ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IOWA: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IOWA (EIN 42-0776568)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-13
- IRS object ID
- 202111339349302996
- 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 | 2021-05-13T12:09:52-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 470617373 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMONSPIRIT HEALTH | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 198 INVERNESS DRIVE WEST | AddressLine1Txt |
| City | ENGLEWOOD | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80112 | 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 | 420776568 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALEGENT HEALTH-COMMUNITY MEMORIAL | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL OF MISSOURI VALLEY IOWA | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ALEG | BusinessNameControlTxt |
| Phone | 4023434323 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 631 N 8TH ST | AddressLine1Txt |
| City | MISSOURI VALLEY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 515551102 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEANETTE WOJTALEWICZ | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4023434323 | PhoneNum |
| Signature | 2021-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANGELA NOEL | PreparerPersonNm |
| PTIN | P01051055 | PTIN |
| Phone | 3032989100 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CLIFF A 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 | $27,764,583 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHIHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1955 | FormationYr |
| Legal Domicile State | IA | 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 | 180 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | $7,852 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $6,852 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $75,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,588,197 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $23,993,095 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,679,354 | CYProgramServiceRevenueAmt |
| PY Investment Income | $825,070 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,381,404 | CYInvestmentIncomeAmt |
| PY Other Revenue | $248,520 | PYOtherRevenueAmt |
| CY Other Revenue | $100,003 | CYOtherRevenueAmt |
| PY Total Revenue | $25,141,685 | PYTotalRevenueAmt |
| CY Total Revenue | $27,748,958 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $9,275 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $14,705 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,362,074 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,668,661 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,080,735 | PYOtherExpensesAmt |
| CY Other Expenses | $10,415,352 | CYOtherExpensesAmt |
| PY Total Expenses | $23,452,084 | PYTotalExpensesAmt |
| CY Total Expenses | $22,098,718 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,689,601 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,650,240 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $50,445,401 | TotalAssetsBOYAmt |
| Total Assets EOY | $62,983,632 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,816,849 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,370,657 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $47,628,552 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $52,612,975 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AS AN AFFILIATE OF 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 | $2,531,309 | ExpenseAmt |
| Grant | $5,710 | GrantAmt |
| Revenue | $9,583,473 | RevenueAmt |
| Desc | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IS PROUD TO OFFER DIAGNOSTIC IMAGING SERVICES - CLOSE TO HOME - WITHIN THE COMMUNITY. THE DIAGNOSTIC IMAGING SERVICES PROVIDED INCLUDE THE FOLLOWING: 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 | $2,118,156 | ExpenseAmt |
| Grant | $1,138 | GrantAmt |
| Revenue | $1,909,193 | RevenueAmt |
| Desc | AS A COMMUNITY HOSPITAL, ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY HAS STAYED COMMITTED TO KEEPING RESIDENTS OF HARRISON COUNTY IN GOOD HEALTH. THROUGH THE YEARS, ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL HAS STRIVED TO IMPROVE THE HEALTH STATUS OF SOUTHWEST IOWA RESIDENT CHILDREN, TEENS, ADULTS, SENIOR CITIZENS, FRIENDS AND NEIGHBORS THROUGH 24-HOUR EMERGENCY CARE WITH HELIPORT ACCOMMODATIONS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,819,232 | ExpenseAmt |
| Grant | $979 | GrantAmt |
| Revenue | $1,643,042 | RevenueAmt |
| Desc | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL PROVIDES A VARIETY OF SPECIALTY CLINICS LOCATED IN THE FOLLOWING CITIES: MISSOURI VALLEY, LOGAN, WOODBINE AND DUNLAP. THE FOCUS OF EACH SPECIALTY CLINIC AREAS ARE THE FOLLOWING: CARDIOLOGY NON-INVASIVE STUDIES, EAR, NOSE AND THROAT, GASTROENTEROLOGY INCLUDING VIDEOSCOPE EQUIPMENT, GENERAL SURGERY/WOUND CARE, EDICAL/SURGICAL CONSULTATION, OB/GYN, ONCOLOGY, OPHTHALMOLOGY, ORTHOPAEDICS, PAIN MANAGEMENT, PODIATRY AND UROLOGY.THE HOSPITAL HEALTH CLINICS IN THE SMALL VILLAGES OF LOGAN, WOODBINE AND DUNLAP, IOWA ARE A TREMENDOUS BENEFIT TO THOSE COMMUNITIES, WHICH SERVE A DISPROPORTIONATELY LARGE ELDERLY AND RURAL POPULATION, AND ARE PROVIDED AS A CONVENIENCE TO THESE COMMUNITIES WHICH WOULD OTHERWISE HAVE NO CLOSE ACCESS TO MEDICAL SERVICES. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $14,644,379 | ExpenseAmt |
| Grant | $6,878 | GrantAmt |
| Revenue | $11,543,646 | RevenueAmt |
| Desc | OTHER PROGRAMS | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $14,644,379 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $6,878 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $11,543,646 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $21,113,076 | 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 | 0 | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | 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 | Yes (1) | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 180 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEANETTE WOJTALEWICZ | PersonNm |
| Phone | 4023434323 | 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 (27 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| ANTHONY JONES | |||||||||
| BOARD MEMBER | 1.00 | 59.00 | Yes (X) | $0 | $2,459,531 | $14,470 | |||
| CLIFF ROBERTSON MD | |||||||||
| BOARD MEMBER/CEO CHI HEALTH | 5.00 | 45.00 | Yes (X) | $0 | $2,271,574 | $46,283 | Yes (X) | ||
| JEANETTE WOJTALEWICZ | |||||||||
| CFO, CHI HEALTH | 5.00 | 45.00 | $0 | $1,053,501 | $42,366 | Yes (X) | |||
| AHMAD ALCHOMMALI MD | |||||||||
| PHYSICIAN | 60.00 | 0.00 | $600,520 | $0 | $45,228 | Yes (X) | |||
| CARY WARD MD | |||||||||
| FORMER OFFICER | 6.00 | 44.00 | $0 | $555,669 | $34,565 | Yes (X) | |||
| AMY L MCGAHA MD | |||||||||
| BOARD MEMBER | 1.00 | 59.00 | Yes (X) | $0 | $434,812 | $26,872 | |||
| NATHANIEL ALVIS MD | |||||||||
| PHYSICIAN | 60.00 | 0.00 | $418,337 | $0 | $43,042 | Yes (X) | |||
| DANIEL RICHTER MD | |||||||||
| PHYSICIAN | 60.00 | 0.00 | $410,002 | $0 | $35,655 | Yes (X) | |||
| STEVE HOUSTON | |||||||||
| FORMER KEY EMPLOYEE | 10.00 | 40.00 | $0 | $371,218 | $34,814 | Yes (X) | |||
| JASON KRUGER MD | |||||||||
| BOARD MEMBER | 1.00 | 59.00 | Yes (X) | $0 | $338,835 | $44,134 | |||
| DEBRA GOLDSMITH | |||||||||
| PRESIDENT, REGIONAL HOSPITAL | 1.00 | 49.00 | $0 | $279,918 | $45,151 | Yes (X) | |||
| CARRIE GRADY MD | |||||||||
| PHYSICIAN | 60.00 | 0.00 | $219,851 | $0 | $40,752 | Yes (X) | |||
| MATTHEW BOGARD MD | |||||||||
| PHYSICIAN | 60.00 | 0.00 | $220,271 | $0 | $22,382 | Yes (X) | |||
| MIKE WATTERS | |||||||||
| FORMER KEY EMPLOYEE | 1.00 | 59.00 | $0 | $191,790 | $32,614 | Yes (X) | |||
| ROBERT VALENTINE | |||||||||
| FORMER PRESIDENT, COMMUNITY MEMORIAL | 50.00 | 0.00 | $189,247 | $0 | $7,438 | Yes (X) | |||
| JONATHAN MOE | |||||||||
| PRESIDENT, COMMUNITY MEMORIAL | 50.00 | 0.00 | $137,425 | $0 | $16,615 | 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 | 12.00 | 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 | $2,195,653 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,956,848 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $532,381 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | 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 |
|---|---|---|---|---|---|
| THOMAS RICE CRNA INC | |||||
| 1154 S 96TH ST | OMAHA | NE | 68124 | ANESTHESIOLOGY SERVICES | $248,400 |
| ALLEVANT SOLUTIONS | |||||
| 4714 GETTYSBURG RD | MECHANICSBURG | PA | 17055 | MEDICAL CONSULTING SERVICES | $247,000 |
| SNYDER CHARLESON THERAPY SERVICES | |||||
| 8031 W CENTER RD 300 | OMAHA | NE | 68124 | THERAPY SERVICES | $124,134 |
| MMC MECHANICAL CONTRACTORS INC | |||||
| 9751 S 142ND ST | OMAHA | NE | 68138 | CONSTRUCTION SERVICES | $122,462 |
| SHARED MEDICAL SERVICES INC | |||||
| 209 LIMESTONE PASS | COTTAGE GROVE | WI | 53527 | DIAGNOSTIC SERVICES | $116,840 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $7,500 | RelatedOrganizationsAmt |
| Government Grants | $1,574,600 | GovernmentGrantsAmt |
| All Other Contributions | $6,097 | AllOtherContributionsAmt |
| Total Contributions | $1,588,197 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| NET PATIENT SERVICES | 900099 | $21,461,130 | $21,461,130 | $0 | $0 |
| PHARMACY SERVICES | 446110 | $3,218,224 | $3,218,224 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,679,354 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $522,792 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $7,852 | UnrelatedBusinessRevenueAmt |
| Exclusion | $514,940 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $43,840 | 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 | $43,840 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43,840 | TotalRevenueColumnAmt |
| Exclusion | $43,840 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $858,612 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $858,612 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $858,612 | TotalRevenueColumnAmt |
| Exclusion | $858,612 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $5,554 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $884 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,670 | TotalRevenueColumnAmt |
| Exclusion | $4,670 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $746 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $246 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $500 | TotalRevenueColumnAmt |
| Exclusion | $500 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $12,578 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $14,495 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,917 | TotalRevenueColumnAmt |
| Exclusion | -$1,917 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| CAFETERIA | 722100 | $28,557 | $0 | $0 | $28,557 |
| SERVICES SOLD | 900099 | $4,594 | $0 | $0 | $4,594 |
| LABORATORY SERVICES | 621500 | $2,025 | $0 | $0 | $2,025 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,734 | TotalRevenueColumnAmt |
| Exclusion | $17,734 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $52,910 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,748,958 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,679,354 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $7,852 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,473,555 | 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 | $3,705 | TotalAmt |
| Program Services | $3,705 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,000 | TotalAmt |
| Program Services | $11,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,488 | TotalAmt |
| Program Services | $248,414 | ProgramServicesAmt |
| Management And General | $13,074 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,031,472 | TotalAmt |
| Program Services | $8,566,824 | ProgramServicesAmt |
| Management And General | $464,648 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $468,098 | TotalAmt |
| Program Services | $444,693 | ProgramServicesAmt |
| Management And General | $23,405 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,313,055 | TotalAmt |
| Program Services | $1,247,402 | ProgramServicesAmt |
| Management And General | $65,653 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $594,548 | TotalAmt |
| Program Services | $564,820 | ProgramServicesAmt |
| Management And General | $29,728 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,014 | TotalAmt |
| Program Services | $123,513 | ProgramServicesAmt |
| Management And General | $6,501 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,894 | TotalAmt |
| Management And General | $1,894 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,861 | TotalAmt |
| Program Services | $3,861 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,781,449 | TotalAmt |
| Program Services | $2,652,634 | ProgramServicesAmt |
| Management And General | $128,815 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,065 | TotalAmt |
| Program Services | $36,162 | ProgramServicesAmt |
| Management And General | $1,903 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,227 | TotalAmt |
| Program Services | $298,516 | ProgramServicesAmt |
| Management And General | $15,711 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,005 | TotalAmt |
| Program Services | $25,654 | ProgramServicesAmt |
| Management And General | $1,351 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $459,754 | TotalAmt |
| Program Services | $436,766 | ProgramServicesAmt |
| Management And General | $22,988 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,922 | TotalAmt |
| Program Services | $10,375 | ProgramServicesAmt |
| Management And General | $547 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $753 | TotalAmt |
| Program Services | $715 | ProgramServicesAmt |
| Management And General | $38 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $463,123 | TotalAmt |
| Program Services | $439,967 | ProgramServicesAmt |
| Management And General | $23,156 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,200 | TotalAmt |
| Program Services | $4,940 | ProgramServicesAmt |
| Management And General | $260 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MISCELLANEOUS EXPENSES | $3,454,377 | $3,280,889 | $173,488 | $0 |
| MEDICAL SUPPLIES | $2,474,867 | $2,474,867 | $0 | $0 |
| REPAIRS AND MAINTENANCE | $183,887 | $174,693 | $9,194 | $0 |
| UNRELATED BUSINESS TAX | $200 | $200 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,754 | TotalAmt |
| Program Services | $62,466 | ProgramServicesAmt |
| Management And General | $3,288 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,098,718 | TotalAmt |
| Program Services | $21,113,076 | ProgramServicesAmt |
| Management And General | $985,642 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,607 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $187,850 | BOYAmt |
| EOY | $206,192 | 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 | $18,619,859 | BOYAmt |
| EOY | $30,077,767 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $346,147 | BOYAmt |
| EOY | $364,426 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $7,462 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,688,782 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,846,085 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,950,278 | BOYAmt |
| EOY | $4,842,697 | 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 | $25,840,118 | BOYAmt |
| EOY | $26,605,359 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $498,542 | BOYAmt |
| EOY | $879,729 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,445,401 | BOYAmt |
| EOY | $62,983,632 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,812,458 | BOYAmt |
| EOY | $7,264,956 | 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 | $0 | BOYAmt |
| EOY | $2,718,954 | 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 | $4,391 | BOYAmt |
| EOY | $386,747 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,816,849 | BOYAmt |
| EOY | $10,370,657 | 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 | $47,628,552 | BOYAmt |
| EOY | $52,612,975 | 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 | $47,628,552 | BOYAmt |
| EOY | $52,612,975 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,445,401 | BOYAmt |
| EOY | $62,983,632 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,650,240 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$615,824 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$49,993 | 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 | $3,861 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $3,861 | 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 | THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: IOWA HOSPITAL ASSOCIATION - $2,817 AMERICAN HOSPITAL ASSOCIATION - $615 CATHOLIC HEALTH ASSOCIATION - $429 | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $556,637 | BeginningYearBalanceAmt |
| Contributions | $1,856 | ContributionsAmt |
| Investment Earnings Or Losses | $10,430 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $8,675 | GrantsOrScholarshipsAmt |
| End Year Balance | $560,248 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $537,445 | BeginningYearBalanceAmt |
| Contributions | $178,926 | ContributionsAmt |
| Investment Earnings Or Losses | -$3,718 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $156,016 | GrantsOrScholarshipsAmt |
| End Year Balance | $556,637 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $444,406 | BeginningYearBalanceAmt |
| Contributions | $101,099 | ContributionsAmt |
| Investment Earnings Or Losses | $1,596 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $9,656 | GrantsOrScholarshipsAmt |
| End Year Balance | $537,445 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $307,308 | BeginningYearBalanceAmt |
| Contributions | $125,355 | ContributionsAmt |
| Investment Earnings Or Losses | $11,743 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| End Year Balance | $444,406 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $362,875 | BeginningYearBalanceAmt |
| Contributions | $32,475 | ContributionsAmt |
| Investment Earnings Or Losses | $10,975 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $99,017 | GrantsOrScholarshipsAmt |
| End Year Balance | $307,308 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.51000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.49000 | TermEndowmentBalanceEOYPct |
| 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 | $861,370 | OtherCostOrOtherBasisAmt |
| Book Value | $861,370 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,392,009 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,835,150 | DepreciationAmt |
| Book Value | $2,556,859 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,933,122 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,865,370 | DepreciationAmt |
| Book Value | $1,067,752 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $502,281 | OtherCostOrOtherBasisAmt |
| Depreciation | $145,565 | DepreciationAmt |
| Book Value | $356,716 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,842,697 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CHI OIP | Desc |
| Book Value | $26,605,359 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $26,605,359 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ENVIRONMENTAL REMEDIATION LIABILITY | $3,977 |
| OPERATING LEASE LIABILITY | $382,458 |
| OTHER LIABILITIES | $312 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $386,747 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | ENDOWMENT FUNDS ARE INTENDED TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICES FOUNDATION AND ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IA. |
| PART X, LINE 2: | ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA'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) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 471 | PersonsServedCnt |
| Total Community Benefit Expns | $237,616 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $237,616 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01080 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 4486 | PersonsServedCnt |
| Total Community Benefit Expns | $2,869,290 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,866,531 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,759 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| 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 |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4957 | PersonsServedCnt |
| Total Community Benefit Expns | $3,106,906 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,866,531 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $240,375 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01090 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 954 | PersonsServedCnt |
| Total Community Benefit Expns | $55,636 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,352 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $53,284 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 25 | PersonsServedCnt |
| Total Community Benefit Expns | $562 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $562 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $3,343,976 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,630,730 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $713,246 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03230 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,528 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,528 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 49 | PersonsServedCnt |
| Total Community Benefit Expns | $5,906 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $140 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,766 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Persons Served | 1028 | PersonsServedCnt |
| Total Community Benefit Expns | $3,407,608 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,633,222 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $774,386 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03510 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Persons Served | 5985 | PersonsServedCnt |
| Total Community Benefit Expns | $6,514,514 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,499,753 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,014,761 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04600 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| 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 |
Economic Development EconomicDevelopmentGrp
| 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 |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $8 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| 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 |
Leadership Development LeadershipDevelopmentGrp
| 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 |
Coalition Building CoalitionBuildingGrp
| 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 |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $8 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $63 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $63 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| 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 |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $79 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $79 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $625,697 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,073,733 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,861,049 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$787,316 | 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 |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AH-COM MEM HOSPITAL OF MISSOURI VALLEY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 631 N 8TH ST | AddressLine1Txt |
| City | MISSOURI VALLEY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51555 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CHIHEALTH.COM | WebsiteAddressTxt |
| State License | 430030H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Facility Reporting Group | A | FacilityReportingGroupCd |
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 | 0 | 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 | 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 | WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | 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 (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B | FACILITY REPORTING GROUP A |
| FACILITY REPORTING GROUP A CONSISTS OF: | - FACILITY 1: AH-COM MEM HOSPITAL OF MISSOURI VALLEY |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: | COMMUNITY INPUT WAS GATHERED THROUGH THE HEALTHY HARRISON COALITION, CO-LED BY CHI HEALTH MISSOURI VALLEY AND HARRISON COUNTY HOME AND PUBLIC HEALTH DEPARTMENT, AND CHI HEALTH MISSOURI VALLEY'S PATIENT AND FAMILY ADVISORY COUNCIL.SPECIFIC POPULATIONS AT HIGHER HEALTH RISK OR THAT HAVE POORER HEALTH OUTCOMES WERE IDENTIFIED IN THE HARRISON COUNTY COMMUNITY AS:-INDIVIDUALS 65 YEARS AND OLDER-LOW-INCOME POPULATION-PERSONS WITH DISABILITIES-INDIVIDUALS IMPACTED BY VIOLENCEON DECEMBER 18, 2018, THE HEALTHY HARRISON COALITION HOSTED A COMMUNITY HEALTH NEEDS ASSESSMENT DATA PRESENTATION FACILITATED BY CHI HEALTH. MEMBERS REPRESENTING SPECIAL POPULATIONS- AGING, DISABILITY, VIOLENCE AND LOW- INCOME- WERE INVITED TO PARTICIPATE. |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B: | HARRISON COUNTY HOME & PUBLIC HEALTH (HCHPH) |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 7D: | SHARED WITH THE HOSPITAL'S PATIENT FAMILY ADVISORY COMMITTEE ON APRIL 4, 2019. |
| 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.THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH REVIEW OF SECONDARY DATA VALIDATED AND PRIORITIZED BY COMMUNITY STAKEHOLDERS CONVENED THROUGH THE HEALTHY HARRISON COALITION. PARTICIPATING STAKEHOLDERS REPRESENTED: HEALTHCARE, PUBLIC HEALTH, EDUCATION, THE AGING POPULATION, LOW- INCOME POPULATION, PERSONS WITH DISABILITIES AND INDIVIDUALS IMPACTED BY VIOLENCE AND SUBSTANCE ABUSE.TOP HEALTH NEEDS (FROM 2018 CHNA):1. AGING2. CANCER3. CARDIOVASCULAR DISEASE4. CHILD ABUSE & NEGLECT5. CHRONIC LOWER RESPIRATORY DISEASE6. MENTAL HEALTH7. OBESITY & LIFESTYLE FACTORS FOR CHRONIC DISEASE8. SEXUALLY TRANSMITTED INFECTIONS9. SUBSTANCE ABUSE10. UNINTENTIONAL INJURIESFOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: NUTRITION, PHYSICAL ACTIVITY & WEIGHTTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN 2019-2021:-SUPPORT HARRISON COUNTY FARMER'S MARKET FRESH FRUIT & VEGETABLE VOUCHER PROGRAM (INCLUDING TRANSPORTATION, EDUCATION AND VOUCHERS)-EXPLORE THE FEASIBILITY OF A COMMUNITY GARDEN IN MISSOURI VALLEY AND SUPPORT COMMUNITY EFFORTS TO IMPLEMENT-ALIGN WITH AND PROMOTE 5-2-1-0 MESSAGING WHICH ENCOURAGES HEALTHY EATING HABITS AND APPROPRIATE LEVELS OF PHYSICAL ACTIVITYPRIORITY HEALTH NEED #2: BEHAVIORAL HEALTHTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN 2019-2021:-SUPPORT AND PROMOTE SCHOOL- BASED MENTAL HEALTH PROGRAMMING FOCUSED ON PREVENTION OF SUICIDE, SUBSTANCE ABUSE AND BUILDING POSITIVE PARENTING SKILLS, SUCH AS:*COPING THROUGH THE TEEN YEARS (SUICIDE PREVENTION)*ME360 (SUBSTANCE ABUSE PREVENTION)*COMMON SENSE PARENTING (IMPROVING PARENT-CHILD INTERACTIONS THROUGH SKILL DEVELOPMENT)-PARTNER WITH CHI HEALTH CLINICS TO IMPROVE CONTINUUM OF CARE FOR PATIENTS WITH POSITIVE DEPRESSION SCREENING-PARTNER WITH THE REGION AND CHI HEALTH PSYCHIATRIC ASSOCIATES TO DELIVER MENTAL HEALTH FIRST AID TRAINING (MHFA)THE HOSPITAL WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS FOR THE FOLLOWING REASONS:AGING: CHI HEALTH MISSOURI VALLEY RECOGNIZES THE GROWING AGING POPULATION IN HARRISON COUNTY PRESENTS CHALLENGES FOR HEALTH SERVICES INFRASTRUCTURE, HOWEVER HARRISON COUNTY HAS SEVERAL RESOURCES THAT EXIST TO OFFER RELEVANT SUPPORT TO ELDERLY POPULATIONS AND BETTER ADDRESS THE CHALLENGES THAT AGING PRESENT. THE COMMUNITY BENEFIT ACTION TEAM (CBAT) HAS EMPLOYED A LIFECOURSE APPROACH TO THE PRIORITY HEALTH NEEDS OF MENTAL HEALTH AND NUTRITION, PHYSICAL ACTIVITY AND WEIGHT STATUS, SO CONSIDERATION OF THE AGING POPULATION WILL BE ADDRESSED WITHIN THE ACTIVITIES AND STRATEGIES SELECTED. ADDITIONALLY, CHI HEALTH MISSOURI VALLEY LEADERSHIP WILL CONTINUE TO PARTICIPATE IN NURSING HOME PROVIDER MEETINGS TO BETTER INFORM CHALLENGES AND UNCOVER SOLUTIONS TO IMPROVING HEALTH AND SERVICE DELIVERY FOR THE AGING POPULATION.CANCER: CANCER WAS NOT SELECTED FOR WORK IN AN EFFORT TO MAXIMIZE EXISTING RESOURCES AND STAFF TIME TO ADDRESS NEEDS OR ROOT CAUSES WHICH HAVE THE POTENTIAL TO IMPACT OTHER IDENTIFIED HEALTH NEEDS. HOWEVER, CHI HEALTH WILL CONTINUE TO HOST A CANCER SUPPORT GROUP AND SMOKING CESSATION SERVICES. NUTRITION AND PHYSICAL ACTIVITY WAS AN IDENTIFIED HEALTH NEED WHICH WAS PRIORITIZED AND WILL INDIRECTLY ADDRESS CANCER.CARDIOVASCULAR DISEASE: THIS HEALTH NEEDS WAS NOT SELECTED FOR WORK IN AN EFFORT TO MAXIMIZE EXISTING RESOURCES AND STAFF TIME TO ADDRESS NEEDS OR ROOT CAUSES WHICH HAVE THE POTENTIAL TO IMPACT OTHER IDENTIFIED HEALTH NEEDS. NUTRITION AND PHYSICAL ACTIVITY WAS AN IDENTIFIED HEALTH NEED WHICH WAS PRIORITIZED IN AN EFFORT TO INDIRECTLY ADDRESS CARDIOVASCULAR DISEASE.CHILD ABUSE & NEGLECT: WHILE THIS HEALTH NEED WAS NOT PRIORITIZED, ACKNOWLEDGMENT WAS MADE BY THE CBAT THAT THIS NEED IS BEING ADDRESSED BY THE CHILD ABUSE PREVENTION COUNCIL, OF WHICH HARRISON COUNTY HOME AND PUBLIC HEALTH DEPARTMENT IS THE CONVENER. HCHPH WILL CONTINUE TO LEAD THESE EFFORTS AND SEEK ADDITIONAL FUNDING. IN ADDITION, CHI HEALTH MISSOURI VALLEY SPONSORS THE ANNUAL RACE TO RESILIENCY. THE ISSUE OF CHILD ABUSE AND NEGLECT MAY BE CONSIDERED THROUGH THE FOCUS ON BEHAVIORAL HEALTH. CHRONIC LOWER RESPIRATORY DISEASE: IN AN EFFORT TO MAXIMIZE STAFF TIME AND RESOURCES, AND BE MINDFUL OF THE HOSPITAL'S CAPACITY TO DO THIS WORK, CHRONIC LOWER RESPIRATORY DISEASE WAS NOT PRIORITIZED FOR WORK. AS NOTED ABOVE, CHI HEALTH MISSOURI VALLEY OFFERS SMOKING CESSATION SERVICES.SEXUALLY TRANSMITTED INFECTIONS: CHI HEALTH MISSOURI VALLEY DID NOT SELECT THIS HEALTH NEED AS IT WAS NOT PRIORITIZED BY THE HEALTHY HARRISON COALITION OR HOSPITAL LEADERSHIP. THIS HEALTH NEED IS BEING ADDRESSED THROUGH THE HARRISON COUNTY HOME AND PUBLIC HEALTH DEPARTMENT.UNINTENTIONAL INJURY: IN AN EFFORT TO MAXIMIZE STAFF TIME AND RESOURCES, AND BE MINDFUL OF THE HOSPITAL'S CAPACITY TO DO THIS WORK, UNINTENTIONAL INJURY WAS NOT PRIORITIZED FOR WORK. |
