SAINT FRANCIS MEDICAL CENTER: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SAINT FRANCIS MEDICAL CENTER (EIN 47-0376601)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-13
IRS object ID
201411339349301621
Schema version
2012v2.1
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)
Timestamp2014-05-13T10:00:08-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN470617373EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CATHOLIC HEALTH INITIATIVESBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1198 INVERNESS DRIVE WESTAddressLine1
CityENGLEWOODCity
StateCOState
ZIP Code80112ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN470376601EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SAINT FRANCIS MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSAINNameControl
Phone3083985407Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12620 W FaidleyAddressLine1
CityGrand IslandCity
StateNEState
ZIP Code68803ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJEANETTE WOJTALEWICZName
TitleCHI NE CFOTitle
Date Signed2014-05-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NamePamela KrohnName
PTINP01210500PTIN
Phone3032989100Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1DAN MCELLIGOTTBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12620 W FaidleyAddressLine1
CityGrand IslandCity
StateNEState
ZIP Code68803ZIPCode
FieldValueIRS element (for citing)
Gross Receipts172280003GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.SAINTFRANCISGI.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1887YearFormation
State Legal DomicileNEStateLegalDomicile
Activity Or Mission DescriptionAN ACUTE CARE HOSPITAL PROVIDING ADVANCED DIAGNOSTIC AND MEDICAL TREATMENT SERVICES TO CENTRAL NEBRASKA. HONORING OUR CATHOLIC TRADITION, WE CARE FOR ALL IN NEED, REGARDLESS OF ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees1272TotalNbrEmployees
Total Nbr Volunteers461TotalNbrVolunteers
Total Gross UBI98371TotalGrossUBI
Net Unrelated Business Txbl Income-39550NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1546682ContributionsGrantsPriorYear
Contributions Grants Current Year1865020ContributionsGrantsCurrentYear
Program Service Revenue Prior Year157725943ProgramServiceRevenuePriorYear
Program Service Revenue CY157538024ProgramServiceRevenueCY
Investment Income Prior Year4937464InvestmentIncomePriorYear
Investment Income Current Year10496008InvestmentIncomeCurrentYear
Other Revenue Prior Year2202507OtherRevenuePriorYear
Other Revenue Current Year2162996OtherRevenueCurrentYear
Total Revenue Prior Year166412596TotalRevenuePriorYear
Total Revenue Current Year172062048TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year10490921GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY334866GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year53218164SalariesEtcPriorYear
Salaries Etc Current Year52600969SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year83630587OtherExpensePriorYear
Other Expenses Current Year99824388OtherExpensesCurrentYear
Total Expenses Prior Year147339672TotalExpensesPriorYear
Total Expenses Current Year152760223TotalExpensesCurrentYear
Revenues Less Expenses Prior Year19072924RevenuesLessExpensesPriorYear
Revenues Less Expenses CY19301825RevenuesLessExpensesCY
Total Assets BOY307478467TotalAssetsBOY
Total Assets EOY331558806TotalAssetsEOY
Total Liabilities BOY13066029TotalLiabilitiesBOY
Total Liabilities EOY12350474TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY294412438NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY319208332NetAssetsOrFundBalancesEOY
Mission DescriptionTHE ORGANIZATION'S MISSION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH BY BRINGING IT NEW LIFE, ENERGY AND VIABILITY IN THE 21ST CENTURY. FIDELITY TO THE GOSPEL URGES US TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS WE MOVE TOWARD THE CREATION OF HEALTHIER COMMUNITIES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense121467326Expense
Grants334866Grants
Revenue157493910Revenue
DescriptionSEE SCHEDULE HDescription
Total Program Service Expense121467326TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10965NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1272NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNEStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Jeanette WojtalewiczBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4023434671TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line112809 West Dodge RoadAddressLine1
CityOmahaCity
StateNEState
ZIP Code68154ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (34 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
DANIEL MCELLIGOTT
PRESIDENT/CEO40.001.00XX048026978255
DANIEL NARANJO
VICE CHAIRPERSON1.000XX000
JENNIFER BROWN MD
EX-OFFICIO1.000XX907700
SUSAN KOENIG
CHAIRPERSON1.000XX000
TERRY PFEIFER
TREASURER1.000XX000
CATHY ALLEN
Board Member1.000X000
DOUGLAS BOON MD
BOARD MEMBER1.000X000
ELLEN HORNADY
Board Member1.000X000
FATHER MICHAEL MCDERMOTT
BOARD MEMBER1.000X130000
KAREN RATHKE
BOARD MEMBER1.000X000
ROBERT LANIK
Board member/SERMC-PRESIDENT/CEO1.0059.00X0102425547149
SCOTT FRANKFORTER
BOARD MEMBER1.000X325000
SISTER NADINE HEIMANN
Board Member1.000X000
STEVE SCHNEIDER
BOARD MEMBER1.000X80000
TIM WOJCIK
BOARD MEMBER1.000X000
VINCENT HERNANDEZ
BOARD MEMBER1.000X000
GERALDINE ZRUST
SECRETARY40.000X54233017960
LISA THAVENET-WEBB
VP of FINANCE/CFO40.001.00X254864043878
DALE HARTWIG
VP of ANCILLARY SVCS40.000255125034389X
DONNA SANDERS
VP of Mission and Community Outreach0.0040.00015892826695X
FRANCINE SPARBY
VP of PATIENT CARE SERVICES40.000235644028428X
MICHAEL S HEIN
VP OF MEDICAL AFFAIRS40.000344134037983X
STEPHEN LEURCK
INTERIM VP MEDICAL AFFAIRS40.000.00311127225490X
BETH A BARTLETT
QUALITY & RISK MANAGMENT DIRECTOR40.000126767036111X
DAVID A CROSS
PHARMACIST40.000208073035161X
DOUGLAS W RICHLING
Director-Pharmacy40.000126259030184X
GREGORY S BALFANY
LEAN/SIX SIGMA PEF IMPRV DIR40.000146137035273X
ROBERT M NORVELL
DIRECTOR, ONCOLOGY SERVICES40.000129978034600X
CRAIG VINCENT
PHYSICIAN-ANESTHESIA0.0040.00038988141138X
JOSHUA GORTEMAKER
PHYSICIAN - ANESTHESIA040.00038522940398X
MEHMET COPUR
PHYSICIAN DIRECTOR-ONCOLOGY0.0060.00070172934944X
MICHAEL HORN
VP OF MEDICAL AFFAIRS0.00010859306741X
RYAN RAMAEKERS
PHYSICIAN - ONCOLOGY0.0040.00047094739172X
TRACI RAUCH
MED DIRECTOR-ANES0.0060.00045469837750X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2315361TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4088485TotalReportableCompFrmRltdOrgs
Total Other Compensation686210TotalOtherCompensation
Number Individuals GT100 K25NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
THE PHYSICIAN NETWORK
2000 Q STREET SUITE 500LINCOLNNE68503EE HEALTH/REV GUARANTEE/MED DIR FEE3505696
CENTRAL NEBRASKA REHABILITATION SVCS
3004 W FAIDLEY AVEGRAND ISLANDNE68802PHYSICAL THERAPY SERVICES3171407
GRAND ISLAND IMAGING CENTER
PO BOX 1962GRAND ISLANDNE688021962IMAGING SERVICES1667111
JOHNSON CONTROLS
5757 N GREEN BAY AVEMILWAUKEEWI532094408CONSTRUCTION901661
ALL ABOUT STAFFING INC
1000 SAWGRASS CORPORATE PKWYSUNRISEFL33323AGENCY LABOR553256
FieldValueIRS element (for citing)
Number Of Contractors GT100 K23NumberOfContractorsGT100K
Related Organizations1506899RelatedOrganizations
Government Grants308978GovernmentGrants
All Other Contributions49143AllOtherContributions
Total Contributions1865020TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICES900099150842082150842082
EQUITY CHANGES OF UNCONSOLIDATED ORGS9000996085865604175144114
RENTAL INCOME900099610077610077
0
0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue157538024TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4357696TotalRevenueColumn
Unrelated Business Revenue-1055UnrelatedBusinessRevenue
Exclusion$4,358,751ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real31875Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real27564Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real4311Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column4311TotalRevenueColumn
Exclusion$4,311ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities6045930Securities
Other101268Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other8886Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities6045930Securities
Other92382Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column6138312TotalRevenueColumn
Exclusion$6,138,312ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory172416GrossSalesOfInventory
Cost Of Goods Sold181505CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-9089TotalRevenueColumn
Exclusion-$9,089ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA722100858271$858,271
SERVICES SOLD900099415416$360,10455312
FINANCIAL SERVICES541200334572$334,572

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column559515TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$559,515ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2167774TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column172062048TotalRevenueColumn
Related Or Exempt Function Income157493910RelatedOrExemptFunctionIncome
Unrelated Business Revenue98371UnrelatedBusinessRevenue
Exclusion$12,604,747ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total334866Total
Program Services334866ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1503114Total
Management And General1503114ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total38115480Total
Program Services34746586ProgramServices
Management And General3368894ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2322359Total
Program Services2036772ProgramServices
Management And General285587ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7830107Total
Program Services6867217ProgramServices
Management And General962890ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2829909Total
Program Services2471417ProgramServices
Management And General358492ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total282672Total
Management And General282672ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total21725471Total
Program Services16711686ProgramServices
Management And General5013785ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total320060Total
Management And General320060ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4085318Total
Program Services3332259ProgramServices
Management And General753059ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total8494080Total
Program Services6005695ProgramServices
Management And General2488385ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2127597Total
Program Services1830434ProgramServices
Management And General297163ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total225683Total
Program Services147909ProgramServices
Management And General77774ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total26129Total
Program Services10425ProgramServices
Management And General15704ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total12723768Total
Management And General12723768ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total8626318Total
Program Services7072893ProgramServices
Management And General1553425ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total700576Total
Program Services700576ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES301643533012791336440
BAD DEBT5491040549102911
REPAIR & MAINTENANCE28432022482805360397
RECRUITMENT217783217783

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1770338Total
Program Services1096844ProgramServices
Management And General673494ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total152760223Total
Program Services121467326ProgramServices
Management And General31292897ManagementAndGeneral
Fundraising0Fundraising

Total Joint Costs TotalJointCosts

FieldValueIRS element (for citing)
Total0Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY70673BOY
EOY61364EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY8731016BOY
EOY6921367EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY21252390BOY
EOY18763312EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY50881EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY132622BOY
EOY84734EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1175114BOY
EOY1457931EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1528447BOY
EOY2201364EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis194449634LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec107385640LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY93335145BOY
EOY87063994EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY170455273BOY
EOY203898063EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY10797787BOY
EOY11055796EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY307478467BOY
EOY331558806EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY11214063BOY
EOY9240586EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY7455BOY
EOY7206EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1844511BOY
EOY3102682EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY13066029BOY
EOY12350474EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY293391107BOY
EOY318159229EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1021331BOY
EOY1049103EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY294412438BOY
EOY319208332EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY307478467BOY
EOY331558806EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses19301825ReconcilationRevenueExpenses
Reconciliation Unrealized Invest7445261ReconciliationUnrealizedInvest
Reconcilation Other Changes-1951192ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$14,334GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationstrueRalliesDemonstrations
Rallies Demonstrations$1,312RalliesDemonstrationsAmount
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB15646TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierDescription of the activities reported on Lines 1a through 1iIdentifier
Return ReferenceSchedule C, Part II-B, Line 1ReturnReference
ExplanationTHE PORTION OF ORGANZIATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: NEBRASKA HOSPITAL ASSOCIATION - $4,861; GRAND ISLAND AREA CHAMBER OF COMMERCE - $106; MORE GOOD JOBS FOR GRAND ISLAND - $5,000; NE CPA - $18; NABHO - $1,225; AONE - $22; TRAUMA CENTER ASSOC OF AMERICA - $580; AHA - $1,818; AND CHA - $705. TRAVEL EXPENSES FOR CFO TO ATTEND AHA CONGRESSIONAL VISITS - $1,312Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1321624OtherCostOrOtherBasis
Book Value1321624BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis83505486OtherCostOrOtherBasis
Depreciation43275196Depreciation
Book Value40230290BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis105454780OtherCostOrOtherBasis
Depreciation61267389Depreciation
Book Value44187391BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4167744OtherCostOrOtherBasis
Depreciation2843055Depreciation
Book Value1324689BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings87063994TotalOfBookValueLandBuildings

Financial Derivatives FinancialDerivatives

FieldValueIRS element (for citing)
Book Value0BookValue

Closely Held Equity Interests CloselyHeldEquityInterests

FieldValueIRS element (for citing)
Book Value0BookValue

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValue
CHI OIP - FIXED INCOME100679125
CHI OIP - EQUITY SECURITIES103218938
FieldValueIRS element (for citing)
Total Of Book Value Securities203898063TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
INTERCOMPANY PAYABLES$2,867,230
ENVIRONMENTAL REMEDIATION LIABILITY$158,236
OTHER$41,755
UNCLAIMED PROPERTY$34,089
UNREDEEMED GIFT CERTIFICATE$1,372
FieldValueIRS element (for citing)
Total Of Amounts3102682TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Other Revenues0OtherRevenues
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal0RevenueSubtotal
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9900TotalRevenuePerForm990
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal0ExpensesSubtotal
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9900TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierFIN 48 (ASC 740) footnoteIdentifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationSAINT FRANCIS MEDICAL CENTER'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI'S FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2013 READS AS FOLLOWS: "CHI IS A TAX-EXEMPT COLORADO CORPORATION AND HAS BEEN GRANTED AN EXEMPTION FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CHI OWNS CERTAIN TAXABLE SUBSIDIARIES AND ENGAGES IN CERTAIN ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE AND THEREFORE SUBJECT TO INCOME TAX. MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS."Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CarefalseFPGReferenceFreeCare
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served2629PersonsServed
Total Community Benefit Expense3557214TotalCommunityBenefitExpense
Net Community Benefit Expense3557214NetCommunityBenefitExpense
Percent Of Total Expense0.02420PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served15445PersonsServed
Total Community Benefit Expense12377082TotalCommunityBenefitExpense
Direct Offsetting Revenue8734983DirectOffsettingRevenue
Net Community Benefit Expense3642099NetCommunityBenefitExpense
Percent Of Total Expense0.02470PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served18074PersonsServed
Total Community Benefit Expense15934296TotalCommunityBenefitExpense
Direct Offsetting Revenue8734983DirectOffsettingRevenue
Net Community Benefit Expense7199313NetCommunityBenefitExpense
Percent Of Total Expense0.04890PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs29NumberOfActivitiesOrPrograms
Persons Served8443PersonsServed
Total Community Benefit Expense885765TotalCommunityBenefitExpense
Direct Offsetting Revenue71368DirectOffsettingRevenue
Net Community Benefit Expense814397NetCommunityBenefitExpense
Percent Of Total Expense0.00550PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served2909PersonsServed
Total Community Benefit Expense932992TotalCommunityBenefitExpense
Direct Offsetting Revenue202057DirectOffsettingRevenue
Net Community Benefit Expense730935NetCommunityBenefitExpense
Percent Of Total Expense0.00500PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served135PersonsServed
Total Community Benefit Expense816TotalCommunityBenefitExpense
Net Community Benefit Expense816NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Total Community Benefit Expense1142694TotalCommunityBenefitExpense
Direct Offsetting Revenue136263DirectOffsettingRevenue
Net Community Benefit Expense1006431NetCommunityBenefitExpense
Percent Of Total Expense0.00680PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served19740PersonsServed
Total Community Benefit Expense300651TotalCommunityBenefitExpense
Net Community Benefit Expense300651NetCommunityBenefitExpense
Percent Of Total Expense0.00200PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs44NumberOfActivitiesOrPrograms
Persons Served31227PersonsServed
Total Community Benefit Expense3262918TotalCommunityBenefitExpense
Direct Offsetting Revenue409688DirectOffsettingRevenue
Net Community Benefit Expense2853230NetCommunityBenefitExpense
Percent Of Total Expense0.01930PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs44NumberOfActivitiesOrPrograms
Persons Served49301PersonsServed
Total Community Benefit Expense19197214TotalCommunityBenefitExpense
Direct Offsetting Revenue9144671DirectOffsettingRevenue
Net Community Benefit Expense10052543NetCommunityBenefitExpense
Percent Of Total Expense0.06820PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense121018TotalCommunityBuildingExpense
Net Community Building Expense121018NetCommunityBuildingExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense5400TotalCommunityBuildingExpense
Net Community Building Expense5400NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense65036TotalCommunityBuildingExpense
Direct Offsetting Revenue2242DirectOffsettingRevenue
Net Community Building Expense62794NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served10PersonsServed
Total Community Building Expense411458TotalCommunityBuildingExpense
Net Community Building Expense411458NetCommunityBuildingExpense
Percent Of Total Expense0.00260PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs6NumberOfActivitiesOrPrograms
Persons Served10PersonsServed
Total Community Building Expense602912TotalCommunityBuildingExpense
Direct Offsetting Revenue2242DirectOffsettingRevenue
Net Community Building Expense600670NetCommunityBuildingExpense
Percent Of Total Expense0.00390PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$5,491,040BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare42625418AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare52075711CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-9450293MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1GRAND ISLAND SURGICAL CENTER LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivitySURGERYDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.5OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership0OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership0.5PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1SAINT FRANCIS MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12620 W FAIDLEYAddressLine1
CityGRAND ISLANDCity
StateNEState
ZIP Code68803ZIPCode
FieldValueIRS element (for citing)
Website AddressWWW.SAINTFRANCISGI.ORGWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SAINT FRANCIS MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiesfalseOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedtrueAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreefalseUsesFPGFree
Uses FPG DiscountedfalseUsesFPGDiscounted
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities5NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
SFMC SKILLED NURSING FACILITY
2116 W FAIDLEYGRAND ISLANDNE68803SKILLED NURSING FACILITY
SAINT FRANCIS MEDICAL CENTER ADTC
2116 W FAIDLEYGRAND ISLANDNE68803OUTPATIENT SUBSTANCE ABUSE
SAINT FRANCIS MEDICAL CENTER ADTC
1755 PRARIE VIEW PLACEKEARNEYNE68847OUTPATIENT SUBSTANCE ABUSE
SAINT FRANCIS MEDICAL CENTER ADTC
314 S 14THORDNE68862OUTPATIENT SUBSTANCE ABUSE
SAINT FRANCIS MEDICAL CENTER ADTC
315 S 8TH STBROKEN BOWNE68822OUTPATIENT SUBSTANCE ABUSE

Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Eligibility criteria for free or discounted careSchedule H, Part I, Line 3cWHEN CATHOLIC HEALTH INITIATIVES (THE ULTIMATE PARENT ORGANIZATION TO SAINT FRANCIS MEDICAL CENTER) ESTABLISHED ITS FINANCIAL ASSISTANCE POLICY IT WAS DETERMINED THAT ESTABLISHING A HOUSEHOLD INCOME SCALE BASED ON THE HUD VERY LOW INCOME GUIDELINES MORE ACCURATELY REFLECTS THE SOCIOECONOMIC DISPERSIONS AMONG THE 69 URBAN AND RURAL COMMUNITIES IN 17 STATES SERVED BY CHI HOSPITALS AND HEALTH CARE FACILITIES. IN COMPARING HUD GUIDELINES TO THE FEDERAL POVERTY GUIDELINES ("FPG"), WE FIND THAT ON AVERAGE HUD GUIDELINES COMPUTE TO APPROXIMATELY 200% TO 250% (AND SOMETIMES 300%) OF FPG. SAINT FRANCIS MEDICAL CENTER BASES ITS FINANCIAL ASSISTANCE ELIGIBILITY ON HUD'S 130% OF VERY LOW INCOME GUIDELINES BASED ON GEOGRAPHY, AND AFFORDS THE UNINSURED AND UNDERINSURED THE ABILITY TO OBTAIN FINANCIAL ASSISTANCE WRITE-OFFS, BASED ON A SLIDING SCALE, RANGING FROM 25%-100% OF CHARGES. AN INDIVIDUAL'S INCOME UNDER THE HUD GUIDELINES IS A SIGNIFICANT FACTOR IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. HOWEVER, IN DETERMINING WHETHER TO EXTEND DISCOUNTED OR FREE CARE TO A PATIENT, THE PATIENT'S ASSETS MAY ALSO BE TAKEN INTO CONSIDERATION. FOR EXAMPLE, A PATIENT SUFFERING A CATASTROPHIC ILLNESS MAY HAVE A REASONABLE LEVEL OF INCOME, BUT A LOW LEVEL OF LIQUID ASSETS SUCH THAT THE PAYMENT OF MEDICAL BILLS WOULD BE SERIOUSLY DETRIMENTAL TO THE PATIENT'S BASIC FINANCIAL (AND ULTIMATELY PHYSICAL) WELL-BEING AND SURVIVAL. SUCH A PATIENT MAY BE EXTENDED DISCOUNTED OR FREE CARE BASED UPON THE FACTS AND CIRCUMSTANCES.
PREPARED COMMUNITY BENEFIT REPORTSCHEDULE H, PART I, LINE 6ASAINT FRANCIS MEDICAL CENTER PREPARES ITS OWN ANNUAL WRITTEN COMMUNITY BENEFIT REPORT. ITS COMMUNITY BENEFIT REPORT IS NOT CONTAINED IN THAT OF A RELATED ORGANIZATION.
Costing Methodology used to calculate financial assistanceSchedule H, Part I, Line 7A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING WORKSHEET 2 TO COMPUTE THE COST-TO CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. WORKSHEET 2 WAS UTILIZED TO COMPUTE THE COST-TO-CHARGE RATIO FOR THE YEAR ENDED 6/30/13 USING THE FOLLOWING FORMULA: OPERATING EXPENSE (LESS NON-PATIENT CARE ACTIVITIES, MEDICARE PROVIDER TAXES, COMMUNITY BENEFIT EXPENSE AND COMMUNITY BUILDING EXPENSE) DIVIDED BY GROSS PATIENT REVENUE (LESS GROSS CHARGES FOR COMMUNITY BENEFIT PROGRAMS). BASED ON THAT FORMULA, $129,642,531/$303,351,960 RESULTS IN A 42.79% COST-TO-CHARGE RATIO.
Bad Debt Expense excluded from financial assistance calculationSchedule H, Part I, Line 7, column(f)5,491,040
Bad debt expense - methodology used to estimate amountSchedule H, Part III, Line 2BAD DEBT IS ESTIMATED BASED ON THE REVIEW OF ACTUAL BAD DEBT WRITEOFFS, NET OF RECOVERIES, AS A PERCENTAGE OF GROSS REVENUE. ALL DISCOUNTS AND PAYMENTS ON THE PATIENT ACCOUNTS ARE NETTED AGAINST THE PATIENT ACCOUNT PRIOR TO THE ACCOUNT GOING TO COLLECTIONS. ACCOUNTS ARE HELD BY A COLLECTION AGENCY FOR 150 DAYS AND RETURNED UNLESS A PAYMENT PLAN IS IN PLACE OR THE ACCOUNT WAS TURNED OVER TO LEGAL FOR PROCESSING. ONCE THE ACCOUNTS ARE RETURNED FROM COLLECTIONS, THE REMAINING BALANCE IS WRITTEN OFF TO BAD DEBT.
Bad debt expense - methodology used to estimate amount as community benefitSchedule H, Part III, Line 3BAD DEBT ESTIMATES ARE NOT INCLUDED IN COMMUNITY BENEFIT.
Bad debt expense - financial statement footnoteSchedule H, Part III, Line 4COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF [42.79]%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. SAINT FRANCIS MEDICAL CENTER DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE. SAINT FRANCIS MEDICAL CENTER DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS: "THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, CHI FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. IN ACCORDANCE WITH ACCOUNTING STANDARDS UPDATE (ASU) NO. 2011-07, PRESENTATION AND DISCLOSURE OF PATIENT SERVICES REVENUE, PROVISION FOR BAD DEBTS, AND ALLOWANCES FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH ENTITIES, THE PROVISION FOR BAD DEBTS IS PRESENTED ON THE CONSOLIDATED STATEMENT OF OPERATIONS AS A DEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) SINCE CHI ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY."
Community benefit & methodology for determining medicare costsSchedule H, Part III, Line 8TO FIGURE MEDICARE COSTS THE MEDICARE GROSS REVENUE (FROM THE FINANCIALS) IS MULTIPLIED BY COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. THIS IS THEN SUBTRACTED FROM THE NET MEDICARE REVENUE (ALSO, FROM THE FINANCIALS) TO COME UP WITH THE SHORTFALL. ALTHOUGH NOT PRESENTED ON THE MEDICARE COST REPORT, IN ORDER TO FACILITATE A MORE ACCURATE UNDERSTANDING OF THE "TRUE" COST OF SERVICES (FOR "SHORTFALL" PURPOSES) THE CHI WORKBOOK ALLOWS A HEALTH CARE FACILITY NOT TO OFFSET COSTS THAT MEDICARE CONSIDERS TO BE NON-ALLOWABLE, BUT FOR WHICH THE FACILITY CAN LEGITIMATELY ARGUE ARE RELATED TO THE CARE OF THE FACILITY'S PATIENTS. IN ADDITION, ALTHOUGH NOT REPORTABLE ON THE MEDICARE COST REPORT, THE CHI WORKBOOK INCLUDES THE COST OF SERVICES THAT ARE PAID VIA A SET FEE-SCHEDULE RATHER THAN BEING REIMBURSED BASED ON COSTS (E.G. OUTPATIENT CLINICAL LABORATORY). FINALLY, THE CHI WORKBOOK ALLOWS A FACILITY TO INCLUDE OTHER HEALTH CARE SERVICES PERFORMED BY A SEPARATE FACILITY (SUCH AS A PHYSICIAN PRACTICE) THAT ARE MAINTAINED ON SEPARATE BOOKS AND RECORDS (AS OPPOSED TO THE MAIN FACILITY'S BOOKS AND RECORDS WHICH HAS ITS COSTS OF SERVICE INCLUDED WITHIN A COST REPORT). TRUE COSTS OF MEDICARE COMPUTED USING THIS METHODOLOGY: TOTAL MEDICARE REVENUE: $42,625,418 TOTAL MEDICARE COSTS: $52,075,711 SURPLUS OR SHORTFALL $(9,450,293) SAINT FRANCIS MEDICAL CENTER BELIEVES THAT EXCLUDING MEDICARE LOSSES FROM COMMUNITY BENEFIT MAKES THE OVERALL COMMUNITY BENEFIT REPORT MORE CREDIBLE FOR THESE REASONS: UNLIKE SUBSIDIZED AREAS SUCH AS BURN UNITS OR BEHAVIORAL-HEALTH SERVICES, MEDICARE IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS. IN FACT, FOR-PROFIT HOSPITALS FOCUS ON ATTRACTING PATIENTS WITH MEDICARE COVERAGE, ESPECIALLY IN THE CASE OF WELL-PAID SERVICES THAT INCLUDE CARDIAC AND ORTHOPEDICS. SIGNIFICANT EFFORT AND RESOURCES ARE DEVOTED TO ENSURING THAT HOSPITALS ARE REIMBURSED APPROPRIATELY BY THE MEDICARE PROGRAM. THE MEDICARE PAYMENT ADVISORY COMMISSION (MEDPAC), AN INDEPENDENT CONGRESSIONAL AGENCY, CAREFULLY STUDIES MEDICARE PAYMENT AND THE ACCESS TO CARE THAT MEDICARE BENEFICIARIES RECEIVE. THE COMMISSION RECOMMENDS PAYMENT ADJUSTMENTS TO CONGRESS ACCORDINGLY. THOUGH MEDICARE LOSSES ARE NOT INCLUDED BY CATHOLIC HOSPITALS AS COMMUNITY BENEFIT, THE CATHOLIC HEALTH ASSOCIATION GUIDELINES ALLOW HOSPITALS TO COUNT AS COMMUNITY BENEFIT SOME PROGRAMS THAT SPECIFICALLY SERVE THE MEDICARE POPULATION. FOR INSTANCE, IF HOSPITALS OPERATE PROGRAMS FOR PATIENTS WITH MEDICARE BENEFITS THAT RESPOND TO IDENTIFIED COMMUNITY NEEDS, GENERATE LOSSES FOR THE HOSPITAL, AND MEET OTHER CRITERIA, THESE PROGRAMS CAN BE INCLUDED IN THE CHA FRAMEWORK IN CATEGORY C AS "SUBSIDIZED HEALTH SERVICES." MEDICARE LOSSES ARE DIFFERENT FROM MEDICAID LOSSES, WHICH ARE COUNTED IN THE CHA COMMUNITY BENEFIT FRAMEWORK, BECAUSE MEDICAID REIMBURSEMENTS GENERALLY DO NOT RECEIVE THE LEVEL OF ATTENTION PAID TO MEDICARE REIMBURSEMENT. MEDICAID PAYMENT IS LARGELY DRIVEN BY WHAT STATES CAN AFFORD TO PAY, AND IS TYPICALLY SUBSTANTIALLY LESS THAN WHAT MEDICARE PAYS.
Collection practices for patients eligible for financial assistanceSchedule H, Part III, Line 9bSAINT FRANCIS MEDICAL CENTER, ALONG WITH ITS AFFILIATED OUTPATIENT FACILITIES ARE PART OF CATHOLIC HEALTH INITIATIVES "CHI". CHI HAS A WRITTEN POLICY (STEWARDSHIP POLICY NO. 16) GOVERNING THE PROCEDURES FOR COLLECTIONS OF PAST DUE ACCOUNTS. ALL HOSPITAL FACILITIES INCLUDED IN THE FILING ORGANIZATION HAVE ADOPTED THIS POLICY AND FOLLOW THESE PRACTICES WITH REGARDS TO COLLECTIONS: PROCEDURES CHI ENTITIES WILL FOLLOW STANDARD PROCEDURES IN COLLECTING SELF-PAY BALANCES AS FOLLOWS: PERMISSIBLE COLLECTIONS ACTIVITY EACH FACILITY MUST ADHERE TO THE FOLLOWING REQUIREMENTS IN RELATION TO THE PURSUIT OF SELF-PAY BALANCES: * FAIR PURSUIT. EACH FACILITY SHALL ENSURE THAT ALL PATIENT AND PATIENT GUARANTOR ACCOUNTS ARE PURSUED FAIRLY. * ETHICS AND INTEGRITY. EACH FACILITY SHALL ENSURE THAT ALL COLLECTION ACTIVITIES CONSISTENTLY REFLECT THE HIGHEST STANDARDS OF ETHICS AND INTEGRITY. * REASONABLE PAYMENT TERMS. EACH FACILITY SHALL OFFER REASONABLE PAYMENT SCHEDULES AND TERMS TO EACH PATIENT AND PATIENT GUARANTOR WITH SELF-PAY BALANCES. ALL COLLECTION ACTIVITIES CONDUCTED BY THE FACILITY OR ITS THIRD-PARTY COLLECTION AGENTS WILL BE IN CONFORMANCE WITH ALL FEDERAL AND STATE LAWS GOVERNING DEBT COLLECTION PRACTICES. COLLECTION ACTIVITY MAY BE IN THE FORM OF LETTERS, EMAILS, PHONE CALLS, AND/OR CREDIT REPORTING AND MAY ALSO INCLUDE WAGE GARNISHMENTS, PLACING OF LIENS ON BUILDINGS OR RESIDENCES OTHER THAN PERSONAL RESIDENCES, INITIATION OF LAWSUIT, AND/OR OTHER ACTIONS AS REQUIRED, EXCEPT AS PROHIBITED BY IMPERMISSIBLE COLLECTIONS ACTIONS BELOW. PRE-COLLECTIONS ACTIVITY * TIMING. GENERALLY, ACCOUNTS WILL NOT BE REFERRED TO COLLECTIONS UNTIL THEY ARE 120 DAYS OLD. HOWEVER, IN CIRCUMSTANCES WHERE INVOICES TO NON-MEDICARE PATIENTS ARE RETURNED UNDELIVERED WITH NO KNOWN ADDRESS, THOSE SELF-PAY BALANCES MAY BE REFERRED TO COLLECTIONS PRIOR TO EXPIRATION OF 120 DAYS. * LIMITATIONS - FINANCIAL ASSISTANCE ELIGIBILITY. THE FACILITY SHALL PERFORM A REASONABLE REVIEW OF EACH PATIENT ACCOUNT PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT (INCLUDING, BUT NOT LIMITED TO, REPORTING THE ACCOUNT TO A COLLECTION AGENCY) TO ENSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G., MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE FACILITY'S FINANCIAL ASSISTANCE POLICY. THAT REASONABLE REVIEW WILL INCLUDE ONE OR MORE OF THE FOLLOWING: * NOTIFICATION TO PATIENT OF THE AVAILABILITY OF FINANCIAL ASSISTANCE ON ADMISSION, PRIOR TO DISCHARGE, AND/OR IN THE BILLING PROCESS; * REVIEW OF FINANCIAL ASSISTANCE APPLICATION SUBMITTED BY OR ON BEHALF OF THE PATIENT; OR * REVIEW OF THE PATIENT'S ELIGIBILITY USING PATIENT ACCOUNT STATISTICAL SCORING SOFTWARE. * COOPERATING EFFORTS. NO FACILITY SHALL SEND ANY UNPAID SELF-PAY ACCOUNT TO A THIRD-PARTY COLLECTION AGENT AS LONG AS THE PATIENT AND PATIENT GUARANTOR ARE COOPERATING WITH THE FACILITY IN EFFORTS TO SETTLE THE ACCOUNT BALANCE WITHIN A REASONABLE TIME FRAME (GENERALLY 18 MONTHS). * SUBSEQUENT ASSESSMENT. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY ACCOUNT THAT SUBSEQUENTLY IS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE SHALL BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO THE FACILITY FOR APPROPRIATE FOLLOW-UP. CHI SHALL DIRECT ITS STAFF AND THIRD-PARTY COLLECTION AGENTS TO CONTINUALLY ASSESS EACH PATIENT AND PATIENT GUARANTOR'S ABILITY TO PAY OR TO BE DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE. COLLECTIONS THE FACILITY MAY USE A THIRD-PARTY COLLECTION AGENT AS A REPRESENTATIVE, ACTING IN THE NAME OF THE FACILITY AND ENGAGED ON A CONTRACTUAL BASIS, FOR THE EXPRESS PURPOSES OF FOLLOWING-UP ON AND POTENTIALLY COLLECTING ANY PATIENT ACCOUNTS RECEIVABLE BALANCES. THE FACILITY SHALL CONTRACTUALLY DEFINE THE STANDARDS AND SCOPE OF PRACTICES TO BE USED BY THIRD-PARTY COLLECTION AGENTS. THOSE STANDARDS AND SCOPE OF PRACTICES SHALL BE CONSISTENT WITH THIS POLICY AND SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING: * STATEMENT MESSAGE. THE FACILITY SHALL REQUIRE ITS THIRD-PARTY COLLECTION AGENTS TO INCLUDE A MESSAGE ON ALL STATEMENTS INDICATING THAT IF A PATIENT OR PATIENT GUARANTOR MEETS CERTAIN STIPULATED INCOME REQUIREMENTS, THE PATIENT OR PATIENT GUARANTOR MAY BE ELIGIBLE FOR FACILITY OR OTHER FINANCIAL ASSISTANCE PROGRAMS. * ADVANCE SETTLEMENT APPROVALS. THE FACILITY SHALL INSTRUCT ITS THIRD-PARTY COLLECTION AGENTS TO SEEK APPROVAL FROM THE AUTHORIZED AND DESIGNATED FACILITY STAFF MEMBER BEFORE ANY SETTLEMENT, AS A RESULT OF BANKRUPTCY PROCEEDINGS, SHALL BE ACCEPTED. * STANDARDS OF CONDUCT. THE FACILITY SHALL REQUIRE THAT THE THIRD-PARTY COLLECTION AGENTS CONDUCT THEMSELVES IN COMPLIANCE WITH THE HIGHEST STANDARDS OF BUSINESS ETHICS AND INTEGRITY AND APPLICABLE LEGAL REQUIREMENTS, AS REFLECTED IN THE CHI STANDARDS OF CONDUCT, AS MAY BE AMENDED BY CHI, AVAILABLE AT THE FOLLOWING WEBSITE: HTTP://WWW.CATHOLICHEALTHINITIATIVES.ORG/CORPORATERESPONSIBILITY. * PROHIBITED COLLECTIONS ACTIONS. THE FACILITY SHALL PROHIBIT THE THIRD-PARTY COLLECTION AGENTS FROM ENGAGING IN PROHIBITED COLLECTIONS ACTIONS AS DEFINED IN IMPERMISSIBLE COLLECTIONS ACTIONS BELOW. * ANNUAL ADHERENCE AUDIT. THE FACILITY OR ITS DESIGNEE SHALL BE PERMITTED TO AUDIT ITS THIRD-PARTY COLLECTION AGENTS AT LEAST ANNUALLY FOR ADHERENCE TO THESE STANDARDS. IMPERMISSIBLE COLLECTIONS ACTIONS CHI ENTITIES SHALL DIRECT THEIR STAFF AND THIRD-PARTY COLLECTION AGENTS THAT THE FOLLOWING ACTIONS ARE ALWAYS PROHIBITED IN RELATION TO THE PURSUIT OF SELF-PAY BALANCES. * UNEMPLOYED WITHOUT SIGNIFICANT INCOME/ASSETS. NO FACILITY SHALL PURSUE ANY LEGAL ACTION FOR NON-PAYMENT OF ANY BILLS AGAINST ANY PATIENT OR PATIENT GUARANTOR WHO IS KNOWN TO BE UNEMPLOYED AND WHO HAS BEEN DETERMINED IN ACCORDANCE WITH CHI STEWARDSHIP POLICY NO. 15, HOSPITAL FINANCIAL ASSISTANCE, ON THE BASIS OF A COMPLETED FINANCIAL ASSISTANCE APPLICATION, TO BE WITHOUT SIGNIFICANT INCOME OR ASSETS. * PRINCIPAL RESIDENCE. NO FACILITY SHALL PURSUE ANY LEGAL ACTION AGAINST ANY PATIENT OR PATIENT GUARANTOR BY SEEKING A REMEDY THAT WOULD INVOLVE FORECLOSING UPON THE PRINCIPLE RESIDENCE OF A PATIENT OR PATIENT GUARANTOR, PLACING A LIEN ON THE PRINCIPAL RESIDENCE, TAKING ANY OTHER ACTION THAT COULD RESULT IN THE INVOLUNTARY SALE OR TRANSFER OF SUCH RESIDENCE, OR INFORMING ANY PATIENT OR PATIENT GUARANTOR THAT HE/SHE MAY BE SUBJECT TO ANY SUCH ACTION. OTHER IMPERMISSIBLE COLLECTION TACTICS: * NO FACILITY SHALL CHARGE INTEREST ON OUTSTANDING BALANCES; * NO FACILITY SHALL REQUIRE PATIENTS OR PATIENT GUARANTORS TO INCUR DEBT OR LOANS WITH RECOURSE TO THE PATIENT'S OR GUARANTOR'S PERSONAL OR REAL PROPERTY ASSETS ("RECOURSE INDEBTEDNESS"); AND * NO FACILITY SHALL INVOKE SO-CALLED "BODY ATTACHMENTS" (I.E., THE ARREST OR JAILING OF PATIENTS IN DEFAULT ON THEIR ACCOUNTS, SUCH AS FOR MISSED COURT APPEARANCES). IN ADDITION TO THE WRITTEN POLICY ALL OF CATHOLIC HEALTH INITIATIVES' HOSPITALS' CONTRACTS WITH THIRD PARTY COLLECTION AGENCIES INCLUDE THE FOLLOWING STANDARDS: * NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL REQUEST BENCH OR ARREST WARRANTS AS A RESULT OF NON-PAYMENT; * NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL SEEK LIENS THAT WOULD REQUIRE THE SALE OR FORECLOSURE OF A PRIMARY RESIDENCE; AND * NO CATHOLIC HEALTH INITIATIVES' COLLECTION AGENCY MAY SEEK COURT ACTION WITHOUT HOSPITAL APPROVAL. FINALLY, COLLECTION AGENCIES ARE TRAINED ON THE CATHOLIC HEALTH INITIATIVES MISSION, CORE VALUES AND STANDARD OF CONDUCT TO MAKE SURE ALL PATIENTS ARE TREATED WITH DIGNITY AND RESPECT
Community Served by Needs AssessmentSchedule H, Part V Section B, Line 3(1) SAINT FRANCIS MEDICAL CENTER - TOWN HALL FORUMS;
Used federal poverty guidelines (FPG) to determine eligibilitySchedule H, Part V Section B, Line 10(1) SAINT FRANCIS MEDICAL CENTER - US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD) VERY LOW-INCOME GUIDELINES ARE USED.;
Used FPG to determine eligibility for providing discounted care criteriaSchedule H, Part V Section B, Line 11(1) SAINT FRANCIS MEDICAL CENTER - US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD) VERY LOW-INCOME GUIDELINES ARE USED.;
Means used to determine amounts billedSchedule H, Part V Section B, Line 20d(1) SAINT FRANCIS MEDICAL CENTER - A PROMPT PAY DISCOUNT IS OFFERED TO ALL PATIENTS WHO ARE CONSIDERED 100% SELF-PAY AND FAIL TO QUALIFY FOR ANY FEDERAL, STATE OR LOCAL ASSISTANCE PROGRAMS. PAYMENTS ON THE SELF-PAY ACCOUNTS MUST MEET THE AGREED UPON DATE IN ORDER TO RECEIVE THE DISCOUNT.;
NEEDS ASSESSMENT AND COMMUNITY INFORMATIONSCHEDULE H, PART VIORGANIZATION'S MISSION, VISION, AND TAX-EXEMPT PURPOSE SAINT FRANCIS MEDICAL CENTER WAS FOUNDED BY THE SISTERS OF SAINT FRANCIS OF COLORADO SPRINGS WITH THE ASSISTANCE FROM A LOCAL CITIZEN'S COMMITTEE IN 1883 IN AN EFFORT TO ADDRESS THE LACK OF MEDICAL FACILITIES IN CENTRAL NEBRASKA. FOLLOWING LOCAL FUNDRAISING EFFORTS, THE DOORS OPENED IN 1887, AND 216 PATIENTS WERE TREATED THE FIRST YEAR. EARLY HOSPITAL RECORDS SHOW SAINT FRANCIS CARING FOR A DIVERSE COMMUNITY OF IMMIGRANTS: GERMAN, NORWEGIAN, SWEDISH AND FRENCH, OFFERING HOPE AND HEALING TO ALL, ESPECIALLY THE POOR. TODAY, SAINT FRANCIS MEDICAL CENTER HAS GROWN INTO A REGIONAL HEALTHCARE FACILITY PROVIDING SPECIALTY MEDICAL SERVICES AND HIGH-TECH HEALTH TREATMENT. AT THE SAME TIME, SAINT FRANCIS MEDICAL CENTER IS FAITHFULLY COMMITTED TO ITS MISSION OF CARING FOR ALL PEOPLE IN NEED, AND WORKING TO IMPROVE THE HEALTH OF THE PEOPLE IT SERVES AND THE COMMUNITY IT CALLS HOME. THE ORGANIZATION IS A PART OF CATHOLIC HEALTH INITIATIVES, A NATIONAL NONPROFIT HEALTH SYSTEM WITH HEADQUARTERS IN ENGLEWOOD, COLO. THE FAITH-BASED SYSTEM OPERATES IN 17 STATES AND INCLUDES 87 HOSPITALS; 40 LONG-TERM CARE, ASSISTED- AND RESIDENTIAL-LIVING FACILITIES; TWO ACADEMIC MEDICAL CENTERS; TWO COMMUNITY HEALTH-SERVICES ORGANIZATIONS; TWO ACCREDITED NURSING COLLEGES; AND HOME HEALTH AGENCIES. TO ENSURE THE ORGANIZATION CONTINUES TO MEET THE NEEDS OF OUR COMMUNITY, SAINT FRANCIS MEDICAL CENTER HAS A COMMUNITY COUNCIL WHICH CONSISTS OF KEY STAKEHOLDERS IN THE COMMUNITY. THIS COMMITTEE MEETS BIMONTHLY AND IS INFORMED OF KEY METRICS IN QUALITY OF CARE AND PATIENT SATISFACTION. THIS COMMITTEE IS EDUCATED ON GENERAL HOSPITAL OPERATIONS AND PROVIDES ESSENTIAL INPUT INTO SAINT FRANCIS' COMMUNITY NEEDS ASSESSMENT AND DETERMINING THE PRIORITIES FOR COMMUNITY BENEFIT FUNDING. SAINT FRANCIS MEDICAL CENTER OPERATES A 24-HOUR EMERGENCY ROOM, 365 DAYS A YEAR. SAINT FRANCIS MEDICAL CENTER PARTICIPATES IN MEDICARE AND MEDICAID, AND HAS AN ACTIVE CHARITY CARE PROGRAM. SAINT FRANCIS PROUDLY CARRIES ON A TRADITION OF SERVING OUR COMMUNITY. EACH YEAR, OUR ORGANIZATION COMMITS FUNDING AND THE TIME AND TALENT OF OUR WORKFORCE TO DEVELOPING AND SUPPORTING INNOVATIVE SOLUTIONS THAT BUILD A HEALTHIER COMMUNITY. THE PROGRAMS AND SERVICES DESCRIBED THROUGHOUT THIS REPORT HAVE A DIRECT BENEFIT TO THE INDIVIDUALS SERVED AS WELL AS BENEFITTING THE LARGER SOCIETY BY REDUCING THE BURDENS ON GOVERNMENT RESOURCES. FOR EXAMPLE, IF SAINT FRANCIS MEDICAL CENTER DID NOT SERVE ALL PEOPLE IN NEED AND PROVIDE CHARITY CARE, THE BURDEN WOULD LIKELY FALL ON TAX SUPPORTED INSTITUTIONS. SAINT FRANCIS MEDICAL CENTER IS INCLUDED IN THE OFFICIAL CATHOLIC DIRECTORY AS A TAX-EXEMPT HOSPITAL. COMMUNITY BENEFIT APPROACH SAINT FRANCIS MEDICAL CENTER SERVES A 25-COUNTY AREA IN CENTRAL NEBRASKA AND IS LOCATED IN GRAND ISLAND, A COMMUNITY OF 48,520. HOME TO A SIGNIFICANT MINORITY POPULATION DUE TO THE LOCAL MEAT PACKING INDUSTRY, GRAND ISLAND'S POPULATION IS 32% MINORITY RESIDENTS. MINORITY STUDENTS MAKE UP MORE THAN HALF OF THE PUBLIC SCHOOL ENROLLMENT. SEVERAL OF THESE COUNTIES, INCLUDING HALL COUNTY (12.5%), HAVE POVERTY LEVELS THAT ARE ABOVE THE STATE AVERAGE OF 10.8%. THE PRIMARY AREA SERVED BY SAINT FRANCIS MEDICAL CENTER IS DEFINED AS HALL, HOWARD, HAMILTON AND MERRICK COUNTIES. AGRI-BUSINESS IS THE PRIMARY INDUSTRY AND GRAND ISLAND (IN HALL COUNTY) SERVES AS A LARGE RETAIL AND EMPLOYMENT IN A RURAL AREA. AS IS TYPICAL IN RURAL COMMUNITIES, THE POPULATION GROWTH FOR THIS SERVICE AREA IS PRIMARILY IN THE 65+ GROUP THAT INCLUDES AGING BABY BOOMERS. HOWEVER THE IMMIGRATION OF YOUNGER, MINORITY FAMILIES INTO GRAND ISLAND HAS LOWERED ITS MEDIAN AGE SLIGHTLY BELOW THAT OF NEARBY COUNTIES. THE SAINT FRANCIS SERVICE AREA OF HALL, HAMILTON, HOWARD AND MERRICK COUNTIES HAS BEEN A EUROPEAN-BASED COMMUNITY THROUGHOUT MUCH OF ITS HISTORY. HOWEVER IN THE PAST TWO DECADES, THE LATINO ETHNIC GROUP IN HALL COUNTY HAS GROWN TO BECOME THE SECOND LARGEST ETHNIC GROUP, AS LISTED IN THE 2010 CENSUS (24% LATINO COMPARED TO 71% WHITE - NON-HISPANIC). FROM 2000 TO 2010, THE LATINO POPULATION IN THE STATE OF NEBRASKA GREW BY ALMOST 50 PERCENT AS RESULT OF BOTH IMMIGRATION AND THE LATINO BIRTH RATE (5.5% TO 9.2%). EMPLOYMENT IS THE NUMBER ONE FACTOR INFLUENCING THE GROWTH OF LATINO AND OTHER MINORITY POPULATIONS. SAINT FRANCIS MEDICAL CENTER'S COMMUNITY BENEFIT PLAN IS BASED ON OUR UNDERSTANDING OF UNIQUE COMMUNITY NEEDS DERIVED FROM COLLABORATIVE NEEDS ASSESSMENTS, FOCUS GROUPS, AND SURVEYS CONDUCTED WITH OUR COMMUNITY PARTNERS. REPRESENTATIVES FROM SAINT FRANCIS WORK COLLABORATIVELY ON SEVERAL COMMUNITY-BASED ORGANIZATIONS TO SUPPORT LOCAL INITIATIVES AND PARTNERSHIPS WHILE REDUCING DUPLICATION AND MAKING THE BEST USE OF LIMITED RESOURCES. ADDITIONALLY, SAINT FRANCIS DEFINES HEALTH IN THE BROADEST SENSE AND BELIEVES THAT EVERYONE, FROM GOVERNMENT, BUSINESS AND INDUSTRY TO SCHOOLS, CHURCHES AND COMMUNITY ORGANIZATIONS HAVE A ROLE TO PLAY IN IMPROVING COMMUNITY HEALTH. WE BELIEVE THAT WHEN EVERYONE WORKS TOGETHER, EVERYONE BENEFITS FROM A HEALTHY COMMUNITY. PROCESS SAINT FRANCIS MEDICAL CENTER HAS COMPILED RESULTS OF TWO STUDIES CONDUCTED IN THE COMMUNITY WITHIN THE PAST THREE YEARS: 1) TOWN HALL MEETING SUMMARY REPORT (FEB., 2011), A HEALTH NEEDS ASSESSMENT CONDUCTED BY SAINT FRANCIS MEDICAL CENTER DURING SIX TOWN HALL MEETINGS AND 2) ENVISIONING THE FUTURE OF PUBLIC HEALTH, (2010), A HEALTH ASSESSMENT STUDY CONDUCTED BY THE CENTRAL DISTRICT HEALTH DEPARTMENT. THE STAFF USED A MATRIX FROM THE TOWN HALL MEETING SUMMARY REPORT AND CROSS-REFERENCED PRIORITIES FROM THE TOWN HALL MEETINGS WITH TOP PRIORITIES FROM THE ENVISIONING THE FUTURE OF PUBLIC HEALTH STUDY. IN ADDITION, THE STAFF FACTORED DATA AND INFORMATION FROM FOUR ADDITIONAL STUDIES 1) THE COUNTY HEALTH RANKINGS & ROADMAPS PROJECT, (2012); 2) CHILD WELL BEING INDICATORS, BASELINE AND COMPARISON DATA (2012); 3) THE NEBRASKA STATE DISPROPORTIONATE MINORITY CONTACT (DMC) ASSESSMENT HALL COUNTY DATA (2012); AND 4) UNDERSTANDING THE NEW DEMOGRAPHICS (2012). THE FOUR COMMUNITY NEEDS, LISTED IN ORDER OF IMPORTANCE TO THE COMMUNITY, ARE 1. ACCESS TO HEALTHCARE 2. GANG VIOLENCE 3. OBESITY 4. TEEN PREGNANCY. THE STAFF THEN NARROWED THE FOCUS OF EACH COMMUNITY NEED INTO A PRIORITY HEALTH NEED, AN ISSUE THAT COULD BE ADDRESSED AND RESTATED AS A STRATEGY AND MEASURED IN AN IMPLEMENTATION PLAN. THESE STRATEGIES ARE: 1. SCREENINGS FOR LOW-INCOME AND MINORITY FAMILIES. 2. THE REDUCTION OF RISK FACTORS AND INCREASE IN PROTECTIVE FACTORS FOR ALL ELEMENTARY STUDENTS AND THE INTERVENTION FOR MIDDLE SCHOOL STUDENTS AT MOST RISK FOR JOINING GANGS. 3. NUTRITION AND FITNESS EDUCATION FOR LOW INCOME AND MINORITY FAMILIES. 4. PARENTING EDUCATION, HIGH SCHOOL GRADUATION AND SELF-DEPENDENCE FOR PARENTING TEENS AND ABSTINENCE EDUCATION FOR YOUNGER TEENS. SAINT FRANCIS HAS PRODUCED A COMMUNITY HEALTH NEEDS ASSESSMENT WHICH ANNOUNCES THE FINDINGS AND PRIORITIES. IT HAS ALSO ENGAGED WITH COMMUNITY PARTNERS TO DEVELOP AN IMPLEMENTATION PLANS WITH STRATEGIES FOR ADDRESSING THE SPECIFIC AREAS OF EMPHASIS. IN ADDITION, THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN HAVE BEEN SHARED WITHIN SAINT FRANCIS WITH THE BOARD OF DIRECTORS, THE CONTINUING MEDICAL EDUCATION COMMITTEE OF THE SAINT FRANCIS MEDICAL STAFF, AND THE SAINT FRANCIS MANAGEMENT TEAM FOR USE IN DEVELOPING GOALS AND OBJECTIVES IN THE ORGANIZATION'S STRATEGIC PLANNING PROCESS. QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT UNCOMPENSATED CARE FOR THE POOR TRUE TO OUR MISSION, MUCH OF OUR COMMUNITY BENEFIT DOLLARS FUND FREE MEDICAL CARE TO INDIVIDUALS WHO CANNOT AFFORD IT. IN FY2013 CHARITY CARE WAS PROVIDED TO MORE THAN 2,600 PATIENTS AND THE COST TO THE ORGANIZATION WAS $3,557,214. SAINT FRANCIS ALSO SERVED 15,445 PATIENTS ON MEDICAID AND INCURRED $3,642,099 IN UNREIMBURSED COSTS FOR SERVICES PROVIDED TO MEDICAID PATIENTS. FREQUENTLY, THE COST OF PROVIDING SERVICES TO MEDICAID PATIENTS IS GREATER THAN THE PAYMENTS SAINT FRANCIS MEDICAL CENTER RECEIVES FROM THE MEDICAID PROGRAM.
NEEDS ASSESSMENT AND COMMUNITY INFORMATIONSCHEDULE H, PART VI(CONTINUED) QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT COMMUNITY HEALTH SERVICES A MAJORITY OF COMMUNITY HEALTH SERVICES DOLLARS FUND COMMUNITY HEALTH EDUCATION. AS A PART OF THE CENTRAL NEBRASKA COMMUNITY, SAINT FRANCIS IS COMMITTED TO PROVIDING HEALTH INFORMATION TO THE PUBLIC. SAINT FRANCIS PROVIDES A VARIETY OF EDUCATIONAL EVENTS, INCLUDING BABY CARE BASICS AND BREASTFEEDING SUPPORT GROUPS FOR NEW PARENTS SUPPORT GROUPS FOR CANCER PATIENTS AND THEIR FAMILIES AND COMMUNITY EDUCATION PROGRAMS. IN FY 2013, WE PRESENTED EDUCATION PROGRAMS ON DIABETES, STROKE AND HEART DISEASE. A SPEAKER'S BUREAU IS AVAILABLE AS WELL AS PRESENTATIONS BY PHYSICIANS AND OTHER HEALTH CARE PROVIDERS ON A VARIETY OF TIMELY HEALTH TOPICS INCLUDING HEART DISEASE, WEIGHT LOSS, STRESS MANAGEMENT, DIABETES MANAGEMENT, BREAST CANCER, ALCOHOL AND DRUG TREATMENT AND MUCH MORE. IN FISCAL YEAR 2013, SAINT FRANCIS CONTRIBUTED $724,610 TO COMMUNITY HEALTH SERVICES. HEALTH PROFESSIONS EDUCATION SAINT FRANCIS MEDICAL CENTER IS COMMITTED TO ENSURING THAT CENTRAL NEBRASKANS HAVE ACCESS TO EXCELLENCE HEALTHCARE PROFESSIONALS AND PROVIDES CONTINUING MEDICAL EDUCATION FOR PHYSICIANS, NURSES AND ALLIED HEALTH PROFESSIONALS. IN FISCAL YEAR 2013, SAINT FRANCIS ASSISTED IN THE EDUCATION OF THE FOLLOWING HEALTH PROFESSIONALS: FAMILY PRACTICE RESIDENTS, MEDICAL STUDENTS, NURSING STUDENTS AND MEDICAL TECHNOLOGISTS. SAINT FRANCIS CONTINUES TO COLLABORATE WITH CENTRAL COMMUNITY COLLEGE AT THEIR NEW HEALTH SCIENCES CENTER TO TRAIN NURSES AND OTHER MEDICAL PROFESSIONALS. SUBSIDIZED HEALTH SERVICES SAINT FRANCIS FUNDS HEALTH SERVICES THAT PROVIDE AN IMPORTANT COMMUNITY NEED YET CANNOT SUSTAIN THEMSELVES FINANCIALLY. IN FISCAL YEAR 2013, SAINT FRANCIS MEDICAL CENTER'S SUBSIDIZED PROGRAMS INCLUDE PRENATAL EDUCATION AND PROJECT CARE, A PROGRAM THAT HELPS PATIENTS WITH NEEDS THAT ARE NOT COVERED BY OTHER FINANCIAL RESOURCES, FOR EXAMPLE TRANSPORTATION TO A SPECIALIST, MEDICAL SUPPLIES NOT COVERED BY INSURANCE. RESEARCH PROGRAMS STAFF AT SAINT FRANCIS MEDICAL CENTER ACTIVELY CONTRIBUTE TO CANCER RESEARCH THROUGH OUR TUMOR REGISTRY AND CLINICAL RESEARCH TRIALS. IN FISCAL YEAR 2013, SAINT FRANCIS SPENT $1,006,431 ON RESEARCH PROGRAMS. COMMUNITY BUILDING ACTIVITIES SAINT FRANCIS IS ACTIVELY INVOLVED IN COLLABORATIVE PROGRAMS THAT AIM TO IMPROVE COMMUNITY HEALTH. IN FISCAL YEAR 2013, SAINT FRANCIS PROMOTED CHILD SAFETY SEAT USAGE THROUGH ITS CHILD SAFETY DEPARTMENT. THE GREATER NEBRASKA PARISH NURSE NETWORK TRAINS AND SUPPORTS PARISH NURSES FOR WORK IN CHURCH CONGREGATIONS THROUGHOUT THE REGION. IN FISCAL YEAR 2013, SAINT FRANCIS AGAIN PARTICIPATED IN PROJECT SEARCH, A PROGRAM THAT TEACHES STUDENTS WITH DISABILITIES JOB SKILLS IN AN EFFORT TO HELP THEM GET JOBS AFTER HIGH SCHOOL GRADUATION. STUDENTS FROM GRAND ISLAND SENIOR HIGH ATTENDED CLASSROOM TRAINING AT SAINT FRANCIS AND WORKED IN NUTRITIONAL SERVICES, MAINTENANCE, AND WOUND CARE DEPARTMENTS AMONG OTHERS. THIS PROGRAM HAS BROUGHT MANY REWARDS FOR THE PARTICIPATING STUDENTS AND THE STAFF MEMBERS WHO SERVED AS THEIR MENTORS.
Patient education of eligibility for assistance.Schedule H, Part VI, Line 3NOTICES ARE POSTED (IN ENGLISH & SPANISH) AT ALL REGISTRATION AREAS STATING THAT A COMMUNITY ASSISTANCE PROGRAM ("CAP") IS AVAILABLE. 1. WHEN A PATIENT PRESENTS FOR SERVICES AT SAINT FRANCIS, AND THE INSURANCE LISTED ON THE ACCOUNT IS SELF-PAY (SP) A CAP APPLICATION AUTOMATICALLY PRINTS WITH THE PATIENT'S PAPERWORK. 1A. IF THE PATIENT IS RECEIVING A SERVICE THAT IS BILLABLE BY SAINT FRANCIS, THEY WILL BE GIVEN THIS CAP APPLICATION AND HAVE EXPLAINED TO THEM WHAT THE APPLICATION IS FOR, HOW TO COMPLETE IT AND WHOM TO CONTACT IF THEY HAVE FURTHER QUESTIONS ABOUT WHAT IS REQUIRED TO COMPLETE THE APPLICATION. 2. WHEN A PATIENT PRESENTS FOR A SERVICE/S THAT IS BILLABLE BY SAINT FRANCIS, HAS INSURANCE COVERAGE AND IN ANY WAY EXPRESSES A CONCERN ON HOW THEY'RE GOING TO PAY THEIR CO-PAY/DEDUCTIBLE/NON COVERED EXPENSES ETC. A CAP APPLICATION WILL BE PRINTED OFF AND EXPLAINED TO THEM WHAT THE APPLICATION IS FOR, HOW TO COMPLETE IT AND WHOM TO CONTACT IF THEY HAVE FURTHER QUESTIONS ABOUT WHAT IS REQUIRED TO COMPLETE THE APPLICATION. 3. A CAP APPLICATION CAN BE PRINTED AT ANY TIME. IF SOMEONE REQUESTS AN APPLICATION, STAFF MAY PRINT ONE FROM THE SYSTEM, OR USE A PRE-PRINTED BLANK APPLICATION.
Affiliated health care systemSchedule H, Part VI, Line 6SAINT FRANCIS MEDICAL CENTER, ALONG WITH ITS AFFILIATED OUTPATIENT FACILITIES ARE PART OF CATHOLIC HEALTH INITIATIVES. CATHOLIC HEALTH INITIATIVES (CHI) IS A NATIONAL FAITH-BASED NONPROFIT HEALTH CARE ORGANIZATION WITH HEADQUARTERS IN ENGLEWOOD, COLORADO. CHI'S EXEMPT PURPOSE IS TO SERVE AS AN INTEGRAL PART OF ITS NATIONAL SYSTEM OF HOSPITALS AND OTHER CHARITABLE ENTITIES, WHICH ARE DESCRIBED AS MARKET-BASED ORGANIZATIONS, OR MBOS. AN MBO IS A DIRECT PROVIDER OF CARE OR SERVICES WITHIN A DEFINED MARKET AREA THAT MAY BE AN INTEGRATED HEALTH SYSTEM AND/OR A STAND-ALONE HOSPITAL OR OTHER FACILITY OR SERVICE PROVIDER. CHI SERVES AS THE PARENT CORPORATION OF ITS MBOS WHICH ARE COMPRISED OF 73 HOSPITALS; 40 LONG-TERM CARE, ASSISTED- AND RESIDENTIAL-LIVING FACILITIES; TWO COMMUNITY HEALTH-SERVICES ORGANIZATIONS; TWO ACCREDITED NURSING COLLEGES; AND HOME HEALTH AGENCIES. TOGETHER, THESE FACILITIES PROVIDED $762 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN THE 2013 FISCAL YEAR, INCLUDING SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. CHI PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED "SHARED SERVICES" FOR THE MBOS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES - INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN -- PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE MBOS. THE COST SAVINGS ACHIEVED THROUGH CHI'S CENTRALIZATION ENABLE MBOS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. SAINT FRANCIS MEDICAL CENTER OPERATES WITH ITS WHOLLY OWNED AFFILIATES AND COMMUNITY PARTNERS, ALONG WITH ITS FUNDRAISING ARM, THE SAINT FRANCIS MEDICAL CENTER FOUNDATION, TO SERVE THE HEALTH CARE NEEDS OF THE GRAND ISLAND, NE AND SURROUNDING COMMUNITIES
State filing of community benefit reportSchedule H, Part VI, Line 7NE

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrantAmount Of Cash GrantAmountOfCashGrant
SAINT FRANCIS MEDICAL CENTER FOUNDATION
2620 W FAIDLEYGRAND ISLANDNE68803470630267501(C)(3)41322FMVEMPLOYEE BENEFITSPROGRAM SUPPORT
CENTRAL CATHOLIC DEVELOPMENT FOUNDATION
1200 RUBY AVENUEGRAND ISLANDNE68803470619982501(C)(3)CAPITAL CAMPAIGN103550
GRAND ISLAND EDUCATION FOUNDATION
PO BOX 4904GRAND ISLANDNE68802470735201501(C)(3)CAREER DEVELOPMENT CENTER100000
GRAND ISLAND COMMUNITY FOUNDATION
PO BOX 430GRAND ISLANDNE68802476032570501(C)(3)STATE FAIR16100
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants4TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedures for monitoring use of grant fundsIdentifier
Return ReferenceSchedule I, Part I, Line 2ReturnReference
ExplanationGRANTS INCLUDED IN PART II ARE TO COMPANIES AND COMMUNITY ORGANIZATIONS WHO ENGAGE IN ACTIVITIES THAT BENEFIT THE COMMUNITY AT LARGE. NO CONSIDERATION IS RECEIVED IN EXCHANGE FOR THESE CONTRIBUTIONS, AS THEY ARE CONSIDERED TO BE A GIFT TO BE USED BY THE RECIPIENT IN ACCORDANCE WITH THEIR CHARITABLE PURPOSE. AS SUCH, USE OF THE FUNDS GIVEN TO THE GRANTEE IS NOT MONITORED BEYOND THE DISTRIBUTION. SAINT FRANCIS MEDICAL CENTER RELIES ON THOSE ORGANIZATIONS TO USE THE GRANTS IN ACCORDANCE WITH EACH ORGANIZATION'S EXEMPT PURPOSE.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (19 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
BETH A BARTLETT
QUALITY & RISK MANAGMENT DIRECTOR11599801030804610154390206720162878000
CRAIG VINCENT
PHYSICIAN-ANESTHESIA03876240002257020596020542043101900
DALE HARTWIG
VP OF ANCILLARY SVCS21410403102309998033005013840289514000
DANIEL MCELLIGOTT
PRESIDENT/CEO030947701219500488420566570215980558524025811
DAVID A CROSS
PHARMACIST19837103913057890210580141030243234000
DONNA SANDERS
VP OF MISSION AND COMMUNITY OUTREACH01323940246170191701954807147018562300
DOUGLAS W RICHLING
DIRECTOR-PHARMACY1229520305502520112130189710156443000
FRANCINE SPARBY
VP OF PATIENT CARE SERVICES19742502837109848020684077440264072000
GREGORY S BALFANY
LEAN/SIX SIGMA PEF IMPRV DIR13211301351305110141010211720181410000
JOSHUA GORTEMAKER
PHYSICIAN - ANESTHESIA03837160001513020596019802042562700
LISA THAVENET-WEBB
VP OF FINANCE/CFO215150030755089590280960157820298742000
MEHMET COPUR
PHYSICIAN DIRECTOR-ONCOLOGY0697720000400902809606848073667300
MICHAEL HORN
VP OF MEDICAL AFFAIRS000010859300067410115334000
MICHAEL S HEIN
VP OF MEDICAL AFFAIRS2825940290460324940205960173870382117000
ROBERT LANIK
BOARD MEMBER/SERMC-PRESIDENT/CEO058415201885340251569033096014053010714040152674
ROBERT M NORVELL
DIRECTOR, ONCOLOGY SERVICES1196270984505060136360209640164578000
RYAN RAMAEKERS
PHYSICIAN - ONCOLOGY0409379041500020068020596018576051011900
STEPHEN LEURCK
INTERIM VP MEDICAL AFFAIRS00003111272254900003111272254900
TRACI RAUCH
MED DIRECTOR-ANES042610602600002592023096014654049244800

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Travel for companionsSchedule J, Part I, Line 1aSAINT FRANCIS MEDICAL CENTER PROVIDES COMPANION TRAVEL FOR ITS BOARD MEMBERS WHEN DEEMED APPROPRIATE. THE AMOUNTS PAID TO BOARD MEMBERS BY THE ORGANIZATION FOR COMPANION TRAVEL ARE GROSSED UP AND INCLUDED AS INCOME ON THE BOARD MEMBER'S FORM 1099 OR W-2 AS APPLICABLE.
Arrangement used to establish the top management official's compensationSchedule J, Part I, Line 3COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY CATHOLIC HEALTH INITIATIVES ("CHI"), A RELATED ORGANIZATION. CHI USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3)WRITTEN EMPLOYMENT CONTRACTS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
Severance or change-of-control paymentSchedule J, Part I, Line 4aPOST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR CATHOLIC HEALTH INITIATIVES ("CHI") AND RELATED ORGANIZATIONS' EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE, INCLUDING THE MBO CEOS. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM CATHOLIC HEALTH INITIATIVES (A RELATED ORGANIZATION) DURING THE 2012 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUAL'S W-2 INCOME AND REPORTABLE COMPENSATION ON SCHEDULE J: MICHAEL HORN - $110,319
Supplemental nonqualified retirement planSchedule J, Part I, Line 4bDURING THE 2012 CALENDAR YEAR CATHOLIC HEALTH INITIATIVES ("CHI"), A RELATED ORGANIZATION, MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR MBO CEOS AND OTHER CHI EMPLOYEES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THAT PLAN: ROBERT LANIK AND DANIEL MCELLIGOTT DURING 2012 THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: DANIEL MCELLIGOTT - $28,561 DURING 2012 THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI FROM THE DEFERRED COMPENSATION PLAN: ROBERT LANIK -$152,674, DANIEL MCELLIGOTT -$25,811 DUE TO THE "SUPER" VESTING RULES UNDER THE CHI DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS TERMINATION, AGE, OR YEARS OF SERVICE ARE ELIGIBLE TO RECEIVE THEIR 2012 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2012, THE FOLLOWING CONTRIBUTIONS THAT WOULD HAVE BEEN MADE BY CHI TO THE DEFERRED COMPENSATION PLAN WERE PAID IN CASH: ROBERT LANIK - $66,797 DURING THE CALENDAR YEAR 2012 ST. FRANCIS MEDICAL CENTER PARTICIPATED IN A CALL PAY PLAN. THE PLAN IS A DEFINED CONTRIBUTION, NONQUALIFIED DEFERRED COMPENSATION PLAN THAT PROVIDES FOR CONTRIBUTIONS TO A PARTICIPANT'S ACCOUNT, BUT DOES NOT PROMISE ANY PARTICULAR ULTIMATE BENEFIT TO PARTICIPANTS. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THE PLAN: DOUG BOON, JENNIFER BROWN, TIMOTHY KNUDSEN, AND STEVE SCHNEIDER DURING THE CALENDAR YEAR 2012 THE FOLLOWING CONTRIBUTIONS WERE MADE TO THE CALL PAY PLAN; DOUG BOON, $12,121; JENNIFER BROWN $7,837; TIMOTHY KNUDSEN, $7,293; STEVEN SCHNEIDER, $45,721.
Non-fixed paymentsSchedule J, Part I, Line 7SAINT FRANCIS MEDICAL CENTER PROVIDES VICE PRESIDENTS AND DIRECTORS WITH A BONUS PROGRAM THAT IS BASED ON A COMBINATION OF PERFORMANCE FACTORS, SUCH AS MEETING THE OPERATING MARGIN AT THE NATIONAL, MBO AND MINISTRY LEVELS AS WELL AS ESTABLISHED METRICS FOR PRODUCTIVITY AND PATIENT SATISFACTION SCORES AT THE MBO LEVEL.

Schedule L IRS990ScheduleL

Loan Table LoanTable

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DR MICHAEL HEINBusinessNameLine1
FieldValueIRS element (for citing)
Relationship With OrganizationKEY EMPLOYEERelationshipWithOrganization
Purpose Of LoanRECRUITMENTPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$85,000OriginalPrincipalAmount
Balance Due50881BalanceDue
DefaultfalseDefault
Approved By BoardtrueApprovedByBoard
Written AgreementtrueWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due50881TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
PATHOLOGY SPECIALISTS - SCOTT FRANKFORTER
25% OWNERSHIP192000PATHOLOGY SERVICESfalse
EAKES OFFICE PLUS - MARK MILLER
20% OWNERSHIP294326OFFICE SUPPLIES/FURNITUREfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
EXECUTIVE COMMITTEE COMPOSITION AND AUTHORITYFORM 990, PART VI, LINE 1APURSUANT TO SECTION 8.6 OF THE BYLAWS OF SAINT FRANCIS MEDICAL CENTER, THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, THE BOARD VICE CHAIR, THE PRESIDENT, CEO AND FOUR VOTING MEMBERS APPOINTED BY THE BOARD. PURSUANT TO SECTION 8.1 OF THE CORPORATION'S BYLAWS, COMMITTEES, SUCH AS THE EXECUTIVE COMMITTEE, THAT ARE GRANTED THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MAY INCLUDE ONLY DIRECTORS OF THE CORPORATION. FURTHER, PURSUANT TO SECTION 8.6 OF THE CORPORATION'S BYLAWS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS.
Classes of members or stockholdersForm 990, Part VI, Section A, Line 6THE ORGANIZATION'S SOLE CORPORATE MEMBER IS CHI NEBRASKA, A NEBRASKA NONPROFIT CORPORATION.
Members or stockholders electing members of governing bodyForm 990, Part VI, Section A, Line 7aIN ACCORDANCE WITH THE ORGANIZATION'S CORPORATION BYLAWS, THE SOLE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE ORGANIZATION'S BOARD OF DIRECTORS.
Decisions requiring approval by members or stockholdersForm 990, Part VI, Section A, Line 7bTHE ORGANIZATION'S CORPORATE MEMBER IS CHI NEBRASKA. PURSUANT TO SECTION 5.4.1 OF THE ORGANIZATION'S BYLAWS, CHI NEBRASKA, AND CATHOLIC HEALTH INITITIAVES (CHI NEBRASKA'S SOLE CORPORATE MEMBER) ("CHI") HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI NEBRASKA BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI NEBRASKA CHIEF EXECUTIVE OFFICER: -SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF SAINT FRANCIS MEDICAL CENTER -AMENDMENT OF THE CORPORATE DOCUMENTS OF SAINT FRANCIS MEDICAL CENTER -APPROVE MEMBERS OF SAINT FRANCIS MEDICAL CENTER'S BOARD -REMOVAL OF A MEMBER OF THE GOVERNING BODY OF SAINT FRANCIS MEDICAL CENTER -APPROVAL OF ISSUANCE OF DEBT BY SAINT FRANCIS MEDICAL CENTER -APPROVAL OF PARTICIPATION OF SAINT FRANCIS MEDICAL CENTER IN A JOINT VENTURE -APPROVAL OF FORMATION OF A NEW CORPORATION BY SAINT FRANCIS MEDICAL CENTER -APPROVAL OF A MERGER INVOLVING SAINT FRANCIS MEDICAL CENTER -APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF SAINT FRANCIS MEDICAL CENTER -TO REQUIRE THE TRANSFER OF ASSETS BY THE SAINT FRANCIS MEDICAL CENTER TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR SAINT FRANCIS MEDICAL CENTER. PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, CHI MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE.
Review of form 990 by governing bodyForm 990, Part VI, Section B, Line 11bCHI NEBRASKA'S (THE ORGANIZATION'S CORPORATE MEMBER) CFO IS RESPONSIBLE FOR REVIEWING THE FINAL TAX RETURN PREPARED BY THE CHI TAX DEPARTMENT FOR ANY POTENTIAL ERRORS, OMISSIONS, OR CLARIFICATIONS NEEDED FOR PROPER PRESENTATION. AFTER THE FINAL CHANGES ARE MADE TO THE FORM 990, THE RETURNS ARE POSTED TO A SECURED BOARD COLLABORATION SITE FOR REVIEW BY THE BOARD MEMBERS. SUBSEQUENT TO DISTRIBUTION TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
Conflict of interest policyForm 990, Part VI, Section B, Line 12cALL BOARD MEMBERS, OFFICERS, DIRECTORS AND OTHER MEMBERS OF MANAGEMENT OF SAINT FRANCIS MEDICAL CENTER WILL COMPLETE THE "AGREEMENT TO DISCLOSE CONFLICT OF INTEREST AND MAINTAIN CONFIDENTIALITY OF INFORMATION" FORM UPON ASSUMING OFFICE OR EMPLOYMENT, AND ANNUALLY THEREAFTER. IF A POTENTIAL CONFLICT OF INTEREST ARISES BETWEEN ANNUAL DISCLOSURE DATES, THE INDIVIDUAL WILL IMMEDIATELY DISCLOSE RELEVANT INFORMATION TO THE CHIEF EXECUTIVE OFFICER OF SAINT FRANCIS MEDICAL CENTER. BOARDS OF ALL CATHOLIC HEALTH INITIATIVES INSTITUTIONS REQUIRE EACH INSTITUTION TO APPROVE A CONFLICT OF INTEREST POLICY WHICH SHALL NOT BE INCONSISTENT WITH THE CHI CONFLICT OF INTEREST POLICY. THE "POLICY REGARDING CONFLICTS OF INTEREST FOR OFFICERS AND DIRECTORS" FOR SAINT FRANCIS MEDICAL CENTER AND ITS AFFILIATES AND "AGREEMENT TO DISCLOSE CONFLICT OF INTEREST AND MAINTAIN CONFIDENTIALITY OF INFORMATION" FORMS ARE MAINTAINED IN THE EXECUTIVE OFFICE. DISCLOSURE, REVIEW AND INITIAL DETERMINATION: 1. GENERAL OBLIGATION. EACH DIRECTOR MUST PROMPTLY AND FULLY REPORT TO THE BOARD CHAIR SITUATIONS THAT MAY CREATE A CONFLICT OF INTEREST WHEN HE OR SHE BECOMES AWARE OF SUCH SITUATIONS. IN THE CASE OF AN OFFICER, DISCLOSURE MUST BE MADE TO THE CORPORATION'S PRESIDENT/CHIEF EXECUTIVE OFFICER WHO WILL REPORT SUCH DISCLOSURE TO THE BOARD CHAIR. IN ANY SITUATION WHEN A DIRECTOR OR OFFICER IS IN DOUBT, FULL DISCLOSURE SHOULD BE MADE SO AS TO PERMIT AN IMPARTIAL AND OBJECTIVE DETERMINATION. A WRITTEN RECORD OF THE DISCLOSURE WILL BE MADE. 2. ANNUAL DISCLOSURE STATEMENT. IN ADDITION TO THE ONGOING DISCLOSURE OBLIGATION, THE CORPORATION'S PRESIDENT/CHIEF EXECUTIVE OFFICER SHALL ANNUALLY SEND TO ALL DIRECTORS AND OFFICERS A COPY OF THIS POLICY AND THE CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DIRECTORS AND OFFICERS MUST PROMPTLY COMPLETE, SIGN, AND RETURN THE STATEMENT TO THE CORPORATION'S PRESIDENT AND CEO. THE COMPLETED STATEMENTS WILL BE REVIEWED BY THE PRESIDENT AND CEO AND THE BOARD CHAIR. 3. REVIEW, EVALUATION AND INITIAL DETERMINATION. THE BOARD CHAIR OR DESIGNEE SHALL MAKE SUCH FURTHER INVESTIGATION OF ANY CONFLICT OF INTEREST DISCLOSURES AS HE OR SHE MAY DEEM APPROPRIATE. IF THE CONFLICT INVOLVES THE BOARD CHAIR, THE VICE CHAIR WILL ASSUME THE CHAIR'S ROLE OUTLINED IN THIS POLICY. BASED ON REVIEW AND EVALUATION OF THE RELEVANT FACTS AND CIRCUMSTANCES, THE BOARD CHAIR WILL MAKE AN INITIAL DETERMINATION AS TO WHETHER A CONFLICT OF INTEREST EXISTS AND WHETHER, PURSUANT TO THIS POLICY, REVIEW AND APPROVAL OR OTHER ACTION BY THE BOARD OF DIRECTORS IS REQUIRED. A WRITTEN RECORD OF THE BOARD CHAIR'S DETERMINATION, INCLUDING RELEVANT FACTS AND CIRCUMSTANCES, WILL BE MADE. THE BOARD CHAIR SHALL THEN MAKE AN APPROPRIATE REPORT TO THE EXECUTIVE COMMITTEE OF THE BOARD CONCERNING SUCH REVIEW, EVALUATION AND DETERMINATION. IF A DIFFERENCE OF OPINION EXISTS BETWEEN THE BOARD CHAIR AND ANOTHER DIRECTOR OR OFFICER AS TO WHETHER THE FACTS AND CIRCUMSTANCES OF A GIVEN SITUATION CONSTITUTE A CONFLICT OF INTEREST OR WHETHER BOARD OF DIRECTORS REVIEW AND APPROVAL OR OTHER ACTION IS REQUIRED WITHIN THIS POLICY, THE MATTER SHALL BE SUBMITTED TO THE BOARD'S EXECUTIVE COMMITTEE, WHICH SHALL MAKE A FINAL DETERMINATION AS TO THE MATTER PRESENTED. SUCH DETERMINATION, INCLUDING RELEVANT FACTS AND CIRCUMSTANCES, WILL BE REFLECTED IN THE COMMITTEE MINUTES AND WILL BE REPORTED TO THE BOARD OFDIRECTORS. BOARD REVIEW: TRANSACTIONAL CONFLICT OF INTEREST 1. THE BOARD OF DIRECTORS SHALL CAREFULLY SCRUTINIZE AND MUST IN GOOD FAITH APPROVE OR DISAPPROVE ANY TRANSACTION IN WHICH THE CORPORATION AND/OR ANY OF ITS AFFILIATES IS A PARTY AND IN WHICH ONE OR MORE OF THE CORPORATION'S DIRECTORS OR OFFICERS EITHER: A. HAS A MATERIAL FINANCIAL INTEREST; OR B. IS A DIRECTOR OR OFFICER OF THE OTHER PARTY OTHER THAN THE CORPORATION'S OWN AFFILIATES. 2. THE BOARD OF DIRECTORS MUST APPROVE THE TRANSACTION BY A MAJORITY OF THE DIRECTORS ON THE BOARD, WITHOUT COUNTING THE VOTE OF ANY DIRECTOR WHO HAS AN INTEREST IN THE TRANSACTION. IN REVIEWING SUCH TRANSACTIONS BETWEEN THE CORPORATION AND VENDORS OR OTHER CONTRACTORS WHO ARE, OR ARE AFFILIATED WITH, DIRECTORS OR OFFICERS, THE BOARD SHALL ACT NO MORE OR LESS FAVORABLY THAN IT WOULD IN REVIEWING TRANSACTIONS WITH UNRELATED THIRD PARTIES. THE TRANSACTION WILL NOT BE APPROVED UNLESS THE BOARD DETERMINES THAT THE TRANSACTION IS FAIR TO THE CORPORATION. OTHER CONFLICTS OF INTEREST: THE BOARD SHALL CAREFULLY REVIEW AND SCRUTINIZE NON-TRANSACTIONAL CONFLICT OF INTEREST (E.G., DISCLOSURE OF NONPUBLIC INFORMATION, COMPETITION WITH THE CORPORATION, FAILURE TO DISCLOSE A CORPORATE OPPORTUNITY, EXCESSIVE GIFTS OR ENTERTAINMENT, ETC.). BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS, THE BOARD SHALL TAKE WHATEVER ACTION IS DEEMED APPROPRIATE WITH RESPECT TO THE DIRECTOR OR OFFICER UNDER THE CIRCUMSTANCES, INCLUDING POSSIBLE DISCIPLINARY OR CORRECTIVE ACTION, IN ORDER TO BEST PROTECT THE INTERESTS OF THE CORPORATION. THE BOARD SHOULD CONSULT WITH A MEMBER OF THE CHI LEGAL RESOURCE GROUP WHEN CONSIDERING DISCIPLINARY OR CORRECTIVE ACTION. DISCLOSURE BY INTERESTED DIRECTOR: WHEN ANY CONFLICT OF INTEREST IS CONSIDERED BY THE BOARD, THE DIRECTOR OR OFFICER MUST DISCLOSE ALL OF THE MATERIAL FACTS TO THE BOARD. THE DIRECTOR SHALL NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. HOWEVER, IF REQUESTED, SUCH DIRECTOR OR OFFICER IS NOT PREVENTED FROM BRIEFLY STATING HIS OR HER POSITION IN THE MATTER, NOR FROM ANSWERING PERTINENT QUESTIONS FROM BOARD MEMBERS, AS HIS OR HER KNOWLEDGE MAY BE OF SIGNIFICANT IMPORTANCE. THE DIRECTOR OR OFFICER SHALL BE EXCUSED FROM THE MEETING DURING DISCUSSION AND VOTE ON THE CONFLICT OF INTEREST. RECORD OF PROCEEDINGS: MINUTES OF THE BOARD OF DIRECTORS SHALL REFLECT THE FOLLOWING: THE INDIVIDUAL MAKING THE DISCLOSURE, THE NATURE OF THE DISCLOSURE, DISCUSSION REGARDING ANY PROPOSED TRANSACTION, THE DECISION MADE BY THE BOARD, AND THAT THE INTERESTED DIRECTOR ABSTAINED FROM VOTING. IMPLEMENTATION AND INTERPRETATION: QUESTIONS REGARDING THE IMPLEMENTATION AND INTERPRETATION OF THIS POLICY SHALL BE REFERRED TO A MEMBER OF THE CHI LEGAL RESOURCE GROUP. POLICY VIOLATIONS: IF THE BOARD REASONABLY BELIEVES THAT A DIRECTOR OR OFFICER HAS FAILED TO DISCLOSE EITHER AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, OR ALL MATERIAL FACTS SURROUNDING AN ACTUAL OR POSSIBLE CONFLICT AS REQUIRED BY THIS POLICY, THE DIRECTOR OR OFFICER WILL BE GIVEN AN OPPORTUNITY TO EXPLAIN SUCH ALLEGED FAILURE TO DISCLOSE. AFTER HEARING THE RESPONSE OF THE DIRECTOR OR OFFICER, THE BOARD WILL CONDUCT SUCH ADDITIONAL INVESTIGATION AS MAY BE APPROPRIATE. IF THE BOARD DETERMINES THAT THE DIRECTOR OR OFFICER HAS IN FACT FAILED TO DISCLOSE AS REQUIRED BY THIS POLICY, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION.
PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIALFORM 990, PART VI, LINE 15ATHE ORGANIZATION'S CEO'S COMPENSATION IS PAID BY CHI. CHI HAS A DEFINED COMPENSATION PHILOSOPHY. BOTH THE EXECUTIVE AND NON-EXECUTIVE COMPENSATION STRUCTURES AND RANGES ARE REVIEWED ANNUALLY IN COMPARISON TO MARKET DATA. CHI USES THE HAY GROUP AS THE INDEPENDENT THIRD PARTY TO ASSESS EXECUTIVE COMPENSATION PROGRAMS AND TO ENSURE THE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. COMPENSATION OF THE SENIOR MOST EXECUTIVES IS REVIEWED ANNUALLY. THE HAY GROUP REVIEWS BOTH CASH AND TOTAL COMPENSATION FOR OVERALL REASONABLENESS, FOR ADHERENCE TO CHI'S COMPENSATION PHILOSOPHY, AND FOR COMPARABILITY TO THE NOT-FOR-PROFIT HEALTHCARE MARKET. THIS INDEPENDENT REVIEW IS DELIVERED BY HAY GROUP TO THE HR COMMITTEE OF THE CHI BOARD OF STEWARDSHIP TRUSTEES ANNUALLY AT THEIR SEPTEMBER MEETING AND MINUTES ARE SHARED WITH THE FULL BOARD AT THE DECEMBER MEETING. THE LAST REVIEW WAS SEPTEMBER 17, 2013. IN ADDITION, IN DECEMBER 2009, HAY GROUP COMPLETED A COMPREHENSIVE REVIEW OF ALL POSITIONS AT THE LEVEL OF VICE PRESIDENT AND ABOVE TO DETERMINE AND VALIDATE APPROPRIATE COMPENSATION LEVELS. THESE LEVELS HAVE BEEN REVIEWED ANNUALLY SINCE AND REVISED BASED ON MARKET DATA, WHERE APPLICABLE.
Process used to establish compensation of other officers/key employeesForm 990, Part VI, Section B, Line 15bHR ADVANTAGE HAS SERVED AS THE INDEPENDENT COMPENSATION CONSULTANT FOR THE NEBRASKA FACILITIES IN 2012. HR ADVANTAGE REVIEWED ALL NEBRASKA MINISTRIES' VP AND EXECUTIVE DIRECTORS COMPENSATION LEVELS AND PROVIDED A REPORT WITH COMPARABILITY DATA TO CHI NEBRASKA HR LEADERS TO REVIEW WITH LOCAL CEOS, CONFIRMING THE REASONABLENESS OF MBO EXECUTIVE'S COMPENSATION AND PHILOSOPHY. COMPENSATION PACKAGE AND BONUS POTENTIAL FOR EXECUTIVE LEADERS ARE APPROVED BY THE LOCAL BOARDS OF EACH MINISTRY. THE HIGHEST PAID EMPLOYEES ARE PHYSICIANS. THEIR COMPENSATION WAS REVIEWED BY AN INDEPENDENT COMPENSATION CONSULTANT. THERE IS A PHYSICIAN EMPLOYMENT AGREEMENT CONTRACT WITH EACH EMPLOYED PHYSICIAN (NOTE PHYSICIANS ARE PAID BY A RELATED ORGANIZATION). CONTRACTS INCLUDE A MAXIMUM COMPENSATION BASED UPON AN OVERALL PERCENTILE NATIONAL COMPENSATION PER SPECIALTY AS REPORTED IN THE MOST RECENT VERSION OF THE PHYSICIAN COMPENSATION AND PRODUCTION SURVEY AS PUBLISHED BY THE MGMA
FORMAL POLICIES CONCERNING PARTICIPATION IN JOINT VENTURESFORM 990, PART VI, LINE 16BSAINT FRANCIS MEDICAL CENTER HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER CHI'S SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS; AND (5) ALL CONTRACTS ENTERED INTO BY THE PARTNERSHIP WITH THE EXEMPT ORGANIZATION MUST BE AT ARM'S-LENGTH, WITH PRICES SET AT FAIR MARKET VALUE. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL.
Governing documents, conflict of interest policy and financial statements available to the publicForm 990, Part VI, Section C, Line 19SAINT FRANCIS MEDICAL CENTER'S FINANCIAL STATEMENTS ARE INCLUDED IN THE CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEATHINT.ORG OR AT WWW.DACBOND.COM THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. THE GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC.
Other ExpensesForm 990, Part IX, Line 11gCONTRACT SERVICES - TOTAL EXPENSE: 9416707, PROGRAM SERVICE EXPENSE: 7243528, MANAGEMENT AND GENERAL EXPENSES: 2173179, FUNDRAISING EXPENSES: ; CONTRACT LABOR - TOTAL EXPENSE: 721160, PROGRAM SERVICE EXPENSE: 554731, MANAGEMENT AND GENERAL EXPENSES: 166429, FUNDRAISING EXPENSES: ; OTHER CONTRACT PROFESSIONALS - TOTAL EXPENSE: 3520670, PROGRAM SERVICE EXPENSE: 2708173, MANAGEMENT AND GENERAL EXPENSES: 812497, FUNDRAISING EXPENSES: ; MEDICAL PROFESSIONALS - TOTAL EXPENSE: 4004881, PROGRAM SERVICE EXPENSE: 3080638, MANAGEMENT AND GENERAL EXPENSES: 924243, FUNDRAISING EXPENSES: ; MISCELLANEOUS PURCHASED SERVICES - TOTAL EXPENSE: 3386169, PROGRAM SERVICE EXPENSE: 2604712, MANAGEMENT AND GENERAL EXPENSES: 781457, FUNDRAISING EXPENSES: ; OTHER FEES FOR SERVICES - TOTAL EXPENSE: 675884, PROGRAM SERVICE EXPENSE: 519904, MANAGEMENT AND GENERAL EXPENSES: 155980, FUNDRAISING EXPENSES: ;
Other changes in net assets or fund balancesForm 990 , Part XI, Line 9GAAP ADJUSTMENT - -2027238; CHI CONNECT DEPRECIATION - 136674; TEMPORARILY RESTRICTED ASSETS - -60628;

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (153 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodePrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgBusiness Name Line2NameOfDisregardedEntity/BusinessNameLine2
ALEGENT CREIGHTON CLINIC
12809 WEST DODGE ROADOMAHANE68154HEALTHCARENE501(C)(3)3ACHtrue
ALEGENT CREIGHTON HEALTH
12809 WEST DODGE ROADOMAHANE68154HEALTHCARENE501(C)(3)3NAtrue
ALEGENT HEALTH - BERGAN MERCY HEALTH SYS
7500 MERCY ROADOMAHANE68124HEALTHCARENE501(C)(3)3ACHtrue
ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA
631 N 8TH STREETMISSOURI VALLEYIA51555HEALTHCAREIA501(C)(3)3AHIMCtrue
ALEGENT HEALTH FOUNDATION
12809 WEST DODGE ROADOMAHANE68154FUNDRAISINGNE501(C)(3)7ACHtrue
ALEGENT HEALTH IMMANUEL MEDICAL CENTER
6901 NORTH 72ND STREETOMAHANE68122HEALTHCARENE501(C)(3)3ACHtrue
ALEGENT HEALTH MEMORIAL HOSPITAL SCHUYLER NE
104 W 17TH STREETSCHUYLERNE68661HEALTHCARENE501(C)(3)3AHIMCtrue
ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA
PO BOX 368CORNINGIA50841HEALTHCAREIA501(C)(3)3AHBMHStrue
ALVERNA APARTMENTS
300 SE 8TH AVENUELITTLE FALLSMN56345LTERM CAREMN501(C)(3)9CHItrue
APPLETREE COURT
601 OAK STREETBRECKENRIDGEMN56520SENIOR HOMESMN501(C)(3)9SFHtrue
BISHOP DRUMM RETIREMENT CENTER
1111 6TH AVENUEDES MOINESIA50314LTERM CAREIA501(C)(3)9CHI-IA CORPtrue
BORNEMANN HEALTH CORPORATION
2500 BERNVILLE RD PO BOX 316READINGPA19603HEALTHCAREPA501(C)(3)11 - Type ICHItrue
CARRINGTON HEALTH CENTER
800 NORTH 4TH STREETCARRINGTONND58421HEALTHCAREND501(C)(3)3CHItrue
CATHOLIC HEALTH INITIATIVES
198 INVERNESS DRIVE WESTENGLEWOODCO80112HEALTHCARECO501(C)(3)9NAtrue
CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
6385 CORPORATE DRIVECOLORADO SPRINGSCO80919FUNDRAISINGCO501(C)(3)7CHICtrue
CATHOLIC HEALTH INITIATIVES INSTITUTE FOR RESEARCH AND INNOVATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112HEALTHCARECO501(C)(3)11 - Type ICHItrue
CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION
6385 CORPORATE DRIVECOLORADO SPRINGSCO80919FUNDRAISINGCO501(C)(3)9CHItrue
CATHOLIC HEALTH INITIATIVES-COLORADO
188 INVERNESS DRIVE WEST SUITE 500ENGLEWOODCO80112HEALTHCARECO501(C)(3)3CHItrue
CATHOLIC HEALTH INITIATIVES-IOWA CORP DBA MERCY MEDICAL CENTER-DES MOINES
1111 6TH AVENUEDES MOINESIA50314HEALTHCAREIA501(C)(3)3CHItrue
CENTENNIAL MEDICAL GROUP INC
2700 STEWART PARKWAYROSEBURGOR97470PHYSICIANSOR501(C)(3)9MMCtrue
CENTRAL KANSAS MEDICAL CENTER
3515 BROADWAYGREAT BENDKS67530SURGERY CNTRKS501(C)(3)3CHItrue
CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PARKWAY SOUTHFARGOND58104HEALTHCAREND501(C)(3)9CHItrue
CHI KENTUCKY INC
3900 OLYMPIC BLVD SUITE 400ERLANGERKY41018HEALTHCAREKY501(C)(3)11 - Type ICHItrue
CHI NATIONAL HOME CARE
198 INVERNESS DRIVE WESTENGLEWOODCO80112HEALTHCARECO501(C)(3)9CHI NHCtrue
CHI NATIONAL SERVICES
198 INVERNESS DRIVE WESTENGLEWOODCO80112HEALTHCARECO501(C)(3)11 - Type ICHItrue
CHI NEBRASKA
6940 O STREETLINCOLNNE68510HEALTHCARENE501(C)(3)11 - Type ICHItrue
COMMUNITY LIMITED CARE DIALYSIS CENTER
619 OAK STREET - ACCOUNTING 3 WESTCINCINNATIOH45206DIALYSISOH501(C)(2)N/AGSHtrue
COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION MISSOURI VALLEY IA
631 N 8TH STREETMISSOURI VALLEYIA51555FUNDRAISINGIA501(C)(3)11 - Type IAHCMHtrue
CONTINUING CARE HOSPITAL
150 NORTH EAGLE CREEK DRIVELEXINGTONKY40509LTACHKY501(C)(3)3SJHStrue
COVENANT HOME CARE
198 INVERNESS DRIVE WESTENGLEWOODCO80112HOME HEALTHPA501(C)(3)11 - Type IINAtrue
ENUMCLAW REGIONAL HOSPITAL ASSOCIATION
1450 BATTERSBY AVENUEENUMCLAWWA98022HEALTHCAREWA501(C)(3)3FHStrue
FLAGET HEALTHCARE INC
4305 NEW SHEPHERDSVILLE ROADBARDSTOWNKY40004HEALTHCAREKY501(C)(3)3KOHtrue
FLAGET MEMORIAL HOSPITAL FOUNDATION
4305 NEW SHEPHERDSVILLE ROADBARDSTOWNKY40004FUNDRAISINGKY501(C)(3)11 - Type IFHtrue
FRANCISCAN FOUNDATION
1717 SOUTH J STREETTACOMAWA98405FUNDRAISINGWA501(C)(3)9FHStrue
FRANCISCAN HEALTH SYSTEM
1717 SOUTH J STREETTACOMAWA98405HEALTHCAREWA501(C)(3)3CHItrue
FRANCISCAN MEDICAL GROUP
1708 SOUTH YAKIMA AVENUETACOMAWA98405HEALTHCAREWA501(C)(3)9FHStrue
FRANCISCAN VILLA OF SOUTH MILWAUKEE
3601 SOUTH CHICAGO AVENUESOUTH MILWAUKEEWI53172HEALTHCAREWI501(C)(3)9CHItrue
GETTYSBURG MEDICAL CENTER
606 EAST GARFIELD AVENUEGETTYSBURGSD57442HEALTHCARESD501(C)(3)3SMHCtrue
GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WESTENGLEWOODCO80112MINISTRIESCO501(C)(3)11 - Type ICHItrue
GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE
619 OAK STREET - ACCOUNTING 3 WESTCINCINNATIOH45206EDUCATIONOH501(C)(3)2GSHtrue
GOOD SAMARITAN FOUNDATION OF CINCINNATI INC
619 OAK STREET - ACCOUNTING 3 WESTCINCINNATIOH45206FUNDRAISINGOH501(C)(3)11 - Type IGSHtrue
GOOD SAMARITAN HOSPITAL
PO BOX 1990KEARNEYNE68848HEALTHCARENE501(C)(3)3CHI NEBRASKAtrue
GOOD SAMARITAN HOSPITAL FOUNDATION
111 W 31ST STREETKEARNEYNE68847FUNDRAISINGNE501(C)(3)7GSHtrue
ST LUKE'S MEDICAL GROUP FKA GREATER HOUSTON HEALTH NETWORK
6624 FANNINHOUSTONTX77030PHY PRACTICESTX501(C)(3)3SLHStrue
HEALTH SET
4200 WEST CONEJOS PLACE 436DENVERCO80204LOW INC.CARECO501(C)(3)7CHICtrue
HEALTHCARE AND WELLNESS FOUNDATION
2400 ST FRANCIS DRIVEBRECKENRIDGEMN56520FUNDRAISINGMN501(C)(3)11 - Type ISFMCtrue
HIGHLINE MEDICAL CENTER
16251 SYLVESTER RD SWBURIENWA98166HEALTHCAREWA501(C)(3)3FHStrue
HOSPITAL ASSOCIATION FOR ST JOSEPH HOSPITAL
7601 OSLER DRIVETOWSONMD21204HEALTHCAREMD501(C)(3)9SJMCtrue
HOUSE OF MERCY
1111 6TH AVENUEDES MOINESIA50314SHELTERIA501(C)(3)7CHI-IA CORPtrue
JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC
539 S 4TH STREETLOUISVILLEKY40202HEALTHCAREKY501(C)(3)3KOHtrue
JEWISH PHYSICIAN GROUP INC
539 S 4TH STREETLOUISVILLEKY40202HEALTHCAREKY501(C)(3)9JHSMHtrue
KENTUCKYONE HEALTH INC FKA JH PROPERTIES INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202HEALTHCAREKY501(C)(3)9CHItrue
LAKEWOOD HEALTH CENTER
600 MAIN AVENUE SOUTHBAUDETTEMN56623HEALTHCAREMN501(C)(3)3CHItrue
LINUS OAKES INC
2700 STEWART PARKWAYROSEBURGOR97470SENIOR LIVINGOR501(C)(3)9MMCtrue
LISBON AREA HEALTH SERVICES
905 MAIN STREETLISBONND58054HEALTHCAREND501(C)(3)3CHItrue
MEMORIAL HEALTH CARE SYSTEM FOUNDATION
2525 DE SALES AVENUECHATTANOOGATN37404FUNDRAISINGTN501(C)(3)7MHCStrue
MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVENUECHATTANOOGATN37404HEALTHCARETN501(C)(3)3CHItrue
MEMORIAL HEALTH PARTNERS FOUNDATION INC
5600 BRAINERD ROAD SUITE 500CHATTANOOGATN37411HEALTHCARETN501(C)(3)9MHCStrue
MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVENUEDES MOINESIA50314AUXILIARYIA501(C)(3)11 - Type ICHI-IA CORPtrue
MERCY CLINICS INC
1111 6TH AVENUEDES MOINESIA50314PHYSICIANIA501(C)(3)9CHI-IA CORPtrue
MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVENUEDES MOINESIA50314EDUCATIONIA501(C)(3)2CHI-IA CORPtrue
MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVENUEDES MOINESIA50314FUNDRAISINGIA501(C)(3)7CHI-IA CORPtrue
MERCY FOUNDATION INC
2700 STEWART PARKWAYROSEBURGOR97470FUNDRAISINGOR501(C)(3)7MMCtrue
MERCY HEALTH CARE FOUNDATION
PO BOX 368CORNINGIA50841FUNDRAISINGNE501(C)(3)11 - Type IAHMHtrue
MERCY HEALTHCARE FOUNDATION
570 CHAUTAUQUA BOULEVARDVALLEY CITYND58072FUNDRAISINGND501(C)(3)11 - Type III - FIMHVCtrue
MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DRIVECOUNCIL BLUFFSIA51503FUNDRAISINGIA501(C)(3)11 - Type IAHBMHStrue
MERCY HOSPITAL OF DEVILS LAKE
1031 SEVENTH STREET NEDEVILS LAKEND58301HEALTHCAREND501(C)(3)3CHItrue
MERCY HOSPITAL OF DEVILS LAKE FOUNDATION
1031 SEVENTH STREET NEDEVILS LAKEND58301FUNDRAISINGND501(C)(3)7CHItrue
MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BOULEVARDVALLEY CITYND58072HEALTHCAREND501(C)(3)3CHItrue
MERCY MEDICAL CENTER
1301 15TH AVENUE WESTWILLISTONND58801HEALTHCAREND501(C)(3)3CHItrue
MERCY MEDICAL CENTER - CENTERVILLE
ONE ST JOSEPHS DRIVECENTERVILLEIA52544HEALTHCAREIA501(C)(3)3CHI-IA CORPtrue
MERCY MEDICAL CENTER INC
2700 STEWART PARKWAYROSEBURGOR97470HEALTHCAREOR501(C)(3)3CHItrue
MERCY MEDICAL FOUNDATION
1301 15TH AVENUE WESTWILLISTONND58801FUNDRAISINGND501(C)(3)11 - Type IMMCtrue
MERCY PROFESSIONAL PRACTICE ASSOCIATES INC
1111 6TH AVENUEDES MOINESIA50314PHYSICIANIA501(C)(3)9CHI-IA CORPtrue
MLIFECARES
198 INVERNESS DRIVE WESTENGLEWOODCO80112PROPERTY MGMTMO501(C)(3)11 - Type ISJRMCtrue
MNMCH INC
198 INVERNESS DRIVE WESTENGLEWOODCO80112HEALTHCAREKS501(C)(3)3SJRMCtrue
MT ST JOSEPH INC
198 INVERNESS DRIVE WESTENGLEWOODCO80112NURSING CAREOR501(C)(3)11 - Type ICHItrue
NEBRASKA HEART HOSPITAL
7500 SOUTH 91ST STREETLINCOLNNE68526HEALTHCARENE501(C)(3)3CHI NEBRASKAtrue
OAKES COMMUNITY HOSPITAL
314 SOUTH 8TH STREETOAKESND58474HEALTHCAREND501(C)(3)3CHItrue
OAKES COMMUNITY HOSPITAL FOUNDATION
1200 N 7TH STREETOAKESND58474FUNDRAISINGND501(C)(3)11 - Type IOCHtrue
PUEBLO STEPUP
1925 EAST ORMAN AVE SUITE G52PUEBLOCO81004COMMUNITYCO501(C)(3)7CHICtrue
SET OF COLORADO SPRINGS INC
2864 S CIRCLE DRIVE SUITE 450COLORADO SPRINGSCO80906LTERM CARECO501(C)(3)7CHICtrue
SAINT CLARE'S COMMUNITY CARE
25 POCONO ROADDENVILLENJ07834HEALTHCARENJ501(C)(3)11 - Type IISCHStrue
SAINT CLARE'S FOUNDATION
25 POCONO ROADDENVILLENJ07834FUNDRAISINGNJ501(C)(3)7SCHStrue
SAINT CLARE'S HEALTH SERVICES INC
25 POCONO ROADDENVILLENJ07834MANAGEMENTNJ501(C)(3)7CHItrue
SAINT CLARE'S HOSPITAL
25 POCONO ROADDENVILLENJ07834HEALTHCARENJ501(C)(3)3SCHStrue
SAINT ELIZABETH FOUNDATION
555 SOUTH 70TH STREETLINCOLNNE68510FUNDRAISINGNE501(C)(3)7SERMCtrue
SAINT ELIZABETH HEALTH SERVICES
555 SOUTH 70TH STREETLINCOLNNE68510HEALTHCARENE501(C)(3)3SERMCtrue
SAINT ELIZABETH REGIONAL MEDICAL CENTER
555 SOUTH 70TH STREETLINCOLNNE68510HEALTHCARENE501(C)(3)3CHI NEBRASKAtrue
SAINT FRANCIS MEDICAL CENTER
2620 WEST FAIDLEYGRAND ISLANDNE68803HEALTHCARENE501(C)(3)3CHI NEBRASKAtrue
SAINT FRANCIS MEDICAL CENTER FOUNDATION
PO BOX 9804GRAND ISLANDNE68802FUNDRAISINGNE501(C)(3)7SFMCtrue
SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC
305 ESTILL STREETBEREAKY40403FUNDRAISINGKY501(C)(3)7SJHStrue
SAINT JOSEPH HEALTH SYSTEM INC
424 LEWIS HARGETT CIRCLE 160LEXINGTONKY40503HEALTHCAREKY501(C)(3)3CHItrue
SAINT JOSEPH LONDON FOUNDATION INC
1001 SAINT JOSEPH LANELONDONKY40741FUNDRAISINGKY501(C)(3)7SJHStrue
SAINT JOSEPH MEDICAL FOUNDATION INC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202PHY PRACTICESKY501(C)(3)3SJHStrue
SAINT JOSEPH MOUNT STERLING FOUNDATION INC
225 FALCON DRIVEMOUNT STERLINGKY40353FUNDRAISINGKY501(C)(3)7SJHStrue
SAINT JOSEPH'S HOSPITAL FOUNDATION
30 WEST 7TH STREETDICKINSONND58601FUNDRAISINGND501(C)(3)11 - Type ISJHHCtrue
SAMARITAN BEHAVIORAL HEALTH
2222 PHILADELPHIA DRIVEDAYTONOH45406HEALTHCAREOH501(C)(3)3SHPtrue
SAMARITAN HEALTH FOUNDATION
2222 PHILADELPHIA DRIVEDAYTONOH45406FUNDRAISINGOH501(C)(3)7SHPtrue
SAMARITAN HEALTH PARTNERS
110 NORTH MAIN STREETDAYTONOH45402HEALTHCAREOH501(C)(3)11 - Type ICHItrue
SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC
104 W 17TH STREETSCHUYLERNE68661FUNDRAISINGNE501(C)(3)11 - Type IAHMHStrue
SJMGROUP
198 INVERNESS DRIVE WESTENGLEWOODCO80112PHYS PRACTICEMO501(C)(3)9SJRMCtrue
SJRMC JOPLIN MISSOURI
198 INVERNESS DRIVE WESTENGLEWOODCO80112HEALTHCAREMO501(C)(3)3CHItrue
SL AUGUSTA CORP
PO BOX 20269HOUSTONTX77225TITLE HOLDINGTX501(C)(2)N/ASL PROPERTIEStrue
ST JOSEPH HEALTH MINISTRIES
1929 LINCOLN HWY E STE 150LANCASTERPA17602HEALTHCAREPA501(C)(3)11 - Type ICHItrue
ST LUKE'S MEDICAL TOWER CORPORATION
6624 FANNIN SUITE 1100HOUSTONTX77030PROPERTY MGMTTX501(C)(3)11 - Type ISL PROPERTIEStrue
ST ANTHONY HOSPITAL
1601 SE COURT AVENUEPENDLETONOR97801HEALTHCAREOR501(C)(3)3CHItrue
ST ANTHONY HOSPITAL FOUNDATION
1601 SE COURT AVENUEPENDLETONOR97801FUNDRAISINGOR501(C)(3)11 - Type ISA HOSPITALtrue
ST ANTHONY'S HOSPITAL ASSOCIATION
FOUR HOSPITAL DRIVEMORRILTONAR72110HEALTHCAREAR501(C)(3)3SVIMCtrue
ST CATHERINE HOSPITAL
401 EAST SPRUCE STREETGARDEN CITYKS67846HEALTHCAREKS501(C)(3)3CHItrue
ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION
401 EAST SPRUCE STREETGARDEN CITYKS67846FUNDRAISINGKS501(C)(3)11 - Type ISCHtrue
ST DOMINIC OF ONTARIO OREGON
351 SW 9TH STREETONTARIOOR97914HEALTHCAREOR501(C)(4)N/ACHItrue
ST FRANCIS HOME
2400 ST FRANCIS DRIVEBRECKENRIDGEMN56520LTERM CAREMN501(C)(3)9CHItrue
ST FRANCIS LIFE CARE CORPORATION
19 POCONO ROADDENVILLENJ07834ELDERLY CARENJ501(C)(3)9SCHStrue
ST FRANCIS MEDICAL CENTER
2400 ST FRANCIS DRIVEBRECKENRIDGEMN56520HEALTHCAREMN501(C)(3)3CHItrue
ST FRANCIS OF BAKER CITY
198 INVERNESS DRIVE WESTENGLEWOODCO80112HEALTHCAREOR501(C)(3)3CHItrue
ST JOHN'S MERCY REGIONAL FOUNDATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112FUNDRAISINGMO501(C)(3)7SJRMCtrue
ST JOSEPH COMMUNITY HEALTH
300 CENTRAL AVENUE SWALBUQUERQUENM87102COMMUNITYNM501(C)(3)11 - Type ICHItrue
ST JOSEPH HOSPITAL FOUNDATION INC
ONE SAITN JOSEPH DRIVELEXINGTONKY40504FUNDRAISINGKY501(C)(3)11 - Type ISJHStrue
ST JOSEPH MEDICAL CENTER FOUNDATION
2500 BERNVILLE ROAD PO BOX 316READINGPA19603FUNDRAISINGPA501(C)(3)11 - Type ISJRHNtrue
ST JOSEPH MEDICAL CENTER FOUNDATION
7601 OSLER DRIVETOWSONMD21204FUNDRAISINGMD501(C)(3)7SJMCtrue
ST JOSEPH MEDICAL CENTER INC
7601 OSLER DRIVETOWSONMD21204HEALTHCAREMD501(C)(3)3CHItrue
ST JOSEPH MEDICAL GROUP
2500 BERNVILLE ROAD PO BOX 316READINGPA19603HEALTHCAREPA501(C)(3)9BHCtrue
ST JOSEPH PHYSICIAN ENTERPRISE INC
7601 OSLER DRIVETOWSONMD21204PHYSICIANSMD501(C)(3)11 - Type ISJMCtrue
ST JOSEPH REGIONAL HEALTH NETWORK
2500 BERNVILLE ROAD PO BOX 316READINGPA19603HEALTHCAREPA501(C)(3)3CHItrue
ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVENUEPARK RAPIDSMN56470HEALTHCAREMN501(C)(3)3CHItrue
ST JOSEPH'S HOSPITAL AND HEALTH CENTER
30 WEST 7TH STREETDICKINSONND58601HEALTHCAREND501(C)(3)3CHItrue
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS
6624 FANNIN SUITE 2505HOUSTONTX77030HEALTHCARETX501(C)(3)3SL CDCtrue
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND DBA ST LUKE'S SUGA
6624 FANNIN SUITE 2505HOUSTONTX77030HEALTHCARETX501(C)(3)3SLHStrueR LAND HOSPITAL
ST LUKE'S HEALTH SYSTEM CORPORATION DBA CHI ST LUKE'S HEALTH
6624 FANNIN SUITE 1100HOUSTONTX77030MANAGEMENTTX501(C)(3)11 - Type ICHItrue
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION
6624 FANNIN SUITE 2505HOUSTONTX77030MANAGEMENTTX501(C)(3)11 - Type ISLHStrue
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE VINTAGE
6624 FANNIN SUITE 2505HOUSTONTX77030HEALTHCARETX501(C)(3)3SL CDCtrue
ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION -PMC
6624 FANNIN SUITE 2505HOUSTONTX77030HEALTHCARETX501(C)(3)3SL CDCtrue
ST LUKE'S COMMUNITY HEALTH SERVICES DBA ST LUKE'S THE WOODLANDS HOSPITAL
6624 FANNIN SUITE 1100HOUSTONTX77030HEALTHCARETX501(C)(3)3SLHStrue
ST LUKE'S HEALTH SYSTEM FOUNDATION
6624 FANNIN SUITE 1100HOUSTONTX77030INVESTMENT MANAGEMENTTX501(C)(3)11 - Type ISLHStrue
ST LUKE'S PROPERTIES CORPORATION
6624 FANNIN SUITE 1100HOUSTONTX77030PROPERTY MGMTTX501(C)(3)11 - Type ISLHStrue
ST LUKE'S FOUNDATION
1213 HERMANN DRIVE SUITE 855HOUSTONTX77004FUNDRAISINGTX501(C)(3)7SLHStrue
ST LUKE'S MEDICAL CENTER
6624 FANNINHOUSTONTX77030HEALTHCARETX501(C)(3)3SLHStrue
ST MARY'S COMMUNITY HOSPITAL
1314 3RD AVENUENEBRASKA CITYNE68410HEALTHCARENE501(C)(3)3CHI NEBRASKAtrue
ST MARY'S HEALTHCARE CENTER
801 EAST SIOUX AVENUEPIERRESD57501HEALTHCARESD501(C)(3)3CHItrue
ST MARY'S HOSPITAL FOUNDATION
1314 3RD AVENUENEBRASKA CITYNE68410FUNDRAISINGNE501(C)(3)7SMHtrue
ST VINCENT FOUNDATION
TWO ST VINCENT CIRCLELITTLE ROCKAR72205FUNDRAISINGAR501(C)(3)11 - Type ISVIMCtrue
ST VINCENT INFIRMARY MEDICAL CENTER
TWO ST VINCENT CIRCLELITTLE ROCKAR72205HEALTHCAREAR501(C)(3)3CHItrue
ST VINCENT MEDICAL GROUP
TWO ST VINCENT CIRCLELITTLE ROCKAR72205HEALTHCAREAR501(C)(3)9SVIMCtrue
ST LUKE'S SUGAR LAND PROPERTIES CORPORATION
6624 FANNIN SUITE 2505HOUSTONTX77030PROPERTY MGMTTX501(C)(3)11 - Type ISL CDC - SLtrue
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH
619 OAK STREET ACCOUNTING-3 WCINCINNATIOH45206HEALTHCAREOH501(C)(3)3CHItrue
THE PHYSICIAN NETWORK
2000 Q STREET SUITE 500LINCOLNNE68503PHYS PRACTICENE501(C)(3)11 - Type ICHI NEBRASKAtrue
TOTAL HEALTHCARE
188 INVERNESS DRIVE WEST SUITE 500ENGLEWOODCO80112HEALTHCARECO501(C)(3)3CHICtrue
UNITY FAMILY HEALTHCARE
815 SE 2ND STREETLITTLE FALLSMN56345HEALTHCAREMN501(C)(3)3CHItrue
VILLA NAZARETH INC
801 PAGE DRIVEFARGOND58103LT CAREND501(C)(3)9CHItrue
VISITING NURSE ASSOCIATION OF ST CLARE'S
191 WOODPORT ROADSPARTANJ07871HOME HEALTHNJ501(C)(3)9SCHStrue
WOMEN'S AUXILIARY OF HIGHLINE COMMUNITY HOSPITAL
16251 SYLVESTER RD SWBURIENWA98166AUXILIARYWA501(C)(3)11 - Type IIHMCtrue
WOODLANDS DOCTOR GROUP
17200 ST LUKES WAY SUITE 170THE WOODLANDSTX77384PHY PRACTICESTX501(C)(3)9SL CHStrue

Form990 Schedule R Part III Form990ScheduleRPartIII (38 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
AUDUBON LAND COMPANY LLC
5390 N ACADEMY BLVD SUITE 300COLORADO SPRINGSCO80918841513085REAL ESTATECOCHICRELATED349918665388false$0false0.501
AVANTAS LLC
11128 JOHN GALT BLVD SUITE 400OMAHANE68137392045003STAFFING OF NURSESNEAHBMHSRELATED-2104054806071false-$439,536false0.95
BERYWOOD OFFICE PROPERTIES LLC
400 BERYWOOD TRAILCLEVELANDTN37312621875199PHYS OFFICETNMHCSRELATED575451013237false$0true0.63
BLUEGRASS REGIONAL IMAGING CENTER
1218 SOUTH BROADWAY SUITE 310LEXINGTONKY40504611386736DIAGNOSTICKYSJHSRELATED3084283317191false$0false0.65
CENTRAL NEBRASKA HOME CARE SERVICES
PO BOX 1146-4510 SECOND AVENUEKEARNEYNE68848470692112HEALTHCARE SRVCNENARELATED228435675251false$0true1
CENTRAL NEBRASKA REHAB SERVICES
3004 W FAIDLEY AVEGRAND ISLANDNE68802810653461PHYSICAL THERAPYNESFMCRELATED17101992712656false$0false0.51
CHI OPERATING INVESTMENT PROGRAM LP
198 INVERNESS DRIVE WESTENGLEWOODCO80112470727942INVESTMENTSCOCHIUNRELATED3449625324617413792false$0true0.7992
HEALTHCARE SUPPORT SERVICES
PO BOX 9804GRAND ISLANDNE68802721546196LAUNDRYNENARELATED985833190677false$0false1
MRI AT ST JOSEPH MEDICAL CENTER LLC
7253 AMBASSADOR ROADBALTIMOREMD21244521958002MEDICAL IMAGINGMDSJMCRELATED4231672174155false$0true0.51
NORTH RIVER SURGERY CENTER LLC
2209 WILDWOOD AVENUESHERWOODAR72120710799771AMBUL SURG CTRARSVIMCRELATED810711077536false$0false0.5745
O'DEA MEDICAL ARTS LIMITED PARTNERSHIP
7601 OSLER DRIVETOWSONMD21204521682964REAL ESTATEMDTMIRELATED94900false$0true0.6658
ORTHOCOLORADO LLC
11650 WEST 2ND PLACELAKEWOODCO80255371577105ORTHO HOSPITALCOTHCRELATED18461538411844false$0false0.6
PENINSULA RADIATION ONCOLOGY LLC
315 MARTIN LUTHER KING JR WAY 111TACOMAWA98405870808610HEALTHCARE SRVCWAFHSRELATED2565673262002false$0false0.6
PENRAD IMAGING
1390 KELLY JOHNSON BLVDCOLORADO SPRINGSCO80920841072619MEDICAL IMAGINGCOCHICRELATED7150943489436false$0false0.7
RUXTON SURGICENTER LLC
8322 BELLONA AVENUE SUITE 201BALTIMOREMD21204522095835SURGERY CENTERMDSJMCRELATED-693450false$0true0.51
SAINT JOSEPH - SCA HOLDINGS LLC
1451 HARRDOSBURG ROADLEXINGTONKY40504453801157OP SURGERYDESJHSRELATED00false$0true0.51
SCA PREMIER SURGERY CENTER OF LOUISVILLE LLC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202721386840SURGERY CENTERKYJHRELATED3388666017false$0true0.51
ST FRANCIS LAND COMPANY LLC
5390 N ACADEMY BLVD SUITE 300COLORADO SPRINGSCO80918263134100REAL ESTATECOCHICRELATED-13096713823763false$0false0.51
ST FRANCIS MEDICAL CENTER ASSOCIATES
1717 SOUTH J STREETTACOMAWA98405911352698MED. OFFICEWAFHSRELATED2387171907063false$0false0.5846
ST JOSEPH-PAML LLC
424 LEWIS HARGETT CIRCLE STE 160LEXINGTONKY40503452116736MGMT SVCSKYSJHSRELATED304461149003false$0true0.625
SUPERIOR MEDICAL IMAGING LLC
5000 NORTH 26TH STREETLINCOLNNE68521262884555OP DIAGNOSTICSNESERMCRELATED-200323821112false$0true0.51
SURGERY CENTER OF LEXINGTON LLC
424 LEWIS HARGETT CIRCLE STE 160LEXINGTONKY40503621179539SURGERY CENTERDESJHSRELATED-2003184079584false$0true0.51
SURGERY CENTER OF LOUISVILLE LLC
200 ABRAHAM FLEXNER WAYLOUISVILLEKY40202621179537SURGERY CENTERKYJHRELATED-15452396101false$0true0.51
ALEGENT HEALTH NORTHWEST IMAGING CENTER LLC
3606 N 156TH STREETOMAHANE68116061786985OP DIAGNOSTICSNEACHRELATED116752776649false$0true0.51
BERGAN MERCY SURGERY CENTER LLC
7710 MERCY ROAD STE 100OMAHANE68124208671994AMBUL SURG CTRNEACHRELATED1420853294472false$0false0.6394
LAKESIDE AMBULATORY SURGICAL CENTER LLC
17031 LAKESIDE HILLS DROMAHANE68130204267902AMBUL SURG CTRNEACHRELATED34658801951221false$0false0.516
LAKESIDE ENDOSCOPY CENTER LLC
17001 LAKESIDE HILLS PLZ STE 201OMAHANE68130205544496ENDOSCOPY SRVCNEACHRELATED14552941013126false$0false0.5228
NEBRASKA SPINE HOSPITAL LLC
6901 N 72ND STREETOMAHANE68122270263191SPINE HOSPITALNEACHRELATED1050173017301869false$0false0.51
PRAIRIE HEALTH VENTURES LLC
421 S 9TH ST 102LINCOLNNE68508204962103TECH SERVICESNEAH-IMCRELATED10118045564586false$68,565true0.627
SAINT JOSEPH-ANC HOME CARE SERVICES
1700 EDISON DRIVE SUITE 300MILFORDOH45150263330545HOME HEALTHKYJHRELATED32081399684824false$0false0.969
LINCOLN CK LEASING LLC
8770 BRYN MAWR SUITE 1370CHICAGOIL60631262496856REAL ESTATENESERMCRELATED397452439334false$0false0.5376
HIGHLINE IMAGING LLC
275 SW 160TH STBURIENWA98166200460005DIAGNOSTICWAHMCRELATED8402221784058false$0false0.8
HC SL VINTAGE I LLC
18000 WEST SARAH LANE SUITE 250BROOKFIELDWI53045270453767PROPERTY HOLDWISL CDC - VINTAGERELATED1027057105658490false$0false0.51
ST LUKE'S HOSPITAL AT THE VINTAGE LLC
6624 FANNIN SUITE 2505HOUSTONTX77030263734516HOSPITALTXSL CDC - VINTAGERELATED-1925374369158748false$0true0.51
PMC HOSPITAL LLC
6624 FANNIN SUITE 2505HOUSTONTX77030273280598HOSPITALTXSL CDC - PMCRELATED109254020751174false$0true0.51
ST LUKE'S DIAGNOSTIC CATH LAB LLP
6620 MAIN ST SUITE 1520HOUSTONTX77030710959365DIAGNOSTICTXSLHS HOLDINGSRELATED273448868814false$0false0.573
ST LUKE'S LAKESIDE HOSPITAL LLC
6624 FANNIN SUITE 2505HOUSTONTX77030300427437HOSPITALTXSL CDC - WOODLANDSRELATED110662825874619false$0true0.51
ST LUKE'S THE WOODLANDS SLEEP CENTER LLC
6624 FANNIN SUITE 800HOUSTONTX77030462795726DIAGNOSTICTXSLHS HOLDINGSRELATED00false$0false0.51

Form990 Schedule R Part IV Form990ScheduleRPartIV (49 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipControlled OrgControlledOrgAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountryBusiness Name Line2NameOfRelatedOrg/BusinessNameLine2
ALTERNATIVE INSURANCE MANAGEMENT SERVICE
3900 OLYMPIC BOULEVARD SUITE 400ERLANGERKY41018841112049MANAGEMENT SERVICESCOCHIC CORPORATION062727461true
AMERICAN NURSING CARE
1700 EDISON DRIVEMILFORDOH45150311085414HOME HEALTHOHCHSC CORPORATION5118606519202071true
AMERIMED INC
1700 EDISON DRIVEMILFORDOH45150311158699HOME HEALTHOHANCC CORPORATION2134392146692191true
BC HOLDING COMPANY INC
1850 BLUEGRASS AVELOUISVILLEKY40215311542851FITNESS CLUBKYJHC CORPORATION001true
CADUCEUS MEDICAL ASSOCIATES INC
5600 BRAINERD ROAD SUITE 500CHATTANOOGATN37411621570736HEALTHCARETNMHCSC CORPORATION010081true
CAPTIVE MANAGEMENT INITIATIVES
980663022CAPTIVE MANAGEMENTCHIC CORPORATION001truePO BOX 10073 APOGEORGETOWNGRAND CAYMANCJKY1-1001CJ
CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH
198 INVERNESS DRIVE WESTENGLEWOODCO80112272269511RESEARCHCOCIRIC CORPORATION-228653812412591true
CGH REALTY COMPANY INC
2500 BERNVILLE RDREADINGPA19603232326801REAL ESTATEPASJHMC CORPORATION001true
COMCARE SERVICES
4231 W 16TH AVENUEDENVERCO80204840904813INACTIVECOCHICC CORPORATION001true
CONSOLIDATED HEALTH SERVICES
1700 EDISON DRIVEMILFORDOH45150311378212HOME HEALTHOHCHIC CORPORATION-879467523794871true
DES MOINES MEDICAL CENTER INC
1111 6TH AVENUEDES MOINESIA50314420837382REAL ESTATEIACHI-IA CORPC CORPORATION6120410640320.9298true
FIRST INITIATIVES INSURANCE LTD
980203038INSURANCECHIC CORPORATION001truePO BOX 10073 APOGEORGETOWNGRAND CAYMANCJKY1-1001CJ
FRANCISCAN SERVICES INC
198 INVERNESS DRIVE WESTENGLEWOODCO80112232487967HEALTHCARECOCHIC CORPORATION-78687182541true
GOOD SAMARITAN OUTREACH SERVICES
PO BOX 1990KEARNEYNE68848470659440MEDICAL CLINICNECHI NEBRASKAC CORPORATION-2574181804681true
HEALTH SYSTEMS ENTERPRISES INC
PO BOX 1990KEARNEYNE68848470664558MANAGEMENTNEGSHC CORPORATION8727813778201true
HEALTHCARE MGMT SERVICES ORG INC
1149 MARKET STTACOMAWA98402911865474HEALTH ORG.WAFHSC CORPORATION001true
MEDQUEST
1301 15TH AVENUE WESTWILLISTONND58801450392137SALE OF DMENDMMC WILLISTONC CORPORATION15351011527151true
MERCY PARK APARTMENTS LTD
1111 6TH AVENUEDES MOINESIA50314421202422HOUSINGIACHI-IA CORPC CORPORATION36923119372181true
MERCY SERVICES CORP
2700 STEWART PARKWAYROSEBURGOR97470930824308RETAIL SALESORMMCC CORPORATION-44059614233771true
MHSERVICES CORPORATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112431457881DMEMOSJRMCC CORPORATION001true
MOUNTAIN MANAGEMENT SERVICES INC
5600 BRAINERD ROAD SUITE 500CHATTANOOGATN37411621570739MGMT SVC ORGTNMHCSC CORPORATION9604464651791true
NAZARETH ASSURANCE COMPANY
030304831INSURANCECHIC CORPORATION001truePO BOX 10073 APOGEORGETOWNGRAND CAYMANCJKY1-1001CJ
PATIENT TRANSPORT SERVICES INC
1700 EDISON DRIVEMILFORDOH45150311100798HOME HEALTHOHANCC CORPORATION-16434054882751true
PHYSICIAN HEALTH SYSTEM NETWORK
1149 MARKET STTACOMAWA98402911746721HEALTH ORG.WAFHSC CORPORATION001true
SAINT CLARES PRIMARY CARE INC
66 FORD ROADDENVILLENJ07834222441202BILLING SERVICESNJSCCCC CORPORATION-35726313612421true
SAMARITAN FAMILY CARE INC
40 W FOURTH ST 1700DAYTONOH45402311299450HEALTHCAREOHSHPC CORPORATION001true
SJH SERVICES CORPORATION
198 INVERNESS DRIVE WESTENGLEWOODCO80112232307408HEALTHCARECOFSIC CORPORATION-19703933317371true
SJL PHYSICIAN MANAGEMENT SERVICES INC
424 LEWIS HARGETT CR 160LEXINGTONKY40503270164198MANAGEMENTKYSJHSC CORPORATION001true
ST ANTHONY DEVELOPMENT COMPANY
1415 SOUTHGATEPENDLETONOR97801931216943ATHLETIC CLUBORSAHC CORPORATION11466329361021true
ST VINCENT COMMUNITY HEALTH SERVICES INC
TWO ST VINCENT CIRCLELITTLE ROCKAR72205710710785HEALTHCAREARSVIMCC CORPORATION2408638152257321true
ST JOSEPH DEVELOPMENT COMPANY INC
1717 SOUTH J STREETTACOMAWA98405911480569RENTALWAFSIC CORPORATION655478123574181true
ST JOSEPH OFFICE PARK ASSOCIATION
1401 HARRODSBURG ROAD BLDG B70LEXINGTONKY40504611079899MANAGEMENTKYSJHSC CORPORATION08821390.85true
TOWSON MANAGEMENT INC
7601 OSLER DRIVETOWSONMD21204521710750MANAGEMENT SERVICESMDFSIC CORPORATION5164571971961true
COLLABHEALTH MANAGED SOLUTIONS INC
198 INVERNESS DRIVE WESTENGLEWOODCO80112461222808HOLDING COCOCHIC CORPORATION0238067071true
COLLABHEALTH PLAN SERVICES INC
198 INVERNESS DRIVE WESTENGLEWOODCO80112461224037ADMIN SERVICESCOCHMSC CORPORATION-1082933382726081true
HIGHLINE MEDICAL GROUP
15811 AMBAUM BLVD SW 170BURIENWA98166911407026MEDICAL SERVICESWAHMCC CORPORATION-604914756891391true
SOUNDPATH HEALTH INC
32129 WEYERHAEUSER WAY S SUITE 201FEDERAL WAYWA98001421720801INSURANCEWACHPSC CORPORATION-154741109769730.556true
SLEHS HOLDINGS INC
6624 FANNIN SUITE 800HOUSTONTX77030760637138HOLDING COTXSLHSC CORPORATION1425313331141031true
ST LUKE'S ANESTHESIOLOGY ASSOCIATES
6624 FANNIN SUITE 1100HOUSTONTX77030461517163MEDICAL CLINICTXSLMCC CORPORATION001true
SLMT PARKING INC
6624 FANNIN SUITE 800HOUSTONTX77030760637140PARKINGTXSLHSC CORPORATION1117934137682211true
ST LUKE'S 6620 MAIN CONDOMINIUM ASSOCIATION
6624 FANNIN SUITE 1100HOUSTONTX77030300355517CONDOMINIUM ASSOCTXSLPCC CORPORATION001true
ST LUKE'S EPISCOPAL HOSPITAL PHYSICIAN HOSPITAL ORGANIZATION INC
6720 BERTNERHOUSTONTX77030760377932PHOTXSLMCC CORPORATION600.6true
ST LUKE'S MEDICAL ARTS CENTER I CONDOMINIUM ASSOCIATION
6624 FANNIN SUITE 1100HOUSTONTX77030300355518CONDOMINIUM ASSOCTXSLPCC CORPORATION001true
ST LUKE'S MEDICAL TOWER CONDOMINIUM ASSOCIATION
6624 FANNIN SUITE 1100HOUSTONTX77030760298751CONDOMINIUM ASSOCTXSLMTCC CORPORATION001true
SUGAR LAND DOCTOR GROUP
1317 LAKE POINTE PARKWAYSUGAR LANDTX77478454270163MEDICAL CLINICTXSL CHSC CORPORATION-11594115665901true
THE TEXAS HEART INSTITUTE AT ST LUKE'S EPISCOPAL HOSPITAL DENTON A COOLEY B
6624 FANNIN SUITE 1100HOUSTONTX77030900064009CONDOMINIUM ASSOCTXSLMCC CORPORATION001trueUILDING CONDOMINIUM ASSOCIATION
ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SERVICES INC
12809 WEST DODGE ROADOMAHANE68154470802396MANAGED CARENEACHC CORPORATION531231345208651true
ALL SAINTS INSURANCE COMPANY SPC LTD
INSURANCESLHSC CORPORATION0438669611truePO BOX 69 GT 720 WEST BAY ROADGEORGETOWNGRAND CAYMANCJKY-1102CJ
VINTAGE DOCTOR GROUP
6624 FANNIN SUITE 1100HOUSTONTX77030MEDICAL CLINICTXSLMCC CORPORATION001true
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
CENTRAL NEBRASKA REHABILITATION SERVICES LLC
L3190802FMV
SAINT FRANCIS MEDICAL CENTER FOUNDATION
C1194705FMV
CENTRAL NEBRASKA REHABILITATION SERVICES LLC
A49625FMV
CENTRAL NEBRASKA REHABILITATION SERVICES LLC
K3604FMV

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