2014-05-13T20:00:23-05:00 2013-06-30 470617373 CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2012-07-01 911939739 FRANCISCAN MEDICAL GROUP FRAN 2536804005 1313 Broadway TACOMA WA 98402 MICHAEL FITZGERALD 2014-05-06 true PAMELA KROHN P01210500 3032989100 2012 2015-11-30 17:44:51Z X STEPHEN SPARE 1313 Broadway Suite 200 TACOMA WA 98402 200341965 false X WWW.FHSHEALTH.ORG X 1999 WA FMG WAS FOUNDED ON THE PRINCIPLE TO PROVIDE COMPASSIONATE CARE TO EVERYONE REGARDLESS OF ABILITY TO PAY OR SOCIAL STATUS. FMG INCLUDES AN EXPANDING NETWORK OF CLINICS. 8 2 1718 37 0 0 57122133 37857530 136496566 158406904 21471 -55243 2515227 4055150 196155397 200264341 13672 5561592 0 0 138587940 168689444 0 0 0 43892300 49765640 182493912 224016676 13661485 -23752335 53422192 50505629 9918781 30754553 43503411 19751076 X 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. 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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." false FRANCISCAN HEALTH SYSTEM 1717 SOUTH J STREET TACOMA WA 98405 910564491 501(C)(3) 6000 SJMC BALL ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1455 BATTERSBY AVENUE ENUMCLAW WA 98022 910715805 501(C)(3) 5551835 REG EXP ALLOCATION Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 THE USE OF GRANT FUNDS IS MONITORED BY ENSURING THAT ONLY 501(C)(3) ORGANIZATIONS RECEIVE GRANTS. THOSE 501(C)(3) ORGANIZATIONS ARE RESPONSIBLE FOR ENSURING THAT THE GRANT FUNDS ARE USED FOR THEIR INTENDED PURPOSES. X X false true false false false true false false false ALEX MOHIT 1162361 0 1500 0 1260 0 20596 0 22451 0 1208168 0 0 0 BAHMAN SAFFARI 941493 0 2500 0 1242 0 20596 0 22515 0 988346 0 0 0 BRIAN BERRY 209695 0 2000 0 839 0 28102 0 18955 0 259591 0 0 0 CLIFF ROBERTSON 0 514688 0 116001 0 42648 0 74007 0 21812 0 769156 0 19916 DEAN FIELD 277585 0 14000 0 635 0 25596 0 13097 0 330913 0 0 0 GREGORY SEMERDJIAN MD 0 65902 0 0 0 508504 0 28096 0 18503 0 621005 0 209933 JANIS FEGLEY 282900 0 19500 0 1196 0 25596 0 8729 0 337921 0 0 0 JOHANN BERNARDO MD 351840 0 70155 0 366 0 25596 0 19493 0 467450 0 0 0 JOHN JIGANTI 1306473 0 500 0 1932 0 20596 0 22316 0 1351817 0 0 0 JOSEPH WILCZEK 0 788016 0 262159 0 306040 0 25596 0 10481 0 1392292 0 175847 KEVIN SCHOENFELDER 799149 0 2500 0 5544 0 20596 0 22451 0 850240 0 0 0 KIMBERLY HARDING 157091 0 12607 0 193 0 12612 0 2473 0 184976 0 0 0 MARIA SALCEDO-WASICEK 353435 0 2500 0 538 0 23096 0 15827 0 395396 0 0 0 MARK ADAMS 0 403312 0 94561 0 38322 0 51784 0 23865 0 611844 0 0 MIKE FITZGERALD 0 490553 0 111276 0 67143 0 74637 0 21812 0 765421 0 19205 RICHARD GRAY MD 953975 0 500 0 1932 0 20596 0 22515 0 999518 0 0 0 STEPHEN SPARE 380505 0 86412 0 51443 0 20596 0 9535 0 548491 0 0 0 TIMOTHY MARSH 99973 0 0 0 114337 0 21248 0 13914 0 249472 0 0 0 SEVERANCE 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. 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: MARK ADAMS, MIKE FITZGERALD, CLIFF ROBERTSON, GREGORY SEMERDJIAN, STEPHEN SPARE AND JOSEPH WILCZEK DURING 2012 THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: MARK ADAMS $31,188 MIKE FITZGERALD $44,041 CLIFF ROBERTSON $45,911 DURING 2012 THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI FROM THE DEFERRED COMPENSATION PLAN: MIKE FITZGERALD $19,205 CLIFF ROBERTSON $19,916 GREGORY SEMERDJIAN $209,933 JOSEPH WILCZEK $175,847 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: GEGORY SEMERDJIAN $5,278 STEPHEN SPARE $19,950 JOSEPH WILCZEK $98,125 Compensation contingent on net earnings of the organization Schedule J, Part I, Line 6a REPORTABLE PHYSICIANS RECEIVE INCENTIVE COMPENSATION BASED ON "NET PROFESSIONAL REVENUE." "NET PROFESSIONAL REVENUE" WAS NOT DETERMINED WITH REFERENCE TO ORGANIZATIONAL NET REVENUE OR ORGANIZATIONAL "NET INCOME." RATHER, AMOUNTS WERE DETERMINED BASED UPON THE PHYSICIAN'S INDIVIDUAL CONTRIBUTION COMPUTED AS: PHYSICIANS PERSONALLY PERFORMED PROFESSIONAL SERVICES (FOR SERVICES RENDERED BY THE PHYSICIAN TO PATIENTS PERSONALLY) LESS SOME SPECIFICALLY STATED PHYSICIAN REVENUE AND REFUNDS. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A I. INTRODUCTION A. MARKET BASED ORGANIZATION MISSION AND VISION FRANCISCAN MEDICAL GROUP WAS FOUNDED IN APRIL 1999 TO PROVIDE COMMUNITY BASED HEALTH CARE SERVICES. SINCE ITS INCEPTION, FRANCISCAN MEDICAL GROUP HAS FOCUSED ON PROVIDING QUALITY HEALTH CARE TO ALL MEMBERS OF THEIR COMMUNITY REGARDLESS OF ABILITY TO PAY FOR SERVICES. COMMUNITY SERVICE HAS ALWAYS BEEN AT THE CORE OF OUR ACTIVITY. B. COMMUNITY BENEFIT APPROACH FRANCISCAN MEDICAL GROUP CLINICS PROVIDE SERVICES ACROSS A LARGE GEOGRAPHY OF SOUTH PUGET SOUND IN WASHINGTON STATE, SERVING A DIVERSE POPULATION IN OUR SERVICE AREA. FRANCISCAN MEDICAL GROUP PROVIDES SERVICES TO PATIENTS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP OR ABILITY TO PAY. THE PROGRAMS AND SERVICES DESCRIBED THROUGHOUT THIS DOCUMENT NOT ONLY SERVE THE COMMUNITY BUT ALSO REDUCE THE BURDEN ON GOVERNMENTAL PROGRAMS, I.E. MEDICARE AND MEDICAID. WITHOUT THE CHARITY CARE PROVIDED BY FRANCISCAN MEDICAL GROUP CLINICS, THE COMMUNITY CHARITY CARE CASES WOULD FALL UPON THE MORE EXPENSIVE EMERGENCY ROOMS IN LOCAL HOSPITALS, INCLUDING THOSE OPERATED BY LOCAL GOVERNMENT. FRANCISCAN MEDICAL GROUP HAS OVER 250 PRIMARY CARE AND SPECIALTY PROVIDERS LOCATED IN OVER 100 CLINICS AND HOSPITALS WITH 711,157 PATIENT VISITS IN 2013. II. QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT: UNCOMPENSATED CARE AS DESCRIBED BELOW, FRANCISCAN MEDICAL GROUP PROVIDED A SIGNIFICANT LEVEL OF CHARITY CARE SERVICES TO THOSE WITH LIMITED OR AN INABILITY TO PAY. TO THE EXTENT MEDICARE AND MEDICAID REIMBURSEMENT IS BELOW COST, FRANCISCAN MEDICAL GROUP RECOGNIZES THESE AMOUNTS AS THE UNCOMPENSATED COST OF PROVIDING CARE. AS MENTIONED ABOVE, FRANCISCAN MEDICAL GROUP PROVIDES SERVICES TO PATIENTS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR ABILITY TO PAY. MOST PHYSICIAN GROUPS IN THE STATE OF WASHINGTON HAVE EITHER PARTIALLY OR FULLY CLOSED THEIR PRACTICES TO NEW MEDICARE AND MEDICAID PATIENTS AS THE REIMBURSEMENT FOR THESE PROGRAMS HAS INCREASINGLY FALLEN SHORT OF THE COST OF PROVIDING THAT CARE. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF FRANCISCAN MEDICAL GROUP, NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND OUR MISSION IS TO SERVE THE COMMUNITY BY PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. THEREFORE, IN KEEPING WITH FRANCISCAN MEDICAL GROUP'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, WE PROVIDE CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS - ALTHOUGH THE COST OF PROVIDING THAT CARE EXCEEDS GOVERNMENTAL PROGRAM REIMBURSEMENT. FOR THE FISCAL YEAR ENDING JUNE 30, 2013, THE COST OF UNCOMPENSATED MEDICARE CARE AMOUNTED TO $29.6 MILLION; FOR MEDICAID IT AMOUNTED TO $ 14.9 MILLION; CHARITY CARE TOTALED $ 1.8 MILLION FOR THE YEAR. III. QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT A. COMMUNITY OUTREACH FOR THE POOR AND THE BROADER COMMUNITY ACTIVITIES OFFERED INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR TERMINALLY ILL PATIENTS, AND A BROAD VARIETY OF COMMUNITY SUPPORT ACTIVITIES. FRANCISCAN MEDICAL GROUP PROVIDES CHARITY CARE FOR PEOPLE WHO ARE POOR. CHARITY CARE IS ALSO PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES WHICH FRANCISCAN MEDICAL GROUP BELIEVES SERVE A BONA FIDE COMMUNITY HEALTH NEED. THESE INCLUDE COMMUNITY EDUCATION SERVICE COST FOR THE COMMUNITY, CLASSES FOR CHILDREN THAT COVER HEALTH CARE TOPICS, EMERGENCY RESPONSE, FIRE SAFETY, BIKE AND TRAFFIC SAFETY, PHOTO AND FINGERPRINTING, ELECTRICAL SAFETY, SEAT BELTS AND OTHER CARE SAFETY, AND OTHER COMMUNITY HEALTH TOPICS. IT IS SIGNIFICANT TO NOTE THAT ALL OF THE FRANCISCAN MEDICAL GROUP PRIMARY CARE CLINICS OPERATE IN COMMUNITIES DESIGNATED BY THE US DEPARTMENT OF HEALTH AS MEDICALLY UNDERSERVED AREAS FOR ACCESS TO PRIMARY CARE. HEALTH FAIRS, EVENTS AND SCREENINGS FRANCISCAN MEDICAL GROUP PROVIDES CHOLESTEROL SCREENINGS, GLUCOSE SCREENINGS, BLOOD PRESSURE CHECKS, AND HEALTH EDUCATION INFORMATION TO THE COMMUNITY. IN FISCAL YEAR 2013, THESE SCREENINGS AND COMMUNITY HEALTH EDUCATION OPPORTUNITIES REACHED APPROXIMATELY 8,320 PEOPLE IN OUR COMMUNITIES. FMG MANAGERS PROVIDED A MINIMUM OF 865 VOLUNTEER HOURS SERVING OUR COMMUNITIES. FUNDRAISERS SUPPORTED ALZHEIMER'S ASSOCIATION AMERICAN CANCER SOCIETY - RELAY FOR LIFE AMERICAN HEART ASSOCIATION AMERICAN DIABETES ASSOCIATION AMERICAN RED CROSS - MT RAINIER CHAPTER UNITED WAY MUSCULAR DYSTROPHY ASSOCIATION TACOMA RESCUE MISSION LEUKEMIA AND LYMPHOMA SOCIETY SALVATION ARMY FRANCISCAN FOUNDATION - CORNERSTONE CLUB FRANCISCAN FOUNDATION - ST JOSEPH HOSPITAL BALL FRANCISCAN FOUNDATION - ST FRANCIS HOSPITAL GALA FRANCISCAN FOUNDATION - HOSPICE GOLF TOURNAMENT FRANCISCAN FOUNDATION - ST FRANCIS HOSPITAL GOLF TOURNAMENT FRANCISCAN FOUNDATION - ST CLARE HOSPITAL GOLF TOURNAMENT ENUMCLAW COMMUNITY HOSPITAL FOUNDATION CATHOLIC CHARITIES MOST OF THESE FUNDRAISING ACTIVITIES WERE SUPPORTED BY ACTUAL FUNDRAISING ACTIVITIES, BUT MOST WERE ALSO SUPPORTED BY CASH DONATIONS FROM FRANCISCAN MEDICAL GROUP. EXECUTIVE COMMITTEE FORM 990, PART VI, LINE 1A PURSUANT TO SECTION 8.5 OF THE BYLAWS OF THE FRANCISCAN MEDICAL GROUP THE EXECUTIVE COMMITTEE IS COMPOSED OF FOUR (4) MEMBERS, INCLUDING TWO (2) PHYSICIAN DIRECTORS, ONE (1) COMMUNITY REPRESENTATIVE NON-PHYSICIAN DIRECTOR AND THE CHAIRPERSON OF THE BOARD (UNLESS SUCH CHAIRPERSON OF THE BOARD IS ALSO ONE OF THE OTHER QUALIFIED MEMBERS, IN WHICH CASE THE FOURTH MEMBER SHALL BE A DIRECTOR APPOINTED BY THE CHAIRPERSON OF THE BOARD). EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE, AND TWO VOTING MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. 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 8.5 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 ACCORDING TO THE BYLAWS OF FRANCISCAN MEDICAL GROUP THE SOLE MEMBER IS FRANCISCAN HEALTH SYSTEM, A WASHINGTON NONPROFIT CORPORATION. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a THE SOLE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b THE ORGANIZATION'S CORPORATE MEMBER IS FRANCISCAN HEALTH SYSTEM ("FHS"). PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, BOTH FRANCISCAN HEALTH SYSTEM AND CATHOLIC HEALTH INITIATIVES ("CHI") (FHS'S SOLE CORPORATE MEMBER) HAVE RESERVED POWERS AS OUTLINED IN THE CHI GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE FRANCISCAN HEALTH SYSTEM (FHS) BOARD: 1. APPROVE MEMBERS OF THE FRANCISCAN MEDICAL GROUP (FMG) BOARD 2. AMENDMENT OF THE CORPORATE DOCUMENTS OF FMG 3. APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF FMG 4. ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR FMG THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: 1. SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF FMG 2. REMOVAL OF A MEMBER OF THE GOVERNING BODY OF FMG 3. APPROVAL OF ISSUANCE OF DEBT BY FMG 4. APPROVAL OF PARTICIPATION OF FMG IN A JOINT VENTURE 5. APPROVAL OF FORMATION OF A NEW CORPORATION BY FMG 6. APPROVAL OF A MERGER INVOLVING FMG 7. APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF FMG 8. TO REQUIRE THE TRANSFER OF ASSETS BY FMG TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. IN ADDITION, PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, FHS OR 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 THE CFO REVIEWS THE TAX RETURN AND ANY NECESSARY CHANGES ARE INCLUDED IN THE FINAL VERSION THAT IS APPROVED FOR FILING WITH THE IRS. IN ADDITION, THE RETURN IS PROVIDED TO THE BOARD PRIOR TO FILING. SUBSEQUENT TO REVIEW, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. Conflict of interest policy Form 990, Part VI, Section B, Line 12c EACH EMPLOYEE IS PROVIDED EDUCATION REGARDING CONFLICT OF INTEREST POLICY AT NEW EMPLOYEE ORIENTATION. AS A PART OF THE ANNUAL PERFORMANCE REVIEW PROCESS, THE FOLLOWING STATEMENT IS INITIALED BY ALL EMPLOYEES: CONFLICTS OF INTEREST: "I WILL COMPLY WITH THE STANDARDS AND GUIDELINES CONTAINED IN THE CONFLICT OF INTEREST POLICY. I UNDERSTAND THAT I AM RESPONSIBLE FOR RECOGNIZING ANY SITUATION IN WHICH A CONFLICT OF INTEREST IS PRESENT OR MIGHT ARISE. I WILL IMMEDIATELY REPORT ANY SUCH SITUATION TO MY MANAGER/VICE PRESIDENT AND WILL TAKE APPROPRIATE ACTION TO ELIMINATE OR PREVENT A CONFLICT." THE GOVERNING BODY IS ALSO REQUIRED TO ANNUALLY DECLARE CONFLICTS OF INTERESTS, AS WELL AS THE MEDICAL STAFF LEADERS. WHEN A CONFLICT IS ACKNOWLEDGED, THE INDIVIDUALS ARE PROHIBITED FROM DELIBERATIONS AND DECISIONS IN THE TRANSACTION. THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS ALL GOVERNANCE CONFLICTS OF INTERESTS, AND AT EACH BOARD MEETING THE CHAIRPERSON ASKS IF THERE ARE ANY CONFLICTS OF INTERESTS RELATED TO CURRENT AGENDA ITEMS. CONFLICTS OF INTERESTS ARE REVIEWED BY THE CFO, CEO, LEGAL OR AT THE APPROPRIATE LEVEL OF MANAGEMENT DEPENDING ON THE NATURE OF THE CONFLICT OF INTEREST. WRITTEN DOCUMENT RETENTION PLAN FORM 990, PART VI, LINE 14 WHILE FRANCISCAN MEDICAL GROUP HAS A WRITTEN DOCUMENT RETENTION PLAN, THE GOVERNING BOARD HAS NOT FORMALLY ADOPTED IT. Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a AN EXTERNAL COMPENSATION FIRM IS USED WHO UTILIZES ACTUAL MARKET DATA COMPENSATION FROM SIMILAR INSTITUTIONS WITH COMPARABLE POSITIONS AND COMPENSATION LEVELS AND CONSIDERING THE ORGANIZATION'S GEOGRAPHIC LOCATION. THE EXECUTIVE COMMITTEE OF THE BOARD ANNUALLY EVALUATES AND APPROVES THE EXECUTIVE COMPENSATION ARRANGEMENT FOR EACH EXECUTIVE FOR FAIR MARKET VALUE ALONG WITH OTHER APPLICABLE FACTORS RELIED ON BY THE BOARD'S DETERMINATION. THE SUPPORTING DOCUMENTATION BECOMES PART OF THE MINUTES OF THE MEETING. THIS PROCESS IS COMPLETED YEARLY. Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b AN EXTERNAL COMPENSATION FIRM IS USED WHO UTILIZES ACTUAL MARKET DATA COMPENSATION FROM SIMILAR INSTITUTIONS WITH COMPARABLE POSITIONS AND COMPENSATION LEVELS AND CONSIDERING THE ORGANIZATION'S GEOGRAPHIC LOCATION. THE EXECUTIVE COMMITTEE OF THE BOARD ANNUALLY EVALUATES AND APPROVES THE EXECUTIVE COMPENSATION ARRANGEMENT FOR EACH EXECUTIVE FOR FAIR MARKET VALUE ALONG WITH OTHER APPLICABLE FACTORS RELIED ON BY THE BOARD'S DETERMINATION. THE SUPPORTING DOCUMENTATION BECOMES PART OF THE MINUTES OF THE MEETING. THIS PROCESS IS COMPLETED YEARLY. Governing documents, conflict of interest policy and financial statements available to the public Form 990, Part VI, Section C, Line 19 THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.COM. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE ON THE WASHINGTON SECRETARY OF STATE'S WEBSITE. THE CONFLICT OF INTEREST POLICY IS AVAILABLE TO THE PUBLIC IN THE ORGANIZATION'S ADMINISTRATION OFFICES. 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 - Type I FH true FRANCISCAN FOUNDATION 1717 SOUTH J STREET TACOMA WA 98405 FUNDRAISING WA 501(C)(3) 9 FHS true FRANCISCAN HEALTH SYSTEM 1717 SOUTH J STREET TACOMA WA 98405 HEALTHCARE WA 501(C)(3) 3 CHI true FRANCISCAN MEDICAL GROUP 1708 SOUTH YAKIMA AVENUE TACOMA WA 98405 HEALTHCARE WA 501(C)(3) 9 FHS true FRANCISCAN VILLA OF SOUTH MILWAUKEE 3601 SOUTH CHICAGO AVENUE SOUTH MILWAUKEE WI 53172 HEALTHCARE WI 501(C)(3) 9 CHI true GETTYSBURG MEDICAL CENTER 606 EAST GARFIELD AVENUE GETTYSBURG SD 57442 HEALTHCARE SD 501(C)(3) 3 SMHC true GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 MINISTRIES CO 501(C)(3) 11 - Type I CHI true GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 EDUCATION OH 501(C)(3) 2 GSH true GOOD SAMARITAN FOUNDATION OF CINCINNATI INC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 FUNDRAISING OH 501(C)(3) 11 - Type I GSH true GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY NE 68848 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST STREET KEARNEY NE 68847 FUNDRAISING NE 501(C)(3) 7 GSH true ST LUKE'S MEDICAL GROUP FKA GREATER HOUSTON HEALTH NETWORK 6624 FANNIN HOUSTON TX 77030 PHY PRACTICES TX 501(C)(3) 3 SLHS true HEALTH SET 4200 WEST CONEJOS PLACE 436 DENVER CO 80204 LOW INC.CARE CO 501(C)(3) 7 CHIC true HEALTHCARE AND WELLNESS FOUNDATION 2400 ST FRANCIS DRIVE BRECKENRIDGE MN 56520 FUNDRAISING MN 501(C)(3) 11 - Type I SFMC true HIGHLINE MEDICAL CENTER 16251 SYLVESTER RD SW BURIEN WA 98166 HEALTHCARE WA 501(C)(3) 3 FHS true HOSPITAL ASSOCIATION FOR ST JOSEPH HOSPITAL 7601 OSLER DRIVE TOWSON MD 21204 HEALTHCARE MD 501(C)(3) 9 SJMC true HOUSE OF MERCY 1111 6TH AVENUE DES MOINES IA 50314 SHELTER IA 501(C)(3) 7 CHI-IA CORP true JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC 539 S 4TH STREET LOUISVILLE KY 40202 HEALTHCARE KY 501(C)(3) 3 KOH true JEWISH PHYSICIAN GROUP INC 539 S 4TH STREET LOUISVILLE KY 40202 HEALTHCARE KY 501(C)(3) 9 JHSMH true KENTUCKYONE HEALTH INC FKA JH PROPERTIES INC 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 HEALTHCARE KY 501(C)(3) 9 CHI true LAKEWOOD HEALTH CENTER 600 MAIN AVENUE SOUTH BAUDETTE MN 56623 HEALTHCARE MN 501(C)(3) 3 CHI true LINUS OAKES INC 2700 STEWART PARKWAY ROSEBURG OR 97470 SENIOR LIVING OR 501(C)(3) 9 MMC true LISBON AREA HEALTH SERVICES 905 MAIN STREET LISBON ND 58054 HEALTHCARE ND 501(C)(3) 3 CHI true MEMORIAL HEALTH CARE SYSTEM FOUNDATION 2525 DE SALES AVENUE CHATTANOOGA TN 37404 FUNDRAISING TN 501(C)(3) 7 MHCS true MEMORIAL HEALTH CARE SYSTEM INC 2525 DE SALES AVENUE CHATTANOOGA TN 37404 HEALTHCARE TN 501(C)(3) 3 CHI true MEMORIAL HEALTH PARTNERS FOUNDATION INC 5600 BRAINERD ROAD SUITE 500 CHATTANOOGA TN 37411 HEALTHCARE TN 501(C)(3) 9 MHCS true MERCY AUXILIARY OF CENTRAL IOWA 1111 6TH AVENUE DES MOINES IA 50314 AUXILIARY IA 501(C)(3) 11 - Type I CHI-IA CORP true MERCY CLINICS INC 1111 6TH AVENUE DES MOINES IA 50314 PHYSICIAN IA 501(C)(3) 9 CHI-IA CORP true MERCY COLLEGE OF HEALTH SCIENCES 1111 6TH AVENUE DES MOINES IA 50314 EDUCATION IA 501(C)(3) 2 CHI-IA CORP true MERCY FOUNDATION OF DES MOINES IA 1111 6TH AVENUE DES MOINES IA 50314 FUNDRAISING IA 501(C)(3) 7 CHI-IA CORP true MERCY FOUNDATION INC 2700 STEWART PARKWAY ROSEBURG OR 97470 FUNDRAISING OR 501(C)(3) 7 MMC true MERCY HEALTH CARE FOUNDATION PO BOX 368 CORNING IA 50841 FUNDRAISING NE 501(C)(3) 11 - Type I AHMH true MERCY HEALTHCARE FOUNDATION 570 CHAUTAUQUA BOULEVARD VALLEY CITY ND 58072 FUNDRAISING ND 501(C)(3) 11 - Type III - FI MHVC true MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS 800 MERCY DRIVE COUNCIL BLUFFS IA 51503 FUNDRAISING IA 501(C)(3) 11 - Type I AHBMHS true MERCY HOSPITAL OF DEVILS LAKE 1031 SEVENTH STREET NE DEVILS LAKE ND 58301 HEALTHCARE ND 501(C)(3) 3 CHI true MERCY HOSPITAL OF DEVILS LAKE FOUNDATION 1031 SEVENTH STREET NE DEVILS LAKE ND 58301 FUNDRAISING ND 501(C)(3) 7 CHI true MERCY HOSPITAL OF VALLEY CITY 570 CHAUTAUQUA BOULEVARD VALLEY CITY ND 58072 HEALTHCARE ND 501(C)(3) 3 CHI true MERCY MEDICAL CENTER 1301 15TH AVENUE WEST WILLISTON ND 58801 HEALTHCARE ND 501(C)(3) 3 CHI true MERCY MEDICAL CENTER - CENTERVILLE ONE ST JOSEPHS DRIVE CENTERVILLE IA 52544 HEALTHCARE IA 501(C)(3) 3 CHI-IA CORP true MERCY MEDICAL CENTER INC 2700 STEWART PARKWAY ROSEBURG OR 97470 HEALTHCARE OR 501(C)(3) 3 CHI true MERCY MEDICAL FOUNDATION 1301 15TH AVENUE WEST WILLISTON ND 58801 FUNDRAISING ND 501(C)(3) 11 - Type I MMC true MERCY PROFESSIONAL PRACTICE ASSOCIATES INC 1111 6TH AVENUE DES MOINES IA 50314 PHYSICIAN IA 501(C)(3) 9 CHI-IA CORP true MLIFECARES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 PROPERTY MGMT MO 501(C)(3) 11 - Type I SJRMC true MNMCH INC 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 HEALTHCARE KS 501(C)(3) 3 SJRMC true MT ST JOSEPH INC 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 NURSING CARE OR 501(C)(3) 11 - Type I CHI true NEBRASKA HEART HOSPITAL 7500 SOUTH 91ST STREET LINCOLN NE 68526 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true OAKES COMMUNITY HOSPITAL 314 SOUTH 8TH STREET OAKES ND 58474 HEALTHCARE ND 501(C)(3) 3 CHI true OAKES COMMUNITY HOSPITAL FOUNDATION 1200 N 7TH STREET OAKES ND 58474 FUNDRAISING ND 501(C)(3) 11 - Type I OCH true PUEBLO STEPUP 1925 EAST ORMAN AVE SUITE G52 PUEBLO CO 81004 COMMUNITY CO 501(C)(3) 7 CHIC true SET OF COLORADO SPRINGS INC 2864 S CIRCLE DRIVE SUITE 450 COLORADO SPRINGS CO 80906 LTERM CARE CO 501(C)(3) 7 CHIC true SAINT CLARE'S COMMUNITY CARE 25 POCONO ROAD DENVILLE NJ 07834 HEALTHCARE NJ 501(C)(3) 11 - Type II SCHS true SAINT CLARE'S FOUNDATION 25 POCONO ROAD DENVILLE NJ 07834 FUNDRAISING NJ 501(C)(3) 7 SCHS true SAINT CLARE'S HEALTH SERVICES INC 25 POCONO ROAD DENVILLE NJ 07834 MANAGEMENT NJ 501(C)(3) 7 CHI true SAINT CLARE'S HOSPITAL 25 POCONO ROAD DENVILLE NJ 07834 HEALTHCARE NJ 501(C)(3) 3 SCHS true SAINT ELIZABETH FOUNDATION 555 SOUTH 70TH STREET LINCOLN NE 68510 FUNDRAISING NE 501(C)(3) 7 SERMC true SAINT ELIZABETH HEALTH SERVICES 555 SOUTH 70TH STREET LINCOLN NE 68510 HEALTHCARE NE 501(C)(3) 3 SERMC true SAINT ELIZABETH REGIONAL MEDICAL CENTER 555 SOUTH 70TH STREET LINCOLN NE 68510 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true SAINT FRANCIS MEDICAL CENTER 2620 WEST FAIDLEY GRAND ISLAND NE 68803 HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA true SAINT FRANCIS MEDICAL CENTER FOUNDATION PO BOX 9804 GRAND ISLAND NE 68802 FUNDRAISING NE 501(C)(3) 7 SFMC true SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC 305 ESTILL STREET BEREA KY 40403 FUNDRAISING KY 501(C)(3) 7 SJHS true SAINT JOSEPH HEALTH SYSTEM INC 424 LEWIS HARGETT CIRCLE 160 LEXINGTON KY 40503 HEALTHCARE KY 501(C)(3) 3 CHI true SAINT JOSEPH LONDON FOUNDATION INC 1001 SAINT JOSEPH LANE LONDON KY 40741 FUNDRAISING KY 501(C)(3) 7 SJHS true SAINT JOSEPH MEDICAL FOUNDATION INC 200 ABRAHAM FLEXNER WAY LOUISVILLE KY 40202 PHY PRACTICES KY 501(C)(3) 3 SJHS true SAINT JOSEPH MOUNT STERLING FOUNDATION INC 225 FALCON DRIVE MOUNT STERLING KY 40353 FUNDRAISING KY 501(C)(3) 7 SJHS true SAINT JOSEPH'S HOSPITAL FOUNDATION 30 WEST 7TH STREET DICKINSON ND 58601 FUNDRAISING ND 501(C)(3) 11 - 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