CHI LISBON HEALTH: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: CHI LISBON HEALTH (EIN 82-0558836)
Tax period: 2013-07-01 to 2014-06-30
Filed: 2015-05-14
IRS object ID: 201541349349302534
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 F
Schedule G
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-05-14T10:21:58-05:00	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	198 INVERNESS DRIVE WEST	AddressLine1
City	ENGLEWOOD	City
State	CO	State
ZIP Code	80112	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	820558836	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LISBON AREA HEALTH SERVICES	BusinessNameLine1

Field	Value	IRS element (for citing)
Business Name Control	LISB	BusinessNameControlTxt
Phone	7016835241	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	905 Main Street	AddressLine1
City	Lisbon	City
State	ND	State
ZIP Code	58054	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	PEGGY LARSON	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Signature	2015-05-14	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Pamela Krohn	PreparerPersonNm
PTIN	P01210500	PTIN
Phone	3032989100	PhoneNum

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	CHI LISBON HEALTH	BusinessNameLine1

Principal Ofcr Business Address PrincipalOfcrBusinessAddress

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	905 Main Street	AddressLine1
City	Lisbon	City
State	ND	State
ZIP Code	58054	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$11,850,622	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.LISBONHOSPITAL.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2002	FormationYr
Legal Domicile State	ND	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE HIGH QUALITY HEALTH CARE WITHIN IDEALS OF COMPASSION AND CONCERN, TO BE COMMITTED TO MAINTAIN OUR PRESENCE INTO THE FUTURE BY SERVING OUR CUSTOMERS, TO ASSURE CONTINUITY OF TOTAL CARE	ActivityOrMissionDesc
Voting Members Governing Body	8	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	131	TotalEmployeeCnt
Total Volunteers	50	TotalVolunteersCnt
Total Gross UBI	-$196	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$196	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$91,875	PYContributionsGrantsAmt
CY Contributions Grants	$98,762	CYContributionsGrantsAmt
PY Program Service Revenue	$11,660,765	PYProgramServiceRevenueAmt
CY Program Service Revenue	$11,563,284	CYProgramServiceRevenueAmt
PY Investment Income	$157,398	PYInvestmentIncomeAmt
CY Investment Income	$132,353	CYInvestmentIncomeAmt
PY Other Revenue	$44,386	PYOtherRevenueAmt
CY Other Revenue	$43,983	CYOtherRevenueAmt
PY Total Revenue	$11,954,424	PYTotalRevenueAmt
CY Total Revenue	$11,838,382	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$10,582	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$4,115,320	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$4,302,857	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$6,495,825	PYOtherExpensesAmt
CY Other Expenses	$6,960,986	CYOtherExpensesAmt
PY Total Expenses	$10,611,145	PYTotalExpensesAmt
CY Total Expenses	$11,274,425	CYTotalExpensesAmt
PY Revenues Less Expenses	$1,343,279	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$563,957	CYRevenuesLessExpensesAmt
Total Assets BOY	$9,317,214	TotalAssetsBOYAmt
Total Assets EOY	$9,803,012	TotalAssetsEOYAmt
Total Liabilities BOY	$2,064,521	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,757,959	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$7,252,693	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$8,045,053	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SEE SCHEDULE O	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$10,143,108	ExpenseAmt
Grant	$1,368	GrantAmt
Revenue	$11,563,284	RevenueAmt
Desc	SEE SCHEDULE H	Desc
Total Program Service Expenses	$10,143,108	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	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	Yes (true)	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	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	false	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	false	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	131	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	8	GoverningBodyVotingMembersCnt
Independent Voting Member	6	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	false	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

Field	Value	IRS element (for citing)
Phone	7012378022	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4784 Amber Valley Parkway	AddressLine1
City	Fargo	City
State	ND	State
ZIP Code	58104	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (10 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
BRIAN SHELTON
CHAIR	1.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
LIZ ANDERSON
SECRETARY	1.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
NEIL OLERUD
Vice Chair	1.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
PEGGY LARSON
ADMINISTRATOR	40.00	0.00	Yes (X)	Yes (X)	$0	$206,460	$43,835
DWAYNE HORGESHIMER
BOARD MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
JASON ENGER
BOARD MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
JEFFREY DROP
Board Member/CHI SVP Division Officer	1.00	60.00	Yes (X)		$0	$827,539	$118,272
SISTER DONNA WELDER
Board Member	1.00	0.00	Yes (X)		$0	$0	$0
AMBER STOWMAN
CONTROLLER	40.00	0.00		Yes (X)	$0	$96,469	$27,087
BECKI THOMPSON
VP Operational Finance	40.00	0.00		Yes (X)	$0	$88,200	$7,012

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,218,668	TotReportableCompRltdOrgAmt
Total Other Compensation	$196,206	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1	CityContractorAddress/USAddress/City	StateContractorAddress/USAddress/State	ZIP CodeContractorAddress/USAddress/ZIPCode	ServicesServicesDesc	CompensationCompensationAmt
NATIONAL MEDICAL RESOURCES
2900 E BROADWAY AVE SUITE 1	BISMARCK	ND	58501	EMERGENCY ROOM COVERAGE	$450,784
LOPERENA RUDOLF MD
PO BOX 71	LISBON	ND	58054	ER PHYSICIAN COVERAGE	$373,988
MOBILITY PLUS
26295 CRYSTAL RD	PELICAN RAPIDS	MN	56572	PHYSICAL/OCCUPATIONAL THERAPY SERVICES	$225,776
ALLIANCE RECRUITING RESOURCES INC
PO BOX 4356 DEPT 611	HOUSTON	TX	772104356	EMERGENCY ROOM COVERAGE	$110,632

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	4	CntrctRcvdGreaterThan100KCnt
Government Grants	$7,550	GovernmentGrantsAmt
All Other Contributions	$91,212	AllOtherContributionsAmt
Total Contributions	$98,762	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICES	900099	$11,494,201	$11,494,201
RENTAL INCOME	900099	$69,083	$69,083
		$0
		$0
		$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

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

Field	Value	IRS element (for citing)
Total Program Service Revenue	$11,563,284	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$71,563	TotalRevenueColumnAmt
Unrelated Business Revenue	-$196	UnrelatedBusinessRevenueAmt
Exclusion	$71,759	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	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

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

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

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

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$58,790	SecuritiesAmt
Other	$2,000	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$58,790	SecuritiesAmt
Other	$2,000	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$60,790	TotalRevenueColumnAmt
Exclusion	$60,790	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$51,962	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$12,240	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$39,722	TotalRevenueColumnAmt
Exclusion	$39,722	ExclusionAmt

Net Income From Gaming NetIncomeFromGamingGrp

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
MEDICAL RECORDS REVENUE/TRANSCRIPTION	541200	$2,264	$2,264
EMERGENCY MEDICAL SERVICES	621910	$1,000	$1,000
CAFETERIA	722100	$318	$318

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$679	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$679	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$4,261	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,838,382	TotalRevenueColumnAmt
Related Or Exempt Func Income	$11,563,284	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	-$196	UnrelatedBusinessRevenueAmt
Exclusion	$176,532	ExclusionAmt

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

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$1,368	TotalAmt
Program Services	$1,368	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

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

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$9,214	TotalAmt
Program Services	$9,214	ProgramServicesAmt

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	$0	TotalAmt

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	$3,368,028	TotalAmt
Program Services	$3,078,759	ProgramServicesAmt
Management And General	$289,269	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$159,260	TotalAmt
Program Services	$145,582	ProgramServicesAmt
Management And General	$13,678	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$541,146	TotalAmt
Program Services	$494,669	ProgramServicesAmt
Management And General	$46,477	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$234,423	TotalAmt
Program Services	$214,289	ProgramServicesAmt
Management And General	$20,134	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

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

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$14,144	TotalAmt
Management And General	$14,144	ManagementAndGeneralAmt

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	$0	TotalAmt

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	$3,045,361	TotalAmt
Program Services	$2,471,649	ProgramServicesAmt
Management And General	$573,712	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$16,278	TotalAmt
Management And General	$16,278	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$450,712	TotalAmt
Program Services	$358,891	ProgramServicesAmt
Management And General	$91,821	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,555,202	TotalAmt
Program Services	$1,555,202	ProgramServicesAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$286,309	TotalAmt
Program Services	$261,719	ProgramServicesAmt
Management And General	$24,590	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$20,369	TotalAmt
Program Services	$10,193	ProgramServicesAmt
Management And General	$10,176	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	$2,417	TotalAmt
Program Services	$268	ProgramServicesAmt
Management And General	$2,149	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$47,559	TotalAmt
Program Services	$47,559	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$420,492	TotalAmt
Program Services	$420,492	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$268,881	TotalAmt
Program Services	$268,881	ProgramServicesAmt

Insurance InsuranceGrp

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

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$632,815	$631,283	$1,532
REPAIRS & MAINTENANCE	$40,572	$40,181	$391
BAD DEBTS	$116,299	$116,299

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$43,576	TotalAmt
Program Services	$16,610	ProgramServicesAmt
Management And General	$26,966	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$11,274,425	TotalAmt
Program Services	$10,143,108	ProgramServicesAmt
Management And General	$1,131,317	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	$1,994	BOYAmt
EOY	$5,691	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$654,775	BOYAmt
EOY	$2,440,356	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$3,411,179	BOYAmt
EOY	$1,658,081	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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$917	BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$210,514	BOYAmt
EOY	$223,697	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$4,044	BOYAmt
EOY	$11,801	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$4,223,891	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$2,782,813	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,573,986	BOYAmt
EOY	$1,441,078	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$3,167,308	BOYAmt
EOY	$3,616,990	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

