2020-07-10T11:00:59-05:00 2019-06-30 470617373 Commonspirit Health 198 Inverness Drive West Englewood CO 80112 990 2018-07-01 410721642 Unity Family Healthcare UNIT 3206325441 815 SE 2nd Street Little Falls MN 56345 Joshua Senger CFO 2020-07-10 true Mark Stocki P00642127 3032989100 2018 2021-01-29 14:40:06Z Steven Smith 815 SE 2nd Street Little Falls MN 56345 76597924 false 0928 X www.chistgabriels.com X 2001 MN The vision is to create the best healthcare experience by igniting the spirit for superior care and service. 11 6 473 270 91465 0 498829 445710 76139837 73886651 1064921 776966 1440974 1409819 79144561 76519146 1434878 80563 0 0 35256102 37155483 0 0 0 38756006 36576525 75446986 73812571 3697575 2706575 63836436 69091085 23032422 25531312 40804014 43559773 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. false false 65209700 80563 73798149 SEE SCHEDULE H 65209700 true true false true false false false false true true true false true true true false true false false false false false false true false true true true true true false false false false false false true false false false false false false true false false false true 0 0 473 true true true false false false false false true false false false false false X 11 6 false false false false true true true true true false false true true true true true true false false true false MN X Vicki Maleski 3206315674 815 SE 2nd Street Little Falls MN 56345 LEE BOYLES FORMER PRESIDENT/CEO 1.0 45.0 X X 0 307832 26336 SR MARY PAT BURGER SECRETARY 1.0 2.0 X X 0 0 0 BRIAN MACKINAC CHAIR 1.0 1.0 X X 0 0 0 STEVEN SMITH CEO/VP OF FINANCE 1.0 45.0 X X 0 186902 37053 RICHARD WEAVER VICE CHAIR 1.0 1.0 X X 0 0 0 JEFFREY DROP Board Member/CHI SVP Division Officer 1.0 50.0 X 0 1388860 40427 GREGORY MCNAMARA MD BOARD MEMBER/PHYSICIAN 45.0 1.0 X 274849 0 41484 VIRGIL MEYER MD BOARD MEMBER/PHYSICIAN 45.0 1.0 X 288118 0 34815 MARK MOE MD BOARD MEMBER/PHYSICIAN 45.0 1.0 X 305724 0 41602 JON VETTER Board Member 1.0 1.0 X 0 0 0 CHRISTINE GAMMON-KRUSCHEK BOARD MEMBER 1.0 1.0 X 0 0 0 KRISTINE ERICKSON BOARD MEMBER 1.0 1.0 X 0 0 0 DAVID EDGERTON JR PHYSICIAN 45.0 0 X 635331 0 42378 PAUL JOHNSON PHYSICIAN 45.0 0 X 777364 0 40539 DAVID JORGENSEN PHYSICIAN 45.0 0 X 649980 0 43065 SAUNG PARK PHYSICIAN 45.0 0 X 577650 0 17058 PHILIP PROSAPIO PHYSICIAN 45.0 0 X 540570 0 34512 RYAN KRAY MD Former Vice Chair/Physician 45.0 1.0 X 244371 0 17491 4293957 1883594 416760 58 true true false LITTLE FALLS ANESTHESIA 808 3RD STREET SUITE 130 LITTLE FALLS MN 56345 ANESTHESIA SERVICES 1767179 AMN HEALTHCARE 12400 HIGH BLUFF DRIVE SAN DIEGO CA 92130 HEALTHCARE CONSULTING 1411435 CENTRACARE LABORATORIES SERVICES 20 NINTH ST SE LONG PRAIRIE MN 56347 LAB SERVICES 829090 CENTRAL MN DIAGNOSTIC 150 10TH ST NW PO BOX 158 MILACA MN 56353 RADIOLOGY SERVICES 721499 WAPITI MED GROUP-LYFJABERG LLC 107 FLYNN DRIVE SUITE 600 MILBANK SD 57252 MEDICAL STAFFING SERVICES 414426 12 X 0 0 24866 0 319355 101489 0 445710 Net Patient Services 900099 70431576 70431576 0 0 Pharmacy Services 446110 3449699 3361197 88502 0 Intercompany Transactions 900099 5376 5376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73886651 464484 0 2963 461521 0 0 0 0 0 0 0 0 284197 0 0 0 284197 0 284197 0 0 284197 245752 66730 0 0 245752 66730 312482 0 0 312482 3712 24866 8330 -4618 0 -4618 0 0 0 0 0 0 50109 70448 -20339 0 0 -20339 Reimbursement of Expenses 900099 721354 0 0 721354 Cafeteria 722100 164123 0 0 164123 Wellness Services 900099 135151 0 0 135151 129951 0 0 129951 1150579 76519146 73798149 91465 2183822 X 51169 51169 29394 29394 985094 985094 29109038 27610251 1498787 1366934 1295121 71813 3967228 3766414 200814 1727189 1640829 86360 131102 131102 6324 6324 13840955 10378611 3462344 0 182362 60180 122182 1400474 1108558 291916 3641473 3605058 36415 1844623 1623268 221355 248374 211118 37256 58247 32036 26211 526309 526309 1546416 1546416 1916383 1648089 268294 427411 418862 8549 Medical Supplies 8360016 7941928 418088 Other taxes 1297669 1232786 64883 Repairs and maintenance 718263 681752 36511 Recruitment and relocation 148985 141536 7449 281139 221337 59802 0 73812571 65209700 8602871 0 1125 2060 9509075 4846640 0 0 11154950 9728323 0 0 0 146446 97713 1769877 1566633 2070 3583 58533922 37220879 21319427 21313043 0 0 15198758 21367422 0 0 0 4734708 10165668 63836436 69091085 5940686 4641746 0 0 423148 423148 0 0 0 0 0 0 0 0 0 16668588 20466418 23032422 25531312 X 40617677 43406795 177008 143649 9329 9329 40804014 43559773 63836436 69091085 X 2706575 490280 -441096 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 6324 false false false 6324 false Schedule C, Part II-B, Line 1f THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN ACADEMY OF FAMILY PHYSICIANS: $620 AMERICAN ACADEMY OF PHYSICIAN ASSISTANTS: $15 AMERICAN ASSOCIATION FOR RESPIRATORY CARE: $19 AMERICAN ASSOCIATION OF ORTHOPAEDIC SURGEONS: $498 AMERICAN BOARD OF FOOT AND ANKLE SURGERY: $88 AMERICAN COLLEGE OF FOOT AND ANKLE SURGEONS: $31 AMERICAN COLLEGE OF OSTEOPATHIC FAMILY PHYSICIANS: $28 AMERICAN HOSPITAL ASSOCIATION: $1,243 AMERICAN MEDICAL ASSOCIATION: $756 AMERICAN OSTEOPATHIC ASSOCIATION: $76 CATHOLIC HEALTH ASSOCIATION: $809 CATHOLIC HEALTH ASSOCIATION OF MN: $442 MN HOSPITAL ASSOCIATION: $951 MN MEDICAL ASSOCIATION: $748 9330 9330 7985 1345 9330 5000 2985 7985 0 5000 5000 0 0 0.0 1.0 0.0 false false 681604 681604 22675628 13396801 9278827 0 0 0 32630958 22870781 9760177 2545732 953297 1592435 21313043 CHI OIP CHI OIP Cash Reserved for Restricted Net Assets CHI OIP Fixed Income CHI OIP CHI OIP CHI OIP CHI OIP 21367422 F 21367422 Dividend Receivable Intercompany Receivables Intercompany Receivables 9364691 Dividend Receivable 800977 10165668 Intercompany Debt 15538542 Deferred Gain on Sale/Leaseback 3023460 Environmental Remediation Liability 1022677 Vendor Accruals 881739 20466418 X Schedule D, Part V, Line 4 Intended uses of endowment funds The income from this permanent endowment is to be used to meet the hospital's greatest needs. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote Unity Family Healthcare's financial information is included in the consolidated audited financial statements of CommonSpirit Health, a related organization. CommonSpirit Health's FIN 48 (ASC 740) footnote for the year ended June 30, 2019, reads as follows: "CommonSpirit has established its status as an organization exempt from income taxes under the 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 judgement occurs. Income tax interest and penalties are recorded as income tax expense. For the years ended June 30, 2019 and 2018, 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 benefits as of June 30, 2019 and 2018. 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". SPRING MAGIC 12398 10618 1780 810 600 1345 295 DRIVE FORE CANCER 16180 14248 1932 5280 0 28578 24866 3712 6090 600 1345 295 8330 -4618 true true X true X 300 true X true true true false true true 1963 615726 615726 0.0083 12384630 13422086 0 0.0 0 0 0 0 0.0 0 1963 13000356 13422086 615726 0.0083 16 3014 215984 0 215984 0.0029 1 3 30956 0 30956 0.0004 1 4581 350282 0 350282 0.0047 0 0 0 0 0 0.0 5 13636 114589 6563 108026 0.0015 23 21234 711811 6563 705248 0.0096 23 23197 13712167 13428649 1320974 0.0179 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 2 6 131301 6192 125109 0.0017 2 6 131301 6192 125109 0.0017 true 1700001 0 16753597 16992929 -239332 X true true 1 1 St Gabriel's Hospital 815 SE Second Street Little Falls MN 56345 www.stgabriels.com 8392027 X X X X St Gabriel's Hospital 1 false false true X X X X X X X X X 18 true true true true X HTTPS://WWW.CHISTGABRIELS.COM/CHNA/ X X true 19 false true false true X 300.0 300.0 X X X X true true X X X true X HTTPS://WWW.CHISTGABRIELS.COM/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.CHISTGABRIELS.COM/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.CHISTGABRIELS.COM/FINANCIAL-ASSISTANCE/ X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E The significant health needs are a prioritized description of the significant health needs of the community. They were identified through the CHNA and are being addressed in the hospital's most recent implementation plan. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - St. Gabriel's Hospital. As a hospital within one of the three counties served by the Morrison-Todd-Wadena Community Health Board, CHI St. Gabriel's Hospital once again turned to colleagues within the hospitals and public health organizations in this region to form a working committee (informally known as the MTW committee) to conduct a formal survey of the community. Members of the MTW Community Health Needs Assessment committee included representatives from: *Public health professionals from Morrison, Todd, and Wadena counties *Lakewood Health System, Staples (Todd County) *Tri-County Health, Wadena (Wadena County) *CentraCare Health -Long Prairie (Todd County) *South Country Health Alliance (a county-based health plan serving 12 Minnesota counties) The Morrison-Todd-Wadena committee, chaired by Katherine Mackedanz, MPH, Community Health Manager, Todd County Health and Human Services, began meeting in the summer of 2018 to plan the 2019 Community Health Survey. The committee approved a final version of the survey in November 2018 and sent it to Anne Kinney, senior research scientist with the Center for Health Statistics in the Minnesota Department of Health, who advised the MTW committee on the survey and worked with contractors in the printing, mailing, and collection of the surveys. The survey was mailed January 25, 2019, to 1,600 households in each of the counties served by the Morrison-Todd-Wadena Community Health Board, with an extra 400 surveys sent to each of the cities in the area: Little Falls, Staples, Long Prairie and Wadena. The original plan was to send 1,600 surveys to randomly chosen households in each of the three counties. However, based upon advice from the Minnesota Department of Health, and in an attempt to increase the number of completed surveys from people ages 18-30, the committee agreed to send an additional 400 surveys to each of the zip codes in the counties that are more likely to be home to people in the 18-35 age group, which are also the communities in which hospitals are located. The Morrison-Todd-Wadena committee planned and conducted interviews with community stakeholders at the same time as planning the survey and waiting for the survey results. Each hospital conducted its own stakeholder interviews based upon the set of questions developed by the committee members in collaboration, expecting that doing so would allow them to compare answers and information after the interviews were completed. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - St. Gabriel's Hospital. The CHNA was conducted with Lakewood Health System, Tri-County Health, and CentraCare Health. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - St. Gabriel's Hospital. The CHNA was conducted with the Morrison-Todd-Wadena Community Health Board. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - St. Gabriel's Hospital. A COPY OF THE CHNA WAS PROVIDED TO MORRISON COUNTY PUBLIC HEALTH. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - St. Gabriel's Hospital. The following outlines the current implementation plan priorities and strategies. 2019-2022 INITIATIVES Obesity: Food Security and Healthy Eating The Fitness Trail in Pine Grove Park and Zoo opened July 9, 2019, and represented a successful collaboration between Morrison County Public Health, CHI St. Gabriel's Health and other community organizations, and was a direct result of a commitment to addressing obesity in the 2016 CHI St. Gabriel's Health CHNA. The opening of the facility, with 10 workout stations and information plaques along the course, presented a strong reminder to the CHI St. Gabriel's Health Strategy Team that they had built a significant momentum recently in helping people increase the amount of physical activity they get in their lives. Goals: *Focus efforts on food security, healthy nutrition education, and fitness. *Continue the momentum developed in Morrison County since the 2016 CHNA. Initiatives: *Fitness Trail in Pine Grove Park -support and encourage use of the facility. *Fitness challenges in public schools -continue current and develop new programs. *In4mative Health -a concept developed by the CHI St. Gabriel's Health dietician working with the St. Francis Health and Wellness's recreational director. Expected implementation in January 2020. *Local Foods, Local Places -a program of the U.S. EPA and USDA. Little Falls is a 2019 Community in this program. Support this initiative as it develops. *Support healthy eating programs in area schools. *Support nutrition education at Sprout, a community-based healthy living non-profit. *Support and develop food rescue initiatives, particularly in aid to the homeless and hungry. Substance Abuse: Continued focus on opioid epidemic CHI St. Gabriel's Health is a proud partner in the Morrison County Prescription Drug Task Force, providing expertise on the medical treatment of overdoses and on the use of drugs to stop overdose reactions. As a result of this work, CHI St. Gabriel's Health was invited to become a training hub for the ECHO program from the University of New Mexico. Two CHI St. Gabriel's Health physicians, Heather Bell and Kurt Devine, now train each week approximately 100 people in the Upper Midwest and across the country, through online video conferencing, on the lessons and practices of this program. This success in addressing the nation's opioid epidemic, but knowing there is much work to do to help people in need, led the CHI St. Gabriel's Health Strategy Team to choose to once again address prescription abuse and substance abuse in its 2019-2022 CHNA initiatives. Goals: *Continue and enhance participation in the Morrison County Prescription Drug Task Force. *Continue efforts of the CHI St. Gabriel's Health Controlled Substance Care Team. *Increase education on the causes of substance abuse, awareness of the specifics of substance abuse, and the opportunities for substance abuse, particularly as they relate to addressing mental health needs, which is the third initiative for the coming three years. Initiatives: *Continue to provide Suboxone, for the initial induction, through the Coborn's Pharmacy or the CHI St. Gabriel's Health Pharmacy, to patients in the Morrison County Jail. *Sober Living/Emergency Housing Facility -in conjunction with Oasis Central Minnesota, CHI St. Gabriel's Health is working to create a combined sober living and emergency homeless shelter in Little Falls. - They have received $100,000 from the Minnesota Legislature and a $75,000 grant from Sourcewell, in Staples, MN, to support this initiative. - Oasis Central Minnesota is applying to the USDA Rural Development Office in Brainerd to secure a loan to purchase St. Camillus Place from CHI St. Gabriel's Health for use as a sober living and emergency homeless shelter. *Stand Up For You -This Morrison County schools substance abuse program, which CHI St. Gabriel's Health has supported since its inception, will continue to be a priority for the 2019-2022 community health needs strategy. Mental Health Three lengthy discussions by the CHNA Strategy Team guided CHI St. Gabriel's Health to focus on mental health in Morrison County as its third initiative. A central concern of the Strategy Team members was helping people deal with depression, stress, and anxiety before they reach a point of abusing drugs or contemplating or attempting suicide. While recognizing that preventing suicide is vital to the health and well being of the community, team members kept returning to the need to teach people, including teens and adolescents, that there are ways to deal with the stresses of life and that health professionals are available in Morrison County to teach them and help them when they need that help. CHI St. Gabriel's Health convened a meeting of the 2019 Strategy Team on September 25, 2019, to address this third initiative, and while meetings of the team earlier in the summer had appeared to be focusing on teen suicide, at this fall meeting the team members stressed the need to help people long before suicide seems like an answer to problems. As a result of this concern, the CHI St. Gabriel's Health leaders chose the broader topic of mental health as its third initiative for the 2019-2022 CHNA period. Goals: *Collaborate as a team to provide the people of Morrison County with greater help to deal with mental health issues then currently exist in the county. *Communicate about mental health opportunities and collaborate as a team to improve and increase the opportunities to help more people before they reach the point of abusing drugs or contemplating suicide. *Draw upon the resources of CHI St. Gabriel's Health to support community organizations working on mental health and suicide prevention initiatives. Initiatives: *Collaborate with Morrison County Social Services to promote and support the use of "Vitals App" (https://thevitalsapp.com/), software that allows people to enter important information in an app on their cell phones that communicates with an app on emergency services, law enforcement and care giver phones on significant health issues. For example, Emergency Department staff could give information on the app to people who come to CHI St. Gabriel's Hospital for mental health care. *Provide support to the Little Falls School District as they work to "train the trainer" in providing the schools with someone who can teach people mental health first aid. *Support Little Falls School District and Northern Pines Mental Health Center in developing their Suicide Prevention Week programming. *Continue to support and participate in the National Children's Mental Health Day, offered annually. *Develop strategies, goals, and action items around the concept of helping people before they reach the dangerous depths of contemplating suicide. Develop ways to help people cope. *Plan and offer a Mental Health Wellness Fair. *Support County Extension efforts to address mental health. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - St. Gabriel's Hospital. 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. 6 Little Falls Orthopedics 1108 1st Street SE Little Falls MN 56345 Outpatient clinic Community Medical Center 200 South First Avenue Pierz MN 56364 Outpatient clinic Randall Lakes Area Clinic 250 White Oak Drive Randall MN 56475 Outpatient clinic Family Medical Center 811 SE Second Street Little Falls MN 56345 Outpatient clinic Schedule H, Part VI, Line 7 States Community Benefit Report Filed Minnesota hospitals ARE required to file hospital-specific community benefit information to the Minnesota Department of Health through the Health Care Cost Information System (HCCIS). Hospitals do this by filling out the Hospital Annual Report, which the Minnesota Hospital Association administers for MDH. MHA then files all of the information in the Hospital Annual Report to MDH as public information. A key issue with this report is that it is limited to "hospital-only" costs and the elements included in the community benefits section is limited. For example, MDH does not allow for the counting of the MinnesotaCare provider tax or MA (Medical Assistance) Surcharge as community benefits costs. Through a separate, voluntary effort, MHA collects community benefit data by health system and creates a statewide summary report for advocacy purposes. MHA collects this data by requesting access to summary data from all Minnesota facilities using the Community Benefit Inventory for Social Accountability (CBISA) software and UFH grants MHA such access. This advocacy collection effort also includes some of the real life stories of community benefits provided by hospitals that change lives and the health of their communities. MHA does not file that information with the state or share the hospital/system level data publically. Schedule H, Part I, Line 3c ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE 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. Schedule H, Part VI, Line 2 Needs Assessment, continued 2 Youth Recreation Initiative In 1997, St. Gabriel's Hospital received a CHI Mission & Ministry Fund grant to enhance recreation opportunities in partnership with the Little Falls Area Schools. Prior to 1997, there had been substantial cuts in a collaborative between the City of Little Falls and the local school district to address youth recreation. The Youth Recreation Initiative, as it is called, has continued despite the fact that grant funding through the Mission & Ministry has long been discontinued. The program has been so favorably received in the community that the leadership of St. Gabriel's Hospital has chosen to continue supporting the program. That level of support totaled more than $40,572 in fiscal year 2019 and impacted 8,603 people. Early on in the program's history, there was a noticeable decline in youth delinquency as measured by interactions with the judicial system and that decline has been maintained. We believe the decline was due to the increased opportunities created for area youth. Support Groups UFH facilities offer a variety of support groups and similar activities, including such activities as the Prostate Cancer Support Group, Eating Disorders Support Group, Adoption Support group, the Alanon Group, the Hospice Family Support activities and the special spiritual services (empty arm for miscarriages, hospice memorial services, etc.). In 2019, the value of the support for this activity was $837. The support groups served approximately 85 people in 2019. Health Screenings/Health Fairs UFH facilities, especially St. Gabriel's Hospital, offer a variety of free health screenings and health fairs for the communities in which we serve. The total value of these activities was nearly $1,120 in FY 2019, with 150 people participating in the health fairs/screenings. The screenings include such things as blood pressure checks at a local extended care facility (not part of UFH), other screenings, firemen physicals, pulmonary screening and flu shots. The Little Falls Area Health Fair, which is held in the SPRING OF EVEN-NUMBERED YEARS, was held in the spring of 2018 had over 300 participants. Donated Space UFH facilities donate the use of our facilities to non-profit organizations. Some of these include TOPS (Take Off Pounds Sensibly), the Mental Health Support Group, and OASIS Share-A-Meal, to name just a few. The total value of the donated space in fiscal year 2019 was $9,804. UFH Participation in Community Health Initiatives One of the larger community benefit activities that UFH supports is the participation in community health initiatives. This involves everything from the Healthy Communities Collaborative to the Violence Prevention Council to the Morrison County EMS board to the Morrison County Ministerial Association and the Elder Network. This activity directly impacted over 36 people in 2019 and was valued at $8,965. Senior Companion Program Finally, health care providers and community service organizations recognize the benefits provided through the St. Gabriel's Hospital Senior Companions program. Patients connect with their individual "companions" before they leave the hospital. Once home, the companions continue to regularly visit with the patients while they continue their recovery. In the past fiscal year (FY2019), the program served different people in the community, with a total community benefit of $1,284. Donations In the fiscal year ending June 30, 2019, UFH donated over $17,610 in cash to local/regional entities such as the Morrison County Relay for Life sponsored by the American Cancer Society, Oasis Share-A-Meal, Youth Frontiers, Centracare Health Foundation, and other not-for-profit organizations. Subsidized Health Services UFH has one much-needed and appreciated community service that operates as a loss to the organization. That service is St. Gabriel's Hospital's home care program-CHI Health at Home Little Falls (formerly Unity Family Home Care). In FY2019, it generated over $350,282 in community benefit. The home care provided 4,578 visits in fiscal 2019 so the benefit to the community is substantial. Physician Recruitment Our primary service area (Morrison County, MN) has a population of approximately 33,821 of which 18.4% are age 65 or older. This elderly population, in particular, requires the skills of two medical specialties--internal medicine and general surgery. Based on the community health needs assessment and physician specialty by population studies, it was determined that at least one and up to four (depending upon the mix of family practice and internal medicine) internists and two general surgeons are needed in the community to adequately serve patients' health needs. In addition, due to the retirement of one pediatrician, a second is needed. Similarly, our two OB/GYNs left in early 2017 creating a significant community need. Physician/provider recruitment has been complicated and created additional challenges due to the fact that there are Health Professional Shortage Areas in Morrison County. The total cost of expenses associated with physician recruitment and retention in these much-needed specialties was over $123,342 in fiscal 2019. Health Professions Education UFH's acute care facility--St. Gabriel's Hospital--serves as clinical education sites for medical professionals. In fiscal year 2019, St. Gabriel's Hospital assisted in the education of the following health professionals: medical students (through the Rural Physician Associate Program); nursing students; pharmacists, radiologic technologists, pharmacists; and nurse anesthetists. The community benefit claimed for that training totaled $30,956 and three people received those services. Schedule H, Part VI, Line 2 Needs assessment, continued 3 Community Building Activities Live Better Live Longer (formerly the Healthy Communities Collaborative of Morrison County) was a collaborative effort of over 20 organizations. It served as a county-wide community health status improvement initiative. LBLL's mission was, "Through collaboration, we build and nurture the total health and well-being of people in Morrison County." Its vision read, "Morrison County stands out as a vibrant, interconnected community for all to live, work, learn, worship and play." Unity Family Healthcare was the sponsoring agency for LBLL and UFH staff members served on its board and communities. LBLL had three tenets Eat, Move, and Belong, which encouraged people in the county to eat better, more nutritious meals (including breast milk for young children); exercise regularly; and become involved in the Morrison County community, whether through recreation, book clubs, churches or whatever the individual chooses. Although UFH needed to discontinue the LBLL program in 2018, many of the collaborators are still pursuing the three tenets of Eat, Move and Belong in a variety of ways. Similarly, Unity Family Healthcare staff members are involved in efforts to improve the health of the people of Morrison County. Individual staff members also donate significant time to coaching and other leadership positions in the community. Schedule H, Part VI, Line 2 Needs Assessment - Continued 1 Community Health Needs Assessment Process UFH regularly performs a community health needs assessment (CHNA) every three years in compliance to the Affordable Care Act (ACA). Prior to implementation of the ACA, the CHNAs were performed by UFH every three to five years in partnership with Morrison County Social Services (MCSS) and Morrison County Public Health (MCPH). The CHNAs include a written survey as well as stakeholder interviews (health, social services, school and court staff, elected officials, etc.). Occasionally, focus groups around particular community health issues or access concerns are also included as part of the assessment process. The three partners have shared the expenses for the CHNAs that were performed in 1989, 1994, 1999, 2004, 2009, 2013, 2016 and 2019. The most recent CHNA was conducted in FY2019 and it is posted on the UFH website (www.chistgabriels.com) along with the 2013 and 2016 CHNAs. St. Gabriel's Hospital has always taken the leadership role in coordinating the community health needs assessment. This past year, in addition to the three long-term partners (MCPH, MCSS and the hospital), the hospital was asked to participate in a regional effort that included the public health agencies in Todd and Wadena counties in addition to Morrison County. As was done in 2013 and 2016, additional collaborators will be part of the implementation strategy development for the CHNA. For the 2019 CHNA, among the people involved were the St. Gabriel's Health Foundation director, three school district representatives, senior groups, primary care providers, a mental health professional, two high school students, and multiple community leaders. As previously stated, the most-recent (2019) CHNA has been posted on the UFH website (www.chistgabriels.com). The report reflects the compilation and analysis of extensive data sources to identify issues having a significant impact on the health and general well-being of area residents. The community health needs assessment process for the hospital-St. Gabriel's Hospital-produced approximately $2.4 million in total community benefit in FY2019, demonstrating the organization's significant investment in examining the health issues of the community and creating an implementation plan to address those issues. After the 2016 CHNA, the amount of community benefit attributed to the CHNA had been decreasing, but went back up in 2019, when the latest CHNA was completed, which was due June 30, 2019. QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT Community Outreach for the Poor Translation Services - One area that has shown continued growth as the community has become more diverse, has been the increase in translation services. In FY2017, the amount was $35,265. In FY2018, the amount was $29,389. In FY2019 the amount was $33,333. Community Financial Application Assistance - UFH financial assistance counselors assist individuals in filling out the paperwork to acquire financial assistance in paying for their medical bills. In 2019 the total number of individuals who received this assistance was 720 and the dollar value of this assistance was $67,781. The amount of assistance has been increasing due to a number of factors influencing their ability to pay their medical bills. Miscellaneous Initiatives for the Poor - Unity Family Healthcare's facilities also donate staff time toward coordinating fund-raising activities for the poor. These range from assisting individuals with accessing financial assistance programs to purchasing school supplies and Christmas presents for needy families, although the individual gifts purchased at Christmas do not qualify as community benefit, since individual staff members make those gifts, the estimated value of these benefits is approximately $2,586 and the number of people impacted is approximately 300. Community Outreach for the Broader Community Youth Development, Partner Violence Prevention, Chronic Disease Management (Patient-Centered Medical Home), and Prescription Drug Abuse Initiatives UFH continues to strategically apply for, receive and manage grants that align both with our community health needs assessment (CHNA) implementation plan and the health needs and issues of the people of Morrison County. A grant UFH has received continuously since 2009 has been focused on reducing partner violence (domestic violence) in Morrison County as measured by the number of domestic assaults charged, the number of Orders for Protection issued and the number of charged violations of Orders for Protection. By all three measures, things improved. In July 1, 2014, this grant initiative received another three years of funding. Secondly, the patient-centered medical home development initiative (PCMHDI), which seeks to improve the health of residents of Morrison County, especially those with chronic disease, by using a Triple AIM approach, has been very well-received in the community and in FY 2014 received certification from the Minnesota Department of Health (MDH) as a medical home. The PCMH recently received re-certification as a medical home by MDH. Finally, the aforementioned prescription drug abuse reduction initiative is making a difference in the lives impacted by such abuse. Together, these grant initiatives (and a few minor initiatives) resulted in $28,982 in community benefits in FY2019. These three initiatives have received funding for fiscal year 2019 so these community benefit efforts are continuing. Furthermore, in a time of tight government budgets, the grant initiatives are enabling the hospital to pursue projects that address well-defined community needs as outlined in our CHNA. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance A cost-accounting methodology was not used. The cost-to-charge ratios for the year ended June 30, 2019 were computed using the following formula: Operating expense (before restructuring, impairment and other losses) divided by gross patient revenue. Based on that formula, $170,820,112 /$70,456,603 results in a 41.25% cost-to-charge ratio for St. Gabriel's Hospital. Worksheet 2 was not used to derive the cost-to-charge ratio. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Costing methodology for amounts reported on line 2 is determined using the Unity Family Healthcare's cost/charge ratios of 41.25% for St. Gabriel's Hospital. When discounts are extended to self-pay patients, these patient account discounts are recorded as a reduction in revenue, not as bad debt expense. Schedule H, Part III, Line 3 Bad Debt Expense Methodology Unity Family Healthcare 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. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Unity Family Healthcare 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 2019 was not significant. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Unity Family Healthcare 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 shortfallss are based on costs, not charges, Unity Family Healthcare, due to its designation as a CAH, received cost-based reimbursement for Medicare purposes, and will not experience significant Medicare-related shortfalls. The total shortfall for FY2019 was $239,332 or approximately 1.4%. 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: $16,753,597 Total Medicare costs: $16,992,929 Surplus (or Shortfall): ($239,332) Unity Family Healthcare believes that excluding Medicare losses from community benefit makes the overall community benefit report more credible for these reasons: * Unlike subsidized areas such as burn units or behavioral-health services, Medicare is not a differentiating feature of tax-exempt health care organizations. In fact, for-profit hospitals focus on attracting patients with Medicare coverage, especially in the case of well-paid services that include cardiac and orthopedics. Significant effort and resources are devoted to ensuring that hospitals are reimbursed appropriately by the Medicare program. The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency, carefully studies Medicare payment and the access to care that Medicare beneficiaries receive. The commission recommends payment adjustments to Congress accordingly. * Though Medicare losses are not included by Catholic hospitals as community benefit, the Catholic Health Association guidelines allow hospitals to count as community benefit some programs that specifically serve the Medicare population. For instance, if hospitals operate programs for patients with Medicare benefits that respond to identified community needs, generate losses for the hospital, and meet other criteria, these programs can be included in the CHA framework in Category C as "subsidized health services." At Unity Family Healthcare, our hospice and home care department-CHI Health at Home (formerly) Unity Family Home Care & Hospice-is an example subsidized health service. * 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. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance 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. Schedule H, Part V, Section B, Line 16a FAP website - St. Gabriel's Hospital: Line 16a URL: HTTPS://WWW.CHISTGABRIELS.COM/FINANCIAL-ASSISTANCE/; Schedule H, Part V, Section B, Line 16b FAP Application website - St. Gabriel's Hospital: Line 16b URL: HTTPS://WWW.CHISTGABRIELS.COM/FINANCIAL-ASSISTANCE/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - St. Gabriel's Hospital: Line 16c URL: HTTPS://WWW.CHISTGABRIELS.COM/FINANCIAL-ASSISTANCE/; Schedule H, Part VI, Line 2 Needs assessment ORGANIZATION'S MISSION, VISION, AND TAX-EXEMPT PURPOSE Unity Family Healthcare's (UFH/CHI St. Gabriel's Health) mission is to nurture the healing ministry of the Church, supported by education and research. Fidelity to the Gospel urges us to emphasize human dignity and social justice as we create healthier communities. Our vision is to create the best possible health care experience by igniting the spirit for superior care and service. UFH was founded by the Franciscan Sisters of Little Falls to carry out the organization's healing ministry. The cornerstone of UFH (also commonly and collectively referred to as CHI St. Gabriel's Health) is St. Gabriel's Hospital, a 25-bed Critical Access Hospital (CAH), which originally was organized in May of 1891 and received its first patients in January of 1892. St. Gabriel's Hospital and the other organizations that comprise UFH-Family Medical Center, Little Falls Orthopedics and CHI Health at Home (Little Falls)-serve all persons in the community on a non-discriminatory basis. The hospital operates an emergency services department that is open to all persons regardless of their ability to pay and it has an open medical staff with privileges available to all qualified physicians and advanced practice clinicians (ACPs) such as physician assistants, nurse practitioners, etc. The UFH board of directors is an eleven-member governing board of individuals who serve as representatives of the community and oversee operations of the UFH facilities. Only two members of the governing board are not directly serving as representatives of the community-the market president and the senior vice president of operations from the Catholic Health Initiatives (CHI) division office in Fargo, ND. St. Gabriel's Hospital engages in the training of health professionals, especially nurses, pharmacists, radiologic technologists, physical therapists, nurse anesthetists and physician assistants. St. Gabriel's Hospital also has been an active participant in the University of Minnesota's Rural Physician Associate Program (RPAP) since its inception in 1973. RPAP provides a "hands-on" experience of serving the primary care needs of people in rural areas. UFH facilities participate in all government-sponsored health care programs such as Medicaid, Medicare, CHAMPUS, MinnesotaCare, MNsure, Tri-Care, and other government health care programs (i.e., the SAGE program, formerly called the Minnesota Breast & Cervical Cancer Control Program, which provides free or low-cost breast and cervical cancer screening services to women at or below 200% of federal poverty guidelines). St. Gabriel's Hospital is a critical access hospital (CAH) and operates a 24-hour emergency room, open 365 days per year. The emergency room is open to all individuals regardless of ability to pay. Furthermore, the hospital has an open medical staff, participates in Medicare and Medicaid, and has an active charity care/financial assistance program. The hospital does not discriminate on the basis of any non-merit factor, including race, national origin, color, religion, sex, sexual orientation, gender identity, disability (physical or mental), age, status as a parent, or genetic information. Community service and improving the health of the people we serve have always been at the forefront of UFH activities. For example, UFH was the first organization in the region to offer prenatal education to expectant mothers through St. Gabriel's Hospital in the 1950s. Other notable efforts to improve health from recent years include: the Youth Recreation Initiative, Youth as Resources (YAR), the Live Better Live Longer breastfeeding initiative, the Bridges: Youth, Family, and Community program, which provided behavioral health counseling and other services to youth in the public schools and other services to families utilizing community resources, the Violence Prevention Initiative and the Prescription Drug Abuse Reduction Initiative. The programs and services described throughout this report not only serve all persons in the community, but also specifically help to reduce the burdens on local government through a spirit of collaboration thanks to, in large, part, our success in securing grant funding for community-based health initiatives, some of which will be discussed later in this document. St. Gabriel's Hospital provides charity care, in addition to a wide range of community benefit activities associated with serving the needs of the poor. Performing these services and picking up the related costs helps local government agencies which might otherwise have to fund the services. UFH also contributes to the quality of life for area residents in one additional significant way-- through its extensive volunteer program. Apart from the many community benefit hours donated to such activities as the emergency medical system and other community health initiatives, UFH has multiple staff members who donate volunteer time to coaching, serving on church boards, etc., that enhance life in central Minnesota. Beyond these efforts, many community members donate their time and talents to serve the people who utilize our facilities. Our volunteer services department is well known throughout the community and the entire Fargo Division of Catholic Health Initiatives for having a comprehensive, well-developed volunteer program. How well-developed? In FYE June 30, 2019, a total of 270 volunteers contributed 20,018 hours of service to UFH. These hours not only contribute mightily to UFH facilities, but also offer a variety of intrinsic rewards that the volunteers say "give meaning" to their lives. Finally, the hospital is included in the Official Catholic Directory as a tax-exempt hospital. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance 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, www.catholichealth.net, 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. Schedule H, Part VI, Line 4 Community information St. Gabriel's Hospital is located in central Minnesota in the city of Little Falls and serves the people of Morrison County, Minnesota, and small portions in the surrounding counties. Morrison County has a population of 33,836 according the most recent (July 2019) estimate from the U.S. Census Bureau (QuickFacts Morrison County, Minnesota, July 2019. Source: U.S. Census Bureau, Population Division). On average, Morrison County is older and "poorer" on average than the population of the state of Minnesota overall. In the county, 19.6% of the population is age 65 or older compared to 15.9% of Minnesotans. The median age for Morrison County is 42.1 and for Minnesota, it is 37.9. The median household income for the county is $36,245 and the per capita income is $28,792, in comparison to $68,411 and $36,245, respectively for Minnesota. The percentage of persons below the poverty level (1-year estimate, which, according to the U.S. Census Bureau itself, is not statistically valid for comparisons with other geographic areas) in the county is 10.1%, while in the state, it is 9.6%. Morrison County has a largely Caucasian population with 97.1% of the population "white." This is in comparison to the state of Minnesota as a whole, which is 84.1% white. Similarly, only 1.3% of the population is foreign born in the county, while Minnesota's foreign-born population is 8.4%. There are 29.5 persons per square mile in the county and for Minnesota as a whole, there are 66.6 persons per square mile. The percentage of people in Morrison County with a disability is 7.9%, compared to 7.3% for the state. A few areas of the county have been designated as Health Professional Shortage Areas (HPSAs), due to economic factors. According to the U.S. Census Bureau data (TownCharts), the median earnings per worker is $41,584 for Morrison County compared to $51,758 for all of Minnesota. The county unemployment rate is currently (December 2019) 7.5%. The state rate is 3.5%. Over the past year, the unemployment rate for the county varies greatly from as low as 3.0% in the past year (2019) to as high as 7.5% while in the state it has ranged from 3.0% to 3.4% (again, in 2019). The total number of jobs in the county (BEA estimates) is 17,576 with approximately two-thirds (66.6%) of these jobs wage and salary positions. The average hourly rate in the county (actually Region 5) is $19.99/hour compared to $25.99/hour for Minnesota. Similarly, the average weekly wage for the county is $754/week, or 31.9% less than the state average of $1,107/week. Since its inception in 1891, St. Gabriel's Hospital has been intimately involved in community health collaboration, initially working with local lumbering companies to develop plans to care for their workers in the late 1800s and early 1900s. More recently, St. Gabriel's has been collaborating with Morrison County Public Health and Morrison County Social Services since the 1980s to examine area health issues, enabling the three partners to set priorities and plans for health improvement. St. Gabriel's Hospital continues our deep commitment and involvement in the community health assessment and action planning today. Schedule H, Part VI, Line 5 Promotion of community health The organization's hospital facility promotes 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 has 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 treats 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. Schedule H, Part VI, Line 6 Affiliated health care system 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 comprises 142 hospitals, including three academic health centers, major teaching hospitals as well as 31 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 2019, CommonSpirit Health provided more than $2.1 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 $4.4 billion with the inclusion of the unpaid costs of Medicare. The health system, which generated operating revenues of $20.96 billion in fiscal year 2019, has total assets of approximately $40.6 billion. CommonSpirit Health provides strategic planning and management services as well as centralized "share services" for its Divisions. The provision of centralized management and shared services including areas such as accounting, human resources, payroll and supply chain provides economies of scale and purchasing power to the Divisions. The cost savings achieved through CommonSpirit Health's centralization enable Divisions to dedicate additional resources to high-quality health care and community outreach services to the most vulnerable members of our society. Schedule H, Part VI, Line 7 State filing of community benefit report MN true YOUTH FRONTIERS INC 6009 EXCELSIOR BLVD MINNEAPOLIS MN 55416 411598977 501(C)(3) 5610 VIOLENCE PREVENTION CENTRACARE HEALTH FOUNDATION 1406 SIXTH AVENUE N ST CLOUD MN 56303 411855173 501(C)(3) 12000 PROGRAM SUPPORT 2 0 SCHOLARSHIPS 4 2000 PATIENT INTERPRETERS 248 27394 BOOK PAYMENTS TO INTERPRETERS FOR NON-ENGLISH SPEAKING PATIENTS Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Requests for grants to be paid to individuals or organizations are sent to the manager of communications and/or the foundation director for approval. These requests are reviewed to ensure their purpose benefits the community and are in line with Unity Family Healthcare's mission and values. Large grant fund requests are reviewed and signed off on by the President/CEO. The foundation director is responsible for working with each grantee to meet their reporting guidelines as stipulated to ensure grant awards are used according to the contract signed by both parties. Grant contracts are maintained in MediTract with reminders of expiration dates to ensure timely reporting and completion. false true false false false false false false false RYAN KRAY MD Former Vice Chair/Physician 229225 0 14337 0 809 0 14592 0 2899 0 261862 0 0 0 LEE BOYLES FORMER PRESIDENT/CEO 0 243637 0 41635 0 22560 0 0 0 26336 0 334168 0 0 STEVEN SMITH CEO/VP OF FINANCE 0 156220 0 18150 0 12532 0 10959 0 26094 0 223955 0 0 JEFFREY DROP Board Member/CHI SVP Division Officer 0 716564 0 535360 0 136936 0 22411 0 18016 0 1429287 0 0 GREGORY MCNAMARA MD BOARD MEMBER/PHYSICIAN 259426 0 12443 0 2980 0 16273 0 25211 0 316333 0 0 0 VIRGIL MEYER MD BOARD MEMBER/PHYSICIAN 257898 0 17274 0 12946 0 16375 0 18440 0 322933 0 0 0 MARK MOE MD BOARD MEMBER/PHYSICIAN 302280 0 2678 0 766 0 16391 0 25211 0 347326 0 0 0 DAVID EDGERTON JR PHYSICIAN 633031 0 0 0 2300 0 15895 0 26483 0 677709 0 0 0 PAUL JOHNSON PHYSICIAN 737152 0 39372 0 840 0 15328 0 25211 0 817903 0 0 0 DAVID JORGENSEN PHYSICIAN 575229 0 69207 0 5544 0 16375 0 26690 0 693045 0 0 0 SAUNG PARK PHYSICIAN 575718 0 0 0 1932 0 6750 0 10308 0 594708 0 0 0 PHILIP PROSAPIO PHYSICIAN 467595 0 64784 0 8191 0 16361 0 18151 0 575082 0 0 0 Schedule J, Part I, Line 4a POST-TERMINATION PAYMENTS DURING THE CALENDAR YEAR 2018, POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR CATHOLIC HEALTH INITIATIVES AND RELATED ORGANIZATIONS' EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE, INCLUDING THE MBO CEOS. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation During the calendar year 2018, compensation for the top management official was established and paid by Catholic Health Initiatives ("CHI"), a related organization. CHI used the following to establish the top management official's compensation: (1) Compensation Committee; (2) Independent Compensation Consultant; (3) Written Employment Contracts; (4) Compensation Survey or Study; (5) Approval by the Board or Compensation Committee. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan During the 2018 calendar year, Catholic Health Initiatives ("CHI"), a related organization, maintained a supplemental non-qualified deferred compensation plan for MBO CEOs/Presidents and other CHI employees at the level of Senior Vice President and above. Due to the "super" vesting rules under the CHI deferred compensation plan, participants who had met certain requirements such as involuntary termination without cause, age, age and years of service, or more than 5 years of plan participation were eligible to receive their 2018 contributions in cash during the calendar year. These cash payouts are included in the participant's reportable compensation in column (iii) Other Reportable Compensation on Schedule J Part II. During 2018, the following contributions and any associated investment income, gain or loss that would have been made by CHI to the deferred compensation plan were paid in cash: Jeffrey Drop - $110,067 Lee Boyles - $13,240 STEPHANIE KRAY SPOUSE OF FORMER DIRECTOR 175913 EMPLOYEE PAYROLL WAGES false Form 990, Part VI, Line 16b JOINT VENTURE POLICY UNITY FAMILY HEALTHCARE HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER COMMONSPIRIT HEALTH'S SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS; AND (5) ALL CONTRACTS ENTERED INTO BY THE PARTNERSHIP WITH THE EXEMPT ORGANIZATION MUST BE AT ARM'S-LENGTH, WITH PRICES SET AT FAIR MARKET VALUE. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL. Form 990, Part VI, Line 15a PROCESS FOR DETERMINING COMPENSATION OF TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CEO'S COMPENSATION IS PAID BY CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI HAS A DEFINED COMPENSATION PHILOSOPHY. BOTH THE EXECUTIVE AND NON-EXECUTIVE COMPENSATION STRUCTURES AND RANGES ARE REVIEWED ANNUALLY IN COMPARISON TO MARKET DATA. Catholic Health Initiatives used Korn Ferry as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of the senior most executives was reviewed annually. Korn Ferry reviewed both cash and total compensation for overall reasonableness, for adherence to Catholic Health Initiatives' compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review was delivered by Korn Ferry to the CHI HR committee of the Board of Stewardship Trustees annually at their September meeting and minutes shared with the full board at the December meeting. The last review was September 25, 2018. In addition, Korn Ferry completed a comprehensive review of all positions at the level of vice president and above in the fall of 2014 to determine and validate appropriate compensation levels. These levels were reviewed annually and revised based on market data, where applicable. Form 990, Part VI, Line 12c Conflict of Interest Policy b) If it is determined that a potential or actual conflict may exist, I. In the case of board or committee members or officers, issues are elevated to the executive committee of the board or board chair. II. In the case of other persons, conflicts issues are elevated to the conflicts of interest review committee ("C-CIRC"). C. Conflicts determination and management: 1. Matters elevated to C-CIRC: a) The C-CIRC determines whether a disclosed or otherwise identified interest is a conflict of interest. If the C-CIRC determines that a COI exists, and adequate controls are not in place to mitigate the conflict, the C-CIRC facilitates development of a COI management plan designed to mitigate the conflict. Designated entity staff are responsible for monitoring the COI management plan and for documenting monitoring activities. 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. b) Appeal - if a person does not agree with a determination made by the C-CIRC, its interpretation of the COI policy, still seeks an exemption or exception, or seeks further clarification of the C-CIRC 's decision, the individual may appeal the decision through his or her manager for reconsideration by the C-CIRC, and the C-CIRC will review and issue a final determination based upon any new or additional information presented. 2. Matters elevated to the executive committee or board chair: a) Determination of existence of conflict - the board chair or his or her designee performs any further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the board chair, the vice chair assumes the chair's role outlined in the COI policy. Based on review and evaluation of the relevant facts and circumstances, the board chair makes an initial determination as to whether a conflict of interest exists and whether, pursuant to the COI policy, review and approval or other action by the board is required. A written record of the board chair's determination, including relevant facts and circumstances, is made. The board chair then makes an appropriate report to the executive committee of the board concerning the COI review, evaluation and determination. If a difference of opinion exists between the board chair and another trustee as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether board review and approval or other action is required under the COI policy, the matter is submitted to the board's executive committee, which makes a final determination as to the matter presented. That determination, including relevant facts and circumstances, is reflected in the executive committee minutes and is reported to the board. b) Board evaluation of transactions involving an officer / board member conflict of interest - I. The board carefully scrutinizes and must in good faith approve or disapprove any transaction in which CHI or a CHI entity is a party and in which the trustee or a corporate officer either: 1. Has a material financial interest; or 2. Is a trustee or corporate officer of the other party (other than a CHI affiliated organization). II. The board must approve the transaction by a majority of the trustees on the board (not counting any interested trustee). In reviewing such transactions between CHI or CHI entities and vendors or other contractors who are, or are affiliated with, trustees or corporate officers, the board acts no more or less favorably than it would in reviewing transactions with unrelated third parties. The transaction is not approved unless the board determines that the transaction is fair to CHI or the CHI entity. III. A conflicted trustee or corporate officer is not permitted to use his or her personal influence with respect to the approval or disapproval of the conflicted transaction. However, if requested, such trustee or corporate officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from trustees, as his or her knowledge may be relevant. The trustee or corporate officer is excused from the meeting during discussion and vote on the conflict of interest. c) Board evaluation of non-transactional conflicts - I. The board carefully reviews and scrutinizes any non-transactional conflict of interest (e.g., disclosure of nonpublic information, competition with CHI or a CHI entity, failure to disclose a corporate opportunity, excessive gifts or entertainment, etc.). II. In such circumstances, by a majority vote of the disinterested trustees, the board takes whatever action is deemed appropriate with respect to the trustee or corporate officer under the circumstances (including possible disciplinary or corrective action) to best protect the interests of CHI or the CHI entity. The board is encouraged to consult with the general counsel of CHI or his or her designee when considering disciplinary or corrective action. III. The conflicted trustee or corporate officer is not permitted to use his or her personal influence with respect to the conflict matter. However, if requested, such trustee or corporate officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from trustees, as his or her knowledge may be relevant. The trustee or corporate officer is excused from the meeting during discussion and vote on the conflict of interest. d) Record of proceedings - with respect to board member and officer conflicts of interest, minutes of the board are expected to reflect the identity of the individual making the disclosure, the nature of the disclosure, discussion regarding any proposed transaction, the decision made by the board, and that the interested trustee or corporate officer was excused during the discussion, and that the interested trustee abstained from voting. D. Conflicts reporting: All conflicts of interest are reported by CHI as required by law, regulations, and policy. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER EMPLOYEES During the tax year ended 6/30/2019, no other officers or key employees received compensation from the organization. Any executive compensation paid to other officers or key employees by related organizations was set by the related organization's compensation committee utilizing both an independent consultant and comparability studies to determine compensation. Therefore, these questions are more appropriately answered as N/A. Form 990, Part VI, Line 1a Delegate broad authority to a committee Pursuant to Section 8.6 of the bylaws of Unity Family Healthcare, the Executive Committee shall consist of only directors of the corporation and shall be composed of the Chairperson, Vice Chairperson, and the President and CEO, each of whom shall serve as an ex officio voting member of the Executive Committee. Each individual appointed shall serve a term of one year or until his or her successor is duly appointed by the Board of Directors. Except as provided by law, the Executive Committee shall have and may exercise such powers as may be delegated to it by the board of directors. Additionally, the Executive Committee shall have and may exercise such powers to transact routine business of the corporation in the interim period between regularly scheduled meetings of the board of directors, provided that such actions taken shall be consistent with and not conflict with any actions or policies of the board of directors or of the corporate member, with the bylaws, or with applicable laws. Form 990, Part VI, Line 6 Classes of members or stockholders THE ORGANIZATION'S SOLE CORPORATE MEMBER IS COMMONSPIRIT HEALTH, A COLORADO NON-PROFIT CORPORATION. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body 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. (CHCF Reserved Rights) Except as otherwise provided in the Corporation's Articles of Incorporation or the laws of the State of organization, Catholic Health Care Federation ("CHCF") shall have such rights as are reserved to the Corporate Member, acting in its capacity as the membership body of CHCF, under the Governance Matrix. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The organization's corporate member is CommonSpirit Health. Pursuant to Section 5.5.1 of the organization's bylaws, the Corporate Member shall have the specific rights set forth in the governance matrix. Pursuant to the governance matrix the following rights are reserved to the CommonSpirit Health Board directly or through powers delegated to the CommonSpirit Health Chief Executive Officer: - Substantial change in the mission or philosophy of Unity Family Healthcare ("UFH"); - Amendment of the corporate documents of UFH; - Approve members of the UFH board; - Removal of a member of the governing body of UFH; - Approval of issuance of debt by UFH; - Approval of participation of UFH in a joint venture; - Approval of formation of a new corporation by UFH; - Approval of a merger involving UFH; - Approval of the sale of all or substantially all of the assets of UFH; - To require the transfer of assets by UFH to CommonSpirit Health to accomplish CommonSpirit Health's goals and objectives, and to satisfy CommonSpirit Health debts. - Adoption of long range and strategic plans for UFH. Pursuant to Section 5.5.2 of the organization's bylaws, CommonSpirit Health may, in exercise of its approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and the President and Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate. (CHCF Reserved Rights) Except as otherwise provided in the Corporation's Articles of Incorporation or the laws of the State of organization, Catholic Health Care Federation ("CHCF") shall have such rights as are reserved to the Corporate Member, acting in its capacity as the membership body of CHCF, under the Governance Matrix. Form 990, Part VI, Line 11b Review of form 990 by governing body Unity Family Healthcare's VP of Finance is responsible for reviewing the Form 990 as prepared by the CommonSpirit Health tax department. The Form 990 is posted to a community board portal where all board members are able to access and review prior to filing. Subsequent to the return being provided to the board the tax department files the return with the appropriate federal and state agencies, making any non-substantive changes necessary to effect e-filing. Any such changes are not re-submitted to the board. Form 990, Part VI, Line 12c Conflict of interest policy The organization has a conflicts of interest ("COI") policy (the "policy") in place to maintain the integrity of its activities. Through February 7, 2019, conflicts were administered solely through Catholic Health Initiatives' ("CHI") Governance Policy No. 1 (described below). On February 8, 2019, in connection with the alignment of the Catholic Health Ministries of CHI and Dignity Health, the CommonSpirit Health Board of Stewardship Trustees approved CommonSpirit Health Corporate Responsibility Policy No. G-001, a CommonSpirit Health conflicts of interest policy. This policy stipulates that, at minimum, the pre-closing CHI COI policies and pre-closing Dignity Health COI policies identify the individuals that are covered under the new policy. In addition, subject to certain exceptions, pre-closing CHI COI policies shall continue to apply to the CHI entities and the individuals who were subject to the Pre-Closing CHI COI policies; and the Pre-Closing Dignity Health COI policies shall continue to apply to the Dignity Health entities and the individuals who were subject to the Pre-Closing Dignity Health COI policies. Until CommonSpirit Health adopts a single process for identifying and managing conflicts of interest for all system entities, the following individuals shall be subject to the Pre-Closing CHI COI policies from and after the effective date of Corporate Responsibility Policy No. G-001: 1. Members of the CommonSpirit Health Board of Stewardship Trustees and members of the committees of the Board of Stewardship Trustees; 2. Corporate officers of CommonSpirit Health; 3. Members of the Board of Directors of Dignity Health and members of the committees of the Board of Directors of Dignity Health. CHI Governance Policy No. 1: The policy applies to the following persons: members of the CHI board of stewardship trustees and its committees; members of any CHI direct affiliate or subsidiary (each a CHI entity) board and their committees; employees of CHI entities, and all CHI researchers (as defined in the policy). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure review process. A. Disclosure obligations: 1. Ongoing: Each person is required to promptly and fully disclose to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The person must disclose the actual or potential conflict as soon as she/he becomes aware of it. In any situation in which the person is in doubt it is expected that full disclosure be made to permit an impartial and objective determination as to the existence of a conflict. 2. Periodic written: In addition to the ongoing disclosure obligation, periodic written conflict of interest disclosure forms must be completed as follows: a) Initially: 1) Upon hiring (employees), 2) Appointment (board / committee members), 3) Upon consideration of affiliation with research sponsor (researchers). b) Annually: 1) Board / committee members, 2) Employees at the level vice president or above, 3) Researchers, 4) Supply chain employees at the level of vice president and above and those employees involved in contracting regardless of employment level, 5) Other employees as determined by CommonSpirit Health leadership. 3. Failure to disclose - an individual who fails to disclose a perceived, potential, or actual conflict of interest, or all material facts surrounding an actual or potential conflict or fails to abide by the final decision regarding the conflict may be subject to disciplinary or corrective actions such as termination of employment, removal from a board or committee, loss or restriction of clinical privileges, or restrictions on research activities in accordance with applicable laws, regulations, rules, contracts, and bylaws. B. Conflicts review: 1. No disclosed conflicts: In the absence of perceived, potential or actual conflicts of interest, no follow-up conflicts review is required or performed. 2. Disclosure of perceived, potential or actual conflicts: a) Are initially reviewed by national or regional legal or corporate responsibility team members (depending upon the role of the individual disclosing the actual or potential conflict) to determine whether an actual or potential for a conflict may exist. Form 990, Part VI, Line 19 Required documents available to the public The Organization's conflict of interest policy and governing documents are not publicly available. The organization's financial statements are included in CommonSpirit Health's consolidated audited financial statements that are available at www.commonspirit.org or www.catholichealthinitiatives.org. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Miscellaneous Revenue - Total Revenue: 129951, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 129951; Form 990, Part IX, Line 11g Other Fees Purchased Services - Total Expense: 5477770, Program Service Expense: 4106222, Management and General Expenses: 1371548, Fundraising Expenses: 0; Contract Labor - Total Expense: 4832460, Program Service Expense: 3624345, Management and General Expenses: 1208115, Fundraising Expenses: 0; Other Fees for Services - Total Expense: 3150180, Program Service Expense: 2362635, Management and General Expenses: 787545, Fundraising Expenses: 0; Contract Services - Total Expense: 319956, Program Service Expense: 239967, Management and General Expenses: 79989, Fundraising Expenses: 0; Consulting - Total Expense: 60589, Program Service Expense: 45442, Management and General Expenses: 15147, Fundraising Expenses: 0; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Capital Resource Pool Contribution - -441096; ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HOSPITAL NE 501(c)(3) 3 ACH false ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HOSPITAL IA 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HOSPITAL IA 501(c)(3) 3 CHI NEBRASKA false ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(c)(3) 10 CSH false APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(c)(3) 10 SFH false Arroyo Grande Community Hospital Foundation 345 S Halcyon Rd Arroyo Grande CA 93420 203256066 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DH false Bakersfield Memorial Hospital 420 34TH Street Bakersfield CA 93301 951802779 HOSPITAL CA 501(c)(3) 3 DCC false Barrow Neurological Foundation 350 West Thomas Road Phoenix AZ 85013 860174371 FUNDRAISING AZ 501(c)(3) 7 DH false BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS TX 77384 274499340 PHYSICIANS TX 501(c)(3) Type I SLCHS false BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760458535 PHYSICIANS TX 501(c)(3) 3 SLHS false BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232187242 HEALTHCARE PA 501(c)(3) Type I CSH false BRAZOSPORT HEALTH FOUNDATION INC 1 West Way Ct LAKE JACKSON TX 77566 760080110 FUNDRAISING FOUNDATION TX 501(c)(3) Type I BRHS false BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DRIVE LAKE JACKSON TX 77566 800240261 PHYSICIANS TX 501(c)(3) 3 BRHS false BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HOSPITAL TX 501(c)(3) 3 SJSC false BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 HEALTHCARE TX 501(c)(3) 10 SJSC false California Hospital Medical Center Foundation 1401 South Grand Avenue Los Angeles CA 90015 954000909 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DCC false CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HOSPITAL ND 501(c)(3) 3 CSH false CATHOLIC HEALTH INITIATIVES - COLORADO 9100 East Mineral Circle Centennial CO 80112 840405257 HOSPITAL CO 501(c)(3) 3 CSH false CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVE DES MOINES IA 50314 420680448 HOSPITAL IA 