ALEGENT HEALTH-MEMORIAL HOSPITAL SCHUYLER: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: ALEGENT HEALTH-MEMORIAL HOSPITAL SCHUYLER (EIN 47-0399853)
Tax period: 2014-07-01 to 2015-06-30
Filed: 2016-05-12
IRS object ID: 201601339349306125
Schema version: 2014v6.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-05-12T20:01:47-05:00	ReturnTs
Tax Period End	2015-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	470617373	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Catholic Health Initiatives	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	12809 WEST DODGE ROAD	AddressLine1Txt
City	OMAHA	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68154	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	470399853	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ALEGENT HEALTH-MEMORIAL HOSPITAL SCHUYLER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	ALEG	BusinessNameControlTxt
Phone	4023434323	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	104 W 17TH STREET	AddressLine1Txt
City	SCHUYLER	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68661	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Jeanette Wojtalewicz	PersonNm
Person Title	CFO	PersonTitleTxt
Signature	2016-05-08	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Donald Neal Jr	PreparerPersonNm
PTIN	P00798244	PTIN
Phone	4023434413	PhoneNum

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-08-17 19:52:53Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CLIFF ROBERTSON	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	104 W 17TH STREET	AddressLine1Txt
City	SCHUYLER	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68661	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$11,981,222	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.CHIHEALTH.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1950	FormationYr
Legal Domicile State	NE	LegalDomicileStateCd
Activity Or Mission	THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	133	TotalEmployeeCnt
Total Volunteers	26	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$6,282	PYContributionsGrantsAmt
CY Contributions Grants	$6,084	CYContributionsGrantsAmt
PY Program Service Revenue	$12,248,149	PYProgramServiceRevenueAmt
CY Program Service Revenue	$11,864,601	CYProgramServiceRevenueAmt
PY Investment Income	$7,518	PYInvestmentIncomeAmt
CY Investment Income	$34,092	CYInvestmentIncomeAmt
PY Other Revenue	$127,614	PYOtherRevenueAmt
CY Other Revenue	$74,695	CYOtherRevenueAmt
PY Total Revenue	$12,389,563	PYTotalRevenueAmt
CY Total Revenue	$11,979,472	CYTotalRevenueAmt
PY Grants And Similar Paid	$230,018	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$400,198	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$7,117,673	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$6,587,791	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$4,605,471	PYOtherExpensesAmt
CY Other Expenses	$5,448,661	CYOtherExpensesAmt
PY Total Expenses	$11,953,162	PYTotalExpensesAmt
CY Total Expenses	$12,436,650	CYTotalExpensesAmt
PY Revenues Less Expenses	$436,401	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$457,178	CYRevenuesLessExpensesAmt
Total Assets BOY	$11,880,183	TotalAssetsBOYAmt
Total Assets EOY	$12,025,729	TotalAssetsEOYAmt
Total Liabilities BOY	$2,385,329	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$3,010,501	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$9,494,854	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$9,015,228	NetAssetsOrFundBalancesEOYAmt
Mission	THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. FIDELITY TO THE GOSPEL URGES THE CORPORATION TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT CREATES HEALTHIER COMMUNITIES. THE CORPORATION, SPONSORED BY A LAY-RELIGIOUS PARTNERSHIP, CALLS OTHER CATHOLIC SPONSORS AND SYSTEMS TO UNITE TO ENSURE THE FUTURE OF CATHOLIC HEALTH CARE. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$1,865,555	ExpenseAmt
Grant	$81,889	GrantAmt
Revenue	$2,438,277	RevenueAmt
Desc	ALEGENT HEALTH MEMORIAL HOSPITAL, SCHUYLER PROVIDES PATIENTS WITH ACCESS TO MEDICAL SPECIALTY SERVICES THROUGH VISITING SPECIALISTS IN THE FOLLOWING AREAS: CARDIOLOGY, EAR, NOSE AND THROAT, GASTROENTEROLOGY, GENERAL SURGERY, WOUND CARE, ONCOLOGY, OPHTHALMOLOGY, ORTHOPAEDICS AND UROLOGY. EACH ONE OF THESE SPECIALTY CLINICS ALLOWS US TO TREAT EACH PATIENT WITH ONE ON ONE SPECIALTY CARE.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$904,328	ExpenseAmt
Grant	$78,383	GrantAmt
Revenue	$2,333,897	RevenueAmt
Desc	ALEGENT HEALTH MEMORIAL HOSPITAL, SCHUYLER HAS STRIVEN TO CONTINUALLY IMPROVE THE HEALTH STATUS OF COLFAX COUNTY RESIDENTS --- CHILDREN, TEENS, ADULTS, SENIOR CITIZENS, FRIENDS AND NEIGHBORS BY PROVIDING DIAGNOSTIC IMAGING SERVICES TO AREA RESIDENTS - CLOSE TO HOME --- RIGHT IN THEIR OWN COMMUNITY. THE DIAGNOSTIC IMAGING SERVICES PROVIDED INCLUDE THE FOLLOWING: CAT SCAN, MRI, NUCLEAR MEDICINE AND BONE DENSITY SCREENING IN ADDITION TO GENERAL RADIOLOGY, MAMMOGRAPHY, SURGICAL RADIOGRAPHY AND ULTRASOUND.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$757,529	ExpenseAmt
Grant	$98,801	GrantAmt
Revenue	$2,941,847	RevenueAmt
Desc	ALEGENT HEALTH MEMORIAL HOSPITAL, SCHUYLER PROVIDES RESIDENTS OF COLFAX COUNTY WITH 24 HOUR EMERGENCY DEPARTMENT CARE AND MEDICAL AND SURGERY SERVICES.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$8,307,416	ExpenseAmt
Grant	$141,125	GrantAmt
Revenue	$4,157,553	RevenueAmt
Desc	OTHER PROGRAM SERVICES	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$8,307,416	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant	$141,125	TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue	$4,157,553	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$11,834,828	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	false	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	133	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (true)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JEANETTE WOJTALEWICZ	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	4023434671	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	12809 WEST DODGE ROAD	AddressLine1Txt
City	OMAHA	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68154	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
MICHAEL DEFREECE
SECRETARY/TREASURER	1.00	11.00	Yes (X)	Yes (X)	$0	$0	$0
RICHARD HERINK
BOARD CHAIR	1.00	11.00	Yes (X)	Yes (X)	$0	$0	$0
CLIFF ROBERTSON
Board Member/CEO CHI Health	1.00	59.00	Yes (X)	Yes (X)	$0	$1,023,504	$178,123
DR Maryanne Stevens RSM
VICE CHAIR	1.00	11.00	Yes (X)	Yes (X)	$0	$0	$0
LARRY BUTLER
Board Member	1.00	11.00	Yes (X)		$0	$0	$0
FR JAMES CLIFTON SJ
Board Member	1.00	11.00	Yes (X)		$0	$0	$0
GREGORY HEIDRICK
Board Member	1.00	11.00	Yes (X)		$0	$2,329	$0
Sister Nadine Heimann
Board Member	1.00	11.00	Yes (X)		$0	$0	$0
MARTIN M MANCUSO MD
Board Member	1.00	59.00	Yes (X)		$0	$391,484	$25,633
MICHAEL ROWAN FACHE
Board member/CHI EVP & COO	1.00	59.00	Yes (X)		$0	$2,500,443	$53,656
BARRY SANDSTROM
Board Member	1.00	11.00	Yes (X)		$0	$0	$0
NATHANIEL BRACKETT MD
BOARD MEMBER	1.00	59.00	Yes (X)		$0	$0	$0
SUSANNE L HRUZA
BOARD MEMBER	1.00	11.00	Yes (X)		$0	$0	$0
AMY L MCGAHA
BOARD MEMBER	1.00	59.00	Yes (X)		$0	$234,004	$9,616
JEANETTE WOJTALEWICZ
CFO, CHI HEALTH	5.00	55.00		Yes (X)	$0	$696,172	$98,208
CONNIE PETERS
OL REGIONAL HOSPITAL ADMINISTRATOR	59.00	1.00			$134,994	$0	$11,318	Yes (X)
RODNEY TRIPLETT
NETWORK EXECUTIVE	20.00	40.00			$0	$197,534	$19,345	Yes (X)
JASON YUNGTUM
VP/REG GENERAL COUNSEL	2.00	58.00			$0	$422,347	$29,415	Yes (X)
MIKE WATTERS
VP-SENIOR COUNCEL	1.00	59.00			$0	$312,583	$41,629	Yes (X)
RENEE SAYER
NURSE PRACTIONER	40.00	0.00			$162,979	$0	$4,426		Yes (X)
THOMAS WONG MD
PHYSICIAN	60.00	0.00			$326,261	$0	$24,030		Yes (X)
CHRISTINA CASSEL MD
PHYSICIAN	60.00	0.00			$196,770	$0	$14,030		Yes (X)
FRANCISCO MACHUCA MD
PHYSICIAN	60.00	0.00			$246,663	$0	$25,963		Yes (X)
JOHANNA MISSAK
PHYSICIAN	60.00	0.00			$293,915	$1,190	$11,212		Yes (X)
Tim Schnack
VP OPERATIONAL FINANCE	9.00	51.00			$0	$290,543	$24,118			Yes (X)
AMY HATCHER
VP DIVISIONAL FINANCE 7/1/14 - 7/13/14	5.00	55.00			$0	$205,947	$10,194			Yes (X)
NANCY WALLACE
SVP HR CHIEF OFFICER	5.00	55.00			$0	$506,487	$0			Yes (X)
SCOTT WOOTEN
FORMER ACH SVP/CFO	0.00	0.00			$0	$1,454,576	$0			Yes (X)
CINDY ALLOWAY
FORMER DIRECTOR	0.00	57.00			$0	$432,670	$26,458			Yes (X)
PATRICIA MASEK
FORMER DIRECTOR	0.00	57.00			$0	$213,146	$23,525			Yes (X)
RICHARD HACHTEN II
Former Board Member/ACH President & CEO	0.00	0.00			$0	$492,165	$35,534			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,361,582	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$9,377,124	TotReportableCompRltdOrgAmt
Total Other Compensation	$666,433	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	7	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	EAST CENTRAL NEBRASKA THERAPY	BusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	879 N 11TH STREET	AddressLine1Txt
City	DAVID CITY	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68632	ZIPCd

Field	Value	IRS element (for citing)
Services	PHYSICAL THERAPY	ServicesDesc
Compensation	$171,522	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Federated Campaigns	$0	FederatedCampaignsAmt
Membership Dues	$0	MembershipDuesAmt
Fundraising	$0	FundraisingAmt
Related Organizations	$5,652	RelatedOrganizationsAmt
Government Grants	$0	GovernmentGrantsAmt
All Other Contributions	$432	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$6,084	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Net patient services	900099	$10,917,904	$10,917,904	$0	$0
Medicare/Medicaid	900099	$299,600	$299,600	$0	$0
Cafeteria	722100	$24,102	$24,102	$0	$0
Laboratory Services	621500	$63,467	$63,467	$0	$0
Product Sales	446199	$559,528	$559,528	$0	$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

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

Field	Value	IRS element (for citing)
Total Program Service Revenue	$11,864,601	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$33,897	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$33,897	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

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

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$195	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$195	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$195	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$195	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$3,697	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$0	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$150	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,547	TotalRevenueColumnAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$3,547	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$535	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$535	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$535	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$2,010	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$1,600	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$410	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$410	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Pharmacy Services	621300	$6,040	$6,040	$0	$0
Information Services	517000	$933	$933	$0	$0
		$0		$0	$0

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$63,230	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$63,230	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$70,203	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,979,472	TotalRevenueColumnAmt
Related Or Exempt Func Income	$11,871,574	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$101,814	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$1,319	TotalAmt
Program Services	$1,319	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$398,879	TotalAmt
Program Services	$398,879	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$146,312	TotalAmt
Program Services	$146,312	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$5,027,727	TotalAmt
Program Services	$4,769,025	ProgramServicesAmt
Management And General	$258,702	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$253,995	TotalAmt
Program Services	$241,295	ProgramServicesAmt
Management And General	$12,700	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$818,004	TotalAmt
Program Services	$777,104	ProgramServicesAmt
Management And General	$40,900	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$341,753	TotalAmt
Program Services	$324,665	ProgramServicesAmt
Management And General	$17,088	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$618	TotalAmt
Program Services	$618	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,242,946	TotalAmt
Program Services	$2,130,799	ProgramServicesAmt
Management And General	$112,147	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$48,297	TotalAmt
Program Services	$45,882	ProgramServicesAmt
Management And General	$2,415	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$571,071	TotalAmt
Program Services	$542,517	ProgramServicesAmt
Management And General	$28,554	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$245,949	TotalAmt
Program Services	$233,652	ProgramServicesAmt
Management And General	$12,297	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$36,179	TotalAmt
Program Services	$34,370	ProgramServicesAmt
Management And General	$1,809	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$244	TotalAmt
Program Services	$232	ProgramServicesAmt
Management And General	$12	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$49,045	TotalAmt
Program Services	$46,593	ProgramServicesAmt
Management And General	$2,452	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$566,085	TotalAmt
Program Services	$537,781	ProgramServicesAmt
Management And General	$28,304	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$24,069	TotalAmt
Program Services	$22,866	ProgramServicesAmt
Management And General	$1,203	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Bad debts	$855,901	$813,106	$42,795
Medical Supplies	$532,046	$505,444	$26,602
Repairs and maintenance	$184,914	$175,668	$9,246
Restructuring Losses	$51,831	$49,239	$2,592

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$39,466	TotalAmt
Program Services	$37,462	ProgramServicesAmt
Management And General	$2,004	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$12,436,650	TotalAmt
Program Services	$11,834,828	ProgramServicesAmt
Management And General	$601,822	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$2,605,049	BOYAmt
EOY	$3,634,443	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,313,477	BOYAmt
EOY	$1,467,540	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$325,346	BOYAmt
EOY	$181,038	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$7,428,013	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,741,967	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$6,282,720	BOYAmt
EOY	$5,686,046	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$258,221	BOYAmt
EOY	$259,880	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$774,701	BOYAmt
EOY	$796,782	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$320,669	BOYAmt
EOY	$0	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$11,880,183	BOYAmt
EOY	$12,025,729	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,130,761	BOYAmt
EOY	$186,904	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$767,254	BOYAmt
EOY	$715,673	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$487,314	BOYAmt
EOY	$2,107,924	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,385,329	BOYAmt
EOY	$3,010,501	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$9,492,398	BOYAmt
EOY	$9,012,772	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,456	BOYAmt
EOY	$2,456	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$9,494,854	BOYAmt
EOY	$9,015,228	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$11,880,183	BOYAmt
EOY	$12,025,729	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$457,178	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$4,482	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$17,966	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$618	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$618	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 DESCRIPTION OF THE ACTIVITIES REPORTED ON LINES 1A THROUGH 1J	FormAndLineReferenceDesc
Explanation	THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: NEBRASKA HOSPITAL ASSOCIATION - $618	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	-$19,067	BeginningYearBalanceAmt
Contributions	$19,680	ContributionsAmt
Other Expenditures	$5,652	OtherExpendituresAmt
End Year Balance	-$5,039	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	-$37,802	BeginningYearBalanceAmt
Contributions	$20,562	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$1,827	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	-$19,067	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	-$29,707	BeginningYearBalanceAmt
Contributions	$21,443	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$29,538	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	-$37,802	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$24,659	BeginningYearBalanceAmt
Contributions	$24,678	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$79,044	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	-$29,707	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$41,983	BeginningYearBalanceAmt
Contributions	$20,899	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$38,223	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$24,659	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.0	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.07	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.93	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,575,977	OtherCostOrOtherBasisAmt
Book Value	$1,575,977	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,716,962	OtherCostOrOtherBasisAmt
Depreciation	$584,671	DepreciationAmt
Book Value	$2,132,291	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

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

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,941,204	OtherCostOrOtherBasisAmt
Depreciation	$1,020,217	DepreciationAmt
Book Value	$920,987	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,193,870	OtherCostOrOtherBasisAmt
Depreciation	$137,079	DepreciationAmt
Book Value	$1,056,791	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$5,686,046	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	CHI OIP	Desc
Book Value	$796,782	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Securities	$796,782	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	Notes Payable	Desc
Amt	$2,107,924	Amt

Field	Value	IRS element (for citing)
Total Liability	$2,107,924	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule D, Part V, Line 4 Intended uses of endowment funds

ENDOWMENT FUNDS ARE INTENDED TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF SCHUYLER MEMORIAL HOSPITAL FOUNDATION, INC AND ALEGENT HEALTH-MEMORIAL HOSPITAL, SCHUYLER.

Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote

ALEGENT HEALTH-MEMORIAL HOSPITAL, SCHUYLER'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, 2014 READS AS FOLLOWS: "CHI IS A TAX-EXEMPT COLORADO CORPORATION AND HAS BEEN GRANTED AN EXEMPTION FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CHI OWNS CERTAIN TAXABLE SUBSIDIARIES AND ENGAGES IN CERTAIN ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE AND THEREFORE SUBJECT TO INCOME TAX. MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS."

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	false	FPGReferenceFreeCareInd
FPG Reference Discounted Care	false	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	319	PersonsServedCnt
Total Community Benefit Expns	$290,814	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$290,814	NetCommunityBenefitExpnsAmt
Total Expense	0.0251	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	1347	PersonsServedCnt
Total Community Benefit Expns	$1,634,936	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,175,156	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$459,780	NetCommunityBenefitExpnsAmt
Total Expense	0.0397	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,510	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,398	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,112	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	1666	PersonsServedCnt
Total Community Benefit Expns	$1,933,260	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,180,554	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$752,706	NetCommunityBenefitExpnsAmt
Total Expense	0.0650	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Persons Served	971	PersonsServedCnt
Total Community Benefit Expns	$31,622	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,958	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$27,664	NetCommunityBenefitExpnsAmt
Total Expense	0.0024	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Persons Served	71	PersonsServedCnt
Total Community Benefit Expns	$248	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$248	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$2,421,760	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,792,871	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$628,889	NetCommunityBenefitExpnsAmt
Total Expense	0.0543	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$936	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$936	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	57	PersonsServedCnt
Total Community Benefit Expns	$7,839	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,281	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,558	NetCommunityBenefitExpnsAmt
Total Expense	0.0006	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	14	ActivitiesOrProgramsCnt
Persons Served	1099	PersonsServedCnt
Total Community Benefit Expns	$2,462,405	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,798,110	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$664,295	NetCommunityBenefitExpnsAmt
Total Expense	0.0574	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	14	ActivitiesOrProgramsCnt
Persons Served	2765	PersonsServedCnt
Total Community Benefit Expns	$4,395,665	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,978,664	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,417,001	NetCommunityBenefitExpnsAmt
Total Expense	0.1224	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	9	PersonsServedCnt
Total Community Benefit Expns	$137	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$137	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$28	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$28	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$459	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$459	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	1	PersonsServedCnt
Total Community Benefit Expns	$88	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$88	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	10	PersonsServedCnt
Total Community Benefit Expns	$712	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$712	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$855,901	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$8,866,680	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$7,920,748	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$945,932	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ALEGENT HEALTH MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Website Address	WWW.CHIHEALTH.COM	WebsiteAddressTxt
State License	170001	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Facility Reporting Group	A	FacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	12	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	www.chihealth.com/chna	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	www.ecdhd.com	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	12	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	http://www.chihealth.com/documents/CHNA/implementation_plan_Schuyler.pdf	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	http://www.chihealth.com/financial-assistance	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	http://www.chihealth.com/documents/Financial_Assistance_Application.pdf	FAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility A, 1	Facility A, 1 - ALEGENT HEALTH MEMORIAL HOSPITAL. The most recent CHNA was conducted using the Mobilizing Action through Planning and Partnerships (MAPP) model. Over 100 individuals participated in the process directly, with an additional 1,000 individuals participating via surveys or focus groups. Over fifty entities listed below had one or more participants in this process. The CHNA and Community Health Improvement Plan (CHIP) process also benefited from consultation with the Good Neighbor Community Health Center (GNCHC) which is the only federally qualified health center within the district. The GNCHC has special expertise in providing service to low-income, medically underserved and minority populations. In addition, representatives from the Hispanic community, the largest minority in the area, also participated in the meetings. East Central District Health Department and Memorial Hospital both had members of their Board of Directors in attendance throughout the planning process. The agencies participating in either the district-wide CHNA or the Colfax County CHIP are listed in alphabetical order. 1 Alegent Creighton Health Memorial Hospital-Schuyler 2 American Red Cross 3 ARC of Platte County 4 Behlen Manufacturing 5 Board Member/ Medical user of the GNCHC 6 Center for Survivors 7 Central Community College 8 Central Nebraska Community Services 9 City of Columbus 10 City of Columbus Parks and Recreation Department 11 City of Schuyler 12 Columbus Chamber of Commerce 13 Columbus Family Practice (Private Medical Clinic) 14 Columbus Housing Authority 15 Columbus Police Department 16 Columbus Public Schools 17 Columbus Telegram 18 Columbus Urgent Care 19 Connect Columbus 20 Crisis Navigators 21 East Central District Health Department 22 Family Resource Center 23 First Nebraska Bank 24 Genoa Community Hospital. 25 Golden Living Center 26 Good Neighbor Community Health Center; Groene Chiropractic Clinic 28 Greystone Manufacturing 29 Harold Stevens Accounting 30 HDR Architectural Firm 31 Jackson Services 32 Local Board of Health public minded citizen 33 Nebraska Department of Health and Human Services 34 Nebraska State Patrol 35 Nebraska State Senator - District 22 36 Pinnacle Bank - Schuyler 37 Platte County Attorney 38 Platte County Emergency Management 39 Progressive Swine Technologies 40 Public Minded Citizens 41 Rainbow Center - Mental Health Center 42 Schuyler Life Teen 43 Schuyler Memorial Hospital Foundation Board 44 Schuyler Ministerial Association 45 Schuyler Public Schools 46 Schuyler Sun 47 Sertoma Service Club 48 Time for Change - Gang Prevention 49 United Way 50 Youth for Christ 51 Victim Assistance
Schedule H, Part V, Section B, Line 6b Facility A, 1	Facility A, 1 - Alegent Health Memorial Hospital. Memorial hospital conducted the CHNA with the East Central District Health Department
Schedule H, Part V, Section B, Line 7 Facility A, 1	Facility A, 1 - ALEGENT HEALTH MEMORIAL HOSPITAL. CHNA was distributed to participating individuals and organizations.
Schedule H, Part V, Section B, Line 11 Facility A, 1	Facility A, 1 - Alegent Health Memorial Hospital. The top 11 community health needs and priorities for Colfax County were identified through the CHNA process and are listed below: * Accidental Death * Activities for Children * Cancer * Diabetes * First Trimester Prenatal Care * GED/High School Equivalency * Hepatitis A and B * Infant Mortality * Radon Levels * Teen Pregnancy * Water Quality Memorial Hospital's Priorities In addition to system-wide community benefit investments in which Memorial shares on a net service revenue basis, Memorial's Implementation Plan focuses on the following priorities and related strategies (identified with the help of the community): Obesity: * Implementation of the NAPSACC program (all 5 day care providers) * Community education around physical activity in relation to school environment and learning * Implementation of the Healthy Families program (training for staff and community) * Expansion of health fruits and vegetables program within schools in county * Funds provided for garden signage for community garden * Provided the "Lana the Iguana" program as a resource to be checked out at the Schuyler Resource Center * Obtained baseline BMI data from children within the county through the school systems * Reviewed the feasibility of implementing a community fitness program in conjunction with community partners * Evaluated the feasibility of developing an instructor for a weight loss or healthy living program * Provided free space and supplies/equipment given to community yoga class for sustainability * Gave funds to maintain community/city pool * Provided In-kind time to perform research on school recess and physical activity poly and practices Family Support for Children Living in Poverty * In-kind time given to prepare reports for EPSDT at ACC * Organized and implemented community event for childcare providers (1800 people attended) * In-kind time on researching, organizing, and creating family educational and developmental flyers for providers to use during well child checks Access to Care * Memorial Hospital is a critical access hospital that provides access to care through the services offered at the hospital and through the ACH Clinic. * Financial assistance is provided through the ACH financial assistance policy * Provided free transportation vouchers for clinic and hospital outpatient visits * Telepsychiatry was implemented into outpatient clinic * Increased clinic hours to allow for increased access * Partnered with local health department on a project for diabetic patients which assigns Care Coach to assist in health planning * Conducted a feasibility study around wellness center * Distributed FOBTS kits at a local health fair * Provided education around colon cancer in the community * Provided community education on and awareness of breast cancer through health fair The following health issues were not addressed in this process as they are being addressed by the Eastern District Health Department, State, Non-profit or Federal support programs; Accidental Death, Cancer, Diabetes, GED/High School Equivalency, Hepatitis A and B, Radon Levels, Water Quality.
Schedule H, Part V, Section B, Line 13 Facility A, 1	Facility A, 1 - Alegent Health Memorial Hospital. Alegent Health Memorial Hospital 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 13 Facility A, 1	Facility A, 1 - Alegent Health Memorial Hospital. Size of Family
Schedule H, Part V, Section B, Line 22 Facility A, 1	Facility A, 1 - ALEGENT HEALTH MEMORIAL HOSPITAL. PATIENTS WHO ARE CONSIDERED SELF PAY PATIENTS ARE PROVIDED AN UP FRONT DISCOUNT BASED ON THE AVERAGE MANAGED CARE CONTRACTS OF THE GEOGRAPHICAL AREA OF 7%

Field	Value	IRS element (for citing)
Facility	5	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
AH MEMORIAL HOSPITAL HOME HEALTH
104 W 17TH STREET	SCHUYLER	NE	68661	HOME HEALTH
AH CLARKSON RURAL HEALTH CLINIC
329 PINE STREET	CLARKSON	NE	68629	RURAL HEALTH CLINIC
AH SCHUYLER RURAL HEALTH CLINIC
1721 COLFAX STREET	SCHUYLER	NE	68661	RURAL HEALTH CLINIC
AH HOWELLS RURAL HEALTH CLINIC
121 SOUTH 6TH STREET	HOWELLS	NE	68641	RURAL HEALTH CLINIC
AH MEM HOSPITAL SKILLED NURSING FACILITY
104 W 17TH STREET	SCHUYLER	NE	68661	SKILLED NURSING FACILITY