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

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$292,497	BOYAmt
EOY	$405,318	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$9,317,214	BOYAmt
EOY	$9,803,012	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$822,589	BOYAmt
EOY	$651,785	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$29,025	BOYAmt
EOY	$2,030	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	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,212,907	BOYAmt
EOY	$1,104,144	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,064,521	BOYAmt
EOY	$1,757,959	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,202,100	BOYAmt
EOY	$7,935,874	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$47,093	BOYAmt
EOY	$105,679	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,500	BOYAmt
EOY	$3,500	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$7,252,693	BOYAmt
EOY	$8,045,053	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$9,317,214	BOYAmt
EOY	$9,803,012	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$563,957	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$322,715	NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments	-$7,780	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	-$86,532	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$1,452	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$1,452	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: AMERICAN HOSPITAL ASSOCIATION - $267 CATHOLIC HEALTH ASSOCIATION - $92 NORTH DAKOTA HOSPITAL ASSOCIATION - $1,093	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,500	BeginningYearBalanceAmt
End Year Balance	$3,500	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$0	BeginningYearBalanceAmt
Contributions	$3,500	ContributionsAmt
End Year Balance	$3,500	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$0	BeginningYearBalanceAmt
End Year Balance	$0	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$0	BeginningYearBalanceAmt
End Year Balance	$0	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$0	BeginningYearBalanceAmt
End Year Balance	$0	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$103,303	OtherCostOrOtherBasisAmt
Book Value	$103,303	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,241,113	OtherCostOrOtherBasisAmt
Depreciation	$951,018	DepreciationAmt
Book Value	$290,095	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	$2,722,002	OtherCostOrOtherBasisAmt
Depreciation	$1,750,164	DepreciationAmt
Book Value	$971,838	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$157,473	OtherCostOrOtherBasisAmt
Depreciation	$81,631	DepreciationAmt
Book Value	$75,842	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$1,441,078	TotalBookValueLandBuildingsAmt

Financial Derivatives FinancialDerivativesGrp

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

Closely Held Equity Interests CloselyHeldEquityInterestsGrp

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

Other Securities OtherSecuritiesGrp (2 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
CHI OIP - FIXED INCOME	$1,761,567	F
CHI OIP - EQUITY SECURITIES	$1,855,423	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$3,616,990	TotalBookValueSecuritiesAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
CHI DEBT MANAGEMENT PROGRAM	$918,428
INTERCOMPANY PAYABLES	$185,716

Field	Value	IRS element (for citing)
Total Liability	$1,104,144	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

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

ENDOWMENT FUNDS ARE HELD TO PROVIDE SUPPORT TO AND FOR THE BENEFIT OF LISBON AREA HEALTH SERVICES.

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

LISBON AREA HEALTH SERVICES' FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI'S FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED JUNE 30, 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 F IRS990ScheduleF

Grants To Org Outside US GrantsToOrgOutsideUSGrp

Field	Value	IRS element (for citing)
Region	EAST ASIA AND THE PACIFIC	RegionTxt
Purpose Of Grant	HOSPITAL SUPPORT	PurposeOfGrantTxt
Non Cash Assistance	$9,214	NonCashAssistanceAmt
Description Of Non Cash Asst	MEDICAL SUPPLIES, EQUIPMENT	DescriptionOfNonCashAsstTxt
Valuation Method Used	BOOK	ValuationMethodUsedDesc

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt
Transfer To Foreign Corp	false	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	false	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	false	PassiveForeignInvestmestCoInd
Foreign Partnership	false	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Name Of Event1	GALA	NameOfEvent1Amt
Gross Receipts Event1	$51,962	GrossReceiptsEvent1Amt
Charitable Contri Event1	$0	CharitableContriEvent1Amt
Gross Revenue Event1	$51,962	GrossRevenueEvent1Amt
Non Cash Prizes Event1	$531	NonCashPrizesEvent1Amt
Food And Beverage Event1	$5,145	FoodAndBeverageEvent1Amt
Entertainment Event1	$500	EntertainmentEvent1Amt
Other Direct Expenses Event1	$6,064	OtherDirectExpensesEvent1Amt
Gross Revenue Event2	$0	GrossRevenueEvent2Amt
Gross Revenue Other Events	$0	GrossRevenueOtherEventsAmt
Gross Receipts Total	$51,962	GrossReceiptsTotalAmt
Charitable Contributions Tot	$0	CharitableContributionsTotAmt
Gross Revenue Total Events	$51,962	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$0	CashPrizesTotalEventsAmt
Non Cash Prizes Total Events	$531	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$0	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$5,145	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$500	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$6,064	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$12,240	DirectExpenseSummaryEventsAmt
Net Income Summary	$39,722	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	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	35	PersonsServedCnt
Total Community Benefit Expns	$36,481	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$36,481	NetCommunityBenefitExpnsAmt
Total Expense	0.00330	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	491	PersonsServedCnt
Total Community Benefit Expns	$752,913	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$752,913	NetCommunityBenefitExpnsAmt
Total Expense	0.06750	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

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

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	526	PersonsServedCnt
Total Community Benefit Expns	$789,394	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$789,394	NetCommunityBenefitExpnsAmt
Total Expense	0.07080	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	8	ActivitiesOrProgramsCnt
Persons Served	488	PersonsServedCnt
Total Community Benefit Expns	$47,317	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,288	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$41,029	NetCommunityBenefitExpnsAmt
Total Expense	0.00370	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	55	PersonsServedCnt
Total Community Benefit Expns	$26,246	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$26,246	NetCommunityBenefitExpnsAmt
Total Expense	0.00240	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

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

Research ResearchGrp

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

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	12	ActivitiesOrProgramsCnt
Persons Served	233	PersonsServedCnt
Total Community Benefit Expns	$28,920	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,070	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$24,850	NetCommunityBenefitExpnsAmt
Total Expense	0.00220	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	24	ActivitiesOrProgramsCnt
Persons Served	776	PersonsServedCnt
Total Community Benefit Expns	$102,483	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,358	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$92,125	NetCommunityBenefitExpnsAmt
Total Expense	0.00830	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	24	ActivitiesOrProgramsCnt
Persons Served	1302	PersonsServedCnt
Total Community Benefit Expns	$891,877	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,358	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$881,519	NetCommunityBenefitExpnsAmt
Total Expense	0.07910	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)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	1	PersonsServedCnt
Total Community Benefit Expns	$2,162	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,162	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	54	PersonsServedCnt
Total Community Benefit Expns	$2,950	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$200	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,750	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	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)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	1	PersonsServedCnt
Total Community Benefit Expns	$8,783	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,720	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,063	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	200	PersonsServedCnt
Total Community Benefit Expns	$486	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$486	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	36	PersonsServedCnt
Total Community Benefit Expns	$61,200	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$61,200	NetCommunityBenefitExpnsAmt
Total Expense	0.00540	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	14	ActivitiesOrProgramsCnt
Persons Served	292	PersonsServedCnt
Total Community Benefit Expns	$75,581	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,920	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$72,661	NetCommunityBenefitExpnsAmt
Total Expense	0.00640	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$116,299	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$6,652,519	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$6,586,652	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$65,867	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LISBON AREA HEALTH SERVICES	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	905 Main Street	AddressLine1
City	LISBON	City
State	ND	State
ZIP Code	58054	ZIPCode

Field	Value	IRS element (for citing)
Website Address	WWW.LISBONHOSPITAL.COM	WebsiteAddressTxt
State License	5031	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	LISBON AREA HEALTH SERVICES	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.lisbonhospital.com	OwnWebsiteURLTxt
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
Medical Indigency	Yes (X)	MedicalIndigencyInd
Insurance Status	Yes (X)	InsuranceStatusInd
Uninsured Discount	Yes (X)	UninsuredDiscountInd
Medicaid Medicare	Yes (X)	MedicaidMedicareInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
Posted On Website	Yes (X)	PostedOnWebsiteInd
Posted In Emergency Room	Yes (X)	PostedInEmergencyRoomInd
Posted In Admission Office	Yes (X)	PostedInAdmissionOfficeInd
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) - LISBON AREA HEALTH SERVICES: TO HELP INFORM FUTURE DECISIONS AND STRATEGIC PLANNING, LISBON AREA HEALTH SERVICES (LAHS) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY. THIS WAS DONE THROUGH A JOINT EFFORT OF LAHS, SARGENT COUNTY DISTRICT HEALTH UNIT, AND RANSOM COUNTY PUBLIC HEALTH DEPARTMENT. COMMUNITY HEALTH DATA WAS USED AND INPUT SOLICITED FROM COMMUNITY MEMBERS VIA INTERVIEWS AND A PUBLIC SURVEY. THE SURVEY WAS WIDELY DISTRIBUTED THROUGHOUT RANSOM AND SARGENT COUNTY BY PAPER FORM AND ONLINE THROUGH SURVEY MONKEY. ADDITIONAL INFORMATION WAS COLLECTED THROUGH KEY INFORMANT INTERVIEWS OF LOCALLY IDENTIFIED COMMUNITY LEADERS. ONE-ON-ONE INTERVIEWS WITH KEY INFORMANTS WERE CONDUCTED IN PERSON IN LISBON IN DECEMBER 2012 AND JANUARY 2013. TOPICS COVERED DURING THESE INTERVIEWS WERE GENERAL HEALTH NEEDS OF THE COMMUNITY, DELIVERY OF HEALTH CARE BY THE LOCAL PROVIDERS, AWARENESS OF THE LOCAL HEALTH SERVICES PROVIDED AT THAT TIME, BARRIERS TO USING THE LOCAL SERVICES, SUGGESTIONS FOR IMPROVING THE HEALTH SERVICES IN THE COMMUNITY, REASONS WHY OR WHY NOT FOR USE OF LOCAL HEALTH SERVICES, AND REASONS WHY COMMUNITY MEMBERS GO OUT OF THE COMMUNITY FOR HEALTH CARE.;
Schedule H, Part V Sec B, Line 7, Needs not addressed in Needs Assessment	(1) - LISBON AREA HEALTH SERVICES: NEEDS NOT ADDRESSED INCLUDE LACK OF EVENING AND WEEKEND HOURS, ADDITIONAL HEALTH SERVICES FOR CANCER PATIENTS, IN-HOME SERVICES, LACK OF MENTAL HEALTH SERVICES, AND A DIALYSIS FACILITY. WE COULD NOT ADDRESS ALL NEEDS DUE TO TIMING, AVAILABILITY, AND BUDGET. ;
Schedule H, Part V Sec B, Line 10, Used federal poverty guidelines (FPG) to determine eligibility	(1) - LISBON AREA HEALTH SERVICES: HUD LOW-INCOME GUIDELINES ARE USED BY LISBON AREA HEALTH SERVICES TO DETERMINE ELIGIBILITY FOR PROVIDING DISCOUNTED CARE.;
Schedule H, Part V Sec B, Line 11, Eligibility for Discounted Care	(1) - LISBON AREA HEALTH SERVICES: HUD LOW-INCOME GUIDELINES ARE USED BY LISBON AREA HEALTH SERVICES TO DETERMINE ELIGIBILITY FOR PROVIDING DISCOUNTED CARE.;
Schedule H, Part V Sec B, Line 20d, How amounts charged to FAP-eligible patients were determined	(1) - LISBON AREA HEALTH SERVICES: LISBON AREA HEALTH SERVICES USES THE AVERAGE OF MANAGED CARE DISCOUNTS TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE.;

Field	Value	IRS element (for citing)
Facility	0	FacilityNum

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c, Eligibility criteria for free or discounted care	WHEN CATHOLIC HEALTH INITIATIVES (THE ULTIMATE PARENT ORGANIZATION TO LISBON AREA HEALTH SERVICES) ESTABLISHED ITS FINANCIAL ASSISTANCE POLICY IT WAS DETERMINED THAT ESTABLISHING A HOUSEHOLD INCOME SCALE BASED ON THE HUD VERY LOW INCOME GUIDELINES MORE ACCURATELY REFLECTS THE SOCIOECONOMIC DISPERSIONS AMONG URBAN AND RURAL COMMUNITIES IN 18 STATES SERVED BY CHI HOSPITALS AND HEALTH CARE FACILITIES. IN COMPARING HUD GUIDELINES TO THE FEDERAL POVERTY GUIDELINES (FPG), WE FIND THAT ON AVERAGE HUD GUIDELINES COMPUTE TO APPROXIMATELY 200% TO 250% (AND SOMETIMES 300%) OF FPG. LISBON AREA HEALTH SERVICES 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 7, Costing Methodology used to calculate financial assistance	A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING THE ORGANIZATION'S COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. THE COST-TO-CHARGE RATIO FOR THE YEAR ENDED 6/30/2014 WAS COMPUTED USING THE FOLLOWING FORMULA: OPERATING EXPENSE (BEFORE RESTRUCTURING, IMPAIRMENT AND OTHER LOSSES) DIVIDED BY GROSS PATIENT REVENUE. BASED ON THAT FORMULA, $11,170,367 /$18,647,491 RESULTS IN A 59.9% COST-TO-CHARGE RATIO. WORKSHEET 2 WAS NOT USED TO DERIVE THE COST-TO-CHARGE RATIO.
Schedule H, Part I, Line 7, col(f), Bad Debt Expense excluded from financial assistance calculation	116,299
Schedule H, Part I, Line 7g, Subsidized Health Services	THERE ARE NO PHYSICIAN CLINICS INCLUDED IN SUBSIDIZED HEALTH SERVICES.
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 59.9%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE.
Schedule H, Part III, Line 3, Bad Debt Expense Methodology	LISBON AREA HEALTH SERVICES DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE.
Schedule H, Part III, Line 4, Bad debt expense - financial statement footnote	LISBON AREA HEALTH SERVICES DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS: "THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, CHI FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. THE PROVISION FOR BAD DEBTS IS PRESENTED ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AS A DEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) SINCE CHI ACCEPTS AND TREATS SUBSTANTIALLY ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY."
Schedule H, Part III, Line 8, Community benefit & methodology for determining medicare costs	LISBON AREA HEALTH SERVICES IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL (CAH). CAHS ARE RURAL COMMUNITY HOSPITALS THAT ARE CERTIFIED TO RECEIVE COST-BASED REIMBURSEMENT FROM MEDICARE. THE REIMBURSEMENT THAT CAHS RECEIVE IS INTENDED TO IMPROVE THEIR FINANCIAL PERFORMANCE AND THEREBY REDUCE HOSPITAL CLOSURES. CAHS ARE CERTIFIED UNDER A DIFFERENT SET OF MEDICARE CONDITIONS OF PARTICIPATION (COP). SHORTFALLS ARE CREATED WHEN A FACILITY RECEIVES PAYMENTS THAT ARE LESS THAN THE COSTS OF CARING FOR PROGRAM BENEFICIARIES. BECAUSE SHORTFALLS ARE BASED ON COSTS, NOT CHARGES, LISBON AREA HEALTH SERVICES, DUE TO THEIR DESIGNATION AS A CAH, RECEIVED COST-BASED REIMBURSEMENT FOR MEDICARE PURPOSES, LISBON AREA HEALTH SERVICES WILL NOT EXPERIENCE MEDICARE RELATED SHORTFALLS. ALTHOUGH NOT PRESENTED ON THE MEDICARE COST REPORT, IN ORDER TO FACILITATE A MORE ACCURATE UNDERSTANDING OF THE "TRUE" COST OF SERVICES (FOR "SHORTFALL" PURPOSES) THE CHI WORKBOOK ALLOWS A HEALTH CARE FACILITY NOT TO OFFSET COSTS THAT MEDICARE CONSIDERS TO BE NON-ALLOWABLE, BUT FOR WHICH THE FACILITY CAN LEGITIMATELY ARGUE ARE RELATED TO THE CARE OF THE FACILITY'S PATIENTS. IN ADDITION, ALTHOUGH NOT REPORTABLE ON THE MEDICARE COST REPORT, THE CHI WORKBOOK INCLUDES THE COST OF SERVICES THAT ARE PAID VIA A SET FEE-SCHEDULE RATHER THAN BEING REIMBURSED BASED ON COSTS (E.G. OUTPATIENT CLINICAL LABORATORY). FINALLY, THE CHI WORKBOOK ALLOWS A FACILITY TO INCLUDE OTHER HEALTH CARE SERVICES PERFORMED BY A SEPARATE FACILITY (SUCH AS A PHYSICIAN PRACTICE) THAT ARE MAINTAINED ON SEPARATE BOOKS AND RECORDS (AS OPPOSED TO THE MAIN FACILITY'S BOOKS AND RECORDS WHICH HAS ITS COSTS OF SERVICE INCLUDED WITHIN A COST REPORT). TRUE COSTS OF MEDICARE COMPUTED USING THIS METHODOLOGY: TOTAL MEDICARE REVENUE: $6,652,519 TOTAL MEDICARE COSTS: $6,586,652 SURPLUS OR SHORTFALL $ 65,867 LISBON AREA HEALTH SERVICES BELIEVES THAT EXCLUDING MEDICARE LOSSES FROM COMMUNITY BENEFIT MAKES THE OVERALL COMMUNITY BENEFIT REPORT MORE CREDIBLE FOR THESE REASONS: UNLIKE SUBSIDIZED AREAS SUCH AS BURN UNITS OR BEHAVIORAL-HEALTH SERVICES, MEDICARE IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS. IN FACT, FOR-PROFIT HOSPITALS FOCUS ON ATTRACTING PATIENTS WITH MEDICARE COVERAGE, ESPECIALLY IN THE CASE OF WELL-PAID SERVICES THAT INCLUDE CARDIAC AND ORTHOPEDICS. SIGNIFICANT EFFORT AND RESOURCES ARE DEVOTED TO ENSURING THAT HOSPITALS ARE REIMBURSED APPROPRIATELY BY THE MEDICARE PROGRAM. THE MEDICARE PAYMENT ADVISORY COMMISSION (MEDPAC), AN INDEPENDENT CONGRESSIONAL AGENCY, CAREFULLY STUDIES MEDICARE PAYMENT AND THE ACCESS TO CARE THAT MEDICARE BENEFICIARIES RECEIVE. THE COMMISSION RECOMMENDS PAYMENT ADJUSTMENTS TO CONGRESS ACCORDINGLY. THOUGH MEDICARE LOSSES ARE NOT INCLUDED BY CATHOLIC HOSPITALS AS COMMUNITY BENEFIT, THE CATHOLIC HEALTH ASSOCIATION GUIDELINES ALLOW HOSPITALS TO COUNT AS COMMUNITY BENEFIT SOME PROGRAMS THAT SPECIFICALLY SERVE THE MEDICARE POPULATION. FOR INSTANCE, IF HOSPITALS OPERATE PROGRAMS FOR PATIENTS WITH MEDICARE BENEFITS THAT RESPOND TO IDENTIFIED COMMUNITY NEEDS, GENERATE LOSSES FOR THE HOSPITAL, AND MEET OTHER CRITERIA, THESE PROGRAMS CAN BE INCLUDED IN THE CHA FRAMEWORK IN CATEGORY C AS "SUBSIDIZED HEALTH SERVICES." MEDICARE LOSSES ARE DIFFERENT FROM MEDICAID LOSSES, WHICH ARE COUNTED IN THE CHA COMMUNITY BENEFIT FRAMEWORK, BECAUSE MEDICAID REIMBURSEMENTS GENERALLY DO NOT RECEIVE THE LEVEL OF ATTENTION PAID TO MEDICARE REIMBURSEMENT. MEDICAID PAYMENT IS LARGELY DRIVEN BY WHAT STATES CAN AFFORD TO PAY, AND IS TYPICALLY SUBSTANTIALLY LESS THAN WHAT MEDICARE PAYS.
Schedule H, Part III, Line 9b, Collection practices for patients eligible for financial assistance	LISBON AREA HEALTH SERVICES DEBT COLLECTION POLICY PROVIDES THAT LISBON AREA HEALTH SERVICES 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 LISBON AREA HEALTH SERVICES COMMUNITY ASSISTANCE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO MEET THE LISBON AREA HEALTH SERVICES COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO LISBON AREA HEALTH SERVICES FOR APPROPRIATE FOLLOW-UP. LISBON AREA HEALTH SERVICES 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, LINES 2, 4 & 5: COMMUNITY NEEDS, INFORMATION, AND BENEFIT	LISBON AREA HEALTH SERVICES STATEMENT OF COMMUNITY BENEFIT I. ORGANIZATION'S MISSION, VISION, AND TAX-EXEMPT PURPOSE THE MISSION OF CHI LISBON HEALTH AND CATHOLIC HEALTH INITIATIVES IS "TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. FIDELITY TO THE GOSPEL URGES 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." OUR VISION IS TO LIVE UP TO OUR NAME AS ONE CHI: CATHOLIC: LIVING OUR MISSION AND CORE VALUES HEALTH: IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE INITIATIVES: PIONEERING MODELS AND SYSTEMS OF CARE TO ENHANCE CARE DELIVERY THE ORGANIZATION'S PRIMARY TAX-EXEMPT PURPOSE IS TO PROVIDE HEALTH CARE TO THE RESIDENTS OF THE SURROUNDING COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. THE GOAL OF CHI LISBON HEALTH IS TO PROVIDE HIGH QUALITY HEALTH CARE TO MEET THE NEEDS OF THE