ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IOWA: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IOWA (EIN 42-0776568)
Tax period: 2013-07-01 to 2014-06-30
Filed: 2015-05-14
IRS object ID: 201521349349304592
Schema version: 2013v4.0
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	2015-05-14T15:02:27-05:00	ReturnTs
Tax Period End	2014-06-30	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	BusinessNameLine1

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	12809 WEST DODGE ROAD	AddressLine1
City	OMAHA	City
State	NE	State
ZIP Code	68154	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	420776568	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEYIOWA	BusinessNameLine1

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	631 N 8TH ST	AddressLine1
City	MISSOURI VALLEY	City
State	IA	State
ZIP Code	515551102	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JEANETTE WOJTALEWICZ	PersonNm
Person Title	CFO	PersonTitleTxt
Signature	2015-05-13	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	ANGELA LEA	PreparerPersonNm
PTIN	P01051055	PTIN
Phone	4023434323	PhoneNum

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Address PrincipalOfcrBusinessAddress

Field	Value	IRS element (for citing)
Business Name Line1	CLIFF A ROBERTSON	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	12809 WEST DODGE ROAD	AddressLine1
City	OMAHA	City
State	NE	State
ZIP Code	68154	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$22,892,117	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	1955	FormationYr
Legal Domicile State	IA	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	11	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	199	TotalEmployeeCnt
Total Volunteers	17	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$649,530	PYContributionsGrantsAmt
CY Contributions Grants	$40,175	CYContributionsGrantsAmt
PY Program Service Revenue	$23,802,810	PYProgramServiceRevenueAmt
CY Program Service Revenue	$22,648,307	CYProgramServiceRevenueAmt
PY Investment Income	$143,331	PYInvestmentIncomeAmt
CY Investment Income	$119,521	CYInvestmentIncomeAmt
PY Other Revenue	$45,612	PYOtherRevenueAmt
CY Other Revenue	$76,323	CYOtherRevenueAmt
PY Total Revenue	$24,641,283	PYTotalRevenueAmt
CY Total Revenue	$22,884,326	CYTotalRevenueAmt
PY Grants And Similar Paid	$682,647	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$948,591	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$13,527,663	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$12,983,981	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$9,521,182	PYOtherExpensesAmt
CY Other Expenses	$8,377,515	CYOtherExpensesAmt
PY Total Expenses	$23,731,492	PYTotalExpensesAmt
CY Total Expenses	$22,310,087	CYTotalExpensesAmt
PY Revenues Less Expenses	$909,791	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$574,239	CYRevenuesLessExpensesAmt
Total Assets BOY	$30,068,486	TotalAssetsBOYAmt
Total Assets EOY	$30,010,683	TotalAssetsEOYAmt
Total Liabilities BOY	$4,112,530	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$3,521,023	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$25,955,956	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$26,489,660	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	$10,842,588	ExpenseAmt
Grant	$481,075	GrantAmt
Revenue	$11,486,007	RevenueAmt
Desc	ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IS PROUD TO OFFER DIAGNOSTIC IMAGING SERVICES - CLOSE TO HOME - WITHIN THE COMMUNITY. THE DIAGNOSTIC IMAGING SERVICES PROVIDED INCLUDE THE FOLLOWING: CT SCANS, MRI AND NUCLEAR MEDICINE IN ADDITION TO GENERAL RADIOLOGY, MAMMOGRAPHY, SURGICAL RADIOGRAPHY AND ULTRASOUND.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$3,039,191	ExpenseAmt
Grant	$134,846	GrantAmt
Revenue	$3,219,542	RevenueAmt
Desc	ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL PROVIDES A VARIETY OF SPECIALTY CLINICS LOCATED IN THE FOLLOWING CITIES: MISSOURI VALLEY, LOGAN, WOODBINE AND DUNLAP. THE FOCUS OF EACH SPECIALTY CLINIC AREAS ARE THE FOLLOWING: CARDIOLOGY NON-INVASIVE STUDIES, EAR, NOSE AND THROAT, GASTROENTEROLOGY INCLUDING VIDEOSCOPE EQUIPMENT, GENERAL SURGERY/WOUND CARE, EDICAL/SURGICAL CONSULTATION, OB/GYN, ONCOLOGY, OPHTHALMOLOGY, ORTHOPAEDICS, PAIN MANAGEMENT, PODIATRY AND UROLOGY. THE HOSPITAL HEALTH CLINICS IN THE SMALL VILLAGES OF LOGAN, WOODBINE AND DUNLAP, IOWA ARE A TREMENDOUS BENEFIT TO THOSE COMMUNITIES, WHICH SERVE A DISPROPORTIONATELY LARGE ELDERLY AND RURAL POPULATION, AND ARE PROVIDED AS A CONVENIENCE TO THESE COMMUNITIES WHICH WOULD OTHERWISE HAVE NO CLOSE ACCESS TO MEDICAL SERVICES.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$1,526,259	ExpenseAmt
Grant	$67,719	GrantAmt
Revenue	$1,616,830	RevenueAmt
Desc	AS A COMMUNITY HOSPITAL, ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY HAS STAYED COMMITTED TO KEEPING RESIDENTS OF HARRISON COUNTY IN GOOD HEALTH. THROUGH THE YEARS, ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL HAS STRIVED TO IMPROVE THE HEALTH STATUS OF SOUTHWEST IOWA RESIDENT CHILDREN, TEENS, ADULTS, SENIOR CITIZENS, FRIENDS AND NEIGHBORS THROUGH THE FOLLOWING SERVICES: 24-HOUR EMERGENCY CARE WITH HELIPORT ACCOMMODATIONS AND CARDIOVASCULAR SERVICES. CARDIOVASCULAR SERVICES INCLUDE THE FOLLOWING: NON-INVASIVE DIAGNOSTIC STUDIES SUCH AS EKG, TELEMETRY MONITORING, TREADMILL STRESS TESTING, ECHO CARDIOGRAM, AND STRESS ECHO CARDIOGRAM.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$5,971,565	ExpenseAmt
Grant	$264,951	GrantAmt
Revenue	$6,325,928	RevenueAmt
Desc	OTHER PROGRAMS	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$5,971,565	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant	$264,951	TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue	$6,325,928	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$21,379,603	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
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	false	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	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	20	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	199	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	11	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	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	BusinessNameLine1

Field	Value	IRS element (for citing)
Phone	4023434671	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	12809 WEST DODGE ROAD	AddressLine1
City	OMAHA	City
State	NE	State
ZIP Code	68154	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (33 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
CLIFF ROBERTSON
Board Member/CEO CHI Health	1.00	59.00	Yes (X)	Yes (X)	$0	$761,591	$100,446
MICHAEL DEFREECE
SECRETARY/TREASURER	1.00	11.00	Yes (X)	Yes (X)	$0	$0	$0
RICHARD HACHTEN II
Board Member/ACH President & CEO	2.00	47.00	Yes (X)	Yes (X)	$0	$4,316,298	$67,124
RICHARD HERINK
BOARD CHAIR	1.00	11.00	Yes (X)	Yes (X)	$0	$0	$0
RICHARD J VIERK
VICE CHAIR	1.00	11.00	Yes (X)	Yes (X)	$0	$0	$0
BARRY SANDSTROM
Board Member	1.00	12.00	Yes (X)		$0	$0	$0
DR MARYANNE STEVENS RSM
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	12.00	Yes (X)		$0	$0	$0
H KEITH SCHMODE
Board Member	1.00	11.00	Yes (X)		$0	$0	$0
LARRY BUTLER
Board Member	1.00	11.00	Yes (X)		$0	$0	$0
MARTIN M MANCUSO MD
Board Member	1.00	67.00	Yes (X)		$0	$416,092	$25,222
MICHAEL ROWAN FACHE
Board member/CHI EVP & COO	1.00	69.00	Yes (X)		$0	$2,769,716	$258,055
PAUL EDGETT III
Board Member/CHI SVP	1.00	54.00	Yes (X)		$0	$1,126,594	$94,198
ROBERT LANIK
Board Member/CHI NE President/CEO	1.00	66.00	Yes (X)		$0	$1,314,093	$48,200
SISTER NADINE HEIMANN
Board Member	1.00	11.00	Yes (X)		$0	$0	$0
JEANETTE WOJTALEWICZ
CFO, CHI HEALTH	5.00	55.00		Yes (X)	$0	$499,985	$59,878
NANCY WALLACE
SVP HR CHIEF OFFICER	5.00	55.00		Yes (X)	$0	$441,427	$37,539
SCOTT WOOTEN
ACH SVP/CFO	2.00	62.00		Yes (X)	$0	$826,804	$10,063
AMY HATCHER
VP DIVISIONAL FINANCE	5.00	55.00			$0	$361,979	$29,782	Yes (X)
JASON YUNGTUM
VP/REG GENERAL COUNSEL	2.00	58.00			$0	$322,322	$30,216	Yes (X)
ROBERT VALENTINE
OL REGIONAL HOSPITAL ADMINISTRATOR	60.00	1.00			$159,390	$0	$9,041	Yes (X)
RODNEY TRIPLETT
NETWORK EXECUTIVE	20.00	40.00			$0	$219,640	$442,526	Yes (X)
TIM SCHNACK
VP OPERATIONAL FINANCE	9.00	51.00			$0	$447,318	$45,657	Yes (X)
AHMAD ALCHOMMALI MD
PHYSICIAN	60.00	0			$400,641	$0	$34,900		Yes (X)
DANIEL RICHTER MD
PHYSICIAN	60.00	0			$421,759	$0	$39,156		Yes (X)
ENRIQUE COHEN MD
PHYSICIAN	60.00	0			$408,179	$0	$45,953		Yes (X)
MARY LOB MD
PHYSICIAN	60.00	0			$523,980	$0	$48,802		Yes (X)
ROBERT CUNARD MD
PHYSICIAN	60.00	0			$539,238	$0	$38,794		Yes (X)
ANTHONY HATCHER
FORMER DIRECTOR	0.00	60.00			$0	$443,555	$34,367			Yes (X)
CHRISTOPHER JANKOVICH
FORMER DIRECTOR/PHYSICIAN	60.00	0			$176,846	$0	$22,175			Yes (X)
MARIE KNEDLER
FORMER VICE-CHAIR	2.00	60.00			$0	$535,370	$81,176			Yes (X)
ROBERT COPPLE
FORMER DIRECTOR	2.00	8.00			$0	$167,435	$36,418			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,630,033	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$14,970,219	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,639,688	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	15	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Related Organizations	$33,609	RelatedOrganizationsAmt
Government Grants	$6,566	GovernmentGrantsAmt
All Other Contributions	$0	AllOtherContributionsAmt
Noncash Contributions	$2,143	NoncashContributionsAmt
Total Contributions	$40,175	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICES	900099	$22,148,204	$22,148,204
PHARMACY SERVICES	446110	$422,133	$422,133
INTERCOMPANY TRANSACTIONS	900099	$77,970	$77,970
		$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	$22,648,307	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$130	TotalRevenueColumnAmt
Exclusion	$130	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$6,512	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$6,512	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,512	TotalRevenueColumnAmt
Exclusion	$6,512	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$119,386	SecuritiesAmt
Other	$4	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$119,386	SecuritiesAmt
Other	$4	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$119,391	TotalRevenueColumnAmt
Exclusion	$119,391	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$5,956	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$845	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,111	TotalRevenueColumnAmt
Exclusion	$5,111	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$1,740	GamingGrossIncomeAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,740	TotalRevenueColumnAmt
Exclusion	$1,740	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$10,527	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$6,947	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,580	TotalRevenueColumnAmt
Exclusion	$3,580	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFETERIA	722100	$27,197	$27,197
LABORATORY SERVICES	621500	$32,183	$32,183
		$0

