2012-05-11T14:09:17-05:00 2011-06-30 990 2010-07-01 820200895 SAINT ALPHONSUS REGIONAL MEDICAL CENTER SAIN 2083672121 1055 NORTH CURTIS ROAD BOISE ID 83706 BLAINE PETERSON 2083672121 2012-05-11 2010 2016-02-24 21:20:13Z SEE SCHEDULE O SALLY JEFFCOAT 1055 NORTH CURTIS ROAD BOISE ID 83706 510563144 0 0928 X WWW.SARMC.ORG X 1958 ID HEALTHCARE SERVICES 13 11 4034 2440 19518 0 1900167 2676617 438611592 491985879 5602454 8733371 3850488 6386801 449964701 509782668 884456 903155 0 0 193960296 228588769 0 0 1127248 241355859 269003649 436200611 498495573 13764090 11287095 564591645 588441049 226076616 271096178 338515029 317344871 HEALTHCARE SERVICES - SEE LINE 4 AND SCHEDULE H FOR ADDITIONAL INFORMATION 0 0 426650799 903155 496412518 SAINT ALPHONSUS REGIONAL MEDICAL CENTER, A NOT-FOR-PROFIT CORPORATION, OWNS AND OPERATES AN ACUTE CARE HOSPITAL IN BOISE, IDAHO. THE HOSPITAL PROVIDES SERVICES TO RESIDENTS OF THE LOCAL GEOGRAPHIC REGION. THE HOSPITAL IS A MEMBER OF TRINITY HEALTH, AN INDIANA NOT-FOR-PROFIT CORPORATION SPONSORED BY CATHOLIC HEALTH MINISTRIES, A PUBLIC JURIDIC PERSON OF THE HOLY ROMAN CATHOLIC CHURCH. FOR MORE INFORMATION ON SPECIFIC SERVICES PROVIDED, PLEASE SEE SAINT ALPHONSUS REGIONAL MEDICAL CENTER'S WEBSITE AT WWW.SARMC.ORG. THE MISSION STATEMENT OF THE HOSPITAL IS AS FOLLOWS:WE SERVE TOGETHER IN TRINITY HEALTHIN THE SPIRIT OF THE GOSPEL TO HEAL BODY, MIND, AND SPIRITTO IMPROVE THE HEALTH OF OUR COMMUNITIESAND TO STEWARD THE RESOURCES ENTRUSTED TO US. 426650799 1 1 0 1 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0 0 1 0 0 1 1 1 0 0 0 0 1 1 1 0 0 1 680 0 1 4034 1 1 1 0 0 0 0 1 1 0 0 0 0 X 13 11 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 OR X KENNETH FRY CFO 2083673445 1055 NORTH CURTIS ROAD BOISE ID 83706 X COYLA ANDERSON 1.00 X 0 0 0 SR MADELEINE MARIE CLAYTON CSC 1.00 X 0 0 0 SR JEANETTE FETTIG CSC 1.00 X 0 0 0 DIANA NICHOLSON 1.00 X 0 0 0 MARK MEIER MD 1.00 X 0 0 0 CHARLES WHITE 1.00 X 0 0 0 SHAUNA WILLIAMS MD 1.00 X 42411 0 0 J RICHARD O'CONNELL 3.00 X 0 761373 137960 KAYE O'RIORDAN 1.00 X 0 0 0 STEVE BROCATO 1.00 X 0 0 0 SR SHARLET WAGNER CSC 1.00 X 0 0 0 SR SHARON FORD RSM 1.00 X 0 0 0 KENNETH HART 1.00 X 0 0 0 RONALD GRAVES 1.00 X 0 0 0 VICTOR YAMAMOTO 1.00 X 0 0 0 JON WAGNILD MD 1.00 X 0 0 0 LYNN HARRIS 1.00 X 0 0 0 SALLY JEFFCOAT 45.00 X X 0 680947 100231 GEORGE JUETTEN 1.00 X X 0 0 0 SEVERINA HAWS 1.00 X X 0 0 0 ROBERT LOKKEN 1.00 X X 0 0 0 BRENT LLOYD 1.00 X X 0 0 0 KENNETH FRY 50.00 X X 0 323347 48104 STEPHANIE WESTERMEIER 45.00 X 199544 105838 34635 BLAINE PETERSON 45.00 X 0 39832 1938 JOSEPH SWEDISH 2.00 X 0 2853932 791453 KEDRICK ADKINS 2.00 X 0 1160870 198248 MICHAEL SLUBOWSKI 2.00 X 0 1153164 271732 MICHAEL MURPHY 2.00 X 0 539823 68542 JANELLE G REILLY 45.00 X 0 363449 36738 JAMES POLK 45.00 X 0 354260 54343 KAREN HODGE 50.00 X 0 213919 86369 JEAN BASOM 50.00 X 0 222559 115776 CHRISTIAN ZIMMERMAN MD 50.00 X 1599082 0 36376 MICHAEL COUGHLIN MD 50.00 X 927511 0 51840 MARK G PARENT MD 50.00 X 812694 0 91226 JEFFREY SHILT MD 50.00 X 743267 0 31644 WALTER SEALE MD 50.00 X 649763 0 102069 4974272 8773313 2259224 245 0 1 0 REHABILITATION MANAGEMENT ASSOCIATES INC 901 N CURTIS 204 BOISE ID 83706 REHABILITATION SERVICES 6396772 INTERMOUNTAIN MEDICAL IMAGING LLC 877 WEST MAIN ST STE 603 BOISE ID 83702 RADIOLOGY SERVICES 3649285 BOISE ANESTHESIA PA PO BOX 5641 PORTLAND OR 97228 ANESTHESIA SERVICES 1620674 TREASURE VALLEY LABORATORY PO BOX 2693 SPOKANE WA 99220 LABORATORY SERVICES 1565563 SAGE PSYCHIATRIC MANAGEMENT PLLC 413 N ALLUMBAUGH BOISE ID 83702 PSYCHIATRIC SERVICES 1228927 108 381961 174612 859053 1260991 67536 2676617 NET PATIENT SVC REV 900099 486621627 486621627 INTERCO. ALLOCATION 900099 5364252 5364252 491985879 3401719 3401719 362809 362809 362809 362809 5665110 70008 403466 5665110 -333458 5331652 5331652 419495 381961 376910 42585 42585 10323 100 10223 10223 CAFETERIA REVENUE 900099 1525387 1525387 BIO-MEDICAL REPAIR 811000 19518 19518 4426279 4426279 5971184 509782668 496412158 19518 10674375 829083 829083 74072 74072 3118708 3118708 54640 54640 185849133 173473590 12047571 327972 13096611 12326452 746847 23312 13973536 12956508 992513 24515 12496141 11091966 1380722 23453 1406300 1377827 28473 1415151 196456 1218695 66426 4250 62176 60549 60549 50032811 45726021 3991986 314804 2521539 619959 1851053 50527 7671812 4857996 2543820 269996 20670114 391933 20278181 9734991 9549821 180055 5115 1412520 888235 470441 53844 7793130 7793130 28313520 24273213 4039874 433 3933956 665361 3268595 MEDICAL SUPPLIES 83953333 83953333 BAD DEBT 20304902 20304902 INTERCO. PURCHASED SVCS 8430470 1088932 7341538 CONTRACT LABOR EXPENSE 7792609 1235401 6557208 HOSPITAL PROVIDER TAX 6476995 6476995 7012521 6440723 538521 33277 498495573 426650799 70717526 1127248 7663251 2135737 2111489 3579548 676909 389843 68535958 69863287 20000 444342 417116 6616014 5830294 985208 941931 459876658 196554463 272042718 263322195 123331106 112223910 48265902 95472730 33918748 34244458 564591645 588441049 49760199 59983631 248000 176068417 211112547 226076616 271096178 X 335200057 313375480 3314972 3969391 338515029 317344871 564591645 588441049 X 11287095 -32457253 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 43497 1 65549 1 2145 1 4670 115861 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: LOBBYING ACTIVITIES PERFORMED BY SAINT ALPHONSUS REGIONAL MEDICAL CENTER (SARMC) INCLUDED THE RETENTION OF AN INDIVIDUAL WHO WAS PAID A RETAINER TO PERFORM THE FOLLOWING: 1. MONITOR AND REPORT ON ALL SIGNIFICANT DEVELOPMENTS IN IDAHO STATE LEGAL, LEGISLATIVE, POLICY AND REGULATORY MATTERS AFFECTING SARMC. 2. REGULARLY MEET IDAHO STATE OFFICIALS ON ISSUES OF CONTINUING CONCERN AND INTEREST TO SARMC AND REPORT THE RESULTS OF SUCH MEETINGS. 3. MONITOR ALL LEGISLATION INTRODUCED DURING EACH LEGISLATIVE SESSION, LOBBY AGAINST LEGISLATION DETERMINED TO BE ADVERSE TO SARMC AND LOBBY IN FAVOR OF ALL MATTERS OF INTEREST AND CONCERN TO SARMC DURING THE SAME LEGISLATIVE SESSION. SAINT ALPHONSUS REGIONAL MEDICAL CENTER ALSO PAYS DUES TO SEVERAL HEALTH ASSOCIATIONS WHO USE A PORTION OF THESE DUES FOR LOBBYING PURPOSES. THESE ORGANIZATIONS HAVE PROVIDED SARMC WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. THAT LOBBYING PORTION IS AS FOLLOWS: IDAHO HOSPITAL ASSOCIATION - $34,185; AMERICAN HOSPITAL ASSOCIATION - $5,381; CATHOLIC HOSPITAL ASSOCIATION - $3,932. SARMC EXECUTIVES ATTENDED "ADVOCACY ACTION DAYS" IN WASHINGTON D.C. DURING THEIR VISITS TO CAPITAL HILL, PARTICIPANTS DISCUSSED THE FOLLOWING: -COVERAGE FOR THE UNINSURED -QUALITY AND EFFICIENCY OF HEALTH CARE -ALIGNMENT OF PAYMENT INCENTIVES IN MEDICARE AND MEDICAID -SAFEGUARDING THE MISSION OF TAX-EXEMPT HOSPITALS 10237747 3033233 362158 12908822 8914610 1704880 381743 10237747 11601314 -2363278 323426 8914610 1.00000 0 0 1284141 8129490 9413631 306260582 102500843 203759739 135940104 94053620 41886484 8262341 8262341 263322195 ABSOLUTE RETURN STRATEGY FUNDS 44200338 F COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 12376095 F BOND FUND 38896297 F 95472730 INTERCOMPANY NOTES RECEIVABLES 765255 OTHER RECEIVABLES 2370677 INTERCOMPANY OTHER LONG TERM ASSETS 23323365 INTERCOMPANY RECEIVABLES 4673544 INVESTMENT IN UNCONSOLIDATED AFFILIATES 3111617 34244458 INTERCOMPANY ACCOUNTS PAYABLE 4995141 DEFERRED COMPENSATION LIABILITY 3111139 ASSET RETIREMENT OBLIGATION (FIN 47) 677812 INTERCOMPANY NOTES PAYABLE 202184901 OTHER LONG TERM LIABILITIES 143554 211112547 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS ARE FOR: - PROJECTS DESIGNED TO ELEVATE THE QUALITY OF HEALTHCARE (INTERNAL GRANTS) - PROJECTS TO MEET IMMEDIATE NEEDS RELATED TO PATIENT CARE QUALITY (OPPORTUNITY GRANTS) - PROJECTS FOR HEALTH AND WELFARE-RELATED COMMUNITY BENEFIT PROJECTS THAT MEET THE NEEDS OF THE POOR AND UNDERSERVED. FESTIVAL OF TREES 683384 318224 365160 8915 137288 186836 PROJECT HAITI DINNER 61225 49695 11530 300 10623 5 56847 14042 42805 2500 14206 16242 801456 381961 419495 2500 23121 137588 213701 376910 42585 1 1 X 1 X 1 X 1 1 0 1 1 1 3612 10457576 10457576 0.02190 25 14741 74179243 63108740 11070503 0.02320 26 18353 84636819 63108740 21528079 0.04510 11 254488 1746603 64925 1681678 0.00350 3 1764 2785716 2785716 0.00580 9 38466 9026628 6211787 2814841 0.00590 1 4 3269 2342435 2342435 0.00490 28 297987 15901382 6276712 9624670 0.02010 54 316340 100538201 69385452 31152749 0.06520 1 2 424 424 0.00000 2 3056 79745 79745 0.00020 2 26 60965 60965 0.00010 5 3084 141134 141134 0.00030 0 9612035 2210768 77275896 83194717 -5918821 X 1 1 1 MRI LIMITED PARTNERSHIP MRI DIAGNOSTICS 0.14170 0.00000 0.83050 2 MRI MOBILE LIMITED PARTNERSHIP MRI DIAGNOSTICS 0.10500 0.00000 0.50380 1 1 SAINT ALPHONSUS REGIONAL MEDICAL CENTER

1055 N CURTIS ROAD BOISE ID 83706

X X X X NOT REQUIRED 1 2 ORTHO INST & BOISE HRT CARE

1070-1071 N CURTIS ROAD BOISE ID 83706

EMPLOYED PHYSICIANS VIEWPOINTE CLINIC

1880 W JUDITH LANE BOISE ID 83705

EMPLOYED PHYSICIANS PART I, LINE 6A: SAINT ALPHONSUS REGIONAL MEDICAL CENTER REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH IN ITS ANNUAL REPORT, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.IN ADDITION, SAINT ALPHONSUS REGIONAL MEDICAL CENTER INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, L7 COL(F): THE FOLLOWING NUMBER, $20,304,902, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II: COMMUNITY BUILDING ACTIVITIES - SAINT ALPHONSUS REGIONAL MEDICAL CENTER STRIVES TO MAKE THE CITIZENS OF OUR COMMUNITY MORE PRODUCTIVE, HEALTHY MEMBERS OF SOCIETY. THROUGH OUR COMMUNITY NEEDS ASSESSMENT AND OTHER COMMUNITY DATA, WE LEARNED THAT SEVERAL AREAS CAN BENEFIT FROM OUR HEALTH CARE EXPERTISE AND MONETARY SUPPORT. THESE INCLUDE AGENCIES THAT SUPPORT ECONOMIC DEVELOPMENT AND JOB CREATION; SUPPORT THE UNINSURED; ADDRESS WELLNESS ISSUES IN THE WORKFORCE; IMPROVE END OF LIFE CARE; EDUCATE REFUGEES REGARDING CHILDBIRTH AND PARENTING; IMPROVE CHILD SAFETY, HEALTH AND EDUCATION; AND SUPPORT SUBSTANCE ABUSE DETOXIFICATION AND SOBERING SERVICES AND CRISIS MENTAL HEALTH.SPECIFIC EXAMPLES OF OUR COMMUNITY BUILDING ACTIVITIES ARE DESCRIBED BELOW:- SUPPORT OF THE VALLEY INITIATIVE FOR PROSPERITY - SAINT ALPHONSUS SUPPORTED THIS BROAD-BASED ECONOMIC DEVELOPMENT INITIATIVE (IN PARTNERSHIP WITH LOCAL CHAMBERS OF COMMERCE AND OTHER LOCAL COMPANIES) THAT AIMED TO BRING NEW BUSINESSES AND JOBS TO THE LOCAL COMMUNITY. SAINT ALPHONSUS HAS INVESTED $20,000 PER YEAR OVER 5 YEARS, AS PART OF OUR COMMITMENT TO HELP OUR COMMUNITIES GROW AND THRIVE.- PARTICIPATION IN LOCAL BOARDS & TASK FORCES: SAINT ALPHONSUS LEADERS AND ASSOCIATES PARTICIPATE IN A VARIETY OF LOCAL NONPROFIT BOARDS AND TASK FORCES AIMED AT IMPROVING THE HEALTH OF OUR COMMUNITIES AND MAKING OUR COMMUNITY A MORE LIVABLE PLACE. EXAMPLES OF BOARD PARTICIPATION INCLUDE: - FAMILY MEDICINE RESIDENCY OF IDAHO: THROUGH ACTIVE PARTICIPATION ON THE BOARD OF FAMILY MEDICINE RESIDENCY OF IDAHO, SAINT ALPHONSUS HAS BEEN ABLE TO HELP GUIDE THE CONTINUING DEVELOPMENT AND EXPANSION OF FAMILY MEDICINE RESIDENCY CAPACITY IN IDAHO - A CRITICAL NEED SINCE IDAHO RANKS 49TH NATIONWIDE IN TERMS OF PRIMARY CARE PHYSICIANS PER CAPITA. THROUGH THIS PARTNERSHIP, WE WERE ALSO ABLE TO DEVELOP A NEW PSYCHIATRIC RESIDENCY PROGRAM BASED IN BOISE, WHICH OVER TIME WILL EXPAND THE PIPELINE OF NEW PSYCHIATRISTS PRACTICING IN OUR REGION, WHICH IS A HEALTH PROVIDER SHORTAGE AREA FOR MENTAL HEALTH. - BOYS & GIRLS CLUBS OF ADA COUNTY: ENHANCEMENT OF BEFORE & AFTER-SCHOOL PROGRAMMING FOR LOCAL AT-RISK YOUTH, INCLUDING A NEW LOCATION IN MERIDIAN, IDAHO. SAINT ALPHONSUS' REPRESENTATIVE ON THE BOYS & GIRLS CLUB BOARD HAS CHAIRED SEVERAL IMPORTANT COMMITTEES, INCLUDING STRATEGIC PLANNING, PROGRAMS, AND THE ANNUAL FUNDRAISER AUCTION, WHICH BRINGS IN THE BULK OF ANNUAL OPERATING FUNDS FOR THE CLUBS. UNDER OUR GUIDANCE, OUR LOCAL CLUBS HAVE ALSO TAKEN ON A SIGNIFICANT ROLE IN PROVIDING MEALS FOR LOW INCOME CHILDREN IN ADA AND CANYON COUNTIES AND HAVE RECEIVED NATIONAL AWARDS FOR THEIR NUTRITION PROGRAMMING. - COMMUNITY MENTAL HEALTH MEETINGS: A SAINT ALPHONSUS REPRESENTATIVE PARTICIPATES IN DISCUSSIONS WITH MENTAL HEALTH PROVIDERS THROUGHOUT THE COMMUNITY, TO WORK THROUGH ISSUES AND IMPROVE COORDINATION OF SERVICES.HEALTH IMPROVEMENT ADVOCACY: SAINT ALPHONSUS HAS BEEN AN ACTIVE PARTICIPANT IN ADVOCACY SUPPORTING HEALTH IMPROVEMENT INITIATIVES SUCH AS: - CHILDHOOD IMMUNIZATION POLICY: LEGISLATION HAS REMEDIED FUNDING ISSUES FOR IDAHO'S CHILDHOOD IMMUNIZATION PROGRAMS AND IMPROVED PARTICIPATION IN THE IMMUNIZATION REMINDER SYSTEM. SAINT ALPHONSUS HAS WORKED WITH IDAHO VOICES FOR CHILDREN AND OTHER PARTNERS TO ADVOCATE FOR THESE IMPROVEMENTS. - IDAHO END OF LIFE COALITION: ADVANCE CARE PLANNING IN IDAHO HAS BEEN IMPROVED AND STREAMLINED. ADVANCE CARE COMMITTEE MEMBERS PROVIDE PROFESSIONAL CONSULTATION ON THE DEVELOPMENT OF IDAHO ADVANCE CARE LEGISLATION INCLUDING REVISION AND STREAMLINING OF THE IDAHO NATURAL DEATH ACT (LIVING WILL AND DURABLE POWER OF ATTORNEY FOR HEALTH CARE), CREATION OF THE HEALTH CARE DIRECTIVE REGISTRY HOUSED IN THE OFFICE OF THE SECRETARY OF STATE, AND THE POST (PHYSICIAN ORDERS FOR SCOPE OF TREATMENT) - THE NEW IDAHO DNR (DO NOT RESUSCITATE) PROGRAM. IN ADDITION, COALITION COMMITTEES DEVELOP INITIATIVES TO RAISE COMMUNITY AWARENESS AND ENCOURAGE PROFESSIONAL DEVELOPMENT ABOUT END-OF-LIFE ISSUES. PART III, LINE 4: SAINT ALPHONSUS REGIONAL MEDICAL CENTER IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM THOSE STATEMENTS: "SUBSTANTIALLY ALL OF THE CORPORATION'S RECEIVABLES ARE RELATED TO PROVIDING HEALTHCARE SERVICES TO PATIENTS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE. THE CORPORATION'S ESTIMATE FOR ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS BY PAYOR."COSTING METHODOLOGY FOR LINES 2 AND 3: AMOUNTS ARE CALCULATED ON LINE 2 USING A COST TO CHARGE RATIO METHODOLOGY.ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.THE AMOUNT ON LINE 3 WAS CALCULATED BASED ON INFORMATION SUPPLIED BY NCO, OUR COLLECTION AGENCY. PART III, LINE 8: SAINT ALPHONSUS MEDICAL CENTER DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CHA RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: SAINT ALPHONSUS REGIONAL MEDICAL CENTER'S COLLECTION POLICY CONTAINS THE CRITERIA FOR FINANCIAL ASSISTANCE, AND CONTAINS THE FOLLOWING VERBIAGE FOR ARRANGEMENTS WITH OUTSIDE COLLECTION AGENCIES: THE AGREEMENT MUST DEFINE THE STANDARDS AND SCOPE OF PRACTICES TO BE USED BY OUTSIDE COLLECTION AGENTS ACTING ON BEHALF OF SAINT ALPHONSUS HEALTH SYSTEM, ALL OF WHICH MUST BE IN COMPLIANCE WITH THIS POLICY. PART VI, LINE 2: NEEDS ASSESSMENT - SAINT ALPHONSUS REGIONAL MEDICAL CENTER ASSESSES THE HEALTH NEEDS OF THE COMMUNITY THROUGH COMMUNITY NEEDS ASSESSMENTS EVERY THREE YEARS. A COMMUNITY NEEDS ASSESSMENT IS A POINT-IN-TIME EFFORT TO MEASURE THE HEALTH AND WELL BEING OF THE COMMUNITY. IT SERVES AS THE BASIS FOR SAINT ALPHONSUS REGIONAL MEDICAL CENTER'S STRATEGIC AND SUBSEQUENT ACTION PLANNING TO DEVELOP HEALTH POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS AND COLLABORATE WITH OTHER COMMUNITY HEALTHCARE PROVIDERS. A COMMUNITY NEEDS ASSESSMENT ALSO SERVES AS A BENCHMARK FOR FUTURE ASSESSMENT OF RELATIVE PROGRESS TOWARD ESTABLISHED COMMUNITY HEALTH OBJECTIVES.THE SAINT ALPHONSUS COMMUNITY NEEDS ASSESSMENT PROVIDES THE OPPORTUNITY TO:- GAIN INSIGHTS INTO THE NEEDS AND ASSETS OF THE COMMUNITIES SERVED - IDENTIFY AND ADDRESS THE NEEDS OF VULNERABLE POPULATIONS WITHIN THE COMMUNITY- ENHANCE HOSPITAL/COMMUNITY RELATIONSHIPS AND THE OPPORTUNITY FOR COLLABORATIVE COMMUNITY ACTION, INCLUDING INVOLVEMENT WITH COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES, COMMISSIONS, ADVISORY GROUPS AND PANELS- PROVIDE THE INFORMATION REQUIRED FOR COMMUNITY OUTREACH PLANNINGTHE SAINT ALPHONSUS COMMUNITY NEEDS ASSESSMENT PROCESS INVOLVES THE GATHERING OF TWO TYPES OF DATA: QUANTITATIVE (DEMOGRAPHICS, HEALTH INDICATORS, ETC.) AND QUALITATIVE (PUBLIC SURVEYS, FORUMS, FOCUS GROUPS). THE DATA HELPS SUPPORT SHORT-TERM AND LONG-TERM DECISIONS ABOUT ALLOCATION OF COMMUNITY HUMAN AND CAPITAL RESOURCES. DURING FY11, SAINT ALPHONSUS PARTNERED WITH UNITED WAY OF TREASURE VALLEY, ST. LUKE'S HEALTH SYSTEM, AND ELKS REHABILITATION HOSPITAL TO CONDUCT A COMPREHENSIVE COMMUNITY NEEDS ASSESSMENT FOCUSING ON HEALTH, EDUCATION AND FINANCIAL INDEPENDENCE. ASSESSMENT WORK WAS LARGELY COMPLETED DURING FY11, AND THE PARTNERS HAVE NOW MOVED INTO THE PROCESS OF PRIORITIZING NEEDS AND CREATING AN IMPLEMENTATION PLAN. BOISE STATE UNIVERSITY SERVED AS RESEARCH PARTNER, AND UTAH FOUNDATION HAS PROVIDED TECHNICAL ASSISTANCE TO THIS PROJECT. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - SAINT ALPHONSUS IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, SAINT ALPHONSUS HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: - PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSSAINT ALPHONSUS COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. SAINT ALPHONSUS HAS SIGNS POSTED IN ALL REGISTRATION AREAS AND PLASTIC TABLE TOP CARDS IN THE REGISTRATION WAITING ROOMS, NOTIFYING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. ALL SELF-PAY PATIENTS ARE OFFERED FINANCIAL ASSISTANCE FORMS. EACH PATIENT RECEIVES A BILLING BROCHURE THAT LISTS PAYMENT OPTIONS AND HOW TO APPLY FOR CHARITY CARE. PATIENTS ALSO ARE SCREENED FOR MEDICAID ELIGIBILITY, UTILIZING FINANCIAL ASSISTANCE FORMS. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY HELP THEM OBTAIN AND PAY FOR HEALTHCARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE.SAINT ALPHONSUS OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH SIGNS POSTED IN REGISTRATION AREAS, PLASTIC TABLE TOP CARDS IN REGISTRATION WAITING ROOMS AND PATIENT BROCHURES. SELF-PAY INPATIENTS AND SURGERY PATIENTS RECEIVE A VISIT FROM A PATIENT ADVOCATE WHO ASSISTS THEM IN COMPLETING FINANCIAL ASSISTANCE FORMS FOR COUNTY INDIGENT ASSISTANCE, MEDICAID, SOCIAL SECURITY AND HOSPITAL CHARITY CARE. SAINT ALPHONSUS HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. SAINT ALPHONSUS MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. THE MEDICAL CENTER EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, BILLING AND COLLECTIONS) ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES. PART VI, LINE 4: COMMUNITY INFORMATION - SAINT ALPHONSUS REGIONAL MEDICAL CENTER SERVES PATIENTS FROM THE PRIMARY, SECONDARY AND TERTIARY SERVICE AREAS LISTED BELOW:- PRIMARY SERVICE AREA: A FIVE-COUNTY REGION INCLUDING ADA, CANYON, ELMORE, GEM AND MALHEUR COUNTIES. - SECONDARY SERVICE AREA: PAYETTE, TWIN FALLS, VALLEY, WASHINGTON, BAKER AND UNION COUNTIES - TERTIARY SERVICE AREA: ADAMS, BLAINE, BOISE, CASSIA, GOODING, JEROME, MINIDOKA, OWYHEE AND ELKO COUNTIESAREA HOSPITAL FACILITIES WITHIN SARMC'S PRIMARY SERVICE AREA INCLUDE ST. LUKE'S BOISE AND MERIDIAN, IDAHO ELKS REHABILITATION CENTER, TREASURE VALLEY HOSPITAL, SAINT ALPHONSUS MEDICAL CENTER-NAMPA, WEST VALLEY MEDICAL CENTER, ELMORE MEDICAL CENTER, SAINT ALPHONSUS MEDICAL CENTER-ONTARIO, AND WALTER KNOX MEMORIAL HOSPITAL.SAINT ALPHONSUS' PRIMARY SERVICE AREA IS A MIX OF URBAN AND RURAL COMMUNITIES WITHIN THE TREASURE VALLEY, BORDERED BY RUGGED MOUNTAINOUS TERRAIN AND DESERT. THE REGION HAS EXPERIENCED RAPID POPULATION GROWTH OVER THE PAST DECADE (FROM 2000-2010), WITH DRAMATIC GROWTH RATES IN ADA & CANYON COUNTIES, THE TWO LARGEST COUNTIES IN THE SERVICE AREA:- ADA COUNTY POPULATION GREW 30.4% FROM 2000-2010- CANYON COUNTY POPULATION GREW 43.7% FROM 2000-2010OTHER RELEVANT STATISTICS CHARACTERIZING SAINT ALPHONSUS' PRIMARY SERVICE AREA ARE INCLUDED BELOW:TOTAL POPULATION (2010):ADA COUNTY - 392,365CANYON COUNTY - 188,923ELMORE COUNTY - 27,028GEM COUNTY - 16,719MALHEUR COUNTY - 31,313PERCENT WHITE PERSONS NOT HISPANIC:ADA COUNTY - 86.5%CANYON COUNTY - 72.3%ELMORE COUNTY - 75.1%GEM COUNTY - 89.1%MALHEUR COUNTY - 63.6%PERCENT HISPANIC/LATINO ORIGIN:ADA COUNTY - 7.1%CANYON COUNTY - 23.9%ELMORE COUNTY - 15.2%GEM COUNTY - 8%MALHEUR COUNTY - 31.5%MEDIAN HOUSEHOLD INCOME:ADA COUNTY - $53,828CANYON COUNTY - $39,457ELMORE COUNTY - $41,922GEM COUNTY - $42,396MALHEUR COUNTY - $35,788PERSONS BELOW POVERTY LEVEL (2009):ADA COUNTY - 11.8%CANYON COUNTY - 18.2%ELMORE COUNTY - 13.8%GEM COUNTY - 14.8%MALHEUR COUNTY - 23.3%APPROXIMATELY 17% OF NON-ELDERLY IDAHO RESIDENTS LACK HEALTH INSURANCE (KAISER HEALTH FACTS). MEDICALLY UNDERSERVED POPULATIONS AND HEALTH PROFESSIONAL SHORTAGE AREAS WITHIN OUR SERVICE AREA INCLUDE A SHORTAGE OF PRIMARY CARE AND MENTAL HEALTH SERVICES.THE LOCAL REFUGEE POPULATION HAS MORE THAN DOUBLED SINCE 2005; MOST OF THESE INDIVIDUALS ARE OF CHILDBEARING AGE. APPROXIMATELY 3,800 REFUGEES CURRENTLY LIVE IN ADA COUNTY, WITH FOUR REFUGEE RESETTLEMENT AGENCIES IN THAT COUNTY PLACING 724 NEW REFUGEES IN 2007. IN 2008, 1,193 REFUGEES AND SPECIAL IMMIGRANTS ARRIVED IN IDAHO, FROM 23 DIFFERENT COUNTRIES, SPEAKING 27 DIFFERENT LANGUAGES (IDAHO OFFICE FOR REFUGEES). THE REGION SEES A HIGH PREVALENCE OF MENTAL HEALTH & SUBSTANCE ABUSE ISSUES, WITH INADEQUATE PUBLIC BEHAVIORAL HEALTH SYSTEMS IN PLACE TO MEET THE EXISTING NEEDS FOR COMMUNITY-BASED AND INPATIENT SERVICES.ON REVIEW OF DEMOGRAPHIC AND SOCIO-ECONOMIC DATA AND TRENDS, SEVERAL FACTORS CLEARLY HAVE AN IMPACT ON THE HEALTH STATUS OF THE COMMUNITIES SERVED BY SAINT ALPHONSUS, WITH IMPLICATIONS FOR FUTURE PLANNING. DRAMATIC POPULATION GROWTH, ESPECIALLY IN ADA AND CANYON COUNTIES, IS EXPECTED TO CONTINUE, WITH A GROWING HISPANIC POPULATION. THE GROWING REFUGEE POPULATION HAS GREATER LANGUAGE INTERPRETATION AND HEALTH EDUCATION NEEDS AS WELL.GROWTH IN IDAHO'S SENIOR POPULATION IS ALSO PROJECTED TO ACCELERATE, WHICH WILL REQUIRE INCREASED HEALTH CARE SPENDING. MAMMOGRAPHY RATES, THE RISING RATE OF LOW BIRTH WEIGHT BABIES, OVERWEIGHT AND OBESITY, TOBACCO USE, MENTAL HEALTH AND DRINKING/DRUG USE ARE ALSO OF GREAT CONCERN. PART VI, LINE 6: OTHER INFORMATION - CONSISTENT WITH ITS NONPROFIT STATUS, SAINT ALPHONSUS USES SURPLUS REVENUES TO REINVEST IN FACILITIES, TECHNOLOGY AND MEDICAL SERVICES FOR THE COMMUNITY, AND COLLABORATES WITH COMMUNITY PARTNERS AND INVESTS IN NEEDED COMMUNITY PROGRAMS SUCH AS FAMILY MEDICINE RESIDENCY OF IDAHO, ALLUMBAUGH HOUSE (SOBERING, DETOXIFICATION & CRISIS MENTAL HEALTH SERVICES), AND HEALTHTEACHER HEALTH LITERACY CURRICULUM FOR THE BOISE SCHOOL DISTRICT.SAINT ALPHONSUS ALSO COLLABORATES WITH UNITED WAY OF TREASURE VALLEY TO ADDRESS COMMUNITY NEEDS IN THE AREAS OF HEALTH, EDUCATION AND INCOME. SAINT ALPHONSUS IS REPRESENTED ON THE UNITED WAY BOARD OF DIRECTORS AND THE HEALTH VISION COUNCIL. IN ADDITION, SAINT ALPHONSUS HAS AN ANNUAL UNITED WAY WORKPLACE GIVING CAMPAIGN TO SUPPORT UNITED WAY INITIATIVES AND GRANTS TO LOCAL NONPROFITS PRODUCING MEASURABLE OUTCOMES IN ADDRESSING TOP COMMUNITY NEEDS.SAINT ALPHONSUS STRONGLY SUPPORTS HEALTHCARE WORKFORCE DEVELOPMENT EFFORTS, INCLUDING ANNUAL FINANCIAL SUPPORT TO THE FAMILY MEDICINE RESIDENCY OF IDAHO, PSYCHIATRIC RESIDENCY, ISU DENTAL RESIDENCY, AND THE BOISE STATE UNIVERSITY NURSING BUILDING FUND. IN ADDITION, SAINT ALPHONSUS SERVES AS A KEY CLINICAL TRAINING SITE FOR NEW PHYSICIANS, NURSES AND OTHER ALLIED HEALTH PROFESSIONALS.SAINT ALPHONSUS IS A REGIONAL TRAUMA CENTER AND TAKES A LEADERSHIP ROLE IN IMPROVING SYSTEMS OF CARE FOR TRAUMA PATIENTS. TRAUMA PREVENTION AND DISASTER PREPAREDNESS EFFORTS IN THE REGION ARE OFTEN LED BY STAFF AT SAINT ALPHONSUS, WHO HAVE CHAMPIONED TOUGHER SEAT BELT AND HELMET LAWS, COORDINATED DRUNK DRIVING PREVENTION EVENTS IN LOCAL HIGH SCHOOLS, AND LED IN RESPONSE PLANNING FOR EVENTS LIKE THE SPECIAL OLYMPICS WORLD WINTER GAMES. SAINT ALPHONSUS ALSO HOSTS AN ANNUAL SKI & MOUNTAIN TRAUMA CONFERENCE TO TRAIN FIRST RESPONDERS (EMS, FIRE, SKI PATROL, ETC.) THROUGHOUT THE NORTHWEST ON BEST PRACTICES FOR TRAUMA CARE IN THE PRE-HOSPITAL SETTING.SAINT ALPHONSUS COORDINATES A REGIONAL TELEMEDICINE NETWORK THROUGHOUT WESTERN & NORTHERN IDAHO AND EASTERN OREGON. SERVICES PROVIDED THROUGH THE NETWORK INCLUDE MUCH-NEEDED SERVICES SUCH AS TELEPSYCHIATRY, STROKE CARE, CLINICAL EDUCATION AND EMERGENCY MEDICINE CONSULTATIONS TO RURAL HOSPITALS IN REMOTE LOCATIONS, OFTEN PREVENTING UNNECESSARY TRANSPORTS AND ALLOWING PATIENTS TO BE CARED FOR CLOSER TO HOME. PART VI, LINE 7: SAINT ALPHONSUS REGIONAL MEDICAL CENTER IS A MEMBER ORGANIZATION OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE SYSTEMS IN THE COUNTRY. BASED IN NOVI, MICHIGAN, TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEVELOP, AND ARE HELD ACCOUNTABLE FOR ACHIEVING, COMMUNITY BENEFIT GOALS THAT INCLUDE DEVELOPING NEEDED SERVICES OR EXPANDING ACCESS TO SERVICES FOR LOW-INCOME INDIVIDUALS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITY THROUGH PROGRAMS TO SERVE THE POOR AND UNINSURED, MANAGE CHRONIC CONDITIONS LIKE DIABETES, HEALTH EDUCATION AND PROMOTION INITIATIVES, AND OUTREACH FOR THE ELDERLY. IN FISCAL YEAR 2011, THIS INCLUDED NEARLY $453 MILLION IN SUCH COMMUNITY BENEFITS. THEREFORE, TRINITY HEALTH TAKES A SYSTEMS APPROACH IN ITS COMMUNITY BENEFIT PLANNING AND IMPLEMENTATION, AND IS CONSEQUENTLY ABLE TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ARE HELPING PROMOTE AND ADDRESS THE HEALTH NEEDS OF THEIR RESPECTIVE COMMUNITIES.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG 1 COMMUNITY HEALTH CLINICS INC 211 16TH AVE NORTH NAMPA ID 83653 820300537 501(C)3 200880 SPONSORSHIP GENESIS WORLD MISSION INC 215 W 35TH ST GARDEN CITY ID 83714 820505073 501(C)3 14680 SPONSORSHIP DAVID A HINDSON MD EDUCATION FOUNDATION INC 439 THATCHER ST BOISE ID 83702 800279825 501(C)3 25000 SPONSORSHIP WOMEN'S AND CHILDREN'S ALLIANCE 720 W WASHINGTON ST BOISE ID 83702 820204464 501(C)3 5000 SPONSORSHIP BOISE METRO CHAMBER OF COMMERCE 250 S 5TH STREET 300 BOISE ID 83702 820100595 501(C)6 5000 VALLEY INITIATIVE FOR PROSPERITY SPONSORSHIP BOYS AND GIRLS CLUB OF ADA COUNTY IDAHO INC 610 E 42ND ST GARDEN CITY ID 83714 820481687 501(C)3 5000 SPONSORSHIP AMERICAN CANCER SOCIETY 2120 FIRST AVENUE NORTH SEATTLE WA 98109 841316555 501(C)3 7000 SPONSORSHIP AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)3 12500 SPONSORSHIP FAMILY ADVOCACY CENTER & EDUC SVC 417 S 6TH STREET BOISE ID 83702 204883532 501(C)3 15000 SPONSORSHIP TREASURE VALLEY FAMILY YMCA 1050 WEST STATE ST BOISE ID 83702 820200908 501(C)3 15875 SPONSORSHIP MAIN STREET MILE INC PO BOX 6331 BOISE ID 83707 113735163 501(C)3 18750 SPONSORSHIP SUSAN G KOMEN BREAST CANCER FOUNDATION DBA SUSAN G KOMEN FOR THE CURE 5005 LBJ FREEWAY DALLAS TX 75244 751835298 501(C)3 30000 4126 COST SURVIVOR CANTEENS SPONSORSHIP ST PAULS BENEVOLENT INSTITUTE 1181 SW 76TH AVE MIAMI FL 33144 226034713 501(C)3 133000 PROJECT HAITI SPONSORSHIP MARCH OF DIMES FOUNDATION 1275 MAMARONECK AVENUE WHITE PLAINS NY 10605 131846366 501(C)3 36714 SPONSORSHIP BOISE STATE UNIVERSITY FOUNDATION INC 2225 UNIVERSITY DRIVE BOISE ID 83706 826010706 501(C)3 125600 SPONSORSHIP UNITED WAY OF TREASURE VALLEY INC 1276 RIVER ST STE 100 BOISE ID 83707 820299013 501(C)3 5000 471 COST GIFT BASKET SPONSORSHIP AMERICAN LUNG ASSOCIATION OF MOUNTAIN PACIFIC 7420 SW BRIDGEPORT RD STE 200 TIGARD OR 97224 930386887 501(C)3 5000 SPONSORSHIP JOHN BUTLER LUNG FOUNDATION 722 HARCOURT RD BOISE ID 83702 820467602 501(C)3 15000 SPONSORSHIP IDAHO STATE UNIVERSITY 921 S 8TH AVE POCATELLO ID 83209 826000924 501(C)3 50000 500 FMV HOSPITAL BED SPONSORSHIP 18 1 AUTO INSURANCE ASSISTANCE 1 99 GIFT CARDS - GROCERIES AND GAS 82 8125 DENTAL ASSISTANCE 2 617 MORTGAGE ASSISTANCE 4 3289 TELEPHONE BILL ASSISTANCE 10 1719 RENT ASSISTANCE 15 12528 TRAVEL ASSISTANCE FOR MEDICAL TREATMENT 1 400 UTILITIES ASSISTANCE 23 3752 SCHOLARSHIPS 10 28250 MEDICAL EQUIPMENT 5 15293 COST MEDICAL MASK & TUBE ($53), WHEELCHAIR ($14,000), SHOWER COMMODE CHAIR ($850), & HYBRID ELITE CUSHION ($390). PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: DONATIONS MADE BY SAINT ALPHONSUS REGIONAL MEDICAL CENTER TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE AND ARE CONSIDERED UNRESTRICTED WITH REGARD TO THE USE OF THE FUNDS. THE CONTRIBUTIONS COMMITTEE REVIEWS REQUESTS AND RECOMMENDS APPROVAL. X X X X X 0 1 0 0 0 0 0 0 0 J RICHARD O'CONNELL 0 533392 0 113794 0 114187 0 116680 0 21280 0 899333 0 0 SALLY JEFFCOAT 0 455371 0 163850 0 61726 0 78781 0 21450 0 781178 0 0 KENNETH FRY 0 258476 0 62444 0 2427 0 31775 0 16329 0 371451 0 0 STEPHANIE WESTERMEIER 143597 105558 55745 0 202 280 18755 0 11012 4868 229311 110706 0 0 JOSEPH SWEDISH 0 1240774 0 645161 0 967997 0 763945 0 27508 0 3645385 0 690161 KEDRICK ADKINS 0 717356 0 326029 0 117485 0 184461 0 13787 0 1359118 0 0 MICHAEL SLUBOWSKI 0 701008 0 291561 0 160595 0 246925 0 24807 0 1424896 0 42832 MICHAEL MURPHY 0 343184 0 68618 0 128021 0 47238 0 21304 0 608365 0 0 JANELLE G REILLY 0 292035 0 70445 0 969 0 20382 0 16356 0 400187 0 0 JAMES POLK 0 281447 0 68676 0 4137 0 37606 0 16737 0 408603 0 0 KAREN HODGE 0 171111 0 40987 0 1821 0 78552 0 7817 0 300288 0 0 JEAN BASOM 0 176982 0 43125 0 2452 0 101917 0 13859 0 338335 0 0 CHRISTIAN ZIMMERMAN MD 1196643 0 399400 0 3039 0 17260 0 19116 0 1635458 0 0 0 MICHAEL COUGHLIN MD 878766 0 42425 0 6320 0 29002 0 22838 0 979351 0 0 0 MARK G PARENT MD 671272 0 136941 0 4481 0 71208 0 20018 0 903920 0 0 0 JEFFREY SHILT MD 647547 0 75000 0 20720 0 13453 0 18191 0 774911 0 0 0 WALTER SEALE MD 643552 0 4846 0 1365 0 70203 0 31866 0 751832 0 0 0 PART I, LINE 4B THE FOLLOWING ARE PARTICIPANTS IN THE TRINITY HEALTH PENSION RESTORATION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($245,000 FOR 2010). THE FOLLOWING ACCRUALS FOR 2010 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $113,498 SALLY JEFFCOAT - $54,476 MICHAEL MURPHY - $26,316 J. RICHARD O'CONNELL - $83,058 MICHAEL SLUBOWSKI - $136,445 JOSEPH SWEDISH - $223,342 THE FOLLOWING ARE PARTICIPANTS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING SERP ACCRUALS FOR 2010 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $49,977 MICHAEL SLUBOWSKI - $77,185 JOSEPH SWEDISH - $511,613 THE FOLLOWING INDIVIDUALS ARE PARTICIPANTS IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN UNDER SECTION 457(F). THE FOLLOWING DEFERRALS FOR CALENDAR 2010 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: MICHAEL COUGHLIN, MD - NONE MARK G. PARENT, MD - $50,000 JEFFREY SHILT, MD - NONE WALTER SEALE, MD - $50,000 CHRISTIAN ZIMMERMAN, MD - NONE JEFFREY SHILT MD X 50000 20000 0 0 1 20000 BLUE CROSS OF IDAHO (BCI) SALLY JEFFCOAT, CEO, ALSO SERVES ON THE BOARD OF BCI 74170753 PAYMENTS MADE BY BLUE CROSS OF IDAHO TO SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. FOR HEALTH CARE SERVICES PROVIDED TO BCI COVERED MEMBERS. 0 ETHAN FRY FAMILY MEMBER OF KENNETH FRY, KEY EMPLOYEE 54640 EMPLOYMENT ARRANGEMENT 0 X 7235 OPINION OF EXPERTS X 27692 OPINION OF EXPERTS X 8 7748 COST X ENTERTAINMENT 6 2975 COST X GIFT CERTIFICATES 44 3577 COST X CONSULTING SERVICES 7 4709 COST X PHOTO PROCESSING 1 1100 COST X ADVERTISING 2 12500 COST 0 1 1 THIRD PARTY USE: PART I, LINE 32B: THE REPORTING ENTITY HAS USED THIRD PARTIES TO PROCESS OR SELL NON-CASH CONTRIBUTIONS WHEN SPECIFIC EXPERTISE IS WARRANTED. WHERE AN EXPERT APPRAISAL IS NECESSARY, A THIRD PARTY APPRAISER WILL BE ENGAGED. OCCASIONALLY THE SERVICES OF AN AGENT ARE ENGAGED TO SELL NON-CASH CONTRIBUTIONS THAT WILL NOT BE USED BY THE REPORTING ENTITY. FORM 990, PART VI, SECTION A, LINE 2 KAYE O'RIORDAN, TRUSTEE, AND BRENT LLOYD, CHAIR, HAVE A BUSINESS RELATIONSHIP. CHARLES WHITE, TRUSTEE, AND KAYE O'RIORDAN, TRUSTEE, HAVE A BUSINESS RELATIONSHIP. CHARLES WHITE, TRUSTEE, AND BRENT LLOYD, CHAIR, HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. IS SAINT ALPHONSUS HEALTH SYSTEM. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A SAINT ALPHONSUS HEALTH SYSTEM IS THE SOLE MEMBER OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. SAINT ALPHONSUS HEALTH SYSTEM HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF TRUSTEES OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER OF THE CORPORATION, SAINT ALPHONSUS HEALTH SYSTEM MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. SAINT ALPHONSUS HEALTH SYSTEM MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING, THE FORM 990 FOR SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE FINANCE COMMITTEE OF SAINT ALPHONSUS HEALTH SYSTEM. (SAINT ALPHONSUS HEALTH SYSTEM IS THE SOLE MEMBER OF THE CORPORATION.) THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. HAS ADOPTED A CONFLICT OF INTEREST POLICY WHICH CONTAINS THE ELEMENTS IN THE MODEL CONFLICT OF INTEREST POLICY ISSUED BY THE IRS. IT APPLIES TO ALL INTERESTED PERSONS OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC., WHICH INCLUDES TRUSTEES, PRINCIPAL OFFICERS AND EXECUTIVES, AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. INTERESTED PERSONS ARE REQUIRED TO ACT AT ALL TIMES IN A MANNER CONSISTENT WITH SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC.'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE BOARD OF TRUSTEES OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE REVIEWED WITH THE BOARD OF TRUSTEES OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 SAINT ALPHONSUS REGIONAL MEDICAL CENTER IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE ANNUAL REPORT (WHICH INCLUDES COMMUNITY BENEFIT MINISTRY INFORMATION) AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, SAINT ALPHONSUS REGIONAL MEDICAL CENTER INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. ESTIMATE OF THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: FORM 990, PART VII, SECTION A, LINE 1, COLUMN B THE HOURS LISTED IN COLUMN B OF PART VII, SECTION A, LINE 1 REFLECT ONLY THE INDIVIDUALS' AVERAGE WEEKLY HOURS SPENT DIRECTLY ON THE ACTIVITIES OF THE REPORTING ORGANIZATION. IN ADDITION, THESE ARE THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: KEDRICK ADKINS - 53 HOURS SALLY JEFFCOAT - 5 HOURS MICHAEL MURPHY - 53 HOURS J. RICHARD O'CONNELL - 52 HOURS BLAINE PETERSEN - 5 HOURS JAMES POLK - 5 HOURS JANELLE REILLY - 5 HOURS MICHAEL SLUBOWSKI - 53 HOURS JOSEPH SWEDISH - 53 HOURS STEPHANIE WESTERMEIR - 5 HOURS DIRECTORS/TRUSTEES OR OFFICERS FORM 990, PART VII, SECTION A, LINE 1: DR. SHAUNA WILLIAMS, BOARD TRUSTEE, PROVIDED SERVICES TO SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. AS AN INDEPENDENT CONTRACTOR. THE AMOUNT SHOWN ON PART VII, SECTION A, LINE 1, REPRESENTS FEES FOR INDEPENDENT CONTRACTOR SERVICES, NOT BOARD FEES. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 14,678,685. EQUITY TRANSFERS TO AFFILIATES: -46,372,822. NET CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE: -665,000. EQUITY GAIN (LOSS) IN UNCONSOLIDATED AFFILIATES: -99,353. OTHER TRANSACTIONS: 1,237. TOTAL TO FORM 990, PART XI, LINE 5: -32,457,253. FORM 990, PART XII, LINE 2: SAINT ALPHONSUS REGIONAL MEDICAL CENTER'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY11 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. FORM 990, PAGE I, DOING BUSINESS AS: SAINT ALPHONSUS FOUNDATION, IDAHO NEUROLOGICAL INSTITUTE, IDAHO ORTHOPAEDIC INSTITUTE, IDAHO REHABILITATION AND PAIN CENTER, SAINT ALPHONSUS BREAST CARE CENTER, SAINT ALPHONSUS CANCER TREATMENT CENTER, SAINT ALPHONSUS CANCER CARE CENTER, SAINT ALPHONSUS SLEEP DISORDERS CENTER, SAINT ALPHONSUS PRIMARY STROKE CENTER, SAINT ALPHONSUS MEDICAL GROUP, SAINT ALPHONSUS EXPRESS CARE ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS MI 49503 272491974 HEALTHCARE SERVICES MI 501(C)(3) 9 TRINITY HEALTH-MICHIGAN 0 AMICARE HOSPICE SERVICES INC 27870 CABOT DRIVE NOVI MI 483772920 382949053 PROVIDE HOSPICE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC 0 AUXILIARY OF HOLY ROSARY HOSPITAL 351 SW 9TH STREET ONTARIO OR 97914 943059469 SUPPORTS SERVICES OF RELATED HOSPITAL OR 501(C)(3) 9 SAINT ALPHONSUS MEDICAL CENTER-ONTARIO 0 BATTLE CREEK HEALTH SYSTEM 300 NORTH AVENUE BATTLE CREEK MI 49016 382776791 HEALTHCARE SERVICES MI 501(C)(3) 3 TRINITY HEALTH - MICHIGAN 0 BATTLE CREEK HEALTH SYSTEM AUXILIARY 300 NORTH AVENUE BATTLE CREEK MI 49016 383355520 SUPPORT OF TAX EXEMPT HEALTH ORGANIZATION MI 501(C)(3) 11, TYPE I BATTLE CREEK HEALTH SYSTEM 0 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 ACUTE/AMBULATORY HEALTHCARE SERVICES IA 501(C)(3) 3 MERCY HEALTH SERVICES-IOWA CORP 0 BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) 11, TYPE I BAUM HARMON MERCY HOSPITAL 0 CAPITAL PARK FAMILY HEALTH CENTER INC 6150 EAST BROAD STREET COLUMBUS OH 43213 311387838 OPERATION OF A FEDERALLY QUALIFIED HEALTH CENTER (FORMERLY) OH 501(C)(3) 3 MOUNT CARMEL HEALTH SYSTEM 0 CATHERINE MCAULEY HEALTH SERVICES CORP PO BOX 995 ANN ARBOR MI 48106 382507173 FURTHER TRINITY HEALTH ACTIVITIES, ORGANIZE AND DEVELOP MEDICAL SERVICES MI 501(C)(3) 11, TYPE II TRINITY HEALTH-MICHIGAN 0 COMMUNITY HEALTH PARTNERS OF SOUTH BEND PO BOX 3998 SOUTH BEND IN 46619 263051440 HEALTHCARE SERVICES IN 501(C)(3) 3 SAINT JOSEPH REGIONAL MEDICAL CENTER INC 0 CRANBROOK HOSPICE CARE 281 ENTERPRISE COURT BLOOMFIELD HILLS MI 48302 383320699 PROVIDE HOSPICE HEALTH SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC 0 DILEY RIDGE MEDICAL CENTER 6150 EAST BROAD STREET COLUMBUS OH 43213 342032340 HOSPITAL CAMPUS IN FAIRFIELD COUNTY OHIO OH 501(C)(3) 3 MOUNT CARMEL HEALTH SYSTEM 0 DUBUQUE MERCY HEALTH FOUNDATION INC 250 MERCY DRIVE DUBUQUE IA 52001 262227941 SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) 11, TYPE I MERCY HEALTH SERVICES-IOWA CORP 0 DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE IA 52040 205383271 SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) 11, TYPE I MERCY HEALTH SERVICES-IOWA CORP 0 HACKLEY HOSPITAL 1700 CLINTON ST PO BOX 3302 MUSKEGON MI 494433302 381358196 HEALTHCARE SERVICES MI 501(C)(3) 3 MERCY HEALTH PARTNERS 0 HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST PO BOX 3302 MUSKEGON MI 494433302 382299878 SELF INSURANCE FOR GENERAL AND MALPRACTICE LIABILITY MI 501(C)(3) 11, TYPE III-FI MERCY HEALTH PARTNERS 0 HACKLEY LIFE COUNSELING 1352 TERRACE ST MUSKEGON MI 494423545 381386362 COUNSELING, EDUCATION, AND SUPPORT MI 501(C)(3) 9 MERCY HEALTH PARTNERS 0 HACKLEY VISITING NURSE SERVICES AND HOSPICE INC 888 TERRACE ST MUSKEGON MI 49440 381359598 PROVIDE HOME HEALTH CARE SERVICES MI 501(C)(3) 7 MERCY HEALTH PARTNERS 0 HOLY CROSS CARENET INC PO BOX 9184 FARMINGTON HILLS MI 48333 521945054 LONG-TERM CARE AND REHABILITATION FOR THE ELDERLY MD 501(C)(3) 9 TRINITY CONTINUING CARE SERVICES 0 HOLY CROSS HOSPITAL FOUNDATION INC 11801 TECH ROAD SILVER SPRING MD 20904 208428450 CHARITABLE FUNDRAISING MD 501(C)(3) 11, TYPE I HOLY CROSS HOSPITAL OF SILVER SPRING INC 0 HOLY CROSS HOSPITAL OF SILVER SPRING INC 1500 FOREST GLEN RD SILVER SPRING MD 209101484 520738041 HEALTHCARE SERVICES MD 501(C)(3) 3 TRINITY HEALTH CORPORATION 0 HOLY CROSS MEDICAL CENTER 27870 CABOT DRIVE NOVI MI 483772920 951985442 HEALTHCARE SERVICES (FORMERLY) CA 501(C)(3) 3 TRINITY HEALTH CORPORATION 0 HOLY ROSARY MEDICAL CENTER FOUNDATION 351 SW 9TH STREET ONTARIO OR 97914 202683560 SUPPORT THE SERVICES OF RELATED HOSPITAL OR 501(C)(3) 11, TYPE I SAINT ALPHONSUS MEDICAL CENTER-ONTARIO 0 HOSPICE OF NORTH IOWA 232 SECOND STREET SE MASON CITY IA 504016208 421173708 HOSPICE HEALTH CARE SERVICES IA 501(C)(3) 7 MERCY HEALTH SERVICES-IOWA CORP 0 HOSPICE OF WASHTENAW II 806 AIRPORT BLVD ANN ARBOR MI 48108 383320707 HOSPICE HEALTH CARE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HEALTH-MICHIGAN 0 HPCN 1675 LEAHY STREET MUSKEGON MI 49442 300207909 HEALTHCARE SERVICES MI 501(C)(3) 11, TYPE II MERCY HEALTH PARTNERS 0 IHA HEALTH SERVICES CORPORATION 24 FRANK LLOYD WRIGHT DR LOBBY J ANN ARBOR MI 48106 383316559 PROVIDES OFFICE-BASED MEDICAL CARE MI 501(C)(3) 9 TRINITY HEALTH-MICHIGAN 0 LAKESHORE COMMUNITY HOSPITAL INC 72 S STATE STREET SHELBY MI 494551228 382549295 ACUTE HEALTHCARE SERVICES MI 501(C)(3) 3 MERCY HEALTH PARTNERS 0 LIFESPAN INC 166 EAST GOODALE AVE BATTLE CREEK MI 490372728 383298476 PROVIDE HOSPICE HEALTH SERVICES MI 501(C)(3) 9 BATTLE CREEK HEALTH SYSTEM 0 MARIAN HOME HEALTHCARE 801 5TH STREET SIOUX CITY IA 51101 383320705 PROVIDE HOME HEALTH CARE SERVICES IA 501(C)(3) 11, TYPE I MERCY HEALTH SERVICES-IOWA CORP 0 MCAULEY CLINIC CORPORATION PO BOX 992 ANN ARBOR MI 48106 382561013 HEALTHCARE SERVICES (FORMERLY) MI 501(C)(3) 3 CATHERINE MCAULEY HEALTH SERVICES CORP 0 MERCY AMICARE HOME HEALTHCARE OAKLAND 281 ENTERPRISE COURT BLOOMFIELD HILLS MI 483020312 383320698 PROVIDE HOME HEALTH CARE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC 0 MERCY AMICARE HOME HEALTHCARE PORT HURON 505 HURON AVENUE PORT HURON MI 48060 383320701 PROVIDE HOME HEALTH CARE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC 0 MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE 684 HARVEY STREET MUSKEGON MI 49442 383321856 PROVIDE HOME HEALTH CARE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC 0 MERCY HEALTH PARTNERS 1415 LEAHY STREET MUSKEGON MI 49442 382589966 HEALTHCARE SYSTEM SUPPORT MI 501(C)(3) 11, TYPE I TRINITY HEALTH-MICHIGAN 0 MERCY HEALTH SERVICES - IOWA CORP 1000 4TH STREET SW MASON CITY IA 50401 311373080 HEALTHCARE SERVICES DE 501(C)(3) 3 TRINITY HEALTH-MICHIGAN 0 MERCY HEALTHCARE FOUNDATION 1410 N 4TH ST CLINTON IA 52732 421316126 FUNDRAISING AND FINANCIAL ASSISTANCE FOR HOSPITAL CHARITABLE SERVICES IA 501(C)(3) 11, TYPE I MERCY MEDICAL CENTER-CLINTON 0 MERCY HOSP & HEALTH SERVICES OF DETROITMARSHALL PARK HEALTH SERVICES INC 27870 CABOT DRIVE NOVI MI 483772920 381562325 SUPPORTS MALPRACTICE CONTINGENCIES OF CLOSED HOSPITAL MI 501(C)(3) 11, TYPE I TRINITY HEALTH-MICHIGAN 0 MERCY HOSPITAL CADILLAC FOUNDATION 400 HOBART CADILLAC MI 496012331 203357131 SUPPORT THE SERVICES OF RELATED HOSPITAL MI 501(C)(3) 11, TYPE I TRINITY HEALTH-MICHIGAN 0 MERCY HOSPITAL GIFT SHOP 2601 ELECTRIC AVE PORT HURON MI 48060 381630480 VOLUNTEER SERVICE AUXILIARY MI 501(C)(3) 11, TYPE I TRINITY HEALTH-MICHIGAN 0 MERCY MEDICAL CENTER - CLINTON INC 1410 NORTH 4TH ST CLINTON IA 527322940 421336618 TO PROVIDE QUALITY HEALTH CARE DE 501(C)(3) 3 MERCY HEALTH SERVICES-IOWA CORP 0 MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION 801 5TH STREET SIOUX CITY IA 51102 141880022 SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) 7 MERCY HEALTH SERVICES-IOWA CORP 0 MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA 1000 4TH STREET SW MASON CITY IA 504012800 421229151 SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) 11, TYPE III-FI MERCY HEALTH SERVICES-IOWA CORP 0 MERCY MEDICAL CENTER FOUNDATION INC 1512 12TH AVENUE ROAD NAMPA ID 83686 261737256 SUPPORT THE SERVICES OF RELATED HOSPITAL ID 501(C)(3) 7 SAINT ALPHONSUS MEDICAL CENTER-NAMPA 0 MERCY NORTH HOMECARE AND HOSPICE 7985 MACKINAW TRAIL CADILLAC MI 49601 383313897 HOME HEALTH AND HOSPICE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC 0 MERCY PAVILION OF BATTLE CREEK 300 NORTH AVENUE BATTLE CREEK MI 49016 382783350 PROVIDES LONG-TERM CARE FOR THE ELDERLY MI 501(C)(3) 9 BATTLE CREEK HEALTH SYSTEM 0 MERCY PHYSICIAN GROUP INC 1512 12TH AVENUE ROAD NAMPA ID 83686 208192593 TO PROVIDE QUALITY HEALTH CARE ID 501(C)(3) 9 SAINT ALPHONSUS MEDICAL CENTER-NAMPA 0 MERCY SERVICES FOR AGING NON-PROFIT HOUSING CORPORATION PO BOX 9184 FARMINGTON HILLS MI 483339184 382719605 PROVIDES LONG-TERM CARE FOR THE ELDERLY MI 501(C)(3) 11, TYPE II TRINITY CONTINUING CARE SERVICES INC 0 MIDWEST MEDFLIGHT 1300 VICTORS WAY ANN ARBOR MI 48108 382684671 AEROMEDICAL TRANSPORT MI 501(C)(3) 9 TRINITY HEALTH-MICHIGAN 0 MOUNT CARMEL CARE CONTINUUM SERVICES CORP 793 WEST STATE STREET COLUMBUS OH 43222 311126211 COOPERATIVE HOSPITAL SERVICE ORGANIZATION OH 501(C)(3) 3 MOUNT CARMEL HEALTH SYSTEM 0 MOUNT CARMEL COLLEGE OF NURSING 6150 EAST BROAD STREET COLUMBUS OH 43213 311308555 COLLEGE OF NURSING OH 501(C)(3) 2 MOUNT CARMEL HEALTH 0 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