MERCY MEDICAL CENTER: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- MERCY MEDICAL CENTER (EIN 45-0231183)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-05
- IRS object ID
- 201141259349301609
- Schema version
- 2009v1.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-05T16:37:42-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | 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 | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450231183 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mercy Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MERC | NameControl |
| Phone | 7017747400 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 15th Ave W | AddressLine1 |
| City | Williston | City |
| State | ND | State |
| ZIP Code | 58801 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kerry Monson | Name |
| Title | CFO | Title |
| Phone | 7017747408 | Phone |
| Date Signed | 2011-05-04 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7208741500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Matt Grimshaw CEO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | same as C above | AddressLine1 |
| City | Williston | City |
| State | ND | State |
| ZIP Code | 58801 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 49539472 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c | X | Organization501c |
| Web Site | www.mercy-williston.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1920 | YearFormation |
| State Legal Domicile | ND | StateLegalDomicile |
| Activity Or Mission Description | Mercy Medical Center is a CAH serving a large geographical area. Community benefits include: Uncompensated Care; Medical Education & Awareness; Support Services; and Community Outreach. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 532 | TotalNbrEmployees |
| Total Nbr Volunteers | 100 | TotalNbrVolunteers |
| Total Gross UBI | 63227 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -4775 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 341912 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1564912 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 42176738 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 46402444 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -263735 | InvestmentIncomePriorYear |
| Investment Income Current Year | 513636 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1652804 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1056251 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 43907719 | TotalRevenuePriorYear |
| Total Revenue Current Year | 49537243 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 17980 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 17587 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 21544635 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 24156162 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 21509398 | OtherExpensePriorYear |
| Other Expenses Current Year | 21372017 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 43072013 | TotalExpensesPriorYear |
| Total Expenses Current Year | 45545766 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 835706 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3991477 | RevenuesLessExpensesCY |
| Total Assets BOY | 30228268 | TotalAssetsBOY |
| Total Assets EOY | 32041745 | TotalAssetsEOY |
| Total Liabilities BOY | 9257695 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 6545222 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 20970573 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 25496523 | NetAssetsOrFundBalancesEOY |
| 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 | 40230089 | Expense |
| Grants | 17587 | Grants |
| Revenue | 46402444 | Revenue |
| Description | SEE SCHEDULE H | Description |
| Total Program Service Expense | 40230089 | 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 |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| 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 |
| 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 | true | 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 |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 49 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 532 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| 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 |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | 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 | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | ND | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Kerry Monson | NamePerson |
| Telephone Number | 7017747408 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 15th Ave W | AddressLine1 |
| City | Williston | City |
| State | ND | State |
| ZIP Code | 58801 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Judy Barbot | |||||||
| Board Member | 1.0 | X | |||||
| David Brendsel | |||||||
| Board Member | 1.0 | X | |||||
| JEFFREY DROP | |||||||
| SVP DIVISION OFFICER | 1.0 | X | 529578 | 69940 | |||
| Laurie Furuseth | |||||||
| Chair | 1.0 | X | X | ||||
| DENNIS GOEBEL | |||||||
| PRESIDENT CEO | 40.0 | X | 208898 | 32526 | X | ||
| MATTHEW GRIMSHAW | |||||||
| PRESIDENT CEO | 40.0 | X | X | ||||
| Robert Kemp | |||||||
| Board Member | 40.0 | X | 36941 | 288477 | |||
| Sr Marie Micheletto | |||||||
| Board Member | 1.0 | X | |||||
| Craig Oksol | |||||||
| Vice Chair | 1.0 | X | X | ||||
| Steve Oyloe | |||||||
| Board member | 1.0 | X | |||||
| Patrick Sogard | |||||||
| Board Member | 1.0 | X | |||||
| Nancy Hoffelt | |||||||
| BOARD MEMBER | 1.0 | X | |||||
| Kerry Monson | |||||||
| CFO/VP of Finance | 40.0 | 22882 | X | 158916 | |||
| Carol LaTurno | |||||||
| Interim CFO | 40.0 | X | |||||
| Tami Solberg | |||||||
| VP of Patient Care | 40.0 | 26262 | X | 135841 | |||
| Michael Boulter | |||||||
| ER Physician | 40.0 | 9339 | 586441 | X | |||
| Morris Bellis | |||||||
| ENT Physician | 40.0 | 29093 | 384625 | X | |||
| David Brown | |||||||
| Anesthesiologist | 40.0 | 28573 | 336266 | X | |||
| David Skurdal | |||||||
| Physician | 40.0 | 31357 | 417430 | X | |||
| Brett Vibeto | |||||||
| General Surgeon | 40.0 | 26016 | 435955 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2743951 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 738476 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 312929 | TotalOtherCompensation |
| Number Individuals GT100 K | 16 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Penny Wilkie | |||||
| 2640 E Divide Ave | Bismarck | ND | 58501 | ER Physician | 194300 |
| Keith Zahn | |||||
| 4972 140th Ave NW | Williston | ND | 58801 | CRNA | 194925 |
| Billings Clinic | |||||
| PO Box 31315 | Billings | MT | 591071315 | Oncology MD's | 185554 |
| Paul Olson | |||||
| 1551 Cook Drive | Minot | ND | 587016866 | ER Physician | 172558 |
| Advanced Diagnostic Radiology | |||||
| PO Box 373 | Tetonia | ID | 83452 | Radiologist | 153517 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| Related Organizations | 1273355 | RelatedOrganizations |
| All Other Contributions | 291557 | AllOtherContributions |
| Total Contributions | 1564912 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Net patient services | 900099 | 46083797 | 46083797 |
| Rental Income | 900099 | 296896 | 296896 |
| Rehab Services Revenue | 621400 | 21751 | 21751 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 46402444 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 249903 | TotalRevenueColumn |
| Unrelated Business Revenue | 25 | UnrelatedBusinessRevenue |
| Exclusion | $249,878 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 260162 | Securities |
| Other | 5800 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2229 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 260162 | Securities |
| Other | 3571 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 263733 | TotalRevenueColumn |
| Exclusion | $263,733 | 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 |
|---|---|---|---|
| Laboratory Services | 621500 | 622195 | $622,195 |
| Cafeteria | 722100 | 115804 | $115,804 |
| Intercompany Transactions | 900099 | 83060 | $83,060 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 235192 | TotalRevenueColumn |
| Unrelated Business Revenue | 63202 | UnrelatedBusinessRevenue |
| Exclusion | $171,981 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1056251 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 49537243 | TotalRevenueColumn |
| Related Or Exempt Function Income | 46402444 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 63227 | UnrelatedBusinessRevenue |
| Exclusion | $1,506,651 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17587 | Total |
| Program Services | 17587 | 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 | 668236 | Total |
| Program Services | 468905 | ProgramServices |
| Management And General | 199331 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19197263 | Total |
| Program Services | 17267604 | ProgramServices |
| Management And General | 1929659 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 976610 | Total |
| Program Services | 901026 | ProgramServices |
| Management And General | 75584 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2058100 | Total |
| Program Services | 1856600 | ProgramServices |
| Management And General | 201500 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1255953 | Total |
| Program Services | 1130358 | ProgramServices |
| Management And General | 125595 | 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 | 447 | Total |
| Management And General | 447 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 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 | 6297510 | Total |
| Program Services | 5348394 | ProgramServices |
| Management And General | 949116 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7148439 | Total |
| Program Services | 6991723 | ProgramServices |
| Management And General | 156716 | 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 | 686206 | Total |
| Program Services | 652888 | ProgramServices |
| Management And General | 33318 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 233040 | Total |
| Program Services | 190692 | ProgramServices |
| Management And General | 42348 | 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 | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 171339 | Total |
| Program Services | 171339 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 933183 | Total |
| Management And General | 933183 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1544330 | Total |
| Program Services | 1491254 | ProgramServices |
| Management And General | 53076 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 609188 | Total |
| Program Services | 151774 | ProgramServices |
| Management And General | 457414 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| INCOME/SALES/PROPERTY TAXES | 39516 | 39516 | |
| Bad Debts | 2634152 | 2634152 | |
| Recruitment and relocation | 454444 | 454444 | |
| Repairs and maintenance | 221622 | 214889 | 6733 |
| Impairment Losses | 76584 | 76584 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 322017 | Total |
| Program Services | 170360 | ProgramServices |
| Management And General | 151657 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45545766 | Total |
| Program Services | 40230089 | ProgramServices |
| Management And General | 5315677 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3480 | BOY |
| EOY | 2709 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 227 | BOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6420772 | BOY |
| EOY | 6759185 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39812 | BOY |
| EOY | 21654 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 786400 | BOY |
| EOY | 726169 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 960096 | BOY |
| EOY | 953699 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39744 | BOY |
| EOY | 46644 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 44836161 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 32059086 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13359350 | BOY |
| EOY | 12777075 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7723469 | BOY |
| EOY | 8352518 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 894918 | BOY |
| EOY | 2402092 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30228268 | BOY |
| EOY | 32041745 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5059438 | BOY |
| EOY | 3963782 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4198257 | BOY |
| EOY | 2581440 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9257695 | BOY |
| EOY | 6545222 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20435428 | BOY |
| EOY | 23454204 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 535145 | BOY |
| EOY | 2042319 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20970573 | BOY |
| EOY | 25496523 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30228268 | BOY |
| EOY | 32041745 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | false | FederalGrantAuditRequired |
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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $2,010 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 2010 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | 990 Sch C Supplemental | Identifier |
| Return Reference | Lobbying Activities Explanation | ReturnReference |
| Explanation | 5.76% of the $17,719 dues paid to ND Hospital Association are used for lobbying. The entity's controlling organization, Catholic Health Initiatives, pays annual dues to the American Hospital Association (AHA) and Catholic Hospital Association (CHA), a portion of which is allocated to lobbying. The amount shown on line 1f represents this entity's share of allocated lobbying expenses. ND Hospital Association - $1021, AHA - $576, and CHA - $413 | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 328028 | OtherCostOrOtherBasis |
| Book Value | 328028 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 27171179 | OtherCostOrOtherBasis |
| Depreciation | 18656866 | Depreciation |
| Book Value | 8514313 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 384131 | OtherCostOrOtherBasis |
| Depreciation | 366901 | Depreciation |
| Book Value | 17230 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 16952823 | OtherCostOrOtherBasis |
| Depreciation | 13035319 | Depreciation |
| Book Value | 3917504 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 12777075 | TotalOfBookValueLandBuildings |
| Financial Derivatives | FinancialDerivatives | |
| Closely Held Equity Interests | CloselyHeldEquityInterests |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| CHI OIP - Fixed Income | 4351247 | F |
| CHI OIP - Equity Securities | 4001271 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 8352518 | TotalOfBookValueSecurities |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INVESTMENT IN UNCONS ORGS | Description |
| Book Value | 2402092 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2402092 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INTERCOMPANY PAYABLE -CHI DEBT PROGRAM | Description |
| Amount | $2,581,440 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2581440 | TotalOfAmounts |
| Total Revenue | 49537243 | TotalRevenue |
| Total Expenses | 45545766 | TotalExpenses |
| Excess Or Deficit For Year | 3991477 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 577000 | NetUnrealizedGLOnInvestments |
| Other | -$42,527 | OtherAmount |
| Total Adjustments | 534473 | TotalAdjustments |
| Excess Or Deficit Per FS | 4525950 | ExcessOrDeficitPerFS |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Other Changes in Net Assets | SCH. D, PART XI, LN 8: | LINE 8 OTHER: CAPITAL RESOURCE POOL - ($92,952) CHI CONNECT DEPRECIATION - $50,425 TOTAL -($42,527) |
| REPORTING OF LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740 | SCH. D, PART XIV | Mercy Medical Center's financial information is included in the consolidated audited financial statements of Catholic Health Initiatives (CHI), a related organization. CHI's FIN 48 footnote for the year ended June 30, 2010 reads as follows: "CHI is a tax-exempt Colorado corporation and has been granted an exemption from federal income tax under Section 501(c)(3) of the Internal Revenue Code. CHI owns certain taxable subsidiaries and engages in certain activities that are unrelated to its exempt purpose and therefore subject to income tax. Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the consolidated financial statements." |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | false | FPGReferenceFreeCare |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1683 | PersonsServed |
| Total Community Benefit Expense | 1100707 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1100707 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02560 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 8182 | PersonsServed |
| Total Community Benefit Expense | 1100707 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1100707 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02560 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 27 | NumberOfActivitiesOrPrograms |
| Persons Served | 20199 | PersonsServed |
| Total Community Benefit Expense | 502204 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 35132 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 467072 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01090 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 90 | PersonsServed |
| Total Community Benefit Expense | 143906 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 143906 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00340 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Persons Served | 1264 | PersonsServed |
| Total Community Benefit Expense | 174637 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13970 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 160667 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00370 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 16 | NumberOfActivitiesOrPrograms |
| Persons Served | 11320 | PersonsServed |
| Total Community Benefit Expense | 217179 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 217179 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00510 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 56 | NumberOfActivitiesOrPrograms |
| Persons Served | 32873 | PersonsServed |
| Total Community Benefit Expense | 1037926 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 49102 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 988824 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02310 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 56 | NumberOfActivitiesOrPrograms |
| Persons Served | 41055 | PersonsServed |
| Total Community Benefit Expense | 2138633 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 49102 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2089531 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04870 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 3300 | PersonsServed |
| Total Community Building Expense | 26081 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 26081 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 176 | PersonsServed |
| Total Community Building Expense | 12528 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 12528 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 24 | PersonsServed |
| Total Community Building Expense | 1424 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1424 | NetCommunityBuildingExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 166 | PersonsServed |
| Total Community Building Expense | 3200 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3200 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 38 | PersonsServed |
| Total Community Building Expense | 313500 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 313500 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00730 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 12 | NumberOfActivitiesOrPrograms |
| Persons Served | 3704 | PersonsServed |
| Total Community Building Expense | 356733 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 356733 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00830 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $2,634,152 | BadDebtExpenseAmount |
| Amount Attributable To | 316098 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 10388026 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 10473119 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -85093 | 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 |
Form990 Schedule H Part V Form990ScheduleHPartV (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|
| Mercy Medical Center | ||||||||
| 1301 15th Ave W | Williston | ND | 58801 | X | X | X | X | OP Clinics (Psych, Family Practice, Gen Ortho) |
| Mercy Medical Center- Home Health | ||||||||
| 1301 15th Ave W | Williston | ND | 58801 | Home Health Agency Licensed in ND | ||||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | If applicable, describe the income-based criteria for determining eligibility for free or discounted care under the organization's charity care policy. Also describe whether the organization uses the asset test or other threshold regardless of income to determine eligibility for free or discounted care. When Catholic Health Initiatives (the ultimate parent organization to Mercy Medical Center) established its charity care 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. In comparing HUD guidelines to the Federal Poverty Guidelines ("FPG"), we find that on average HUD guidelines compute to approximately 200% to 250% (and sometimes 300%) of FPG. Mercy Medical Center bases its charity care eligibility on HUD's 130% of Very Low Income Guidelines based on geography, and affords the uninsured and underinsured the ability to obtain charity care write-offs, based on a sliding scale, ranging from 25%-100% of charges. An individual's income under the HUD guidelines is a significant factor in determining eligibility for charity care. 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. | IncomeBasedCriteria |
| Annual Community Benefit Expln | If the organization's community benefit report is contained in a report prepared by a related organization, rather than a separate report prepared by the organization, identify the related organization. Mercy Medical Center prepares its own annual written community benefit report. Its community benefit report is not contained in that of a related organization. | AnnualCommunityBenefitExpln |
| Costing Method Used | 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). 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. A cost accounting system was not used to compute amounts in the table; rather costs in the table were computed using the organization's cost-to-charge ratio. The cost-to-charge ratio covers all patient segments. The cost-to-charge ratio for the year ended 6/30/10 was computed using the following formula: Operating expense (before restructuring, impairment and other losses) divided by gross patient revenue. Based on that formula, $45,545,766 / $76,975,763 results in a 59.17% cost-to-charge ratio. Worksheet 2 was not used to derive the cost-to-charge ratio. | CostingMethodUsed |
| Subsidized Health Services Expln | To the extent that an organization includes any costs associated with physician clinics as subsidized health services in Part I, line 7g it must describe that it has done so and report in Part VI such costs included in part I, line 7g, line 1 There are no physician clinics included in subsidized health services. | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | If applicable, state the bad debt expense included on Form 990 Part IX, line 25, column (A) but subtracted for purposes of calculating the percentage in this column. Note: Column F is supposed to be "net community benefit expense" in column (e) divided by the sum of "total functional expenses" on Form 990, Part IX, line 25, column A (less bad debt expense), and the organizations proportionate share of total expenses of all joint ventures for which it reports expenses on the table on part 1. Total bad debt expense reported on Form 990 Part IX, line 25, Column A was $ 2,634,152. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | 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. 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 charity care policy, if sufficient information has been available to make a determination as to their eligibility. 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. Costing methodology for amounts reported on line 2 is determined using the organization's cost/charge ratio of 59.17%. When discounts are extended to self-pay patients, these patient account discounts are recorded as a reduction in revenue, not as bad debt expense. Mercy Medical Center 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 does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of Catholic Health Initiatives. The consolidated footnote reads as follows: "The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators. Management periodically 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." | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Section B, Line 8 (A) 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. (B) 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. (A) Mercy Medical Center is designated as a Critical Access Hospital ("CAH"). CAHs are rural community hospitals that are certified to receive cost-based reimbursement from Medicare. The reimbursement that CAHs receive is intended to improve their financial performance and thereby reduce hospital closures. CAHs are certified under a different set of Medicare Conditions of Participation (CoP). Shortfalls are created when a facility receives payments that are less than the costs of caring for program beneficiaries. Because shortfalls are based on costs, not charges, and Mercy Medical Center, due to their designation as a CAH, received cost-based reimbursement for Medicare purposes, Mercy Medical Center will not experience Medicare related shortfalls. (B) However Mercy Medical Center and its affiliates, believe 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. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | 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 charity care or 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's debt collection policy provides that Mercy Medical Center ("MMC") 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 MMC'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 MMC community assistance policy is required to be returned immediately by the third-party collection agent to MMC for appropriate follow-up. Mercy Medical Center 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. | DebtCollectionPolicy |
| Number Of Facility Type Expln | List the number of each type of facility, other than those required to be licensed, registered or similarly recognized as a health care facility under state law (for example, 2 rehabilitation clinics, 4 diagnostic centers, 3 skilled nursing facilities, etc) 1 Home Health Facility | NumberOfFacilityTypeExpln |
| Needs Assessment | Describe how the organization assesses the health care needs of the communities it serves. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves. Describe how the organization's community building activities, as reported in Part II, promote the health of the communities the organization serves. Provide any other information important to describing how the organization's hospitals or other health care facilities further its exempt purpose by promoting 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 (MMC), Williston, ND, is a sole community hospital, which transitioned to a Critical Access Hospital (CAH) effective September 20, 2008. The roots of MMC originated in Dublin, Ireland, where Catherine McAuley established the Sisters of Mercy in 1831. Catherine's mission was to give back to the community by providing for the needs of the poor. In order to bring healthcare to western North Dakota, the Sisters of Mercy founded Mercy Hospital in 1920. Since then, MMC has continued the legacy of giving back to the communities it serves and carrying on the mission of providing for those in need. In 1974, Mercy Hospital moved to its current location at 1301 15th Avenue West. Along with the move came new changes and an expansion of services. Today, MMC is composed of: 1) provider-based clinics, including the Craven-Hagan Clinic providing family practice, along with general, orthopedic and ENT surgery, and outpatient Behavioral Health Services, 2) a wide variety of outpatient services including the Leonard P. Nelson Family Cancer Treatment Center, and Mercy Recovery Center chemical dependency unit. MMC provides healthcare for a region with a population of approximately 50,000 and provides employment for nearly 450 people. In 1996 MMC and all of its service lines became a part of the Catholic Health Initiatives (CHI) system. MMC and CHI continue the essential healthcare commitment of its founding congregations: To build healthy communities by caring for the vulnerable; caring for the whole person in body, mind and spirit; and going outside the walls of its facilities to care for people in need. In 2008 MMC transitioned to a Critical Access Hospital (CAH) operating under a 25-bed limit. This transition helped reverse a negative operating margin recorded for 3 consecutive years. In November of 2009, Mercy Medical Center launched a $5 million capital campaign "Cancer Care Close to Home", which is well underway. To date, $1.9 million has been raised, of which Mercy employees proudly committed to donating $275,000 in support of the campaign. The campaign funds will be used to advance the Leonard P. Nelson Cancer Treatment Center. The upgrades will accommodate the steady increase in patient volumes, due to an aging population and will include the purchase of a new linear accelerator which will provide enhanced treatment technology delivering greater precision and results. The mission of MMC and CHI 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. Our Core Values are: Reverence: Profound respect and awe of all of creation, the foundation that shapes spirituality, our relationships with others and our journey to God. Integrity: Moral wholeness, soundness, fidelity, trust, truthfulness in all we do. Compassion: Solidarity with one another, capacity to enter into another's joy and sorrow. Excellence: Preeminent performance, becoming the benchmark putting forth our personal and professional best. Our Vision is to live up to our name as One CHI: Catholic: Living our Mission and Core Values Health: Improving the health of the people and communities we serve Initiatives: Pioneering models and systems of care to enhance care delivery It is MMC's goal to hold true to our Core Values of Reverence, Integrity, Compassion, and Excellence, and in doing so we strive to partner with regional organizations, agencies, and entities to provide community benefits so that together we can build a healthier community. The following report outlines the community benefits and services MMC has provided to the region this past year. As a non-profit Catholic healthcare organization, we treat patients regardless of their ability to pay. This is consistent with our Mission and Core Values. In addition, MMC provides thousands of dollars in resources, including time and contributions, to many organizations throughout the region. Community service has been a vital component of MMC since its inception. MMC operates a 24-hour emergency room 365 days per year. That emergency room is open to all individuals regardless of their ability to pay. Mercy has an open medical staff, participates in Medicare and Medicaid, and has an active charity care program. MMC is included in the Official Catholic Directory as a tax-exempt hospital. COMMUNITY BENEFIT APPROACH Throughout its history MMC has been intimately involved in community health collaboration and has played a key role in evaluating area health issues, setting priorities and plans for improvement. Mercy continues our deep commitment and involvement in the community health collaborative today. Process Mercy Medical Center's Community Benefit Plan is based on our understanding of unique community needs derived from collaborative needs assessments, focus groups, and surveys conducted with our community partners. It is generally recognized that the health of the community is not the responsibility of any one entity, but rather requires the coordinated efforts of many entities - public and private - to realize an improved health status of a community. MMC has been working with public and private entities in our service area to measure and improve the health status of the community. The most recent assessment, completed in 2004, reflects the compilation and analysis of extensive data sources to identify issues having a significant impact on the health and general well being of area residents. Information relating to community health issues were gathered from four focus groups. There were 32 participants including nine consumer representatives, six health care providers, ten business and industry representatives, and seven clergy and religious leaders. Focus group participants were asked to identify those segments of the community that do not have ready access to health care services; the types of services they have difficulty accessing; the root causes behind these access issues; and gaps in the services that could be addressed to better meet these access needs. Summary of Assessment Findings All four of the groups had individuals that expressed gratitude for the hospital and primary care services that are available through Mercy Medical Center and its physicians. They believed that existing access-to-care issues can be improved through community collaboration. Most participants remarked that access to health care in Williston is not an overwhelming problem, but one that is certainly challenged by the community's remote location in western North Dakota. Nine key factors having the greatest impact on the overall wellness of the area emerged in the review: Ready Access to Primary Care, Ready Access to Specialty Care, Ready Access to Quality Care, Availability and Cost of Health Insurance, Denial of Care, Charity Care, Access to Affordable Prescription Drugs, Access to Home Care, Adult Day Care, Assisted Living and Transportation, and Access to Adequate Parenting and Appropriate Home Care. Our next assessment is scheduled to begin early in 2011. Uncompensated Care for the Poor During the fiscal year ending June 30, 2010, MMC provided benefits to the poor in our community of $2,089,531 as indicated above. Approximately 41,055 people benefited from these services. As a non-profit healthcare facility, Mercy provides healthcare services to all those in need, regardless of their ability to pay. MMC recognizes the variance between its cost and reimbursement for services provided when quantifying its charity care benefit. For fiscal year 2010, MMC provided $1,100,707 in discounts to the uninsured and underinsured. QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT Community Outreach for the Poor Mercy Rider Program The Mercy Rider Program began operations in 1990 as a program to assist women and children with transportation to doctor's appointments. Since then, it has grown into a program that assists those with very low income, which includes adults and children, disabled, and the elderly. This program provides much needed transportation assistance in the community for individuals who would otherwise have significant challenges relating to essential transportation. Indi | NeedsAssessment |
| Patient Education Assistance | 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 charity care policy. Mercy Medical Center includes information concerning its financial assistance policy on its website. In addition, MMC prominently displays its charity care 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 MMC outpatient facilities. In addition, Mercy Medical Center 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 MMC's charity care 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 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. MMC'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. | PatientEducationAssistance |
| Community Information | Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves. Please refer to the Needs Assessment Narrative, Part VI, Item 2. above. | CommunityInformation |
| Community Building Activities | Describe how the organization's community building activities, as reported in Part II, promote the health of the communities the organization serves. Please refer to the Needs Assessment Narrative, Part VI, Item 2. above. | CommunityBuildingActivities |
| Other Information | Provide any other information important to describing how the organization's hospitals or other health care facilities further its exempt purpose by promoting health of the community (e.g. open medical staff, community board, use of surplus funds, etc). Please refer to the Needs Assessment Narrative, Part VI, Item 2. above. | OtherInformation |
| Affiliated Health Care System | 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, 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; and two community health-services organizations. Together, these facilities provided $590 million in charity care and community benefit in the 2010 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. Cost savings associated with centralized services for the fiscal year ended June 30, 2010 include more than $105 million in supply chain expense, approximately $30 million for insurance costs and more than $3.9 million as the result of a system-wide effort to coordinate and negotiate technology and equipment purchases. 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 operates with its wholly owned affiliates and community partners, along with its fundraising arm, the Mercy Medical Foundation, to serve the health care needs of the Williston, ND communities. | AffiliatedHealthCareSystem |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
| No Grant More Than5000 | X | NoGrantMoreThan5000 |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedures for monitoring the use of grants | Identifier |
| Return Reference | Schedule I Part I Q2 | ReturnReference |
| Explanation | Grants/Donations are given as needed to organizations in the local area. The amounts given are reviewed by the Foundation Director. A record of all grants/donations is kept and monitored year to year. No grant is more than $5,000. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 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 (10 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Michael Boulter | |||||||||||
| 565537 | 15360 | 5544 | 9339 | 595780 | |||||||
| Morris Bellis | |||||||||||
| 359996 | 19481 | 5148 | 29093 | 413718 | |||||||
| David Brown | |||||||||||
| 328905 | 7361 | 28573 | 364839 | ||||||||
| JEFFREY DROP | |||||||||||
| 348817 | 96464 | 84297 | 25583 | 44357 | 599518 | ||||||
| DENNIS GOEBEL | |||||||||||
| 164875 | 44024 | 32526 | 241424 | 20016 | |||||||
| Robert Kemp | |||||||||||
| 104271 | 183634 | 572 | 36941 | 325418 | |||||||
| Kerry Monson | |||||||||||
| 133041 | 25601 | 274 | 22882 | 181798 | |||||||
| Tami Solberg | |||||||||||
| 113546 | 22021 | 274 | 26262 | 162103 | |||||||
| David Skurdal | |||||||||||
| 389806 | 22080 | 5544 | 31357 | 448787 | |||||||
| Brett Vibeto | |||||||||||
| 414115 | 21084 | 756 | 26016 | 461971 | |||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| METHODS USED TO ESTABLISH CEO/EXECUTIVE DIRECTOR COMPENSATION | Sch J Part I Q 3 | Compensation for the top management official was established and paid by Catholic Health Initiatives, a related organization. CHI used the following methods to establish the top management official's compensation: (1) Compensation committee; (2) independent compensation consultant; (3) written employment contracts; (4) compensation survey or study; (5) approval by the board or compensation committee. |
| Post-Termination Payments | Sch J Part I Q 4a | Post-termination payments are addressed in executive employment agreements for CHI 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 agreements are periodically reviewed for overall reasonableness in light of the executives overall compensation package. For the calendar year 2009, Dennis Goebel, former CEO, received a severance payment of $12,967.23 from Catholic Health Initiatives. The severance payment was included in the individuals' reportable compensation for Schedule J. |
| Supplemental Nonqualified Compensation | Sch J Part I Q 4b | DURING THE 2009 CALENDAR YEAR, CHI MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR SENIOR VICE PRESIDENTS AND ABOVE, INCLUDING MBO CEOs. THE FOLLOWING REPORTABLE INDIVIDUAL WAS ELIGIBLE TO PARTICIPATE AND RECEIVED THE FOLLOWING CONTRIBUTIONS TO THE NON-QUALIFIED PLAN FOR THE 2009 CALENDAR YEAR: JEFFREY DROP- $25,583 THE FOLLOWING INDIVIDUAL RECEIVED PAYMENTS FROM THE SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN DURING THE 2009 CALENDAR YEAR, AND THE FOLLOWING AMOUNTS WERE INCLUDED IN THE INDIVIDUALS' REPORTABLE COMPENSATION FOR SHCEDULE J: DENNIS GOEBEL- $20,016 |
| Incentive Compensation | Sch J Part I Q 7 | Mercy Medical Center maintains a variable pay plan for employees at the level of Manager and above (except for physicians) that puts a certain amount of compensation at risk. Awards of incentive compensation under the variable pay plan are made based upon achievement of organizational objectives including performance in relation to budget, and achievement of individual goals. All compensation, including any incentive compensation, is capped to ensure that compensation remains at Fair Market Value. Physician incentive compensation is based on RVUs. The value of a WRVU, is determined with reference to the most recent MGMA data, and is derived by averging wRVU values at the 75 percentile for Family Practice w/o Obstetrics, Family Practice w/ Obstetrics, and Internal Medicine (hereafter "Value per wRVU"). Physicians shall be compensated at 50% of the value per wRVU for all wRVUs up to 4000 wRVUs. Physicians shall be compensated at 100% of the value per wRVU for all wRVUs over 4000 wRVUs. |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Dr Brett Vibeto | NamePerson |
| Purpose Of Loan | Sign On Bonus | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $50,000 | OriginalPrincipalAmount |
| Balance Due | 21654 | BalanceDue |
| Default | false | Default |
| Approved By Board | true | ApprovedByBoard |
| Written Agreement | true | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 21654 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Explanation of Significant Changes | Form 990 Part III Q3 | IP Mental Health Unit was closed effective March 29, 2010 due to lack of appropriate physician coverage. |
| Executive Committee Composition and Authority: | Form 990 Part VI Q 1a | THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION AND SHALL BE COMPOSED OF THE CHAIRPERSON, VICE CHAIRPERSON, AND THE PRESIDENT AND CEO, EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE. EACH INDIVIDUAL APPOINTED SHALL SERVE FOR A TERM OF ONE YEAR. EXCEPT AS PROVIDED BY LAW, THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. ADDITIONALLY, THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE SUCH POWERS TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SHCEDULED MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT SUCH ACTIONS TAKEN SHALL BE CONSISTENT WITH AND NOT CONFLICT WITH ANY ACTIONS OR POLICIES OF THE BOARD OF DIRECTORS OR OF THE CORPORATE MEMBER, WITH THESE BYLAWS, OR WITH APPLICABLE LAWS. |
| The Organization's Corporate Members/ Stockholders: | Form 990 Part VI Q 6 | ACCORDING TO THE BYLAWS OF MERCY MEDICAL CENTER, THE ENTITYS SOLE CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES, A COLORADO NONPROFIT CORPORATION. |
| Members/Stockholders Electing Governing Body Members: | Form 990 Part VI Q 7a | ACCORDING TO THE ORGANIZATION'S ARTICLES AND BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30TH OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. |
| Approval of Governing Body Decisions by Members/Stockholders: | Form 990 Part VI Q 7b | Mercy Medical Center's (MMC) corporate member is Catholic Health Initiatives ("CHI"). Pursuant to Section 5.4 of MMC's bylaws, the Corporate Member shall have the specific rights set forth in the governance matrix. Pursuant to the governance matrix the following rights are reserved to the CHI Board directly or through powers delegated to the CHI Chief Executive Officer: o Substantial change in the mission or philosophy of MMC o Amendment of the corporate documents of MMC o Approve members of the MMC board o Removal of a member of the governing body of MMC o Approval of issuance of debt by MMC o Approval of participation of MMC in a joint venture o Approval of formation of a new corporation by MMC o Approval of a merger involving MMC o Approval of the sale of all or substantially all of the assets of MMC o To require the transfer of assets by MMC to CHI to accomplish CHI's goals and objectives, and to satisfy CHI debts o Adoption of long range and strategic plans for MMC In addition, pursuant to Section 5.5.2 of the organization's bylaws, CHI may, in exercise of its approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and the President and Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate. |
| Process the Organization uses to review form 990: | Form 990 Part VI Q 11 | The CFO reviews and signs the Form 990 after it has been prepared by the CHI Tax Department. The 2009 Form 990 will be distributed to each member of the board via e-mail prior to filing. Subsequent to review by the board and 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. Any such changes are not re-submitted to the board. |
| Procedures for Monitoring and Enforcing the COI Policy | Form 990 Part VI Q 12c | It is the Policy of Mercy Medical Center ("the Corporation") that: o Each of the Corporation's directors (for purposes of this Policy, the term "director" shall also include members of any Board Committee who do not serve on the Board of Directors of the Corporation) and officers act at all times in a manner that furthers the Corporation's charitable purpose of service to the community and exercises care that he or she does not act in a manner that furthers his or her private interests to the detriment of the Corporation's community benefit purposes; and o Each of the Corporation's directors and officers avoids conflicts of interest and otherwise fully discloses to the Corporation any potential or actual conflicts of interest if such conflicts cannot be avoided so that such conflicts are dealt with in the best interests of the Corporation. This Policy: (1) covers all directors and officers who hold the title vice president and above; (2) applies to all Affiliates of the Corporation; and (3) is intended to supplement, but not replace, any applicable state laws governing conflicts of interest applicable to nonprofit corporations. "Affiliate" includes any entity directly or indirectly controlling, controlled by, or under common control with the Corporation whether through membership or stock ownership. If a director or officer has a potential or actual conflict with the Corporation and/or any of its Affiliates, such director or officer is deemed to also have a potential or actual conflict with respect to the Corporation and all of its Affiliates. IV. DISCLOSURE, REVIEW AND INITIAL DETERMINATION 1. General Obligation Each director must promptly and fully report to the Board Chair situations that may create a conflict of interest when he or she becomes aware of such situations. In the case of an officer, disclosure must be made to the Corporation's President and CEO who will report such disclosure to the Board Chair. In any situation where a director or officer is in doubt, full disclosure should be made so as to permit an impartial and objective determination. A written record of the disclosure will be made. 2. Annual Disclosure Statement In addition to the ongoing disclosure obligation, the Corporation's President and CEO shall annually send to all directors and officers a copy of this Policy statement and the Conflict of Interest Disclosure Statement. The directors and officers must promptly complete, sign, and return the statement to the Corporation's President and CEO. The completed statements will be reviewed by the President and CEO and the Board Chair. 3. Review, Evaluation, and Initial Determination The Board Chair or designee shall make such further investigation of conflicts of interest disclosures as he or she may deem appropriate. If the conflict involves the Board Chair, the Vice Chair will assume the Chair's role outlined in this Policy. Based on review and evaluation of the relevant facts and circumstances, the Board Chair will make an initial determination as to whether a conflict of interest exists and whether, pursuant to this Policy statement, review and approval or other action by the Board of Directors is required. A written record of the Board Chair's determination, including relevant facts and circumstances, will be made. The Board Chair shall then make an appropriate report to the Executive Committee of the Board concerning such review, evaluation and determination. If there is a difference of opinion between the Board Chair and another director or officer as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether Board of Directors review and approval or other action is required within this Policy statement, the matter shall be submitted to the Board's Executive Committee, which shall make a final determination as to the matter presented. Such determination, including relevant facts and circumstances, will be reflected in the Committee minutes and will be reported to the Board of Directors. V. BOARD REVIEW 1. Transactional Conflicts of Interest The Board of Directors shall carefully scrutinize and must in good faith approve or disapprove any transaction in which the Corporation and/or any of its Affiliates is a party and in which one or more of the Corporation's directors or officers either: o Has a material financial interest; or o Is a director or officer of the other party (other than the Corporation's own Affiliates). The Board of Directors must approve the transaction by a majority of the directors on the Board, without counting the vote of any director who has an interest in the transaction. In reviewing such transactions between the Corporation and vendors or other contractors who are, or are affiliated with, directors or officers, the Board shall act no more or less favorably than it would in reviewing transactions with unrelated third parties. The transaction will not be approved unless the Board determines that the transaction is fair to the Corporation. 2. Other Conflicts of Interest The Board shall carefully review and scrutinize non-transactional conflicts of interests (e.g., disclosure of nonpublic information, competition with the Corporation, failure to disclose a corporate opportunity, excessive gifts or entertainment, etc.). By a majority vote of the disinterested directors, the Board shall take whatever action is deemed appropriate under the circumstances with respect to the director or officer in order to best protect the interests of the Corporation including possible disciplinary or corrective action. The Board should consult with a member of the CHI Legal Resource Group when considering disciplinary or corrective action. 3. Disclosure by Interested Director When conflicts of interest are considered by the Board, the director or officer must disclose all of the material facts to the Board. The director or officer shall not vote or use his or her personal influence on the matter. However, if requested, such director or officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from Board members, as his or her knowledge may be of significant importance. The director or officer shall be excused from the meeting during discussion and vote on the conflict of interest. 4. Record of Proceedings Minutes of the Board of Directors shall reflect the following: the individual making the disclosure, the nature of the disclosure, discussion regarding any proposed transaction, the decision made by the Board, and that the interested director abstained from voting. 5. Implementation and Interpretation Questions regarding the implementation and interpretation of this Policy shall be referred to a member of the CHI Legal Resource Group. VI. POLICY VIOLATIONS If the Board reasonably believes that a director or officer has failed to disclose either an actual or potential conflict of interest, or all material facts surrounding an actual or possible conflict as required by this Policy, the director or officer will be given an opportunity to explain such alleged failure to disclose. After hearing the response of the director or officer, the Board will conduct such additional investigation as may be appropriate. If the Board determines that the director or officer has in fact failed to disclose as required by this Policy, the Board shall take appropriate disciplinary or corrective action. |
| Process for Determining CEO's Compensation | Form 990 Part VI Q 15a | The organization's CEO's compensation is paid by CHI. CHI uses the Hay Group as an independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of CHI's senior most executives (including each MBO CEO) is reviewed on an individual basis annually. The Hay Group reviews both cash and total compensation for overall reasonableness, for adherence to CHI's compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review is delivered by Hay Group to the HR Committee of the CHI Board of Stewardship Trustees annually at their September meeting and minutes are shared with the full board at the December meeting. The last review was September, 2010. In addition, in December 2009, Hay Group completed a comprehensive review of all CHI positions at the level of Vice President and above to determine and validate appropriate compensation levels. |
| Process for Determining Compensation - Officers/Key Employees | Form 990 Part VI Q 15b | The Chief Financial Officer reports to a division Chief Financial Officer who reviews and adjusts the compensation for senior leadership. Compensation for senior leadership is also internally reviewed by a compensation committee on the board of directors. A market comparison is done annually. |
| Public Inspection of Documents | Form 990 Part VI Q 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AREN'T PUBICLY AVAILABLE. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINACIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.ORG. |
| Estimate of Hours Devoted to Related Organizations: | Form 990 Part VII | 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, 60 HOUR-PER-WEEK EMPLOYEES. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (132 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 |
|---|---|---|---|---|---|---|---|---|---|
| St Joseph Community Health Services | |||||||||
| 300 Central SW Suite 300 | Albuquerque | NM | 87102 | 710897107 | Community | NM | 501(c)(3) | 11a | CHI |
| St Joseph Community Health Foundation | |||||||||
| 300 Central SW Suite 300 | Albuquerque | NM | 87102 | 850253087 | Foundation | NM | 501(c)(3) | 7 | SJCHS |
| St Francis of Baker City | |||||||||
| 3325 Pocahontas Road | Baker City | OR | 97814 | 930412495 | Hospital | OR | 501(c)(3) | 3 | CHI |
| St Elizabeth Health Care Foundation | |||||||||
| 3325 Pocahontas Road | Baker City | OR | 97814 | 943164869 | Foundation | OR | 501(c)(3) | 7 | SEHS |
| Flaget Memorial Hospital Foundation Inc | |||||||||
| 4305 New Shepherdsville Road | Bardstown | KY | 40004 | 562351341 | Fundraising | KY | 501(c)(3) | 11a | FH |
| Flaget Healthcare DBA Flaget Memorial | |||||||||
| 4305 New Shepherdsville Road | Bardstown | KY | 40004 | 611345363 | Hospital | KY | 501(c)(3) | 3 | CHI |
| Lakewood Health Center | |||||||||
| 600 Main Avenue South | Baudette | MN | 56623 | 410758434 | LTerm Care | MN | 501(c)(3) | 3 | CHI |
| Appletree Court | |||||||||
| 601 Oak Street | Breckenridge | MN | 56520 | 411850500 | Senior Homes | MN | 501(c)(3) | 9 | SFH |
| Healthcare and Wellness Foundation | |||||||||
| 2400 St Francis Drive | Breckenridge | MN | 56520 | 760761782 | Foundation | MN | 501(c)(3) | 11a | SFMC |
| St Francis Home | |||||||||
| 2400 St Francis Drive | Breckenridge | MN | 56520 | 410729978 | LTerm Care | MN | 501(c)(3) | 9 | CHI |
| St Francis Medical Center | |||||||||
| 2400 St Francis Drive | Breckenridge | MN | 56520 | 410695598 | Healthcare | MN | 501(c)(3) | 3 | CHI |
| Carrington Health Center | |||||||||
| 800 North 4th Street | Carrington | ND | 58421 | 450227311 | Healthcare | ND | 501(c)(3) | 3 | CHI |
| Saint Clare's Community Care | |||||||||
| 66 Ford Road | Denville | NJ | 07834 | 222876836 | Healthcare | NJ | 501(c)(3) | 11b | SCHS |
| Saint Clare's Foundation Inc | |||||||||
| 66 Ford Road | Denville | NJ | 07834 | 222502997 | Fundraising | NJ | 501(c)(3) | 7 | SCHS |
| Good Samaritan College of Nursing & Heal | |||||||||
| 375 Dixmyth Ave | Cincinnati | OH | 45220 | 311778403 | Education | KY | 501(c)(3) | 2 | GHS |
| Total Healthcare | |||||||||
| PO Box 7021 | Colorado Springs | CO | 80933 | 840927232 | Healthcare | CO | 501(c)(3) | 3 | CHI Colorado |
| Memorial Health Care System Inc | |||||||||
| 2525 De Sales Avenue | Chattanooga | TN | 37404 | 620532345 | Hospital | TN | 501(c)(3) | 3 | CHI |
| Memorial Health Care System Foundation | |||||||||
| 2525 De Sales Avenue | Chattanooga | TN | 37404 | 621839548 | Foundation | TN | 501(c)(3) | 7 | MHCS |
| Memorial Health Partners Foundation Inc | |||||||||
| 6028 Shallowford Road | Chattanooga | TN | 37421 | 030417049 | Healthcare | TN | 501(c)(3) | 9 | MHCS |
| The Community Limited Care Dialysis Cent | |||||||||
| 619 Oak Street Accounting-3 West | Cincinnati | OH | 45206 | 237419853 | Dialysis | OH | 501(c)(2) | none | GSH |
| Good Samaritan Foundation of Cincinnati | |||||||||
| 619 Oak Street Accounting-3 West | Cincinnati | OH | 45206 | 311206047 | Foundation | OH | 501(c)(3) | 11a | GSH |
| The Good Samaritan Hospital of Cincinnat | |||||||||
| 619 Oak Street Accounting-3 West | Cincinnati | OH | 45206 | 310537486 | Hospital | OH | 501(c)(3) | 3 | TRI-HEALTH |
| Saint Clare's Hospital | |||||||||
| 66 Ford Road | Denville | NJ | 07834 | 223319886 | Hospital | NJ | 501(c)(3) | 3 | CHI |
| St Francis Life Care Corporation | |||||||||
| 19 Pocono Road | Denville | NJ | 07834 | 222536017 | Elderly Care | NJ | 501(c)(3) | 9 | SCHS |
| TriHealth Physician Institute | |||||||||
| 619 Oak Street Accounting-3 West | Cincinnati | OH | 45206 | 311074519 | Physicians | OH | 501(c)(3) | 11a | GSH |
| Catholic Health Initiatives Colorado Fou | |||||||||
| 961 East Colorado Avenue | Colorado Springs | CO | 80903 | 840902211 | Foundation | CO | 501(c)(3) | 7 | CHI Colorado |
| 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 |
| Catholic Health Initiatives | |||||||||
| 1999 Broadway Suite 4000 | Denver | CO | 80202 | 470617373 | Healthcare | CO | 501(c)(3) | 9 | CHI |
| Catholic Health Care Federation | |||||||||
| 1999 Broadway Suite 4000 | Denver | CO | 80202 | 208473567 | Jurdic Person | CO | 501(c)(3) | 11a | CHI |
| Global Health Initiatives | |||||||||
| 1999 Broadway Suite 4000 | Denver | CO | 80202 | 201536108 | Ministries | CO | 501(c)(3) | 11a | CHI |
| Health SET | |||||||||
| 4200 West Conejos Place 436 | Denver | CO | 80204 | 841102943 | Low Inc.Care | CO | 501(c)(3) | 7 | CHI Colorado |
| Bishop Drumm Retirement Center | |||||||||
| 1111 6th Avenue | Des Moines | IA | 50314 | 420725196 | LTerm Care | IA | 501(c)(3) | 9 | CHI-IA Corp |
| Mercy Medical Center - Des Moines AKA | |||||||||
| 1111 6th Avenue | Des Moines | IA | 50314 | 420680448 | Hospital | IA | 501(c)(3) | 3 | CHI-IA Corp |
| House of Mercy | |||||||||
| 1111 6th Avenue | Des Moines | IA | 50314 | 421323808 | Shelter | IA | 501(c)(3) | 7 | CHI-IA Corp |
| Mercy Auxiliary of Central Iowa | |||||||||
| 1111 6th Avenue | Des Moines | IA | 50314 | 426076069 | Auxiliary | IA | 501(c)(3) | 11a | CHI-IA Corp |
| Mercy Clinics Inc | |||||||||
| 1111 6th Avenue | Des Moines | IA | 50314 | 421193699 | Physician | IA | 501(c)(3) | 9 | CHI-IA Corp |
| Mercy College of Health Sciences | |||||||||
| 1111 6th Avenue | Des Moines | IA | 50314 | 421511682 | Education | IA | 501(c)(3) | 2 | CHI-IA Corp |
| Mercy Foundation of Des Moines IA | |||||||||
| 1111 6th Avenue | Des Moines | IA | 50314 | 237358794 | Foundation | IA | 501(c)(3) | 7 | CHI-IA Corp |
| Mercy Medical Center - Centerville FKA | |||||||||
| 1 St Josephs Drive | Centerville | IA | 52544 | 420680308 | Hospital | IA | 501(c)(3) | 3 | CHI-IA Corp |
| Mercy Professional Practice Associates | |||||||||
| 1111 6th Avenue | Des Moines | IA | 50314 | 421470935 | Physician | IA | 501(c)(3) | 9 | CHI-IA Corp |
| Mercy Hospital of Devils Lake | |||||||||
| 1031 East Seventh Street | Devils Lake | ND | 58301 | 450227012 | Healthcare | ND | 501(c)(3) | 3 | CHI |
| Saint Joseph's Hospital Foundation | |||||||||
| 30 West 7th Street | Dickinson | ND | 58601 | 363418207 | Foundation | ND | 501(c)(3) | 11a | SJHHC |
| St Joseph's Hospital and Health Center | |||||||||
| 30 West 7th Street | Dickinson | ND | 58601 | 450226429 | Healthcare | ND | 501(c)(3) | 3 | CHI |
| Mercy Regional Medical Center of Durango | |||||||||
| 1010 Three Springs Blvd | Durango | CO | 81301 | 840405515 | Hospital | CO | 501(c)(3) | 3 | CHI |
| CHI Kentucky Inc | |||||||||
| 3900 Olympic Blvd Suite 400 | Erlanger | KY | 41018 | 202741651 | Healthcare | KY | 501(c)(3) | 11a | CHI |
| Villa Nazareth Inc | |||||||||
| 801 Page Drive | Fargo | ND | 58103 | 450226714 | LT Care | ND | 501(c)(3) | 9 | CHI |
| St Catherine Hospital | |||||||||
| 401 East Spruce Street | Garden City | KS | 67846 | 480543721 | Hospital | KS | 501(c)(3) | 3 | CHI |
| St Catherine Hospital Development Found | |||||||||
| 401 East Spruce Street | Garden City | KS | 67846 | 200598702 | Foundation | KS | 501(c)(3) | 11a | SCH |
| Saint Francis Medical Center Foundation | |||||||||
| PO Box 9804 | Grand Island | NE | 68802 | 470630267 | Foundation | NE | 501(c)(3) | 7 | SFMC |
| Saint Francis Medical Center | |||||||||
| PO Box 9804 | Grand Island | NE | 68802 | 470376601 | HealthCare | NE | 501(c)(3) | 3 | CHI Nebraska |
| Central Kansas Medical Center | |||||||||
| 3515 Broadway | Great Bend | KS | 67530 | 480543724 | Hospital | KS | 501(c)(3) | 3 | CHI |
| St Joseph Memorial Hospital | |||||||||
| 923 Carroll Ave | Larned | KS | 67550 | 481253246 | Hospital | KS | 501(c)(3) | 3 | CKMC |
| MNMCH Inc | |||||||||
| 220 North Pennsylvania | Columbus | KS | 66725 | 481216238 | Hospital | KS | 501(c)(3) | 3 | SJRMC |
| Mercy Lifecare Systems | |||||||||
| 2727 McClelland Blvd | Joplin | MO | 64804 | 431305163 | Property Mgmt | MO | 501(c)(3) | 11a | SJRMC |
| St John's Medical Group | |||||||||
| 2727 McClelland Blvd | Joplin | MO | 64804 | 431882377 | Phys Practice | MO | 501(c)(3) | 9 | SJRMC |
| St John's Mercy Regional Foundation | |||||||||
| 2727 McClelland Blvd | Joplin | MO | 64804 | 431308084 | Foundation | MO | 501(c)(3) | 7 | SJRMC |
| St John's Regional Medical Center | |||||||||
| 2727 McClelland Blvd | Joplin | MO | 64804 | 440545809 | Hospital | MO | 501(c)(3) | 3 | CHI |
| Good Samaritan Hospital | |||||||||
| PO Box 1990 | Kearney | NE | 68848 | 470379755 | HealthCare | NE | 501(c)(3) | 3 | CHI Nebraska |
| Good Samaritan Hospital Foundation | |||||||||
| PO Box 1810 | Kearney | NE | 68848 | 470659443 | Foundation | NE | 501(c)(3) | 7 | GSH |
| St Joseph Health Ministries | |||||||||
| 1929 Lincoln Hwy E Ste 150 | Lancaster | PA | 17602 | 232342997 | Health | PA | 501(c)(3) | 11a | CHI |
| St Joseph Health Ministries Foundation | |||||||||
| 1929 Lincoln Hwy E Ste 150 | Lancaster | PA | 17602 | 232605579 | Fundraising | PA | 501(c)(3) | 11a | SJHM |
| St Joseph Health Services Inc | |||||||||
| 1929 Lincoln Hwy E Ste 150 | Lancaster | PA | 17602 | 201425375 | Dental care | PA | 501(c)(3) | 11a | SJHM |
| Continuing Care Hospital | |||||||||
| 150 North Eagle Creek Drive | Lexington | KY | 40509 | 611400619 | LTACH | KY | 501(c)(3) | 3 | SJHS |
| Saint Joseph Berea Hospital Foundation | |||||||||
| 305 Estill Street | Berea | KY | 40403 | 260152877 | Foundation | KY | 501(c)(3) | 7 | SJHS |
| Saint Joseph Health System Inc | |||||||||
| 150 N Eagle Creek Dr | Lexington | KY | 40509 | 611334601 | Hospital | KY | 501(c)(3) | 3 | CHI |
| St Joseph Hospital Foundation Inc | |||||||||
| One St Joseph Drive | Lexington | KY | 40504 | 611159649 | Foundation | KY | 501(c)(3) | 11a | SJHS |
| Saint Joseph Medical Foundation Inc | |||||||||
| One St Joseph Drive | Lexington | KY | 40504 | 311539059 | Phy Practices | KY | 501(c)(3) | 3 | SJHS |
| Visiting Nurse Association of Saint Clar | |||||||||
| 191 Woodport Road | Sparta | NJ | 07871 | 221768334 | Home Health | NJ | 501(c)(3) | 9 | SCHS |
| Saint Elizabeth Foundation | |||||||||
| 555 South 70th Street | Lincoln | NE | 68510 | 470625523 | Foundation | NE | 501(c)(3) | 7 | SERMC |
| Saint Elizabeth Health Services | |||||||||
| 555 South 70th Street | Lincoln | NE | 68510 | 363233120 | Healthcare | NE | 501(c)(3) | 3 | SERMC |
| CHI Nebraska | |||||||||
| 555 South 70th Street | Lincoln | NE | 68510 | 363233121 | Healthcare | NE | 501(c)(3) | 11a | CHI |
| Saint Elizabeth Regional Medical Center | |||||||||
| 555 South 70th Street | Lincoln | NE | 68510 | 470379836 | Healthcare | NE | 501(c)(3) | 3 | CHI Nebraska |
| The Physician Network | |||||||||
| 8055 O Street Suite 300 | Lincoln | NE | 68510 | 470780857 | Healthcare | NE | 501(c)(3) | 11a | CHI Nebraska |
| Lisbon Area Health Services | |||||||||
| 905 Main Street | Lisbon | ND | 58054 | 820558836 | Healthcare | ND | 501(c)(3) | 3 | CHI |
| Alverna Apartments | |||||||||
| 300 SE 8th Avenue | Little Falls | MN | 56345 | 411351177 | Lterm Care | MN | 501(c)(3) | 9 | CHI |
| Unity Family Healthcare | |||||||||
| 815 2nd Street SE | Little Falls | MN | 56345 | 410721642 | Healthcare | MN | 501(c)(3) | 3 | CHI |
| St Anthony's Hospital Association | |||||||||
| 4 Hospital Drive | Morrilton | AR | 72110 | 710245507 | Healthcare | AR | 501(c)(3) | 3 | SVIMC |
| St Vincent Infirmary Medical Center | |||||||||
| 2 St Vincent Circle | Little Rock | AR | 72205 | 710236917 | Healthcare | AR | 501(c)(3) | 3 | CHI |
| St Vincent Medical Group | |||||||||
| 2 St Vincent Circle | Little Rock | AR | 72205 | 710830696 | Healthcare | AR | 501(c)(3) | 9 | SVIMC |
| Maria-Joseph Center | |||||||||
| 4830 Salem Avenue | Dayton | OH | 45416 | 310935118 | Healthcare | OH | 501(c)(3) | 9 | SHP |
| Saint Joseph London Foundation Inc | |||||||||
| 310 East Ninth Street | London | KY | 40741 | 260438748 | Foundation | KY | 501(c)(3) | 11a | SJHS |
| Samaritan Behavioral Health | |||||||||
| 601 S Edwin C Moses Blvd | Dayton | OH | 45408 | 020633634 | Hospital | OH | 501(c)(3) | 3 | SHP |
| Mercy Medical Center | |||||||||
| 1512 12th Avenue Road | Nampa | ID | 83686 | 820200896 | Hospital | ID | 501(c)(3) | 3 | CHI |
| Mercy Medical Center Foundation | |||||||||
| 1512 12th Avenue Road | Nampa | ID | 83686 | 261737256 | Foundation | ID | 501(c)(3) | 11a | Mercy Med Ct |
| Mercy Physician Group Inc | |||||||||
| 1512 12th Avenue Road | Nampa | ID | 83686 | 208192593 | Phys Group | ID | 501(c)(3) | 9 | Mercy Med Ct |
| St Mary's Hospital | |||||||||
| 1314 3rd Avenue | Nebraska City | NE | 68410 | 470443636 | Hospital | NE | 501(c)(3) | 3 | CHI Nebraska |
| St Mary's Hospital Foundation | |||||||||
| 1314 3rd Avenue | Nebraska City | NE | 68410 | 470707604 | Foundation | NE | 501(c)(3) | 7 | SMH |
| Oakes Community Hospital | |||||||||
| 314 South 8th Street | Oakes | ND | 58474 | 450231675 | Hospital | ND | 501(c)(3) | 3 | CHI |
| Oakes Community Hospital Foundation | |||||||||
| 314 South 8th Street | Oakes | ND | 58474 | 710966606 | Foundation | ND | 501(c)(3) | 11a | OCH |
| St Dominic at Ontario | |||||||||
| 351 SW 9th Street | Ontario | OR | 97914 | 930433692 | Hospital | OR | 501(c)(3) | 3 | CHI |
| Holy Rosary Medical Center Foundation | |||||||||
| 351 SW 9th Street | Ontario | OR | 97914 | 202683560 | Foundation | OR | 501(c)(3) | 11a | HRMC |
| St Joseph's Area Health Services | |||||||||
| 600 Pleasant Avenue | Park Rapids | MN | 56470 | 410695603 | Hospital | MN | 501(c)(3) | 3 | CHI |
| St Anthony Hospital | |||||||||
| 1601 SE Court Avenue | Pendleton | OR | 97801 | 930391614 | Hospital | OR | 501(c)(3) | 3 | CHI |
| St Anthony Hospital Foundation | |||||||||
| 1601 SE Court Avenue | Pendleton | OR | 97801 | 930992727 | Foundation | OR | 501(c)(3) | 11a | SA Hospital |
| Gettysburg Medical Center | |||||||||
| 606 East Garfield Avenue | Gettysburg | SD | 57442 | 460234354 | Hospital | SD | 501(c)(3) | 3 | SMHC |
| St Mary's Healthcare Center | |||||||||
| 801 East Sioux Avenue | Pierre | SD | 57501 | 460230199 | Healthcare | SD | 501(c)(3) | 3 | CHI |
| Mt St Joseph Inc | |||||||||
| 3060 SE Stark Street | Portland | OR | 97214 | 930386870 | Nursing Care | OR | 501(c)(3) | 9 | CHI |
| Pueblo Stepup | |||||||||
| 1925 East Orman Avenue Suite G52 | Pueblo | CO | 81004 | 841234295 | Community | CO | 501(c)(3) | 7 | CHI |
| Bornemann Healthcare Corporation | |||||||||
| 2500 Bernville Road PO Box 316 | Reading | PA | 19603 | 232187242 | Healthcare | PA | 501(c)(3) | 11a | CHI |
| St Joseph Medical Center Foundation | |||||||||
| 2500 Bernville Road PO Box 316 | Reading | PA | 19603 | 232649362 | Foundation | PA | 501(c)(3) | 11a | SJRHN |
| St Joseph Medical Group | |||||||||
| 2500 Bernville Road PO Box 316 | Reading | PA | 19603 | 208544021 | Healthcare | PA | 501(c)(3) | 9 | BHC |
| St Joseph Regional Health Network | |||||||||
| 2500 Bernville Road PO Box 316 | Reading | PA | 19603 | 231352211 | Healthcare | PA | 501(c)(3) | 3 | CHI |
| Linus Oakes Inc | |||||||||
| 2700 Stewart Parkway | Roseburg | OR | 97470 | 930821381 | Senior Living | OR | 501(c)(3) | 9 | MMC |
| Mercy Foundation Inc | |||||||||
| 2700 Stewart Parkway | Roseburg | OR | 97470 | 936088946 | Foundation | OR | 501(c)(3) | 7 | MMC |
| Mercy Medical Center | |||||||||
| 2700 Stewart Parkway | Roseburg | OR | 97470 | 930386868 | Hospital | OR | 501(c)(3) | 3 | CHI |
| Franciscan Villa of South Milwaukee Inc | |||||||||
| 3601 South Chicago Avenue | South Milwaukee | WI | 53172 | 391093829 | Healthcare | WI | 501(c)(3) | 9 | CHI |
| Enumclaw Community Hospital | |||||||||
| 1450 Battersby Avenue | Enumclaw | WA | 98022 | 910715805 | Hospital | WA | 501(c)(3) | 3 | FHS |
| Franciscan Foundation | |||||||||
| 1717 South J Street | Tacoma | WA | 98405 | 911145592 | Fundraising | WA | 501(c)(3) | 9 | FHS |
| Franciscan Health System FKA Franciscan | |||||||||
| 1717 South J Street | Tacoma | WA | 98405 | 910564491 | Healthcare | WA | 501(c)(3) | 3 | CHI |
| Franciscan Medical Group | |||||||||
| 1708 South Yakima Avenue | Tacoma | WA | 98405 | 911939739 | Healthcare | WA | 501(c)(3) | 9 | FHS |
| St Joseph Medical Center Foundation In | |||||||||
| 7601 Osler Drive | Towson | MD | 21204 | 521681044 | Fundraising | MD | 501(c)(3) | 7 | SJMC |
| St Joseph Medical Center Inc | |||||||||
| 7601 Osler Drive | Towson | MD | 21204 | 520591461 | Hospital | MD | 501(c)(3) | 3 | CHI |
| St Joseph Physician Enterprises | |||||||||
| 7601 Osler Drive | Towson | MD | 21204 | 521311775 | Physicians | MD | 501(c)(3) | 11a | CHI |
| Samaritan Health Foundation | |||||||||
| 2222 Philadelphia Drive | Dayton | OH | 45406 | 237296923 | Foundation | OH | 501(c)(3) | 7 | SHP |
| Mercy Hospital of Valley City | |||||||||
| 570 Chautauqua Boulevard | Valley City | ND | 58072 | 450226553 | Hospital | ND | 501(c)(3) | 3 | CHI |
| Mercy Medical Center | |||||||||
| 1301 15th Avenue West | Williston | ND | 58801 | 450231183 | Healthcare | ND | 501(c)(3) | 3 | CHI |
| Mercy Medical Foundation | |||||||||
| 1301 15th Avenue West | Williston | ND | 58801 | 450381803 | Foundation | ND | 501(c)(3) | 11a | MMC |
| Samaritan Health Partners | |||||||||
| 2222 Philadelphia Drive | Dayton | OH | 45406 | 311107411 | Healthcare | OH | 501(c)(3) | 11a | CHI |
| St Vincent Foundation | |||||||||
| Two St Vincent Circle | Little Rock | AR | 72205 | 510169537 | Fundraising | AR | 501(c)(3) | 11a | SVIMC |
| Auxiliary of Holy Rosary Hospital Inc | |||||||||
| 351 SW 9th Street | Ontario | OR | 97914 | 943059469 | Hospital | OR | 501(c)(3) | 9 | HRMC |
| The Mercy Hospital of Devils Lake Fdn | |||||||||
| 1031 East Seventh Street | Devils Lake | ND | 58301 | 352367360 | Foundation | ND | 501(c)(3) | 11a | MHDL |
| Alegent Health - Bergan Mercy Health Sys | |||||||||
| 7500 Mercy Road | Omaha | NE | 68124 | 470484764 | Hospital | NE | 501(c)(3) | 3 | CHI |
| Alegent Health - Mercy Hospital Corning | |||||||||
| PO Box 368 | Corning | IA | 50841 | 420782518 | Hospital | IA | 501(c)(3) | 3 | AHBMHS |
| Mercy Health Care Foundation | |||||||||
| PO Box 368 | Corning | IA | 50841 | 421461064 | Foundation | NE | 501(c)(3) | 11a | AHMH |
| Mercy Hospital Foundation Council Bluff | |||||||||
| 800 Mercy Drive | Council Bluffs | IA | 51503 | 421178204 | Foundation | IA | 501(c)(3) | 11a | AHBMHS |
| CHI Institute For Research and Innovatio | |||||||||
| 198 Inverness Drive West | Englewood | CO | 80112 | 271050565 | Healthcare | CO | 501(c)(3) | 11a | CHI |
| CHI Colorado | |||||||||
| 188 Inverness Drive West | Englewood | CO | 80112 | 840405257 | Healthcare | CO | 501(c)(3) | 3 | CHI |
| Saint Joseph Mount Sterling Foundation | |||||||||
| 50 Sterling Avenue | Mount Sterling | KY | 40353 | 272884584 | Foundation | KY | 501(c)(3) | 7 | SJHS |
| Centennial Medical Group Inc | |||||||||
| 2700 Stewart Parkway | Roseburg | OR | 97470 | 900433062 | Physicians | OR | 501(c)(3) | 9 | MMC |
| CHI National Foundation | |||||||||
| 198 Inverness Drive West | Englewood | CO | 80112 | 270930004 | Foundation | CO | 501(c)(3) | 11a | CHI |
| Saint Clare's Health Services Inc | |||||||||
| 25 Pocono Road | Denville | NJ | 07834 | 223639733 | Management | NJ | 501(c)(3) | 7 | CHI |
| Good Samaritan Hospital | |||||||||
| 2222 Philadelphia Drive | Dayton | OH | 45406 | 310536981 | Hospital | OH | 501(c)(3) | 3 | SHP |
Form990 Schedule R Part III Form990ScheduleRPartIII (17 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Superior Medical Imaging LLC | |||||||||||||
| 5000 North 26th Street | Lincoln | NE | 68521 | 262884555 | OP Diagnostics | NE | SERMC | Related | -155495 | 993429 | false | $272 | false |
| Central Nebraska Rehab Services | |||||||||||||
| 3004 W Faidley Ave | Grand Island | NE | 68802 | 810653461 | Physical Therapy | NE | CHI | Related | 1816979 | 2933623 | false | $5,050 | false |
| Mercy West Endoscopy LLC | |||||||||||||
| 1601 NW 114th St Suite 244 | Clive | IA | 50325 | 900129077 | Ambulatory Surg | IA | CHI-IA Corp | Related | 1917716 | 1695121 | false | false | |
| Audubon Land Company LLC | |||||||||||||
| 5390 N Academy Blvd Suite 300 | Colorado Springs | CO | 80918 | 841513085 | Real Estate | CO | THC | Related | 67577 | 9001605 | false | false | |
| Breckenridge Medical Clinic LLC | |||||||||||||
| 555 South Park Avenue Plaza 11 | Breckenridge | CO | 80424 | 651295958 | Medical Clinic | CO | THC | Related | false | false | |||
| Penrad Imaging | |||||||||||||
| 1390 Kelly Johnson Blvd | Colorado Springs | CO | 80920 | 841072619 | Medical Imaging | CO | THC | Related | 1922441 | 8248492 | false | false | |
| St Anthony Regional Mtn Cancer Center | |||||||||||||
| 4231 W 16th Avenue | Denver | CO | 80112 | 371568013 | Cancer Center | CO | THC | Related | 60513 | 318803 | false | false | |
| St Francis Land Company | |||||||||||||
| 5390 N Academy Blvd Suite 300 | Colorado Springs | CO | 80918 | 263134100 | Real Estate | CO | THC | Related | -180979 | 14886022 | false | false | |
| OrthoColorado LLC | |||||||||||||
| 11650 West 2nd Place | Lakewood | CO | 80255 | 371577105 | Ortho Hospital | CO | THC | Related | -5375165 | 15265510 | false | false | |
| Mercy Outpatient Surgery Center LLC | |||||||||||||
| 1512 12th Avenue Road | Nampa | ID | 83686 | 841380439 | Surgery Center | ID | MMC | Related | -812036 | 949357 | false | $4,620 | true |
| Peninsula Radiation Oncology | |||||||||||||
| 314 Martin Luther King Jr Way 11 | Tacoma | WA | 98405 | 870808610 | Healthcare Srvc | WA | FHS | Related | -516076 | 3860362 | false | false | |
| Healthcare Support Services LLC | |||||||||||||
| PO Box 9804 | Grand Island | NE | 68802 | 721546196 | Laundry | NE | CHI | Related | 199968 | 3913481 | false | $58,436 | false |
| Bluegrass Regional Imaging Center | |||||||||||||
| 1218 South Broadway Suite 310 | Lexington | KY | 40504 | 611386736 | Diagnostic | KY | SJ HospitalLex | Related | 242456 | 3773725 | false | false | |
| North River Surgery Center LLC | |||||||||||||
| 2209 Wildwood Avenue | Sherwood | AR | 72120 | 710799771 | Ambul Surg Ctr | AR | SVIMC | Related | 213989 | 1696001 | false | false | |
| CHI Operating Investment Program LP | |||||||||||||
| 198 Inverness Drive West | Englewood | CO | 80112 | 470727942 | Investments | CO | CHI | Investment | 58022 | 4069968 | false | $14,031 | true |
| Ruxton Surgicenter LLC | |||||||||||||
| 8322 Bellona Avenue Suite 201 | Baltimore | MD | 21204 | 522095835 | Surgery Center | MD | SJMC | Related | -75716 | 3421084 | false | true | |
| Central Nebraska Home Care Services | |||||||||||||
| PO Box 1146-4510 Second Avenue | Kearney | NE | 68848 | 470692112 | Healthcare Srvc | NE | HSEINC | Related | -102982 | 1021500 | false | true | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (30 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 | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mercy Health Services Corporation | ||||||||||||
| 2727 McClelland Blvd | Joplin | MO | 64804 | 431457881 | DME | MO | St John's RMC | C Corp | -1033832 | 2093683 | 1.00000 | |
| Mountain Management Services Inc | ||||||||||||
| 6028D Shallowford Road | Chattanooga | TN | 37422 | 621570739 | mgmt svc org | TN | MHCS | C Corp | 348642 | 4530845 | 1.00000 | |
| MedQuest | ||||||||||||
| 1301 15th Avenue West | Williston | ND | 58801 | 450392137 | Sale of DME | ND | MHof Williston | C Corp | -16794 | 911494 | 1.00000 | |
| St Anthony Development Company | ||||||||||||
| 1415 Southgate | Pendleton | OR | 97801 | 931216943 | Athletic Club | OR | St Anthony H | C Corp | 41861 | 3047938 | 1.00000 | |
| GOOD SAMARITAN OUTREACH SERVICES | ||||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470659440 | MEDICAL CLINIC | NE | CHI Nebraska | C Corp | -2491623 | 840232 | 1.00000 | |
| HEALTH SYSTEMS ENTERPRISES INC | ||||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470664558 | MANAGEMENT | NE | GSH | C Corp | 10957 | 1559747 | 1.00000 | |
| Mercy Park Apartments Ltd | ||||||||||||
| 1111 6th Avenue | Des Moines | IA | 50314 | 421202422 | Housing | IA | CHI-IA Corp | C Corp | 227244 | 1806199 | 1.00000 | |
| Des Moines Medical Center Inc | ||||||||||||
| 1111 6th Avenue | Des Moines | IA | 50314 | 420837382 | Real Estate | IA | CHI-IA Corp | C Corp | 1123173 | 0.92980 | ||
| Comcare Services | ||||||||||||
| 4231 W 16th Avenue | Denver | CO | 80204 | 840904813 | Inactive | CO | CHIC | C Corp | 1.00000 | |||
| Mednow Inc | ||||||||||||
| 1512 12th Avenue Road | Nampa | ID | 83686 | 820389927 | Outpat Pharmacy | ID | Mercy Med Ctr | C Corp | -672954 | 5348476 | 1.00000 | |
| Saint Clare's Primary Care Inc | ||||||||||||
| 66 Ford Road | Denville | NJ | 07834 | 222441202 | Billing Services | NJ | SCCC | C Corp | -350630 | 2590487 | 1.00000 | |
| Healthcare Mgmt Services Org Inc | ||||||||||||
| 1149 Market St | Tacoma | WA | 98402 | 911865474 | Health Org. | WA | FHS | C Corp | 1.00000 | |||
| Physician Health System Network | ||||||||||||
| 1149 Market St | Tacoma | WA | 98402 | 911746721 | Health Org. | WA | FHS | C Corp | 1.00000 | |||
| Mercy Services Corp | ||||||||||||
| 2700 Stewart Parkway | Roseburg | OR | 97470 | 930824308 | Retail Sales | OR | Mercy Medical | C Corp | -499409 | 1403001 | 1.00000 | |
| Caduceus Medical Associates Inc | ||||||||||||
| 6028 Shallowford Road Suite D | Chattanooga | TN | 37422 | 621570736 | Healthcare | TN | MHCS | C Corp | 1008 | 1.00000 | ||
| CENTRAL KANSAS HEALTH SERVICES ASSOCIATI | ||||||||||||
| 3515 Broadway | Great Bend | KS | 67530 | 481042853 | MEDICAL EQUIPMENT | KS | CKMC | C Corp | 110125 | 1.00000 | ||
| St Vincent Community Health Services In | ||||||||||||
| Two St Vincent Circle | Little Rock | AR | 72205 | 710710785 | Healthcare | AR | SVIMC | C Corp | 2404944 | 10195000 | 1.00000 | |
| Alternative Insurance Management Service | ||||||||||||
| 3900 Olympic Boulevard Suite 400 | Erlanger | KY | 41018 | 841112049 | Management Servic | CO | CHI | C Corp | 3272176 | 1.00000 | ||
| Nazareth Assurance Company | ||||||||||||
| 76 St Paul Street Suite 500 | Burlington | VT | 05401 | 030304831 | Insurance | VT | CHI | C Corp | 1.00000 | |||
| Franciscan Services Inc | ||||||||||||
| 198 Inverness Drive West | Englewood | CO | 80112 | 232487967 | Healthcare | CO | CHI | C Corp | 194756 | 12598258 | 1.00000 | |
| SJH Services Corporation | ||||||||||||
| 198 Inverness Drive West | Englewood | CO | 80112 | 232307408 | Healthcare | CO | FSI | C Corp | 314346 | 3423012 | 1.00000 | |
| St Joseph Development Company Inc | ||||||||||||
| 1717 South J Street | Tacoma | WA | 98405 | 911480569 | Rental | WA | FSI | C Corp | 1677122 | 11984725 | 1.00000 | |
| Towson Management Inc | ||||||||||||
| 7601 Osler Drive | Towson | MD | 21204 | 521710750 | Management Servic | MD | FSI | C Corp | 99315 | 498383 | 1.00000 | |
| Captive Management Initiatives | ||||||||||||
| 980663022 | Captive Managemen | CHI | C Corp | 1.00000 | CJ | |||||||
| First Initiatives Insurance Ltd | ||||||||||||
| 980203038 | Insurance | CHI | C Corp | 1.00000 | CJ | |||||||
| Center for Translational Research | ||||||||||||
| 198 Inverness Drive West | Englewood | CO | 80112 | 272269511 | Healthcare | CO | CHI | C Corp | -840949 | 1746201 | 1.00000 | |
| Samaritan Family Care Inc | ||||||||||||
| 40 W Fourth St 1700 | Dayton | OH | 45402 | 311299450 | Healthcare | OH | SHP | LLC | -1199836 | 4894397 | 1.00000 | |
| SJL Physician Management Services Inc | ||||||||||||
| 424 Lewis Hargett Cr 160 | Lexington | KY | 40503 | 999999999 | Management | KY | SJHS | C Corp | 1.00000 | |||
| CGH Realty Company Inc | ||||||||||||
| 215 N 12th St | Reading | PA | 19603 | 232326801 | Real Estate | PA | SJHM | C Corp | 1007 | 42415 | 1.00000 | |
| St Joseph Office Park Association | ||||||||||||
| 1401 HarrodsBurg Road Bldg B70 | Lexington | KY | 40504 | 611079899 | Management | KY | SJHS | C Corp | 10217 | 572843 | 0.85000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | true | 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 | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| Mercy Medical Foundation | |
| a | 10260 |
| MedQuest | |
| a | 64125 |
| MedQuest | |
| k | 52236 |
| MedQuest | |
| p | 441679 |
| Catholic Health Initiatives | |
| l | 6177800 |
| Catholic Health Initiatives | |
| o | 667348 |
| Catholic Health Initiatives | |
| q | 1788156 |
| Mercy Medical Foundation | |
| c | 1273355 |