Miscellaneous Revenue MiscellaneousRevenueGrp

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

Field	Value	IRS element (for citing)
Other Revenue Total	$59,380	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$22,884,326	TotalRevenueColumnAmt
Related Or Exempt Func Income	$22,648,307	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$195,844	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	$3,846	TotalAmt
Program Services	$3,846	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$944,745	TotalAmt
Program Services	$944,745	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$169,931	TotalAmt
Program Services	$161,434	ProgramServicesAmt
Management And General	$8,497	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$10,177,174	TotalAmt
Program Services	$9,659,819	ProgramServicesAmt
Management And General	$517,355	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$194,368	TotalAmt
Program Services	$184,650	ProgramServicesAmt
Management And General	$9,718	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,806,313	TotalAmt
Program Services	$1,715,997	ProgramServicesAmt
Management And General	$90,316	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$636,195	TotalAmt
Program Services	$604,385	ProgramServicesAmt
Management And General	$31,810	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$130,508	TotalAmt
Program Services	$123,983	ProgramServicesAmt
Management And General	$6,525	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$3,556	TotalAmt
Program Services	$3,556	ProgramServicesAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$3,634,187	TotalAmt
Program Services	$3,450,524	ProgramServicesAmt
Management And General	$183,663	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$42,988	TotalAmt
Program Services	$40,839	ProgramServicesAmt
Management And General	$2,149	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$581,293	TotalAmt
Program Services	$552,228	ProgramServicesAmt
Management And General	$29,065	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$308,571	TotalAmt
Program Services	$293,142	ProgramServicesAmt
Management And General	$15,429	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$32,226	TotalAmt
Program Services	$30,615	ProgramServicesAmt
Management And General	$1,611	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$17,530	TotalAmt
Program Services	$17,530	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$438,651	TotalAmt
Program Services	$416,718	ProgramServicesAmt
Management And General	$21,933	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$93,456	TotalAmt
Program Services	$88,783	ProgramServicesAmt
Management And General	$4,673	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
BAD DEBTS	$1,019,507	$1,019,507
MEDICAL SUPPLIES	$1,916,251	$1,916,251
0	$0
0	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$158,791	TotalAmt
Program Services	$151,051	ProgramServicesAmt
Management And General	$7,740	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$22,310,087	TotalAmt
Program Services	$21,379,603	ProgramServicesAmt
Management And General	$930,484	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Joint Costs TotalJointCostsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$10,721,832	BOYAmt
EOY	$9,471,676	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$7,445,870	BOYAmt
EOY	$10,018,270	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$2,831,928	BOYAmt
EOY	$3,665,625	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$518,981	BOYAmt
EOY	$418,301	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$7,136,910	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,198,641	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$5,625,217	BOYAmt
EOY	$5,938,269	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$631,267	BOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,293,391	BOYAmt
EOY	$498,542	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$30,068,486	BOYAmt
EOY	$30,010,683	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$179,543	BOYAmt
EOY	$3,085,956	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$377,985	BOYAmt
EOY	$81,747	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$3,555,002	BOYAmt
EOY	$353,320	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$4,112,530	BOYAmt
EOY	$3,521,023	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$25,955,956	BOYAmt
EOY	$26,489,660	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$25,955,956	BOYAmt
EOY	$26,489,660	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$30,068,486	BOYAmt
EOY	$30,010,683	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$574,239	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$40,535	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
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	$3,556	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$3,556	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 1i	FormAndLineReferenceDesc
Explanation	THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: IOWA HOSPITAL ASSOCIATION - $3,556	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$335,621	BeginningYearBalanceAmt
Contributions	$39,603	ContributionsAmt
Investment Earnings Or Losses	$32,444	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$48,975	GrantsOrScholarshipsAmt
End Year Balance	$358,693	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$369,561	BeginningYearBalanceAmt
Contributions	$50,991	ContributionsAmt
Investment Earnings Or Losses	$12,902	InvestmentEarningsOrLossesAmt
Other Expenditures	$97,833	OtherExpendituresAmt
End Year Balance	$335,621	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$328,728	BeginningYearBalanceAmt
Contributions	$44,542	ContributionsAmt
Investment Earnings Or Losses	$18,879	InvestmentEarningsOrLossesAmt
Other Expenditures	$22,588	OtherExpendituresAmt
End Year Balance	$369,561	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$353,265	BeginningYearBalanceAmt
Contributions	$46,478	ContributionsAmt
Investment Earnings Or Losses	$21,280	InvestmentEarningsOrLossesAmt
Other Expenditures	$92,295	OtherExpendituresAmt
End Year Balance	$328,728	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$349,614	BeginningYearBalanceAmt
Contributions	$58,502	ContributionsAmt
Investment Earnings Or Losses	-$7,103	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$1,000	GrantsOrScholarshipsAmt
Other Expenditures	$46,748	OtherExpendituresAmt
End Year Balance	$353,265	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.00000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	1.00000	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	$861,370	OtherCostOrOtherBasisAmt
Book Value	$861,370	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,293,353	OtherCostOrOtherBasisAmt
Depreciation	$578,257	DepreciationAmt
Book Value	$3,715,096	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Book Value	$0	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,836,508	OtherCostOrOtherBasisAmt
Depreciation	$526,610	DepreciationAmt
Book Value	$1,309,898	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$145,679	OtherCostOrOtherBasisAmt
Depreciation	$93,774	DepreciationAmt
Book Value	$51,905	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$5,938,269	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
ENVIRONMENTAL REMEDIATION LIABILITY	$4,370
INTERCOMPANY PAYABLES	$95,847
LONG TERM DEBT - CHI	$253,103

Field	Value	IRS element (for citing)
Total Liability	$353,320	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 COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICES FOUNDATION AND ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IA.

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

ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA'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	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	844	PersonsServedCnt
Total Community Benefit Expns	$562,456	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$562,456	NetCommunityBenefitExpnsAmt
Total Expense	0.02640	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	2630	PersonsServedCnt
Total Community Benefit Expns	$2,912,861	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,157,823	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$755,038	NetCommunityBenefitExpnsAmt
Total Expense	0.03550	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$48,004	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$69,931	DirectOffsettingRevenueAmt
Net Community Benefit Expns	-$21,927	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	3474	PersonsServedCnt
Total Community Benefit Expns	$3,523,321	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,227,754	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,295,567	NetCommunityBenefitExpnsAmt
Total Expense	0.06190	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Persons Served	195285	PersonsServedCnt
Total Community Benefit Expns	$42,689	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,734	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$39,955	NetCommunityBenefitExpnsAmt
Total Expense	0.00190	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	60	PersonsServedCnt
Total Community Benefit Expns	$602	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$602	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$2,906,063	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,838,294	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$67,769	NetCommunityBenefitExpnsAmt
Total Expense	0.00320	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$3,621	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,621	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	63	PersonsServedCnt
Total Community Benefit Expns	$14,394	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$14,394	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	19	ActivitiesOrProgramsCnt
Persons Served	195408	PersonsServedCnt
Total Community Benefit Expns	$2,967,369	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,841,028	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$126,341	NetCommunityBenefitExpnsAmt
Total Expense	0.00600	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	19	ActivitiesOrProgramsCnt
Persons Served	198882	PersonsServedCnt
Total Community Benefit Expns	$6,490,690	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,068,782	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,421,908	NetCommunityBenefitExpnsAmt
Total Expense	0.06790	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$8	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$8	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	7	PersonsServedCnt
Total Community Benefit Expns	$2,412	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,412	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	36000	PersonsServedCnt
Total Community Benefit Expns	$10,480	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,480	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	1	PersonsServedCnt
Total Community Benefit Expns	$3	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$185	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$185	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	36008	PersonsServedCnt
Total Community Benefit Expns	$13,088	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,088	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$568,579	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$10,249,259	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$11,392,034	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,142,775	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	AH-COM MEM HOSPITAL OF MISSOURI VALLEY	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	631 N 8TH ST	AddressLine1
City	MISSOURI VALLEY	City
State	IA	State
ZIP Code	51555	ZIPCode

Field	Value	IRS element (for citing)
Website Address	WWW.CHIHEALTH.COM	WebsiteAddressTxt
State License	LICENSE# 430030H	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	BusinessNameLine1

