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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-10T14:00:21-05:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CATHOLIC HEALTH INITIATIVES | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 198 INVERNESS DRIVE WEST | AddressLine1 |
| City | ENGLEWOOD | City |
| State | CO | State |
| ZIP Code | 80112 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420680308 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEDICAL CENTER - CENTERVILLE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MERC | NameControl |
| Phone | 5154373413 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 St Josephs Drive | AddressLine1 |
| City | Centerville | City |
| State | IA | State |
| ZIP Code | 52544 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STEVE KUKLA | Name |
| Title | SR VP & CFO | Title |
| Date Signed | 2012-05-10 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7208741500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Name Of Principal Officer Business NameOfPrincipalOfficerBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLINT CHRISTIANSON | BusinessNameLine1 |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 St Josephs Drive | AddressLine1 |
| City | Centerville | City |
| State | IA | State |
| ZIP Code | 52544 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 26832287 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MERCYCENTERVILLE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1965 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | MERCY 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 Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 303 | TotalNbrEmployees |
| Total Nbr Volunteers | 11 | TotalNbrVolunteers |
| Total Gross UBI | 502 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 929790 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 916315 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 24743241 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 25249567 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 302196 | InvestmentIncomePriorYear |
| Investment Income Current Year | 545736 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 153270 | OtherRevenuePriorYear |
| Other Revenue Current Year | 120669 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 26128497 | TotalRevenuePriorYear |
| Total Revenue Current Year | 26832287 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 18725 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 13846 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 13286621 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12908069 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 12156 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 11922892 | OtherExpensePriorYear |
| Other Expenses Current Year | 11439638 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 25228238 | TotalExpensesPriorYear |
| Total Expenses Current Year | 24361553 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 900259 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2470734 | RevenuesLessExpensesCY |
| Total Assets BOY | 18911256 | TotalAssetsBOY |
| Total Assets EOY | 20619452 | TotalAssetsEOY |
| Total Liabilities BOY | 4039867 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2621621 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 14871389 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 17997831 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE 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 Services | false | SignificantNewProgramServices |
| Significant Change | true | SignificantChange |
| Expense | 22627800 | Expense |
| Grants | 13846 | Grants |
| Revenue | 25249567 | Revenue |
| Description | SEE SCHEDULE H. | Description |
| Total Program Service Expense | 22627800 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | true | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 303 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Randall L Rubin | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5156437860 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 6th Avenue | AddressLine1 |
| City | Des Moines | City |
| State | IA | State |
| ZIP Code | 50314 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| BILL BUSS | |||||||
| DIRECTOR | 1 | X | 0 | 0 | 0 | ||
| CLINTON CHRISTIANSON | |||||||
| CEO | 40 | X | 200751 | 0 | 17173 | X | |
| MADELINE CUMMINS | |||||||
| DIRECTOR | 1 | X | 0 | 0 | 0 | ||
| LEANNE DROBNICH | |||||||
| VICE CHAIR | 1 | X | 0 | 300904 | 37969 | X | |
| DAVID FRASER | |||||||
| DIRECTOR/PHYSICIAN | 40 | X | 247220 | 0 | 18715 | ||
| DAVID HOWE | |||||||
| DIRECTOR | 1 | X | 0 | 0 | 0 | ||
| DR KATHY LANGE | |||||||
| DIRECTOR | 1 | X | 0 | 0 | 0 | ||
| JOSEPH LEVALLEY | |||||||
| DIRECTOR/SVP MMC DSM | 1 | X | 0 | 389431 | 45136 | ||
| ROBERT PONTIUS | |||||||
| CHAIRMAN | 1 | X | 0 | 0 | 0 | X | |
| DR PAUL PONCY | |||||||
| DIRECTOR | 1 | X | 0 | 0 | 0 | ||
| MARLENE SPROUSE | |||||||
| DIRECTOR | 1 | X | 0 | 0 | 0 | ||
| SR CAMILLA VERRET RSM | |||||||
| DIRECTOR | 1 | X | 0 | 0 | 0 | ||
| LORI RATHBUN | |||||||
| VP OPERATIONS/TREASURER | 40 | 113682 | 0 | 26889 | X | ||
| MIKE CRAVER | |||||||
| DIRECTOR | 1 | X | 0 | 0 | 0 | ||
| SR JEANNE CHRISTENSEN RSM | |||||||
| DIRECTOR | 1 | X | 0 | 0 | 0 | ||
| ERICA COLLINS | |||||||
| PHYSICIAN | 40 | 230723 | 0 | 28249 | X | ||
| NANCY BARTON | |||||||
| PHYSICIAN | 40 | 143626 | 34250 | 24075 | X | ||
| JAMES MCCONVILLE | |||||||
| PHYSICIAN | 40 | 147251 | 0 | 10034 | X | ||
| BETA HAMON | |||||||
| PHYSICIAN | 40 | 109640 | 0 | 23359 | X | ||
| JEFFREY WILLIER | |||||||
| DIRECTOR OF PHARMACY | 40 | 106315 | 0 | 26935 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1299208 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 724585 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 258534 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EMCARE PHYSICIAN SERVICES | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7032 COLLECTION DRIVE | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60693 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | PHYSICIAN SERVICES | DescriptionOfServices |
| Compensation | 1433035 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Related Organizations | 855987 | RelatedOrganizations |
| Government Grants | 59828 | GovernmentGrants |
| All Other Contributions | 500 | AllOtherContributions |
| Total Contributions | 916315 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICES | 900099 | 25135871 | 25135871 |
| PROGRAM SERVICE REVENUE | 900099 | 85211 | 85211 |
| EMERGENCY MEDICAL SERVICES | 900099 | 28485 | 28485 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 25249567 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 181118 | TotalRevenueColumn |
| Unrelated Business Revenue | 502 | UnrelatedBusinessRevenue |
| Exclusion | $180,616 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 364618 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 364618 | Securities |
| Other | 0 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 364618 | TotalRevenueColumn |
| Exclusion | $364,618 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| CAFETERIA | 722100 | 57941 | $57,941 |
| REIMBURSEMENT OF EXPENSES | 900099 | 36581 | $36,581 |
| MEALS ON WHEELS | 900099 | 18951 | $18,951 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7196 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $7,196 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 120669 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 26832287 | TotalRevenueColumn |
| Related Or Exempt Function Income | 25249567 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 502 | UnrelatedBusinessRevenue |
| Exclusion | $665,903 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13846 | Total |
| Program Services | 13846 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 606840 | Total |
| Program Services | 260064 | ProgramServices |
| Management And General | 334620 | ManagementAndGeneral |
| Fundraising | 12156 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9415742 | Total |
| Program Services | 9221044 | ProgramServices |
| Management And General | 194698 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 551037 | Total |
| Program Services | 523963 | ProgramServices |
| Management And General | 27074 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1610585 | Total |
| Program Services | 1593180 | ProgramServices |
| Management And General | 17405 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 723865 | Total |
| Program Services | 689576 | ProgramServices |
| Management And General | 34289 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2627811 | Total |
| Program Services | 2458983 | ProgramServices |
| Management And General | 168828 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3872991 | Total |
| Program Services | 3780031 | ProgramServices |
| Management And General | 92960 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 608795 | Total |
| Program Services | 608795 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74223 | Total |
| Program Services | 65554 | ProgramServices |
| Management And General | 8669 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2296 | Total |
| Program Services | 859 | ProgramServices |
| Management And General | 1437 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 69709 | Total |
| Program Services | 69709 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 752964 | Total |
| Management And General | 752964 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 656343 | Total |
| Program Services | 650690 | ProgramServices |
| Management And General | 5653 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 171608 | Total |
| Program Services | 171608 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 1941266 | 1941266 | |
| REPAIRS AND MAINTENANCE | 481703 | 460590 | 21113 |
| EDUCATION | 36819 | 29817 | 7002 |
| DUES & SUBSCRIPTIONS | 41521 | 19643 | 21878 |
| OTHER EXPENSES | 101589 | 68582 | 33007 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24361553 | Total |
| Program Services | 22627800 | ProgramServices |
| Management And General | 1721597 | ManagementAndGeneral |
| Fundraising | 12156 | Fundraising |
Total Joint Costs TotalJointCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 650 | BOY |
| EOY | 783 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3523412 | BOY |
| EOY | 1706715 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3971310 | BOY |
| EOY | 3104812 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 332952 | BOY |
| EOY | 367915 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 140415 | BOY |
| EOY | 176419 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 16404352 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 11679629 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5090138 | BOY |
| EOY | 4724723 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5852379 | BOY |
| EOY | 10538085 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18911256 | BOY |
| EOY | 20619452 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2136028 | BOY |
| EOY | 1250424 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1903839 | BOY |
| EOY | 1371197 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4039867 | BOY |
| EOY | 2621621 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14871389 | BOY |
| EOY | 17997831 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14871389 | BOY |
| EOY | 17997831 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18911256 | BOY |
| EOY | 20619452 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2470734 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 655708 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $3,456 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 3456 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | GRANTS PAID FOR LOBBYING | Identifier |
| Return Reference | SCHEDULE C, PART II-B | ReturnReference |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 160349 | OtherCostOrOtherBasis |
| Book Value | 160349 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10346583 | OtherCostOrOtherBasis |
| Depreciation | 7025130 | Depreciation |
| Book Value | 3321453 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5512083 | OtherCostOrOtherBasis |
| Depreciation | 4366356 | Depreciation |
| Book Value | 1145727 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 385337 | OtherCostOrOtherBasis |
| Depreciation | 288143 | Depreciation |
| Book Value | 97194 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4724723 | TotalOfBookValueLandBuildings |
Financial Derivatives FinancialDerivatives
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
Closely Held Equity Interests CloselyHeldEquityInterests
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| CHI OIP - FIXED INCOME | 5066638 | F |
| CHI OIP - EQUITY SECURITIES | 5471447 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 10538085 | TotalOfBookValueSecurities |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CHI DEBT PROGRAM | Description |
| Amount | $1,371,197 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1371197 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FIN 48 (ASC 740) footnote | Identifier |
| Return Reference | Schedule D, Part X, Line 2 | ReturnReference |
| Explanation | MERCY 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | false | FPGReferenceFreeCare |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 187964 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 187964 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00840 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 187964 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 187964 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00840 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 12 | NumberOfActivitiesOrPrograms |
| Persons Served | 27649 | PersonsServed |
| Total Community Benefit Expense | 33049 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 250 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 32799 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 106 | PersonsServed |
| Total Community Benefit Expense | 943 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 943 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 33115 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 33115 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 19 | NumberOfActivitiesOrPrograms |
| Persons Served | 27755 | PersonsServed |
| Total Community Benefit Expense | 67107 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 250 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 66857 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00300 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 19 | NumberOfActivitiesOrPrograms |
| Persons Served | 27755 | PersonsServed |
| Total Community Benefit Expense | 255071 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 250 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 254821 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01140 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 7343 | PersonsServed |
| Total Community Building Expense | 68625 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 18362 | DirectOffsettingRevenue |
| Net Community Building Expense | 50263 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00210 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 25 | PersonsServed |
| Total Community Building Expense | 604 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 604 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 7368 | PersonsServed |
| Total Community Building Expense | 69229 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 18362 | DirectOffsettingRevenue |
| Net Community Building Expense | 50867 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00210 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $883,082 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 8761921 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 9133179 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -371258 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEDICAL CENTER - CENTERVILLE | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE ST JOSEPHS DRIVE | AddressLine1 |
| City | CENTERVILLE | City |
| State | IA | State |
| ZIP Code | 52544 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEDICAL CENTER - CENTERVILLE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY CENTERVILLE LONGTERM CARE FACILITY | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE ST JOSEPHS DRIVE | AddressLine1 |
| City | CENTERVILLE | City |
| State | IA | State |
| ZIP Code | 52544 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | NURSING HOME | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Eligibility criteria for free or discounted care | Schedule H, Part I, Line 3c | IF 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 calculation | Schedule H, Part I, Line 7, column(f) | 1,941,266 |
| Costing Methodology used to calculate financial assistance | Schedule H, Part I, Line 7 | PROVIDE 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 footnote | Schedule H, Part III, Line 4 | PROVIDE 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 costs | Schedule H, Part III, Line 8 | DESCRIBE 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 assistance | Schedule H, Part III, Line 9b | IF 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 3 | DESCRIBE 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 system | Schedule H, Part VI, Line 6 | IF 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 report | Schedule H, Part VI, Line 7 | IA |
| NEEDS ASSESSMENT AND COMMUNITY INFORMATION | SCHEDULE H, PART VI, LINES 1,2,4, AND 5 | NEEDS 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 INFORMATION | SCHEDULE 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RATHBUN LAKE AREA YMCA | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 708 S MAIN STREET | AddressLine1 |
| City | CENTERVILLE | City |
| State | IA | State |
| ZIP Code | 52544 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 262927214 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 10000 | AmountOfCashGrant |
| Amount Of Non Cash Assistance | 0 | AmountOfNonCashAssistance |
| Method Of Valuation | N/A | MethodOfValuation |
| Description Of Non Cash Assistance | N/A | DescriptionOfNonCashAssistance |
| Purpose Of Grant | COMMUNITY SUPPORT | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedures for monitoring use of grant funds | Identifier |
| Return Reference | Schedule I, Part I, Line 2 | ReturnReference |
| Explanation | ALL OF OUR GRANTS ARE MADE TO 501(C)(3) ORGANIZATIONS TO ENSURE THE GRANTS ARE USED FOR CHARITABLE PURPOSES. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CLINTON CHRISTIANSON | |||||||||||||
| 160178 | 0 | 19645 | 0 | 20928 | 0 | 14978 | 0 | 2195 | 0 | 217924 | 0 | 0 | 0 |
| LEANNE DROBNICH | |||||||||||||
| 0 | 209154 | 0 | 58496 | 0 | 33254 | 0 | 30833 | 0 | 7136 | 0 | 338873 | 0 | 0 |
| DAVID FRASER | |||||||||||||
| 221624 | 0 | 23486 | 0 | 2110 | 0 | 6227 | 0 | 12488 | 0 | 265935 | 0 | 0 | 0 |
| JOSEPH LEVALLEY | |||||||||||||
| 0 | 280844 | 0 | 75457 | 0 | 33130 | 0 | 25128 | 0 | 20008 | 0 | 434567 | 0 | 0 |
| ERICA COLLINS | |||||||||||||
| 218019 | 0 | 10902 | 0 | 1802 | 0 | 21113 | 0 | 7136 | 0 | 258972 | 0 | 0 | 0 |
| NANCY BARTON | |||||||||||||
| 127013 | 0 | 15323 | 0 | 1290 | 34250 | 5731 | 0 | 18344 | 0 | 167701 | 34250 | 0 | 0 |
| JAMES MCCONVILLE | |||||||||||||
| 129676 | 0 | 14898 | 0 | 2677 | 0 | 3560 | 0 | 6474 | 0 | 157285 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Non-fixed payments | Schedule J, Part I, Line 7 | THE 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 PAYMENTS | SCHEDULE J, PART I, LINE 4A | POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR CATHOLIC HEALTH INITIATIVES ("CHI") AND RELATED ORGANIZATIONS' EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE, INCLUDING THE MBO CEOS. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2010 CALENDAR YEAR. |
| SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN | SCHEDULE J, PART I, LINE 4B | DURING 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)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Significant changes in program services | Form 990, Part III, Line 3 | DURING 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 stockholders | Form 990, Part VI, Section A, Line 6 | THE 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 body | Form 990, Part VI, Section A, Line 7a | THE 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 stockholders | Form 990, Part VI, Section A, Line 7b | THE 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 body | Form 990, Part VI, Section B, Line 11a | THE 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 policy | Form 990, Part VI, Section B, Line 12c | ALL 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 official | Form 990, Part VI, Section B, Line 15a | THE 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 employees | Form 990, Part VI, Section B, Line 15b | THE 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 Disclosure | Form 990, Part VI, Section C, Line 19 | THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.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 COMMITTEE | FORM 990, PART VI, LINE 1A | THE 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 ORGANIZATIONS | PART VII, SECTION A | COMPENSATION 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 balances | Form 990, Part XI, Line 5 | NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - 655708; |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (124 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| ALEGENT HEALTH - BERGAN MERCY HEALTH SYS | ||||||||||
| 7500 MERCY ROAD | OMAHA | NE | 68124 | 470484764 | HEALTHCARE | NE | 501(C)(3) | 3 | CHI | true |
| ALEGENT HEALTH - MERCY HOSPITAL CORNING | ||||||||||
| PO BOX 368 | CORNING | IA | 50841 | 420782518 | HEALTHCARE | IA | 501(C)(3) | 3 | AHBMHS | true |
| ALVERNA APARTMENTS | ||||||||||
| 300 SE 8TH AVENUE | LITTLE FALLS | MN | 56345 | 411351177 | LTERM CARE | MN | 501(C)(3) | 9 | CHI | true |
| APPLETREE COURT | ||||||||||
| 601 OAK STREET | BRECKENRIDGE | MN | 56520 | 411850500 | SENIOR HOMES | MN | 501(C)(3) | 9 | SFH | true |
| BISHOP DRUMM RETIREMENT CENTER | ||||||||||
| 1111 6TH AVENUE | DES MOINES | IA | 50314 | 420725196 | LTERM CARE | IA | 501(C)(3) | 9 | CHI-IA CORP | true |
| BORNEMANN HEALTHCARE CORPORATION | ||||||||||
| 2500 BERNVILLE RD PO BOX 316 | READING | PA | 19603 | 232187242 | HEALTHCARE | PA | 501(C)(3) | 11 - Type I | CHI | true |
| CARRINGTON HEALTH CENTER | ||||||||||
| 800 NORTH 4TH STREET | CARRINGTON | ND | 58421 | 450227311 | HEALTHCARE | ND | 501(C)(3) | 3 | CHI | true |
| CATHOLIC HEALTH CARE FEDERATION | ||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 208473567 | JURIDIC PERSON | CO | 501(C)(3) | 11 - Type I | CHI | true |
| CATHOLIC HEALTH INITIATIVES | ||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 470617373 | HEALTHCARE | CO | 501(C)(3) | 9 | CHI | true |
| CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION | ||||||||||
| 961 EAST COLORADO AVENUE | COLORADO SPRINGS | CO | 80903 | 840902211 | FUNDRAISING | CO | 501(C)(3) | 7 | CHI COLORADO | true |
| CENTENNIAL MEDICAL GROUP INC | ||||||||||
| 2700 STEWART PARKWAY | ROSEBURG | OR | 97470 | 900433062 | PHYSICIANS | OR | 501(C)(3) | 9 | MMC | true |
| CHI COLORADO | ||||||||||
| 188 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 840405257 | HEALTHCARE | CO | 501(C)(3) | 3 | CHI | true |
| CHI HEALTH CONNECT AT HOME - FARGO | ||||||||||
| 4816 AMBER VALLEY PARKWAY | FARGO | ND | 58104 | 271966847 | HEALTHCARE | ND | 501(C)(3) | 3 | CHI | true |
| CHI INSTITUTE FOR RESEARCH AND INNOVATION | ||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 271050565 | HEALTHCARE | CO | 501(C)(3) | 11 - Type I | CHI | true |
| CHI KENTUCKY INC | ||||||||||
| 3900 OLYMPIC BLVD SUITE 400 | ERLANGER | KY | 41018 | 202741651 | HEALTHCARE | KY | 501(C)(3) | 11 - Type I | CHI | true |
| CHI NATIONAL FOUNDATION | ||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 270930004 | FUNDRAISING | CO | 501(C)(3) | 11 - Type I | CHI | true |
| CHI NATIONAL HOME CARE | ||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 451261716 | HEALTHCARE | CO | 501(C)(3) | 11 - Type I | CHI | true |
| CHI NATIONAL SERVICES | ||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 452532084 | HEALTHCARE | CO | 501(C)(3) | 9 | CHI | true |
| CHI NEBRASKA | ||||||||||
| 555 SOUTH 70TH STREET | LINCOLN | NE | 68510 | 363233121 | HEALTHCARE | NE | 501(C)(3) | 11 - Type I | CHI | true |
| CHI-IOWA CORP | ||||||||||
| 1111 6TH AVENUE | DES MOINES | IA | 50314 | 420680448 | HEALTHCARE | IA | 501(C)(3) | 3 | MHN | true |
| CONTINUING CARE HOSPITAL | ||||||||||
| 150 NORTH EAGLE CREEK DRIVE | LEXINGTON | KY | 40509 | 611400619 | LTACH | KY | 501(C)(3) | 3 | SJHS | true |
| ENUMCLAW REGIONAL HOSPITAL ASSOCIATION | ||||||||||
| 1450 BATTERSBY AVENUE | ENUMCLAW | WA | 98022 | 910715805 | HEALTHCARE | WA | 501(C)(3) | 3 | FHS | true |
| FLAGET HEALTHCARE DBA FLAGET MEMORIAL HOSPITAL | ||||||||||
| 4305 NEW SHEPHERDSVILLE ROAD | BARDSTOWN | KY | 40004 | 611345363 | HEALTHCARE | KY | 501(C)(3) | 3 | CHI | true |
| FLAGET MEMORIAL HOSPITAL FOUNDATION INC | ||||||||||
| 4305 NEW SHEPHERDSVILLE ROAD | BARDSTOWN | KY | 40004 | 562351341 | FUNDRAISING | KY | 501(C)(3) | 11 - Type I | FH | true |
| FRANCISCAN FOUNDATION | ||||||||||
| 1717 SOUTH J STREET | TACOMA | WA | 98405 | 911145592 | FUNDRAISING | WA | 501(C)(3) | 9 | FHS | true |
| FRANCISCAN HEALTH SYSTEM FKA FRANCISCAN HEALTH SYSTEM WEST | ||||||||||
| 1717 SOUTH J STREET | TACOMA | WA | 98405 | 910564491 | HEALTHCARE | WA | 501(C)(3) | 3 | CHI | true |
| FRANCISCAN MEDICAL GROUP | ||||||||||
| 1708 SOUTH YAKIMA AVENUE | TACOMA | WA | 98405 | 911939739 | HEALTHCARE | WA | 501(C)(3) | 9 | FHS | true |
| FRANCISCAN VILLA OF SOUTH MILWAUKEE INC | ||||||||||
| 3601 SOUTH CHICAGO AVENUE | SOUTH MILWAUKEE | WI | 53172 | 391093829 | HEALTHCARE | WI | 501(C)(3) | 9 | CHI | true |
| GETTYSBURG MEDICAL CENTER | ||||||||||
| 606 EAST GARFIELD AVENUE | GETTYSBURG | SD | 57442 | 460234354 | HEALTHCARE | SD | 501(C)(3) | 3 | SMHC | true |
| GLOBAL HEALTH INITIATIVES | ||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 201536108 | MINISTRIES | CO | 501(C)(3) | 11 - Type I | CHI | true |
| GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE | ||||||||||
| 375 DIXMYTH AVE | CINCINNATI | OH | 45220 | 311778403 | EDUCATION | KY | 501(C)(3) | 2 | GHS | true |
| GOOD SAMARITAN FOUNDATION OF CINCINNATI INC | ||||||||||
| 619 OAK STREET ACCOUNTING-3 W | CINCINNATI | OH | 45206 | 311206047 | FUNDRAISING | OH | 501(C)(3) | 11 - Type I | GSH | true |
| GOOD SAMARITAN HOSPITAL | ||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470379755 | HEALTHCARE | NE | 501(C)(3) | 3 | CHI NEBRASKA | true |
| GOOD SAMARITAN HOSPITAL FOUNDATION | ||||||||||
| PO BOX 1810 | KEARNEY | NE | 68848 | 470659443 | FUNDRAISING | NE | 501(C)(3) | 7 | GSH | true |
| HEALTH SET | ||||||||||
| 4200 WEST CONEJOS PLACE 436 | DENVER | CO | 80204 | 841102943 | LOW INC.CARE | CO | 501(C)(3) | 7 | CHI COLORADO | true |
| HEALTHCARE AND WELLNESS FOUNDATION | ||||||||||
| 2400 ST FRANCIS DRIVE | BRECKENRIDGE | MN | 56520 | 760761782 | FUNDRAISING | MN | 501(C)(3) | 11 - Type I | SFMC | true |
| HOSPITAL ASSOCIATION FOR ST JOSEPH HOSPITAL | ||||||||||
| 7601 OSLER DRIVE | TOWSON | MD | 21204 | 526050777 | HEALTHCARE | MD | 501(C)(3) | 9 | SJMC | true |
| HOUSE OF MERCY | ||||||||||
| 1111 6TH AVENUE | DES MOINES | IA | 50314 | 421323808 | SHELTER | IA | 501(C)(3) | 7 | CHI-IA CORP | true |
| LAKEWOOD HEALTH CENTER | ||||||||||
| 600 MAIN AVENUE SOUTH | BAUDETTE | MN | 56623 | 410758434 | LTERM CARE | MN | 501(C)(3) | 3 | CHI | true |
| LINUS OAKES INC | ||||||||||
| 2700 STEWART PARKWAY | ROSEBURG | OR | 97470 | 930821381 | SENIOR LIVING | OR | 501(C)(3) | 9 | MMC | true |
| LISBON AREA HEALTH SERVICES | ||||||||||
| 905 MAIN STREET | LISBON | ND | 58054 | 820558836 | HEALTHCARE | ND | 501(C)(3) | 3 | CHI | true |
| MEMORIAL HEALTH CARE SYSTEM FOUNDATION | ||||||||||
| 2525 DE SALES AVENUE | CHATTANOOGA | TN | 37404 | 621839548 | FUNDRAISING | TN | 501(C)(3) | 7 | MHCS | true |
| MEMORIAL HEALTH CARE SYSTEM INC | ||||||||||
| 2525 DE SALES AVENUE | CHATTANOOGA | TN | 37404 | 620532345 | HEALTHCARE | TN | 501(C)(3) | 3 | CHI | true |
| MEMORIAL HEALTH PARTNERS FOUNDATION INC | ||||||||||
| 6028 SHALLOWFORD ROAD | CHATTANOOGA | TN | 37421 | 030417049 | HEALTHCARE | TN | 501(C)(3) | 9 | MHCS | true |
| MERCY AUXILIARY OF CENTRAL IOWA | ||||||||||
| 1111 6TH AVENUE | DES MOINES | IA | 50314 | 426076069 | AUXILIARY | IA | 501(C)(3) | 11 - Type I | CHI-IA CORP | true |
| MERCY CLINICS INC | ||||||||||
| 1111 6TH AVENUE | DES MOINES | IA | 50314 | 421193699 | PHYSICIAN | IA | 501(C)(3) | 9 | CHI-IA CORP | true |
| MERCY COLLEGE OF HEALTH SCIENCES | ||||||||||
| 1111 6TH AVENUE | DES MOINES | IA | 50314 | 421511682 | EDUCATION | IA | 501(C)(3) | 2 | CHI-IA CORP | true |
| MERCY FOUNDATION OF DES MOINES IA | ||||||||||
| 1111 6TH AVENUE | DES MOINES | IA | 50314 | 237358794 | FUNDRAISING | IA | 501(C)(3) | 7 | CHI-IA CORP | true |
| MERCY FOUNDATION INC | ||||||||||
| 2700 STEWART PARKWAY | ROSEBURG | OR | 97470 | 936088946 | FUNDRAISING | OR | 501(C)(3) | 7 | MMC | true |
| MERCY HEALTH CARE FOUNDATION | ||||||||||
| PO BOX 368 | CORNING | IA | 50841 | 421461064 | FUNDRAISING | NE | 501(C)(3) | 11 - Type I | AHMH | true |
| MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS | ||||||||||
| 800 MERCY DRIVE | COUNCIL BLUFFS | IA | 51503 | 421178204 | FUNDRAISING | IA | 501(C)(3) | 11 - Type I | AHBMHS | true |
| MERCY HOSPITAL OF DEVILS LAKE | ||||||||||
| 1031 EAST SEVENTH STREET | DEVILS LAKE | ND | 58301 | 450227012 | HEALTHCARE | ND | 501(C)(3) | 3 | CHI | true |
| MERCY HOSPITAL OF VALLEY CITY | ||||||||||
| 570 CHAUTAUQUA BOULEVARD | VALLEY CITY | ND | 58072 | 450226553 | HEALTHCARE | ND | 501(C)(3) | 3 | CHI | true |
| MERCY LIFECARE SYSTEMS | ||||||||||
| 2727 MCCLELLAND BLVD | JOPLIN | MO | 64804 | 431305163 | PROPERTY MGMT | MO | 501(C)(3) | 11 - Type I | SJRMC | true |
| MERCY MEDICAL CENTER | ||||||||||
| 1301 15TH AVENUE WEST | WILLISTON | ND | 58801 | 450231183 | HEALTHCARE | ND | 501(C)(3) | 3 | CHI | true |
| MERCY MEDICAL CENTER | ||||||||||
| 2700 STEWART PARKWAY | ROSEBURG | OR | 97470 | 930386868 | HEALTHCARE | OR | 501(C)(3) | 3 | CHI | true |
| MERCY MEDICAL FOUNDATION | ||||||||||
| 1301 15TH AVENUE WEST | WILLISTON | ND | 58801 | 450381803 | FUNDRAISING | ND | 501(C)(3) | 11 - Type I | MMC | true |
| MERCY PROFESSIONAL PRACTICE ASSOCIATES INC | ||||||||||
| 1111 6TH AVENUE | DES MOINES | IA | 50314 | 421470935 | PHYSICIAN | IA | 501(C)(3) | 9 | CHI-IA CORP | true |
| MERCY REGIONAL MEDICAL CENTER OF DURANGO | ||||||||||
| 1010 THREE SPRINGS BLVD | DURANGO | CO | 81301 | 840405515 | HEALTHCARE | CO | 501(C)(3) | 3 | CHI | true |
| MNMCH INC | ||||||||||
| 220 NORTH PENNSYLVANIA | COLUMBUS | KS | 66725 | 481216238 | HEALTHCARE | KS | 501(C)(3) | 3 | SJRMC | true |
| MT ST JOSEPH INC | ||||||||||
| 3060 SE STARK STREET | PORTLAND | OR | 97214 | 930386870 | NURSING CARE | OR | 501(C)(3) | 9 | CHI | true |
| OAKES COMMUNITY HOSPITAL | ||||||||||
| 314 SOUTH 8TH STREET | OAKES | ND | 58474 | 450231675 | HEALTHCARE | ND | 501(C)(3) | 3 | CHI | true |
| OAKES COMMUNITY HOSPITAL FOUNDATION | ||||||||||
| 314 SOUTH 8TH STREET | OAKES | ND | 58474 | 710966606 | FUNDRAISING | ND | 501(C)(3) | 11 - Type I | OCH | true |
| PUEBLO STEPUP | ||||||||||
| 1925 EAST ORMAN AVE SUITE G52 | PUEBLO | CO | 81004 | 841234295 | COMMUNITY | CO | 501(C)(3) | 7 | CHI | true |
| SET OF COLORADO SPRINGS INC | ||||||||||
| 825 E PIKES PEAK AVENUE BLDG 29 | COLORADO SPRINGS | CO | 80903 | 841183335 | LTERM CARE | CO | 501(C)(3) | 7 | CHI COLORADO | true |
| SAINT CLARE'S COMMUNITY CARE | ||||||||||
| 66 FORD ROAD | DENVILLE | NJ | 07834 | 222876836 | HEALTHCARE | NJ | 501(C)(3) | 11 - Type II | SCHS | true |
| SAINT CLARE''S FOUNDATION INC | ||||||||||
| 66 FORD ROAD | DENVILLE | NJ | 07834 | 222502997 | FUNDRAISING | NJ | 501(C)(3) | 7 | SCHS | true |
| SAINT CLARE''S HEALTH SERVICES INC | ||||||||||
| 25 POCONO ROAD | DENVILLE | NJ | 07834 | 223639733 | MANAGEMENT | NJ | 501(C)(3) | 7 | CHI | true |
| SAINT CLARE'S HOSPITAL | ||||||||||
| 66 FORD ROAD | DENVILLE | NJ | 07834 | 223319886 | HEALTHCARE | NJ | 501(C)(3) | 3 | CHI | true |
| SAINT ELIZABETH FOUNDATION | ||||||||||
| 555 SOUTH 70TH STREET | LINCOLN | NE | 68510 | 470625523 | FUNDRAISING | NE | 501(C)(3) | 7 | SERMC | true |
| SAINT ELIZABETH HEALTH SERVICES | ||||||||||
| 555 SOUTH 70TH STREET | LINCOLN | NE | 68510 | 363233120 | HEALTHCARE | NE | 501(C)(3) | 3 | SERMC | true |
| SAINT ELIZABETH REGIONAL MEDICAL CENTER | ||||||||||
| 555 SOUTH 70TH STREET | LINCOLN | NE | 68510 | 470379836 | HEALTHCARE | NE | 501(C)(3) | 3 | CHI NEBRASKA | true |
| SAINT FRANCIS MEDICAL CENTER | ||||||||||
| PO BOX 9804 | GRAND ISLAND | NE | 68802 | 470376601 | HEALTHCARE | NE | 501(C)(3) | 3 | CHI NEBRASKA | true |
| SAINT FRANCIS MEDICAL CENTER FOUNDATION | ||||||||||
| PO BOX 9804 | GRAND ISLAND | NE | 68802 | 470630267 | FUNDRAISING | NE | 501(C)(3) | 7 | SFMC | true |
| SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC | ||||||||||
| 305 ESTILL STREET | BEREA | KY | 40403 | 260152877 | FUNDRAISING | KY | 501(C)(3) | 7 | SJHS | true |
| SAINT JOSEPH HEALTH SYSTEM INC | ||||||||||
| 150 N EAGLE CREEK DR | LEXINGTON | KY | 40509 | 611334601 | HEALTHCARE | KY | 501(C)(3) | 3 | CHI | true |
| SAINT JOSEPH LONDON FOUNDATION INC | ||||||||||
| 310 EAST NINTH STREET | LONDON | KY | 40741 | 260438748 | FUNDRAISING | KY | 501(C)(3) | 11 - Type I | SJHS | true |
| SAINT JOSEPH MEDICAL FOUNDATION INC | ||||||||||
| ONE ST JOSEPH DRIVE | LEXINGTON | KY | 40504 | 311539059 | PHY PRACTICES | KY | 501(C)(3) | 3 | SJHS | true |
| SAINT JOSEPH MOUNT STERLING FOUNDATION INC | ||||||||||
| 50 STERLING AVENUE | MOUNT STERLING | KY | 40353 | 272884584 | FUNDRAISING | KY | 501(C)(3) | 7 | SJHS | true |
| SAINT JOSEPH'S HOSPITAL FOUNDATION | ||||||||||
| 30 WEST 7TH STREET | DICKINSON | ND | 58601 | 363418207 | FUNDRAISING | ND | 501(C)(3) | 11 - Type I | SJHHC | true |
| SAMARITAN BEHAVIORAL HEALTH | ||||||||||
| 601 S EDWIN C MOSES BLVD | DAYTON | OH | 45408 | 020633634 | HEALTHCARE | OH | 501(C)(3) | 3 | SHP | true |
| SAMARITAN HEALTH FOUNDATION | ||||||||||
| 2222 PHILADELPHIA DRIVE | DAYTON | OH | 45406 | 237296923 | FUNDRAISING | OH | 501(C)(3) | 7 | SHP | true |
| SAMARITAN HEALTH PARTNERS | ||||||||||
| 2222 PHILADELPHIA DRIVE | DAYTON | OH | 45406 | 311107411 | HEALTHCARE | OH | 501(C)(3) | 11 - Type I | CHI | true |
| ST JOSEPH HEALTH MINISTRIES | ||||||||||
| 1929 LINCOLN HWY E STE 150 | LANCASTER | PA | 17602 | 232342997 | HEALTH | PA | 501(C)(3) | 11 - Type I | CHI | true |
| ST JOSEPH HEALTH MINISTRIES FOUNDATION | ||||||||||
| 1929 LINCOLN HWY E STE 150 | LANCASTER | PA | 17602 | 232605579 | FUNDRAISING | PA | 501(C)(3) | 11 - Type I | SJHM | true |
| ST ANTHONY HOSPITAL | ||||||||||
| 1601 SE COURT AVENUE | PENDLETON | OR | 97801 | 930391614 | HEALTHCARE | OR | 501(C)(3) | 3 | CHI | true |
| ST ANTHONY HOSPITAL FOUNDATION | ||||||||||
| 1601 SE COURT AVENUE | PENDLETON | OR | 97801 | 930992727 | FUNDRAISING | OR | 501(C)(3) | 11 - Type I | SA HOSPITAL | true |
| ST ANTHONY'S HOSPITAL ASSOCIATION | ||||||||||
| 4 HOSPITAL DRIVE | MORRILTON | AR | 72110 | 710245507 | HEALTHCARE | AR | 501(C)(3) | 3 | SVIMC | true |
| ST CATHERINE HOSPITAL | ||||||||||
| 401 EAST SPRUCE STREET | GARDEN CITY | KS | 67846 | 480543721 | HEALTHCARE | KS | 501(C)(3) | 3 | CHI | true |
| ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION | ||||||||||
| 401 EAST SPRUCE STREET | GARDEN CITY | KS | 67846 | 200598702 | FUNDRAISING | KS | 501(C)(3) | 11 - Type I | SCH | true |
| ST DOMINIC AT ONTARIO | ||||||||||
| 351 SW 9TH STREET | ONTARIO | OR | 97914 | 930433692 | HEALTHCARE | OR | 501(C)(3) | 3 | CHI | true |
| ST FRANCIS HOME | ||||||||||
| 2400 ST FRANCIS DRIVE | BRECKENRIDGE | MN | 56520 | 410729978 | LTERM CARE | MN | 501(C)(3) | 9 | CHI | true |
| ST FRANCIS LIFE CARE CORPORATION | ||||||||||
| 19 POCONO ROAD | DENVILLE | NJ | 07834 | 222536017 | ELDERLY CARE | NJ | 501(C)(3) | 9 | SCHS | true |
| ST FRANCIS MEDICAL CENTER | ||||||||||
| 2400 ST FRANCIS DRIVE | BRECKENRIDGE | MN | 56520 | 410695598 | HEALTHCARE | MN | 501(C)(3) | 3 | CHI | true |
| ST FRANCIS OF BAKER CITY | ||||||||||
| 3325 POCAHONTAS ROAD | BAKER CITY | OR | 97814 | 930412495 | HEALTHCARE | OR | 501(C)(3) | 3 | CHI | true |
| ST JOHN'S MEDICAL GROUP | ||||||||||
| 2727 MCCLELLAND BLVD | JOPLIN | MO | 64804 | 431882377 | PHYS PRACTICE | MO | 501(C)(3) | 9 | SJRMC | true |
| ST JOHN'S MERCY REGIONAL FOUNDATION | ||||||||||
| 2727 MCCLELLAND BLVD | JOPLIN | MO | 64804 | 431308084 | FUNDRAISING | MO | 501(C)(3) | 7 | SJRMC | true |
| ST JOHN'S REGIONAL MEDICAL CENTER | ||||||||||
| 2727 MCCLELLAND BLVD | JOPLIN | MO | 64804 | 440545809 | HEALTHCARE | MO | 501(C)(3) | 3 | CHI | true |
| ST JOSEPH COMMUNITY HEALTH SERVICES | ||||||||||
| 300 CENTRAL AVE SW SUITE 3000W | ALBUQUERQUE | NM | 87102 | 710897107 | COMMUNITY | NM | 501(C)(3) | 11 - Type I | CHI | true |
| ST JOSEPH HEALTH SERVICES INC | ||||||||||
| 1929 LINCOLN HWY E STE 150 | LANCASTER | PA | 17602 | 201425375 | DENTAL CARE | PA | 501(C)(3) | 11 - Type I | SJHM | true |
| ST JOSEPH HOSPITAL FOUNDATION INC | ||||||||||
| ONE ST JOSEPH DRIVE | LEXINGTON | KY | 40504 | 611159649 | FUNDRAISING | KY | 501(C)(3) | 11 - Type I | SJHS | true |
| ST JOSEPH MEDICAL CENTER FOUNDATION | ||||||||||
| 2500 BERNVILLE ROAD PO BOX 316 | READING | PA | 19603 | 232649362 | FUNDRAISING | PA | 501(C)(3) | 11 - Type I | SJRHN | true |
| ST JOSEPH MEDICAL CENTER FOUNDATION INC | ||||||||||
| 7601 OSLER DRIVE | TOWSON | MD | 21204 | 521681044 | FUNDRAISING | MD | 501(C)(3) | 7 | SJMC | true |
| ST JOSEPH MEDICAL CENTER INC | ||||||||||
| 7601 OSLER DRIVE | TOWSON | MD | 21204 | 520591461 | HEALTHCARE | MD | 501(C)(3) | 3 | CHI | true |
| ST JOSEPH MEDICAL GROUP | ||||||||||
| 2500 BERNVILLE ROAD PO BOX 316 | READING | PA | 19603 | 208544021 | HEALTHCARE | PA | 501(C)(3) | 9 | BHC | true |
| ST JOSEPH PHYSICIAN ENTERPRISES | ||||||||||
| 7601 OSLER DRIVE | TOWSON | MD | 21204 | 521311775 | PHYSICIANS | MD | 501(C)(3) | 11 - Type I | CHI | true |
| ST JOSEPH REGIONAL HEALTH NETWORK | ||||||||||
| 2500 BERNVILLE ROAD PO BOX 316 | READING | PA | 19603 | 231352211 | HEALTHCARE | PA | 501(C)(3) | 3 | CHI | true |
| ST JOSEPH'S AREA HEALTH SERVICES | ||||||||||
| 600 PLEASANT AVENUE | PARK RAPIDS | MN | 56470 | 410695603 | HEALTHCARE | MN | 501(C)(3) | 3 | CHI | true |
| ST JOSEPH'S HOSPITAL AND HEALTH CENTER | ||||||||||
| 30 WEST 7TH STREET | DICKINSON | ND | 58601 | 450226429 | HEALTHCARE | ND | 501(C)(3) | 3 | CHI | true |
| ST MARY'S HEALTHCARE CENTER | ||||||||||
| 801 EAST SIOUX AVENUE | PIERRE | SD | 57501 | 460230199 | HEALTHCARE | SD | 501(C)(3) | 3 | CHI | true |
| ST MARY'S HOSPITAL | ||||||||||
| 1314 3RD AVENUE | NEBRASKA CITY | NE | 68410 | 470443636 | HEALTHCARE | NE | 501(C)(3) | 3 | CHI NEBRASKA | true |
| ST MARY'S HOSPITAL FOUNDATION | ||||||||||
| 1314 3RD AVENUE | NEBRASKA CITY | NE | 68410 | 470707604 | FUNDRAISING | NE | 501(C)(3) | 7 | SMH | true |
| ST ROSE AMBULATORY AND SURGERY CENTER FKA CENTRAL KANSAS MEDICAL CENTER | ||||||||||
| 3515 BROADWAY | GREAT BEND | KS | 67530 | 480543724 | SURGERY CNTR | KS | 501(C)(3) | 3 | CHI | true |
| ST VINCENT FOUNDATION | ||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 510169537 | FUNDRAISING | AR | 501(C)(3) | 11 - Type I | SVIMC | true |
| ST VINCENT INFIRMARY MEDICAL CENTER | ||||||||||
| 2 ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 710236917 | HEALTHCARE | AR | 501(C)(3) | 3 | CHI | true |
| ST VINCENT MEDICAL GROUP | ||||||||||
| 2 ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 710830696 | HEALTHCARE | AR | 501(C)(3) | 9 | SVIMC | true |
| THE COMMUNITY LIMITED CARE DIALYSIS CENTER | ||||||||||
| 619 OAK STREET ACCOUNTING-3 W | CINCINNATI | OH | 45206 | 237419853 | DIALYSIS | OH | 501(C)(2) | N/A | GSH | true |
| THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH | ||||||||||
| 619 OAK STREET ACCOUNTING-3 W | CINCINNATI | OH | 45206 | 310537486 | HEALTHCARE | OH | 501(C)(3) | 3 | TRI-HEALTH | true |
| THE MERCY HOSPITAL OF DEVILS LAKE FDN | ||||||||||
| 1031 EAST SEVENTH STREET | DEVILS LAKE | ND | 58301 | 352367360 | FUNDRAISING | ND | 501(C)(3) | 11 - Type I | MHDL | true |
| THE PHYSICIAN NETWORK | ||||||||||
| 8055 O STREET SUITE 300 | LINCOLN | NE | 68510 | 470780857 | PHYS PRACTICE | NE | 501(C)(3) | 11 - Type I | CHI NEBRASKA | true |
| TOTAL HEALTHCARE | ||||||||||
| PO BOX 7021 | COLORADO SPRINGS | CO | 80933 | 840927232 | HEALTHCARE | CO | 501(C)(3) | 3 | CHI COLORADO | true |
| UNITY FAMILY HEALTHCARE | ||||||||||
| 815 2ND STREET SE | LITTLE FALLS | MN | 56345 | 410721642 | HEALTHCARE | MN | 501(C)(3) | 3 | CHI | true |
| VILLA NAZARETH INC | ||||||||||
| 801 PAGE DRIVE | FARGO | ND | 58103 | 450226714 | LT CARE | ND | 501(C)(3) | 9 | CHI | true |
| VISITING NURSE ASSOCIATION OF SAINT CLARE'S | ||||||||||
| 191 WOODPORT ROAD | SPARTA | NJ | 07871 | 221768334 | HOME HEALTH | NJ | 501(C)(3) | 9 | SCHS | true |
Form990 Schedule R Part III Form990ScheduleRPartIII (20 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | Code VCodeVAmount | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AUDUBON LAND COMPANY LLC | ||||||||||||||
| 5390 N ACADEMY BLVD SUITE 300 | COLORADO SPRINGS | CO | 80918 | 841513085 | REAL ESTATE | CO | THC | RELATED | -157673 | 14390550 | false | $0 | false | 0.501 |
| AVANTAS LLC | ||||||||||||||
| 1207 SOUTH 13 STREET | OMAHA | NE | 68108 | 392045003 | HEALTHCARE | NE | AHMH | UNRELATED | false | false | 0.95 | |||
| BERYWOOD OFFICE PROPERTIES LLC | ||||||||||||||
| 400 BERYWOOD TRAIL | CLEVELAND | TN | 37312 | 621875199 | PHYS OFFICE | TN | MHCS | RELATED | false | true | 0.63 | |||
| BLUEGRASS REGIONAL IMAGING CENTER | ||||||||||||||
| 1218 SOUTH BROADWAY SUITE 310 | LEXINGTON | KY | 40504 | 611386736 | DIAGNOSTIC | KY | SJ HOSPITAL LEX | RELATED | false | false | 0.65 | |||
| CENTRAL NEBRASKA HOME CARE SERVICES | ||||||||||||||
| PO BOX 1146-4510 SECOND AVENUE | KEARNEY | NE | 68848 | 470692112 | HEALTHCARE SRVC | NE | HSE INC | RELATED | -99941 | 1021498 | false | -$48,712 | true | 1 |
| CENTRAL NEBRASKA REHAB SERVICE | ||||||||||||||
| 3004 W FAIDLEY AVE | GRAND ISLAND | NE | 68802 | 810653461 | PHYSICAL THERAPY | NE | CHI | RELATED | 1857991 | 2262775 | false | $0 | false | 0.51 |
| CHI OPERATING INVESTMENT PROGRAM LP | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 470727942 | INVESTMENTS | CO | CHI | UNRELATED | 139679805 | 2069974790 | false | $371,292 | true | 1 |
| HEALTHCARE SUPPORT SERVICES | ||||||||||||||
| PO BOX 9804 | GRAND ISLAND | NE | 68802 | 721546196 | LAUNDRY | NE | CHI | RELATED | 196124 | 3913481 | false | -$58,436 | false | 1 |
| NORTH RIVER SURGERY CENTER LLC | ||||||||||||||
| 2209 WILDWOOD AVENUE | SHERWOOD | AR | 72120 | 710799771 | AMBUL SURG CTR | AR | SVIMC | RELATED | 198313 | 1758688 | false | $0 | false | 0.5745 |
| ORTHOCOLORADO LLC | ||||||||||||||
| 11650 WEST 2ND PLACE | LAKEWOOD | CO | 80255 | 371577105 | ORTHO HOSPITAL | CO | THC | RELATED | -3249314 | 10905384 | false | $0 | false | 0.6 |
| PENINSULA RADIATION ONCOLOGY | ||||||||||||||
| 314 MARTIN LUTHER KING JR WAY 11 | TACOMA | WA | 98405 | 870808610 | HEALTHCARE SRVC | WA | FHS | RELATED | 131195 | 3052504 | false | $0 | false | 0.6 |
| PENRAD IMAGING | ||||||||||||||
| 1139 KELLY JOHNSON BLVD | COLORADO SPRINGS | CO | 80920 | 841072619 | MEDICAL IMAGING | CO | THC | RELATED | 1857228 | 5457224 | false | $0 | false | 0.7 |
| RUXTON SURGICENTER LLC | ||||||||||||||
| 8322 BELLONA AVENUE SUITE 201 | BALTIMORE | MD | 21204 | 522095835 | SURGERY CENTER | MD | SJMC | RELATED | false | true | 0.51 | |||
| SAINT JOSEPH - SCA HOLDINGS LLC | ||||||||||||||
| 424 LEWIS HARGETT CIRCLE STE 160 | LEXINGTON | KY | 40503 | 453801157 | OP SURGERY | DE | SJHS | RELATED | 0 | 0 | false | $0 | false | 0.51 |
| ST ANTHONY REGIONAL MTN CANCER CENTER | ||||||||||||||
| 4231 W 16TH AVENUE | DENVER | CO | 80112 | 371568013 | CANCER CENTER | CO | THC | RELATED | -290552 | 0 | false | $0 | false | 0.51 |
| ST FRANCIS LAND COMPANY | ||||||||||||||
| 5390 N ACADEMY BLVD SUITE 300 | COLORADO SPRINGS | CO | 80918 | 263134100 | REAL ESTATE | CO | THC | RELATED | -180979 | 14886022 | false | $0 | false | 0.51 |
| ST FRANCIS MEDICAL CENTER ASSOCIATES | ||||||||||||||
| 1717 SOUTH J STREET | TACOMA | WA | 98405 | 911352698 | MED. OFFICE | WA | FHS | RELATED | 116948 | 1652280 | false | $0 | false | 0.54 |
| ST JOSEPH-PAML LLC | ||||||||||||||
| 424 LEWIS HARGETT CIRCLE STE 160 | LEXINGTON | KY | 40503 | 452116736 | MGMT SERVICES | KY | SJHS | RELATED | 0 | 0 | false | $0 | true | 0.625 |
| SUPERIOR MEDICAL IMAGING LLC | ||||||||||||||
| 5000 NORTH 26TH STREET | LINCOLN | NE | 68521 | 262884555 | OP DIAGNOSTICS | NE | SERMC | RELATED | false | false | 0.51 | |||
| SURGERY CENTER OF LEXINGTON LLC | ||||||||||||||
| 1451 HARRODSBURG ROAD | LEXINGTON | KY | 40504 | 621179539 | SURGERY CENTER | DE | SJHS | RELATED | 808840 | 4236901 | false | $0 | false | 0.51 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (45 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALTERNATIVE INSURANCE MANAGEMENT SERVICES | |||||||||||||||||
| 3900 OLYMPIC BOULEVARD SUITE 400 | ERLANGER | KY | 41018 | 841112049 | MANAGEMENT SERVICES | CO | CHI | C CORPORATION | 0 | 3267441 | 1 | ||||||
| AMERICAN NURSING CARE | |||||||||||||||||
| 1700 EDISON DRIVE | MILFORD | OH | 45150 | 311085414 | HOME HEALTH | OH | CHS | C CORPORATION | 1778617 | 44470358 | 1 | ||||||
| AMERIMED INC | |||||||||||||||||
| 1700 EDISON DRIVE | MILFORD | OH | 45150 | 311158699 | HOME HEALTH | OH | ANC | C CORPORATION | 2395230 | 11869657 | 1 | ||||||
| CADUCEUS MEDICAL ASSOCIATES INC | |||||||||||||||||
| 6028 SHALLOWFORD ROAD SUITE D | CHATTANOOGA | TN | 37422 | 621570736 | HEALTHCARE | TN | MHCS | C CORPORATION | 0 | 1008 | 1 | ||||||
| CAPTIVE MANAGEMENT INITIATIVES | |||||||||||||||||
| 980663022 | CAPTIVE MANAGEMENT | CHI | C CORPORATION | 0 | 0 | 1 | PO BOX 10073 APO | GEORGETOWN | GEORGETOWN, GRAND CAYMAN | CJ | KY1-1001 | CJ | |||||
| CENTER FOR TRANSLATIONAL RESEARCH | |||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 272269511 | HEALTHCARE | CO | CHI | C CORPORATION | -2247962 | 1668589 | 1 | ||||||
| CENTRAL KANSAS HEALTH SERVICES ASSOCIATION | |||||||||||||||||
| 3515 BROADWAY | GREAT BEND | KS | 67530 | 481042853 | MEDICAL EQUIPMENT | KS | CKMC | C CORPORATION | 0 | 0 | 1 | ||||||
| CGH REALTY COMPANY INC | |||||||||||||||||
| 215 N 12TH ST | READING | PA | 19603 | 232326801 | REAL ESTATE | PA | SJHM | C CORPORATION | 1007 | 42415 | 1 | ||||||
| COMCARE SERVICES | |||||||||||||||||
| 4231 W 16TH AVENUE | DENVER | CO | 80204 | 840904813 | INACTIVE | CO | CHIC | C CORPORATION | 0 | 0 | 1 | ||||||
| CONSOLIDATED HEALTH SERVICES | |||||||||||||||||
| 1700 EDISON DRIVE | MILFORD | OH | 45150 | 311378212 | HOME HEALTH | OH | CHI | C CORPORATION | 0 | 11595125 | 1 | ||||||
| DAVID DEYLE CHARITABLE REMAINDER UNITRUST | |||||||||||||||||
| PO BOX 1810 | KEARNEY | NE | 68848 | 476192395 | INVESTMENTS | NE | GSHF | TRUST | 4880 | 166425 | 1 | ||||||
| DES MOINES MEDICAL CENTER INC | |||||||||||||||||
| 1111 6TH AVENUE | DES MOINES | IA | 50314 | 420837382 | REAL ESTATE | IA | CHI-IA CORP | C CORPORATION | 0 | 1253452 | 0.9298 | ||||||
| FIRST INITIATIVES INSURANCE LTD | |||||||||||||||||
| 980203038 | INSURANCE | CHI | C CORPORATION | 0 | 0 | 1 | PO BOX 10073 APO | GEORGETOWN | GEORGETOWN, GRAND CAYMAN | CJ | KY1-1001 | CJ | |||||
| FRANCISCAN SERVICES INC | |||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 232487967 | HEALTHCARE | CO | CHI | C CORPORATION | -507578 | 11914284 | 1 | ||||||
| GOOD SAMARITAN OUTREACH SERVICES | |||||||||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470659440 | MEDICAL CLINIC | NE | CHI NEBRASKA | C CORPORATION | -2921063 | 355110 | 1 | ||||||
| HAROLD W RASE 1995 CHARITABLE UNITRUST | |||||||||||||||||
| 30 WEST 7TH STREET | DICKINSON | ND | 58601 | 456090420 | INVESTMENTS | ND | SJHHC | TRUST | 1240 | 21553 | 1 | ||||||
| HAROLD W RASE 1996 CHARITABLE UNITRUST | |||||||||||||||||
| 30 WEST 7TH STREET | DICKINSON | ND | 58601 | 206037112 | INVESTMENTS | ND | SJHHC | TRUST | 900 | 15495 | 1 | ||||||
| HAROLD W RASE 1997 CHARITABLE UNITRUST | |||||||||||||||||
| 30 WEST 7TH STREET | DICKINSON | ND | 58601 | 206037104 | INVESTMENTS | ND | SJHHC | TRUST | 1025 | 20261 | 1 | ||||||
| HAROLD W RASE 1999 CHARITABLE UNITRUST | |||||||||||||||||
| 30 WEST 7TH STREET | DICKINSON | ND | 58601 | 206037099 | INVESTMENTS | ND | SJHHC | TRUST | 1313 | 25027 | 1 | ||||||
| HEALTH SYSTEMS ENTERPRISES INC | |||||||||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470664558 | MANAGEMENT | NE | GSH | C CORPORATION | 25289 | 1443049 | 1 | ||||||
| HEALTHCARE MGMT SERVICES ORG INC | |||||||||||||||||
| 1149 MARKET ST | TACOMA | WA | 98402 | 911865474 | HEALTH ORG. | WA | FHS | C CORPORATION | 0 | 0 | 1 | ||||||
| JAMES & HENRIETTA NISTLER UNITRUST | |||||||||||||||||
| 30 WEST 7TH STREET | DICKINSON | ND | 58601 | 206021899 | INVESTMENTS | ND | SJHHC | TRUST | -16708 | 41455 | 1 | ||||||
| JEANNE DEYLE CHARITABLE REMAINDER UNITRUST | |||||||||||||||||
| PO BOX 1810 | KEARNEY | NE | 68848 | 476192398 | INVESTMENTS | NE | GSHF | TRUST | 4880 | 166320 | 1 | ||||||
| JOSEPH A SCHUSTER ANNUITY TRUST #1 | |||||||||||||||||
| 400 UNIVERSITY AVENUE | DES MOINES | IA | 50314 | 421195122 | INVESTMENTS | IA | MFDM | TRUST | 18924 | 441488 | 1 | ||||||
| LODESCA MILLER CHARITABLE REMAINDER UNITRUST | |||||||||||||||||
| PO BOX 1810 | KEARNEY | NE | 68848 | 476186933 | INVESTMENTS | NE | GSHF | TRUST | 3387 | 86367 | 1 | ||||||
| MEDQUEST | |||||||||||||||||
| 1301 15TH AVENUE WEST | WILLISTON | ND | 58801 | 450392137 | SALE OF DME | ND | MH OF WILLISTON | C CORPORATION | 9852 | 962554 | 1 | ||||||
| MERCY HEALTH SERVICES CORPORATION | |||||||||||||||||
| 2727 MCCLELLAND BLVD | JOPLIN | MO | 64804 | 431457881 | DME | MO | ST JOHN'S RMC | C CORPORATION | -1533371 | 1369083 | 1 | ||||||
| MERCY PARK APARTMENTS LTD | |||||||||||||||||
| 1111 6TH AVENUE | DES MOINES | IA | 50314 | 421202422 | HOUSING | IA | CHI-IA CORP | C CORPORATION | 264489 | 1796053 | 1 | ||||||
| MERCY SERVICES CORP | |||||||||||||||||
| 2700 STEWART PARKWAY | ROSEBURG | OR | 97470 | 930824308 | RETAIL SALES | OR | MMC | C CORPORATION | -690267 | 954798 | 1 | ||||||
| MOUNTAIN MANAGEMENT SERVICES INC | |||||||||||||||||
| 6028D SHALLOWFORD ROAD | CHATTANOOGA | TN | 37422 | 621570739 | MGMT SVC ORG | TN | MHCS | C CORPORATION | -386020 | 4667998 | 1 | ||||||
| NAZARETH ASSURANCE COMPANY | |||||||||||||||||
| 76 ST PAUL STREET SUITE 500 | BURLINGTON | VT | 05401 | 030304831 | INSURANCE | VT | CHI | C CORPORATION | -379 | 123535 | 1 | ||||||
| PATIENT TRANSPORT SERVICES INC | |||||||||||||||||
| 1700 EDISON DRIVE | MILFORD | OH | 45150 | 311100798 | HOME HEALTH | OH | ANC | C CORPORATION | 662425 | 5325941 | 1 | ||||||
| PHYSICIAN HEALTH SYSTEM NETWORK | |||||||||||||||||
| 1149 MARKET ST | TACOMA | WA | 98402 | 911746721 | HEALTH ORG. | WA | FHS | C CORPORATION | 0 | 0 | 1 | ||||||
| RAY & SHIRLEY DAVID 1999 UNITRUST | |||||||||||||||||
| 30 WEST 7TH STREET | DICKINSON | ND | 58601 | 206037077 | INVESTMENTS | ND | SJHHC | TRUST | 1250 | 24194 | 1 | ||||||
| ROBERT & WANDA CHARITABLE REMAINDER UNITRUST | |||||||||||||||||
| PO BOX 1810 | KEARNEY | NE | 68848 | 266191916 | INVESTMENTS | NE | GSHF | TRUST | 13030 | 537775 | 1 | ||||||
| SAINT CLARE''S PRIMARY CARE INC | |||||||||||||||||
| 66 FORD ROAD | DENVILLE | NJ | 07834 | 222441202 | BILLING SERVICES | NJ | SCCC | C CORPORATION | -342970 | 2177166 | 1 | ||||||
| SAMARITAN FAMILY CARE INC | |||||||||||||||||
| 40 W FOURTH ST 1700 | DAYTON | OH | 45402 | 311299450 | HEALTHCARE | OH | SHP | C CORPORATION | 1 | ||||||||
| SJH SERVICES CORPORATION | |||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 232307408 | HEALTHCARE | CO | FSI | C CORPORATION | -518360 | 3180100 | 1 | ||||||
| SJL PHYSICIAN MANAGEMENT SERVICES INC | |||||||||||||||||
| 424 LEWIS HARGETT CR 160 | LEXINGTON | KY | 40503 | 270164198 | MANAGEMENT | KY | SJHS | C CORPORATION | 0 | 0 | 1 | ||||||
| ST ANTHONY DEVELOPMENT COMPANY | |||||||||||||||||
| 1415 SOUTHGATE | PENDLETON | OR | 97801 | 931216943 | ATHLETIC CLUB | OR | ST ANTHONY H | C CORPORATION | 53891 | 3007554 | 1 | ||||||
| ST VINCENT COMMUNITY HEALTH SERVICES INC | |||||||||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 710710785 | HEALTHCARE | AR | SVIMC | C CORPORATION | 2309129 | 14049375 | 1 | ||||||
| ST JOSEPH DEVELOPMENT COMPANY | |||||||||||||||||
| 1717 SOUTH J STREET | TACOMA | WA | 98405 | 911480569 | RENTAL | WA | FSI | C CORPORATION | -36395 | 12168022 | 1 | ||||||
| ST JOSEPH OFFICE PARK ASSOCIATION | |||||||||||||||||
| 1401 HARRODSBURG ROAD BLDG B70 | LEXINGTON | KY | 40504 | 611079899 | MANAGEMENT | KY | SJHS | C CORPORATION | 16644 | 882139 | 0.85 | ||||||
| TOM DEYLE CHARITABLE REMAINDER UNITRUST | |||||||||||||||||
| PO BOX 1810 | KEARNEY | NE | 68848 | 476192393 | INVESTMENTS | NE | GSHF | TRUST | 4884 | 166321 | 1 | ||||||
| TOWSON MANAGEMENT INC | |||||||||||||||||
| 7601 OSLER DRIVE | TOWSON | MD | 21204 | 521710750 | MANAGEMENT SERVICES | MD | FSI | C CORPORATION | -469016 | 498393 | 1 | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MERCY FOUNDATION OF DES MOINES IA | ||
| C | 103023 | FMV |
| CHI-IOWA CORP | ||
| C | 752964 | FMV |
| CHI-IOWA CORP | ||
| O | 71765 | FMV |
| CATHOLIC HEALTH INITIATIVES | ||
| L | 192052 | FMV |
| CATHOLIC HEALTH INITIATIVES | ||
| O | 228640 | FMV |
| CATHOLIC HEALTH INITIATIVES | ||
| Q | 217632 | FMV |