COMMUNITIES WE SERVE. WE ARE COMMITTED TO MAINTAIN OUR PRESENCE INTO THE FUTURE BY SERVING OUR CUSTOMERS WITH DEDICATED SKILLED STAFF. AS A PROVIDER OF COMMUNITY BASED, FAMILY ORIENTED HEALTH CARE, CHI LISBON HEALTH BELIEVES IT CAN BEST MAINTAIN THIS LEVEL OF SERVICE THROUGH A CUSTOMER FOCUS, WHERE WE CONTINUALLY STRIVE TO UNDERSTAND AND EXCEED THE EXPECTATIONS OF OUR CUSTOMERS. CHI LISBON HEALTH IS 62 YEARS OLD THIS YEAR. ESTABLISHED ON FEBRUARY 1, 1952, CHI LISBON HEALTH DELIVERED 497 BABIES AND TREATED 998 PATIENTS BY DECEMBER 31, 1953. OVER THE NEXT 60 YEARS, THE HOSPITAL INCREASED IN SIZE AND ADDED AN ARRAY OF PROGRAMS, SERVICES, AND TECHNOLOGICAL INNOVATIONS TO MEET THE CHANGING NEEDS OF PATIENTS IN THE GROWING COMMUNITY. TODAY CHI LISBON HEALTH IS A NOT-FOR-PROFIT, 25-BED CRITICAL ACCESS HOSPITAL ADMITTING OVER 550 PATIENTS EACH YEAR, PERFORMING ROUGHLY 242 SURGERIES, ACCOMMODATING AROUND 9,383 OUTPATIENT SERVICES (WHICH INCLUDE LABORATORY AND RADIOLOGY VISITS) AND TREATING 1,865 PATIENTS THROUGH ITS EMERGENCY DEPARTMENT. SINCE 1952, THE HOSPITAL HAS BUILT TWO EXPANSIONS AND ADDED NEW SERVICES, INCLUDING CARDIAC REHABILITATION, DIGITAL MAMMOGRAPHY, AND RESPIRATORY CARE. OTHER SERVICES CURRENTLY OFFERED INCLUDE: MEDICAL, SURGICAL (GENERAL, LAPAROSCOPIC, UROLOGY, CATARACTS, COLONOSCOPY, AND ENDOSCOPY), SWINGBED, NUCLEAR MEDICINE, MRI, CT SCAN, ULTRASOUND, EEG, CHEMOTHERAPY, RADIOLOGY, EKG, OCCUPATIONAL THERAPY, PHYSICAL THERAPY, AND A CLINICAL LAB (CHEMISTRY, HEMATOLOGY, BLOOD BANKING, AND MICROBIOLOGY). PHYSICIANS, ALONG WITH OTHER SUPPORT STAFF, ARE ON SITE OR ON CALL TO MEET EMERGENCY NEEDS. ON OCTOBER 15, 2013, CHI LISBON HEALTH OPENED A CLINIC WITHIN THE FACILITY TO BETTER SERVE THEIR COMMUNITY. THIS CLINIC IS STAFFED WITH A FAMILY NURSE PRACTITIONER CERTIFIED, WITH HOPES OF ADDING A DOCTOR WITHIN THE YEAR. THE CLINIC SAW 513 PATIENTS IN FY14; IT IS OPEN MONDAY-FRIDAY FROM 9AM-5PM. MEDICAL NEED AND CARE COME FIRST AT CHI LISBON HEALTH. CHI LISBON HEALTH WILL PROVIDE MEDICALLY NECESSARY HEALTH CARE SERVICES TO ALL PERSONS WHO ARE IN NEED, REGARDLESS OF AGE, RACE, RELIGION, NATIONAL ORIGIN, GENDER, HANDICAP, SEXUAL ORIENTATION, OR ABILITY TO PAY. COMMUNITY BENEFIT PROGRAMS FOR THE POOR ARE GEARED TO REDUCING MORBIDITY AND MORTALITY IN BENEFICIARIES OF MEDICAID AND STATE OR LOCAL INDIGENT PROGRAMS. CHI LISBON HEALTH HAS A GOVERNING BOARD OF DIRECTORS WHOSE MEMBERSHIP INCLUDES REPRESENTATIVES FROM LISBON AND THE IMMEDIATE SURROUNDING AREA, INCLUDING ONE REPRESENTATIVE FROM OUR FOUNDING ORDER, THE SISTERS OF THE PRESENTATION OF THE BLESSED VIRGIN MARY. CHI LISBON HEALTH ALSO HAS A QUALITY COMMITTEE - PATIENT FAMILY ADVISORY COUNCIL AND A FOUNDATION BOARD ADVISORY COUNCIL OF 9. THE FOUNDATION COUNCIL WAS DEVELOPED IN 2010 AND HAS A LARGE GALA FUNDRAISER EACH YEAR. THE GALA HAS AVERAGED $30,000-$40,000 RAISED TO HELP NEEDED DEPARTMENTS IN THE HOSPITAL. THESE FUNDS ARE HOW WE STARTED AN RT DEPARTMENT AT CHI LISBON HEALTH.
SCHEDULE H, PART VI, LINES 2, 4 & 5: COMMUNITY NEEDS, INFORMATION, AND BENEFIT	LISBON AREA HEALTH SERVICES STATEMENT OF COMMUNITY BENEFIT (CONTINUED) II. COMMUNITY BENEFIT APPROACH COMMUNITY BENEFIT IS A PLANNED, ORGANIZED, MANAGED, AND MEASURED APPROACH TO A HEALTH CARE ORGANIZATION'S PARTICIPATION IN MEETING IDENTIFIED COMMUNITY HEALTH NEEDS. IT IMPLIES COLLABORATION WITH A "COMMUNITY" TO "BENEFIT" ITS RESIDENTS - PARTICULARLY PEOPLE WHO ARE POOR, MINORITIES, AND OTHER UNDERSERVED GROUPS - BY IMPROVING HEALTH STATUS AND QUALITY OF LIFE. COMMUNITY BENEFITS ARE PROGRAMS OR ACTIVITIES THAT PROVIDE TREATMENT OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS AND MEET AT LEAST ONE OF THESE COMMUNITY BENEFIT OBJECTIVES: -IMPROVE ACCESS TO HEALTH CARE SERVICES -ENHANCE HEALTH OF THE COMMUNITY -ADVANCE MEDICAL OR HEALTH CARE KNOWLEDGE -RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS CHI LISBON HEALTH IS LOCATED IN LISBON, RANSOM COUNTY, NORTH DAKOTA, AND PROVIDES HEALTH CARE SERVICES TO THE FOLLOWING COUNTIES: DICKEY, LAMOURE, RANSOM, AND SARGENT IN NORTH DAKOTA. ACCORDING TO THE U.S. CENSUS BUREAU, THE NORTH DAKOTA COUNTIES HAVE A TOTAL AREA OF 4,000 SQUARE MILES. LISBON IS IN THE HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS), THE MEDICALLY UNDERSERVED AREAS/POPULATIONS, AS WELL AS MENTAL HEALTH PROFESSIONAL SHORTAGE AREA. HPSAS ARE DESIGNATED BY HEALTH RESOURCES AND SERVICE ADMINISTRATION (HRSA), DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND CENTER FOR RURAL HEALTH - UND AS HAVING SHORTAGES OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS AND MAY BE GEOGRAPHIC (A COUNTY OR SERVICE AREA), DEMOGRAPHIC (LOW INCOME POPULATION), OR INSTITUTIONAL (COMPREHENSIVE HEALTH CENTER, FEDERALLY QUALIFIED HEALTH CENTER, OR OTHER PUBLIC FACILITY). MEDICALLY UNDERSERVED AREAS/POPULATIONS ARE AREAS OR POPULATIONS DESIGNATED BY HRSA AS HAVING TOO FEW PRIMARY CARE PROVIDERS, HIGH INFANT MORTALITY, HIGH POVERTY, AND/OR A HIGH ELDERLY POPULATION. NORTH DAKOTA COUNTIES DESIGNATED AS FRONTIER (LESS THAN 7 PERSONS PER SQUARE MILE FROM 2010 CENSUS) THAT ARE SERVED BY CHI LISBON HEALTH INCLUDE DICKEY, LAMOURE, SARGENT, AND RANSOM COUNTIES. FRONTIER AREAS FACE GREATER CHALLENGES IN PROVIDING ACCESS TO HEALTH AND HUMAN SERVICES THAN THOSE FACED BY LESS ISOLATED RURAL COMMUNITIES. ACCESS TO AN ADEQUATE SUPPLY OF HEALTH CARE PROVIDERS IS A CONCERN IN BOTH NORTH DAKOTA AND NATIONALLY. CENTER FOR RURAL HEALTH PROJECTIONS INDICATE THAT BY 2020, ABOUT ONE-THIRD OF THE STATE'S PHYSICIANS WILL BE AT A LIKELY AGE OF RETIREMENT, WITH THE PERCENTAGE BEING SLIGHTLY LOWER FOR PRIMARY CARE IN COMPARISON TO NON-PRIMARY CARE. ABOUT 90 PERCENT OF NORTH DAKOTA PHYSICIANS ARE LOCATED IN THE TEN LARGEST CITIES; OVER 83 PERCENT OF THE PRIMARY CARE PHYSICIANS ARE LOCATED IN THOSE CITIES. HOWEVER, ACCORDING TO THE USDA ECONOMIC RESEARCH SERVICE, THE 2009 POPULATION ESTIMATE FOR NORTH DAKOTA RECORDED 51 PERCENT OF THE STATE'S POPULATION AS RURAL; THUS, ABOUT NINE OUT OF TEN PHYSICIANS ARE PRACTICING IN ESSENTIALLY URBAN AREAS OF THE STATE, AND ABOUT FIVE OUT OF TEN NORTH DAKOTANS ARE EITHER URBAN OR RURAL. REGARDING OTHER HEALTH CARE DISCIPLINES, JOB SERVICE OF NORTH DAKOTA EXPECTS SIGNIFICANT GROWTH (OVER TEN PERCENT) IN DEMAND FOR PHARMACISTS, OCCUPATIONAL THERAPISTS, PHYSICAL THERAPISTS, MEDICAL AND CLINICAL LABORATORY TECHNOLOGISTS AND TECHNICIANS, PHYSICIAN ASSISTANTS, AND REGISTERED NURSES. COMMUNITY ASSESSMENT, PROCESS, AND SUMMARY TO HELP INFORM FUTURE DECISIONS AND STRATEGIC PLANNING, CHI LISBON HEALTH CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY. THIS WAS DONE THROUGH A JOINT EFFORT OF CHI LISBON HEALTH, SARGENT COUNTY DISTRICT HEALTH UNIT, AND RANSOM COUNTY PUBLIC HEALTH DEPARTMENT. COMMUNITY HEALTH DATA WAS USED AND INPUT SOLICITED FROM COMMUNITY MEMBERS BY INTERVIEWS AND A PUBLIC SURVEY. THE SURVEY WAS WIDELY DISTRIBUTED THROUGHOUT RANSOM AND SARGENT COUNTIES BY PAPER FORM AND ONLINE THROUGH SURVEY MONKEY. ADDITIONAL INFORMATION WAS COLLECTED THROUGH KEY INFORMANT INTERVIEWS OF LOCALLY IDENTIFIED COMMUNITY LEADERS. THE COMPLETE CHNA IS ON THE HOSPITAL'S WEBSITE. A NEEDS ASSESSMENT WAS DONE IN THE COMMUNITY WHEN OPEN DOOR WAS NEW TO THE AREA. OPEN DOOR IS A NON-PROFIT ORGANIZATION. THEY CONTACTED BUSINESSES FOR WORK FOR THEIR CLIENTS WITH DEVELOPMENTAL DISABILITIES. CHI LISBON HEALTH DONATES TO THE NON-PROFIT WITH AN HOURLY STIPEND, SUPERVISION, AND TRAINING. THEIR CLIENTS WITH DEVELOPMENTAL DISABILITIES HELP DIETARY DEPARTMENT WITH DAILY CHORES. UNCOMPENSATED CARE FOR THE POOR CHI LISBON HEALTH PROVIDES CARE TO EVERYONE, REGARDLESS OF HIS OR HER ABILITY TO PAY. BENEFITS FOR THE POOR ARE TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE THEY HAVE INADEQUATE RESOURCES AND/OR ARE UNINSURED OR UNDERINSURED. CHARITY CARE IS FREE OR DISCOUNTED HEALTH AND HEALTH-RELATED SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD TO PAY FOR MEDICALLY NECESSARY HEALTH CARE. ELIGIBILITY IS BASED ON HOUSEHOLD INCOME AS WELL AS OTHER ASSETS. CONSIDERATION IS GIVEN TO A PATIENT WHO HAS SIGNIFICANT OR CATASTROPHIC MEDICAL BILLS AND DOES NOT MEET THE INCOME GUIDELINES. CHARITY CARE IS GIVEN TO UNINSURED, LOW-INCOME PATIENTS WHO ARE NOT EXPECTED TO PAY ALL OR PART OF A BILL OR WHO ARE ABLE TO PAY ONLY A PORTION USING AN INCOME-RELATED FEE SCHEDULE. COMMUNITY BENEFIT PROGRAMS FOR THE POOR ARE GEARED TO REDUCING MORBIDITY AND MORTALITY IN BENEFICIARIES OF MEDICAID OR STATE OR LOCAL INDIGENT PROGRAMS. FINANCIAL ASSISTANCE APPLICATIONS MAY BE OBTAINED FROM CHI LISBON HEALTH IN PERSON OR ON THEIR WEBSITE.