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
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 Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	www.chihealth.com	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	www.harrisoncountyhealth.org	OtherWebsiteURLTxt
Rpt Available Upon Request	Yes (X)	RptAvailableUponRequestInd
Adopt Implementation Strategy	Yes (X)	AdoptImplementationStrategyInd
Exec Implementation Strategy	Yes (X)	ExecImplementationStrategyInd
Develop Community Wide Plan	Yes (X)	DevelopCommunityWidePlanInd
Exec Community Wide Plan	Yes (X)	ExecCommunityWidePlanInd
Include Operational Plan	Yes (X)	IncludeOperationalPlanInd
Adopt Budget	Yes (X)	AdoptBudgetInd
Prioritize Health Needs	Yes (X)	PrioritizeHealthNeedsInd
Prioritize Services	Yes (X)	PrioritizeServicesInd
All Needs Addressed	false	AllNeedsAddressedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Used Deter Elig Free Care	false	FPGUsedDeterEligFreeCareInd
FPG Used Determ Elig Dscnt Care	false	FPGUsedDetermEligDscntCareInd
Explained Basis	Yes (true)	ExplainedBasisInd
Income Level	Yes (X)	IncomeLevelInd
Asset Level	Yes (X)	AssetLevelInd
Uninsured Discount	Yes (X)	UninsuredDiscountInd
Residency	Yes (X)	ResidencyInd
Other Factors	Yes (X)	OtherFactorsInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
Posted On Website	Yes (X)	PostedOnWebsiteInd
Attached To Invoice	Yes (X)	AttachedToInvoiceInd
Posted In Emergency Room	Yes (X)	PostedInEmergencyRoomInd
Posted In Admission Office	Yes (X)	PostedInAdmissionOfficeInd
Provided On Admission	Yes (X)	ProvidedOnAdmissionInd
Available On Request	Yes (X)	AvailableOnRequestInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Collection Activities	false	CollectionActivitiesInd
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 (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment	(1) A - AH-COM MEM HOSPITAL OF MISSOURI VALLEY: COMMUNITY MEMORIAL HOSPITAL AND THE HARRISON COUNTY HEALTH DEPARTMENT ENGAGED DIVERSE STAKEHOLDERS IN THEIR CHNA AND PLANNING PROCESSES OVER A PERIOD OF MANY PLANNING MONTHS. THE MEMBERS OF THE STEERING COMMITTEE WERE CHOSEN BASED ON THEIR PROFESSIONAL ROLES, EXPERTISE AND KNOWLEDGE OF THE HEALTH OF THE COUNTY. ADDITIONAL PATIENTS, FAMILIES AND COMMUNITY MEMBERS WERE ENGAGED IN THE SERIES OF MEETINGS TO SELECT PRIORITIES AND CREATE IMPLEMENTATION PLANS. THE FOLLOWING INDIVIDUALS REPRESENTING THE FOLLOWING ORGANIZATIONS PARTICIPATED IN THE CHNA: * NICOLE CARRITT - ADMINISTRATOR HARRISON COUNTY HOME & PUBLIC HEALTH (REPLACED BY BRENT SARON) * BOB VALENTINE - ADMINISTRATOR ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL * DR. CARRIE GRADY - FAMILY PRACTICE PHYSICIAN ALEGENT HEALTH LOGAN CLINIC * LYNNE TREMEL - WEST CENTRAL COMMUNITY ACTION, MATT PITT - HARRISON COUNTY ENVIRONMENTAL HEALTH * LARRY OLIVER - HARRISON COUNTY EMERGENCY MANAGEMENT ADMINISTRATOR, * JULIE FLORIAN - HARRISON COUNTY HOME & PUBLIC HEALTH (TOBACCO CONTROL) * DIANE FOSS - HMS DECAT & ECI * JIM POEHLMAN - MOSAIC * MARY ARNDT - MOSAIC * MELISSA MEEKER - LOGAN MAGNOLIA SCHOOL NURSE * RENEE FOREST - WOODBINE SCHOOL NURSE * RICH POPE - HARRISON COUNTY ISU EXTENSION DIRECTOR * PAT HART - PISGAH RESIDENT ;
Schedule H, Part V Sec B, Line 7, Needs not addressed in Needs Assessment	(1) A - AH-COM MEM HOSPITAL OF MISSOURI VALLEY: THE COMMUNITY IDENTIFIED THE TOP 11 COMMUNITY HEALTH NEEDS AND PRIORITIES FOR COLFAX COUNTY LISTED IN PART VI, 2. THE FOLLOWING HEALTH ISSUES WERE NOT ADDRESS IN THIS PROCESS AS THEY ARE BEING ADDRESSED BY CURRENT 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 Sec B, Line 10, Used federal poverty guidelines (FPG) to determine eligibility	(1) A - AH-COM MEM HOSPITAL OF MISSOURI VALLEY: ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA 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 Sec B, Line 11, Eligibility for Discounted Care	(1) A - AH-COM MEM HOSPITAL OF MISSOURI VALLEY: ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA 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 Sec B, Line 12i, Other factors used in determining amounts charged to patients	(1) A - AH-COM MEM HOSPITAL OF MISSOURI VALLEY: SIZE OF FAMILY IS ALSO USED IN THE CALCULATION;

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/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	FacilityFacilityTxt
AH LOGAN RURAL HEALTH CLINIC
122 WEST 8TH STREET	LOGAN	IA	51546	RURAL HEALTH CLINIC
AH WOODBINE RURAL HEALTH CLINIC
410 ELY	WOODBINE	IA	51579	RURAL HEALTH CLINIC
AH MISSOURI VALLEY RURAL HEALTH CLINIC
809 EAST ELM STREET	MISSOURI VALLEY	IA	51555	RURAL HEALTH CLINIC
AH DUNLAP RURAL HEALTH CLINIC
707 IOWA AVENUE	DUNLAP	IA	51529	RURAL HEALTH CLINIC
AH CMH SKILLED NURSING FACILITY
631 N 8TH STREET	MISSOURI VALLEY	IA	51555	SKILLED NURSING FACILITY

Supplemental Information Detail SupplementalInformationDetail (19 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c, Eligibility criteria for free or discounted care	WHEN CATHOLIC HEALTH INITIATIVES (THE ULTIMATE PARENT ORGANIZATION TO ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA) 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-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA 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 6a, Community benefit report prepared by related organization	ALEGENT CREIGHTON HEALTH
SCHEDULE H, PART I, LINE 6A, ORGANIZATION'S COMMUNITY BENEFIT NARRATIVE	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 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 I, LINE 7, BAD DEBT EXPENSE	BAD DEBT OF $1,019,507 INCLUDED IN FUNCTIONAL EXPENSE TOTAL PART IX, LINE 25, COLUMN (A) IS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7, COLUMN (F).
Schedule H, Part I, Line 7, col(f), Bad Debt Expense excluded from financial assistance calculation	1,019,507
Schedule H, Part I, Line 7g, Subsidized Health Services	ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA PROVIDES SUBSIDIZED HEALTH TO THE BROADER COMMUNITY THROUGH ITS RURAL HEALTH CLINIC. THE AMOUNT INCLUDED AS A SUBSIDIZED HEALTH SERVICE IS $67,769
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: - LIVE WELL OMAHA KIDS. AS A RESULT OF COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2006 WHICH POINTED TO CHILDHOOD OBESITY AS A SERIOUS HEALTH NEEDS ISSUE ACROSS ALL OMAHA METROPOLITAN SERVICE AREAS (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, NEBRASKA, 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 BUILT THE 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 COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY ON A NET SERVICE REVENUE BASIS. - COMMUNITY AND ECONOMIC DEVELOPMENT INCLUDING SUPPORT OF LOCAL CHAMBERS OF COMMERCE - STRATEGIC PLANNING AND CONSULTING SERVICES FOR COMMUNITY - SPONSORSHIP OF COMMUNITY NOT FOR PROFITS AND FUNDRAISING EVENTS - SUPPORT OF INTERNATIONAL HEALTH MINISTRIES IN TANZANIA AND DOMINICAN REPUBLIC - SUPPORT OF THE FEDERALLY QUALIFIED HEALTHCARE CENTERS - PARISH NURSING PROGRAM - COMMUNITY HEALTH FAIRS, SUPPORT GROUPS AND COMMUNITY EDUCATION - SCHOOL BASED HEALTHCARE SERVICES - LEADERSHIP IN AND FUNDING OF HEALTH COALITIONS LEADERS OF ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IA, ARE INVOLVED IN LEADERSHIP ROLES AS BOTH THE VICE PRESIDENT AND DIRECTOR OF ECONOMIC DEVELOPMENT ON THE MISSOURI VALLEY CHAMBER OF COMMERCE. THE HOSPITAL ALSO PROMOTES COMMUNITY BUILDING AND SAFE PHYSICAL ACTIVITY THROUGH ITS SUPPORT OF THE MISSOURI VALLEY SCHOOLS BACKPACK PROGRAM TO PROVIDE MEALS TO CHILDREN WHO MIGHT OTHERWISE GO WITHOUT AND THROUGH ITS BICYCLE HELMET SAFETY PROGRAM. HOSPITAL LEADERS WORK WITH THE SOUTHWEST IOWA PLANNING COUNCIL TO DEVELOP A SHORT AND LONG RANGE ECONOMIC GROWTH PLAN, WHICH CENTERED ON A FLOOD PREVENTION/ELIMINATION PLAN. THE HOSPITAL ALSO SUPPORTS THE TEAMMATES MENTORING PROGRAM AND VARIOUS OTHER STUDENT PROGRAMS THROUGHOUT HARRISON COUNTY.
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 55.77%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE.
Schedule H, Part III, Line 3, Bad Debt Expense Methodology	ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE.
Schedule H, Part III, Line 4, Bad debt expense - financial statement footnote	ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS: "THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, CHI FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. THE PROVISION FOR BAD DEBTS IS PRESENTED ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AS A DEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) SINCE CHI ACCEPTS AND TREATS SUBSTANTIALLY ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY."
Schedule H, Part III, Line 8, Community benefit & methodology for determining medicare costs	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 LINE 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-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA'S DEBT COLLECTION POLICY PROVIDES THAT ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA 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-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA' COMMUNITY 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-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA' COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO [INSERT FILING ORGANIZATION NAME] FOR APPROPRIATE FOLLOW-UP. [INSERT FILING ORGANIZATION NAME] 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: * NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL REQUEST BENCH OR ARREST WARRANTS AS A RESULT OF NON-PAYMENT; * NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL SEEK LIENS THAT WOULD REQUIRE THE SALE OR FORECLOSURE OF A PRIMARY RESIDENCE; AND * NO CATHOLIC HEALTH INITIATIVES' COLLECTION AGENCY MAY SEEK COURT ACTION WITHOUT HOSPITAL APPROVAL. FINALLY, COLLECTION AGENCIES ARE TRAINED ON THE CATHOLIC HEALTH INITIATIVES MISSION, CORE VALUES AND STANDARD OF CONDUCT TO MAKE SURE ALL PATIENTS ARE TREATED WITH DIGNITY AND RESPECT.
Schedule H, Part VI, Line 2, Needs assessment.	THE PROCESS TO DEVELOP ASSESSMENTS OF THE 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 INTO THE COMMITTEE OF THE BOARD OF DIRECTORS CHARGED WITH HEALTH PLANNING OVERSIGHT * INTO THE ANNUAL STRATEGIC PLANNING AND BUDGETING PROCESSES OF ALEGENT CREIGHTON HEALTH. PARTICULAR TO COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IA, LEADERS FROM THE HOSPITAL ARE ON THE HARRISON COUNTY HOME AND PUBLIC HEALTH DEPARTMENT COMMITTEE TO DEVELOP A CHNA AND A COMMUNITY HEALTH IMPROVEMENT PLAN. THIS PARTNERSHIP RESULTS IN A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY 2 YEARS AS REQUIRED BY STATE LAW. THIS LOCAL EFFORT IS SUPPORTED BY THE ALEGENT CREIGHTON HEALTH SYSTEM
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.CHIHEALTH.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 COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IA (POPULATION-2,838), SERVES HARRISON COUNTY, IOWA WITH AN ESTIMATED POPULATION OF 14,548, A TWO-YEAR DECREASE OF 2.6 PERCENT FROM 2010. HARRISON COUNTY IS ONE OF THE 3 IOWA COUNTIES INCLUDED IN THE GREATER OMAHA CSA. IT IS NESTLED IN THE SCENIC LOESS HILLS, NEAR THE MISSOURI RIVER. HARRISON COUNTY ENCOMPASSES APPROXIMATELY 696 SQUARE MILES AND IS COMPOSED OF 10 INCORPORATED TOWNS, 6 UNINCORPORATED TOWNS AND 20 TOWNSHIPS. THE RACIAL AND ETHNIC MAKEUP IS PREDOMINANTLY WHITE (98.3%). THE MEDIAN HOUSEHOLD INCOME IS $53,939, COMPARED TO $51,129 FOR THE STATE OF IOWA. HARRISON COUNTY CONTAINS 10 PUBLIC SCHOOL DISTRICTS AND APPROXIMATELY ONE THIRD OF THE STUDENTS IN EACH OF THESE SCHOOL DISTRICTS RECEIVE FREE OR REDUCED LUNCH.
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 UNPAID COSTS OF MEDICAID * COMMUNITY HEALTH IMPROVEMENT SERVICES- O COMMUNITY EDUCATION, CLASSES AND PROGRAMS (CHILDBIRTH, DIABETES, ONCOLOGY, PHYSICAL ACTIVITY, HEALTHY EATING AND COOKING, HEALTH CAREERS, CANCER, SPORTS MEDICINE ETC) O SUPPORT GROUPS (CANCER, BEREAVEMENT, YOUTH ETC) O COMMUNITY HEALTH FAIRS AND SCREENINGS O IMMUNIZATION CLINICS O PARISH NURSING PROGRAM AND FAITH COMMUNITY OUTREACH O SCHOOL BASED HEALTHCARE SERVICES * HEALTH PROFESSIONAL EDUCATION- O CLINICAL PRECEPTORSHIPS FOR HEALTHCARE PROFESSIONALS O SCHOLARSHIPS AND MENTORSHIPS O AFFILIATION WITH AND SUPPORT OF CREIGHTON UNIVERSITY SCHOOL OF MEDICINE O 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 O SUPPORT OF THE FEDERALLY QUALIFIED HEALTHCARE CENTERS (AND HOPE MEDICAL COALITION WHICH PROVIDES ACCESS TO MEDICAL SERVICES SPECIFICALLY FOR THE UNDERSERVED O CORPORATE SPONSORSHIPS O TANZANIA AND DOMINICAN REPUBLIC HEALTH MINISTRIES O STAFF SERVICE ON HEALTH RELATED BOARD AND COALITIONS * SUBSIDIZED HEALTHCARE SERVICE INCLUDING BEHAVIORAL HEALTH, NICU, HOME HEALTH AND HOSPICE * COMMUNITY BUILDING ACTIVITIES- O COMMUNITY AND ECONOMIC DEVELOPMENT INCLUDING SUPPORT OF LOCAL CHAMBERS OF COMMERCE O STRATEGIC PLANNING AND CONSULTING SERVICES FOR COMMUNITY O HEALTH COALITIONS * 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. COMMUNITY MEMORIAL HOSPITAL-MISSOURI VALLEY, IA PROVIDES PROMOTES THE HEALTH OF ITS COMMUNITY THROUGH FINANCIAL AND IN-KIND DONATIONS TO SUPPORT COMMUNITY NEEDS. THE HOSPITAL PROVIDES STAFF, LEADERSHIP, ADMINISTRATIVE SUPPORT AND FINANCIAL BACKING TO A NUMBER OF COMMUNITY HEALTH AND ECONOMIC DEVELOPMENT COALITIONS, INCLUDING-HARRISON COUNTY HOME CARE PROVIDERS, HEALTHY HARRISON COUNTY AND HARRISON COUNTY BOARD OF PUBLIC HEALTH AND LOCAL CHAMBER OF COMMERCE ORGANIZATION. IN ADDITION, THE HOSPITAL PROVIDES SPORTS PHYSICALS, MENTAL HEALTH FIRST AID TRAINING AND MENTAL HEALTH MEDICATION VOUCHERS, SCHOLARSHIPS FOR FUTURE HEALTHCARE PROFESSIONALS, AND GENERAL HEALTH PROMOTION THROUGH PUBLIC HEALTH AWARENESS DAYS. COMMUNITY INPUT IS SOUGHT THROUGH THE HOSPITAL'S COMMUNITY ADVISORY BOARD. COMMUNITY MEMORIAL HOSPITAL-MISSOURI VALLEY, IA IS GOVERNED BY A BOARD OF DIRECTORS PRIMARILY COMPRISED OF VOLUNTEER MEMBERS OF OUR LOCAL COMMUNITY WHO ARE LEADERS IN THE FIELDS OF BUSINESS, HEALTHCARE, ACCOUNTING AND MEDICINE AND UNDERSTAND THEIR ROLE IN PROVIDING STRONG CORPORATE GOVERNANCE. THE HOSPITAL HAS FULL-TIME EMERGENCY DEPARTMENT THAT IS OPEN TO THE PUBLIC AND PROVIDES MEDICAL SCREENING EXAMINATIONS AND STABILIZING TREATMENT WITHIN THE CAPABILITIES AND CAPACITIES OF THE HOSPITALS REGARDLESS OF BUT NOT LIMITED TO THE PATIENT'S RACE, COLOR, SEX, AGE, AND/OR ABILITY TO PAY. THE HOSPITALS ARE IN COMPLIANCE WITH THE FEDERAL EMTALA REGULATIONS. IN ADDITION, TOGETHER WITH UNRELATED HOSPITALS IN THE AREA, WORK CLOSELY WITH LOCAL FIRE AND RESCUE DEPARTMENTS TO ENSURE THAT AMBULANCES TAKE PATIENTS TO THE APPROPRIATE HOSPITAL. THIS IS GENERALLY THE HOSPITAL THAT IS CLOSEST GEOGRAPHICALLY WITH EXCEPTIONS BASED ON PATIENT PREFERENCE, PATIENT'S PHYSICIAN PREFERENCE, AND CAPACITY OR THE AVAILABILITY OF SPECIALIZED FACILITIES OR PROGRAMS RELATED TO THE PATIENT'S CONDITION. FINALLY, THE HOSPITAL MAINTAINS DETAILED PROCEDURES REGARDING WHEN AND UNDER WHAT CIRCUMSTANCES A PATIENT CAN BE TRANSFERRED. UNDER THIS POLICY, NO PATIENT WILL BE TRANSFERRED BASED ON RACE, CREED, RELIGION OR ABILITY TO PAY.
Schedule H, Part VI, Line 6, Affiliated health care system	COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA, ALONG WITH ITS AFFILIATED OUTPATIENT FACILITIES ARE PART OF CATHOLIC HEALTH INITIATIVES (CHI). 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 4 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 $910 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN THE 2014 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 SHARE 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 ENABLES MBOS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA OPERATES WITH ITS WHOLLY OWNED AFFILIATES AND COMMUNITY PARTNERS, ALONG WITH ITS FUNDRAISING ARM, ALEGENT CREIGHTON HEALTH FOUNDATION, TO SERVE THE HEALTH CARE NEEDS OF OMAHA, NE AND SOUTHWEST, IA.
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 (2 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc	Cash GrantCashGrantAmt
CHARITY CARE/FINANCIAL ASSISTANCE	844	$939,745	BOOK	REDUCTION OR WRITE OFF OF PATIENT SERVICES
AUXILIARY SCHOLARSHIP	6				$5,000

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE I, PART III, CHARITY CARE/FINANCIAL ASSISTANCE

ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA 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	Yes (true)	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	Yes (true)	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (23 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
MARIE KNEDLER
FORMER VICE-CHAIR	$0	$312,471	$0	$116,780	$0	$106,119	$0	$58,115	$0	$23,061	$0	$616,546	$0	$58,178
RICHARD HACHTEN II
BOARD MEMBER/ACH PRESIDENT & CEO	$0	$1,002,940	$0	$3,138,518	$0	$174,840	$0	$53,071	$0	$14,053	$0	$4,383,422	$0	$155,803
CLIFF ROBERTSON
BOARD MEMBER/CEO CHI HEALTH	$0	$575,759	$0	$114,665	$0	$71,167	$0	$77,744	$0	$22,702	$0	$862,037	$0	$48,435
ROBERT COPPLE
FORMER DIRECTOR	$0	$130,673	$0	$27,761	$0	$9,001	$0	$11,141	$0	$25,277	$0	$203,853	$0	$0
ANTHONY HATCHER
FORMER DIRECTOR	$0	$432,222	$0	$0	$0	$11,333	$0	$17,850	$0	$16,517	$0	$477,922	$0	$0
CHRISTOPHER JANKOVICH
FORMER DIRECTOR/PHYSICIAN	$165,057	$0	$0	$0	$11,789	$0	$0	$0	$22,175	$0	$199,021	$0	$0	$0
PAUL EDGETT III
BOARD MEMBER/CHI SVP	$0	$496,880	$0	$515,695	$0	$114,019	$0	$72,192	$0	$22,006	$0	$1,220,792	$0	$92,265
ROBERT LANIK
BOARD MEMBER/CHI NE PRESIDENT/CEO	$0	$650,100	$0	$502,592	$0	$161,401	$0	$33,702	$0	$14,498	$0	$1,362,293	$0	$28,040
MARTIN M MANCUSO MD
BOARD MEMBER	$0	$368,040	$0	$0	$0	$48,052	$0	$7,500	$0	$17,722	$0	$441,314	$0	$0
MICHAEL ROWAN FACHE
BOARD MEMBER/CHI EVP & COO	$0	$1,098,277	$0	$1,471,311	$0	$200,128	$0	$238,353	$0	$19,702	$0	$3,027,771	$0	$175,028
NANCY WALLACE
SVP HR CHIEF OFFICER	$0	$270,444	$0	$120,851	$0	$50,132	$0	$31,152	$0	$6,387	$0	$478,966	$0	$20,943
JEANETTE WOJTALEWICZ
CFO, CHI HEALTH	$0	$426,811	$0	$51,596	$0	$21,578	$0	$39,641	$0	$20,237	$0	$559,863	$0	$0
SCOTT WOOTEN
ACH SVP/CFO	$0	$441,373	$0	$249,118	$0	$136,313	$0	$0	$0	$10,063	$0	$836,867	$0	$102,692
TIM SCHNACK
VP OPERATIONAL FINANCE	$0	$291,367	$0	$141,395	$0	$14,556	$0	$22,950	$0	$22,707	$0	$492,975	$0	$0
RODNEY TRIPLETT
NETWORK EXECUTIVE	$0	$178,221	$0	$30,937	$0	$10,482	$0	$418,878	$0	$23,648	$0	$662,166	$0	$0
ROBERT VALENTINE
OL REGIONAL HOSPITAL ADMINISTRATOR	$129,168	$0	$23,832	$0	$6,390	$0	$7,952	$0	$1,089	$0	$168,431	$0	$0	$0
JASON YUNGTUM
VP/REG GENERAL COUNSEL	$0	$209,106	$0	$78,997	$0	$34,219	$0	$3,269	$0	$26,947	$0	$352,538	$0	$24,139
AMY HATCHER
VP DIVISIONAL FINANCE	$0	$194,936	$0	$141,564	$0	$25,479	$0	$15,300	$0	$14,482	$0	$391,761	$0	$0
AHMAD ALCHOMMALI MD
PHYSICIAN	$358,751	$0	$0	$0	$41,890	$0	$14,025	$0	$20,875	$0	$435,541	$0	$0	$0
ENRIQUE COHEN MD
PHYSICIAN	$381,038	$0	$0	$0	$27,141	$0	$16,466	$0	$29,487	$0	$454,132	$0	$0	$0
ROBERT CUNARD MD
PHYSICIAN	$506,538	$0	$0	$0	$32,700	$0	$15,300	$0	$23,494	$0	$578,032	$0	$0	$0
MARY LOB MD
PHYSICIAN	$497,085	$0	$0	$0	$26,895	$0	$22,922	$0	$25,880	$0	$572,782	$0	$0	$0
DANIEL RICHTER MD
PHYSICIAN	$404,439	$0	$0	$0	$17,320	$0	$17,450	$0	$21,706	$0	$460,915	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 3, Arrangement used to establish the top management official's compensation	CERTAIN TOP MANAGEMENT OFFICIALS WERE COMPENSATED BY ALEGENT CREIGHTON HEALTH, A RELATED ORGANIZATION. ACTING AS PRUDENT STEWARDS OF ITS FINANCIAL RESOURCES, THE ALEGENT CREIGHTON HEALTH BOARD COMPENSATION COMMITTEE RECOMMENDS AND THE BOARD EXECUTIVE COMMITTEE APPROVES THE EXECUTIVE COMPENSATION PHILOSOPHY, POLICY AND GUIDELINES. IT DOES SO WITH THE OBJECTIVE OF ATTRACTING AND RETAINING TOP EXECUTIVE TALENT TO ENSURE ALEGENT CREIGHTON HEALTH IS ABLE TO FULFILL ITS FAITH-BASED MISSION. THE ALEGENT CREIGHTON HEALTH COMPENSATION COMMITTEE FOLLOWS A THOROUGH AND INTENTIONAL PROCESS THAT INCLUDES CONSULTATION WITH INDEPENDENT, EXPERT COUNSEL AND CAREFULLY COMPARES COMPENSATION LEVELS TO MARKET-BASED COMPENSATION OF SIMILAR SIZED, NON-PROFIT AND FOR-PROFIT HEALTH SYSTEMS AND ALSO UTILIZES A BLEND OF NON-PROFIT AND GENERAL INDUSTRY DATA FOR EXECUTIVE ROLES WHERE THE RECRUITING MARKET IS ARGUABLY BROADER THAN THE NON-PROFIT SECTOR. TOTAL COMPENSATION FOR EXECUTIVES PAID BY ALEGENT CREIGHTON HEALTH INCLUDES BASE COMPENSATION, AND ALSO INCLUDES PERFORMANCE-BASED INCENTIVE COMPENSATION FOR ACHIEVING BOARD-SET GOALS FOR CLINICAL QUALITY, PATIENT SAFETY AND SATISFACTION, PHYSICIAN PERCEPTION, STRATEGIC AND FACILITY PLANNING AND FINANCIAL PERFORMANCE. IT MAY ALSO INCLUDE OTHER CASH PAYMENTS SUCH AS ONE-TIME RELOCATION COSTS, AND/OR CASH PAYMENTS FOR DEFERRED COMPENSATION. THE ESTABLISHMENT OF SOME OF THE REPORTABLE INDIVIDUALS COMPENSATION REMAINED WITH ALEGENT CREIGHTON HEALTH DURING 2013. COMPENSATION FOR CERTAIN EXECUTIVES WAS ESTABLISHED AND PAID BY CHI OR FRANCISCAN HEALTH SYSTEM (FHS), RELATED ORGANZIATIONS. CHI AND FHS USED THE FOLLOWING TO ESTABLISH THIS 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 2013 CALENDAR YEAR, CATHOLIC HEALTH INITIATIVES (CHI) AND FRANCISCAN HEALTH SYSTEM (FHS), RELATED ORGANIZATIONS, MAINTAINED SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLANS FOR CEOS AND OTHER CHI EMPLOYEES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICPATE IN CHI OR FHS' S SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN: PAUL EDGETT RICHARD HACHTEN II ROBERT LANIK CLIFF ROBERTSON MICHAEL ROWAN JEANETTE WOJTALEWICZ SCOTT WOOTEN DURING 2013 THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI OR FHS TO THE DEFERRED COMPENSAITON PLANS: PAUL EDGETT - $43,590 CLIFF ROBERTSON - $49,142 MICHAEL ROWEN - $214,851 JEANETTE WOJTALEWICZ - $13,589 DURING 2013 THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI OR FHS FROM THE DEFERRED COMPENSATION PLANS: PAUL EDGETT - $92,265 ROBERT LANIK - $28,040 CLIFF ROBERTSON - $48,435 MICHAEL ROWAN - $175,028 SCOTT WOOTEN - $38,073 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 2013 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 2013, THE FOLLOWING CONTRIBUTIONS THAT WOULD HAVE BEEN MADE BY CHI TO THE DEFERRED COMPENSATION PLANS WERE PAID IN CASH: RICHARD HACHTEN II - $133,616 ROBERT LANIK - $101,293 DURING THE 2013 CALENDAR YEAR, ALEGENT CREIGHTON HEALTH, A RELATED ORGANIZATION, MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR SENIOR VICE PRESIDENTS AND VICE PRESIDENTS PAID BY ALEGENT CREIGHTON HEALTH. DURING 2013 THE FOLLOWING DISTRIBUTIONS WERE MADE BY ALEGENT CREIGHTON HEALTH FROM THE DEFERRED COMPENSATION PLAN THESE SUPPLEMENTAL DISTRIBUTIONS WERE INCLUDED IN THE INDIVIDUAL'S W-2 INCOME AND REPORTABLE AS COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): RICHARD HACHTEN II - $151,803 SCOTT WOOTEN - $64,619 JASON YUNGTUM - $24,139 NANCY WALLACE - $20,943 MARIE KNEDLER - $58,178
Schedule J, Part I, Line 6a, Compensation contingent on net earnings of the organization	COMPENSATION FOR MEMBERS OF MANAGEMENT OF ALEGENT CREIGHTON HEALTH AND RELATED ENTITIES IS DETERMINED AT A SYSTEM LEVEL. MEMBERS OF MANAGEMENT ARE ELIGIBLE FOR AN ANNUAL INCENTIVE BONUS .INCENTIVE AWARDS ARE BASED ON FOUR INDIVIDUAL PERFORMANCE MEASURES WHICH ARE LINKED TO FOUR SYSTEM PERFORMANCE GOALS. FOR EACH MANAGER, 75% OF THE INCENTIVE AWARD WILL BE DETERMINED BY SYSTEM PERFORMANCE GOALS AND 25% DETERMINED BY INDIVIDUAL PERFORMANCE MEASURES. ONE OF THE FOUR SYSTEM PERFORMANCE GOALS IS DEPENDENT UPON THE FINANCIAL RESULTS OF THE ENTIRE ALEGENT CREIGHTON HEALTH SYSTEM FOR THE FISCAL YEAR.
Schedule J, Part I, Line 6b, Compensation contingent on net earnings of a related organization	SEE DISCLOSURE FOR SCHEDULE J, PART I, LINE 6A
SCHEDULE J, PART II, ALEGENT CREIGHTON HEALTH EXECUTIVES AND POTENTIAL SEVERANCE PAYMENTS	EXECUTIVES PAID BY ALEGENT CREIGHTON HEALTH HAVE A PROVISION IN THEIR COMPENSATION AGREEMENT THAT PROVIDES FOR POTENTIAL SEVERANCE PAYMENTS IN THE EVENT OF TERMINATION WITHOUT CAUSE OR CHANGE OF CONTROL. THE AMOUNT OF SEVERANCE AN EXECUTIVE MAY OR MAY NOT RECEIVE IF TERMINATED ACCORDING TO COMPENSATION AGREEMENT IS REPORTED AS DEFERRED COMPENSATION IN COLUMN C.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART V, LINE 1C, PAYMENTS TO VENDORS	PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF THE ALEGENT CREIGHTON HEALTH SYSTEM ARE MADE BY ALEGENT CREIGHTON HEALTH, THEREFORE NO FORM 1099S ARE ISSUED BY ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA. ALEGENT CREIGHTON HEALTH FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099S ISSUED BY ALEGENT CREIGHTON HEALTH ON BEHALF OF ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA ARE REPORTED TO THE IRS.
FORM 990, PART V, LINE 2A, EMLOYEES OF AH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA	THE EMPLOYEES LISTED IN PART I, LINE 5A AND PART V, LINE 2A ARE EMPLOYED BY ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA. HOWEVER, THROUGH A COMMON PAY AGENT AGREEMENT, THE EMPLOYEES ARE PAID BY ALEGENT CREIGHTON HEALTH AND PAYROLL EXPENSES ARE ALLOCATED TO ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA.
Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders	ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL MISSOURI VALLEY, IOWA HAS ONE MEMBER, WHICH IS ALEGENT HEALTH-IMMANUEL MEDICAL CENTER.
Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body	ALEGENT HEALTH-IMMANUEL MEDICAL CENTER APPOINTS INDIVIDUALS TO SERVE ON THE BOARD OF DIRECTORS. THE BOARD OF ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IA, OR A NOMINATING COMMITTEE OF THE BOARD OF ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IA, PRESENTS A SLATE OF NOMINEES AND THEIR CREDENTIALS TO ALEGENT HEALTH-IMMANUEL MEDICAL CENTER FOR APPROVAL. ALEGENT HEALTH-IMMANUEL MEDICAL CENTER MAY REJECT ANY NOMINEE OR APPOINT INDIVIDUALS DIRECTLY TO THE BOARD OF DIRECTORS, OR REQUEST ADDITIONAL NOMINEES BY GIVING WRITTEN NOTICE OF SUCH ACTIONS TO THE CHAIRMAN OF THE BOARD.
Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders	THE POWERS, DUTIES AND RIGHTS RESERVED ALEGENT HEALTH-IMMANUEL MEDICAL CENTER ARE, BUT ARE NOT LIMITED TO, THE FOLLOWING: A. TO AMEND, REVISE OR ALTER THE ARTICLES OF INCORPORATION OR THE BYLAWS; B. TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, MEMBERS OF THE BOARD OF DIRECTORS; C. TO APPROVE ANY MERGER OR CONSOLIDATION OF THIS CORPORATION INTO OR WITH ANY OTHER CORPORATION, ORGANIZATION OR ASSOCIATION, AND TO APPROVE THE DISSOLUTION OR OTHERWISE WRAPPING UP OF THE AFFAIRS; D. TO APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE CORPORATIONS ASSETS; E. TO APPROVE THE INCORPORATION OR DISSOLUTION OF AFFILIATED ENTITIES, ORGANIZATIONS OR ASSOCIATIONS; AND F. TO RECEIVE THE ANNUAL REPORT OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Sec B, 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 DIRECTOR 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, Sec B, Line 12c, Conflict of interest policy	ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA 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. ANY IDENTIFIED POTENTIAL CONFLICTS ARE REPORTED TO THE ENTITIES BOARD CHAIR, WHO IS CHARGED WITH FURTHER INVESTIGATION OF THE CONFLICT(S). AS HE OR SHE DEEMS APPROPRIATE: DOCUMENTATION OF CONCLUSIONS WITH RESPECT TO THE EXISTENCE OF A CONFLICT (INCLUDING RELEVANT FACTS AND CIRCUMSTANCES); AND REPORTING TO THE BOARD EXECUTIVE COMMITTEE CONCERNING THE REVIEW, EVALUATION AND CONFLICT DETERMINATION. TO THE EXTENT THAT THE BOARD CHAIR AND ANY OTHER TRUSTEE DISAGREE AS TO WHETHER A CIRCUMSTANCE GIVES RISE TO A CONFLICT, THE BOARD EXECUTIVE COMMITTEE MAKES THE FINAL DETERMINATION AS TO THE EXISTENCE OF A CONFLICT. THE CONFLICTED TRUSTEE IS EXCLUDED FROM VOTING AS TO THE EXISTENCE OF A CONFLICT, AND IS EXCUSED FROM THE ROOM WHILE VOTING CONCERNING THE MATTER IS CONDUCTED. IN ANY CIRCUMSTANCE WHERE A TRUSTEE HAS BEEN IDENTIFIED AS HAVING A CONFLICT OF INTEREST WITH RESPECT TO A PARTICULAR TRANSACTION, THAT TRUSTEE IS ALSO EXCLUDED FROM VOTING WITH RESPECT THAT PARTICULAR TRANSACTION. THE CONFLICT OF INTEREST POLICY WITH RESPECT TO EMPLOYEES REQUIRES THAT ALL EMPLOYEES COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE FORM AT THE TIME OF HIRING. THEREAFTER, DIRECTOR LEVEL AND ABOVE EMPLOYEES MUST ANNUALLY CERTIFY AS PART OF THE PERFORMANCE EVALUATION PROCESS THAT THEY HAVE NO CONFLICTS OF INTEREST. FURTHER, ALL EMPLOYEES, REGARDLESS OF EMPLOYMENT LEVEL, ARE SUBJECT TO A GENERAL OBLIGATION TO DISCLOSE TO THEIR SUPERVISOR ANY CONFLICTS THAT ARISE DURING THE YEAR. FAILURE TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS MAY RESULT IN DISCIPLINARY ACTION.
Form 990, Part VI, Sec B, Line 15a, Process to establish compensation of top management official	CERTAIN EXECUTIVES AND MEMBERS OF MANAGEMENT WERE PAID BY CHI, A RELATED ORGANIZATION, DURING CALENDAR YEAR 2013. FOR THOSE PAID BY CHI, COMPENSATION WAS DETERMINED UNDER THE COMPENSATION PHILOSOPHY OF CHI. UNDER CHI'S 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 DELIVEREC BY THE 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. IN ADDITION, THE HAY GROUP COMPLETES A COMPREHENSIVE ANNUAL REVIEW OF ALL CHI POSITIONS AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THESE COMPENSATION LEVELS ARE REVISED ANNUALLY BASED ON MARKET DATA, WHERE APPLICABLE. FOR OTHER MEMBERS OF MANAGEMENT WHO WERE PAID UNDER ALEGENT CREIGHTON HEALTH FOR CALENDAR YEAR 2013, ALEGENT CREIGHTON HEALTH HUMAN RESOURCES COMPLETES A COMPENSATION MARKET STUDY TO DETERMINE SALARY. ADDITIONALLY, CLIFF ROBERTSON'S COMPENSATION IS PAID BY FHS, A RELATED ORGANIZATION. 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, Sec B, Line 15b, Process to establish compensation of other employees	SEE DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15A
Form 990, Part VI, Sec C, 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 IOWA SECRETARY OF STATE WEBSITE. 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 IX, Line 11g, Other Expenses	OTHER FEES FOR SERVICES - TOTAL EXPENSE: 3634187, PROGRAM SERVICE EXPENSE: 3450524, MANAGEMENT AND GENERAL EXPENSES: 183663, FUNDRAISING EXPENSES: ;
, PRIOR PERIOD ADJUSTMENT	PRIOR PERIOD ADJUSTMENT FOR ASSET REVALUATION DUE TO CHI ACQUISITION.
Form 990 , Part XI, Line 9, Other changes in net assets or fund balances	TRANSFER OF GOODWILL TO ALEGENT HEALTH - -40535;
FORM 990, PART XII, LINE 2C, AUDITED FINANCIAL STATEMENTS	FOR FISCAL YEAR ENDING JUNE 30, 2014, THE FINANCIAL STATEMENTS OF ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA 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 (158 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1	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)
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)	11 - Type I	CHI	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)	9	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)	11 - Type I	CHI	Yes (true)
CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	460992796	HEALTHCARE	CO	501(C)(3)	11 - 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)	11 - Type I	CHI	Yes (true)
CHI KENTUCKY INC
3900 OLYMPIC BLVD STE 400	ERLANGER	KY	41018	202741651	HEALTHCARE	KY	501(C)(3)	11 - 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)	11 - Type I	CHI	Yes (true)
CHI NEBRASKA
6940 O ST STE 200	LINCOLN	NE	68510	363233121	HEALTHCARE	NE	501(C)(3)	11 - Type III - FI	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)	11 - 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)	N/A	GSH	Yes (true)
COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION
631 N 8TH ST	MISSOURI VALLEY	IA	51555	421294399	FUNDRAISING	IA	501(C)(3)	11 - 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)	11 - 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)	11 - Type I	FH	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 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)
GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	201536108	MINISTRIES	CO	501(C)(3)	11 - 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)	11 - 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)	11 - 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
539 S 4TH ST	LOUISVILLE	KY	40202	611029768	HEALTHCARE	KY	501(C)(3)	3	KOH	Yes (true)
KENTUCKYONE HEALTH MEDICAL GROUP INC
539 S 4TH ST	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)
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)	11 - Type III - FI	MHSET	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)	11 - 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)	11 - 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)	11 - Type I	AHMH-CORNING	Yes (true)
MERCY HEALTHCARE FOUNDATION
570 CHAUTAUQUA BLVD	VALLEY CITY	ND	58072	450435338	FUNDRAISING	ND	501(C)(3)	11 - Type III - FI	MHVC	Yes (true)
MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DR	COUNCIL BLUFFS	IA	51503	421178204	FUNDRAISING	IA	501(C)(3)	11 - 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)	11 - 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)
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)	11 - Type I	OCH	Yes (true)
PINEYWOODS MEDICAL DEVELOPMENT CORP
PO BOX 1447	LUFKIN	TX	75902	752493116	PROPERTY MGMT	TX	501(C)(3)	11 - Type III - FI	MHSET	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)	11 - 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)	11 - 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
424 LEWIS HARGETT CIRCLE STE 160	LEXINGTON	KY	40503	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)	11 - 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 MEDICAL FOUNDATION INC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	311539059	PHYSICIANS	KY	501(C)(3)	3	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)	11 - 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)	11 - Type I	CHI	Yes (true)
SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC
104 W 17TH ST	SCHUYLER	NE	68661	363630014	FUNDRAISING	NE	501(C)(3)	11 - 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)	N/A	SLPC	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)	11 - 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)	11 - Type I	SCH	Yes (true)
ST DOMINIC OF ONTARIO OREGON
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	930433692	HEALTHCARE	OR	501(C)(4)	N/A	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 COMMUNITY HEALTH
1516 5TH ST NW	ALBUQUERQUE	NM	87102	710897107	COMMUNITY	NM	501(C)(3)	11 - Type I	CHI	Yes (true)
ST JOSEPH HEALTH MINISTRIES
1929 LINCOLN HWY E STE 150	LANCASTER	PA	17602	232342997	HEALTHCARE	PA	501(C)(3)	11 - Type I	CHI	Yes (true)
ST JOSEPH MEDICAL CENTER FOUNDATION
2500 BERNVILLE RD PO BOX 316	READING	PA	19603	232649362	FUNDRAISING	PA	501(C)(3)	11 - 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 ENTERPRISE INC
201 INTERNATIONAL CIRCLE STE 212	HUNT VALLEY	MD	21030	521311775	PHYSICIANS	MD	501(C)(3)	11 - Type I	SJMC	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'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 LUKE'S COMMUNITY DEVELOPMENT CORPORATION
6624 FANNIN ST STE 2505	HOUSTON	TX	77030	260274448	MANAGEMENT	TX	501(C)(3)	11 - 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)	11 - Type I	CHI	Yes (true)
ST LUKE'S HEALTH SYSTEM FOUNDATION
6624 FANNIN ST STE 1100	HOUSTON	TX	77030	760127715	INVESTMENT MGMT	TX	501(C)(3)	11 - Type I	SLHS	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)	11 - 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)	11 - 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)	11 - 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)	11 - 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)
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)	11 - 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)
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/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	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	$116,752	$776,649	false	$0	Yes (true)	0.51
AUDUBON LAND COMPANY LLC
5390 N ACADEMY BLVD STE 300	COLORADO SPRINGS	CO	80918	841513085	REAL ESTATE	CO	CHIC	RELATED	$34,991	$8,665,388	false	$0	false	0.501
AVANTAS LLC
11128 JOHN GALT BLVD STE 400	OMAHA	NE	68137	392045003	STAFFING OF NURSES	NE	AHBMHS	RELATED	-$319,683	$4,762,246	false	-$439,535	false	0.95
BERGAN MERCY SURGERY CENTER LLC
7710 MERCY RD STE 200	OMAHA	NE	68124	208671994	AMBUL SURG CTR	NE	ACH	RELATED	$142,085	$3,294,472	false	$0	false	0.6394
BERYWOOD OFFICE PROPERTIES LLC
400 BERYWOOD TRAIL	CLEVELAND	TN	37312	621875199	PHYS OFFICE	TN	MHCS	RELATED	$57,545	$1,013,237	false	$0	Yes (true)	0.63
BLUEGRASS REGIONAL IMAGING CENTER
1218 SOUTH BRDWAY STE 310	LEXINGTON	KY	40504	611386736	DIAGNOSTIC IMAGING	KY	SJHS	RELATED	$308,428	$3,317,191	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	$2,478	$4,571,498	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	-$195,425	$216,945	false	-$77,269	Yes (true)	1
CENTRAL NEBRASKA REHAB SERVICE
620 DIERS AVE STE 300	GRAND ISLAND	NE	68803	810653461	PHYSICAL THERAPY	NE	SFMC	RELATED	$2,132,606	$3,494,427	false	$0	false	0.51
CHI OPERATING INVESTMENT PROGRAM LP
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	470727942	INVESTMENTS	CO	CHI	UNRELATED	$344,962,532	$4,617,413,792	false	$0	Yes (true)	0.928
CHICAMSURG SURGERY CENTERS LLC
188 INVERNESS DRIVE WEST 500	ENGLEWOOD	CO	80112	111222333	SURGERY CENTER	CO	CHIC	RELATED	$0	$0	false	$0	false	0.51
HC SL VINTAGE I LLC
18000 W SARAH LANE STE 250	BROOKFIELD	WI	53045	270453767	PROPERTY HOLDING	WI	SL CDC-V	RELATED	$1,027,057	$105,658,490	false	$0	false	0.51
HEALTHCARE SUPPORT SERVICES
PO BOX 9804	GRAND ISLAND	NE	68802	721546196	LAUNDRY	NE	NA	RELATED	$98,584	$3,190,678	false	$97,006	false	1
HEARTLAND ONCOLOGY LLC
2337 E CRAWFORD ST	SALINA	KS	67401	222333444	ONCOLOGY	KS	SCH	RELATED	$0	$0	false	$0	false	0.51
HIGHLINE IMAGING LLC
275 SW 160TH ST	BURIEN	WA	98166	200460005	DIAGNOSTIC IMAGING	WA	HMC	RELATED	$375,761	$1,784,057	false	$0	false	0.8
LAKESIDE AMBULATORY SURGICAL CENTER LLC
17031 LAKESIDE HILLS DR	OMAHA	NE	68130	204267902	AMBUL SURG CTR	NE	ACH	RELATED	$3,465,880	$1,951,221	false	$0	false	0.51
LAKESIDE ENDOSCOPY CENTER LLC
17001 LAKESIDE HILLS PLZ STE 201	OMAHA	NE	68130	205544496	ENDOSCOPY SRVC	NE	ACH	RELATED	$1,455,294	$1,013,126	false	$0	false	0.5228
LINCOLN CK LEASING LLC
6003 OLD CHENEY RD	LINCOLN	NE	68516	262496856	REAL ESTATE	NE	SERMC	RELATED	$574,064	$425,034	false	$0	false	0.5376
LOUISVILLE SC LTD
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	062119566	SURGERY CENTER	AL	SCOFL	RELATED	$417,359	$478,373	false	$0	Yes (true)	0.611
NEBRASKA SPINE HOSPITAL LLC
6901 N 72ND ST	OMAHA	NE	68122	270263191	SPINE HOSPITAL	NE	ACH	RELATED	$10,501,730	$17,301,869	false	$0	false	0.51
NORTH RIVER SURGERY CENTER LLC
2209 WILDWOOD AVE	SHERWOOD	AR	72120	710799771	AMBUL SURG CTR	AR	SVIMC	RELATED	$81,071	$1,077,536	false	$0	false	0.5745
ORTHOCOLORADO LLC
11650 WEST 2ND PLACE	LAKEWOOD	CO	80255	371577105	ORTHO HOSPITAL	CO	THC	RELATED	$1,846,183	$8,411,844	false	$0	false	0.6
PENINSULA RADIATION ONCOLOGY LLC
315 MLK JR WAY STE 111	TACOMA	WA	98405	870808610	HEALTHCARE SRVC	WA	FHS	RELATED	$256,567	$3,262,002	false	$0	false	0.6
PENRAD IMAGING
1390 KELLY JOHNSON BLVD	COLORADO SPRINGS	CO	80920	841072619	MEDICAL IMAGING	CO	CHIC	RELATED	$715,094	$3,489,436	false	$0	false	0.7
PMC HOSPITAL LLC
4600 E SAM HOUSTON PKWY	SOUTH PASADENA	TX	77505	273280598	HOSPITAL	TX	SL CDC-PMC	RELATED	$1,092,540	$20,751,174	false	$0	Yes (true)	0.51
PRAIRIE HEALTH VENTURES LLC
421 S 9TH ST STE 102	LINCOLN	NE	68508	204962103	TECH SRVC	NE	AH-IMC	RELATED	$1,011,804	$5,564,586	false	$68,565	Yes (true)	0.6575
PREMIER SURGERY CENTER OF LOUISVILLE LP
3000 RIVERCHASE GALLERIA STE 500	BIRMINGHAM	AL	35244	721378216	SURGERY CENTER	AL	SCA	RELATED	$88,900	$254,399	false	$0	Yes (true)	0.51
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
424 LEWIS HARGETT CIRCLE STE 160	LEXINGTON	KY	40503	452116736	MGMT SVCS	KY	SJHS	RELATED	-$52,573	$93,769	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	JH	RELATED	$88,608	$256,606	false	$0	false	1
SCA PREMIER SURGERY CENTER OF LOUISVILLE LLC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	721386840	SURGERY CENTER	KY	JH	RELATED	$42,319	$631,595	false	$0	Yes (true)	0.51
ST FRANCIS LAND COMPANY
5390 N ACADEMY BLVD STE 300	COLORADO SPRINGS	CO	80918	263134100	REAL ESTATE	CO	CHIC	RELATED	-$130,967	$13,823,763	false	$0	false	0.51
ST FRANCIS MEDICAL CENTER ASSOCIATES
1717 SOUTH J ST	TACOMA	WA	98405	911352698	MED OFFICE	WA	FHS	RELATED	$238,717	$19,017,063	false	$0	false	0.5421
ST LUKE''S DIAGNOSTIC CATH LAB LLP
6620 MAIN ST STE 1520	HOUSTON	TX	77030	710959365	DIAGNOSTICS	TX	SLHS HOLDINGS	RELATED	$273,448	$868,814	false	$0	false	0.573
ST LUKE''S HOSPITAL AT THE VINTAGE LLC
6624 FANNIN STE 2505	HOUSTON	TX	77030	263734516	HOSPITAL	TX	SLHS	RELATED	-$19,253,743	$69,158,748	false	$0	Yes (true)	0.51
ST LUKE''S LAKESIDE HOSPITAL LLC
6624 FANNIN STE 2505	HOUSTON	TX	77030	300427437	HOSPITAL	TX	SL CDC-W	RELATED	$1,106,628	$25,874,619	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	$0	$0	false	$0	Yes (true)	0.5
SUPERIOR MEDICAL IMAGING LLC
5000 NORTH 26TH ST	LINCOLN	NE	68521	262884555	OP DIAGNOSTICS	NE	SERMC	RELATED	-$200,323	$821,112	false	$0	Yes (true)	0.51
SURGERY CENTER OF LEXINGTON LLC
424 LEWIS HARGETT CIRCLE STE 160	LEXINGTON	KY	40503	621179539	SURGERY CENTER	DE	SJHS	RELATED	-$200,318	$4,079,584	false	$0	Yes (true)	0.51
SURGERY CENTER OF LOUISVILLE LLC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	621179537	SURGERY CENTER	KY	JH	RELATED	-$15,452	$396,101	false	$0	Yes (true)	0.51

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (59 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Address Line1ForeignAddress/AddressLine1	CityForeignAddress/City	Province Or StateForeignAddress/ProvinceOrState	CountryForeignAddress/Country	Postal CodeForeignAddress/PostalCode	Business Name Line2RelatedOrganizationName/BusinessNameLine2
ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SERVICES INC
12809 WEST DODGE RD	OMAHA	NE	68154	470802396	MANAGED CARE	NE	CHI NEBRASKA	C CORPORATION	$5,312,313	$4,520,865	1	Yes (true)
ALL SAINTS INSURANCE COMPANY SPC LTD
					INSURANCE		CHI	C CORPORATION	$0	$43,866,961	1	Yes (true)	CJ
ALTERNATIVE INSURANCE MANAGEMENT SERVICE
3900 OLYMPIC BLVD STE 400	ERLANGER	KY	41018	841112049	MANAGEMENT SERVICES	CO	CHI	C CORPORATION	$0	$6,272,746	1	Yes (true)
AMERICAN NURSING CARE INC
1700 EDISON DR	MILFORD	OH	45150	311085414	HOME HEALTH	OH	CHS	C CORPORATION	$5,118,606	$51,920,207	1	Yes (true)
AMERIMED INC
1700 EDISON DR	MILFORD	OH	45150	311158699	HOME HEALTH	OH	ANC	C CORPORATION	$2,134,392	$14,669,219	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
2525 DE SALES AVE	CHATTANOOGA	TN	37404	621570736	HEALTHCARE	TN	MHCS	C CORPORATION	$0	$1,008	1	Yes (true)
CAPTIVE MANAGEMENT INITIATIVES LTD
				980663022	CAPTIVE MANAGEMENT		CHI	C CORPORATION	$0	$0	1	Yes (true)	CJ	PO BOX 10073 APO	GEORGETOWN	GRAND CAYMAN	CJ	KY1-1001
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	-$2,286,538	$1,241,259	1	Yes (true)
CGH REALTY COMPANY INC
2500 BERNVILLE RD	READING	PA	19603	232326801	REAL ESTATE	PA	SJHM	C CORPORATION	$0	$0	1	Yes (true)
CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER CONDO ASSOC
6624 FANNIN STE 2505	HOUSTON	TX	77030	455079545	CONDO ASSOC	TX	CHI-SLHBCM	C CORPORATION	$0	$0	1	Yes (true)
CLEARRIVER HEALTH
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	464495960	INSURANCE	TN	PHPSI	C CORPORATION	$0	$0	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	-$879,467	$52,379,487	1	Yes (true)
DES MOINES MEDICAL CENTER INC
1111 6TH AVE	DES MOINES	IA	50314	420837382	REAL ESTATE	IA	CHI-IA CORP	C CORPORATION	$67,314	$1,064,032	0.9298	Yes (true)
EAST TEXAS CLINICAL SERVICES INC
2801 VIA FORTUNA 500	AUSTIN	TX	78746	454736213	HEALTHCARE	TX	MHSET	C CORPORATION	$632,545	$16,782	1	Yes (true)
FIRST INITIATIVES INSURANCE LTD
				980203038	INSURANCE		CHI	C CORPORATION	$0	$0	1	Yes (true)	CJ	PO BOX 10073 APO	GEORGETOWN	GRAND CAYMAN	CJ	KY1-1001
FRANCISCAN SERVICES INC
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	232487967	HEALTHCARE	CO	CHI	C CORPORATION	$434,854	$718,254	1	Yes (true)
GOOD SAMARITAN OUTREACH SERVICES
PO BOX 1990	KEARNEY	NE	68848	470659440	MEDICAL CLINIC	NE	CHI NEBRASKA	C CORPORATION	-$7,280	$180,468	1	Yes (true)
HEALTH SYSTEMS ENTERPRISES INC
PO BOX 1990	KEARNEY	NE	68848	470664558	MGMT	NE	GSH	C CORPORATION	$87,278	$1,377,820	1	Yes (true)
HEALTHCARE MGMT SERVICES ORGANIZATION INC
1717 SOUTH J ST	TACOMA	WA	98405	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	$0	$0	1	Yes (true)
HIGHLINE MEDICAL GROUP
15811 AMBAUM BLVD SW STE 170	BURIEN	WA	98166	911586438	MEDICAL SERVICES	WA	HMC	C CORPORATION	-$6,049,147	$5,689,139	1	Yes (true)
MEDQUEST
1602 WEST 11TH ST	WILLISTON	ND	58801	450392137	SALE OF DME	ND	MMC WILLISTON	C CORPORATION		$1,152,715	1	Yes (true)
MERCY PARK APARTMENTS LTD
1111 6TH AVE	DES MOINES	IA	50314	421202422	HOUSING	IA	CHI-IA CORP	C CORPORATION	$273,525	$1,937,218	1	Yes (true)
MERCY SERVICES CORP
2700 STEWART PARKWAY	ROSEBURG	OR	97471	930824308	RETAIL SALES	OR	MMC	C CORPORATION	$0	$142,337	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	$96,044	$6,465,179	1	Yes (true)
NAZARETH ASSURANCE COMPANY
				030304831	INSURANCE		CHI	C CORPORATION	$0	$0	1	Yes (true)	CJ	PO BOX 10073 APO	GEORGETOWN	GRAND CAYMAN	CJ	KY1-1001
PATIENT TRANSPORT SERVICES INC
1700 EDISON DR	MILFORD	OH	45150	311100798	HOME HEALTH	OH	ANC	C CORPORATION	-$164,340	$5,488,275	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	-$5,339,325	$38,272,608	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	$0	1	Yes (true)
QUALCHOICE HOLDINGS INC
12615 CHENAL PARKWAY STE 300	LITTLE ROCK	AR	72211	274075520	HOLDING CO	AR	PHPS	C CORPORATION	$0	$0	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	$0	1	Yes (true)
RIVERLINK HEALTH
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	464380824	INSURANCE	OH	PHPS	C CORPORATION	$0	$0	1	Yes (true)
RIVERLINK HEALTH OF KENTUCKY INC
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	464828332	INSURANCE	KY	PHPS	C CORPORATION	$0	$0	1	Yes (true)
SAINT CLARE''S PRIMARY CARE INC
66 FORD RD	DENVILLE	NJ	07834	222441202	BILLING SERVICES	NJ	SCCC	C CORPORATION	-$235,604	$1,361,242	1	Yes (true)
SAMARITAN FAMILY CARE INC
40 W FOURTH ST STE 1700	DAYTON	OH	45402	311299450	HEALTHCARE	OH	SHP	C CORPORATION	$0	$0	1	Yes (true)
SJH SERVICES CORPORATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	232307408	HEALTHCARE	CO	FSI	C CORPORATION	-$197,039	$3,331,737	1	Yes (true)
SJL PHYSICIAN MANAGEMENT SERVICES INC
424 LEWIS HARGETT CR STE 160	LEXINGTON	KY	40503	270164198	MGMT	KY	SJHS	C CORPORATION	$0	$0	1	Yes (true)
SLMT PARKING INC
6624 FANNIN STE 800	HOUSTON	TX	77030	760637140	PARKING	TX	SLHS	C CORPORATION	$1,117,934	$13,768,221	1	Yes (true)
SOUNDPATH HEALTH INC
32129 WEYERHAEUSER WAY S STE 201	FEDERAL WAY	WA	98001	421720801	INSURANCE	WA	PHPS	C CORPORATION	-$154,741	$10,976,973	0.626	Yes (true)
ST ANTHONY DEVELOPMENT COMPANY
1415 SOUTHGATE	PENDLETON	OR	97801	931216943	ATHLETIC CLUB	OR	SAH	C CORPORATION	$114,663	$2,936,102	1	Yes (true)
ST JOSEPH DEVELOPMENT COMPANY INC
1717 SOUTH J ST	TACOMA	WA	98405	911480569	RENTAL	WA	FSI	C CORPORATION	$63,164	$11,845,439	1	Yes (true)
ST JOSEPH OFFICE PARK ASSOCIATION
1401 HARRODSBURG RD BLDG B70	LEXINGTON	KY	40504	611079899	MGMT	KY	SJHS	C CORPORATION	$0	$882,139	0.85	Yes (true)
ST LUKE'S 6620 MAIN CONDOMINIUM ASSOCIATION
6624 FANNIN STE 2505	HOUSTON	TX	77030	300355517	CONDO ASSOC	TX	SLPC	C CORPORATION	$0	$0	1	Yes (true)
ST LUKE'S ANESTHESIOLOGY ASSOCIATES
6624 FANNIN STE 1100	HOUSTON	TX	77030	461517163	MEDICAL CLINIC	TX	CHI-SLH	C CORPORATION	$0	$0	1	Yes (true)
ST LUKE''S EPISCOPAL HOSPITAL PHYSICIAN HOSPITAL ORGANIZATION INC
6720 BERTNER MC4-262	HOUSTON	TX	77030	760377932	PHO	TX	CHI-SLH	C CORPORATION	$6	$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	$1,425,313	$33,114,103	1	Yes (true)
ST LUKE'S MEDICAL ARTS CENTER I CONDOMINIUM ASSOCIATION
6624 FANNIN STE 2505	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 2505	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	$2,408,638	$15,225,732	1	Yes (true)
STABLEVIEW HEALTH INC
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	464373713	INSURANCE	KY	PHPS	C CORPORATION	$0	$0	1	Yes (true)
SUGAR LAND DOCTOR GROUP
1317 LAKE POINTE PARKWAY	SUGAR LAND	TX	77478	454270163	MEDICAL CLINIC	TX	SLCDC-SL	C CORPORATION	$0	$0	1	Yes (true)
THE TEXAS HEART INSTITUTE AT ST LUKE'S EPISCOPAL HOSPITAL DENTON A COOLEY B
6624 FANNIN STE 2505	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	$516,457	$197,196	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	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	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