ST MARYS COMMUNITY HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: ST MARYS COMMUNITY HOSPITAL (EIN 47-0443636)
Tax period: 2010-07-01 to 2011-06-30
Filed: 2012-04-30
IRS object ID: 201231219349300208
Schema version: 2010v3.2
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-04-30T10:00:15-05:00	Timestamp
Tax Period End Date	2011-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CATHOLIC HEALTH INITIATIVES	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	198 INVERNESS DRIVE WEST	AddressLine1
City	ENGLEWOOD	City
State	CO	State
ZIP Code	80112	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	470443636	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ST MARY'S COMMUNITY HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	STMA	NameControl
Phone	4028733321	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1314 3rd Avenue	AddressLine1
City	Nebraska City	City
State	NE	State
ZIP Code	68410	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	SHAWN CLOSNER	Name
Title	VP OF FINANCE	Title
Date Signed	2012-04-23	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	7208741500	Phone

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

Field	Value	IRS element (for citing)
Business Name Line1	DANIEL KELLY	BusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1314 3rd Avenue	AddressLine1
City	Nebraska City	City
State	NE	State
ZIP Code	68410	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	17608129	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Group Exemption Number	0928	GroupExemptionNumber
Organization501c3	X	Organization501c3
Web Site	WWW.STMARYSHOSPITALNECITY.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1927	YearFormation
State Legal Domicile	NE	StateLegalDomicile
Activity Or Mission Description	ST. MARY'S IS A NOT FOR PROFIT CRITICAL ACCESS HOSPITAL THAT PROVIDES ACUTE CARE FOR THE BENEFIT OF ALL REGARDLESS OF ABILITY TO PAY AND PROMOTES HEALTH THROUGH COMMUNITY OUTREACH INITIATIVES AND PARTNERSHIPS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	162	TotalNbrEmployees
Total Nbr Volunteers	15	TotalNbrVolunteers
Total Gross UBI	15662	TotalGrossUBI
Net Unrelated Business Txbl Income	14662	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	190696	ContributionsGrantsPriorYear
Contributions Grants Current Year	71174	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	15178699	ProgramServiceRevenuePriorYear
Program Service Revenue CY	16780295	ProgramServiceRevenueCY
Investment Income Prior Year	345425	InvestmentIncomePriorYear
Investment Income Current Year	623610	InvestmentIncomeCurrentYear
Other Revenue Prior Year	128402	OtherRevenuePriorYear
Other Revenue Current Year	94931	OtherRevenueCurrentYear
Total Revenue Prior Year	15843222	TotalRevenuePriorYear
Total Revenue Current Year	17570010	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	9243	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	6927	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	7083475	SalariesEtcPriorYear
Salaries Etc Current Year	7215703	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	7193437	OtherExpensePriorYear
Other Expenses Current Year	8638593	OtherExpensesCurrentYear
Total Expenses Prior Year	14286155	TotalExpensesPriorYear
Total Expenses Current Year	15861223	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	1557067	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	1708787	RevenuesLessExpensesCY
Total Assets BOY	16859586	TotalAssetsBOY
Total Assets EOY	19027049	TotalAssetsEOY
Total Liabilities BOY	2025265	TotalLiabilitiesBOY
Total Liabilities EOY	1778708	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	14834321	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	17248341	NetAssetsOrFundBalancesEOY
Mission Description	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.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	12049758	Expense
Grants	6927	Grants
Revenue	16780295	Revenue
Description	SEE SCHEDULE H.	Description
Total Program Service Expense	12049758	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	true	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	162	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Form990-T Filed	true	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	11	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	false	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	Sharon Crunk	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	4028738929	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1314 3rd Avenue	AddressLine1
City	Nebraska City	City
State	NE	State
ZIP Code	68410	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
STACY BLUM
BOARD MEMBER	1	X	0	254589	38416
LIDIA BORER
BOARD MEMBER	1	X	0	0	0
BRETT GAY
BOARD MEMBER	1	X	215	0	0
PATRICK HAVERTY
BOARD MEMBER	1	X	0	0	0
SHARON M CRUNK
BOARD MEMBER	1	X	0	0	0
ROBERT LANIK
PRESIDENT/CEO - CHI NE	1	X	0	689847	45724
MICHAEL MCCABE
BOARD MEMBER	1	X	0	0	0
KATHRYN NELSON
SECRETARY/TREASURER	1	X	0	0	0	X
DANIEL KELLY
PRESIDENT/CEO	40	X	0	206222	40171	X
JONATHAN STELLING
BOARD VICE CHAIR	1	X	0	271265	38594	X
SCOTT VANDERVEEN
BOARD CHAIR PERSON	1	X	0	0	0	X
SHAWN CLOSNER
VP OF FINANCE	40		91106	0	25082	X
JOAN BECCARD
PHARMACY DIRECTOR	40		102719	0	28997		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	194040	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	1421923	TotalReportableCompFrmRltdOrgs
Total Other Compensation	216984	TotalOtherCompensation
Number Individuals GT100 K	1	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
KETTER & ASSOCIATES
1819 F STREET	AUBURN	NE	68305	THERAPY SERVICES	451005
SLEEP TIGHT ANESTHESIA PC
2640 WHITAKER ROAD	NEBRASKA CITY	NE	68410	ANESTHESIA SERVICES	384450

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	2	NumberOfContractorsGT100K
Related Organizations	26755	RelatedOrganizations
All Other Contributions	44419	AllOtherContributions
Noncash Contributions	3211	NoncashContributions
Total Contributions	71174	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	PATIENT SERVICES	Description
Business Code	900099	BusinessCode
Total Revenue Column	16780295	TotalRevenueColumn
Related Or Exempt Function Income	16780295	RelatedOrExemptFunctionIncome

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	16780295	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	193030	TotalRevenueColumn
Unrelated Business Revenue	580	UnrelatedBusinessRevenue
Exclusion	$192,450	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	7453	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	29252	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-21799	Real
Personal	0	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-21799	TotalRevenueColumn
Exclusion	-$21,799	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	427226	Securities
Other	3354	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	427226	Securities
Other	3354	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	430580	TotalRevenueColumn
Exclusion	$430,580	ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	13419	GrossSalesOfInventory
Cost Of Goods Sold	8867	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	4552	TotalRevenueColumn
Exclusion	$4,552	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Unrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA	722100	44473	$44,473
LABORATORY SERVICES	621500	47808	$32,726	15082
MEALS ON WHEELS	624100	12189	$12,189

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	7708	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$7,708	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	112178	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	17570010	TotalRevenueColumn
Related Or Exempt Function Income	16780295	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	15662	UnrelatedBusinessRevenue
Exclusion	$702,879	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	6427	Total
Program Services	6427	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	500	Total
Program Services	500	ProgramServices

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	94592	Total
Program Services	7567	ProgramServices
Management And General	87025	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	5266783	Total
Program Services	4278115	ProgramServices
Management And General	988668	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	304766	Total
Program Services	243813	ProgramServices
Management And General	60953	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1166310	Total
Program Services	933048	ProgramServices
Management And General	233262	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	383252	Total
Program Services	306602	ProgramServices
Management And General	76650	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	2936086	Total
Program Services	1972345	ProgramServices
Management And General	963741	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	0	Total

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	2378718	Total
Program Services	2110020	ProgramServices
Management And General	268698	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	314199	Total
Program Services	226223	ProgramServices
Management And General	87976	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	46558	Total
Program Services	28339	ProgramServices
Management And General	18219	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	25010	Total
Program Services	9662	ProgramServices
Management And General	15348	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	54939	Total
Program Services	54939	ProgramServices

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	502215	Total
Management And General	502215	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	847138	Total
Program Services	510296	ProgramServices
Management And General	336842	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	32786	Total
Management And General	32786	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
BAD DEBT EXPENSE	913450	913450
REPAIRS AND MAINTENANCE	478036	373207	104829
DUES & SUBSCRIPTIONS	35825	16915	18910
EDUCATION	19572	17989	1583
OTHER EXPENSES	54061	40301	13760

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	15861223	Total
Program Services	12049758	ProgramServices
Management And General	3811465	ManagementAndGeneral
Fundraising	0	Fundraising

Total Joint Costs TotalJointCosts

Field	Value	IRS element (for citing)
Total	0	Total

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	300	BOY
EOY	300	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	1788900	BOY
EOY	2876548	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	2330724	BOY
EOY	2360710	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	204518	BOY
EOY	208506	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	31975	BOY
EOY	40588	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	13477871	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	9411247	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	4488693	BOY
EOY	4066624	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	7943097	BOY
EOY	9402394	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	71379	BOY
EOY	71379	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	16859586	BOY
EOY	19027049	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	835527	BOY
EOY	686453	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	1189738	BOY
EOY	1092255	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	2025265	BOY
EOY	1778708	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	14830870	BOY
EOY	17245088	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	3451	BOY
EOY	3253	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	14834321	BOY
EOY	17248341	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	16859586	BOY
EOY	19027049	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	1708787	ReconcilationRevenueExpenses
Reconcilation Other Changes	705233	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	true	GrantsOtherOrganizations
Grants Other Organizations	$287	GrantsOtherOrganizationsAmount
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	false	OtherActivities
Total Lobbying Expenditures IIB	287	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES	Identifier
Return Reference	SCHEDULE C, PART II-B, LINE 1F	ReturnReference
Explanation	THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $72 AND CATHOLIC HEALTH ASSOCIATION - $215	Explanation

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	31012	OtherCostOrOtherBasis
Book Value	31012	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	322014	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	8103637	OtherCostOrOtherBasis
Depreciation	5369080	Depreciation
Book Value	3056571	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Book Value	0	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4748606	OtherCostOrOtherBasis
Depreciation	3951558	Depreciation
Book Value	797048	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	272602	OtherCostOrOtherBasis
Depreciation	90609	Depreciation
Book Value	181993	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	4066624	TotalOfBookValueLandBuildings

Financial Derivatives FinancialDerivatives

Field	Value	IRS element (for citing)
Book Value	0	BookValue

Closely Held Equity Interests CloselyHeldEquityInterests

Field	Value	IRS element (for citing)
Book Value	0	BookValue

Other Securities OtherSecurities (2 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
CHI OIP - FIXED INCOME	4468540	F
CHI OIP - EQUITY SECURITIES	4933854	F

Field	Value	IRS element (for citing)
Total Of Book Value Securities	9402394	TotalOfBookValueSecurities
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
UNCLAIMED PROPERTY	$1,058
CHI DEBT PROGRAM	$1,091,197

Field	Value	IRS element (for citing)
Total Of Amounts	1092255	TotalOfAmounts
Total Revenue	17583877	TotalRevenue
Total Expenses	15872013	TotalExpenses
Excess Or Deficit For Year	1711864	ExcessOrDeficitForYear
Other	$0	OtherAmount
Total Adjustments	0	TotalAdjustments
Excess Or Deficit Per FS	1711864	ExcessOrDeficitPerFS
Other Revenues	0	OtherRevenues
Revenue Not Rptd F990	0	RevenueNotRptdF990
Revenue Subtotal	0	RevenueSubtotal
Other Revenues Not Included	0	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	0	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	0	TotalRevenuePerForm990
Other Expenses Included	0	OtherExpensesIncluded
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	0	ExpensesSubtotal
Other Expenses Not Included	0	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	0	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	0	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

Field	Value	IRS element (for citing)
Identifier	FIN 48 (ASC 740) footnote	Identifier
Return Reference	Schedule D, Part X, Line 2	ReturnReference
Explanation	ST. MARY'S COMMUNITY HOSPITAL'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, 2011 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. AS OF JUNE 30, 2011, CHI HAS CURRENT NET DEFERRED TAX ASSETS OF $2.1 MILLION AND A NONCURRENT NET DEFERRED TAX LIABILITY OF $5.4 MILLION RELATED TO THESE TAXABLE ACTIVITIES. MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS."	Explanation

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	false	FPGReferenceFreeCare
FPG Reference Discounted Care	false	FPGReferenceDiscountedCare
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	false	ExpensesExceededBudget
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Persons Served	245	PersonsServed
Total Community Benefit Expense	272511	TotalCommunityBenefitExpense
Net Community Benefit Expense	272511	NetCommunityBenefitExpense
Percent Of Total Expense	0.01820	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	245	PersonsServed
Total Community Benefit Expense	272511	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	272511	NetCommunityBenefitExpense
Percent Of Total Expense	0.01820	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	10	NumberOfActivitiesOrPrograms
Persons Served	779	PersonsServed
Total Community Benefit Expense	105765	TotalCommunityBenefitExpense
Direct Offsetting Revenue	105	DirectOffsettingRevenue
Net Community Benefit Expense	105660	NetCommunityBenefitExpense
Percent Of Total Expense	0.00710	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	3	NumberOfActivitiesOrPrograms
Persons Served	31	PersonsServed
Total Community Benefit Expense	17048	TotalCommunityBenefitExpense
Net Community Benefit Expense	17048	NetCommunityBenefitExpense
Percent Of Total Expense	0.00110	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	13	NumberOfActivitiesOrPrograms
Persons Served	7592	PersonsServed
Total Community Benefit Expense	21545	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3720	DirectOffsettingRevenue
Net Community Benefit Expense	17825	NetCommunityBenefitExpense
Percent Of Total Expense	0.00120	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	26	NumberOfActivitiesOrPrograms
Persons Served	8402	PersonsServed
Total Community Benefit Expense	144358	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3825	DirectOffsettingRevenue
Net Community Benefit Expense	140533	NetCommunityBenefitExpense
Percent Of Total Expense	0.00940	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	26	NumberOfActivitiesOrPrograms
Persons Served	8647	PersonsServed
Total Community Benefit Expense	416869	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3825	DirectOffsettingRevenue
Net Community Benefit Expense	413044	NetCommunityBenefitExpense
Percent Of Total Expense	0.02760	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Building Expense	1021	TotalCommunityBuildingExpense
Net Community Building Expense	1021	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Total Community Building Expense	50322	TotalCommunityBuildingExpense
Net Community Building Expense	50322	NetCommunityBuildingExpense
Percent Of Total Expense	0.00320	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	181	PersonsServed
Total Community Building Expense	6707	TotalCommunityBuildingExpense
Net Community Building Expense	6707	NetCommunityBuildingExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	200	PersonsServed
Total Community Building Expense	10740	TotalCommunityBuildingExpense
Net Community Building Expense	10740	NetCommunityBuildingExpense
Percent Of Total Expense	0.00070	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	15	PersonsServed
Total Community Building Expense	1774	TotalCommunityBuildingExpense
Net Community Building Expense	1774	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	7	NumberOfActivitiesOrPrograms
Persons Served	396	PersonsServed
Total Community Building Expense	70564	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	70564	NetCommunityBuildingExpense
Percent Of Total Expense	0.00440	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$617,431	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	5886157	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	5827633	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	58524	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ST MARY'S COMMUNITY HOSPITAL	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	1314 3RD AVENUE	AddressLine1
City	NEBRASKA CITY	City
State	NE	State
ZIP Code	68410	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ST MARY'S COMMUNITY HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Eligibility criteria for free or discounted care	Schedule H, Part I, Line 3c	IF APPLICABLE, DESCRIBE THE INCOME-BASED CRITERIA FOR DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. WHEN CATHOLIC HEALTH INITIATIVES (THE ULTIMATE PARENT ORGANIZATION TO ST. MARY'S COMMUNITY HOSPITAL) 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 19 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. ST. MARY'S COMMUNITY HOSPITAL 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. ALSO DESCRIBE WHETHER THE ORGANIZATION USES AN ASSET TEST OR OTHER THRESHOLD, REGARDLESS OF INCOME, TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. 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.
Bad Debt Expense excluded from financial assistance calculation	Schedule H, Part I, Line 7, column(f)	913,450
Costing Methodology used to calculate financial assistance	Schedule H, Part I, Line 7	PROVIDE AN EXPLANATION OF THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. IF A COST ACCOUNTING SYSTEM WAS USED, INDICATE WHETHER THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED OR SELF PAY). ALSO INDICATE WHETHER A COST-TO-CHARGE RATIO WAS USED FOR ANY OF THE FIGURES REPORTED IN THE TABLE. DESCRIBE WHETHER THIS COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, AND, IF NOT, WHAT KIND OF COST-TO-CHARGE RATIO WAS USED AND HOW IT WAS DERIVED. IF SOME OTHER COSTING METHODOLOGY WAS USED BESIDES A COST ACCOUNTING SYSTEM, COST-TO-CHARGE RATIO, OR A COMBINATION OF THE TWO, DESCRIBE THE METHOD USED. A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING THE ORGANIZATION'S COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. THE COST-TO-CHARGE RATIO FOR THE YEAR ENDED 6/30/11 WAS COMPUTED USING THE FOLLOWING FORMULA: OPERATING EXPENSE (BEFORE RESTRUCTURING, IMPAIRMENT AND OTHER LOSSES) DIVIDED BY GROSS PATIENT REVENUE. WORKSHEET 2 WAS NOT USED TO DERIVE THE COST-TO-CHARGE RATIO.
Bad debt expense - financial statement footnote	Schedule H, Part III, Line 4	PROVIDE THE RATIONALE AND THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED IN PART III, LINES 2 AND 3. DESCRIBE HOW THE ORGANIZATION ACCOUNTS FOR DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS IN DETERMINING BAD DEBT EXPENSE. COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 67.59%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. ALSO DESCRIBE THE METHOD THE ORGANIZATION USES TO DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, IF SUFFICIENT INFORMATION HAS BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBILITY. DESCRIBE THE RATIONALE, IF ANY, FOR INCLUDING ANY PORTION OF BAD DEBT AS COMMUNITY BENEFIT. ALSO PROVIDE, IF APPLICABLE, THE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE. IF THE ORGANIZATION'S FINANCIAL STATEMENTS INCLUDE A FOOTNOTE ON THESE ISSUES THAT ALSO INCLUDES OTHER INFORMATION, REPORT ONLY THE RELEVANT PORTIONS OF THE FOOTNOTE. IF THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN SUCH A FOOTNOTE, STATE THAT THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE SUCH A FOOTNOTE AND EXPLAIN HOW THE FINANCIAL STATEMENTS ACCOUNT FOR BAD DEBT, IF AT ALL. ST. MARY'S COMMUNITY HOSPITAL 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. ST. MARY'S COMMUNITY HOSPITAL 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 CONSIDERING 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."
Community benefit & methodology for determining medicare costs	Schedule H, Part III, Line 8	DESCRIBE THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT, AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6. ST. MARY'S COMMUNITY HOSPITAL IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL ("CAH"). CAHS ARE RURAL COMMUNITY HOSPITALS THAT ARE CERTIFIED TO RECEIVE COST-BASED REIMBURSEMENT FROM MEDICARE. THE REIMBURSEMENT THAT CAHS RECEIVE IS INTENDED TO IMPROVE THEIR FINANCIAL PERFORMANCE AND THEREBY REDUCE HOSPITAL CLOSURES. CAHS ARE CERTIFIED UNDER A DIFFERENT SET OF MEDICARE CONDITIONS OF PARTICIPATION (COP). SHORTFALLS ARE CREATED WHEN A FACILITY RECEIVES PAYMENTS THAT ARE LESS THAN THE COSTS OF CARING FOR PROGRAM BENEFICIARIES. BECAUSE SHORTFALLS ARE BASED ON COSTS, NOT CHARGES, ST. MARY'S COMMUNITY HOSPITAL, DUE TO THEIR DESIGNATION AS A CAH, RECEIVED COST-BASED REIMBURSEMENT FOR MEDICARE PURPOSES, ST. MARY'S COMMUNITY HOSPITAL WILL NOT EXPERIENCE MEDICARE RELATED SHORTFALLS.
Collection practices for patients eligible for financial assistance	Schedule H, Part III, Line 9b	IF THE ORGANIZATION HAS A WRITTEN DEBT COLLECTION POLICY AND ANSWERED "YES," TO PART III, LINE 9B, DESCRIBE THE COLLECTION PRACTICES SET FORTH IN THE POLICY THAT APPLY TO PATIENTS WHO IT KNOWS QUALIFY FOR FINANCIAL ASSISTANCE, WHETHER OR NOT SUCH PRACTICES APPLY SPECIFICALLY TO SUCH PATIENTS OR MORE BROADLY TO ALSO COVER OTHER TYPES OF PATIENTS. ST. MARY'S COMMUNITY HOSPITAL'S DEBT COLLECTION POLICY PROVIDES THAT ST. MARY'S COMMUNITY HOSPITAL WILL PERFORM A REASONABLE REVIEW OF EACH INPATIENT ACCOUNT PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH ST. MARY'S COMMUNITY HOSPITAL'S COMMUNITY ASSISTANCE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO MEET THE ST. MARY'S COMMUNITY HOSPITAL COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO ST. MARY'S COMMUNITY HOSPITAL FOR APPROPRIATE FOLLOW-UP. ST. MARY'S COMMUNITY HOSPITAL REQUIRES 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 FINANCIAL ASSISTANCE. 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.
Patient education of eligibility for assistance.	Schedule H, Part VI, Line 3	DESCRIBE HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. ST. MARY'S COMMUNITY HOSPITAL INCLUDES INFORMATION CONCERNING ITS FINANCIAL ASSISTANCE POLICY ON ITS WEBSITE. IN ADDITION, ST. MARY'S PROMINENTLY DISPLAYS ITS FINANCIAL ASSISTANCE POLICY IN BOTH ENGLISH AND SPANISH IN OBVIOUS LOCATIONS THROUGHOUT THE HOSPITALS, INCLUDING THE EMERGENCY ROOMS AND OTHER PATIENT INTAKE AREAS. IN ADDITION, ST. MARY'S REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR FINANCIAL ASSISTANCE UNDER ST. MARY'S FINANCIAL ASSISTANCE POLICY. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY AND PROCEDURES INCLUDING AN APPLICATION FOR ASSISTANCE. ST. MARY'S REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON ENGLISH-SPEAKING INDIVIDUALS. ST. MARY'S STAFF WILL ALSO ASSIST THE PATIENT/GUARANTOR WITH APPLYING FOR OTHER AVAILABLE COVERAGE (SUCH AS MEDICAID), IF NECESSARY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES.
Affiliated health care system	Schedule H, Part VI, Line 6	IF THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, DESCRIBE THE RESPECTIVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED. ST. MARY'S COMMUNITY HOSPITAL IN NEBRASKA CITY, NEBRASKA IS 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 $612 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN THE 2011 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. ST. MARY'S OPERATES WITH ITS WHOLLY OWNED AFFILIATES AND COMMUNITY PARTNERS, ALONG WITH ITS FUNDRAISING ARM, ST. MARY'S COMMUNITY HOSPITAL FOUNDATION, TO SERVE THE HEALTH CARE NEEDS OF THE NEBRASKA CITY AND SURROUNDING COMMUNITIES.
NEEDS ASSESSMENT AND COMMUNITY INFORMATION	SCHEDULE H, PART VI, LINES 1,2,4 AND 5	ORGANIZATION'S MISSION, VISION, AND TAX-EXEMPT PURPOSE ST. MARY'S COMMUNITY HOSPITAL WAS FOUNDED TO ALLEVIATE A SHORTAGE OF HOSPITAL BEDS IN THE COMMUNITY IN 1927. AS A CATHOLIC HOSPITAL, ST. MARY'S EMBRACED THE MISSION OF THE FOUNDING RELIGIOUS CONGREGATION, WHICH HAS SINCE JOINED WITH OTHER RELIGIOUS CONGREGATIONS TO FORM CATHOLIC HEALTH INITIATIVES. THE MISSION OF ST. MARY'S IS TO DEVELOP A HEALTHY COMMUNITY AND PROVIDE CARE TO ALL IN NEED. IT HAS A BOARD OF DIRECTORS THAT IS COMPRISED OF INDEPENDENT COMMUNITY REPRESENTATIVES. ST. MARY'S OPERATES A 24-HOUR EMERGENCY ROOM 365 DAYS PER YEAR. THAT EMERGENCY ROOM IS OPEN TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. ST. MARY'S HAS AN OPEN MEDICAL STAFF, PARTICIPATES IN MEDICARE AND MEDICAID, AND HAS AN ACTIVE CHARITY CARE PROGRAM. COMMUNITY SERVICE HAS ALWAYS BEEN AT THE CORE OF ST. MARY'S ACTIVITIES. EACH YEAR, SERVICES AND PROGRAMS ARE EXPANDED TO PROMOTE A HEALTHY COMMUNITY. THE PROGRAMS AND SERVICES DESCRIBED THROUGHOUT THIS REPORT NOT ONLY SERVE THE COMMUNITY, BUT ALSO REDUCE THE BURDENS ON THE GOVERNMENT. FOR EXAMPLE, IF ST. MARY'S DID NOT PROVIDE CHARITY CARE, THE BURDEN OF PROVIDING CHARITY CARE WOULD FALL ON A GOVERNMENT-SUPPORTED INSTITUTION. ST. MARY'S COMMUNITY HOSPITAL IS INCLUDED IN THE OFFICIAL CATHOLIC DIRECTORY AS A TAX-EXEMPT HOSPITAL. COMMUNITY BENEFIT APPROACH LOCATED IN NEBRASKA CITY, NEBRASKA, ST. MARY'S COMMUNITY HOSPITAL SERVES OTOE COUNTY, NEBRASKA AND THE SURROUNDING COUNTIES IN SOUTHEAST NEBRASKA AS WELL AS SOUTHWEST IOWA. THIS ENCOMPASSES THE HOSPITALS HOME ZIP CODE AREA AND THE 11 NEIGHBORING ZIP CODES. OTOE COUNTY HAS A POPULATION OF 15,740. ALMOST ONE HALF OF THE COUNTY'S POPULATION RESIDE IN NEBRASKA CITY WHILE THE OTHER HALF LIVE IN AND NEAR ONE OF THE NINE OTHER COMMUNITIES. OTOE COUNTY: THE MOST RECENT 2011 ESTIMATES BASED ON THE LAST OFFICIAL COUNT FROM 2010 FROM THE U.S. CENSUS BUREAU REFLECT OTOE COUNTY AS AN OLDER AND MORE DIVERSE COMMUNITY. OTOE COUNTY HAS A MEDIAN AGE OF 39.1 OTOE COUNTY MEDIAN HOUSEHOLD INCOME: $46,160 OTOE COUNTY UNEMPLOYMENT RATE: 3.9% OTOE COUNTY; PERCENTAGE OF PERSONS LIVING BELOW THE POVERTY LINE: 12.2% OTOE COUNTY HISPANIC POPULATION: 5.1% MEDICALLY UNDERSERVED POPULATION: 11.2% UNINSURED THE BABY BOOMERS BORN BETWEEN 1946 AND 1964 ARE THE LARGEST GENERATION WITH MANY REACHING THE STATUS OF A SENIOR CITIZEN. CITY OF NEBRASKA CITY: LARGEST POPULATION IS WHITE: 91.5% HISPANIC POPULATION: 7.5% MEDIAN INCOME: $55,350 JOBS HAVE DECREASED BY 70 SINCE 12/31/2011 ST. MARY'S COMMUNITY HOSPITAL HAS BEEN COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES FOR A NUMBER OF YEARS. IN 2004, ST. MARY'S OFFICIALLY LAUNCHED THE HEALTHY COMMUNITIES COALITION PROCESS TO LOOK AT AREA HEALTH ISSUES, SET PRIORITIES AND PLAN FOR IMPROVEMENT. A WIDE VARIETY OF CITIZENS FROM THE PUBLIC AND PRIVATE SECTORS PARTICIPATED IN THIS PROCESS. ST. MARY'S CONTINUES OUR DEEP COMMITMENT AND INVOLVEMENT IN THE COMMUNITY HEALTH COLLABORATIVE TODAY. PROCESS ST. MARY'S COMMUNITY HOSPITAL'S COMMUNITY BENEFIT PLAN IS BASED ON OUR UNDERSTANDING OF THE UNIQUE COMMUNITIES' NEEDS DERIVED FROM COLLABORATIVE NEEDS ASSESSMENTS, FOCUS GROUPS, AND SURVEYS CONDUCTED WITH OUR COMMUNITY PARTNERS. IN 2007, ST. MARY'S COMMUNITY HOSPITAL'S HEALTHY COMMUNITIES COALITION AND OTOE COUNTY COALITION MERGED TO FORM PARTNERS FOR OTOE COUNTY (P4OC) COALITION. THE COALITION STRIVES TO MAXIMIZE RESOURCES (FINANCIAL AND HUMAN), REDUCE DUPLICATION OF WORK AND EFFECTIVELY MEET THE NEEDS AND PRIORITIES OF NEBRASKA CITY AND OTOE COUNTY. P4OC ENCOURAGES INDIVIDUALS, ORGANIZATIONS AND INSTITUTIONS TO TAKE RESPONSIBILITY FOR IMPROVING THE HEALTH AND QUALITY OF LIFE IN THEIR COMMUNITIES. P4OC HAS BEEN WORKING FOR SEVERAL YEARS TO MEASURE AND IMPROVE THE HEALTH STATUS OF THE COMMUNITY. SUMMARY OF ASSESSMENT FINDINGS ST. MARY'S COMMUNITY HOSPITAL IN COLLABORATION WITH PARTNERS FOR OTOE COUNTY (P4OC) COALITION COMPLETED THE HEALTHY COMMUNITIES' ASSESSMENT PROCESS IN 2007. IN SUBSEQUENT YEARS, ST. MARY'S HAS WORKED WITH COMMUNITY PARTNERS TO CONDUCT ADDITIONAL FOCUS GROUPS AND SURVEYS TO GAUGE COMMUNITY NEEDS. THESE PROCESSES IDENTIFIED ISSUES HAVING A SIGNIFICANT IMPACT ON THE OVERALL HEALTH OF THE POPULATION OF NEBRASKA CITY AND OTOE COUNTY. FROM THESE IDENTIFIED ISSUES, P40C DEVELOPED GOALS. IN FISCAL YEAR 2010, THE GOAL AREAS WERE EVALUATED TO BETTER RESPOND TO COMMUNITY NEEDS. THE OVERARCHING COALITION GOAL IS TO BUILD A COMMUNITY WHERE EVERY FAMILY THRIVES. KEY FACTORS IDENTIFIED AS HAVING THE GREATEST IMPACT ON THE OVERALL WELLNESS OF THE AREA CURRENTLY GUIDE ST. MARY'S COMMUNITY HOSPITAL COMMUNITY BENEFIT PLAN AND INCLUDE THE FOLLOWING: HEALTHY LIFESTYLES AND BEHAVIORS VIOLENCE PREVENTION CHILD AND MATERNAL HEALTH ACCESS TO BASIC NEEDS/COMMUNITY HEALTH SERVICES *EDUCATIONAL PROGRAMS
NEEDS ASSESSMENT AND COMMUNITY INFORMATION	SCHEDULE H, PART VI, LINES 1,2,4 AND 5	QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT COMMUNITY OUTREACH FOR THE POOR ST. MARY'S COMMUNITY HOSPITAL IS DEDICATED TO SERVING ALL PEOPLE IN OUR COMMUNITY REGARDLESS OF ABILITY TO PAY. ST. MARY'S COMMUNITY HOSPITAL'S CHARITY CARE POLICY PROVIDES FOR UNCOMPENSATED OR DISCOUNTED MEDICAL SERVICES FOR INDIVIDUALS WHO HAVE DEMONSTRATED NEED IN EXCESS OF INSURANCE, PERSONAL RESOURCES, AND FUNDS AVAILABLE THROUGH FEDERAL, STATE, AND LOCAL MEDICAL FUNDING PROGRAMS. CHARITY CARE MAY BE PROVIDED TO PATIENTS WHO ARE UNINSURED, UNDERINSURED, OR DETERMINED TO BE MEDICALLY INDIGENT. TOTAL NET COMMUNITY BENEFITS FOR THE PERIOD JULY 1, 2010- JUNE 30, 2011 TOTALED $413,044, MOST OF WHICH WAS TRADITIONAL CHARITY CARE BUT ALSO INCLUDED OTHER INITIATIVES. ST. MARY'S COMMUNITY HOSPITAL PROVIDES SUPPORT TO LOW INCOME FAMILIES IN THE REGION THROUGH VARIOUS OUTREACH INITIATIVES. IN FISCAL YEAR 2011, ST. MARY'S HOSTED ITS ANNUAL BACK TO SCHOOL EVENT. THIS OUTREACH PROGRAM BENEFITED LOW INCOME CHILDREN AND FAMILIES IN THE REGION AND WAS DEVELOPED IN RESPONSE TO AN IDENTIFIED NEED. THIS INITIATIVE SERVED OVER 350 AREA CHILDREN AND PROVIDED SCHOOL SUPPLIES AS WELL AS EDUCATIONAL MATERIALS TO SUPPORT A HEALTHY LIFESTYLE. ST. MARY'S, IN A COLLABORATIVE COMMUNITY EFFORT, WORKED TO HELP AREA FAMILIES WHO REQUESTED AND QUALIFIED FOR ASSISTANCE THROUGH THE SOUTHEAST NEBRASKA COMMUNITY ACTION AND THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES. COMMUNITY OUTREACH FOR THE BROADER COMMUNITY IN COLLABORATION WITH THE UNIVERSITY OF NEBRASKA MEDICAL CENTER (UNMC), ST. MARY'S SERVES AS A TELEMEDICINE HOST SITE. TELEMEDICINE IS THE USE OF MEDICAL INFORMATION EXCHANGED FROM ONE SITE TO ANOTHER VIA ELECTRONIC COMMUNICATION TO IMPROVE A PATIENT'S HEALTH STATUS. THIS IMPORTANT SERVICE PROVIDES ACCESS TO MENTAL HEALTH CARE NOT READILY AVAILABLE LOCALLY. ST. MARY'S COMMUNITY HOSPITAL PROVIDES STAFF AND RESOURCES TO SUPPORT THE COMMUNITY MEALS ON WHEELS PROGRAM. ST. MARY'S FOOD PREPARATION AND ORGANIZATION OF THE DELIVERY ROUTES KEEP THIS MUCH NEEDED SERVICE OPERATIONAL. THIS NUTRITION PROGRAM PROVIDES IN-HOME MEALS TO SENIORS AND OTHER HOME-BOUND PERSONS AND HELPS ENSURE A HEALTHIER COMMUNITY. ADDITIONAL COMMUNITY HEALTH SERVICES PROVIDED BY ST. MARY'S THAT IMPROVE COMMUNITY HEALTH AND EXTEND BEYOND TRADITIONAL PATIENT CARE INCLUDE TELEPHONE TRIAGE SERVICES, INFANT HEARING SCREENINGS, DIABETES EDUCATION AND SMOKING CESSATION CLASSES. COLLABORATIVE EFFORTS TO IMPROVE COMMUNITY HEALTH ST. MARY'S COMMUNITY HOSPITAL IN COLLABORATION WITH COMMUNITY PARTNERS PROVIDES COORDINATION, FUNDING AND RESOURCES FOR GROWING GREAT KIDS IN SOUTHEAST NEBRASKA (GGK). GGK IS A PARENTING EDUCATION PROGRAM THAT WORKS WITH FAMILIES WHO ARE PREGNANT, OR WHO HAVE CHILDREN NEWBORN TO AGE THREE. THIS PROGRAM PROVIDES A SYSTEMATIC APPROACH TO REACH OUT TO ALL FAMILIES IN THE PROGRAM AREA OFFERING COMMUNITY SUPPORT BASED ON THE FAMILIES' STRENGTHS AND INDIVIDUAL SITUATIONS; PROMOTES POSITIVE PARENT-CHILD RELATIONSHIPS; PROMOTES HEALTHY CHILDHOOD GROWTH AND DEVELOPMENT; AND ENHANCES FAMILY FUNCTIONING. GGK OFFERS A MOTHER/BABY HOME VISIT BY A REGISTERED NURSE (RN), COMMUNITY PARENTING CLASSES AND REGULARLY SCHEDULED IN-HOME VISITS BY A FAMILY RESOURCE SPECIALIST THAT MAY BE PROVIDED UP TO THE CHILD'S THIRD BIRTHDAY. IN ADDITION, THE PROGRAM WORKS TO ESTABLISH EFFECTIVE LINKAGES BETWEEN PARENTS AND COMMUNITY RESOURCES TO REDUCE DEPENDENCE ON PUBLIC ASSISTANCE AND INCREASE SELF-SUFFICIENCY. HEALTH PROFESSIONS EDUCATION ST. MARY'S COMMUNITY HOSPITAL SERVED AS A TRAINING SITE FOR VARIOUS HEALTH CARE PROFESSIONS WHICH EXPOSE HEALTH CARE WORKERS TO THE RURAL EXPERIENCE AND ATTRACT NEW GRADUATES TO MEET FUTURE NEEDS. IN FISCAL YEAR 2011, ST. MARY'S COMMUNITY HOSPITAL SERVED AS A TRAINING SITE FOR THE FOLLOWING HEALTHCARE PROFESSIONS; LABORATORY, IMAGING SERVICES, NURSING AND OCCUPATIONAL THERAPY. COMMUNITY BUILDING ACTIVITIES AS PART OF ITS MISSION, ST. MARY'S COMMUNITY HOSPITAL HELPS ENSURE COMMUNITY NEEDS ARE MET. THIS IS ONLY POSSIBLE THROUGH THE DEVELOPMENT OF STRONG COLLABORATIVE RELATIONSHIPS. ST. MARY'S PROVIDES DEDICATED STAFF TO SUPPORT THE WORK OF PARTNERS FOR OTOE COUNTY (P4OC). THE COALITION IS A COUNTY WIDE PARTNERSHIP OF COMMUNITY ORGANIZATIONS, BUSINESSES, AND INDIVIDUALS OF ALL AGES WORKING TOGETHER FOR POSITIVE CHANGE IN OTOE COUNTY. THE PURPOSE IS TO MAXIMIZE COMMUNITY RESOURCES, HUMAN AND FINANCIAL, WHILE CREATING POSITIVE CHANGE AND IMPROVING THE HEALTH AND QUALITY OF LIFE FOR PEOPLE OF ALL AGES WHO LIVE, WORK, ATTEND SCHOOL AND VISIT OTOE COUNTY.
STATE COMMUNITY BENEFIT REPORT	SCHEDULE H, PART VI, LINE 7	IF APPLICABLE, IDENTIFY ALL STATES WITH WHICH THE ORGANIZATION FILES, OR A RELATED ORGANIZATION FILES ON ITS BEHALF, A COMMUNITY BENEFIT REPORT. THE STATE OF NEBRASKA DOES NOT MANDATE COMMUNITY BENEFIT REPORTING BUT ST. MARY'S COMMUNITY HOSPITAL DOES VOLUNTARY REPORTING THROUGH THE NEBRASKA HOSPITAL ASSOCIATION. CHI'S MBO'S ARE COMPRISED OF APPROXIMATELY 100 TAX-EXEMPT ORGANIZATIONS IN 19 STATES. CHI IS IN THE PROCESS OF IDENTIFYING IN WHICH STATES EACH OF THESE ORGANIZATIONS FILES A COMMUNITY BENEFIT REPORT.
COMMUNITY BENEFIT REPORT	SCHEDULE H, PART I, LINE 6A	ST. MARY'S COMMUNITY HOSPITAL PREPARES ITS OWN ANNUAL WRITTEN COMMUNITY BENEFIT REPORT. ITS COMMUNITY BENEFIT REPORT IS NOT CONTAINED IN THAT OF A RELATED ORGANIZATION.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained
No Grant More Than5000	X	NoGrantMoreThan5000

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Procedures for monitoring use of grant funds	Identifier
Return Reference	Schedule I, Part I, Line 2	ReturnReference
Explanation	THE ORGANIZATION MADE A GRANT TO ST. MARY'S HOSPITAL FOUNDATION, A RELATED ORGANIZATION. UPON PROVIDING SATISFACTORY WRITTEN EVIDENCE THAT THE FUNDS WERE USED FOR THE PURPOSE THE GRANT WAS MADE, THE HOSPITAL RELEASES THE RESTRICTION AND THE FUNDS ARE TRANSFERRED.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	true	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	true	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
STACY BLUM
0	212089	0	28600	0	13900	0	20228	0	18188	0	293005	0	0
ROBERT LANIK
0	503686	0	124161	0	62000	0	32478	0	13246	0	735571	0	0
DANIEL KELLY
0	140831	0	43567	0	21824	0	29250	0	10921	0	246393	0	0
JONATHAN STELLING
0	224079	0	46519	0	667	0	20228	0	18366	0	309859	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Supplemental nonqualified retirement plan	Schedule J, Part I, Line 4b	DURING THE 2010 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 DANIEL KELLY DURING 2010 THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: DANIEL KELLY - $12,240 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 2010 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 2010, THE FOLLOWING CONTRIBUTIONS THAT WOULD HAVE BEEN MADE BY CHI TO THE DEFERRED COMPENSATION PLAN WERE PAID IN CASH: ROBERT LANIK - $35,026
Non-fixed payments	Schedule J, Part I, Line 7	DURING FY2011, SMCH MAINTAINED A DISCRETIONARY BONUS PROGRAM ACCRUED FOR IN FY2011, TO BE PAID OUT IN NOVEMBER, 2011 (FY2012). AWARDS OF COMPENSATION FROM THIS PLAN ARE BASED ON THE ACHIEVEMENT OF CERTAIN ORGANIZATIONAL TARGETS (GENERALLY ASSOCIATED WITH PATIENT SATISFACTION, FINANCIAL PERFORMANCE, AND QUALITY INITIATIVES) AND ARE PAYABLE AS A FIXED PERCENTAGE OF EACH PARTICIPANT'S BASE COMPENSATION IF SUCH TARGETS ARE ACHIEVED.
COMPENSATION OF TOP MANAGEMENT OFFICIAL	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 PAYMENTS	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.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Classes of members or stockholders	Form 990, Part VI, Section A, Line 6	THE SOLE MEMBER OF THE ORGANIZATION IS CHI NEBRASKA, A NEBRASKA NON-PROFIT CORPORATION.
Members or stockholders electing members of governing body	Form 990, Part VI, Section A, Line 7a	ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION.
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, BOTH CHI NEBRASKA AND CATHOLIC HEALTH INITIATIVES ("CHI") (CHI NEBRASKA'S SOLE CORPORATE MEMBER) HAVE RESERVED POWERS AS OUTLINED IN THE CHI GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE HELD BY THE CHI NEBRASKA BOARD: APPROVE MEMBERS OF THE ST. MARY'S COMMUNITY HOSPITAL BOARD AMENDMENT OF THE CORPORATE DOCUMENTS OF ST. MARY'S COMMUNITY HOSPITAL APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF ST. MARY'S COMMUNITY HOSPITAL ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR ST. MARY'S COMMUNITY HOSPITAL THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF ST. MARY'S COMMUNITY HOSPITAL REMOVAL OF A MEMBER OF THE GOVERNING BODY OF ST. MARY'S COMMUNITY HOSPITAL APPROVAL OF ISSUANCE OF DEBT BY ST. MARY'S COMMUNITY HOSPITAL APPROVAL OF PARTICIPATION OF ST. MARY'S COMMUNITY HOSPITAL IN A JOINT VENTURE APPROVAL OF FORMATION OF A NEW CORPORATION BY ST. MARY'S COMMUNITY HOSPITAL APPROVAL OF A MERGER INVOLVING THE ST. MARY'S COMMUNITY HOSPITAL APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF ST. MARY'S COMMUNITY HOSPITAL TO REQUIRE THE TRANSFER OF ASSETS BY THE ST. MARY'S COMMUNITY HOSPITAL TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. PURSUANT TO SECTION 5.4.2 OF THE ORGANIZATION'S BYLAWS, CHI NEBRASKA OR CHI MAY, IN EXERCISE OF THEIR APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND ITS PRESIDENT AND THE 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	ONCE THE RETURN IS PREPARED, IT IS REVIEWED BY THE VP OF FINANCE. THE VP OF FINANCE THEN PRESENTS THE RETURN AT THE FINANCE/AUDIT COMMITTEE BOARD MEETING FOR REVIEW. COPIES OF THE 990 ARE PROVIDED TO ALL BOARD MEMBERS AFTER THE REVIEW BY THE FINANCE/AUDIT COMMITTEE. THE TAX DEPARTMENT THE 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	ST. MARY'S COMMUNITY HOSPITAL HAS A BOARD POLICY THAT REFERENCES THE DUALITY OF INTEREST AND CONFLICT OF INTEREST POLICIES PROVIDED BY CHI NATIONAL. AT THE ANNUAL BOARD AND BOARD COMMITTEE MEETINGS ALL MEMBERS ARE REQUESTED TO SIGN CONFLICT OF INTEREST STATEMENTS. THE SIGNED STATEMENTS ARE RETAINED IN THE ADMINISTRATIVE FILES. ALL MEMBERS ARE REQUESTED TO DECLARE POTENTIAL CONFLICTS OF INTEREST AT EACH BOARD AND/OR COMMITTEE MEETING OF THE BOARD (FINANCE, AUDIT AND COMPLIANCE COMMITTEE AND THE PERFORMANCE IMPROVEMENT COMMITTEE). IF THE BOARD FINDS THAT A CONFLICT DOES EXIST REGARDING THE AGENDA ITEMS TO BE PRESENTED FOR ACTION, MEMBERS ARE REQUESTED TO ABSTAIN FROM VOTING. IN ADDITION, A QUESTIONNAIRE IS SENT ANNUALLY TO ALL BOARD MEMBERS, TOP PAID VENDORS, AND TOP PAID EMPLOYEES ASKING THEM TO DISCLOSE ANY BUSINESS OR FAMILY RELATIONSHIPS.
Process used to establish compensation of top management official	Form 990, Part VI, Section B, 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, 2011. 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.
Process used to establish compensation of other officers/key employees	Form 990, Part VI, Section B, Line 15b	ANY EXECUTIVE COMPENSATION PAID BY ST. MARY'S COMMUNITY HOSPITAL WAS SET BY THE EXECUTIVE COMMITTEE UTILIZING COMPARABILITY STUDIES TO DETERMINE OFFICER COMPENSATION AS REQUIRED BY THE ORGANIZATION'S EXECUTIVE COMPENSATION REVIEW POLICY. THE BOARD OF DIRECTORS OVERSEES THE COMPENSATION SETTING PROCESS AND ENSURES REASONABLENESS AND COMPLIANCE WITH THE ORGANIZATION'S COMPENSATION PHILOSOPHY.
Public Disclosure	Form 990, Part VI, Section C, Line 19	THE ORGANIZATION'S FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. 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.ORG. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE.
EXECUTIVE COMMITTEE	FORM 990, PART VI, LINE 1A	THE EXECUTIVE COMMITTEE CONSISTS ONLY OF DIRECTORS OF THE CORPORATION AND IS COMPOSED OF THE CHAIR OF THE BOARD, THE VICE CHAIR OF THE BOARD, AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, EACH OF WHOM SERVE AS EX OFFICIO VOTING MEMBERS OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT THE ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIODS BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT THEIR ACTIONS ARE CONSISTENT WITH ANY ACTIONS OR POLICIES OF THE BOARD OR THE CORPORATE MEMBER. ALL ACTIONS TAKEN ARE CONTEMPORANEOUSLY DOCUMENTED AND REPORTED TO THE BOARD AT THE NEXT REGULARLY SCHEDULED MEETING.
DOCUMENT RETENTION & DESTRUCTION POLICY	FORM 990, PART VI, LINE 14	THE ORGANIZATION'S BOARD HAS NOT FORMALLY ADOPTED A DOCUMENT RETENTION & DESTRUCTION POLICY. THE ORGANIZATION HAS STANDARD PROCEDURES THAT ARE FOLLOWED BUT THE ORGANIZATION'S BOARD HAS NOT OFFICIALLY ADOPTED THE POLICY. THE BOARD WILL ADOPT THE DOCUMENT RETENTION & DESTRUCTION POLICY DURING THE YEAR ENDED JUNE 30, 2012.
HOURS DEVOTED TO RELATED ORGANIZATIONS	FORM 990, PART VII	COMPENSATION REPORTED ON FORM 990, PART VII WAS PAID TO THESE INDIVIDUALS BY RELATED ORGANIZATIONS IN EXCHANGE FOR THE FULFILLMENT OF THEIR DUTIES AS FULL-TIME, 60 HOUR-PER-WEEK EMPLOYEES.
Other changes in net assets or fund balances	Form 990, Part XI, Line 5	NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - 846698; CHI CONNECT DEPRECIATION - 44751; CAPITAL RESOURCE POOL CONTRIBUTION - -186216;

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (124 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
ALEGENT HEALTH - BERGAN MERCY HEALTH SYS
7500 MERCY ROAD	OMAHA	NE	68124	470484764	HEALTHCARE	NE	501(C)(3)	3	CHI	true
ALEGENT HEALTH - MERCY HOSPITAL CORNING
PO BOX 368	CORNING	IA	50841	420782518	HEALTHCARE	IA	501(C)(3)	3	AHBMHS	true
ALVERNA APARTMENTS
300 SE 8TH AVENUE	LITTLE FALLS	MN	56345	411351177	LTERM CARE	MN	501(C)(3)	9	CHI	true
APPLETREE COURT
601 OAK STREET	BRECKENRIDGE	MN	56520	411850500	SENIOR HOMES	MN	501(C)(3)	9	SFH	true
BISHOP DRUMM RETIREMENT CENTER
1111 6TH AVENUE	DES MOINES	IA	50314	420725196	LTERM CARE	IA	501(C)(3)	9	CHI-IA CORP	true
BORNEMANN HEALTHCARE CORPORATION
2500 BERNVILLE RD PO BOX 316	READING	PA	19603	232187242	HEALTHCARE	PA	501(C)(3)	11 - Type I	CHI	true
CARRINGTON HEALTH CENTER
800 NORTH 4TH STREET	CARRINGTON	ND	58421	450227311	HEALTHCARE	ND	501(C)(3)	3	CHI	true
CATHOLIC HEALTH CARE FEDERATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	208473567	JURIDIC PERSON	CO	501(C)(3)	11 - Type I	CHI	true
CATHOLIC HEALTH INITIATIVES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	470617373	HEALTHCARE	CO	501(C)(3)	9	CHI	true
CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
961 EAST COLORADO AVENUE	COLORADO SPRINGS	CO	80903	840902211	FUNDRAISING	CO	501(C)(3)	7	CHI COLORADO	true
CENTENNIAL MEDICAL GROUP INC
2700 STEWART PARKWAY	ROSEBURG	OR	97470	900433062	PHYSICIANS	OR	501(C)(3)	9	MMC	true
CHI COLORADO
188 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	840405257	HEALTHCARE	CO	501(C)(3)	3	CHI	true
CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PARKWAY	FARGO	ND	58104	271966847	HEALTHCARE	ND	501(C)(3)	3	CHI	true
CHI INSTITUTE FOR RESEARCH AND INNOVATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	271050565	HEALTHCARE	CO	501(C)(3)	11 - Type I	CHI	true
CHI KENTUCKY INC
3900 OLYMPIC BLVD SUITE 400	ERLANGER	KY	41018	202741651	HEALTHCARE	KY	501(C)(3)	11 - Type I	CHI	true
CHI NATIONAL FOUNDATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	270930004	FUNDRAISING	CO	501(C)(3)	11 - Type I	CHI	true
CHI NATIONAL HOME CARE
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	451261716	HEALTHCARE	CO	501(C)(3)	11 - Type I	CHI	true
CHI NATIONAL SERVICES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	452532084	HEALTHCARE	CO	501(C)(3)	9	CHI	true
CHI NEBRASKA
555 SOUTH 70TH STREET	LINCOLN	NE	68510	363233121	HEALTHCARE	NE	501(C)(3)	11 - Type I	CHI	true
CHI-IOWA CORP
1111 6TH AVENUE	DES MOINES	IA	50314	420680448	HEALTHCARE	IA	501(C)(3)	3	MHN	true
CONTINUING CARE HOSPITAL
150 NORTH EAGLE CREEK DRIVE	LEXINGTON	KY	40509	611400619	LTACH	KY	501(C)(3)	3	SJHS	true
ENUMCLAW REGIONAL HOSPITAL ASSOCIATION
1450 BATTERSBY AVENUE	ENUMCLAW	WA	98022	910715805	HEALTHCARE	WA	501(C)(3)	3	FHS	true
FLAGET HEALTHCARE DBA FLAGET MEMORIAL HOSPITAL
4305 NEW SHEPHERDSVILLE ROAD	BARDSTOWN	KY	40004	611345363	HEALTHCARE	KY	501(C)(3)	3	CHI	true
FLAGET MEMORIAL HOSPITAL FOUNDATION INC
4305 NEW SHEPHERDSVILLE ROAD	BARDSTOWN	KY	40004	562351341	FUNDRAISING	KY	501(C)(3)	11 - Type I	FH	true
FRANCISCAN FOUNDATION
1717 SOUTH J STREET	TACOMA	WA	98405	911145592	FUNDRAISING	WA	501(C)(3)	9	FHS	true
FRANCISCAN HEALTH SYSTEM FKA FRANCISCAN HEALTH SYSTEM WEST
1717 SOUTH J STREET	TACOMA	WA	98405	910564491	HEALTHCARE	WA	501(C)(3)	3	CHI	true
FRANCISCAN MEDICAL GROUP
1708 SOUTH YAKIMA AVENUE	TACOMA	WA	98405	911939739	HEALTHCARE	WA	501(C)(3)	9	FHS	true
FRANCISCAN VILLA OF SOUTH MILWAUKEE INC
3601 SOUTH CHICAGO AVENUE	SOUTH MILWAUKEE	WI	53172	391093829	HEALTHCARE	WI	501(C)(3)	9	CHI	true
GETTYSBURG MEDICAL CENTER
606 EAST GARFIELD AVENUE	GETTYSBURG	SD	57442	460234354	HEALTHCARE	SD	501(C)(3)	3	SMHC	true
GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	201536108	MINISTRIES	CO	501(C)(3)	11 - Type I	CHI	true
GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE
375 DIXMYTH AVE	CINCINNATI	OH	45220	311778403	EDUCATION	KY	501(C)(3)	2	GHS	true
GOOD SAMARITAN FOUNDATION OF CINCINNATI INC
619 OAK STREET ACCOUNTING-3 W	CINCINNATI	OH	45206	311206047	FUNDRAISING	OH	501(C)(3)	11 - Type I	GSH	true
GOOD SAMARITAN HOSPITAL
PO BOX 1990	KEARNEY	NE	68848	470379755	HEALTHCARE	NE	501(C)(3)	3	CHI NEBRASKA	true
GOOD SAMARITAN HOSPITAL FOUNDATION
PO BOX 1810	KEARNEY	NE	68848	470659443	FUNDRAISING	NE	501(C)(3)	7	GSH	true
HEALTH SET
4200 WEST CONEJOS PLACE 436	DENVER	CO	80204	841102943	LOW INC.CARE	CO	501(C)(3)	7	CHI COLORADO	true
HEALTHCARE AND WELLNESS FOUNDATION
2400 ST FRANCIS DRIVE	BRECKENRIDGE	MN	56520	760761782	FUNDRAISING	MN	501(C)(3)	11 - Type I	SFMC	true
HOSPITAL ASSOCIATION FOR ST JOSEPH HOSPITAL
7601 OSLER DRIVE	TOWSON	MD	21204	526050777	HEALTHCARE	MD	501(C)(3)	9	SJMC	true
HOUSE OF MERCY
1111 6TH AVENUE	DES MOINES	IA	50314	421323808	SHELTER	IA	501(C)(3)	7	CHI-IA CORP	true
LAKEWOOD HEALTH CENTER
600 MAIN AVENUE SOUTH	BAUDETTE	MN	56623	410758434	LTERM CARE	MN	501(C)(3)	3	CHI	true
LINUS OAKES INC
2700 STEWART PARKWAY	ROSEBURG	OR	97470	930821381	SENIOR LIVING	OR	501(C)(3)	9	MMC	true
LISBON AREA HEALTH SERVICES
905 MAIN STREET	LISBON	ND	58054	820558836	HEALTHCARE	ND	501(C)(3)	3	CHI	true
MEMORIAL HEALTH CARE SYSTEM FOUNDATION
2525 DE SALES AVENUE	CHATTANOOGA	TN	37404	621839548	FUNDRAISING	TN	501(C)(3)	7	MHCS	true
MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVENUE	CHATTANOOGA	TN	37404	620532345	HEALTHCARE	TN	501(C)(3)	3	CHI	true
MEMORIAL HEALTH PARTNERS FOUNDATION INC
6028 SHALLOWFORD ROAD	CHATTANOOGA	TN	37421	030417049	HEALTHCARE	TN	501(C)(3)	9	MHCS	true
MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVENUE	DES MOINES	IA	50314	426076069	AUXILIARY	IA	501(C)(3)	11 - Type I	CHI-IA CORP	true
MERCY CLINICS INC
1111 6TH AVENUE	DES MOINES	IA	50314	421193699	PHYSICIAN	IA	501(C)(3)	9	CHI-IA CORP	true
MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVENUE	DES MOINES	IA	50314	421511682	EDUCATION	IA	501(C)(3)	2	CHI-IA CORP	true
MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVENUE	DES MOINES	IA	50314	237358794	FUNDRAISING	IA	501(C)(3)	7	CHI-IA CORP	true
MERCY FOUNDATION INC
2700 STEWART PARKWAY	ROSEBURG	OR	97470	936088946	FUNDRAISING	OR	501(C)(3)	7	MMC	true
MERCY HEALTH CARE FOUNDATION
PO BOX 368	CORNING	IA	50841	421461064	FUNDRAISING	NE	501(C)(3)	11 - Type I	AHMH	true
MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DRIVE	COUNCIL BLUFFS	IA	51503	421178204	FUNDRAISING	IA	501(C)(3)	11 - Type I	AHBMHS	true
MERCY HOSPITAL OF DEVILS LAKE
1031 EAST SEVENTH STREET	DEVILS LAKE	ND	58301	450227012	HEALTHCARE	ND	501(C)(3)	3	CHI	true
MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BOULEVARD	VALLEY CITY	ND	58072	450226553	HEALTHCARE	ND	501(C)(3)	3	CHI	true
MERCY LIFECARE SYSTEMS
2727 MCCLELLAND BLVD	JOPLIN	MO	64804	431305163	PROPERTY MGMT	MO	501(C)(3)	11 - Type I	SJRMC	true
MERCY MEDICAL CENTER
1301 15TH AVENUE WEST	WILLISTON	ND	58801	450231183	HEALTHCARE	ND	501(C)(3)	3	CHI	true
MERCY MEDICAL CENTER
2700 STEWART PARKWAY	ROSEBURG	OR	97470	930386868	HEALTHCARE	OR	501(C)(3)	3	CHI	true
MERCY MEDICAL CENTER - CENTERVILLE
1 ST JOSEPHS DRIVE	CENTERVILLE	IA	52544	420680308	HEALTHCARE	IA	501(C)(3)	3	CHI-IA CORP	true
MERCY MEDICAL FOUNDATION
1301 15TH AVENUE WEST	WILLISTON	ND	58801	450381803	FUNDRAISING	ND	501(C)(3)	11 - Type I	MMC	true
MERCY PROFESSIONAL PRACTICE ASSOCIATES INC
1111 6TH AVENUE	DES MOINES	IA	50314	421470935	PHYSICIAN	IA	501(C)(3)	9	CHI-IA CORP	true
MERCY REGIONAL MEDICAL CENTER OF DURANGO
1010 THREE SPRINGS BLVD	DURANGO	CO	81301	840405515	HEALTHCARE	CO	501(C)(3)	3	CHI	true
MNMCH INC
220 NORTH PENNSYLVANIA	COLUMBUS	KS	66725	481216238	HEALTHCARE	KS	501(C)(3)	3	SJRMC	true
MT ST JOSEPH INC
3060 SE STARK STREET	PORTLAND	OR	97214	930386870	NURSING CARE	OR	501(C)(3)	9	CHI	true
OAKES COMMUNITY HOSPITAL
314 SOUTH 8TH STREET	OAKES	ND	58474	450231675	HEALTHCARE	ND	501(C)(3)	3	CHI	true
OAKES COMMUNITY HOSPITAL FOUNDATION
314 SOUTH 8TH STREET	OAKES	ND	58474	710966606	FUNDRAISING	ND	501(C)(3)	11 - Type I	OCH	true
PUEBLO STEPUP
1925 EAST ORMAN AVE SUITE G52	PUEBLO	CO	81004	841234295	COMMUNITY	CO	501(C)(3)	7	CHI	true
SET OF COLORADO SPRINGS INC
825 E PIKES PEAK AVENUE BLDG 29	COLORADO SPRINGS	CO	80903	841183335	LTERM CARE	CO	501(C)(3)	7	CHI COLORADO	true
SAINT CLARE'S COMMUNITY CARE
66 FORD ROAD	DENVILLE	NJ	07834	222876836	HEALTHCARE	NJ	501(C)(3)	11 - Type II	SCHS	true
SAINT CLARE''S FOUNDATION INC
66 FORD ROAD	DENVILLE	NJ	07834	222502997	FUNDRAISING	NJ	501(C)(3)	7	SCHS	true
SAINT CLARE''S HEALTH SERVICES INC
25 POCONO ROAD	DENVILLE	NJ	07834	223639733	MANAGEMENT	NJ	501(C)(3)	7	CHI	true
SAINT CLARE'S HOSPITAL
66 FORD ROAD	DENVILLE	NJ	07834	223319886	HEALTHCARE	NJ	501(C)(3)	3	CHI	true
SAINT ELIZABETH FOUNDATION
555 SOUTH 70TH STREET	LINCOLN	NE	68510	470625523	FUNDRAISING	NE	501(C)(3)	7	SERMC	true
SAINT ELIZABETH HEALTH SERVICES
555 SOUTH 70TH STREET	LINCOLN	NE	68510	363233120	HEALTHCARE	NE	501(C)(3)	3	SERMC	true
SAINT ELIZABETH REGIONAL MEDICAL CENTER
555 SOUTH 70TH STREET	LINCOLN	NE	68510	470379836	HEALTHCARE	NE	501(C)(3)	3	CHI NEBRASKA	true
SAINT FRANCIS MEDICAL CENTER
PO BOX 9804	GRAND ISLAND	NE	68802	470376601	HEALTHCARE	NE	501(C)(3)	3	CHI NEBRASKA	true
SAINT FRANCIS MEDICAL CENTER FOUNDATION
PO BOX 9804	GRAND ISLAND	NE	68802	470630267	FUNDRAISING	NE	501(C)(3)	7	SFMC	true
SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC
305 ESTILL STREET	BEREA	KY	40403	260152877	FUNDRAISING	KY	501(C)(3)	7	SJHS	true
SAINT JOSEPH HEALTH SYSTEM INC
150 N EAGLE CREEK DR	LEXINGTON	KY	40509	611334601	HEALTHCARE	KY	501(C)(3)	3	CHI	true
SAINT JOSEPH LONDON FOUNDATION INC
310 EAST NINTH STREET	LONDON	KY	40741	260438748	FUNDRAISING	KY	501(C)(3)	11 - Type I	SJHS	true
SAINT JOSEPH MEDICAL FOUNDATION INC
ONE ST JOSEPH DRIVE	LEXINGTON	KY	40504	311539059	PHY PRACTICES	KY	501(C)(3)	3	SJHS	true
SAINT JOSEPH MOUNT STERLING FOUNDATION INC
50 STERLING AVENUE	MOUNT STERLING	KY	40353	272884584	FUNDRAISING	KY	501(C)(3)	7	SJHS	true
SAINT JOSEPH'S HOSPITAL FOUNDATION
30 WEST 7TH STREET	DICKINSON	ND	58601	363418207	FUNDRAISING	ND	501(C)(3)	11 - Type I	SJHHC	true
SAMARITAN BEHAVIORAL HEALTH
601 S EDWIN C MOSES BLVD	DAYTON	OH	45408	020633634	HEALTHCARE	OH	501(C)(3)	3	SHP	true
SAMARITAN HEALTH FOUNDATION
2222 PHILADELPHIA DRIVE	DAYTON	OH	45406	237296923	FUNDRAISING	OH	501(C)(3)	7	SHP	true
SAMARITAN HEALTH PARTNERS
2222 PHILADELPHIA DRIVE	DAYTON	OH	45406	311107411	HEALTHCARE	OH	501(C)(3)	11 - Type I	CHI	true
ST JOSEPH HEALTH MINISTRIES
1929 LINCOLN HWY E STE 150	LANCASTER	PA	17602	232342997	HEALTH	PA	501(C)(3)	11 - Type I	CHI	true
ST JOSEPH HEALTH MINISTRIES FOUNDATION
1929 LINCOLN HWY E STE 150	LANCASTER	PA	17602	232605579	FUNDRAISING	PA	501(C)(3)	11 - Type I	SJHM	true
ST ANTHONY HOSPITAL
1601 SE COURT AVENUE	PENDLETON	OR	97801	930391614	HEALTHCARE	OR	501(C)(3)	3	CHI	true
ST ANTHONY HOSPITAL FOUNDATION
1601 SE COURT AVENUE	PENDLETON	OR	97801	930992727	FUNDRAISING	OR	501(C)(3)	11 - Type I	SA HOSPITAL	true
ST ANTHONY'S HOSPITAL ASSOCIATION
4 HOSPITAL DRIVE	MORRILTON	AR	72110	710245507	HEALTHCARE	AR	501(C)(3)	3	SVIMC	true
ST CATHERINE HOSPITAL
401 EAST SPRUCE STREET	GARDEN CITY	KS	67846	480543721	HEALTHCARE	KS	501(C)(3)	3	CHI	true
ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION
401 EAST SPRUCE STREET	GARDEN CITY	KS	67846	200598702	FUNDRAISING	KS	501(C)(3)	11 - Type I	SCH	true
ST DOMINIC AT ONTARIO
351 SW 9TH STREET	ONTARIO	OR	97914	930433692	HEALTHCARE	OR	501(C)(3)	3	CHI	true
ST FRANCIS HOME
2400 ST FRANCIS DRIVE	BRECKENRIDGE	MN	56520	410729978	LTERM CARE	MN	501(C)(3)	9	CHI	true
ST FRANCIS LIFE CARE CORPORATION
19 POCONO ROAD	DENVILLE	NJ	07834	222536017	ELDERLY CARE	NJ	501(C)(3)	9	SCHS	true
ST FRANCIS MEDICAL CENTER
2400 ST FRANCIS DRIVE	BRECKENRIDGE	MN	56520	410695598	HEALTHCARE	MN	501(C)(3)	3	CHI	true
ST FRANCIS OF BAKER CITY
3325 POCAHONTAS ROAD	BAKER CITY	OR	97814	930412495	HEALTHCARE	OR	501(C)(3)	3	CHI	true
ST JOHN'S MEDICAL GROUP
2727 MCCLELLAND BLVD	JOPLIN	MO	64804	431882377	PHYS PRACTICE	MO	501(C)(3)	9	SJRMC	true
ST JOHN'S MERCY REGIONAL FOUNDATION
2727 MCCLELLAND BLVD	JOPLIN	MO	64804	431308084	FUNDRAISING	MO	501(C)(3)	7	SJRMC	true
ST JOHN'S REGIONAL MEDICAL CENTER
2727 MCCLELLAND BLVD	JOPLIN	MO	64804	440545809	HEALTHCARE	MO	501(C)(3)	3	CHI	true
ST JOSEPH COMMUNITY HEALTH SERVICES
300 CENTRAL AVE SW SUITE 3000W	ALBUQUERQUE	NM	87102	710897107	COMMUNITY	NM	501(C)(3)	11 - Type I	CHI	true
ST JOSEPH HEALTH SERVICES INC
1929 LINCOLN HWY E STE 150	LANCASTER	PA	17602	201425375	DENTAL CARE	PA	501(C)(3)	11 - Type I	SJHM	true
ST JOSEPH HOSPITAL FOUNDATION INC
ONE ST JOSEPH DRIVE	LEXINGTON	KY	40504	611159649	FUNDRAISING	KY	501(C)(3)	11 - Type I	SJHS	true
ST JOSEPH MEDICAL CENTER FOUNDATION
2500 BERNVILLE ROAD PO BOX 316	READING	PA	19603	232649362	FUNDRAISING	PA	501(C)(3)	11 - Type I	SJRHN	true
ST JOSEPH MEDICAL CENTER FOUNDATION INC
7601 OSLER DRIVE	TOWSON	MD	21204	521681044	FUNDRAISING	MD	501(C)(3)	7	SJMC	true
ST JOSEPH MEDICAL CENTER INC
7601 OSLER DRIVE	TOWSON	MD	21204	520591461	HEALTHCARE	MD	501(C)(3)	3	CHI	true
ST JOSEPH MEDICAL GROUP
2500 BERNVILLE ROAD PO BOX 316	READING	PA	19603	208544021	HEALTHCARE	PA	501(C)(3)	9	BHC	true
ST JOSEPH PHYSICIAN ENTERPRISES
7601 OSLER DRIVE	TOWSON	MD	21204	521311775	PHYSICIANS	MD	501(C)(3)	11 - Type I	CHI	true
ST JOSEPH REGIONAL HEALTH NETWORK
2500 BERNVILLE ROAD PO BOX 316	READING	PA	19603	231352211	HEALTHCARE	PA	501(C)(3)	3	CHI	true
ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVENUE	PARK RAPIDS	MN	56470	410695603	HEALTHCARE	MN	501(C)(3)	3	CHI	true
ST JOSEPH'S HOSPITAL AND HEALTH CENTER
30 WEST 7TH STREET	DICKINSON	ND	58601	450226429	HEALTHCARE	ND	501(C)(3)	3	CHI	true
ST MARY'S HEALTHCARE CENTER
801 EAST SIOUX AVENUE	PIERRE	SD	57501	460230199	HEALTHCARE	SD	501(C)(3)	3	CHI	true
ST MARY'S HOSPITAL FOUNDATION
1314 3RD AVENUE	NEBRASKA CITY	NE	68410	470707604	FUNDRAISING	NE	501(C)(3)	7	SMH	true
ST ROSE AMBULATORY AND SURGERY CENTER FKA CENTRAL KANSAS MEDICAL CENTER
3515 BROADWAY	GREAT BEND	KS	67530	480543724	SURGERY CNTR	KS	501(C)(3)	3	CHI	true
ST VINCENT FOUNDATION
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	510169537	FUNDRAISING	AR	501(C)(3)	11 - Type I	SVIMC	true
ST VINCENT INFIRMARY MEDICAL CENTER
2 ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	710236917	HEALTHCARE	AR	501(C)(3)	3	CHI	true
ST VINCENT MEDICAL GROUP
2 ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	710830696	HEALTHCARE	AR	501(C)(3)	9	SVIMC	true
THE COMMUNITY LIMITED CARE DIALYSIS CENTER
619 OAK STREET ACCOUNTING-3 W	CINCINNATI	OH	45206	237419853	DIALYSIS	OH	501(C)(2)	N/A	GSH	true
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH
619 OAK STREET ACCOUNTING-3 W	CINCINNATI	OH	45206	310537486	HEALTHCARE	OH	501(C)(3)	3	TRI-HEALTH	true
THE MERCY HOSPITAL OF DEVILS LAKE FDN
1031 EAST SEVENTH STREET	DEVILS LAKE	ND	58301	352367360	FUNDRAISING	ND	501(C)(3)	11 - Type I	MHDL	true
THE PHYSICIAN NETWORK
8055 O STREET SUITE 300	LINCOLN	NE	68510	470780857	PHYS PRACTICE	NE	501(C)(3)	11 - Type I	CHI NEBRASKA	true
TOTAL HEALTHCARE
PO BOX 7021	COLORADO SPRINGS	CO	80933	840927232	HEALTHCARE	CO	501(C)(3)	3	CHI COLORADO	true
UNITY FAMILY HEALTHCARE
815 2ND STREET SE	LITTLE FALLS	MN	56345	410721642	HEALTHCARE	MN	501(C)(3)	3	CHI	true
VILLA NAZARETH INC
801 PAGE DRIVE	FARGO	ND	58103	450226714	LT CARE	ND	501(C)(3)	9	CHI	true
VISITING NURSE ASSOCIATION OF SAINT CLARE'S
191 WOODPORT ROAD	SPARTA	NJ	07871	221768334	HOME HEALTH	NJ	501(C)(3)	9	SCHS	true

Form990 Schedule R Part III Form990ScheduleRPartIII (20 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	Code VCodeVAmount	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
AUDUBON LAND COMPANY LLC
5390 N ACADEMY BLVD SUITE 300	COLORADO SPRINGS	CO	80918	841513085	REAL ESTATE	CO	THC	RELATED	-157673	14390550	false	$0	false	0.501
AVANTAS LLC
1207 SOUTH 13 STREET	OMAHA	NE	68108	392045003	HEALTHCARE	NE	AHMH	UNRELATED			false		false	0.95
BERYWOOD OFFICE PROPERTIES LLC
400 BERYWOOD TRAIL	CLEVELAND	TN	37312	621875199	PHYS OFFICE	TN	MHCS	RELATED			false		true	0.63
BLUEGRASS REGIONAL IMAGING CENTER
1218 SOUTH BROADWAY SUITE 310	LEXINGTON	KY	40504	611386736	DIAGNOSTIC	KY	SJ HOSPITAL LEX	RELATED			false		false	0.65
CENTRAL NEBRASKA HOME CARE SERVICES
PO BOX 1146-4510 SECOND AVENUE	KEARNEY	NE	68848	470692112	HEALTHCARE SRVC	NE	HSE INC	RELATED	-99941	1021498	false	-$48,712	true	1
CENTRAL NEBRASKA REHAB SERVICE
3004 W FAIDLEY AVE	GRAND ISLAND	NE	68802	810653461	PHYSICAL THERAPY	NE	CHI	RELATED	1857991	2262775	false	$0	false	0.51
CHI OPERATING INVESTMENT PROGRAM LP
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	470727942	INVESTMENTS	CO	CHI	UNRELATED	139679805	2069974790	false	$371,292	true	1
HEALTHCARE SUPPORT SERVICES
PO BOX 9804	GRAND ISLAND	NE	68802	721546196	LAUNDRY	NE	CHI	RELATED	196124	3913481	false	-$58,436	false	1
NORTH RIVER SURGERY CENTER LLC
2209 WILDWOOD AVENUE	SHERWOOD	AR	72120	710799771	AMBUL SURG CTR	AR	SVIMC	RELATED	198313	1758688	false	$0	false	0.5745
ORTHOCOLORADO LLC
11650 WEST 2ND PLACE	LAKEWOOD	CO	80255	371577105	ORTHO HOSPITAL	CO	THC	RELATED	-3249314	10905384	false	$0	false	0.6
PENINSULA RADIATION ONCOLOGY
314 MARTIN LUTHER KING JR WAY 11	TACOMA	WA	98405	870808610	HEALTHCARE SRVC	WA	FHS	RELATED	131195	3052504	false	$0	false	0.6
PENRAD IMAGING
1139 KELLY JOHNSON BLVD	COLORADO SPRINGS	CO	80920	841072619	MEDICAL IMAGING	CO	THC	RELATED	1857228	5457224	false	$0	false	0.7
RUXTON SURGICENTER LLC
8322 BELLONA AVENUE SUITE 201	BALTIMORE	MD	21204	522095835	SURGERY CENTER	MD	SJMC	RELATED			false		true	0.51
SAINT JOSEPH - SCA HOLDINGS LLC
424 LEWIS HARGETT CIRCLE STE 160	LEXINGTON	KY	40503	453801157	OP SURGERY	DE	SJHS	RELATED	0	0	false	$0	false	0.51
ST ANOTHONY REGIONAL MTN CANCER CENTER
4231 W 16TH AVENUE	DENVER	CO	80112	371568013	CANCER CENTER	CO	THC	RELATED	-290552	0	false	$0	false	0.51
ST FRANCIS LAND COMPANY
5390 N ACADEMY BLVD SUITE 300	COLORADO SPRINGS	CO	80918	263134100	REAL ESTATE	CO	THC	RELATED	-180979	14886022	false	$0	false	0.51
ST FRANCIS MEDICAL CENTER ASSOCIATES
1717 SOUTH J STREET	TACOMA	WA	98405	911352698	MED. OFFICE	WA	FHS	RELATED	116948	1652280	false	$0	false	0.54
ST JOSEPH-PAML LLC
424 LEWIS HARGETT CIRCLE STE 160	LEXINGTON	KY	40503	452116736	MGMT SERVICES	KY	SJHS	RELATED	0	0	false	$0	true	0.625
SUPERIOR MEDICAL IMAGING LLC
5000 NORTH 26TH STREET	LINCOLN	NE	68521	262884555	OP DIAGNOSTICS	NE	SERMC	RELATED			false		false	0.51
SURGERY CENTER OF LEXINGTON LLC
1451 HARRODSBURG ROAD	LEXINGTON	KY	40504	621179539	SURGERY CENTER	DE	SJHS	RELATED	808840	4236901	false	$0	false	0.51

Form990 Schedule R Part IV Form990ScheduleRPartIV (45 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership	Address Line1AddressForeign/AddressLine1	CityAddressForeign/City	Province Or StateAddressForeign/ProvinceOrState	CountryAddressForeign/Country	Postal CodeAddressForeign/PostalCode	Legal Domicile Foreign CountryLegalDomicileForeignCountry
ALTERNATIVE INSURANCE MANAGEMENT SERVICES
3900 OLYMPIC BOULEVARD SUITE 400	ERLANGER	KY	41018	841112049	MANAGEMENT SERVICES	CO	CHI	C CORPORATION	0	3267441	1
AMERICAN NURSING CARE
1700 EDISON DRIVE	MILFORD	OH	45150	311085414	HOME HEALTH	OH	CHS	C CORPORATION	1778617	44470358	1
AMERIMED INC
1700 EDISON DRIVE	MILFORD	OH	45150	311158699	HOME HEALTH	OH	ANC	C CORPORATION	2395230	11869657	1
CADUCEUS MEDICAL ASSOCIATES INC
6028 SHALLOWFORD ROAD SUITE D	CHATTANOOGA	TN	37422	621570736	HEALTHCARE	TN	MHCS	C CORPORATION	0	1008	1
CAPTIVE MANAGEMENT INITIATIVES
				980663022	CAPTIVE MANAGEMENT		CHI	C CORPORATION	0	0	1	PO BOX 10073 APO	GEORGETOWN	GEORGETOWN, GRAND CAYMAN	CJ	KY1-1001	CJ
CENTER FOR TRANSLATIONAL RESEARCH
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	272269511	HEALTHCARE	CO	CHI	C CORPORATION	-2247962	1668589	1
CENTRAL KANSAS HEALTH SERVICES ASSOCIATION
3515 BROADWAY	GREAT BEND	KS	67530	481042853	MEDICAL EQUIPMENT	KS	CKMC	C CORPORATION	0	0	1
CGH REALTY COMPANY INC
215 N 12TH ST	READING	PA	19603	232326801	REAL ESTATE	PA	SJHM	C CORPORATION	1007	42415	1
COMCARE SERVICES
4231 W 16TH AVENUE	DENVER	CO	80204	840904813	INACTIVE	CO	CHIC	C CORPORATION	0	0	1
CONSOLIDATED HEALTH SERVICES
1700 EDISON DRIVE	MILFORD	OH	45150	311378212	HOME HEALTH	OH	CHI	C CORPORATION	0	11595125	1
DAVID DEYLE CHARITABLE REMAINDER UNITRUST
PO BOX 1810	KEARNEY	NE	68848	476192395	INVESTMENTS	NE	GSHF	TRUST	4880	166425	1
DES MOINES MEDICAL CENTER INC
1111 6TH AVENUE	DES MOINES	IA	50314	420837382	REAL ESTATE	IA	CHI-IA CORP	C CORPORATION	0	1253452	0.9298
FIRST INITIATIVES INSURANCE LTD
				980203038	INSURANCE		CHI	C CORPORATION	0	0	1	PO BOX 10073 APO	GEORGETOWN	GEORGETOWN, GRAND CAYMAN	CJ	KY1-1001	CJ
FRANCISCAN SERVICES INC
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	232487967	HEALTHCARE	CO	CHI	C CORPORATION	-507578	11914284	1
GOOD SAMARITAN OUTREACH SERVICES
PO BOX 1990	KEARNEY	NE	68848	470659440	MEDICAL CLINIC	NE	CHI NEBRASKA	C CORPORATION	-2921063	355110	1
HAROLD W RASE 1995 CHARITABLE UNITRUST
30 WEST 7TH STREET	DICKINSON	ND	58601	456090420	INVESTMENTS	ND	SJHHC	TRUST	1240	21553	1
HAROLD W RASE 1996 CHARITABLE UNITRUST
30 WEST 7TH STREET	DICKINSON	ND	58601	206037112	INVESTMENTS	ND	SJHHC	TRUST	900	15495	1
HAROLD W RASE 1997 CHARITABLE UNITRUST
30 WEST 7TH STREET	DICKINSON	ND	58601	206037104	INVESTMENTS	ND	SJHHC	TRUST	1025	20261	1
HAROLD W RASE 1999 CHARITABLE UNITRUST
30 WEST 7TH STREET	DICKINSON	ND	58601	206037099	INVESTMENTS	ND	SJHHC	TRUST	1313	25027	1
HEALTH SYSTEMS ENTERPRISES INC
PO BOX 1990	KEARNEY	NE	68848	470664558	MANAGEMENT	NE	GSH	C CORPORATION	25289	1443049	1
HEALTHCARE MGMT SERVICES ORG INC
1149 MARKET ST	TACOMA	WA	98402	911865474	HEALTH ORG.	WA	FHS	C CORPORATION	0	0	1
JAMES & HENRIETTA NISTLER UNITRUST
30 WEST 7TH STREET	DICKINSON	ND	58601	206021899	INVESTMENTS	ND	SJHHC	TRUST	-16708	41455	1
JEANNE DEYLE CHARITABLE REMAINDER UNITRUST
PO BOX 1810	KEARNEY	NE	68848	476192398	INVESTMENTS	NE	GSHF	TRUST	4880	166320	1
JOSEPH A SCHUSTER ANNUITY TRUST #1
400 UNIVERSITY AVENUE	DES MOINES	IA	50314	421195122	INVESTMENTS	IA	MFDM	TRUST	18924	441488	1
LODESCA MILLER CHARITABLE REMAINDER UNITRUST
PO BOX 1810	KEARNEY	NE	68848	476186933	INVESTMENTS	NE	GSHF	TRUST	3387	86367	1
MEDQUEST
1301 15TH AVENUE WEST	WILLISTON	ND	58801	450392137	SALE OF DME	ND	MH OF WILLISTON	C CORPORATION	9852	962554	1
MERCY HEALTH SERVICES CORPORATION
2727 MCCLELLAND BLVD	JOPLIN	MO	64804	431457881	DME	MO	ST JOHN'S RMC	C CORPORATION	-1533371	1369083	1
MERCY PARK APARTMENTS LTD
1111 6TH AVENUE	DES MOINES	IA	50314	421202422	HOUSING	IA	CHI-IA CORP	C CORPORATION	264489	1796053	1
MERCY SERVICES CORP
2700 STEWART PARKWAY	ROSEBURG	OR	97470	930824308	RETAIL SALES	OR	MMC	C CORPORATION	-690267	954798	1
MOUNTAIN MANAGEMENT SERVICES INC
6028D SHALLOWFORD ROAD	CHATTANOOGA	TN	37422	621570739	MGMT SVC ORG	TN	MHCS	C CORPORATION	-386020	4667998	1
NAZARETH ASSURANCE COMPANY
76 ST PAUL STREET SUITE 500	BURLINGTON	VT	05401	030304831	INSURANCE	VT	CHI	C CORPORATION	-379	123535	1
PATIENT TRANSPORT SERVICES INC
1700 EDISON DRIVE	MILFORD	OH	45150	311100798	HOME HEALTH	OH	ANC	C CORPORATION	662425	5325941	1
PHYSICIAN HEALTH SYSTEM NETWORK
1149 MARKET ST	TACOMA	WA	98402	911746721	HEALTH ORG.	WA	FHS	C CORPORATION	0	0	1
RAY & SHIRLEY DAVID 1999 UNITRUST
30 WEST 7TH STREET	DICKINSON	ND	58601	206037077	INVESTMENTS	ND	SJHHC	TRUST	1250	24194	1
ROBERT & WANDA CHARITABLE REMAINDER UNITRUST
PO BOX 1810	KEARNEY	NE	68848	266191916	INVESTMENTS	NE	GSHF	TRUST	13030	537775	1
SAINT CLARE''S PRIMARY CARE INC
66 FORD ROAD	DENVILLE	NJ	07834	222441202	BILLING SERVICES	NJ	SCCC	C CORPORATION	-342970	2177166	1
SAMARITAN FAMILY CARE INC
40 W FOURTH ST 1700	DAYTON	OH	45402	311299450	HEALTHCARE	OH	SHP	C CORPORATION			1
SJH SERVICES CORPORATION
198 INVERNESS DRIVE WEST	ENGLEWOOD	CO	80112	232307408	HEALTHCARE	CO	FSI	C CORPORATION	-518360	3180100	1
SJL PHYSICIAN MANAGEMENT SERVICES INC
424 LEWIS HARGETT CR 160	LEXINGTON	KY	40503	270164198	MANAGEMENT	KY	SJHS	C CORPORATION	0	0	1
ST ANTHONY DEVELOPMENT COMPANY
1415 SOUTHGATE	PENDLETON	OR	97801	931216943	ATHLETIC CLUB	OR	ST ANTHONY H	C CORPORATION	53891	3007554	1
ST VINCENT COMMUNITY HEALTH SERVICES INC
TWO ST VINCENT CIRCLE	LITTLE ROCK	AR	72205	710710785	HEALTHCARE	AR	SVIMC	C CORPORATION	2309129	14049375	1
ST JOSEPH DEVELOPMENT COMPANY
1717 SOUTH J STREET	TACOMA	WA	98405	911480569	RENTAL	WA	FSI	C CORPORATION	-36395	12168022	1
ST JOSEPH OFFICE PARK ASSOCIATION
1401 HARRODSBURG ROAD BLDG B70	LEXINGTON	KY	40504	611079899	MANAGEMENT	KY	SJHS	C CORPORATION	16644	882139	0.85
TOM DEYLE CHARITABLE REMAINDER UNITRUST
PO BOX 1810	KEARNEY	NE	68848	476192393	INVESTMENTS	NE	GSHF	TRUST	4884	166321	1
TOWSON MANAGEMENT INC
7601 OSLER DRIVE	TOWSON	MD	21204	521710750	MANAGEMENT SERVICES	MD	FSI	C CORPORATION	-469016	498393	1

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	true	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	true	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	true	SharingOfFacilities
Sharing Of Paid Employees	true	SharingOfPaidEmployees
Reimbursement Paid To Other Org	true	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	true	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	true	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
CATHOLIC HEALTH INITIATIVES
L	1478067	FMV
ST ELIZABETH REGIONAL MEDICAL CENTER
P	149022	FMV
CATHOLIC HEALTH INITIATIVES
Q	149628	FMV