SCHEDULE H, PART VI, LINES 2, 4 & 5: COMMUNITY NEEDS, INFORMATION, AND BENEFIT	LISBON AREA HEALTH SERVICES STATEMENT OF COMMUNITY BENEFIT (CONTINUED) III. QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT IN FISCAL YEAR ENDED JUNE 30, 2014, CHI LISBON HEALTH PROVIDED BENEFITS FOR LOW INCOME INDIVIDUALS AND PROVIDED BROADER COMMUNITY BENEFITS TO SPECIFIC INDIVIDUALS AND/OR OUR SERVICE AREA POPULATION AT LARGE. THE MAJOR COMPONENTS OF THESE COMMUNITY SERVICES ARE AS FOLLOWS: COMMUNITY BENEFIT PROVIDED TO THE POOR FINANCIAL ASSISTANCE ESTIMATED NUMBER OF PEOPLE SERVED - 35; COMMUNITY BENEFIT COST - $36,481 UNPAID COSTS OF MEDICAID ESTIMATED NUMBER OF PEOPLE SERVED - 491; COMMUNITY BENEFIT COST - $752,913 COMMUNITY BENEFIT OPERATIONS ESTIMATED NUMBER OF PEOPLE SERVED - 41; COMMUNITY BENEFIT COST - $3,694 COMMUNITY BUILDING ACTIVITIES ESTIMATED NUMBER OF PEOPLE SERVED - 36; COMMUNITY BENEFIT COST - $61,200 FINANCIAL AND IN-KIND CONTRIBUTIONS ESTIMATED NUMBER OF PEOPLE SERVED - 0; COMMUNITY BENEFIT COST - $9,564 TOTAL COMMUNITY BENEFIT PROVIDED TO THE POOR ESTIMATED NUMBER OF PEOPLE SERVED - 603; COMMUNITY BENEFIT COST - $863,852 COMMUNITY BENEFIT PROVIDED TO THE BROADER COMMUNITY COMMUNITY BENEFIT OPERATIONS ESTIMATED NUMBER OF PEOPLE SERVED - 304; COMMUNITY BENEFIT COST - $10,015 COMMUNITY BUILDING ACTIVITIES ESTIMATED NUMBER OF PEOPLE SERVED - 256; COMMUNITY BENEFIT COST - $11,461 COMMUNITY HEALTH IMPROVEMENT SERVICES ESTIMATED NUMBER OF PEOPLE SERVED - 143; COMMUNITY BENEFIT COST - $27,320 FINANCIAL AND IN-KIND CONTRIBUTIONS ESTIMATED NUMBER OF PEOPLE SERVED - 233; COMMUNITY BENEFIT COST - $15,286 HEALTH PROFESSIONS EDUCATION ESTIMATED NUMBER OF PEOPLE SERVED - 55; COMMUNITY BENEFIT COST - $26,246 TOTAL COMMUNITY BENEFIT PROVIDED TO THE BROADER COMMUNITY ESTIMATED NUMBER OF PEOPLE SERVED - 991; COMMUNITY BENEFIT COST - $90,328 TOTAL COMMUNITY BENEFIT PROVIDED TO THE POOR AND THE BROADER COMMUNITY ESTIMATED NUMBER OF PEOPLE SERVED - 1,594; COMMUNITY BENEFIT COST - $954,180 IN ADDITION, CHI LISBON HEALTH REPORTS THE FOLLOWING HUMAN INVESTMENTS AND STATISTICS: NUMBER OF ACTIVITIES: 37 STAFF HOURS: 3,964 VOLUNTEER HOURS: 146 CHI LISBON HEALTH PROVIDES UNCOMPENSATED CARE TO THOSE IN NEED FOR ALL SERVICES PROVIDED AT THE FACILITY. SIGNIFICANT RESOURCES ARE CONSUMED IN SERVICES TO INDIGENT POPULATIONS NATIVE TO OUR SERVICE AREA. COMMUNITY BENEFIT IS APPROXIMATELY 8.5% OF CHI LISBON HEALTH'S EXPENSES AND 8.2% OF THEIR REVENUES. THE UNPAID COST OF MEDICARE IS NOT INCLUDED IN TOTAL COMMUNITY BENEFIT.
SCHEDULE H, PART VI, LINES 2, 4 & 5: COMMUNITY NEEDS, INFORMATION, AND BENEFIT	LISBON AREA HEALTH SERVICES STATEMENT OF COMMUNITY BENEFIT (CONTINUED) IV. QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT COMMUNITY BENEFIT IS THE NAME GIVEN TO THE PROGRAMS WE CREATE IN RESPONSE TO HEALTH NEEDS IN OUR SERVICE AREAS. AN IMPORTANT PART OF OUR MISSION IS BUILDING HEALTHIER COMMUNITIES THROUGH PROGRAMS DESIGNED TO SERVE THE NEEDS OF PEOPLE WHO ARE POOR AND DISADVANTAGED IN OUR COMMUNITY. THIS TYPE OF COMMUNITY BENEFIT HAS THE ADDED, POSITIVE SIDE-EFFECT OF DELIVERING AN IMPROVED QUALITY OF LIFE FOR EVERYONE. COMMUNITY BENEFIT MOST OFTEN TAKES PLACE OUTSIDE THE WALLS OF OUR FACILITIES AND INVOLVES PARTNER ORGANIZATIONS IN THE COMMUNITY. OUR COMMUNITY BENEFIT ACTIVITIES ARE DESIGNED TO: -IDENTIFY AND INCREASE AWARENESS OF HEALTH NEEDS IN LISBON -PROVIDE RESOURCES TO MEET THOSE NEEDS -CREATE COLLABORATION BETWEEN COMMUNITY ORGANIZATIONS THAT FOCUS ON HEALTH AND WELL BEING -TACKLE PROBLEMS SUCH AS POVERTY, HOMELESSNESS, OR OTHER BEHAVIORS (SUCH AS DOMESTIC VIOLENCE OR UNDERAGE DRINKING) THAT CAN CONTRIBUTE TO POOR HEALTH COMMUNITY OUTREACH FOR THE POOR CHI LISBON HEALTH AND CHI'S FARGO DIVISION INTERNATIONAL SISTER-TO-SISTER HOSPITAL PROGRAM OF THE NEW INDIGENOUS PEOPLE'S HOSPITAL OPENED ON MAY 18, 2012, IN NUEVA VIZCAYA, PHILIPPINES. THE HOSPITAL, LOCATED IN A REMOTE REGION OF THE COUNTRY, NOW PROVIDES CARE TO IMPOVERISHED TRIBAL PEOPLE. THE NEW CLINIC AND HOSPITAL WAS IMMEDIATELY BUSY AND PROVIDED CARE TO MORE THAN 600 PEOPLE THE DAY THEY OPENED. CHI LISBON HEALTH GATHERS SUPPLIES AND EQUIPMENT, AS WELL AS DONATIONS FOR THE HOSPITAL. CHI LISBON HEALTH SENDS SUPPLIES TO PROJECT HERO (HEALTHCARE EQUIPMENT RECYCLING ORGANIZATION), A NON-PROFIT CLEARINGHOUSE THAT COLLECTS AND REDISTRIBUTES DONATED HEALTH CARE MATERIALS TO BENEFIT THOSE IN NEED. IN 2014 HERO SUPPLIED OVER 3,757 INDIVIDUALS REGIONALLY, AND SUPPLIES WERE SENT TO 70 COUNTIES, WITH 60 GLOBAL MEDICAL MISSIONS AND 72,119 TOTAL POUNDS OF SUPPLIES USED. THIS HAS SAVED MORE THAN 162,997 POUNDS FROM BEING TOSSED INTO LANDFILLS. HERO WORKS WITH SEVERAL AGENCY AND HEALTH CARE PARTNERS TO REDISTRIBUTE VIABLE MEDICAL PRODUCTS TO THOSE WITH HEALTH NEEDS. THE FARGO DIVISION PHILIPPINES OUTREACH PROGRAM RECEIVED A GENEROUS THREE-YEAR GRANT FROM THE CHI MISSION AND MINISTRY FUND TO COVER THE COST OF SHIPPING CONTAINERS FULL OF MEDICAL EQUIPMENT AND SUPPLIES TO THE INDIGENOUS PEOPLE'S HOSPITAL, OUR SISTER HOSPITAL, IN THE PHILIPPINES. SISTER ADELLINA JAVELLANA, HOSPITAL ADMINISTRATOR, PROVIDED A LIST OF WHAT IS MOST NEEDED TO TREAT THE IMPOVERISHED TRIBAL PEOPLE OF A REMOTE, MOUNTAINOUS REGION OF THE PHILIPPINES AT THE INDIGENOUS PEOPLE'S HOSPITAL. WE HAVE PARTNERED WITH MEDSHARE, A NONPROFIT MEDICAL EQUIPMENT RECOVERY AND REDISTRIBUTION ORGANIZATION IN THE SAN LEANDRO, CALIFORNIA, TO ACQUIRE THE REQUESTED ITEMS. THE OPEN DOOR PROJECT PROVIDES AN OPPORTUNITY FOR THE DEVELOPMENTALLY DISABLED TO DEVELOP NEW DAILY LIVING SKILLS WORKING SIDE BY SIDE WITH THE CHI LISBON HEALTH DIETARY DEPARTMENT. TRAINING AND SUPERVISION IS PROVIDED FOR THE TASKS THEY DO DAILY. RANSOM COUNTY FOOD PANTRY IS AVAILABLE TO THOSE IN NEED AND CHI LISBON HEALTH SUPPORTS THE PANTRY WITH FINANCIAL AND/OR IN-KIND DONATIONS. COMMUNITY OUTREACH FOR THE BROADER COMMUNITY CHI LISBON HEALTH IS DEDICATED TO CARING FOR THE BROADER COMMUNITY, A STRONG TRADITION THAT IS VITAL AND NECESSARY TO MAINTAIN PROGRESS IN RURAL AREAS WITH LIMITED RESOURCES. CHI LISBON HEALTH PROVIDES AND SUPPORTS VARIOUS SERVICES AND PROGRAMS THAT BENEFIT THE COMMUNITY FOR WHICH THERE IS NO REIMBURSEMENT OR WHERE REIMBURSEMENT IS NOT ADEQUATE TO COVER THE HOSPITAL'S COST. BENEFITS FOR THE BROADER COMMUNITY ARE PERSONS OTHER THAN A "TARGET POPULATION" WHO BENEFIT FROM A HEALTH CARE ORGANIZATION'S COMMUNITY SERVICES AND PROGRAMS. IN-KIND SERVICES INCLUDE HOURS SPENT BY STAFF AS PART OF THEIR WORK ASSIGNMENT