ALEGENT HEALTH MERCY HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: ALEGENT HEALTH MERCY HOSPITAL (EIN 42-0782518)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-05-12
IRS object ID: 201421329349302842
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-12T15:00:14-05:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	470617373	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CATHOLIC HEALTH INITIATIVES	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

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

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	420782518	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ALEGENT HEALTH-MERCY HOSPITAL CORNING IA	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	ALEG	NameControl
Phone	4023434323	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	P O BOX 368	AddressLine1
City	CORNING	City
State	IA	State
ZIP Code	50841	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	JEANETTE WOJTALEWICZ	Name
Title	CFO	Title
Date Signed	2014-05-08	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	ANGELA LEA	Name
PTIN	P01051055	PTIN
Phone	4023434413	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

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

Address Principal Officer US AddressPrincipalOfficerUS

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

Field	Value	IRS element (for citing)
Gross Receipts	18785887	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.ALEGENTCREIGHTON.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1953	YearFormation
State Legal Domicile	IA	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE HIGH QUALITY CARE FOR THE BODY, MIND, AND SPIRIT OF EVERY PERSON.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	6	NbrIndependentVotingMembers
Total Nbr Employees	158	TotalNbrEmployees
Total Nbr Volunteers	77	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	133698	ContributionsGrantsPriorYear
Contributions Grants Current Year	864000	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	17931045	ProgramServiceRevenuePriorYear
Program Service Revenue CY	17636824	ProgramServiceRevenueCY
Investment Income Prior Year	-29615	InvestmentIncomePriorYear
Investment Income Current Year	1008	InvestmentIncomeCurrentYear
Other Revenue Prior Year	164844	OtherRevenuePriorYear
Other Revenue Current Year	272581	OtherRevenueCurrentYear
Total Revenue Prior Year	18199972	TotalRevenuePriorYear
Total Revenue Current Year	18774413	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	499566	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	560249	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	7892290	SalariesEtcPriorYear
Salaries Etc Current Year	8214567	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	8898900	OtherExpensePriorYear
Other Expenses Current Year	9284168	OtherExpensesCurrentYear
Total Expenses Prior Year	17290756	TotalExpensesPriorYear
Total Expenses Current Year	18058984	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	909216	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	715429	RevenuesLessExpensesCY
Total Assets BOY	16710448	TotalAssetsBOY
Total Assets EOY	17358308	TotalAssetsEOY
Total Liabilities BOY	2103247	TotalLiabilitiesBOY
Total Liabilities EOY	2035678	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	14607201	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	15322630	NetAssetsOrFundBalancesEOY
Mission Description	FAITHFUL TO THE HEALING MINISTRY OF JESUS CHRIST, OUR MISSION IS TO PROVIDE HIGH QUALITY CARE FOR THE BODY, MIND AND SPIRIT OF EVERY PERSON. OUR COMMITMENT TO HEALING CALLS US TO: CREATE CARING AND COMPASSIONATE ENVIRONMENTS RESPECT THE DIGNITY OF EVERY PERSON CARE FOR THE RESOURCES ENTRUSTED TO US AS RESPONSIBLE STEWARDS COLLABORATE WITH OTHERS TO IMPROVE THE HEALTH OF OUR COMMUNITIES ATTEND ESPECIALLY TO THE NEEDS OF THOSE WHO ARE POOR AND DISADVANTAGED ACT WITH INTEGRITY IN ALL ENDEAVORS TO ACHIEVE THIS MISSION, WE PLEDGE TO BE CREATIVE, VISIONARY LEADERS COMMITTED TO HOLISTIC HEALTHCARE IN THE REGION.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	8502599	Expense
Grants	49628	Grants
Revenue	1578096	Revenue
Description	ALEGENT HEALTH MERCY HOSPITAL, CORNING PROVIDES SEVERAL SPECIALTY CLINICS EACH WEEK THROUGH VISITING SPECIALISTS IN THE FOLLOWING AREAS: AUDIOLOGY, EAR, NOSE AND THROAT, CARDIOVASCULAR SERVICES, DERMATOLOGY, GASTROENTEROLOGY, GENERAL SURGERY/WOUND CARE, GYNECOLOGY/OBSTETRICS, ONCOLOGY, OPTHALMOLOGY, ORTHOPEDIC SURGERY, PODIATRY, UROLOGY, SPEECH AND OCCUPATIONAL THERAPY AND PSYCHIATRY.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	6634208	Expense
Grants	255822	Grants
Revenue	8134690	Revenue
Description	ALEGENT HEALTH MERCY HOSPITAL, CORNING HAS STRIVED TO IMPROVE THE HEALTH STATUS OF CHILDREN, TEENS, ADULTS, SENIOR CITIZENS, FRIENDS AND NEIGHBORS IN THIS RURAL COMMUNITY. MERCY HOSPITAL-CORNING IS PROUD TO OFFER HEALTHCARE SERVICES CLOSE TO HOME WITHIN THE COMMUNITY. ALEGENT HEALTH MERCY HOSPITAL, CORNING PROVIDES A VARIETY OF DIAGNOSTIC SERVICES TO THE COMMUNITY, SUCH AS CT SCANS, MRI AND NUCLEAR MEDICINE IN ADDITION TO GENERAL RADIOLOGY, MAMMOGRAPHY, SURGICAL RADIOGRAPHY AND ULTRASOUND.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	1969501	Expense
Grants	254799	Grants
Revenue	8102123	Revenue
Description	ALEGENT HEALTH MERCY HOSPITAL, CORNING SUPPORTS THE MISSION BY CONTINUALLY MAKING SERVICES MORE CONVENIENT AND ACCESSIBLE WHILE MAINTAINING A LEVEL OF EFFICIENCY. THE HOSPITAL OFFERS THE FOLLOWING SERVICES TO OUR PATIENTS: 24-HOUR EMERGENCY CARE WITH HELIPORT ACCOMMODATIONS, DIAGNOSTIC IMAGING SERVICES, CARDIOVASCULAR SERVICES, CHEMOTHERAPY AND ELECTROENCEPHALOGRAMS (EEGS) PHYSICAL THERAPY.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	17106308	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	true	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	true	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Info In Schedule O Part V	X	InfoInScheduleOPartV
Number Forms Transmitted With1096	31	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	158	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	11	NbrVotingGoverningBodyMembers
Number Independent Voting Members	6	NumberIndependentVotingMembers
Family Or Business Relationship	true	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

Field	Value	IRS element (for citing)
Telephone Number	4023434323	TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee
DEBRA GOLDSMITH
EX-OFFICIO/ADMINISTRATOR	60.00	1.00	X	X	134605	0	36372
JANE RYCHNOVSKY
SECRETARY	2.00	0	X	X	0	0	0
LINDA SHEARER
VICE PRESIDENT	2.00	0	X	X	0	0	0
RICHARD HOGAN
PRESIDENT	2.00	0	X	X	0	0	0
RODNEY TRIPLETT
DIRECTOR/NETWORK EXECUTIVE	2.00	44.00	X	X	0	182403	43859
D RANDALL PRITZA MD
DIRECTOR	2.00	60.00	X		0	556430	34581
DENISE MCNITT
DIRECTOR	2.00	40.00	X		0	196513	36139
KARL MCCARTY
DIRECTOR	2.00	0	X		0	0	0
MICHAEL GRUNDMAN
DIRECTOR	2.00	1.00	X		0	0	0
RANDY ALLMAN
DIRECTOR	2.00	0	X		0	0	0
TIM MAXA
DIRECTOR	2.00	0	X		0	0	0
RICHARD II HACHTEN
ACH PRESIDENT & CEO	2.00	63.00		X	0	2196142	2994304
SCOTT WOOTEN
ACH SVP/CFO	2.00	62.00		X	0	783424	1590996
BETHEL KOPP MD
PHYSICIAN	60.00	0			395712	0	29299	X
JOHN SAFRANEK MD
PHYSICIAN	60.00	0			182768	0	0	X
JOSEPH PICCOLO
PHYSICIAN	60.00	0			175252	0	30661	X
MAEN HADDADIN MD
PHYSICIAN	60.00	0			633173	0	40542	X
STEPHEN GRUBA MD
PHYSICIAN	60.00	0			269279	0	32046	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1790789	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	3914912	TotalReportableCompFrmRltdOrgs
Total Other Compensation	4868799	TotalOtherCompensation
Number Individuals GT100 K	8	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
DON SABO
713 CENTER STREET	STANTON	IA	51573	PHYSICIAN SERVICES	273520
REHABVISIONS
11623 ARBOR STREET	OMAHA	NE	68144	REHAB SERVICES	266181
SHARED MEDICAL SERVICES
209 LIMESTONE PASS	COTTAGE GROVE	WI	53527	DIAGNOSTIC IMAGING	118750

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	3	NumberOfContractorsGT100K
Membership Dues	639	MembershipDues
Related Organizations	775725	RelatedOrganizations
Government Grants	78801	GovernmentGrants
All Other Contributions	8835	AllOtherContributions
Total Contributions	864000	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SVC REVENUE	621500	17033319	17033319
AFFILIATE REVENUE	900099	192214	192214
HEALTH PROMOTIONS	611710	14002	14002
PHARMACY CASH SALES	900099	397289	397289
		0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	17636824	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1008	TotalRevenueColumn
Exclusion	$1,008	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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

Royalties Revenue RoyaltiesRevenue

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

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	4190	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	1091	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	3099	Real
Personal	0	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	3098	TotalRevenueColumn
Exclusion	$3,098	ExclusionAmount

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	0	Securities
Other	0	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

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

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	4783	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	0	CntrbtnsRprtdFundraisingEvents

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	4783	TotalRevenueColumn
Exclusion	$4,783	ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

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

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	12392	GrossSalesOfInventory
Cost Of Goods Sold	10381	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	2011	TotalRevenueColumn
Exclusion	$2,011	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA	722320	84604	$84,604
CONTRACT INCOME	900099	46439		46439
OTHER OPERATING REVENUE	900099	131646		131646

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	262689	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	18774413	TotalRevenueColumn
Related Or Exempt Function Income	17814909	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$95,504	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	11405	Total
Program Services	11405	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	548844	Total
Program Services	548844	ProgramServices

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	183199	Total
Management And General	183199	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	6578141	Total
Program Services	6249234	ProgramServices
Management And General	328907	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	268564	Total
Program Services	255136	ProgramServices
Management And General	13428	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	780868	Total
Program Services	741825	ProgramServices
Management And General	39043	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	403795	Total
Program Services	383605	ProgramServices
Management And General	20190	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	98479	Total
Program Services	93556	ProgramServices
Management And General	4924	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	13112	Total
Management And General	13112	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	2397	Total
Program Services	2397	ProgramServices

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	566906	Total
Program Services	566887	ProgramServices
Management And General	18	ManagementAndGeneral
Fundraising	0	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	80606	Total
Program Services	76575	ProgramServices
Management And General	4030	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	2855253	Total
Program Services	2712491	ProgramServices
Management And General	142763	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	785346	Total
Program Services	785346	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	39546	Total
Program Services	37569	ProgramServices
Management And General	1977	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	17676	Total
Program Services	16792	ProgramServices
Management And General	884	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	14472	Total
Program Services	14472	ProgramServices

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	763511	Total
Program Services	725335	ProgramServices
Management And General	38176	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	49583	Total
Program Services	47104	ProgramServices
Management And General	2479	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
PURCHASED SERVICES	3093554	2938876	154678
BAD DEBTS	806398	806398
MEMBERSHIP & DUES	42722	40585	2137
TAXES & LICENSES	17128	16270	858

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	37479	Total
Program Services	35605	ProgramServices
Management And General	1874	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	18058984	Total
Program Services	17106308	ProgramServices
Management And General	952677	ManagementAndGeneral
Fundraising	0	Fundraising

Total Joint Costs TotalJointCosts

Field	Value	IRS element (for citing)
Total	0	Total

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	469395	BOY
EOY	1012925	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	0	BOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	2794326	BOY
EOY	2118444	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	387137	BOY
EOY	393295	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	17464813	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	10440790	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	6684743	BOY
EOY	7024023	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	6374847	BOY
EOY	6809620	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	16710448	BOY
EOY	17358308	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	368862	BOY
EOY	67968	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
EOY	0	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	345126	BOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	1389259	BOY
EOY	1967710	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	2103247	BOY
EOY	2035678	EOY

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	14607201	BOY
EOY	15322630	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	14607201	BOY
EOY	15322630	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	16710448	BOY
EOY	17358308	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	715429	ReconcilationRevenueExpenses
Reconcilation Other Changes	0	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	true	FederalGrantAuditRequired
Federal Grant Audit Performed	true	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	true	GrantsOtherOrganizations
Grants Other Organizations	$2,397	GrantsOtherOrganizationsAmount
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	false	OtherActivities
Total Lobbying Expenditures IIB	2397	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	Description of the activities reported on Lines 1a through 1i	Identifier
Return Reference	Schedule C, Part II-B, Line 1	ReturnReference
Explanation	AMOUNTS PAID TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES TOTAL $2,397. THIS INCLUDES DUES PAID TO VARIOUS ORGANIZATIONS INCLUDING THE CATHOLIC HEALTH ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	35634	BeginningOfYearBalance
Contributions	293627	Contributions
Other Expenditures	26916	OtherExpenditures
End Of Year Balance	302345	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	20846	BeginningOfYearBalance
Contributions	33908	Contributions
Other Expenditures	19120	OtherExpenditures
End Of Year Balance	35634	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	20338	BeginningOfYearBalance
Contributions	27073	Contributions
Investment Earnings Or Losses	-26565	InvestmentEarningsOrLosses
End Of Year Balance	20846	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	982	BeginningOfYearBalance
Contributions	19356	Contributions
End Of Year Balance	20338	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3471	BeginningOfYearBalance
Other Expenditures	2489	OtherExpenditures
End Of Year Balance	982	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.00000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.00000	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	1.00000	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	true	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	true	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	7500	OtherCostOrOtherBasis
Book Value	7500	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	6844985	OtherCostOrOtherBasis
Depreciation	3537214	Depreciation
Book Value	3307771	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	0	Depreciation
Book Value	0	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	9400705	OtherCostOrOtherBasis
Depreciation	6688591	Depreciation
Book Value	2712114	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1211623	OtherCostOrOtherBasis
Depreciation	214985	Depreciation
Book Value	996638	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	7024023	TotalOfBookValueLandBuildings

Other Assets OtherAssets

Field	Value	IRS element (for citing)
Description	DUE TO/FROM ALLOCATIONS-INTERCOMPANY	Description
Book Value	6809620	BookValue

Field	Value	IRS element (for citing)
Total Book Value Other Assets	6809620	TotalBookValueOtherAssets
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
AMOUNTS DUE TO THIRD PARTY PAYORS	$1,628,709
INTERCOMPANY PAYABLES	$339,001

Field	Value	IRS element (for citing)
Total Of Amounts	1967710	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Intended uses of endowment funds	Schedule D, Part V, Line 4	ENDOWMENT FUNDS ARE INTENDED TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF MERCY HEALTH CARE FOUNDATION AND ALEGENT HEALTH MERCY HOSPITAL, CORNING, IA.
FIN 48 (ASC 740) footnote	Schedule D, Part X, Line 2	ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI'S FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2013 READS AS FOLLOWS: "CHI IS A TAX-EXEMPT COLORADO CORPORATION AND HAS BEEN GRANTED AN EXEMPTION FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CHI OWNS CERTAIN TAXABLE SUBSIDIARIES AND ENGAGES IN CERTAIN ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE AND THEREFORE SUBJECT TO INCOME TAX. MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS."

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	false	FPGReferenceFreeCare
FPG Reference Discounted Care	false	FPGReferenceDiscountedCare
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	true	ExpensesExceededBudget
Unable To Provide Care	false	UnableToProvideCare
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Persons Served	685	PersonsServed
Total Community Benefit Expense	285759	TotalCommunityBenefitExpense
Net Community Benefit Expense	285759	NetCommunityBenefitExpense
Percent Of Total Expense	0.01660	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Persons Served	3092	PersonsServed
Total Community Benefit Expense	1248817	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1305183	DirectOffsettingRevenue
Net Community Benefit Expense	-56366	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	11579	TotalCommunityBenefitExpense
Direct Offsetting Revenue	16016	DirectOffsettingRevenue
Net Community Benefit Expense	-4437	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	3777	PersonsServed
Total Community Benefit Expense	1546155	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1321199	DirectOffsettingRevenue
Net Community Benefit Expense	224956	NetCommunityBenefitExpense
Percent Of Total Expense	0.01660	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Persons Served	407	PersonsServed
Total Community Benefit Expense	122232	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3806	DirectOffsettingRevenue
Net Community Benefit Expense	118426	NetCommunityBenefitExpense
Percent Of Total Expense	0.00690	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Persons Served	34	PersonsServed
Total Community Benefit Expense	525	TotalCommunityBenefitExpense
Net Community Benefit Expense	525	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1065523	TotalCommunityBenefitExpense
Direct Offsetting Revenue	746655	DirectOffsettingRevenue
Net Community Benefit Expense	318868	NetCommunityBenefitExpense
Percent Of Total Expense	0.01840	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4058	TotalCommunityBenefitExpense
Net Community Benefit Expense	4058	NetCommunityBenefitExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Persons Served	18	PersonsServed
Total Community Benefit Expense	24827	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3	DirectOffsettingRevenue
Net Community Benefit Expense	24824	NetCommunityBenefitExpense
Percent Of Total Expense	0.00140	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	459	PersonsServed
Total Community Benefit Expense	1217165	TotalCommunityBenefitExpense
Direct Offsetting Revenue	750464	DirectOffsettingRevenue
Net Community Benefit Expense	466701	NetCommunityBenefitExpense
Percent Of Total Expense	0.02690	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	4236	PersonsServed
Total Community Benefit Expense	2763320	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2071663	DirectOffsettingRevenue
Net Community Benefit Expense	691657	NetCommunityBenefitExpense
Percent Of Total Expense	0.04350	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	3325	TotalCommunityBuildingExpense
Net Community Building Expense	3325	NetCommunityBuildingExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Persons Served	1	PersonsServed
Total Community Building Expense	5514	TotalCommunityBuildingExpense
Net Community Building Expense	5514	NetCommunityBuildingExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	1	PersonsServed
Total Community Building Expense	8839	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	8839	NetCommunityBuildingExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$447,713	BadDebtExpenseAmount
Amount Attributable To	10531	AmountAttributableTo
Amount Reimbursed By Medicare	6519480	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	9092977	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-2573497	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ALEGENT HEALTH MERCY HOSPITAL CORNING	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	603 ROSARY DRIVE	AddressLine1
City	CORNING	City
State	IA	State
ZIP Code	50841	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ALEGENT HEALTH MERCY HOSPITAL CORNING	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	true	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Information Gaps	X	InformationGaps
Needs Assessment Conducted	12	NeedsAssessmentConducted
Take Into Account	true	TakeIntoAccount
Other Facilities	false	OtherFacilities
CHNA Widely Available	true	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Other Method	X	OtherMethod
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	false	AllNeedsAddressed
Organization Incur Excise Tax	false	OrganizationIncurExciseTax
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	false	UsesFPGFree
Uses FPG Discounted	false	UsesFPGDiscounted
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Uninsured Discount	X	UninsuredDiscount
Other Factors	X	OtherFactors
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Attached To Invoices	X	AttachedToInvoices
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Provided On Admission	X	ProvidedOnAdmission
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	true	ActionsOnNonpayment
Collection Activities	false	CollectionActivities
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Average Negotiated Rates	X	AverageNegotiatedRates
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	4	NumberOfOtherFacilities

Other Facilities OtherFacilities (4 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
AH CORNING RURAL HEALTH CLINIC
601 ROSARY DRIVE	CORNING	IA	50841	RURAL HEALTH CLINIC
AH BEDFORD RURAL HEALTH CLINIC
618 COURT AVE	BEDFORD	IA	50833	RURAL HEALTH CLINIC
AH LENOX RURAL HEALTH CLINIC
810 1/2 E VAN BUREN ST	LENOX	IA	50851	RURAL HEALTH CLINIC
AH MERCY HOSP SKILLED NURSING FACILITY
603 ROSARY DRIVE	CORNING	IA	50841	SKILLED NURSING FACILITY

Form990 Schedule H Part VI Form990ScheduleHPartVI (24 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Eligibility criteria for free or discounted care	Schedule H, Part I, Line 3c	WHEN CATHOLIC HEALTH INITIATIVES (THE ULTIMATE PARENT ORGANIZATION TO ALEGENT HEALTH-MERCY HOSPITAL) ESTABLISHED ITS FINANCIAL ASSISTANCE POLICY IT WAS DETERMINED THAT ESTABLISHING A HOUSEHOLD INCOME SCALE BASED ON THE HUD VERY LOW INCOME GUIDELINES MORE ACCURATELY REFLECTS THE SOCIOECONOMIC DISPERSIONS AMONG URBAN AND RURAL COMMUNITIES IN 17 STATES SERVED BY CHI HOSPITALS AND HEALTH CARE FACILITIES. IN COMPARING HUD GUIDELINES TO THE FEDERAL POVERTY GUIDELINES ("FPG"), WE FIND THAT ON AVERAGE HUD GUIDELINES COMPUTE TO APPROXIMATELY 200% TO 250% (AND SOMETIMES 300%) OF FPG. ALEGENT HEALTH-MERCY HOSPITAL BASES ITS FINANCIAL ASSISTANCE ELIGIBILITY ON HUD'S 130% OF VERY LOW INCOME GUIDELINES BASED ON GEOGRAPHY, AND AFFORDS THE UNINSURED AND UNDERINSURED THE ABILITY TO OBTAIN FINANCIAL ASSISTANCE WRITE-OFFS, BASED ON A SLIDING SCALE, RANGING FROM 25%-100% OF CHARGES. 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.
Community benefit report prepared by related organization	Schedule H, Part I, Line 6a	ALEGENT CREIGHTON HEALTH
COMMUNITY BENEFIT REPORT AVAILABLE TO PUBLIC	SCHEDULE H, PART I, LINE 6A	THE ALEGENT CREIGHTON HEALTH SYSTEM PRODUCES AN ANNUAL PUBLIC COMMUNITY BENEFIT REPORT THAT IS MAILED TO A CORE CONSTITUENCY, PLACED IN KEY PLACES THROUGHOUT THE ORGANIZATION AND DISTRIBUTED IN COMMUNITY MEETINGS. IT IS ALSO AVAILABLE ON THE COMPANY'S INTRANET SITE, AND ON ITS PUBLIC WEBSITE AT TTP://WWW.ALEGENTCREIGHTON.COM/ COMMUNITY-BENEFIT.
Costing Methodology used to calculate financial assistance	Schedule H, Part I, Line 7	THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WERE WORKSHEETS 1-8 PROVIDED WITH THE SCHEDULE H INSTRUCTIONS. THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CALCULATE TOTAL COMMUNITY BENEFIT EXPENSE FOR CHARITY CARE, MEDICAID AND OTHER MEANS TESTED.
Bad Debt Expense excluded from financial assistance calculation	Schedule H, Part I, Line 7, column(f)	806,399
Subsidized Health Services	Schedule H, Part I, Line 7g	ALEGENT CREIGHTON HEALTH MERCY HOSPITAL, CORNING, IA (42-0782518), PROVIDES SUBSIDIZED HEALTH SERVICES TO THE BROADER COMMUNITY THROUGH ITS RURAL HEALTH CLINIC. THE AMOUNT INCLUDED AS SUBSIDIZED SERVICES IS $318,868.
Community Building Activities	Schedule H, Part II	ALEGENT CREIGHTON HEALTH HAS A HISTORY OF CENTRALIZED COMMUNITY BENEFIT INVESTMENTS, AS WELL AS HOSPITAL SPECIFIC INVESTMENTS THAT ADDRESS COMMUNITY HEALTH NEEDS WHICH INCLUDE COMMUNITY BUILDING SUCH AS: -LIVE WELL OMAHA KIDS- AS A RESULT OF COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2006 WHICH POINTED TO CHILDHOOD OBESITY AS A SERIOUS HEALTH NEEDS ISSUE ACROSS ALL OMAHA MSA COUNTIES SERVED, THE ALEGENT CREIGHTON HEALTH SYSTEM PARTNERED WITH THE COMMUNITY TO MAKE A MULTI-YEAR COMMITMENT TO IMPACT CHILDHOOD OBESITY THROUGH COMMUNITY BASED BEST PRACTICE INTERVENTIONS. THIS INITIATIVE HAS HAD A PRIMARY FOCUS OF IMPACT IN DOUGLAS COUNTY, BUT THE FUNDING TO UNDERWRITE HAS COME FROM THE FISCAL PERFORMANCE OF ALL ALEGENT CREIGHTON HEALTH HOSPITALS. THE COMMUNITY COALITION KNOWN AS LIVE WELL OMAHA KIDS (LWOK) IS STAFFED AND FUNDED BY ALEGENT CREIGHTON HEALTH. AN EXECUTIVE COMMITTEE CONSISTING OF COMMUNITY LEADERS AND POLICY MAKERS HAVE DIRECTED AN ECOLOGICAL APPROACH TO IMPROVE PROGRAMS, POLICIES AND THE BUILT ENVIRONMENT TO PROMOTE PHYSICAL ACTIVITY AND HEALTHY EATING AND BUILD CAPACITY FOR HEALTHY CHOICES AT THE INDIVIDUAL AND ORGANIZATIONAL LEVEL. MORE THAN 200 VOLUNTEERS AND 90 ORGANIZATIONS HAVE PARTICIPATED IN THE PLANNING AND IMPLEMENTATION OF LWOK INITIATIVES. A PORTION OF THIS INVESTMENT IN LWOK IS ALLOCATED TO CORNING HOSPITAL ON A NET SERVICE REVENUE BASIS. -COMMUNITY AND ECONOMIC DEVELOPMENT INCLUDING SUPPORT OF LOCAL CHAMBERS OF COMMERCE -STRATEGIC PLANNING AND CONSULTING SERVICES FOR COMMUNITY -SPONSORSHIP OF COMMUNITY NOT FOR PROFITS AND FUNDRAISING EVENTS -SUPPORT OF INTERNATIONAL HEALTH MINISTRIES IN TANZANIA AND DOMINICAN REPUBLIC -SUPPORT OF THE FEDERALLY QUALIFIED HEALTHCARE CENTERS -PARISH NURSING PROGRAM -COMMUNITY HEALTH FAIRS, SUPPORT GROUPS AND COMMUNITY EDUCATION -SCHOOL BASED HEALTHCARE SERVICES -LEADERSHIP IN AND FUNDING OF HEALTH COALITIONS CORNING HOSPITAL LEADERSHIP PARTICIPATES IN COMMUNITY TOBACCO AND ECONOMIC DEVELOPMENT COALITIONS. THROUGH A CONTRACT WITH THE STATE, ALEGENT CREIGHTON HEALTH AND FAMILY HOME CARE SERVE AS THE LOCAL HEALTH DEPARTMENT FOR ADAMS COUNTY, IOWA. THE HOSPITAL ALSO PROMOTES COMMUNITY BUILDING AND PHYSICAL ACTIVITY THROUGH ITS WELLNESS CENTER AND FUNDING OF ENHANCEMENTS TO THE LOCAL SWIMMING POOL. CORNING HOSPITAL'S LEADERSHIP SERVES ON ADAMS COUNTY ECONOMIC DEVELOPMENT BOARD AND THE HOSPITAL MAKES CONTRIBUTIONS TO ECONOMIC DEVELOPMENT THAT ENHANCES THE HEALTH OF THE COMMUNITY. CORNING HOSPITAL PROVIDES ADMINISTRATIVE SUPPORT FOR A COMMUNITY DAYCARE BY MAINTAINING THE FINANCIAL RECORDS FOR THE DAYCARE.
Bad debt expense - methodology used to estimate amount	Schedule H, Part III, Line 2	COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 55.52%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE.
Bad debt expense - methodology used to estimate amount as community benefit	Schedule H, Part III, Line 3	ALEGENT HEALTH-MERCY HOSPITAL 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.
Bad debt expense - financial statement footnote	Schedule H, Part III, Line 4	ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS: "THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, CHI FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. IN ACCORDANCE WITH ACCOUNTING STANDARDS UPDATE (ASU) NO. 2011-07, PRESENTATION AND DISCLOSURE OF PATIENT SERVICES REVENUE, PROVISION FOR BAD DEBTS, AND ALLOWANCES FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH ENTITIES, THE PROVISION FOR BAD DEBTS IS PRESENTED ON THE CONSOLIDATED STATEMENT OF OPERATIONS AS A DEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) SINCE CHI ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY."
Community benefit & methodology for determining medicare costs	Schedule H, Part III, Line 8	THE ALEGENT CREIGHTON HEALTH SYSTEM AND CATHOLIC HEALTH INITIATIVES DOES NOT CONSIDER MEDICARE SHORTFALLS TO BE COMMUNITY BENEFIT PER THE RECOMMENDATION OF THE CATHOLIC HEALTH ASSOCIATION. THE MEDICARE CHARGES REPORTED ON LINE 5 AND 6 ARE FROM MEDICARE COST REPORTS WHICH USE A COST TO CHARGE RATIO.
Collection practices for patients eligible for financial assistance	Schedule H, Part III, Line 9b	THE ALEGENT CREIGHTON HEALTH SYSTEM'S SELF PAY BILLING AND BAD DEBT POLICY HAS A CLEARLY DELINEATED PROCESS AND GUIDELINES FOR COLLECTIONS AGENCIES TO FOLLOW, INCLUDING EXPLICIT INSTRUCTIONS TO ADHERE TO THE SAME FINANCIAL ASSISTANCE GUIDELINES AS ALEGENT CREIGHTON HEALTH. 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.
Community Served by Needs Assessment	Schedule H, Part V Section B, Line 3	(1) ALEGENT HEALTH MERCY HOSPITAL, CORNING - ALEGENT HEALTH MERCY HOSPITAL AND THE PUBLIC HEALTH AGENCIES OF BOTH ADAMS AND TAYLOR COUNTY COLLABORATED TO CONDUCT THE CHNA. KATHY WEST, AN ALEGENT HEALTH HOME TEAM LEAD REPRESENTED ADAMS COUNTY PUBLIC HEALTH AND JOAN GALLAGHER, TAYLOR COUNTY PUBLIC HEALTH DIRECTOR REPRESENTED TAYLOR COUNTY PUBLIC HEALTH. THE CHNA WAS CONDUCTED BY THOROUGH REVIEW OF DATA AND FOCUS GROUP MEETINGS. THE FOCUS GROUPS INCLUDED THE FOLLOWING LEADERS REPRESENTING A BROAD VIEW OF THE COMMUNITY'S HEALTH NEEDS: EMPOWERMENT BOARD MEMBERS- * DOUG BIRT- ADAMS COUNTY BOARD OF SUPERVISORS * KATHY WEST RN BSN - ADAMS COUNTY PUBLIC HEALTH/ALEGENT HEALTH AT HOME * KIM WILKINSON- MATURA (HUMAN SERVICES) * PATTY MORRIS- CORNING COMMUNITY SCHOOL PRINCIPAL * MYRNA RUMMER- CORNING COMMUNITY FAITH REPRESENTATIVE * KATRINA FLEHARTY- MIDWEST OPPORTUNITIES (BUSINESS REPRESENTATIVE) * KYLE DASHER- CROSSROADS MENTAL HEALTH ( CONSUMER REPRESENTATIVE) * CRYSTAL SCHAFER - PRESCOTT COMMUNITY SCHOOL EDUCATOR * LAURA COOPER- PRESCOTT COMMUNITY PARENT REPRESENTATIVE ADAMS COUNTY LOCAL EMERGENCY PLANNING COMMITTEE (LEPC) * DON WILLETT- CORNING FIRE DEPARTMENT * ALICIA REED- ALEGENT HEALTH MERCY HOSPITAL REPRESENTATIVE * BRENT SPURRIER- ADAMS COUNTY AMBULANCE SERVICE PARAMEDIC * CARL GOODSON- ADAMS COUNTY ENVIRONMENTAL HEALTH * GUY GRACE- CITY OF CORNING MAYOR * PHILICIA HANCOCK- ALEGENT HEALTH INFECTION CONTROL SPECIALIST ADAMS COUNTY BOARD OF HEALTH * DR. STEPHEN GRUBA MD, ALEGENT HEALTH CLINIC * HARTFORD COOPER- NODAWAY, IOWA REPRESENTATIVE * DR. MARIA FULLER DDS * WAYNE MOORE- CORNING, IOWA REPRESENTATIVE ALEGENT HEALTH AT HOME/HOSPICE OF SOUTHWEST IOWA/ADAMS COUNTY PUBLIC HEALTH/ PARENTS AS TEACHERS * KATHY WEST RN BSN - TEAM LEAD * TINA ANDERSON RN * TERESA HARDY RN * BONNIE BERGGREN RN * MARILYN BERGMAN * SARAH HYNNEK * CHRIS HEIMKE- PARENTS AS TEACHERS COORDINATOR * SHYLA SCHAFER- PARENTS AS TEACHERS * KAREN BOSWELL- HOME CARE AIDE * GLORIA KIBBE- HOME CARE AIDE * MARY O'RILEY- SOCIAL WORKER * RANDY ALLMAN- CHAPLAIN, ADAMS COUNTY INTERAGENCY COMMITTEE * ANDREA CORBINO-AREA 14 ON AGING * ANGIE PETTIT- MATURA ORAL HEALTH COORDINATOR * CHRIS NELSON- ISU EXTENSION FOR ADAMS COUNTY * JOCELYN BLAZEK- DECAT COORDINATOR * PJ WEST- FADDS COORDINATOR * VICTORIA BRAMMER- COMMUNITY PARTNERSHIPS FOR PROTECTING CHILDREN THE HOSPITAL PLAYS A KEY ROLE IN THE ADAMS COUNTY PUBLIC HEALTH BY EMPLOYING STAFF THAT PROVIDE ALL OF THE COUNTY PUBLIC HEALTH SERVICES THROUGH A CONTRACTUAL ARRANGEMENT WITH THE COUNTY BOARD OF SUPERVISORS. THE HOSPITAL WORKS COLLABORATIVELY WITH THE TAYLOR COUNTY PUBLIC HEALTH AGENCY TO PROVIDE NEEDED SERVICES THROUGH IN KIND ARRANGEMENTS OR FROM CONTRACTUAL AGREEMENTS. ;
Availability of Needs Assessment	Schedule H, Part V Section B, Line 5c	(1) ALEGENT HEALTH MERCY HOSPITAL, CORNING - CHNA WAS ALSO POSTED ON THE RESPECTIVE HEALTH AGENCY'S WEBSITES AND WAS SHARED WITH PARTICIPATING INDIVIDUALS AND ORGANIZATIONS.;
Needs not addressed in Needs Assessment	Schedule H, Part V Section B, Line 7	(1) ALEGENT HEALTH MERCY HOSPITAL, CORNING - DUE TO AVAILABILITY OF DATA, EXISTING RESOURCES AND AN ABILITY TO MAKE AN IMPACT ON PRIORITY HEALTH ISSUES, TWO ISSUES WERE PRIORITIZED 1) REDUCE HYPERTENSION IN A GROUP OF MEN AND WOMEN, AGES 45-75, 2) INCREASE THE NUMBER OF MAMMOGRAMS BY 5% (BASELINE-865, 2006-2010). ADDITIONAL PRIORITIES WERE IDENTIFIED BY THE SERIOUSNESS OF THE ISSUE, AVAILABILITY OF COMMUNITY RESOURCES TO MEET THE NEEDS, AND NUMBER PERSONS AFFECTED. ADDITIONAL PRIORITIES IDENTIFIED INCLUDE: DIABETES, PREGNANCY AND BIRTH, SMOKING, BINGE DRINKING, MOTOR VEHICLE ACCIDENTS, STROKE, ASTHMA, SEXUALLY TRANSMITTED DISEASE, EDUCATIONAL ATTAINMENT, DISASTER PREPAREDNESS, AND TRANSPORTATION. THESE WILL BE LED BY OTHER ENTITIES WHILE THE CHIP WORK FOCUSES ON DRIVING THE TWO PRIORITIZED ISSUES.;
Used federal poverty guidelines (FPG) to determine eligibility	Schedule H, Part V Section B, Line 10	(1) ALEGENT HEALTH MERCY HOSPITAL, CORNING - US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD) VERY LOW-INCOME GUIDELINES ARE USED.;
Used FPG to determine eligibility for providing discounted care criteria	Schedule H, Part V Section B, Line 11	(1) ALEGENT HEALTH MERCY HOSPITAL, CORNING - US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD) VERY LOW-INCOME GUIDELINES ARE USED.;
Other factors included in calculating amounts charges to patients	Schedule H, Part V Section B, Line 12h	(1) ALEGENT HEALTH MERCY HOSPITAL, CORNING - SIZE OF FAMILY IS ALSO USED IN THE CALCULATION.;
Needs assessment.	Schedule H, Part VI, Line 2	THE PROCESS TO DEVELOP ASSESSMENTS OF THE COMMUNITY HEALTH NEEDS (CHNA) IS COLLABORATIVE IN NATURE AND INVOLVES HEALTH DEPARTMENTS, EXISTING HEALTH COALITIONS, COMMUNITY MEMBERS AND HOSPITAL LEADERSHIP, AND IS SUPPORTED BY ALEGENT CREIGHTON HEALTH'S COMMUNITY BENEFIT AND HEALTHIER COMMUNITIES DEPARTMENT STAFF. EACH ALEGENT CREIGHTON HEALTH HOSPITAL PARTICIPATES IN THE CHNA PROCESS FOR THE COUNTY IN WHICH THE FACILITY IS LOCATED AT LEAST EVERY 3 YEARS IN PARTNERSHIP WITH THE LOCAL HEALTH DEPARTMENTS. THE ASSESSMENT VARIES IN EACH COMMUNITY BUT INCLUDES REVIEW OF PRIMARY DATA (SUCH AS SURVEYS, KEY INFORMANT INTERVIEWS, FOCUS GROUPS) AND SECONDARY DATA (SUCH AS COUNTY HEALTH RANKINGS, BRFRSS, YRBS, CENSUS DATA ETC) LEADERSHIP FROM ALEGENT CREIGHTON HEALTH PARTICIPATE IN MULTIPLE INTERNAL AND EXTERNAL VENUES TO GARNER COMMUNITY INPUT, PRIORITIZE COMMUNITY HEALTH NEEDS AND DEVELOP COMMUNITY HEALTH IMPROVEMENT PLANS. THE CHNA REPORT FOR EACH COMMUNITY IS MADE AVAILABLE TO THE PUBLIC BY POSTING THE REPORT ON THE ALEGENT CREIGHTON HEALTH EXTERNAL WEBSITE AND BY MAKING IT AVAILABLE IN COMMUNITY VENUES. THE CHNAS ARE INTEGRATED INTO THE GOVERNANCE AND PLANNING FOR ALEGENT CREIGHTON HEALTH ON TWO LEVELS- * REPORTING INTO THE COMMITTEE OF THE BOARD OF DIRECTORS CHARGED WITH HEALTH PLANNING OVERSIGHT * INTO THE ANNUAL STRATEGIC PLANNING AND BUDGETING PROCESSES OF ALEGENT CREIGHTON HEALTH. ALEGENT HEALTH MERCY HOSPITAL IN CORNING, IA COLLABORATES WITH THE PUBLIC HEALTH AGENCIES OF BOTH ADAMS AND TAYLOR COUNTY TO CONDUCT THE CHNA AT LEAST EVERY THREE YEARS. THE CHNA IS CONDUCTED BY THOROUGH REVIEW OF AVAILABLE DATA AND FOCUS GROUP MEETINGS. THE HOSPITAL PLAYS A KEY ROLE IN THE ADAMS COUNTY PUBLIC HEALTH BY EMPLOYING STAFF THAT PROVIDE ALL OF THE COUNTY PUBLIC HEALTH SERVICES THROUGH A CONTRACTUAL ARRANGEMENT WITH THE COUNTY BOARD OF SUPERVISORS. THE HOSPITAL WORKS COLLABORATIVELY WITH THE TAYLOR COUNTY PUBLIC HEALTH AGENCY TO PROVIDE NEEDED SERVICES THROUGH IN KIND ARRANGEMENTS AND CONTRACTUAL AGREEMENTS.
Patient education of eligibility for assistance.	Schedule H, Part VI, Line 3	THERE ARE SEVERAL FINANCIAL ASSISTANCE ACCESS POINTS THROUGHOUT A PATIENT'S CARE CYCLE. BILLS CONTAIN FINANCIAL ASSISTANCE VERBIAGE; SIGNS ARE POSTED IN CLINICS AND HOSPITAL, AND THERE IS INFORMATION ON FINANCIAL ASSISTANCE POSTED AT REGISTRATION POINTS THROUGHOUT CLINICS AND HOSPITALS. INFORMATION ON THE ALEGENT CREIGHTON HEALTH SYSTEM'S FINANCIAL ASSISTANCE POLICIES ARE LOCATED SEVERAL PLACES ON THE SYSTEM'S WEBSITE- WWW.ALEGENTCREIGHTON.COM. ALL EFFORTS ARE MADE TO ESTABLISH WHETHER PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE PRIOR TO SERVICE IF POSSIBLE, OTHERWISE AS SOON AS POSSIBLE FOLLOWING SERVICE. ALEGENT CREIGHTON HEALTH REPRESENTATIVES HELP PATIENTS SEEK REIMBURSEMENT FROM LOCAL, STATE AND FEDERAL PROGRAMS AT NO CHARGE TO THE PATIENT. AFTER THESE EFFORTS AND RESOURCES HAVE BEEN EXHAUSTED, PATIENTS ARE ASSISTED IN THE APPLICATION PROCESS FOR FINANCIAL ASSISTANCE CONSISTENT WITH ALEGENT CREIGHTON HEALTH'S FINANCIAL ASSISTANCE POLICY. THE APPLICATION PROCESS REQUIRES THAT THE PATIENT COMPLETE A PERSONAL FINANCIAL APPLICATION AND PROVIDE VERIFICATION DOCUMENTS. VERIFICATION INCLUDES EMPLOYMENT VERIFICATION AND OBTAINING DOCUMENTATION OF THE APPLICANT'S FINANCIAL CONDITION SUCH AS FEDERAL TAX RETURN, PAY STUB, NET WORTH AND/OR LIQUID ASSETS AND REASONABLE HOUSEHOLD OR BUSINESS EXPENSES. FINANCIAL ASSISTANCE MAY STILL BE GRANTED IN CERTAIN CIRCUMSTANCES INVOLVING A CATASTROPHIC OCCURRENCE RESULTING IN MEDICAL BILLS GROSSLY EXCEEDING THE PATIENT'S ABILITY TO PAY, AND IN THESE SITUATIONS, THE PATIENT'S RESPONSIBILITY WILL BE LIMITED TO 20% OF THE FAMILY'S GROSS ANNUAL INCOME.
Community information.	Schedule H, Part VI, Line 4	ALEGENT HEALTH MERCY HOSPITAL, CORNING, IA SERVES ADAMS AND TAYLOR COUNTIES IN IOWA. CORNING IS LOCATED IN THE ROLLING HILLS OF SOUTHWEST IOWA. THERE IS AN ESTIMATED 2012 POPULATION OF 4,004 IN ADAMS COUNTY, A DECREASE OF OVER 2.9 PERCENT FROM 2010 TO DATE AND 6,305 IN TAYLOR COUNTY, A DECREASE OF 1.7 PERCENT FROM 2010 TO 2012. THERE ARE APPROXIMATELY 955 SQUARE MILES COMBINED. CENSUS ESTIMATES SHOW THAT ADAMS (98.0%) AND TAYLOR COUNTIES (98.1%) RACIAL AND ETHNIC MAKEUP IS PREDOMINANTLY WHITE. ACCORDING TO THE COUNTY HEALTH RANKINGS, ADAMS COUNTY HEALTH RANKING IS 97TH OUT OF THE 99 COUNTIES IN IOWA; AND TAYLOR COUNTY RANKS 41ST OUT OF 99. THE MEDIAN HOUSEHOLD INCOME IN ADAMS COUNTY IS $42,062, AND IN TAYLOR COUNTY IS $43,155 COMPARED TO $49,545 FOR THE STATE OF IOWA. IN ADAMS COUNTY, THE CORNING SCHOOLS PROVIDE FREE OR REDUCED LUNCH TO 47.3% AND THE PRESCOTT SCHOOLS TO 71% OF THEIR STUDENTS. THE NUMBER OF STUDENTS RECEIVING FREE OR REDUCED LUNCH IN TAYLOR COUNTY RANGES FROM 47.5% IN THE BEDFORD SCHOOL DISTRICT, 55.8% IN THE LENOX SCHOOL DISTRICT TO 78.9% IN THE CLEARFIELD SCHOOL DISTRICT. OVER ONE-FIFTH OF THE POPULATION OF BOTH COUNTIES IS AGED 65 AND OLDER.
Promotion of community health	Schedule H, Part VI, Line 5	ALEGENT CREIGHTON HEALTH HAS A HISTORY OF CENTRALIZED COMMUNITY BENEFIT AND HOSPITAL SPECIFIC COMMUNITY BENEFIT INVESTMENTS TO ADDRESS COMMUNITY HEALTH NEEDS OF THE PARTICULAR SERVICE AREA. EXAMPLES OF HOW ALEGENT CREIGHTON HEALTH FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES INCLUDE: - FINANCIAL ASSISTANCE AND UNPAID COSTS OF MEDICAID - COMMUNITY HEALTH IMPROVEMENT SERVICES - COMMUNITY EDUCATION, CLASSES AND PROGRAMS (CHILDBIRTH, DIABETES, ONCOLOGY, PHYSICAL ACTIVITY, HEALTHY EATING AND COOKING, HEALTH CAREERS, CANCER, SPORTS MEDICINE ETC) - SUPPORT GROUPS (CANCER, BEREAVEMENT, YOUTH ETC) - COMMUNITY HEALTH FAIRS AND SCREENINGS - IMMUNIZATION CLINICS - PARISH NURSING PROGRAM AND FAITH COMMUNITY OUTREACH - SCHOOL BASED HEALTHCARE SERVICES - HEALTH PROFESSIONAL EDUCATION-- CLINICAL PRECEPTORSHIPS FOR HEALTHCARE PROFESSIONALS - SCHOLARSHIPS AND MENTORSHIPS - AFFILIATION WITH AND SUPPORT OF THE CREIGHTON UNIVERSITY SCHOOL OF MEDICIN - PHYSICIAN RESIDENCY AND FELLOWSHIP PROGRAMS TRAINING MORE THAN 200 RESIDENTS AND FELLOWS ANNUALLY - RESEARCH-PARTICIPATION IN THE MISSOURI VALLEY CANCER CONSORTIUM - FINANCIAL AND IN-KIND CONTRIBUTIONS - SUPPORT OF THE FEDERALLY QUALIFIED HEALTHCARE CENTERS (FQHC) AND HOPE MEDICAL COALITION WHICH PROVIDES ACCESS TO MEDICAL SERVICES SPECIFICALLY FOR THE UNDERSERVED - CORPORATE SPONSORSHIPS - TANZANIA AND DOMINICAN REPUBLIC HEALTH MINISTRIES - STAFF SERVICE ON HEALTH RELATED BOARD AND COALITIONS - FREE TRANSPORTATION FOR PEOPLE IN NEED FOLLOWING TREATMENT - SUBSIDIZED HEALTHCARE SERVICE INCLUDING BEHAVIORAL HEALTH, NICU, EMERGENCY CARE, HOME HEALTH AND HOSPICE - COMMUNITY BUILDING ACTIVITIES- - COMMUNITY AND ECONOMIC DEVELOPMENT INCLUDING SUPPORT OF LOCAL CHAMBERS OF COMMERCE - STRATEGIC PLANNING AND CONSULTING SERVICES FOR COMMUNITY - HEALTH COALITIONS - THE PRIMARY CARE PHYSICIAN CLINICS THAT ARE PART OF THE PARENT CORPORATION PROVIDE ACCESS TO CARE THROUGH THE SYSTEM'S FINANCIAL ASSISTANCE POLICY AND PARTICIPATE IN MEDICAL STUDENT PRECEPTORSHIPS THAT ADVANCE THE HEALTHCARE PROVIDER EDUCATION PROCESS. - ALEGENT CREIGHTON HEALTH HAS OPEN MEDICAL STAFFS - ALEGENT CREIGHTON HEALTH IS ONE OF THREE HEALTH SYSTEMS THAT FUND THE OPERATIONS OF A COALITION THAT EXISTS TO PROVIDE ACCESS FOR THE PATIENTS OF THREE AREA FEDERALLY QUALIFIED HEALTHCARES TO SPECIALTY PHYSICIAN SERVICES AND HOSPITAL BASED DIAGNOSTICS AND TREATMENT - ALEGENT CREIGHTON HEALTH IS THE SOLE, COMPREHENSIVE MENTAL HEALTH PROVIDER IN THE OMAHA MSA AREA - ALEGENT CREIGHTON HEALTH IS A JOINT VENTURE PARTNER IN A NOT-FOR-PROFIT HOSPICE INPATIENT HOSPITAL AND PROVIDES THE MANAGEMENT SUPPORT CONTRACT. - ALEGENT CREIGHTON HEALTH BUDGETS FOR AN EMERGENCY FUND AS A SUBSET OF OTHER COMMUNITY DONATIONS TO RESPOND TO CRISIS OR UNPLANNED FUNDING NEEDS OF A VITAL COMMUNITY SERVICE, WHICH HAS FIRST USED IN FY11 WITH THE ECONOMIC DOWNTURN. PARTICULAR TO ALEGENT CREIGHTON HEALTH MERCY HOSPITAL, CORNING, IA, THE HOSPITAL PROVIDES STAFF LEADERSHIP, ADMINISTRATIVE SUPPORT AND FINANCIAL SUPPORT TO A NUMBER OF COMMUNITY HEALTH AND ECONOMIC DEVELOPMENT COALITION'S INCLUDING-ALEGENT HEALTH HOME CARE AND HOSPICE WHICH OPERATES AS THE LOCAL PUBLIC HEALTH DEPARTMENT, ADAMS COUNTY TOBACCO FREE COALITION, CORNING ECONOMIC DEVELOPMENT BOARD AND THE ADAMS COUNTY ECONOMIC DEVELOPMENT CORPORATION. THE HOSPITAL FUNDS THE RENOVATION OF THE COMMUNITY SWIMMING POOL AND THE ALEGENT CREIGHTON HEALTH WELLNESS CENTER AND MANAGES THE ADAMS COUNTY RESCUE SQUAD. THE HOSPITAL SEEKS COMMUNITY INPUT THROUGH ITS CRITICAL ASSESS HOSPITAL ADVISORY BOARD.
Affiliated health care system	Schedule H, Part VI, Line 6	ALEGENT HEALTH-MERCY HOSPITAL, 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 73 HOSPITALS; 40 LONG-TERM CARE, ASSISTED- AND RESIDENTIAL-LIVING FACILITIES; TWO COMMUNITY HEALTH-SERVICES ORGANIZATIONS; TWO ACCREDITED NURSING COLLEGES; AND HOME HEALTH AGENCIES. TOGETHER, THESE FACILITIES PROVIDED $762 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN THE 2013 FISCAL YEAR, INCLUDING SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. CHI PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED "SHARED SERVICES" FOR THE MBOS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES - INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN -- PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE MBOS. THE COST SAVINGS ACHIEVED THROUGH CHI'S CENTRALIZATION ENABLE MBOS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. ALEGENT HEALTH-MERCY HOSPITAL OPERATES WITH ITS WHOLLY OWNED AFFILIATES AND COMMUNITY PARTNERS, ALONG WITH ITS FUNDRAISING ARM, MERCY HEALTH CARE FOUNDATION, TO SERVE THE HEALTH CARE NEEDS OF THE CORNING, IA COMMUNITIES.
State filing of community benefit report	Schedule H, Part VI, Line 7	IA, NE

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	ADAMS COMMUNITY ECONOMIC DEVELOPMENT	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 102	AddressLine1
City	CRESTON	City
State	IA	State
ZIP Code	50801	ZIPCode

Field	Value	IRS element (for citing)
EIN Of Recipient	421301169	EINOfRecipient
IRC Section	501(C)(3)	IRCSection
Amount Of Cash Grant	6000	AmountOfCashGrant
Purpose Of Grant	GENERAL SUPPORT	PurposeOfGrant

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	1	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrant	Number Of RecipientsNumberOfRecipients	Amount Of Cash GrantAmountOfCashGrant	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Method Of ValuationMethodOfValuation	Description Of Non Cash AssistanceDescriptionOfNonCashAssistance
ROSE ANN AUXILIARY SCHOLARSHIPS	3	600
CHARITY CARE	685		548244	BOOK	REDUCTION OR WRITE OFF OF PATIENT SERVICES

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Procedures for monitoring use of grant funds	Identifier
Return Reference	Schedule I, Part I, Line 2	ReturnReference
Explanation	ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IOWA RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. BUSINESS OFFICE STAFF HELP PATIENTS SEEK LOCAL, STATE, AND FEDERAL REIMBURSEMENT AT NO CHARGE WHEN NO OTHER SOURCE OF PAYMENT IS AVAILABLE. FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS WITH DEMONSTRATED INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES. THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS ACCOUNTS RECEIVABLE. SCHEDULE I, PART I, LINE 2: THE ORGANIZATION MAKES GRANTS TO OTHER 501(C)(3) ORGANIZATIONS AND THE FUNDS ARE ONLY PROVIDED FOR CHARITABLE PURPOSES.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	true	SeverancePayment
Supplemental Nonqual Retire Plan	true	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	true	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	true	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
BETHEL KOPP MD
PHYSICIAN	375342	0	0	0	20370	0	16968	0	12331	0	425011	0	0	0
D RANDALL PRITZA MD
DIRECTOR	0	543275	0	0	0	13155	0	18716	0	15865	0	591011	0	0
DEBRA GOLDSMITH
EX-OFFICIO/ADMINISTRATOR	94957	0	26886	0	12762	0	13901	0	22471	0	170977	0	0	0
DENISE MCNITT
DIRECTOR	0	143133	0	40888	0	12492	0	13959	0	22180	0	232652	0	0
JOHN SAFRANEK MD
PHYSICIAN	182768	0	0	0	0	0	0	0	0	0	182768	0	0	0
JOSEPH PICCOLO
PHYSICIAN	159601	0	0	0	15651	0	10987	0	19674	0	205913	0	0	0
MAEN HADDADIN MD
PHYSICIAN	604720	0	0	0	28453	0	15000	0	25542	0	673715	0	0	0
RICHARD II HACHTEN
ACH PRESIDENT & CEO	0	855912	0	653989	0	686241	0	2978035	0	16269	0	5190446	0	585895
RODNEY TRIPLETT
DIRECTOR/NETWORK EXECUTIVE	0	133764	0	37021	0	11618	0	17944	0	25915	0	226262	0	0
SCOTT WOOTEN
ACH SVP/CFO	0	382290	0	265839	0	135295	0	1570941	0	20055	0	2374420	0	58678
STEPHEN GRUBA MD
PHYSICIAN	258109	0	0	0	11170	0	20911	0	11135	0	301325	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
GOVERNANCE OF EXECUTIVE COMPENSATION	SCHEDULE J, PART I, LINE 3	ACTING AS PRUDENT STEWARDS OF ITS FINANCIAL RESOURCES, THE ALEGENT CREIGHTON HEALTH BOARD COMPENSATION COMMITTEE RECOMMENDS AND THE BOARD EXECUTIVE COMMITTEE APPROVES EXECUTIVE COMPENSATION PHILOSOPHY, POLICY AND GUIDELINES. IT DOES SO WITH THE OBJECTIVE OF ATTRACTING AND RETAINING TOP EXECUTIVE TALENT TO ENSURE ALEGENT CREIGHTON HEALTH IS ABLE TO FULFILL ITS FAITH-BASED MISSION AND ACHIEVE ITS VISION OF BECOMING WORLD-CLASS. THE ALEGENT CREIGHTON HEALTH COMPENSATION COMMITTEE FOLLOWS A THOROUGH AND INTENTIONAL PROCESS THAT INCLUDES CONSULTATION WITH INDEPENDENT, EXPERT COUNSEL AND CAREFULLY COMPARES COMPENSATION LEVELS TO MARKET-BASED COMPENSATION OF SIMILAR SIZED, NON-PROFIT AND FOR-PROFIT HEALTH SYSTEMS AND ALSO UTILIZES A BLEND OF NON-PROFIT AND GENERAL INDUSTRY DATA FOR EXECUTIVE ROLES WHERE THE RECRUITING MARKET IS ARGUABLY BROADER THAN THE NON-PROFIT SECTOR. TOTAL COMPENSATION INCLUDES BASE COMPENSATION, AND ALSO INCLUDES PERFORMANCE-BASED INCENTIVE COMPENSATION FOR ACHIEVING BOARD-SET GOALS FOR CLINICAL QUALITY, PATIENT SAFETY AND SATISFACTION, PHYSICIAN PERCEPTION, STRATEGIC AND FACILITY PLANNING AND FINANCIAL PERFORMANCE. IT MAY ALSO INCLUDE OTHER CASH PAYMENTS SUCH AS ONE-TIME RELOCATION COSTS, AND/OR CASH PAYMENTS FOR DEFERRED COMPENSATION.
Severance or change-of-control payment	Schedule J, Part I, Line 4a	THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS AS EXECUTIVES OF ALEGENT CREIGHTON HEALTH DURING THE 2012 CALENDAR YEAR AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUAL'S W-2 INCOME AND REPORTABLE AS COMPENSATION ON SCHEDULE J: RICHARD HACHTEN, II - $444,672 SEVERANCE PAID TO RICHARD HACHTEN IN CALENDAR YEAR 2012 RELATES TO A CORRECTION MADE TO REPORT ADDITIONAL SEVERANCE OWED TO HIM FROM A PREVIOUS SEPARATION OF SERVICE. THE ADDITIONAL SEVERANCE WAS REPORTED ON A CORRECTED W-2C AND APPLICABLE TAXES WERE SUBMITTED TO THE IRS.
Supplemental nonqualified retirement plan	Schedule J, Part I, Line 4b	THE FOLLOWING REPORTABLE INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FROM ALEGENT CREIGHTON HEALTH (A RELATED ORGANIZATION) DURING THE 2012 CALENDAR YEAR. AMOUNTS DEFERRED FROM THE PLAN WERE INCLUDED COLUMN C OF THE SCHEDULE J: RICHARD HACHTEN II - $155,803 SCOTT WOOTEN - $48,613 THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED A PAY OUT FROM PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FROM ALEGENT CREIGHTON HEALTH (A RELATED ORGANIZATION) DURING THE 2012 CALENDAR YEAR. AMOUNTS PAID OUT WERE INCLUDED IN THE INDIVIDUALS WAGES AND REPORTED IN COLUMN E OF THE SCHEDULE J: RICHARD HACHTEN II - $141,223 SCOTT WOOTEN - $58,678.
Compensation contingent on net earnings of the organization	Schedule J, Part I, Line 6a	COMPENSATION FOR MEMBERS OF MANAGEMENT OF ALEGENT CREIGHTON HEALTH AND RELATED ENTITIES IS DETERMINED AT A SYSTEM LEVEL. MEMBERS OF MANAGEMENT INCLUDE RICHARD HACHTEN II, SCOTT WOOTEN, DEBRA GOLDSMITH, DENISE MCNITT AND RODNEY TRIPLETT. MEMBERS OF ALEGENT CREIGHTON HEALTH MANAGEMENT ARE ELIGIBLE FOR AN ANNUAL INCENTIVE BONUS. INCENTIVE AWARDS ARE BASED ON FOUR INDIVIDUAL PERFORMANCE MEASURES WHICH ARE LINKED TO FOUR SYSTEM PERFORMANCE GOALS. FOR EACH MANAGER, 75% OF THE INCENTIVE AWARD WILL BE DETERMINED BY SYSTEM PERFORMANCE GOALS AND 25% DETERMINED BY INDIVIDUAL PERFORMANCE MEASURES. ONE OF THE FOUR SYSTEM PERFORMANCE GOALS IS DEPENDENT ON THE NET FINANCIAL RESULTS OF THE ENTIRE ALEGENT CREIGHTON HEALTH SYSTEM FOR THE FISCAL YEAR.
Compensation contingent on net earnings of a related organization	Schedule J, Part I, Line 6b	COMPENSATION FOR MEMBERS OF MANAGEMENT OF ALEGENT CREIGHTON HEALTH AND RELATED ENTITIES IS DETERMINED AT A SYSTEM LEVEL. MEMBERS OF MANAGEMENT INCLUDE RICHARD HACHTEN II, SCOTT WOOTEN, DEBRA GOLDSMITH, DENISE MCNITT AND RODNEY TRIPLETT. MEMBERS OF ALEGENT CREIGHTON HEALTH MANAGEMENT ARE ELIGIBLE FOR AN ANNUAL INCENTIVE BONUS. INCENTIVE AWARDS ARE BASED ON FOUR INDIVIDUAL PERFORMANCE MEASURES WHICH ARE LINKED TO FOUR SYSTEM PERFORMANCE GOALS. FOR EACH MANAGER, 75% OF THE INCENTIVE AWARD WILL BE DETERMINED BY SYSTEM PERFORMANCE GOALS AND 25% DETERMINED BY INDIVIDUAL PERFORMANCE MEASURES. ONE OF THE FOUR SYSTEM PERFORMANCE GOALS IS DEPENDENT ON THE NET FINANCIAL RESULTS OF THE ENTIRE ALEGENT CREIGHTON HEALTH SYSTEM FOR THE FISCAL YEAR.
POTENTIAL SEVERANCE PAYMENTS	SCHEDULE J, PART II	THE ALEGENT CREIGHTON HEALTH EXECUTIVES HAVE A PROVISION IN THEIR COMPENSATION AGREEMENT THAT PROVIDES FOR POTENTIAL SEVERANCE PAYMENTS IN THE EVENT OF TERMINATION WITHOUT CAUSE OR CHANGE OF CONTROL. THE AMOUNT OF SEVERANCE AN EXECUTIVE MAY OR MAY NOT RECEIVE IF TERMINATED ACCORDING TO THE COMPENSATION AGREEMENT IS INCLUDED AS DEFERRED COMPENSATION IN COLUMN C.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	MICHAEL GRUNDMAN-BOARD MEMBER	BusinessNameLine1

Field	Value	IRS element (for citing)
Relationship	DAUGHTER IS AN EMPLOYEE	Relationship
Amount Of Transaction	46075	AmountOfTransaction
Description Of Transaction	EMPLOYMENT	DescriptionOfTransaction
Sharing Of Revenues	false	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
PAYMENTS TO VENDORS	FORM 990, PART V, LINE 1C	PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF THE ALEGENT CREIGHTON HEALTH SYSTEM ARE MADE BY ALEGENT CREIGHTON HEALTH, THEREFORE NO FORM 1099S ARE ISSUED BY ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA. ALEGENT CREIGHTON HEALTH FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099S ISSUED BY ALEGENT CREIGHTON HEALTH ON BEHALF OF ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA ARE REPORTED TO THE IRS.
EMLOYEES OF ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA	FORM 990, PART V, LINE 2A	THE EMPLOYEES LISTED IN PART I, LINE 5 AND PART V, LINE 2A ARE EMPLOYED BY ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA. HOWEVER, THROUGH A COMMON PAY AGENT AGREEMENT, THE EMPLOYEES ARE PAID BY ALEGENT CREIGHTON HEALTH AND PAYROLL EXPENSES ARE ALLOCATED TO ALEGENT ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA.
Family/business relationships amongst interested persons	Form 990, Part VI, Section A, Line 2	STEPHEN GRUBA AND BETEL KOPP - FAMILY RELATIONSHIP
Classes of members or stockholders	Form 990, Part VI, Section A, Line 6	ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM IS THE SOLE MEMBER OF ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IOWA.
Members or stockholders electing members of governing body	Form 990, Part VI, Section A, Line 7a	ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM APPOINTS INDIVIDUALS TO SERVE ON THE BOARD OF DIRECTORS. THE BOARD, OR A NOMINATING COMMITTEE OF THE BOARD, PRESENT A SLATE OF NOMINEES AND THEIR CREDENTIALS TO THE MEMBER FOR APPROVAL. ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM MAY REJECT ANY NOMINEE OR APPOINT INDIVIDUALS DIRECTLY TO THE BOARD OF DIRECTORS, OR REQUEST ADDITIONAL NOMINEES BY GIVING WRITTEN NOTICE OF SUCH ACTIONS TO THE CHAIRMAN OF THE BOARD.
Decisions requiring approval by members or stockholders	Form 990, Part VI, Section A, Line 7b	THE POWERS, DUTIES AND RIGHTS RESERVED TO ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM WILL BE, BUT ARE NOT LIMITED TO, THE FOLLOWING: A. TO AMEND, REVISE OR ALTER THE ARTICLES OF INCORPORATION OR THE BYLAWS; B. TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, MEMBERS OF THE BOARD OF DIRECTORS; C. TO APPROVE ANY MERGER OR CONSOLIDATION INTO OR WITH ANY OTHER CORPORATION, ORGANIZATION OR ASSOCIATION, AND TO APPROVE THE DISSOLUTION OR OTHERWISE WRAPPING UP OF THE AFFAIRS; D. TO APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE ASSETS; E. TO APPROVE THE INCORPORATION OR DISSOLUTION OF AFFILIATED ENTITIES ORGANIZATIONS OR ASSOCIATIONS; AND F. TO RECEIVE THE ANNUAL REPORT OF THE BOARD OF DIRECTORS.
Review of form 990 by governing body	Form 990, Part VI, Section B, Line 11b	CHI NEBRASKA'S (THE ORGANIZATION'S CORPORATE MEMBER) CFO IS RESPONSIBLE FOR REVIEWING THE FINAL TAX RETURN PREPARED BY THE CHI TAX DEPARTMENT FOR ANY POTENTIAL ERRORS, OMISSIONS, OR CLARIFICATIONS NEEDED FOR PROPER PRESENTATION. AFTER THE FINAL CHANGES ARE MADE TO THE FORM 990, THE RETURNS ARE POSTED TO A SECURED BOARD COLLABORATION SITE FOR REVIEW BY THE BOARD MEMBERS. SUBSEQUENT TO DISTRIBUTION 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.
Conflict of interest policy	Form 990, Part VI, Section B, Line 12c	WRITTEN CONFLICT OF INTEREST POLICY - ALEGENT HEALTH MERCY HOSPITAL, CORNING, IOWA HAS ADOPTED THE CONFLICT OF INTEREST POLICY AND CONFLICT INVESTIGATION PROCESS OF ALEGENT CREIGHTON HEALTH. ANNUAL COMPLETION OF THE DISCLOSURE STATEMENT IS REQUIRED BY THE BOARD OF DIRECTORS. STATED DISCLOSURES ARE INVESTIGATED BY THE ALEGENT CREIGHTON HEALTH COMPLIANCE OFFICER AND REPORTED TO THE CONFLICTS OF INTEREST COMMITTEE. THE CONFLICTS OF INTEREST COMMITTEE REVIEWS THE INVESTIGATION AND MAKES RECOMMENDATIONS TO THE GOVERNANCE COMMITTEE. THE GOVERNANCE COMMITTEE MAKES THE FINAL DETERMINATION OF WHETHER OR NOT THERE IS A DISQUALIFYING EVENT AND COMMUNICATES IT TO THE ALEGENT HEALTH MERCY HOSPITAL, CORNING, IOWA BOARD OF DIRECTORS. AT ANY TIME A BOARD MEMBER OR KEY EMPLOYEE MAY DECLARE A CONFLICT OF INTEREST AND RECUSE HIS/HERSELF FROM THE DISCUSSION. THE INDIVIDUAL IS ALSO REQUIRED TO DISCLOSE ANY KNOWN OR POSSIBLE CONFLICTS OF INTEREST THAT ARISE DURING THE CALENDAR YEAR.
Process used to establish compensation of top management official	Form 990, Part VI, Section B, Line 15a	THE GOVERNING BOARD OF ALEGENT CREIGHTON HEALTH ENGAGED THE SERVICES OF AN INDEPENDENT CONSULTING FIRM THAT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT THAT IS QUALIFIED TO AND REGULARLY PERFORMS EXECUTIVE AND OFFICER COMPENSATION STUDIES. THE CONSULTING FIRM CONDUCTED A REVIEW AND ANALYSIS OF THE TOTAL COMPENSATION PAID TO THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, BASED ON COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS AND DETERMINED THAT THE COMPENSATION WAS REASONABLE. THE CONSULTING FIRM ISSUED AN OPINION LETTER TO ALEGENT CREIGHTON HEALTH AS TO THE REASONABLENESS OF THE TOTAL COMPENSATION PAID TO EMPLOYEES IDENTIFIED AS DISQUALIFIED PERSONS. THE OPINION LETTER SETTING FORTH THE FINDINGS WAS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE GOVERNING BOARD. CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS WERE MAINTAINED. THIS PROCESS WAS USED FOR THE SENIOR VICE PRESIDENT, CHEIF FINANCIAL OFFICER, PRESIDENT & CHEIF EXECUTIVE OFFICER.
Process used to establish compensation of other officers/key employees	Form 990, Part VI, Section B, Line 15b	SEE DISCLOSURE FOR PART VI, 15A.
Governing documents, conflict of interest policy and financial statements available to the public	Form 990, Part VI, Section C, Line 19	THE CONFLICT OF INTEREST POLICY IS MADE AVAILABLE TO THE PUBLIC ON THE WEBSITE AT WWW.ALEGENTCREIGHTON.COM. ALEGENT HEALTH MEMORIAL HOSPITAL, CORNING, IOWA DOES NOT MAKE THE FINANCIAL STATEMENTS OR GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. HOWEVER, ARTICLES OF INCORPORATION ARE AVAILABLE AT WWW.SOS.STATE.IA.US.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (153 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Business Name Line2NameOfDisregardedEntity/BusinessNameLine2
ALEGENT CREIGHTON CLINIC
12809 WEST DODGE ROAD	OMAHA	NE	68154	HEALTHCARE	NE	501(C)(3)	3	ACH	true
ALEGENT CREIGHTON HEALTH
12809 WEST DODGE ROAD	OMAHA	NE	68154	HEALTHCARE	NE	501(C)(3)	3	NA	true
ALEGENT HEALTH - BERGAN MERCY HEALTH SYS
7500 MERCY ROAD	OMAHA	NE	68124	HEALTHCARE	NE	501(C)(3)	3	ACH	true
ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA
631 N 8TH STREET	MISSOURI VALLEY	IA	51555	HEALTHCARE	IA	501(C)(3)	3	AHIMC	true
ALEGENT HEALTH FOUNDATION
12809 WEST DODGE ROAD	OMAHA	NE	68154	FUNDRAISING	NE	501(C)(3)	7	ACH	true
ALEGENT HEALTH IMMANUEL MEDICAL CENTER
6901 NORTH 72ND STREET	OMAHA	NE	68122	HEALTHCARE	NE	501(C)(3)	3	ACH	true
ALEGENT HEALTH MEMORIAL HOSPITAL SCHUYLER NE
104 W 17TH STREET	SCHUYLER	NE	68661	HEALTHCARE	NE	501(C)(3)	3	AHIMC	true
ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA
PO BOX 368	CORNING	IA	50841	HEALTHCARE	IA	501(C)(3)	3	AHBMHS	true
ALVERNA APARTMENTS
300 SE 8TH AVENUE	LITTLE FALLS	MN	56345	LTERM CARE	MN	501(C)(3)	9	CHI	true
APPLETREE COURT
601 OAK STREET	BRECKENRIDGE	MN	56520	SENIOR HOMES	MN	501(C)(3)	9	SFH	true
BISHOP DRUMM RETIREMENT CENTER
1111 6TH AVENUE	DES MOINES	IA	50314	LTERM CARE	IA	501(C)(3)	9	CHI-IA CORP	true
BORNEMANN HEALTH CORPORATION
2500 BERNVILLE RD PO BOX 316	READING	PA	19603	HEALTHCARE	PA	501(C)(3)	11 - Type I	CHI	true
CARRINGTON HEALTH CENTER
800 NORTH 4TH STREET	CARRINGTON	ND	58421	HEALTHCARE	ND	501(C)(3)	3	CHI	true
CATHOLIC HEALTH INITIATIVES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	HEALTHCARE	CO	501(C)(3)	9	NA	true
CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
6385 CORPORATE DRIVE	COLORADO SPRINGS	CO	80919	FUNDRAISING	CO	501(C)(3)	7	CHIC	true
CATHOLIC HEALTH INITIATIVES INSTITUTE FOR RESEARCH AND INNOVATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	HEALTHCARE	CO	501(C)(3)	11 - Type I	CHI	true
CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION
6385 CORPORATE DRIVE	COLORADO SPRINGS	CO	80919	FUNDRAISING	CO	501(C)(3)	9	CHI	true
CATHOLIC HEALTH INITIATIVES-COLORADO
188 INVERNESS DRIVE WEST SUITE 500	ENGLEWOOD	CO	80112	HEALTHCARE	CO	501(C)(3)	3	CHI	true
CATHOLIC HEALTH INITIATIVES-IOWA CORP DBA MERCY MEDICAL CENTER-DES MOINES
1111 6TH AVENUE	DES MOINES	IA	50314	HEALTHCARE	IA	501(C)(3)	3	CHI	true
CENTENNIAL MEDICAL GROUP INC
2700 STEWART PARKWAY	ROSEBURG	OR	97470	PHYSICIANS	OR	501(C)(3)	9	MMC	true
CENTRAL KANSAS MEDICAL CENTER
3515 BROADWAY	GREAT BEND	KS	67530	SURGERY CNTR	KS	501(C)(3)	3	CHI	true
CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PARKWAY SOUTH	FARGO	ND	58104	HEALTHCARE	ND	501(C)(3)	9	CHI	true
CHI KENTUCKY INC
3900 OLYMPIC BLVD SUITE 400	ERLANGER	KY	41018	HEALTHCARE	KY	501(C)(3)	11 - Type I	CHI	true
CHI NATIONAL HOME CARE
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	HEALTHCARE	CO	501(C)(3)	9	CHI NHC	true
CHI NATIONAL SERVICES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	HEALTHCARE	CO	501(C)(3)	11 - Type I	CHI	true
CHI NEBRASKA
6940 O STREET	LINCOLN	NE	68510	HEALTHCARE	NE	501(C)(3)	11 - Type I	CHI	true
COMMUNITY LIMITED CARE DIALYSIS CENTER
619 OAK STREET - ACCOUNTING 3 WEST	CINCINNATI	OH	45206	DIALYSIS	OH	501(C)(2)	N/A	GSH	true
COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION MISSOURI VALLEY IA
631 N 8TH STREET	MISSOURI VALLEY	IA	51555	FUNDRAISING	IA	501(C)(3)	11 - Type I	AHCMH	true
CONTINUING CARE HOSPITAL
150 NORTH EAGLE CREEK DRIVE	LEXINGTON	KY	40509	LTACH	KY	501(C)(3)	3	SJHS	true
COVENANT HOME CARE
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	HOME HEALTH	PA	501(C)(3)	11 - Type II	NA	true
ENUMCLAW REGIONAL HOSPITAL ASSOCIATION
1450 BATTERSBY AVENUE	ENUMCLAW	WA	98022	HEALTHCARE	WA	501(C)(3)	3	FHS	true
FLAGET HEALTHCARE INC
4305 NEW SHEPHERDSVILLE ROAD	BARDSTOWN	KY	40004	HEALTHCARE	KY	501(C)(3)	3	KOH	true
FLAGET MEMORIAL HOSPITAL FOUNDATION
4305 NEW SHEPHERDSVILLE ROAD	BARDSTOWN	KY	40004	FUNDRAISING	KY	501(C)(3)	11 - Type I	FH	true
FRANCISCAN FOUNDATION
1717 SOUTH J STREET	TACOMA	WA	98405	FUNDRAISING	WA	501(C)(3)	9	FHS	true
FRANCISCAN HEALTH SYSTEM
1717 SOUTH J STREET	TACOMA	WA	98405	HEALTHCARE	WA	501(C)(3)	3	CHI	true
FRANCISCAN MEDICAL GROUP
1708 SOUTH YAKIMA AVENUE	TACOMA	WA	98405	HEALTHCARE	WA	501(C)(3)	9	FHS	true
FRANCISCAN VILLA OF SOUTH MILWAUKEE
3601 SOUTH CHICAGO AVENUE	SOUTH MILWAUKEE	WI	53172	HEALTHCARE	WI	501(C)(3)	9	CHI	true
GETTYSBURG MEDICAL CENTER
606 EAST GARFIELD AVENUE	GETTYSBURG	SD	57442	HEALTHCARE	SD	501(C)(3)	3	SMHC	true
GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	MINISTRIES	CO	501(C)(3)	11 - Type I	CHI	true
GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE
619 OAK STREET - ACCOUNTING 3 WEST	CINCINNATI	OH	45206	EDUCATION	OH	501(C)(3)	2	GSH	true
GOOD SAMARITAN FOUNDATION OF CINCINNATI INC
619 OAK STREET - ACCOUNTING 3 WEST	CINCINNATI	OH	45206	FUNDRAISING	OH	501(C)(3)	11 - Type I	GSH	true
GOOD SAMARITAN HOSPITAL
PO BOX 1990	KEARNEY	NE	68848	HEALTHCARE	NE	501(C)(3)	3	CHI NEBRASKA	true
GOOD SAMARITAN HOSPITAL FOUNDATION
111 W 31ST STREET	KEARNEY	NE	68847	FUNDRAISING	NE	501(C)(3)	7	GSH	true
ST LUKE'S MEDICAL GROUP FKA GREATER HOUSTON HEALTH NETWORK
6624 FANNIN	HOUSTON	TX	77030	PHY PRACTICES	TX	501(C)(3)	3	SLHS	true
HEALTH SET
4200 WEST CONEJOS PLACE 436	DENVER	CO	80204	LOW INC.CARE	CO	501(C)(3)	7	CHIC	true
HEALTHCARE AND WELLNESS FOUNDATION
2400 ST FRANCIS DRIVE	BRECKENRIDGE	MN	56520	FUNDRAISING	MN	501(C)(3)	11 - Type I	SFMC	true
HIGHLINE MEDICAL CENTER
16251 SYLVESTER RD SW	BURIEN	WA	98166	HEALTHCARE	WA	501(C)(3)	3	FHS	true
HOSPITAL ASSOCIATION FOR ST JOSEPH HOSPITAL
7601 OSLER DRIVE	TOWSON	MD	21204	HEALTHCARE	MD	501(C)(3)	9	SJMC	true
HOUSE OF MERCY
1111 6TH AVENUE	DES MOINES	IA	50314	SHELTER	IA	501(C)(3)	7	CHI-IA CORP	true
JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC
539 S 4TH STREET	LOUISVILLE	KY	40202	HEALTHCARE	KY	501(C)(3)	3	KOH	true
JEWISH PHYSICIAN GROUP INC
539 S 4TH STREET	LOUISVILLE	KY	40202	HEALTHCARE	KY	501(C)(3)	9	JHSMH	true
KENTUCKYONE HEALTH INC FKA JH PROPERTIES INC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	HEALTHCARE	KY	501(C)(3)	9	CHI	true
LAKEWOOD HEALTH CENTER
600 MAIN AVENUE SOUTH	BAUDETTE	MN	56623	HEALTHCARE	MN	501(C)(3)	3	CHI	true
LINUS OAKES INC
2700 STEWART PARKWAY	ROSEBURG	OR	97470	SENIOR LIVING	OR	501(C)(3)	9	MMC	true
LISBON AREA HEALTH SERVICES
905 MAIN STREET	LISBON	ND	58054	HEALTHCARE	ND	501(C)(3)	3	CHI	true
MEMORIAL HEALTH CARE SYSTEM FOUNDATION
2525 DE SALES AVENUE	CHATTANOOGA	TN	37404	FUNDRAISING	TN	501(C)(3)	7	MHCS	true
MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVENUE	CHATTANOOGA	TN	37404	HEALTHCARE	TN	501(C)(3)	3	CHI	true
MEMORIAL HEALTH PARTNERS FOUNDATION INC
5600 BRAINERD ROAD SUITE 500	CHATTANOOGA	TN	37411	HEALTHCARE	TN	501(C)(3)	9	MHCS	true
MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVENUE	DES MOINES	IA	50314	AUXILIARY	IA	501(C)(3)	11 - Type I	CHI-IA CORP	true
MERCY CLINICS INC
1111 6TH AVENUE	DES MOINES	IA	50314	PHYSICIAN	IA	501(C)(3)	9	CHI-IA CORP	true
MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVENUE	DES MOINES	IA	50314	EDUCATION	IA	501(C)(3)	2	CHI-IA CORP	true
MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVENUE	DES MOINES	IA	50314	FUNDRAISING	IA	501(C)(3)	7	CHI-IA CORP	true
MERCY FOUNDATION INC
2700 STEWART PARKWAY	ROSEBURG	OR	97470	FUNDRAISING	OR	501(C)(3)	7	MMC	true
MERCY HEALTH CARE FOUNDATION
PO BOX 368	CORNING	IA	50841	FUNDRAISING	NE	501(C)(3)	11 - Type I	AHMH	true
MERCY HEALTHCARE FOUNDATION
570 CHAUTAUQUA BOULEVARD	VALLEY CITY	ND	58072	FUNDRAISING	ND	501(C)(3)	11 - Type III - FI	MHVC	true
MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DRIVE	COUNCIL BLUFFS	IA	51503	FUNDRAISING	IA	501(C)(3)	11 - Type I	AHBMHS	true
MERCY HOSPITAL OF DEVILS LAKE
1031 SEVENTH STREET NE	DEVILS LAKE	ND	58301	HEALTHCARE	ND	501(C)(3)	3	CHI	true
MERCY HOSPITAL OF DEVILS LAKE FOUNDATION
1031 SEVENTH STREET NE	DEVILS LAKE	ND	58301	FUNDRAISING	ND	501(C)(3)	7	CHI	true
MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BOULEVARD	VALLEY CITY	ND	58072	HEALTHCARE	ND	501(C)(3)	3	CHI	true
MERCY MEDICAL CENTER
1301 15TH AVENUE WEST	WILLISTON	ND	58801	HEALTHCARE	ND	501(C)(3)	3	CHI	true
MERCY MEDICAL CENTER - CENTERVILLE
ONE ST JOSEPHS DRIVE	CENTERVILLE	IA	52544	HEALTHCARE	IA	501(C)(3)	3	CHI-IA CORP	true
MERCY MEDICAL CENTER INC
2700 STEWART PARKWAY	ROSEBURG	OR	97470	HEALTHCARE	OR	501(C)(3)	3	CHI	true
MERCY MEDICAL FOUNDATION
1301 15TH AVENUE WEST	WILLISTON	ND	58801	FUNDRAISING	ND	501(C)(3)	11 - Type I	MMC	true
MERCY PROFESSIONAL PRACTICE ASSOCIATES INC
1111 6TH AVENUE	DES MOINES	IA	50314	PHYSICIAN	IA	501(C)(3)	9	CHI-IA CORP	true
MLIFECARES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	PROPERTY MGMT	MO	501(C)(3)	11 - Type I	SJRMC	true
MNMCH INC
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	HEALTHCARE	KS	501(C)(3)	3	SJRMC	true
MT ST JOSEPH INC
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	NURSING CARE	OR	501(C)(3)	11 - Type I	CHI	true
NEBRASKA HEART HOSPITAL
7500 SOUTH 91ST STREET	LINCOLN	NE	68526	HEALTHCARE	NE	501(C)(3)	3	CHI NEBRASKA	true
OAKES COMMUNITY HOSPITAL
314 SOUTH 8TH STREET	OAKES	ND	58474	HEALTHCARE	ND	501(C)(3)	3	CHI	true
OAKES COMMUNITY HOSPITAL FOUNDATION
1200 N 7TH STREET	OAKES	ND	58474	FUNDRAISING	ND	501(C)(3)	11 - Type I	OCH	true
PUEBLO STEPUP
1925 EAST ORMAN AVE SUITE G52	PUEBLO	CO	81004	COMMUNITY	CO	501(C)(3)	7	CHIC	true
SET OF COLORADO SPRINGS INC
2864 S CIRCLE DRIVE SUITE 450	COLORADO SPRINGS	CO	80906	LTERM CARE	CO	501(C)(3)	7	CHIC	true
SAINT CLARE'S COMMUNITY CARE
25 POCONO ROAD	DENVILLE	NJ	07834	HEALTHCARE	NJ	501(C)(3)	11 - Type II	SCHS	true
SAINT CLARE'S FOUNDATION
25 POCONO ROAD	DENVILLE	NJ	07834	FUNDRAISING	NJ	501(C)(3)	7	SCHS	true
SAINT CLARE'S HEALTH SERVICES INC
25 POCONO ROAD	DENVILLE	NJ	07834	MANAGEMENT	NJ	501(C)(3)	7	CHI	true
SAINT CLARE'S HOSPITAL
25 POCONO ROAD	DENVILLE	NJ	07834	HEALTHCARE	NJ	501(C)(3)	3	SCHS	true
SAINT ELIZABETH FOUNDATION
555 SOUTH 70TH STREET	LINCOLN	NE	68510	FUNDRAISING	NE	501(C)(3)	7	SERMC	true
SAINT ELIZABETH HEALTH SERVICES
555 SOUTH 70TH STREET	LINCOLN	NE	68510	HEALTHCARE	NE	501(C)(3)	3	SERMC	true
SAINT ELIZABETH REGIONAL MEDICAL CENTER
555 SOUTH 70TH STREET	LINCOLN	NE	68510	HEALTHCARE	NE	501(C)(3)	3	CHI NEBRASKA	true
SAINT FRANCIS MEDICAL CENTER
2620 WEST FAIDLEY	GRAND ISLAND	NE	68803	HEALTHCARE	NE	501(C)(3)	3	CHI NEBRASKA	true
SAINT FRANCIS MEDICAL CENTER FOUNDATION
PO BOX 9804	GRAND ISLAND	NE	68802	FUNDRAISING	NE	501(C)(3)	7	SFMC	true
SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC
305 ESTILL STREET	BEREA	KY	40403	FUNDRAISING	KY	501(C)(3)	7	SJHS	true
SAINT JOSEPH HEALTH SYSTEM INC
424 LEWIS HARGETT CIRCLE 160	LEXINGTON	KY	40503	HEALTHCARE	KY	501(C)(3)	3	CHI	true
SAINT JOSEPH LONDON FOUNDATION INC
1001 SAINT JOSEPH LANE	LONDON	KY	40741	FUNDRAISING	KY	501(C)(3)	7	SJHS	true
SAINT JOSEPH MEDICAL FOUNDATION INC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	PHY PRACTICES	KY	501(C)(3)	3	SJHS	true
SAINT JOSEPH MOUNT STERLING FOUNDATION INC
225 FALCON DRIVE	MOUNT STERLING	KY	40353	FUNDRAISING	KY	501(C)(3)	7	SJHS	true
SAINT JOSEPH'S HOSPITAL FOUNDATION
30 WEST 7TH STREET	DICKINSON	ND	58601	FUNDRAISING	ND	501(C)(3)	11 - Type I	SJHHC	true
SAMARITAN BEHAVIORAL HEALTH
2222 PHILADELPHIA DRIVE	DAYTON	OH	45406	HEALTHCARE	OH	501(C)(3)	3	SHP	true
SAMARITAN HEALTH FOUNDATION
2222 PHILADELPHIA DRIVE	DAYTON	OH	45406	FUNDRAISING	OH	501(C)(3)	7	SHP	true
SAMARITAN HEALTH PARTNERS
110 NORTH MAIN STREET	DAYTON	OH	45402	HEALTHCARE	OH	501(C)(3)	11 - Type I	CHI	true
SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC
104 W 17TH STREET	SCHUYLER	NE	68661	FUNDRAISING	NE	501(C)(3)	11 - Type I	AHMHS	true
SJMGROUP
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	PHYS PRACTICE	MO	501(C)(3)	9	SJRMC	true
SJRMC JOPLIN MISSOURI
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	HEALTHCARE	MO	501(C)(3)	3	CHI	true
SL AUGUSTA CORP
PO BOX 20269	HOUSTON	TX	77225	TITLE HOLDING	TX	501(C)(2)	N/A	SL PROPERTIES	true
ST JOSEPH HEALTH MINISTRIES
1929 LINCOLN HWY E STE 150	LANCASTER	PA	17602	HEALTHCARE	PA	501(C)(3)	11 - Type I	CHI	true
ST LUKE'S MEDICAL TOWER CORPORATION
6624 FANNIN SUITE 1100	HOUSTON	TX	77030	PROPERTY MGMT	TX	501(C)(3)	11 - Type I	SL PROPERTIES	true
ST ANTHONY HOSPITAL
1601 SE COURT AVENUE	PENDLETON	OR	97801	HEALTHCARE	OR	501(C)(3)	3	CHI	true
ST ANTHONY HOSPITAL FOUNDATION
1601 SE COURT AVENUE	PENDLETON	OR	97801	FUNDRAISING	OR	501(C)(3)	11 - Type I	SA HOSPITAL	true
ST ANTHONY'S HOSPITAL ASSOCIATION
FOUR HOSPITAL DRIVE	MORRILTON	AR	72110	HEALTHCARE	AR	501(C)(3)	3	SVIMC	true
ST CATHERINE HOSPITAL
401 EAST SPRUCE STREET	GARDEN CITY	KS	67846	HEALTHCARE	KS	501(C)(3)	3	CHI	true
ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION
401 EAST SPRUCE STREET	GARDEN CITY	KS	67846	FUNDRAISING	KS	501(C)(3)	11 - Type I	SCH	true
ST DOMINIC OF ONTARIO OREGON
351 SW 9TH STREET	ONTARIO	OR	97914	HEALTHCARE	OR	501(C)(4)	N/A	CHI	true
ST FRANCIS HOME
2400 ST FRANCIS DRIVE	BRECKENRIDGE	MN	56520	LTERM CARE	MN	501(C)(3)	9	CHI	true
ST FRANCIS LIFE CARE CORPORATION
19 POCONO ROAD	DENVILLE	NJ	07834	ELDERLY CARE	NJ	501(C)(3)	9	SCHS	true
ST FRANCIS MEDICAL CENTER
2400 ST FRANCIS DRIVE	BRECKENRIDGE	MN	56520	HEALTHCARE	MN	501(C)(3)	3	CHI	true
ST FRANCIS OF BAKER CITY
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	HEALTHCARE	OR	501(C)(3)	3	CHI	true
ST JOHN'S MERCY REGIONAL FOUNDATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	FUNDRAISING	MO	501(C)(3)	7	SJRMC	true
ST JOSEPH COMMUNITY HEALTH
300 CENTRAL AVENUE SW	ALBUQUERQUE	NM	87102	COMMUNITY	NM	501(C)(3)	11 - Type I	CHI	true
ST JOSEPH HOSPITAL FOUNDATION INC
ONE SAITN JOSEPH DRIVE	LEXINGTON	KY	40504	FUNDRAISING	KY	501(C)(3)	11 - Type I	SJHS	true
ST JOSEPH MEDICAL CENTER FOUNDATION
2500 BERNVILLE ROAD PO BOX 316	READING	PA	19603	FUNDRAISING	PA	501(C)(3)	11 - Type I	SJRHN	true
ST JOSEPH MEDICAL CENTER FOUNDATION
7601 OSLER DRIVE	TOWSON	MD	21204	FUNDRAISING	MD	501(C)(3)	7	SJMC	true
ST JOSEPH MEDICAL CENTER INC
7601 OSLER DRIVE	TOWSON	MD	21204	HEALTHCARE	MD	501(C)(3)	3	CHI	true
ST JOSEPH MEDICAL GROUP
2500 BERNVILLE ROAD PO BOX 316	READING	PA	19603	HEALTHCARE	PA	501(C)(3)	9	BHC	true
ST JOSEPH PHYSICIAN ENTERPRISE INC
7601 OSLER DRIVE	TOWSON	MD	21204	PHYSICIANS	MD	501(C)(3)	11 - Type I	SJMC	true
ST JOSEPH REGIONAL HEALTH NETWORK
2500 BERNVILLE ROAD PO BOX 316	READING	PA	19603	HEALTHCARE	PA	501(C)(3)	3	CHI	true
ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVENUE	PARK RAPIDS	MN	56470	HEALTHCARE	MN	501(C)(3)	3	CHI	true
ST JOSEPH'S HOSPITAL AND HEALTH CENTER
30 WEST 7TH STREET	DICKINSON	ND	58601	HEALTHCARE	ND	501(C)(3)	3	CHI	true
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS
6624 FANNIN SUITE 2505	HOUSTON	TX	77030	HEALTHCARE	TX	501(C)(3)	3	SL CDC	true
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND DBA ST LUKE'S SUGA
6624 FANNIN SUITE 2505	HOUSTON	TX	77030	HEALTHCARE	TX	501(C)(3)	3	SLHS	true	R LAND HOSPITAL
ST LUKE'S HEALTH SYSTEM CORPORATION DBA CHI ST LUKE'S HEALTH
6624 FANNIN SUITE 1100	HOUSTON	TX	77030	MANAGEMENT	TX	501(C)(3)	11 - Type I	CHI	true
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION
6624 FANNIN SUITE 2505	HOUSTON	TX	77030	MANAGEMENT	TX	501(C)(3)	11 - Type I	SLHS	true
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE VINTAGE
6624 FANNIN SUITE 2505	HOUSTON	TX	77030	HEALTHCARE	TX	501(C)(3)	3	SL CDC	true
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION -PMC
6624 FANNIN SUITE 2505	HOUSTON	TX	77030	HEALTHCARE	TX	501(C)(3)	3	SL CDC	true
ST LUKE'S COMMUNITY HEALTH SERVICES DBA ST LUKE'S THE WOODLANDS HOSPITAL
6624 FANNIN SUITE 1100	HOUSTON	TX	77030	HEALTHCARE	TX	501(C)(3)	3	SLHS	true
ST LUKE'S HEALTH SYSTEM FOUNDATION
6624 FANNIN SUITE 1100	HOUSTON	TX	77030	INVESTMENT MANAGEMENT	TX	501(C)(3)	11 - Type I	SLHS	true
ST LUKE'S PROPERTIES CORPORATION
6624 FANNIN SUITE 1100	HOUSTON	TX	77030	PROPERTY MGMT	TX	501(C)(3)	11 - Type I	SLHS	true
ST LUKE'S FOUNDATION
1213 HERMANN DRIVE SUITE 855	HOUSTON	TX	77004	FUNDRAISING	TX	501(C)(3)	7	SLHS	true
ST LUKE'S MEDICAL CENTER
6624 FANNIN	HOUSTON	TX	77030	HEALTHCARE	TX	501(C)(3)	3	SLHS	true
ST MARY'S COMMUNITY HOSPITAL
1314 3RD AVENUE	NEBRASKA CITY	NE	68410	HEALTHCARE	NE	501(C)(3)	3	CHI NEBRASKA	true
ST MARY'S HEALTHCARE CENTER
801 EAST SIOUX AVENUE	PIERRE	SD	57501	HEALTHCARE	SD	501(C)(3)	3	CHI	true
ST MARY'S HOSPITAL FOUNDATION
1314 3RD AVENUE	NEBRASKA CITY	NE	68410	FUNDRAISING	NE	501(C)(3)	7	SMH	true
ST VINCENT FOUNDATION
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	FUNDRAISING	AR	501(C)(3)	11 - Type I	SVIMC	true
ST VINCENT INFIRMARY MEDICAL CENTER
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	HEALTHCARE	AR	501(C)(3)	3	CHI	true
ST VINCENT MEDICAL GROUP
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	HEALTHCARE	AR	501(C)(3)	9	SVIMC	true
ST LUKE'S SUGAR LAND PROPERTIES CORPORATION
6624 FANNIN SUITE 2505	HOUSTON	TX	77030	PROPERTY MGMT	TX	501(C)(3)	11 - Type I	SL CDC - SL	true
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH
619 OAK STREET ACCOUNTING-3 W	CINCINNATI	OH	45206	HEALTHCARE	OH	501(C)(3)	3	CHI	true
THE PHYSICIAN NETWORK
2000 Q STREET SUITE 500	LINCOLN	NE	68503	PHYS PRACTICE	NE	501(C)(3)	11 - Type I	CHI NEBRASKA	true
TOTAL HEALTHCARE
188 INVERNESS DRIVE WEST SUITE 500	ENGLEWOOD	CO	80112	HEALTHCARE	CO	501(C)(3)	3	CHIC	true
UNITY FAMILY HEALTHCARE
815 SE 2ND STREET	LITTLE FALLS	MN	56345	HEALTHCARE	MN	501(C)(3)	3	CHI	true
VILLA NAZARETH INC
801 PAGE DRIVE	FARGO	ND	58103	LT CARE	ND	501(C)(3)	9	CHI	true
VISITING NURSE ASSOCIATION OF ST CLARE'S
191 WOODPORT ROAD	SPARTA	NJ	07871	HOME HEALTH	NJ	501(C)(3)	9	SCHS	true
WOMEN'S AUXILIARY OF HIGHLINE COMMUNITY HOSPITAL
16251 SYLVESTER RD SW	BURIEN	WA	98166	AUXILIARY	WA	501(C)(3)	11 - Type II	HMC	true
WOODLANDS DOCTOR GROUP
17200 ST LUKES WAY SUITE 170	THE WOODLANDS	TX	77384	PHY PRACTICES	TX	501(C)(3)	9	SL CHS	true

Form990 Schedule R Part III Form990ScheduleRPartIII (38 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	Code VCodeVAmount	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
AUDUBON LAND COMPANY LLC
5390 N ACADEMY BLVD SUITE 300	COLORADO SPRINGS	CO	80918	841513085	REAL ESTATE	CO	CHIC	RELATED	34991	8665388	false	$0	false	0.501
AVANTAS LLC
11128 JOHN GALT BLVD SUITE 400	OMAHA	NE	68137	392045003	STAFFING OF NURSES	NE	AHBMHS	RELATED	-210405	4806071	false	-$439,536	false	0.95
BERYWOOD OFFICE PROPERTIES LLC
400 BERYWOOD TRAIL	CLEVELAND	TN	37312	621875199	PHYS OFFICE	TN	MHCS	RELATED	57545	1013237	false	$0	true	0.63
BLUEGRASS REGIONAL IMAGING CENTER
1218 SOUTH BROADWAY SUITE 310	LEXINGTON	KY	40504	611386736	DIAGNOSTIC	KY	SJHS	RELATED	308428	3317191	false	$0	false	0.65
CENTRAL NEBRASKA HOME CARE SERVICES
PO BOX 1146-4510 SECOND AVENUE	KEARNEY	NE	68848	470692112	HEALTHCARE SRVC	NE	NA	RELATED	228435	675251	false	$0	true	1
CENTRAL NEBRASKA REHAB SERVICES
3004 W FAIDLEY AVE	GRAND ISLAND	NE	68802	810653461	PHYSICAL THERAPY	NE	SFMC	RELATED	1710199	2712656	false	$0	false	0.51
CHI OPERATING INVESTMENT PROGRAM LP
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	470727942	INVESTMENTS	CO	CHI	UNRELATED	344962532	4617413792	false	$0	true	0.7992
HEALTHCARE SUPPORT SERVICES
PO BOX 9804	GRAND ISLAND	NE	68802	721546196	LAUNDRY	NE	NA	RELATED	98583	3190677	false	$0	false	1
MRI AT ST JOSEPH MEDICAL CENTER LLC
7253 AMBASSADOR ROAD	BALTIMORE	MD	21244	521958002	MEDICAL IMAGING	MD	SJMC	RELATED	423167	2174155	false	$0	true	0.51
NORTH RIVER SURGERY CENTER LLC
2209 WILDWOOD AVENUE	SHERWOOD	AR	72120	710799771	AMBUL SURG CTR	AR	SVIMC	RELATED	81071	1077536	false	$0	false	0.5745
O'DEA MEDICAL ARTS LIMITED PARTNERSHIP
7601 OSLER DRIVE	TOWSON	MD	21204	521682964	REAL ESTATE	MD	TMI	RELATED	9490	0	false	$0	true	0.6658
ORTHOCOLORADO LLC
11650 WEST 2ND PLACE	LAKEWOOD	CO	80255	371577105	ORTHO HOSPITAL	CO	THC	RELATED	1846153	8411844	false	$0	false	0.6
PENINSULA RADIATION ONCOLOGY LLC
315 MARTIN LUTHER KING JR WAY 111	TACOMA	WA	98405	870808610	HEALTHCARE SRVC	WA	FHS	RELATED	256567	3262002	false	$0	false	0.6
PENRAD IMAGING
1390 KELLY JOHNSON BLVD	COLORADO SPRINGS	CO	80920	841072619	MEDICAL IMAGING	CO	CHIC	RELATED	715094	3489436	false	$0	false	0.7
RUXTON SURGICENTER LLC
8322 BELLONA AVENUE SUITE 201	BALTIMORE	MD	21204	522095835	SURGERY CENTER	MD	SJMC	RELATED	-69345	0	false	$0	true	0.51
SAINT JOSEPH - SCA HOLDINGS LLC
1451 HARRDOSBURG ROAD	LEXINGTON	KY	40504	453801157	OP SURGERY	DE	SJHS	RELATED	0	0	false	$0	true	0.51
SCA PREMIER SURGERY CENTER OF LOUISVILLE LLC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	721386840	SURGERY CENTER	KY	JH	RELATED	3388	666017	false	$0	true	0.51
ST FRANCIS LAND COMPANY LLC
5390 N ACADEMY BLVD SUITE 300	COLORADO SPRINGS	CO	80918	263134100	REAL ESTATE	CO	CHIC	RELATED	-130967	13823763	false	$0	false	0.51
ST FRANCIS MEDICAL CENTER ASSOCIATES
1717 SOUTH J STREET	TACOMA	WA	98405	911352698	MED. OFFICE	WA	FHS	RELATED	238717	1907063	false	$0	false	0.5846
ST JOSEPH-PAML LLC
424 LEWIS HARGETT CIRCLE STE 160	LEXINGTON	KY	40503	452116736	MGMT SVCS	KY	SJHS	RELATED	30446	1149003	false	$0	true	0.625
SUPERIOR MEDICAL IMAGING LLC
5000 NORTH 26TH STREET	LINCOLN	NE	68521	262884555	OP DIAGNOSTICS	NE	SERMC	RELATED	-200323	821112	false	$0	true	0.51
SURGERY CENTER OF LEXINGTON LLC
424 LEWIS HARGETT CIRCLE STE 160	LEXINGTON	KY	40503	621179539	SURGERY CENTER	DE	SJHS	RELATED	-200318	4079584	false	$0	true	0.51
SURGERY CENTER OF LOUISVILLE LLC
200 ABRAHAM FLEXNER WAY	LOUISVILLE	KY	40202	621179537	SURGERY CENTER	KY	JH	RELATED	-15452	396101	false	$0	true	0.51
ALEGENT HEALTH NORTHWEST IMAGING CENTER LLC
3606 N 156TH STREET	OMAHA	NE	68116	061786985	OP DIAGNOSTICS	NE	ACH	RELATED	116752	776649	false	$0	true	0.51
BERGAN MERCY SURGERY CENTER LLC
7710 MERCY ROAD STE 100	OMAHA	NE	68124	208671994	AMBUL SURG CTR	NE	ACH	RELATED	142085	3294472	false	$0	false	0.6394
LAKESIDE AMBULATORY SURGICAL CENTER LLC
17031 LAKESIDE HILLS DR	OMAHA	NE	68130	204267902	AMBUL SURG CTR	NE	ACH	RELATED	3465880	1951221	false	$0	false	0.516
LAKESIDE ENDOSCOPY CENTER LLC
17001 LAKESIDE HILLS PLZ STE 201	OMAHA	NE	68130	205544496	ENDOSCOPY SRVC	NE	ACH	RELATED	1455294	1013126	false	$0	false	0.5228
NEBRASKA SPINE HOSPITAL LLC
6901 N 72ND STREET	OMAHA	NE	68122	270263191	SPINE HOSPITAL	NE	ACH	RELATED	10501730	17301869	false	$0	false	0.51
PRAIRIE HEALTH VENTURES LLC
421 S 9TH ST 102	LINCOLN	NE	68508	204962103	TECH SERVICES	NE	AH-IMC	RELATED	1011804	5564586	false	$68,565	true	0.627
SAINT JOSEPH-ANC HOME CARE SERVICES
1700 EDISON DRIVE SUITE 300	MILFORD	OH	45150	263330545	HOME HEALTH	KY	JH	RELATED	3208139	9684824	false	$0	false	0.969
LINCOLN CK LEASING LLC
8770 BRYN MAWR SUITE 1370	CHICAGO	IL	60631	262496856	REAL ESTATE	NE	SERMC	RELATED	397452	439334	false	$0	false	0.5376
HIGHLINE IMAGING LLC
275 SW 160TH ST	BURIEN	WA	98166	200460005	DIAGNOSTIC	WA	HMC	RELATED	840222	1784058	false	$0	false	0.8
HC SL VINTAGE I LLC
18000 WEST SARAH LANE SUITE 250	BROOKFIELD	WI	53045	270453767	PROPERTY HOLD	WI	SL CDC - VINTAGE	RELATED	1027057	105658490	false	$0	false	0.51
ST LUKES HOSPITAL AT THE VINTAGE LLC
6624 FANNIN SUITE 2505	HOUSTON	TX	77030	263734516	HOSPITAL	TX	SL CDC - VINTAGE	RELATED	-19253743	69158748	false	$0	true	0.51
PMC HOSPITAL LLC
6624 FANNIN SUITE 2505	HOUSTON	TX	77030	273280598	HOSPITAL	TX	SL CDC - PMC	RELATED	1092540	20751174	false	$0	true	0.51
ST LUKES DIAGNOSTIC CATH LAB LLP
6620 MAIN ST SUITE 1520	HOUSTON	TX	77030	710959365	DIAGNOSTIC	TX	SLHS HOLDINGS	RELATED	273448	868814	false	$0	false	0.573
ST LUKES LAKESIDE HOSPITAL LLC
6624 FANNIN SUITE 2505	HOUSTON	TX	77030	300427437	HOSPITAL	TX	SL CDC - WOODLANDS	RELATED	1106628	25874619	false	$0	true	0.51
ST LUKES THE WOODLANDS SLEEP CENTER LLC
6624 FANNIN SUITE 800	HOUSTON	TX	77030	462795726	DIAGNOSTIC	TX	SLHS HOLDINGS	RELATED	0	0	false	$0	false	0.51

Form990 Schedule R Part IV Form990ScheduleRPartIV (49 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership	Controlled OrgControlledOrg	Address Line1AddressForeign/AddressLine1	CityAddressForeign/City	Province Or StateAddressForeign/ProvinceOrState	CountryAddressForeign/Country	Postal CodeAddressForeign/PostalCode	Legal Domicile Foreign CountryLegalDomicileForeignCountry	Business Name Line2NameOfRelatedOrg/BusinessNameLine2
ALTERNATIVE INSURANCE MANAGEMENT SERVICE
3900 OLYMPIC BOULEVARD SUITE 400	ERLANGER	KY	41018	841112049	MANAGEMENT SERVICES	CO	CHI	C CORPORATION	0	6272746	1	true
AMERICAN NURSING CARE
1700 EDISON DRIVE	MILFORD	OH	45150	311085414	HOME HEALTH	OH	CHS	C CORPORATION	5118606	51920207	1	true
AMERIMED INC
1700 EDISON DRIVE	MILFORD	OH	45150	311158699	HOME HEALTH	OH	ANC	C CORPORATION	2134392	14669219	1	true
BC HOLDING COMPANY INC
1850 BLUEGRASS AVE	LOUISVILLE	KY	40215	311542851	FITNESS CLUB	KY	JH	C CORPORATION	0	0	1	true
CADUCEUS MEDICAL ASSOCIATES INC
5600 BRAINERD ROAD SUITE 500	CHATTANOOGA	TN	37411	621570736	HEALTHCARE	TN	MHCS	C CORPORATION	0	1008	1	true
CAPTIVE MANAGEMENT INITIATIVES
				980663022	CAPTIVE MANAGEMENT		CHI	C CORPORATION	0	0	1	true	PO BOX 10073 APO	GEORGETOWN	GRAND CAYMAN	CJ	KY1-1001	CJ
CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	272269511	RESEARCH	CO	CIRI	C CORPORATION	-2286538	1241259	1	true
CGH REALTY COMPANY INC
2500 BERNVILLE RD	READING	PA	19603	232326801	REAL ESTATE	PA	SJHM	C CORPORATION	0	0	1	true
COMCARE SERVICES
4231 W 16TH AVENUE	DENVER	CO	80204	840904813	INACTIVE	CO	CHIC	C CORPORATION	0	0	1	true
CONSOLIDATED HEALTH SERVICES
1700 EDISON DRIVE	MILFORD	OH	45150	311378212	HOME HEALTH	OH	CHI	C CORPORATION	-879467	52379487	1	true
DES MOINES MEDICAL CENTER INC
1111 6TH AVENUE	DES MOINES	IA	50314	420837382	REAL ESTATE	IA	CHI-IA CORP	C CORPORATION	61204	1064032	0.9298	true
FIRST INITIATIVES INSURANCE LTD
				980203038	INSURANCE		CHI	C CORPORATION	0	0	1	true	PO BOX 10073 APO	GEORGETOWN	GRAND CAYMAN	CJ	KY1-1001	CJ
FRANCISCAN SERVICES INC
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	232487967	HEALTHCARE	CO	CHI	C CORPORATION	-7868	718254	1	true
GOOD SAMARITAN OUTREACH SERVICES
PO BOX 1990	KEARNEY	NE	68848	470659440	MEDICAL CLINIC	NE	CHI NEBRASKA	C CORPORATION	-257418	180468	1	true
HEALTH SYSTEMS ENTERPRISES INC
PO BOX 1990	KEARNEY	NE	68848	470664558	MANAGEMENT	NE	GSH	C CORPORATION	87278	1377820	1	true
HEALTHCARE MGMT SERVICES ORG INC
1149 MARKET ST	TACOMA	WA	98402	911865474	HEALTH ORG.	WA	FHS	C CORPORATION	0	0	1	true
MEDQUEST
1301 15TH AVENUE WEST	WILLISTON	ND	58801	450392137	SALE OF DME	ND	MMC WILLISTON	C CORPORATION	153510	1152715	1	true
MERCY PARK APARTMENTS LTD
1111 6TH AVENUE	DES MOINES	IA	50314	421202422	HOUSING	IA	CHI-IA CORP	C CORPORATION	369231	1937218	1	true
MERCY SERVICES CORP
2700 STEWART PARKWAY	ROSEBURG	OR	97470	930824308	RETAIL SALES	OR	MMC	C CORPORATION	-440596	1423377	1	true
MHSERVICES CORPORATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	431457881	DME	MO	SJRMC	C CORPORATION	0	0	1	true
MOUNTAIN MANAGEMENT SERVICES INC
5600 BRAINERD ROAD SUITE 500	CHATTANOOGA	TN	37411	621570739	MGMT SVC ORG	TN	MHCS	C CORPORATION	96044	6465179	1	true
NAZARETH ASSURANCE COMPANY
				030304831	INSURANCE		CHI	C CORPORATION	0	0	1	true	PO BOX 10073 APO	GEORGETOWN	GRAND CAYMAN	CJ	KY1-1001	CJ
PATIENT TRANSPORT SERVICES INC
1700 EDISON DRIVE	MILFORD	OH	45150	311100798	HOME HEALTH	OH	ANC	C CORPORATION	-164340	5488275	1	true
PHYSICIAN HEALTH SYSTEM NETWORK
1149 MARKET ST	TACOMA	WA	98402	911746721	HEALTH ORG.	WA	FHS	C CORPORATION	0	0	1	true
SAINT CLARES PRIMARY CARE INC
66 FORD ROAD	DENVILLE	NJ	07834	222441202	BILLING SERVICES	NJ	SCCC	C CORPORATION	-357263	1361242	1	true
SAMARITAN FAMILY CARE INC
40 W FOURTH ST 1700	DAYTON	OH	45402	311299450	HEALTHCARE	OH	SHP	C CORPORATION	0	0	1	true
SJH SERVICES CORPORATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	232307408	HEALTHCARE	CO	FSI	C CORPORATION	-197039	3331737	1	true
SJL PHYSICIAN MANAGEMENT SERVICES INC
424 LEWIS HARGETT CR 160	LEXINGTON	KY	40503	270164198	MANAGEMENT	KY	SJHS	C CORPORATION	0	0	1	true
ST ANTHONY DEVELOPMENT COMPANY
1415 SOUTHGATE	PENDLETON	OR	97801	931216943	ATHLETIC CLUB	OR	SAH	C CORPORATION	114663	2936102	1	true
ST VINCENT COMMUNITY HEALTH SERVICES INC
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	710710785	HEALTHCARE	AR	SVIMC	C CORPORATION	2408638	15225732	1	true
ST JOSEPH DEVELOPMENT COMPANY INC
1717 SOUTH J STREET	TACOMA	WA	98405	911480569	RENTAL	WA	FSI	C CORPORATION	655478	12357418	1	true
ST JOSEPH OFFICE PARK ASSOCIATION
1401 HARRODSBURG ROAD BLDG B70	LEXINGTON	KY	40504	611079899	MANAGEMENT	KY	SJHS	C CORPORATION	0	882139	0.85	true
TOWSON MANAGEMENT INC
7601 OSLER DRIVE	TOWSON	MD	21204	521710750	MANAGEMENT SERVICES	MD	FSI	C CORPORATION	516457	197196	1	true
COLLABHEALTH MANAGED SOLUTIONS INC
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	461222808	HOLDING CO	CO	CHI	C CORPORATION	0	23806707	1	true
COLLABHEALTH PLAN SERVICES INC
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	461224037	ADMIN SERVICES	CO	CHMS	C CORPORATION	-1082933	38272608	1	true
HIGHLINE MEDICAL GROUP
15811 AMBAUM BLVD SW 170	BURIEN	WA	98166	911407026	MEDICAL SERVICES	WA	HMC	C CORPORATION	-6049147	5689139	1	true
SOUNDPATH HEALTH INC
32129 WEYERHAEUSER WAY S SUITE 201	FEDERAL WAY	WA	98001	421720801	INSURANCE	WA	CHPS	C CORPORATION	-154741	10976973	0.556	true
SLEHS HOLDINGS INC
6624 FANNIN SUITE 800	HOUSTON	TX	77030	760637138	HOLDING CO	TX	SLHS	C CORPORATION	1425313	33114103	1	true
ST LUKE'S ANESTHESIOLOGY ASSOCIATES
6624 FANNIN SUITE 1100	HOUSTON	TX	77030	461517163	MEDICAL CLINIC	TX	SLMC	C CORPORATION	0	0	1	true
SLMT PARKING INC
6624 FANNIN SUITE 800	HOUSTON	TX	77030	760637140	PARKING	TX	SLHS	C CORPORATION	1117934	13768221	1	true
ST LUKE'S 6620 MAIN CONDOMINIUM ASSOCIATION
6624 FANNIN SUITE 1100	HOUSTON	TX	77030	300355517	CONDOMINIUM ASSOC	TX	SLPC	C CORPORATION	0	0	1	true
ST LUKE'S EPISCOPAL HOSPITAL PHYSICIAN HOSPITAL ORGANIZATION INC
6720 BERTNER	HOUSTON	TX	77030	760377932	PHO	TX	SLMC	C CORPORATION	6	0	0.6	true
ST LUKE'S MEDICAL ARTS CENTER I CONDOMINIUM ASSOCIATION
6624 FANNIN SUITE 1100	HOUSTON	TX	77030	300355518	CONDOMINIUM ASSOC	TX	SLPC	C CORPORATION	0	0	1	true
ST LUKE'S MEDICAL TOWER CONDOMINIUM ASSOCIATION
6624 FANNIN SUITE 1100	HOUSTON	TX	77030	760298751	CONDOMINIUM ASSOC	TX	SLMTC	C CORPORATION	0	0	1	true
SUGAR LAND DOCTOR GROUP
1317 LAKE POINTE PARKWAY	SUGAR LAND	TX	77478	454270163	MEDICAL CLINIC	TX	SL CHS	C CORPORATION	-1159411	566590	1	true
THE TEXAS HEART INSTITUTE AT ST LUKE'S EPISCOPAL HOSPITAL DENTON A COOLEY B
6624 FANNIN SUITE 1100	HOUSTON	TX	77030	900064009	CONDOMINIUM ASSOC	TX	SLMC	C CORPORATION	0	0	1	true							UILDING CONDOMINIUM ASSOCIATION
ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SERVICES INC
12809 WEST DODGE ROAD	OMAHA	NE	68154	470802396	MANAGED CARE	NE	ACH	C CORPORATION	5312313	4520865	1	true
ALL SAINTS INSURANCE COMPANY SPC LTD
					INSURANCE		SLHS	C CORPORATION	0	43866961	1	true	PO BOX 69 GT 720 WEST BAY ROAD	GEORGETOWN	GRAND CAYMAN	CJ	KY-1102	CJ
VINTAGE DOCTOR GROUP
6624 FANNIN SUITE 1100	HOUSTON	TX	77030		MEDICAL CLINIC	TX	SLMC	C CORPORATION	0	0	1	true

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	true	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	false	DividendsRelatedOrganization
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	true	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	true	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

Field	Value	IRS element (for citing)
Business Name Line1	MERCY HEALTH CARE FOUNDATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Transaction Type	C	TransactionType
Amount Involved	775725	AmountInvolved
Method Of Amt Determination	BOOK VALUE	MethodOfAmtDetermination