GOOD SAMARITAN HOSPITAL: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SAMARITAN HOSPITAL (EIN 47-0379755)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-13
- IRS object ID
- 202101339349305665
- Schema version
- 2019v5.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-13T17:06:02-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1225 17TH ST STE 800 | AddressLine1Txt |
| City | DENVER | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470379755 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SAMARITAN HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GOOD | BusinessNameControlTxt |
| Phone | 3088657900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1990 | AddressLine1Txt |
| City | KEARNEY | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68848 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEANETTE WOJTALEWICZ | PersonNm |
| Person Title | CFO, CHI HEALTH | PersonTitleTxt |
| Phone | 3088657900 | PhoneNum |
| Signature | 2021-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARK SHELTON | PreparerPersonNm |
| PTIN | P01203482 | PTIN |
| Phone | 3033827856 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHI HEALTH GOOD SAMARITAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CLIFF ROBERTSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 WEST DODGE ROAD | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68154 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $202,469,598 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHIHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1924 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 1182 | TotalEmployeeCnt |
| Total Volunteers | 235 | TotalVolunteersCnt |
| Total Gross UBI | $127,197 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $77,580 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $172,561 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,449,071 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $170,975,201 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $168,444,858 | CYProgramServiceRevenueAmt |
| PY Investment Income | $11,056,237 | PYInvestmentIncomeAmt |
| CY Investment Income | $19,088,756 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,628,804 | PYOtherRevenueAmt |
| CY Other Revenue | $4,486,913 | CYOtherRevenueAmt |
| PY Total Revenue | $185,832,803 | PYTotalRevenueAmt |
| CY Total Revenue | $202,469,598 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $389,835 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $389,437 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $58,482,878 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $57,181,550 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $103,911,999 | PYOtherExpensesAmt |
| CY Other Expenses | $109,147,491 | CYOtherExpensesAmt |
| PY Total Expenses | $162,784,712 | PYTotalExpensesAmt |
| CY Total Expenses | $166,718,478 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $23,048,091 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $35,751,120 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $665,352,447 | TotalAssetsBOYAmt |
| Total Assets EOY | $774,601,926 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $156,009,870 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $231,797,795 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $509,342,577 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $542,804,131 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AS COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $17,985,742 | ExpenseAmt |
| Grant | $122,341 | GrantAmt |
| Revenue | $52,548,142 | RevenueAmt |
| Desc | GOOD SAMARITAN HOSPITAL HAS STRIVED TO IMPROVE THE HEALTH STATUS OF CHILDREN, TEENS, ADULTS, SENIOR CITIZENS, FRIENDS AND NEIGHBORS IN THIS RURAL COMMUNITY. GOOD SAMARITAN HOSPITAL IS PROUD TO OFFER HEALTHCARE SERVICES CLOSE TO HOME WITHIN THE COMMUNITY. GOOD SAMARITAN HOSPITAL PROVIDES A VARIETY OF DIAGNOSTIC SERVICES TO THE COMMUNITY, SUCH AS CT SCANS, MRI AND NUCLEAR MEDICINE IN ADDITION TO GENERAL RADIOLOGY, MAMMOGRAPHY, SURGICAL RADIOGRAPHY AND ULTRASOUND. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,921,269 | ExpenseAmt |
| Grant | $32,711 | GrantAmt |
| Revenue | $14,050,113 | RevenueAmt |
| Desc | THE MISSION OF KEARNEY'S GOOD SAMARITAN HEART CENTER IS TO PROVIDE ADVANCED, COMPREHENSIVE CARE CLOSE TO HOME. OPENED IN 1990 WITH THE FIRST CARDIAC CATHETERIZATION LAB IN OUTSTATE NEBRASKA, THE GOOD SAMARITAN HEART CENTER HAS EVOLVED INTO A FULL SERVICE CARDIAC AND VASCULAR CARE CENTER PROVIDING ALL ADULT CARDIAC AND VASCULAR PROCEDURES ONCE FOUND ONLY IN METROPOLITAN AREAS. IN 2005, GOOD SAMARITAN WAS GIVEN OFFICIAL CHEST PAIN CENTER DESIGNATION BY THE SOCIETY OF CHEST PAIN CENTERS AND RECOGNIZED FOR OFFERING STATE-OF-THE-ART HEART CARE TO ITS PATIENTS, BECOMING THE FIRST MEDICAL FACILITY IN THE STATE OF NEBRASKA TO RECEIVE THIS ACCREDITATION. BEING AN ACCREDITED CENTER MEANS THAT WE FOLLOW STRICTER PROTOCOL-DRIVEN AND SYSTEMATIC GUIDELINES THAT ALLOW A REDUCTION IN TIME TO TREATMENT DURING THE EARLY STAGES OF HEART ATTACK, WHEN TREATMENTS ARE MOST EFFECTIVE. IT ALSO ENABLES US TO BETTER MONITOR PATIENTS WHEN IT IS NOT CLEAR WHETHER THEY ARE HAVING A CORONARY EVENT, MAKING SURE OUR PATIENTS ARE NEITHER SENT HOME TOO EARLY NOR NEEDLESSLY ADMITTED. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $38,946,612 | ExpenseAmt |
| Grant | $112,003 | GrantAmt |
| Revenue | $48,108,056 | RevenueAmt |
| Desc | CHI HEALTH GOOD SAMARITAN IS VERIFIED BY THE AMERICAN COLLEGE OF SURGEONS (ACS) AS A LEVEL II TRAUMA CENTER. VERIFICATION BY THE ACS DEMONSTRATES THAT GOOD SAMARITAN HAS MET STRINGENT CRITERIA REFLECTING COMMITMENT, EXCELLENCE AND ASSURANCE OF HIGH QUALITY CARE FOR ALL TRAUMA PATIENTS.GOOD SAMARITAN IS ONE OF ONLY A HANDFUL OF HOSPITALS IN THE NATION THAT OPERATES BOTH A GROUND AND AIR AMBULANCE SERVICE AS PART OF OUR TRAUMA PROGRAM AND IN SUPPORT OF THE OTHER MEDICAL SPECIALTIES OFFERED BY OUR FACILITY. OUR GROUND AMBULANCE SERVICE PROVIDES EMERGENCY ADVANCED LIFE SUPPORT RESPONSE TO BUFFALO COUNTY AND SURROUNDING COMMUNITIES AS WELL AS LONG DISTANCE BASIC, ADVANCED AND CRITICAL CARE TRANSPORTATION OF PATIENTS FROM ONE FACILITY TO ANOTHER THROUGHOUT NEBRASKA. GOOD SAMARITAN AIRCARE, OUR ORGANIZATION'S AIR AMBULANCE SERVICE, PROVIDES BOTH INTER-FACILITY AND SCENE RESPONSE FOR CRITICALLY ILL AND INJURED PATIENTS THROUGHOUT CENTRAL NEBRASKA AND NORTHERN KANSAS. GOOD SAMARITAN IS PROUD OF ITS LONG-STANDING RELATIONSHIP WITH RODGERS HELICOPTER SERVICES, LLC IN PROVIDING OUR AIR AMBULANCE OPERATION TO THIS REGION FOR MORE THAN THREE DECADES.IN ADDITION, TRAUMA PREVENTION EFFORTS IN KEARNEY AND SURROUNDING COMMUNITIES HELP BOOST PUBLIC AWARENESSS THROUGH MANY FORUMS INCLUDING BIKE RODEOS, CLASSES PROMOTING RESPONSIBLE DECISION-MAKING -- SEAT BELT USE AND DRINKING AND DRIVING, CAR SEAT SAFETY AND NUMEROUS OTHER PROGRAMS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $65,505,414 | ExpenseAmt |
| Grant | $122,382 | GrantAmt |
| Revenue | $52,565,797 | RevenueAmt |
| Desc | OTHER SERVICES | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $65,505,414 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $122,382 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $52,565,797 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $129,359,037 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1182 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEANETTE WOJTALEWICZ | PersonNm |
| Phone | 4023434671 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12809 WEST DODGE ROAD | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68154 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| ANTHONY JONES | |||||||||
| BOARD MEMBER | 1.00 | 49.00 | Yes (X) | $0 | $2,459,531 | $14,470 | |||
| CLIFF ROBERTSON MD | |||||||||
| BOARD MEMBER/CEO CHI HEALTH | 1.00 | 49.00 | Yes (X) | $0 | $2,271,574 | $46,283 | Yes (X) | ||
| JEANETTE WOJTALEWICZ | |||||||||
| CFO, CHI HEALTH | 1.00 | 49.00 | $0 | $1,053,501 | $42,366 | Yes (X) | |||
| CARY WARD MD | |||||||||
| CHIEF MEDICAL OFFICER | 5.00 | 45.00 | $0 | $555,669 | $34,565 | Yes (X) | |||
| MICHAEL SCHNIEDERS | |||||||||
| PRESIDENT GSH | 45.00 | 0.00 | $0 | $493,835 | $34,720 | Yes (X) | |||
| AMY L MCGAHA MD | |||||||||
| BOARD MEMBER | 1.00 | 59.00 | Yes (X) | $0 | $434,812 | $26,872 | |||
| STEVE HOUSTON | |||||||||
| SVP STRATEGY AND TECHNOLOGY | 5.00 | 45.00 | $0 | $371,218 | $34,814 | Yes (X) | |||
| JASON KRUGER MD | |||||||||
| BOARD MEMBER | 1.00 | 59.00 | Yes (X) | $0 | $338,835 | $44,134 | |||
| NANCY WALLACE | |||||||||
| FORMER SVP CHIEF HR OFFICER | 5.00 | 45.00 | $0 | $315,144 | $25,201 | Yes (X) | |||
| MIKE WATTERS | |||||||||
| FORMER VP-SENIOR COUNSEL | 5.00 | 45.00 | $0 | $191,790 | $32,614 | Yes (X) | |||
| JACQUELINE LIESS | |||||||||
| NURSE PRACTIONER | 10.00 | 35.00 | $48,046 | $129,197 | $35,734 | Yes (X) | |||
| NICKI BOHL | |||||||||
| DIRECTOR PHARMACY | 45.00 | 0.00 | $176,653 | $0 | $27,527 | Yes (X) | |||
| KENT HOXMEIER | |||||||||
| COORDINATOR-PERFUSIONIST | 0.00 | 45.00 | $5,092 | $159,457 | $36,484 | Yes (X) | |||
| RANDALL DE FREECE | |||||||||
| DIRECTOR-FOUNDATION | 0.00 | 45.00 | $164,798 | $0 | $28,772 | Yes (X) | |||
| KEVIN JOHNSON | |||||||||
| PHARMACIST | 45.00 | 0.00 | $174,097 | $0 | $10,421 | Yes (X) | |||
| JENNIFER BEATY MD | |||||||||
| BOARD MEMBER | 1.00 | 11.00 | Yes (X) | $0 | $0 | $0 | |||
| LARRY BUTLER | |||||||||
| FORMER TREASURER | 1.00 | 11.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| FR JAMES CLIFTON SJ | |||||||||
| SECRETARY | 1.00 | 11.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| RICHARD HERINK | |||||||||
| BOARD CHAIR | 1.00 | 11.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| SUSANNE L HRUZA MD | |||||||||
| BOARD MEMBER | 1.00 | 11.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT LANIK | |||||||||
| TREASURER | 1.00 | 11.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| THOMAS MURRAY PHD | |||||||||
| BOARD MEMBER | 1.00 | 11.00 | Yes (X) | $0 | $0 | $0 | |||
| BARRY SANDSTROM | |||||||||
| BOARD MEMBER | 1.00 | 11.00 | Yes (X) | $0 | $0 | $0 | |||
| SISTER MAURITA SOUKUP | |||||||||
| VICE CHAIR | 1.00 | 12.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| BILL YATES | |||||||||
| BOARD MEMBER | 1.00 | 11.00 | Yes (X) | $0 | $0 | $0 | |||
| NADINE HEIMANN OSF | |||||||||
| BOARD MEMBER | 1.00 | 11.00 | Yes (X) | $0 | $0 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $568,686 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,774,563 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $474,977 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 48 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| RENAL CARE GROUP OF MIDWEST | |||||
| 1007 N EMPORIA | WICHITA | KS | 67214 | PATIENT SERVICES | $791,172 |
| RODGERS HELICOPTER SERVICES | |||||
| 4965 AIRPORT ROAD | KEARNEY | NE | 688473372 | TRANSPORTATION SERVICES | $707,264 |
| KEARNEY PHYSICIAN MGMT GRP LLC | |||||
| 3219 CENTRAL AVENUE | KEARNEY | NE | 68847 | MANAGEMENT SERVICES | $605,010 |
| NEBRASKA NEUROSURGERY & SPINE | |||||
| 3219 CENTRAL AVENUE SUITE 103 | KEARNEY | NE | 68847 | MEDICAL SERVICES | $494,980 |
| G4S SECURE SOLUTIONS USA INC | |||||
| 1395 UNIVERSITY DR | JUPITER | FL | 33458 | SECURITY SERVICES | $482,949 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 25 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $212,555 | RelatedOrganizationsAmt |
| Government Grants | $10,236,516 | GovernmentGrantsAmt |
| Total Contributions | $10,449,071 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| PATIENT SERVICES | 900099 | $167,272,108 | $167,272,108 | $0 | $0 |
| SERVICES SOLD | 900099 | $1,172,750 | $0 | $0 | $1,172,750 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $168,444,858 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,418,814 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $72,419 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,346,395 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,443,434 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,443,434 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,443,434 | TotalRevenueColumnAmt |
| Exclusion | $3,443,434 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $14,624,917 | SecuritiesAmt |
| Other | $45,025 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $14,624,917 | SecuritiesAmt |
| Other | $45,025 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,669,942 | TotalRevenueColumnAmt |
| Exclusion | $14,669,942 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| EMERGENCY MEDICAL SERV | 621910 | $391,968 | $0 | $0 | $391,968 |
| CAFETERIA | 722100 | $228,729 | $0 | $0 | $228,729 |
| LABORATORY SERVICES | 621500 | $68,203 | $0 | $54,778 | $13,425 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $354,579 | TotalRevenueColumnAmt |
| Exclusion | $354,579 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,043,479 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $202,469,598 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $167,272,108 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $127,197 | UnrelatedBusinessRevenueAmt |
| Exclusion | $24,621,222 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $389,437 | TotalAmt |
| Program Services | $389,437 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,631,914 | TotalAmt |
| Program Services | $39,268,723 | ProgramServicesAmt |
| Management And General | $4,363,191 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,166,831 | TotalAmt |
| Program Services | $1,950,148 | ProgramServicesAmt |
| Management And General | $216,683 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,319,568 | TotalAmt |
| Program Services | $7,487,611 | ProgramServicesAmt |
| Management And General | $831,957 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,063,237 | TotalAmt |
| Program Services | $2,756,914 | ProgramServicesAmt |
| Management And General | $306,323 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,494 | TotalAmt |
| Program Services | $4,945 | ProgramServicesAmt |
| Management And General | $549 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,572 | TotalAmt |
| Management And General | $6,572 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,630,963 | TotalAmt |
| Program Services | $29,948,013 | ProgramServicesAmt |
| Management And General | $1,682,950 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $582 | TotalAmt |
| Program Services | $524 | ProgramServicesAmt |
| Management And General | $58 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,275,898 | TotalAmt |
| Program Services | $2,048,308 | ProgramServicesAmt |
| Management And General | $227,590 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $343,767 | TotalAmt |
| Program Services | $309,391 | ProgramServicesAmt |
| Management And General | $34,376 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,365,880 | TotalAmt |
| Program Services | $6,629,292 | ProgramServicesAmt |
| Management And General | $736,588 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,653 | TotalAmt |
| Program Services | $111,288 | ProgramServicesAmt |
| Management And General | $12,365 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,308 | TotalAmt |
| Program Services | $2,978 | ProgramServicesAmt |
| Management And General | $330 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,927 | TotalAmt |
| Program Services | $1,927 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,575,556 | TotalAmt |
| Program Services | $6,818,000 | ProgramServicesAmt |
| Management And General | $757,556 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $338,407 | TotalAmt |
| Program Services | $304,566 | ProgramServicesAmt |
| Management And General | $33,841 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $28,417,550 | $28,417,550 | $0 | $0 |
| INTRACOMPANY ALLOCATION | $27,997,916 | $0 | $27,997,916 | $0 |
| REPAIRS AND MAINTENANCE | $2,683,005 | $2,548,855 | $134,150 | $0 |
| UNRELATED BUSINESS TAXE | $2,542 | $0 | $2,542 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,471 | TotalAmt |
| Program Services | $360,567 | ProgramServicesAmt |
| Management And General | $13,904 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,718,478 | TotalAmt |
| Program Services | $129,359,037 | ProgramServicesAmt |
| Management And General | $37,359,441 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $4,726 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $233,518,488 | BOYAmt |
| EOY | $380,659,745 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,518,840 | BOYAmt |
| EOY | $28,897,014 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,176 | BOYAmt |
| EOY | $109,952 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,441,347 | BOYAmt |
| EOY | $6,395,532 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $421,614 | BOYAmt |
| EOY | $414,210 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $253,819,380 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $167,309,316 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,394,387 | BOYAmt |
| EOY | $86,510,064 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $269,892,070 | BOYAmt |
| EOY | $225,820,268 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,301,156 | BOYAmt |
| EOY | $2,301,156 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,729,369 | BOYAmt |
| EOY | $43,489,259 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $665,352,447 | BOYAmt |