Supplemental Information Detail SupplementalInformationDetail (19 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 6a Community Benefit Report available to the public	Yes, the Alegent Creighton Health system produces an annual public community benefit report that is mailed to a core constituency, placed in key places throughout the organization and distributed in community meetings. It is also available on the company's intranet site, and on its public website at http://www.chihealth.com/community-benefit.
Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care	When Catholic Health Initiatives (the ultimate parent organization to Alegent Health Memorial Hospital Schuyler, NE) 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 17 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. Alegent Health Memorial Hospital Schuyler 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 Services	Alegent Creighton Health Memorial Hospital, Schuyler, NE (47-0399853) provides subsidized health services to the broader community through its rural health clinic. The amount included as subsidized services is $628,889.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	855901
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	The costing methodology used to calculate the amounts reported in the table were worksheets 1-8 provided with the schedule H instructions. The cost to charge ratio derived from worksheet 2 was used to calculate total community benefit expense for charity care, Medicaid and other means tested.
Schedule H, Part II Community Building Activities	Alegent Creighton Health has a history of centralized community benefit investments, as well as hospital specific investments that address community health needs which include community building such as: a. Live Well Omaha Kids- As a result of community health needs assessment conducted in 2006 which pointed to childhood obesity as a serious health need issue across all Omaha MSA counties served, the Alegent Creighton Health system partnered with the community to make a multi-year commitment to impact childhood obesity through community based best practice interventions. This initiative has had a primary focus of impact in Douglas County, but the funding to underwrite has come from the fiscal performance of all Alegent Creighton Health hospitals. The community coalition known as Live Well Omaha Kids (LWOK) is staffed and funded by Alegent Creighton Health. An Executive Committee consisting of community leaders and policy makers have directed an ecological approach to improve programs, policies and the built environment to promote physical activity and healthy eating and build capacity for healthy choices at the individual and organizational level. More than 200 volunteers and 90 organizations have participated in the planning and implementation of LWOK initiatives. A portion of this investment in LWOK is allocated to the hospitals on a net service revenue basis. b. Community and economic development including support of local Chambers of Commerce c. Strategic planning and consulting services for community d. Sponsorship of community not for profits and fundraising events e. Support of international health ministries in Tanzania and Dominican Republic f. Support of the federally qualified healthcare centers g. Parish nursing program; supporting 40 congregations h. Community health fairs, support groups and community education i. School based healthcare services j. Leadership in and funding of health coalitions including- k. Live Well Omaha-a coalition founded by ACH and the county health department that serves as convener of business, healthcare and community leaders to review health trends and catalyze community action to address health issues. Alegent Creighton Health serves on the Board of Directors, is a member at the highest level and leases staff to Live Well Omaha. l. Live Well Pottawattamie County -an emerging coalition to address obesity in Pottawattamie County. ACH provides strategic planning, grant writing and staff support. m. Omaha by Design- a coalition that support healthy and sustainable community development and land use n. Violence prevention-a partnership with Catholic Health Initiatives, Women's Center for Advancement, University of Nebraska-Omaha and Creighton University to implement a campus based violence prevention Plan known as "Green Dot." Alegent Creighton Health also supports eCPR training to provide community capacity and skills to address the trauma associated with violence. o. Metro Area Continuum of Care for the Homeless- Board service and financial support to this coalition addressing homelessness in the service area. p. Hope Medical Coalition-Board service and annual operating subsidy. Alegent Creighton Health's hospitals and physicians provide specialty care to patients unable to afford medical services. q. Participation in and funding of maternal health, breastfeeding, substance abuse, cancer, diabetes and other community health coalitions r. Mental health coalitions including National Alliance on Mental Illness, Nebraska, Nebraska Association of Behavioral Health Care Organizations, and the Juvenile Justice Provider Forum Behavioral Health Committee. Alegent Creighton Health Memorial Hospital, Schuyler, NE provides staff leadership, administrative support and financial support to a number of community health and economic development coalitions including-East Central Health Department, Good Neighbor Community Health Center and Schuyler Chamber of Commerce. The hospital manages and serves as fiscal agent for the local Salvation Army bell ringers program.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 83.94%. WHEN DISCOUNTS ARE EXTENDED TO SELFPAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	ALEGENT HEALTH MEMORIAL HOSPITAL SCHUYLER DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Alegent Health Memorial Hospital Schuyler does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of Catholic Health Initiatives. The consolidated footnote reads as follows: "The provision for bad debts is based upon management's assessment of historical and expected net collections, taking into consideration historical business and economic conditions, trends in health care coverage and other collection indicators. Management routinely assesses the adequacy of the allowances for uncollectible accounts based upon historical write-off experience by payor category. The results of these reviews are used to modify, as necessary, the provision for bad debts and to establish appropriate allowances for uncollectible net patient accounts receivable. After satisfaction of amounts due from insurance, CHI follows established guidelines for placing certain patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by each facility. In accordance with Accounting Standards Update (ASU) No. 2011-07, Presentation and Disclosure of Patient Services Revenue, Provision for Bad Debts, and Allowances for Doubtful Accounts for Certain Health Entities, the provision for bad debts is presented on the consolidated statement of operations as a deduction from patient services revenues (net of contractual allowances and discounts) since CHI accepts and treats all patients without regard to the ability to pay."
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	The Alegent Creighton Health system does not consider Medicare shortfalls to be community benefit, per the recommendation of the Catholic Health Association. The Medicare charges reported on lines 5 and 6 are from Medicare cost reports which used a cost to charge ratio.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	ALEGENT HEALTH MEMORIAL HOSPITAL SCHUYLER'S DEBT COLLECTION POLICY PROVIDES THAT ALEGENT HEALTH MEMORIAL HOSPITAL SCHUYLER WILL PERFORM A REASONABLE REVIEW OF EACH INPATIENT ACCOUNT PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAUMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G MEDICAID) AND TO NOT QUALIFY FOR COVERAGE UNDER THE FINANCIAL ASSISTANCE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO MEET THE ALEGENT HEALTH MEMORIAL HOSPITAL SCHUYLER'S FINANCIAL ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO (NAME OF ENTITY) FOR APPROPRIATE FOLLOW-UP. ALEGENT HEALTH MEMORIAL HOSPITAL SCHUYLER REQUIRES 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 FINANCIAL ASSISTANCE. ALL OF CATHOLIC HEALTH INITIATIVES' HOSPITALS' CONTRACTS WITH THIRD-PARTY COLLECTION AGENCIES INCLUDE THE FOLLOWING STANDARDS: 1. NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL REQUEST BENCH OR ARREST WARRANTS AS A RESULT OF NON-PAYMENT; 2. NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL SEEK LIENS THAT WOULD REQUIRE THE SALE OR FORECLOSURE OF A PRIMARY RESIDENCE; AND 3. NO CHI COLLECTION AGENCY MAY SEEK COURT ACTION WITHOUT HOSPITAL APPROVAL FINALLY, COLLECTION AGENCIES ARE TRAINED ON THE CHI 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	A - ALEGENT HEALTH MEMORIAL HOSPITAL: Line 16a URL: http://www.chihealth.com/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	A - ALEGENT HEALTH MEMORIAL HOSPITAL: Line 16b URL: http://www.chihealth.com/documents/Financial_Assistance_Application.pdf;
Schedule H, Part VI, Line 2 Needs assessment	The process to develop assessments of the community health needs (CHNA) is collaborative in nature and involves health departments, existing health coalitions, community members and hospital leadership, and is supported by the Alegent Creighton Health's Community Benefit and Healthier Communities Department staff. Each Alegent Creighton Health hospital participates in the CHNA process for the county in which the facility is located at least every 3 years in partnership with the local health departments. The assessment varies in each community but includes review of primary data (such as surveys, key informant interviews, focus groups) and secondary data (such as County Health Rankings, BRFRSS, YRBS, census data etc) Leadership from Alegent Creighton Health participate in multiple internal and external venues to garner community input, prioritize community health needs and develop community health improvement plans. The CHNA report for each community is made available to the public by posting the report on the Alegent Creighton Health external website and by making it available in community venues. The CHNAs are integrated into the governance and planning for Alegent Creighton Health on two levels: * Reporting to the Board of Directors * Reporting into the annual strategic planning and budgeting processes of Alegent Creighton Health. * Implementation plans approved by Board of Directors. Particular to Alegent Creighton Health Memorial Hospital, Schuyler, NE, works with the East Central District Health Department to conduct CHNA for Boone, Colfax, Nance and Platte Counties, NE. Hospital leadership serves on the CHNA Steering Committee and provides financial and in-kind support for the CHNA and the development of a collaborative community health improvement plan. This local effort is also supported by the Alegent Creighton Health system. In 2012, leadership from Memorial Hospital collaborated with the East Central District Health Department (ECDHD) to conduct a community health needs assessment (CHNA) for the four rural counties served by the ECDHD, which include Colfax County, the county in which Memorial Hospital is located. The ECDHD has completed a CHNA and developed a community improvement plan (CHIP) every five years since 2002 using the Mobilizing for Action through Planning and Partnership (MAPP) process. During this third iteration of the MAPP process, ECDHD served as the co-lead agency with Memorial Hospital. Memorial Hospital provided strong support in both personnel and financial resources. Memorial Hospital's leadership and staff have been involved as a partner in the CHNA planning process for the entire ten year period through service on the CHNA steering committee, participation in the MAPP process, staff support and by hosting meetings. Input from diverse sectors including medically underserved, low-income, minority populations and individuals from diverse age groups were obtained through surveys, targeted focus groups, open public meetings and target invitations to community leaders and agencies.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	There are several financial assistance access points throughout a patient's care cycle. Bills contain financial assistance verbiage; signs are posted in clinics and hospital, and there is information on financial assistance posted at registration points throughout clinics and hospitals. Information on The Alegent Creighton Health System's financial assistance policies are located several places on the system's website- www.alegentcreighton.com. All efforts are made to establish whether patients are eligible for financial assistance prior to service if possible, otherwise as soon as possible following service. Alegent Creighton Health representatives help patients seek reimbursement from local, state and federal programs at no charge to the patient. After these efforts and resources have been exhausted, patients are assisted in the application process for financial assistance consistent with Alegent Creighton Health's Financial Assistance Policy. The application process requires that the patient complete a personal financial application and provide verification documents. Verification includes employment verification and obtaining documentation of the applicant's financial condition such as federal tax return, pay stub, net worth and/or liquid assets and reasonable household or business expenses. Financial assistance may still be granted in certain circumstances involving a catastrophic occurrence resulting in medical bills grossly exceeding the patient's ability to pay, and in these situations, the patient's responsibility will be limited to 20% of the family's gross annual income.
Schedule H, Part VI, Line 4 Community information	Alegent Creighton Health Memorial Hospital, Schuyler, NE, serves Colfax County, Nebraska, with an estimated population of 10,653, an increase of 1.3 percent over 2000. The hospital is a 25-bed critical-access hospital. The population of Schuyler was 6,283 in 2012. Census estimates show that Colfax County's racial and ethnic makeup is 72.6% white and over 41% Hispanic. From 2005 to 2010, the district's Hispanic population grew 533 percent, from 201 students to 1,272. Hispanic students in the Schuyler Community Schools total 1582 out of 1984 students in December, 2013. Nearly 87% of the students at Schuyler Elementary School are eligible for free or reduced cost lunch. The median household income in Colfax County is $43,703 compared to $51,381 in Nebraska. With the establishment of Cargill Meat Solutions packaging plant, the demographics of Schuyler have undergone rapid and lasting change. It is currently one of Nebraska's most predominantly Hispanic communities.
Schedule H, Part VI, Line 5 Promotion of community health	Alegent Creighton Health has a history of centralized community benefit and hospital specific community benefit investments to address community health needs of the particular service area. Examples of how Alegent Creighton Health furthers its exempt purpose by promoting the health of the community include: * Financial Assistance and covering the unpaid costs of Medicaid * Community health improvement services- * Community education, classes and programs (childbirth, diabetes, oncology, physical activity, healthy eating and cooking, health careers, cancer, sports medicine etc) * Support groups (cancer, bereavement, youth etc) * Community health fairs and screenings * Immunization clinics * Parish nursing program and faith community outreach * School based healthcare services * Health professional education- * Clinical preceptorships for healthcare professionals * Scholarships and mentorships * Affiliation with and support of Creighton University School of Medicine * Physician residency and fellowship programs training more than 200 residents and fellows annually * Research-Participation in the Missouri Valley Cancer Consortium * Financial and in-kind contributions * Support of the Federally Qualified Healthcare Centers (and Hope Medical Coalition which provides access to medical services specifically for the underserved * Corporate sponsorships * Tanzania and Dominican Republic health ministries * Staff service on health related board and coalitions * Subsidized healthcare service including behavioral health, NICU, home health and hospice * Community building activities- * Community and economic development including support of local Chambers of Commerce * Strategic planning and consulting services for community * Health coalitions * Live Well Omaha-a coalition founded by ACH and the county health department that serves as convener of business, healthcare and community leaders to review health trends and catalyze community action to address health issues. ACH serves on the Board of Directors, is a member at the highest level and leases staff to Live Well Omaha. * Live Well Omaha Kids-a coalition funded and staffed for seven years by ACH to address childhood obesity * Live Well Pottawattamie-an emerging coalition to address obesity in Pottawattamie County. ACH provides strategic planning, grant writing and staff support. * Violence prevention-a partnership with Catholic Health Initiatives, Women's Center for Advancement, University of Nebraska-Omaha and Creighton University to implement a campus based violence prevention Plan known as "Green Dot." * Metro Area Continuum of Care for the Homeless- Board service and financial support to this coalition addressing homelessness in the service area. * Hope Medical Coalition-Board service and annual operating subsidy. ACH hospitals and physicians provide specialty care to patients unable to afford medical services. * Participation in and funding of maternal health, breastfeeding, substance abuse, cancer, diabetes and other community health coalitions * Mental health coalitions including National Alliance on Mental Illness, Nebraska Association of Behavioral Health Care Organizations, and the Juvenile Justice Provider Forum Behavioral Health Committee. * The primary care physician clinics that are part of the parent corporation provide access to care through the system's Financial Assistance Policy and participate in medical student preceptorships that advance the healthcare provider education process . * Alegent Creighton Health has Open Medical staffs * Alegent Creighton Health is one of three health systems that fund the operations of a coalition that exists to provide access for the patients of three area federally qualified healthcares to specialty physician services and hospital based diagnostics and treatment * Alegent Creighton Health is the sole comprehensive mental health provider in the Omaha MSA area * Alegent Creighton Health is a joint venture partner in a not-for-profit Hospice inpatient hospital and provides the management support contract. * Alegent Creighton Health budgets for an emergency fund as a subset of other community donations to respond to crisis or unplanned funding needs of a vital community service, which has first used in FY11 with the economic downturn. Part I 7.i Alegent Creighton Health Memorial Hospital Schuyler, further promotes the health of its community through financial and in-kind donations to support community needs. Community input is sought through the hospital's Community Advisory Board.
Schedule H, Part VI, Line 6 Affiliated health care system	Alegent Creighton Health Memorial Hospital Schuyler 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 92 hospitals, including four academic medical centers, and 24 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 $981 million in charity care and community benefit in the 2015 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. Alegent Creighton Health Memorial Hospital Schuyler operates with its wholly owned affiliates and community partners, along with its fundraising arm, the Alegent Creighton Health Foundation, Inc., to serve the health care needs of the Colfax County community.
Schedule H, Part VI, Line 7 State filing of community benefit report	IA, NE

