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MERCY MEDICAL CENTER-CENTERVILLE: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
MERCY MEDICAL CENTER-CENTERVILLE (EIN 42-0680308)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-05-14
IRS object ID
201741349349300914
Schema version
2015v3.0
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)
Return2017-05-14T11:02:48-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

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 Begin2015-07-01TaxPeriodBeginDt

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 RUBINPersonNm
Person TitleSVP, CFOPersonTitleTxt
Signature2016-11-08SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMark StockiPreparerPersonNm
PTINP00642127PTIN
Phone3032989100PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

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$27,888,732GrossReceiptsAmt
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 Body12VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee173TotalEmployeeCnt
Total Volunteers8TotalVolunteersCnt
Total Gross UBI$1,834TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$18,164NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$967,915PYContributionsGrantsAmt
CY Contributions Grants$760,664CYContributionsGrantsAmt
PY Program Service Revenue$27,183,829PYProgramServiceRevenueAmt
CY Program Service Revenue$25,765,355CYProgramServiceRevenueAmt
PY Investment Income$743,855PYInvestmentIncomeAmt
CY Investment Income$1,093,469CYInvestmentIncomeAmt
PY Other Revenue$284,433PYOtherRevenueAmt
CY Other Revenue$269,244CYOtherRevenueAmt
PY Total Revenue$29,180,032PYTotalRevenueAmt
CY Total Revenue$27,888,732CYTotalRevenueAmt
PY Grants And Similar Paid$455,086PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$152,258CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$12,654,507PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,807,406CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$20,876CYTotalFundraisingExpenseAmt
PY Other Expenses$13,591,504PYOtherExpensesAmt
CY Other Expenses$12,417,299CYOtherExpensesAmt
PY Total Expenses$26,701,097PYTotalExpensesAmt
CY Total Expenses$26,376,963CYTotalExpensesAmt
PY Revenues Less Expenses$2,478,935PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,511,769CYRevenuesLessExpensesAmt
Total Assets BOY$33,007,156TotalAssetsBOYAmt
Total Assets EOY$32,859,325TotalAssetsEOYAmt
Total Liabilities BOY$3,004,654TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,614,899TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$30,002,502NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$30,244,426NetAssetsOrFundBalancesEOYAmt
MissionSee schedule O.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$24,715,902ExpenseAmt
Grant$152,258GrantAmt
Revenue$25,765,355RevenueAmt
DescSEE SCHEDULE H.Desc
Total Program Service Expenses$24,715,902TotalProgramServiceExpensesAmt
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 OutstandingfalseLoanOutstandingInd
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
Employee173EmployeeCnt
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 Members12GoverningBodyVotingMembersCnt
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
BILL BUSS
Board Vice Chair1.00Yes (X)Yes (X)$0$0$0
CLINTON CHRISTIANSON
PRESIDENT/CEO40.00Yes (X)Yes (X)$263,078$24$31,776
MIKE CRAVER
Board Chair/ Treasurer1.00Yes (X)Yes (X)$0$0$0
ANN YOUNG
SECRETARY1.01.0Yes (X)Yes (X)$115,826$25$6,848
SR JEANNE CHRISTENSEN RSM
DIRECTOR1.01.0Yes (X)$0$0$0
DAVID FRASER
Director/Physician40.00Yes (X)$285,111$0$22,995
MICHAEL O'CONNOR
DIRECTOR1.00Yes (X)$0$0$0
DR PAUL PONCY
Director1.00Yes (X)$0$0$0
ROBERT RITZ
Board Member/President CHI Iowa Corp1.045.0Yes (X)$0$976,360$92,891
LOTTIE WILSON
Board Member1.00Yes (X)$0$0$0
SR MAURA CLARK
Board Member1.00.0Yes (X)$0$0$0
JOHN GLENN
Director1.00Yes (X)$0$0$0
RANDALL RUBIN
SVP, CFO1.047.0Yes (X)$0$319,705$43,946
MICHAEL WEGNER
COO CHI IA1.047.0Yes (X)$0$558,209$33,861
NANCY BARTON
Physician40.00$204,869$24$22,367Yes (X)
ERICA COLLINS
Physician40.00$254,911$25$12,762Yes (X)
NEAL SOKOL
GENERAL SURGEON40.00$287,499$25$17,725Yes (X)
JENNIFER HADEN
PHYSICIAN40.00$277,468$25$21,018Yes (X)
RYAN ARNEVIK
PHYSICIAN40.00$213,185$24$11,168Yes (X)
LORI RATHBUN
Treasurer/VP Operations0.00.0$0$234,507$38,538Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,901,947TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,088,953TotReportableCompRltdOrgAmt
Total Other Compensation$355,895TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K16IndivRcvdGreaterThan100KCnt
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/ZIPCdServicesServicesDescCompensationCompensationAmt
EMERGENCY PRACTICE ASSOC INC
3840 W 9th StWaterlooIA50704PHYSICIAN SERVICES$1,331,805
EMCARE PHYSICIAN SERVICES
7032 COLLECTION DRIVECHICAGOIL60693PHYSICIAN SERVICES$373,321
BLOOMFIELD ANESTHETISTS
105 E LOCUST STBLOOMFIELDIA52537PHYSICIAN SERVICES$336,540
PSYCHIATRIC MEDICAL CARE LLC
4322 Harding Pike Ste 417NashvilleTN37205locum tenens staffing$285,378
ALL ABOUT STAFFING
1000 SAWGRASS CORP PARKWAYSUNRISEFL33323MEDICAL SERVICES$277,754
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
Federated Campaigns$0FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$0FundraisingAmt
Related Organizations$615,853RelatedOrganizationsAmt
Government Grants$144,811GovernmentGrantsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$760,664TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
Net patient services900099$25,606,570$25,606,570$0$0
Medicare/Medicaid900099$158,785$158,785$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$25,765,355TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$459,540TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$1,834UnrelatedBusinessRevenueAmt
Exclusion$457,706ExclusionAmt

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$84,064RealAmt
Personal$0PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

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

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$84,064RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$84,064TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$84,064ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$633,479SecuritiesAmt
Other$450OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

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

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$633,479SecuritiesAmt
Other$450OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$633,929TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$633,929ExclusionAmt
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$50,513$0$0$50,513
Other Program Service Revenue900099$48,926$0$0$48,926
Intercompany Transactions900099$43,514$0$0$43,514

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$42,227TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$42,227ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$185,180OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$27,888,732TotalRevenueColumnAmt
Related Or Exempt Func Income$25,765,355RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$1,834UnrelatedBusinessRevenueAmt
Exclusion$1,360,879ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$32,952TotalAmt
Program Services$32,952ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$119,306TotalAmt
Program Services$119,306ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$725,633TotalAmt
Program Services$328,982ProgramServicesAmt
Management And General$375,775ManagementAndGeneralAmt
Fundraising$20,876FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,222,124TotalAmt
Program Services$10,037,776ProgramServicesAmt
Management And General$184,348ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$578,818TotalAmt
Program Services$566,901ProgramServicesAmt
Management And General$11,917ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,520,658TotalAmt
Program Services$1,461,213ProgramServicesAmt
Management And General$59,445ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$760,173TotalAmt
Program Services$722,164ProgramServicesAmt
Management And General$38,009ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,379,399TotalAmt
Program Services$5,301,290ProgramServicesAmt
Management And General$78,109ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$60,914TotalAmt
Program Services$6,091ProgramServicesAmt
Management And General$54,823ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,085,485TotalAmt
Program Services$1,009,501ProgramServicesAmt
Management And General$75,984ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$51,431TotalAmt
Management And General$51,431ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$717,050TotalAmt
Program Services$717,050ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$50,699TotalAmt
Program Services$36,503ProgramServicesAmt
Management And General$14,196ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$5,323TotalAmt
Program Services$2,928ProgramServicesAmt
Management And General$2,395ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$28,531TotalAmt
Program Services$28,531ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$375,874TotalAmt
Program Services$375,874ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$727,235TotalAmt
Program Services$719,963ProgramServicesAmt
Management And General$7,272ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$89,685TotalAmt
Program Services$89,685ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Bad debts$297,412$297,412
Medical Supplies$2,283,146$2,283,146
CHI IA MBO Assessment$398,662$398,662
Repairs and maintenance$495,919$486,001$9,918

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$370,534TotalAmt
Program Services$92,633ProgramServicesAmt
Management And General$277,901ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$26,376,963TotalAmt
Program Services$24,715,902ProgramServicesAmt
Management And General$1,640,185ManagementAndGeneralAmt
Fundraising$20,876FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,307BOYAmt
EOY$1,284EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,696,418BOYAmt
EOY$3,912,340EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,414,351BOYAmt
EOY$4,012,991EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$199,081BOYAmt
EOY$170,191EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$397,899BOYAmt
EOY$375,858EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$55,146BOYAmt
EOY$85,563EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$20,275,517LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$14,489,839LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,517,556BOYAmt
EOY$5,785,678EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$20,725,398BOYAmt
EOY$18,515,420EOYAmt

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$33,007,156BOYAmt
EOY$32,859,325EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,818,802BOYAmt
EOY$2,085,456EOYAmt

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

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$1,185,852BOYAmt
EOY$529,443EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,004,654BOYAmt
EOY$2,614,899EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$30,002,502BOYAmt
EOY$30,244,426EOYAmt

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$30,002,502BOYAmt
EOY$30,244,426EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$33,007,156BOYAmt
EOY$32,859,325EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,511,769ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,269,845NetUnrlzdGainsLossesInvstAmt
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$4,212GrantsOtherOrganizationsAmt
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Total Lobbying Expenditures$4,212TotalLobbyingExpendituresAmt

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 - $651 Catholic Health Association - $396 $15,070 IN ANNUAL DUES WAS PAID TO THE IOWA HOSPITAL ASSOCIATION AND $3,165 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 - $651 Catholic Health Association - $396 $15,070 IN ANNUAL DUES WAS PAID TO THE IOWA HOSPITAL ASSOCIATION AND $3,165 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$8,420,562DepreciationAmt
Book Value$2,413,835BookValueAmt

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$8,634,458OtherCostOrOtherBasisAmt
Depreciation$5,744,159DepreciationAmt
Book Value$2,890,299BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$646,313OtherCostOrOtherBasisAmt
Depreciation$325,118DepreciationAmt
Book Value$321,195BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,785,678TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (4 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
CHI OIP - Fixed Income
CHI OIP - Equity Securities
CHI Operating Investment Program, LP
CHI OIP$18,515,420F
FieldValueIRS element (for citing)
Total Book Value Securities$18,515,420TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
accrued expenses$426,149
intercompany payables$102,360
Other$934
FieldValueIRS element (for citing)
Total Liability$529,443TotalLiabilityAmt
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, 2016, 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 CarefalseFPGReferenceFreeCareInd
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
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$53,711TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$53,711NetCommunityBenefitExpnsAmt
Total Expense0.0021TotalExpensePct

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$53,711TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$53,711NetCommunityBenefitExpnsAmt
Total Expense0.0021TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs22ActivitiesOrProgramsCnt
Persons Served1740PersonsServedCnt
Total Community Benefit Expns$135,558TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$135,558NetCommunityBenefitExpnsAmt
Total Expense0.0052TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs5ActivitiesOrProgramsCnt
Persons Served112PersonsServedCnt
Total Community Benefit Expns$7,707TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,707NetCommunityBenefitExpnsAmt
Total Expense0.0003TotalExpensePct

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 Programs18ActivitiesOrProgramsCnt
Persons Served60PersonsServedCnt
Total Community Benefit Expns$83,473TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$83,473NetCommunityBenefitExpnsAmt
Total Expense0.0032TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs45ActivitiesOrProgramsCnt
Persons Served1912PersonsServedCnt
Total Community Benefit Expns$226,738TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$226,738NetCommunityBenefitExpnsAmt
Total Expense0.0087TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs45ActivitiesOrProgramsCnt
Persons Served1912PersonsServedCnt
Total Community Benefit Expns$280,449TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$280,449NetCommunityBenefitExpnsAmt
Total Expense0.0108TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

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

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$1,322TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,322NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Persons Served100PersonsServedCnt
Total Community Benefit Expns$2,839TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,839NetCommunityBenefitExpnsAmt
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$408TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$408NetCommunityBenefitExpnsAmt
Total Expense0.0000TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$1,857TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,857NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served150PersonsServedCnt
Total Community Benefit Expns$803TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$803NetCommunityBenefitExpnsAmt
Total Expense0.0000TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$9,675TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,675NetCommunityBenefitExpnsAmt
Total Expense0.0004TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs11ActivitiesOrProgramsCnt
Persons Served302PersonsServedCnt
Total Community Benefit Expns$16,904TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$16,904NetCommunityBenefitExpnsAmt
Total Expense0.0006TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$297,412BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,345,173ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$10,398,081CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$52,908MedicareSurplusOrShortfallAmt

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 AbbreviationOHStateAbbreviationCd
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
Information GapsYes (X)InformationGapsInd
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 WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttp://www.mercycenterville.org/about-us/community-benefits.aspxStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
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
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledYes (true)AmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (4 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
Schedule H, Part V, Section B, Line 13 Facility , 1Facility , 1 - MERCY MEDICAL CENTER - CENTERVILLE. When Catholic Health Initiatives (the ultimate parent organization to MERCY MEDICAL CENTER - CENTERVILLE established its financial assistance policy it was determined that establishing a household income scale based on the HUD very low income guidelines more accurately reflects the socioeconomic dispersions among urban and rural communities in 18 states served by CHI hospitals and health care facilities. In comparing HUD guidelines to the Federal Poverty Guidelines (FPG), we find that on average HUD guidelines compute to approximately 200% to 250% (and sometimes 300%) of FPG. MERCY MEDICAL CENTER - CENTERVILLE bases its financial assistance eligibility on HUD's 130% of Very Low Income Guidelines based on geography, and affords the uninsured and underinsured the ability to obtain financial assistance write-offs, based on a sliding scale, ranging from 25%-100% of charges.
Schedule H, Part V, Section B, Line 22 Facility , 1Facility , 1 - Mercy Medical Center - Centerville. The organization will not charge individuals who are eligible for financial assistance more than amounts generally billed to those who have insurance.
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 (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part VI LINES 2, 4, 5 - NEEDS ASSESSMENT AND COMMUNITY INFORMATIONI. Organization's Mission, Vision, and Tax-Exempt Purpose Mercy 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 and the county's only 911 ambulance service. 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, and Sleep Lab. 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. II. Community Benefit Approach Mercy 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.
Schedule H, Part VI LINES 2, 4, 5 - NEEDS ASSESSMENT AND COMMUNITY INFORMATION (CONTINUED)(Continued) QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT I. Community Outreach for the Poor Senior Transportation The hospital sponsors a community bus 4 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 Diabetes Education & Support Group Mercy offers a certified diabetes education and support group from patients with diabetes and their spouses. This program offers both presentations for various disciplines involved in managing diabetes as well as discussion. Diabetes Screening Mercy offers diabetes screenings to the community in an effort to identify potential diabetics or those with the disease who are unaware they have the disease to provide interventions with their physician. 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. Blood Pressure Clinics & Health Promotion Education The hospital provided blood pressure and glucose screenings to the community throughout the year and also provided community education on heart disease and diabetes. Infection Control Training for Community The hospital provided infection control training for area businesses. The update included basic blood borne pathogens and exposure reporting for community businesses. Participants were engaged to understand how blood borne pathogens relates to their duties in emergencies they may encounter. Influenza Vaccinations The hospital provided flu vaccines to the mentally handicapped in the community's three group homes. 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. Amish Hemophilia Clinic In collaboration with the University of Iowa Hospitals and Clinics, Mercy provided clinical space and a support nurse for area Amish community diagnosed with various blood disorders. Patients received a physical exam, hemophilia education, dental exam, physical therapy exam and phlebotomy services. Appanoose County Mental Health In partnership with Appanoose County, Centerville Community Betterment, Law Enforcement and the 8th district court, Mercy has helped to developed, executed and continues to maintain a mental health crisis stabilization program. Utilizing on call therapists in the emergency room for mental health assessment and appropriate follow up care utilizing local resources instead of inpatient mental health units. The group has also developed a short term crisis stabilization house assisted by the hospital's effort. The results of the initiative reduced inpatient mental health admissions from the county by almost 80% allowing people to receive appropriate care, in the appropriate setting in their own community. 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.
Schedule H, Part I, Line 3c Eligibility criteria for free or discounted careWhen Catholic Health Initiatives (the ultimate parent organization to MERCY MEDICAL CENTER - CENTERVILLE) established its financial assistance policy it was determined that establishing a household income scale based on the HUD very low income guidelines more accurately reflects the socioeconomic dispersions among urban and rural communities in 18 states served by CHI hospitals and health care facilities. In comparing HUD guidelines to the Federal Poverty Guidelines (FPG), we find that on average HUD guidelines compute to approximately 200% to 250% (and sometimes 300%) of FPG. MERCY MEDICAL CENTER - CENTERVILLE bases its financial assistance eligibility on HUD's 130% of Very Low Income Guidelines based on geography, and affords the uninsured and underinsured the ability to obtain financial assistance write-offs, based on a sliding scale, ranging from 25%-100% of charges. An individual's income under the HUD guidelines is a significant factor in determining eligibility for financial assistance. However, in determining whether to extend discounted or free care to a patient, the patient's assets may also be taken into consideration. For example, a patient suffering a catastrophic illness may have a reasonable level of income, but a low level of liquid assets such that the payment of medical bills would be seriously detrimental to the patient's basic financial (and ultimately physical) well-being and survival. Such a patient may be extended discounted or free care based upon the facts and circumstances.
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 calculation297412
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceThe cost-to-charge ratio for the year ended 6/30/16 was computed using the following formula: Operating expense (before restructuring, impairment and other losses) divided by gross patient revenue. Based on that formula, $24,926,122/$55,367,335 results in a 45.02% 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 45.02%. 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 allowance for uncollectible accounts based upon historical write-off experience by payor category. The results of these reviews are used to modify, as necessary, the provision for bad debts and to establish appropriate allowances for uncollectible net patient accounts receivable. After satisfaction of amounts due from insurance, CHI follows established guidelines for placing certain 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 on the consolidated statements of operations as a deduction from patient services revenues (net of contractual allowances and discounts) since CHI accepts and treats substantially all patients without regard to the ability to pay."
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare 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: $10,345,173 Total Medicare costs: $10,398,081 Shortfall: ($52,908) 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 assistanceMercy Medical Center - Centerville along with its affiliated outpatient facilities are part of Catholic Health Initiatives "CHI". CHI has a written policy (Stewardship policy No. 16) governing the procedures for collections of past due accounts. All hospital facilities included in the filing organization have adopted this policy and follow these practices with regards to collections: PROCEDURES CHI Entities will follow standard procedures in collecting Self-Pay Balances as follows: Permissible Collections Activity Each Facility must adhere to the following requirements in relation to the pursuit of Self-Pay Balances: * Fair Pursuit. Each Facility shall ensure that all patient and patient guarantor accounts are pursued fairly. * Ethics and Integrity. Each Facility shall ensure that all collection activities consistently reflect the highest standards of ethics and integrity. * Reasonable Payment Terms. Each Facility shall offer reasonable payment schedules and terms to each patient and patient guarantor with Self-Pay Balances. All collection activities conducted by the Facility or its third-party collection agents will be in conformance with all federal and state laws governing debt collection practices. Collection activity may be in the form of letters, emails, phone calls, and/or credit reporting and may also include wage garnishments, placing of liens on buildings or residences other than personal residences, initiation of lawsuit, and/or other actions as required, except as prohibited by Impermissible Collections Actions below. Pre-Collections Activity * Timing. Generally, accounts will not be referred to collections until they are 120 days old. However, in circumstances where invoices to non-Medicare patients are returned undelivered with no known address, those Self-Pay Balances may be referred to collections prior to expiration of 120 days. * Limitations - Financial Assistance Eligibility. The Facility shall perform a reasonable review of each patient account prior to turning an account over to a third-party collection agent and prior to instituting any legal action for non-payment (including, but not limited to, reporting the account to a collection agency) to ensure that the patient and patient guarantor are not eligible for any assistance program (e.g., Medicaid) and do not qualify for coverage through the Facility's financial assistance policy. That reasonable review will include one or more of the following: - Notification to patient of the availability of financial assistance on admission, prior to discharge, and/or in the billing process; - Review of Financial Assistance Application submitted by or on behalf of the patient; or - Review of the patient's eligibility using patient account statistical scoring software. * Cooperating Efforts. No Facility shall send any unpaid self-pay account to a third-party collection agent as long as the patient and patient guarantor are cooperating with the Facility in efforts to settle the account balance within a reasonable time frame (generally 18 months). * Subsequent Assessment. After having been turned over to a third-party collection agent, any account that subsequently is determined to qualify for financial assistance shall be returned immediately by the third-party collection agent to the Facility for appropriate follow-up. CHI shall direct its staff and third-party collection agents to continually assess each patient and patient guarantor's ability to pay or to be determined eligible for financial assistance. Collections The Facility may use a third-party collection agent as a representative, acting in the name of the Facility and engaged on a contractual basis, for the express purposes of following-up on and potentially collecting any patient accounts receivable balances. The Facility shall contractually define the standards and scope of practices to be used by third-party collection agents. Those standards and scope of practices shall be consistent with this Policy and shall, at a minimum, include the following: * Statement Message. The Facility shall require its third-party collection agents to include a message on all statements indicating that if a patient or patient guarantor meets certain stipulated income requirements, the patient or patient guarantor may be eligible for Facility or other financial assistance programs. * Advance Settlement Approvals. The Facility shall instruct its third-party collection agents to seek approval from the authorized and designated Facility staff member before any settlement, as a result of bankruptcy proceedings, shall be accepted. * Standards of Conduct. The Facility shall require that the third-party collection agents conduct themselves in compliance with the highest standards of business ethics and integrity and applicable legal requirements, as reflected in the CHI Standards of Conduct, as may be amended by CHI, available at the following website: http://www.catholichealthinitiatives.org/corporateresponsibility. * Prohibited Collections Actions. The Facility shall prohibit the third-party collection agents from engaging in prohibited collections actions as defined in Impermissible Collections Actions below. * Annual Adherence Audit. The Facility or its designee shall be permitted to audit its third-party collection agents at least annually for adherence to these standards. Impermissible Collections Actions CHI Entities shall direct their staff and third-party collection agents that the following actions are always prohibited in relation to the pursuit of Self-Pay Balances. * Unemployed Without Significant Income/Assets. No Facility shall pursue any legal action for non-payment of any bills against any patient or patient guarantor who is known to be unemployed and who has been determined in accordance with CHI Stewardship Policy No. 15, Hospital Financial Assistance, on the basis of a completed Financial Assistance Application, to be without significant income or assets. * Principal Residence. No Facility shall pursue any legal action against any patient or patient guarantor by seeking a remedy that would involve foreclosing upon the principle residence of a patient or patient guarantor, placing a lien on the principal residence, taking any other action that could result in the involuntary sale or transfer of such residence, or informing any patient or patient guarantor that he/she may be subject to any such action. * Other Impermissible Collection Tactics. - No Facility shall charge interest on outstanding balances; - No Facility shall require patients or patient guarantors to incur debt or loans with recourse to the patient's or guarantor's personal or real property assets ("recourse indebtedness"); and - No Facility shall invoke so-called "body attachments" (i.e., the arrest or jailing of patients in default on their accounts, such as for missed court appearances). In addition to the written policy all of Catholic Health Initiatives' hospitals' contracts with third party collection agencies include the following standards: * Neither CHI hospitals nor their collection agencies will request bench or arrest warrants as a result of non-payment; * Neither CHI hospitals nor their collection agencies will seek liens that would require the sale or foreclosure of a primary residence; and * No Catholic Health Initiatives' collection agency may seek court action without hospital approval. Finally, collection agencies are trained on the Catholic Health Initiatives Mission, Core Values and Standard of Conduct to make sure all patients are treated with dignity and respect.
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 3 Patient education of eligibility for assistanceMercy Medical Center - Centerville, along with its affiliated outpatient facilities are part of Catholic Health Initiatives "CHI". CHI has a written policy (Stewardship policy No. 15) governing the procedures for determining and informing patients about the entity's financial assistance policy. All hospital facilities included in the filing organization have adopted the policy. The policy states the organization will include information concerning its financial assistance policy on its website. In addition, Mercy Medical Center - Centerville prominently displays its financial assistance policy in both English and Spanish in obvious locations throughout the hospitals, including the emergency rooms and other patient intake areas, as well as in Mercy Medical Center - Centerville outpatient facilities. In addition, Mercy Medical Center - Centerville 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 financial assistance under Mercy Medical Center - Centerville's financial assistance policy. 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 and procedures including an application for assistance. Mercy Medical Center - Centerville 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. Mercy Medical Center - Centerville's staff will also assist the patient/guarantor with applying for other available coverage (such as Medicaid), if necessary. Counselors assist Medicare eligible patients in enrollment by providing referrals to the appropriate government agencies.
Schedule H, Part VI, Line 6 Affiliated health care systemMercy Medical Center - Centerville, along with its affiliated outpatient facilities are part of Catholic Health Initiatives. Catholic Health Initiatives (CHI) is a national faith-based nonprofit health care organization with headquarters in Englewood, Colorado. CHI's exempt purpose is to serve as an integral part of its national system of hospitals and other charitable entities, which are described as market-based organizations, or MBOs. An MBO is a direct provider of care or services within a defined market area that may be an integrated health system and/or a stand-alone hospital or other facility or service provider. CHI serves as the parent corporation of its MBOs which are comprised of 104 hospitals, including four academic medical centers, and 30 critical access facilities; community health service organizations; accredited nursing colleges; home health agencies; and other facilities that span the inpatient and outpatient continuum of care. Together, these facilities provided $1.1 billion in financial assistance and community benefit in the 2016 fiscal year, including services for the poor, free clinics, education and research. CHI provides strategic planning and management services as well as centralized "shared 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. Mercy Medical Center - Centerville operates with its wholly owned affiliates and community partners, along with its fundraising arm, the Mercy Foundation of Des Moines, IA, to serve the health care needs of the Appanoose county, Iowa communities.
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

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Rathbun Lake Area YMCABusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1708 Main StreetAddressLine1Txt
CityCentervilleCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52544ZIPCd
FieldValueIRS element (for citing)
Recipient EIN262927214RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$14,150CashGrantAmt
Purpose Of GrantCommunity SupportPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant Typecharity care and financial assistanceGrantTypeTxt
Recipient60RecipientCnt
Non Cash Assistance$119,306NonCashAssistanceAmt
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$208,519$0$18,294$0$36,265$24$13,156$0$18,620$0$294,854$24$0$0
DAVID FRASER
Director/Physician$281,220$0$0$0$3,891$0$15,167$0$7,828$0$308,106$0$0$0
ROBERT RITZ
Board Member/President CHI Iowa Corp$0$653,672$0$264,977$0$57,711$0$72,925$0$19,966$0$1,069,251$0$0
LORI RATHBUN
Treasurer/VP Operations$0$174,006$0$31,025$0$29,476$0$12,584$0$25,954$0$273,045$0$0
RANDALL RUBIN
SVP, CFO$0$286,264$0$18,128$0$15,313$0$15,117$0$28,829$0$363,651$0$0
MICHAEL WEGNER
COO CHI IA$0$428,870$0$74,480$0$54,859$0$15,775$0$18,086$0$592,070$0$0
NANCY BARTON
Physician$182,229$0$20,000$0$2,640$24$10,925$0$11,442$0$227,236$24$0$0
ERICA COLLINS
Physician$252,598$0$0$0$2,313$25$8,582$0$4,180$0$267,673$25$0$0
NEAL SOKOL
GENERAL SURGEON$265,575$0$700$0$21,224$25$3,479$0$14,246$0$305,224$25$0$0
JENNIFER HADEN
PHYSICIAN$248,108$0$0$0$29,360$25$7,778$0$13,240$0$298,486$25$0$0
RYAN ARNEVIK
PHYSICIAN$181,876$0$0$0$31,309$24$2,605$0$8,563$0$224,353$24$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planDuring the 2015 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 RITZ During 2015 the following contributions were made by CHI to the deferred compensation plan: ROBERT RITZ - $57,150
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 O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 1 MISSION STATEMENTTHE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. FIDELITY TO THE GOSPEL URGES THE CORPORATION TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT CREATES HEALTHIER COMMUNITIES. THE CORPORATION, SPONSORED BY A LAY-RELIGIOUS PARTNERSHIP, CALLS OTHER CATHOLIC SPONSORS AND SYSTEMS TO UNITE TO ENSURE THE FUTURE OF CATHOLIC HEALTH CARE. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION.
Form 990, Part VI, Line 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 bodyThe sole corporate member has the right to approve and remove with or without cause the members of the governing board.
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.
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 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 board and board committee members of CHI Entities; all CHI employees; all CHI physicians (both employed and non-employed) and all physician administrators and leaders; advanced practice clinicians (both employed and non-employed); 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 has a general ongoing obligation to promptly and fully report 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 report 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. The board, board committee members, and new employees are required to make disclosures at the time of their initial hiring/appointment. All non-employed, credentialed or contracted physicians are required to make disclosures at the time of their credentialing and during any subsequent reappointment or recredentialing. All researchers are required to make disclosures upon consideration of affiliation with a research sponsor. In addition to the general ongoing and initial disclosure obligations, there is an annual disclosure obligation. All corporate officers, board and board committee members, employees at the level of manager and above, researchers, supply chain employees, employed physicians, physician administrators and leaders, and employed advanced practice clinicians must complete a new conflict of interest disclosure annually. Disclosures of perceived, potential or actual conflicts involving financial interests are forwarded to the Conflicts of Interest Review Committee ("C-CIRC") or Legal Services Group for review depending on the position of the person involved. The C-CIRC reviews COI questionnaires containing disclosures of perceived or possible conflicts for employees at a level of manager or above, supply chain employees, researchers and physicians, physician administrators and leaders, and advanced practice clinicians (both employed and non-employed). In the determination of a conflict, a COI management plan will be developed for that person. With respect to those audiences for which the C-CIRC has review responsibility, the C-CIRC will facilitate development of any such conflict of interest management plan in collaboration with local CRP staff. A designated CHI Entity staff will be 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 COI. If the C-CIRC determines that there is a potential or actual conflict of interest 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 the COI management plan. If a Person does not agree with a determination made by the C-CIRC, its interpretation of the Policy or Addenda, or seeks an exemption or exception, the following steps should be followed. The Employee disputing the review decision, interpretation of the Policy, or seeking exemption or exception must present the matter to the Employee's immediate direct manager or supervisor for review and determination. If the Employee and the manager do not agree with the review decision, interpretation of the Policy, or seek exemption or exception, the manager shall consult with the manager's Vice President (or higher if the manager is a Vice President) to reach a determination. If the matter remains unresolved, it shall be referred to the CHI Vice President of Human Resources and the CHI Corporate Responsibility Officer. If they are unable to reach agreement, the matter shall be referred to the CHI General Counsel, whose decision shall be final. 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). Annual COI disclosures of all trustee and corporate officers 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. The Board Chair or designee shall make such further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the Board Chair, the Vice Chair will assume the Chair's role. 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. 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. The trustee or corporate officer shall be excused from the meeting during discussion and vote on the conflict of interest. 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 will act as it would in reviewing transactions with unrelated third parties. The transaction is not to be approved unless the Board determines that the transaction is fair to CHI or the CHI Entity. 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. All determinations of conflicts of interest are reported as required by law, regulations, and CHI policy.
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 the fiscal year ended June 30, 2016.
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 the fiscal year ended June 30, 2016.
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.catholichealthinit.org or at www.dacbond.com. 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: 42227, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 42227;
Form 990, Part IX, Line 11g Other FeesOther Fees for Services - Total Expense: 0, Program Service Expense: 0, Management and General Expenses: 0, Fundraising Expenses: 0; Medical Professional - Total Expense: 2096410, Program Service Expense: 2065970, Management and General Expenses: 30440, Fundraising Expenses: ; Clinical Engineering - Total Expense: 241314, Program Service Expense: 237810, Management and General Expenses: 3504, Fundraising Expenses: ; Laboratory - Total Expense: 71391, Program Service Expense: 70354, Management and General Expenses: 1037, Fundraising Expenses: ; Contracted Services - Total Expense: 1676364, Program Service Expense: 1652023, Management and General Expenses: 24341, Fundraising Expenses: ; Revenue Recovery Center - Total Expense: 1233726, Program Service Expense: 1215812, Management and General Expenses: 17914, Fundraising Expenses: ; Consulting - Total Expense: 60195, Program Service Expense: 59321, Management and General Expenses: 874, Fundraising Expenses: ;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (187 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)(33ACHYes (true)
ALEGENT CREIGHTON HEALTH
12809 W DODGE RDOMAHANE68154470757164HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
ALEGENT CREIGHTON HEALTH FOUNDATION
12809 W DODGE RDOMAHANE68154470648586FUNDRAISINGNE501(c)(37ACHYes (true)
ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM
7500 MERCY RDOMAHANE68124470484764HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA
631 N 8TH STMISSOURI VALLEYIA51555420776568HEALTHCAREIA501(c)(33CHI NEBRASKAYes (true)
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
6901 N 72ND STOMAHANE68122470376615HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER
104 W 17TH STSCHUYLERNE68661470399853HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA
PO BOX 368CORNINGIA50841420782518HEALTHCAREIA501(c)(33CHI NEBRASKAYes (true)
ALVERNA APARTMENTS
300 SE 8TH AVELITTLE FALLSMN56345411351177LTERM CAREMN501(c)(39CHIYes (true)
APPLETREE COURT
601 OAK STBRECKENRIDGEMN56520411850500SENIOR LIVINGMN501(c)(39SFHYes (true)
BAYLOR ST LUKE'S HEALTH VENTURES
17200 ST LUKES WAY STE 170THE WOODLANDSTX77384274499340PHYSICIANSTX501(c)(39SLCHSYes (true)
BELLEVILLE ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802274005511HEALTHCARETX501(c)(33SHSCYes (true)
BISHOP DRUMM RETIREMENT CENTER
1111 6TH AVEDES MOINESIA50314420725196LTERM CAREIA501(c)(39CHI-IA CORPYes (true)
BORNEMANN HEALTHCARE CORPORATION
2500 BERNVILLE RD PO BOX 316READINGPA19603232187242HEALTHCAREPA501(c)(3Type ICHIYes (true)
BRAZOSPORT HEALTH FOUNDATION INC
129 CIRCLE WAY STE 102LAKE JACKSONTX77566760080110FUNDRAISINGTX501(c)(3Type IBRHSYes (true)
BRAZOSPORT REGIONAL PHYSICIAN SERVICES
100 MEDICAL DRIVELAKE JACKSONTX77566800240261HEALTHCARETX501(c)(33BRHSYes (true)
BURLESON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802742759890HEALTHCARETX501(c)(33SJSCYes (true)
BURLESON ST JOSEPH MANOR
2801 FRANCISCAN DRIVEBRYANTX77802742913931HEALTHCARETX501(c)(39SJSCYes (true)
CARRINGTON HEALTH CENTER
800 N 4TH STCARRINGTONND58421450227311HEALTHCAREND501(c)(33CHIYes (true)
CATHOLIC HEALTH INITIATIVES
198 INVERNESS DRIVE WESTENGLEWOODCO80112470617373HEALTHCARECO501(c)(3Type INAYes (true)
CATHOLIC HEALTH INITIATIVES - COLORADO
188 INVERNESS DRIVE WEST STE 500ENGLEWOODCO80112840405257HEALTHCARECO501(c)(33CHIYes (true)
CATHOLIC HEALTH INITIATIVES - IOWA CORP
1111 6TH AVEDES MOINESIA50314420680448HEALTHCAREIA501(c)(33CHIYes (true)
CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
6385 CORPORATE DR STE 301COLORADO SPRINGSCO80919840902211FUNDRAISINGCO501(c)(37CHICYes (true)
CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION
6385 CORPORATE DRCOLORADO SPRINGSCO80919270930004FUNDRAISINGCO501(c)(3Type ICHIYes (true)
CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES
198 INVERNESS DRIVE WESTENGLEWOODCO80112460992796HEALTHCARECO501(c)(3Type ICHINSYes (true)
CENTENNIAL MEDICAL GROUP INC
2700 STEWART PKWYROSEBURGOR97471263946191PHYSICIANSOR501(c)(39MMCYes (true)
CENTRAL KANSAS MEDICAL CENTER
3515 BROADWAYGREAT BENDKS67530480543724SURGERY CENTERKS501(c)(33CHIYes (true)
CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PKWY SFARGOND58104271966847HEALTHCAREMN501(c)(39CHIYes (true)
CHI INSTITUTE FOR RESEARCH AND INNOVATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112271050565HEALTHCARECO501(c)(3Type ICHIYes (true)
CHI KENTUCKY INC
3900 OLYMPIC BLVD STE 400ERLANGERKY41018202741651HEALTHCAREKY501(c)(3Type ICHIYes (true)
CHI NATIONAL HOME CARE
198 INVERNESS DRIVE WESTENGLEWOODCO80112451261716HEALTHCARECO501(c)(39CHI NSYes (true)
CHI NATIONAL SERVICES
198 INVERNESS DRIVE WESTENGLEWOODCO80112452532084HEALTHCARECO501(c)(3Type ICHIYes (true)
CHI NEBRASKA
6940 O ST STE 200LINCOLNNE68510363233121HEALTHCARENE501(c)(3Type ICHIYes (true)
CHI ST JOSEPH CHILDREN'S HEALTH
1929 LINCOLN HWY E STE 150LANCASTERPA17602232342997HEALTHCAREPA501(c)(3Type ICHIYes (true)
CHI ST JOSEPH'S CHILDREN
1516 5TH ST NWALBUQUERQUENM87102710897107COMMUNITYNM501(c)(3Type ICHIYes (true)
CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER
6624 FANNIN STHOUSTONTX77030741161938HEALTHCARETX501(c)(33SLHSYes (true)
CHI ST VINCENT HOSPITAL HOT SPRINGS
300 WERNER STHOT SPRINGSAR71913710236913HEALTHCAREAR501(c)(33CHISVHSYes (true)
CHI ST VINCENT HOT SPRINGS
300 WERNER STHOT SPRINGSAR71913261125064HOLDING COAR501(c)(3Type IISVIMCYes (true)
CHI ST VINCENT MEDICAL GROUP HOT SPRINGS
1 MERCY LANE STE 201HOT SPRINGSAR71913261125131HEALTHCAREAR501(c)(33CHISVHSYes (true)
COMMUNITY LIMITED CARE DIALYSIS CENTER
619 OAK ST ACCOUNTING-3 WCINCINNATIOH45206237419853HOLDING COOH501(c)(2GSHYes (true)
COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION
631 N 8TH STMISSOURI VALLEYIA51555421294399FUNDRAISINGIA501(c)(3Type IAH-CMHMVYes (true)
CONTINUING CARE HOSPITAL
150 NORTH EAGLE CREEK DRLEXINGTONKY40509611400619LT ACHKY501(c)(33SJHSYes (true)
COVENANT HOME CARE
198 INVERNESS DRIVE WESTENGLEWOODCO80112232028429HOME HEALTHPA501(c)(3Type IICHI NHCYes (true)
ENUMCLAW REGIONAL HOSPITAL ASSOCIATION
1450 BATTERSBY AVEENUMCLAWWA98022910715805HEALTHCAREWA501(c)(33FHSYes (true)
FLAGET HEALTHCARE INC
4305 NEW SHEPHERDSVILLE RDBARDSTOWNKY40004611345363HEALTHCAREKY501(c)(33KOHYes (true)
FLAGET MEMORIAL HOSPITAL FOUNDATION INC
4305 NEW SHEPHERDSVILLE RDBARDSTOWNKY40004562351341FUNDRAISINGKY501(c)(3Type IFHYes (true)
FRANCISCAN CARE CENTER
4111 N HOLLAND-SYLVANIA RDTOLEDOOH43623341931806HEALTHCAREOH501(c)(39FLCYes (true)
FRANCISCAN FOUNDATION
1717 SOUTH J STTACOMAWA98405911145592FUNDRAISINGWA501(c)(39FHSYes (true)
FRANCISCAN HEALTH SYSTEM
1717 SOUTH J STTACOMAWA98405910564491HEALTHCAREWA501(c)(33CHIYes (true)
FRANCISCAN HEALTH VENTURES FKA SJMGROUP
TACOMA FNC CTR BLDG 1145 BROADWAYTACOMAWA98402431882377PHYSICIANSMO501(c)(39CHIYes (true)
FRANCISCAN LIVING COMMUNITIES
5942 RENAISSANCE PLACE STE ATOLEDOOH43623341892096HEALTHCAREOH501(c)(3Type ISFHYes (true)
FRANCISCAN MEDICAL GROUP
1313 BROADWAY STE 200TACOMAWA98402911939739HEALTHCAREWA501(c)(39FHSYes (true)
FRANCISCAN VILLA OF SOUTH MILWAUKEE INC
3601 S CHICAGO AVESOUTH MILWAUKEEWI53172391093829HEALTHCAREWI501(c)(39CHIYes (true)
GARRISON MEMORIAL HOSPITAL
407 THIRD AVENUE SOUTHEASTGARRISONND58540450227752HEALTHCAREND501(c)(33SAMCYes (true)
GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WESTENGLEWOODCO80112201536108MINISTRIESCO501(c)(3Type ICHIYes (true)
GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE
619 OAK ST ACCOUNTING-3 WCINCINNATIOH45206311778403EDUCATIONOH501(c)(32GSHYes (true)
GOOD SAMARITAN FOUNDATION OF CINCINNATI INC
619 OAK ST ACCOUNTING-3 WCINCINNATIOH45206311206047FUNDRAISINGOH501(c)(3Type IGSHYes (true)
GOOD SAMARITAN HOSPITAL
PO BOX 1990KEARNEYNE68848470379755HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
GOOD SAMARITAN HOSPITAL FOUNDATION
111 W 31ST STKEARNEYNE68847470659443FUNDRAISINGNE501(c)(37GSHYes (true)
GOOD SAMARITAN HOSPITAL FOUNDATION - DAYTON
110 N MAIN ST STE 500DAYTONOH45402237296923FUNDRAISINGOH501(c)(37SHPYes (true)
HARRISON MEDICAL CENTER
2520 CHERRY AVEBREMERTONWA98310910565546HEALTHCAREWA501(c)(33FHSYes (true)
HARRISON MEDICAL CENTER FOUNDATION
2520 CHERRY AVEBREMERTONWA98310911197626FUNDRAISINGWA501(c)(37HMCYes (true)
HEALTHCARE AND WELLNESS FOUNDATION
2400 ST FRANCIS DRBRECKENRIDGEMN56520760761782FUNDRAISINGMN501(c)(3Type ISFMCYes (true)
HIGHLINE MEDICAL CENTER
16251 SYLVESTER RD SWBURIENWA98166910712166HEALTHCAREWA501(c)(33FHSYes (true)
HOUSE OF MERCY
1111 6TH AVEDES MOINESIA50314421323808SHELTERIA501(c)(37CHI-IA CORPYes (true)
JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202611029768HEALTHCAREKY501(c)(33KOHYes (true)
KENTUCKYONE HEALTH MEDICAL GROUP INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202611352729HEALTHCAREKY501(c)(39JHSMHYes (true)
KENTUCKYONE HEALTH INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202611029769HEALTHCAREKY501(c)(39CHIYes (true)
LAKEWOOD HEALTH CENTER
600 MAIN AVE SBAUDETTEMN56623410758434HEALTHCAREMN501(c)(33CHIYes (true)
LAKEWOOD REGIONAL HEALTHCARE FOUNDATION
600 MAIN AVE SBAUDETTEMN56623411893795FUNDRAISINGND501(c)(37LHCYes (true)
LINUS OAKES INC
2700 STEWART PKWYROSEBURGOR97471930821381SENIOR LIVINGOR501(c)(39MMCYes (true)
LISBON AREA HEALTH SERVICES
905 MAIN STLISBONND58054820558836HEALTHCAREND501(c)(33CHIYes (true)
LUFKIN VISION ACQUISITIONS
PO BOX 1447LUFKINTX75901820563768PROPERTY MGMTTX501(c)(3Type III-FIMHSETYes (true)
MADISON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802742761145HEALTHCARETX501(c)(33SJSCYes (true)
MADONNA MANOR INC
2344 AMSTERDAM ROADVILLA HILLSKY51017610654635LIVING ASSISTKY501(c)(31FLCYes (true)
MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC
2525 DE SALES AVECHATTANOOGATN37404621839548FUNDRAISINGTN501(c)(37MHCSYes (true)
MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVECHATTANOOGATN37404620532345HEALTHCARETN501(c)(33CHIYes (true)
MEMORIAL HEALTH PARTNERS FOUNDATION INC
5600 BRAINERD RD STE 500CHATTANOOGATN37411030417049HEALTHCARETN501(c)(39MHCSYes (true)
MEMORIAL HEALTH SYSTEM OF EAST TEXAS
PO BOX 1447LUFKINTX75902750755367HEALTHCARETX501(c)(33CHIYes (true)
MEMORIAL MEDICAL CENTER - LIVINGSTON
PO BOX 1447LUFKINTX75902760436439HEALTHCARETX501(c)(33MHSETYes (true)
MEMORIAL MEDICAL CENTER - SAN AUGUSTINE
PO BOX 1447LUFKINTX75902752663904HEALTHCARETX501(c)(33MHSETYes (true)
MEMORIAL MULTISPECIALTY ASSOCIATES
1201 FRANK AVELUFKINTX95904752721155PHYSICIANSTX501(c)(3Type III-FIMHSETYes (true)
MEMORIAL SPECIALTY HOSPITAL
PO BOX 1447LUFKINTX95902752492741HEALTHCARETX501(c)(33MHSETYes (true)
MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVEDES MOINESIA50314426076069AUXILIARYIA501(c)(3Type IMF-DM IAYes (true)
MERCY CLINICS INC
1111 6TH AVEDES MOINESIA50314421193699PHYSICIANSIA501(c)(39CHI-IA CORPYes (true)
MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVEDES MOINESIA50314421511682EDUCATIONIA501(c)(32CHI-IA CORPYes (true)
MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVEDES MOINESIA50314237358794FUNDRAISINGIA501(c)(37CHI-IA CORPYes (true)
MERCY FOUNDATION INC
2700 STEWART PKWYROSEBURGOR97471936088946FUNDRAISINGOR501(c)(37MMCYes (true)
MERCY HEALTH CARE FOUNDATION
PO BOX 368CORNINGIA50841421461064FUNDRAISINGIA501(c)(3Type IAHMH-CorningYes (true)
MERCY HEALTHCARE FOUNDATION
570 CHAUTAUQUA BLVDVALLEY CITYND58072450435338FUNDRAISINGND501(c)(3Type IMHVCYes (true)
MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DRCOUNCIL BLUFFSIA51503421178204FUNDRAISINGIA501(c)(3Type IAHBMHSYes (true)
MERCY HOSPITAL OF DEVILS LAKE
1031 7TH ST NEDEVILS LAKEND58301450227012HEALTHCAREND501(c)(33CHIYes (true)
MERCY HOSPITAL OF DEVILS LAKE FOUNDATION
1031 7TH ST NEDEVILS LAKEND58301352367360FUNDRAISINGND501(c)(37MHDLYes (true)
MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BLVDVALLEY CITYND58072450226553HEALTHCAREND501(c)(33CHIYes (true)
MERCY MEDICAL CENTER
1301 15TH AVE WESTWILLISTONND58801450231183HEALTHCAREND501(c)(33CHIYes (true)
MERCY MEDICAL CENTER - CENTERVILLE
ONE ST JOSEPHS DRIVECENTERVILLEIA52544420680308HEALTHCAREIA501(c)(33CHI-IA CORPYes (true)
MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER
1111 6TH AVEDES MOINESIA50314421470935PHYSICIANSIA501(c)(39CHI-IA CORPYes (true)
MERCY MEDICAL CENTER INC
2700 STEWART PKWYROSEBURGOR97471930386868HEALTHCAREOR501(c)(33CHIYes (true)
MERCY MEDICAL FOUNDATION
1301 15TH AVE WESTWILLISTONND58801450381803FUNDRAISINGND501(c)(3Type IMMCYes (true)
NEBRASKA HEART HOSPITAL
7500 S 91ST STLINCOLNNE68526392031968HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
North Central Health Care Alliance dba PrimeCare Health Group
401 N 9th StBISMARCKND585014507450439894HEALTHCAREND501(c)(39NHCAYes (true)
OAKES COMMUNITY HOSPITAL
1200 N 7TH STOAKESND58474450231675HEALTHCAREND501(c)(33CHIYes (true)
OAKES COMMUNITY HOSPITAL FOUNDATION
1200 N 7TH STOAKESND58474710966606FUNDRAISINGND501(c)(3Type IOCHYes (true)
PINEYWOODS MEDICAL DEVELOPMENT CORP
PO BOX 1447LUFKINTX75902752493116PROPERTY MGMTTX501(c)(3Type III-FIMHSETYes (true)
PROVIDENCE CARE CENTER
2025 HAYES AVENUESANDUSKYOH44870341658625HEALTHCAREOH501(c)(39FLCYes (true)
PROVIDENCE CARE CENTERS
2025 HAYES AVENUESANDUSKYOH44870341826099HOLDING COOH501(c)(3Type IIFLCYes (true)
PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION
5055 PROVIDENCE DRIVESANDUSKYOH44870341896807LIVING COMMOH501(c)(39FLCYes (true)
PUEBLO STEPUP
1925 E ORMAN AVE STE G52PUEBLOCO81004841234295COMMUNITYCO501(c)(37CHICYes (true)
REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE
12844 MILITARY RD STUKWILAWA98168911170040HEALTHCAREWA501(c)(33FHSYes (true)
SET OF COLORADO SPRINGS INC
2864 S CIRCLE DR STE 450COLORADO SPRINGSCO80906841183335LTERM CARECO501(c)(37CHICYes (true)
SAINT CLARE'S COMMUNITY CARE INC
25 POCONO RDDENVILLENJ07834222876836HEALTHCARENJ501(c)(3Type IISCHSYes (true)
SAINT CLARE'S FOUNDATION INC
25 POCONO RDDENVILLENJ07834222502997FUNDRAISINGNJ501(c)(37SCHSYes (true)
SAINT CLARE'S HEALTH SERVICES INC
25 POCONO RDDENVILLENJ07834223639733MANAGEMENTNJ501(c)(3Type IICHIYes (true)
SAINT CLARE'S HOSPITAL INC
25 POCONO RDDENVILLENJ07834223319886HEALTHCARENJ501(c)(33SCHSYes (true)
SAINT ELIZABETH FOUNDATION
555 S 70TH STLINCOLNNE68510470625523FUNDRAISINGNE501(c)(37SERMCYes (true)
SAINT ELIZABETH HEALTH SERVICES
555 S 70TH STLINCOLNNE68510363233120HEALTHCARENE501(c)(33SERMCYes (true)
SAINT ELIZABETH REGIONAL MEDICAL CENTER
555 S 70TH STLINCOLNNE68510470379836HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
SAINT FRANCIS MEDICAL CENTER
2620 W FAIDLEYGRAND ISLANDNE68803470376601HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
SAINT FRANCIS MEDICAL CENTER FOUNDATION
PO BOX 9804GRAND ISLANDNE68802470630267FUNDRAISINGNE501(c)(37SFMCYes (true)
SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC
305 ESTILL STBEREAKY40403260152877FUNDRAISINGKY501(c)(37SJHSYes (true)
SAINT JOSEPH HEALTH SYSTEM INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202611334601HEALTHCAREKY501(c)(33KOHYes (true)
SAINT JOSEPH HOSPITAL FOUNDATION INC
ONE SAINT JOSEPH DRIVELEXINGTONKY40504611159649FUNDRAISINGKY501(c)(3Type ISJHSYes (true)
SAINT JOSEPH LONDON FOUNDATION INC
1001 SAINT JOSEPH LANELONDONKY40741260438748FUNDRAISINGKY501(c)(37SJHSYes (true)
SAINT JOSEPH MOUNT STERLING FOUNDATION INC
225 FALCON DRMOUNT STERLINGKY40353272884584FUNDRAISINGKY501(c)(37SJHSYes (true)
SAINT JOSEPH'S HOSPITAL FOUNDATION
30 WEST 7TH STDICKINSONND58601363418207FUNDRAISINGND501(c)(3Type ISJHHCYes (true)
SAMARITAN BEHAVIORAL HEALTH INC
601 S EDWIN C MOSES BLVDDAYTONOH45417020633634HEALTHCAREOH501(c)(37SHPYes (true)
SAMARITAN HEALTH PARTNERS
110 N MAIN ST STE 500DAYTONOH45402311107411HEALTHCAREOH501(c)(3Type ICHIYes (true)
SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC
104 W 17TH STSCHUYLERNE68661363630014FUNDRAISINGNE501(c)(3Type IAHMHSYes (true)
SJRMC JOPLIN MISSOURI
198 INVERNESS DRIVE WESTENGLEWOODCO80112440545809HEALTHCAREMO501(c)(33CHIYes (true)
SL AUGUSTA CORP
PO BOX 20269HOUSTONTX77225760226623TITLE HOLDINGTX501(c)(2SLPCYes (true)
ST ALEXIUS MEDICAL CENTER
900 EAST BROADWAY AVENUEBISMARCKND58501450226711HEALTHCAREND501(c)(33CHIYes (true)
ST ANTHONY HOSPITAL
1601 SE COURT AVEPENDLETONOR97801930391614HEALTHCAREOR501(c)(33CHIYes (true)
ST ANTHONY HOSPITAL FOUNDATION
1601 SE COURT AVEPENDLETONOR97801930992727FUNDRAISINGOR501(c)(3Type ISAHYes (true)
ST ANTHONY'S HOSPITAL ASSOCIATION
FOUR HOSPITAL DRMORRILTONAR72110710245507HEALTHCAREAR501(c)(33SVIMCYes (true)
ST CATHERINE HOSPITAL
401 EAST SPRUCE STGARDEN CITYKS67846480543721HEALTHCAREKS501(c)(33CHIYes (true)
ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION
401 EAST SPRUCE STGARDEN CITYKS67846200598702FUNDRAISINGKS501(c)(3Type ISCHYes (true)
ST CLARE COMMONS
5942 RENAISSANCE PLACE STE ATOLEDOOH43623270163752LIVING COMMOH501(c)(39FLCYes (true)
ST DOMINIC OF ONTARIO OREGON
198 INVERNESS DRIVE WESTENGLEWOODCO80112930433692HEALTHCAREOR501(c)(4CHIYes (true)
ST FRANCIS HOME
2400 ST FRANCIS DRBRECKENRIDGEMN56520410729978LTERM CAREMN501(c)(39CHIYes (true)
ST FRANCIS LIFE CARE CORPORATION
19 POCONO RDDENVILLENJ07834222536017ELDERLY CARENJ501(c)(39SCHSYes (true)
ST FRANCIS MEDICAL CENTER
2400 ST FRANCIS DRBRECKENRIDGEMN56520410695598HEALTHCAREMN501(c)(33CHIYes (true)
ST FRANCIS OF BAKER CITY
198 INVERNESS DRIVE WESTENGLEWOODCO80112930412495HEALTHCAREOR501(c)(33CHIYes (true)
ST JOSEPH FOUNDATION OF BRYAN TEXAS
2801 FRANCISCAN DRIVEBRYANTX77802742351158FUNDRAISINGTX501(c)(3Type ISJSCYes (true)
ST JOSEPH MANOR
2801 FRANCISCAN DRIVEBRYANTX77802742847594HEALTHCARETX501(c)(39SJSCYes (true)
ST JOSEPH MEDICAL CENTER INC
201 INTERNATIONAL CIRCLE STE 212HUNT VALLEYMD21030520591461HEALTHCAREMD501(c)(33CHIYes (true)
ST JOSEPH PHYSICIAN ASSOCIATES
2801 FRANCISCAN DRIVEBRYANTX77802203159302HEALTHCARETX501(c)(33SJSCYes (true)
ST JOSEPH PHYSICIAN ENTERPRISE INC
201 INTERNATIONAL CIRCLE STE 212HUNT VALLEYMD21030521311775PHYSICIANSMD501(c)(3Type ISJMCYes (true)
ST JOSEPH REGIONAL HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802741282696HEALTHCARETX501(c)(33SJSCYes (true)
ST JOSEPH REGIONAL HEALTH PARTNERS
2801 FRANCISCAN DRIVEBRYANTX77802454088170HEALTHCARETX501(c)(33SJSCYes (true)
ST JOSEPH REGIONAL HEALTH PARTNERS ACO
2801 FRANCISCAN DRIVEBRYANTX77802463265423HEALTHCARETX501(c)(33SJSCYes (true)
ST JOSEPH SERVICES CORPORATION
2801 FRANCISCAN DRIVEBRYANTX77802742455161MANAGEMENTTX501(c)(3Type ISFHYes (true)
ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVEPARK RAPIDSMN56470410695603HEALTHCAREMN501(c)(33CHIYes (true)
ST JOSEPH'S HOSPITAL AND HEALTH CENTER
30 WEST 7TH STDICKINSONND58601450226429HEALTHCAREND501(c)(33CHIYes (true)
ST LEONARD
8100 CLYO ROADCENTERVILLEOH45458341940863LIVING COMMOH501(c)(39FLCYes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION
6624 FANNIN ST STE 2505HOUSTONTX77030260274448MANAGEMENTTX501(c)(3Type ISLHSYes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC
6624 FANNIN ST STE 2505HOUSTONTX77030273733278HEALTHCARETX501(c)(33SLCDCYes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND
6624 FANNIN ST STE 2505HOUSTONTX77030261947374HEALTHCARETX501(c)(33SLHSYes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS
6624 FANNIN ST STE 2505HOUSTONTX77030260335902HEALTHCARETX501(c)(33SLCDCYes (true)
ST LUKE'S COMMUNITY HEALTH SERVICES
6624 FANNIN ST STE 1100HOUSTONTX77030760536234HEALTHCARETX501(c)(33SLHSYes (true)
ST LUKE'S FOUNDATION
1213 HERMANN DRIVE STE 855HOUSTONTX77004453811485FUNDRAISINGTX501(c)(37SLHSYes (true)
ST LUKE'S HEALTH SYSTEM CORPORATION
6624 FANNIN ST STE 1100HOUSTONTX77030760536232MANAGEMENTTX501(c)(3Type ICHIYes (true)
ST LUKE'S HOSPITAL AT THE VINTAGE
6624 FANNIN ST STE 2505HOUSTONTX77030263734606HEALTHCARETX501(c)(33SLHSYes (true)
ST LUKE'S MEDICAL GROUP
6624 FANNIN STHOUSTONTX77030760458535PHYSICIANSTX501(c)(33SLHSYes (true)
ST LUKE'S MEDICAL TOWER CORPORATION
6624 FANNIN ST STE 1100HOUSTONTX77030760531713PROPERTY MGMTTX501(c)(3Type ICHI-SLHYes (true)
ST LUKE'S PROPERTIES CORPORATION
6624 FANNIN ST STE 1100HOUSTONTX77030760531716PROPERTY MGMTTX501(c)(3Type ISLHSYes (true)
ST LUKE'S SUGAR LAND PROPERTIES CORPORATION
6624 FANNIN ST STE 2505HOUSTONTX77030454120549PROPERTY MGMTTX501(c)(3Type ISLCDC-SLYes (true)
ST MARY'S COMMUNITY HOSPITAL
1314 3RD AVENEBRASKA CITYNE68410470443636HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
ST MARY'S HOSPITAL FOUNDATION
1314 3RD AVENEBRASKA CITYNE68410470707604FUNDRAISINGNE501(c)(37SMCHYes (true)
ST VINCENT FOUNDATION
TWO ST VINCENT CIRCLELITTLE ROCKAR72205510169537FUNDRAISINGAR501(c)(3Type ISVIMCYes (true)
ST VINCENT INFIRMARY MEDICAL CENTER
TWO ST VINCENT CIRCLELITTLE ROCKAR72205710236917HEALTHCAREAR501(c)(33CHIYes (true)
ST VINCENT MEDICAL GROUP
TWO ST VINCENT CIRCLELITTLE ROCKAR72205710830696HEALTHCAREAR501(c)(39SVIMCYes (true)
SYLVANIA FRANCISCAN HEALTH
1715 INDIAN WOOD CIR 200MAUMEEOH43537341412964HEALTHCAREOH501(c)(3Type ICHIYes (true)
SYLVANIA FRANCISCAN HEALTH FOUNDATION
1715 INDIAN WOOD CIR 200MAUMEEOH43537455357161FUNDRAISINGOH501(c)(3Type IFLCYes (true)
THE COMMONS OF PROVIDENCE
5000 PROVIDENCE DRIVESANDUSKYOH44870341826097ASSIST LIVINGOH501(c)(39FLCYes (true)
THE COMMUNITY HOSPITAL OF BRAZOSPORT
100 MEDICAL DRIVELAKE JACKSONTX77566741385192HEALTHCARETX501(c)(33SLHSYes (true)
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH
619 OAK ST ACCOUNTING-3 WCINCINNATIOH45206310537486HEALTHCAREOH501(c)(33CHIYes (true)
THE PHYSICIAN NETWORK
2000 Q ST STE 500LINCOLNNE68503470780857PHYSICIANSNE501(c)(3Type ICHI NEBRASKAYes (true)
TOTAL HEALTHCARE
188 INVERNESS DRIVE WEST STE 500ENGLEWOODCO80112840927232HEALTHCARECO501(c)(33CHICYes (true)
TRINITY HEALTH FOUNDATION
380 SUMMIT AVENUESTEUBENVILLEOH43952311329423FUNDRAISINGOH501(c)(3Type ITHSYes (true)
TRINITY HEALTH SYSTEM
380 SUMMIT AVENUESTEUBENVILLEOH43952341818681HEALTHCAREOH501(c)(3Type ISFHYes (true)
TRINITY HEALTH SYSTEM GROUP
380 SUMMIT AVENUESTEUBENVILLEOH43952300752920HEALTHCAREOH501(c)(33THSYes (true)
TRINITY HOSPITAL HOLDING COMPANY
380 SUMMIT AVENUESTEUBENVILLEOH43952341842025HEALTHCAREOH501(c)(33THSYes (true)
TRINITY HOSPITAL TWIN CITY
819 NORTH FIRST STREETDENNISONOH44621275401105HEALTHCAREOH501(c)(33CHIYes (true)
TRI-STATE HEALTH SERVICES INC
ONE ROSS PARK BLVDSTEUBENVILLEOH43952341522484ASSIST LIVINGOH501(c)(3THSYes (true)
UNITY FAMILY HEALTHCARE
815 SE 2ND STLITTLE FALLSMN56345410721642HEALTHCAREMN501(c)(33CHIYes (true)
VILLA NAZARETH INC
801 PAGE DRFARGOND58103450226714LTERM CAREND501(c)(39CHIYes (true)
VISITING NURSE ASSOCIATION OF ST CLARE'S INC
191 WOODPORT RDSPARTANJ07871221768334HOME HEALTHNJ501(c)(39SCHSYes (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
5390 N Academy Blvd STE 300COLORADO SPRINGSCO80918841513085Real EstateCOCHICRelated$250,214$23,193,712false$0false0.5
AVON EMERGENCY AND URGENT CARE CENTER LLC
188 INVERNESS DRIVE WEST 500ENGLEWOODCO80112811727282HEALTHCARE SRVCCOCHICRelated$0$0false$0Yes (true)0.77
BAYLOR CHI ST LUKES HEALTH SERVICES LLC
6624 Fannin St Ste 1100HOUSTONTX77030472079184HEALTHCARE SRVCTXSLHSRelated$0$0false$0Yes (true)0.65
BERGAN MERCY SURGERY CENTER LLC
7710 Mercy Rd Ste 200OMAHANE68124208671994AMBUL SURG CTRNEACHRelated$709,407$1,953,385false$0false0.58
BERYWOOD OFFICE PROPERTIES LLC
400 BERYWOOD TRAILCLEVELANDTN37312621875199PHYS OFFICETNMHCSRelated$127,778$958,445false$0Yes (true)0.63
BLUEGRASS REGIONAL IMAGING CENTER
1218 SOUTH BROADWAY STE 310LEXINGTONKY40504611386736DIAGNOSTIC IMAGINGKYSJHSRelated$312,944$3,261,145false$0false0.65
CATHOLIC HEALTH INITIATIVES PHYSICIAN SERVICES LLC
198 INVERNESS DRIVE WESTENGLEWOODCO80112462945938PRACTICE MGMT SRVCDECHIRelated-$572,758$28,961,482false$0Yes (true)0.8
CENTRAL NEBRASKA HOME CARE SERVICES
PO BOX 1146 4502 N SECOND AVEKEARNEYNE68848470692112HEALTHCARE SRVCNEnaRelated-$33,398$156,208false$0Yes (true)1.0
CENTRAL NEBRASKA REHABILITATION SERVICES LLC
3004 W FAIDLEY AVENUEGRAND ISLANDNE68803810653461Physical TherapyNESFMCRelated$2,441,607$3,412,341false$0false0.51
CENTURA-SCA HOLDINGS LLC
569 BROOK VILLAGE STE 901BIRMINGHAMAL35209474823023OP SURGERY CENTERALCHICRelated$525,814$1,305,299false$0Yes (true)0.65
CHI OPERATING INVESTMENT PROGRAM LP
198 INVERNESS DRIVE WESTENGLEWOODCO80112470727942INVESTMENTSCOCHIUnrelated$332,023,271$6,703,637,716false$515,470Yes (true)1.0
CHI ST LUKE'S HEALTH EMERGENCY CENTER LLC
6624 Fannin St Ste 1100HOUSTONTX77030810743412URGENT CARETXSLHSRelated$0$0false$0Yes (true)0.65
CHICAMSURG Surgery Centers LLC
188 INVERNESS DRIVE WEST 500ENGLEWOODCO80112465683027SURGERY CENTERCOCHICRelated$0$0false$0false0.51
CHICLARKIN VENTURES LLC
188 INVERNESS DRIVE WEST 500ENGLEWOODCO80112474210888URGENT CARECOCHICRelated$0$0false$0Yes (true)0.87
Colorado Springs CK Leasing LLC
8770 W Bryn Mawr Ste 1370CHICAGOIL60631262982714REAL ESTATECOCHICRelated$599,151$425,148false$0Yes (true)0.4
HC SL VINTAGE I LLC
18000 W SARAH LANE STE 250BROOKFIELDWI53045270453767PROPERTY HOLDINGWISL HOSP-VINTAGERelated$1,365,254$375,590,761false$0false0.51
HEALTHCARE SUPPORT SERVICES LLC
PO BOX 9804GRAND ISLANDNE68802721546196LAUNDRYNEnaRelated$256,166$3,371,484false$0false1.0
Heartland Oncology LLC
2337 E Crawford StSALINAKS67401464265403ONCOLOGYKSSCHRelated-$457,809$1,985,911false$0false0.51
HIGHLINE IMAGING LLC
PO BOX 184BRUSH PRAIRIEWA98606200460005DIAGNOSTIC IMAGINGWAHMCRelated$65,074$1,408,012false$0false0.8
LAKESIDE AMBULATORY SURGICAL CENTER LLC
17031 LAKESIDE HILLS DROMAHANE68130204267902AMBUL SURG CTRNEACHRelated$4,111,597$2,474,455false$0false0.54
LAKESIDE ENDOSCOPY CENTER LLC
17001 LAKESIDE HILLS PLZ STE 201OMAHANE68130205544496ENDOSCOPY SRVCNEACHRelated$670,348$721,021false$0false0.51
LINCOLN CK LEASING LLC
6003 Old Cheney RdLincolnNE68516262496856Real EstateNESERMCRelated$488,450$230,998false$0false0.54
NEBRASKA SPINE HOSPITAL LLC
6901 N 72ND STOMAHANE68122270263191SPINE HOSPITALNEACHRelated$10,386,143$19,795,974false$0false0.51
NORTH RIVER SURGERY CENTER LLC
2209 WILDWOOD AVESHERWOODAR72120710799771AMBUL SURG CTRARSVIMCRelated$163,900$1,280,229false$0false0.57
ORTHOCOLORADO LLC
11650 WEST 2ND PLACELAKEWOODCO80255371577105ORTHO HOSPITALCOTHCRelated$9,902,290$2,561,198false$0false0.6
PENINSULA RADIATION ONCOLOGY LLC
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Penrad Imaging
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PMC HOSPITAL LLC
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PRAIRIE HEALTH VENTURES LLC
421 S 9TH ST STE 102LINCOLNNE68508204962103TECH SRVCNEAH-IMCRelated$1,126,606$2,905,862false$0Yes (true)0.66
Pueblo Ambulatory Surgery Center LLC
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Saint JOSEPH - PAML LLC
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SAINT JOSEPH - SCA HOLDINGS LLC
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SAINT JOSEPH-ANC HOME CARE SERVICES
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SCA Premier Surgery Center of Louisville LLC
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ST FRANCIS LAND COMPANY
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ST FRANCIS MEDICAL CENTER ASSOCIATES
1717 SOUTH J STTACOMAWA98405911352698MED OFFICEWAFHSRelated$265,442$1,984,098false$0false0.61
ST LUKE'S DIAGNOSTIC CATH LAB LLP
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Alegent HealthCreighton St Joseph Managed Care Services Inc
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All Saints Insurance Company SPC Ltd
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ALLIANCE HEALTH PROVIDERS OF BRAZOS Valley Inc
2801 FRACNISCAN DRIVEBRYANTX77802742466914HealthcareTXSJSCC Corporation$204,115$535,1651Yes (true)
Alternative Insurance Management Service Inc
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AMERICAN NURSING CARE Inc
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AMERIMED INC
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BC HOLDING COMPANY INC
1850 BLUEGRASS AVELOUISVILLEKY40215311542851Fitness ClubKYJHSMHC Corporation$0$01Yes (true)
BrazoSport Health Alliance
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Caduceus Medical Associates INC
5600 Brainerd Road Ste 500ChattanoogaTN37411621570736HealthcareTNMHCSC Corporation$0$1,0081Yes (true)
Captive Management Initiatives Ltd
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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$510,763$3,054,9891Yes (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-$186,666$6,973,9841Yes (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$1,151,0780.93Yes (true)
Diversified Health Resources Inc
100 MEDICAL DRIVELAKE JACKSONTX77566760222679Health CareTXBRHSC Corporation$0$01Yes (true)
East Texas Clinical Services Inc
2801 Via Fortuna 500AustinTX78746454736213HealthcareTXMHSETC Corporation$0$16,7821Yes (true)
First Initiatives Insurance LTD
980203038InsuranceCHIC Corporation$0$01Yes (true)PO BOX 10073 APOGeorgetownGRAND CAYMANCJKY11001CJ
Franciscan Services Inc
198 INVERNESS DRIVE WESTEnglewoodCO80112232487967HealthcareCOCHIC Corporation$318,497$11,891,6451Yes (true)
Good Samaritan Outreach Services
PO Box 1990KearneyNE68848470659440Medical ClinicNECHI NebraskaC Corporation$0$01Yes (true)
HarvestPlains Health of Iowa
32129 Weyerhaeuser Way S STE 201FEDERAL WAYWA98001473451750InsuranceWAQCHPSC Corporation$2,182$3,002,1821Yes (true)
Health Systems Enterprises Inc
1700 EDISON DRMILFORDOH45150470664558MGMTNEGSHC Corporation$84,269$1,115,2101Yes (true)
Healthcare MGMT Services Organization INC
1149 MARKET STTacomaWA98402911865474Health Org.WAFHSC Corporation$0$01Yes (true)
HeartlandPlains Health
198 INVERNESS DRIVE WESTEnglewoodCO80112464368223InsuranceNEPHPSIC Corporation$1,755,860$3,679,1331Yes (true)
Highline Medical Group
15811 AMBUAN Blvd SW STE ABurienWA98166911407026Medical ServicesWAHMCC Corporation$0$01Yes (true)
Medquest
1301 15TH AVENUE WESTWillistonND58801450392137Sale of DMENDMMC WillistonC Corporation$677,839$1,583,3251Yes (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$1,888,173$2,376,8121Yes (true)
Mercy Services Corp
2700 STEWART PARKWAYRoseburgOR97471930824308Retail SalesORMMCC Corporation$2,502,051$1,446,1081Yes (true)
MHI Clinical Services
1201 W Frank AveLufkinTX75904461967952HealthcareTXMHSETC Corporation$10,063,699$1,339,6191Yes (true)
Mountain Management Services Inc
6028 Shallowford RdChattanoogaTN37421621570739MGMT SVC ORGTNMHCSC Corporation$31,344,101$6,237,9321Yes (true)
Nazareth Assurance Company
030304831InsuranceCHIC Corporation$0$01Yes (true)PO BOX 10073 APOGeorgetownGRAND CAYMANCJKY11001CJ
PATIENT TRANSPORT SERVICES INC
1700 EDISON DRMILFORDOH45150311100798HOME HEALTHOHANCC Corporation$9,010,987$6,688,7831Yes (true)
PhysicianHealth System Network
1149 MARKET STTacomaWA98402911746721Health Org.WAFHSC Corporation$0$01Yes (true)
QCA Health Plan Inc
12615 Chenal Parkway STE 300Little RockAR72211710794605InsuranceARQCHIC Corporation$104,106,960$86,204,0291Yes (true)
QualChoice Advantage
32129 WEYERHAEUSER WAY S STE 201FEDERAL WAYWA98001473433912InsuranceWAQCPSC Corporation$2,767$3,502,7671Yes (true)
QualChoice Health Plan Services Inc (fka CollabHealth Plan Services Inc)
198 INVERNESS DRIVE WESTEnglewoodCO80112461224037Admin ServicesCOQCHIC Corporation$17,917,443$64,152,8981Yes (true)
QualChoice Health Inc (fka CollabHealth Managed Solutions Inc)
198 INVERNESS DRIVE WESTEnglewoodCO80112461222808Holding CoCOCHIC Corporation$2,010,400-$2,237,6561Yes (true)
QualChoice Holdings Inc
12615 Chenal Parkway STE 300Little RockAR72211274075520Holding CoARPHPSC Corporation$0$10,1901Yes (true)
QualChoice Life and Health Insurance Company Inc
12615 Chenal Parkway STE 300Little RockAR72211710386640InsuranceARQCHC Corporation$19,949,469$19,444,6331Yes (true)
QualChoice of Nebraska
2401 S 73rd StOmahaNE68124810738827InsuranceNEQCHC Corporation$0$01Yes (true)
RiverLink Health
198 INVERNESS DRIVE WESTEnglewoodCO80112464380824InsuranceOHPHPSC Corporation$2,069,874$3,679,8791Yes (true)
RiverLink Health of Kentucky Inc
198 INVERNESS DRIVE WESTEnglewoodCO80112464828332InsuranceKYPHPSC Corporation$1,590,037$5,958,7861Yes (true)
Ross Park Pharmacy Inc
380 SUMMIT AVESTEUBENVILLEOH43952341832654PharmacyOHTHSC Corporation$1,104,611$2,024,4311Yes (true)
Saint Clare's Primary Care Inc
66 FORD RDDenvilleNJ07834222441202Billing ServicesNJSCCCC Corporation$499,042$1,183,2471Yes (true)
SAMARITAN FAMILY CARE INC
40 W FOURTH ST STE 1700DaytonOH45402311299450HealthcareOHSHPC Corporation$0$01Yes (true)
SJH Services Corporation
198 INVERNESS DRIVE WESTEnglewoodCO80112232307408HealthcareCOFSIC Corporation$2,007,370$2,441,2861Yes (true)
SJL PHYSICIAN MANAGEMENT SERVICES INC
424 LEWIS HARGETT CR STE 160LexingtonKY40503270164198MgmtKYSJHSC Corporation$41$01Yes (true)
SLMT Parking Inc
6624 Fannin STE 800HoustonTX77030760637140ParkingTXSLHSC Corporation$3,345,698$205,2001Yes (true)
SoundPath Health Inc
32129 Weyerhaeuser Way S STE 201Federal WayWA98001421720801InsuranceWAPHPSC Corporation$138,106,211$32,840,9091Yes (true)
St Alexius Health Services Inc
900 East Broadway AvenueBismarckND58501450402812HealthcareNDSAMCC Corporation$0$01Yes (true)
St Anthony Development Company
1415 SouthgatePendletonOR97801931216943Athletic ClubORSAHC Corporation$1,541,465$2,192,2871Yes (true)
St Joseph Development Company Inc
1717 SOUTH J STTacomaWA98405911480569RentalWAFSIC Corporation$3,758,845$12,828,4931Yes (true)
ST JOSEPH OFFICE PARK ASSOCIATION
1401 HARRODSBURG RD BLDG B70LexingtonKY40504611079899MgmtKYSJHSC Corporation$200,108$1,137,6600.85Yes (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$00.6Yes (true)
St Luke's Health System Holdings Inc
6624 Fannin STE 800HoustonTX77030760637138Holding CoTXSLHSC Corporation$2,163,924$4,389,0841Yes (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$4,033,444$16,764,1501Yes (true)
StableView Health Inc
198 INVERNESS DRIVE WESTEnglewoodCO80112464373713InsuranceKYPHPSC Corporation$301,615$5,787,2961Yes (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-$76,969$259,9911Yes (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