WHILE ON HEALTH CARE ORGANIZATION WORK TIME, OVERHEAD EXPENSES OF SPACE PROVIDED TO NOT FOR-PROFIT COMMUNITY GROUPS (FOR MEETINGS), AND DONATIONS OF FOOD, EQUIPMENT, AND SUPPLIES. COLLABORATIVE EFFORTS TO IMPROVE COMMUNITY HEALTH THESE ACTIVITIES ARE CARRIED OUT TO IMPROVE COMMUNITY HEALTH. THEY EXTEND BEYOND PATIENT CARE ACTIVITIES AND INCLUDE SERVICES DIRECTED TO INDIVIDUALS AND TO A LARGER POPULATION. COMMUNITY HEALTH IMPROVEMENT SERVICES DO NOT GENERATE INPATIENT OR OUTPATIENT BILLS, ALTHOUGH THEY MAY INVOLVE A NOMINAL PATIENT FEE AND/OR A SLIDING SCALE FEE. EACH YEAR, SERVICES ARE EXPANDED TO PROMOTE A HEALTHY COMMUNITY. THE PROGRAMS IN CBISA AND SUMMARIZED ON THIS RETURN NOT ONLY BENEFIT AND SERVE THE COMMUNITY AS A WHOLE, BUT ALSO GREATLY REDUCE THE BURDENS ON OUR LOCAL HEALTH DEPARTMENT, A GOVERNMENT FUNDED HEALTH CARE SYSTEM. CHNA STRATEGIC PLANNING, "HEALTH SERVICES FOR OBESITY AND EDUCATION ON WHAT TO DO TO BE HEALTHIER" SHOWED HIGH ON THE SURVEY AND IN THE COUNTY HEALTH NEEDS PROFILE. WORKING TOGETHER WITH THE LOCAL COUNTY EXTENSION OFFICE AND THE PUBLIC HEALTH DEPARTMENT WE WERE ABLE TO HOLD CLASSES FOR THE COMMUNITY ON HOW TO PREPARE FOOD AND TO EAT HEALTHIER. BLOOD PRESSURE CHECKS AND FASTING CHOLESTEROL CHECKS WERE DONE WITH THIS PROJECT ALSO. WITH THE HELP OF GRANT FUNDS WE WERE ALSO ABLE TO SUPPLY NEEDED EQUIPMENT FOR A GROUP TO START UP A LOCAL FITNESS CLUB AT NO CHARGE FOR COMMUNITY MEMBERS TO ATTEND. RELAY FOR LIFE IS THE AMERICAN CANCER SOCIETY'S SIGNATURE ACTIVITY. IT OFFERS EVERYONE IN THE COMMUNITY AN OPPORTUNITY TO PARTICIPATE IN THE FIGHT AGAINST CANCER. THE FUNDS RAISED AT RELAY SAVE LIVES BY FUNDING CUTTING-EDGE CANCER RESEARCH, EARLY DETECTION AND PREVENTION EDUCATION, ADVOCACY EFFORTS, AND LIFE-AFFIRMING PATIENT SERVICES. IT IS BECAUSE OF COMMUNITY INVOLVEMENT THAT LIVES ARE SAVED, HELP REACHES THOSE BATTLING CANCER, AND INDIVIDUALS ARE EMPOWERED TO FIGHT BACK AGAINST THE DISEASE. CHI LISBON HEALTH SPONSORED A RELAY FOR LIFE TEAM, AND VARIOUS ACTIVITIES WERE HELD TO RAISE FUNDS TO AID THE FIGHT AGAINST CANCER. A CHI LISBON HEALTH NURSING STAFF MEMBER SERVES ON THE ARN BOARD OF DIRECTORS. CHI LISBON HEALTH PROVIDES STAFF TO PRESENT COMMUNITY EDUCATION THROUGH DIFFERENT VENUES SUCH AS COMMUNITY EDUCATION AND HEALTH FAIR AND A COMMUNITY EDUCATION WINDOW THAT DISPLAYS EDUCATIONAL MESSAGES. HEALTH PROFESSIONS EDUCATION HELPING PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A DISTINGUISHING CHARACTERISTIC OF NOT-FOR-PROFIT HEALTH CARE AND CONSTITUTES A SIGNIFICANT COMMUNITY BENEFIT. LAB, RADIOLOGY, PHARMACY, AND NURSING STUDENTS HAVE THE ADVANTAGE OF SPENDING TIME WITH THE PROFESSIONALS FOR ON THE JOB MENTORING.
SCHEDULE H, PART VI, LINES 2, 4 & 5: COMMUNITY NEEDS, INFORMATION, AND BENEFIT	LISBON AREA HEALTH SERVICES STATEMENT OF COMMUNITY BENEFIT (CONTINUED) V. COMMUNITY BUILDING ACTIVITIES COMMUNITY BUILDING ACTIVITIES INCLUDE PROGRAMS THAT ADDRESS UNDERLYING CAUSES OF HEALTH PROBLEMS IN ORDER TO IMPROVE HEALTH STATUS AND QUALITY OF LIFE. THEY FOCUS ON THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS, AND ENVIRONMENTAL PROBLEMS. THESE ACTIVITIES SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF THE HEALTH CARE ORGANIZATION. COMMUNITY-BUILDING ACTIVITIES INCLUDE CASH AND IN-KIND DONATIONS AND BUDGETED EXPENDITURES FOR THE DEVELOPMENT OF COMMUNITY HEALTH PROGRAMS AND PARTNERSHIPS. CHI LISBON HEALTH EMPLOYEES PARTICIPATE IN COMMUNITY COALITIONS AND OTHER COLLABORATIVE EFFORTS WITH ORGANIZATIONS IN DICKEY, LAMOURE, SARGENT, AND RANSOM COUNTIES TO ADDRESS HEALTH AND SAFETY ISSUES. THE VISION BRINGS PEOPLE TOGETHER AND FORMS THE FOUNDATION OF BOTH SHORT AND LONG TERM STRATEGIES TO MEET IDENTIFIED NEEDS AND PROBLEMS. IT DEVELOPS A COMMON THREAD ENCOMPASSING A DIVERSE ARRAY OF VIEWPOINTS, OPINIONS, FACTS, AND TRENDS. CHI LISBON HEALTH ENCOURAGES EMPLOYEES TO BELONG TO ORGANIZATIONS THAT WORK TOGETHER TO PROMOTE HEALTHY COMMUNITIES. MEMBERSHIPS INCLUDE KIWANIS, MINISTERIAL ASSOCIATION, FOOD PANTRY COMMITTEE, COUNTY PANDEMIC PLANNING COMMITTEE, EMERGENCY PLANNING COMMITTEE, ABUSE RESOURCE NETWORK COMMITTEE, STUDENTS AGAINST DESTRUCTIVE DECISIONS (SADD), VIOLENCE PREVENTION COALITION, AND VOLUNTEERING WITH THEIR RESPECTIVE CHURCHES. ECONOMIC DEVELOPMENT IS IMPORTANT TO CHI LISBON HEALTH TO ASSIST SMALL BUSINESS DEVELOPMENT IN NEIGHBORHOODS WITH VULNERABLE POPULATIONS AND CREATE NEW EMPLOYMENT OPPORTUNITIES IN AREAS WITH HIGH RATES OF JOBLESSNESS. LISBON CIVIC AND COMMERCE ORGANIZATION PROMOTES COMMUNITY AND CIVIC EVENTS INCLUDING ECONOMIC DEVELOPMENT. *COMMUNITY BENEFIT OPERATIONS: COMMUNITY BENEFIT OPERATIONS INCLUDE COSTS ASSOCIATED WITH DEDICATED STAFF WHO WORK WITH CHARITY CARE AND WITH PLANNING AND OPERATING COMMUNITY BENEFIT PROGRAMS. LOOKING TOWARD THE FUTURE, CHI LISBON HEALTH WILL CONTINUE TO THRIVE BECAUSE OF THE SUPPORT FROM OUR PATIENTS, OUR PHYSICIANS, AND OUR AREA COMMUNITIES. CHI LISBON HEALTH LOOKS FORWARD TO PROVIDING THE CARE THAT COMMUNITY MEMBERS HAVE COME TO TRUST AND EXPECT FOR MANY YEARS TO COME.
Schedule H, Part VI, Line 3, Patient education of eligibility for assistance.	LISBON AREA HEALTH SERVICES (LAHS), INCLUDES INFORMATION CONCERNING ITS FINANCIAL ASSISTANCE POLICY ON ITS WEBSITE. IN ADDITION, LAHS PROMINENTLY DISPLAYS ITS FINANCIAL ASSISTANCE POLICY IN BOTH ENGLISH AND SPANISH IN OBVIOUS LOCATIONS THROUGHOUT THE HOSPITALS, INCLUDING THE EMERGENCY ROOMS AND OTHER PATIENT INTAKE AREAS, AS WELL AS IN LAHS OUTPATIENT FACILITIES. IN ADDITION, LAHS REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR FINANCIAL ASSISTANCE UNDER LAHS' FINANCIAL ASSISTANCE POLICY. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY AND PROCEDURES INCLUDING AN APPLICATION FOR ASSISTANCE. LAHS REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON-ENGLISH-SPEAKING INDIVIDUALS. LAHS' STAFF WILL ALSO ASSIST THE PATIENT/GUARANTOR WITH APPLYING FOR OTHER AVAILABLE COVERAGE (SUCH AS MEDICAID), IF NECESSARY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES.
Schedule H, Part VI, Line 6, Affiliated health care system	LISBON AREA HEALTH SERVICES, ALONG WITH ITS AFFILIATED OUTPATIENT FACILITIES, ARE PART OF CATHOLIC HEALTH INITIATIVES. CATHOLIC HEALTH INITIATIVES (CHI) IS A NATIONAL FAITH-BASED NONPROFIT HEALTH CARE ORGANIZATION WITH HEADQUARTERS IN ENGLEWOOD, COLORADO. CHI'S EXEMPT PURPOSE IS TO SERVE AS AN INTEGRAL PART OF ITS NATIONAL SYSTEM OF HOSPITALS AND OTHER CHARITABLE ENTITIES, WHICH ARE DESCRIBED AS MARKET-BASED ORGANIZATIONS, OR MBOS. AN MBO IS A DIRECT PROVIDER OF CARE OR SERVICES WITHIN A DEFINED MARKET AREA THAT MAY BE AN INTEGRATED HEALTH SYSTEM AND/OR A STAND-ALONE HOSPITAL OR OTHER FACILITY OR SERVICE PROVIDER. CHI SERVES AS THE PARENT CORPORATION OF ITS MBOS WHICH ARE COMPRISED OF 92 HOSPITALS, INCLUDING FOUR ACADEMIC MEDICAL CENTERS, AND 24 CRITICAL ACCESS FACILITIES; COMMUNITY HEALTH SERVICE ORGANIZATIONS; ACCREDITED NURSING COLLEGES; HOME HEALTH AGENCIES; AND OTHER FACILITIES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. TOGETHER, THESE FACILITIES PROVIDED $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 SHARED SERVICES - INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN -- PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE MBOS. THE COST SAVINGS ACHIEVED THROUGH CHI'S CENTRALIZATION ENABLE MBOS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. LISBON AREA HEALTH SERVICES OPERATES WITH ITS WHOLLY OWNED AFFILIATES AND COMMUNITY PARTNERS TO SERVE THE HEALTH CARE NEEDS OF THE LISBON, ND COMMUNITIES.

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
PEGGY LARSON
ADMINISTRATOR	$0	$145,421	$0	$26,311	$0	$34,728	$0	$30,804	$0	$13,031	$0	$250,295	$0	$12,652
JEFFREY DROP
BOARD MEMBER/CHI SVP DIVISION OFFICER	$0	$425,696	$0	$343,145	$0	$58,698	$0	$96,266	$0	$22,006	$0	$945,811	$0	$33,686

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 3, Arrangement used to establish the top management official's compensation	COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) WRITTEN EMPLOYMENT CONTRACTS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
SCHEDULE J, PART I, LINE 4A, SEVERANCE OR CHANGE-OF-CONTROL PAYMENTS	POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR CATHOLIC HEALTH INITIATIVES (CHI) AND RELATED ORGANIZATIONS' EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE, INCLUDING THE MBO CEOS. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2013 CALENDAR YEAR.
Schedule J, Part I, Line 4b, Supplemental nonqualified retirement plan	DURING THE 2013 CALENDAR YEAR CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION, MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR MBO CEOS AND OTHER CHI EMPLOYEES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THAT PLAN: JEFFREY DROP AND PEGGY LARSON DURING 2013 THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: JEFFREY DROP - $67,664 PEGGY LARSON - $13,155 DURING 2013 THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI FROM THE DEFERRED COMPENSATION PLAN: JEFFREY DROP - $33,686 PEGGY LARSON - $12,652

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 1, ORGANIZATION'S MISSION	THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. FIDELITY TO THE GOSPEL URGES THE CORPORATION TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT CREATES HEALTHIER COMMUNITIES. THE CORPORATION, SPONSORED BY A LAY-RELIGIOUS PARTNERSHIP, CALLS OTHER CATHOLIC SPONSORS AND SYSTEMS TO UNITE TO ENSURE THE FUTURE OF CATHOLIC HEALTH CARE. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION.
Form 990, Part VI, Sec A, Line 1a, Delegate broad authority to a committee	PURSUANT TO SECTION 8.6 OF THE BYLAWS OF LISBON AREA HEALTH SERVICES, THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, THE BOARD VICE CHAIR, THE PRESIDENT AND CEO, EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE, AND TWO VOTING MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. EACH INDIVIDUAL APPOINTED TO THE EXECUTIVE COMMITTEE SHALL SERVE FOR A TERM OF ONE YEAR OR UNTIL HIS OR HER SUCCESSOR IS DULY APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. PURSUANT TO SECTION 8.1 OF THE CORPORATION'S BYLAWS, COMMITTEES, SUCH AS THE EXECUTIVE COMMITTEE, THAT ARE GRANTED THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MAY INCLUDE ONLY DIRECTORS OF THE CORPORATION. FURTHER, PURSUANT TO SECTION 8.6 OF THE CORPORATION'S BYLAWS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders	ACCORDING TO THE BYLAWS OF LISBON AREA HEALTH SERVICES, THE ORGANIZATION'S SOLE MEMBER IS CATHOLIC HEALTH INITIATIVES, A COLORADO NONPROFIT CORPORATION.
Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body	THE ORGANIZATION'S SOLE CORPORATE MEMBER HAS THE POWER TO APPOINT, REPLACE, OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders	THE ORGANIZATION'S CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES (CHI). PURSUANT TO ARTICLE V, SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: - SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF LISBON AREA HEALTH SERVICES (LAHS) - AMENDMENT OF THE CORPORATE DOCUMENTS OF LAHS - APPROVE MEMBERS OF THE LAHS BOARD - REMOVAL OF A MEMBER OF THE GOVERNING BODY OF LAHS - APPROVAL OF ISSUANCE OF DEBT BY LAHS - APPROVAL OF PARTICIPATION OF LAHS IN A JOINT VENTURE - APPROVAL OF FORMATION OF A NEW CORPORATION BY LAHS - APPROVAL OF A MERGER INVOLVING LAHS - APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF LAHS - TO REQUIRE THE TRANSFER OF ASSETS BY LAHS TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS - ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR LAHS PURSUANT TO ARTICLE V, SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, CHI MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE.
Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body	THE DIVISION OFFICE'S DIRECTOR OF ACCOUNTING ASSISTS THE CATHOLIC HEALTH INITIATIVES TAX DEPARTMENT IN PREPARATION OF THE RETURN; ONCE PREPARED, THE DIRECTOR REVIEWS A DRAFT OF THE RETURN AND PROVIDES A COPY TO ALL BOARD MEMBERS PRIOR TO FILING. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy	LISBON AREA HEALTH SERVICES HAD IN EFFECT A CONFLICT OF INTEREST POLICY COVERING ALL DIRECTORS AND OFFICERS HOLDING THE TITLE OF VICE PRESIDENT OR ABOVE. THE POLICY PLACES ON EACH DIRECTOR A GENERAL OBLIGATION TO DISCLOSE TO THE CHAIR OF THE BOARD OF DIRECTORS ANY SITUATION THAT MAY CREATE A CONFLICT AS SOON AS THEY BECOME AWARE OF SUCH SITUATION. COVERED OFFICERS MUST MAKE SUCH DISCLOSURES TO THE PRESIDENT AND CEO OF LISBON AREA HEALTH SERVICES WHO HAS A DUTY TO REPORT SUCH SITUATIONS TO THE BOARD CHAIR. IF ANY DOUBT EXISTS, DIRECTORS AND COVERED OFFICERS ARE REQUIRED TO MAKE A FULL DISCLOSURE TO PERMIT AN IMPARTIAL AND OBJECTIVE DETERMINATION. THE POLICY REQUIRES WRITTEN RECORD OF ALL DISCLOSURES. ADDITIONALLY, ALL DIRECTORS AND COVERED OFFICERS ARE REQUIRED TO, AT LEAST ANNUALLY, COMPLETE, SIGN AND SUBMIT A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE PRESIDENT AND CEO REVIEW THESE STATEMENTS WITH THE BOARD CHAIR. THE BOARD CHAIR OR A DESIGNEE CONDUCTS FURTHER INVESTIGATION OF CONFLICTS OF INTEREST DISCLOSURES AT THEIR DISCRETION. BASED UPON THE REVIEW AND EVALUATION OF THE RELEVANT FACTS AND CIRCUMSTANCES, THE BOARD CHAIR MAKES AN INITIAL DETERMINATION AS TO WHETHER A CONFLICT EXISTS AND WHETHER REVIEW AND APPROVAL OR OTHER ACTION BY THE BOARD IS REQUIRED. A WRITTEN RECORD OF THE BOARD CHAIR'S DETERMINATION IS KEPT. THE BOARD CHAIR THEN MAKES A REPORT TO THE EXECUTIVE COMMITTEE OF THE BOARD. DIFFERENCES OF OPINION BETWEEN THE BOARD CHAIR AND ANOTHER OFFICER OR DIRECTOR AS TO WHETHER THE FACTS AND CIRCUMSTANCES OF A GIVEN SITUATION CONSTITUTE A CONFLICT OF INTEREST OR WHETHER BOARD OF DIRECTORS REVIEW AND APPROVAL OR OTHER ACTION IS REQUIRED ARE SUBMITTED TO THE EXECUTIVE COMMITTEE TO MAKE A FINAL DETERMINATION AS TO THE MATTER. THE COMMITTEE MINUTES ARE TO REFLECT THE DETERMINATION INCLUDING ALL RELEVANT FACTS AND CIRCUMSTANCES AND THEN REPORTED TO THE BOARD OF DIRECTORS. A DIRECTOR OR OFFICER IS PROHIBITED FROM VOTING OR USING HIS OR HER PERSONAL INFLUENCE ON THE MATTER UNDER CONSIDERATION. FURTHER, THEY ARE TO BE EXCUSED FROM THE MEETING DURING THE DISCUSSION AND VOTE ON THE CONFLICT OF INTEREST.
FORM 990, PART VI, LINE 14, DOCUMENT RETENTION AND DESTRUCTION POLICY	THE ORGANIZATION HAS A DOCUMENT RETENTION AND DESTRUCTION POLICY THAT IT FOLLOWS; HOWEVER, THE POLICY HAD NOT BEEN FORMALLY ADOPTED BY THE ORGANIZATION'S GOVERNING BODY AT YEAR-END.
FORM 990, PART VI, LINE 15A, PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL	THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION IS PAID BY CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI HAS A DEFINED COMPENSATION PHILOSOPHY. BOTH THE EXECUTIVE AND NON-EXECUTIVE COMPENSATION STRUCTURES AND RANGES ARE REVIEWED ANNUALLY IN COMPARISON TO MARKET DATA. CHI USES THE HAY GROUP AS THE INDEPENDENT THIRD PARTY TO ASSESS EXECUTIVE COMPENSATION PROGRAMS AND TO ENSURE THE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. COMPENSATION OF THE SENIOR MOST EXECUTIVES IS REVIEWED ANNUALLY. THE HAY GROUP REVIEWS BOTH CASH AND TOTAL COMPENSATION FOR OVERALL REASONABLENESS, FOR ADHERENCE TO CHI'S COMPENSATION PHILOSOPHY, AND FOR COMPARABILITY TO THE NOT-FOR-PROFIT HEALTHCARE MARKET. THIS INDEPENDENT REVIEW IS DELIVERED BY HAY GROUP TO THE HR COMMITTEE OF THE CHI BOARD OF STEWARDSHIP TRUSTEES ANNUALLY AT THEIR SEPTEMBER MEETING AND MINUTES ARE SHARED WITH THE FULL BOARD AT THE DECEMBER MEETING. THE LAST REVIEW WAS SEPTEMBER 18, 2014. IN ADDITION, IN DECEMBER 2009, HAY GROUP COMPLETED A COMPREHENSIVE REVIEW OF ALL POSITIONS AT THE LEVEL OF VICE PRESIDENT AND ABOVE TO DETERMINE AND VALIDATE APPROPRIATE COMPENSATION LEVELS. THESE LEVELS HAVE BEEN REVIEWED ANNUALLY SINCE AND REVISED BASED ON MARKET DATA, WHERE APPLICABLE.
FORM 990, PART VI, LINE 15B, PROCESS USED TO ESTABLISH COMPENSATION OF OTHER EMPLOYEES	DURING THE TAX YEAR ENDED 6/30/2014, NO OFFICERS, DIRECTORS OR TRUSTEES RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THEREFORE, THESE QUESTIONS ARE MORE APPROPRIATELY ANSWERED AS N/A.
Form 990, Part VI, Sec C, Line 19, Required documents available to the public	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. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST FROM THE ADMINISTRATION DEPARTMENT. IN ADDITION, THE GOVERNING DOCUMENTS ARE AVAILABLE FROM THE NORTH DAKOTA SECRETARY OF STATE.
Form 990, Part IX, Line 11g, Other Expenses	OTHER FEES FOR SERVICES - TOTAL EXPENSE: 1699379, PROGRAM SERVICE EXPENSE: 1125667, MANAGEMENT AND GENERAL EXPENSES: 573712, FUNDRAISING EXPENSES: ; CENTRAL FUNCTION SERVICES ASSESSMENT - TOTAL EXPENSE: 742975, PROGRAM SERVICE EXPENSE: 742975, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; CLINICAL SERVICES - TOTAL EXPENSE: 340392, PROGRAM SERVICE EXPENSE: 340392, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; NURSING SERVICES - TOTAL EXPENSE: 128186, PROGRAM SERVICE EXPENSE: 128186, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; VIRTUAL HEALTH SERVICES - TOTAL EXPENSE: 134429, PROGRAM SERVICE EXPENSE: 134429, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ;
Form 990 , Part XI, Line 9, Other changes in net assets or fund balances	CAPITAL RESOURCE POOL CONTRIBUTION - -86532;

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	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd