue$31,440,257CYTotalRevenueAmt
PY Grants And Similar Paid$152,258PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$508,463CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$13,807,406PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,713,414CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$37,842CYTotalFundraisingExpenseAmt
PY Other Expenses$12,417,299PYOtherExpensesAmt
CY Other Expenses$12,763,229CYOtherExpensesAmt
PY Total Expenses$26,376,963PYTotalExpensesAmt
CY Total Expenses$27,985,106CYTotalExpensesAmt
PY Revenues Less Expenses$1,511,769PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,455,151CYRevenuesLessExpensesAmt
Total Assets BOY$32,859,325TotalAssetsBOYAmt
Total Assets EOY$37,491,112TotalAssetsEOYAmt
Total Liabilities BOY$2,614,899TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,963,867TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$30,244,426NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$34,527,245NetAssetsOrFundBalancesEOYAmt
MissionTHE 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.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$26,236,806ExpenseAmt
Grant$508,463GrantAmt
Revenue$29,102,779RevenueAmt
DescSEE SCHEDULE H.Desc
Total Program Service Expenses$26,236,806TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingYes (true)LoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee269EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Randall L RubinBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5156437860PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11111 6th AvenueAddressLine1Txt
CityDes MoinesCityNm
State AbbreviationIAStateAbbreviationCd
ZIP50314ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
CLINTON CHRISTIANSON
PRESIDENT/CEO40.00Yes (X)Yes (X)$251,633$0$24,854
MIKE CRAVER
Board Chair1.00Yes (X)Yes (X)$0$0$0
BILL BUSS
Board Vice Chair1.00Yes (X)Yes (X)$0$0$0
SR JEANNE CHRISTENSEN RSM
DIRECTOR1.01.0Yes (X)$0$0$0
DAVID FRASER
Director/Physician40.00Yes (X)$297,591$0$24,462
JOHN GLENN
Director1.00Yes (X)$0$0$0
MICHAEL O'CONNOR
DIRECTOR1.00Yes (X)$0$0$0
ROBERT RITZ
Director / President CHI Corp1.045.0Yes (X)$0$1,059,026$92,308
LOTTIE WILSON
Board Member1.00Yes (X)$0$0$0
Rajni Batra MD
Director1.00Yes (X)$0$0$0
SR Margaret Wiegel RSM
Director1.00Yes (X)$0$0$0
RANDALL RUBIN
SVP, CFO / Board Treasurer1.050.0Yes (X)$0$420,410$30,320
MICHAEL WEGNER
COO CHI IA1.047.0Yes (X)$0$519,803$31,200
ANN YOUNG
DIRECTOR HEALTHCARE EXP / Board Secretary40.01.0Yes (X)$115,038$0$6,009
RYAN ARNEVIK
PHYSICIAN40.00$330,644$0$27,579Yes (X)
NANCY BARTON
Physician40.00$219,098$0$25,383Yes (X)
ERICA COLLINS
Physician40.00$245,115$0$20,980Yes (X)
JENNIFER HADEN
PHYSICIAN40.00$238,695$0$18,574Yes (X)
NEAL SOKOL
GENERAL SURGEON40.00$312,285$0$23,139Yes (X)
LORI RATHBUN
PRESIDENT-NETWORK HSP0.00.0$0$211,666$26,575Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,010,099TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,210,905TotReportableCompRltdOrgAmt
Total Other Compensation$351,383TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K17IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmtAddress Line2ContractorAddress/USAddress/AddressLine2Txt
EMERGENCY PRACTICE ASSOC INC
3840 W 9th StWaterlooIA50704PHYSICIAN SERVICES$1,602,478
PSYCHIATRIC MEDICAL CARE LLC
4322 Harding Pike Ste 417NashvilleTN37205locum tenens staffing$368,598
BLOOMFIELD ANESTHETISTS
105 E LOCUST STBLOOMFIELDIA52537PHYSICIAN SERVICES$350,048
KC CENTERVILLE LC
5000 Westown ParkwayWest Des MoinesIA50266Medical Services$173,277Suite 400
NUCLEAR SONICS
1333 SW Ordnance RdAnkenyIA50023Physician Services$137,094
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
Federated Campaigns$0FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$0FundraisingAmt
Related Organizations$541,846RelatedOrganizationsAmt
Government Grants$67,842GovernmentGrantsAmt
All Other Contributions$0AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$609,688TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
Net patient services900099$29,096,899$29,096,899$0$0
Medicare/Medicaid900099$5,880$5,880$0$0
$0$0$0$0
$0$0$0$0
$0$0$0$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$29,102,779TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$503,325TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$3,133UnrelatedBusinessRevenueAmt
Exclusion$500,192ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$91,604RealAmt
Personal$0PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$91,604RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$91,604TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$91,604ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$937,750SecuritiesAmt
Other$2,202OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$937,750SecuritiesAmt
Other$2,202OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$939,951TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$939,951ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$0ContriRptFundraisingEventAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
Cafeteria722100$45,584$0$0$45,584
Other Program Service Revenue900099$50,853$0$0$50,853
Intercompany Transactions900099$60,819$0$0$60,819

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$35,654TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$35,654ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$192,910OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,440,257TotalRevenueColumnAmt
Related Or Exempt Func Income$29,102,779RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$3,133UnrelatedBusinessRevenueAmt
Exclusion$1,724,657ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$44,075TotalAmt
Program Services$44,075ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$464,388TotalAmt
Program Services$464,388ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$756,832TotalAmt
Program Services$264,891ProgramServicesAmt
Management And General$454,099ManagementAndGeneralAmt
Fundraising$37,842FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,016,500TotalAmt
Program Services$10,884,372ProgramServicesAmt
Management And General$132,128ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$573,187TotalAmt
Program Services$568,006ProgramServicesAmt
Management And General$5,181ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,567,295TotalAmt
Program Services$1,500,854ProgramServicesAmt
Management And General$66,441ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$799,600TotalAmt
Program Services$759,620ProgramServicesAmt
Management And General$39,980ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$17,125TotalAmt
Management And General$17,125ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,533,782TotalAmt
Program Services$5,453,432ProgramServicesAmt
Management And General$80,351ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$70,978TotalAmt
Program Services$7,098ProgramServicesAmt
Management And General$63,880ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,073,724TotalAmt
Program Services$998,563ProgramServicesAmt
Management And General$75,161ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$44,643TotalAmt
Management And General$44,643ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$742,031TotalAmt
Program Services$742,031ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$45,617TotalAmt
Program Services$32,844ProgramServicesAmt
Management And General$12,773ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$6,594TotalAmt
Program Services$3,627ProgramServicesAmt
Management And General$2,967ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$19,742TotalAmt
Program Services$19,742ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$274,027TotalAmt
Program Services$274,027ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$708,211TotalAmt
Program Services$701,129ProgramServicesAmt
Management And General$7,082ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$81,134TotalAmt
Program Services$81,134ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Bad debts$455,260$455,260
Medical Supplies$2,359,921$2,359,921
CHI IA MBO Assessment$513,894$513,894
Repairs and maintenance$572,131$560,688$11,443

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$244,415TotalAmt
Program Services$61,104ProgramServicesAmt
Management And General$183,311ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$27,985,106TotalAmt
Program Services$26,236,806ProgramServicesAmt
Management And General$1,710,459ManagementAndGeneralAmt
Fundraising$37,842FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,284BOYAmt
EOY$1,425EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,912,340BOYAmt
EOY$2,115,930EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,012,991BOYAmt
EOY$4,034,357EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$143,514EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$170,191BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$375,858BOYAmt
EOY$377,177EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$85,563BOYAmt
EOY$70,879EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$21,703,690LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$15,195,431LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,785,678BOYAmt
EOY$6,508,259EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$18,515,420BOYAmt
EOY$24,239,571EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$32,859,325BOYAmt
EOY$37,491,112EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,085,456BOYAmt
EOY$2,042,644EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$529,443BOYAmt
EOY$921,223EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,614,899BOYAmt
EOY$2,963,867EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$30,244,426BOYAmt
EOY$34,527,245EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$30,244,426BOYAmt
EOY$34,527,245EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$32,859,325BOYAmt
EOY$37,491,112EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$3,455,151ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$827,668NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsYes (true)GrantsOtherOrganizationsInd
Grants Other Organizations$4,658GrantsOtherOrganizationsAmt
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Total Lobbying Expenditures$4,658TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYThe portion of organization dues that are related to lobbying are as follows: American Hospital Association - $650 Catholic Health Association - $521 $16,604 IN ANNUAL DUES WAS PAID TO THE IOWA HOSPITAL ASSOCIATION AND $3,487 WAS ALLOCATED AS LOBBYING EXPENSES
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYThe portion of organization dues that are related to lobbying are as follows: American Hospital Association - $650 Catholic Health Association - $521 $16,604 IN ANNUAL DUES WAS PAID TO THE IOWA HOSPITAL ASSOCIATION AND $3,487 WAS ALLOCATED AS LOBBYING EXPENSES

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$160,349OtherCostOrOtherBasisAmt
Book Value$160,349BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,834,397OtherCostOrOtherBasisAmt
Depreciation$8,560,172DepreciationAmt
Book Value$2,274,225BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

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

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,795,986OtherCostOrOtherBasisAmt
Depreciation$6,302,584DepreciationAmt
Book Value$2,493,402BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,912,958OtherCostOrOtherBasisAmt
Depreciation$332,675DepreciationAmt
Book Value$1,580,283BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,508,259TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (5 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
CHI OIP - Fixed Income
CHI OIP - Equity Securities
CHI Operating Investment Program, LP
CHI OIP
CHI OIP$24,239,571F
FieldValueIRS element (for citing)
Total Book Value Securities$24,239,571TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
accrued expenses$355,245
intercompany payables$249,164
Other$934
CHI Debt Program$315,880
FieldValueIRS element (for citing)
Total Liability$921,223TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteFormAndLineReferenceDesc
ExplanationMercy Medical Center - Centerville's financial information is included in the consolidated audited financial statements of Catholic Health Initiatives (CHI), a related organization. CHI's FIN 48 (ASC 740) footnote for the year ended June 30, 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."ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$197,831TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$197,831NetCommunityBenefitExpnsAmt
Total Expense0.0072TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$197,831TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$197,831NetCommunityBenefitExpnsAmt
Total Expense0.0072TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs17ActivitiesOrProgramsCnt
Persons Served23083PersonsServedCnt
Total Community Benefit Expns$123,299TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$123,299NetCommunityBenefitExpnsAmt
Total Expense0.0045TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs6ActivitiesOrProgramsCnt
Persons Served128PersonsServedCnt
Total Community Benefit Expns$11,922TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$11,922NetCommunityBenefitExpnsAmt
Total Expense0.0004TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs19ActivitiesOrProgramsCnt
Persons Served233PersonsServedCnt
Total Community Benefit Expns$56,610TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$56,610NetCommunityBenefitExpnsAmt
Total Expense0.0021TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs42ActivitiesOrProgramsCnt
Persons Served23444PersonsServedCnt
Total Community Benefit Expns$191,831TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$191,831NetCommunityBenefitExpnsAmt
Total Expense0.0070TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs42ActivitiesOrProgramsCnt
Persons Served23444PersonsServedCnt
Total Community Benefit Expns$389,662TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$389,662NetCommunityBenefitExpnsAmt
Total Expense0.0142TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served61PersonsServedCnt
Total Community Benefit Expns$661TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$661NetCommunityBenefitExpnsAmt
Total Expense0.0000TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$1,696TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,696NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served100PersonsServedCnt
Total Community Benefit Expns$1,529TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,529NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served52PersonsServedCnt
Total Community Benefit Expns$216TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$216NetCommunityBenefitExpnsAmt
Total Expense0.0000TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$1,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,500NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served65PersonsServedCnt
Total Community Benefit Expns$10,301TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$10,301NetCommunityBenefitExpnsAmt
Total Expense0.0004TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs9ActivitiesOrProgramsCnt
Persons Served278PersonsServedCnt
Total Community Benefit Expns$15,903TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$15,903NetCommunityBenefitExpnsAmt
Total Expense0.0006TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$455,260BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$4,827,910ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$13,685,300CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$8,857,390MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mercy Medical Center - CentervilleBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One St Josephs DriveAddressLine1Txt
CityCentervilleCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52544ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.MercyCenterville.orgWebsiteAddressTxt
State License040050HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Mercy Medical Center - CentervilleBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://www.mercycenterville.org/about-us/community-benefits.aspxOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsitefalseStrategyPostedWebsiteInd
Strategy AttachedYes (true)StrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.0FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.0FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp://www.mercycenterville.org/patient-visitor-info/patients/financial-assistance-policy.aspxFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttp://www.mercycenterville.org/patient-visitor-info/patients/financial-assistance-policy.aspxFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttp://www.mercycenterville.org/patient-visitor-info/patients/financial-assistance-policy.aspxFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1Facility , 1 - Mercy Medical Center - Centerville. Mercy Medical Center - Centerville along with Appanoose County Public Health Nursing Office and VVV Consultants, LLC. worked together to research and develop the CHNA. As part of this process a comprehensive healthcare survey was sent to approximately 1,000 service area families and a public town hall meeting was held in March 2016 to identify and prioritize service area health needs. All Town Hall priority-setting and scoring processes involve the input of key stakeholders in attendance. Individuals and organizations attending the Town Halls were critically important to the success of the CHNA. The following list outlines partners invited to Town Hall: local hospital, public health community, mental health community, free clinics, community-based clinics, service providers, local residents, community leaders, opinion leaders, school leaders, business leaders, local government, faith-based organizations and persons (or organizations serving them), people with chronic conditions, uninsured community members, low income residents and minority groups.
Schedule H, Part V, Section B, Line 11 Facility , 1Facility , 1 - Mercy Medical Center - Centerville. See attached. Can be found at the end of the return, behind the implementation strategy.
Schedule H, Part V, Section B, Line 13 Facility , 1Facility , 1 - Mercy Medical Center - Centerville. 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.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mercy Centerville Longterm Care FacilityBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One St Josephs DriveAddressLine1Txt
CityCentervilleCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52544ZIPCd
FieldValueIRS element (for citing)
Facilitynursing homeFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 3c financial assistance eligibility criteriaUnless eligible for Presumptive Financial Assistance, the following eligibility criteria must be met in order for a patient to qualify for Financial Assistance: * The patient must have a minimum account balance of thirty-five dollars ($35.00) with the CHI Hospital Organization. Multiple account balances may be combined to reach this amount. Patients/Guarantors with balances below thirty-five dollars ($35) may contact a financial counselor to make monthly installment payment arrangements. * The patient's Family Income must be at or below 300% of the FPG. * The patient must comply with Patient Cooperation Standards as described [in the FAP]. * The patient must submit a completed Financial Assistance application. For patients and Guarantors who are unable to provide required documentation, a Hospital Facility may grant Presumptive Financial Assistance based on information obtained from other resources. In particular, presumptive eligibility may be determined on the basis of individual life circumstances that may include: * Recipient of state-funded prescription programs; * Homeless or one who received care from a homeless clinic; * Participation in Women, Infants and Children programs (WIC); * Food stamp eligibility; * Subsidized school lunch program eligibility; * Eligibility for other state or local assistance programs (e.g., Medicaid spend-down); * Low income/subsidized housing is provided as a valid address; or * Patient is deceased with no known estate.
Schedule H, Part I, Line 7g Subsidized Health ServicesThere are no physician clinics included in subsidized health services.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation455260
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceThe cost-to-charge ratio for the year ended 6/30/17 was computed using the following formula: Operating expense (before restructuring, impairment and other losses) divided by gross patient revenue. Based on that formula, 26,471,252/ 62,138,680 results in a 42.60% cost-to-charge ratio. 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 amountCosting methodology for amounts reported on line 2 is determined using the organization's cost/charge ratio of 42.60%. 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 MethodologyMercy Medical Center - Centerville 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 footnoteMercy Medical Center - Centerville does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of Catholic Health Initiatives. The consolidated footnote reads as follows: The provision for bad debts is based upon management's assessment of historical and expected net collections, taking into consideration historical business and economic conditions, trends in health care coverage, and other collection indicators. Management routinely assesses the adequacy of the allowances for uncollectible accounts based upon historical write-off experience by payor category. The results of these reviews are used to modify, as necessary, the provision for bad debts and to establish appropriate allowances for uncollectible net patient accounts receivable. After satisfaction of amounts due from insurance, CHI follows established guidelines for placing certain patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by each facility. The provision for bad debts is presented in the consolidated statement of operations as a deduction from patient services revenues (net of contractual allowances and discounts) since CHI accepts and treats all patients without regard to the ability to pay.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsMercy Medical Center - Centerville 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, Mercy Medical Center - Centerville, due to their designation as a CAH, received cost-based reimbursement for Medicare purposes, Mercy Medical Center - Centerville 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: $4,827,910 Total Medicare costs: $13,685,300 Shortfall: ($8,857,390) Mercy Medical Center - Centerville 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 assistanceThe 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- Mercy Medical Center - Centerville: Line 16a URL: http://www.mercycenterville.org/patient-visitor-info/patients/financial-assistance-policy.aspx;
Schedule H, Part V, Section B, Line 16b FAP Application website- Mercy Medical Center - Centerville: Line 16b URL: http://www.mercycenterville.org/patient-visitor-info/patients/financial-assistance-policy.aspx;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website- Mercy Medical Center - Centerville: Line 16c URL: http://www.mercycenterville.org/patient-visitor-info/patients/financial-assistance-policy.aspx;
Schedule H, Part VI, Line 2 Needs assessmentMercy Medical Center-Centerville is a 25 bed critical access not-for-profit Catholic hospital located in Centerville, IA. The hospital is included in the Official Catholic Directory as a tax-exempt hospital. The mission of the hospital is to nurture the healing ministry of the Church by bringing it new life, energy, and viability in the 21st century. The medical fraternity in Centerville founded the hospital as the Centerville Hospital in 1902. At the community's request, management and operations of the hospital were taken over by the Sisters of Mercy in 1910. Since that time, Mercy has continued to reach out to provide education, health care and services, collaborating with local partners to improve the health of the community. Guided by our values of Reverence, Integrity, Compassion, and Excellence, we hold ourselves to a high standard of giving to the poor and broader community. Mercy Centerville employs 209 people with a medical staff of 9 family practice providers, 2 general surgeons, 1 ob-gyn, 1 internal medicine, and 1 pediatrician. Consulting specialty clinics at the hospital are also available in the areas of pathology, allergy, urology, otolaryngology, cardiology, oncology, podiatry, vascular surgery, dermatology, nephrology and orthopedics. Just like fire and police protection, the hospital provides 24-hour emergency room physicians. Diagnostic capability includes x-ray, ultrasound, vascular ultrasound, CT scan, PET-CT scan, nuclear medicine, MRI, digital mammography and bone densitometry. Other services include Physical & Occupational Therapy, Respiratory Therapy, Obstetrics, Surgery, Ambulance, Cardiac Rehabilitation, and Social and Pastoral Care programs. The hospital also operates a 20-bed Long-Term Care facility, Sleep Lab and Geriatric Outpatient Mental Health The hospital's services are provided to the community on a non-discriminatory basis and include an emergency room staffed 24/7 with emergency room physicians that is open to all persons regardless of ability to pay. The hospital is governed by a board in which independent persons representative of the community comprise the majority. The hospital participates in government-sponsored health care programs like Medicaid and Medicare.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistanceNotification about the availability of Financial Assistance from CHI Hospital Organizations shall be disseminated by various means, which may include, but not be limited to: * Conspicuous publication of notices in patient bills; * Notices posted in emergency rooms, urgent care centers, admitting/registration departments, business offices, and at other public places as a Hospital Facility may elect; and * Publication of a summary of this Policy on the Hospital Facility's website, www.catholichealth.net, and at other places within the communities served by the Hospital Facility as it may elect. Such notices and summary information shall include a contact number and shall be provided in English, Spanish, and other primary languages spoken by the population served by an individual Hospital Facility, as applicable. Referral of patients for Financial Assistance may be made by any member of the CHI Hospital Organization non-medical or medical staff, including physicians, nurses, financial counselors, social workers, case managers, chaplains, and religious sponsors. A request for assistance may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws. In addition, Hospital registration clerks are trained to provide consultation to those who have no insurance or potentially inadequate insurance concerning their financial options including application for Medicaid and for assistance under the Financial Assistance Policy. Counselors assist Medicare eligible patients in enrollment by providing referrals to the appropriate government agencies. Once it is determined that the patient does not qualify for any third party funding, the patient is verbally notified about the existence of Financial Assistance Application and additional screening takes place by a Hospital employee to determine if the patient is eligible for charity service prior to discharge. Upon registration (and once all EMTALA requirements are met), patients who are identified as uninsured (and not covered by Medicare or Medicaid) are provided with a packet of information that addresses the Financial Assistance Policy, the plain language summary of that policy, and an application for assistance. Hospital registration clerks read the organization's medical assistance policy to those who appear to be incapable of reading, and provide translators for non-English-speaking individuals. Patients that have been discharged prior to charity screening, such as emergency room patients, receive a written notification of possible eligibility for services. If the patient is determined not to be eligible for government assistance, he/she may notify the hospital that they seek charity assistance. The appropriate charity form is sent to the patient/guarantor for completion and then returned to the hospital for evaluation and qualification. Once determination of eligibility is made, the patient is sent a notice informing him/her if they qualify for full, partial, or no charity care services. Hospital Facilities must make reasonable efforts through its billing and collections processes, pursuant to Treas. Reg. §1.501(r)-6(c), to determine whether any individual is eligible for Financial Assistance.
Schedule H, Part VI, Line 4 Community informationMercy Medical Center has provided Centerville and the people of Appanoose County with many ongoing community benefits since its beginning. Foremost, as a private hospital, it has saved the community over one million dollars annually in property taxes compared to surrounding counties who support public hospitals. True to its mission, Mercy-Centerville has made a commitment to improving the health of the community before they become ill. The hospital has financial assistance policies and programs for low-income persons like the Uninsured/Underinsured Patient Discount Policy and the Self-Pay and Third-Party Discounts Policy. QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT: The hospital served 23,722 persons in FY17 with a cost of community benefit of $403,648. QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT I. Community Outreach for the Poor Senior Transportation The hospital sponsors a community bus 5 days per week which provides free transportation to medical appointments or general errands for the elderly and others with low income who are unable to drive or have no one to transport them. Medical Eligibility & Counseling Services Provide dedicated person to assist uninsured and underinsured patient's with links to health care services and government programs. Operation Santa Hotline Provide and maintain a hotline for Operation Santa, a non-profit community group who gives food and presents to local families living in poverty. II. Community Outreach for the Broader Community Alzheimer's Support Group Mercy holds a monthly Alzheimer's support group to meet the growing needs of the elderly facing Alzheimer's and those who are providing care to them in the home. The group has both a morning and evening session for the convenience of caregivers. Narcotics Anonymous The hospital provided facilities once a week throughout the year to narcotics anonymous, allowing the group a safe and confidential environment to assist and support their recovery. Kids Health Fair Mercy was a lead sponsor and participant in the Appanoose County Healthy Kids Fair. The kids fair targeted youth and families promoting good health habits, hygiene, nutrition and exercise for kids. Athletic Coverage Mercy provided free athletic coverage at community school sponsored athletic events - football and baseball. Includes screening, evaluating and treating injuries. Parkinson's Support Group Mercy holds a monthly support group for area residents suffering from Parkinson's. Led by a hospital physical therapist, the program helped to educate those with Parkinson's and their caregivers about living with Parkinson's and the resources available to assist them in their everyday life living with the disease. Cancer Support Group Mercy provided a monthly support group for cancer patients and families. The program provides a forum for discussion, problems, resources and overall support for these people who are living with the disease. Breastfeeding Support Group Mercy provided the areas only breastfeeding support group within a one hours drive. Specially trained registered nurses managed the program and provided support and education to new mothers, promoting the benefits of breastfeeding through assistive techniques and resources. Heart Healthy Eating & Living Mercy provided a monthly program to people with cardiac disease on the benefits of eating healthy and regular exercise to manage or prevent further cardiac events. Athletic Physicals Mercy provided greatly reduced athletic physicals to the local Centerville school district families.
Schedule H, Part VI, Line 5 Promotion of community healthThe organization's hospital facility(ies) promote health for the benefit of the community. Medical staff privileges in the hospital are available to all qualified physicians in the area, consistent with the size and nature of its facilities. The organization's hospital facility(ies) have an open medical staff. Its board of trustees is composed of prominent citizens in the community. Excess funds are generally applied to expansion and replacement of existing facilities and equipment, amortization of indebtedness, improvement in patient care, and medical training, education, and research. The facility(ies) treat persons paying their bills with the aid of public programs like Medicare and Medicaid. All patients presenting at the hospital for emergency and other medically necessary care are treated regardless of their ability to pay for such treatment.
Schedule H, Part VI, Line 6 Affiliated health care systemThe 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 reportIA

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
Rathbun Lake Area YMCA
708 Main StreetCentervilleIA52544262927214501(c)(3)$16,125Community Support
Appanoose Community Care Services
19890 St Josephs DrCentervilleIA52544420893264501(c)(3)$5,624Community Support
Main Street Centerville
307 N 13th St Ste 500CentervilleIA52544262038472501(c)(3)$5,000Community Support
FieldValueIRS element (for citing)
Total501c3 Org3Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant Typecharity care and financial assistanceGrantTypeTxt
Recipient230RecipientCnt
Non Cash Assistance$464,388NonCashAssistanceAmt
Valuation Method UsedBookValuationMethodUsedDesc
Non Cash AssistanceREDUCTION OR WRITE-OFF OF PATIENT SERVICESNonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule I, Part III assistance to individualsMercy Medical Center - Centerville RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. BUSINESS OFFICE STAFF HELPS PATIENTS SEEK LOCAL, STATE, AND FEDERAL REIMBURSEMENT AT NO CHARGE WHEN NO OTHER SOURCE OF PAYMENT IS AVAILABLE. FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS WITH DEMONSTRATED INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES. THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS ACCOUNTS RECEIVABLE.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.All of our grants are made to 501(c)(3) organizations to ensure the grants are used for charitable purposes.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
CLINTON CHRISTIANSON
PRESIDENT/CEO$210,999$0$24,705$0$15,929$0$15,900$0$8,954$0$276,487$0$0$0
DAVID FRASER
Director/Physician$292,846$0$0$0$4,745$0$15,789$0$8,673$0$322,053$0$0$0
ROBERT RITZ
Director / President CHI Corp$0$698,889$0$308,825$0$51,312$0$77,838$0$14,470$0$1,151,334$0$28,583
LORI RATHBUN
PRESIDENT-NETWORK HSP$0$131,010$0$31,938$0$48,718$0$13,748$0$12,827$0$238,241$0$0
RANDALL RUBIN
SVP, CFO / Board Treasurer$0$358,346$0$41,224$0$20,840$0$15,900$0$14,420$0$450,730$0$0
MICHAEL WEGNER
COO CHI IA$0$446,233$0$52,613$0$20,957$0$15,900$0$15,300$0$551,003$0$0
RYAN ARNEVIK
PHYSICIAN$244,479$0$50,000$0$36,165$0$14,216$0$13,363$0$358,223$0$0$0
NANCY BARTON
Physician$196,214$0$20,000$0$2,884$0$13,368$0$12,015$0$244,481$0$0$0
ERICA COLLINS
Physician$242,820$0$0$0$2,295$0$15,270$0$5,710$0$266,095$0$0$0
JENNIFER HADEN
PHYSICIAN$167,758$0$0$0$70,937$0$11,125$0$7,449$0$257,269$0$0$0
NEAL SOKOL
GENERAL SURGEON$296,367$0$0$0$15,918$0$15,903$0$7,236$0$335,424$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 4a Severance PaymentsPost-termination payments are addressed in executive employment agreements for Catholic Health Initiatives (CHI) and related organizations' employees at the level of Vice President and above, including the MBO CEOs. These employment agreements require that in order for the executive to receive post-termination payments, these individuals must execute a general release and settlement agreement. Post-termination payment arrangements are periodically reviewed for overall reasonableness in light of the executive's overall compensation package.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planDuring 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: Robert P. Ritz During 2016 the following contributions were made by CHI to the deferred compensation plan: Robert P. Ritz - $61,938.00 During 2016 the following distributions were made by CHI from the deferred compensation plan: Robert P. Ritz - $28,582.78
Schedule J, Part I, Line 7 Non-fixed paymentsThe organization maintains a variable pay program for certain eligible employees that puts a portion of compensation at risk. Awards of incentive compensation are made based upon the achievement of organizational objectives.

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)

Relationship With OrgRelationshipWithOrgTxtLoan PurposeLoanPurposeTxtLoan From OrganizationLoanFromOrganizationIndOriginal PrincipalOriginalPrincipalAmtBalance DueBalanceDueAmtDefaultDefaultIndBoard Or Committee ApprovalBoardOrCommitteeApprovalIndWritten AgreementWrittenAgreementInd
Dr RYAN ARNEVIK
PHYSICIANPhysician RecruitmentYes (X)$100,640$22,466falseYes (true)Yes (true)
Dr NEAL SOKOL
GENERAL SURGEONPhysician RecruitmentYes (X)$206,171$121,048falseYes (true)Yes (true)
FieldValueIRS element (for citing)
Total Balance Due$143,514TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 12c Conflict of Interest PolicyThe 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 committeeTHE EXECUTIVE COMMITTEE CONSISTS ONLY OF DIRECTORS OF THE ORGANIZATION AND IS COMPOSED OF THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON OF THE BOARD, AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, EACH OF WHOM SERVE AS EX OFFICIO VOTING MEMBERS OF THE EXECUTIVE COMMITTEE, AND ANY ADDITIONAL VOTING MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT THE ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIODS BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT THEIR ACTIONS ARE CONSISTENT WITH ANY ACTIONS OR POLICIES OF THE BOARD OR THE CORPORATE MEMBER. ALL ACTIONS TAKEN ARE CONTEMPORANEOUSLY DOCUMENTED AND REPORTED TO THE BOARD AT THE EARLIEST MEETING.
Form 990, Part VI, Line 6 Classes of members or stockholdersThe entity's sole corporate member is Catholic Health Initiatives - Iowa, Corp d/b/a Mercy Medical Center - Des Moines, an Iowa nonprofit corporation.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyAccording 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 stockholdersThe organization's corporate member is Catholic Health Initiatives - Iowa, Corp d/b/a Mercy Medical Center - Des Moines, an Iowa nonprofit corporation. Pursuant to Section 5.4 of the organization's bylaws, both Catholic Health Initiatives - Iowa, Corp and Catholic Health Initiatives ("CHI") (Catholic Health Initiatives - Iowa, Corp's sole corporate member) have reserved powers as outlined in the CHI governance matrix. Pursuant to the governance matrix the following rights are held by Catholic Health Initiatives - Iowa, Corp: *Approve members of the Mercy Medical Center - Centerville board; *Amendment of the corporate documents of Mercy Medical Center - Centerville; *Approve removal of a member of the governing body of Mercy Medical Center - Centerville; *Adoption of long range and strategic plans for Mercy Medical Center - Centerville; 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 Mercy Medical Center - Centerville; *Removal of a member of the governing body of Mercy Medical Center - Centerville; *Approval of issuance of debt by Mercy Medical Center - Centerville; *Approval of participation of Mercy Medical Center - Centerville in a joint venture; *Approval of formation of a new corporation by Mercy Medical Center - Centerville; *Approval of a merger involving Mercy Medical Center - Centerville; *Approval of the sale of all or substantially all of the assets of Mercy Medical Center - Centerville; *To require the transfer of assets by Mercy Medical Center - Centerville to CHI to accomplish CHI's goals and objectives, and to satisfy CHI debts. Pursuant to Section 5.5 of the organization's bylaws, Catholic Health Initiatives - Iowa, Corp or CHI may, in exercise of their approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and its President and the Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate. (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 bodyThe organization's accounting personnel work with the CHI tax department personnel to prepare the form 990. When available, the CFO reviews the return and any necessary revisions are included in the final version which is approved for filing with the IRS. Subsequent to review by the chief financial officer, the tax department files the return with the appropriate federal and state agencies, making any non-substantive changes necessary to effect e-filing. Subsequent to e-filing, the final e-filed form 990 is presented to the board at a regularly scheduled board meeting.
Form 990, Part VI, Line 12c Conflict of interest policyCatholic 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 15a Process to establish compensation of top management officialThe organization uses a third-party consultant to survey compensation trends annually and to recommend a compensation range for the CEO. This recommendation is presented to the board for final determination and approval. The salaries are compared to industry standards and guidelines for appropriateness. This process was last undertaken in June 2016 for calendar 2017.
Form 990, Part VI, Line 15b Process to establish compensation of other employeesThe organization uses a third-party consultant to survey compensation trends annually and to recommend compensation ranges for the other officers and key employees. These recommendations are presented to the board for final determination and approval. The salaries are compared to industry standards and guidelines for appropriateness. This process was last undertaken in June 2016 for calendar 2017.
Form 990, Part VI, Line 19 Required documents available to the publicThe organization's financial statements are included in Catholic Health Initiatives consolidated audited financial statements that are available at www.catholichealthinitiatives.org. The organization's governing documents are available on the Iowa Secretary of State's website. The conflict of interest policy is not publicly available.
Form 990, Part VIII, Line 11d Other Miscellaneous RevenueOther Miscellaneous Revenue - Total Revenue: 35654, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 35654;
Form 990, Part IX, Line 11g Other FeesMedical Professional - Total Expense: 2234602, Program Service Expense: 2202156, Management and General Expenses: 32446, Fundraising Expenses: ; Clinical Engineering - Total Expense: 257245, Program Service Expense: 253510, Management and General Expenses: 3735, Fundraising Expenses: ; Laboratory - Total Expense: 67096, Program Service Expense: 66121, Management and General Expenses: 974, Fundraising Expenses: ; Contracted Services - Total Expense: 695605, Program Service Expense: 685505, Management and General Expenses: 10100, Fundraising Expenses: ; Revenue Recovery Center - Total Expense: 1164326, Program Service Expense: 1147420, Management and General Expenses: 16906, Fundraising Expenses: ; Consulting - Total Expense: 13333, Program Service Expense: 13139, Management and General Expenses: 194, Fundraising Expenses: ; Other - Total Expense: 1101577, Program Service Expense: 1085582, Management and General Expenses: 15995, Fundraising Expenses: ;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (186 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
ALEGENT CREIGHTON CLINIC
12809 W DODGE RDOMAHANE68154470765154HEALTHCARENE501(c)(3)3ACHYes (true)
ALEGENT CREIGHTON HEALTH
12809 W DODGE RDOMAHANE68154470757164HEALTHCARENE501(c)(3)3CHI NEBRASKAYes (true)
ALEGENT CREIGHTON HEALTH FOUNDATION
12809 W DODGE RDOMAHANE68154470648586FUNDRAISINGNE501(c)(3)7ACHYes (true)
ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM
7500 MERCY RDOMAHANE68124470484764HEALTHCARENE501(c)(3)3CHI NEBRASKAYes (true)
ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA
631 N 8TH STMISSOURI VALLEYIA51555420776568HEALTHCAREIA501(c)(3)3CHI NEBRASKAYes (true)
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
6901 N 72ND STOMAHANE68122470376615HEALTHCARENE501(c)(3)3CHI NEBRASKAYes (true)
ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER
104 W 17TH STSCHUYLERNE68661470399853HEALTHCARENE501(c)(3)3CHI NEBRASKAYes (true)
ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA
PO BOX 368CORNINGIA50841420782518HEALTHCAREIA501(c)(3)3CHI NEBRASKAYes (true)
ALVERNA APARTMENTS
300 SE 8TH AVELITTLE FALLSMN56345411351177LTERM CAREMN501(c)(3)10CHIYes (true)
APPLETREE COURT
601 OAK STBRECKENRIDGEMN56520411850500SENIOR LIVINGMN501(c)(3)10SFHYes (true)
BAYLOR ST LUKE'S HEALTH VENTURES
17200 ST LUKES WAY STE 170THE WOODLANDSTX77384274499340PHYSICIANSTX501(c)(3)Type ISLCHSYes (true)
BELLEVILLE ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802274005511HEALTHCARETX501(c)(3)3SHSCYes (true)
BISHOP DRUMM RETIREMENT CENTER
1111 6TH AVEDES MOINESIA50314420725196LTERM CAREIA501(c)(3)10CHI-IA CORPYes (true)
BORNEMANN HEALTHCARE CORPORATION
2500 BERNVILLE RD PO BOX 316READINGPA19603232187242HEALTHCAREPA501(c)(3)Type ICHIYes (true)
BRAZOSPORT HEALTH FOUNDATION INC
129 CIRCLE WAY STE 102LAKE JACKSONTX77566760080110FUNDRAISINGTX501(c)(3)Type IBRHSYes (true)
BRAZOSPORT REGIONAL PHYSICIAN SERVICES
100 MEDICAL DRIVELAKE JACKSONTX77566800240261HEALTHCARETX501(c)(3)3BRHSYes (true)
BURLESON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802742759890HEALTHCARETX501(c)(3)3SJSCYes (true)
BURLESON ST JOSEPH MANOR
2801 FRANCISCAN DRIVEBRYANTX77802742913931HEALTHCARETX501(c)(3)10SJSCYes (true)
CARRINGTON HEALTH CENTER
800 N 4TH STCARRINGTONND58421450227311HEALTHCAREND501(c)(3)3CHIYes (true)
CATHOLIC HEALTH INITIATIVES
198 INVERNESS DRIVE WESTENGLEWOODCO80112470617373HEALTHCARECO501(c)(3)Type INAYes (true)
CATHOLIC HEALTH INITIATIVES - COLORADO
188 INVERNESS DRIVE WEST STE 500ENGLEWOODCO80112840405257HEALTHCARECO501(c)(3)3CHIYes (true)
CATHOLIC HEALTH INITIATIVES - IOWA CORP
1111 6TH AVEDES MOINESIA50314420680448HEALTHCAREIA501(c)(3)3CHIYes (true)
CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
6385 CORPORATE DR STE 301COLORADO SPRINGSCO80919840902211FUNDRAISINGCO501(c)(3)7CHICYes (true)
CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION
6385 CORPORATE DRCOLORADO SPRINGSCO80919270930004FUNDRAISINGCO501(c)(3)Type ICHIYes (true)
CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES
198 INVERNESS DRIVE WESTENGLEWOODCO80112460992796HEALTHCARECO501(c)(3)Type ICHINSYes (true)
CENTENNIAL MEDICAL GROUP INC
2700 STEWART PKWYROSEBURGOR97471263946191PHYSICIANSOR501(c)(3)10MMCYes (true)
CENTRAL KANSAS MEDICAL CENTER
3515 BROADWAYGREAT BENDKS67530480543724SURGERY CENTERKS501(c)(3)3CHIYes (true)
CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PKWY SFARGOND58104271966847HEALTHCAREMN501(c)(3)10CHIYes (true)
CHI INSTITUTE FOR RESEARCH AND INNOVATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112271050565HEALTHCARECO501(c)(3)Type ICHIYes (true)
CHI KENTUCKY INC
3900 OLYMPIC BLVD STE 400ERLANGERKY41018202741651HEALTHCAREKY501(c)(3)Type ICHIYes (true)
CHI NATIONAL HOME CARE
198 INVERNESS DRIVE WESTENGLEWOODCO80112451261716HEALTHCARECO501(c)(3)10CHI NSYes (true)
CHI NATIONAL SERVICES
198 INVERNESS DRIVE WESTENGLEWOODCO80112452532084HEALTHCARECO501(c)(3)Type ICHIYes (true)
CHI NEBRASKA
6940 O ST STE 200LINCOLNNE68510363233121HEALTHCARENE501(c)(3)Type ICHIYes (true)
CHI ST JOSEPH CHILDREN'S HEALTH
1929 LINCOLN HWY E STE 150LANCASTERPA17602232342997HEALTHCAREPA501(c)(3)Type ICHIYes (true)
CHI ST JOSEPH'S CHILDREN
1516 5TH ST NWALBUQUERQUENM87102710897107COMMUNITYNM501(c)(3)Type ICHIYes (true)
CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER
6624 FANNIN ST 1100HOUSTONTX77030741161938HEALTHCARETX501(c)(3)3SLHSYes (true)
CHI ST VINCENT HOSPITAL HOT SPRINGS
300 WERNER STHOT SPRINGSAR71913710236913HEALTHCAREAR501(c)(3)3CHISVHSYes (true)
CHI ST VINCENT HOT SPRINGS
300 WERNER STHOT SPRINGSAR71913261125064HOLDING COAR501(c)(3)Type IISVIMCYes (true)
CHI ST VINCENT MEDICAL GROUP HOT SPRINGS
1 MERCY LANE STE 201HOT SPRINGSAR71913261125131HEALTHCAREAR501(c)(3)3CHISVHSYes (true)
COMMUNITY LIMITED CARE DIALYSIS CENTER
619 OAK ST ACCOUNTING-3 WCINCINNATIOH45206237419853HOLDING COOH501(c)(1)GSHYes (true)
COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION
631 N 8TH STMISSOURI VALLEYIA51555421294399FUNDRAISINGIA501(c)(3)Type IAH-CMHMVYes (true)
CONTINUING CARE HOSPITAL
150 NORTH EAGLE CREEK DRLEXINGTONKY40509611400619LT ACHKY501(c)(3)3SJHSYes (true)
COVENANT HOME CARE
198 INVERNESS DRIVE WESTENGLEWOODCO80112232028429HOME HEALTHPA501(c)(3)Type ICHI NHCYes (true)
ENUMCLAW REGIONAL HOSPITAL ASSOCIATION
1450 BATTERSBY AVEENUMCLAWWA98022910715805HEALTHCAREWA501(c)(3)3FHSYes (true)
FLAGET HEALTHCARE INC
4305 NEW SHEPHERDSVILLE RDBARDSTOWNKY40004611345363HEALTHCAREKY501(c)(3)3KOHYes (true)
FLAGET MEMORIAL HOSPITAL FOUNDATION INC
4305 NEW SHEPHERDSVILLE RDBARDSTOWNKY40004562351341FUNDRAISINGKY501(c)(3)Type IFHYes (true)
FRANCISCAN CARE CENTER
4111 N HOLLAND-SYLVANIA RDTOLEDOOH43623341931806HEALTHCAREOH501(c)(3)10FLCYes (true)
FRANCISCAN FOUNDATION
1717 SOUTH J STTACOMAWA98405911145592FUNDRAISINGWA501(c)(3)10FHSYes (true)
FRANCISCAN HEALTH SYSTEM
1717 SOUTH J STTACOMAWA98405910564491HEALTHCAREWA501(c)(3)3CHIYes (true)
FRANCISCAN HEALTH VENTURES FKA SJMGROUP
TACOMA FNC CTR BLDG 1145 BROADWAYTACOMAWA98402431882377PHYSICIANSMO501(c)(3)10CHIYes (true)
FRANCISCAN LIVING COMMUNITIES
5942 RENAISSANCE PLACE STE ATOLEDOOH43623341892096HEALTHCAREOH501(c)(3)Type IISFHYes (true)
FRANCISCAN MEDICAL GROUP
1313 BROADWAY STE 200TACOMAWA98402911939739HEALTHCAREWA501(c)(3)10FHSYes (true)
FRANCISCAN VILLA OF SOUTH MILWAUKEE INC
3601 S CHICAGO AVESOUTH MILWAUKEEWI53172391093829HEALTHCAREWI501(c)(3)10CHIYes (true)
GARRISON MEMORIAL HOSPITAL
407 THIRD AVENUE SOUTHEASTGARRISONND58540450227752HEALTHCAREND501(c)(3)3SAMCYes (true)
GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WESTENGLEWOODCO80112201536108MINISTRIESCO501(c)(3)Type ICHIYes (true)
GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE
619 OAK ST ACCOUNTING-3 WCINCINNATIOH45206311778403EDUCATIONOH501(c)(3)2GSHYes (true)
GOOD SAMARITAN FOUNDATION OF CINCINNATI INC
619 OAK ST ACCOUNTING-3 WCINCINNATIOH45206311206047FUNDRAISINGOH501(c)(3)Type IGSHYes (true)
GOOD SAMARITAN HOSPITAL
110 N MAIN ST STE 500DAYTONOH45402310536981HEALTHCAREOH501(c)(3)3SHPYes (true)
GOOD SAMARITAN HOSPITAL
PO BOX 1990KEARNEYNE68848470379755HEALTHCARENE501(c)(3)3CHI NEBRASKAYes (true)
GOOD SAMARITAN HOSPITAL FOUNDATION
111 W 31ST STKEARNEYNE68847470659443FUNDRAISINGNE501(c)(3)7GSHYes (true)
GOOD SAMARITAN HOSPITAL FOUNDATION - DAYTON
110 N MAIN ST STE 500DAYTONOH45402237296923FUNDRAISINGOH501(c)(3)7SHPYes (true)
HARRISON MEDICAL CENTER
2520 CHERRY AVEBREMERTONWA98310910565546HEALTHCAREWA501(c)(3)3FHSYes (true)
HARRISON MEDICAL CENTER FOUNDATION
2520 CHERRY AVEBREMERTONWA98310911197626FUNDRAISINGWA501(c)(3)7HMCYes (true)
HEALTHCARE AND WELLNESS FOUNDATION
2400 ST FRANCIS DRBRECKENRIDGEMN56520760761782FUNDRAISINGMN501(c)(3)Type ISFMCYes (true)
HIGHLINE MEDICAL CENTER
16251 SYLVESTER RD SWBURIENWA98166910712166HEALTHCAREWA501(c)(3)3FHSYes (true)
HOUSE OF MERCY
1111 6TH AVEDES MOINESIA50314421323808SHELTERIA501(c)(3)7CHI-IA CORPYes (true)
JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202611029768HEALTHCAREKY501(c)(3)3KOHYes (true)
KENTUCKYONE HEALTH MEDICAL GROUP INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202611352729HEALTHCAREKY501(c)(3)10JHSMHYes (true)
KENTUCKYONE HEALTH INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202611029769HEALTHCAREKY501(c)(3)Type IICHIYes (true)
LAKEWOOD HEALTH CENTER
600 MAIN AVE SBAUDETTEMN56623410758434HEALTHCAREMN501(c)(3)3CHIYes (true)
LAKEWOOD REGIONAL HEALTHCARE FOUNDATION
600 MAIN AVE SBAUDETTEMN56623411893795FUNDRAISINGND501(c)(3)7LHCYes (true)
LINUS OAKES INC
2700 STEWART PKWYROSEBURGOR97471930821381SENIOR LIVINGOR501(c)(3)10MMCYes (true)
LISBON AREA HEALTH SERVICES
905 MAIN STLISBONND58054820558836HEALTHCAREND501(c)(3)3CHIYes (true)
LUFKIN VISION ACQUISITIONS
PO BOX 1447LUFKINTX75901820563768PROPERTY MGMTTX501(c)(3)Type IMHSETYes (true)
MADISON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802742761145HEALTHCARETX501(c)(3)3SJSCYes (true)
MADONNA MANOR INC
2344 AMSTERDAM ROADVILLA HILLSKY51017610654635LIVING ASSISTKY501(c)(3)10FLCYes (true)
MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC
2525 DE SALES AVECHATTANOOGATN37404621839548FUNDRAISINGTN501(c)(3)7MHCSYes (true)
MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVECHATTANOOGATN37404620532345HEALTHCARETN501(c)(3)3CHIYes (true)
MEMORIAL HEALTH PARTNERS FOUNDATION INC
5600 BRAINERD RD STE 500CHATTANOOGATN37411300417049HEALTHCARETN501(c)(3)10MHCSYes (true)
MEMORIAL HEALTH SYSTEM OF EAST TEXAS
PO BOX 1447LUFKINTX75902750755367HEALTHCARETX501(c)(3)3CHIYes (true)
MEMORIAL MEDICAL CENTER - LIVINGSTON
PO BOX 1447LUFKINTX75902760436439HEALTHCARETX501(c)(3)3MHSETYes (true)
MEMORIAL MEDICAL CENTER - SAN AUGUSTINE
PO BOX 1447LUFKINTX75902752663904HEALTHCARETX501(c)(3)3MHSETYes (true)
MEMORIAL MULTISPECIALTY ASSOCIATES
1201 FRANK AVELUFKINTX95904752721155PHYSICIANSTX501(c)(3)Type IMHSETYes (true)
MEMORIAL SPECIALTY HOSPITAL
PO BOX 1447LUFKINTX95902752492741HEALTHCARETX501(c)(3)3MHSETYes (true)
MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVEDES MOINESIA50314426076069AUXILIARYIA501(c)(3)Type IMF-DM IAYes (true)
MERCY CLINICS INC
1111 6TH AVEDES MOINESIA50314421193699PHYSICIANSIA501(c)(3)10CHI-IA CORPYes (true)
MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVEDES MOINESIA50314421511682EDUCATIONIA501(c)(3)2CHI-IA CORPYes (true)
MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVEDES MOINESIA50314237358794FUNDRAISINGIA501(c)(3)7CHI-IA CORPYes (true)
MERCY FOUNDATION INC
2700 STEWART PKWYROSEBURGOR97471936088946FUNDRAISINGOR501(c)(3)7MMCYes (true)
MERCY HEALTH CARE FOUNDATION
PO BOX 368CORNINGIA50841421461064FUNDRAISINGIA501(c)(3)Type IAHMH-CorningYes (true)
MERCY HEALTHCARE FOUNDATION
570 CHAUTAUQUA BLVDVALLEY CITYND58072450435338FUNDRAISINGND501(c)(3)Type IMHVCYes (true)
MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DRCOUNCIL BLUFFSIA51503421178204FUNDRAISINGIA501(c)(3)Type IAHBMHSYes (true)
MERCY HOSPITAL OF DEVILS LAKE
1031 7TH ST NEDEVILS LAKEND58301450227012HEALTHCAREND501(c)(3)3CHIYes (true)
MERCY HOSPITAL OF DEVILS LAKE FOUNDATION
1031 7TH ST NEDEVILS LAKEND58301352367360FUNDRAISINGND501(c)(3)7MHDLYes (true)
MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BLVDVALLEY CITYND58072450226553HEALTHCAREND501(c)(3)3CHIYes (true)
MERCY MEDICAL CENTER
1301 15TH AVE WESTWILLISTONND58801450231183HEALTHCAREND501(c)(3)3CHIYes (true)
MERCY MEDICAL CENTER - CENTERVILLE
ONE ST JOSEPHS DRIVECENTERVILLEIA52544420680308HEALTHCAREIA501(c)(3)3CHI-IA CORPYes (true)
MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER
1111 6TH AVEDES MOINESIA50314421470935PHYSICIANSIA501(c)(3)3CHI-IA CORPYes (true)
MERCY MEDICAL CENTER INC
2700 STEWART PKWYROSEBURGOR97471930386868HEALTHCAREOR501(c)(3)3CHIYes (true)
MERCY MEDICAL FOUNDATION
1301 15TH AVE WESTWILLISTONND58801450381803FUNDRAISINGND501(c)(3)Type IMMCYes (true)
NEBRASKA HEART HOSPITAL
7500 S 91ST STLINCOLNNE68526392031968HEALTHCARENE501(c)(3)3CHI NEBRASKAYes (true)
North Central Health Care Alliance dba PrimeCare Health Group
401 N 9th StBISMARCKND585014507450439894HEALTHCAREND501(c)(3)8NHCAYes (true)
OAKES COMMUNITY HOSPITAL
1200 N 7TH STOAKESND58474450231675HEALTHCAREND501(c)(3)3CHIYes (true)
OAKES COMMUNITY HOSPITAL FOUNDATION
1200 N 7TH STOAKESND58474710966606FUNDRAISINGND501(c)(3)Type IOCHYes (true)
PINEYWOODS MEDICAL DEVELOPMENT CORP
PO BOX 1447LUFKINTX75902752493116PROPERTY MGMTTX501(c)(3)Type IMHSETYes (true)
PROVIDENCE CARE CENTER
2025 HAYES AVENUESANDUSKYOH44870341658625HEALTHCAREOH501(c)(3)10FLCYes (true)
PROVIDENCE CARE CENTERS
2025 HAYES AVENUESANDUSKYOH44870341826099HOLDING COOH501(c)(3)Type IIFLCYes (true)
PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION
5055 PROVIDENCE DRIVESANDUSKYOH44870341896807LIVING COMMOH501(c)(3)10FLCYes (true)
PUEBLO STEPUP
1925 E ORMAN AVE STE G52PUEBLOCO81004841234295COMMUNITYCO501(c)(3)7CHICYes (true)
REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE
12844 MILITARY RD STUKWILAWA98168911170040HEALTHCAREWA501(c)(3)3FHSYes (true)
SET OF COLORADO SPRINGS INC
2864 S CIRCLE DR STE 450COLORADO SPRINGSCO80906841183335LTERM CARECO501(c)(3)7CHICYes (true)
SAINT CLARE'S COMMUNITY CARE INC
25 POCONO RDDENVILLENJ07834222876836HEALTHCARENJ501(c)(3)10SCHSYes (true)
SAINT CLARE'S FOUNDATION INC
25 POCONO RDDENVILLENJ07834222502997FUNDRAISINGNJ501(c)(3)6SCHSYes (true)
SAINT CLARE'S HEALTH SERVICES INC
25 POCONO RDDENVILLENJ07834223639733MANAGEMENTNJ501(c)(3)10CHIYes (true)
SAINT CLARE'S HOSPITAL INC
25 POCONO RDDENVILLENJ07834223319886HEALTHCARENJ501(c)(3)2SCHSYes (true)
SAINT ELIZABETH FOUNDATION
555 S 70TH STLINCOLNNE68510470625523FUNDRAISINGNE501(c)(3)7SERMCYes (true)
SAINT ELIZABETH HEALTH SERVICES
555 S 70TH STLINCOLNNE68510363233120HEALTHCARENE501(c)(3)3SERMCYes (true)
SAINT ELIZABETH REGIONAL MEDICAL CENTER
555 S 70TH STLINCOLNNE68510470379836HEALTHCARENE501(c)(3)3CHI NEBRASKAYes (true)
SAINT FRANCIS MEDICAL CENTER
2620 W FAIDLEYGRAND ISLANDNE68803470376601HEALTHCARENE501(c)(3)3CHI NEBRASKAYes (true)
SAINT FRANCIS MEDICAL CENTER FOUNDATION
PO BOX 9804GRAND ISLANDNE68802470630267FUNDRAISINGNE501(c)(3)7SFMCYes (true)
SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC
305 ESTILL STBEREAKY40403260152877FUNDRAISINGKY501(c)(3)7SJHSYes (true)
SAINT JOSEPH HEALTH SYSTEM INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202611334601HEALTHCAREKY501(c)(3)3KOHYes (true)
SAINT JOSEPH HOSPITAL FOUNDATION INC
ONE SAINT JOSEPH DRIVELEXINGTONKY40504611159649FUNDRAISINGKY501(c)(3)Type ISJHSYes (true)
SAINT JOSEPH LONDON FOUNDATION INC
1001 SAINT JOSEPH LANELONDONKY40741260438748FUNDRAISINGKY501(c)(3)7SJHSYes (true)
SAINT JOSEPH MOUNT STERLING FOUNDATION INC
225 FALCON DRMOUNT STERLINGKY40353272884584FUNDRAISINGKY501(c)(3)7SJHSYes (true)
SAINT JOSEPH'S HOSPITAL FOUNDATION
30 WEST 7TH STDICKINSONND58601363418207FUNDRAISINGND501(c)(3)Type ISJHHCYes (true)
SAMARITAN BEHAVIORAL HEALTH INC
601 S EDWIN C MOSES BLVDDAYTONOH45417020633634HEALTHCAREOH501(c)(3)7SHPYes (true)
SAMARITAN HEALTH PARTNERS
110 N MAIN ST STE 500DAYTONOH45402311107411HEALTHCAREOH501(c)(3)Type ICHIYes (true)
SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC
104 W 17TH STSCHUYLERNE68661363630014FUNDRAISINGNE501(c)(3)Type IAHMHSYes (true)
SJRMC JOPLIN MISSOURI
198 INVERNESS DRIVE WESTENGLEWOODCO80112440545809HEALTHCAREMO501(c)(3)3CHIYes (true)
ST ALEXIUS MEDICAL CENTER
900 EAST BROADWAY AVENUEBISMARCKND58501450226711HEALTHCAREND501(c)(3)3CHIYes (true)
ST ANTHONY HOSPITAL
1601 SE COURT AVEPENDLETONOR97801930391614HEALTHCAREOR501(c)(3)3CHIYes (true)
ST ANTHONY HOSPITAL FOUNDATION
1601 SE COURT AVEPENDLETONOR97801930992727FUNDRAISINGOR501(c)(3)Type ISAHYes (true)
ST ANTHONY'S HOSPITAL ASSOCIATION
FOUR HOSPITAL DRMORRILTONAR72110710245507HEALTHCAREAR501(c)(3)3SVIMCYes (true)
ST CATHERINE HOSPITAL
401 EAST SPRUCE STGARDEN CITYKS67846480543721HEALTHCAREKS501(c)(3)3CHIYes (true)
ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION
401 EAST SPRUCE STGARDEN CITYKS67846200598702FUNDRAISINGKS501(c)(3)Type ISCHYes (true)
ST CLARE COMMONS
5942 RENAISSANCE PLACE STE ATOLEDOOH43623270163752LIVING COMMOH501(c)(3)10FLCYes (true)
ST DOMINIC OF ONTARIO OREGON
198 INVERNESS DRIVE WESTENGLEWOODCO80112930433692HEALTHCAREOR501(c)(4)CHIYes (true)
ST FRANCIS HOME
2400 ST FRANCIS DRBRECKENRIDGEMN56520410729978LTERM CAREMN501(c)(3)10CHIYes (true)
ST FRANCIS LIFE CARE CORPORATION
19 POCONO RDDENVILLENJ07834222536017ELDERLY CARENJ501(c)(3)8SCHSYes (true)
ST FRANCIS MEDICAL CENTER
2400 ST FRANCIS DRBRECKENRIDGEMN56520410695598HEALTHCAREMN501(c)(3)3CHIYes (true)
ST JOSEPH FOUNDATION OF BRYAN TEXAS
2801 FRANCISCAN DRIVEBRYANTX77802742351158FUNDRAISINGTX501(c)(3)Type IISJSCYes (true)
ST JOSEPH MANOR
2801 FRANCISCAN DRIVEBRYANTX77802742847594HEALTHCARETX501(c)(3)10SJSCYes (true)
ST JOSEPH MEDICAL CENTER INC
201 INTERNATIONAL CIRCLE STE 212HUNT VALLEYMD21030520591461HEALTHCAREMD501(c)(3)3CHIYes (true)
ST JOSEPH PHYSICIAN ASSOCIATES
2801 FRANCISCAN DRIVEBRYANTX77802203159302HEALTHCARETX501(c)(3)3SJSCYes (true)
ST JOSEPH PHYSICIAN ENTERPRISE INC
201 INTERNATIONAL CIRCLE STE 212HUNT VALLEYMD21030521311775PHYSICIANSMD501(c)(3)Type ISJMCYes (true)
ST JOSEPH REGIONAL HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802741282696HEALTHCARETX501(c)(3)3SJSCYes (true)
ST JOSEPH REGIONAL HEALTH PARTNERS
2801 FRANCISCAN DRIVEBRYANTX77802454088170HEALTHCARETX501(c)(3)3SJSCYes (true)
ST JOSEPH REGIONAL HEALTH PARTNERS ACO
2801 FRANCISCAN DRIVEBRYANTX77802463265423HEALTHCARETX501(c)(3)10SJSCYes (true)
ST JOSEPH SERVICES CORPORATION
2801 FRANCISCAN DRIVEBRYANTX77802742455161MANAGEMENTTX501(c)(3)Type ISFHYes (true)
ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVEPARK RAPIDSMN56470410695603HEALTHCAREMN501(c)(3)3CHIYes (true)
ST JOSEPH'S HOSPITAL AND HEALTH CENTER
30 WEST 7TH STDICKINSONND58601450226429HEALTHCAREND501(c)(3)3CHIYes (true)
ST LEONARD
8100 CLYO ROADCENTERVILLEOH45458341940863LIVING COMMOH501(c)(3)10FLCYes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC
6624 FANNIN ST STE 2505HOUSTONTX77030273733278HEALTHCARETX501(c)(3)3SLCDCYes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND
6624 FANNIN ST STE 2505HOUSTONTX77030261947374HEALTHCARETX501(c)(3)3SLHSYes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS
6624 FANNIN ST STE 2505HOUSTONTX77030260335902HEALTHCARETX501(c)(3)3SLCDCYes (true)
ST LUKE'S COMMUNITY HEALTH SERVICES
6624 FANNIN ST STE 1100HOUSTONTX77030760536234HEALTHCARETX501(c)(3)3SLHSYes (true)
ST LUKE'S FOUNDATION
1213 HERMANN DRIVE STE 855HOUSTONTX77004453811485FUNDRAISINGTX501(c)(3)7SLHSYes (true)
ST LUKE'S HEALTH SYSTEM CORPORATION
6624 FANNIN ST STE 1100HOUSTONTX77030760536232MANAGEMENTTX501(c)(3)Type ICHIYes (true)
ST LUKE'S HOSPITAL AT THE VINTAGE
6624 FANNIN ST STE 2505HOUSTONTX77030263734606HEALTHCARETX501(c)(3)3SLHSYes (true)
ST LUKE'S MEDICAL GROUP
6624 FANNIN ST STE 1100HOUSTONTX77030760458535PHYSICIANSTX501(c)(3)3SLHSYes (true)
ST LUKE'S MEDICAL TOWER CORPORATION
6624 FANNIN ST STE 1100HOUSTONTX77030760531713PROPERTY MGMTTX501(c)(3)Type ICHI-SLHYes (true)
ST LUKE'S PROPERTIES CORPORATION
6624 FANNIN ST STE 1100HOUSTONTX77030760531716PROPERTY MGMTTX501(c)(3)Type ISLHSYes (true)
ST LUKE'S SUGAR LAND PROPERTIES CORPORATION
6624 FANNIN ST STE 2505HOUSTONTX77030454120549PROPERTY MGMTTX501(c)(3)Type ISLCDC-SLYes (true)
ST MARY'S COMMUNITY HOSPITAL
1314 3RD AVENEBRASKA CITYNE68410470443636HEALTHCARENE501(c)(3)3CHI NEBRASKAYes (true)
ST MARY'S HOSPITAL FOUNDATION
1314 3RD AVENEBRASKA CITYNE68410470707604FUNDRAISINGNE501(c)(3)7SMCHYes (true)
ST VINCENT FOUNDATION
TWO ST VINCENT CIRCLELITTLE ROCKAR72205510169537FUNDRAISINGAR501(c)(3)Type ISVIMCYes (true)
ST VINCENT INFIRMARY MEDICAL CENTER
TWO ST VINCENT CIRCLELITTLE ROCKAR72205710236917HEALTHCAREAR501(c)(3)3CHIYes (true)
ST VINCENT MEDICAL GROUP
TWO ST VINCENT CIRCLELITTLE ROCKAR72205710830696HEALTHCAREAR501(c)(3)10SVIMCYes (true)
SYLVANIA FRANCISCAN HEALTH
1715 INDIAN WOOD CIR 200MAUMEEOH43537341412964HEALTHCAREOH501(c)(3)Type ICHIYes (true)
SYLVANIA FRANCISCAN HEALTH FOUNDATION
1715 INDIAN WOOD CIR 200MAUMEEOH43537455357161FUNDRAISINGOH501(c)(3)Type IFLCYes (true)
THE COMMONS OF PROVIDENCE
5000 PROVIDENCE DRIVESANDUSKYOH44870341826097ASSIST LIVINGOH501(c)(3)10FLCYes (true)
THE COMMUNITY HOSPITAL OF BRAZOSPORT
100 MEDICAL DRIVELAKE JACKSONTX77566741385192HEALTHCARETX501(c)(3)3SLHSYes (true)
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH
619 OAK ST ACCOUNTING-3 WCINCINNATIOH45206310537486HEALTHCAREOH501(c)(3)3CHIYes (true)
THE HEART INSTITUTE OF DAYTON
110 N MAIN ST STE 500DAYTONOH45402300502367HEALTHCAREOH501(c)(3)10CHSYes (true)
THE PHYSICIAN NETWORK
2000 Q ST STE 500LINCOLNNE68503470780857PHYSICIANSNE501(c)(3)Type ICHI NEBRASKAYes (true)
TOTAL HEALTHCARE
188 INVERNESS DRIVE WEST STE 500ENGLEWOODCO80112840927232HEALTHCARECO501(c)(3)3CHICYes (true)
TRINITY HEALTH FOUNDATION
380 SUMMIT AVENUESTEUBENVILLEOH43952311329423FUNDRAISINGOH501(c)(3)Type ITHSYes (true)
TRINITY HEALTH SYSTEM
380 SUMMIT AVENUESTEUBENVILLEOH43952341818681HEALTHCAREOH501(c)(3)Type ISFHYes (true)
TRINITY HEALTH SYSTEM GROUP
380 SUMMIT AVENUESTEUBENVILLEOH43952300752920HEALTHCAREOH501(c)(3)2THSYes (true)
TRINITY HOSPITAL HOLDING COMPANY
380 SUMMIT AVENUESTEUBENVILLEOH43952341842025HEALTHCAREOH501(c)(3)3THSYes (true)
TRINITY HOSPITAL TWIN CITY
819 NORTH FIRST STREETDENNISONOH44621275401105HEALTHCAREOH501(c)(3)3SFHYes (true)
TRI-STATE HEALTH SERVICES INC
ONE ROSS PARK BLVDSTEUBENVILLEOH43952341522484ASSIST LIVINGOH501(c)(3)7THSYes (true)
UNITY FAMILY HEALTHCARE
815 SE 2ND STLITTLE FALLSMN56345410721642HEALTHCAREMN501(c)(3)3CHIYes (true)
VILLA NAZARETH INC
801 PAGE DRFARGOND58103450226714LTERM CAREND501(c)(3)10CHIYes (true)
VISITING NURSE ASSOCIATION OF ST CLARE'S INC
191 WOODPORT RDSPARTANJ07871221768334HOME HEALTHNJ501(c)(3)8SCHSYes (true)

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Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndUBI Code VUBICodeVAmtGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
Alegent Health Northwest Imaging Center LLC
3606 N 156th StOMAHANE68116061786985OP DiagnosticsNEACHRelated-$7,263$485,853false$0Yes (true)0.51
Audubon Land Company LLC
630 Southpointe Court 200COLORADO SPRINGSCO80906841513085Real EstateCOCHICRelated$330,065$9,984,045false$0false0.73
AVON EMERGENCY AND URGENT CARE CENTER LLC
9100 E Mineral CircleCentennialCO80112811727282HEALTHCARE SRVCCOCHICRelated-$1,002,190$6,646,607false$0Yes (true)0.77
BAYLOR CHI ST LUKES HEALTH SERVICES LLC
6624 Fannin St Ste 1100HOUSTONTX77030472079184HEALTHCARE SRVCTXSLHSRelated$0$3,250,000false$0Yes (true)0.65
BERGAN MERCY SURGERY CENTER LLC
7710 Mercy Rd Ste 200OMAHANE68124208671994AMBUL SURG CTRNEACHRelated$1,308,113$2,778,497false$0false0.51
BERYWOOD OFFICE PROPERTIES LLC
2501 Citico AvenueCHATTANOGATN37404621875199PHYS OFFICETNMHCSRelated$133,390$918,922false$0Yes (true)0.63
BLUEGRASS REGIONAL IMAGING CENTER
1218 SOUTH BROADWAY STE 310LEXINGTONKY40504611386736DIAGNOSTIC IMAGINGKYSJHSRelated$20,471$3,315,748false$0false0.65
CATHOLIC HEALTH INITIATIVES PHYSICIAN SERVICES LLC
198 INVERNESS DRIVE WESTENGLEWOODCO80112462945938PRACTICE MGMT SRVCDECHIRelated$118,502$43,489,364false$0Yes (true)0.8
CENTRAL NEBRASKA REHABILITATION SERVICES LLC
3004 W FAIDLEY AVENUEGRAND ISLANDNE68803810653461Physical TherapyNESFMCRelated$3,452,843$3,798,424false$0false0.51
CENTURA-SCA HOLDINGS LLC
569 BROOK VILLAGE STE 901BIRMINGHAMAL35209474823023OP SURGERY CENTERALCHICRelated$238,314$1,149,906false$0Yes (true)0.65
CHI OPERATING INVESTMENT PROGRAM LP
198 INVERNESS DRIVE WESTENGLEWOODCO80112470727942INVESTMENTSCOCHIUnrelated$460,894,424$6,934,279,715false$745,024Yes (true)1
CHI ST LUKE'S HEALTH EMERGENCY CENTER LLC
6624 Fannin St Ste 1100HOUSTONTX77030810743412URGENT CARETXSLHSRelated-$2,234,613$19,321,224false$0Yes (true)0.65
CHICAMSURG Surgery Centers LLC
1A Burton Hills BlvdNashvilleTN37215465683027SURGERY CENTERCOCHICRelated$38,311$123,437false$0false0.51
CHICLARKIN VENTURES LLC
9100 E Mineral CircleCentennialCO80112474210888URGENT CARECOCHICRelated-$2,957,202$7,086,404false$0Yes (true)0.87
Colorado Springs CK Leasing LLC
630 Southpointe Court 200COLORADO SPRINGSCO80906262982714REAL ESTATECOCHICRelated$506,130-$62,688false$0Yes (true)0.52
HC SL VINTAGE I LLC
18000 W SARAH LANE STE 250BROOKFIELDWI53045270453767PROPERTY HOLDINGWISL HOSP-VINTAGERelated$1,609,644$53,760,469false$0false0.51
HEALTHCARE SUPPORT SERVICES LLC
PO BOX 9804GRAND ISLANDNE68802721546196LAUNDRYNEnaRelated$2,752,364$3,361,559false$0false1
Heartland Oncology LLC
2337 E Crawford StSalinaKS67401464265403ONCOLOGYKSSCHRelated-$457,809$1,985,911false$0false0.51
HIGHLINE IMAGING LLC
PO BOX 184BRUSH PRAIRIEWA98606200460005DIAGNOSTIC IMAGINGWAHMCRelated$998,974$210,552false$0false0.8
LAKESIDE AMBULATORY SURGICAL CENTER LLC
17031 LAKESIDE HILLS DROMAHANE68130204267902AMBUL SURG CTRNEACHRelated$3,231,701$934,253false$0false0.54
LAKESIDE ENDOSCOPY CENTER LLC
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LINCOLN CK LEASING LLC
555 SOUTH 70TH STREETLincolnNE68510262496856Real EstateNESERMCRelated$1,040,431$650,676false$0false0.54
NEBRASKA SPINE HOSPITAL LLC
6901 N 72ND ST STE 20300OMAHANE68122270263191SPINE HOSPITALNEACHRelated$14,574,331$24,063,010false$0false0.51
NORTH RIVER SURGERY CENTER LLC
2209 WILDWOOD AVESHERWOODAR72120710799771AMBUL SURG CTRARSVIMCRelated$213,304$1,526,210false$0false0.61
ORTHOCOLORADO LLC
11650 WEST 2ND PLACELAKEWOODCO80255371577105ORTHO HOSPITALCOTHCRelated$15,065,598$5,758,345false$0false0.6
PENINSULA RADIATION ONCOLOGY LLC
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Penrad Imaging
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PMC HOSPITAL LLC
3100 MAIN ST STE 500HOUSTONTX77002273280598HOSPITALTXSL CDC-PMCRelated$3,486,396$60,785,684false$0Yes (true)0.51
PRAIRIE HEALTH VENTURES LLC
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Pueblo Ambulatory Surgery Center LLC
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Saint JOSEPH - PAML LLC
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ST FRANCIS LAND COMPANY
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ST LUKE'S DIAGNOSTIC CATH LAB LLP
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AMERIMED INC
1700 EDISON DRMILFORDOH45150311158699HOME HEALTHOHANCC Corporation$19,796,409$16,432,6991Yes (true)
BC HOLDING COMPANY INC
1850 BLUEGRASS AVELOUISVILLEKY40215311542851Fitness ClubKYJHSMHC Corporation$0$01Yes (true)
BrazoSport Health Alliance
1 WEST WAY COURTLAKE JACKSONTX77566760518376Health CareTXBRHSC Corporation$146,745$35,5291Yes (true)
Caduceus Medical Associates INC
5600 Brainerd Road Ste 500ChattanoogaTN37411621570736HealthcareTNMHCSC Corporation$0$1,0081Yes (true)
Captive Management Initiatives Ltd
980663022Captive ManagementCHIC Corporation$3,500$120,5021Yes (true)PO BOX 10073 APOGeorgetownGRAND CAYMANCJKY11001CJ
Carmona-DeSoto Building Horizontal Property Regime Inc
300 Werner StHot SpringsAR71913710771076HealthcareARCHI-SVHSC Corporation$0$01Yes (true)
Catholic Health Initiatives Center for Translational Research
198 INVERNESS DRIVE WESTEnglewoodCO80112272269511ResearchCOCIRIC Corporation$593,807$1,997,6921Yes (true)
CHI St Luke's Health Baylor College of Medicine Medical Center Condominium
6624 Fannin STE 1100HoustonTX77030465079545Condo AssocTXCHI-SLHBCMC Corporation$0$01Yes (true)Assoc
ClearRiver Health
198 INVERNESS DRIVE WESTEnglewoodCO80112464495960InsuranceTNPHPSIC Corporation$4,366,514$6,164,2621Yes (true)
Comcare Services Inc
5570 DTC ParkwayEnglewoodCO80111840904813InactiveCOCHICC Corporation$0$01Yes (true)
CONSOLIDATED HEALTH SERVICES
1700 EDISON DRMILFORDOH45150311378212HOME HEALTHOHCHIC Corporation$247,400$51,845,0301Yes (true)
Des Moines Medical Center Inc
1111 6TH AVEDes MoinesIA50314420837382Real EstateIACHI-IA CorpC Corporation$71,628$1,110,4630.93Yes (true)
Diversified Health Resources Inc
100 MEDICAL DRIVELAKE JACKSONTX77566760222679Health CareTXBRHSC Corporation$22,921$182,5381Yes (true)
East Texas Clinical Services Inc
2801 Via Fortuna 500AustinTX78746454736213HealthcareTXMHSETC Corporation$44,581,192$35,638,8661Yes (true)
First Initiatives Insurance LTD
980203038InsuranceCHIC Corporation$0$01Yes (true)PO BOX 10073 APOGeorgetownGRAND CAYMANCJKY11001CJ
Franciscan Services Inc
198 INVERNESS DRIVE WESTEnglewoodCO80112232487967HealthcareCOCHIC Corporation$0$13,121,3521Yes (true)
Good Samaritan Outreach Services
PO Box 1990KearneyNE68848470659440Medical ClinicNECHI NebraskaC Corporation$448,704$238,4781Yes (true)
HarvestPlains Health of Iowa
32129 Weyerhaeuser Way S STE 201FEDERAL WAYWA98001473451750InsuranceWAQCHPSC Corporation$2,707,777$3,405,9181Yes (true)
Health Systems Enterprises Inc
PO BOX 1990KearneyNE68848470664558MGMTNEGSHC Corporation$90,144$1,266,5551Yes (true)
Healthcare MGMT Services Organization INC
1149 MARKET STTacomaWA98402911865474Health Org.WAFHSC Corporation$0$01Yes (true)
HeartlandPlains Health
198 INVERNESS DRIVE WESTEnglewoodCO80112464368223InsuranceNEPHPSIC Corporation$6,332,841$4,591,1811Yes (true)
Highline Medical Group
1717 S J StreetTacomaWA98405911407026Medical ServicesWAHMCC Corporation$0$01Yes (true)
Medquest
1301 15TH AVENUE WESTWillistonND58801450392137Sale of DMENDMMC WillistonC Corporation$476,061$1,341,6311Yes (true)
Memorial CV Service Line Management Company LLC
1201 W Frank AveLufkinTX75904463622849Heath CareTXMHSETC Corporation$0$01Yes (true)
Mercy Park Apartments LTD
1111 6th AVEDes MoinesIA50314421202422HousingIACHI-IA CorpC Corporation$1,012,298$3,213,7611Yes (true)
Mercy Services Corp
2700 STEWART PARKWAYRoseburgOR97471930824308Retail SalesORMMCC Corporation$718,096$44,7811Yes (true)
MHI Clinical Services
1201 W Frank AveLufkinTX75904461967952HealthcareTXMHSETC Corporation$8,216,376$1,714,0601Yes (true)
Mountain Management Services Inc
6028 Shallowford RdChattanoogaTN37421621570739MGMT SVC ORGTNMHCSC Corporation$9,959,066$2,332,0981Yes (true)
PATIENT TRANSPORT SERVICES INC
1700 EDISON DRMILFORDOH45150311100798HOME HEALTHOHANCC Corporation$9,129,926$6,575,4701Yes (true)
PhysicianHealth System Network
1149 MARKET STTacomaWA98402911746721Health Org.WAFHSC Corporation$0$01Yes (true)
QCA Health Plan Inc
12615 Chenal Parkway STE 300Little RockAR72211710794605InsuranceARQCHIC Corporation$220,347,460$75,215,7791Yes (true)
QualChoice Advantage
32129 WEYERHAEUSER WAY S STE 201FEDERAL WAYWA98001473433912InsuranceWAQCPSC Corporation$12,065,527$5,101,8721Yes (true)
QualChoice Health Plan Services Inc (fka CollabHealth Plan Services Inc)
198 INVERNESS DRIVE WESTEnglewoodCO80112461224037Admin ServicesCOQCHIC Corporation$70,645,496$188,158,5781Yes (true)
QualChoice Health Inc (fka CollabHealth Managed Solutions Inc)
198 INVERNESS DRIVE WESTEnglewoodCO80112461222808Holding CoCOCHIC Corporation$2,722-$97,729,8321Yes (true)
QualChoice Holdings Inc
198 INVERNESS DRIVE WESTEnglewoodCO80112274075520Holding CoARPHPSC Corporation$0$10,1901Yes (true)
QualChoice Life and Health Insurance Company Inc
12615 Chenal Parkway STE 300Little RockAR72211710386640InsuranceARQCHC Corporation$133,112,090$51,130,3741Yes (true)
QualChoice of Nebraska
2401 S 73rd StOmahaNE68124810738827InsuranceNEQCHC Corporation$0$01Yes (true)
RiverLink Health
198 INVERNESS DRIVE WESTEnglewoodCO80112464380824InsuranceOHPHPSC Corporation$9,313,011$5,354,3481Yes (true)
RiverLink Health of Kentucky Inc
198 INVERNESS DRIVE WESTEnglewoodCO80112464828332InsuranceKYPHPSC Corporation$8,544,070$6,502,0401Yes (true)
Ross Park Pharmacy Inc
380 SUMMIT AVESTEUBENVILLEOH43952341832654PharmacyOHTHSC Corporation$1,100,838$1,680,8831Yes (true)
Saint Clare's Primary Care Inc
66 FORD RDDenvilleNJ07834222441202Billing ServicesNJSCCCC Corporation$0$651,9581Yes (true)
SAMARITAN FAMILY CARE INC
40 W FOURTH ST STE 1700DaytonOH45402311299450HealthcareOHSHPC Corporation$0$01Yes (true)
SJH Services Corporation
198 INVERNESS DRIVE WESTEnglewoodCO80112232307408HealthcareCOFSIC Corporation$0$1,598,6101Yes (true)
SJL PHYSICIAN MANAGEMENT SERVICES INC
424 LEWIS HARGETT CR STE 160LexingtonKY40503270164198MgmtKYSJHSC Corporation$0$01Yes (true)
SLMT Parking Inc
6624 Fannin STE 800HoustonTX77030760637140ParkingTXSLHSC Corporation$1,721,167-$1,156,5301Yes (true)
SoundPath Health Inc
32129 Weyerhaeuser Way S STE 201Federal WayWA98001421720801InsuranceWAPHPSC Corporation$198,821,947$55,632,8341Yes (true)
St Alexius Health Services Inc
900 East Broadway AvenueBismarckND58501450402812HealthcareNDSAMCC Corporation$0$01Yes (true)
St Anthony Development Company
1415 SouthgatePendletonOR97801931216943Athletic ClubORSAHC Corporation$1,610,317$2,059,2821Yes (true)
St Joseph Development Company Inc
1717 SOUTH J STTacomaWA98405911480569RentalWAFSIC Corporation$4,387,694$34,715,3091Yes (true)
St Luke's 6620 Main Condominium Association
6624 Fannin STE 1100HoustonTX77030300355517Condo AssocTXSLPCC Corporation$0$01Yes (true)
St Luke's Anesthesiology Associates
6624 Fannin STE 1100HoustonTX77030461517163Medical ClinicTXCHI-SLHC Corporation$0$01Yes (true)
St Luke's Episcopal Hospital Physician Hospital Organization Inc
6720 Bertner MC4-262HoustonTX77030760377932PHOTXCHI-SLHC Corporation$0$01Yes (true)
St Luke's Health System Holdings Inc
6624 Fannin STE 800HoustonTX77030760637138Holding CoTXSLHSC Corporation$3,216,555$38,523,7891Yes (true)
St Luke's Medical Arts Center I Condominium Association
6624 Fannin STE 1100HoustonTX77030300355518Condo AssocTXSLPCC Corporation$0$01Yes (true)
St Luke's Medical Tower Condominium Association
6624 Fannin STE 1100HoustonTX77030760298751Condo AssocTXSLMTCC Corporation$0$01Yes (true)
St Vincent Community Health Services Inc
TWO ST VINCENT CIRCLELittle RockAR72205710710785HealthcareARSVIMCC Corporation$844,897$27,995,5291Yes (true)
StableView Health Inc
198 INVERNESS DRIVE WESTEnglewoodCO80112464373713InsuranceKYPHPSC Corporation$1,645,346$5,436,4391Yes (true)
Sugar Land Doctor Group
1317 Lake Point ParkwaySugar LandTX77478454270163Medical ClinicTXSLCDC-SLC Corporation$0$01Yes (true)
The Texas Heart Institute at St Luke's Episcopal Hospital Denton A Cooley B
6624 Fannin STE 1100HoustonTX77030900064009Condo AssocTXCHI-SLHC Corporation$0$01Yes (true)uilding Comdominium Association
Towson Management Inc
7601 OSLER DRTowsonMD21204521710750Mgmt ServicesMDFSIC Corporation$0$01Yes (true)
TRINITY MANAGEMENT SERVICES ORGANIZATION
380 SUMMIT AVESTEUBENVILLEOH43952341471026Mgmt ServicesOHTHSC Corporation$11,470,832$192,5091Yes (true)
Vintage Doctor Group
6624 Fannin STE 1100HoustonTX77030Medical ClinicTXCHI-SLHC Corporation$0$01Yes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd