2015-05-14T10:21:58-05:00 2014-06-30 470617373 CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2013-07-01 820558836 LISBON AREA HEALTH SERVICES LISB 7016835241 905 Main Street Lisbon ND 58054 PEGGY LARSON PRESIDENT 2015-05-14 true Pamela Krohn P01210500 3032989100 2013 2016-02-25 16:41:14Z CHI LISBON HEALTH PEGGY LARSON 905 Main Street Lisbon ND 58054 11850622 false 0928 X WWW.LISBONHOSPITAL.COM X 2002 ND 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 8 6 131 50 -196 -196 91875 98762 11660765 11563284 157398 132353 44386 43983 11954424 11838382 0 10582 0 0 4115320 4302857 0 0 0 6495825 6960986 10611145 11274425 1343279 563957 9317214 9803012 2064521 1757959 7252693 8045053 X SEE SCHEDULE O false false 10143108 1368 11563284 SEE SCHEDULE H 10143108 true true false true false false false false true true true false false true true false true false false false true false false true false true true false false true false false false false false false false false false false false false false true false false false false true 0 0 131 true false false false false false false false false false false X 8 6 false false false false true true true true true false false true true true true true false false false false X Amber Stowman 7012378022 4784 Amber Valley Parkway Fargo ND 58104 BRIAN SHELTON CHAIR 1.00 0.00 X X 0 0 0 LIZ ANDERSON SECRETARY 1.00 0.00 X X 0 0 0 NEIL OLERUD Vice Chair 1.00 0.00 X X 0 0 0 PEGGY LARSON ADMINISTRATOR 40.00 0.00 X X 0 206460 43835 DWAYNE HORGESHIMER BOARD MEMBER 1.00 0.00 X 0 0 0 JASON ENGER BOARD MEMBER 1.00 0.00 X 0 0 0 JEFFREY DROP Board Member/CHI SVP Division Officer 1.00 60.00 X 0 827539 118272 SISTER DONNA WELDER Board Member 1.00 0.00 X 0 0 0 AMBER STOWMAN CONTROLLER 40.00 0.00 X 0 96469 27087 BECKI THOMPSON VP Operational Finance 40.00 0.00 X 0 88200 7012 0 1218668 196206 0 false true false NATIONAL MEDICAL RESOURCES 2900 E BROADWAY AVE SUITE 1 BISMARCK ND 58501 EMERGENCY ROOM COVERAGE 450784 LOPERENA RUDOLF MD PO BOX 71 LISBON ND 58054 ER PHYSICIAN COVERAGE 373988 MOBILITY PLUS 26295 CRYSTAL RD PELICAN RAPIDS MN 56572 PHYSICAL/OCCUPATIONAL THERAPY SERVICES 225776 ALLIANCE RECRUITING RESOURCES INC PO BOX 4356 DEPT 611 HOUSTON TX 772104356 EMERGENCY ROOM COVERAGE 110632 4 7550 91212 98762 PATIENT SERVICES 900099 11494201 11494201 RENTAL INCOME 900099 69083 69083 0 0 0 0 0 0 0 11563284 71563 -196 71759 0 0 0 0 0 0 0 58790 2000 58790 2000 60790 60790 51962 12240 39722 39722 0 0 MEDICAL RECORDS REVENUE/TRANSCRIPTION 541200 2264 2264 EMERGENCY MEDICAL SERVICES 621910 1000 1000 CAFETERIA 722100 318 318 679 0 0 679 4261 11838382 11563284 -196 176532 X 1368 1368 0 9214 9214 0 0 0 3368028 3078759 289269 159260 145582 13678 541146 494669 46477 234423 214289 20134 0 14144 14144 0 0 0 0 3045361 2471649 573712 0 16278 16278 450712 358891 91821 1555202 1555202 0 286309 261719 24590 20369 10193 10176 0 2417 268 2149 47559 47559 420492 420492 268881 268881 0 MEDICAL SUPPLIES 632815 631283 1532 REPAIRS & MAINTENANCE 40572 40181 391 BAD DEBTS 116299 116299 43576 16610 26966 0 11274425 10143108 1131317 0 0 1994 5691 654775 2440356 3411179 1658081 0 0 0 0 917 210514 223697 4044 11801 4223891 2782813 1573986 1441078 3167308 3616990 0 0 292497 405318 9317214 9803012 822589 651785 29025 2030 0 0 0 0 1212907 1104144 2064521 1757959 X 7202100 7935874 47093 105679 3500 3500 7252693 8045053 9317214 9803012 X 563957 322715 -7780 -86532 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 1452 false false false 1452 false Schedule C, Part II-B, Line 1, Description of the activities reported on Lines 1a through 1i 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 3500 3500 0 3500 3500 0 0 0 0 0 0 1.00000 false false 103303 103303 1241113 951018 290095 0 2722002 1750164 971838 157473 81631 75842 1441078 0 0 CHI OIP - FIXED INCOME 1761567 F CHI OIP - EQUITY SECURITIES 1855423 F 3616990 0 CHI DEBT MANAGEMENT PROGRAM 918428 INTERCOMPANY PAYABLES 185716 1104144 X 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." EAST ASIA AND THE PACIFIC HOSPITAL SUPPORT 9214 MEDICAL SUPPLIES, EQUIPMENT BOOK 1 0 false false false false false false GALA 51962 0 51962 531 5145 500 6064 0 0 51962 0 51962 0 531 0 5145 500 6064 12240 39722 true true X false false true true false true true 35 36481 0 36481 0.00330 491 752913 0 752913 0.06750 0 0.00000 0 526 789394 0 789394 0.07080 8 488 47317 6288 41029 0.00370 4 55 26246 0 26246 0.00240 0 0.00000 0 0.00000 12 233 28920 4070 24850 0.00220 24 776 102483 10358 92125 0.00830 24 1302 891877 10358 881519 0.07910 0 0.00000 1 1 2162 0 2162 0.00020 7 54 2950 200 2750 0.00020 0 0.00000 0 0.00000 3 1 8783 2720 6063 0.00050 2 200 486 0 486 0.00000 1 36 61200 0 61200 0.00540 0 0.00000 14 292 75581 2920 72661 0.00640 true 116299 0 6652519 6586652 65867 X true true 1 1 LISBON AREA HEALTH SERVICES 905 Main Street LISBON ND 58054 WWW.LISBONHOSPITAL.COM 5031 X X X X LISBON AREA HEALTH SERVICES 1 true X X X X X X X X X 12 true false true X www.lisbonhospital.com X X X X X X X X X false false true false false true X X X X X X true true X X X X true false true X false false 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.; 0 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. false true false false false false false false false PEGGY LARSON ADMINISTRATOR 0 145421 0 26311 0 34728 0 30804 0 13031 0 250295 0 12652 JEFFREY DROP BOARD MEMBER/CHI SVP DIVISION OFFICER 0 425696 0 343145 0 58698 0 96266 0 22006 0 945811 0 33686 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 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; ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HEALTHCARE NE 501(C)(3) 3 ACH true ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true ALEGENT CREIGHTON HEALTH FOUNDATION 12809 W DODGE RD OMAHA NE 68154 470648586 FUNDRAISING NE 501(C)(3) 7 ACH true ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA 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 true ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HEALTHCARE IA 501(C)(3) 3 CHI NEBRASKA true ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(C)(3) 9 CHI true APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(C)(3) 9 SFH true BISHOP DRUMM RETIREMENT CENTER 1111 6TH AVE DES MOINES IA 50314 420725196 LTERM CARE IA 501(C)(3) 9 CHI-IA CORP true BORNEMANN HEALTHCARE CORPORATION 2500 BERNVILLE RD PO BOX 316 READING PA 19603 232187242 HEALTHCARE PA 501(C)(3) 11 - Type I CHI true CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HEALTHCARE ND 501(C)(3) 3 CHI true CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 470617373 HEALTHCARE CO 501(C)(3) 9 NA true CATHOLIC HEALTH INITIATIVES - COLORADO 188 INVERNESS DRIVE WEST STE 500 ENGLEWOOD CO 80112 840405257 HEALTHCARE CO 501(C)(3) 3 CHI true CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVE DES MOINES IA 50314 420680448 HEALTHCARE IA 501(C)(3) 3 CHI true CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 6385 CORPORATE DR STE 301 COLORADO SPRINGS CO 80919 840902211 FUNDRAISING CO 501(C)(3) 7 CHIC true CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 6385 CORPORATE DR COLORADO SPRINGS CO 80919 270930004 FUNDRAISING CO 501(C)(3) 11 - Type I CHI true CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 460992796 HEALTHCARE CO 501(C)(3) 11 - Type I CHINS true CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG OR 97471 263946191 PHYSICIANS OR 501(C)(3) 9 MMC true CENTRAL KANSAS MEDICAL CENTER 3515 BROADWAY GREAT BEND KS 67530 480543724 SURGERY CENTER KS 501(C)(3) 3 CHI true CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO ND 58104 271966847 HEALTHCARE MN 501(C)(3) 9 CHI true CHI INSTITUTE FOR RESEARCH AND INNOVATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 271050565 HEALTHCARE CO 501(C)(3) 11 - Type I CHI true CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER KY 41018 202741651 HEALTHCARE KY 501(C)(3) 11 - Type I CHI true CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 451261716 HEALTHCARE CO 501(C)(3) 9 CHI NS true CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 452532084 HEALTHCARE CO 501(C)(3) 11 - Type I CHI true CHI NEBRASKA 6940 O ST STE 200 LINCOLN NE 68510 363233121 HEALTHCARE NE 501(C)(3) 11 - Type III - FI CHI 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 true CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 710236913 HEALTHCARE AR 501(C)(3) 3 CHISVHS true CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125064 HOLDING CO AR 501(C)(3) 11 - Type II SVIMC 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 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 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 true CONTINUING CARE HOSPITAL 150 NORTH EAGLE CREEK DR LEXINGTON KY 40509 611400619 LT ACH KY 501(C)(3) 3 SJHS true COVENANT HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232028429 HOME HEALTH PA 501(C)(3) 11 - Type II CHI NHC true ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1450 BATTERSBY AVE ENUMCLAW WA 98022 910715805 HEALTHCARE WA 501(C)(3) 3 FHS true FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 611345363 HEALTHCARE KY 501(C)(3) 3 KOH true FLAGET MEMORIAL HOSPITAL FOUNDATION INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 562351341 FUNDRAISING KY 501(C)(3) 11 - Type I FH true FRANCISCAN FOUNDATION 1717 SOUTH J ST TACOMA WA 98405 911145592 FUNDRAISING WA 501(C)(3) 9 FHS true FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA WA 98405 910564491 HEALTHCARE WA 501(C)(3) 3 CHI true FRANCISCAN HEALTH VENTURES FKA SJMGROUP TACOMA FNC CTR BLDG 1145 BROADWAY TACOMA WA 98402 431882377 PHYSICIANS MO 501(C)(3) 9 CHI true FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 200 TACOMA WA 98402 911939739 HEALTHCARE WA 501(C)(3) 9 FHS true FRANCISCAN VILLA OF SOUTH MILWAUKEE INC 3601 S CHICAGO AVE SOUTH MILWAUKEE WI 53172 391093829 HEALTHCARE WI 501(C)(3) 9 CHI true GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 201536108 MINISTRIES CO 501(C)(3) 11 - Type I CHI 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 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 true GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY NE 68848 470379755 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST ST KEARNEY NE 68847 470659443 FUNDRAISING NE 501(C)(3) 7 GSH true GOOD SAMARITAN HOSPITAL FOUNDATION - DAYTON 110 N MAIN ST STE 500 DAYTON OH 45402 237296923 FUNDRAISING OH 501(C)(3) 7 SHP true HARRISON MEDICAL CENTER 2520 CHERRY AVE BREMERTON WA 98310 910565546 HEALTHCARE WA 501(C)(3) 3 FHS true HARRISON MEDICAL CENTER FOUNDATION 2520 CHERRY AVE BREMERTON WA 98310 911197626 FUNDRAISING WA 501(C)(3) 7 HMC true HEALTH SET 2420 W 26TH AVE STE 460D DENVER CO 80211 841102943 LOW INC CARE CO 501(C)(3) 7 CHIC true HEALTHCARE AND WELLNESS FOUNDATION 2400 ST FRANCIS DR BRECKENRIDGE MN 56520 760761782 FUNDRAISING MN 501(C)(3) 11 - Type I SFMC true HIGHLINE MEDICAL CENTER 16251 SYLVESTER RD SW BURIEN WA 98166 910712166 HEALTHCARE WA 501(C)(3) 3 FHS true HOUSE OF MERCY 1111 6TH AVE DES MOINES IA 50314 421323808 SHELTER IA 501(C)(3) 7 CHI-IA CORP true JEWISH HOSPITAL AND ST MARY''S HEALTHCARE INC 539 S 4TH ST LOUISVILLE KY 40202 611029768 HEALTHCARE KY 501(C)(3) 3 KOH true KENTUCKYONE HEALTH MEDICAL GROUP INC 539 S 4TH ST LOUISVILLE KY 40202 611352729 HEALTHCARE KY 501(C)(3) 9 JHSMH true KENTUCKYONE HEALTH INC 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 611029769 HEALTHCARE KY 501(C)(3) 9 CHI true LAKEWOOD HEALTH CENTER 600 MAIN AVE S BAUDETTE MN 56623 410758434 HEALTHCARE MN 501(C)(3) 3 CHI true LINUS OAKES INC 2700 STEWART PKWY ROSEBURG OR 97471 930821381 SENIOR LIVING OR 501(C)(3) 9 MMC true LISBON AREA HEALTH SERVICES 905 MAIN ST LISBON ND 58054 820558836 HEALTHCARE ND 501(C)(3) 3 CHI true LUFKIN VISION ACQUISITIONS PO BOX 1447 LUFKIN TX 75901 820563768 PROPERTY MGMT TX 501(C)(3) 11 - Type III - FI MHSET true MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC 2525 DE SALES AVE CHATTANOOGA TN 37404 621839548 FUNDRAISING TN 501(C)(3) 7 MHCS true MEMORIAL HEALTH CARE SYSTEM INC 2525 DE SALES AVE CHATTANOOGA TN 37404 620532345 HEALTHCARE TN 501(C)(3) 3 CHI true MEMORIAL HEALTH PARTNERS FOUNDATION INC 5600 BRAINERD RD STE 500 CHATTANOOGA TN 37411 030417049 HEALTHCARE TN 501(C)(3) 9 MHCS true MEMORIAL HEALTH SYSTEM OF EAST TEXAS PO BOX 1447 LUFKIN TX 75902 750755367 HEALTHCARE TX 501(C)(3) 3 CHI true MEMORIAL MEDICAL CENTER - LIVINGSTON PO BOX 1447 LUFKIN TX 75902 760436439 HEALTHCARE TX 501(C)(3) 3 MHSET true MEMORIAL MEDICAL CENTER - SAN AUGUSTINE PO BOX 1447 LUFKIN TX 75902 752663904 HEALTHCARE TX 501(C)(3) 3 MHSET true MEMORIAL MULTISPECIALTY ASSOCIATES 1201 FRANK AVE LUFKIN TX 95904 752721155 PHYSICIANS TX 501(C)(3) 11 - Type III - FI MHSET true MEMORIAL SPECIALTY HOSPITAL PO BOX 1447 LUFKIN TX 95902 752492741 HEALTHCARE TX 501(C)(3) 3 MHSET true MERCY AUXILIARY OF CENTRAL IOWA 1111 6TH AVE DES MOINES IA 50314 426076069 AUXILIARY IA 501(C)(3) 11 - 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