501(c)(3) 3 CSH false CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 1150 Kelly Johnson Blvd 204 COLORADO SPRINGS CO 80920 840902211 FUNDRAISING FOUNDATION CO 501(c)(3) 7 CHIC false CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 1150 Kelly Johnson Blvd 204 COLORADO SPRINGS CO 80920 270930004 HEALTHCARE CO 501(c)(3) Type I CSH false CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 460992796 PHYSICIANS CO 501(c)(3) Type I CHINS false CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG OR 97471 263946191 SURGERY CENTER OR 501(c)(3) 10 MMC false CENTRAL KANSAS MEDICAL CENTER 3515 BROADWAY GREAT BEND KS 67530 480543724 HOSPITAL KS 501(c)(3) 3 CSH false CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO ND 58104 271966847 FUNDRAISING FOUNDATION MN 501(c)(3) 10 CSH false CHI HEALTH FOUNDATION 12809 W DODGE RD OMAHA NE 68154 470648586 FUNDRAISING FOUNDATION NE 501(c)(3) 7 ACH false CHI INSTITUTE FOR RESEARCH AND INNOVATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 271050565 HEALTHCARE CO 501(c)(3) Type I CSH false CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER KY 41018 202741651 HEALTHCARE KY 501(c)(3) Type I CSH false CHI LIVING COMMUNITIES 5942 RENAISSANCE PLACE STE A TOLEDO OH 43623 341892096 HEALTHCARE OH 501(c)(3) Type II SFH false CHI Memorial Hospital - Georgia 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 822748395 HOSPITAL GA 501(c)(3) 3 MHCS false CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 451261716 HEALTHCARE CO 501(c)(3) 10 CHI NS false CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 452532084 HEALTHCARE CO 501(c)(3) Type I CSH false CHI NEBRASKA 12809 West Dodge Road Omaha NE 68510 363233121 HEALTHCARE NE 501(c)(3) Type I CSH false CHI ST JOSEPH CHILDREN'S HEALTH 1929 LINCOLN HWY E STE 150 LANCASTER PA 17602 232342997 HEALTHCARE PA 501(c)(3) Type I CSH false CHI ST JOSEPH'S CHILDREN 1516 5TH ST NW ALBUQUERQUE NM 87102 710897107 COMMUNITY NM 501(c)(3) Type I CSH false CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 710236913 HOSPITAL AR 501(c)(3) 3 CHISVHS false CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125064 HOLDING CO AR 501(c)(3) Type II SVIMC false CHI ST VINCENT MEDICAL GROUP HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125131 PHYSICIANS AR 501(c)(3) 3 CHISVHS false COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 470617373 HEALTHCARE CO 501(c)(3) Type I NA false Community Hospital of San Bernardino 1805 Medical Center Drive San Bernardino CA 92411 951643373 HOSPITAL CA 501(c)(3) 3 DCC false COMMUNITY LIMITED CARE DIALYSIS CENTER 619 OAK ST ACCOUNTING-3 W CINCINNATI OH 45206 237419853 HOLDING CO OH 501(c)(4) GSH false COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION 631 N 8TH ST MISSOURI VALLEY IA 51555 421294399 FUNDRAISING FOUNDATION IA 501(c)(3) Type I AH-CMHMV false CONTINUING CARE HOSPITAL One Saint Joseph Drive LEXINGTON KY 40504 611400619 HOSPITAL KY 501(c)(3) 3 SJHS false Dignity Community Care 185 Berry Street Suite 300 San Francisco CA 94107 815009488 HOSPITAL CO 501(c)(3) 3 NA false DIGNITY HEALTH 185 BERRY STREET STE 300 SAN FRANCISCO CA 94107 941196203 HOSPITAL CA 501(c)(3) 3 CSH false Dignity Health Connected Living 200 Mercy Oaks Drive Redding CA 96003 237115371 Senior Center Services CA 501(c)(3) 7 DH false Dignity Health Foundation 185 Berry Street San Francisco CA 94107 462037641 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DH false Dignity Health Foundation - Inland Empire 2101 N Waterman Avenue San Bernardino CA 92404 237440086 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DH false Dignity Health Foundation East Valley 475 South Dobson Road Chandler AZ 85224 742418514 FUNDRAISING FOUNDATION AZ 501(c)(3) Type I DH false Dignity Health HPL Self-Insurance Trust 185 Berry Street San Francisco CA 94107 943006034 Self Insurance CA 501(c)(3) Type I DH false Dignity Health Insurance Nevada Ltd 185 Berry Street San Francisco NV 94107 813800752 Self Insurance NV 501(c)(3) Type I DH false Dignity Health Medical Foundation 3400 Data Drive Rancho Cordova CA 95670 680220314 MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC CA 501(c)(3) Type I DCC false Dignity Health Workers Comp Self-Insurance Trust 185 Berry Street San Francisco CA 94107 946612446 Self Insurance CA 501(c)(3) Type I DH false Dominican Health Services 1555 Soquel Drive Santa Cruz CA 95065 770056778 Community Health System CA 501(c)(3) Type I DH false Dominican Hospital Foundation 1555 Soquel Drive Santa Cruz CA 95065 942450442 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DH false Dominican Oaks Corporation 1555 Soquel Drive Santa Cruz CA 95065 770127719 Operation and management of housing complex to elderly persons CA 501(c)(3) 10 DHS false East Texas Clinical Services 2801 VIA FORTUNA SUITE 500 AUSTIN TX 78746 454736213 HEALTHCARE TX 501(c)(3) Type I SLHS false ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1455 BATTERSBY AVE ENUMCLAW WA 98022 910715805 HOSPITAL WA 501(c)(3) 3 FHS false FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 611345363 HOSPITAL KY 501(c)(3) 3 KOH false FLAGET MEMORIAL HOSPITAL FOUNDATION INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 562351341 FUNDRAISING FOUNDATION KY 501(c)(3) Type I FH false FRANCISCAN CARE CENTER 4111 N HOLLAND-SYLVANIA RD TOLEDO OH 43623 341931806 HEALTHCARE OH 501(c)(3) 10 FLC false FRANCISCAN FOUNDATION 1717 SOUTH J ST TACOMA WA 98405 911145592 FUNDRAISING FOUNDATION WA 501(c)(3) 10 FHS false FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA WA 98405 910564491 HOSPITAL WA 501(c)(3) 3 CSH false FRANCISCAN HEALTH VENTURES FKA SJMGROUP TACOMA FNC CTR BLDG 1145 BROADWAY TACOMA WA 98402 431882377 PHYSICIANS MO 501(c)(3) 10 CSH false FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 200 TACOMA WA 98402 911939739 HEALTHCARE WA 501(c)(3) 10 FHS false FRANCISCAN VILLA OF SOUTH MILWAUKEE INC 3601 S CHICAGO AVE SOUTH MILWAUKEE WI 53172 391093829 HEALTHCARE WI 501(c)(3) 10 CSH false French Hospital Medical Center Foundation 1911 Johnson Avenue San Luis Obispo CA 93401 203256125 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DCC false GARRISON MEMORIAL HOSPITAL 407 THIRD AVENUE SOUTHEAST GARRISON ND 58540 450227752 HOSPITAL ND 501(c)(3) 3 SAMC false Glendale Memorial Health Foundation 1420 South Central Avenue Glendale CA 91204 953625651 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DCC false GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 201536108 MINISTRIES CO 501(c)(3) Type I CSH false GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE 619 OAK ST ACCOUNTING-3 W CINCINNATI OH 45206 311778403 EDUCATION OH 501(c)(3) 2 GSH false GOOD SAMARITAN FOUNDATION OF CINCINNATI INC 619 OAK ST ACCOUNTING-3 W CINCINNATI OH 45206 311206047 FUNDRAISING FOUNDATION OH 501(c)(3) Type I GSH false GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY NE 68848 470379755 HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA false GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST ST KEARNEY NE 68847 470659443 FUNDRAISING FOUNDATION NE 501(c)(3) 7 GSH false HARRISON MEDICAL CENTER 2520 CHERRY AVE BREMERTON WA 98310 910565546 HOSPITAL WA 501(c)(3) 3 FHS false HARRISON MEDICAL CENTER FOUNDATION 2520 CHERRY AVE BREMERTON WA 98310 911197626 FUNDRAISING FOUNDATION WA 501(c)(3) 7 HMC false HEALTH FOUNDATION OF KENTUCKYONE INC 1451 HARRODSBURG RD STE D-308 LEXINGTON KY 40504 832170324 FUNDRAISING FOUNDATION KY 501(c)(3) Type II KOH false HEALTHCARE AND WELLNESS FOUNDATION 2400 ST FRANCIS DR BRECKENRIDGE MN 56520 760761782 FUNDRAISING FOUNDATION MN 501(c)(3) Type I SFMC false HIGHLINE MEDICAL CENTER 16251 SYLVESTER RD SW BURIEN WA 98166 910712166 HOSPITAL WA 501(c)(3) 3 FHS false HOUSE OF MERCY 1111 6TH AVE DES MOINES IA 50314 421323808 SHELTER IA 501(c)(3) 7 CHI-IA CORP false JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC 250 E Liberty St Ste 500 LOUISVILLE KY 40202 611029768 HOSPITAL KY 501(c)(3) 3 KOH false KENTUCKYONE HEALTH MEDICAL GROUP INC 100 E Liberty St Ste 800 LOUISVILLE KY 40202 611352729 HEALTHCARE KY 501(c)(3) 10 JHSMH false KENTUCKYONE HEALTH INC 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 611029769 HEALTHCARE KY 501(c)(3) Type II CSH false LAKEWOOD HEALTH CENTER 600 MAIN AVE S BAUDETTE MN 56623 410758434 HOSPITAL MN 501(c)(3) 3 CSH false LAKEWOOD REGIONAL HEALTHCARE FOUNDATION 600 MAIN AVE S BAUDETTE MN 56623 411893795 FUNDRAISING FOUNDATION ND 501(c)(3) 7 LHC false LINUS OAKES INC 2700 STEWART PKWY ROSEBURG OR 97471 930821381 SENIOR LIVING OR 501(c)(3) 10 MMC false LISBON AREA HEALTH SERVICES 905 MAIN ST LISBON ND 58054 820558836 HOSPITAL ND 501(c)(3) 3 CSH false LUFKIN VISION ACQUISITIONS PO BOX 1447 LUFKIN TX 75901 820563768 PROPERTY MGMT TX 501(c)(3) Type I MHSET false MADISON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742761145 HOSPITAL TX 501(c)(3) 3 SJSC false MADONNA MANOR INC 2344 AMSTERDAM ROAD VILLA HILLS KY 51017 610654635 LIVING ASSIST KY 501(c)(3) 10 FLC false Marian Regional Medical Center Foundation 1400 E Church Street Santa Maria CA 93454 953818027 FUNDRAISING FOUNDATION CA 501(c)(3) Type I DH false Mark Twain Medical Center 768 Mountain Ranch Road San Andreas CA 95249 680127677 HOSPITAL CA 501(c)(3) 3 NA false MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC 2525 DE SALES AVE CHATTANOOGA TN 37404 621839548 FUNDRAISING FOUNDATION TN 501(c)(3) 7 MHCS false MEMORIAL HEALTH CARE SYSTEM INC 2525 DE SALES AVE CHATTANOOGA TN 37404 620532345 HOSPITAL TN 501(c)(3) 3 CSH false MEMORIAL HEALTH PARTNERS FOUNDATION INC 5600 BRAINERD RD STE 500 CHATTANOOGA TN 37411 030417049 HEALTHCARE TN 501(c)(3) 10 MHCS false MEMORIAL HEALTH SYSTEM OF EAST TEXAS PO BOX 1447 LUFKIN TX 75902 750755367 HOSPITAL TX 501(c)(3) 3 SLHS false MEMORIAL MEDICAL CENTER - LIVINGSTON PO BOX 1447 LUFKIN TX 75902 760436439 HOSPITAL TX 501(c)(3) 3 MHSET false MEMORIAL MEDICAL CENTER - SAN AUGUSTINE PO BOX 1447 LUFKIN TX 75902 752663904 HOSPITAL TX 501(c)(3) 3 MHSET false MEMORIAL MULTISPECIALTY ASSOCIATES 1201 FRANK AVE LUFKIN TX 95904 752721155 PHYSICIANS TX 501(c)(3) Type I MHSET false MEMORIAL SPECIALTY 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