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MERCY MEDICAL CENTER-CENTERVILLE: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MERCY MEDICAL CENTER-CENTERVILLE (EIN 42-0680308)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-10
IRS object ID
201221319349301947
Schema version
2010v3.2
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-10T14:00:21-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CATHOLIC HEALTH INITIATIVESBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1198 INVERNESS DRIVE WESTAddressLine1
CityENGLEWOODCity
StateCOState
ZIP Code80112ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN420680308EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY MEDICAL CENTER - CENTERVILLEBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMERCNameControl
Phone5154373413Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 St Josephs DriveAddressLine1
CityCentervilleCity
StateIAState
ZIP Code52544ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSTEVE KUKLAName
TitleSR VP & CFOTitle
Date Signed2012-05-10DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone7208741500Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1CLINT CHRISTIANSONBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11 St Josephs DriveAddressLine1
CityCentervilleCity
StateIAState
ZIP Code52544ZIPCode
FieldValueIRS element (for citing)
Gross Receipts26832287GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.MERCYCENTERVILLE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1965YearFormation
State Legal DomicileIAStateLegalDomicile
Activity Or Mission DescriptionMERCY MEDICAL CENTER-CENTERVILLE IS A NOT-FOR-PROFIT CATHOLIC HEALTH ORGANIZATION CREATING HEALTHIER COMMUNITIES BY OPERATING A 25-BED ACUTE CARE HOSPITAL AND A 20-BED SKILLED NURSING FACILITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees303TotalNbrEmployees
Total Nbr Volunteers11TotalNbrVolunteers
Total Gross UBI502TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year929790ContributionsGrantsPriorYear
Contributions Grants Current Year916315ContributionsGrantsCurrentYear
Program Service Revenue Prior Year24743241ProgramServiceRevenuePriorYear
Program Service Revenue CY25249567ProgramServiceRevenueCY
Investment Income Prior Year302196InvestmentIncomePriorYear
Investment Income Current Year545736InvestmentIncomeCurrentYear
Other Revenue Prior Year153270OtherRevenuePriorYear
Other Revenue Current Year120669OtherRevenueCurrentYear
Total Revenue Prior Year26128497TotalRevenuePriorYear
Total Revenue Current Year26832287TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year18725GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY13846GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year13286621SalariesEtcPriorYear
Salaries Etc Current Year12908069SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year12156TotalFundrsngExpCurrentYear
Other Expense Prior Year11922892OtherExpensePriorYear
Other Expenses Current Year11439638OtherExpensesCurrentYear
Total Expenses Prior Year25228238TotalExpensesPriorYear
Total Expenses Current Year24361553TotalExpensesCurrentYear
Revenues Less Expenses Prior Year900259RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2470734RevenuesLessExpensesCY
Total Assets BOY18911256TotalAssetsBOY
Total Assets EOY20619452TotalAssetsEOY
Total Liabilities BOY4039867TotalLiabilitiesBOY
Total Liabilities EOY2621621TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY14871389NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY17997831NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE ORGANIZATION'S MISSION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH BY BRINGING IT NEW LIFE, ENERGY AND VIABILITY IN THE 21ST CENTURY. FIDELITY TO THE GOSPEL URGES US TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS WE MOVE TOWARD THE CREATION OF HEALTHIER COMMUNITIES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangetrueSignificantChange
Expense22627800Expense
Grants13846Grants
Revenue25249567Revenue
DescriptionSEE SCHEDULE H.Description
Total Program Service Expense22627800TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees303NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledIAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Randall L RubinBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5156437860TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11111 6th AvenueAddressLine1
CityDes MoinesCity
StateIAState
ZIP Code50314ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
BILL BUSS
DIRECTOR1X000
CLINTON CHRISTIANSON
CEO40X200751017173X
MADELINE CUMMINS
DIRECTOR1X000
LEANNE DROBNICH
VICE CHAIR1X030090437969X
DAVID FRASER
DIRECTOR/PHYSICIAN40X247220018715
DAVID HOWE
DIRECTOR1X000
DR KATHY LANGE
DIRECTOR1X000
JOSEPH LEVALLEY
DIRECTOR/SVP MMC DSM1X038943145136
ROBERT PONTIUS
CHAIRMAN1X000X
DR PAUL PONCY
DIRECTOR1X000
MARLENE SPROUSE
DIRECTOR1X000
SR CAMILLA VERRET RSM
DIRECTOR1X000
LORI RATHBUN
VP OPERATIONS/TREASURER40113682026889X
MIKE CRAVER
DIRECTOR1X000
SR JEANNE CHRISTENSEN RSM
DIRECTOR1X000
ERICA COLLINS
PHYSICIAN40230723028249X
NANCY BARTON
PHYSICIAN401436263425024075X
JAMES MCCONVILLE
PHYSICIAN40147251010034X
BETA HAMON
PHYSICIAN40109640023359X
JEFFREY WILLIER
DIRECTOR OF PHARMACY40106315026935X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1299208TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs724585TotalReportableCompFrmRltdOrgs
Total Other Compensation258534TotalOtherCompensation
Number Individuals GT100 K8NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1EMCARE PHYSICIAN SERVICESBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17032 COLLECTION DRIVEAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60693ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesPHYSICIAN SERVICESDescriptionOfServices
Compensation1433035Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Related Organizations855987RelatedOrganizations
Government Grants59828GovernmentGrants
All Other Contributions500AllOtherContributions
Total Contributions916315TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICES9000992513587125135871
PROGRAM SERVICE REVENUE9000998521185211
EMERGENCY MEDICAL SERVICES9000992848528485

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue25249567TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column181118TotalRevenueColumn
Unrelated Business Revenue502UnrelatedBusinessRevenue
Exclusion$180,616ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities364618Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities364618Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column364618TotalRevenueColumn
Exclusion$364,618ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA72210057941$57,941
REIMBURSEMENT OF EXPENSES90009936581$36,581
MEALS ON WHEELS90009918951$18,951

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column7196TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$7,196ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue120669TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column26832287TotalRevenueColumn
Related Or Exempt Function Income25249567RelatedOrExemptFunctionIncome
Unrelated Business Revenue502UnrelatedBusinessRevenue
Exclusion$665,903ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total13846Total
Program Services13846ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total606840Total
Program Services260064ProgramServices
Management And General334620ManagementAndGeneral
Fundraising12156Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total9415742Total
Program Services9221044ProgramServices
Management And General194698ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total551037Total
Program Services523963ProgramServices
Management And General27074ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1610585Total
Program Services1593180ProgramServices
Management And General17405ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total723865Total
Program Services689576ProgramServices
Management And General34289ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2627811Total
Program Services2458983ProgramServices
Management And General168828ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3872991Total
Program Services3780031ProgramServices
Management And General92960ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total608795Total
Program Services608795ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total74223Total
Program Services65554ProgramServices
Management And General8669ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2296Total
Program Services859ProgramServices
Management And General1437ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total69709Total
Program Services69709ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total752964Total
Management And General752964ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total656343Total
Program Services650690ProgramServices
Management And General5653ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total171608Total
Program Services171608ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE19412661941266
REPAIRS AND MAINTENANCE48170346059021113
EDUCATION36819298177002
DUES & SUBSCRIPTIONS415211964321878
OTHER EXPENSES1015896858233007

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total24361553Total
Program Services22627800ProgramServices
Management And General1721597ManagementAndGeneral
Fundraising12156Fundraising

Total Joint Costs TotalJointCosts

FieldValueIRS element (for citing)
Total0Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY650BOY
EOY783EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3523412BOY
EOY1706715EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3971310BOY
EOY3104812EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY332952BOY
EOY367915EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY140415BOY
EOY176419EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis16404352LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec11679629LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5090138BOY
EOY4724723EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY5852379BOY
EOY10538085EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY18911256BOY
EOY20619452EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2136028BOY
EOY1250424EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1903839BOY
EOY1371197EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4039867BOY
EOY2621621EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY14871389BOY
EOY17997831EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14871389BOY
EOY17997831EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY18911256BOY
EOY20619452EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2470734ReconcilationRevenueExpenses
Reconcilation Other Changes655708ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$3,456GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB3456TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierGRANTS PAID FOR LOBBYINGIdentifier
Return ReferenceSCHEDULE C, PART II-BReturnReference
Explanation$16,149 IN ANNUAL DUES WAS PAID TO THE IOWA HOSPITAL ASSOCIATION AND $3,456 WAS ALLOCATED AS LOBBYING EXPENSES. THE AMOUNT SHOWN IN LINE 1F ABOVE REPRESENTS THIS ENTITY'S SHARE OF ALLOCATED LOBBYING EXPENSES.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis160349OtherCostOrOtherBasis
Book Value160349BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis10346583OtherCostOrOtherBasis
Depreciation7025130Depreciation
Book Value3321453BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis5512083OtherCostOrOtherBasis
Depreciation4366356Depreciation
Book Value1145727BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis385337OtherCostOrOtherBasis
Depreciation288143Depreciation
Book Value97194BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4724723TotalOfBookValueLandBuildings

Financial Derivatives FinancialDerivatives

FieldValueIRS element (for citing)
Book Value0BookValue

Closely Held Equity Interests CloselyHeldEquityInterests

FieldValueIRS element (for citing)
Book Value0BookValue

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
CHI OIP - FIXED INCOME5066638F
CHI OIP - EQUITY SECURITIES5471447F
FieldValueIRS element (for citing)
Total Of Book Value Securities10538085TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionCHI DEBT PROGRAMDescription
Amount$1,371,197Amount
FieldValueIRS element (for citing)
Total Of Amounts1371197TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48 (ASC 740) footnoteIdentifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationMERCY MEDICAL CENTER - CENTERVILLE'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES - IOWA, CORP (CHI-IOWA CORP). CHI-IOWA CORP'S FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2011 READS AS FOLLOWS: "THE CORPORATION AND ALL SUBSIDIARIES, EXCEPT MPA, AND DMMC ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE CODE. ASC 740, INCOME TAXES, PRESCRIBES CRITERIA FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE, AND TRANSITION. MANAGEMENT HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT HAVE NOT BEEN REFLECTED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION'S FEDERAL INCOME TAX RETURNS ARE OPEN TO EXAMINATION FOR THE YEARS ENDED JUNE 30, 2008 THROUGH JUNE 30, 2011."Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CarefalseFPGReferenceFreeCare
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense187964TotalCommunityBenefitExpense
Net Community Benefit Expense187964NetCommunityBenefitExpense
Percent Of Total Expense0.00840PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense187964TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense187964NetCommunityBenefitExpense
Percent Of Total Expense0.00840PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs12NumberOfActivitiesOrPrograms
Persons Served27649PersonsServed
Total Community Benefit Expense33049TotalCommunityBenefitExpense
Direct Offsetting Revenue250DirectOffsettingRevenue
Net Community Benefit Expense32799NetCommunityBenefitExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served106PersonsServed
Total Community Benefit Expense943TotalCommunityBenefitExpense
Net Community Benefit Expense943NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Total Community Benefit Expense33115TotalCommunityBenefitExpense
Net Community Benefit Expense33115NetCommunityBenefitExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs19NumberOfActivitiesOrPrograms
Persons Served27755PersonsServed
Total Community Benefit Expense67107TotalCommunityBenefitExpense
Direct Offsetting Revenue250DirectOffsettingRevenue
Net Community Benefit Expense66857NetCommunityBenefitExpense
Percent Of Total Expense0.00300PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs19NumberOfActivitiesOrPrograms
Persons Served27755PersonsServed
Total Community Benefit Expense255071TotalCommunityBenefitExpense
Direct Offsetting Revenue250DirectOffsettingRevenue
Net Community Benefit Expense254821NetCommunityBenefitExpense
Percent Of Total Expense0.01140PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served7343PersonsServed
Total Community Building Expense68625TotalCommunityBuildingExpense
Direct Offsetting Revenue18362DirectOffsettingRevenue
Net Community Building Expense50263NetCommunityBuildingExpense
Percent Of Total Expense0.00210PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served25PersonsServed
Total Community Building Expense604TotalCommunityBuildingExpense
Net Community Building Expense604NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served7368PersonsServed
Total Community Building Expense69229TotalCommunityBuildingExpense
Direct Offsetting Revenue18362DirectOffsettingRevenue
Net Community Building Expense50867NetCommunityBuildingExpense
Percent Of Total Expense0.00210PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$883,082BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare8761921AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare9133179CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-371258MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY MEDICAL CENTER - CENTERVILLEBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1ONE ST JOSEPHS DRIVEAddressLine1
CityCENTERVILLECity
StateIAState
ZIP Code52544ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MERCY MEDICAL CENTER - CENTERVILLEBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY CENTERVILLE LONGTERM CARE FACILITYBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1ONE ST JOSEPHS DRIVEAddressLine1
CityCENTERVILLECity
StateIAState
ZIP Code52544ZIPCode
FieldValueIRS element (for citing)
Facility TypeNURSING HOMEFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Eligibility criteria for free or discounted careSchedule H, Part I, Line 3cIF APPLICABLE, DESCRIBE THE INCOME-BASED CRITERIA FOR DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. WHEN CATHOLIC HEALTH INITIATIVES (THE ULTIMATE PARENT ORGANIZATION TO MERCY MEDICAL CENTER - CENTERVILLE) 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 THE 69 URBAN AND RURAL COMMUNITIES IN 19 STATES SERVED BY CHI HOSPITALS AND HEALTH CARE FACILITIES. MERCY MEDICAL CENTER - CENTERVILLE 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. ALSO DESCRIBE WHETHER THE ORGANIZATION USES AN ASSET TEST OR OTHER THRESHOLD, REGARDLESS OF INCOME, TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. 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.
Bad Debt Expense excluded from financial assistance calculationSchedule H, Part I, Line 7, column(f)1,941,266
Costing Methodology used to calculate financial assistanceSchedule H, Part I, Line 7PROVIDE AN EXPLANATION OF THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. IF A COST ACCOUNTING SYSTEM WAS USED, INDICATE WHETHER THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED OR SELF PAY). A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING THE ORGANIZATION'S COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. ALSO INDICATE WHETHER A COST-TO-CHARGE RATIO WAS USED FOR ANY OF THE FIGURES REPORTED IN THE TABLE. DESCRIBE WHETHER THIS COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, AND, IF NOT, WHAT KIND OF COST-TO-CHARGE RATIO WAS USED AND HOW IT WAS DERIVED. IF SOME OTHER COSTING METHODOLOGY WAS USED BESIDES A COST ACCOUNTING SYSTEM, COST-TO-CHARGE RATIO, OR A COMBINATION OF THE TWO, DESCRIBE THE METHOD USED. THE COST-TO-CHARGE RATIO FOR THE YEAR ENDED 6/30/11 WAS COMPUTED USING THE FOLLOWING FORMULA: OPERATING EXPENSE (BEFORE RESTRUCTURING, IMPAIRMENT AND OTHER LOSSES) DIVIDED BY GROSS PATIENT REVENUE. BASED ON THAT FORMULA, 22,420,286 /$49,289,666 RESULTS IN A 45.49% COST-TO-CHARGE RATIO. WORKSHEET 2 WAS NOT USED TO DERIVE THE COST-TO-CHARGE RATIO.
Bad debt expense - financial statement footnoteSchedule H, Part III, Line 4PROVIDE THE RATIONALE AND THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED IN PART III, LINES 2 AND 3. DESCRIBE HOW THE ORGANIZATION ACCOUNTS FOR DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS IN DETERMINING BAD DEBT EXPENSE. COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 45.49%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. ALSO DESCRIBE THE METHOD THE ORGANIZATION USES TO DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, IF SUFFICIENT INFORMATION HAS BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBILITY. DESCRIBE THE RATIONALE, IF ANY, FOR INCLUDING ANY PORTION OF BAD DEBT AS COMMUNITY BENEFIT. ALSO PROVIDE, IF APPLICABLE, THE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE. IF THE ORGANIZATION'S FINANCIAL STATEMENTS INCLUDE A FOOTNOTE ON THESE ISSUES THAT ALSO INCLUDES OTHER INFORMATION, REPORT ONLY THE RELEVANT PORTIONS OF THE FOOTNOTE. IF THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN SUCH A FOOTNOTE, STATE THAT THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE SUCH A FOOTNOTE AND EXPLAIN HOW THE FINANCIAL STATEMENTS ACCOUNT FOR BAD DEBT, IF AT ALL. MERCY MEDICAL CENTER - CENTERVILLE 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. MERCY MEDICAL CENTER - CENTERVILLE'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS INCLUDE THE FOLLOWING FOOTNOTE CONCERNING BAD DEBT EXPENSE: "THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING 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."
Community benefit & methodology for determining medicare costsSchedule H, Part III, Line 8DESCRIBE THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT, AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6. USING ESSENTIALLY THE SAME MEDICARE COST REPORT PRINCIPLES AS TO THE ALLOCATION OF GENERAL SERVICES COSTS AND "APPORTIONMENT" METHODS, THE "CHI WORKBOOK" CALCULATES A PAYERS' GROSS ALLOWABLE COSTS BY SERVICE (SO AS TO FACILITATE A CORRESPONDING COMPARISON BETWEEN GROSS ALLOWABLE COSTS AND ULTIMATE PAYMENTS RECEIVED). THE TERM "GROSS ALLOWABLE COSTS" MEANS COSTS BEFORE ANY DEDUCTIBLES OR CO-INSURANCE ARE SUBTRACTED. MERCY MEDICAL CENTER - CENTERVILLE'S ULTIMATE REIMBURSEMENT WILL BE REDUCED BY ANY APPLICABLE COPAYMENT/ DEDUCTIBLE. WHERE MEDICARE IS THE SECONDARY INSURER, AMOUNTS DUE FROM THE INSURED'S PRIMARY PAYER WERE NOT SUBTRACTED FROM MEDICARE ALLOWABLE COSTS BECAUSE THE AMOUNTS ARE TYPICALLY IMMATERIAL. DESCRIBE, IF APPLICABLE, THE EXTENT TO WHICH ANY SHORTFALL REPORTED IN PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT, AND THE RATIONALE FOR THE ORGANIZATION'S POSITION. MERCY MEDICAL CENTER - CENTERVILLE BELIEVES THAT EXCLUDING MEDICARE LOSSES FROM COMMUNITY BENEFIT MAKES THE OVERALL COMMUNITY BENEFIT REPORT MORE CREDIBLE FOR THESE REASONS: UNLIKE SUBSIDIZED AREAS SUCH AS BURN UNITS OR BEHAVIORAL-HEALTH SERVICES, MEDICARE IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS. IN FACT, FOR-PROFIT HOSPITALS FOCUS ON ATTRACTING PATIENTS WITH MEDICARE COVERAGE, ESPECIALLY IN THE CASE OF WELL-PAID SERVICES THAT INCLUDE CARDIAC AND ORTHOPEDICS. SIGNIFICANT EFFORT AND RESOURCES ARE DEVOTED TO ENSURING THAT HOSPITALS ARE REIMBURSED APPROPRIATELY BY THE MEDICARE PROGRAM. THE MEDICARE PAYMENT ADVISORY COMMISSION (MEDPAC), AN INDEPENDENT CONGRESSIONAL AGENCY, CAREFULLY STUDIES MEDICARE PAYMENT AND THE ACCESS TO CARE THAT MEDICARE BENEFICIARIES RECEIVE. THE COMMISSION RECOMMENDS PAYMENT ADJUSTMENTS TO CONGRESS ACCORDINGLY. THOUGH MEDICARE LOSSES ARE NOT INCLUDED BY CATHOLIC HOSPITALS AS COMMUNITY BENEFIT, THE CATHOLIC HEALTH ASSOCIATION GUIDELINES ALLOW HOSPITALS TO COUNT AS COMMUNITY BENEFIT SOME PROGRAMS THAT SPECIFICALLY SERVE THE MEDICARE POPULATION. FOR INSTANCE, IF HOSPITALS OPERATE PROGRAMS FOR PATIENTS WITH MEDICARE BENEFITS THAT RESPOND TO IDENTIFIED COMMUNITY NEEDS, GENERATE LOSSES FOR THE HOSPITAL, AND MEET OTHER CRITERIA, THESE PROGRAMS CAN BE INCLUDED IN THE CHA FRAMEWORK IN CATEGORY C AS "SUBSIDIZED HEALTH SERVICES." MEDICARE LOSSES ARE DIFFERENT FROM MEDICAID LOSSES, WHICH ARE COUNTED IN THE CHA COMMUNITY BENEFIT FRAMEWORK, BECAUSE MEDICAID REIMBURSEMENTS GENERALLY DO NOT RECEIVE THE LEVEL OF ATTENTION PAID TO MEDICARE REIMBURSEMENT. MEDICAID PAYMENT IS LARGELY DRIVEN BY WHAT STATES CAN AFFORD TO PAY, AND IS TYPICALLY SUBSTANTIALLY LESS THAN WHAT MEDICARE PAYS.
Collection practices for patients eligible for financial assistanceSchedule H, Part III, Line 9bIF THE ORGANIZATION HAS A WRITTEN DEBT COLLECTION POLICY AND ANSWERED "YES," TO PART III, LINE 9B, DESCRIBE THE COLLECTION PRACTICES SET FORTH IN THE POLICY THAT APPLY TO PATIENTS WHO IT KNOWS QUALIFY FOR FINANCIAL ASSISTANCE, WHETHER OR NOT SUCH PRACTICES APPLY SPECIFICALLY TO SUCH PATIENTS OR MORE BROADLY TO ALSO COVER OTHER TYPES OF PATIENTS. MERCY MEDICAL CENTER - CENTERVILLE'S DEBT COLLECTION POLICY PROVIDES THAT MERCY MEDICAL CENTER - CENTERVILLE WILL PERFORM A REASONABLE REVIEW OF EACH INPATIENT ACCOUNT PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH MERCY MEDICAL CENTER - CENTERVILLE'S COMMUNITY ASSISTANCE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO MEET THE MERCY MEDICAL CENTER - CENTERVILLE COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO MERCY MEDICAL CENTER - CENTERVILLE FOR APPROPRIATE FOLLOW-UP. MERCY MEDICAL CENTER - CENTERVILLE REQUIRES ITS THIRD-PARTY COLLECTION AGENTS TO INCLUDE A MESSAGE ON ALL STATEMENTS INDICATING THAT IF A PATIENT OR PATIENT GUARANTOR MEETS CERTAIN STIPULATED INCOME REQUIREMENTS, THE PATIENT OR PATIENT GUARANTOR MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. ALL OF CATHOLIC HEALTH INITIATIVES' HOSPITALS' CONTRACTS WITH THIRD PARTY COLLECTION AGENCIES INCLUDE THE FOLLOWING STANDARDS: *NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL REQUEST BENCH OR ARREST WARRANTS AS A RESULT OF NON-PAYMENT; *NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL SEEK LIENS THAT WOULD REQUIRE THE SALE OR FORECLOSURE OF A PRIMARY RESIDENCE; AND *NO CATHOLIC HEALTH INITIATIVES' COLLECTION AGENCY MAY SEEK COURT ACTION WITHOUT HOSPITAL APPROVAL. FINALLY, COLLECTION AGENCIES ARE TRAINED ON THE CATHOLIC HEALTH INITIATIVES MISSION, CORE VALUES AND STANDARD OF CONDUCT TO MAKE SURE ALL PATIENTS ARE TREATED WITH DIGNITY AND RESPECT.
Patient education of eligibility for assistance.Schedule H, Part VI, Line 3DESCRIBE HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. MERCY MEDICAL CENTER - CENTERVILLE INCLUDES INFORMATION CONCERNING ITS FINANCIAL ASSISTANCE POLICY ON ITS WEBSITE. IN ADDITION, MERCY MEDICAL CENTER - CENTERVILLE PROMINENTLY DISPLAYS ITS FINANCIAL ASSISTANCE POLICY IN BOTH ENGLISH AND SPANISH IN OBVIOUS LOCATIONS THROUGHOUT THE HOSPITALS, INCLUDING THE EMERGENCY ROOMS AND OTHER PATIENT INTAKE AREAS, AS WELL AS IN MERCY MEDICAL CENTER - CENTERVILLE OUTPATIENT FACILITIES. IN ADDITION, MERCY MEDICAL CENTER - CENTERVILLE REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR FINANCIAL ASSISTANCE UNDER MERCY MEDICAL CENTER - CENTERVILLE'S FINANCIAL ASSISTANCE POLICY. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY AND PROCEDURES INCLUDING AN APPLICATION FOR ASSISTANCE.MERCY MEDICAL CENTER - CENTERVILLE REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON ENGLISH-SPEAKING INDIVIDUALS. MERCY MEDICAL CENTER - CENTERVILLE'S STAFF WILL ALSO ASSIST THE PATIENT/GUARANTOR WITH APPLYING FOR OTHER AVAILABLE COVERAGE (SUCH AS MEDICAID), IF NECESSARY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES.
Affiliated health care systemSchedule H, Part VI, Line 6IF THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, DESCRIBE THE RESPECTIVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED. MERCY MEDICAL CENTER - CENTERVILLE, 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 $612 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN THE 2011 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. MERCY MEDICAL CENTER - CENTERVILLE OPERATES TO SERVE THE HEALTH CARE NEEDS OF THE CENTERVILLE, IA AND SURROUNDING APPANOOSE COUNTY COMMUNITIES.
State filing of community benefit reportSchedule H, Part VI, Line 7IA
NEEDS ASSESSMENT AND COMMUNITY INFORMATIONSCHEDULE H, PART VI, LINES 1,2,4, AND 5NEEDS ASSESSMENT. DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES, IN ADDITION TO ANY NEEDS ASSESSMENTS REPORTED IN PART V, SECTION B. COMMUNITY INFORMATION. DESCRIBE THE COMMUNITY THE ORGANIZATION SERVES, TAKING INTO ACCOUNT THE GEOGRAPHIC AREA AND DEMOGRAPHIC CONSTITUENTS IT SERVES. PROMOTION OF COMMUNITY HEALTH. PROVIDE ANY OTHER INFORMATION IMPORTANT TO DESCRIBING HOW THE ORGANIZATION'S HOSPITAL FACILITIES OR OTHER HEALTH CARE FACILITIES FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY (E.G., OPEN MEDICAL STAFF, COMMUNITY BOARD, USE OF SURPLUS FUNDS, ETC.). ORGANIZATION'S MISSION, VISION, AND TAX-EXEMPT PURPOSE: MERCY MEDICAL CENTER-CENTERVILLE IS A 25-BED CRITICAL ACCESS NOT-FOR-PROFIT CATHOLIC HOSPITAL LOCATED IN CENTERVILLE, IA. THE HOSPITAL IS INCLUDED IN THE OFFICIAL CATHOLIC DIRECTORY AS A TAX-EXEMPT HOSPITAL. THE MISSION OF THE HOSPITAL IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH BY BRINGING IT NEW LIFE, ENERGY, AND VIABILITY IN THE 21ST CENTURY. THE MEDICAL FRATERNITY IN CENTERVILLE FOUNDED THE HOSPITAL AS THE CENTERVILLE HOSPITAL IN 1902. AT THE COMMUNITY'S REQUEST, MANAGEMENT AND OPERATIONS OF THE HOSPITAL WERE TAKEN OVER BY THE SISTERS OF MERCY IN 1910. SINCE THAT TIME, MERCY HAS CONTINUED TO REACH OUT TO PROVIDE EDUCATION, HEALTH CARE AND SERVICES IN OUR COMMUNITY. GUIDED BY OUR VALUES OF REVERENCE, INTEGRITY, COMPASSION, AND EXCELLENCE, WE HOLD OURSELVES TO A HIGH STANDARD OF GIVING TO THE POOR AND BROADER COMMUNITY. MERCY CENTERVILLE EMPLOYS 240 PEOPLE WITH A MEDICAL STAFF OF 9 FAMILY PRACTICE PHYSICIANS, 2 GENERAL SURGEONS, 1 OB-GYN, 1 INTERNAL MEDICINE, AND 1 PEDIATRICIAN. CONSULTING SPECIALTY CLINICS AT THE HOSPITAL ARE ALSO AVAILABLE IN THE AREAS OF PATHOLOGY, ALLERGY, UROLOGY, ORTHOPEDICS, NEUROLOGY, OTOLARYNGOLOGY, CARDIOLOGY, ONCOLOGY, PODIATRY, OPHTHALMOLOGY, VASCULAR SURGERY, PLASTIC SURGERY, DERMATOLOGY, NEPHROLOGY AND ORTHOPEDICS. JUST LIKE FIRE AND POLICE PROTECTION, THE HOSPITAL PROVIDES 24-HOUR EMERGENCY ROOM PHYSICIANS AND THE COUNTY'S ONLY AMBULANCE SERVICE. DIAGNOSTIC CAPABILITY INCLUDES X-RAY, ULTRASOUND, VASCULAR ULTRASOUND, CT SCAN, PET-CT SCAN, NUCLEAR MEDICINE, MRI AND BONE DENSITOMETRY. OTHER SERVICES INCLUDE PHYSICAL & OCCUPATIONAL THERAPY, RESPIRATORY THERAPY, OBSTETRICS, SURGERY, HOME CARE, HOSPICE, AMBULANCE, CARDIAC REHABILITATION, AND SOCIAL AND PASTORAL CARE PROGRAMS. THE HOSPITAL ALSO OPERATES A 20-BED LONG-TERM CARE FACILITY, DIALYSIS CENTER AND SLEEP LAB. THE HOSPITAL'S SERVICES ARE PROVIDED TO THE COMMUNITY ON A NON-DISCRIMINATORY BASIS AND INCLUDE AN EMERGENCY ROOM STAFFED 24/7 WITH EMERGENCY ROOM PHYSICIANS THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. THE HOSPITAL IS GOVERNED BY A BOARD IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE THE MAJORITY. THE HOSPITAL PARTICIPATES IN GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS LIKE MEDICAID AND MEDICARE. COMMUNITY BENEFIT APPROACH: MERCY MEDICAL CENTER HAS PROVIDED CENTERVILLE AND THE PEOPLE OF APPANOOSE COUNTY WITH MANY ONGOING COMMUNITY BENEFITS SINCE ITS BEGINNING. FOREMOST, AS A PRIVATE HOSPITAL, IT HAS SAVED THE COMMUNITY NEARLY A HALF MILLION DOLLARS ANNUALLY IN PROPERTY TAXES COMPARED TO SURROUNDING COUNTIES WHO SUPPORT PUBLIC HOSPITALS. TRUE TO ITS MISSION, MERCY-CENTERVILLE HAS MADE A COMMITMENT TO IMPROVING THE HEALTH OF THE COMMUNITY BEFORE THEY BECOME ILL. THE HOSPITAL HAS FINANCIAL ASSISTANCE POLICIES AND PROGRAMS FOR LOW-INCOME PERSONS LIKE THE UNINSURED/UNDERINSURED PATIENT DISCOUNT POLICY AND THE SELF-PAY AND THIRD-PARTY DISCOUNTS POLICY.
NEEDS ASSESSMENT AND COMMUNITY INFORMATIONSCHEDULE H, PART VI, LINES 1,2,4, AND 5(CONTINUED) QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT: I. COMMUNITY OUTREACH FOR THE POOR SENIOR TRANSPORTATION THE HOSPITAL SPONSORS A COMMUNITY BUS WHICH PROVIDES TRANSPORTATION TO MEDICAL APPOINTMENTS FOR THE ELDERLY AND THOSE WITH LOW INCOME WHO ARE UNABLE TO DRIVE OR HAVE NO ONE TO TRANSPORT THEM. THE BUS SERVED 864 RIDERS LAST YEAR. INFLUENZA VACCINATIONS MERCY CENTERVILLE PROVIDES FLU VACCINES FOR THE BUSINESSES AT THEIR WORKSITE, INCLUDING VACCINES FOR RESIDENTS AND STAFF OF A COMMUNITY OF MENTALLY CHALLENGED INDIVIDUALS WHO LIVE AT THE HOME. 121 COMMUNITY MEMBERS WERE SERVED THROUGH THIS VACCINATION PROGRAM. MEALS ON WHEELS THE HOSPITAL PROVIDES MEAL PREPARATION AND DIETICIAN CONSULTANT SERVICE FOR THE COUNTY MEALS ON WHEELS PROGRAM. THIS PROGRAM SERVED 6,822 MEALS ON WHEELS TO THE POOR AND ELDERLY IN THE COMMUNITY. II. COMMUNITY OUTREACH FOR THE BROADER COMMUNITY DIABETES EDUCATION & SUPPORT GROUP MERCY OFFERS A CERTIFIED DIABETES EDUCATION AND SUPPORT GROUP FROM PATIENTS WITH DIABETES AND THEIR SPOUSES. THIS PROGRAM OFFERS BOTH PRESENTATIONS FROM VARIOUS DISCIPLINES INVOLVED IN MANAGING DIABETES AS WELL AS DISCUSSION. 188 INDIVIDUALS TOOK PART IN THIS EDUCATION TO ASSIST THEM IN MANAGING THEIR DIABETES. ALZHEIMER'S SUPPORT GROUP MERCY HOLDS A MONTHLY ALZHEIMER'S SUPPORT GROUP TO MEET THE GROWING NEEDS OF THE ELDERLY FACING ALZHEIMER'S AND THOSE WHO ARE PROVIDING CARE TO THEM IN THE HOME. THE GROUP HAS BOTH A MORNING AND EVENING SESSION FOR THE CONVENIENCE OF CAREGIVERS. 23 PEOPLE BENEFITED FROM THE SERVICES OF THIS PROGRAM LAST YEAR. AMBULANCE STANDBY FOR PUBLIC ACTIVITIES THE HOSPITAL ALLOWS ITS AMBULANCE TO STANDBY AT COMMUNITY EVENTS AND BALL GAMES AT NO CHARGE TO THE COMMUNITY OR ENTITY REQUESTING THIS SERVICE. 22,000 PEOPLE WERE SERVED THROUGH THIS SERVICE. BLOOD PRESSURE CLINICS & HEALTH PROMOTION EDUCATION THE HOSPITAL PROVIDED BLOOD PRESSURE AND GLUCOSE SCREENINGS TO THE COMMUNITY THROUGHOUT THE YEAR AND PROVIDED COMMUNITY EDUCATION ON HEART DISEASE AND DIABETES. 451 PEOPLE BENEFITTED FROM THESE HEALTH/WELLNESS PROGRAMS. INFECTION CONTROL TRAINING FOR COMMUNITY THE HOSPITAL PROVIDED INFECTION CONTROL TRAINING FOR AREA BUSINESSES. THE UPDATE INCLUDED BASIC BLOODBORNE PATHOGENS AND EXPOSURE REPORTING FOR COMMUNITY BUSINESSES. PARTICIPANTS WERE ENGAGED TO UNDERSTAND HOW BLOOD BORNE PATHOGENS RELATES TO THEIR DUTIES IN EMERGENCIES THEY MAY ENCOUNTER. 70 PEOPLE PARTICIPATED IN THIS PROGRAM. NARCOTICS ANONYMOUS THE HOSPITAL PROVIDES FACILITIES ONCE A WEEK THROUGHOUT THE YEAR TO NARCOTICS ANONYMOUS, ALLOWING THE GROUP A SAFE AND CONFIDENTIAL ENVIRONMENT TO ASSIST AND SUPPORT THEIR RECOVERY.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RATHBUN LAKE AREA YMCABusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1708 S MAIN STREETAddressLine1
CityCENTERVILLECity
StateIAState
ZIP Code52544ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient262927214EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant10000AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Method Of ValuationN/AMethodOfValuation
Description Of Non Cash AssistanceN/ADescriptionOfNonCashAssistance
Purpose Of GrantCOMMUNITY SUPPORTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedures for monitoring use of grant fundsIdentifier
Return ReferenceSchedule I, Part I, Line 2ReturnReference
ExplanationALL OF OUR GRANTS ARE MADE TO 501(C)(3) ORGANIZATIONS TO ENSURE THE GRANTS ARE USED FOR CHARITABLE PURPOSES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CLINTON CHRISTIANSON
160178019645020928014978021950217924000
LEANNE DROBNICH
020915405849603325403083307136033887300
DAVID FRASER
22162402348602110062270124880265935000
JOSEPH LEVALLEY
0280844075457033130025128020008043456700
ERICA COLLINS
21801901090201802021113071360258972000
NANCY BARTON
1270130153230129034250573101834401677013425000
JAMES MCCONVILLE
1296760148980267703560064740157285000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Non-fixed paymentsSchedule J, Part I, Line 7THE ORGANIZATION MAINTAINS A VARIABLE PAY PROGRAM FOR CERTAIN ELIGIBLE EMPLOYEES THAT PUTS A PORTION OF COMPENSATION AT RISK. AWARDS OF INCENTIVE COMPENSATION ARE MADE BASED UPON THE ACHIEVEMENT OF ORGANIZATIONAL OBJECTIVES.
SEVERANCE PAYMENTSSCHEDULE J, PART I, LINE 4APOST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR CATHOLIC HEALTH INITIATIVES ("CHI") AND RELATED ORGANIZATIONS' EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE, INCLUDING THE MBO CEOS. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2010 CALENDAR YEAR.
SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANSCHEDULE J, PART I, LINE 4BDURING THE 2010 CALENDAR YEAR CATHOLIC HEALTH INITIATIVES ("CHI"), A RELATED ORGANIZATION, MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR MBO CEOS AND OTHER CHI EMPLOYEES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Significant changes in program servicesForm 990, Part III, Line 3DURING THE FISCAL YEAR ENDING JUNE 30, 2011, CATHOLIC HEALTH INITIATIVES ("CHI"), A RELATED ORGANIZATION, CREATED CHI NATIONAL HOME CARE ("CNHC"), A COLORADO NONPROFIT CORPORATION THAT WILL BE OPERATED TO HOUSE CHI'S TAX-EXEMPT HOME HEALTH ACTIVITIES. CHI NATIONAL SERVICES ("CNS"), A COLORADO NONPROFIT AND THE SOLE CORPORATE MEMBER OF CNHC, WAS FORMED TO SERVE AS A SUPPORT STRUCTURE FOR CHI'S NATIONAL SERVICE LINES ACROSS THE COUNTRY. CHI NATIONAL SERVICES WILL SERVE AS A HOLDING COMPANY, PERMITTING MAXIMUM OPERATIONAL AND GOVERNANCE FLEXIBILITY WITH RESPECT TO THE FUTURE FOR-PROFIT AND CURRENT TAX-EXEMPT NATIONAL BUSINESS LINES SERVED BY CHI. THE CONSOLIDATION OF THE HOME CARE OPERATIONS WILL REDUCE VARIATION IN CLINICAL OUTCOMES, LOWER THE COST OF ADMINISTRATIVE AND BACK OFFICE SERVICES, ENHANCE GROWTH THROUGH THE STANDARDIZED MARKETING PROGRAM, AND ENHANCE OVERALL CORPORATE COMPLIANCE THROUGH STANDARDIZATION AND REVIEW. DURING THE FISCAL YEAR ENDING JUNE, 30 2011, MERCY MEDICAL CENTER - CENTERVILLE TRANSFERRED THEIR HOME CARE SERVICE DIVISION TO CNHC.
Classes of members or stockholdersForm 990, Part VI, Section A, Line 6THE ENTITY'S SOLE CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES - IOWA, CORP D/B/A MERCY MEDICAL CENTER - DES MOINES, AN IOWA NONPROFIT CORPORATION.
Members or stockholders electing members of governing bodyForm 990, Part VI, Section A, Line 7aTHE SOLE CORPORATE MEMBER HAS THE RIGHT TO APPROVE AND REMOVE WITH OR WITHOUT CAUSE THE MEMBERS OF THE GOVERNING BOARD.
Decisions requiring approval by members or stockholdersForm 990, Part VI, Section A, Line 7bTHE ORGANIZATION'S CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES - IOWA, CORP D/B/A MERCY MEDICAL CENTER - DES MOINES, AN IOWA NONPROFIT CORPORATION. PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, BOTH CATHOLIC HEALTH INITIATIVES - IOWA, CORP AND CATHOLIC HEALTH INITIATIVES ("CHI") (CATHOLIC HEALTH INITIATIVES - IOWA, CORP'S SOLE CORPORATE MEMBER) HAVE RESERVED POWERS AS OUTLINED IN THE CHI GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE HELD BY CATHOLIC HEALTH INITIATIVES - IOWA, CORP: *APPROVE MEMBERS OF THE MERCY MEDICAL CENTER - CENTERVILLE BOARD; *AMENDMENT OF THE CORPORATE DOCUMENTS OF MERCY MEDICAL CENTER - CENTERVILLE; *APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF MERCY MEDICAL CENTER - CENTERVILLE; *ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR MERCY MEDICAL CENTER - CENTERVILLE; THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: *SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF MERCY MEDICAL CENTER - CENTERVILLE; *REMOVAL OF A MEMBER OF THE GOVERNING BODY OF MERCY MEDICAL CENTER - CENTERVILLE; *APPROVAL OF ISSUANCE OF DEBT BY MERCY MEDICAL CENTER - CENTERVILLE; *APPROVAL OF PARTICIPATION OF MERCY MEDICAL CENTER - CENTERVILLE IN A JOINT VENTURE; *APPROVAL OF FORMATION OF A NEW CORPORATION BY MERCY MEDICAL CENTER - CENTERVILLE; *APPROVAL OF A MERGER INVOLVING MERCY MEDICAL CENTER - CENTERVILLE; *APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF MERCY MEDICAL CENTER - CENTERVILLE; *TO REQUIRE THE TRANSFER OF ASSETS BY MERCY MEDICAL CENTER - CENTERVILLE TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. PURSUANT TO SECTION 5.5 OF THE ORGANIZATION'S BYLAWS, CATHOLIC HEALTH INITIATIVES - IOWA, CORP OR CHI MAY, IN EXERCISE OF THEIR APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND ITS PRESIDENT AND THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE.
Review of form 990 by governing bodyForm 990, Part VI, Section B, Line 11aTHE ORGANIZATION'S ACCOUNTING PERSONNEL WORK WITH THE CHI TAX DEPARTMENT PERSONNEL TO PREPARE THE FORM 990. WHEN AVAILABLE, THE CFO REVIEWS THE RETURN AND ANY NECESSARY REVISIONS ARE INCLUDED IN THE FINAL VERSION WHICH IS APPROVED FOR FILING WITH THE IRS. SUBSEQUENT TO REVIEW BY THE CHIEF FINANCIAL OFFICER, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. SUBSEQUENT TO E-FILING, THE FINAL E-FILED FORM 990 IS PRESENTED TO THE BOARD AT A REGULARLY SCHEDULED BOARD MEETING.
Conflict of interest policyForm 990, Part VI, Section B, Line 12cALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT. IN ADDITION, ANY BOARD MEMBER WITH A CONFLICT IS REQUIRED TO DECLARE THE CONFLICT BEFORE THE BEGINNING OF EACH BOARD OR COMMITTEE MEETING. THE ENTIRE BOARD OR COMMITTEE DETERMINES WHETHER THE AFFECTED BOARD MEMBER SHOULD BE EXCLUDED FROM THE MEETING DUE TO THE DISCLOSED CONFLICT.
Process used to establish compensation of top management officialForm 990, Part VI, Section B, Line 15aTHE ORGANIZATION USES A THIRD-PARTY CONSULTANT TO SURVEY COMPENSATION TRENDS ANNUALLY AND TO RECOMMEND A COMPENSATION RANGE FOR THE CEO. THIS RECOMMENDATION IS PRESENTED TO THE BOARD FOR FINAL DETERMINATION AND APPROVAL. THE SALARIES ARE COMPARED TO INDUSTRY STANDARDS AND GUIDELINES FOR APPROPRIATENESS. THIS PROCESS WAS LAST UNDERTAKEN IN THE FISCAL YEAR ENDED JUNE 30, 2011.
Process used to establish compensation of other officers/key employeesForm 990, Part VI, Section B, Line 15bTHE ORGANIZATION USES A THIRD-PARTY CONSULTANT TO SURVEY COMPENSATION TRENDS ANNUALLY AND TO RECOMMEND COMPENSATION RANGES FOR THE OTHER OFFICERS AND KEY EMPLOYEES. THESE RECOMMENDATIONS ARE PRESENTED TO THE BOARD FOR FINAL DETERMINATION AND APPROVAL. THE SALARIES ARE COMPARED TO INDUSTRY STANDARDS AND GUIDELINES FOR APPROPRIATENESS. THIS PROCESS WAS LAST UNDERTAKEN IN THE FISCAL YEAR ENDED JUNE 30, 2011.
Public DisclosureForm 990, Part VI, Section C, Line 19THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.COM. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE ON THE IOWA SECRETARY OF STATE'S WEBSITE. THE CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE.
EXECUTIVE COMMITTEEFORM 990, PART VI, LINE 1ATHE EXECUTIVE COMMITTEE CONSISTS ONLY OF DIRECTORS OF THE ORGANIZATION AND IS COMPOSED OF THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON OF THE BOARD, AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, EACH OF WHOM SERVE AS EX OFFICIO VOTING MEMBERS OF THE EXECUTIVE COMMITTEE, AND ANY ADDITIONAL VOTING MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT THE ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIODS BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT THEIR ACTIONS ARE CONSISTENT WITH ANY ACTIONS OR POLICIES OF THE BOARD OR THE CORPORATE MEMBER. ALL ACTIONS TAKEN ARE CONTEMPORANEOUSLY DOCUMENTED AND REPORTED TO THE BOARD AT THE EARLIEST MEETING.
HOURS DEVOTED TO RELATED ORGANIZATIONSPART VII, SECTION ACOMPENSATION REPORTED ON FORM 990, PART VII WAS PAID TO THESE INDIVIDUALS BY RELATED ORGANIZATIONS IN EXCHANGE FOR THE FULFILLMENT OF THEIR DUTIES AS FULL-TIME, 40 HOUR-PER-WEEK EMPLOYEES.
Other changes in net assets or fund balancesForm 990, Part XI, Line 5NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - 655708;

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (124 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
ALEGENT HEALTH - BERGAN MERCY HEALTH SYS
7500 MERCY ROADOMAHANE68124470484764HEALTHCARENE501(C)(3)3CHItrue
ALEGENT HEALTH - MERCY HOSPITAL CORNING
PO BOX 368CORNINGIA50841420782518HEALTHCAREIA501(C)(3)3AHBMHStrue
ALVERNA APARTMENTS
300 SE 8TH AVENUELITTLE FALLSMN56345411351177LTERM CAREMN501(C)(3)9CHItrue
APPLETREE COURT
601 OAK STREETBRECKENRIDGEMN56520411850500SENIOR HOMESMN501(C)(3)9SFHtrue
BISHOP DRUMM RETIREMENT CENTER
1111 6TH AVENUEDES MOINESIA50314420725196LTERM CAREIA501(C)(3)9CHI-IA CORPtrue
BORNEMANN HEALTHCARE CORPORATION
2500 BERNVILLE RD PO BOX 316READINGPA19603232187242HEALTHCAREPA501(C)(3)11 - Type ICHItrue
CARRINGTON HEALTH CENTER
800 NORTH 4TH STREETCARRINGTONND58421450227311HEALTHCAREND501(C)(3)3CHItrue
CATHOLIC HEALTH CARE FEDERATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112208473567JURIDIC PERSONCO501(C)(3)11 - Type ICHItrue
CATHOLIC HEALTH INITIATIVES
198 INVERNESS DRIVE WESTENGLEWOODCO80112470617373HEALTHCARECO501(C)(3)9CHItrue
CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
961 EAST COLORADO AVENUECOLORADO SPRINGSCO80903840902211FUNDRAISINGCO501(C)(3)7CHI COLORADOtrue
CENTENNIAL MEDICAL GROUP INC
2700 STEWART PARKWAYROSEBURGOR97470900433062PHYSICIANSOR501(C)(3)9MMCtrue
CHI COLORADO
188 INVERNESS DRIVE WESTENGLEWOODCO80112840405257HEALTHCARECO501(C)(3)3CHItrue
CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PARKWAYFARGOND58104271966847HEALTHCAREND501(C)(3)3CHItrue
CHI INSTITUTE FOR RESEARCH AND INNOVATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112271050565HEALTHCARECO501(C)(3)11 - Type ICHItrue
CHI KENTUCKY INC
3900 OLYMPIC BLVD SUITE 400ERLANGERKY41018202741651HEALTHCAREKY501(C)(3)11 - Type ICHItrue
CHI NATIONAL FOUNDATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112270930004FUNDRAISINGCO501(C)(3)11 - Type ICHItrue
CHI NATIONAL HOME CARE
198 INVERNESS DRIVE WESTENGLEWOODCO80112451261716HEALTHCARECO501(C)(3)11 - Type ICHItrue
CHI NATIONAL SERVICES
198 INVERNESS DRIVE WESTENGLEWOODCO80112452532084HEALTHCARECO501(C)(3)9CHItrue
CHI NEBRASKA
555 SOUTH 70TH STREETLINCOLNNE68510363233121HEALTHCARENE501(C)(3)11 - Type ICHItrue
CHI-IOWA CORP
1111 6TH AVENUEDES MOINESIA50314420680448HEALTHCAREIA501(C)(3)3MHNtrue
CONTINUING CARE HOSPITAL
150 NORTH EAGLE CREEK DRIVELEXINGTONKY40509611400619LTACHKY501(C)(3)3SJHStrue
ENUMCLAW REGIONAL HOSPITAL ASSOCIATION
1450 BATTERSBY AVENUEENUMCLAWWA98022910715805HEALTHCAREWA501(C)(3)3FHStrue
FLAGET HEALTHCARE DBA FLAGET MEMORIAL HOSPITAL
4305 NEW SHEPHERDSVILLE ROADBARDSTOWNKY40004611345363HEALTHCAREKY501(C)(3)3CHItrue
FLAGET MEMORIAL HOSPITAL FOUNDATION INC
4305 NEW SHEPHERDSVILLE ROADBARDSTOWNKY40004562351341FUNDRAISINGKY501(C)(3)11 - Type IFHtrue
FRANCISCAN FOUNDATION
1717 SOUTH J STREETTACOMAWA98405911145592FUNDRAISINGWA501(C)(3)9FHStrue
FRANCISCAN HEALTH SYSTEM FKA FRANCISCAN HEALTH SYSTEM WEST
1717 SOUTH J STREETTACOMAWA98405910564491HEALTHCAREWA501(C)(3)3CHItrue
FRANCISCAN MEDICAL GROUP
1708 SOUTH YAKIMA AVENUETACOMAWA98405911939739HEALTHCAREWA501(C)(3)9FHStrue
FRANCISCAN VILLA OF SOUTH MILWAUKEE INC
3601 SOUTH CHICAGO AVENUESOUTH MILWAUKEEWI53172391093829HEALTHCAREWI501(C)(3)9CHItrue
GETTYSBURG MEDICAL CENTER
606 EAST GARFIELD AVENUEGETTYSBURGSD57442460234354HEALTHCARESD501(C)(3)3SMHCtrue
GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WESTENGLEWOODCO80112201536108MINISTRIESCO501(C)(3)11 - Type ICHItrue
GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE
375 DIXMYTH AVECINCINNATIOH45220311778403EDUCATIONKY501(C)(3)2GHStrue
GOOD SAMARITAN FOUNDATION OF CINCINNATI INC
619 OAK STREET ACCOUNTING-3 WCINCINNATIOH45206311206047FUNDRAISINGOH501(C)(3)11 - Type IGSHtrue
GOOD SAMARITAN HOSPITAL
PO BOX 1990KEARNEYNE68848470379755HEALTHCARENE501(C)(3)3CHI NEBRASKAtrue
GOOD SAMARITAN HOSPITAL FOUNDATION
PO BOX 1810KEARNEYNE68848470659443FUNDRAISINGNE501(C)(3)7GSHtrue
HEALTH SET
4200 WEST CONEJOS PLACE 436DENVERCO80204841102943LOW INC.CARECO501(C)(3)7CHI COLORADOtrue
HEALTHCARE AND WELLNESS FOUNDATION
2400 ST FRANCIS DRIVEBRECKENRIDGEMN56520760761782FUNDRAISINGMN501(C)(3)11 - Type ISFMCtrue
HOSPITAL ASSOCIATION FOR ST JOSEPH HOSPITAL
7601 OSLER DRIVETOWSONMD21204526050777HEALTHCAREMD501(C)(3)9SJMCtrue
HOUSE OF MERCY
1111 6TH AVENUEDES MOINESIA50314421323808SHELTERIA501(C)(3)7CHI-IA CORPtrue
LAKEWOOD HEALTH CENTER
600 MAIN AVENUE SOUTHBAUDETTEMN56623410758434LTERM CAREMN501(C)(3)3CHItrue
LINUS OAKES INC
2700 STEWART PARKWAYROSEBURGOR97470930821381SENIOR LIVINGOR501(C)(3)9MMCtrue
LISBON AREA HEALTH SERVICES
905 MAIN STREETLISBONND58054820558836HEALTHCAREND501(C)(3)3CHItrue
MEMORIAL HEALTH CARE SYSTEM FOUNDATION
2525 DE SALES AVENUECHATTANOOGATN37404621839548FUNDRAISINGTN501(C)(3)7MHCStrue
MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVENUECHATTANOOGATN37404620532345HEALTHCARETN501(C)(3)3CHItrue
MEMORIAL HEALTH PARTNERS FOUNDATION INC
6028 SHALLOWFORD ROADCHATTANOOGATN37421030417049HEALTHCARETN501(C)(3)9MHCStrue
MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVENUEDES MOINESIA50314426076069AUXILIARYIA501(C)(3)11 - Type ICHI-IA CORPtrue
MERCY CLINICS INC
1111 6TH AVENUEDES MOINESIA50314421193699PHYSICIANIA501(C)(3)9CHI-IA CORPtrue
MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVENUEDES MOINESIA50314421511682EDUCATIONIA501(C)(3)2CHI-IA CORPtrue
MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVENUEDES MOINESIA50314237358794FUNDRAISINGIA501(C)(3)7CHI-IA CORPtrue
MERCY FOUNDATION INC
2700 STEWART PARKWAYROSEBURGOR97470936088946FUNDRAISINGOR501(C)(3)7MMCtrue
MERCY HEALTH CARE FOUNDATION
PO BOX 368CORNINGIA50841421461064FUNDRAISINGNE501(C)(3)11 - Type IAHMHtrue
MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DRIVECOUNCIL BLUFFSIA51503421178204FUNDRAISINGIA501(C)(3)11 - Type IAHBMHStrue
MERCY HOSPITAL OF DEVILS LAKE
1031 EAST SEVENTH STREETDEVILS LAKEND58301450227012HEALTHCAREND501(C)(3)3CHItrue
MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BOULEVARDVALLEY CITYND58072450226553HEALTHCAREND501(C)(3)3CHItrue
MERCY LIFECARE SYSTEMS
2727 MCCLELLAND BLVDJOPLINMO64804431305163PROPERTY MGMTMO501(C)(3)11 - Type ISJRMCtrue
MERCY MEDICAL CENTER
1301 15TH AVENUE WESTWILLISTONND58801450231183HEALTHCAREND501(C)(3)3CHItrue
MERCY MEDICAL CENTER
2700 STEWART PARKWAYROSEBURGOR97470930386868HEALTHCAREOR501(C)(3)3CHItrue
MERCY MEDICAL FOUNDATION
1301 15TH AVENUE WESTWILLISTONND58801450381803FUNDRAISINGND501(C)(3)11 - Type IMMCtrue
MERCY PROFESSIONAL PRACTICE ASSOCIATES INC
1111 6TH AVENUEDES MOINESIA50314421470935PHYSICIANIA501(C)(3)9CHI-IA CORPtrue
MERCY REGIONAL MEDICAL CENTER OF DURANGO
1010 THREE SPRINGS BLVDDURANGOCO81301840405515HEALTHCARECO501(C)(3)3CHItrue
MNMCH INC
220 NORTH PENNSYLVANIACOLUMBUSKS66725481216238HEALTHCAREKS501(C)(3)3SJRMCtrue
MT ST JOSEPH INC
3060 SE STARK STREETPORTLANDOR97214930386870NURSING CAREOR501(C)(3)9CHItrue
OAKES COMMUNITY HOSPITAL
314 SOUTH 8TH STREETOAKESND58474450231675HEALTHCAREND501(C)(3)3CHItrue
OAKES COMMUNITY HOSPITAL FOUNDATION
314 SOUTH 8TH STREETOAKESND58474710966606FUNDRAISINGND501(C)(3)11 - Type IOCHtrue
PUEBLO STEPUP
1925 EAST ORMAN AVE SUITE G52PUEBLOCO81004841234295COMMUNITYCO501(C)(3)7CHItrue
SET OF COLORADO SPRINGS INC
825 E PIKES PEAK AVENUE BLDG 29COLORADO SPRINGSCO80903841183335LTERM CARECO501(C)(3)7CHI COLORADOtrue
SAINT CLARE'S COMMUNITY CARE
66 FORD ROADDENVILLENJ07834222876836HEALTHCARENJ501(C)(3)11 - Type IISCHStrue
SAINT CLARE''S FOUNDATION INC
66 FORD ROADDENVILLENJ07834222502997FUNDRAISINGNJ501(C)(3)7SCHStrue
SAINT CLARE''S HEALTH SERVICES INC
25 POCONO ROADDENVILLENJ07834223639733MANAGEMENTNJ501(C)(3)7CHItrue
SAINT CLARE'S HOSPITAL
66 FORD ROADDENVILLENJ07834223319886HEALTHCARENJ501(C)(3)3CHItrue
SAINT ELIZABETH FOUNDATION
555 SOUTH 70TH STREETLINCOLNNE68510470625523FUNDRAISINGNE501(C)(3)7SERMCtrue
SAINT ELIZABETH HEALTH SERVICES
555 SOUTH 70TH STREETLINCOLNNE68510363233120HEALTHCARENE501(C)(3)3SERMCtrue
SAINT ELIZABETH REGIONAL MEDICAL CENTER
555 SOUTH 70TH STREETLINCOLNNE68510470379836HEALTHCARENE501(C)(3)3CHI NEBRASKAtrue
SAINT FRANCIS MEDICAL CENTER
PO BOX 9804GRAND ISLANDNE68802470376601HEALTHCARENE501(C)(3)3CHI NEBRASKAtrue
SAINT FRANCIS MEDICAL CENTER FOUNDATION
PO BOX 9804GRAND ISLANDNE68802470630267FUNDRAISINGNE501(C)(3)7SFMCtrue
SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC
305 ESTILL STREETBEREAKY40403260152877FUNDRAISINGKY501(C)(3)7SJHStrue
SAINT JOSEPH HEALTH SYSTEM INC
150 N EAGLE CREEK DRLEXINGTONKY40509611334601HEALTHCAREKY501(C)(3)3CHItrue
SAINT JOSEPH LONDON FOUNDATION INC
310 EAST NINTH STREETLONDONKY40741260438748FUNDRAISINGKY501(C)(3)11 - Type ISJHStrue
SAINT JOSEPH MEDICAL FOUNDATION INC
ONE ST JOSEPH DRIVELEXINGTONKY40504311539059PHY PRACTICESKY501(C)(3)3SJHStrue
SAINT JOSEPH MOUNT STERLING FOUNDATION INC
50 STERLING AVENUEMOUNT STERLINGKY40353272884584FUNDRAISINGKY501(C)(3)7SJHStrue
SAINT JOSEPH'S HOSPITAL FOUNDATION
30 WEST 7TH STREETDICKINSONND58601363418207FUNDRAISINGND501(C)(3)11 - Type ISJHHCtrue
SAMARITAN BEHAVIORAL HEALTH
601 S EDWIN C MOSES BLVDDAYTONOH45408020633634HEALTHCAREOH501(C)(3)3SHPtrue
SAMARITAN HEALTH FOUNDATION
2222 PHILADELPHIA DRIVEDAYTONOH45406237296923FUNDRAISINGOH501(C)(3)7SHPtrue
SAMARITAN HEALTH PARTNERS
2222 PHILADELPHIA DRIVEDAYTONOH45406311107411HEALTHCAREOH501(C)(3)11 - Type ICHItrue
ST JOSEPH HEALTH MINISTRIES
1929 LINCOLN HWY E STE 150LANCASTERPA17602232342997HEALTHPA501(C)(3)11 - Type ICHItrue
ST JOSEPH HEALTH MINISTRIES FOUNDATION
1929 LINCOLN HWY E STE 150LANCASTERPA17602232605579FUNDRAISINGPA501(C)(3)11 - Type ISJHMtrue
ST ANTHONY HOSPITAL
1601 SE COURT AVENUEPENDLETONOR97801930391614HEALTHCAREOR501(C)(3)3CHItrue
ST ANTHONY HOSPITAL FOUNDATION
1601 SE COURT AVENUEPENDLETONOR97801930992727FUNDRAISINGOR501(C)(3)11 - Type ISA HOSPITALtrue
ST ANTHONY'S HOSPITAL ASSOCIATION
4 HOSPITAL DRIVEMORRILTONAR72110710245507HEALTHCAREAR501(C)(3)3SVIMCtrue
ST CATHERINE HOSPITAL
401 EAST SPRUCE STREETGARDEN CITYKS67846480543721HEALTHCAREKS501(C)(3)3CHItrue
ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION
401 EAST SPRUCE STREETGARDEN CITYKS67846200598702FUNDRAISINGKS501(C)(3)11 - Type ISCHtrue
ST DOMINIC AT ONTARIO
351 SW 9TH STREETONTARIOOR97914930433692HEALTHCAREOR501(C)(3)3CHItrue
ST FRANCIS HOME
2400 ST FRANCIS DRIVEBRECKENRIDGEMN56520410729978LTERM CAREMN501(C)(3)9CHItrue
ST FRANCIS LIFE CARE CORPORATION
19 POCONO ROADDENVILLENJ07834222536017ELDERLY CARENJ501(C)(3)9SCHStrue
ST FRANCIS MEDICAL CENTER
2400 ST FRANCIS DRIVEBRECKENRIDGEMN56520410695598HEALTHCAREMN501(C)(3)3CHItrue
ST FRANCIS OF BAKER CITY
3325 POCAHONTAS ROADBAKER CITYOR97814930412495HEALTHCAREOR501(C)(3)3CHItrue
ST JOHN'S MEDICAL GROUP
2727 MCCLELLAND BLVDJOPLINMO64804431882377PHYS PRACTICEMO501(C)(3)9SJRMCtrue
ST JOHN'S MERCY REGIONAL FOUNDATION
2727 MCCLELLAND BLVDJOPLINMO64804431308084FUNDRAISINGMO501(C)(3)7SJRMCtrue
ST JOHN'S REGIONAL MEDICAL CENTER
2727 MCCLELLAND BLVDJOPLINMO64804440545809HEALTHCAREMO501(C)(3)3CHItrue
ST JOSEPH COMMUNITY HEALTH SERVICES
300 CENTRAL AVE SW SUITE 3000WALBUQUERQUENM87102710897107COMMUNITYNM501(C)(3)11 - Type ICHItrue
ST JOSEPH HEALTH SERVICES INC
1929 LINCOLN HWY E STE 150LANCASTERPA17602201425375DENTAL CAREPA501(C)(3)11 - Type ISJHMtrue
ST JOSEPH HOSPITAL FOUNDATION INC
ONE ST JOSEPH DRIVELEXINGTONKY40504611159649FUNDRAISINGKY501(C)(3)11 - Type ISJHStrue
ST JOSEPH MEDICAL CENTER FOUNDATION
2500 BERNVILLE ROAD PO BOX 316READINGPA19603232649362FUNDRAISINGPA501(C)(3)11 - Type ISJRHNtrue
ST JOSEPH MEDICAL CENTER FOUNDATION INC
7601 OSLER DRIVETOWSONMD21204521681044FUNDRAISINGMD501(C)(3)7SJMCtrue
ST JOSEPH MEDICAL CENTER INC
7601 OSLER DRIVETOWSONMD21204520591461HEALTHCAREMD501(C)(3)3CHItrue
ST JOSEPH MEDICAL GROUP
2500 BERNVILLE ROAD PO BOX 316READINGPA19603208544021HEALTHCAREPA501(C)(3)9BHCtrue
ST JOSEPH PHYSICIAN ENTERPRISES
7601 OSLER DRIVETOWSONMD21204521311775PHYSICIANSMD501(C)(3)11 - Type ICHItrue
ST JOSEPH REGIONAL HEALTH NETWORK
2500 BERNVILLE ROAD PO BOX 316READINGPA19603231352211HEALTHCAREPA501(C)(3)3CHItrue
ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVENUEPARK RAPIDSMN56470410695603HEALTHCAREMN501(C)(3)3CHItrue
ST JOSEPH'S HOSPITAL AND HEALTH CENTER
30 WEST 7TH STREETDICKINSONND58601450226429HEALTHCAREND501(C)(3)3CHItrue
ST MARY'S HEALTHCARE CENTER
801 EAST SIOUX AVENUEPIERRESD57501460230199HEALTHCARESD501(C)(3)3CHItrue
ST MARY'S HOSPITAL
1314 3RD AVENUENEBRASKA CITYNE68410470443636HEALTHCARENE501(C)(3)3CHI NEBRASKAtrue
ST MARY'S HOSPITAL FOUNDATION
1314 3RD AVENUENEBRASKA CITYNE68410470707604FUNDRAISINGNE501(C)(3)7SMHtrue
ST ROSE AMBULATORY AND SURGERY CENTER FKA CENTRAL KANSAS MEDICAL CENTER
3515 BROADWAYGREAT BENDKS67530480543724SURGERY CNTRKS501(C)(3)3CHItrue
ST VINCENT FOUNDATION
TWO ST VINCENT CIRCLELITTLE ROCKAR72205510169537FUNDRAISINGAR501(C)(3)11 - Type ISVIMCtrue
ST VINCENT INFIRMARY MEDICAL CENTER
2 ST VINCENT CIRCLELITTLE ROCKAR72205710236917HEALTHCAREAR501(C)(3)3CHItrue
ST VINCENT MEDICAL GROUP
2 ST VINCENT CIRCLELITTLE ROCKAR72205710830696HEALTHCAREAR501(C)(3)9SVIMCtrue
THE COMMUNITY LIMITED CARE DIALYSIS CENTER
619 OAK STREET ACCOUNTING-3 WCINCINNATIOH45206237419853DIALYSISOH501(C)(2)N/AGSHtrue
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH
619 OAK STREET ACCOUNTING-3 WCINCINNATIOH45206310537486HEALTHCAREOH501(C)(3)3TRI-HEALTHtrue
THE MERCY HOSPITAL OF DEVILS LAKE FDN
1031 EAST SEVENTH STREETDEVILS LAKEND58301352367360FUNDRAISINGND501(C)(3)11 - Type IMHDLtrue
THE PHYSICIAN NETWORK
8055 O STREET SUITE 300LINCOLNNE68510470780857PHYS PRACTICENE501(C)(3)11 - Type ICHI NEBRASKAtrue
TOTAL HEALTHCARE
PO BOX 7021COLORADO SPRINGSCO80933840927232HEALTHCARECO501(C)(3)3CHI COLORADOtrue
UNITY FAMILY HEALTHCARE
815 2ND STREET SELITTLE FALLSMN56345410721642HEALTHCAREMN501(C)(3)3CHItrue
VILLA NAZARETH INC
801 PAGE DRIVEFARGOND58103450226714LT CAREND501(C)(3)9CHItrue
VISITING NURSE ASSOCIATION OF SAINT CLARE'S
191 WOODPORT ROADSPARTANJ07871221768334HOME HEALTHNJ501(C)(3)9SCHStrue

Form990 Schedule R Part III Form990ScheduleRPartIII (20 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
AUDUBON LAND COMPANY LLC
5390 N ACADEMY BLVD SUITE 300COLORADO SPRINGSCO80918841513085REAL ESTATECOTHCRELATED-15767314390550false$0false0.501
AVANTAS LLC
1207 SOUTH 13 STREETOMAHANE68108392045003HEALTHCARENEAHMHUNRELATEDfalsefalse0.95
BERYWOOD OFFICE PROPERTIES LLC
400 BERYWOOD TRAILCLEVELANDTN37312621875199PHYS OFFICETNMHCSRELATEDfalsetrue0.63
BLUEGRASS REGIONAL IMAGING CENTER
1218 SOUTH BROADWAY SUITE 310LEXINGTONKY40504611386736DIAGNOSTICKYSJ HOSPITAL LEXRELATEDfalsefalse0.65
CENTRAL NEBRASKA HOME CARE SERVICES
PO BOX 1146-4510 SECOND AVENUEKEARNEYNE68848470692112HEALTHCARE SRVCNEHSE INCRELATED-999411021498false-$48,712true1
CENTRAL NEBRASKA REHAB SERVICE
3004 W FAIDLEY AVEGRAND ISLANDNE68802810653461PHYSICAL THERAPYNECHIRELATED18579912262775false$0false0.51
CHI OPERATING INVESTMENT PROGRAM LP
198 INVERNESS DRIVE WESTENGLEWOODCO80112470727942INVESTMENTSCOCHIUNRELATED1396798052069974790false$371,292true1
HEALTHCARE SUPPORT SERVICES
PO BOX 9804GRAND ISLANDNE68802721546196LAUNDRYNECHIRELATED1961243913481false-$58,436false1
NORTH RIVER SURGERY CENTER LLC
2209 WILDWOOD AVENUESHERWOODAR72120710799771AMBUL SURG CTRARSVIMCRELATED1983131758688false$0false0.5745
ORTHOCOLORADO LLC
11650 WEST 2ND PLACELAKEWOODCO80255371577105ORTHO HOSPITALCOTHCRELATED-324931410905384false$0false0.6
PENINSULA RADIATION ONCOLOGY
314 MARTIN LUTHER KING JR WAY 11TACOMAWA98405870808610HEALTHCARE SRVCWAFHSRELATED1311953052504false$0false0.6
PENRAD IMAGING
1139 KELLY JOHNSON BLVDCOLORADO SPRINGSCO80920841072619MEDICAL IMAGINGCOTHCRELATED18572285457224false$0false0.7
RUXTON SURGICENTER LLC
8322 BELLONA AVENUE SUITE 201BALTIMOREMD21204522095835SURGERY CENTERMDSJMCRELATEDfalsetrue0.51
SAINT JOSEPH - SCA HOLDINGS LLC
424 LEWIS HARGETT CIRCLE STE 160LEXINGTONKY40503453801157OP SURGERYDESJHSRELATED00false$0false0.51
ST ANTHONY REGIONAL MTN CANCER CENTER
4231 W 16TH AVENUEDENVERCO80112371568013CANCER CENTERCOTHCRELATED-2905520false$0false0.51
ST FRANCIS LAND COMPANY
5390 N ACADEMY BLVD SUITE 300COLORADO SPRINGSCO80918263134100REAL ESTATECOTHCRELATED-18097914886022false$0false0.51
ST FRANCIS MEDICAL CENTER ASSOCIATES
1717 SOUTH J STREETTACOMAWA98405911352698MED. OFFICEWAFHSRELATED1169481652280false$0false0.54
ST JOSEPH-PAML LLC
424 LEWIS HARGETT CIRCLE STE 160LEXINGTONKY40503452116736MGMT SERVICESKYSJHSRELATED00false$0true0.625
SUPERIOR MEDICAL IMAGING LLC
5000 NORTH 26TH STREETLINCOLNNE68521262884555OP DIAGNOSTICSNESERMCRELATEDfalsefalse0.51
SURGERY CENTER OF LEXINGTON LLC
1451 HARRODSBURG ROADLEXINGTONKY40504621179539SURGERY CENTERDESJHSRELATED8088404236901false$0false0.51

Form990 Schedule R Part IV Form990ScheduleRPartIV (45 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
ALTERNATIVE INSURANCE MANAGEMENT SERVICES
3900 OLYMPIC BOULEVARD SUITE 400ERLANGERKY41018841112049MANAGEMENT SERVICESCOCHIC CORPORATION032674411
AMERICAN NURSING CARE
1700 EDISON DRIVEMILFORDOH45150311085414HOME HEALTHOHCHSC CORPORATION1778617444703581
AMERIMED INC
1700 EDISON DRIVEMILFORDOH45150311158699HOME HEALTHOHANCC CORPORATION2395230118696571
CADUCEUS MEDICAL ASSOCIATES INC
6028 SHALLOWFORD ROAD SUITE DCHATTANOOGATN37422621570736HEALTHCARETNMHCSC CORPORATION010081
CAPTIVE MANAGEMENT INITIATIVES
980663022CAPTIVE MANAGEMENTCHIC CORPORATION001PO BOX 10073 APOGEORGETOWNGEORGETOWN, GRAND CAYMANCJKY1-1001CJ
CENTER FOR TRANSLATIONAL RESEARCH
198 INVERNESS DRIVE WESTENGLEWOODCO80112272269511HEALTHCARECOCHIC CORPORATION-224796216685891
CENTRAL KANSAS HEALTH SERVICES ASSOCIATION
3515 BROADWAYGREAT BENDKS67530481042853MEDICAL EQUIPMENTKSCKMCC CORPORATION001
CGH REALTY COMPANY INC
215 N 12TH STREADINGPA19603232326801REAL ESTATEPASJHMC CORPORATION1007424151
COMCARE SERVICES
4231 W 16TH AVENUEDENVERCO80204840904813INACTIVECOCHICC CORPORATION001
CONSOLIDATED HEALTH SERVICES
1700 EDISON DRIVEMILFORDOH45150311378212HOME HEALTHOHCHIC CORPORATION0115951251
DAVID DEYLE CHARITABLE REMAINDER UNITRUST
PO BOX 1810KEARNEYNE68848476192395INVESTMENTSNEGSHFTRUST48801664251
DES MOINES MEDICAL CENTER INC
1111 6TH AVENUEDES MOINESIA50314420837382REAL ESTATEIACHI-IA CORPC CORPORATION012534520.9298
FIRST INITIATIVES INSURANCE LTD
980203038INSURANCECHIC CORPORATION001PO BOX 10073 APOGEORGETOWNGEORGETOWN, GRAND CAYMANCJKY1-1001CJ
FRANCISCAN SERVICES INC
198 INVERNESS DRIVE WESTENGLEWOODCO80112232487967HEALTHCARECOCHIC CORPORATION-507578119142841
GOOD SAMARITAN OUTREACH SERVICES
PO BOX 1990KEARNEYNE68848470659440MEDICAL CLINICNECHI NEBRASKAC CORPORATION-29210633551101
HAROLD W RASE 1995 CHARITABLE UNITRUST
30 WEST 7TH STREETDICKINSONND58601456090420INVESTMENTSNDSJHHCTRUST1240215531
HAROLD W RASE 1996 CHARITABLE UNITRUST
30 WEST 7TH STREETDICKINSONND58601206037112INVESTMENTSNDSJHHCTRUST900154951
HAROLD W RASE 1997 CHARITABLE UNITRUST
30 WEST 7TH STREETDICKINSONND58601206037104INVESTMENTSNDSJHHCTRUST1025202611
HAROLD W RASE 1999 CHARITABLE UNITRUST
30 WEST 7TH STREETDICKINSONND58601206037099INVESTMENTSNDSJHHCTRUST1313250271
HEALTH SYSTEMS ENTERPRISES INC
PO BOX 1990KEARNEYNE68848470664558MANAGEMENTNEGSHC CORPORATION2528914430491
HEALTHCARE MGMT SERVICES ORG INC
1149 MARKET STTACOMAWA98402911865474HEALTH ORG.WAFHSC CORPORATION001
JAMES & HENRIETTA NISTLER UNITRUST
30 WEST 7TH STREETDICKINSONND58601206021899INVESTMENTSNDSJHHCTRUST-16708414551
JEANNE DEYLE CHARITABLE REMAINDER UNITRUST
PO BOX 1810KEARNEYNE68848476192398INVESTMENTSNEGSHFTRUST48801663201
JOSEPH A SCHUSTER ANNUITY TRUST #1
400 UNIVERSITY AVENUEDES MOINESIA50314421195122INVESTMENTSIAMFDMTRUST189244414881
LODESCA MILLER CHARITABLE REMAINDER UNITRUST
PO BOX 1810KEARNEYNE68848476186933INVESTMENTSNEGSHFTRUST3387863671
MEDQUEST
1301 15TH AVENUE WESTWILLISTONND58801450392137SALE OF DMENDMH OF WILLISTONC CORPORATION98529625541
MERCY HEALTH SERVICES CORPORATION
2727 MCCLELLAND BLVDJOPLINMO64804431457881DMEMOST JOHN'S RMCC CORPORATION-153337113690831
MERCY PARK APARTMENTS LTD
1111 6TH AVENUEDES MOINESIA50314421202422HOUSINGIACHI-IA CORPC CORPORATION26448917960531
MERCY SERVICES CORP
2700 STEWART PARKWAYROSEBURGOR97470930824308RETAIL SALESORMMCC CORPORATION-6902679547981
MOUNTAIN MANAGEMENT SERVICES INC
6028D SHALLOWFORD ROADCHATTANOOGATN37422621570739MGMT SVC ORGTNMHCSC CORPORATION-38602046679981
NAZARETH ASSURANCE COMPANY
76 ST PAUL STREET SUITE 500BURLINGTONVT05401030304831INSURANCEVTCHIC CORPORATION-3791235351
PATIENT TRANSPORT SERVICES INC
1700 EDISON DRIVEMILFORDOH45150311100798HOME HEALTHOHANCC CORPORATION66242553259411
PHYSICIAN HEALTH SYSTEM NETWORK
1149 MARKET STTACOMAWA98402911746721HEALTH ORG.WAFHSC CORPORATION001
RAY & SHIRLEY DAVID 1999 UNITRUST
30 WEST 7TH STREETDICKINSONND58601206037077INVESTMENTSNDSJHHCTRUST1250241941
ROBERT & WANDA CHARITABLE REMAINDER UNITRUST
PO BOX 1810KEARNEYNE68848266191916INVESTMENTSNEGSHFTRUST130305377751
SAINT CLARE''S PRIMARY CARE INC
66 FORD ROADDENVILLENJ07834222441202BILLING SERVICESNJSCCCC CORPORATION-34297021771661
SAMARITAN FAMILY CARE INC
40 W FOURTH ST 1700DAYTONOH45402311299450HEALTHCAREOHSHPC CORPORATION1
SJH SERVICES CORPORATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112232307408HEALTHCARECOFSIC CORPORATION-51836031801001
SJL PHYSICIAN MANAGEMENT SERVICES INC
424 LEWIS HARGETT CR 160LEXINGTONKY40503270164198MANAGEMENTKYSJHSC CORPORATION001
ST ANTHONY DEVELOPMENT COMPANY
1415 SOUTHGATEPENDLETONOR97801931216943ATHLETIC CLUBORST ANTHONY HC CORPORATION5389130075541
ST VINCENT COMMUNITY HEALTH SERVICES INC
TWO ST VINCENT CIRCLELITTLE ROCKAR72205710710785HEALTHCAREARSVIMCC CORPORATION2309129140493751
ST JOSEPH DEVELOPMENT COMPANY
1717 SOUTH J STREETTACOMAWA98405911480569RENTALWAFSIC CORPORATION-36395121680221
ST JOSEPH OFFICE PARK ASSOCIATION
1401 HARRODSBURG ROAD BLDG B70LEXINGTONKY40504611079899MANAGEMENTKYSJHSC CORPORATION166448821390.85
TOM DEYLE CHARITABLE REMAINDER UNITRUST
PO BOX 1810KEARNEYNE68848476192393INVESTMENTSNEGSHFTRUST48841663211
TOWSON MANAGEMENT INC
7601 OSLER DRIVETOWSONMD21204521710750MANAGEMENT SERVICESMDFSIC CORPORATION-4690164983931
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MERCY FOUNDATION OF DES MOINES IA
C103023FMV
CHI-IOWA CORP
C752964FMV
CHI-IOWA CORP
O71765FMV
CATHOLIC HEALTH INITIATIVES
L192052FMV
CATHOLIC HEALTH INITIATIVES
O228640FMV
CATHOLIC HEALTH INITIATIVES
Q217632FMV