| EOY | $774,601,926 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,560,030 | BOYAmt |
| EOY | $36,231,980 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,429,181 | BOYAmt |
| EOY | $54,000 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $141,020,659 | BOYAmt |
| EOY | $195,511,815 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,009,870 | BOYAmt |
| EOY | $231,797,795 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $509,342,577 | BOYAmt |
| EOY | $542,804,131 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $509,342,577 | BOYAmt |
| EOY | $542,804,131 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $665,352,447 | BOYAmt |
| EOY | $774,601,926 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $35,751,120 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$13,087,635 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $730,000 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $10,068,068 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $6,572 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $6,572 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LINE 1F: THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: NEBRASKA HOSPITAL ASSOCIATION $3,088 CATHOLIC HEALTH ASSOCIATION $1,432 AMERICAN HOSPITAL ASSOCIATION $2,052. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,131,082 | BeginningYearBalanceAmt |
| Contributions | $183,346 | ContributionsAmt |
| Investment Earnings Or Losses | $34,380 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $19,469 | OtherExpendituresAmt |
| End Year Balance | $2,329,339 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,052,871 | BeginningYearBalanceAmt |
| Contributions | $60,000 | ContributionsAmt |
| Investment Earnings Or Losses | $45,960 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $27,749 | OtherExpendituresAmt |
| End Year Balance | $2,131,082 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,757,597 | BeginningYearBalanceAmt |
| Contributions | $301,538 | ContributionsAmt |
| Investment Earnings Or Losses | $25,856 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $32,120 | OtherExpendituresAmt |
| End Year Balance | $2,052,871 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,752,166 | BeginningYearBalanceAmt |
| Contributions | $5,586 | ContributionsAmt |
| Investment Earnings Or Losses | $15,456 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $15,611 | OtherExpendituresAmt |
| End Year Balance | $1,757,597 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,707,795 | BeginningYearBalanceAmt |
| Contributions | $50,000 | ContributionsAmt |
| Investment Earnings Or Losses | $8,580 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $14,209 | OtherExpendituresAmt |
| End Year Balance | $1,752,166 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.72700 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.27300 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,917,997 | OtherCostOrOtherBasisAmt |
| Book Value | $7,917,997 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $97,578,522 | OtherCostOrOtherBasisAmt |
| Depreciation | $47,273,345 | DepreciationAmt |
| Book Value | $50,305,177 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $46,800 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,927 | DepreciationAmt |
| Book Value | $27,873 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $134,619,255 | OtherCostOrOtherBasisAmt |
| Depreciation | $113,569,829 | DepreciationAmt |
| Book Value | $21,049,426 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,656,806 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,447,215 | DepreciationAmt |
| Book Value | $7,209,591 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $86,510,064 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CHI OIP | Desc |
| Book Value | $225,820,268 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $225,820,268 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTERCOMPANY RECEIVABLES | $26,418,810 |
| RIGHT OF USE ASSETS | $13,466,472 |
| INVESTMENTS IN UNCONSOLIDATED ORGANIZATIONS | $2,295,851 |
| DEFERRED COMPENSATION | $1,308,126 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $43,489,259 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY PAYABLES | $181,081,667 |
| LT PORTION OF LEASE LIABILITIES | $10,025,540 |
| CURRENT PORTION OF LEASE LIABILITIES | $4,369,765 |
| OTHER LIABILITIES | $34,843 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $195,511,815 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE FOUNDATION'S ENDOWMENT FUNDS ARE USED TO PROVIDE FINANCIAL SUPPORT FOR HOSPITAL PROGRAMS THAT ENHANCE THE HEALTH OF THE KEARNEY COMMUNITY AND SURROUNDING AREAS. |
| PART X, LINE 2: | GOOD SAMARITAN HOSPITAL'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH'S ASC 740 FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2020, READS AS FOLLOWS: COMMONSPIRIT HAS ESTABLISHED ITS STATUS AS AN ORGANIZATION EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND THE LAWS OF THE STATES IN WHICH IT OPERATES, AND AS SUCH, IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, COMMONSPIRIT'S EXEMPT ORGANIZATIONS ARE SUBJECT TO INCOME TAXES ON NET INCOME DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, WHICH DOES NOT FURTHER THE ORGANIZATIONS' EXEMPT PURPOSES. NO SIGNIFICANT INCOME TAX PROVISION HAS BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR NET INCOME DERIVED FROM UNRELATED TRADE OR BUSINESS. COMMONSPIRIT'S FOR-PROFIT SUBSIDIARIES ACCOUNT FOR INCOME TAXES RELATED TO THEIR OPERATIONS. THE FOR-PROFIT SUBSIDIARIES RECOGNIZE DEFERRED TAX ASSETS AND LIABILITIES FOR TEMPORARY DIFFERENCES BETWEEN THE FINANCIAL REPORTING BASIS AND THE TAX BASIS OF THEIR ASSETS AND LIABILITIES, ALONG WITH NET OPERATING LOSS AND TAX CREDIT CARRYOVERS, FOR TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION CRITERIA. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. INCOME TAX INTEREST AND PENALTIES ARE RECORDED AS INCOME TAX EXPENSE. FOR THE YEARS ENDED JUNE 30, 2020 AND 2019, COMMONSPIRIT'S TAXABLE ENTITIES RECORDED AN IMMATERIAL AMOUNT OF INTEREST AND PENALTIES AS PART OF THE PROVISION FOR INCOME TAXES. COMMONSPIRIT'S TAXABLE ENTITIES DID NOT HAVE ANY MATERIAL UNRECOGNIZED INCOME TAX EXPENSE AS OF JUNE 30, 2020 AND 2019. COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3535 | PersonsServedCnt |
| Total Community Benefit Expns | $7,079,960 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,079,960 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04250 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 5802 | PersonsServedCnt |
| Total Community Benefit Expns | $15,859,161 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,251,703 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,607,458 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02760 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 9337 | PersonsServedCnt |
| Total Community Benefit Expns | $22,939,121 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,251,703 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,687,418 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07010 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 23 | ActivitiesOrProgramsCnt |
| Persons Served | 464563 | PersonsServedCnt |
| Total Community Benefit Expns | $706,669 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $55,900 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $650,769 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 354 | PersonsServedCnt |
| Total Community Benefit Expns | $830,378 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $154,741 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $675,637 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00410 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $11,914 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,914 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 145 | PersonsServedCnt |
| Total Community Benefit Expns | $230,410 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,094 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $229,316 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 44 | ActivitiesOrProgramsCnt |
| Persons Served | 465062 | PersonsServedCnt |
| Total Community Benefit Expns | $1,779,371 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $211,735 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,567,636 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00950 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 44 | ActivitiesOrProgramsCnt |
| Persons Served | 474399 | PersonsServedCnt |
| Total Community Benefit Expns | $24,718,492 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,463,438 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,255,054 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07960 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 50 | PersonsServedCnt |
| Total Community Benefit Expns | $354 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $354 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $63 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $63 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $61 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $61 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 315 | PersonsServedCnt |
| Total Community Benefit Expns | $50,696 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $50,696 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 365 | PersonsServedCnt |
| Total Community Benefit Expns | $51,174 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $51,174 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $11,182,569 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $51,637,654 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $67,196,370 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$15,558,716 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 KEARNEY AMBULATORY SURGICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | SURGERY | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.20600 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.00000 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.43720 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | OtherOtherDesc | Facility Reporting GroupFacilityReportingGroupCd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| GOOD SAMARITAN HOSPITAL | |||||||||||
| 1 | 10 EAST 31ST STREET PO BOX 1990 | KEARNEY | NE | 68848 | WWW.GSHS.ORG | 070001 | Yes (X) | Yes (X) | Yes (X) | ACUTE HOSPITAL | A |
| RICHARD YOUNG BEHAVIORAL HEALTH CENTER | |||||||||||
| 2 | 1755 PRAIRIE VIEW PL | KEARNEY | NE | 68847 | WWW.GSHS.ORG | 070002 | Yes (X) | PSYCHIATRIC HOSPITAL | A | ||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FACILITY REPORTING GROUP - A | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.CHIHEALTH.COM/CHNA | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B | FACILITY REPORTING GROUP A |
| FACILITY REPORTING GROUP A CONSISTS OF: | - FACILITY 1: GOOD SAMARITAN HOSPITAL, - FACILITY 2: RICHARD YOUNG BEHAVIORAL HEALTH CENTER |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: | THE ASSESSMENTS USED WERE PROVIDED BY BUFFALO COUNTY COMMUNITY PARTNERS (BCCP) AND TWO RIVERS PUBLIC HEALTH DEPARTMENT (TRPHD). EACH PROCESS WAS UNIQUE, AND INVOLVED INPUT FROM KEY COMMUNITY STAKEHOLDERS. INPUT TO BCCP'S ASSESSMENTS WAS SECURED THROUGH ITS 2,500 COMMUNITY MEMBERS, AND BOTH BCCP AND TRPHD'S RECEIVED INPUT FROM STAKEHOLDERS THAT REPRESENTED LOW-INCOME AND UNINSURED POPULATIONS, AGING POPULATIONS, MINORITY POPULATIONS, INDIVIDUALS WITH LIMITED RESOURCES, AND THOSE AFFECTED BY VIOLENCE. INPUT TO CONFIRM THE TOP HEALTH NEEDS IN THE COMMUNITY FOR THE GSH/RYBH CHNA WAS SOUGHT FROM KEY LEADERS AT BCCP AND TRPHD WHO PROVIDED INPUT BASED ON THEIR PROCESSES, AND REPRESENT A BROAD ARRAY OF STAKEHOLDERS SERVING LOW-INCOME AND AT-RISK INDIVIDUALS, AS WELL AS MINORITIES, THE AGING, AND THOSE AFFECTED BY VIOLENCE. TAKING INTO CONSIDERATION BOTH THE BCCP AND TRPHD PROCESS AND DATA, INFORMATION REGARDING COMMUNITY INPUT WAS THEN PRESENTED TO THE GSH/RYBH COMMUNITY BOARD. IDENTIFIED NEEDS FROM BOTH PROCESSES WERE THEN DISCUSSED AND ACCEPTED BY THE GSH/RYBH COMMUNITY BOARD AND TRPHD LEADERSHIP. |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: | THE CHNA WAS CONDUCTED WITH GOOD SAMARITAN HOSPITAL, GOOD SAMARITAN LTC, WHICH IS A STATE LICENSED HOSPITAL FACILITY, CONSIDERED PART OF GSH, AND GOOD SAMARITAN/RICHARD YOUNG BEHAVIORAL HEALTH CENTER (RYBHC), ALL LICENSED HOSPITAL FACILITIES WITHIN THE REPORTING GROUP. |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B: | GOOD SAMARITAN HOSPITAL/RICHARD YOUNG BEHAVIORAL HEALTH CENTER (RYBHC) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN PARTNERSHIP WITH BUFFALO COUNTY COMMUNITY PARTNERS AND TWO RIVERS PUBLIC HEALTH DEPARTMENT. IN ADDITION, NUMEROUS COMMUNITY PARTNERS PARTICIPATED IN THE CHNA PROCESS. |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 7D: | THE DATA AND RESULTS WERE SHARED WITH THE COMMUNITY BOARD FOR GSH AND RYBH, AS WELL AS HOSPITAL ADMINISTRATION AND THE BCCP COMMUNITY BOARD. THE RESULTS WERE ALSO VALIDATED BY TRPHD. |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: | THE MOST RECENT CHNA AND CORRESPONDING IMPLEMENTATION PLAN WAS COMPLETED IN THE TAX REPORTING YEAR 2018. THE FOLLOWING OUTLINES THE CURRENT IMPLEMENTATION PLAN PRIORITIES AND STRATEGIES. THIS PLAN WAS POSTED PUBLICLY ON WWW.CHIHEALTH.COM/CHNA. THIS IS A JOINT PLAN BETWEEN CHI HEALTH GOOD SAMARITAN AND RICHARD YOUNG BEHAVIORAL HEALTH CENTER.THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH THE CHNA ASSESSMENT PROCESS AND THEY WERE FURTHER VALIDATED BY THE GSH/RYBHC COMMUNITY BOARD:TOP HEALTH NEEDS (FROM 2018 CHNA):1. ACCESS TO CARE2. ALZHEIMER'S DISEASE & DEMENTIA3. BEHAVIORAL HEALTH4. WEIGHT STATUS5. VIOLENCE6. CHRONIC DISEASE7. LIFESTYLE CHOICES AND PERSONAL ACCOUNTABILITYFOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: ACCESS TO HEALTHCARE SERVICESTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN 2019-2021:* ENGAGE WITH LOCAL HEALTH AND HUMAN SERVICE AGENCIES TO IMPROVE ACCESS TO CLINIC AND COMMUNITY BASED HEALTH SERVICES THROUGH OPTIMIZATION OF SERVICE OFFERINGS, COORDINATION OF CARE, PROMOTION OF SERVICES, AND INSURANCE ENROLLMENT SERVICE TO SERVE THOSE MOST IN NEED IN BUFFALO COUNTY.* EXPLORE AND IDENTIFY OPPORTUNITIES FOR ALIGNMENT WITH EXISTING HEALTHCARE ACCESS IMPROVEMENT EFFORTS THROUGH TWO RIVERS PUBLIC HEALTH (GOOD SAMARITAN)* EXPLORE OPPORTUNITIES TO SUPPORT HELPCARE CLINIC THROUGH ESTABLISHING VOLUNTEER CLINICS TO IMPROVE ACCESS FOR UN/UNDER-INSURED AND IMPROVE DIABETES MANAGEMENT WORK (GOOD SAMARITAN)* CONTINUE TO EXPLORE AND BUILD CAPACITY FOR INTEGRATION OF BEHAVIORAL HEALTH INTO PRIMARY CARE (GOOD SAMARITAN & RYBH)* CONTINUE FUNDING AND SUPPORT OF BUFFALO COUNTY COMMUNITY PARTNERS (BCCP) EFFORTS TO MONITOR AND IMPROVE THE OVERALL HEALTH STATUS OF THE COMMUNITY THROUGH: (GOOD SAMARITAN)- VIOLENCE PREVENTION PROGRAMMING- INCREASING CAPACITY OF COMMUNITY-BASED SERVICES TO REDUCE STIGMA AND IMPROVE BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE ABUSE)- PROMOTE PREVENTIVE HEALTHCARE ACCESS- PROMOTE HEALTHY BEHAVIORS TO REDUCE CHRONIC DISEASE* ENGAGE WITH EXISTING WORK RELATED TO EARLY CHILDHOOD SERVICES TO EXPLORE COMMUNITY CAPACITY AND INTEREST IN EXPANDING MATERNAL HOME VISITING TO IMPROVE HEALTH LITERACY, HEALTHCARE ACCESS, AND OVERALL HEALTH OUTCOMES FOR FAMILIES (I.E. PREGNANT AND PARENTING WOMEN WITH CHILDREN AGES 0-3) (GOOD SAMARITAN)PRIORITY HEALTH NEED #2: BEHAVIORAL HEALTH (TO INCLUDE VIOLENCE)TO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN 2019-2021:* COLLABORATE WITH LOCAL COMMUNITY, PUBLIC HEALTH, AND HEALTHCARE PARTNERS TO SUPPORT COMMUNITY BASED STRATEGIES TO ADDRESS MENTAL ILLNESS, SUBSTANCE ABUSE, VIOLENT BEHAVIORS, WHILE CONTINUING TO BUILD AND OPTIMIZE BEHAVIORAL HEALTH SERVICES INTERNALLY.* EXPLORE AND BETTER UNDERSTAND OPPORTUNITIES FOR ALIGNMENT WITH REGION 3 BEHAVIORAL HEALTH SERVICES TO:- ENSURE AVAILABLE FUNDING AND SUPPORT IS PROVIDED FOR KEY STRATEGIES SUCH AS CRISIS RESPONSE, TRAINING, AND SYSTEM OF CARE WORK (RYBH)- IMPROVE CONTINUUM OF CARE MODELS TO ENSURE ACCESS AND UTILIZATION OF APPROPRIATE MENTAL AND PHYSICAL HEALTH SERVICES (RYBH)* CONTINUE INTENTIONAL COOPERATION AND COORDINATION WITH THE FOLLOWING EXTERNAL PARTNERS:- KEARNEY PUBLIC SCHOOLS RELATED TO YOUTH ADMITTED/TREATED/RELEASED FROM RYBH -ESPECIALLY WHEN BULLYING IS IDENTIFIED AS AN ISSUE (RYBH)- SUPPORT TO CENTRAL NEBRASKA/KEARNEY LOSS TEAM (LOCAL OUTREACH TO SUICIDE SURVIVORS)(RYBH)* CONTINUE TO EXPLORE AND BUILD CAPACITY FOR INTEGRATION OF BEHAVIORAL HEALTH IN PRIMARY CARE (GOOD SAMARITAN & RYBH)* ENSURE CONTINUED PARTICIPATION AND SUPPORT IN THE HEALTHY MINDS COALITION LED BY BCCP, TO ENSURE ON-GOING COMMUNITY-BASED STRATEGIES TO IMPROVE THE STIGMA OF MENTAL ILLNESS AND INFORM THE IMPROVEMENT OF CLINICAL SERVICE OFFERINGS. (GOOD SAMARITAN & RYBH)* EXPLORE ALIGNMENT OPPORTUNITIES WITH TWO RIVERS PUBLIC HEALTH DEPT. (GOOD SAMARITAN & RYBH)THE HOSPITAL WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS FOR THE FOLLOWING REASONS:IN ACKNOWLEDGING THE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS, GOOD SAMARITAN AND RYBH PRIORITIZED THE HEALTH ISSUES ABOVE IN ORDER TO MOST EFFECTIVELY FOCUS RESOURCES AND MEANINGFULLY IMPACT THE SELECTED HEALTH ISSUES. THE HOSPITALS TOOK INTO CONSIDERATION EXISTING PARTNERSHIPS, AVAILABLE RESOURCES, THE HOSPITAL'S LEVEL OF EXPERTISE, EXISTING INITIATIVES (OR LACK THEREOF), POTENTIAL FOR IMPACT, AND THE COMMUNITY'S INTEREST IN THE HOSPITAL ENGAGING IN THAT AREA IN ORDER TO SELECT THE PRIORITIES. THE FOLLOWING IDENTIFIED NEEDS WILL NOT BE PRIORITIZED IN THIS IMPLEMENTATION PLAN FOR THE FOLLOWING REASONS.ALZHEIMER'S DISEASE AND DEMENTIA - IN ORDER TO MEANINGFULLY ADDRESS AND IMPACT THE SELECT HEALTH NEEDS PRIORITIZED ABOVE, GOOD SAMARITAN AND RYBH WILL NOT PRIORITIZE ALZHEIMER'S AND DEMENTIA ON THIS ISP. ADDITIONALLY, THE HOSPITAL CONTRIBUTES SIGNIFICANT IN-KIND AND FINANCIAL RESOURCES TO BUFFALO COUNTY COMMUNITY PARTNERS (BCCP), WHICH ACTIVELY MANAGES A LOCAL COALITION TO ADDRESS CHALLENGES RELATED TO ALZHEIMER'S AND DEMENTIA FOR THOSE LIVING WITH THE DISEASE AND THOSE CAREGIVERS SUPPORTING THEM.CHRONIC DISEASE - IN ORDER TO MEANINGFULLY ADDRESS THE SELECT PRIORITY HEALTH NEEDS ABOVE AND MAXIMIZE IMPACT, GOOD SAMARITAN AND RYBH DID NOT PRIORITIZE CHRONIC DISEASE FOR WORK ON THIS ISP. HOWEVER, THE HOSPITALS HAVE PRIORITIZED ACCESS TO HEALTHCARE SERVICES AND THESE EFFORTS MAY INDIRECTLY IMPROVE THE ABILITY OF HEALTHCARE SERVICES AND COMMUNITY PARTNERS TO ADDRESS CHRONIC DISEASE ON AN INDIVIDUAL BASIS. SPECIFICALLY, GOOD SAMARITAN WILL BE WORKING CLOSELY WITH THE HELPCARE CLINIC IN KEARNEY TO SUPPORT DIABETES MANAGEMENT FOR THOSE UN/UNDER-INSURED IN THE BUFFALO COUNTY AREA. ADDITIONALLY, THE HOSPITAL CONTRIBUTES SIGNIFICANT IN-KIND AND FINANCIAL RESOURCES TO BUFFALO COUNTY COMMUNITY PARTNERS (BCCP), WHICH ACTIVELY MANAGES A LOCAL COALITION TO ADDRESS CHALLENGES RELATED TO HEALTHY EATING, ACTIVE LIVING, AND DIABETES PREVENTION NETWORK TO SUPPORT PROVIDER REFERRALS FOR DIABETIC PATIENTS TO RECEIVE SUPPORT. GOOD SAMARITAN ALSO OFFERS A STATE-OF-THE-ART WELLNESS CENTER THAT PROVIDE A VARIETY OF RESOURCES RELATED TO CHRONIC DISEASE MANAGEMENT, INCLUDING INDIVIDUAL EXERCISE EQUIPMENT AND GROUP EXERCISE CLASSES. THE WELLNESS CENTER ALSO PROVIDES MEMBERSHIP DISCOUNTS TO ADULTS OVER 60 YEARS OLD, AND BUSINESS MEMBERSHIPS TO THOSE WHO ARE ACTIVE MEMBERS OF ACTIVATE BUFFALO COUNTY, A LOCAL COALITION DEDICATED TO PROMOTING WELLNESS AT WORK.LIFESTYLE CHOICES & PERSONAL ACCOUNTABILITY - IN ORDER TO MEANINGFULLY ADDRESS THE SELECT PRIORITY HEALTH NEEDS ABOVE AND MAXIMIZE IMPACT, GOOD SAMARITAN AND RYBH DID NOT PRIORITIZE WORK IN THIS AREA. INDIVIDUAL BEHAVIORS SUCH AS CONSUMING HEALTHY FOODS, GETTING ACTIVE, AND AVOIDING RISKY BEHAVIORS SUCH AS SMOKING REQUIRE MULTI-DIMENSIONAL APPROACHES THAT INCLUDE STAKEHOLDERS FROM VARIOUS SECTORS INCORPORATING POLICIES THAT HELP MAKE THE HEALTHY CHOICES THE EASY CHOICES. AS SUCH, THERE IS ALREADY AN EXISTING COALITION LED BY BCCP (BE WELL) THAT WORKS TO PROMOTE POLICY AND ENVIRONMENT CHANGES THAT HELP DRIVE HEALTHY BEHAVIORS AND HEALTHY CHOICES. GOOD SAMARITAN CONTRIBUTES FINANCIALLY TO THIS COALITION AND WILL CONTINUE TO SUPPORT EFFORTS AS CAPACITY ALLOWS.WEIGHT STATUS (NUTRITION, PHYSICAL ACTIVITY, AND OBESITY) - IN ORDER TO MEANINGFULLY ADDRESS THE SELECT PRIORITY HEALTH NEEDS ABOVE AND MAXIMIZE IMPACT, GOOD SAMARITAN AND RYBH DID NOT PRIORITIZE WORK IN THIS AREA. HOWEVER, GOOD SAMARITAN HAS LONG SUPPORTED, AND WILL CONTINUE TO SUPPORT WORK RELATED TO PROMOTING POLICY AND ENVIRONMENT CHANGE TO PROMOTE HEALTHY EATING AND ACTIVE LIVING THROUGH THE BE WELL COALITION, LED BY BCCP. |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13H: | THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.PATIENT COOPERATION STANDARDS - A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD-PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A CHI HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS. |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
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| PART I, LINE 3C: | UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE:* THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.* THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 300% OF THE FPG.* THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED [IN THE FAP].* THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:* RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS;* HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS CLINIC;* PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);* FOOD STAMP ELIGIBILITY;* SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY;* ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID SPEND-DOWN);* LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR* PATIENT IS DECEASED WITH NO KNOWN ESTATE. |
| PART I, LINE 6A: | THE 2018 COMMUNITY BENEFIT REPORT FOR GOOD SAMARITAN HOSPITAL WAS PREPARED BY ALEGENT CREIGHTON HEALTH, DBA CHI HEALTH, A RELATED ORGANIZATION. THE COMMUNITY BENEFIT REPORT CONTAINS INFORMATION FOR SEVERAL RELATED ORGANIZATIONS IN IOWA AND NEBRASKA. |
| PART I, LINE 7: | A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING WORKSHEET 2 TO COMPUTE THE COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | CHI HEALTH HAS A HISTORY OF CENTRALIZED COMMUNITY BENEFIT INVESTMENTS, AS WELL AS HOSPITAL SPECIFIC INVESTMENTS THAT ADDRESS COMMUNITY HEALTH NEEDS WHICH INCLUDE SUPPORT OF LOCAL HEALTH COALITIONS, INVESTMENTS IN PARTNERSHIPS AND PROGRAMS THAT ADDRESS TOP COMMUNITY HEALTH NEEDS, PARTICIPATION IN LOCAL COMMITTEES AND BOARDS TIED TO TOP HEALTH NEEDS, AND INVESTMENTS IN MANY OTHER WAYS AS DESCRIBED IN OTHER AREAS OF THE SCHEDULE H NARRATIVE. BELOW ARE SPECIFIC EXAMPLES OF WORK THAT FALLS WITHIN THE DEFINITION OF COMMUNITY BUILDING ACTIVITIES. THESE ACTIVITIES ARE CRITICAL IN HELPING BUILD SOCIAL, HEALTH, AND ECONOMIC OPPORTUNITIES IN OUR COMMUNITY THAT ULTIMATELY DRIVE HEALTH STATUS AND QUALITY OF LIFE FOR OUR RESIDENTS: - WORKFORCE DEVELOPMENT-THE FOLLOWING ACTIVITIES WORK TO STRENGTHEN THE COMMUNITY'S CAPACITY TO PROMOTE THE HEALTH AND WELL-BEING OF OUR RESIDENTS BY DRIVING ENTRY INTO HEALTHCARE CAREERS:* HEALTHCARE CAREER EXPLORATION CAMP-DAY CAMP FUNDED BY CHI HEALTH FOR STUDENTS GRADES 10-12 TO GIVE THEM THE OPPORTUNITY TO EXPLORE A VARIETY OF HEALTHCARE PROFESSIONS* PRESENTATIONS TO HIGH SCHOOL STUDENTS ABOUT HEALTHCARE CAREERS* PROVIDED CONTRIBUTION TO KEARNEY HEALTH OPPORTUNITIES PROGRAM (KHOP) WHICH IS A COOPERATIVE PROGRAM BETWEEN UNIVERSITY OF NEBRASKA KEARNEY AND THE UNIVERSITY OF NEBRASKA MEDICAL CENTER. THE PURPOSE OF THE PROGRAM IS TO RECRUIT AND EDUCATE STUDENTS FROM RURAL NEBRASKA WHO ARE COMMITTED TO RETURNING TO RURAL NEBRASKA TO PRACTICE HEALTHCARE.- COMMUNITY AND ECONOMIC DEVELOPMENT INCLUDING SUPPORT OF LOCAL CHAMBERS OF COMMERCE |
| PART III, LINE 2: | COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 31.88%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. |
| PART III, LINE 3: | GOOD SAMARITAN HOSPITAL DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE. |
| PART III, LINE 4: | GOOD SAMARITAN HOSPITAL DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS:COMMONSPIRIT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITE-OFFS AND COLLECTIONS IN ESTIMATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE. UPDATES TO THE HINDSIGHT ANALYSIS IS PERFORMED AT LEAST QUARTERLY USING PRIMARILY A ROLLING EIGHTEEN-MONTH COLLECTION HISTORY AND WRITE-OFF DATA. SUBSEQUENT CHANGES TO ESTIMATES OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT REVENUE IN THE PERIOD OF CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN A THIRD-PARTY PAYOR'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE IN PURCHASED SERVICES AND OTHER IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGE IN NET ASSETS. BAD DEBT EXPENSE FOR 2020 WAS NOT SIGNIFICANT. |
| PART III, LINE 8: | USING ESSENTIALLY THE SAME MEDICARE COST REPORT PRINCIPLES AS TO THE ALLOCATION OF GENERAL SERVICES COSTS AND "APPORTIONMENT" METHODS, THE"CHI WORKBOOK" CALCULATES A PAYERS' GROSS ALLOWABLE COSTS BY SERVICE (SO AS TO FACILITATE A CORRESPONDING COMPARISON BETWEEN GROSS ALLOWABLE COSTS AND ULTIMATE PAYMENTS RECEIVED). THE TERM "GROSS ALLOWABLE COSTS" MEANS COSTS BEFORE ANY DEDUCTIBLES OR CO-INSURANCE ARE SUBTRACTED. GOOD SAMARITAN HOSPITAL'S ULTIMATE REIMBURSEMENT WILL BE REDUCED BY ANY APPLICABLE COPAYMENT/ DEDUCTIBLE. WHERE MEDICARE IS THE SECONDARY INSURER, AMOUNTS DUE FROM THE INSURED'S PRIMARY PAYER WERE NOT SUBTRACTED FROM MEDICARE ALLOWABLE COSTS BECAUSE THE AMOUNTS ARE TYPICALLY IMMATERIAL. ALTHOUGH NOT PRESENTED ON THE MEDICARE COST REPORT, IN ORDER TO FACILITATE A MORE ACCURATE UNDERSTANDING OF THE "TRUE" COST OF SERVICES (FOR "SHORTFALL" PURPOSES) THE CHI WORKBOOK ALLOWS A HEALTH CARE FACILITY NOT TO OFFSET COSTS THAT MEDICARE CONSIDERS TO BE NON-ALLOWABLE, BUT FOR WHICH THE FACILITY CAN LEGITIMATELY ARGUE ARE RELATED TO THE CARE OF THE FACILITY'S PATIENTS. IN ADDITION, ALTHOUGH NOT REPORTABLE ON THE MEDICARE COST REPORT, THE CHI WORKBOOK INCLUDES THE COST OF SERVICES THAT ARE PAID VIA A SET FEE-SCHEDULE RATHER THAN BEING REIMBURSED BASED ON COSTS (E.G. OUTPATIENT CLINICAL LABORATORY). FINALLY, THE CHI WORKBOOK ALLOWS A FACILITY TO INCLUDE OTHER HEALTH CARE SERVICES PERFORMED BY A SEPARATE FACILITY (SUCH AS A PHYSICIAN PRACTICE) THAT ARE MAINTAINED ON SEPARATE BOOKS AND RECORDS (AS OPPOSED TO THE MAIN FACILITY'S BOOKS AND RECORDS WHICH HAS ITS COSTS OF SERVICE INCLUDED WITHIN A COST REPORT). TRUE COSTS OF MEDICARE COMPUTED USING THIS METHODOLOGY:TOTAL MEDICARE REVENUE: $ 51,637,654TOTAL MEDICARE COSTS: $ 67,196,370SURPLUS (OR SHORTFALL): ($ 15,558,716)GOOD SAMARITAN HOSPITAL BELIEVES THAT EXCLUDING MEDICARE LOSSES FROM COMMUNITY BENEFIT MAKES THE OVERALL COMMUNITY BENEFIT REPORT MORE CREDIBLE FOR THESE REASONS: UNLIKE SUBSIDIZED AREAS SUCH AS BURN UNITS OR BEHAVIORAL-HEALTH SERVICES, MEDICARE IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS. IN FACT, FOR-PROFIT HOSPITALS FOCUS ON ATTRACTING PATIENTS WITH MEDICARE COVERAGE, ESPECIALLY IN THE CASE OF WELL-PAID SERVICES THAT INCLUDE CARDIAC AND ORTHOPEDICS. SIGNIFICANT EFFORT AND RESOURCES ARE DEVOTED TO ENSURING THAT HOSPITALS ARE REIMBURSED APPROPRIATELY BY THE MEDICARE PROGRAM. THE MEDICARE PAYMENT ADVISORY COMMISSION (MEDPAC), AN INDEPENDENT CONGRESSIONAL AGENCY, CAREFULLY STUDIES MEDICARE PAYMENT AND THE ACCESS TO CARE THAT MEDICARE BENEFICIARIES RECEIVE. THE COMMISSION RECOMMENDS PAYMENT ADJUSTMENTS TO CONGRESS ACCORDINGLY. THOUGH MEDICARE LOSSES ARE NOT INCLUDED BY CATHOLIC HOSPITALS AS COMMUNITY BENEFIT, THE CATHOLIC HEALTH ASSOCIATION GUIDELINES ALLOW HOSPITALS TO COUNT AS COMMUNITY BENEFIT SOME PROGRAMS THAT SPECIFICALLY SERVE THE MEDICARE POPULATION. FOR INSTANCE, IF HOSPITALS OPERATE PROGRAMS FOR PATIENTS WITH MEDICARE BENEFITS THAT RESPOND TO IDENTIFIED COMMUNITY NEEDS, GENERATE LOSSES FOR THE HOSPITAL, AND MEET OTHER CRITERIA, THESE PROGRAMS CAN BE INCLUDED IN THE CHA FRAMEWORK IN CATEGORY C AS "SUBSIDIZED HEALTH SERVICES." MEDICARE LOSSES ARE DIFFERENT FROM MEDICAID LOSSES, WHICH ARE COUNTED IN THE CHA COMMUNITY BENEFIT FRAMEWORK, BECAUSE MEDICAID REIMBURSEMENTS GENERALLY DO NOT RECEIVE THE LEVEL OF ATTENTION PAID TO MEDICARE REIMBURSEMENT. MEDICAID PAYMENT IS LARGELY DRIVEN BY WHAT STATES CAN AFFORD TO PAY, AND IS TYPICALLY SUBSTANTIALLY LESS THAN WHAT MEDICARE PAYS. |
| PART III, LINE 9B: | THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY APPLIES TO ALL INDIVIDUALS PRESENTING FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE POLICY CONTAINS PROVISIONS FOR COLLECTING AMOUNTS DUE FROM THOSE PATIENTS WHO THE ORGANIZATION KNOWS TO QUALIFY FOR FINANCIAL ASSISTANCE EITHER THROUGH THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS OR THROUGH PRESUMPTIVE ELIGIBILITY PROCESSES. BEFORE ENGAGING IN EXTRAORDINARY COLLECTION ACTIONS (ECAS) TO OBTAIN PAYMENT FOR EMCARE, HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. IN NO EVENT WILL AN ECA BE INITIATED PRIOR TO 120 DAYS FROM THE DATE THE FACILITY PROVIDES THE FIRST POST-DISCHARGE BILLING STATEMENT (I.E., DURING THE NOTIFICATION PERIOD) UNLESS ALL REASONABLE EFFORTS HAVE BEEN MADE.HOSPITAL FACILITIES WILL NOT REFER ACCOUNTS FOR COLLECTION WHERE THE PATIENT HAS INITIALLY APPLIED FOR FINANCIAL ASSISTANCE, AND THE HOSPITAL FACILITY HAS NOT YET MADE REASONABLE EFFORTS WITH RESPECT TO THE ACCOUNT. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. PATIENTS WHO QUALIFY FOR MEDICAID ARE PRESUMED TO QUALIFY FOR FULL CHARITY WRITE OFF. ANY CHARGES FOR DAYS OR SERVICES WRITTEN OFF (EXCLUDING MEDICAID DENIALS RELATED TO TIMELINESS OF BILLING, INSUFFICIENT MEDICAL RECORD DOCUMENTATION, MISSING INVOICES, AUTHORIZATION, OR ELIGIBILITY ISSUES) AS A RESULT OF A MEDICAID ARE BOOKED AS CHARITY.SOME MEDICAID PLANS OFFER COVERAGE FOR A LIMITED OR RESTRICTED LIST OF SERVICES. IF A PATIENT IS ELIGIBLE FOR MEDICAID, ANY CHARGES FOR DAYS OR SERVICES NOT COVERED BY THE PATIENT'S COVERAGE MAY BE WRITTEN OFF TO CHARITY WITHOUT A COMPLETED APPLICATION. THIS DOES NOT INCLUDE ANY SHARE OF COST (SOC) OR OTHER PATIENT COST-SHARING AMOUNTS SUCH AS DEDUCTIBLES OR COPAYMENTS, AS SUCH COSTS ARE DETERMINED BY THE STATE TO BE AN AMOUNT THAT THE PATIENT MUST PAY BEFORE THE PATIENT IS ELIGIBLE FOR MEDICAID. HEALTH AND HUMAN SERVICES (HSS) USES THE TERM "SPEND DOWN" INSTEAD OF SHARE OF COST.ALL COLLECTION ACTIVITIES CONDUCTED BY THE FACILITY, A DESIGNATED SUPPLIER, OR ITS THIRD-PARTY COLLECTION AGENTS WILL BE IN CONFORMANCE WITH ALL FEDERAL AND STATE LAWS GOVERNING DEBT COLLECTION PRACTICES. ALL THIRD-PARTY AGREEMENTS GOVERNING COLLECTION AND RECOVERY ACTIVITIES MUST INCLUDE A PROVISION REQUIRING COMPLIANCE WITH THE HOSPITAL FACILITIES' FINANCIAL ASSISTANCE AND BILLING AND COLLECTIONS POLICY AND INDEMNIFICATION FOR FAILURES AS A RESULT OF ITS NONCOMPLIANCE. THIS INCLUDES, BUT IS NOT LIMITED TO, AGREEMENTS BETWEEN THIRD PARTIES WHO SUBSEQUENTLY SELL OR REFER DEBT OF THE HOSPITAL FACILITY. |
| PART VI, LINE 2: | THE PROCESS OF IDENTIFYING THE COMMUNITY HEALTH NEEDS IN BUFFALO COUNTY WAS ACCOMPLISHED BY REVIEWING SECONDARY DATA, PARTICIPATING IN TWO COMMUNITY-BASED PROCESSES, REVIEWING AND VALIDATING THE DATA AND PRIORITIZATION THROUGH AN INTERNAL PROCESS, AND FINALLY COLLECTING INPUT AND VALIDATION OF THE NEEDS FROM TRPHD, THE LOCAL PUBLIC HEALTH AGENCY. SECONDARY DATA INCLUDED IN THIS NEEDS ASSESSMENT WAS SOURCED FROM THE TWO EXTERNAL CHNA PROCESSES, AS WELL AS FROM VARIOUS SOURCES SUCH AS CENSUS QUICK FACTS, COMMUNITY COMMONS, COUNTY HEALTH RANKINGS, AND NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE REVIEW TOOK INTO ACCOUNT PREVALENCE, TREND, DISPARITIES, SEVERITY OF HEALTH OUTCOMES, AND COMPARISONS AGAINST AVAILABLE BENCHMARKS.IN ORDER TO FULLY INFORM THE HOSPITALS' CHNA PROCESS, GS & RYBHC FORMED AN INTERNAL, MULTI-DISCIPLINARY TEAM CALLED A COMMUNITY BENEFIT ACTION TEAM (CBAT). CBAT MEMBERS HAVE ENGAGED IN BOTH THE AFOREMENTIONED PROCESSES, AND DETERMINED THE PROCESS FOR ENGAGING INTERNAL STAKEHOLDERS FOR INPUT AND VALIDATION. SUMMARY OF ASSESSMENT FINDINGS TOP HEALTH NEEDS:1. ACCESS TO CARE2. ALZHEIMER'S DISEASE & DEMENTIA3. BEHAVIORAL HEALTH4. WEIGHT STATUS5. VIOLENCE6. CHRONIC DISEASE7. LIFESTYLE CHOICES AND PERSONAL ACCOUNTABILITY |
| PART VI, LINE 3: | NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM CHI HOSPITAL ORGANIZATIONS SHALL BE DISSEMINATED BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT NOT BE LIMITED TO: - CONSPICUOUS PUBLICATION OF NOTICES IN PATIENT BILLS; - NOTICES POSTED IN EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING/REGISTRATION DEPARTMENTS, BUSINESS OFFICES, AND AT OTHER PUBLIC PLACES AS A HOSPITAL FACILITY MAY ELECT; AND - PUBLICATION OF A SUMMARY OF THIS POLICY ON THE HOSPITAL FACILITY'S WEBSITE AND AT OTHER PLACES WITHIN THE COMMUNITIES SERVED BY THE HOSPITAL FACILITY AS IT MAY ELECT. SUCH NOTICES AND SUMMARY INFORMATION SHALL INCLUDE A CONTACT NUMBER AND SHALL BE PROVIDED IN ENGLISH, SPANISH, AND OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY AN INDIVIDUAL HOSPITAL FACILITY, AS APPLICABLE. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE CHI HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.IN ADDITION, HOSPITAL 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 ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES. ONCE IT IS DETERMINED THAT THE PATIENT DOES NOT QUALIFY FOR ANY THIRD PARTY FUNDING, THE PATIENT IS VERBALLY NOTIFIED ABOUT THE EXISTENCE OF FINANCIAL ASSISTANCE APPLICATION AND ADDITIONAL SCREENING TAKES PLACE BY A HOSPITAL EMPLOYEE TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR CHARITY SERVICE PRIOR TO DISCHARGE. 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, THE PLAIN LANGUAGE SUMMARY OF THAT POLICY, AND AN APPLICATION FOR ASSISTANCE. HOSPITAL 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. PATIENTS THAT HAVE BEEN DISCHARGED PRIOR TO CHARITY SCREENING, SUCH AS EMERGENCY ROOM PATIENTS, RECEIVE A WRITTEN NOTIFICATION OF POSSIBLE ELIGIBILITY FOR SERVICES. IF THE PATIENT IS DETERMINED NOT TO BE ELIGIBLE FOR GOVERNMENT ASSISTANCE, HE/SHE MAY NOTIFY THE HOSPITAL THAT THEY SEEK CHARITY ASSISTANCE. THE APPROPRIATE CHARITY FORM IS SENT TO THE PATIENT/GUARANTOR FOR COMPLETION AND THEN RETURNED TO THE HOSPITAL FOR EVALUATION AND QUALIFICATION. ONCE DETERMINATION OF ELIGIBILITY IS MADE, THE PATIENT IS SENT A NOTICE INFORMING HIM/HER IF THEY QUALIFY FOR FULL, PARTIAL, OR NO CHARITY CARE SERVICES.HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER ANY INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. |
| PART VI, LINE 4: | FOR THE PURPOSE OF THE CHNA AND FUTURE IMPLEMENTATION STRATEGY, GS AND RYBHC CONSIDER ITS PRIMARY COMMUNITY TO BE BUFFALO COUNTY, NEBRASKA. THIS WAS DETERMINED BY AN INTERDISCIPLINARY TEAM FROM THE HOSPITAL [COMMUNITY BENEFIT ACTION TEAM (CBAT)].TOTAL POPULATION 2014: 49,732PERCENT BELOW 18 YEARS OF AGE: 23.3%PERCENT 65 AND OLDER: 14%PERCENT FEMALE: 50.1%PERCENT BLACK OR AFRICAN AMERICAN: 1.3%PERCENT AMERICAN INDIAN AND ALASKAN NATIVE: 0.6%PERCENT ASIAN: 1.8%PERCENT NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER: 0.1%PERCENT HISPANIC POPULATION: 9.1%PERCENT NON-HISPANIC WHITE: 86.7%MEDIAN HOUSEHOLD INCOME: $55,053PERSONS IN POVERTY: 12.7%CHILDREN IN POVERTY: 12%UNEMPLOYMENT RATE: 2%PERCENT POPULATION W/HS DIPLOMA: 93.8%PERCENT POPULATION W/ BACHELOR'S: 33.6%PERCENT OF POPULATION UNDER 65 WITHOUT INSURANCE: 8.3%PERCENT OF UNINSURED CHILDREN UNDER 19 YEARS: 5.7% |
| PART VI, LINE 5: | THE ORGANIZATION'S HOSPITAL FACILITIES PROMOTE HEALTH FOR THE BENEFIT OF THE COMMUNITY. MEDICAL STAFF PRIVILEGES IN THE HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, CONSISTENT WITH THE SIZE AND NATURE OF ITS FACILITIES. THE ORGANIZATION'S HOSPITAL FACILITIES HAVE AN OPEN MEDICAL STAFF. ITS BOARD OF TRUSTEES IS COMPOSED OF PROMINENT CITIZENS IN THE COMMUNITY. EXCESS FUNDS ARE GENERALLY APPLIED TO EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, IMPROVEMENT IN PATIENT CARE, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH. THE FACILITIES TREAT PERSONS PAYING THEIR BILLS WITH THE AID OF PUBLIC PROGRAMS LIKE MEDICARE AND MEDICAID. ALL PATIENTS PRESENTING AT THE HOSPITAL FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ARE TREATED REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH TREATMENT. CHI HEALTH HAS A HISTORY OF CENTRALIZED COMMUNITY BENEFIT AND HOSPITAL SPECIFIC COMMUNITY BENEFIT INVESTMENTS TO ADDRESS COMMUNITY HEALTH NEEDS OF THE PARTICULAR SERVICE AREA. EXAMPLES OF HOW CHI HEALTH FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY INCLUDE: * FINANCIAL ASSISTANCE AND UNPAID COSTS OF MEDICAID* COMMUNITY HEALTH IMPROVEMENT SERVICES- - COMMUNITY EDUCATION, CLASSES AND PROGRAMS (COVID19, TRAUMA, EMS, COMMUNITY BEHAVIORAL HEALTH SUPPORT AND EDUCATION, DIABETES, CANCER, PHYSICAL ACTIVITY AND HEALTHY EATING AND COOKING) - AIRCARE-STAFF PRESENTED SAFETY IN-SERVICES TO RURAL COMMUNITIES AND PARTICIPATED IN HEALTH FAIRS TO ADVANCE THE KNOWLEDGE OF THE COMMUNITY.- SUPPORT GROUPS (CANCER, BEREAVEMENT, YOUTH, ETC.) - COMMUNITY HEALTH FAIRS AND SCREENINGS- SCHOOL BASED HEALTHCARE SERVICES- MENTAL HEALTH HOTLINE-STAFF AND OPERATE 717-HOPE MENTAL HEALTH HOTLINE FOR ANYONE IN THE COMMUNITY TO ACCESS. THIS PROGRAM AVERAGES OVER 5,000 PHONE CALLS PER MONTH FROM COMMUNITY MEMBERS IN NEED.- PARISH NURSING PROGRAM AND FAITH COMMUNITY HEALTH NETWORK-THE CHI HEALTH FAITH COMMUNITY HEALTH NETWORK PARTNERS WITH CONGREGATIONS OF ALL FAITHS TO BUILD CAPACITY AND SUPPORT THE GROWTH OF HEALTH MINISTRIES WHICH PROMOTE HEALTH, HEALING AND WHOLENESS IN THE COMMUNITIES SERVED.- 5-4-3-2-1GO!- HEALTHY LIFESTYLE CAMPAIGN FOR KIDS; OPERATED IN SCHOOLS, OUT OF SCHOOL SETTINGS, CLINICS, COMMUNITY SETTINGS IN DOUGLAS, SARPY, CASS, AND COLFAX COUNTIES IN NE. INITIAL WORK COMPLETED BY CHI HEALTH IN FY19 AND FOLLOWING CONTRACTOR DEPARTURE, WORK WAS TRANSITIONED THROUGH A GRANT TO LIVE WELL OMAHA FOR THE BROADER OMAHA COMMUNITY STRATEGY IN DOUGLAS COUNTY AS PART OF A 2-YEAR GRANT. - COUNSELING AND ASSISTANCE IN ENROLLING INDIVIDUALS IN MEANS TESTED INSURANCE PROGRAMS TO IMPROVE ACCESS TO CARE.- PROJECT SEARCH-HIGH SCHOOL TRANSITION PROGRAM THAT ASSISTS STUDENTS WITH DISABILITIES WITH A CONNECTION TO EMPLOYMENT. - RICHARD YOUNG BEHAVIORAL HEALTH CENTER-PROVIDED ENHANCED ACCESS TO INDIVIDUALS BY OFFERING FREE INITIAL ASSESSMENTS BY LICENSED MENTAL HEALTH PROFESSIONALS AND A CRISIS LINE TO RESPOND TO CRISIS CALLS.- TEEN NET-TEEN PARENTING PROGRAM WHICH INCLUDES PRENATAL AND PARENTING RESOURCES FOR TEENS; FUNDING THROUGH GOOD SAMARITAN HOSPITAL AND KEARNEY PUBLIC SCHOOLS- INJURY PREVENTION PROGRAMS-TRAUMA DEPARTMENT SUPPORTS COMMUNITY EDUCATION PROGRAMS AND INITIATIVES; SEE BELOW SOME EXAMPLES:* CHILD PASSENGER SAFETY INSPECTION STATIONS TO PROPERLY FIT CAR SEATS IN VEHICLES AND DONATIONS OF CAR SEATS FOR THOSE THAT QUALIFY* SAFETY PROGRAMS WHICH PRESENTED ADVICE ON EVERYTHING FROM BIKE SAFETY, TO WATER SAFETY, FIRE SAFETY, ATV SAFETY, FARM SAFETY AND MUCH MORE* FALL PREVENTION EDUCATIONAL EVENTS- LIFELINE-PROVIDED LIFELINE PERSONAL RESPONSE SYSTEMS FOR 30 ELDERLY PATIENTS TO ENSURE RAPID RESPONSE AND MEDICAL ASSISTANCE IF NEEDED- SUBSIDIZED LOW INCOME, NON-PATIENT OUTPATIENT DIALYSIS TREATMENTS IN THE COMMUNITY TO GIVE THEM THE CARE THAT THEY REQUIRE- SUPPORT TO HEALTH COALITIONS AND INVESTMENTS IN SOCIAL AND ENVIRONMENTAL IMPROVEMENT STRATEGIES. THESE ARE PROGRAMS, ACTIVITIES AND PARTNERSHIPS THAT IMPROVE THE HEALTH OF PERSONS IN THE COMMUNITY BY ADDRESSING THE DETERMINANTS OF HEALTH, WHICH INCLUDES THE SOCIAL, ECONOMIC AND PHYSICAL ENVIRONMENT. SEE SPECIFIC EXAMPLES BY COMMUNITY BELOW:REGIONAL- NEBRASKA APPLESEED-PROVIDED FUNDS TO SUPPORT HUNGER/FOOD ACCESS EFFORTS; THIS INCLUDES SUMMER MEALS PROGRAM OUTREACH, ENRICHMENT PROGRAMMING AT SUMMER MEALS SITES AND SUPPORT TO LAUNCH STATE'S FIRST SNAP EMPLOYMENT & TRAINING (E&T) THIRD PARTY PARTNERSHIP, WHICH PROVIDES JOB TRAINING FOR SNAP RECIPIENTS. IN THIS RECENT YEAR NEBRASKA APPLESEED PROVIDED SNAP OUTREACH TO NEWLY ELIGIBLE INDIVIDUALS THAT WERE EXPERIENCING ECONOMIC HARDSHIP DUE TO COVID19.- ALZHEIMER'S ASSOCIATION-PROVIDED FUNDS TO SUPPORT THE CONTINUED OFFERING OF FREE SUPPORT SERVICES FOR FAMILIES WITH A LOVED ONE WITH DEMENTIA/ALZHEIMER'S. SUPPORTS INCLUDE ASSISTANCE IN FINDING MEMORY UNITS, APPROPRIATE LEVELS OF CARE OR SPECIALTY PROVIDERS, CAREGIVER SUPPORT GROUPS, ETC. - NEBRASKA BREASTFEEDING COALITION-PROVIDED FUNDS THAT SUPPORTS THE BUILDING OF COALITION INFRASTRUCTURE TO INCLUDE EVALUATION OF EXISTING WORK AND DEVELOPMENT OF LONG-TERM STRATEGIC PLAN TO SECURE SUSTAINABLE FUNDING. FUTURE FOCUS IS MOVING TOWARD STRATEGIES THAT CONNECT BREASTFEEDING AND BREASTFEEDING SUPPORT WITH MENTAL HEALTH. - NEBRASKA EXTENSION-PROVIDED FUNDS TO SUPPORT DOUBLE UP FOOD BUCKS IN OMAHA AND LINCOLN; PROGRAM FOR SNAP RECIPIENTS TO RECEIVE AN ADDITIONAL $1 FOR EVERY $1 THEY SPEND ON FRUITS AND VEGETABLES AT PARTICIPATING SITES; NUTRITION/COOKING EDUCATION IS ALSO PROVIDED AT ALL SITES.KEARNEY* BUFFALO COUNTY COMMUNITY PARTNERS-PROVIDED FINANCIAL SUPPORT AND LEADERSHIP TO THIS COMMUNITY COALITION THAT IS A COUNTY-WIDE EFFORT TO ADDRESS THE LEADING HEALTH ISSUES IN THE COUNTY. BCCP CONDUCTS DATA ASSESSMENTS AND SURVEYS TO MONITOR THE HEALTH STATUS OF THE COMMUNITY, SHARED WITH PARTNERS, AND SUPPORT COALITIONS TO ADDRESS THE PROBLEMS AND UNITE RESOURCES AROUND THIS CHANGE.* BUFFALO COUNTY COMMUNITY PARTNERS-PROVIDED FUNDING FOR A1C KITS FOR THE DIABETES REFERRAL NETWORK SCREENING FAIRS.* BE WELL BUFFALO COUNTY COALITION-PROVIDED FUNDS TO SUPPORT THE ESTABLISHMENT OF BE WELL COALITION TO ADVOCATE FOR A HEALTHY COMMUNITY CULTURE THROUGH INFRASTRUCTURE, EDUCATION AND PROGRAMS TO SUPPORT HEALTHY CHOICES. * HEALTHY MINDS BEHAVIORAL HEALTH/VIOLENCE PREVENTION COALITION-PROVIDED FUNDS TO SUPPORT SECOND STEP CURRICULUM IN LOCAL SCHOOLS WHICH IS A SOCIAL-EMOTIONAL DEVELOPMENT PROGRAM DESIGNED TO REDUCE AND PREVENT VIOLENCE. ALSO SUPPORTED MENTAL HEALTH FIRST AID TRAINING FOR LOCAL TEACHERS.* HELPCARE CLINIC-PROVIDED FUNDING THAT SUPPORTS CHRONIC DISEASE MANAGEMENT PROGRAMING - TO INCLUDE STAFF TIME, ADMINISTRATIVE SUPPORT, AND LAB/MEDICAL SUPPLIES.* KEARNEY SAFETY-PROVIDED 350 BIKE HELMETS FOR SAFETY AND HEAD INJURY PREVENTION EVENTS FOR THE KEARNEY AREA. HEALTH PROFESSIONAL EDUCATION-* SUPPORTS THE EDUCATION OF MEDICAL STUDENTS BY PROVIDING SPECIALTY SPECIFIC PHYSICIAN-SUPERVISED ROTATIONS IN CONJUNCTION WITH MEDICAL SCHOOLS. OTHER STUDENTS FROM VARIOUS PROGRAMS AND COLLEGES ARE PROVIDED EDUCATIONAL EXPERIENCES AT GOOD SAMARITAN HOSPITAL. APRNS, RNS, LPNS, PSYCH STUDENTS, MASTER'S LEVEL COUNSELING STUDENTS, AND RECREATIONAL THERAPISTS ARE PROVIDED A BROAD RANGE OF EDUCATIONAL EXPERIENCES FROM FIELD EXPERIENCES TO INTERNSHIPS.* ADMINISTRATION AND STUDENT ONBOARDING COSTS FOR NURSING PRECEPTORSHIPS AND CLINICALS* STAFF TIME FACILITATING THE SMALL-GROUP ETHICS CASE DISCUSSIONS WITH MEDICAL STUDENTS* CLINICAL PASTORAL EDUCATION* SCHOLARSHIPS FOR HEALTHCARE EDUCATION* ACADEMIC AFFILIATION WITH CREIGHTON UNIVERSITY AND ITS HEALTH PROFESSIONS PROGRAMS, INCLUDING THE SCHOOL OF MEDICINE, COLLEGE OF ARTS & SCIENCES, SCHOOL OF DENTISTRY, SCHOOL OF PHARMACY AND HEALTH PROFESSIONS, COLLEGE OF NURSING.* PHYSICIAN RESIDENCY AND FELLOWSHIP PROGRAMS TRAIN MORE THAN 250 RESIDENTS AND FELLOWS ANNUALLY RESEARCH- * UNFUNDED STAFF SUPPORT OF THE NATIONAL CANCER INSTITUTE COMMUNITY ONCOLOGY RESEARCH PROGRAM (NCORP)* TRAUMA INFORMED CARE-THIS WAS AN IDENTIFIED NEED ON THE COMMUNITY HEALTH IMPROVEMENT PLAN. CHI HEALTH IS PARTNERING TO IMPLEMENT STAFF TRAINING FOR AWARENESS OF TRAUMA AND ITS IMPACT AND COMPLETING A RESEARCH STUDY ON THE EFFECTIVENESS OF THE TRAINING TO HELP BUILD PUBLIC TRAINING AND EDUCATION RESOURCES. |
| PART VI, LINE 6: | THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH AS A SINGLE MINISTRY IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 21 STATES AND IS THE SOLE CORPORATE MEMBER OF OTHER PRIMARILY NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. COMMONSPIRIT HEALTH IS COMPRISED OF 137 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. IN FISCAL YEAR 2020, COMMONSPIRIT HEALTH PROVIDED MORE THAN $2.2 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $4.5 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $29.57 BILLION IN FISCAL YEAR 2020, HAS TOTAL ASSETS OF APPROXIMATELY $46.77 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. 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 DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. |
| SCHEDULE H, PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH (CONT'D) | FINANCIAL AND IN-KIND CONTRIBUTIONS-* CORPORATE SPONSORSHIPS* TANZANIA HEALTH MINISTRY-CHI HEALTH IS A MINISTRY PARTNER WITH THE MACHAME LUTHERAN HOSPITAL IN TANZANIA WHICH PROVIDES FULL SERVICE HEALTH CARE IN A DESPERATELY IMPOVERISHED AREA OF THE COUNTRY INCLUDING A FULL SERVICE HOSPITAL, PHARMACY, HOSPICE OUTREACH, CLINICS, CLINICAL OFFICER SCHOOL, AND THE RECENTLY ESTABLISHED SCHOOL OF NURSING. * STAFF SERVICE ON HEALTH RELATED BOARD AND COALITIONS* PARTICIPATION IN AND FUNDING OF MATERNAL HEALTH, SUBSTANCE ABUSE, FOOD ACCESS, VIOLENCE PREVENTION, CANCER AND OTHER COMMUNITY HEALTH COALITIONS.* PARTICIPATION IN AND SPONSORSHIP OF MENTAL HEALTH COALITIONS INCLUDING VOICES FOR CHILDREN, COMMUNITY ALLIANCE FOUNDATION AND PROJECT HARMONY.* EMPLOYEE COSTS OF COORDINATING COMMUNITY EVENTS NOT SPONSORED BY CHI HEALTH (RELAY FOR LIFE, BLOOD DRIVES, ETC.)* IN-KIND STAFF TIME ORGANIZING THE DONATION OF ITEMS TO VARIOUS NON-PROFIT GROUPS AND VOLUNTEERING TIME AT FOOD BANK OF THE HEARTLAND* IN-KIND DONATIONS OF PPE FOR SURROUNDING COMMUNITIES TO ASSIST IN STAYING SAFE DURING THE PANDEMIC.* IN-KIND DONATIONS OF SPACE, FOOD AND STAFF TIME PROVIDING STRATEGIC PLANNING, FACILITATION AND CONSULTING SERVICES FOR NOT-FOR-PROFIT ORGANIZATIONS AND COMMUNITY GROUPS* IN-KIND DONATIONS (STAFF TIME, SPACE, ETC.) SUPPORTING GRANTS FOR BEHAVIORAL HEALTH, VIOLENCE PREVENTION, AND COMMUNITY LINK.* PURCHASED OVER 350 BIKE HELMETS FOR BIKE SAFETY AND HEAD INJURY PREVENTION EVENTS IN THE KEARNEY, NE AREA.* BUFFALO COUNTY COMMUNITY PARTNERS (BCCP)- IN-KIND SPACE PROVIDED TO THIS HEALTH COALITION THAT IS A COUNTY-WIDE EFFORT TO ADDRESS THE LEADING HEALTH ISSUES IN THE COUNTY.* PROJECT SEARCH-HIGH SCHOOL TRANSITION PROGRAM THAT ASSISTS STUDENTS WITH DISABILITIES WITH A CONNECTION TO EMPLOYMENT. GOOD SAMARITAN HOSTS THE PROGRAM ON-SITE AT NO COST TO THE PROGRAM.* FAMILY ADVOCACY NETWORK (FAN)-IN-KIND OFFICE SPACE FOR THIS ORGANIZATION THAT CONNECTS ALL AGENCIES AND THE FAMILY TO PROVIDE AN EXPERIENCED, MULTIDISCIPLINARY RESPONSE TO ABUSE AND SEXUAL ASSAULT.* HELPCARE CLINIC-IN-KIND SPACE FOR THIS ORGANIZATION THAT EXISTS TO PROVIDE MEDICAL CARE, FREE OF COST, TO PERSONS WHO HAVE NO INSURANCE AND DO NOT QUALIFY FOR MEDICAID OR MEDICARE BUT INCOME FALLS BELOW 200% OF THE FEDERAL POVERTY LEVEL. SOME OF THE SERVICES OFFERED HERE ARE OUTPATIENT PRIMARY MEDICAL CARE, PREVENTIVE MEDICAL SERVICES, NONCRITICAL ACUTE CARE, AND BEHAVIORAL SERVICES. COMMUNITY BUILDING ACTIVITIES- * HEALTHCARE CAREER EXPLORATION CAMP-DAY CAMP FUNDED BY CHI HEALTH FOR STUDENTS GRADES 10-12 TO GIVE THEM THE OPPORTUNITY TO EXPLORE A VARIETY OF HEALTHCARE PROFESSIONS* PRESENTATIONS TO HIGH SCHOOL STUDENTS ABOUT HEALTHCARE CAREERS* PROVIDED CONTRIBUTION TO KEARNEY HEALTH OPPORTUNITIES PROGRAM (KHOP) WHICH IS A COOPERATIVE PROGRAM BETWEEN UNIVERSITY OF NEBRASKA KEARNEY AND THE UNIVERSITY OF NEBRASKA MEDICAL CENTER. THE PURPOSE OF THE PROGRAM IS TO RECRUIT AND EDUCATE STUDENTS FROM RURAL NEBRASKA WHO ARE COMMITTED TO RETURNING TO RURAL NEBRASKA TO PRACTICE HEALTHCARE.* COMMUNITY AND ECONOMIC DEVELOPMENT INCLUDING SUPPORT OF LOCAL CHAMBERS OF COMMERCE |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| GOOD SAMARITAN FOUNDATION | |||||||
| 111 W 31ST STREET | KEARNEY | NE | 688472916 | 470659443 | 501(C)(3) | $350,000 | HOSPITAL HEALTH FUNDS |
| AMERICAN HEART ASSOCIATION | |||||||
| PO BOX 50035 | PRESCOTT | AZ | 863045035 | 135613797 | 501(C)(3) | $10,750 | GENERAL SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MOST DISBURSEMENTS IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PROGRAMS ARE MADE DIRECTLY IN THE ACTIVE CONDUCT OF THE ACTIVITIES CONSTITUTING THE EXEMPT PURPOSE OR FUNCTION OF THE ORGANIZATION. OTHERWISE, DISTRIBUTIONS IN FURTHERANCE OF THE INSTITUTION'S EXEMPT PROGRAMS ARE MADE IN ACCORDANCE WITH PROCEDURES SUBJECT TO CONDITIONS ESTABLISHED BY THE INSTITUTION'S GOVERNING BOARD OR MANAGEMENT DESIGNED TO ENSURE THAT RECIPIENTS OF SUCH DISBURSEMENTS FROM THE ORGANIZATION ARE ADEQUATELY INVESTIGATED AND GRANTED TO QUALIFIED RECIPIENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANTHONY JONES | ||||||||||||||
| BOARD MEMBER | $0 | $1,193,615 | $0 | $1,247,337 | $0 | $18,579 | $0 | $0 | $0 | $14,470 | $0 | $2,474,001 | $0 | $0 |
| CLIFF ROBERTSON MD | ||||||||||||||
| BOARD MEMBER/CEO CHI HEALTH | $0 | $1,062,248 | $0 | $848,919 | $0 | $360,407 | $0 | $16,675 | $0 | $29,608 | $0 | $2,317,857 | $0 | $136,676 |
| JEANETTE WOJTALEWICZ | ||||||||||||||
| CFO, CHI HEALTH | $0 | $569,967 | $0 | $340,681 | $0 | $142,853 | $0 | $15,642 | $0 | $26,724 | $0 | $1,095,867 | $0 | $48,668 |
| CARY WARD MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $0 | $509,754 | $0 | $23,303 | $0 | $22,612 | $0 | $16,294 | $0 | $18,271 | $0 | $590,234 | $0 | $0 |
| MICHAEL SCHNIEDERS | ||||||||||||||
| PRESIDENT GSH | $0 | $424,758 | $0 | $23,040 | $0 | $46,037 | $0 | $16,449 | $0 | $18,271 | $0 | $528,555 | $0 | $0 |
| AMY L MCGAHA MD | ||||||||||||||
| BOARD MEMBER | $0 | $433,436 | $0 | $0 | $0 | $1,376 | $0 | $16,574 | $0 | $10,298 | $0 | $461,684 | $0 | $0 |
| STEVE HOUSTON | ||||||||||||||
| SVP STRATEGY AND TECHNOLOGY | $0 | $333,551 | $0 | $15,372 | $0 | $22,295 | $0 | $16,675 | $0 | $18,139 | $0 | $406,032 | $0 | $0 |
| JASON KRUGER MD | ||||||||||||||
| BOARD MEMBER | $0 | $338,106 | $0 | $0 | $0 | $729 | $0 | $16,505 | $0 | $27,629 | $0 | $382,969 | $0 | $0 |
| NANCY WALLACE | ||||||||||||||
| FORMER SVP CHIEF HR OFFICER | $0 | $104,558 | $0 | $12,441 | $0 | $198,145 | $0 | $11,953 | $0 | $13,248 | $0 | $340,345 | $0 | $0 |
| MIKE WATTERS | ||||||||||||||
| FORMER VP-SENIOR COUNSEL | $0 | $184,089 | $0 | $0 | $0 | $7,701 | $0 | $16,525 | $0 | $16,089 | $0 | $224,404 | $0 | $0 |
| JACQUELINE LIESS | ||||||||||||||
| NURSE PRACTIONER | $48,046 | $126,905 | $0 | $2,000 | $0 | $292 | $0 | $10,341 | $1,083 | $24,310 | $49,129 | $163,848 | $0 | $0 |
| NICKI BOHL | ||||||||||||||
| DIRECTOR PHARMACY | $173,227 | $0 | $3,194 | $0 | $232 | $0 | $11,160 | $0 | $16,367 | $0 | $204,180 | $0 | $0 | $0 |
| KENT HOXMEIER | ||||||||||||||
| COORDINATOR-PERFUSIONIST | $5,092 | $159,050 | $0 | $0 | $0 | $407 | $0 | $10,038 | $79 | $26,367 | $5,171 | $195,862 | $0 | $0 |
| RANDALL DE FREECE | ||||||||||||||
| DIRECTOR-FOUNDATION | $160,182 | $0 | $2,909 | $0 | $1,707 | $0 | $10,282 | $0 | $18,490 | $0 | $193,570 | $0 | $0 | $0 |
| KEVIN JOHNSON | ||||||||||||||
| PHARMACIST | $173,998 | $0 | $0 | $0 | $99 | $0 | $9,956 | $0 | $465 | $0 | $184,518 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | DURING THE CALENDAR YEAR 2019, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| SCHEDULE J, PART 1, LINE 4A - SEVERANCE OR CHANGE-OF-CONTROL PAYMENT | FOR REPORTABLE INDIVIDUALS EMPLOYED PRIOR TO 2019, POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. OFFICERS, KEY EMPLOYEES AND CERTAIN HIGHLY COMPENSATED EMPLOYEES WHO BEGAN EMPLOYMENT AFTER NOVEMBER 1ST OF 2019 ARE COVERED BY A SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM COMMONSPIRIT HEALTH DURING THE 2019 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): NANCY WALLACE, $180,001. |
| SCHEDULE J, PART 1, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN | DURING THE 2019 CALENDAR YEAR, COMMONSPIRIT MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/HOSPITAL PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2019 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: CLIFF ROBERTSON, $139,927; JEANETTE WOJTALEWICZ, $62,916. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2019 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. INCLUDE IF APPLICABLE: DURING 2019, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: CLIFF ROBERTSON, $182,082; JEANETTE WOJTALEWICZ, $57,305; MICHAEL SCHNIEDERS, $21,369. |
| SCHEDULE J, PART 1, LINE 7 - NON-FIXED PAYMENTS | DURING THE 2019 CALENDAR YEAR, COMMONSPIRIT MAINTAINED A VARIABLE PAY PROGRAM FOR MANAGERS AND ABOVE THAT PUTS A CERTAIN AMOUNT OF COMPENSATION AT RISK. AWARDS OF INCENTIVE COMPENSATION UNDER THE VARIABLE PAY PROGRAM ARE MADE BASED UPON ACHIEVEMENT OF ORGANIZATIONAL OBJECTIVES INCLUDING FINANCIAL OUTCOMES, QUALITY IMPROVEMENT, AND OTHER MEASURES AS DETERMINED ANNUALLY BY THE HR COMMITTEE OF THE BOARD OF STEWARDSHIP TRUSTEES. HOWEVER, ELIGIBLE AWARDS PAYABLE UNDER THIS PROGRAM ARE DEPENDENT ON REACHING MINIMUM LEVELS OF OPERATING MARGIN AND CHARITY CARE LEVELS, UNLESS THE HR COMMITTEE OF THE BOARD OF STEWARDSHIP TRUSTEES USES ITS DISCRETION TO APPROVE AN EXCEPTION. SUCH EXCEPTIONS ARE NOT APPLIED TO INDIVIDUALS OR CLASSES OF INDIVIDUALS, BUT RATHER TO THE PROGRAM AS A WHOLE. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1C | PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH ARE MADE BY COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH FILES THE FORM 1099'S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099'S ISSUED BY COMMONSPIRIT HEALTH ON BEHALF OF GOOD SAMARITAN HOSPITAL ARE REPORTED TO THE IRS. |
| FORM 990, PART VI, SECTION A, LINE 1 | PURSUANT TO SECTION 8.1 OF THE CORPORATION'S BYLAWS, COMMITTEES, SUCH AS THE EXECUTIVE COMMITTEE, THAT ARE GRANTED THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MAY INCLUDE ONLY DIRECTORS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS CHI NEBRASKA, A NEBRASKA NONPROFIT CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 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. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ORGANIZATION'S CORPORATE MEMBER IS CHI NEBRASKA. PURSUANT TO SECTION 5.4.1 OF THE ORGANIZATION'S BYLAWS, BOTH CHI NEBRASKA AND COMMONSPIRIT HEALTH HAVE RESERVED POWERS AS OUTLINED IN THE COMMONSPIRIT HEALTH GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE HELD BY THE CHI NEBRASKA'S BOARD: * APPROVE MEMBERS OF THE GOOD SAMARITAN HOSPITAL BOARD. * AMENDMENT OF THE CORPORATE DOCUMENTS OF THE GOOD SAMARITAN HOSPITAL. * APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE GOOD SAMARITAN HOSPITAL. * ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR THE GOOD SAMARITAN HOSPITAL. THE FOLLOWING RIGHTS ARE RESERVED TO THE COMMONSPIRIT HEALTH BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE COMMONSPIRIT HEALTH CHIEF EXECUTIVE OFFICER: * SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF THE GOOD SAMARITAN HOSPITAL. * REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE GOOD SAMARITAN HOSPITAL. * APPROVAL OF ISSUANCE OF DEBT BY GOOD SAMARITAN HOSPITAL. * APPROVAL OF PARTICIPATION OF GOOD SAMARITAN HOSPITAL IN A JOINT VENTURE. * APPROVAL OF FORMATION OF A NEW CORPORATION BY GOOD SAMARITAN HOSPITAL. * APPROVAL OF A MERGER INVOLVING THE GOOD SAMARITAN HOSPITAL. * APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE GOOD SAMARITAN HOSPITAL. * TO REQUIRE THE TRANSFER OF ASSETS BY THE GOOD SAMARITAN HOSPITAL TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH DEBTS. PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, CHI NEBRASKA OR COMMONSPIRIT HEALTH MAY, IN EXERCISE OF THEIR APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND ITS PRESIDENT AND THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. |
| FORM 990, PART VI, SECTION B, LINE 11B | FOLLOWING THE PREPARATION OF THE FORM 990 BY TAX ANALYSTS OF COMMONSPIRIT HEALTH, A RELATED ORGANIZATION, THE RETURN IS REVIEWED BY THE COMMONSPIRIT HEALTH TAX DIRECTOR AND THE LOCAL CHIEF FINANCIAL OFFICER. ADDITIONALLY, THE BOARD OF DIRECTORS ARE PROVIDED THE FINAL FORM 990 AND RELATED SCHEDULES TO REVIEW AND ARE ABLE TO ASK THE CHIEF FINANCIAL OFFICER AND TAX DIRECTOR QUESTIONS PRIOR TO FILING WITH THE IRS. UPON CHIEF FINANCIAL OFFICER APPROVAL AND SIGNATURE, THE TAX ANALYST FILES THE FINAL FORM 990 AS PRESENTED TO THE BOARD AND FINANCE COMMITTEE, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY IN ORDER TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO MAINTAIN THE INTEGRITY OF ITS ACTIVITIES. THE POLICY APPLIES TO THE FOLLOWING PERSONS ("COVERED PERSONS"): MEMBERS OF THE COMMONSPIRIT HEALTH ("COMMONSPIRIT") BOARD OF STEWARDSHIP TRUSTEES AND ITS COMMITTEES; COMMONSPIRIT HEALTH CORPORATE OFFICERS; MEMBERS OF THE DIGNITY HEALTH BOARD OF STEWARDSHIP TRUSTEES AND ITS COMMITTEES. IN ADDITION, THE POLICY APPLIES TO ORGANIZATIONS THAT WERE AFFILIATES AND SUBSIDIARIES OF COMMONSPIRIT HEALTH PRIOR TO ITS AFFILIATION WITH DIGNITY HEALTH ("CHI ENTITIES"). COVERED PERSONS OF CHI ENTITIES INCLUDE: MEMBERS OF ANY CHI ENTITY DIRECT AFFILIATE OR SUBSIDIARY BOARD AND THEIR COMMITTEES; EMPLOYEES OF CHI ENTITIES; AND CHI ENTITY RESEARCHERS (AS DEFINED BY THE POLICY). DISCLOSURE, REVIEW AND MANAGEMENT OF PERCEIVED, POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. ALL COVERED PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS AND MUST DISCLOSE THAT CONFLICT TO HIS/HER DIRECT MANAGER (OR OTHER PERSON AS IS APPROPRIATE PER POLICY). SUCH DISCLOSURE IS REQUIRED ON A TRANSACTIONAL BASIS AT THE TIME SUCH CONFLICTS ARISE, WHEN AN INDIVIDUAL BECOMES A COVERED PERSON (E.G. UPON HIRING OR BOARD APPOINTMENT), AND ANNUALLY THEREAFTER. DISCLOSURES OF PERCEIVED, POTENTIAL OR ACTUAL CONFLICTS ARE INITIALLY REVIEWED BY NATIONAL OR REGIONAL LEGAL OR CORPORATE RESPONSIBILITY TEAM MEMBERS TO DETERMINE WHETHER AN ACTUAL OR POTENTIAL CONFLICT MAY EXIST. IF IT IS DETERMINED THAT A POTENTIAL OR ACTUAL CONFLICT EXISTS, ISSUES ARE ELEVATED TO THE BOARD EXECUTIVE COMMITTEE OR BOARD CHAIR (FOR BOARD OR OFFICER CONFLICTS), OR THE CONFLICTS OF INTEREST REVIEW COMMITTEE (FOR ANY OTHER CONFLICT). THE PROCEDURES FOR ADDRESSING A CONFLICT RELATED TO A PROPOSED TRANSACTION IN THE CASE OF GOVERNING BODIES OR A CORPORATE OFFICER INCLUDE, BUT ARE NOT LIMITED TO 1) DISCLOSURE TO THE BOARD, 2) THE TRUSTEE OR CORPORATE OFFICER BEING EXCUSED FROM THE MEETING DURING DISCUSSION AND VOTE ON THE CONFLICT OF INTEREST (ALTHOUGH HE OR SHE MAY RESPOND TO PERTINENT QUESTIONS IF THE KNOWLEDGE IS RELEVANT), AND 3) BOARD APPROVAL OF THE TRANSACTION BY A MAJORITY OF DISINTERESTED MEMBERS. IN ADDITION, BOARDS CAREFULLY REVIEW AND SCRUTINIZE ANY NON-TRANSACTIONAL CONFLICTS OF INTEREST. IN SUCH CIRCUMSTANCES, BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES, THE BOARD TAKES WHATEVER ACTION IS DEEMED APPROPRIATE. FOR CONFLICTS NOT INVOLVING A BOARD MEMBER OR OFFICER, THE CONFLICTS OF INTEREST REVIEW COMMITTEE ("C-CIRC") WILL FACILITATE A COI MANAGEMENT PLAN TO MITIGATE THE CONFLICT IF ADEQUATE CONTROLS AREN'T ALREADY IN PLACE. NOTWITHSTANDING THE FOREGOING, AT ITS SOLE DISCRETION, AN ENTITY MAY REJECT A PERSON'S REQUEST TO ENTER INTO THE RELATIONSHIP IN QUESTION, OR REQUIRE THE RELATIONSHIP BE SUFFICIENTLY ALTERED TO AVOID A POTENTIAL CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION WAS PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. THE COMMONSPIRIT HEALTH BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR APPROVING REASONABLE COMPENSATION PACKAGES FOR EACH OFFICER AND CERTAIN KEY EMPLOYEES (INCLUDING THE PRESIDENT/CEO). THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EXECUTIVES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES OUTSIDE LEGAL COUNSEL AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF STEWARDSHIP TRUSTEES. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED. COMPENSATION FOR THE OTHER OFFICERS OF GOOD SAMARITAN HOSPITAL WAS ESTABLISHED BY THE CHI HEALTH CEO AND HUMAN RESOURCES DIRECTOR USING THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION: (1) COMPENSATION SURVEYS OR STUDIES (2) INDEPENDENT COMPENSATION CONSULTANT AND (3) APPROVAL BY THE BOARD COMPENSATION COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST FROM THE ADMINISTRATION DEPARTMENT. IN ADDITION, THE ARTICLES OF INCORPORATION ARE AVAILABLE FROM THE NEBRASKA (IOWA) SECRETARY OF STATE WEBSITE. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG. |
| FORM 990, PART IX, LINE 11G | OTHER FEES: PROGRAM SERVICE EXPENSES 12,562,738. MANAGEMENT AND GENERAL EXPENSES 661,197. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,223,935. CONSULTING: PROGRAM SERVICE EXPENSES 259,805. MANAGEMENT AND GENERAL EXPENSES 13,674. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 273,479. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,937,606. MANAGEMENT AND GENERAL EXPENSES 215,290. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,152,896. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 3,264,865. MANAGEMENT AND GENERAL EXPENSES 171,835. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,436,700. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 11,922,999. MANAGEMENT AND GENERAL EXPENSES 620,954. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,543,953. |
| FORM 990, PART XI, LINE 9: | ASC 842 ADJUSTMENT 9,080,962. CHANGES IN EQUITY OF UNCONSOLIDATED ORGS 987,106. |
| FORM 990, PART VI, LINE 16B - FORMAL POLICIES CONCERNING JOINT VENTURES | GOOD SAMARITAN HOSPITAL HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER, COMMONSPIRIT HEALTH'S SYSTEM WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; (4) RETURNS OF CAPITAL, ALLOCATIONS AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS; AND (5) ALL CONTRACTS ENTERED INTO BY THE PARTNERSHIP WITH THE EXEMPT ORGANIZATION MUST BE AT ARM'S-LENGTH, WITH PRICES SET AT FAIR MARKET VALUE. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (217 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ALEGENT CREIGHTON CLINIC | |||||||||||
| 12809 W DODGE RD | OMAHA | NE | 68154 | 470765154 | HOSPITAL | NE | 501(C)(3) | LINE 3 | ACH | 0 | |
| ALEGENT CREIGHTON HEALTH | |||||||||||
| 12809 W DODGE RD | OMAHA | NE | 68154 | 470757164 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM | |||||||||||
| 7500 MERCY RD | OMAHA | NE | 68124 | 470484764 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA | |||||||||||
| 631 N 8TH ST | MISSOURI VALLEY | IA | 51555 | 420776568 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH - IMMANUEL MEDICAL CENTER | |||||||||||
| 6901 N 72ND ST | OMAHA | NE | 68122 | 470376615 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER | |||||||||||
| 104 W 17TH ST | SCHUYLER | NE | 68661 | 470399853 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA | |||||||||||
| PO BOX 368 | CORNING | IA | 50841 | 420782518 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALVERNA APARTMENTS | |||||||||||
| 300 SE 8TH AVE | LITTLE FALLS | MN | 56345 | 411351177 | LTERM CARE | MN | 501(C)(3) | LINE 10 | CSH | 0 | |
| APPLETREE COURT | |||||||||||
| 601 OAK ST | BRECKENRIDGE | MN | 56520 | 411850500 | SENIOR LIVING | MN | 501(C)(3) | LINE 10 | SFH | 0 | |
| ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION | |||||||||||
| 345 S HALCYON RD | ARROYO GRANDE | CA | 93420 | 203256066 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| BAKERSFIELD MEMORIAL HOSPITAL | |||||||||||
| 420 34TH STREET | BAKERSFIELD | CA | 93301 | 951802779 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| BARROW NEUROLOGICAL FOUNDATION | |||||||||||
| 350 WEST THOMAS ROAD | PHOENIX | AZ | 85013 | 860174371 | FUNDRAISING | AZ | 501(C)(3) | LINE 7 | DH | 0 | |
| BAYLOR ST LUKE'S HEALTH VENTURES | |||||||||||
| 17200 ST LUKES WAY STE 170 | THE WOODLANDS | TX | 77384 | 274499340 | PHYSICIANS | TX | 501(C)(3) | LINE 12A, I | SLCHS | 0 | |
| BAYLOR ST LUKE'S MEDICAL GROUP | |||||||||||
| 6624 FANNIN ST STE 1100 | HOUSTON | TX | 77030 | 760458535 | PHYSICIANS | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| BORNEMANN HEALTHCARE CORPORATION | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 232187242 | HEALTHCARE | PA | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| BRAZOSPORT HEALTH FOUNDATION INC | |||||||||||
| 1 WEST WAY CT | LAKE JACKSON | TX | 77566 | 760080110 | FUNDRAISING FOUNDATION | TX | 501(C)(3) | LINE 12A, I | BRHS | 0 | |
| BRAZOSPORT REGIONAL PHYSICIAN SERVICES | |||||||||||
| 100 MEDICAL DRIVE | LAKE JACKSON | TX | 77566 | 800240261 | PHYSICIANS | TX | 501(C)(3) | LINE 3 | BRHS | 0 | |
| BURLESON ST JOSEPH HEALTH CENTER | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742759890 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SJSC | 0 | |
| BURLESON ST JOSEPH MANOR | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742913931 | HEALTHCARE | TX | 501(C)(3) | LINE 10 | SJSC | 0 | |
| CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION | |||||||||||
| 1401 SOUTH GRAND AVENUE | LOS ANGELES | CA | 90015 | 954000909 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| CARRINGTON HEALTH CENTER | |||||||||||
| 800 N 4TH ST | CARRINGTON | ND | 58421 | 450227311 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| CATHOLIC HEALTH INITIATIVES - COLORADO | |||||||||||
| 9100 EAST MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 840405257 | HOSPITAL | CO | 501(C)(3) | LINE 3 | CSH | 0 | |
| CATHOLIC HEALTH INITIATIVES - IOWA CORP | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 420680448 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CSH | 0 | |
| CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION | |||||||||||
| 1150 KELLY JOHNSON BLVD 204 | COLORADO SPRINGS | CO | 80920 | 840902211 | FUNDRAISING FOUNDATION | CO | 501(C)(3) | LINE 7 | CHIC | 0 | |
| CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION | |||||||||||
| 1150 KELLY JOHNSON BLVD 204 | COLORADO SPRINGS | CO | 80920 | 270930004 | HEALTHCARE | CO | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 460992796 | PHYSICIANS | CO | 501(C)(3) | LINE 12A, I | CHINS | 0 | |
| CENTENNIAL MEDICAL GROUP INC | |||||||||||
| 2700 STEWART PKWY | ROSEBURG | OR | 97471 | 263946191 | SURGERY CENTER | OR | 501(C)(3) | LINE 10 | MMC | 0 | |
| CENTRAL CALIFORNIA HEALTH CENTERS | |||||||||||
| 300 OLD RIVER ROAD STE 200 | BAKERSFIELD | CA | 93311 | 844171789 | CLINIC | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| CENTRAL KANSAS MEDICAL CENTER | |||||||||||
| 3515 BROADWAY | GREAT BEND | KS | 67530 | 480543724 | HOSPITAL | KS | 501(C)(3) | LINE 3 | CSH | 0 | |
| CHI HEALTH CONNECT AT HOME - FARGO | |||||||||||
| 4816 AMBER VALLEY PKWY S | FARGO | ND | 58104 | 271966847 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | LINE 10 | CSH | 0 | |
| CHI HEALTH FOUNDATION | |||||||||||
| 12809 W DODGE RD | OMAHA | NE | 68154 | 470648586 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | ACH | 0 | |
| COMMONSPIRIT HEALTH RESEARCH INSTITUTE | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 271050565 | HEALTHCARE | CO | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI KENTUCKY INC | |||||||||||
| 3900 OLYMPIC BLVD STE 400 | ERLANGER | KY | 41018 | 202741651 | HEALTHCARE | KY | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI LIVING COMMUNITIES | |||||||||||
| 5942 RENAISSANCE PLACE STE A | TOLEDO | OH | 43623 | 341892096 | HEALTHCARE | OH | 501(C)(3) | LINE 12B, II | SFH | 0 | |
| CHI MEMORIAL HOSPITAL - GEORGIA | |||||||||||
| 100 GROSS CRESCENT CIRCLE | FORT OGLETHORPE | GA | 30742 | 822748395 | HOSPITAL | GA | 501(C)(3) | LINE 3 | MHCS | 0 | |
| CHI NATIONAL HOME CARE | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 451261716 | HEALTHCARE | CO | 501(C)(3) | LINE 10 | CHI NS | 0 | |
| CHI NATIONAL SERVICES | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 452532084 | HEALTHCARE | CO | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI NEBRASKA | |||||||||||
| 12809 WEST DODGE ROAD | OMAHA | NE | 68510 | 363233121 | HEALTHCARE | NE | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI ST JOSEPH CHILDREN'S HEALTH | |||||||||||
| 1929 LINCOLN HWY E STE 150 | LANCASTER | PA | 17602 | 232342997 | HEALTHCARE | PA | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI ST JOSEPH'S CHILDREN | |||||||||||
| 1516 5TH ST NW | ALBUQUERQUE | NM | 87102 | 710897107 | COMMUNITY | NM | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI ST VINCENT HOSPITAL HOT SPRINGS | |||||||||||
| 300 WERNER ST | HOT SPRINGS | AR | 71913 | 710236913 | HOSPITAL | AR | 501(C)(3) | LINE 3 | CHISVHS | 0 | |
| CHI ST VINCENT HOT SPRINGS | |||||||||||
| 300 WERNER ST | HOT SPRINGS | AR | 71913 | 261125064 | HOLDING CO | AR | 501(C)(3) | LINE 12B, II | SVIMC | 0 | |
| CHI ST VINCENT MEDICAL GROUP HOT SPRINGS | |||||||||||
| 300 WERNER ST | HOT SPRINGS | AR | 71913 | 261125131 | PHYSICIANS | AR | 501(C)(3) | LINE 3 | CHISVHS | 0 | |
| COMMONSPIRIT HEALTH | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 470617373 | HEALTHCARE | CO | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| COMMONSPIRIT HEALTH OPERATING INVESTMENT POOL LLC | |||||||||||
| 185 BERRY STREET STE 300 | SAN FRANCISCO | CA | 94107 | 850919176 | INVESTMENTS | CA | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| COMMUNITY HOSPITAL OF SAN BERNARDINO | |||||||||||
| 1805 MEDICAL CENTER DRIVE | SAN BERNARDINO | CA | 92411 | 951643373 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| COMMUNITY LIMITED CARE DIALYSIS CENTER | |||||||||||
| 619 OAK ST ACCOUNTING-3 W | CINCINNATI | OH | 45206 | 237419853 | HOLDING CO | OH | 501(C)(4) | LINE 3 | GSH | 0 | |
| COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION | |||||||||||
| 631 N 8TH ST | MISSOURI VALLEY | IA | 51555 | 421294399 | FUNDRAISING FOUNDATION | IA | 501(C)(3) | LINE 12A, I | AH-CMHMV | 0 | |
| CONTINUING CARE HOSPITAL | |||||||||||
| ONE SAINT JOSEPH DRIVE | LEXINGTON | KY | 40504 | 611400619 | HOSPITAL | KY | 501(C)(3) | LINE 3 | SJHS | 0 | |
| DIGNITY COMMUNITY CARE | |||||||||||
| 185 BERRY STREET SUITE 300 | SAN FRANCISCO | CA | 94107 | 815009488 | HOSPITAL | CO | 501(C)(3) | LINE 3 | CSH | 0 | |
| DIGNITY HEALTH | |||||||||||
| 185 BERRY STREET STE 300 | SAN FRANCISCO | CA | 94107 | 941196203 | HOSPITAL | CA | 501(C)(3) | LINE 3 | CSH | 0 | |
| DIGNITY HEALTH CONNECTED LIVING | |||||||||||
| 200 MERCY OAKS DRIVE | REDDING | CA | 96003 | 237115371 | SENIOR CENTER SERVICES | CA | 501(C)(3) | LINE 7 | DH | 0 | |
| DIGNITY HEALTH FOUNDATION | |||||||||||
| 185 BERRY STREET | SAN FRANCISCO | CA | 94107 | 462037641 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH FOUNDATION - INLAND EMPIRE | |||||||||||
| 2101 N WATERMAN AVENUE | SAN BERNARDINO | CA | 92404 | 237440086 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH FOUNDATION EAST VALLEY | |||||||||||
| 475 SOUTH DOBSON ROAD | CHANDLER | AZ | 85224 | 742418514 | FUNDRAISING FOUNDATION | AZ | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH HPL SELF-INSURANCE TRUST | |||||||||||
| 185 BERRY STREET | SAN FRANCISCO | CA | 94107 | 943006034 | SELF INSURANCE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH INSURANCE NEVADA LTD | |||||||||||
| 185 BERRY STREET | SAN FRANCISCO | NV | 94107 | 813800752 | SELF INSURANCE | NV | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH MEDICAL FOUNDATION | |||||||||||
| 3400 DATA DRIVE | RANCHO CORDOVA | CA | 95670 | 680220314 | MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| DIGNITY HEALTH WORKERS COMP SELF-INSURANCE TRUST | |||||||||||
| 185 BERRY STREET | SAN FRANCISCO | CA | 94107 | 946612446 | SELF INSURANCE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DOMINICAN HEALTH SERVICES | |||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 770056778 | COMMUNITY HEALTH SYSTEM | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DOMINICAN HOSPITAL FOUNDATION | |||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 942450442 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DOMINICAN OAKS CORPORATION | |||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 770127719 | OPERATION AND MANAGEMENT OF HOUSING COMPLEX TO ELDERLY PERSONS | CA | 501(C)(3) | LINE 10 | DHS | 0 | |
| EAST TEXAS CLINICAL SERVICES | |||||||||||
| 2801 VIA FORTUNA SUITE 500 | AUSTIN | TX | 78746 | 454736213 | HEALTHCARE | TX | 501(C)(3) | LINE 12A, I | SLHS | 0 | |
| ENUMCLAW REGIONAL HOSPITAL ASSOCIATION | |||||||||||
| 1455 BATTERSBY AVE | ENUMCLAW | WA | 98022 | 910715805 | HOSPITAL | WA | 501(C)(3) | LINE 3 | FHS | 0 | |
| FLAGET HEALTHCARE INC | |||||||||||
| 4305 NEW SHEPHERDSVILLE RD | BARDSTOWN | KY | 40004 | 611345363 | HOSPITAL | KY | 501(C)(3) | LINE 3 | KOH | 0 | |
| FLAGET MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 4305 NEW SHEPHERDSVILLE RD | BARDSTOWN | KY | 40004 | 562351341 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 12A, I | FH | 0 | |
| FRANCISCAN CARE CENTER | |||||||||||
| 4111 N HOLLAND-SYLVANIA RD | TOLEDO | OH | 43623 | 341931806 | HEALTHCARE | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| FRANCISCAN FOUNDATION | |||||||||||
| 1717 SOUTH J ST | TACOMA | WA | 98405 | 911145592 | FUNDRAISING FOUNDATION | WA | 501(C)(3) | LINE 10 | FHS | 0 | |
| FRANCISCAN HEALTH SYSTEM | |||||||||||
| 1717 SOUTH J ST | TACOMA | WA | 98405 | 910564491 | HOSPITAL | WA | 501(C)(3) | LINE 3 | CSH | 0 | |
| FRANCISCAN HEALTH VENTURES FKA SJMGROUP | |||||||||||
| TACOMA FNC CTR BLDG 1145 BROADWAY | TACOMA | WA | 98402 | 431882377 | PHYSICIANS | MO | 501(C)(3) | LINE 10 | CSH | 0 | |
| FRANCISCAN MEDICAL GROUP | |||||||||||
| 1313 BROADWAY STE 200 | TACOMA | WA | 98402 | 911939739 | HEALTHCARE | WA | 501(C)(3) | LINE 10 | FHS | 0 | |
| FRANCISCAN VILLA OF SOUTH MILWAUKEE INC | |||||||||||
| 3601 S CHICAGO AVE | SOUTH MILWAUKEE | WI | 53172 | 391093829 | HEALTHCARE | WI | 501(C)(3) | LINE 10 | CSH | 0 | |
| FRENCH HOSPITAL MEDICAL CENTER FOUNDATION | |||||||||||
| 1911 JOHNSON AVENUE | SAN LUIS OBISPO | CA | 93401 | 203256125 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| GARRISON MEMORIAL HOSPITAL | |||||||||||
| 407 THIRD AVENUE SOUTHEAST | GARRISON | ND | 58540 | 450227752 | HOSPITAL | ND | 501(C)(3) | LINE 3 | SAMC | 0 | |
| GLENDALE MEMORIAL HEALTH FOUNDATION | |||||||||||
| 1420 SOUTH CENTRAL AVENUE | GLENDALE | CA | 91204 | 953625651 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| GLOBAL HEALTH INITIATIVES | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 201536108 | MINISTRIES | CO | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE | |||||||||||
| 619 OAK ST ACCOUNTING-3 W | CINCINNATI | OH | 45206 | 311778403 | EDUCATION | OH | 501(C)(3) | LINE 2 | GSH | 0 | |
| GOOD SAMARITAN FOUNDATION OF CINCINNATI INC | |||||||||||
| 619 OAK ST ACCOUNTING-3 W | CINCINNATI | OH | 45206 | 311206047 | FUNDRAISING FOUNDATION | OH | 501(C)(3) | LINE 12A, I | GSH | 0 | |
| GOOD SAMARITAN HOSPITAL | |||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470379755 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| GOOD SAMARITAN HOSPITAL FOUNDATION | |||||||||||
| 111 W 31ST ST | KEARNEY | NE | 68847 | 470659443 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | GSH | Yes (1) | |
| HARRISON MEDICAL CENTER | |||||||||||
| 2520 CHERRY AVE | BREMERTON | WA | 98310 | 910565546 | HOSPITAL | WA | 501(C)(3) | LINE 3 | FHS | 0 | |
| HARRISON MEDICAL CENTER FOUNDATION | |||||||||||
| 2520 CHERRY AVE | BREMERTON | WA | 98310 | 911197626 | FUNDRAISING FOUNDATION | WA | 501(C)(3) | LINE 7 | HMC | 0 | |
| HEALTH FOUNDATION OF KENTUCKYONE INC | |||||||||||
| 1451 HARRODSBURG RD STE D-308 | LEXINGTON | KY | 40504 | 832170324 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 12B, II | KOH | 0 | |
| HEALTHCARE AND WELLNESS FOUNDATION | |||||||||||
| 2400 ST FRANCIS DR | BRECKENRIDGE | MN | 56520 | 760761782 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | LINE 12A, I | SFMC | 0 | |
| HIGHLINE MEDICAL CENTER | |||||||||||
| 16251 SYLVESTER RD SW | BURIEN | WA | 98166 | 910712166 | HOSPITAL | WA | 501(C)(3) | LINE 3 | FHS | 0 | |
| HOUSE OF MERCY | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 421323808 | SHELTER | IA | 501(C)(3) | LINE 7 | CHI-IA CORP | 0 | |
| JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC | |||||||||||
| 250 E LIBERTY ST STE 500 | LOUISVILLE | KY | 40202 | 611029768 | HOSPITAL | KY | 501(C)(3) | LINE 3 | KOH | 0 | |
| KENTUCKYONE HEALTH MEDICAL GROUP INC | |||||||||||
| 100 E LIBERTY ST STE 800 | LOUISVILLE | KY | 40202 | 611352729 | HEALTHCARE | KY | 501(C)(3) | LINE 10 | JHSMH | 0 | |
| KENTUCKYONE HEALTH INC | |||||||||||
| 200 ABRAHAM FLEXNER WAY | LOUISVILLE | KY | 40202 | 611029769 | HEALTHCARE | KY | 501(C)(3) | LINE 12B, II | CSH | 0 | |
| LAKEWOOD HEALTH CENTER | |||||||||||
| 600 MAIN AVE S | BAUDETTE | MN | 56623 | 410758434 | HOSPITAL | MN | 501(C)(3) | LINE 3 | CSH | 0 | |
| LAKEWOOD REGIONAL HEALTHCARE FOUNDATION | |||||||||||
| 600 MAIN AVE S | BAUDETTE | MN | 56623 | 411893795 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 7 | LHC | 0 | |
| LISBON AREA HEALTH SERVICES | |||||||||||
| 905 MAIN ST | LISBON | ND | 58054 | 820558836 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| LUFKIN VISION ACQUISITIONS | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75901 | 820563768 | PROPERTY MGMT | TX | 501(C)(3) | LINE 12A, I | MHSET | 0 | |
| MADISON ST JOSEPH HEALTH CENTER | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742761145 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SJSC | 0 | |
| MADONNA MANOR INC | |||||||||||
| 2344 AMSTERDAM ROAD | VILLA HILLS | KY | 51017 | 610654635 | LIVING ASSIST | KY | 501(C)(3) | LINE 10 | CHILC | 0 | |
| MARIAN REGIONAL MEDICAL CENTER FOUNDATION | |||||||||||
| 1400 E CHURCH STREET | SANTA MARIA | CA | 93454 | 953818027 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| MARK TWAIN MEDICAL CENTER | |||||||||||
| 768 MOUNTAIN RANCH ROAD | SAN ANDREAS | CA | 95249 | 680127677 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC | |||||||||||
| 2525 DE SALES AVE | CHATTANOOGA | TN | 37404 | 621839548 | FUNDRAISING FOUNDATION | TN | 501(C)(3) | LINE 7 | MHCS | 0 | |
| MEMORIAL HEALTH CARE SYSTEM INC | |||||||||||
| 2525 DE SALES AVE | CHATTANOOGA | TN | 37404 | 620532345 | HOSPITAL | TN | 501(C)(3) | LINE 3 | CSH | 0 | |
| MEMORIAL HEALTH PARTNERS FOUNDATION INC | |||||||||||
| 5600 BRAINERD RD STE 500 | CHATTANOOGA | TN | 37411 | 030417049 | HEALTHCARE | TN | 501(C)(3) | LINE 10 | MHCS | 0 | |
| MEMORIAL HEALTH SYSTEM OF EAST TEXAS | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 750755367 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| MEMORIAL MEDICAL CENTER - LIVINGSTON | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 760436439 | HOSPITAL | TX | 501(C)(3) | LINE 3 | MHSET | 0 | |
| MEMORIAL MEDICAL CENTER - SAN AUGUSTINE | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 752663904 | HOSPITAL | TX | 501(C)(3) | LINE 3 | MHSET | 0 | |
| MEMORIAL MULTISPECIALTY ASSOCIATES | |||||||||||
| 1201 FRANK AVE | LUFKIN | TX | 95904 | 752721155 | PHYSICIANS | TX | 501(C)(3) | LINE 12A, I | MHSET | 0 | |
| MERCY AUXILIARY OF CENTRAL IOWA | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 426076069 | AUXILIARY | IA | 501(C)(3) | LINE 12A, I | MF-DM IA | 0 | |
| MERCY CLINICS INC | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 421193699 | PHYSICIANS | IA | 501(C)(3) | LINE 10 | CHI-IA CORP | 0 | |
| MERCY COLLEGE OF HEALTH SCIENCES | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 421511682 | EDUCATION | IA | 501(C)(3) | LINE 2 | CHI-IA CORP | 0 | |
| MERCY FOUNDATION BAKERSFIELD | |||||||||||
| PO BOX 119 | BAKERSFIELD | CA | 93302 | 770201321 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| MERCY FOUNDATION OF DES MOINES IA | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 237358794 | FUNDRAISING FOUNDATION | IA | 501(C)(3) | LINE 7 | CHI-IA CORP | 0 | |
| MERCY FOUNDATION INC | |||||||||||
| 2700 STEWART PKWY | ROSEBURG | OR | 97471 | 936088946 | FUNDRAISING FOUNDATION | OR | 501(C)(3) | LINE 7 | MMC | 0 | |
| MERCY HEALTH CARE FOUNDATION | |||||||||||
| PO BOX 368 | CORNING | IA | 50841 | 421461064 | FUNDRAISING FOUNDATION | IA | 501(C)(3) | LINE 12A, I | AHMH-CORNING | 0 | |
| MERCY HEALTHCARE FOUNDATION | |||||||||||
| 570 CHAUTAUQUA BLVD | VALLEY CITY | ND | 58072 | 450435338 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 12A, I | MHVC | 0 | |
| MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS | |||||||||||
| 800 MERCY DR | COUNCIL BLUFFS | IA | 51503 | 421178204 | FUNDRAISING FOUNDATION | IA | 501(C)(3) | LINE 12A, I | AHBMHS | 0 | |
| MERCY HOSPITAL OF DEVILS LAKE | |||||||||||
| 1031 7TH ST NE | DEVILS LAKE | ND | 58301 | 450227012 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| MERCY HOSPITAL OF DEVILS LAKE FOUNDATION | |||||||||||
| 1031 7TH ST NE | DEVILS LAKE | ND | 58301 | 352367360 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 7 | MHDL | 0 | |
| MERCY HOSPITAL OF VALLEY CITY | |||||||||||
| 570 CHAUTAUQUA BLVD | VALLEY CITY | ND | 58072 | 450226553 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| MERCY MCMAHON TERRACE | |||||||||||
| 3865 J STREET | SACRAMENTO | CA | 95816 | 680117340 | SENIOR CITIZEN'S HOUSING/RETIREMENT COMMUNITIES | CA | 501(C)(3) | LINE 10 | DH | 0 | |
| MERCY MEDICAL CENTER | |||||||||||
| 1301 15TH AVE WEST | WILLISTON | ND | 58801 | 450231183 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| MERCY MEDICAL CENTER - CENTERVILLE | |||||||||||
| ONE ST JOSEPHS DRIVE | CENTERVILLE | IA | 52544 | 420680308 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CHI-IA CORP | 0 | |
| MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER | |||||||||||
| 204 N 4TH AVE E | NEWTON | IA | 50314 | 421470935 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CHI-IA CORP | 0 | |
| MERCY MEDICAL CENTER MERCED FOUNDATION | |||||||||||
| 301 E 13TH STREET | MERCED | CA | 95340 | 770035928 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| MERCY MEDICAL CENTER INC | |||||||||||
| 2700 STEWART PKWY | ROSEBURG | OR | 97471 | 930386868 | HOSPITAL | OR | 501(C)(3) | LINE 3 | CSH | 0 | |
| MERCY MEDICAL FOUNDATION | |||||||||||
| 1301 15TH AVE WEST | WILLISTON | ND | 58801 | 450381803 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 12A, I | MMC | 0 | |
| NEBRASKA HEART HOSPITAL | |||||||||||
| 7500 S 91ST ST | LINCOLN | NE | 68526 | 392031968 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| NORTHLAND HEALTHCARE ALLIANCE | |||||||||||
| 2223 EAST ROSSER AVENUE | BISMARCK | ND | 58501 | 911845296 | MANAGEMENT | ND | 501(C)(3) | LINE 7 | NCHA | 0 | |
| NORTHRIDGE HOSPITAL FOUNDATION | |||||||||||
| 18300 ROSCOE BLVD | NORTHRIDGE | CA | 91328 | 237444901 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| OAKES COMMUNITY HOSPITAL | |||||||||||
| 1200 N 7TH ST | OAKES | ND | 58474 | 450231675 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| OAKES COMMUNITY HOSPITAL FOUNDATION | |||||||||||
| 1200 N 7TH ST | OAKES | ND | 58474 | 710966606 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 12A, I | OCH | 0 | |
| PACIFIC CENTRAL COAST HEALTH CENTERS | |||||||||||
| 1400 E CHURCH STREET | SANTA MARIA | CA | 93454 | 770447575 | CLINIC | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| PINEYWOODS MEDICAL DEVELOPMENT CORP | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 752493116 | PROPERTY MGMT | TX | 501(C)(3) | LINE 12A, I | MHSET | 0 | |
| PORT CITY OPERATING COMPANY LLC | |||||||||||
| 3400 DATA DRIVE | RANCHO CORDOVA | CA | 95670 | 465322209 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DH | 0 | |
| PROVIDENCE CARE CENTER | |||||||||||
| 2025 HAYES AVENUE | SANDUSKY | OH | 44870 | 341658625 | HEALTHCARE | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| PROVIDENCE CARE CENTERS | |||||||||||
| 2025 HAYES AVENUE | SANDUSKY | OH | 44870 | 341826099 | HOLDING CO | OH | 501(C)(3) | LINE 12B, II | CHILC | 0 | |
| PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION | |||||||||||
| 5055 PROVIDENCE DRIVE | SANDUSKY | OH | 44870 | 341896807 | LIVING COMM | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| PUEBLO STEPUP | |||||||||||
| 1925 E ORMAN AVE STE G52 | PUEBLO | CO | 81004 | 841234295 | COMMUNITY | CO | 501(C)(3) | LINE 7 | CHIC | 0 | |
| REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE | |||||||||||
| 16251 SYLVESTER ROAD SW | BURIEN | WA | 98166 | 911170040 | HOSPITAL | WA | 501(C)(3) | LINE 3 | FHS | 0 | |
| SET OF COLORADO SPRINGS INC | |||||||||||
| 9100 E MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 841183335 | SENIOR CENTER SERVICES | CO | 501(C)(3) | LINE 7 | CHIC | 0 | |
| SAINT CLARE'S COMMUNITY CARE INC | |||||||||||
| 25 POCONO RD | DENVILLE | NJ | 07834 | 222876836 | HEALTHCARE | NJ | 501(C)(3) | LINE 10 | SCHS | 0 | |
| SAINT CLARE'S FOUNDATION INC | |||||||||||
| 25 POCONO RD | DENVILLE | NJ | 07834 | 222502997 | FUNDRAISING FOUNDATION | NJ | 501(C)(3) | LINE 3 | CSH | 0 | |
| SAINT CLARE'S HEALTH SERVICES INC | |||||||||||
| 25 POCONO RD | DENVILLE | NJ | 07834 | 223639733 | MANAGEMENT | NJ | 501(C)(3) | LINE 10 | CSH | 0 | |
| SAINT CLARE'S HOSPITAL INC | |||||||||||
| 25 POCONO RD | DENVILLE | NJ | 07834 | 223319886 | HEALTHCARE | NJ | 501(C)(3) | LINE 2 | SCHS | 0 | |
| SAINT ELIZABETH FOUNDATION | |||||||||||
| 555 S 70TH ST | LINCOLN | NE | 68510 | 470625523 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | SERMC | 0 | |
| SAINT ELIZABETH HEALTH SERVICES | |||||||||||
| 555 S 70TH ST | LINCOLN | NE | 68510 | 363233120 | HOSPITAL | NE | 501(C)(3) | LINE 3 | SERMC | 0 | |
| SAINT ELIZABETH REGIONAL MEDICAL CENTER | |||||||||||
| 555 S 70TH ST | LINCOLN | NE | 68510 | 470379836 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| SAINT FRANCIS MEDICAL CENTER | |||||||||||
| 2620 W FAIDLEY | GRAND ISLAND | NE | 68803 | 470376601 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| SAINT FRANCIS MEDICAL CENTER FOUNDATION | |||||||||||
| PO BOX 9804 | GRAND ISLAND | NE | 68802 | 470630267 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | SFMC | 0 | |
| SAINT FRANCIS MEMORIAL HOSPITAL | |||||||||||
| 900 HYDE STREET | SAN FRANCISCO | CA | 94109 | 941156295 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC | |||||||||||
| 305 ESTILL ST | BEREA | KY | 40403 | 260152877 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 7 | SJHS | 0 | |
| SAINT JOSEPH HEALTH SYSTEM INC | |||||||||||
| 200 ABRAHAM FLEXNER WAY | LOUISVILLE | KY | 40202 | 611334601 | HOSPITAL | KY | 501(C)(3) | LINE 3 | KOH | 0 | |
| SAINT JOSEPH HOSPITAL FOUNDATION INC | |||||||||||
| 701 BOB OLINK DR 200 | LEXINGTON | KY | 40504 | 611159649 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 12A, I | SJHS | 0 | |
| SAINT JOSEPH LONDON FOUNDATION INC | |||||||||||
| 1001 SAINT JOSEPH LANE | LONDON | KY | 40741 | 260438748 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 7 | SJHS | 0 | |
| SAINT JOSEPH MOUNT STERLING FOUNDATION INC | |||||||||||
| 225 FALCON DR | MOUNT STERLING | KY | 40353 | 272884584 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 7 | SJHS | 0 | |
| SAINT JOSEPH'S HOSPITAL FOUNDATION | |||||||||||
| 2500 FAIRWAY STREET | DICKINSON | ND | 58601 | 363418207 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 12A, I | SJHHC | 0 | |
| SAN GABRIEL VALLEY MEDICAL CENTER FOUNDATION | |||||||||||
| 438 WEST LAS TUNAS DRIVE | SAN GABRIEL | CA | 91776 | 953430341 | INACTIVE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 104 W 17TH ST | SCHUYLER | NE | 68661 | 363630014 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 12A, I | AHMHS | 0 | |
| SIERRA NEVADA MEMORIAL-MINERS HOSPITAL | |||||||||||
| 155 GLASSON WAY | GRASS VALLEY | CA | 95945 | 941439787 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| SJRMC JOPLIN MISSOURI | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 440545809 | HOSPITAL | MO | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST FRANCIS FOUNDATION OF SANTA BARBARA | |||||||||||
| 2323 DE LA VINA ST SUITE 104 | SANTA BARBARA | CA | 93105 | 237137119 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST FRANCIS HOSPITAL SUPPORT CORPORATION | |||||||||||
| 601 E MICHELTORENA STREET | SANTA BARBARA | CA | 93103 | 770022302 | INACTIVE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST JOHNS HEALTHCARE FOUNDATION | |||||||||||
| 1600 NORTH ROSE AVENUE | OXNARD | CA | 93030 | 202865781 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST JOSEPHS FOUNDATION (PHOENIX) | |||||||||||
| 350 WEST THOMAS ROAD | PHOENIX | AZ | 85013 | 942941245 | FUNDRAISING FOUNDATION | AZ | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST JOSEPHS FOUNDATION OF SAN JOAQUIN | |||||||||||
| 1800 N CALIFORNIA STREET | STOCKTON | CA | 95204 | 510432777 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST MARY MEDICAL CENTER FOUNDATION | |||||||||||
| 1050 LINDEN AVENUE | LONG BEACH | CA | 90813 | 237153876 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST MARY PROFESSIONAL BUILDING INC | |||||||||||
| 1050 LINDEN AVENUE | LONG BEACH | CA | 90813 | 237373088 | INACTIVE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST MARYS MEDICAL CENTER FOUNDATION | |||||||||||
| 450 STANYAN STREET | SAN FRANCISCO | CA | 94117 | 943336143 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST ROSE DOMINICAN HEALTH FOUNDATION | |||||||||||
| 3001 ST ROSE PARKWAY | HENDERSON | NV | 89052 | 880349432 | FUNDRAISING FOUNDATION | NV | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST ALEXIUS MEDICAL CENTER | |||||||||||
| 900 EAST BROADWAY AVENUE | BISMARCK | ND | 58501 | 450226711 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST ANTHONY HOSPITAL | |||||||||||
| 2801 ST ANTHONY WAY | PENDLETON | OR | 97801 | 930391614 | HOSPITAL | OR | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST ANTHONY HOSPITAL FOUNDATION | |||||||||||
| 2801 ST ANTHONY WAY | PENDLETON | OR | 97801 | 930992727 | FUNDRAISING FOUNDATION | OR | 501(C)(3) | LINE 12A, I | SAH | 0 | |
| ST ANTHONY'S HOSPITAL ASSOCIATION | |||||||||||
| FOUR HOSPITAL DR | MORRILTON | AR | 72110 | 710245507 | HOSPITAL | AR | 501(C)(3) | LINE 3 | SVIMC | 0 | |
| ST CATHERINE HOSPITAL | |||||||||||
| 401 EAST SPRUCE ST | GARDEN CITY | KS | 67846 | 480543721 | HOSPITAL | KS | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION | |||||||||||
| 401 EAST SPRUCE ST | GARDEN CITY | KS | 67846 | 200598702 | FUNDRAISING FOUNDATION | KS | 501(C)(3) | LINE 12A, I | SCH | 0 | |
| ST CLARE COMMONS | |||||||||||
| 12469 FIVE POINT ROAD | TOLEDO | OH | 43551 | 270163752 | LIVING COMM | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| ST DOMINIC OF ONTARIO OREGON | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 930433692 | HEALTHCARE | OR | 501(C)(4) | LINE 3 | CSH | 0 | |
| ST FRANCIS HOME | |||||||||||
| 2400 ST FRANCIS DR | BRECKENRIDGE | MN | 56520 | 410729978 | LTERM CARE | MN | 501(C)(3) | LINE 10 | CSH | 0 | |
| ST FRANCIS LIFE CARE CORPORATION | |||||||||||
| 19 POCONO RD | DENVILLE | NJ | 07834 | 222536017 | ELDERLY CARE | NJ | 501(C)(3) | LINE 8 | SCHS | 0 | |
| ST FRANCIS MEDICAL CENTER | |||||||||||
| 2400 ST FRANCIS DR | BRECKENRIDGE | MN | 56520 | 410695598 | HOSPITAL | MN | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST JOSEPH FOUNDATION OF BRYAN TEXAS | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742351158 | FUNDRAISING FOUNDATION | TX | 501(C)(3) | LINE 12B, II | SJSC | 0 | |
| ST JOSEPH MANOR | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742847594 | HEALTHCARE | TX | 501(C)(3) | LINE 10 | SJSC | 0 | |
| ST JOSEPH MEDICAL CENTER INC | |||||||||||
| 201 INTERNATIONAL CIRCLE STE 212 | HUNT VALLEY | MD | 21030 | 520591461 | HOSPITAL | MD | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST JOSEPH PHYSICIAN ASSOCIATES | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 203159302 | PHYSICIANS | TX | 501(C)(3) | LINE 3 | SJSC | 0 | |
| ST JOSEPH PHYSICIAN ENTERPRISE INC | |||||||||||
| 201 INTERNATIONAL CIRCLE STE 212 | HUNT VALLEY | MD | 21030 | 521311775 | PHYSICIANS | MD | 501(C)(3) | LINE 12A, I | SJMC | 0 | |
| ST JOSEPH REGIONAL HEALTH CENTER | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 741282696 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SJSC | 0 | |
| ST JOSEPH REGIONAL HEALTH PARTNERS | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 454088170 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SJSC | 0 | |
| ST JOSEPH REGIONAL HEALTH PARTNERS ACO | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 463265423 | HEALTHCARE | TX | 501(C)(3) | LINE 10 | SJSC | 0 | |
| ST JOSEPH SERVICES CORPORATION | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742455161 | MANAGEMENT | TX | 501(C)(3) | LINE 12A, I | SLHS | 0 | |
| ST JOSEPH'S AREA HEALTH SERVICES | |||||||||||
| 600 PLEASANT AVE | PARK RAPIDS | MN | 56470 | 410695603 | HOSPITAL | MN | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST JOSEPH'S HOSPITAL AND HEALTH CENTER | |||||||||||
| 2500 FAIRWAY ST | DICKINSON | ND | 58601 | 450226429 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST LEONARD | |||||||||||
| 8100 CLYO ROAD | CENTERVILLE | OH | 45458 | 341940863 | LIVING COMM | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 273733278 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 261947374 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 260335902 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| ST LUKE'S COMMUNITY HEALTH SERVICES | |||||||||||
| 6624 FANNIN ST STE 1100 | HOUSTON | TX | 77030 | 760536234 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| ST LUKE'S FOUNDATION | |||||||||||
| 1213 HERMANN DRIVE STE 855 | HOUSTON | TX | 77004 | 453811485 | FUNDRAISING FOUNDATION | TX | 501(C)(3) | LINE 7 | SLHS | 0 | |
| ST LUKE'S HEALTH SYSTEM CORPORATION | |||||||||||
| PO BOX 20269 | HOUSTON | TX | 77225 | 760536232 | MANAGEMENT | TX | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| ST LUKE'S HOSPITAL AT THE VINTAGE | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 263734606 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| ST LUKE'S PROPERTIES CORPORATION | |||||||||||
| 1213 HERMANN DRIVE STE 855 | HOUSTON | TX | 77004 | 760531716 | PROPERTY MGMT | TX | 501(C)(3) | LINE 12A, I | SLHS | 0 | |
| ST LUKE'S SUGAR LAND PROPERTIES CORPORATION | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 454120549 | PROPERTY MGMT | TX | 501(C)(3) | LINE 12A, I | SLCDC-SL | 0 | |
| ST MARY'S COMMUNITY HOSPITAL | |||||||||||
| 1301 GRUNDMAN BOULEVARD | NEBRASKA CITY | NE | 68410 | 470443636 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ST MARY'S HOSPITAL FOUNDATION | |||||||||||
| 1314 3RD AVE | NEBRASKA CITY | NE | 68410 | 470707604 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | SMCH | 0 | |
| ST VINCENT FOUNDATION | |||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 510169537 | FUNDRAISING FOUNDATION | AR | 501(C)(3) | LINE 12A, I | SVIMC | 0 | |
| ST VINCENT INFIRMARY MEDICAL CENTER | |||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 710236917 | HOSPITAL | AR | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST VINCENT MEDICAL GROUP | |||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 710830696 | HEALTHCARE | AR | 501(C)(3) | LINE 10 | SVIMC | 0 | |
| SYLVANIA FRANCISCAN HEALTH | |||||||||||
| 1715 INDIAN WOOD CIR 200 | MAUMEE | OH | 43537 | 341412964 | HEALTHCARE | OH | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| SYLVANIA FRANCISCAN HEALTH FOUNDATION | |||||||||||
| 1715 INDIAN WOOD CIR 200 | MAUMEE | OH | 43537 | 455357161 | FUNDRAISING FOUNDATION | OH | 501(C)(3) | LINE 12A, I | SFH | 0 | |
| THE COMMONS OF PROVIDENCE | |||||||||||
| 5000 PROVIDENCE DRIVE | SANDUSKY | OH | 44870 | 341826097 | ASSIST LIVING | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| THE COMMUNITY HOSPITAL OF BRAZOSPORT | |||||||||||
| 100 MEDICAL DRIVE | LAKE JACKSON | TX | 77566 | 741385192 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH | |||||||||||
| 619 OAK ST ACCOUNTING-3 W | CINCINNATI | OH | 45206 | 310537486 | HOSPITAL | OH | 501(C)(3) | LINE 3 | CSH | 0 | |
| THE PHYSICIAN NETWORK | |||||||||||
| 2000 Q ST STE 500 | LINCOLN | NE | 68503 | 470780857 | PHYSICIANS | NE | 501(C)(3) | LINE 12A, I | CHI NEBRASKA | 0 | |
| TOTAL HEALTHCARE | |||||||||||
| 9100 E MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 840927232 | HOSPITAL | CO | 501(C)(3) | LINE 3 | CHIC | 0 | |
| TRINITY HEALTH FOUNDATION | |||||||||||
| 380 SUMMIT AVENUE | STEUBENVILLE | OH | 43952 | 311329423 | FUNDRAISING FOUNDATION | OH | 501(C)(3) | LINE 12A, I | THS | 0 | |
| TRINITY HEALTH SYSTEM | |||||||||||
| 380 SUMMIT AVENUE | STEUBENVILLE | OH | 43952 | 341818681 | HEALTHCARE | OH | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| TRINITY HOSPITAL TWIN CITY | |||||||||||
| 819 NORTH FIRST STREET | DENNISON | OH | 44621 | 275401105 | HOSPITAL | OH | 501(C)(3) | LINE 3 | THS | 0 | |
| TRI-STATE HEALTH SERVICES INC | |||||||||||
| ONE ROSS PARK BLVD | STEUBENVILLE | OH | 43952 | 341522484 | ASSIST LIVING | OH | 501(C)(3) | LINE 7 | THS | 0 | |
| UNITY FAMILY HEALTHCARE | |||||||||||
| 815 SE 2ND ST | LITTLE FALLS | MN | 56345 | 410721642 | HOSPITAL | MN | 501(C)(3) | LINE 3 | CSH | 0 | |
| VILLA NAZARETH INC | |||||||||||
| 801 PAGE DR | FARGO | ND | 58103 | 450226714 | LTERM CARE | ND | 501(C)(3) | LINE 10 | CSH | 0 | |
| VISITING NURSE ASSOCIATION OF ST CLARE'S INC | |||||||||||
| 191 WOODPORT RD | SPARTA | NJ | 07871 | 221768334 | HOME HEALTH | NJ | 501(C)(3) | LINE 10 | SCHS | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (81 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | UBI Code VUBICodeVAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMERICAN MERCY HOME CARE LLC | |||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 830486150 | HOME HEALTH | OH | N/A | N/A | 0 | 0 | |||||||||
| ARIZONA CARE NETWORK - NEXT LLC | |||||||||||||||||||
| 350 W THOMAS RD | PHOENIX | AZ | 85018 | 474696671 | CARE NETWORK | AZ | N/A | N/A | 0 | 0 | |||||||||
| ARIZONA CARE NETWORK LLC (ACN LLC) | |||||||||||||||||||
| 350 W THOMAS RD | PHOENIX | AZ | 85013 | 454494682 | CARE NETWORK | AZ | N/A | N/A | 0 | 0 | |||||||||
| AUDUBON LAND COMPANY LLC | |||||||||||||||||||
| 630 SOUTHPOINTE COURT 200 | COLORADO SPRINGS | CO | 80906 | 841513085 | REAL ESTATE | CO | N/A | N/A | 0 | 0 | |||||||||
| AVON EMERGENCY AND URGENT CARE CENTER LLC | |||||||||||||||||||
| 9100 E MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 811727282 | HEALTHCARE SRVC | CO | N/A | N/A | 0 | 0 | |||||||||
| BAYLOR CHI ST LUKES HEALTH SERVICES LLC | |||||||||||||||||||
| 6624 FANNIN ST STE 1100 | HOUSTON | TX | 77030 | 472079184 | HEALTHCARE SRVC | TX | N/A | N/A | 0 | 0 | |||||||||
| BERGAN MERCY SURGERY CENTER LLC | |||||||||||||||||||
| 7710 MERCY RD STE 200 | OMAHA | NE | 68124 | 208671994 | AMBUL SURG CTR | NE | N/A | N/A | 0 | 0 | |||||||||
| BERYWOOD OFFICE PROPERTIES LLC | |||||||||||||||||||
| 2501 CITICO AVENUE | CHATTANOGA | TN | 37404 | 621875199 | PHYS OFFICE | TN | N/A | N/A | 0 | 0 | |||||||||
| BIOLIFE DIGNITY HEALTH INTERNATIONAL LTD | |||||||||||||||||||
| HEALTH SERVICES | N/A | N/A | 0 | 0 | 709 WING ON PLAZA 62 MODY ROAD TS | HONG KONG | CH | CH | |||||||||||
| BLUEGRASS REGIONAL IMAGING CENTER | |||||||||||||||||||
| 1218 SOUTH BROADWAY STE 310 | LEXINGTON | KY | 40504 | 611386736 | DIAGNOSTIC IMAGING | KY | N/A | N/A | 0 | 0 | |||||||||
| CBCC OUTSMARTING CANCER LLC | |||||||||||||||||||
| 6501 TRUXTUN AVENUE | BAKERSFIELD | CA | 93309 | 461602286 | RADIATION / ONCOLOGY INCLUDING CYBERKNIFE | CA | N/A | N/A | 0 | 0 | |||||||||
| CENTRAL NEBRASKA REHABILITATION SERVICES LLC | |||||||||||||||||||
| 3004 W FAIDLEY AVENUE | GRAND ISLAND | NE | 68803 | 810653461 | PHYSICAL THERAPY | NE | N/A | N/A | 0 | 0 | |||||||||
| CENTURA-SCA HOLDINGS LLC | |||||||||||||||||||
| 569 BROOK VILLAGE STE 901 | BIRMINGHAM | AL | 35209 | 474823023 | OP SURGERY CENTER | AL | N/A | N/A | 0 | 0 | |||||||||
| CHI OPERATING INVESTMENT PROGRAM LP | |||||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 470727942 | INVESTMENTS | CO | RELATED | 0 | 0 | GSH | $5,767,376 | $225,820,264 | $72,419 | 0.04210 | |||||
| CHICAMSURG SURGERY CENTERS LLC | |||||||||||||||||||
| 1A BURTON HILLS BLVD | NASHVILLE | TN | 37215 | 465683027 | SURGERY CENTER | CO | N/A | N/A | 0 | 0 | |||||||||
| COLORADO SPRINGS CK LEASING LLC | |||||||||||||||||||
| 630 SOUTHPOINTE COURT 200 | COLORADO SPRINGS | CO | 80906 | 262982714 | REAL ESTATE | CO | N/A | N/A | 0 | 0 | |||||||||
| COMMUNITY MERCY HOME CARE SERVICES OF SPRINGFIELD LLC | |||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311746556 | HOME HEALTH | OH | N/A | N/A | 0 | 0 | |||||||||
| DE JV LLC | |||||||||||||||||||
| 8686 NEW TRAILS DRIVE | THE WOODLANDS | TX | 77381 | 320496548 | EMERGENCY CARE | NV | N/A | N/A | 0 | 0 | |||||||||
| DHHP SURGERY CENTERS LLC | |||||||||||||||||||
| 1513 S GRAND AVENUE STE 350 | LOS ANGELES | CA | 90015 | 831847466 | SURGERY | CA | N/A | N/A | 0 | 0 | |||||||||
| DHRT HOLDINGS LLC | |||||||||||||||||||
| 185 BERRY STREET SUITE 300 | SAN FRANCISCO | CA | 94107 | 352484591 | HOLDING COMPANY | DE | N/A | N/A | 0 | 0 | |||||||||
| DIGNITY- GOHEALTHURGENT CARE MANAGEMENT LLC | |||||||||||||||||||
| 5555 GLENRIDGE CONNECTOR SUITE 700 | ATLANTA | GA | 30342 | 352548698 | MANAGEMENT SERVICES | DE | N/A | N/A | 0 | 0 | |||||||||
| DIGNITY HEALTH AT HOME LLC | |||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 824674115 | HEALTHCARE SRVC | DE | N/A | N/A | 0 | 0 | |||||||||
| DIGNITY HEALTH SPECIALTY PHARMACY LLC | |||||||||||||||||||
| 185 BERRY STREET SUITE 300 | SAN FRANCISCO | CA | 94107 | 320589462 | SPECIALTY PHARMACY SERVICES | DE | N/A | N/A | 0 | 0 | |||||||||
| DIGNITY HOME RECOVERY CARE LLC | |||||||||||||||||||
| 49 MUSIC SQUARE WEST SUITE 401 | NASHVILLE | TN | 37203 | 832832522 | HOME RECOVERY PROGRAM | DE | N/A | N/A | 0 | 0 | |||||||||
| DIGNITYUSP LAS VEGAS SURGERY CENTERS LLC | |||||||||||||||||||
| 15305 DALLAS PARKWAY SUITE 1600 LB | ADDISON | TX | 75001 | 202999237 | SURGERY | TX | N/A | N/A | 0 | 0 | |||||||||
| DIGNITYUSP NORCAL SURGERY CENTERS LLC | |||||||||||||||||||
| 15305 DALLAS PARKWAY SUITE 1600 LB | ADDISON | TX | 75001 | 202468509 | SURGERY | TX | N/A | N/A | 0 | 0 | |||||||||
| DIGNITYUSP PHOENIX SURGERY CENTERS LLC | |||||||||||||||||||
| 15305 DALLAS PARKWAY SUITE 1600 LB | ADDISON | TX | 75001 | 134248908 | SURGERY | TX | N/A | N/A | 0 | 0 | |||||||||
| DIGNITYUSPJOHN MUIR EAST BAY SURG CTRS LLC | |||||||||||||||||||
| 15305 DALLAS PARKWAY SUITE 1600 LB | ADDISON | TX | 75001 | 352584991 | SURGERY | TX | N/A | N/A | 0 | 0 | |||||||||
| DIGNITY-ABRAZO HEALTH NETWORK LLC | |||||||||||||||||||
| 3030 N CENTRAL AVENUE SUITE 1402 | PHOENIX | AZ | 85012 | 465477985 | MANAGEMENT SERVICES | AZ | N/A | N/A | 0 | 0 | |||||||||
| DOMINICAN MAGNETIC RESONANCE IMAGING CENTER | |||||||||||||||||||
| 1545 SOQUEL DRIVE | SANTA CRUZ | CA | 94065 | 770095477 | IMAGING CENTER | CA | N/A | N/A | 0 | 0 | |||||||||
| ECCS ACQUISITION COMPANY LLC | |||||||||||||||||||
| 2940 NORTH CIRCLE DRIVE | COLORADO SPRINGS | CO | 80909 | 352656413 | AMBUL SURG CTR | CO | N/A | N/A | 0 | 0 | |||||||||
| FOLSOM SIERRA ENDOSCOPY CENTER LP | |||||||||||||||||||
| 1650 CREEKSIDE DRIVE 1600 | FOLSOM | CA | 95630 | 680482416 | ENDOSCOPY | CA | N/A | N/A | 0 | 0 | |||||||||
| FRANCISCAN MEDICAL PAVILION BONNEY LAKE LLC | |||||||||||||||||||
| 6622 WOLLOCHET DR NW | GIG HARBOR | WA | 98335 | 463494108 | REAL ESTATE | WA | N/A | N/A | 0 | 0 | |||||||||
| FRANCISCAN SPECIALTY CARE LLC | |||||||||||||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 813725123 | HEALTHCARE SRVC | WA | N/A | N/A | 0 | 0 | |||||||||
| GOOD SAMARITAN HOME CARE SERVICES OF VINCENNE IN LLC | |||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 201792869 | HOME HEALTH | OH | N/A | N/A | 0 | 0 | |||||||||
| HC SL VINTAGE I LLC | |||||||||||||||||||
| 18000 W SARAH LANE STE 250 | BROOKFIELD | WI | 53045 | 270453767 | PROPERTY HOLDING | WI | N/A | N/A | 0 | 0 | |||||||||
| HEALTHCARE SUPPORT SERVICES LLC | |||||||||||||||||||
| PO BOX 9804 | GRAND ISLAND | NE | 68802 | 721546196 | LAUNDRY | NE | N/A | RELATED | 0 | 0 | $114 | 0.50000 | |||||||
| HEARTLAND ONCOLOGY LLC | |||||||||||||||||||
| 2337 E CRAWFORD ST | SALINA | KS | 67401 | 464265403 | ONCOLOGY | KS | N/A | N/A | 0 | 0 | |||||||||
| LAKESIDE AMBULATORY SURGICAL CENTER LLC | |||||||||||||||||||
| 17031 LAKESIDE HILLS DR | OMAHA | NE | 68130 | 204267902 | AMBUL SURG CTR | NE | N/A | N/A | 0 | 0 | |||||||||
| LAKESIDE ENDOSCOPY CENTER LLC | |||||||||||||||||||
| 17001 LAKESIDE HILLS PLZ STE 201 | OMAHA | NE | 68130 | 205544496 | ENDOSCOPY SRVC | NE | N/A | N/A | 0 | 0 | |||||||||
| LINCOLN CK LEASING LLC | |||||||||||||||||||
| 555 SOUTH 70TH STREET | LINCOLN | NE | 68510 | 262496856 | REAL ESTATE | NE | N/A | N/A | 0 | 0 | |||||||||
| MEMORIAL MEDICAL PLAZA | |||||||||||||||||||
| 3838 SAN DIMAS SUITE B 201 | BAKERSFIELD | CA | 93301 | 364510880 | REAL ESTATE | CA | N/A | N/A | 0 | 0 | |||||||||
| MERCY DAVIS CANCER CENTER MANAGEMENT CO LLC | |||||||||||||||||||
| 2740 M STREET | MERCED | CA | 95340 | 943358445 | MANAGEMENT OF CANCER CENTER | CA | N/A | N/A | 0 | 0 | |||||||||
| MERCY REHABILITATION HOSPITAL LLC | |||||||||||||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 814437201 | HEALTHCARE SRVC | TX | N/A | N/A | 0 | 0 | |||||||||
| MILITARY ROAD PROPERTIES LLC | |||||||||||||||||||
| 181 S 333RD STREET STE 250 | FEDERAL WAY | WA | 98003 | 912067879 | REAL ESTATE | WA | N/A | N/A | 0 | 0 | |||||||||
| NEBRASKA SPINE HOSPITAL LLC | |||||||||||||||||||
| 6901 N 72ND ST STE 20300 | OMAHA | NE | 68122 | 270263191 | SPINE HOSPITAL | NE | N/A | N/A | 0 | 0 | |||||||||
| NICU OPERATING CO OF SANTA CRUZ LLC | |||||||||||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 460502935 | NEONATAL HEALTHCARE | CA | N/A | N/A | 0 | 0 | |||||||||
| NORTH RIVER SURGERY CENTER LLC | |||||||||||||||||||
| 2209 WILDWOOD AVE | SHERWOOD | AR | 72120 | 710799771 | AMBUL SURG CTR | AR | N/A | N/A | 0 | 0 | |||||||||
| NORTHERN PLAINS LABORATORY LLC | |||||||||||||||||||
| 401 N 9 STREET | BISMARK | ND | 58501 | 841641341 | DIAGNOSTIC SERVICES | ND | N/A | N/A | 0 | 0 | |||||||||
| NSC CHANNEL ISLANDS LLC | |||||||||||||||||||
| 3000 RIVERCHASE GALLERIA SUITE 500 | BIRMINGHAM | AL | 35244 | 770418197 | AMBULATORY SURGICAL CENTER | CA | N/A | N/A | 0 | 0 | |||||||||
| OMG ARIZONA LLC | |||||||||||||||||||
| 130 SUTTER STREET 2ND FLR | SAN FRANCISCO | CA | 94104 | 471708588 | MEDICAL OFFICE | AZ | N/A | N/A | 0 | 0 | |||||||||
| ORTHOCOLORADO LLC | |||||||||||||||||||
| 11650 WEST 2ND PLACE | LAKEWOOD | CO | 80228 | 371577105 | ORTHO HOSPITAL | CO | N/A | N/A | 0 | 0 | |||||||||
| PARK RAPIDS AREA HEALTH CARE | |||||||||||||||||||
| 600 PLEASANT AVENUE S | PARK RAPIDS | MN | 56470 | 204926259 | HEALTHCARE SRVC | MN | N/A | N/A | 0 | 0 | |||||||||
| PASADENA URGENCY CENTER LLC | |||||||||||||||||||
| 4600 E SAM HOUSTON PKWY SOUTH | PASADENA | TX | 77505 | 812482854 | URGENT CARE | TX | N/A | N/A | 0 | 0 | |||||||||
| PATIENT TRANSPORT SERVICES OF COLUMBUS INC | |||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 264601285 | AMBULANCE | OH | N/A | N/A | 0 | 0 | |||||||||
| PENINSULA RADIATION ONCOLOGY LLC | |||||||||||||||||||
| 314 MLK JR WAY STE 11 | TACOMA | WA | 98405 | 870808610 | HEALTHCARE SRVC | WA | N/A | N/A | 0 | 0 | |||||||||
| PENRAD IMAGING LLC | |||||||||||||||||||
| 1390 KELLY JOHNSON BLVD | COLORADO SPRINGS | CO | 80920 | 841072619 | MEDICAL IMAGING | CO | N/A | N/A | 0 | 0 | |||||||||
| PERFORMANCE MEDICAL EQUIPMENT & RESPIRATORY SVSC LLC | |||||||||||||||||||
| 19625 62ND AVENUE SOUTH STE 101 | KENT | WA | 98032 | 452901632 | HOLDING COMPANY | WA | N/A | N/A | 0 | 0 | |||||||||
| PLAZA SURGERY CENTER LP | |||||||||||||||||||
| 525 E PLAZA DRIVE SUITE 100 | SANTA MARIA | CA | 93454 | 770573567 | SURGERY | CA | N/A | N/A | 0 | 0 | |||||||||
| PMC HOSPITAL LLC | |||||||||||||||||||
| 3100 MAIN ST STE 500 | HOUSTON | TX | 77002 | 273280598 | HOSPITAL | TX | N/A | N/A | 0 | 0 | |||||||||
| PRECISION MEDICINE ALLIANCE LLC | |||||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 352569159 | DIAGNOSTIC SERVICES | CO | N/A | N/A | 0 | 0 | |||||||||
| PUEBLO AMBULATORY SURGERY CENTER LLC | |||||||||||||||||||
| 25 MONTEBELLO RD | PUEBLO | CO | 81003 | 621488737 | SURGERY CENTER | CO | N/A | N/A | 0 | 0 | |||||||||
| RADIATION ONCOLOGY CENTERS OF VENTURA COUNTY | |||||||||||||||||||
| 1700 N ROSE AVENUE SUITE 120 | OXNARD | CA | 93030 | 770191706 | IMAGING | CA | N/A | N/A | 0 | 0 | |||||||||
| RBR MANAGEMENT LLC | |||||||||||||||||||
| 91 CORPORATE PARK DRIVE SUITE 120 | HENDERSON | NV | 89074 | 271466450 | AMBULANCE | NV | N/A | N/A | 0 | 0 | |||||||||
| REID-ANC HOME CARE SERVICES LLC | |||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 371454747 | HOME HEALTH | IN | N/A | N/A | 0 | 0 | |||||||||
| SAINT JOSEPH - SCA HOLDINGS LLC | |||||||||||||||||||
| 1451 HARRODSBURG RD | LEXINGTON | KY | 40503 | 453801157 | OP SURGERY | DE | N/A | N/A | 0 | 0 | |||||||||
| SAINT JOSEPH-ANC HOME CARE SERVICES | |||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 263330545 | HOME HEALTH | KY | N/A | N/A | 0 | 0 | |||||||||
| SANTA CRUZ COMPREHENSIVE IMAGING LLC | |||||||||||||||||||
| 1661 SOQUEL DRIVE SUITE G | SANTA CRUZ | CA | 95065 | 010550623 | IMAGING | CA | N/A | N/A | 0 | 0 | |||||||||
| SANTA CRUZ LAND & BUILDING LP | |||||||||||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 770285236 | REAL ESTATE | CA | N/A | N/A | 0 | 0 | |||||||||
| SANTA CRUZ SURGERY CENTER LLC | |||||||||||||||||||
| 3003 PAUL SWEET ROAD | SANTA CRUZ | CA | 95065 | 770194916 | SURGERY | CA | N/A | N/A | 0 | 0 | |||||||||
| SOUTHEASTERN HOME CARE LLC | |||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 271219638 | HOME HEALTH | OH | N/A | N/A | 0 | 0 | |||||||||
| ST JOSEPH'S SURGERY CENTER LP | |||||||||||||||||||
| 15305 DALLAS PARKWAY SUITE 1600 LB | ADDISON | TX | 75001 | 201019390 | SURGERY | TX | N/A | N/A | 0 | 0 | |||||||||
| ST ELIZABETH HOME CARE SERVICES LLC | |||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 261236191 | HOME HEALTH | KY | N/A | N/A | 0 | 0 | |||||||||
| ST FRANCIS LAND COMPANY | |||||||||||||||||||
| 5390 N ACADEMY BLVD STE 300 | COLORADO SPRINGS | CO | 80918 | 263134100 | REAL ESTATE | CO | N/A | N/A | 0 | 0 | |||||||||
| ST LUKE'S DIAGNOSTIC CATH LAB LLP | |||||||||||||||||||
| 6624 FANNIN ST STE 800 | HOUSTON | TX | 77030 | 710959365 | DIAGNOSTICS | TX | N/A | N/A | 0 | 0 | |||||||||
| ST LUKE'S LAKESIDE HOSPITAL LLC | |||||||||||||||||||
| 6624 FANNIN STE 2505 | HOUSTON | TX | 77030 | 300427437 | HOSPITAL | TX | N/A | N/A | 0 | 0 | |||||||||
| ST LUKE'S THE WOODLANDS SLEEP CENTER LLC | |||||||||||||||||||
| 6624 FANNIN STE 800 | HOUSTON | TX | 77030 | 462795726 | DIAGNOSTICS | TX | N/A | N/A | 0 | 0 | |||||||||
| TEMPLETON SURGERY CENTER LLC | |||||||||||||||||||
| 1310 LAS TABLAS ROAD SUITE 104 | TEMPLETON | CA | 94365 | 202246616 | SURGERY | CA | N/A | N/A | 0 | 0 | |||||||||
| THE MEDICAL PAVILION AT ST JOHN'S | |||||||||||||||||||
| 1700 ROSE AVENUE | OXNARD | CA | 93030 | 770332349 | REAL ESTATE | CA | N/A | N/A | 0 | 0 | |||||||||
| THREE SPRING IMAGING LLC | |||||||||||||||||||
| 1 MERCADO ST STE 200A | DURANGO | CO | 81301 | 813571570 | HEALTHCARE SRVC | CO | N/A | N/A | 0 | 0 | |||||||||
| VALLEY PHYSICIANS SURGERY CENTER AT NORTHRIDGE LLC | |||||||||||||||||||
| 18330 ROSCOE BLVD | NORTHRIDGE | CA | 91328 | 800864336 | SURGERY | CA | N/A | N/A | 0 | 0 | |||||||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (65 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SERVICES INC | ||||||||||||||||||
| 12809 WEST DODGE RD | OMAHA | NE | 68154 | 470802396 | MANAGED CARE | NE | N/A | C | 0 | |||||||||
| ALL SAINTS INSURANCE COMPANY SPC LTD | ||||||||||||||||||
| 980556913 | INSURANCE | N/A | C | 0 | PO BOX 10073 APO | GEORGETOWN | GRAND CAYMAN | CJ | CJ | |||||||||
| ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY INC | ||||||||||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742466914 | HEALTHCARE | TX | N/A | C | 0 | |||||||||
| ALTERNATIVE INSURANCE MANAGEMENT SERVICE INC | ||||||||||||||||||
| 3900 OLYMPIC BLVD STE 400 | ERLANGER | KY | 41018 | 841112049 | MANAGEMENT SERVICES | CO | N/A | C | 0 | |||||||||
| AMERICAN NURSING CARE INC | ||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311085414 | HOME HEALTH | OH | N/A | C | 0 | |||||||||
| AMERIMED INC | ||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311158699 | HOME HEALTH | OH | N/A | C | 0 | |||||||||
| BC HOLDING COMPANY INC | ||||||||||||||||||
| 1850 BLUEGRASS AVE | LOUISVILLE | KY | 40215 | 311542851 | FITNESS CLUB | KY | N/A | C | 0 | |||||||||
| BRAZOSPORT HEALTH ALLIANCE | ||||||||||||||||||
| 1 WEST WAY COURT | LAKE JACKSON | TX | 77566 | 760518376 | HEALTH CARE | TX | N/A | C | 0 | |||||||||
| CADUCEUS MEDICAL ASSOCIATES INC | ||||||||||||||||||
| 5600 BRAINERD ROAD STE 500 | CHATTANOOGA | TN | 37411 | 621570736 | HEALTHCARE | TN | N/A | C | 0 | |||||||||
| CAPTIVE MANAGEMENT INITIATIVES LTD | ||||||||||||||||||
| 980663022 | CAPTIVE MANAGEMENT | N/A | C | 0 | PO BOX 10073 APO | GEORGETOWN | GRAND CAYMAN | CJ | CJ | |||||||||
| CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH | ||||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 272269511 | RESEARCH | CO | N/A | C | 0 | |||||||||
| CHI ST LUKE'S HEALTH - MEMORIAL CONDOMINIUM ASSOCIATION INC | ||||||||||||||||||
| 1201 W FRANK AVE | LUFKIN | TX | 75904 | 834184717 | CONDO ASSOC | TX | N/A | C | 0 | |||||||||
| CLEARRIVER HEALTH | ||||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 464495960 | INSURANCE | TN | N/A | C | 0 | |||||||||
| COASTAL SURGICAL SPECIALISTS INC | ||||||||||||||||||
| 921 OAK PARK BLVD SUITE 101 | PISMO BEACH | CA | 93449 | 743000596 | HEALTHCARE | CA | N/A | S | 0 | |||||||||
| COMCARE SERVICES INC | ||||||||||||||||||
| 5570 DTC PARKWAY | ENGLEWOOD | CO | 80111 | 840904813 | INACTIVE | CO | N/A | C | 0 | |||||||||
| CONSOLIDATED HEALTH SERVICES | ||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311378212 | HOME HEALTH | OH | N/A | C | 0 | |||||||||
| DES MOINES MEDICAL CENTER INC | ||||||||||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 420837382 | REAL ESTATE | IA | N/A | C | 0 | |||||||||
| DIGNITY HEALTH HOLDING CORPORATION | ||||||||||||||||||
| 185 BERRY STREET SUITE 300 | SAN FRANCISCO | CA | 94107 | 460675371 | HOLDING CO | NV | N/A | C | 0 | |||||||||
| DIGNITY HEALTH INSURANCE LTD (CAYMAN ISLAND CORPORATION) | ||||||||||||||||||
| 981065338 | INSURANCE | N/A | C | 0 | PO BOX 1051 KY1-1102 | GRAND CAYMAN ISLANDS | GRAND CAYMAN | CJ | CJ | |||||||||
| DIGNITY HEALTH PROVIDER RESOURCES INC | ||||||||||||||||||
| 185 BERRY STREET SUITE 300 | SAN FRANCISCO | CA | 94107 | 473366764 | HEALTH PLAN | CA | N/A | C | 0 | |||||||||
| DIVERSIFIED HEALTH RESOURCES INC | ||||||||||||||||||
| 100 MEDICAL DRIVE | LAKE JACKSON | TX | 77566 | 760222679 | HEALTH CARE | TX | N/A | C | 0 | |||||||||
| FIRST INITIATIVES INSURANCE LTD | ||||||||||||||||||
| 980203038 | INSURANCE | N/A | C | 0 | PO BOX 10073 APO | GEORGETOWN | GRAND CAYMAN | CJ | CJ | |||||||||
| FRANCISCAN CITY URGENT CARE SERVICES PS DBA CITY MD - FRANCISCAN URGENT C | ||||||||||||||||||
| C/O CPGUSA 1345 AVE OF THE AMERICAS | NEW YORK | NY | 10105 | 812174959 | HEALTHCARE | NY | N/A | C | 0 | |||||||||
| FRANCISCAN SERVICES INC | ||||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 232487967 | HEALTHCARE | CO | N/A | C | 0 | |||||||||
| GOOD SAMARITAN OUTREACH SERVICES | ||||||||||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470659440 | MEDICAL CLINIC | NE | N/A | C | 0 | |||||||||
| HARVESTPLAINS HEALTH OF IOWA | ||||||||||||||||||
| 32129 WEYERHAEUSER WAY S STE 201 | FEDERAL WAY | WA | 98001 | 473451750 | INSURANCE | WA | N/A | C | 0 | |||||||||
| HEALTH SERVICES OF THE PACIFIC CENTRAL COAST INC | ||||||||||||||||||
| 1400 E CHURCH STREET | SANTA MARIA | CA | 93454 | 770074057 | HEALTHCARE | CA | N/A | C | 0 | |||||||||
| HEALTH SYSTEMS ENTERPRISES INC | ||||||||||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470664558 | MGMT | NE | C | Yes (1) | GSH | $9,450 | $1,215,906 | 1.00000 | ||||||
| HEALTHCARE MGMT SERVICES ORGANIZATION INC | ||||||||||||||||||
| 1149 MARKET ST | TACOMA | WA | 98402 | 911865474 | HEALTH ORG. | WA | N/A | C | 0 | |||||||||
| HEARTLANDPLAINS HEALTH | ||||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 464368223 | INSURANCE | NE | N/A | C | 0 | |||||||||
| HIGHLINE MEDICAL GROUP | ||||||||||||||||||
| 1717 S J STREET | TACOMA | WA | 98405 | 911407026 | MEDICAL SERVICES | WA | N/A | C | 0 | |||||||||
| INTEGRATED MEDICAL SERVICES | ||||||||||||||||||
| 9250 N 3RD STREET SUITE 4010 | PHOENIX | AZ | 85020 | 860783428 | MULTI-SPECIALTY PHYSICIANS GROUP | AZ | N/A | C | 0 | |||||||||
| KOMG-LOUISVILLE REGION INC | ||||||||||||||||||
| 201 ABRAHAM FLEXNER WAY | LOUISVILLE | KY | 40202 | 832481198 | HEALTHCARE | KY | N/A | C | 0 | |||||||||
| MANAGEMENT SERVICES ORGANIZATION OF SANTA MARIA INC | ||||||||||||||||||
| 1400 E CHURCH STREET | SANTA MARIA | CA | 93454 | 770318135 | HEALTH CARE MGMT | CA | N/A | C | 0 | |||||||||
| MEDICAL OFFICE BUILDING HORIZONTAL PROPERTY REGIME INC | ||||||||||||||||||
| 300 WERNER ST | HOT SPRINGS | AR | 71913 | 710720429 | REAL ESTATE | AR | N/A | C | 0 | |||||||||
| MEDQUEST | ||||||||||||||||||
| 1301 15TH AVENUE WEST | WILLISTON | ND | 58801 | 450392137 | SALE OF DME | ND | N/A | C | 0 | |||||||||
| MEMORIAL CV SERVICE LINE MANAGEMENT COMPANY LLC | ||||||||||||||||||
| 1201 W FRANK AVE | LUFKIN | TX | 75904 | 463622849 | HEATH CARE | TX | N/A | C | 0 | |||||||||
| MERCY PARK APARTMENTS LTD | ||||||||||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 421202422 | HOUSING | IA | N/A | C | 0 | |||||||||
| MERCY SERVICES CORP | ||||||||||||||||||
| 2700 STEWART PARKWAY | ROSEBURG | OR | 97471 | 930824308 | RETAIL SALES | OR | N/A | C | 0 | |||||||||
| MHI CLINICAL SERVICES | ||||||||||||||||||
| 1201 W FRANK AVE | LUFKIN | TX | 75904 | 461967952 | HEALTHCARE | TX | N/A | C | 0 | |||||||||
| MILLENNIUM SURGERY CENTER INC | ||||||||||||||||||
| 9300 STOCKDALE HWY 200 | BAKERSFIELD | CA | 93311 | 770513445 | HEALTHCARE | CA | N/A | S | 0 | |||||||||
| MOUNTAIN MANAGEMENT SERVICES INC | ||||||||||||||||||
| 6028 SHALLOWFORD RD | CHATTANOOGA | TN | 37421 | 621570739 | MGMT SVC ORG | TN | N/A | C | 0 | |||||||||
| NORTH CENTRAL HEALTH CARE ALLIANCE | ||||||||||||||||||
| PO BOX 5538 | BISMARK | ND | 58506 | 450439894 | HEALTHCARE | ND | N/A | C | 0 | |||||||||
| PATIENT TRANSPORT SERVICES INC | ||||||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311100798 | HOME HEALTH | OH | N/A | C | 0 | |||||||||
| QUALCHOICE ADVANTAGE | ||||||||||||||||||
| 32129 WEYERHAEUSER WAY S STE 201 | FEDERAL WAY | WA | 98001 | 473433912 | INSURANCE | WA | N/A | C | 0 | |||||||||
| QUALCHOICE HEALTH PLAN SERVICES INC (FKA COLLABHEALTH PLAN SERVICES INC) | ||||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 461224037 | ADMIN SERVICES | CO | N/A | C | 0 | |||||||||
| QUALCHOICE HEALTH INC (FKA COLLABHEALTH MANAGED SOLUTIONS INC) | ||||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 461222808 | HOLDING CO | CO | N/A | C | 0 | |||||||||
| QUALCHOICE HOLDINGS INC | ||||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 274075520 | HOLDING CO | AR | N/A | C | 0 | |||||||||
| QUALCHOICE OF NEBRASKA | ||||||||||||||||||
| 2401 S 73RD ST | OMAHA | NE | 68124 | 810738827 | INACTIVE | NE | N/A | C | 0 | |||||||||
| RIVERLINK HEALTH | ||||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 464380824 | INSURANCE | OH | N/A | C | 0 | |||||||||
| RIVERLINK HEALTH OF KENTUCKY INC | ||||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 464828332 | INSURANCE | KY | N/A | C | 0 | |||||||||
| ROSS PARK PHARMACY INC | ||||||||||||||||||
| 380 SUMMIT AVE | STEUBENVILLE | OH | 43952 | 341832654 | PHARMACY | OH | N/A | C | 0 | |||||||||
| SAINT CLARE'S PRIMARY CARE INC | ||||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 222441202 | BILLING SERVICES | NJ | N/A | C | 0 | |||||||||
| SJH SERVICES CORPORATION | ||||||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 232307408 | HEALTHCARE | CO | N/A | C | 0 | |||||||||
| SJL PHYSICIAN MANAGEMENT SERVICES INC | ||||||||||||||||||
| 424 LEWIS HARGETT CR STE 160 | LEXINGTON | KY | 40503 | 270164198 | MGMT | KY | N/A | C | 0 | |||||||||
| SOUNDPATH HEALTH INC | ||||||||||||||||||
| 32129 WEYERHAEUSER WAY S STE 201 | FEDERAL WAY | WA | 98001 | 421720801 | INSURANCE | WA | N/A | C | 0 | |||||||||
| ST MARY HEALTH VENTURES INC | ||||||||||||||||||
| 1050 LINDEN AVENUE | LONG BEACH | CA | 90813 | 951912528 | RETAIL PHARMACY | CA | N/A | C | 0 | |||||||||
| ST ANTHONY DEVELOPMENT COMPANY | ||||||||||||||||||
| 1415 SOUTHGATE | PENDLETON | OR | 97801 | 931216943 | ATHLETIC CLUB | OR | N/A | C | 0 | |||||||||
| ST JOSEPH DEVELOPMENT COMPANY INC | ||||||||||||||||||
| 1717 SOUTH J ST | TACOMA | WA | 98405 | 911480569 | RENTAL | WA | N/A | C | 0 | |||||||||
| ST LUKE'S HEALTH SYSTEM HOLDINGS INC | ||||||||||||||||||
| 6624 FANNIN STE 800 | HOUSTON | TX | 77030 | 760637138 | HOLDING CO | TX | N/A | C | 0 | |||||||||
| ST VINCENT COMMUNITY HEALTH SERVICES INC | ||||||||||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 710710785 | HEALTHCARE | AR | N/A | C | 0 | |||||||||
| STE HOLDINGS | ||||||||||||||||||
| 12809 WEST DODGE RD | OMAHA | NE | 68154 | 822383629 | HOLDING CO | NE | N/A | C | 0 | |||||||||
| SUGAR LAND DOCTOR GROUP | ||||||||||||||||||
| 1317 LAKE POINT PARKWAY | SUGAR LAND | TX | 77478 | 454270163 | MEDICAL CLINIC | TX | N/A | C | 0 | |||||||||
| TOWSON MANAGEMENT INC | ||||||||||||||||||
| 7601 OSLER DR | TOWSON | MD | 21204 | 521710750 | MGMT SERVICES | MD | N/A | C | 0 | |||||||||
| TRINITY MANAGEMENT SERVICES ORGANIZATION | ||||||||||||||||||
| 380 SUMMIT AVE | STEUBENVILLE | OH | 43952 | 341471026 | MGMT SERVICES | OH | N/A | C | 0 | |||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| GOOD SAMARITAN HOSPITAL FOUNDATION | ||
| B | $350,000 | BOOK |
| GOOD SAMARITAN HOSPITAL FOUNDATION | ||
| C | $137,610 | BOOK |
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