| 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - AH LOGAN RURAL HEALTH CLINIC | ||||
| 122 W 8TH STREET | LOGAN | IA | 51546 | RURAL HEALTH CLINIC |
| 2 - AH WOODBINE RURAL HEALTH CLINIC | ||||
| 410 ELY | WOODBINE | IA | 51579 | RURAL HEALTH CLINIC |
| 3 - AH MISSOURI VALLEY RURAL HEALTH CLINIC | ||||
| 809 EAST ELM STREET | MISSOURI VALLEY | IA | 51555 | RURAL HEALTH CLINIC |
| 4 - AH DUNLAP RURAL HEALTH CLINIC | ||||
| 707 IOWA AVE | DUNLAP | IA | 51529 | RURAL HEALTH CLINIC |
| 5 - AH CMH SKILLED NURSING FACILITY | ||||
| 631 N 8TH STREET | MISSOURI VALLEY | IA | 51555 | SKILLED NURSING FACILITY |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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: | ALEGENT CREIGHTON HEALTH, DBA CHI HEALTH (A RELATED ORGANIZATION) PRODUCES AN ANNUAL PUBLIC COMMUNITY BENEFIT REPORT THAT IS MAILED TO A CORE CONSTITUENCY, PLACED IN KEY PLACES THROUGHOUT THE ORGANIZATION AND DISTRIBUTED IN COMMUNITY MEETINGS. IT IS ALSO AVAILABLE ON THE COMPANY'S INTRANET SITE AND ON ITS PUBLIC WEBSITE AT HTTP://WWW.CHIHEALTH.COM/COMMUNITY-BENEFIT. 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 I, LINE 7G: | INCLUDED IN SUBSIDIZED HEALTH SERVICES ARE THE FOLLOWING PHYSICIAN CLINICS:-CHI HEALTH MISSOURI VALLEY RURAL HEALTH CLINIC-CHI HEALTH DUNLAP RURAL HEALTH CLINIC-CHI HEALTH LOGAN RURAL HEALTH CLINIC-CHI HEALTH WOODBINE RURAL HEALTH CLINICTHE TOTAL EXPENSES ASSOCIATED WITH OPERATING THESE CLINICS WERE $3,343,976. REVENUE OFFSETS WERE $2,630,730. ACCORDINGLY, THE TOTAL SUBSIDIZED COST OF THESE NECESSARY SERVICES WAS $713,246. THE CLINICS MEET A COMMUNITY NEED FOR PRIMARY CARE SERVICES OUTSIDE OF THE EMERGENCY ROOM SETTING. |
| 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-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 57.49%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. |
| PART III, LINE 3: | ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA 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: | ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA 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: | ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IOWA IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL (CAH). CAHS ARE RURAL COMMUNITY HOSPITALS THAT ARE CERTIFIED TO RECEIVE COST-BASED REIMBURSEMENT FROM MEDICARE. THE REIMBURSEMENT THAT CAHS RECEIVE IS INTENDED TO IMPROVE THEIR FINANCIAL PERFORMANCE AND THEREBY REDUCE HOSPITAL CLOSURES. CAHS ARE CERTIFIED UNDER A DIFFERENT SET OF MEDICARE CONDITIONS OF PARTICIPATION (COP).SHORTFALLS ARE CREATED WHEN A FACILITY RECEIVES PAYMENTS THAT ARE LESS THAN THE COSTS OF CARING FOR PROGRAM BENEFICIARIES. BECAUSE SHORTFALLS ARE BASED ON COSTS, NOT CHARGES, ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IOWA, DUE TO THEIR DESIGNATION AS A CAH, RECEIVED COST-BASED REIMBURSEMENT FOR MEDICARE PURPOSES, ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IOWA WILL NOT EXPERIENCE MEDICARE RELATED SHORTFALLS.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: $9,073,733TOTAL MEDICARE COSTS: $9,861,049SURPLUS OR SHORTFALL: ($787,316)ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IOWA 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 PAYMENTS 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 COMMUNITY HEALTH NEEDS IN HARRISON COUNTY WAS LED BY CHI HEALTH, IN PARTNERSHIP WITH HARRISON COUNTY HOME AND PUBLIC HEALTH DEPARTMENT (HCHPH).-HARRISON COUNTY HOME & PUBLIC HEALTH DEPARTMENT PARTNERS WITH STATE PUBLIC HEALTH, POLICYMAKERS, HEALTH CARE PROVIDERS, BUSINESS AND MANY OTHERS TO FULFILL ITS MISSION TO PROMOTE PHYSICAL AND MENTAL HEALTH AND PREVENT DISEASE, INJURY, AND DISABILITY FOR THE RESIDENTS OF HARRISON COUNTY, IA.OVERALL METHODOLOGY:A COMPREHENSIVE EXAMINATION OF EXISTING SECONDARY DATA SOURCES WAS COMPLETED BY CHI HEALTH MISSOURI VALLEY AND HCHPH IN LATE 2018 THROUGH EARLY 2019, FOCUSING PRIMARILY ON THE FOLLOWING SOURCES:-CENTER FOR APPLIED RESEARCH AND ENGAGEMENT SYSTEMS (CARES) ENGAGEMENT NETWORK 2019 HTTPS://ENGAGEMENTNETWORK.ORG-CHILD & FAMILY POLICY CENTER HTTPS://WWW.CFPCIOWA.ORG/EN/DATA/KIDS_COUNT/CHILD_ABUSE_AND_NEGLECT/-COUNTY HEALTH RANKINGS AND ROADMAPS 2018 WWW.COUNTYHEALTHRANKINGS.ORG-IOWA DEPARTMENT OF PUBLIC HEALTH TRACKING PORTAL HTTP://IDPH.IOWA.GOV/PUBLICHEALTHDATA/SEARCH-IOWA BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) - HTTPS://IDPH.IOWA.GOV/PORTALS/1/FILES/BRFSS/2016BRFSSANNUALREPORT.PDF-2016 IOWA YOUTH SURVEY - HTTP://WWW.IOWAYOUTHSURVEY.IOWA.GOV/IMAGES/2016_COUNTY_REPORTS/43.HARRISON.PDF THE STATE OF OBESITY - HTTP://STATEOFOBESITY.ORG/STATES/IA/-U.S. CENSUS BUREAU/ AMERICAN COMMUNITY SURVEY- HTTPS://WWW.CENSUS.GOV/IN ORDER TO ANALYZE DATA, BENCHMARKING IS VITAL. THIS WAS ACCOMPLISHED BY REVIEWING TREND DATA PROVIDED BY THE IOWA DEPARTMENT OF PUBLIC HEALTH, IOWA YOUTH SURVEY, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA, AND HEALTHY PEOPLE 2020 (HP2020). |
| 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: | CHI HEALTH MISSOURI VALLEY'S IDENTIFIED PRIMARY SERVICE AREA IS HARRISON COUNTY WHICH IS LOCATED ON THE WESTERN BORDER OF IOWA, AND DIRECTLY NORTH OF POTTAWATTAMIE COUNTY AND THE OMAHA/COUNCIL BLUFFS METRO AREA. HARRISON COUNTY REPRESENTS BETWEEN 75%-90% OF PATIENTS SERVED BY CHI HEALTH MISSOURI VALLEY, AND THEREFORE THE HOSPITAL SELECTED THE COUNTY AS THE FOCUS FOR THEIR CHNA. IMPORTANTLY, ANOTHER CHI HEALTH ENTITY, MERCY COUNCIL BLUFFS, IS LOCATED IN NEIGHBORING POTTAWATTAMIE COUNTY, IOWA. CHI HEALTH MERCY COUNCIL BLUFFS ALSO COMPLETED A CHNA AND RELATED IMPLEMENTATION PLAN.CHI HEALTH MISSOURI VALLEY RESIDES IN MISSOURI VALLEY, IOWA. MISSOURI VALLEY IS IN THE SOUTHWEST CORNER OF HARRISON COUNTY, A NON-METROPOLITAN COUNTY LOCATED IN WEST CENTRAL IOWA. HARRISON COUNTY IS COMPOSED OF NINE SCHOOL DISTRICTS AND 10 INCORPORATED TOWNS: DUNLAP, LITTLE SIOUX, LOGAN, MAGNOLIA, MISSOURI VALLEY, MODALE, MONDAMIN, PERSIA, PISGAH AND WOODBINE. LOGAN IS THE COUNTY SEAT AND THERE ARE ALSO SIX UNINCORPORATED TOWNS, AND 20 TOWNSHIPS.POPULATION CHARACTERISTICS:POPULATION DATA SHOWS A PRIMARILY NON-HISPANIC WHITE POPULATION, AND A SLIGHTLY HIGHER PERCENTAGE OF RESIDENTS OVER 65 YEARS OF AGE (19.6%) COMPARED TO THE STATE OF IOWA (16.7%). AS A PREDOMINANTLY RURAL COUNTY, HARRISON COUNTY COVERS APPROXIMATELY 697 SQUARE MILES AND HAS A POPULATION DENSITY OF 21 PERSONS PER SQUARE MILE. LOGAN IS THE COUNTY SEAT AND IS LOCATED APPROXIMATELY 40 MINUTES FROM THE OMAHA/COUNCIL BLUFFS METRO AREA.HARRISON COUNTY:-14,134 TOTAL POPULATION-23.1% OF POPULATION IS UNDER 18 YEARS OF AGE-0.4% OF POPULATION IS NON-HISPANIC AFRICAN AMERICAN-0.4% OF POPULATION IS AMERICAN INDIAN/ALASKAN NATIVE-0.3% OF POPULATION IS ASIAN-0.0% OF POPULATION IS NATIVE HAWAIIAN-1.8% OF POPULATION IS HISPANIC-96.2% OF POPULATION IS NON-HISPANIC WHITE-$57,558 IS THE MEDIAN HOUSEHOLD INCOME-2.8% OF POPULATION IS UNEMPLOYED-10% OF POPULATION IS LIVING IN POVERTY-13.08% OF CHILDREN UNDER AGE 18 LIVE IN POVERTY IN HARRISON COUNTY (COMPARED TO 14.75% OF IOWA OVERALL)-5.4% OF POPULATION IS UNINSURED-3.1% OF CHILDREN ARE UNINSURED-92.0% OF RESIDENTS 25 YEARS OR OLDER ARE HIGH SCHOOL GRADUATES |
| PART VI, LINE 5: | THE ORGANIZATION'S HOSPITAL FACILITY(IES) 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 FACILITY(IES) 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 FACILITY(IES) 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 (BICYCLE HELMET SAFETY, COMMUNITY BEHAVIORAL HEALTH SUPPORT AND EDUCATION, DIABETES, CANCER, PHYSICAL ACTIVITY AND HEALTHY EATING AND COOKING)*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.*TRANSPORTATION TO PATIENTS WHO CANNOT AFFORD TRANSPORTATION TO ATTEND TO THEIR MEDICAL NEEDS.*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-TYPICALLY PROVIDES 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 (UP TO $20/DAY) ON FRUITS AND VEGETABLES AT PARTICIPATING SITES; NUTRITION/COOKING EDUCATION IS ALSO PROVIDED AT ALL SITESMISSOURI VALLEY:-HEALTHY HARRISON COALITION-PROVIDED SUPPORT OF THE FARMER'S MARKET VOUCHER PROGRAM-STRATEGIC PLANNING FACILITATION-CONTRACTED AN OUTSIDE CONSULTANT TO MERGE THE MMG BEHAVIORAL HEALTH COALITION AND HEALTHY HARRISON COALITION UNDER ONE LEADERSHIP TO HELP PROVIDE STRUCTURE AND STRATEGIC PLANNING TO IMPLEMENT STRATEGIES TO ADDRESS COMMON COMMUNITY HEALTH NEEDS.-HEALTH PROFESSIONAL EDUCATION-*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 -SUBSIDIZED HEALTH SERVICES - HEALTHCARE SERVICES INCLUDING EMERGENCY CARE AND CLINICAL CARE IN THE RURAL HEALTH SETTING-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.-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.*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.-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*COMMUNITY AND ECONOMIC DEVELOPMENT INCLUDING SUPPORT OF LOCAL CHAMBERS OF COMMERCE |
| 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 I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 11 | RecipientCnt |
| Cash Grant | $11,000 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 2: | 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. |
| PART III: | SCHOLARSHIPS ARE PROVIDED BY THE CHI HEALTH MISSOURI VALLEY AUXILIARY. THE FUND IS SET UP TO HELP HARRISON COUNTY GRADUATES OF PROMISING ABILITIES DISCOVER THEIR TALENTS IN THE HEALTH FIELD AND TO HELP FINANCE THEIR EDUCATION FOR SAID CAREERS. SCHOLARSHIPS ARE AWARDED TO CANDIDATES SHOWING THE GREATEST MERIT AND POTENTIAL. MINIMUM GRADEPOINT IS NOT THE ONLY FACTOR USED TO SELECT THE RECIPIENTS OF THE SCHOLARSHIPS, BUT ALSO COMMUNITY SERVICE, EXTRACURRICULAR ACTIVITIES, GRADES, AND FINANCIAL NEED. IT IS THE INTENTION OF THE SCHOLARSHIP COMMITTEE THAT THE SCHOLARSHIPS BE USED FOR TUITION AND RELATED EXPENSES SUCH AS FEES, BOOKS, SUPPLIES, AND EQUIPMENT REQUIRED FOR COURSES OF INSTRUCTION AT A QUALIFIED EDUCATIONAL ORGANIZATION. THE COMMITTEE CONSISTS OF TEACHERS, AUXILIANS, AND GUIDANCE COUNSELORS. |
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 (16 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 |
| AHMAD ALCHOMMALI MD | ||||||||||||||
| PHYSICIAN | $596,908 | $0 | $0 | $0 | $3,612 | $0 | $16,286 | $0 | $28,942 | $0 | $645,748 | $0 | $0 | $0 |
| CARY WARD MD | ||||||||||||||
| FORMER OFFICER | $0 | $509,754 | $0 | $23,303 | $0 | $22,612 | $0 | $16,294 | $0 | $18,271 | $0 | $590,234 | $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 |
| NATHANIEL ALVIS MD | ||||||||||||||
| PHYSICIAN | $417,581 | $0 | $0 | $0 | $756 | $0 | $16,354 | $0 | $26,688 | $0 | $461,379 | $0 | $0 | $0 |
| DANIEL RICHTER MD | ||||||||||||||
| PHYSICIAN | $404,458 | $0 | $0 | $0 | $5,544 | $0 | $15,625 | $0 | $20,030 | $0 | $445,657 | $0 | $0 | $0 |
| STEVE HOUSTON | ||||||||||||||
| FORMER KEY EMPLOYEE | $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 |
| DEBRA GOLDSMITH | ||||||||||||||
| PRESIDENT, REGIONAL HOSPITAL | $0 | $235,136 | $0 | $10,584 | $0 | $34,198 | $0 | $27,972 | $0 | $17,179 | $0 | $325,069 | $0 | $17,782 |
| CARRIE GRADY MD | ||||||||||||||
| PHYSICIAN | $219,195 | $0 | $0 | $0 | $656 | $0 | $15,760 | $0 | $24,992 | $0 | $260,603 | $0 | $0 | $0 |
| MATTHEW BOGARD MD | ||||||||||||||
| PHYSICIAN | $219,972 | $0 | $0 | $0 | $299 | $0 | $3,373 | $0 | $19,009 | $0 | $242,653 | $0 | $0 | $0 |
| MIKE WATTERS | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $184,089 | $0 | $0 | $0 | $7,701 | $0 | $16,525 | $0 | $16,089 | $0 | $224,404 | $0 | $0 |
| ROBERT VALENTINE | ||||||||||||||
| FORMER PRESIDENT, COMMUNITY MEMORIAL | $38,915 | $0 | $0 | $0 | $150,332 | $0 | $7,073 | $0 | $365 | $0 | $196,685 | $0 | $16,060 | $0 |
| JONATHAN MOE | ||||||||||||||
| PRESIDENT, COMMUNITY MEMORIAL | $84,287 | $0 | $0 | $0 | $53,138 | $0 | $4,676 | $0 | $11,939 | $0 | $154,040 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 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. COMPENSATION FOR THE OTHER OFFICERS OF ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA 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. |
| PART I, LINES 4A-B | SCHEDULE J, PART I, LINE 4A - SEVERANCE OR CHANGE-OF-CONTROL PAYMENTS: 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 ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IOWA 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): ROBERT VALENTINE, $130,172. SCHEDULE J, PART I, 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; DEBRA GOLDSMITH, $17,924, AND ROBERT VALENTINE, $17,739. 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; AND JEANETTE WOJTALEWICZ, $57,305. |
| PART I, LINE 7 | 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 (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1C: PAYMENTS TO VENDORS | PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH (CSH) ARE MADE BY CSH, THEREFORE NO FORM 1099S ARE ISSUED BY ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA. CSH FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099S ISSUED BY CSH ON BEHALF OF ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA ARE REPORTED TO THE IRS. |
| FORM 990, PART VI, SECTION A, LINE 6 | CHI NEBRASKA IS THE SOLE MEMBER OF ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL MISSOURI VALLEY, IOWA. |
| 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 ALEGENT HEALTH- COMMUNITY MEMORIAL HOSPITAL BOARD. *AMENDMENT OF THE CORPORATE DOCUMENTS OF THE ALEGENT HEALTH- COMMUNITY MEMORIAL HOSPITAL. *APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL. *ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR THE ALEGENT HEALTH- COMMUNITY MEMORIAL 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 ALEGENT HEALTH- COMMUNITY MEMORIAL HOSPITAL. *REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE ALEGENT HEALTH- COMMUNITY MEMORIAL HOSPITAL. *APPROVAL OF ISSUANCE OF DEBT BY ALEGENT HEALTH- COMMUNITY MEMORIAL HOSPITAL. *APPROVAL OF PARTICIPATION OF ALEGENT HEALTH- COMMUNITY MEMORIAL HOSPITAL IN A JOINT VENTURE. *APPROVAL OF FORMATION OF A NEW CORPORATION BY ALEGENT HEALTH- COMMUNITY MEMORIAL HOSPITAL. *APPROVAL OF A MERGER INVOLVING THE ALEGENT HEALTH- COMMUNITY MEMORIAL HOSPITAL. *APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ALEGENT HEALTH- COMMUNITY MEMORIAL HOSPITAL. *TO REQUIRE THE TRANSFER OF ASSETS BY THE SAINT ALEGENT HEALTH- COMMUNITY MEMORIAL 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 (CSH), A RELATED ORGANIZATION, THE RETURN IS REVIEWED BY THE CSH 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 15B | 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 ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA 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 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 | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,197,701. MANAGEMENT AND GENERAL EXPENSES 115,668. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,313,369. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 250,552. MANAGEMENT AND GENERAL EXPENSES 2,390. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 252,942. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 156,103. MANAGEMENT AND GENERAL EXPENSES 8,216. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 164,319. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 48,278. MANAGEMENT AND GENERAL EXPENSES 2,541. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50,819. |
| FORM 990, PART XI, LINE 9: | AUXILIARY ADJUSTMENT 6,718. ASC 842 ADJUSTMENT -2,450. OTHER CHANGES IN NET ASSETS -54,261. |
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 MO 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 12A, I | 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 12A, I | 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 SUITE 200 | 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) | 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 | Yes (1) | |
| 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 200 | SAN FRANCISCO | CA | 94107 | 815009488 | HOSPITAL | CO | 501(C)(3) | LINE 3 | CSH | 0 | |
| DIGNITY HEALTH | |||||||||||
| 185 BERRY STREET SUITE 200 | 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 SUITE 200 | 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 SUITE 200 | SAN FRANCISCO | CA | 94107 | 943006034 | SELF INSURANCE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH INSURANCE NEVADA LTD | |||||||||||
| 185 BERRY STREET SUITE 200 | 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 SUITE 200 | 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 | 0 | |
| 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 12A, I | 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 12A, I | 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 | |
| MEMORIAL SPECIALTY HOSPITAL | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 95902 | 752492741 | HOSPITAL | TX | 501(C)(3) | LINE 3 | 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 12A, I | 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 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 3 | 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) | 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 12A, I | 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 | 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 | CSH | $743,528 | $26,605,359 | 0.00500 | |||||
| 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 200 | 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 200 | 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 | N/A | 0 | 0 | ||||||||
| 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 (64 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 200 | 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 200 | 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 | ||||||||||||||
| 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 | N/A | C | 0 | |||||
| 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 | |||||
| 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 | ||||||||||||||
| 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 | 0 | 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 | 0 | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | 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 | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEMORIAL HOSPITAL SERVICES FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $7,500 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |
Comments