2014-05-13T10:00:08-05:00 2013-06-30 470617373 CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2012-07-01 470376601 SAINT FRANCIS MEDICAL CENTER SAIN 3083985407 2620 W Faidley Grand Island NE 68803 JEANETTE WOJTALEWICZ 2014-05-15 true Pamela Krohn P01210500 3032989100 2012 2015-11-30 17:44:51Z DAN MCELLIGOTT 2620 W Faidley Grand Island NE 68803 172280003 false 0928 X WWW.SAINTFRANCISGI.ORG X 1887 NE AN 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. 16 14 1272 461 98371 -39550 1546682 1865020 157725943 157538024 4937464 10496008 2202507 2162996 166412596 172062048 10490921 334866 0 0 53218164 52600969 0 0 0 83630587 99824388 147339672 152760223 19072924 19301825 307478467 331558806 13066029 12350474 294412438 319208332 THE 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. false false 121467326 334866 157493910 SEE SCHEDULE H 121467326 true true false true false false false false false true true false false true true false true false false false false false false false false true true true false true false false false true false false false true false false false false false true true true false false true 5 0 true 1272 true true true false false false false false false false false false X 16 14 false false false false true true true true true false false true true true true true true false true true false NE X Jeanette Wojtalewicz 4023434671 12809 West Dodge Road Omaha NE 68154 DANIEL MCELLIGOTT 40.00 1.00 X X 0 480269 78255 DANIEL NARANJO 1.00 0 X X 0 0 0 JENNIFER BROWN MD 1.00 0 X X 9077 0 0 SUSAN KOENIG 1.00 0 X X 0 0 0 TERRY PFEIFER 1.00 0 X X 0 0 0 CATHY ALLEN 1.00 0 X 0 0 0 DOUGLAS BOON MD 1.00 0 X 0 0 0 ELLEN HORNADY 1.00 0 X 0 0 0 FATHER MICHAEL MCDERMOTT 1.00 0 X 1300 0 0 KAREN RATHKE 1.00 0 X 0 0 0 ROBERT LANIK 1.00 59.00 X 0 1024255 47149 SCOTT FRANKFORTER 1.00 0 X 3250 0 0 SISTER NADINE HEIMANN 1.00 0 X 0 0 0 STEVE SCHNEIDER 1.00 0 X 800 0 0 TIM WOJCIK 1.00 0 X 0 0 0 VINCENT HERNANDEZ 1.00 0 X 0 0 0 GERALDINE ZRUST 40.00 0 X 54233 0 17960 LISA THAVENET-WEBB 40.00 1.00 X 254864 0 43878 DALE HARTWIG 40.00 0 X 255125 0 34389 DONNA SANDERS 0.00 40.00 X 0 158928 26695 FRANCINE SPARBY 40.00 0 X 235644 0 28428 MICHAEL S HEIN 40.00 0 X 344134 0 37983 STEPHEN LEURCK 40.00 0.00 X 311127 22549 0 BETH A BARTLETT 40.00 0 X 126767 0 36111 DAVID A CROSS 40.00 0 X 208073 0 35161 DOUGLAS W RICHLING 40.00 0 X 126259 0 30184 GREGORY S BALFANY 40.00 0 X 146137 0 35273 ROBERT M NORVELL 40.00 0 X 129978 0 34600 CRAIG VINCENT 0.00 40.00 X 0 389881 41138 JOSHUA GORTEMAKER 0 40.00 X 0 385229 40398 MEHMET COPUR 0.00 60.00 X 0 701729 34944 MICHAEL HORN 0.00 0 X 108593 0 6741 RYAN RAMAEKERS 0.00 40.00 X 0 470947 39172 TRACI RAUCH 0.00 60.00 X 0 454698 37750 2315361 4088485 686210 25 true true false THE PHYSICIAN NETWORK 2000 Q STREET SUITE 500 LINCOLN NE 68503 EE HEALTH/REV GUARANTEE/MED DIR FEE 3505696 CENTRAL NEBRASKA REHABILITATION SVCS 3004 W FAIDLEY AVE GRAND ISLAND NE 68802 PHYSICAL THERAPY SERVICES 3171407 GRAND ISLAND IMAGING CENTER PO BOX 1962 GRAND ISLAND NE 688021962 IMAGING SERVICES 1667111 JOHNSON CONTROLS 5757 N GREEN BAY AVE MILWAUKEE WI 532094408 CONSTRUCTION 901661 ALL ABOUT STAFFING INC 1000 SAWGRASS CORPORATE PKWY SUNRISE FL 33323 AGENCY LABOR 553256 23 1506899 308978 49143 1865020 PATIENT SERVICES 900099 150842082 150842082 EQUITY CHANGES OF UNCONSOLIDATED ORGS 900099 6085865 6041751 44114 RENTAL INCOME 900099 610077 610077 0 0 0 0 0 0 157538024 4357696 -1055 4358751 0 0 31875 27564 4311 0 4311 4311 6045930 101268 8886 6045930 92382 6138312 6138312 0 0 172416 181505 -9089 -9089 CAFETERIA 722100 858271 858271 SERVICES SOLD 900099 415416 55312 360104 FINANCIAL SERVICES 541200 334572 334572 559515 0 0 559515 2167774 172062048 157493910 98371 12604747 334866 334866 0 0 0 1503114 1503114 0 38115480 34746586 3368894 2322359 2036772 285587 7830107 6867217 962890 2829909 2471417 358492 0 282672 282672 0 0 0 0 21725471 16711686 5013785 0 320060 320060 4085318 3332259 753059 8494080 6005695 2488385 0 2127597 1830434 297163 225683 147909 77774 0 26129 10425 15704 0 12723768 12723768 8626318 7072893 1553425 700576 700576 MEDICAL SUPPLIES 30164353 30127913 36440 BAD DEBT 5491040 5491029 11 REPAIR & MAINTENANCE 2843202 2482805 360397 RECRUITMENT 217783 217783 1770338 1096844 673494 0 152760223 121467326 31292897 0 0 70673 61364 8731016 6921367 21252390 18763312 0 50881 0 132622 84734 1175114 1457931 1528447 2201364 194449634 107385640 93335145 87063994 170455273 203898063 0 0 10797787 11055796 307478467 331558806 11214063 9240586 7455 7206 0 1844511 3102682 13066029 12350474 X 293391107 318159229 1021331 1049103 294412438 319208332 307478467 331558806 X 19301825 7445261 -1951192 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false true 14334 false true 1312 false 15646 false Description of the activities reported on Lines 1a through 1i Schedule C, Part II-B, Line 1 THE 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 - $1,312 1321624 1321624 83505486 43275196 40230290 0 105454780 61267389 44187391 4167744 2843055 1324689 87063994 0 0 CHI OIP - FIXED INCOME 100679125 CHI OIP - EQUITY SECURITIES 103218938 203898063 0 INTERCOMPANY PAYABLES 2867230 ENVIRONMENTAL REMEDIATION LIABILITY 158236 OTHER 41755 UNCLAIMED PROPERTY 34089 UNREDEEMED GIFT CERTIFICATE 1372 3102682 X 0 0 0 0 0 0 0 0 0 0 0 0 FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 SAINT 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." true true X false false true true false true true 2629 3557214 3557214 0.02420 15445 12377082 8734983 3642099 0.02470 0 0.00000 0 18074 15934296 8734983 7199313 0.04890 29 8443 885765 71368 814397 0.00550 4 2909 932992 202057 730935 0.00500 1 135 816 816 0.00000 2 1142694 136263 1006431 0.00680 8 19740 300651 300651 0.00200 44 31227 3262918 409688 2853230 0.01930 44 49301 19197214 9144671 10052543 0.06820 0 0.00000 0 0.00000 1 121018 121018 0.00080 1 5400 5400 0.00000 0 0.00000 1 65036 2242 62794 0.00040 0 0.00000 3 10 411458 411458 0.00260 0 0.00000 6 10 602912 2242 600670 0.00390 true 5491040 0 42625418 52075711 -9450293 X true true GRAND ISLAND SURGICAL CENTER LLC SURGERY 0.5 0 0.5 1 1 SAINT FRANCIS MEDICAL CENTER

2620 W FAIDLEY GRAND ISLAND NE 68803

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OUTPATIENT SUBSTANCE ABUSE SAINT FRANCIS MEDICAL CENTER ADTC

1755 PRARIE VIEW PLACE KEARNEY NE 68847

OUTPATIENT SUBSTANCE ABUSE SAINT FRANCIS MEDICAL CENTER ADTC

314 S 14TH ORD NE 68862

OUTPATIENT SUBSTANCE ABUSE SAINT FRANCIS MEDICAL CENTER ADTC

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OUTPATIENT SUBSTANCE ABUSE Eligibility criteria for free or discounted care Schedule H, Part I, Line 3c WHEN 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 REPORT SCHEDULE H, PART I, LINE 6A SAINT 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 assistance Schedule H, Part I, Line 7 A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING WORKSHEET 2 TO COMPUTE THE COST-TO CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. 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 calculation Schedule H, Part I, Line 7, column(f) 5,491,040 Bad debt expense - methodology used to estimate amount Schedule H, Part III, Line 2 BAD 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 benefit Schedule H, Part III, Line 3 BAD DEBT ESTIMATES ARE NOT INCLUDED IN COMMUNITY BENEFIT. Bad debt expense - financial statement footnote Schedule H, Part III, Line 4 COSTING 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 costs Schedule H, Part III, Line 8 TO 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 assistance Schedule H, Part III, Line 9b SAINT 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 Assessment Schedule H, Part V Section B, Line 3 (1) SAINT FRANCIS MEDICAL CENTER - TOWN HALL FORUMS; Used federal poverty guidelines (FPG) to determine eligibility Schedule 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 criteria Schedule 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 billed Schedule 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 INFORMATION SCHEDULE H, PART VI ORGANIZATION'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 INFORMATION SCHEDULE 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 3 NOTICES 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 system Schedule H, Part VI, Line 6 SAINT 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 report Schedule H, Part VI, Line 7 NE true SAINT FRANCIS MEDICAL CENTER FOUNDATION 2620 W FAIDLEY GRAND ISLAND NE 68803 470630267 501(C)(3) 41322 FMV EMPLOYEE BENEFITS PROGRAM SUPPORT CENTRAL CATHOLIC DEVELOPMENT FOUNDATION 1200 RUBY AVENUE GRAND ISLAND NE 68803 470619982 501(C)(3) 103550 CAPITAL CAMPAIGN GRAND ISLAND EDUCATION FOUNDATION PO BOX 4904 GRAND ISLAND NE 68802 470735201 501(C)(3) 100000 CAREER DEVELOPMENT CENTER GRAND ISLAND COMMUNITY FOUNDATION PO BOX 430 GRAND ISLAND NE 68802 476032570 501(C)(3) 16100 STATE FAIR 4 0 Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 GRANTS 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. X true true true true false false false false false true false BETH A BARTLETT 115998 0 10308 0 461 0 15439 0 20672 0 162878 0 0 0 CRAIG VINCENT 0 387624 0 0 0 2257 0 20596 0 20542 0 431019 0 0 DALE HARTWIG 214104 0 31023 0 9998 0 33005 0 1384 0 289514 0 0 0 DANIEL MCELLIGOTT 0 309477 0 121950 0 48842 0 56657 0 21598 0 558524 0 25811 DAVID A CROSS 198371 0 3913 0 5789 0 21058 0 14103 0 243234 0 0 0 DONNA SANDERS 0 132394 0 24617 0 1917 0 19548 0 7147 0 185623 0 0 DOUGLAS W RICHLING 122952 0 3055 0 252 0 11213 0 18971 0 156443 0 0 0 FRANCINE SPARBY 197425 0 28371 0 9848 0 20684 0 7744 0 264072 0 0 0 GREGORY S BALFANY 132113 0 13513 0 511 0 14101 0 21172 0 181410 0 0 0 JOSHUA GORTEMAKER 0 383716 0 0 0 1513 0 20596 0 19802 0 425627 0 0 LISA THAVENET-WEBB 215150 0 30755 0 8959 0 28096 0 15782 0 298742 0 0 0 MEHMET COPUR 0 697720 0 0 0 4009 0 28096 0 6848 0 736673 0 0 MICHAEL HORN 0 0 0 0 108593 0 0 0 6741 0 115334 0 0 0 MICHAEL S HEIN 282594 0 29046 0 32494 0 20596 0 17387 0 382117 0 0 0 ROBERT LANIK 0 584152 0 188534 0 251569 0 33096 0 14053 0 1071404 0 152674 ROBERT M NORVELL 119627 0 9845 0 506 0 13636 0 20964 0 164578 0 0 0 RYAN RAMAEKERS 0 409379 0 41500 0 20068 0 20596 0 18576 0 510119 0 0 STEPHEN LEURCK 0 0 0 0 311127 22549 0 0 0 0 311127 22549 0 0 TRACI RAUCH 0 426106 0 26000 0 2592 0 23096 0 14654 0 492448 0 0 Travel for companions Schedule J, Part I, Line 1a SAINT 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 compensation Schedule J, Part I, Line 3 COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY CATHOLIC HEALTH INITIATIVES ("CHI"), A RELATED ORGANIZATION. CHI USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3)WRITTEN EMPLOYMENT CONTRACTS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. Severance or change-of-control payment Schedule J, Part I, Line 4a POST-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 plan Schedule J, Part I, Line 4b DURING 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 payments Schedule J, Part I, Line 7 SAINT 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. DR MICHAEL HEIN KEY EMPLOYEE RECRUITMENT X 85000 50881 false true true 50881 PATHOLOGY SPECIALISTS - SCOTT FRANKFORTER 25% OWNERSHIP 192000 PATHOLOGY SERVICES false EAKES OFFICE PLUS - MARK MILLER 20% OWNERSHIP 294326 OFFICE SUPPLIES/FURNITURE false EXECUTIVE COMMITTEE COMPOSITION AND AUTHORITY FORM 990, PART VI, LINE 1A PURSUANT 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 stockholders Form 990, Part VI, Section A, Line 6 THE ORGANIZATION'S SOLE CORPORATE MEMBER IS CHI NEBRASKA, A NEBRASKA NONPROFIT CORPORATION. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a IN 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 stockholders Form 990, Part VI, Section A, Line 7b THE ORGANIZATION'S CORPORATE MEMBER IS CHI NEBRASKA. PURSUANT TO SECTION 5.4.1 OF THE ORGANIZATION'S BYLAWS, 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 body Form 990, Part VI, Section B, Line 11b CHI 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 policy Form 990, Part VI, Section B, Line 12c ALL 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 OFFICIAL FORM 990, PART VI, LINE 15A THE 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 employees Form 990, Part VI, Section B, Line 15b HR 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 VENTURES FORM 990, PART VI, LINE 16B SAINT 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 public Form 990, Part VI, Section C, Line 19 SAINT 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 Expenses Form 990, Part IX, Line 11g CONTRACT 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 balances Form 990 , Part XI, Line 9 GAAP ADJUSTMENT - -2027238; CHI CONNECT DEPRECIATION - 136674; TEMPORARILY RESTRICTED ASSETS - -60628; ALEGENT CREIGHTON CLINIC 12809 WEST DODGE ROAD OMAHA NE 68154 HEALTHCARE NE 501(C)(3) 3 ACH true ALEGENT CREIGHTON HEALTH 12809 WEST DODGE ROAD OMAHA NE 68154 HEALTHCARE NE 501(C)(3) 3 NA true ALEGENT HEALTH - BERGAN MERCY HEALTH SYS 7500 MERCY ROAD OMAHA NE 68124 HEALTHCARE NE 501(C)(3) 3 ACH true ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA 631 N 8TH STREET MISSOURI VALLEY IA 51555 HEALTHCARE IA 501(C)(3) 3 AHIMC true ALEGENT HEALTH FOUNDATION 12809 WEST DODGE ROAD OMAHA NE 68154 FUNDRAISING NE 501(C)(3) 7 ACH true ALEGENT HEALTH IMMANUEL MEDICAL CENTER 6901 NORTH 72ND STREET OMAHA NE 68122 HEALTHCARE NE 501(C)(3) 3 ACH true ALEGENT HEALTH MEMORIAL HOSPITAL SCHUYLER NE 104 W 17TH STREET SCHUYLER NE 68661 HEALTHCARE NE 501(C)(3) 3 AHIMC true ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 HEALTHCARE IA 501(C)(3) 3 AHBMHS true ALVERNA APARTMENTS 300 SE 8TH AVENUE LITTLE FALLS MN 56345 LTERM CARE MN 501(C)(3) 9 CHI true APPLETREE COURT 601 OAK STREET BRECKENRIDGE MN 56520 SENIOR HOMES MN 501(C)(3) 9 SFH true BISHOP DRUMM RETIREMENT CENTER 1111 6TH AVENUE DES MOINES IA 50314 LTERM CARE IA 501(C)(3) 9 CHI-IA CORP true BORNEMANN HEALTH CORPORATION 2500 BERNVILLE RD PO BOX 316 READING PA 19603 HEALTHCARE PA 501(C)(3) 11 - Type I CHI true CARRINGTON HEALTH CENTER 800 NORTH 4TH STREET CARRINGTON ND 58421 HEALTHCARE ND 501(C)(3) 3 CHI true CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 HEALTHCARE CO 501(C)(3) 9 NA true CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 6385 CORPORATE DRIVE COLORADO SPRINGS CO 80919 FUNDRAISING CO 501(C)(3) 7 CHIC true CATHOLIC HEALTH INITIATIVES INSTITUTE FOR RESEARCH AND INNOVATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 HEALTHCARE CO 501(C)(3) 11 - Type I CHI true CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 6385 CORPORATE DRIVE COLORADO SPRINGS CO 80919 FUNDRAISING CO 501(C)(3) 9 CHI true CATHOLIC HEALTH INITIATIVES-COLORADO 188 INVERNESS DRIVE WEST SUITE 500 ENGLEWOOD CO 80112 HEALTHCARE CO 501(C)(3) 3 CHI true CATHOLIC HEALTH INITIATIVES-IOWA CORP DBA MERCY MEDICAL CENTER-DES MOINES 1111 6TH AVENUE DES MOINES IA 50314 HEALTHCARE IA 501(C)(3) 3 CHI true CENTENNIAL MEDICAL GROUP INC 2700 STEWART PARKWAY ROSEBURG OR 97470 PHYSICIANS OR 501(C)(3) 9 MMC true CENTRAL KANSAS MEDICAL CENTER 3515 BROADWAY GREAT BEND KS 67530 SURGERY CNTR KS 501(C)(3) 3 CHI true CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PARKWAY SOUTH FARGO ND 58104 HEALTHCARE ND 501(C)(3) 9 CHI true CHI KENTUCKY INC 3900 OLYMPIC BLVD SUITE 400 ERLANGER KY 41018 HEALTHCARE KY 501(C)(3) 11 - Type I CHI true CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 HEALTHCARE CO 501(C)(3) 9 CHI NHC true CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 HEALTHCARE CO 501(C)(3) 11 - Type I CHI true CHI NEBRASKA 6940 O STREET LINCOLN NE 68510 HEALTHCARE NE 501(C)(3) 11 - Type I CHI true COMMUNITY LIMITED CARE DIALYSIS CENTER 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 DIALYSIS OH 501(C)(2) N/A GSH true COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION MISSOURI VALLEY IA 631 N 8TH STREET MISSOURI VALLEY IA 51555 FUNDRAISING IA 501(C)(3) 11 - Type I AHCMH true CONTINUING CARE HOSPITAL 150 NORTH EAGLE CREEK DRIVE LEXINGTON KY 40509 LTACH KY 501(C)(3) 3 SJHS true COVENANT HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 HOME HEALTH PA 501(C)(3) 11 - Type II NA true ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1450 BATTERSBY AVENUE ENUMCLAW WA 98022 HEALTHCARE WA 501(C)(3) 3 FHS true FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE ROAD BARDSTOWN KY 40004 HEALTHCARE KY 501(C)(3) 3 KOH true FLAGET MEMORIAL HOSPITAL FOUNDATION 4305 NEW SHEPHERDSVILLE ROAD BARDSTOWN KY 40004 FUNDRAISING KY 501(C)(3) 11 - 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