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	CHARITY CARE	GrantTypeTxt
Recipient	319	RecipientCnt
Non Cash Assistance	$398,879	NonCashAssistanceAmt
Valuation Method Used	Book	ValuationMethodUsedDesc
Non Cash Assistance	Write off of patient services	NonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds	MOST DISBURSEMENTS IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PROGRAMS ARE MADE DIRECTLY IN THE ACTIVE CONDUCT OF THE ACTIVITIES CONSTITUTING THE EXEMPT PURPOSE OR FUNCTION OF THE ORGANIZATION. OTHERWISE, DISTRIBUTIONS IN FURTHERANCE OF THE INSTITUTION'S EXEMPT PROGRAMS ARE MADE IN ACCORDANCE WITH PROCEDURES SUBJECT TO CONDITIONS ESTABLISHED BY THE INSTITUTION'S GOVERNING BOARD OR MANAGEMENT DESIGNED TO ENSURE THAT RECIPIENTS OF SUCH DISBURSEMENTS FROM THE ORGANIZATION ARE ADEQUATELY INVESTIGATED AND GRANTED TO QUALIFIED RECIPIENTS.
Schedule I, Part III, Column (b) Estimated Number of Recipients	ALEGENT HEALTH MEMORIAL HOSPITAL, SCHUYLER 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.	MOST DISBURSEMENTS IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PROGRAMS ARE MADE DIRECTLY IN THE ACTIVE CONDUCT OF THE ACTIVITIES CONSTITUTING THE EXEMPT PURPOSE OR FUNCTION OF THE ORGANIZATION. OTHERWISE, DISTRIBUTIONS IN FURTHERANCE OF THE INSTITUTION'S EXEMPT PROGRAMS ARE MADE IN ACCORDANCE WITH PROCEDURES SUBJECT TO CONDITIONS ESTABLISHED BY THE INSTITUTION'S GOVERNING BOARD OR MANAGEMENT DESIGNED TO ENSURE THAT RECIPIENTS OF SUCH DISBURSEMENTS FROM THE ORGANIZATION ARE ADEQUATELY INVESTIGATED AND GRANTED TO QUALIFIED RECIPIENTS.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (20 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RICHARD HACHTEN II
Former Board Member/ACH President & CEO	$0	$159,899	$0	$112,521	$0	$219,745	$0	$31,152	$0	$4,382	$0	$527,699	$0	$0
CLIFF ROBERTSON
Board Member/CEO CHI Health	$0	$772,865	$0	$115,809	$0	$134,830	$0	$151,369	$0	$26,754	$0	$1,201,627	$0	$54,120
CINDY ALLOWAY
FORMER DIRECTOR	$0	$344,557	$0	$75,537	$0	$12,576	$0	$9,100	$0	$17,358	$0	$459,128	$0	$0
PATRICIA MASEK
FORMER DIRECTOR	$0	$156,461	$0	$44,255	$0	$12,430	$0	$7,535	$0	$15,990	$0	$236,671	$0	$0
MARTIN M MANCUSO MD
Board Member	$0	$388,633	$0	$0	$0	$2,851	$0	$9,079	$0	$16,554	$0	$417,117	$0	$0
MICHAEL ROWAN FACHE
Board member/CHI EVP & COO	$0	$1,195,620	$0	$788,897	$0	$515,926	$0	$32,602	$0	$21,054	$0	$2,554,099	$0	$224,413
AMY L MCGAHA
BOARD MEMBER	$0	$233,848	$0	$0	$0	$156	$0	$8,002	$0	$1,614	$0	$243,620	$0	$0
NANCY WALLACE
SVP HR CHIEF OFFICER	$0	$309,173	$0	$173,948	$0	$23,366	$0	$0	$0	$0	$0	$506,487	$0	$0
SCOTT WOOTEN
FORMER ACH SVP/CFO	$0	$0	$0	$1,454,576	$0	$0	$0	$0	$0	$0	$0	$1,454,576	$0	$0
JEANETTE WOJTALEWICZ
CFO, CHI HEALTH	$0	$464,487	$0	$208,308	$0	$23,377	$0	$75,918	$0	$22,290	$0	$794,380	$0	$0
Tim Schnack
VP OPERATIONAL FINANCE	$0	$240,321	$0	$49,241	$0	$981	$0	$9,100	$0	$15,018	$0	$314,661	$0	$0
AMY HATCHER
VP DIVISIONAL FINANCE 7/1/14 - 7/13/14	$0	$144,291	$0	$48,584	$0	$13,072	$0	$5,618	$0	$4,576	$0	$216,141	$0	$0
RODNEY TRIPLETT
NETWORK EXECUTIVE	$0	$168,252	$0	$28,938	$0	$344	$0	$5,150	$0	$14,195	$0	$216,879	$0	$0
JASON YUNGTUM
VP/REG GENERAL COUNSEL	$0	$232,111	$0	$170,543	$0	$19,693	$0	$7,717	$0	$21,698	$0	$451,762	$0	$0
MIKE WATTERS
VP-SENIOR COUNCEL	$0	$229,154	$0	$39,598	$0	$43,831	$0	$22,685	$0	$18,944	$0	$354,212	$0	$0
RENEE SAYER
NURSE PRACTIONER	$162,564	$0	$0	$0	$415	$0	$4,398	$0	$28	$0	$167,405	$0	$0	$0
THOMAS WONG MD
PHYSICIAN	$316,640	$0	$0	$0	$9,621	$0	$9,100	$0	$14,930	$0	$350,291	$0	$0	$0
CHRISTINA CASSEL MD
PHYSICIAN	$176,396	$0	$0	$0	$20,374	$0	$6,218	$0	$7,812	$0	$210,800	$0	$0	$0
FRANCISCO MACHUCA MD
PHYSICIAN	$246,501	$0	$0	$0	$162	$0	$6,226	$0	$19,737	$0	$272,626	$0	$0	$0
JOHANNA MISSAK
PHYSICIAN	$253,744	$1,190	$40,000	$0	$171	$0	$3,115	$0	$8,097	$0	$305,127	$1,190	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	Compensation for the top management official was established and paid by the following related organizations: Catholic Health Initiatives (CHI) and Franciscan Health System (FHS). CHI and FHS used the following to establish the top management official's compensation: (1) Compensation Committee; (2) Independent Compensation Consultant; (3) Written Employment Contracts; (4) Compensation Survey or Study; (5) Approval by the Board or Compensation Committee.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	DURING THE 2014 CALENDAR YEAR, CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION, MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR MARKET BASED ORGANIZATION CEOS AND OTHER CHI EMPLOYEES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN CHI'S SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN: CLIFF ROBERTSON MICHAEL ROWAN JEANETTE WOJTALEWICZ DURING 2014 THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: CLIFF ROBERTSON - $113,667 RICHARD ROLSTON - $45,001 JEANETTE WOJTALEWICZ - $40,766 DURING 2014 THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI FROM THE DEFERRED COMPENSATION PLAN: CLIFF ROBERTSON - $54,120 MICHAEL ROWAN - $224,413 DUE TO THE "SUPER" VESTING RULES UNDER THE CHI DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS TERMINATION, AGE, OR YEARS OF SERVICE WERE ELIGIBLE TO RECEIVE THEIR 2014 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION, ON SCHEDULE J, PART II. DURING 2014, THE FOLLOWING CONTRIBUTIONS THAT WOULD HAVE BEEN MADE BY CHI TO THE DEFERRED COMPENSATION PLAN WERE PAID IN CASH: Michael Rowan - $266,409 Richard Hachten II - $22,269
Schedule J, Part I, Line 7 Non-fixed payments	CATHOLIC HEALTH INITIATIVES (CHI) MAINTAINS A VARIABLE PAY PROGRAM FOR MANAGERS AND ABOVE THAT PUTS A CERTAIN AMOUNT OF COMPENSATION AT RISK. AWARDS OF INCENTIVE COMPENSATION UNDER THE VARIABLE PAY PROGRAM ARE MADE BASED UPON ACHIEVEMENT OF ORGANIZATIONAL OBJECTIVES INCLUDING FINANCIAL OUTCOMES, QUALITY IMPROVEMENT, AND OTHER MEASURES AS DETERMINED ANNUALLY BY THE BOARD OF STEWARDSHIP TRUSTEES. HOWEVER, ELIGIBLE AWARDS PAYABLE UNDER THIS PROGRAM ARE DEPENDENT ON HITTING MINIMUM LEVELS OF OPERATING MARGIN AND CHARITY CARE LEVELS, UNLESS THE HR COMMITTEE OF THE BOARD OF STEWARDSHIP TRUSTEES USES THEIR DISCRETION TO APPROVE AN EXCEPTION.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part III, Line 4d Description of other program services	(Expenses $ 8,307,416 including grants of $ 141,125)(Revenue $ 4,157,553) OTHER PROGRAM SERVICES
Form 990, Part V, Line 1c PAYMENTS TO VENDORS	PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF CHI ARE MADE BY CHI, THEREFORE NO FORM 1099S ARE ISSUED BY ALEGENT Health-Memorial Hospital, Schuyler. CHI FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099S ISSUED BY CHI ON BEHALF OF ALEGENT Health-Memorial, Schuyler ARE REPORTED TO THE IRS.
Form 990, Part VI, Line 4 Significant changes to organizational documents	Alegent Health-Memorial Hospital, Schuyler AMENDED its BYLAWS on October 1, 2013. The amendment made CHI Nebraska, a Nebraska nonprofit corporation, the sole member of the corporation.
Form 990, Part VI, Line 6 Classes of members or stockholders	CHI Nebraska IS THE SOLE MEMBER OF ALEGENT HEALTH-MEMORIAL HOSPITAL, SCHUYLER.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	According to the organization's bylaws, directors shall be appointed or refused by the corporate member. The corporate member may appoint one or more individuals to the board of directors, and may at any time remove, with or without cause, any member of the board of directors. According to the organization's bylaws, directors of the corporation shall be appointed by the corporate member no later than June 30 of each year. The names and qualifications of each individual accepted by the board of directors shall be submitted to the corporate member, who shall appoint or refuse each nominee in accordance with the corporate member's bylaws and with endorsement of the senior vice president of operations. The corporate member may unilaterally appoint one or more individuals to the board of directors should the board fail to furnish the corporate member with a list of individuals qualified to serve on the board of directors of the corporation.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	The organization's corporate member is CHI Nebraska. Pursuant to Section 5.4.1 of the organization's bylaws, both CHI Nebraska and Catholic Health Initiatives ("CHI") have reserved powers as outlined in the CHI governance matrix. Pursuant to the governance matrix the following rights are held by the CHI Nebraska's Board: * Approve members of the Alegent Health- Memorial Hospital, Schuyler board. * Amendment of the corporate documents of the Alegent Health- Memorial Hospital, Schuyler. Approve removal of a member of the governing body of the Alegent Health- Memorial Hospital, Schuyler. Adoption of long range and strategic plans for the Alegent Health- Memorial Hospital, Schuyler. The following rights are reserved to the CHI Board directly or through powers delegated to the CHI Chief Executive Officer: * Substantial change in the mission or philosophy of the Alegent Health- Memorial Hospital, Schuyler. * Removal of a member of the governing body of the Alegent Health- Memorial Hospital, Schuyler. * Approval of issuance of debt by Alegent Health- Memorial Hospital, Schuyler. * Approval of participation of Alegent Health- Memorial Hospital, Schuyler in a joint venture. Approval of formation of a new corporation by Alegent Health- Memorial Hospital, Schuyler. Approval of a merger involving the Alegent Health- Memorial Hospital, Schuyler. * Approval of the sale of all or substantially all of the assets of the Alegent Health- Memorial Hospital, Schuyler. * To require the transfer of assets by the Alegent Health- Memorial Hospital, Schuyler to CHI to accomplish CHI's goals and objectives, and to satisfy CHI debts. Pursuant to Section 5.5.2 of the organization's bylaws, CHI Nebraska or CHI may, in exercise of their approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and its President and the Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate.
Form 990, Part VI, Line 11b Review of form 990 by governing body	FOLLOWING THE PREPARATION OF THE FORM 990 BY TAX ANALYSTS OF CATHOLIC HEALTH INITIATIVES, A RELATED ORGANIZATION, THE RETURN IS REVIEWED BY THE CHI TAX DIRECTOR AND THE LOCAL CHIEF FINANCIAL OFFICER. AFTER INCORPORATION OF ANY CHANGES RESULTING FROM THIS REVIEW, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AND MEMBERS OF THE FINANCE COMMITTEE OF THE BOARD A WEEK IN ADVANCE OF THE FINANCE COMMITTEE MEETING. THE FORM 990 IS REVIEWED AT THE FINANCE COMMITTEE MEETING AND THE CHIEF FINANCIAL OFFICER AND CHI TAX DIRECTOR ARE PRESENT AT THE MEETING TO ANSWER QUESTIONS. ADDITIONALLY, THE BOARD OF DIRECTORS ARE PROVIDED THE FINAL FORM 990 AND RELATED SCHEDULES TO REVIEW AND ARE ABLE TO ASK THE CHIEF FINANCIAL OFFICER AND TAX DIRECTOR QUESTIONS PRIOR TO FILING WITH THE IRS. UPON CHIEF FINANCIAL OFFICER APPROVAL AND SIGNATURE, THE TAX Analyst FILES THE FINAL FORM 990 AS PRESENTED TO THE BOARD AND FINANCE COMMITTEE, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY IN ORDER TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
Form 990, Part VI, Line 12c Conflict of interest policy	ALEGENT HEALTH MEMORIAL HOSPITAL, SCHUYLER HAS ADOPTED THE CONFLICT OF INTEREST POLICY AND CONFLICT INVESTIGATION PROCESS OF CATHOLIC HEALTH INITIATIVES, A RELATED ORGANIZATION. ALL OFFICERS, TRUSTEES AND EMPLOYEES ARE COVERED BY A CONFLICT OF INTEREST POLICY. ADDITIONALLY, ALL OFFICERS, TRUSTEES AND EMPLOYEES ARE REQUIRED TO ACT IN ACCORDANCE WITH CHI'S STANDARDS OF CONDUCT, WHICH INCLUDE THE AVOIDANCE OF CONFLICTS OF INTEREST OR THE APPEARANCE OF CONFLICTS. THE CHI CONFLICT OF INTEREST POLICY PROVIDES THAT ALL MEMBERS OF THE BOARD OF DIRECTORS AND OF ANY BOARD COMMITTEE ARE REQUIRED TO PROMPTLY AND FULLY DISCLOSE TO THE ENTITIES BOARD CHAIR SITUATIONS THAT MAY CREATE A CONFLICT OF INTEREST WHEN THEY BECOME AWARE OF THE SITUATION. IN ADDITION, ALL MEMBERS OF THE BOARD ARE REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST VIA COMPLETION OF THE CONFLICT OF INTEREST DISCLOSURE FORM WHICH IS REVIEWED BY THE CORPORATE RESPONSIBILITY TEAM AND GENERAL COUNSEL. 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 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 official	Compensation for the top management official was established and paid by the following related organizations: Catholic Health Initiatives (CHI) and Franciscan Health System (FHS) CHI has a defined compensation philosophy. Both the executive and non-executive compensation structures and ranges are reviewed annually in comparison to market data. CHI uses The Hay Group as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of the senior most executives is reviewed annually. The Hay Group reviews both cash and total compensation for overall reasonableness, for adherence to CHI's compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review is delivered by Hay Group to the HR committee of the CHI Board of Stewardship Trustees annually at their September meeting and minutes are shared with the full board at the December meeting. The last review was September 14, 2015. In addition, Hay Group completed a comprehensive review of all positions at the level of vice president and above in the fall of 2014 to determine and validate appropriate compensation levels. These levels have been reviewed annually since and revised based on market data, where applicable. FHS USES AN EXTERNAL COMPENSATION FIRM WHO UTILIZES ACTUAL MARKET DATA COMPENSATION FROM SIMILAR INSTITUTIONS WITH COMPARABLE POSITIONS AND COMPENSATION LEVELS AND CONSIDERING THE ORGANIZATION'S GEOGRAPHIC LOCATION. THE EXECUTIVE COMMITTEE OF THE BOARD ANNUALLY EVALUATES AND APPROVES THE EXECUTIVE COMPENSATION ARRANGEMENT FOR EACH EXECUTIVE FOR FAIR MARKET VALUE ALONG WITH OTHER APPLICABLE FACTORS RELIED ON BY THE BOARD'S DETERMINATION. THE SUPPORTING DOCUMENTATION BECOMES PART OF THE MINUTES OF THE MEETING. THIS PROCESS IS COMPLETED YEARLY.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	SEE DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15A.
Form 990, Part VI, Line 19 Required documents available to the public	THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST FROM THE ADMINISTRATION DEPARTMENT. IN ADDITION, THE ARTICLES OF INCORPORATION ARE AVAILABLE FROM THE NEBRASKA (IOWA) SeCRETARY OF STATE WEBSITE HTTP://WWW.SOS.NE.GOV/BUSINESS THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.ORG.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Other Miscellaneous Revenue - Total Revenue: 63230, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 63230;
Form 990, Part IX, Line 11g Other Fees	Other Fees for Services - Total Expense: 2242946, Program Service Expense: 2130799, Management and General Expenses: 112147, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Discounted Operations - -17966;
Form 990, Part XII, Line 2c AUDITED FINANCIAL STATEMENTS	FOR FISCAL YEAR ENDING JUNE 30, 2015, THE FINANCIAL STATEMENTS OF Alegent Health-Memorial Hospital, Schuyler ARE INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES (CHI). THE CHI FINANCE COMMITTEE OVERSEES THE INDEPENDENT AUDIT PROCESS AND SELECT THE INDEPENDENT AUDITOR TO CONDUCT THE CONSOLIDATED FINANCIAL STATEMENT AUDIT.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (184 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
ALEGENT CREIGHTON CLINIC
12809 W DODGE RD	OMAHA	NE	68154	470765154	HEALTHCARE	NE	501(c)(3	3	ACH	Yes (true)
ALEGENT CREIGHTON HEALTH
12809 W DODGE RD	OMAHA	NE	68154	470757164	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes (true)
ALEGENT CREIGHTON HEALTH FOUNDATION
12809 W DODGE RD	OMAHA	NE	68154	470648586	FUNDRAISING	NE	501(c)(3	7	ACH	Yes (true)
ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM
7500 MERCY RD	OMAHA	NE	68124	470484764	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes (true)
ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA
631 N 8TH ST	MISSOURI VALLEY	IA	51555	420776568	HEALTHCARE	IA	501(c)(3	3	CHI NEBRASKA	Yes (true)
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
6901 N 72ND ST	OMAHA	NE	68122	470376615	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes (true)
ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER
104 W 17TH ST	SCHUYLER	NE	68661	470399853	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes (true)
ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA
PO BOX 368	CORNING	IA	50841	420782518	HEALTHCARE	IA	501(c)(3	3	CHI NEBRASKA	Yes (true)
ALVERNA APARTMENTS
300 SE 8TH AVE	LITTLE FALLS	MN	56345	411351177	LTERM CARE	MN	501(c)(3	9	CHI	Yes (true)
APPLETREE COURT
601 OAK ST	BRECKENRIDGE	MN	56520	411850500	SENIOR LIVING	MN	501(c)(3	9	SFH	Yes (true)
BELLEVILLE ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	274005511	HEALTHCARE	TX	501(c)(3	3	SHSC	Yes (true)
BISHOP DRUMM RETIREMENT CENTER
1111 6TH AVE	DES MOINES	IA	50314	420725196	LTERM CARE	IA	501(c)(3	9	CHI-IA CORP	Yes (true)
BORNEMANN HEALTHCARE CORPORATION
2500 BERNVILLE RD PO BOX 316	READING	PA	19603	232187242	HEALTHCARE	PA	501(c)(3	Type I	CHI	Yes (true)
BURLESON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742759890	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes (true)
BURLESON ST JOSEPH MANOR
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742913931	HEALTHCARE	TX	501(c)(3	9	SJSC	Yes (true)
CARRINGTON HEALTH CENTER
800 N 4TH ST	CARRINGTON	ND	58421	450227311	HEALTHCARE	ND	501(c)(3	3	CHI	Yes (true)
CATHOLIC HEALTH INITIATIVES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	470617373	HEALTHCARE	CO	501(c)(3	Type I	NA	Yes (true)
CATHOLIC HEALTH INITIATIVES - COLORADO
188 INVERNESS DRIVE WEST STE 500	ENGLEWOOD	CO	80112	840405257	HEALTHCARE	CO	501(c)(3	3	CHI	Yes (true)
CATHOLIC HEALTH INITIATIVES - IOWA CORP
1111 6TH AVE	DES MOINES	IA	50314	420680448	HEALTHCARE	IA	501(c)(3	3	CHI	Yes (true)
CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
6385 CORPORATE DR STE 301	COLORADO SPRINGS	CO	80919	840902211	FUNDRAISING	CO	501(c)(3	7	CHIC	Yes (true)
CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION
6385 CORPORATE DR	COLORADO SPRINGS	CO	80919	270930004	FUNDRAISING	CO	501(c)(3	Type I	CHI	Yes (true)
CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	460992796	HEALTHCARE	CO	501(c)(3	Type I	CHINS	Yes (true)
CENTENNIAL MEDICAL GROUP INC
2700 STEWART PKWY	ROSEBURG	OR	97471	263946191	PHYSICIANS	OR	501(c)(3	9	MMC	Yes (true)
CENTRAL KANSAS MEDICAL CENTER
3515 BROADWAY	GREAT BEND	KS	67530	480543724	SURGERY CENTER	KS	501(c)(3	3	CHI	Yes (true)
CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PKWY S	FARGO	ND	58104	271966847	HEALTHCARE	MN	501(c)(3	9	CHI	Yes (true)
CHI INSTITUTE FOR RESEARCH AND INNOVATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	271050565	HEALTHCARE	CO	501(c)(3	Type I	CHI	Yes (true)
CHI KENTUCKY INC
3900 OLYMPIC BLVD STE 400	ERLANGER	KY	41018	202741651	HEALTHCARE	KY	501(c)(3	Type I	CHI	Yes (true)
CHI NATIONAL HOME CARE
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	451261716	HEALTHCARE	CO	501(c)(3	9	CHI NS	Yes (true)
CHI NATIONAL SERVICES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	452532084	HEALTHCARE	CO	501(c)(3	Type I	CHI	Yes (true)
CHI NEBRASKA
6940 O ST STE 200	LINCOLN	NE	68510	363233121	HEALTHCARE	NE	501(c)(3	Type I	CHI	Yes (true)
CHI ST JOSEPH'S CHILDREN
1516 5TH ST NW	ALBUQUERQUE	NM	87102	710897107	COMMUNITY	NM	501(c)(3	Type I	CHI	Yes (true)
CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER
6624 FANNIN ST	HOUSTON	TX	77030	741161938	HEALTHCARE	TX	501(c)(3	3	SLHS	Yes (true)
CHI ST VINCENT HOSPITAL HOT SPRINGS
300 WERNER ST	HOT SPRINGS	AR	71913	710236913	HEALTHCARE	AR	501(c)(3	3	CHISVHS	Yes (true)
CHI ST VINCENT HOT SPRINGS
300 WERNER ST	HOT SPRINGS	AR	71913	261125064	HOLDING CO	AR	501(c)(3	Type II	SVIMC	Yes (true)
CHI ST VINCENT MEDICAL GROUP HOT SPRINGS
1 MERCY LANE STE 201	HOT SPRINGS	AR	71913	261125131	HEALTHCARE	AR	501(c)(3	3	CHISVHS	Yes (true)
COMMUNITY LIMITED CARE DIALYSIS CENTER
619 OAK ST ACCOUNTING-3 W	CINCINNATI	OH	45206	237419853	HOLDING CO	OH	501(c)(2		GSH	Yes (true)
COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION
631 N 8TH ST	MISSOURI VALLEY	IA	51555	421294399	FUNDRAISING	IA	501(c)(3	Type I	AH-CMHMV	Yes (true)
CONTINUING CARE HOSPITAL
150 NORTH EAGLE CREEK DR	LEXINGTON	KY	40509	611400619	LT ACH	KY	501(c)(3	3	SJHS	Yes (true)
COVENANT HOME CARE
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	232028429	HOME HEALTH	PA	501(c)(3	Type II	CHI NHC	Yes (true)
ENUMCLAW REGIONAL HOSPITAL ASSOCIATION
1450 BATTERSBY AVE	ENUMCLAW	WA	98022	910715805	HEALTHCARE	WA	501(c)(3	3	FHS	Yes (true)
FLAGET HEALTHCARE INC
4305 NEW SHEPHERDSVILLE RD	BARDSTOWN	KY	40004	611345363	HEALTHCARE	KY	501(c)(3	3	KOH	Yes (true)
FLAGET MEMORIAL HOSPITAL FOUNDATION INC
4305 NEW SHEPHERDSVILLE RD	BARDSTOWN	KY	40004	562351341	FUNDRAISING	KY	501(c)(3	Type I	FH	Yes (true)
FRANCISCAN CARE CENTER
4111 N HOLLAND-SYLVANIA RD	TOLEDO	OH	43623	341931806	HEALTHCARE	OH	501(c)(3	9	FLC	Yes (true)
FRANCISCAN FOUNDATION
1717 SOUTH J ST	TACOMA	WA	98405	911145592	FUNDRAISING	WA	501(c)(3	9	FHS	Yes (true)
FRANCISCAN HEALTH SYSTEM
1717 SOUTH J ST	TACOMA	WA	98405	910564491	HEALTHCARE	WA	501(c)(3	3	CHI	Yes (true)
FRANCISCAN HEALTH VENTURES FKA SJMGROUP
TACOMA FNC CTR BLDG 1145 BROADWAY	TACOMA	WA	98402	431882377	PHYSICIANS	MO	501(c)(3	9	CHI	Yes (true)
FRANCISCAN LIVING COMMUNITIES
5942 RENAISSANCE PLACE STE A	TOLEDO	OH	43623	341892096	HEALTHCARE	OH	501(c)(3	Type I	SFH	Yes (true)
FRANCISCAN MEDICAL GROUP
1313 BROADWAY STE 200	TACOMA	WA	98402	911939739	HEALTHCARE	WA	501(c)(3	9	FHS	Yes (true)
FRANCISCAN VILLA OF SOUTH MILWAUKEE INC
3601 S CHICAGO AVE	SOUTH MILWAUKEE	WI	53172	391093829	HEALTHCARE	WI	501(c)(3	9	CHI	Yes (true)
GARRISON MEMORIAL HOSPITAL
407 THIRD AVENUE SOUTHEAST	GARRISON	ND	58540	450227752	HEALTHCARE	ND	501(c)(3	3	SAMC	Yes (true)
GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	201536108	MINISTRIES	CO	501(c)(3	Type I	CHI	Yes (true)
GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE
619 OAK ST ACCOUNTING-3 W	CINCINNATI	OH	45206	311778403	EDUCATION	OH	501(c)(3	2	GSH	Yes (true)
GOOD SAMARITAN FOUNDATION OF CINCINNATI INC
619 OAK ST ACCOUNTING-3 W	CINCINNATI	OH	45206	311206047	FUNDRAISING	OH	501(c)(3	Type I	GSH	Yes (true)
GOOD SAMARITAN HOSPITAL
PO BOX 1990	KEARNEY	NE	68848	470379755	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes (true)
GOOD SAMARITAN HOSPITAL FOUNDATION
111 W 31ST ST	KEARNEY	NE	68847	470659443	FUNDRAISING	NE	501(c)(3	7	GSH	Yes (true)
GOOD SAMARITAN HOSPITAL FOUNDATION - DAYTON
110 N MAIN ST STE 500	DAYTON	OH	45402	237296923	FUNDRAISING	OH	501(c)(3	7	SHP	Yes (true)
HARRISON MEDICAL CENTER
2520 CHERRY AVE	BREMERTON	WA	98310	910565546	HEALTHCARE	WA	501(c)(3	3	FHS	Yes (true)
HARRISON MEDICAL CENTER FOUNDATION
2520 CHERRY AVE	BREMERTON	WA	98310	911197626	FUNDRAISING	WA	501(c)(3	7	HMC	Yes (true)
HEALTH SET
2420 W 26TH AVE STE 460D	DENVER	CO	80211	841102943	LOW INC CARE	CO	501(c)(3	7	CHIC	Yes (true)
HEALTHCARE AND WELLNESS FOUNDATION
2400 ST FRANCIS DR	BRECKENRIDGE	MN	56520	760761782	FUNDRAISING	MN	501(c)(3	Type I	SFMC	Yes (true)
HIGHLINE MEDICAL CENTER
16251 SYLVESTER RD SW	BURIEN	WA	98166	910712166	HEALTHCARE	WA	501(c)(3	3	FHS	Yes (true)
HOUSE OF MERCY
1111 6TH AVE	DES MOINES	IA	50314	421323808	SHELTER	IA	501(c)(3	7	CHI-IA CORP	Yes (true)
JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	611029768	HEALTHCARE	KY	501(c)(3	3	KOH	Yes (true)
KENTUCKYONE HEALTH MEDICAL GROUP INC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	611352729	HEALTHCARE	KY	501(c)(3	9	JHSMH	Yes (true)
KENTUCKYONE HEALTH INC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	611029769	HEALTHCARE	KY	501(c)(3	9	CHI	Yes (true)
LAKEWOOD HEALTH CENTER
600 MAIN AVE S	BAUDETTE	MN	56623	410758434	HEALTHCARE	MN	501(c)(3	3	CHI	Yes (true)
LAKEWOOD REGIONAL HEALTHCARE FOUNDATION
600 MAIN AVE S	BAUDETTE	MN	56623	411893795	FUNDRAISING	ND	501(c)(3	7	LHC	Yes (true)
LINUS OAKES INC
2700 STEWART PKWY	ROSEBURG	OR	97471	930821381	SENIOR LIVING	OR	501(c)(3	9	MMC	Yes (true)
LISBON AREA HEALTH SERVICES
905 MAIN ST	LISBON	ND	58054	820558836	HEALTHCARE	ND	501(c)(3	3	CHI	Yes (true)
LUFKIN VISION ACQUISITIONS
PO BOX 1447	LUFKIN	TX	75901	820563768	PROPERTY MGMT	TX	501(c)(3	Type III-FI	MHSET	Yes (true)
MADISON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742761145	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes (true)
MADONNA MANOR INC
2344 AMSTERDAM ROAD	VILLA HILLS	KY	51017	610654635	LIVING ASSIST	KY	501(c)(3	1	FLC	Yes (true)
MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC
2525 DE SALES AVE	CHATTANOOGA	TN	37404	621839548	FUNDRAISING	TN	501(c)(3	7	MHCS	Yes (true)
MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVE	CHATTANOOGA	TN	37404	620532345	HEALTHCARE	TN	501(c)(3	3	CHI	Yes (true)
MEMORIAL HEALTH PARTNERS FOUNDATION INC
5600 BRAINERD RD STE 500	CHATTANOOGA	TN	37411	030417049	HEALTHCARE	TN	501(c)(3	9	MHCS	Yes (true)
MEMORIAL HEALTH SYSTEM OF EAST TEXAS
PO BOX 1447	LUFKIN	TX	75902	750755367	HEALTHCARE	TX	501(c)(3	3	CHI	Yes (true)
MEMORIAL MEDICAL CENTER - LIVINGSTON
PO BOX 1447	LUFKIN	TX	75902	760436439	HEALTHCARE	TX	501(c)(3	3	MHSET	Yes (true)
MEMORIAL MEDICAL CENTER - SAN AUGUSTINE
PO BOX 1447	LUFKIN	TX	75902	752663904	HEALTHCARE	TX	501(c)(3	3	MHSET	Yes (true)
MEMORIAL MULTISPECIALTY ASSOCIATES
1201 FRANK AVE	LUFKIN	TX	95904	752721155	PHYSICIANS	TX	501(c)(3	Type III-FI	MHSET	Yes (true)
MEMORIAL SPECIALTY HOSPITAL
PO BOX 1447	LUFKIN	TX	95902	752492741	HEALTHCARE	TX	501(c)(3	3	MHSET	Yes (true)
MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVE	DES MOINES	IA	50314	426076069	AUXILIARY	IA	501(c)(3	Type I	MF-DM IA	Yes (true)
MERCY CLINICS INC
1111 6TH AVE	DES MOINES	IA	50314	421193699	PHYSICIANS	IA	501(c)(3	9	CHI-IA CORP	Yes (true)
MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVE	DES MOINES	IA	50314	421511682	EDUCATION	IA	501(c)(3	2	CHI-IA CORP	Yes (true)
MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVE	DES MOINES	IA	50314	237358794	FUNDRAISING	IA	501(c)(3	7	CHI-IA CORP	Yes (true)
MERCY FOUNDATION INC
2700 STEWART PKWY	ROSEBURG	OR	97471	936088946	FUNDRAISING	OR	501(c)(3	7	MMC	Yes (true)
MERCY HEALTH CARE FOUNDATION
PO BOX 368	CORNING	IA	50841	421461064	FUNDRAISING	IA	501(c)(3	Type I	AHMH-Corning	Yes (true)
MERCY HEALTHCARE FOUNDATION
570 CHAUTAUQUA BLVD	VALLEY CITY	ND	58072	450435338	FUNDRAISING	ND	501(c)(3	Type I	MHVC	Yes (true)
MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DR	COUNCIL BLUFFS	IA	51503	421178204	FUNDRAISING	IA	501(c)(3	Type I	AHBMHS	Yes (true)
MERCY HOSPITAL OF DEVILS LAKE
1031 7TH ST NE	DEVILS LAKE	ND	58301	450227012	HEALTHCARE	ND	501(c)(3	3	CHI	Yes (true)
MERCY HOSPITAL OF DEVILS LAKE FOUNDATION
1031 7TH ST NE	DEVILS LAKE	ND	58301	352367360	FUNDRAISING	ND	501(c)(3	7	MHDL	Yes (true)
MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BLVD	VALLEY CITY	ND	58072	450226553	HEALTHCARE	ND	501(c)(3	3	CHI	Yes (true)
MERCY MEDICAL CENTER
1301 15TH AVE WEST	WILLISTON	ND	58801	450231183	HEALTHCARE	ND	501(c)(3	3	CHI	Yes (true)
MERCY MEDICAL CENTER - CENTERVILLE
ONE ST JOSEPHS DRIVE	CENTERVILLE	IA	52544	420680308	HEALTHCARE	IA	501(c)(3	3	CHI-IA CORP	Yes (true)
MERCY MEDICAL CENTER INC
2700 STEWART PKWY	ROSEBURG	OR	97471	930386868	HEALTHCARE	OR	501(c)(3	3	CHI	Yes (true)
MERCY MEDICAL FOUNDATION
1301 15TH AVE WEST	WILLISTON	ND	58801	450381803	FUNDRAISING	ND	501(c)(3	Type I	MMC	Yes (true)
MERCY PROFESSIONAL PRACTICE ASSOCIATES INC
1111 6TH AVE	DES MOINES	IA	50314	421470935	PHYSICIANS	IA	501(c)(3	9	CHI-IA CORP	Yes (true)
NEBRASKA HEART HOSPITAL
7500 S 91ST ST	LINCOLN	NE	68526	392031968	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes (true)
NORTH CENTRAL HEALTH CARE ALLIANCE DBA PRIMECARE HEALTH GROUP
401 N 9th St	BISMARCK	ND	585014507	450439894	HEALTHCARE	ND	501(c)(3	9	NHCA	Yes (true)
OAKES COMMUNITY HOSPITAL
1200 N 7TH ST	OAKES	ND	58474	450231675	HEALTHCARE	ND	501(c)(3	3	CHI	Yes (true)
OAKES COMMUNITY HOSPITAL FOUNDATION
1200 N 7TH ST	OAKES	ND	58474	710966606	FUNDRAISING	ND	501(c)(3	Type I	OCH	Yes (true)
PINEYWOODS MEDICAL DEVELOPMENT CORP
PO BOX 1447	LUFKIN	TX	75902	752493116	PROPERTY MGMT	TX	501(c)(3	Type III-FI	MHSET	Yes (true)
PROVIDENCE CARE CENTER
2025 HAYES AVENUE	SANDUSKY	OH	44870	341658625	HEALTHCARE	OH	501(c)(3	9	FLC	Yes (true)
PROVIDENCE CARE CENTERS
2025 HAYES AVENUE	SANDUSKY	OH	44870	341826099	HOLDING CO	OH	501(c)(3	Type II	FLC	Yes (true)
PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION
5055 PROVIDENCE DRIVE	SANDUSKY	OH	44870	341896807	LIVING COMM	OH	501(c)(3	9	FLC	Yes (true)
PUEBLO STEPUP
1925 E ORMAN AVE STE G52	PUEBLO	CO	81004	841234295	COMMUNITY	CO	501(c)(3	7	CHIC	Yes (true)
REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE
12844 MILITARY RD S	TUKWILA	WA	98168	911170040	HEALTHCARE	WA	501(c)(3	3	FHS	Yes (true)
SET OF COLORADO SPRINGS INC
2864 S CIRCLE DR STE 450	COLORADO SPRINGS	CO	80906	841183335	LTERM CARE	CO	501(c)(3	7	CHIC	Yes (true)
SAINT CLARE'S COMMUNITY CARE INC
25 POCONO RD	DENVILLE	NJ	07834	222876836	HEALTHCARE	NJ	501(c)(3	Type II	SCHS	Yes (true)
SAINT CLARE'S FOUNDATION INC
25 POCONO RD	DENVILLE	NJ	07834	222502997	FUNDRAISING	NJ	501(c)(3	7	SCHS	Yes (true)
SAINT CLARE'S HEALTH SERVICES INC
25 POCONO RD	DENVILLE	NJ	07834	223639733	MANAGEMENT	NJ	501(c)(3	Type II	CHI	Yes (true)
SAINT CLARE'S HOSPITAL INC
25 POCONO RD	DENVILLE	NJ	07834	223319886	HEALTHCARE	NJ	501(c)(3	3	SCHS	Yes (true)
SAINT ELIZABETH FOUNDATION
555 S 70TH ST	LINCOLN	NE	68510	470625523	FUNDRAISING	NE	501(c)(3	7	SERMC	Yes (true)
SAINT ELIZABETH HEALTH SERVICES
555 S 70TH ST	LINCOLN	NE	68510	363233120	HEALTHCARE	NE	501(c)(3	3	SERMC	Yes (true)
SAINT ELIZABETH REGIONAL MEDICAL CENTER
555 S 70TH ST	LINCOLN	NE	68510	470379836	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes (true)
SAINT FRANCIS MEDICAL CENTER
2620 W FAIDLEY	GRAND ISLAND	NE	68803	470376601	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes (true)
SAINT FRANCIS MEDICAL CENTER FOUNDATION
PO BOX 9804	GRAND ISLAND	NE	68802	470630267	FUNDRAISING	NE	501(c)(3	7	SFMC	Yes (true)
SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC
305 ESTILL ST	BEREA	KY	40403	260152877	FUNDRAISING	KY	501(c)(3	7	SJHS	Yes (true)
SAINT JOSEPH HEALTH SYSTEM INC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	611334601	HEALTHCARE	KY	501(c)(3	3	KOH	Yes (true)
SAINT JOSEPH HOSPITAL FOUNDATION INC
ONE SAINT JOSEPH DRIVE	LEXINGTON	KY	40504	611159649	FUNDRAISING	KY	501(c)(3	Type I	SJHS	Yes (true)
SAINT JOSEPH LONDON FOUNDATION INC
1001 SAINT JOSEPH LANE	LONDON	KY	40741	260438748	FUNDRAISING	KY	501(c)(3	7	SJHS	Yes (true)
SAINT JOSEPH MOUNT STERLING FOUNDATION INC
225 FALCON DR	MOUNT STERLING	KY	40353	272884584	FUNDRAISING	KY	501(c)(3	7	SJHS	Yes (true)
SAINT JOSEPH'S HOSPITAL FOUNDATION
30 WEST 7TH ST	DICKINSON	ND	58601	363418207	FUNDRAISING	ND	501(c)(3	Type I	SJHHC	Yes (true)
SAMARITAN BEHAVIORAL HEALTH INC
601 S EDWIN C MOSES BLVD	DAYTON	OH	45417	020633634	HEALTHCARE	OH	501(c)(3	7	SHP	Yes (true)
SAMARITAN HEALTH PARTNERS
110 N MAIN ST STE 500	DAYTON	OH	45402	311107411	HEALTHCARE	OH	501(c)(3	Type I	CHI	Yes (true)
SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC
104 W 17TH ST	SCHUYLER	NE	68661	363630014	FUNDRAISING	NE	501(c)(3	Type I	AHMHS	Yes (true)
SJRMC JOPLIN MISSOURI
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	440545809	HEALTHCARE	MO	501(c)(3	3	CHI	Yes (true)
SL AUGUSTA CORP
PO BOX 20269	HOUSTON	TX	77225	760226623	TITLE HOLDING	TX	501(c)(2		SLPC	Yes (true)
ST ALEXIUS MEDICAL CENTER
900 EAST BROADWAY AVENUE	BISMARCK	ND	58501	450226711	HEALTHCARE	ND	501(c)(3	3	CHI	Yes (true)
ST ANTHONY HOSPITAL
1601 SE COURT AVE	PENDLETON	OR	97801	930391614	HEALTHCARE	OR	501(c)(3	3	CHI	Yes (true)
ST ANTHONY HOSPITAL FOUNDATION
1601 SE COURT AVE	PENDLETON	OR	97801	930992727	FUNDRAISING	OR	501(c)(3	Type I	SAH	Yes (true)
ST ANTHONY'S HOSPITAL ASSOCIATION
FOUR HOSPITAL DR	MORRILTON	AR	72110	710245507	HEALTHCARE	AR	501(c)(3	3	SVIMC	Yes (true)
ST CATHERINE HOSPITAL
401 EAST SPRUCE ST	GARDEN CITY	KS	67846	480543721	HEALTHCARE	KS	501(c)(3	3	CHI	Yes (true)
ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION
401 EAST SPRUCE ST	GARDEN CITY	KS	67846	200598702	FUNDRAISING	KS	501(c)(3	Type I	SCH	Yes (true)
ST CLARE COMMONS
5942 RENAISSANCE PLACE STE A	TOLEDO	OH	43623	270163752	LIVING COMM	OH	501(c)(3	9	FLC	Yes (true)
ST DOMINIC OF ONTARIO OREGON
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	930433692	HEALTHCARE	OR	501(c)(4		CHI	Yes (true)
ST FRANCIS HOME
2400 ST FRANCIS DR	BRECKENRIDGE	MN	56520	410729978	LTERM CARE	MN	501(c)(3	9	CHI	Yes (true)
ST FRANCIS LIFE CARE CORPORATION
19 POCONO RD	DENVILLE	NJ	07834	222536017	ELDERLY CARE	NJ	501(c)(3	9	SCHS	Yes (true)
ST FRANCIS MEDICAL CENTER
2400 ST FRANCIS DR	BRECKENRIDGE	MN	56520	410695598	HEALTHCARE	MN	501(c)(3	3	CHI	Yes (true)
ST FRANCIS OF BAKER CITY
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	930412495	HEALTHCARE	OR	501(c)(3	3	CHI	Yes (true)
ST JOSEPH FOUNDATION OF BRYAN TEXAS
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742351158	FUNDRAISING	TX	501(c)(3	Type I	SJSC	Yes (true)
ST JOSEPH HEALTH MINISTRIES
1929 LINCOLN HWY E STE 150	LANCASTER	PA	17602	232342997	HEALTHCARE	PA	501(c)(3	Type I	CHI	Yes (true)
ST JOSEPH MANOR
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742847594	HEALTHCARE	TX	501(c)(3	9	SJSC	Yes (true)
ST JOSEPH MEDICAL CENTER FOUNDATION
2500 BERNVILLE RD PO BOX 316	READING	PA	19603	232649362	FUNDRAISING	PA	501(c)(3	Type I	SJRHN	Yes (true)
ST JOSEPH MEDICAL CENTER INC
201 INTERNATIONAL CIRCLE STE 212	HUNT VALLEY	MD	21030	520591461	HEALTHCARE	MD	501(c)(3	3	CHI	Yes (true)
ST JOSEPH MEDICAL GROUP
2500 BERNVILLE RD PO BOX 316	READING	PA	19603	208544021	HEALTHCARE	PA	501(c)(3	9	BHC	Yes (true)
ST JOSEPH PHYSICIAN ASSOCIATES
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	203159302	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes (true)
ST JOSEPH PHYSICIAN ENTERPRISE INC
201 INTERNATIONAL CIRCLE STE 212	HUNT VALLEY	MD	21030	521311775	PHYSICIANS	MD	501(c)(3	Type I	SJMC	Yes (true)
ST JOSEPH REGIONAL HEALTH CENTER
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	741282696	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes (true)
ST JOSEPH REGIONAL HEALTH NETWORK
2500 BERNVILLE RD PO BOX 316	READING	PA	19603	231352211	HEALTHCARE	PA	501(c)(3	3	CHI	Yes (true)
ST JOSEPH REGIONAL HEALTH PARTNERS
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	454088170	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes (true)
ST JOSEPH REGIONAL HEALTH PARTNERS ACO
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	463265423	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes (true)
ST JOSEPH SERVICES CORPORATION
2801 FRANCISCAN DRIVE	BRYAN	TX	77802	742455161	MANAGEMENT	TX	501(c)(3	Type I	SFH	Yes (true)
ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVE	PARK RAPIDS	MN	56470	410695603	HEALTHCARE	MN	501(c)(3	3	CHI	Yes (true)
ST JOSEPH'S HOSPITAL AND HEALTH CENTER
30 WEST 7TH ST	DICKINSON	ND	58601	450226429	HEALTHCARE	ND	501(c)(3	3	CHI	Yes (true)
ST LEONARD
8100 CLYO ROAD	CENTERVILLE	OH	45458	341940863	LIVING COMM	OH	501(c)(3	9	FLC	Yes (true)
ST LEONARD FOUNDATION
8100 CLYO ROAD	CENTERVILLE	OH	45458	320102715	FUNDRAISING	OH	501(c)(3	7	SLEO	Yes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	260274448	MANAGEMENT	TX	501(c)(3	Type I	SLHS	Yes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	273733278	HEALTHCARE	TX	501(c)(3	3	SLCDC	Yes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	261947374	HEALTHCARE	TX	501(c)(3	3	SLHS	Yes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	260335902	HEALTHCARE	TX	501(c)(3	3	SLCDC	Yes (true)
ST LUKE'S COMMUNITY HEALTH SERVICES
6624 FANNIN ST STE 1100	HOUSTON	TX	77030	760536234	HEALTHCARE	TX	501(c)(3	3	SLHS	Yes (true)
ST LUKE'S FOUNDATION
1213 HERMANN DRIVE STE 855	HOUSTON	TX	77004	453811485	FUNDRAISING	TX	501(c)(3	7	SLHS	Yes (true)
ST LUKE'S HEALTH SYSTEM CORPORATION
6624 FANNIN ST STE 1100	HOUSTON	TX	77030	760536232	MANAGEMENT	TX	501(c)(3	Type I	CHI	Yes (true)
ST LUKE'S HOSPITAL AT THE VINTAGE
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	263734606	HEALTHCARE	TX	501(c)(3	3	SLHS	Yes (true)
ST LUKE'S MEDICAL GROUP
6624 FANNIN ST	HOUSTON	TX	77030	760458535	PHYSICIANS	TX	501(c)(3	3	SLHS	Yes (true)
ST LUKE'S MEDICAL TOWER CORPORATION
6624 FANNIN ST STE 1100	HOUSTON	TX	77030	760531713	PROPERTY MGMT	TX	501(c)(3	Type I	CHI-SLH	Yes (true)
ST LUKE'S PROPERTIES CORPORATION
6624 FANNIN ST STE 1100	HOUSTON	TX	77030	760531716	PROPERTY MGMT	TX	501(c)(3	Type I	SLHS	Yes (true)
ST LUKE'S SUGAR LAND PROPERTIES CORPORATION
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	454120549	PROPERTY MGMT	TX	501(c)(3	Type I	SLCDC-SL	Yes (true)
ST MARY'S COMMUNITY HOSPITAL
1314 3RD AVE	NEBRASKA CITY	NE	68410	470443636	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes (true)
ST MARY'S HOSPITAL FOUNDATION
1314 3RD AVE	NEBRASKA CITY	NE	68410	470707604	FUNDRAISING	NE	501(c)(3	7	SMCH	Yes (true)
ST VINCENT FOUNDATION
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	510169537	FUNDRAISING	AR	501(c)(3	Type I	SVIMC	Yes (true)
ST VINCENT INFIRMARY MEDICAL CENTER
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	710236917	HEALTHCARE	AR	501(c)(3	3	CHI	Yes (true)
ST VINCENT MEDICAL GROUP
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	710830696	HEALTHCARE	AR	501(c)(3	9	SVIMC	Yes (true)
SYLVANIA FRANCISCAN HEALTH
1715 INDIAN WOOD CIR 200	MAUMEE	OH	43537	341412964	HEALTHCARE	OH	501(c)(3	Type I	CHI	Yes (true)
SYLVANIA FRANCISCAN HEALTH FOUNDATION
1715 INDIAN WOOD CIR 200	MAUMEE	OH	43537	455357161	FUNDRAISING	OH	501(c)(3	Type I	FLC	Yes (true)
THE COMMONS OF PROVIDENCE
5000 PROVIDENCE DRIVE	SANDUSKY	OH	44870	341826097	ASSIST LIVING	OH	501(c)(3	9	FLC	Yes (true)
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH
619 OAK ST ACCOUNTING-3 W	CINCINNATI	OH	45206	310537486	HEALTHCARE	OH	501(c)(3	3	CHI	Yes (true)
THE PHYSICIAN NETWORK
2000 Q ST STE 500	LINCOLN	NE	68503	470780857	PHYSICIANS	NE	501(c)(3	Type I	CHI NEBRASKA	Yes (true)
TOTAL HEALTHCARE
188 INVERNESS DRIVE WEST STE 500	ENGLEWOOD	CO	80112	840927232	HEALTHCARE	CO	501(c)(3	3	CHIC	Yes (true)
TRINITY HOSPITAL TWIN CITY
819 NORTH FIRST STREET	DENNISON	OH	44621	275401105	HEALTHCARE	OH	501(c)(3	3	SFH	Yes (true)
UNITY FAMILY HEALTHCARE
815 SE 2ND ST	LITTLE FALLS	MN	56345	410721642	HEALTHCARE	MN	501(c)(3	3	CHI	Yes (true)
VILLA NAZARETH INC
801 PAGE DR	FARGO	ND	58103	450226714	LTERM CARE	ND	501(c)(3	9	CHI	Yes (true)
VISITING NURSE ASSOCIATION OF ST CLARE'S INC
191 WOODPORT RD	SPARTA	NJ	07871	221768334	HOME HEALTH	NJ	501(c)(3	9	SCHS	Yes (true)
WOODLANDS DOCTOR GROUP
17200 ST LUKES WAY STE 170	THE WOODLANDS	TX	77384	274499340	PHYSICIANS	TX	501(c)(3	9	SLCHS	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (41 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	UBI Code VUBICodeVAmt	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
Alegent Health Northwest Imaging Center LLC
3606 N 156th St	OMAHA	NE	68116	061786985	OP Diagnostics	NE	ACH	Related	-$147,872	$429,431	false	$0	Yes (true)	0.51
Audubon Ambulatory Surgery Center LLC
3030 North Circle Dr	COLORADO SPRINGS	CO	80909	841482638	AMBUL SURG CTR	CO	CHIC	Related	$3,069,333	$3,517,273	false	$0	Yes (true)	0.561
Audubon Land Company LLC
5390 N Academy Blvd STE 300	COLORADO SPRINGS	CO	80918	841513085	Real Estate	CO	CHIC	Related	$116,620	$10,842,022	false	$0	false	0.694
AVANTAS LLC
11128 JOHN GALT BLVD STE 400	OMAHA	NE	68137	392045003	Staffing of Nurses	NE	AHBMHS	Related	$270,464	$4,883,491	false	-$449,169	false	0.95
BERGAN MERCY SURGERY CENTER LLC
7710 Mercy Rd Ste 200	OMAHA	NE	68124	208671994	AMBUL SURG CTR	NE	ACH	Related	$262,283	$2,676,707	false	$0	false	0.6357
BERYWOOD OFFICE PROPERTIES LLC
400 BERYWOOD TRAIL	CLEVELAND	TN	37312	621875199	PHYS OFFICE	TN	MHCS	Related	$77,646	$976,529	false	$0	Yes (true)	0.63
BLUEGRASS REGIONAL IMAGING CENTER
1218 SOUTH BROADWAY STE 310	LEXINGTON	KY	40504	611386736	DIAGNOSTIC IMAGING	KY	SJHS	Related	$216,144	$3,219,211	false	$0	false	0.65
CATHOLIC HEALTH INITIATIVES PHYSICIAN SERVICES LLC
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	462945938	PRACTICE MGMT SRVC	DE	CHI	Related	-$572,398	$4,681,573	false	$0	Yes (true)	0.8
CENTRAL NEBRASKA HOME CARE SERVICES
PO BOX 1146 4502 N SECOND AVE	KEARNEY	NE	68848	470692112	HEALTHCARE SRVC	NE	na	Related	-$49,959	$152,789	false	-$22,980	Yes (true)	1
CENTRAL NEBRASKA REHABILITATION SERVICES LLC
3004 W FAIDLEY AVENUE	GRAND ISLAND	NE	68803	810653461	Physical Therapy	NE	SFMC	Related	$2,441,607	$3,412,341	false	$0	false	0.51
CHI OPERATING INVESTMENT PROGRAM LP
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	470727942	INVESTMENTS	CO	CHI	Unrelated	$0	$0	false	$0	Yes (true)	1
CHICAMSURG Surgery Centers LLC
188 INVERNESS DRIVE WEST 500	ENGLEWOOD	CO	80112	465683027	SURGERY CENTER	CO	CHIC	Related	$0	$0	false	$0	false	0.51
CHICLARKIN VENTURES LLC
188 INVERNESS DRIVE WEST 500	ENGLEWOOD	CO	80112	474210888	URGENT CARE	CO	CHIC	Related	$0	$0	false	$0	Yes (true)	0.87
Colorado Springs CK Leasing LLC
8770 W Bryn Mawr Ste 1370	CHICAGO	IL	60631	262982714	REAL ESTATE	CO	CHI	Related	$120,659	$1,039,682	false	$0	Yes (true)	0.66
HC SL VINTAGE I LLC
18000 W SARAH LANE STE 250	BROOKFIELD	WI	53045	270453767	PROPERTY HOLDING	WI	SL HOSP-VINTAGE	Related	$1,365,254	$55,596,761	false	$0	false	0.51
HEALTHCARE SUPPORT SERVICES LLC
PO BOX 9804	GRAND ISLAND	NE	68802	721546196	LAUNDRY	NE	na	Related	$317,516	$3,231,655	false	$98,557	false	1
Heartland Oncology LLC
2337 E Crawford St	Salina	KS	67401	464265403	ONCOLOGY	KS	SCH	Related	$0	$0	false	$0	false	0.51
HIGHLINE IMAGING LLC
PO BOX 184	BRUSH PRAIRIE	WA	98606	200460005	DIAGNOSTIC IMAGING	WA	HMC	Related	$65,074	$1,408,012	false	$0	false	0.8
LAKESIDE AMBULATORY SURGICAL CENTER LLC
17031 LAKESIDE HILLS DR	OMAHA	NE	68130	204267902	AMBUL SURG CTR	NE	ACH	Related	$3,533,817	$1,380,299	false	$0	false	0.5393
LAKESIDE ENDOSCOPY CENTER LLC
17001 LAKESIDE HILLS PLZ STE 201	OMAHA	NE	68130	205544496	ENDOSCOPY SRVC	NE	ACH	Related	$1,590,148	$895,940	false	$0	false	0.5096
LINCOLN CK LEASING LLC
6003 Old Cheney Rd	Lincoln	NE	68516	262496856	Real Estate	NE	SERMC	Related	$488,450	$230,998	false	$0	false	0.5376
NEBRASKA SPINE HOSPITAL LLC
6901 N 72ND ST	OMAHA	NE	68122	270263191	SPINE HOSPITAL	NE	ACH	Related	$13,895,341	$16,839,322	false	$0	false	0.51
NORTH RIVER SURGERY CENTER LLC
2209 WILDWOOD AVE	SHERWOOD	AR	72120	710799771	AMBUL SURG CTR	AR	SVIMC	Related	$141,898	$0	false	$0	false	0.5745
ORTHOCOLORADO LLC
11650 WEST 2ND PLACE	LAKEWOOD	CO	80255	371577105	ORTHO HOSPITAL	CO	THC	Related	$9,103,000	$2,202,895	false	$0	false	0.6
PENINSULA RADIATION ONCOLOGY LLC
314 MLK JR WAY STE 11	TACOMA	WA	98405	870808610	HEALTHCARE SRVC	WA	FHS	Related	$278,198	$2,753,330	false	$0	false	0.6
Penrad Imaging
1390 Kelly Johnson Blvd	COLORADO SPRINGS	CO	80920	841072619	Medical Imaging	CO	CHIC	Related	-$9,742	$2,091,440	false	$0	false	0.7
PMC HOSPITAL LLC
3100 MAIN ST STE 500	HOUSTON	TX	77002	273280598	HOSPITAL	TX	SL CDC-PMC	Related	$5,287,747	$67,411,280	false	$0	Yes (true)	0.51
PRAIRIE HEALTH VENTURES LLC
421 S 9TH ST STE 102	LINCOLN	NE	68508	204962103	TECH SRVC	NE	AH-IMC	Related	$0	$0	false	$0	Yes (true)	0.6575
Pueblo Ambulatory Surgery Center LLC
188 INVERNESS DRIVE WEST 500	ENGLEWOOD	CO	80112	621488737	SURGERY CENTER	CO	CHIC	Related	$0	$0	false	$0	false	0.51
Saint JOSEPH - PAML LLC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	452116736	MGMT SVCS	KY	SJHS	Related	$60,881	$406,070	false	$0	Yes (true)	0.625
SAINT JOSEPH - SCA HOLDINGS LLC
1451 Harrodsburg RD	LEXINGTON	KY	40503	453801157	OP SURGERY	DE	SJHS	Related	$0	$0	false	$0	Yes (true)	0.51
SAINT JOSEPH-ANC HOME CARE SERVICES
1700 EDISON DR	MILFORD	OH	45150	263330545	HOME HEALTH	KY	JHSMH	Related	$7,722,504	$1,056,144	false	$0	false	1
SCA Premier Surgery Center of Louisville LLC
200 Abraham Flexner Way	LOUISVILLE	KY	40202	721386840	SURGERY CENTER	KY	JHSMH	Related	-$177,796	$2,205,015	false	$0	false	0.51
ST FRANCIS LAND COMPANY
5390 N ACADEMY BLVD STE 300	COLORADO SPRINGS	CO	80918	263134100	REAL ESTATE	CO	CHIC	Related	-$217,802	$12,693,252	false	$0	false	0.51
ST FRANCIS MEDICAL CENTER ASSOCIATES
1717 SOUTH J ST	TACOMA	WA	98405	911352698	MED OFFICE	WA	FHS	Related	$265,783	$1,961,020	false	$0	false	0.6108
ST LUKE'S DIAGNOSTIC CATH LAB LLP
6624 FANNIN ST STE 800	HOUSTON	TX	77030	710959365	DIAGNOSTICS	TX	SLHS HOLDINGS	Related	$611,532	$1,117,217	false	$0	false	0.6145
ST LUKE'S LAKESIDE HOSPITAL LLC
6624 FANNIN STE 2505	HOUSTON	TX	77030	300427437	HOSPITAL	TX	SL CDC-W	Related	$277,867	$42,485,184	false	$0	Yes (true)	0.51
ST LUKE'S THE WOODLANDS SLEEP CENTER LLC
6624 FANNIN STE 800	HOUSTON	TX	77030	462795726	DIAGNOSTICS	TX	SLHSH	Related	-$76,879	$1,171,971	false	$0	Yes (true)	0.51
Superior Medical Imaging LLC
5000 North 26th ST	LINCOLN	NE	68521	262884555	OP Diagnostics	NE	SERMC	Related	$0	$0	false	$0	Yes (true)	0.51
SURGERY CENTER OF LEXINGTON LLC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	621179539	SURGERY CENTER	KY	SJHS	Related	$187,315	$2,777,419	false	$0	Yes (true)	0.51
SURGERY CENTER OF LOUISVILLE LLC
200 Abraham Flexner Way	LOUISVILLE	KY	40202	621179537	SURGERY CENTER	KY	JHSMH	Related	$11,207	$803,899	false	$0	Yes (true)	0.51

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (62 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line2RelatedOrganizationName/BusinessNameLine2Txt
Alegent HealthCreighton St Joseph Managed Care Services Inc
12809 West Dodge Rd	Omaha	NE	68154	470802396	Managed Care	NE	CHI Nebraska	C Corporation	-$3,506,547	$6,404,877	1	Yes (true)
All Saints Insurance Company SPC Ltd
					Insurance		CHI	C Corporation	$0	$0	1	Yes (true)	PO BOX 10073 APO	Georgetown	GRAND CAYMAN	CJ	KY11001	CJ
ALLIANCE HEALTH PROVIDERS OF BRAZOS
2801 FRACNISCAN DRIVE	BRYAN	TX	77802	742466914	Healthcare	TX	SJSC	C Corporation	$204,115	$535,165	1	Yes (true)
Alternative Insurance Management Service Inc
3900 OLYMPIC BLVD STE 400	Erlanger	KY	41018	841112049	Management Services	CO	CHI	C Corporation	$7,902	$6,274,993	1	Yes (true)
AMERICAN NURSING CARE Inc
1700 EDISON DR	MILFORD	OH	45150	311085414	HOME HEALTH	OH	CHS	C Corporation	$0	$0	1	Yes (true)
AMERIMED INC
1700 EDISON DR	MILFORD	OH	45150	311158699	HOME HEALTH	OH	ANC	C Corporation	$0	$0	1	Yes (true)
BC HOLDING COMPANY INC
1850 BLUEGRASS AVE	LOUISVILLE	KY	40215	311542851	Fitness Club	KY	JHSMH	C Corporation	$0	$0	1	Yes (true)
Caduceus Medical Associates INC
5600 Brainerd Road Ste 500	Chattanooga	TN	37411	621570736	Healthcare	TN	MHCS	C Corporation	$0	$1,008	1	Yes (true)
Captive Management Initiatives Ltd
				980663022	Captive Management		CHI	C Corporation	$38,500	$164,455	1	Yes (true)	PO BOX 10073 APO	Georgetown	GRAND CAYMAN	CJ	KY11001	CJ
Carmona-DeSoto Building Horizontal Property Regime Inc
300 Werner St	Hot Springs	AR	71913	710771076	Healthcare	AR	CHI-SVHS	C Corporation	$0	$0	1	Yes (true)
Catholic Health Initiatives Center for Translational Research
198 INVERNESS DRIVE WEST	Englewood	CO	80112	272269511	Research	CO	CIRI	Trust	$207	$1,241,259	1	Yes (true)
CGH REALTY COMPANY INC
2500 Bernville Rd	Reading	PA	19603	232326801	Real Estate	PA	SJHM	C Corporation	$9,432	$57,096	1	Yes (true)
CHI St Luke's Health Baylor College of Medicine Medical Center Condominium
6624 Fannin STE 1100	Houston	TX	77030	465079545	Condo Assoc	TX	CHI-SLHBCM	C Corporation	$0	$0	1	Yes (true)							Assoc
ClearRiver Health
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464495960	Insurance	TN	PHPSI	C Corporation	$36,560	$6,936,559	1	Yes (true)
Comcare Services Inc
5570 DTC Parkway	Englewood	CO	80111	840904813	Inactive	CO	CHIC	C Corporation	$0	$0	1	Yes (true)
CONSOLIDATED HEALTH SERVICES
1700 EDISON DR	MILFORD	OH	45150	311378212	HOME HEALTH	OH	CHI	C Corporation	$0	$0	1	Yes (true)
Des Moines Medical Center Inc
1111 6TH AVE	Des Moines	IA	50314	420837382	Real Estate	IA	CHI-IA Corp	C Corporation	$66,600	$1,084,162	0.9298	Yes (true)
East Texas Clinical Services Inc
2801 Via Fortuna 500	Austin	TX	78746	454736213	Healthcare	TX	MHSET	C Corporation	$0	$16,782	1	Yes (true)
First Initiatives Insurance LTD
				980203038	Insurance		CHI	C Corporation	$0	$0	1	Yes (true)	PO BOX 10073 APO	Georgetown	GRAND CAYMAN	CJ	KY11001	CJ
Franciscan Services Inc
198 INVERNESS DRIVE WEST	Englewood	CO	80112	232487967	Healthcare	CO	CHI	C Corporation	$0	$11,732,007	1	Yes (true)
Good Samaritan Outreach Services
PO Box 1990	Kearney	NE	68848	470659440	Medical Clinic	NE	CHI Nebraska	C Corporation	$0	$0	1	Yes (true)
Health Systems Enterprises Inc
1700 EDISON DR	MILFORD	OH	45150	470664558	MGMT	NE	GSH	C Corporation	$117,378	$1,101,845	1	Yes (true)
Healthcare MGMT Services Organization INC
1149 MARKET ST	Tacoma	WA	98402	911865474	Health Org.	WA	FHS	C Corporation	$0	$0	1	Yes (true)
HeartlandPlains Health
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464368223	Insurance	NE	PHPSI	C Corporation	$16,717	$3,317,219	1	Yes (true)
Highline Medical Group
15811 AMBUAN Blvd SW STE A	Burien	WA	98166	911407026	Medical Services	WA	HMC	C Corporation	$4,004,636	$7,896,793	1	Yes (true)
Medquest
1301 15TH AVENUE WEST	Williston	ND	58801	450392137	Sale of DME	ND	MMC Williston	C Corporation	$680,617	$2,138,655	1	Yes (true)
Mercy Park Apartments LTD
1111 6th AVE	Des Moines	IA	50314	421202422	Housing	IA	CHI-IA Corp	C Corporation	$1,871,589	$2,272,598	1	Yes (true)
Mercy Services Corp
2700 STEWART PARKWAY	Roseburg	OR	97471	930824308	Retail Sales	OR	MMC	C Corporation	$2,365,469	$1,363,682	1	Yes (true)
MHI Clinical Services
1201 W Frank Ave	Lufkin	TX	75904	461967952	Healthcare	TX	MHSET	C Corporation	$0	$0	1	Yes (true)
Mountain Management Services Inc
6028 Shallowford Rd	Chattanooga	TN	37421	621570739	MGMT SVC ORG	TN	MHCS	C Corporation	$30,454,753	$7,395,265	1	Yes (true)
Nazareth Assurance Company
				030304831	Insurance		CHI	C Corporation	$0	$0	1	Yes (true)	PO BOX 10073 APO	Georgetown	GRAND CAYMAN	CJ	KY11001	CJ
PATIENT TRANSPORT SERVICES INC
1700 EDISON DR	MILFORD	OH	45150	311100798	HOME HEALTH	OH	ANC	C Corporation	$0	$0	1	Yes (true)
PhysicianHealth System Network
1149 MARKET ST	Tacoma	WA	98402	911746721	Health Org.	WA	FHS	C Corporation	$0	$0	1	Yes (true)
Prominence Health Plan Services Inc (fka CollabHealth Plan Services Inc)
198 INVERNESS DRIVE WEST	Englewood	CO	80112	461224037	Admin Services	CO	PHI	C Corporation	$5,403,442	$38,272,607	1	Yes (true)
Prominence Health Inc (fka CollabHealth Managed Solutions Inc)
198 INVERNESS DRIVE WEST	Englewood	CO	80112	461222808	Holding Co	CO	CHI	C Corporation	$0	$23,806,707	1	Yes (true)
QCA Health Plan Inc
12615 Chenal Parkway STE 300	Little Rock	AR	72211	710794605	Insurance	AR	QCHI	C Corporation	$0	$64,017,278	1	Yes (true)
QualChoice Holdings Inc
12615 Chenal Parkway STE 300	Little Rock	AR	72211	274075520	Holding Co	AR	PHPS	C Corporation	$0	$10,190	1	Yes (true)
QualChoice Life and Health Insurance Company Inc
12615 Chenal Parkway STE 300	Little Rock	AR	72211	710386640	Insurance	AR	QCH	C Corporation	$0	$7,484,480	1	Yes (true)
RiverLink Health
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464380824	Insurance	OH	PHPS	C Corporation	$18,330	$3,418,330	1	Yes (true)
RiverLink Health of Kentucky Inc
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464828332	Insurance	KY	PHPS	C Corporation	$28,342	$5,528,676	1	Yes (true)
Saint Clare's Primary Care Inc
66 FORD RD	Denville	NJ	07834	222441202	Billing Services	NJ	SCCC	C Corporation	$1,080,457	$1,584,958	1	Yes (true)
SAMARITAN FAMILY CARE INC
40 W FOURTH ST STE 1700	Dayton	OH	45402	311299450	Healthcare	OH	SHP	C Corporation	$0	$0	1	Yes (true)
SFH ASSURANCE LTD
				981056892	Insurance		SFH	C Corporation	$0	$0	1	Yes (true)	PO BOX 10073 APO	Georgetown	GRAND CAYMAN	CJ	KY11001	CJ
SJH Services Corporation
198 INVERNESS DRIVE WEST	Englewood	CO	80112	232307408	Healthcare	CO	FSI	C Corporation	$0	$0	1	Yes (true)
SJL PHYSICIAN MANAGEMENT SERVICES INC
200 Abraham Flexner Way	Louisville	KY	40202	270164198	Mgmt	KY	SJHS	C Corporation	$51,739	$0	1	Yes (true)
SLMT Parking Inc
6624 Fannin STE 800	Houston	TX	77030	760637140	Parking	TX	SLHS	C Corporation	$3,907,811	$14,848,162	1	Yes (true)
SoundPath Health Inc
32129 Weyerhaeuser Way S STE 201	Federal Way	WA	98001	421720801	Insurance	WA	PHPS	C Corporation	$152,264,069	$31,407,675	1	Yes (true)
St Alexius Health Services Inc
900 East Broadway Avenue	Bismarck	ND	58501	450402812	Healthcare	ND	SAMC	C Corporation	$0	$1,263	1	Yes (true)
St Anthony Development Company
1415 Southgate	Pendleton	OR	97801	931216943	Athletic Club	OR	SAH	C Corporation	$1,570,570	$2,201,473	1	Yes (true)
St Joseph Development Company Inc
1717 SOUTH J ST	Tacoma	WA	98405	911480569	Rental	WA	FSI	C Corporation	$0	$0	1	Yes (true)
ST JOSEPH OFFICE PARK ASSOCIATION
1451 HARRODSBURG RD STE D202	Lexington	KY	40504	611079899	Mgmt	KY	SJHS	C Corporation	$0	$0	0.85	Yes (true)
St Luke's 6620 Main Condominium Association
6624 Fannin STE 1100	Houston	TX	77030	300355517	Condo Assoc	TX	SLPC	C Corporation	$0	$0	1	Yes (true)
St Luke's Anesthesiology Associates
6624 Fannin STE 1100	Houston	TX	77030	461517163	Medical Clinic	TX	CHI-SLH	C Corporation	$4,178,843	$2,295,469	1	Yes (true)
St Luke's Episcopal Hospital Physician Hospital Organization Inc
6720 Bertner MC4-262	Houston	TX	77030	760377932	PHO	TX	CHI-SLH	C Corporation	$550,615	$0	0.6	Yes (true)
St Luke's Health System Holdings Inc (fka SLEHS Holdings Inc)
6624 Fannin STE 800	Houston	TX	77030	760637138	Holding Co	TX	SLHS	C Corporation	$1,919,866	$25,724,802	1	Yes (true)
St Luke's Medical Arts Center I Condominium Association
6624 Fannin STE 1100	Houston	TX	77030	300355518	Condo Assoc	TX	SLPC	C Corporation	$0	$0	1	Yes (true)
St Luke's Medical Tower Condominium Association
6624 Fannin STE 1100	Houston	TX	77030	760298751	Condo Assoc	TX	SLMTC	C Corporation	$0	$0	1	Yes (true)
St Vincent Community Health Services Inc
TWO ST VINCENT CIRCLE	Little Rock	AR	72205	710710785	Healthcare	AR	SVIMC	C Corporation	$4,570,363	$16,185,431	1	Yes (true)
StableView Health Inc
198 INVERNESS DRIVE WEST	Englewood	CO	80112	464373713	Insurance	KY	PHPS	C Corporation	$28,342	$5,528,676	1	Yes (true)
Sugar Land Doctor Group
1317 Lake Point Parkway	Sugar Land	TX	77478	454270163	Medical Clinic	TX	SLCDC-SL	C Corporation	$788,883	$991,134	1	Yes (true)
The Texas Heart Institute at St Luke's Episcopal Hospital Denton A Cooley B
6624 Fannin STE 1100	Houston	TX	77030	900064009	Condo Assoc	TX	CHI-SLH	C Corporation	$0	$0	1	Yes (true)							uilding Comdominium Association
Towson Management Inc
7601 OSLER DR	Towson	MD	21204	521710750	Mgmt Services	MD	FSI	C Corporation	$0	$0	1	Yes (true)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd