FURP.ORG / PUBLIC DATA EXPLORER

MEMORIAL MEDICAL CENTER-SAN AUGUSTINE: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
MEMORIAL MEDICAL CENTER-SAN AUGUSTINE (EIN 75-2663904)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-05-06
IRS object ID
201631279349301423
Schema version
2014v6.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-05-06T17:00:20-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN470617373PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CATHOLIC HEALTH INITIATIVESBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1198 INVERNESS DRIVE WESTAddressLine1Txt
CityENGLEWOODCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80112ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN752663904EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Memorial Medical Center - San AugustineBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMEMOBusinessNameControlTxt
Phone9366348111PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 1447AddressLine1Txt
CityLUFKINCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75902ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKENNETH MILLERPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Signature2016-05-06SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDONALD NEAL JRPreparerPersonNm
PTINP00798244PTIN
Phone7208741500PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1CHI ST LUKE'S HEALTH MEMORIAL SAN AUGUSTINEBusinessNameLine1Txt

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1DARLENE WILLIAMSBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 1447AddressLine1Txt
CityLUFKINCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75902ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,692,506GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionTHE MISSION IS TO SUPPORT, MANAGE, & FURNISH FACILITIES TO PROVIDE QUALITY CRITICAL ACCESS TO HEALTHCARE SERVICES FOR THE CITIZENS OF SAN AUGUSTINE & SURROUNDING COUNTIES AND TO FACILITATE & ENCOURAGE EDUCATION & TRAINING ACTIVITIES TO PROMOTE THE HEALTH & WELFARE OF THOSE CITIZENS.ActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee75TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$2,355,961PYProgramServiceRevenueAmt
CY Program Service Revenue$4,691,935CYProgramServiceRevenueAmt
PY Investment Income$3PYInvestmentIncomeAmt
CY Investment Income$571CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$2,355,964PYTotalRevenueAmt
CY Total Revenue$4,692,506CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,439,543PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,173,776CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,557,451PYOtherExpensesAmt
CY Other Expenses$2,882,982CYOtherExpensesAmt
PY Total Expenses$2,996,994PYTotalExpensesAmt
CY Total Expenses$6,056,758CYTotalExpensesAmt
PY Revenues Less Expenses-$641,030PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,364,252CYRevenuesLessExpensesAmt
Total Assets BOY$3,375,055TotalAssetsBOYAmt
Total Assets EOY$2,282,252TotalAssetsEOYAmt
Total Liabilities BOY$7,082,518TotalLiabilitiesBOYAmt
Total Liabilities EOY$7,353,967TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$3,707,463NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$5,071,715NetAssetsOrFundBalancesEOYAmt
MissionTHE MISSION IS TO SUPPORT, MANAGE & FURNISH FACILITIES TO PROVIDE QUALITY CRITICAL ACCESS HEALTHCARE SERVICES FOR THE CITIZENS OF SAN AUGUSTINE & SURROUNDING COUNTIES AND TO FACILITATE & ENCOURAGE EDUCATION & TRAINING ACTIVITIES TO PROMOTE THE HEALTH & WELFARE OF THOSE CITIZENS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$5,022,732ExpenseAmt
Revenue$4,679,370RevenueAmt
DescHOSPITAL SERVICES PROVIDED TO PATIENTS IN SAN AUGUSTINE AND SURROUNDING AREA, INCLUDING 350 ADMISSIONS, 8,404 OUTPATIENT VISITS, 6,991 EMERGENCY ROOM VISITS AND 1,246 PATIENT DAYS.Desc
Total Program Service Expenses$5,022,732TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee75EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KENNETH MILLERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9366348111PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11201 W FRANK AVENUEAddressLine1Txt
CityLUFKINCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75904ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JOHN F GLICK
CHAIRMAN1.002.00Yes (X)Yes (X)$0$0$0
GIBSON FRIESEN
VICE CHAIRMAN1.002.00Yes (X)Yes (X)$0$0$0
CHARLENE SMITH M D
DIRECTOR1.002.00Yes (X)$0$0$0
RAVINDER BACHIREDDY M D
DIRECTOR1.002.00Yes (X)$0$107,940$0
M HUNT HUBER M D
DIRECTOR1.002.00Yes (X)$0$40,517$0
DAVID W GLENN M D
DIRECTOR1.002.00Yes (X)$0$28,425$0
SID ROBERTS M D
DIRECTOR1.002.00Yes (X)$0$44,100$0
Michael Covert
Pres & CEO CHI St. Luke's Health System1.0059.00Yes (X)$0$651,547$5,310
JACK SWEENY
DIRECTOR1.002.00Yes (X)$0$0$0
MIKE ARNOLD M D
DIRECTOR1.002.00Yes (X)$0$0$0
RAY BALDWIN
DIRECTOR1.002.00Yes (X)$0$0$0
GEORGE FIDONE M D
DIRECTOR1.002.00Yes (X)$0$0$0
RONA FRIESEN
DIRECTOR1.002.00Yes (X)$0$0$0
RANDY GEORGE
DIRECTOR1.002.00Yes (X)$0$0$0
CORKY EVANS
DIRECTOR1.002.00Yes (X)$0$0$0
JUDY COCHRAN
DIRECTOR1.002.00Yes (X)$0$0$0
PATRICIA MCKENSZIE ED D
DIRECTOR1.002.00Yes (X)$0$0$0
CARL RAY POLK
DIRECTOR1.002.00Yes (X)$0$0$0
BEN OGLETREE
DIRECTOR1.002.00Yes (X)$0$0$0
KENNETH MILLER
OFFICER/CFO5.0045.00Yes (X)$0$120,674$13,714
DARLENE WILLIAMS
ADMINISTRATOR, CNE40.000.00Yes (X)$139,468$0$17,819
FieldValueIRS element (for citing)
Total Reportable Comp From Org$139,468TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$993,203TotReportableCompRltdOrgAmt
Total Other Compensation$36,843TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
EMCARE
7032 COLLECTION CENTER DRCHICAGOIL60693ER PHYSICIANS$446,143
WILLIAM BASSUKCLINICAL ENGINEERING
1606 DOE CRESTSAN ANTONIOTX78248EQUIPMENT MAINTENANCE$362,596
HELPING HANDS NURSING AGENCY
P O BOX 297JASPERTX75951CONTRACT NURSES$185,764
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
PATIENT SERVICE REVENUE621990$4,646,209$4,646,209
COPY MACHINE INCOME621990$6,543$6,543
RENTAL INCOME - AFFILIATE621990$7,020$7,020
CAFETERIA SERVICES621990$12,565$12,565
ELECTRONIC RECORDS REVENUE621990$18,950$18,950

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$648TotalRevenueColumnAmt
Related Or Exempt Func Income$648RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$4,691,935TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$571TotalRevenueColumnAmt
Exclusion$571ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,692,506TotalRevenueColumnAmt
Related Or Exempt Func Income$4,679,370RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$13,136ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$139,468TotalAmt
Management And General$139,468ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,644,099TotalAmt
Program Services$2,457,052ProgramServicesAmt
Management And General$187,047ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$65,903TotalAmt
Program Services$58,289ProgramServicesAmt
Management And General$7,614ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$152,791TotalAmt
Program Services$134,879ProgramServicesAmt
Management And General$17,912ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$171,515TotalAmt
Program Services$151,698ProgramServicesAmt
Management And General$19,817ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$11,062TotalAmt
Management And General$11,062ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$704TotalAmt
Management And General$704ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$856,596TotalAmt
Program Services$749,065ProgramServicesAmt
Management And General$107,531ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$11,199TotalAmt
Program Services$315ProgramServicesAmt
Management And General$10,884ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$219,099TotalAmt
Program Services$210,704ProgramServicesAmt
Management And General$8,395ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$140,045TotalAmt
Program Services$140,045ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$6,288TotalAmt
Program Services$1,187ProgramServicesAmt
Management And General$5,101ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$144TotalAmt
Program Services$144ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$437,794TotalAmt
Program Services$437,794ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$41,255TotalAmt
Program Services$41,255ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
HOME OFFICE COST ALLOCATION$490,428$490,428
PATIENT CARE SUPPLIES$357,464$357,464
OTHER EXPENSE$41,433$15,132$26,301
REPAIRS & MAINTENANCE$257,900$7,421$250,479

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$11,571TotalAmt
Program Services$6,061ProgramServicesAmt
Management And General$5,510ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,056,758TotalAmt
Program Services$5,022,732ProgramServicesAmt
Management And General$1,034,026ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,831BOYAmt
EOY$11,960EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$496,783BOYAmt
EOY$270,959EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$112,539BOYAmt
EOY$138,044EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$19,000BOYAmt
EOY$9,883EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,966,258LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$472,016LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,715,489BOYAmt
EOY$1,494,242EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$26,413BOYAmt
EOY$357,164EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,375,055BOYAmt
EOY$2,282,252EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$294,846BOYAmt
EOY$332,134EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,787,672BOYAmt
EOY$7,021,833EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,082,518BOYAmt
EOY$7,353,967EOYAmt

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$3,707,463BOYAmt
EOY-$5,071,715EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$3,707,463BOYAmt
EOY-$5,071,715EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,375,055BOYAmt
EOY$2,282,252EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,364,252ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$58,446OtherCostOrOtherBasisAmt
Depreciation$8,012DepreciationAmt
Book Value$50,434BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,907,812OtherCostOrOtherBasisAmt
Depreciation$464,004DepreciationAmt
Book Value$1,443,808BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,494,242TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATE$26,747
MISCELLANEOUS RECEIVABLES
DUE FROM MEDICARE/MEDICAID$330,417
FieldValueIRS element (for citing)
Total Book Value Other Assets$357,164TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
SICK TIME PAYABLE
PENSION PLAN PAYABLE$114,005
INSURANCE RESERVE PAYABLE
DUE TO AFFILIATES$6,907,828
FieldValueIRS element (for citing)
Total Liability$7,021,833TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteFormAndLineReferenceDesc
ExplanationCHI, THE SOLE MEMBER OF MEMORIAL HEALTH SYSTEM OF EAST TEXAS, IS A TAX EXEMPT COLORADO CORPORATION AND HAS BEEN GRANTED EXEMPTION FROM FEDERAL INCOME TAX UNDER SECTION 501 (C) (3) OF THE INTERNAL REVENUE CODE. CHI OWNS CERTAIN TAXABLE SUBSIDIARIES AND ENGAGES IN CERTAIN ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE AND THEREFORE SUBJECT TO INCOME TAX. MANAGEMENT REVIEWS ITS TAX POSITION ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$197,345TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$197,345NetCommunityBenefitExpnsAmt
Total Expense0.0328TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$901,537TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$416,338DirectOffsettingRevenueAmt
Net Community Benefit Expns$485,199NetCommunityBenefitExpnsAmt
Total Expense0.0805TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$1,098,882TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$416,338DirectOffsettingRevenueAmt
Net Community Benefit Expns$682,544NetCommunityBenefitExpnsAmt
Total Expense0.1133TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,510TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,510NetCommunityBenefitExpnsAmt
Total Expense0.0009TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$5,510TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,510NetCommunityBenefitExpnsAmt
Total Expense0.0009TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$1,104,392TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$416,338DirectOffsettingRevenueAmt
Net Community Benefit Expns$688,054NetCommunityBenefitExpnsAmt
Total Expense0.1142TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$1,154,959BadDebtExpenseAmt
Bad Debt Expense Attributable$577,480BadDebtExpenseAttributableAmt
Reimbursed By Medicare$2,637,603ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$2,521,203CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$116,400MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MMC - SAN AUGUSTINEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Website Addresshttp://www.memorialhealth.usWebsiteAddressTxt
State License000072StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MMC - SAN AUGUSTINEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://www.memorialhealth.us/community/health-needs-assessmenttOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt12ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttp://www.memorialhealth.us/community/health-needs-assessmentStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care2.0FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care4.0FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTP://WWW.MEMORIALHEALTH.USFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTP://WWW.MEMORIALHEALTH.USFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTP://WWW.MEMORIALHEALTH.USFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
FAP Actions On NonpaymentfalseFAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesYes (true)GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1Facility , 1 - MMC - SAN AUGUSTINE. INTERVIEW METHODOLOGY -MEMORIAL HEALTH SYSTEM OF EAST TEXAS PROVIDED CHC CONSULTING WITH A LIST OF PEOPLE WITH SPECIAL KNOWLEDGE OF ANGELINA, POLK AND SAN AUGUSTINE COUNTIES INCLUDING PUBLIC HEALTH REPRESENTATIVES, NOT-FOR-PROFIT ORGANIZATION PROFESSIONALS, CHARITIES AND OTHER INDIVIDUALS WHO FOCUS SPECIFICALLY ON UNDERREPRESENTED GROUPS. -FROM THAT LIST. 21 IN DEPTH INTERVIEWS WERE CONDUCTED USING A STRUCTURED INTERVIEW GUIDE. IN ORDER TO FURTHER QUANTIFY THE DATA, A FOLLOW UP SURVEY WAS SENT TO THE LIST OF 21 WITH THE OPTION TO FORWARD THE SURVEY ON TO OTHERS. -EXTENSIVE NOTES WERE TAKEN DURING EACH INTERVIEW AND THEN QUANTIFIED BASED ON RESPONSES, COMMUNITIES AND POPULATIONS (MINORITY, ELDERLY, UN/UNDERINSURED, ETC.) SERVED, AND PRIORITIES IDENTIFIED BE RESPONDENTS. QUALITATIVE DATA FROM THE INTERVIEWS WAS ALSO ANALYZED AND REPORTED. SURVEY CONSTRUCTION, DISTRIBUTION, AND COLLECTION -AN ELECTRONIC SURVEY WAS CONSTRUCTED USING SURVEY MONKEY (TM) SOFTWARE IN ORDER TO GATHER OPINIONS AND INPUT OF THOSE WITH SPECIAL KNOWLEDGE REGARDING THE HEALTH NEEDS AND PRIORITIES OF THE STUDY AREA. -THE SURVEY WAS RESTRICTED SO THAT RESPONDENTS COULD ONLY COMPLETE THE SURVEY ONCE PER COMPUTER TO PROTECT INTEGRITY OF THE DATA. -THE SURVEY WAS INITIALLY DISTRIBUTED TO THE 21 INTERVIEWERS, RECIPIENTS WERE ALLOWED TO FORWARD THE SURVEY TO OTHER STAKEHOLDERS IN THE COMMUNITY. THE SURVEY REMAINED OPEN FOR APPROXIMATELY ONE MONTH. -RESPONSES WERE QUANTIFIED AND ANALYZED FOR REPORTING PURPOSES, INCLUDING ANY FREE-FORM COMMENTS. INTERVIEWEE LIST -TINA BATTIS, DEPUTY ADMINISTRATOR, ALABAMECOUSHATTA TRIBE -DEBORAH WALTERS, RN, DIRECTOR, CASE MANAGEMENT AND SOCIAL WORK, MHSET -MARILYN KEGLER, DIRECTOR OF NURSES, LUFKIN ISD -MARSHALL MCMILLAN, MEMBER, MMC-SAN AUGUSTINE BOARD OF DIRECTORS, CHAIR, BOYS AND GIRLS CLUB OF SAN AUGUSTINE -JOHN L. BRINK, RN, NURSE MANAGER, CARDIAC CATH LAB/CARDIAC REHAB, MHSET/MEMBER OF THE ANGELINA COUNTY HEART ALLIANCE -DR. SID ROBERTS, RADIATION ONCOLOGIST -JEAN HINES, SAN AUGUSTINE COUNTY HOSPITAL DISTRICT BOARD MEMBER -CARLA HIGHT, DIRECTOR, UNITED WAY - ANGELINA COUNTY -JUDGE SAMMYE JOHNSON, SAN AUGUSTINE COUNTY JUDGE -BRITTNEY JOHNSON, PROJECT MANAGER, SAN AUGUSTINE COUNTY -SHARON SHAW, ADMINISTRATOR, ANGELINA COUNTY AND CITIES HEALTH DISTRICT -DR. ROBERT FAYLE, NEUROLOGST -JERRY HATHORNE, CHAIRMAN, POLK COUNTY ADVISORY COMMITTEE -SUSAN RUSHING, CEO, BURKE CENTER LETHA TULLOS, REGIONAL VICE PRESIDENT FOR THE EAST TEXAS REGION, AMERICAN CANCER SOCIETY -CARRIE YOCUM, ADMINISTRATOR, TWIN LAKES REHABILITATION AND CARE CENTER -RAY POLK, DIABETES ACTIVIST AND FORMER BOARD MEMBER, MEMORIAL MEDICAL CENTER - LUFKIN -PHYLLIS GRANDBEORGE, EXECUTIVE DIRECTOR, ALCOHOL AND DRUG ABUSE COUNCIL -HEATHER KARTYE, EXECUTIVE DIRECTOR, FAMILY CRISIS CENTER OF EAST TEXAS -MINERVA PALOMINO, SOCIAL WORKER, MHSET -JUDGE JOHN THOMPSON, JUDGE, POLK COUNTY
Schedule H, Part V, Section B, Line 6a Facility , 1Facility , 1 - MMC - SAN AUGUSTINE. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED TO INCLUDE ALL FOUR (4) FACILITIES WHICH COMPRISE MEMORIAL HEALTH SYSTEM OF EAST TEXAS: (1)MEMORIAL MEDICAL CENTER OF EAST TEXAS (LUFKIN), (2) MEMORIAL MEDICAL CENTER - LIVINGSTON, (3) MEMORIAL MEDICAL CENTER - SAN AUGUSTINE, AND (4) MEMORIAL SPECIALTY HOSPITAL.
Schedule H, Part V, Section B, Line 11 Facility , 1Facility , 1 - .
Schedule H, Part V, Section B, Line 22 Facility , 1Facility , 1 - . THE HOSPITAL CHARGED FAP ELIGIBLE INDIVIDUALS, THE SAME RATES AS ALL OTHER PATIENTS.
Schedule H, Part V, Section B, Line 24 Facility , 1Facility , 1 - MMC - SAN AUGUSTINE. ALL PATIENTS ARE EQUALLY CHARGED. PATIENTS WHO FILE AN APPLICATION FOR FINANCIAL ASSISTANCE ARE NOT BILLED UNLESS IT IS LATER DETERMINED THAT THEY DO NOT QUALIFY FOR ASSISTANCE.
FieldValueIRS element (for citing)
Facility0FacilityNum

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 11 MMC San AugustineForm 990, Schedule H, Part V, Section B - Community Health Needs Assessment - Line 11 CHI ST. LUKE'S HEALTH MEMORIAL SAN AUGUSTINE IMPLEMENTATION PLAN UPDATE 2015 Measurable Objectives and Implementation Activities PRIORITY #1: CHI St. Luke's Health Memorial San Augustine focuses financial and staff resources on educating the community about diabetes prevalence, prevention, and disease management. Objective #1: CHI St. Luke's Health focuses financial and staff resources on educating the community about diabetes prevalence, prevention, and disease management. Implementation Activities: * CHI St. Luke's Health produces a monthly cooking show, Memorial Cooking Innovations, which is a 30 minute cooking show featuring a registered dietitian and a certified chef. The show features diabetic and heart friendly foods that are delicious and easy to prepare and is broadcast on the local government access television channels daily and in 62 cities across the United States. Additionally, the broadcast is made available to view at any time online at http://www.memorialhealth.us/cooking. Memorial Cooking Innovation recipes and nutritional messages are also featured monthly in the "Healthy Cooking" section of the local newspaper. * CHI St. Luke's Health Memorial San Augustine offers space for a support group. * CHI St. Luke's Health Memorial San Augustine contracts with a certified dietician. * CHI St. Luke's health Memorial San Augustine allows accent health televisions in the waiting areas which have educational content that plays a minimum of 12 hours per day; the content regularly changes and includes diabetes prevention and management. This program promotes immunizations, screenings and has segments on healthy eating. Objective #2: CHI St. Luke's Health Memorial San Augustine participates in a variety of health related events, such as campaigns and luncheons, to increase awareness and promote early cancer detection through appropriate screenings. Implementation Activities: * CHI St. Luke's Health Memorial San Augustine sponsors a local program for breast cancer awareness called Go Pink Night at the Rodeo. * CHI St. Luke's Health Memorial San Augustine actively participates in Mammography Month. A free gift is offered to those scheduling a mammogram at one of CHI St. Luke's Memorial facilities. * CHI St. Luke's Health Memorial San Augustine works the Breast and Cervical Cancer Screening Program in Conjunction with CHI St. Luke's Health Memorial Lufkin to provide free or low cost Digital Mammograms and Cervical screening on site in San Augustine hospital at least monthly. Objective #3: CHI St. Luke's Health Memorial San Augustine engages in collaborative initiatives to educate the community on a variety of health topics. Implementation Activities: * CHI St. Luke's Health Memorial San Augustine participates in local speaking about health related topics for Chamber activities. Additionally we participate in public education forums that are held at industries, schools, assisted living centers, retirement centers, and civic clubs. * CHI St. Luke's Health Memorial San Augustine participates in health fairs for industries and communities. * CHI St. Luke's Health Memorial San Augustine is a participant with the Angelina Cities and Counties Health District in providing education to prevent CHF, UTI and Pneumonia.
Schedule H, Part V, Section B, Line 11 MMC San AugustineObjective #4: CHI St. Luke's Health Memorial San Augustine serves as a resource to other healthcare providers in the community, and as a clinical resource for allied health academic institutions. Implementation Activities: * CHI St. Luke's Health Memorial San Augustine serves as a resource for other healthcare providers, such as nursing homes, the Regional Advisory Council, the Emergency Preparedness Team, the Southeast Texas Regional Advisory Council, the Rural East Texas Health Network and EMS. Our administrator serves on the Local (President) and Regional (member and former board member) Rural East Texas Health Network and serves as Secretary of the Deep East Texas Regional Advisory Council. * CHI St. Luke's Health serves as a clinical resource for allied health academic institutions. This includes nursing and laboratory students though our relationship with Panola College Carthage Texas. PRIORITY #2: The community needs increased access to affordable primary care. Objective #1: CHI St. Luke's Health Memorial San Augustine coordinates with various providers to offer affordable and discounted care to community members. Implementation Activities: * CHI St. Luke's Health Memorial San Augustine collaborates with Express Lab to offer very affordable lab testing at all of the system's facilities. Many of the discounted screenings offered at CHI St. Luke's Health Memorial San Augustine are offered through Express Lab. Objective #2: CHI St. Luke's Health Memorial San Augustine provides staff members that aim to connect patients with available resources and affordable healthcare options. Implementation Activities: * CHI St. Luke's Health Memorial San Augustine employees an Indigent Health Care staff member, who works to connect indigent and disabled patients to available payer sources. The hospital contributes all of the staff member's salary. PRIORITY #3: The community needs additional healthcare providers. * Primary care physicians, mental health providers, and physicians accepting Medicare and Medicaid HMO products. Objective #1: CHI St. Luke's Health Memorial San Augustine has recruited primary care physicians and a chiropractor. Implementation Activities: * CHI St. Luke's Health Memorial San Augustine has actively recruited and employed primary care physicians through arrangement with Memorial Clinics, based on a 2014 Medical Staff Development Plan. The hospital has recruited and/or employed 2 primary care physicians and the chiropractor since 2013 and expects to add an additional 2 providers in 2016. We continue to look at specialist and physician extenders such as Nurse Practitioners. PRIORITY #4: There is a need to address unhealthy lifestyles, such as smoking and obesity. Objective #1: CHI St. Luke's Health Memorial San Augustine has engaged in a variety of initiatives to promote healthy lifestyles, such as good nutrition and smoking cessation. Implementation Activities: * CHI St. Luke's Health Memorial has participated in the city wide, smoke free initiative. In addition, all of CHI St. Luke's Health Memorial's campuses are smoke free. * In 2015, CHI St. Luke's Health Memorial increased community outreach in San Augustine through Health & Wellness Fairs providing education and how to access resources. We partnered with community and businesses to conduct 10 Health & Wellness Fairs in San Augustine and surrounding areas. * In addition, the hospital partnered with the San Augustine County Chamber of Commerce to sponsor Let's Get Fit San Augustine, an eight-week program designed to get local residents moving and exercising and making healthy food choices in order to maintain a healthy lifestyle. Memorial Clinics physicians participated as expert speakers. * CHI St. Luke's Health Memorial San Augustine has encouraged improved health and well-being among staff by offering discounted or free services to employees and discounted health insurance premiums for participating in annual wellness assessments. * CHI St. Luke's Health Memorial provides nutritional articles on a monthly basis to various news sources, including the Lufkin Daily News, the San Augustine Tribune, and East Texas Magazines. * CHI St. Luke's Health Memorial San Augustine provides healthy options in the facility's cafeteria; we began a campaign to stop frying and July 1, 2015 we no longer fry anything in our cafeteria. * CHI St. Luke's Health Memorial San Augustine provides financial support and volunteers to organizations that strive to improve healthy lifestyles in the community. Some of these organizations include: o The American Cancer Society o Angelina Cities and County Health District * Smoking cessation and lifestyle changes are also addressed in the public health fairs (detailed under Priority #6). Objective #2: CHI St. Luke's Health Memorial San Augustine offers and provides space for programs that work to address unhealthy lifestyles through education, group meetings, or classes. Implementation Activities: * CHI St. Luke's Health Memorial San Augustine offers space for support groups. * CHI St. Luke's Health Memorial San Augustine continues to offer CPR at reduced rates.
Schedule H, Part V, Section B, Line 11 MMC San AugustinePRIORITY #5: There is a lack of mental health and behavioral health continuum of care. Objective #1: CHI St. Luke's Health Memorial San Augustine provides financial support, staff, and volunteers to organizations that either offer services or strive to address mental health and substance abuse concerns in the community. Implementation Activities: * CHI St. Luke's Health Memorial San Augustine provides financial support and volunteers to organizations that offer prevention and/or treatment for alcohol and drug abuse, underage drinking, etc. Some of these organizations include: o Alcohol Drug Abuse Council of Deep East Texas o Burke Center * CHI St. Luke's Health Memorial San Augustine is providing leadership to various boards. For example the hospital administrator serves on the Rural East Texas Health Network Board (Memorial Medical Center San Augustine was one of the founding members) and is also the president of the local advisory board for the RETHN. PRIORITY #6: There is a need to decrease health disparities by targeting specific populations. * The high prevalence of diabetes * Low income, un/underinsured and elderly * A safe place for treatment for undocumented persons * A culturally sensitive, language appropriate healthcare environment for minority populations. Objective #1: As a part of the larger health system CHI St. Luke's Health Memorial San Augustine has focused on decreasing health disparities among specific populations by collaborating, organizing, and participating in a variety of initiatives that target specific groups. Implementation Activities: * CHI St. Luke's Health Memorial continues to be a presenting sponsor for the Senior Expo. * In collaboration with the larger system CHI St. Luke's Health Memorial San Augustine sponsors or endorses community wide health fairs and health screenings, and Screenings at Festivals. * CHI St. Luke's Health Memorial provides Women's Special Services that offers mammograms, GYN exams, and pap smears and GYN educational services to the uninsured population in the community. CHI St. Luke's Health Memorial San Augustine participates in these service offerings by providing a treatment room for examinations and providing digital mammography. * CHI St. Luke's Health Memorial provides bacterial pneumonia and flu vaccinations at all of its facilities. * CHI St. Luke's Health memorial San Augustine has provided support and assisted with training in the school and nursing homes for infection prevention. PRIORITY #7: There is a need to increase access to transportation for healthcare services for individuals without access (such as elderly and low income residents). Objective #1: CHI St. Luke's Health Memorial San Augustine has worked to provide access to transportation and transportation vouchers to patients at the hospital. Implementation Activities: * We have worked with local vendors and churches to assist community members with transportation need to get to the cancer center/appointments out of the community. * The hospital district solely has provided ambulance service for the community 911 and for transports.
Schedule H, Part I, Line 6a Community benefit report prepared by related organizationMEMORIAL HEALTH SYSTEM OF ET
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceTHE HOSPITAL USED A COST-TO-CHARGE RATIO TO CALCULATE AMOUNTS REPORTED IN THIS TABLE. THIS COST-TO-CHARGE RATIO WAS DEVELOPED USING THE FORMAT SHOWN IN IRS WKST 2 -"RATIO OF PATIENT CARE COST-TO-CHARGES:. IN ACCORDANCE WITH THE INSTRUCTIONS, EXPENSES REPORTED ON PART IX, LINE 25, COLUMN A IN THE AMOUNT OF $6,056,758 WERE REDUCED BY $5,510 IN COMMUNITY BENEFITS AND $26,776 IN REVENUE FROM NON PATIENT SERVICES. THE REMAINING EXPENSES OF $6,024,472 WERE USED IN THE CALCUATION OF OF THE COST-TO- CHARGE RATIO. BAD DEBTS EXPENSE WAS NOT INCLUDED ON PART IX, LINE 25, COLUMN A OF FORM 990.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountTHE AMOUNT SHOWN ON LINE 2 WAS DETERMINED BY USING THE COSTING METHODOLOGY DERIVED FROM WORKSHEET 2 - "RATIO OF PATIENT CARE COST-TO-CHARGES". THE HOSPITAL ACCOUNTS FOR DISCOUNTS AS DEDUCTIONS FROM GROSS PATIENT REVENUE AND WHERE APPLICABLE, PAYMENT OF PATIENT ACCOUNTS AS DEDUCTIONS FROM UNCOLLECTIBLE (BAD DEBTS EXPENSE ACCOUNTS
Schedule H, Part III, Line 3 Bad Debt Expense MethodologyTHE AMOUNT SHOWN ON LINE 3 IS BASED ON THE HOSPITAL'S ESTIMATE THAT 50% OF THE ACCOUNTS RECORDED AS BAD DEBT EXPENSE WOULD HAVE BEEN CLASSIFIED AS CHARITY (COMMUNITY BENEFIT) HAD THE APPROPRIATE INFORMATION BEEN OBTAINED. THIS ESTIMATE IS BASED PRIMARILY ON THE POPULATION OF SAN AUGUSTINE COUNTY'S MEDIAN HOUSEHOLD INCOME ($28,390), THAT 26.4% OF COUNTY RESIDENTS HAD INCOMES BELOW THE FEDERAL POVERTY LEVEL, THAT 77% OF GROSS PATIENT REVENUE WAS FROM OUTPATIENTS AND THAT THE HOSPITAL DID NOT EMPLOY ADEQUATE PERSONNEL TO IDENTIFY AND FOLLOW UP ON PATIENT ACCOUNTS THAT WOULD HAVE QUALIFIED FOR CHARITY STATUS. THERE ARE ALSO VARIOUS OTHER REASONS WHY ADEQUATE INFORMATION WAS NOT OBTAINED. THESE REASONS INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING: LANGUAGE BARRIERS WITH THE SPANISH SPEAKING POPULATION A PATIENT'S LACK OF UNDERSTANDING ABOUT THE PROCESS AND WHERE TO FIND THE INFORMATION REQUESTED SOME PATIENT'S ARE UNABLE OR UNWILLING TO SUPPLY SUPPORTING DOCUMENTATION LACK OF UNDERSTANDING BY THE PATIENT OF HOW A CHARITY CLASSIFICATION RATHER THAN A BAD DEBT CLASSIFICATION MAY BENEFIT THEM.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnoteTHE HOSPITAL DOES NOT REPORT BAD DEBTS EXPENSES (UNCOLLECTIBLE ACCOUNTS) IN ACCORDANCE WITH HFMA STATEMENT NO. 15. THE HOSPITAL ACCOUNTS FOR ANY LOSSES ON ACCOUNTS RECEIVABLE USING THE ALLOWANCE METHOD. THE HOSPITAL IS A MEMBER OF A SYSTEM WITH CONSOLIDATED FINANCIAL STATEMENTS. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS FOOTNOTE TO NET PATIENT ACCOUNTS RECEIVABLE FOR THE YEAR ENDED JUNE 30, 2015, INCLUDES THE FOLLOWING: "THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS." ALSO, SEE PAGE 9 OF THE ATTACHED CONSOLIDATED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES FOR THE REMAINDER OF THE FOOTNOTE. .
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsAS NO COST REPORT WAS REQUIRED TO BE FILED FOR THE YEAR ENDED JUNE 30, 2015, THE HOSPITAL USED A COST-TO-CHARGE RATIO TO CALCULATE AMOUNTS REPORTED IN SECTION B. THIS COST-TO-CHARGE RATIO WAS DEVELOPED USING THE FORMAT SHOWN IN IRS WKST 2 -"RATIO OF PATIENT CARE COST-TO-CHARGES".
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistanceAS SOON AS SUFFICIENT INFORMATION IS AVAILABLE CONCERNING THE PATIENT'S FINANCIAL RESOURCES AND ELIGIBILITY FOR GOVERNMENT ASSISTANCE, A DETERMINATION IS MADE CONCERNING THE PATIENT'S ELIGIBILITY FOR CHARITY. NO COLLECTION EFFORTS ARE PURSUED ON A CHARITY ACCOUNT AFTER SUCH DETERMINATION IS MADE.
Schedule H, Part V, Section B, Line 16a FAP website- MMC - SAN AUGUSTINE: Line 16a URL: HTTP://WWW.MEMORIALHEALTH.US;
Schedule H, Part V, Section B, Line 16b FAP Application website- MMC - SAN AUGUSTINE: Line 16b URL: HTTP://WWW.MEMORIALHEALTH.US;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website- MMC - SAN AUGUSTINE: Line 16c URL: HTTP://WWW.MEMORIALHEALTH.US;
Schedule H, Part VI, Line 2 Needs assessmentIN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT REQUIRED BY LAW, OUR PHYSICIANS HAVE NUMEROUS COMMITTEES AT THE HOSPITAL, IN PART TO KEEP US INFORMED ABOUT COMMUNITY MEDICAL NEEDS.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistanceTHE HOSPITAL INFORMS AND EDUCATES PATIENTS BY PROVIDING PATIENT HANDBOOKS WHICH CONTAIN INFORMATION FOR UNINSURED PATIENTS AS WELL AS FINANCIAL COUNSELOR INFORMATION. PATIENT BILLS HAVE INFORMATION AND WORDING IN THEM WHICH STATES FOR THEM TO CALL THE BUSINESS OFFICE FOR POSSIBLE DISCOUNTS OF UP TO 50%. WE USE A CALCULATION SHEET FOR INCOME LEVELS WHICH TAKES INTO ACCOUNT THE NUMBER OF FAMILY MEMBERS IN THE HOUSEHOLD AND THEIR TOTAL INCOME, WHICH TRANSLATES INTO THEIR TOTAL DISCOUNT AMOUNT AND DISCOUNT PERCENTAGE. THE ADMISSION SUPERVISOR MAILS APPLICATIONS FOR FINANCIAL ASSISTANCE TO PATIENTS MONDAY-FRIDAY FROM THE EMERGENCY DEPARTMENT VISITS THAT ARE LISTED AS SELF PAY; ADDITIONALLY SHE ASSISTS PATIENTS DURING THE WORKING HOURS WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS; SHE ALSO DISCUSSES THE COUNTY INDIGENT PROGRAM WITH THEM AND GIVES REFERRALS TO THE ON-SITE COUNTY INDIGENT INTAKE COORDINATOR. THE HOSPITAL EMPLOYEES A PERSON TO ASSIST WITH APPLICATIONS AND RESOURCES AND A SOCIAL WORKER THAT WORKS THREE DAYS PER WEEK.
Schedule H, Part VI, Line 4 Community informationSAN AUGUSTINE COUNTY WITH AN APPROXIMATE POPULATION OF 8,610 AS OF 2014, IS CONSIDERED A RURAL COUNTY. IT IS A FEDERALLY DESIGNATED MEDICALLY UNDER SERVED AREA; HEALTH PROFESSIONAL SHORTAGE AREA AND MENTAL HEALTH PROFESSIONAL SHORTAGE AREA PER A RECENT HRSA SHORTAGE AREA REVIEW AND PER THE 2000 TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER'S RURAL HEALTH STUDY, WE ARE ALSO A FRONTIER AREA. AS OF 2013, THE POPULATION'S AVERAGE INCOME IS $28,390; 26.4% OF COMMUNITY RESIDENTS WITH INCOME BELOW THE FEDERAL POVERTY GUIDELINE. IN 2011 WE HAD AN AVERAGE UNEMPLOYMENT RATE OF 12.4%. APPROXIMATELY 18-20% OF OUR PATIENT BASE IS UNINSURED, APPROXIMATELY 20% OF OUR PATIENT BASE IS MEDICAID RECIPIENTS, AND APPROXIMATELY 55% OF OUR PATIENT BASE IS MEDICARE RECIPIENTS. THE HOSPITAL IS THE ONLY HEALTH CARE FACILITY IN SAN AUGUSTINE COUNTY, AND IS THEREFORE THE ONLY HOSPITAL WHICH DIRECTLY SERVES OUR COMMUNITY. WE ARE A MEDICARE DESIGNATED CRITICAL ACCESS FACILITY. THE CITY OF SAN AUGUSTINE IS THE COUNTY SEAT AND THE HOSPITAL SERVES AS THE MEDICAL HUB OF SAN AUGUSTINE COUNTY. WE HAVE MISSION DELORES VISITOR CENTER AND RV PARK LOCATED ONE MILE FROM THE HOSPITAL. WE ARE WITHIN 20 MINUTES OF LAKE SAM RAYBURN AND TOLEDO BEND RESERVOIR AND THE BIG THICKET NATIONAL RESERVE. WE ARE A CERTIFIED RETIREMENT COMMUNITY SO THE HOSPITAL SERVES A LARGE POPULATION OF RETIREES, VACATIONERS, HUNTERS AND NATURE LOVERS.
Schedule H, Part VI, Line 5 Promotion of community healthTHE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY THROUGH PARTICIPATION IN VARIOUS EDUCATIONAL ACTIVITIES WITH FOCUS ON CPR, DIABETIC EDUCATION AND SUPPORT GROUPS AS 12.6% OF OUR POPULATION IS DIABETIC. THE HOSPITAL PARTICIPATES IN HEALTH FAIRS AT THE HOSPITAL, HEALTH FAIRS AT THE SASSAFRAS FESTIVAL, SPEAKING/HEALTH EDUCATION AT ROTARY, LIONS CLUB AND OTHER AREA ORGANIZATIONS, PARTICIPATING IN BUSINESS AFTER HOURS, RELAY FOR LIFE, AND RURAL EAST TEXAS HEALTH HETWORK OF MENTAL HEALTH. THERE WAS A FOCUS ON STROKE WARNING SIGNS IN SOME OF THE PROGRAMS OFFERED IN 2014. ANNUALLY, WE PARTICIPATE IN A HEALTH FAIR AT THE LOCAL ELECTRIC CO-OP, PROVIDING HEALTH SCREENINGS AND FREE BLOOD PRESSURES. THE HOSPITAL HOSTS A COMMUNICATION/EDUCATION MEETING WITH LOCAL NURSING HOMES, ASSISTED LIVING AND DEVELOPMENT CENTER ON A QUARTERLY BASIS. THE HOSPITAL ALSO PARTNERS WITH THE FOLLOWING COMMUNITY GROUPS: CANCER SUPPORT GROUP, PANOLA COLLEGE LVN NURSING PROGRAMS AND PHLEBOTOMY PROGRAMS, AND WITH AREA HIGH SCHOOLS HEALTH CAREERS PROGRAMS WHICH ALLOW HIGH SCHOOL STUDENTS TO PARTICIPATE IN CLINICAL STUDIES AT THE HOSPITAL. WE ARE ACTIVE MEMBERS OF DEEP EAST TEXAS REGIONAL AREA COUNCIL TRAUMA SERVICES AREA H; IMPROVING TRAUMA CARE AND PREVENTION TO THE COMMUNITIES WE SERVE. THE HOSPITAL IS WORKING WITH THE SOUTHEAST TEXAS REGIONAL AREA COUNCIL FOR TRAUMA PREPAREDNESS, STEMI AND STROKECARE AND WITH CHI'S HOUSTON DIVISION ON STANDARDIZING SOME OF THE EMERGENCY PREPAREDNESS AND SAFETY PRACTICES.
Schedule H, Part VI, Line 6 Affiliated health care systemIN ADDITION TO THE CUSTOMIZED OUTREACH IN EACH INDIVIDUAL COMMUNITY, THE CORPORATE STRUCTURE PROVIDES EACH HOSPITAL IN ANGELINA, POLK AND SAN AUGUSTINE COUNTIES WITH IMPROVED MEDICAL TECHNOLOGY THROUGH A COMMON COMPUTER SYSTEM, COMMUNICATION TO ALL COMMUNITIES THROUGH THE CORPORATE MARKETING DEPARTMENT, AND COORDINATION OF MEDICAL TRAINING FOR ALL CLINICAL EMPLOYEES. MEMORIAL SPECIALTY HOSPITAL IS ABLE TO PROVIDE CARE FOR CRITICALLY ILL, MEDICALLY COMPLEX PATIENTS WHOSE NEEDS CANNOT BE MET IN OTHER POST-ACUTE CARE ENVIRONMENTS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Michael Covert
Pres & CEO CHI St. Luke's Health System$0$362,439$0$250,000$0$39,108$0$0$0$5,310$0$656,857$0$0
DARLENE WILLIAMS
ADMINISTRATOR, CNE$139,468$0$0$0$0$0$4,106$0$13,713$0$157,287$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationFormAndLineReferenceDesc
ExplanationWITH THE APPROVAL OF A COMPENSATION COMMITTEE, THE CEO OF MEMORIAL HEALTH SYSTEM OF EAST TEXAS (THE MEMBER) DETERMINES THE SALARY OF THE ADMINISTRATOR.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, Line 1a FORM 1096MEMORIAL HEALTH SYSTEM OF EAST TEXAS (MHSET) PAYS THE HOSPITAL'S BILLS FOR SERVICES THAT WOULD REQUIRE THE PREPARATION OF FORMS 1099 AND THE RELATED FORM 1096, AND REPORTS SUCH PAYMENTS UNDER ITS FEDERAL IDENTIFICATION NUMBER (75-0755367). THE HOSPITAL REIMBURSES MHSET FOR SUCH PAYMENTS.
Form 990, Part VI, Line 2 Family/business relationships amongst interested personsGIBSON FRIESEN AND RONA FRIESEN - Family relationship, CORKY EVANS AND JUDY COCHRAN - Business relationship, HUNT HUBER, M. D. AND DAVID GLENN, M. D. - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholdersMEMORIAL HEALTH SYSTEM OF EAST TEXAS IS THE SOLE CORPORATE MEMBER. CATHOLIC HEALTH INITIATIVES (CHI) IS THE SOLE CORPORATE MEMBER OF MEMORIAL HEALTH SYSTEM OF EAST TEXAS.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyTHE BOARD OF DIRECTORS OF THE MEMBER (MEMORIAL HEALTH SYSTEM OF EAST TEXAS) ALSO SERVE AS MEMBERS OF THE BOARD OF DIRECTORS OF MMC-SAN AUGUSTINE. THE MANAGEMENT OF OF MHSET PROVIDES OVERSITE OF FINANCIAL AND CLINICAL OPERATIONS.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersTHE MEMBER (MEMORIAL HEALTH SYSTEM OF EAST TEXAS) APPROVES THE INDIVIDUALS SELECTED TO THE BOARD OF DIRECTORS OF MMC-SAN AUGUSTINE AND HAS FINAL APPROVAL OF ALL ACTIONS OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyTHE BOARD OF DIRECTORS, BY RESOLUTION, APPOINTS A SPECIAL COMMITTEE TO REVIEW THE FORMS 990 AND 990T PRIOR TO FILING. ONCE THE RETURNS ARE COMPLETED, THEY ARE PROVIDED TO THIS COMMITTEE FOR THEIR REVIEW AND APPROVAL FOR FILING. EMPLOYEES OF THE CORPORATION RESPONSIBLE FOR THE PREPARATION AND REVIEW OF THE RETURNS ARE AVAILABLE TO RESPOND TO QUESTIONS OR PROVIDE BACKGROUND AS NEEDED. ONCE THE DIRECTORS RESPONSIBLE FOR REVIEWING THE RETURNS ARE SATISFIED THEY ARE COMPLETE, THE RETURNS ARE APPROVED TO BE FILED. SUBSEQUENT TO PRESENTATION TO THE BOARD'S COMMITTEE, THE TAX DEPARTMENT FILES THE RETURNS WITH THE IRS, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE COMMITTEE. AFTER FILING, THE RETURNS ARE MADE AVAILABLE TO ALL DIRECTORS FOR THEIR REVIEW.
Form 990, Part VI, Line 12c Conflict of interest policyPRIOR TO THE INITIAL MEETING OF A CALENDAR YEAR, EACH MEMBER OF THE BOARD AND OFFICER OF THE CORPORATION IS PROVIDED A COPY OF THE CONFLICTS OF INTEREST POLICY, A STATEMENT ACKNOWLEDGING ITS RECEIPT AND DISCLOSURE OF OUTSIDE INTERESTS AND ACTIVITIES FORM. THE POLICY IS DISCUSSED WITH THE BOARD AND EACH OFFICER. EACH BOARD MEMBER AND OFFICER COMPLETES THE DISCLOSURE OF OUTSIDE INTERESTS AND ACTIVITIES FORM AND RETURNS THEM TO THE CHIEF EXECUTIVE OFFICER (CEO) OF MEMORIAL HEALTH SYSTEM OF EAST TEXAS (MHSET). THE CEO AND MHSET'S GENERAL COUNSEL REVIEW EACH STATEMENT ACKNOWLEDGING RECEIPT OF THE POLICY AND DISCLOSURES TO FAMILIARIZE THEMSELVES WITH THE POTENTIAL CONFLICTS.
Form 990, Part VI, Line 15a Process to establish compensation of top management officialTHE SALARY OF THE ADMINISTRATOR OF THE CORPORATION IS SET BY THE CHIEF EXECUTIVE OFFICER OF MEMORIAL HEALTH SYSTEM OF EAST TEXAS. THIS PROCESS IS PERFORMED ANNUALLY.
Form 990, Part VI, Line 19 Required documents available to the publicTHE ORGANIZATION'S FINANCIAL STATEMENTS , CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST, AT SUCH TIMES THAT ARE SCHEDULED WITH THE CHIEF FINANCIAL OFFICER OF MEMORIAL HEALTH SYSTEM OF EAST TEXAS. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT,ORG.
Form 990, Part VIII, Line 2a PATIENT SERVICE REVENUEPATIENT SERVICE REVENUE WAS DETERMINED AS FOLLOWS: GROSS CHARGES TO PATIENTS - $18,403.494 LESS: MEDICARE CONTRACTUAL ADJUSTMENTS - ($4,837,247) MEDICAID CONTRACTUAL ADJUSTMENTS - ($269,080) MANAGED CARE ADJUSTMENTS - ($4,383,353) CHARITY DEDUCTIONS - ($602,764) UNCOLLECTIBLE ACCOUNTS - ($3,527,671) OTHER DISCOUNTS - ($137,170) NET PATIENT SERVICE REVENUE - 4,646,209
Form 990, Part VIII, Line 2f Other Program Service RevenueOther Income - Total Revenue: 648, Related or Exempt Function Revenue: 648, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other FeesOUTSIDE SERVICES - OTHER - Total Expense: 314893, Program Service Expense: 207362, Management and General Expenses: 107531, Fundraising Expenses: ; OUTSIDE SERVICES - ED PHYSICIANS - Total Expense: 392965, Program Service Expense: 392965, Management and General Expenses: , Fundraising Expenses: ; OUTSIDE SERVICES - BIOMED - Total Expense: 148738, Program Service Expense: 148738, Management and General Expenses: , Fundraising Expenses: ;
FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCESEFFECTIVE JUNE 1, 2014 CATHOLIC HEALTH INITIATIVES (CHI) BECAME THE SOLE CORPORATE MEMBER OF MEMORIAL HEALTH SYSTEM OF EAST TEXAS. UPON THE CHANGE IN MEMBERSHIP TO CHI, THE ASSETS AND LIABILITIES OF MEMORIAL SPECIALTY HOSPITAL WERE REVALUED TO FAIR MARKET VALUE, BASED ON LEVEL 3 INPUTS, INCLUDING ESTIMATED FUTURE CASH FLOWS AND PROBABILITY-WEIGHTED PERFORMANCE ASSUMPTIONS.,

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (184 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
ALEGENT CREIGHTON CLINIC
12809 W DODGE RDOMAHANE68154470765154HEALTHCARENE501(c)(33ACHYes (true)
ALEGENT CREIGHTON HEALTH
12809 W DODGE RDOMAHANE68154470757164HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
ALEGENT CREIGHTON HEALTH FOUNDATION
12809 W DODGE RDOMAHANE68154470648586FUNDRAISINGNE501(c)(37ACHYes (true)
ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM
7500 MERCY RDOMAHANE68124470484764HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA
631 N 8TH STMISSOURI VALLEYIA51555420776568HEALTHCAREIA501(c)(33CHI NEBRASKAYes (true)
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
6901 N 72ND STOMAHANE68122470376615HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER
104 W 17TH STSCHUYLERNE68661470399853HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA
PO BOX 368CORNINGIA50841420782518HEALTHCAREIA501(c)(33CHI NEBRASKAYes (true)
ALVERNA APARTMENTS
300 SE 8TH AVELITTLE FALLSMN56345411351177LTERM CAREMN501(c)(39CHIYes (true)
APPLETREE COURT
601 OAK STBRECKENRIDGEMN56520411850500SENIOR LIVINGMN501(c)(39SFHYes (true)
BELLEVILLE ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802274005511HEALTHCARETX501(c)(33SHSCYes (true)
BISHOP DRUMM RETIREMENT CENTER
1111 6TH AVEDES MOINESIA50314420725196LTERM CAREIA501(c)(39CHI-IA CORPYes (true)
BORNEMANN HEALTHCARE CORPORATION
2500 BERNVILLE RD PO BOX 316READINGPA19603232187242HEALTHCAREPA501(c)(3Type ICHIYes (true)
BURLESON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802742759890HEALTHCARETX501(c)(33SJSCYes (true)
BURLESON ST JOSEPH MANOR
2801 FRANCISCAN DRIVEBRYANTX77802742913931HEALTHCARETX501(c)(39SJSCYes (true)
CARRINGTON HEALTH CENTER
800 N 4TH STCARRINGTONND58421450227311HEALTHCAREND501(c)(33CHIYes (true)
CATHOLIC HEALTH INITIATIVES
198 INVERNESS DRIVE WESTENGLEWOODCO80112470617373HEALTHCARECO501(c)(3Type INAYes (true)
CATHOLIC HEALTH INITIATIVES - COLORADO
188 INVERNESS DRIVE WEST STE 500ENGLEWOODCO80112840405257HEALTHCARECO501(c)(33CHIYes (true)
CATHOLIC HEALTH INITIATIVES - IOWA CORP
1111 6TH AVEDES MOINESIA50314420680448HEALTHCAREIA501(c)(33CHIYes (true)
CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
6385 CORPORATE DR STE 301COLORADO SPRINGSCO80919840902211FUNDRAISINGCO501(c)(37CHICYes (true)
CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION
6385 CORPORATE DRCOLORADO SPRINGSCO80919270930004FUNDRAISINGCO501(c)(3Type ICHIYes (true)
CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES
198 INVERNESS DRIVE WESTENGLEWOODCO80112460992796HEALTHCARECO501(c)(3Type ICHINSYes (true)
CENTENNIAL MEDICAL GROUP INC
2700 STEWART PKWYROSEBURGOR97471263946191PHYSICIANSOR501(c)(39MMCYes (true)
CENTRAL KANSAS MEDICAL CENTER
3515 BROADWAYGREAT BENDKS67530480543724SURGERY CENTERKS501(c)(33CHIYes (true)
CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PKWY SFARGOND58104271966847HEALTHCAREMN501(c)(39CHIYes (true)
CHI INSTITUTE FOR RESEARCH AND INNOVATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112271050565HEALTHCARECO501(c)(3Type ICHIYes (true)
CHI KENTUCKY INC
3900 OLYMPIC BLVD STE 400ERLANGERKY41018202741651HEALTHCAREKY501(c)(3Type ICHIYes (true)
CHI NATIONAL HOME CARE
198 INVERNESS DRIVE WESTENGLEWOODCO80112451261716HEALTHCARECO501(c)(39CHI NSYes (true)
CHI NATIONAL SERVICES
198 INVERNESS DRIVE WESTENGLEWOODCO80112452532084HEALTHCARECO501(c)(3Type ICHIYes (true)
CHI NEBRASKA
6940 O ST STE 200LINCOLNNE68510363233121HEALTHCARENE501(c)(3Type ICHIYes (true)
CHI ST JOSEPH'S CHILDREN
1516 5TH ST NWALBUQUERQUENM87102710897107COMMUNITYNM501(c)(3Type ICHIYes (true)
CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER
6624 FANNIN STHOUSTONTX77030741161938HEALTHCARETX501(c)(33SLHSYes (true)
CHI ST VINCENT HOSPITAL HOT SPRINGS
300 WERNER STHOT SPRINGSAR71913710236913HEALTHCAREAR501(c)(33CHISVHSYes (true)
CHI ST VINCENT HOT SPRINGS
300 WERNER STHOT SPRINGSAR71913261125064HOLDING COAR501(c)(3Type IISVIMCYes (true)
CHI ST VINCENT MEDICAL GROUP HOT SPRINGS
1 MERCY LANE STE 201HOT SPRINGSAR71913261125131HEALTHCAREAR501(c)(33CHISVHSYes (true)
COMMUNITY LIMITED CARE DIALYSIS CENTER
619 OAK ST ACCOUNTING-3 WCINCINNATIOH45206237419853HOLDING COOH501(c)(2GSHYes (true)
COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION
631 N 8TH STMISSOURI VALLEYIA51555421294399FUNDRAISINGIA501(c)(3Type IAH-CMHMVYes (true)
CONTINUING CARE HOSPITAL
150 NORTH EAGLE CREEK DRLEXINGTONKY40509611400619LT ACHKY501(c)(33SJHSYes (true)
COVENANT HOME CARE
198 INVERNESS DRIVE WESTENGLEWOODCO80112232028429HOME HEALTHPA501(c)(3Type IICHI NHCYes (true)
ENUMCLAW REGIONAL HOSPITAL ASSOCIATION
1450 BATTERSBY AVEENUMCLAWWA98022910715805HEALTHCAREWA501(c)(33FHSYes (true)
FLAGET HEALTHCARE INC
4305 NEW SHEPHERDSVILLE RDBARDSTOWNKY40004611345363HEALTHCAREKY501(c)(33KOHYes (true)
FLAGET MEMORIAL HOSPITAL FOUNDATION INC
4305 NEW SHEPHERDSVILLE RDBARDSTOWNKY40004562351341FUNDRAISINGKY501(c)(3Type IFHYes (true)
FRANCISCAN CARE CENTER
4111 N HOLLAND-SYLVANIA RDTOLEDOOH43623341931806HEALTHCAREOH501(c)(39FLCYes (true)
FRANCISCAN FOUNDATION
1717 SOUTH J STTACOMAWA98405911145592FUNDRAISINGWA501(c)(39FHSYes (true)
FRANCISCAN HEALTH SYSTEM
1717 SOUTH J STTACOMAWA98405910564491HEALTHCAREWA501(c)(33CHIYes (true)
FRANCISCAN HEALTH VENTURES FKA SJMGROUP
TACOMA FNC CTR BLDG 1145 BROADWAYTACOMAWA98402431882377PHYSICIANSMO501(c)(39CHIYes (true)
FRANCISCAN LIVING COMMUNITIES
5942 RENAISSANCE PLACE STE ATOLEDOOH43623341892096HEALTHCAREOH501(c)(3Type ISFHYes (true)
FRANCISCAN MEDICAL GROUP
1313 BROADWAY STE 200TACOMAWA98402911939739HEALTHCAREWA501(c)(39FHSYes (true)
FRANCISCAN VILLA OF SOUTH MILWAUKEE INC
3601 S CHICAGO AVESOUTH MILWAUKEEWI53172391093829HEALTHCAREWI501(c)(39CHIYes (true)
GARRISON MEMORIAL HOSPITAL
407 THIRD AVENUE SOUTHEASTGARRISONND58540450227752HEALTHCAREND501(c)(33SAMCYes (true)
GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WESTENGLEWOODCO80112201536108MINISTRIESCO501(c)(3Type ICHIYes (true)
GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE
619 OAK ST ACCOUNTING-3 WCINCINNATIOH45206311778403EDUCATIONOH501(c)(32GSHYes (true)
GOOD SAMARITAN FOUNDATION OF CINCINNATI INC
619 OAK ST ACCOUNTING-3 WCINCINNATIOH45206311206047FUNDRAISINGOH501(c)(3Type IGSHYes (true)
GOOD SAMARITAN HOSPITAL
PO BOX 1990KEARNEYNE68848470379755HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
GOOD SAMARITAN HOSPITAL FOUNDATION
111 W 31ST STKEARNEYNE68847470659443FUNDRAISINGNE501(c)(37GSHYes (true)
GOOD SAMARITAN HOSPITAL FOUNDATION - DAYTON
110 N MAIN ST STE 500DAYTONOH45402237296923FUNDRAISINGOH501(c)(37SHPYes (true)
HARRISON MEDICAL CENTER
2520 CHERRY AVEBREMERTONWA98310910565546HEALTHCAREWA501(c)(33FHSYes (true)
HARRISON MEDICAL CENTER FOUNDATION
2520 CHERRY AVEBREMERTONWA98310911197626FUNDRAISINGWA501(c)(37HMCYes (true)
HEALTH SET
2420 W 26TH AVE STE 460DDENVERCO80211841102943LOW INC CARECO501(c)(37CHICYes (true)
HEALTHCARE AND WELLNESS FOUNDATION
2400 ST FRANCIS DRBRECKENRIDGEMN56520760761782FUNDRAISINGMN501(c)(3Type ISFMCYes (true)
HIGHLINE MEDICAL CENTER
16251 SYLVESTER RD SWBURIENWA98166910712166HEALTHCAREWA501(c)(33FHSYes (true)
HOUSE OF MERCY
1111 6TH AVEDES MOINESIA50314421323808SHELTERIA501(c)(37CHI-IA CORPYes (true)
JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202611029768HEALTHCAREKY501(c)(33KOHYes (true)
KENTUCKYONE HEALTH MEDICAL GROUP INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202611352729HEALTHCAREKY501(c)(39JHSMHYes (true)
KENTUCKYONE HEALTH INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202611029769HEALTHCAREKY501(c)(39CHIYes (true)
LAKEWOOD HEALTH CENTER
600 MAIN AVE SBAUDETTEMN56623410758434HEALTHCAREMN501(c)(33CHIYes (true)
LAKEWOOD REGIONAL HEALTHCARE FOUNDATION
600 MAIN AVE SBAUDETTEMN56623411893795FUNDRAISINGND501(c)(37LHCYes (true)
LINUS OAKES INC
2700 STEWART PKWYROSEBURGOR97471930821381SENIOR LIVINGOR501(c)(39MMCYes (true)
LISBON AREA HEALTH SERVICES
905 MAIN STLISBONND58054820558836HEALTHCAREND501(c)(33CHIYes (true)
LUFKIN VISION ACQUISITIONS
PO BOX 1447LUFKINTX75901820563768PROPERTY MGMTTX501(c)(3Type III-FIMHSETYes (true)
MADISON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802742761145HEALTHCARETX501(c)(33SJSCYes (true)
MADONNA MANOR INC
2344 AMSTERDAM ROADVILLA HILLSKY51017610654635LIVING ASSISTKY501(c)(31FLCYes (true)
MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC
2525 DE SALES AVECHATTANOOGATN37404621839548FUNDRAISINGTN501(c)(37MHCSYes (true)
MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVECHATTANOOGATN37404620532345HEALTHCARETN501(c)(33CHIYes (true)
MEMORIAL HEALTH PARTNERS FOUNDATION INC
5600 BRAINERD RD STE 500CHATTANOOGATN37411030417049HEALTHCARETN501(c)(39MHCSYes (true)
MEMORIAL HEALTH SYSTEM OF EAST TEXAS
PO BOX 1447LUFKINTX75902750755367HEALTHCARETX501(c)(33CHIYes (true)
MEMORIAL MEDICAL CENTER - LIVINGSTON
PO BOX 1447LUFKINTX75902760436439HEALTHCARETX501(c)(33MHSETYes (true)
MEMORIAL MEDICAL CENTER - SAN AUGUSTINE
PO BOX 1447LUFKINTX75902752663904HEALTHCARETX501(c)(33MHSETYes (true)
MEMORIAL MULTISPECIALTY ASSOCIATES
1201 FRANK AVELUFKINTX95904752721155PHYSICIANSTX501(c)(3Type III-FIMHSETYes (true)
MEMORIAL SPECIALTY HOSPITAL
PO BOX 1447LUFKINTX95902752492741HEALTHCARETX501(c)(33MHSETYes (true)
MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVEDES MOINESIA50314426076069AUXILIARYIA501(c)(3Type IMF-DM IAYes (true)
MERCY CLINICS INC
1111 6TH AVEDES MOINESIA50314421193699PHYSICIANSIA501(c)(39CHI-IA CORPYes (true)
MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVEDES MOINESIA50314421511682EDUCATIONIA501(c)(32CHI-IA CORPYes (true)
MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVEDES MOINESIA50314237358794FUNDRAISINGIA501(c)(37CHI-IA CORPYes (true)
MERCY FOUNDATION INC
2700 STEWART PKWYROSEBURGOR97471936088946FUNDRAISINGOR501(c)(37MMCYes (true)
MERCY HEALTH CARE FOUNDATION
PO BOX 368CORNINGIA50841421461064FUNDRAISINGIA501(c)(3Type IAHMH-CorningYes (true)
MERCY HEALTHCARE FOUNDATION
570 CHAUTAUQUA BLVDVALLEY CITYND58072450435338FUNDRAISINGND501(c)(3Type IMHVCYes (true)
MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DRCOUNCIL BLUFFSIA51503421178204FUNDRAISINGIA501(c)(3Type IAHBMHSYes (true)
MERCY HOSPITAL OF DEVILS LAKE
1031 7TH ST NEDEVILS LAKEND58301450227012HEALTHCAREND501(c)(33CHIYes (true)
MERCY HOSPITAL OF DEVILS LAKE FOUNDATION
1031 7TH ST NEDEVILS LAKEND58301352367360FUNDRAISINGND501(c)(37MHDLYes (true)
MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BLVDVALLEY CITYND58072450226553HEALTHCAREND501(c)(33CHIYes (true)
MERCY MEDICAL CENTER
1301 15TH AVE WESTWILLISTONND58801450231183HEALTHCAREND501(c)(33CHIYes (true)
MERCY MEDICAL CENTER - CENTERVILLE
ONE ST JOSEPHS DRIVECENTERVILLEIA52544420680308HEALTHCAREIA501(c)(33CHI-IA CORPYes (true)
MERCY MEDICAL CENTER INC
2700 STEWART PKWYROSEBURGOR97471930386868HEALTHCAREOR501(c)(33CHIYes (true)
MERCY MEDICAL FOUNDATION
1301 15TH AVE WESTWILLISTONND58801450381803FUNDRAISINGND501(c)(3Type IMMCYes (true)
MERCY PROFESSIONAL PRACTICE ASSOCIATES INC
1111 6TH AVEDES MOINESIA50314421470935PHYSICIANSIA501(c)(39CHI-IA CORPYes (true)
NEBRASKA HEART HOSPITAL
7500 S 91ST STLINCOLNNE68526392031968HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
NORTH CENTRAL HEALTH CARE ALLIANCE DBA PRIMECARE HEALTH GROUP
401 N 9th StBISMARCKND585014507450439894HEALTHCAREND501(c)(39NHCAYes (true)
OAKES COMMUNITY HOSPITAL
1200 N 7TH STOAKESND58474450231675HEALTHCAREND501(c)(33CHIYes (true)
OAKES COMMUNITY HOSPITAL FOUNDATION
1200 N 7TH STOAKESND58474710966606FUNDRAISINGND501(c)(3Type IOCHYes (true)
PINEYWOODS MEDICAL DEVELOPMENT CORP
PO BOX 1447LUFKINTX75902752493116PROPERTY MGMTTX501(c)(3Type III-FIMHSETYes (true)
PROVIDENCE CARE CENTER
2025 HAYES AVENUESANDUSKYOH44870341658625HEALTHCAREOH501(c)(39FLCYes (true)
PROVIDENCE CARE CENTERS
2025 HAYES AVENUESANDUSKYOH44870341826099HOLDING COOH501(c)(3Type IIFLCYes (true)
PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION
5055 PROVIDENCE DRIVESANDUSKYOH44870341896807LIVING COMMOH501(c)(39FLCYes (true)
PUEBLO STEPUP
1925 E ORMAN AVE STE G52PUEBLOCO81004841234295COMMUNITYCO501(c)(37CHICYes (true)
REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE
12844 MILITARY RD STUKWILAWA98168911170040HEALTHCAREWA501(c)(33FHSYes (true)
SET OF COLORADO SPRINGS INC
2864 S CIRCLE DR STE 450COLORADO SPRINGSCO80906841183335LTERM CARECO501(c)(37CHICYes (true)
SAINT CLARE'S COMMUNITY CARE INC
25 POCONO RDDENVILLENJ07834222876836HEALTHCARENJ501(c)(3Type IISCHSYes (true)
SAINT CLARE'S FOUNDATION INC
25 POCONO RDDENVILLENJ07834222502997FUNDRAISINGNJ501(c)(37SCHSYes (true)
SAINT CLARE'S HEALTH SERVICES INC
25 POCONO RDDENVILLENJ07834223639733MANAGEMENTNJ501(c)(3Type IICHIYes (true)
SAINT CLARE'S HOSPITAL INC
25 POCONO RDDENVILLENJ07834223319886HEALTHCARENJ501(c)(33SCHSYes (true)
SAINT ELIZABETH FOUNDATION
555 S 70TH STLINCOLNNE68510470625523FUNDRAISINGNE501(c)(37SERMCYes (true)
SAINT ELIZABETH HEALTH SERVICES
555 S 70TH STLINCOLNNE68510363233120HEALTHCARENE501(c)(33SERMCYes (true)
SAINT ELIZABETH REGIONAL MEDICAL CENTER
555 S 70TH STLINCOLNNE68510470379836HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
SAINT FRANCIS MEDICAL CENTER
2620 W FAIDLEYGRAND ISLANDNE68803470376601HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
SAINT FRANCIS MEDICAL CENTER FOUNDATION
PO BOX 9804GRAND ISLANDNE68802470630267FUNDRAISINGNE501(c)(37SFMCYes (true)
SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC
305 ESTILL STBEREAKY40403260152877FUNDRAISINGKY501(c)(37SJHSYes (true)
SAINT JOSEPH HEALTH SYSTEM INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202611334601HEALTHCAREKY501(c)(33KOHYes (true)
SAINT JOSEPH HOSPITAL FOUNDATION INC
ONE SAINT JOSEPH DRIVELEXINGTONKY40504611159649FUNDRAISINGKY501(c)(3Type ISJHSYes (true)
SAINT JOSEPH LONDON FOUNDATION INC
1001 SAINT JOSEPH LANELONDONKY40741260438748FUNDRAISINGKY501(c)(37SJHSYes (true)
SAINT JOSEPH MOUNT STERLING FOUNDATION INC
225 FALCON DRMOUNT STERLINGKY40353272884584FUNDRAISINGKY501(c)(37SJHSYes (true)
SAINT JOSEPH'S HOSPITAL FOUNDATION
30 WEST 7TH STDICKINSONND58601363418207FUNDRAISINGND501(c)(3Type ISJHHCYes (true)
SAMARITAN BEHAVIORAL HEALTH INC
601 S EDWIN C MOSES BLVDDAYTONOH45417020633634HEALTHCAREOH501(c)(37SHPYes (true)
SAMARITAN HEALTH PARTNERS
110 N MAIN ST STE 500DAYTONOH45402311107411HEALTHCAREOH501(c)(3Type ICHIYes (true)
SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC
104 W 17TH STSCHUYLERNE68661363630014FUNDRAISINGNE501(c)(3Type IAHMHSYes (true)
SJRMC JOPLIN MISSOURI
198 INVERNESS DRIVE WESTENGLEWOODCO80112440545809HEALTHCAREMO501(c)(33CHIYes (true)
SL AUGUSTA CORP
PO BOX 20269HOUSTONTX77225760226623TITLE HOLDINGTX501(c)(2SLPCYes (true)
ST ALEXIUS MEDICAL CENTER
900 EAST BROADWAY AVENUEBISMARCKND58501450226711HEALTHCAREND501(c)(33CHIYes (true)
ST ANTHONY HOSPITAL
1601 SE COURT AVEPENDLETONOR97801930391614HEALTHCAREOR501(c)(33CHIYes (true)
ST ANTHONY HOSPITAL FOUNDATION
1601 SE COURT AVEPENDLETONOR97801930992727FUNDRAISINGOR501(c)(3Type ISAHYes (true)
ST ANTHONY'S HOSPITAL ASSOCIATION
FOUR HOSPITAL DRMORRILTONAR72110710245507HEALTHCAREAR501(c)(33SVIMCYes (true)
ST CATHERINE HOSPITAL
401 EAST SPRUCE STGARDEN CITYKS67846480543721HEALTHCAREKS501(c)(33CHIYes (true)
ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION
401 EAST SPRUCE STGARDEN CITYKS67846200598702FUNDRAISINGKS501(c)(3Type ISCHYes (true)
ST CLARE COMMONS
5942 RENAISSANCE PLACE STE ATOLEDOOH43623270163752LIVING COMMOH501(c)(39FLCYes (true)
ST DOMINIC OF ONTARIO OREGON
198 INVERNESS DRIVE WESTENGLEWOODCO80112930433692HEALTHCAREOR501(c)(4CHIYes (true)
ST FRANCIS HOME
2400 ST FRANCIS DRBRECKENRIDGEMN56520410729978LTERM CAREMN501(c)(39CHIYes (true)
ST FRANCIS LIFE CARE CORPORATION
19 POCONO RDDENVILLENJ07834222536017ELDERLY CARENJ501(c)(39SCHSYes (true)
ST FRANCIS MEDICAL CENTER
2400 ST FRANCIS DRBRECKENRIDGEMN56520410695598HEALTHCAREMN501(c)(33CHIYes (true)
ST FRANCIS OF BAKER CITY
198 INVERNESS DRIVE WESTENGLEWOODCO80112930412495HEALTHCAREOR501(c)(33CHIYes (true)
ST JOSEPH FOUNDATION OF BRYAN TEXAS
2801 FRANCISCAN DRIVEBRYANTX77802742351158FUNDRAISINGTX501(c)(3Type ISJSCYes (true)
ST JOSEPH HEALTH MINISTRIES
1929 LINCOLN HWY E STE 150LANCASTERPA17602232342997HEALTHCAREPA501(c)(3Type ICHIYes (true)
ST JOSEPH MANOR
2801 FRANCISCAN DRIVEBRYANTX77802742847594HEALTHCARETX501(c)(39SJSCYes (true)
ST JOSEPH MEDICAL CENTER FOUNDATION
2500 BERNVILLE RD PO BOX 316READINGPA19603232649362FUNDRAISINGPA501(c)(3Type ISJRHNYes (true)
ST JOSEPH MEDICAL CENTER INC
201 INTERNATIONAL CIRCLE STE 212HUNT VALLEYMD21030520591461HEALTHCAREMD501(c)(33CHIYes (true)
ST JOSEPH MEDICAL GROUP
2500 BERNVILLE RD PO BOX 316READINGPA19603208544021HEALTHCAREPA501(c)(39BHCYes (true)
ST JOSEPH PHYSICIAN ASSOCIATES
2801 FRANCISCAN DRIVEBRYANTX77802203159302HEALTHCARETX501(c)(33SJSCYes (true)
ST JOSEPH PHYSICIAN ENTERPRISE INC
201 INTERNATIONAL CIRCLE STE 212HUNT VALLEYMD21030521311775PHYSICIANSMD501(c)(3Type ISJMCYes (true)
ST JOSEPH REGIONAL HEALTH CENTER
2801 FRANCISCAN DRIVEBRYANTX77802741282696HEALTHCARETX501(c)(33SJSCYes (true)
ST JOSEPH REGIONAL HEALTH NETWORK
2500 BERNVILLE RD PO BOX 316READINGPA19603231352211HEALTHCAREPA501(c)(33CHIYes (true)
ST JOSEPH REGIONAL HEALTH PARTNERS
2801 FRANCISCAN DRIVEBRYANTX77802454088170HEALTHCARETX501(c)(33SJSCYes (true)
ST JOSEPH REGIONAL HEALTH PARTNERS ACO
2801 FRANCISCAN DRIVEBRYANTX77802463265423HEALTHCARETX501(c)(33SJSCYes (true)
ST JOSEPH SERVICES CORPORATION
2801 FRANCISCAN DRIVEBRYANTX77802742455161MANAGEMENTTX501(c)(3Type ISFHYes (true)
ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVEPARK RAPIDSMN56470410695603HEALTHCAREMN501(c)(33CHIYes (true)
ST JOSEPH'S HOSPITAL AND HEALTH CENTER
30 WEST 7TH STDICKINSONND58601450226429HEALTHCAREND501(c)(33CHIYes (true)
ST LEONARD
8100 CLYO ROADCENTERVILLEOH45458341940863LIVING COMMOH501(c)(39FLCYes (true)
ST LEONARD FOUNDATION
8100 CLYO ROADCENTERVILLEOH45458320102715FUNDRAISINGOH501(c)(37SLEOYes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION
6624 FANNIN ST STE 2505HOUSTONTX77030260274448MANAGEMENTTX501(c)(3Type ISLHSYes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC
6624 FANNIN ST STE 2505HOUSTONTX77030273733278HEALTHCARETX501(c)(33SLCDCYes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND
6624 FANNIN ST STE 2505HOUSTONTX77030261947374HEALTHCARETX501(c)(33SLHSYes (true)
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS
6624 FANNIN ST STE 2505HOUSTONTX77030260335902HEALTHCARETX501(c)(33SLCDCYes (true)
ST LUKE'S COMMUNITY HEALTH SERVICES
6624 FANNIN ST STE 1100HOUSTONTX77030760536234HEALTHCARETX501(c)(33SLHSYes (true)
ST LUKE'S FOUNDATION
1213 HERMANN DRIVE STE 855HOUSTONTX77004453811485FUNDRAISINGTX501(c)(37SLHSYes (true)
ST LUKE'S HEALTH SYSTEM CORPORATION
6624 FANNIN ST STE 1100HOUSTONTX77030760536232MANAGEMENTTX501(c)(3Type ICHIYes (true)
ST LUKE'S HOSPITAL AT THE VINTAGE
6624 FANNIN ST STE 2505HOUSTONTX77030263734606HEALTHCARETX501(c)(33SLHSYes (true)
ST LUKE'S MEDICAL GROUP
6624 FANNIN STHOUSTONTX77030760458535PHYSICIANSTX501(c)(33SLHSYes (true)
ST LUKE'S MEDICAL TOWER CORPORATION
6624 FANNIN ST STE 1100HOUSTONTX77030760531713PROPERTY MGMTTX501(c)(3Type ICHI-SLHYes (true)
ST LUKE'S PROPERTIES CORPORATION
6624 FANNIN ST STE 1100HOUSTONTX77030760531716PROPERTY MGMTTX501(c)(3Type ISLHSYes (true)
ST LUKE'S SUGAR LAND PROPERTIES CORPORATION
6624 FANNIN ST STE 2505HOUSTONTX77030454120549PROPERTY MGMTTX501(c)(3Type ISLCDC-SLYes (true)
ST MARY'S COMMUNITY HOSPITAL
1314 3RD AVENEBRASKA CITYNE68410470443636HEALTHCARENE501(c)(33CHI NEBRASKAYes (true)
ST MARY'S HOSPITAL FOUNDATION
1314 3RD AVENEBRASKA CITYNE68410470707604FUNDRAISINGNE501(c)(37SMCHYes (true)
ST VINCENT FOUNDATION
TWO ST VINCENT CIRCLELITTLE ROCKAR72205510169537FUNDRAISINGAR501(c)(3Type ISVIMCYes (true)
ST VINCENT INFIRMARY MEDICAL CENTER
TWO ST VINCENT CIRCLELITTLE ROCKAR72205710236917HEALTHCAREAR501(c)(33CHIYes (true)
ST VINCENT MEDICAL GROUP
TWO ST VINCENT CIRCLELITTLE ROCKAR72205710830696HEALTHCAREAR501(c)(39SVIMCYes (true)
SYLVANIA FRANCISCAN HEALTH
1715 INDIAN WOOD CIR 200MAUMEEOH43537341412964HEALTHCAREOH501(c)(3Type ICHIYes (true)
SYLVANIA FRANCISCAN HEALTH FOUNDATION
1715 INDIAN WOOD CIR 200MAUMEEOH43537455357161FUNDRAISINGOH501(c)(3Type IFLCYes (true)
THE COMMONS OF PROVIDENCE
5000 PROVIDENCE DRIVESANDUSKYOH44870341826097ASSIST LIVINGOH501(c)(39FLCYes (true)
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH
619 OAK ST ACCOUNTING-3 WCINCINNATIOH45206310537486HEALTHCAREOH501(c)(33CHIYes (true)
THE PHYSICIAN NETWORK
2000 Q ST STE 500LINCOLNNE68503470780857PHYSICIANSNE501(c)(3Type ICHI NEBRASKAYes (true)
TOTAL HEALTHCARE
188 INVERNESS DRIVE WEST STE 500ENGLEWOODCO80112840927232HEALTHCARECO501(c)(33CHICYes (true)
TRINITY HOSPITAL TWIN CITY
819 NORTH FIRST STREETDENNISONOH44621275401105HEALTHCAREOH501(c)(33SFHYes (true)
UNITY FAMILY HEALTHCARE
815 SE 2ND STLITTLE FALLSMN56345410721642HEALTHCAREMN501(c)(33CHIYes (true)
VILLA NAZARETH INC
801 PAGE DRFARGOND58103450226714LTERM CAREND501(c)(39CHIYes (true)
VISITING NURSE ASSOCIATION OF ST CLARE'S INC
191 WOODPORT RDSPARTANJ07871221768334HOME HEALTHNJ501(c)(39SCHSYes (true)
WOODLANDS DOCTOR GROUP
17200 ST LUKES WAY STE 170THE WOODLANDSTX77384274499340PHYSICIANSTX501(c)(39SLCHSYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (41 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndUBI Code VUBICodeVAmtGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
Alegent Health Northwest Imaging Center LLC
3606 N 156th StOMAHANE68116061786985OP DiagnosticsNEACHRelated-$147,872$429,431false$0Yes (true)0.51
Audubon Ambulatory Surgery Center LLC
3030 North Circle DrCOLORADO SPRINGSCO80909841482638AMBUL SURG CTRCOCHICRelated$3,069,333$3,517,273false$0Yes (true)0.561
Audubon Land Company LLC
5390 N Academy Blvd STE 300COLORADO SPRINGSCO80918841513085Real EstateCOCHICRelated$116,620$10,842,022false$0false0.694
AVANTAS LLC
11128 JOHN GALT BLVD STE 400OMAHANE68137392045003Staffing of NursesNEAHBMHSRelated$270,464$4,883,491false-$449,169false0.95
BERGAN MERCY SURGERY CENTER LLC
7710 Mercy Rd Ste 200OMAHANE68124208671994AMBUL SURG CTRNEACHRelated$262,283$2,676,707false$0false0.6357
BERYWOOD OFFICE PROPERTIES LLC
400 BERYWOOD TRAILCLEVELANDTN37312621875199PHYS OFFICETNMHCSRelated$77,646$976,529false$0Yes (true)0.63
BLUEGRASS REGIONAL IMAGING CENTER
1218 SOUTH BROADWAY STE 310LEXINGTONKY40504611386736DIAGNOSTIC IMAGINGKYSJHSRelated$216,144$3,219,211false$0false0.65
CATHOLIC HEALTH INITIATIVES PHYSICIAN SERVICES LLC
198 INVERNESS DRIVE WESTENGLEWOODCO80112462945938PRACTICE MGMT SRVCDECHIRelated-$572,398$4,681,573false$0Yes (true)0.8
CENTRAL NEBRASKA HOME CARE SERVICES
PO BOX 1146 4502 N SECOND AVEKEARNEYNE68848470692112HEALTHCARE SRVCNEnaRelated-$49,959$152,789false-$22,980Yes (true)1
CENTRAL NEBRASKA REHABILITATION SERVICES LLC
3004 W FAIDLEY AVENUEGRAND ISLANDNE68803810653461Physical TherapyNESFMCRelated$2,441,607$3,412,341false$0false0.51
CHI OPERATING INVESTMENT PROGRAM LP
198 INVERNESS DRIVE WESTENGLEWOODCO80112470727942INVESTMENTSCOCHIUnrelated$0$0false$0Yes (true)1
CHICAMSURG Surgery Centers LLC
188 INVERNESS DRIVE WEST 500ENGLEWOODCO80112465683027SURGERY CENTERCOCHICRelated$0$0false$0false0.51
CHICLARKIN VENTURES LLC
188 INVERNESS DRIVE WEST 500ENGLEWOODCO80112474210888URGENT CARECOCHICRelated$0$0false$0Yes (true)0.87
Colorado Springs CK Leasing LLC
8770 W Bryn Mawr Ste 1370CHICAGOIL60631262982714REAL ESTATECOCHIRelated$120,659$1,039,682false$0Yes (true)0.66
HC SL VINTAGE I LLC
18000 W SARAH LANE STE 250BROOKFIELDWI53045270453767PROPERTY HOLDINGWISL HOSP-VINTAGERelated$1,365,254$55,596,761false$0false0.51
HEALTHCARE SUPPORT SERVICES LLC
PO BOX 9804GRAND ISLANDNE68802721546196LAUNDRYNEnaRelated$317,516$3,231,655false$98,557false1
Heartland Oncology LLC
2337 E Crawford StSalinaKS67401464265403ONCOLOGYKSSCHRelated$0$0false$0false0.51
HIGHLINE IMAGING LLC
PO BOX 184BRUSH PRAIRIEWA98606200460005DIAGNOSTIC IMAGINGWAHMCRelated$65,074$1,408,012false$0false0.8
LAKESIDE AMBULATORY SURGICAL CENTER LLC
17031 LAKESIDE HILLS DROMAHANE68130204267902AMBUL SURG CTRNEACHRelated$3,533,817$1,380,299false$0false0.5393
LAKESIDE ENDOSCOPY CENTER LLC
17001 LAKESIDE HILLS PLZ STE 201OMAHANE68130205544496ENDOSCOPY SRVCNEACHRelated$1,590,148$895,940false$0false0.5096
LINCOLN CK LEASING LLC
6003 Old Cheney RdLincolnNE68516262496856Real EstateNESERMCRelated$488,450$230,998false$0false0.5376
NEBRASKA SPINE HOSPITAL LLC
6901 N 72ND STOMAHANE68122270263191SPINE HOSPITALNEACHRelated$13,895,341$16,839,322false$0false0.51
NORTH RIVER SURGERY CENTER LLC
2209 WILDWOOD AVESHERWOODAR72120710799771AMBUL SURG CTRARSVIMCRelated$141,898$0false$0false0.5745
ORTHOCOLORADO LLC
11650 WEST 2ND PLACELAKEWOODCO80255371577105ORTHO HOSPITALCOTHCRelated$9,103,000$2,202,895false$0false0.6
PENINSULA RADIATION ONCOLOGY LLC
314 MLK JR WAY STE 11TACOMAWA98405870808610HEALTHCARE SRVCWAFHSRelated$278,198$2,753,330false$0false0.6
Penrad Imaging
1390 Kelly Johnson BlvdCOLORADO SPRINGSCO80920841072619Medical ImagingCOCHICRelated-$9,742$2,091,440false$0false0.7
PMC HOSPITAL LLC
3100 MAIN ST STE 500HOUSTONTX77002273280598HOSPITALTXSL CDC-PMCRelated$5,287,747$67,411,280false$0Yes (true)0.51
PRAIRIE HEALTH VENTURES LLC
421 S 9TH ST STE 102LINCOLNNE68508204962103TECH SRVCNEAH-IMCRelated$0$0false$0Yes (true)0.6575
Pueblo Ambulatory Surgery Center LLC
188 INVERNESS DRIVE WEST 500ENGLEWOODCO80112621488737SURGERY CENTERCOCHICRelated$0$0false$0false0.51
Saint JOSEPH - PAML LLC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202452116736MGMT SVCSKYSJHSRelated$60,881$406,070false$0Yes (true)0.625
SAINT JOSEPH - SCA HOLDINGS LLC
1451 Harrodsburg RDLEXINGTONKY40503453801157OP SURGERYDESJHSRelated$0$0false$0Yes (true)0.51
SAINT JOSEPH-ANC HOME CARE SERVICES
1700 EDISON DRMILFORDOH45150263330545HOME HEALTHKYJHSMHRelated$7,722,504$1,056,144false$0false1
SCA Premier Surgery Center of Louisville LLC
200 Abraham Flexner WayLOUISVILLEKY40202721386840SURGERY CENTERKYJHSMHRelated-$177,796$2,205,015false$0false0.51
ST FRANCIS LAND COMPANY
5390 N ACADEMY BLVD STE 300COLORADO SPRINGSCO80918263134100REAL ESTATECOCHICRelated-$217,802$12,693,252false$0false0.51
ST FRANCIS MEDICAL CENTER ASSOCIATES
1717 SOUTH J STTACOMAWA98405911352698MED OFFICEWAFHSRelated$265,783$1,961,020false$0false0.6108
ST LUKE'S DIAGNOSTIC CATH LAB LLP
6624 FANNIN ST STE 800HOUSTONTX77030710959365DIAGNOSTICSTXSLHS HOLDINGSRelated$611,532$1,117,217false$0false0.6145
ST LUKE'S LAKESIDE HOSPITAL LLC
6624 FANNIN STE 2505HOUSTONTX77030300427437HOSPITALTXSL CDC-WRelated$277,867$42,485,184false$0Yes (true)0.51
ST LUKE'S THE WOODLANDS SLEEP CENTER LLC
6624 FANNIN STE 800HOUSTONTX77030462795726DIAGNOSTICSTXSLHSHRelated-$76,879$1,171,971false$0Yes (true)0.51
Superior Medical Imaging LLC
5000 North 26th STLINCOLNNE68521262884555OP DiagnosticsNESERMCRelated$0$0false$0Yes (true)0.51
SURGERY CENTER OF LEXINGTON LLC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202621179539SURGERY CENTERKYSJHSRelated$187,315$2,777,419false$0Yes (true)0.51
SURGERY CENTER OF LOUISVILLE LLC
200 Abraham Flexner WayLOUISVILLEKY40202621179537SURGERY CENTERKYJHSMHRelated$11,207$803,899false$0Yes (true)0.51

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (62 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCdBusiness Name Line2RelatedOrganizationName/BusinessNameLine2Txt
Alegent HealthCreighton St Joseph Managed Care Services Inc
12809 West Dodge RdOmahaNE68154470802396Managed CareNECHI NebraskaC Corporation-$3,506,547$6,404,8771Yes (true)
All Saints Insurance Company SPC Ltd
InsuranceCHIC Corporation$0$01Yes (true)PO BOX 10073 APOGeorgetownGRAND CAYMANCJKY11001CJ
ALLIANCE HEALTH PROVIDERS OF BRAZOS
2801 FRACNISCAN DRIVEBRYANTX77802742466914HealthcareTXSJSCC Corporation$204,115$535,1651Yes (true)
Alternative Insurance Management Service Inc
3900 OLYMPIC BLVD STE 400ErlangerKY41018841112049Management ServicesCOCHIC Corporation$7,902$6,274,9931Yes (true)
AMERICAN NURSING CARE Inc
1700 EDISON DRMILFORDOH45150311085414HOME HEALTHOHCHSC Corporation$0$01Yes (true)
AMERIMED INC
1700 EDISON DRMILFORDOH45150311158699HOME HEALTHOHANCC Corporation$0$01Yes (true)
BC HOLDING COMPANY INC
1850 BLUEGRASS AVELOUISVILLEKY40215311542851Fitness ClubKYJHSMHC Corporation$0$01Yes (true)
Caduceus Medical Associates INC
5600 Brainerd Road Ste 500ChattanoogaTN37411621570736HealthcareTNMHCSC Corporation$0$1,0081Yes (true)
Captive Management Initiatives Ltd
980663022Captive ManagementCHIC Corporation$38,500$164,4551Yes (true)PO BOX 10073 APOGeorgetownGRAND CAYMANCJKY11001CJ
Carmona-DeSoto Building Horizontal Property Regime Inc
300 Werner StHot SpringsAR71913710771076HealthcareARCHI-SVHSC Corporation$0$01Yes (true)
Catholic Health Initiatives Center for Translational Research
198 INVERNESS DRIVE WESTEnglewoodCO80112272269511ResearchCOCIRITrust$207$1,241,2591Yes (true)
CGH REALTY COMPANY INC
2500 Bernville RdReadingPA19603232326801Real EstatePASJHMC Corporation$9,432$57,0961Yes (true)
CHI St Luke's Health Baylor College of Medicine Medical Center Condominium
6624 Fannin STE 1100HoustonTX77030465079545Condo AssocTXCHI-SLHBCMC Corporation$0$01Yes (true)Assoc
ClearRiver Health
198 INVERNESS DRIVE WESTEnglewoodCO80112464495960InsuranceTNPHPSIC Corporation$36,560$6,936,5591Yes (true)
Comcare Services Inc
5570 DTC ParkwayEnglewoodCO80111840904813InactiveCOCHICC Corporation$0$01Yes (true)
CONSOLIDATED HEALTH SERVICES
1700 EDISON DRMILFORDOH45150311378212HOME HEALTHOHCHIC Corporation$0$01Yes (true)
Des Moines Medical Center Inc
1111 6TH AVEDes MoinesIA50314420837382Real EstateIACHI-IA CorpC Corporation$66,600$1,084,1620.9298Yes (true)
East Texas Clinical Services Inc
2801 Via Fortuna 500AustinTX78746454736213HealthcareTXMHSETC Corporation$0$16,7821Yes (true)
First Initiatives Insurance LTD
980203038InsuranceCHIC Corporation$0$01Yes (true)PO BOX 10073 APOGeorgetownGRAND CAYMANCJKY11001CJ
Franciscan Services Inc
198 INVERNESS DRIVE WESTEnglewoodCO80112232487967HealthcareCOCHIC Corporation$0$11,732,0071Yes (true)
Good Samaritan Outreach Services
PO Box 1990KearneyNE68848470659440Medical ClinicNECHI NebraskaC Corporation$0$01Yes (true)
Health Systems Enterprises Inc
1700 EDISON DRMILFORDOH45150470664558MGMTNEGSHC Corporation$117,378$1,101,8451Yes (true)
Healthcare MGMT Services Organization INC
1149 MARKET STTacomaWA98402911865474Health Org.WAFHSC Corporation$0$01Yes (true)
HeartlandPlains Health
198 INVERNESS DRIVE WESTEnglewoodCO80112464368223InsuranceNEPHPSIC Corporation$16,717$3,317,2191Yes (true)
Highline Medical Group
15811 AMBUAN Blvd SW STE ABurienWA98166911407026Medical ServicesWAHMCC Corporation$4,004,636$7,896,7931Yes (true)
Medquest
1301 15TH AVENUE WESTWillistonND58801450392137Sale of DMENDMMC WillistonC Corporation$680,617$2,138,6551Yes (true)
Mercy Park Apartments LTD
1111 6th AVEDes MoinesIA50314421202422HousingIACHI-IA CorpC Corporation$1,871,589$2,272,5981Yes (true)
Mercy Services Corp
2700 STEWART PARKWAYRoseburgOR97471930824308Retail SalesORMMCC Corporation$2,365,469$1,363,6821Yes (true)
MHI Clinical Services
1201 W Frank AveLufkinTX75904461967952HealthcareTXMHSETC Corporation$0$01Yes (true)
Mountain Management Services Inc
6028 Shallowford RdChattanoogaTN37421621570739MGMT SVC ORGTNMHCSC Corporation$30,454,753$7,395,2651Yes (true)
Nazareth Assurance Company
030304831InsuranceCHIC Corporation$0$01Yes (true)PO BOX 10073 APOGeorgetownGRAND CAYMANCJKY11001CJ
PATIENT TRANSPORT SERVICES INC
1700 EDISON DRMILFORDOH45150311100798HOME HEALTHOHANCC Corporation$0$01Yes (true)
PhysicianHealth System Network
1149 MARKET STTacomaWA98402911746721Health Org.WAFHSC Corporation$0$01Yes (true)
Prominence Health Plan Services Inc (fka CollabHealth Plan Services Inc)
198 INVERNESS DRIVE WESTEnglewoodCO80112461224037Admin ServicesCOPHIC Corporation$5,403,442$38,272,6071Yes (true)
Prominence Health Inc (fka CollabHealth Managed Solutions Inc)
198 INVERNESS DRIVE WESTEnglewoodCO80112461222808Holding CoCOCHIC Corporation$0$23,806,7071Yes (true)
QCA Health Plan Inc
12615 Chenal Parkway STE 300Little RockAR72211710794605InsuranceARQCHIC Corporation$0$64,017,2781Yes (true)
QualChoice Holdings Inc
12615 Chenal Parkway STE 300Little RockAR72211274075520Holding CoARPHPSC Corporation$0$10,1901Yes (true)
QualChoice Life and Health Insurance Company Inc
12615 Chenal Parkway STE 300Little RockAR72211710386640InsuranceARQCHC Corporation$0$7,484,4801Yes (true)
RiverLink Health
198 INVERNESS DRIVE WESTEnglewoodCO80112464380824InsuranceOHPHPSC Corporation$18,330$3,418,3301Yes (true)
RiverLink Health of Kentucky Inc
198 INVERNESS DRIVE WESTEnglewoodCO80112464828332InsuranceKYPHPSC Corporation$28,342$5,528,6761Yes (true)
Saint Clare's Primary Care Inc
66 FORD RDDenvilleNJ07834222441202Billing ServicesNJSCCCC Corporation$1,080,457$1,584,9581Yes (true)
SAMARITAN FAMILY CARE INC
40 W FOURTH ST STE 1700DaytonOH45402311299450HealthcareOHSHPC Corporation$0$01Yes (true)
SFH ASSURANCE LTD
981056892InsuranceSFHC Corporation$0$01Yes (true)PO BOX 10073 APOGeorgetownGRAND CAYMANCJKY11001CJ
SJH Services Corporation
198 INVERNESS DRIVE WESTEnglewoodCO80112232307408HealthcareCOFSIC Corporation$0$01Yes (true)
SJL PHYSICIAN MANAGEMENT SERVICES INC
200 Abraham Flexner WayLouisvilleKY40202270164198MgmtKYSJHSC Corporation$51,739$01Yes (true)
SLMT Parking Inc
6624 Fannin STE 800HoustonTX77030760637140ParkingTXSLHSC Corporation$3,907,811$14,848,1621Yes (true)
SoundPath Health Inc
32129 Weyerhaeuser Way S STE 201Federal WayWA98001421720801InsuranceWAPHPSC Corporation$152,264,069$31,407,6751Yes (true)
St Alexius Health Services Inc
900 East Broadway AvenueBismarckND58501450402812HealthcareNDSAMCC Corporation$0$1,2631Yes (true)
St Anthony Development Company
1415 SouthgatePendletonOR97801931216943Athletic ClubORSAHC Corporation$1,570,570$2,201,4731Yes (true)
St Joseph Development Company Inc
1717 SOUTH J STTacomaWA98405911480569RentalWAFSIC Corporation$0$01Yes (true)
ST JOSEPH OFFICE PARK ASSOCIATION
1451 HARRODSBURG RD STE D202LexingtonKY40504611079899MgmtKYSJHSC Corporation$0$00.85Yes (true)
St Luke's 6620 Main Condominium Association
6624 Fannin STE 1100HoustonTX77030300355517Condo AssocTXSLPCC Corporation$0$01Yes (true)
St Luke's Anesthesiology Associates
6624 Fannin STE 1100HoustonTX77030461517163Medical ClinicTXCHI-SLHC Corporation$4,178,843$2,295,4691Yes (true)
St Luke's Episcopal Hospital Physician Hospital Organization Inc
6720 Bertner MC4-262HoustonTX77030760377932PHOTXCHI-SLHC Corporation$550,615$00.6Yes (true)
St Luke's Health System Holdings Inc (fka SLEHS Holdings Inc)
6624 Fannin STE 800HoustonTX77030760637138Holding CoTXSLHSC Corporation$1,919,866$25,724,8021Yes (true)
St Luke's Medical Arts Center I Condominium Association
6624 Fannin STE 1100HoustonTX77030300355518Condo AssocTXSLPCC Corporation$0$01Yes (true)
St Luke's Medical Tower Condominium Association
6624 Fannin STE 1100HoustonTX77030760298751Condo AssocTXSLMTCC Corporation$0$01Yes (true)
St Vincent Community Health Services Inc
TWO ST VINCENT CIRCLELittle RockAR72205710710785HealthcareARSVIMCC Corporation$4,570,363$16,185,4311Yes (true)
StableView Health Inc
198 INVERNESS DRIVE WESTEnglewoodCO80112464373713InsuranceKYPHPSC Corporation$28,342$5,528,6761Yes (true)
Sugar Land Doctor Group
1317 Lake Point ParkwaySugar LandTX77478454270163Medical ClinicTXSLCDC-SLC Corporation$788,883$991,1341Yes (true)
The Texas Heart Institute at St Luke's Episcopal Hospital Denton A Cooley B
6624 Fannin STE 1100HoustonTX77030900064009Condo AssocTXCHI-SLHC Corporation$0$01Yes (true)uilding Comdominium Association
Towson Management Inc
7601 OSLER DRTowsonMD21204521710750Mgmt ServicesMDFSIC Corporation$0$01Yes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd