CATHOLIC HEALTH INITIATIVES COLORADO: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
CATHOLIC HEALTH INITIATIVES COLORADO (EIN 84-0405257)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-16
IRS object ID
201121369349302937
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-16T13:34:15-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CATHOLIC HEALTH INITIATIVESBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1198 INVERNESS DRIVE WESTAddressLine1
CityENGLEWOODCity
StateCOState
ZIP Code80112ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN840405257EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CATHOLIC HEALTH INITIATIVES-COLORADOBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCATHNameControl
Phone3032906500Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1188 Inverness Dr W Ste 500AddressLine1
CityEnglewoodCity
StateCOState
ZIP Code80112ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRANDY SAFADYName
TitleEVP-CFOTitle
Date Signed2011-05-16DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMARK STOCKIName
Phone7208741500Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGary CampbellNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1188 Inverness Dr W Ste 500AddressLine1
CityENGLEWOODCity
StateCOState
ZIP Code80112ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1309188618GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501cXOrganization501c
Web SiteWWW.CENTURA.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1968YearFormation
State Legal DomicileCOStateLegalDomicile
Activity Or Mission DescriptionCatholic Health Initiatives-Colorado is a faith based organization that invests in charity care, community programs and sponsorships designed to nuture the health of the people of Colorado.ActivityOrMissionDescription
Nbr Voting Members Governing Body2NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees8878TotalNbrEmployees
Total Nbr Volunteers1903TotalNbrVolunteers
Total Gross UBI3790347TotalGrossUBI
Net Unrelated Business Txbl Income-227419NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year7321470ContributionsGrantsPriorYear
Contributions Grants Current Year5982890ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1213905929ProgramServiceRevenuePriorYear
Program Service Revenue CY1278868064ProgramServiceRevenueCY
Investment Income Prior Year-3156703InvestmentIncomePriorYear
Investment Income Current Year12219220InvestmentIncomeCurrentYear
Other Revenue Prior Year8705672OtherRevenuePriorYear
Other Revenue Current Year10416508OtherRevenueCurrentYear
Total Revenue Prior Year1226776368TotalRevenuePriorYear
Total Revenue Current Year1307486682TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year986225GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1070056GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year429980884SalariesEtcPriorYear
Salaries Etc Current Year445908679SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year770963630OtherExpensePriorYear
Other Expenses Current Year810045737OtherExpensesCurrentYear
Total Expenses Prior Year1201930739TotalExpensesPriorYear
Total Expenses Current Year1257024472TotalExpensesCurrentYear
Revenues Less Expenses Prior Year24845629RevenuesLessExpensesPriorYear
Revenues Less Expenses CY50462210RevenuesLessExpensesCY
Total Assets BOY1487552102TotalAssetsBOY
Total Assets EOY2684130347TotalAssetsEOY
Total Liabilities BOY541265497TotalLiabilitiesBOY
Total Liabilities EOY1692285079TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY946286605NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY991845268NetAssetsOrFundBalancesEOY
Mission DescriptionWe extend the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense1049969049Expense
Grants1070056Grants
Revenue1279185878Revenue
DescriptionSee Schedule HDescription
Total Program Service Expense1049969049TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees8878NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members2NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKyle EngmanNamePerson
Telephone Number3038048108TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1188 Inverness Drive West 500AddressLine1
CityEnglewoodCity
StateCOState
ZIP Code80112ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Colleen Blye
Board Member/EVP CHI CFO1.0X1034338154237
John DiCola
Board Member/SVP1.0X730610135191
Michael Rowan
Board Member/EVP COO CHI1.0X1315743184636
Gary Campbell
CEO/President1.0X0
Kris Ordelheide
Secretary/SVP Legal Svcs1.0X0
Randolph Safady
EVP CFO/Treasurer1.0X0
Todd Folkenberg
VP Ops - St Anthony40.030157228810X
Peter Makowski
CEO - St Anthony Hospitals40.082384569422X
James O'Connell
Exec Liason - Comm Outreach40.037512583514X
Daniel Reeves
CFO of Penrose St Francis40.025500216845X
Margaret Sabin
CEO - Penrose St Francis40.022137542099X
David Thompson
CFO - St Anthony Central40.044598324044X
Jameson Smith
COO - Penrose St Francis40.030628263033X
Michael Drewek
Physician40.027279721543X
A Stewart Levy
Physician40.025766867471X
John Mehall
Physician40.038671708010X
John Nichols
Physician40.043365662997X
Dirk Pikaart
Physician40.023368688806X
FieldValueIRS element (for citing)
Total Reportable Comp From Org6376594TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3080691TotalReportableCompFrmRltdOrgs
Total Other Compensation905429TotalOtherCompensation
Number Individuals GT100 K326NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcestrueCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Triage Consulting Group
221 Main St Suite 1100San FranciscoCA94105Collections1511878
Colorado Springs Surgical Associate
555 N Nevada Suite 5015Colorado SpringsCO80907Physician1473266
SE Colorado Lithotripsy LP
6242 E 41st St Dept 2721TulsaOK74182Physician1425000
North Metro Anesthesia
4323 S Holly StEnglewoodCO80111Physician1360632
Audubon Orthotic Prosthetic
3030 N Circle Dr Suite 110Colorado SpringsCO80909Physician1325413
FieldValueIRS element (for citing)
Number Of Contractors GT100 K197NumberOfContractorsGT100K
Related Organizations5263912RelatedOrganizations
Government Grants441929GovernmentGrants
All Other Contributions277049AllOtherContributions
Total Contributions5982890TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Patient Services90009912712466461271246646
Rental Income90009970883067088306
Education611710618331618331
Equity changes of unconsolidated orgs900099-85219232595-317814
FieldValueIRS element (for citing)
Total Program Service Revenue1278868064TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column11517352TotalRevenueColumn
Exclusion$11,517,352ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real374805Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real6541Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real368264Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column368264TotalRevenueColumn
Unrelated Business Revenue7200UnrelatedBusinessRevenue
Exclusion$361,064ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities83758Securities
Other1725017Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other1106907Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities83758Securities
Other618110Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column701868TotalRevenueColumn
Exclusion$701,868ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory861687GrossSalesOfInventory
Cost Of Goods Sold588488CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column273239TotalRevenueColumn
Exclusion$273,239ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Pharmacy Services44611035103093250176$260,133
Cafeteria7221003287085198271$3,088,814
Services Sold9000992053977633940$1,420,037

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column923634TotalRevenueColumn
Unrelated Business Revenue18574UnrelatedBusinessRevenue
Exclusion$905,060ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue9775005TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1307486682TotalRevenueColumn
Related Or Exempt Function Income1279185878RelatedOrExemptFunctionIncome
Unrelated Business Revenue3790347UnrelatedBusinessRevenue
Exclusion$18,527,567ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1054636Total
Program Services1054636ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total15420Total
Program Services15420ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total358675897Total
Program Services286940718ProgramServices
Management And General71735179ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total19709288Total
Program Services15767430ProgramServices
Management And General3941858ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total41556559Total
Program Services33245247ProgramServices
Management And General8311312ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total25966935Total
Program Services20773548ProgramServices
Management And General5193387ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total52066359Total
Program Services41653087ProgramServices
Management And General10413272ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total58670Total
Management And General58670ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total236712708Total
Program Services189370167ProgramServices
Management And General47342541ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3284787Total
Program Services2857420ProgramServices
Management And General427367ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total200534570Total
Program Services185376145ProgramServices
Management And General15158425ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total20214473Total
Program Services16395130ProgramServices
Management And General3819343ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total2031064Total
Program Services1624851ProgramServices
Management And General406213ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1284471Total
Program Services1027577ProgramServices
Management And General256894ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total6359074Total
Program Services6359074ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total56484216Total
Program Services45187373ProgramServices
Management And General11296843ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total12694490Total
Program Services10155592ProgramServices
Management And General2538898ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad debts148404194148404194
Income/sales/property taxes49977671399821379995534
Repairs and maintenance16223099129784814925251
Dues & subscriptions16719111337529334382
Recruitment and relocation1233713461680772033

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total810267Total
Program Services682246ProgramServices
Management And General128021ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1257024472Total
Program Services1049969049ProgramServices
Management And General207055423ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY80875335BOY
EOY27364168EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY145134BOY
EOY67740EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY188551800BOY
EOY180059121EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY3232912BOY
EOY2906720EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY26667507BOY
EOY26542203EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3485711BOY
EOY3324096EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1527392391LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec589677496LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY746342750BOY
EOY937714896EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY4838865BOY
EOY5253524EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY30040593BOY
EOY26862722EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY1767642BOY
EOY640985EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY401603853BOY
EOY1473394172EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1487552102BOY
EOY2684130347EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY94546412BOY
EOY138700365EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY1861759BOY
EOY5975588EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1030137BOY
EOY295269EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY443827189BOY
EOY1547313857EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY541265497BOY
EOY1692285079EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY946286605BOY
EOY991845268EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY946286605BOY
EOY991845268EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1487552102BOY
EOY2684130347EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$18,659GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB18659TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
Identifier990 Sch C SupplementalIdentifier
Return ReferenceLobbying ActivitiesReturnReference
ExplanationTHE ENTITY'S CONTROLLING ORGANIZATION, CATHOLIC HEALTH INITIATIVES, PAYS ANNUAL DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND CATHOLIC HOSPITAL ASSOCIATION (CHA), A PORTION OF WHICH IS ALLOCATED TO LOBBYING. A PORTION OF THE AMOUNT SHOWN IN LINE 1F ABOVE REPRESENTS THIS ENTITY'S SHARE OF ALLOCATED LOBBYING EXPENSES: AHA $10,864; CHA $7,795Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis57186840OtherCostOrOtherBasis
Book Value57186840BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1882025InvestmentCostOrOtherBasis
Other Cost Or Other Basis596220392OtherCostOrOtherBasis
Depreciation218062656Depreciation
Book Value380039761BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis7793037InvestmentCostOrOtherBasis
Other Cost Or Other Basis211396816OtherCostOrOtherBasis
Depreciation143458760Depreciation
Book Value75731093BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis135643InvestmentCostOrOtherBasis
Other Cost Or Other Basis197984367OtherCostOrOtherBasis
Depreciation139296449Depreciation
Book Value58826561BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis454793272OtherCostOrOtherBasis
Depreciation88862631Depreciation
Book Value365930641BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings937714896TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
INTERCOMPANY RECEIVABLE1410896939
INV IN UNCONSOLIDATED ORGS60835905
ASSETS HELD FOR SALE-SUMMIT1661328
FieldValueIRS element (for citing)
Total Book Value Other Assets1473394172TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
ESTATE PLAN/HEALTH PLAN LIAB.$1,439,558
FUTURE SERVICE OBLIGATION$1,330,623
INTERCOMPANY PAYABLES$1,523,800,824
WORKERS COMP/UE CLAIMS LIAB.$188,867
ASBESTOS REMOVAL$8,260,297
OTHER LIABILITIES$12,293,688
FieldValueIRS element (for citing)
Total Of Amounts1547313857TotalOfAmounts
Total Revenue1307486682TotalRevenue
Total Expenses1257024472TotalExpenses
Excess Or Deficit For Year50462210ExcessOrDeficitForYear
Net Unrealized GL On Investments238675NetUnrealizedGLOnInvestments
Prior Period Adjustments547678PriorPeriodAdjustments
Other-$5,689,900OtherAmount
Total Adjustments-4903547TotalAdjustments
Excess Or Deficit Per FS45558663ExcessOrDeficitPerFS

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
REPORTING OF LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48schedule d, part xCATHOLIC HEALTH INITIATIVES - COLORADO's financial information is included in the consolidated audited financial statements of Catholic Health Initiatives (CHI), a related organization. CHI's FIN 48 footnote for the year ended June 30, 2010 reads as follows: "CHI is a tax-exempt Colorado corporation and has been granted an exemption from federal income tax under Section 501(c)(3) of the Internal Revenue Code. CHI owns certain taxable subsidiaries and engages in certain activities that are unrelated to its exempt purpose and therefore subject to income tax. Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the consolidated financial statements."
OTHER ADJUSTMENTSSCH D, PART XI, LINE 8CAPITAL RESOURCE POOL ALLOCATIONS $(7,304,328) EQUITY ADJUSTMENT BRECKENRIDGE MED CTR 1,676,299 OTHER ADJUSTMENTS (61,871) ----------- TOTAL $(5,689,900)

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense56609761TotalCommunityBenefitExpense
Direct Offsetting Revenue6577364DirectOffsettingRevenue
Net Community Benefit Expense50032397NetCommunityBenefitExpense
Percent Of Total Expense0.04510PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense80724617TotalCommunityBenefitExpense
Direct Offsetting Revenue45928379DirectOffsettingRevenue
Net Community Benefit Expense34796238NetCommunityBenefitExpense
Percent Of Total Expense0.03140PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense34628340TotalCommunityBenefitExpense
Direct Offsetting Revenue24355750DirectOffsettingRevenue
Net Community Benefit Expense10272590NetCommunityBenefitExpense
Percent Of Total Expense0.00930PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense171962718TotalCommunityBenefitExpense
Direct Offsetting Revenue76861493DirectOffsettingRevenue
Net Community Benefit Expense95101225NetCommunityBenefitExpense
Percent Of Total Expense0.08580PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense4515710TotalCommunityBenefitExpense
Direct Offsetting Revenue1613543DirectOffsettingRevenue
Net Community Benefit Expense2902167NetCommunityBenefitExpense
Percent Of Total Expense0.00260PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense7704017TotalCommunityBenefitExpense
Direct Offsetting Revenue2892751DirectOffsettingRevenue
Net Community Benefit Expense4811266NetCommunityBenefitExpense
Percent Of Total Expense0.00430PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1824664TotalCommunityBenefitExpense
Direct Offsetting Revenue346174DirectOffsettingRevenue
Net Community Benefit Expense1478490NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense5289TotalCommunityBenefitExpense
Net Community Benefit Expense5289NetCommunityBenefitExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense197204TotalCommunityBenefitExpense
Direct Offsetting Revenue10650DirectOffsettingRevenue
Net Community Benefit Expense186554NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense14246884TotalCommunityBenefitExpense
Direct Offsetting Revenue4863118DirectOffsettingRevenue
Net Community Benefit Expense9383766NetCommunityBenefitExpense
Percent Of Total Expense0.00840PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense186209602TotalCommunityBenefitExpense
Direct Offsetting Revenue81724611DirectOffsettingRevenue
Net Community Benefit Expense104484991NetCommunityBenefitExpense
Percent Of Total Expense0.09420PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served542PersonsServed
Total Community Building Expense204876TotalCommunityBuildingExpense
Net Community Building Expense204876NetCommunityBuildingExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Total Community Building Expense165956TotalCommunityBuildingExpense
Net Community Building Expense165956NetCommunityBuildingExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense815TotalCommunityBuildingExpense
Net Community Building Expense815NetCommunityBuildingExpense

Other Other

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense15759TotalCommunityBuildingExpense
Net Community Building Expense15759NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served542PersonsServed
Total Community Building Expense387406TotalCommunityBuildingExpense
Net Community Building Expense387406NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$37,057,228BadDebtExpenseAmount
Amount Reimbursed By Medicare246536197AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare310039546CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-63503349MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part V Form990ScheduleHPartV (47 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr24 HoursEr24HoursOtherOtherResearch FacilityResearchFacility
St Anthony Central Hospital
4231 W 16th AveDenverCO80204XXXX
St Anthony North Hospital
2551 W 84th AveWestminsterCO80031XXXX
St Anthony Summit Medical Center
340 Peak One DriveFriscoCO80443XXX
St Anthony Hospital
11600 West 2nd PlaceLakewoodCO80228SAC replacement to open June 2011
Senior Health Center West
1601 Lowell BlvdDenverCO80204primary care geriatrics
Intermountain Neuro Physicians
4231 W 16th AveDenverCO80204outpatient neuro
St Anthony Granby Medical Center
480 E Agate AvenueGranbyCO80446primary care urgent care/ER
St Anthony 7 Mile Medical Clinic
145 Parsenn Rd PO Box 1285Winter ParkCO80482primary care urgent care
St Anthony Copper Mountain Clinic
860 Copper RdCopper MountainCO80443primary care urgent care
St Anthony Keystone Medical Clinic
1252 County Road 8KeystoneCO80435primary care urgent care/ER
Breckenridge Medical Clinic
555 S Park Ave Plaza II PO Box 690BreckenridgeCO80424primary care urgent care/ER
Senior Health Center North
8510 Bryant St Suite 350WestminsterCO80031primary care clinic geriatrics
Family Medicine Clinic North
8510 Bryant St Suite 210WestminsterCO80031primary care clinic residency facility
Women's Health Specialists
8510 Bryant St Suite 500WestminsterCO80031women's care clinic
North Vista Medical Group
1333 W 120th Ave Suite 307WestminsterCO80234primary care
North Vista Medical Group
1333 W 120th Ave Suite 307WestminsterCO80234outpatient clinic
Primary Care Services
4231 W 16th AveDenverCO80204primary care clinic
Psychiatric Services
4231 W 16th AveDenverCO80204outpatient clinic
Peak One Surgery Center
340 Peak One DriveFriscoCO80443ambulatory surgery center
St Anthony Health Center Evergreen
1520 Evergreen PkwyEvergreenCO80439Physician practice
North Metro Internal Medicine
51 West 84th AvenueThorntonCO80260Physician practice
Associated Surgeons
2460 West 26th Ave Suite 420CDenverCO80211General Surgery
Chambers Specialty Surgical Care
4231 W 16th AveDenverCO80204General Surgery
Summit Cardiology
360 Peak One Dr 390FriscoCO80443Cardiology Practice
Villas at Sunny Acres
2501 East 104th AveThorntonCO80233Skilled Nursing Fac. Assted. Living Indep. Living
Gardens at St Elizabeth
2835 West 32nd AveDenverCO80211Indep. Living Assted. Living Memory Care/Day Care
Medalion Retirement Community
1719 East Bijou StColo SpringsCO80909Skilled Nursing Fac. Assted. Living Indep. Living
Namaste Alzheimer Center
2 Penrose BoulevardColo SpringsCO80906Alzheimer's Care Adult Day Care
Villa Pueblo Senior Living Community
1111 Bonforte BlvdPuebloCO81001Skilled Nursing Fac. Assted. Living Indep. Living
Progressive Care Center
1338 Phay AveCanon CityCO81212Skilled Nursing Fac. Respite Care Memory Care
Centura Home Infusion
1391 Speer Blvd 600DenverCO80204Pharmacy Servicing Homebound Infusion Patients
Centura Home Oxygen-Denver
2590 W 2nd Ave Suite 5DenverCO80219Home Medical Equip Servicing Homebound Oxygen Patients
Centura Home Oxygen-Colorado Springs
4260 Buckingham Dr 100Colorado SpringsCO80907Home Medical Equip Servicing Homebound Oxygen Patients
Centura Home Oxygen-Pueblo
4025 Club Manor DrivePuebloCO81008Home Medical Equip Servicing Homebound Oxygen Patients
St Anthonys Hospice
1391 Speer Blvd 600DenverCO80204Admin Office Home Hospice Coordination
Penrose Home Care
7015 Tall Oaks DriveColorado SpringsCO80919Admin Office Home Care Coordination
St Mary Corwin Home Services
4025 Club Manor DrivePuebloCO81003Admin Office Home Care Coordination
Mercy Home Health
One Mercado Street 270DurangoCO81301Admin Office Home Care Coordination
Hospice of Mercy
One Mercado Street 270DurangoCO81301Admin Office Home Hospice Coordination
Penrose Hospital
2222 N Nevada AveColorado SpringsCO80907XXXXICU & CCU Cancer Center IP RehabX
Total Health Care
2222 N Nevada AveColorado SpringsCO80907OP Rehab Clinic Property Management CCOM
StFrancis Health Center
825 E Pikes Peak AveColorado SpringsCO80904XIP & OP Psych Sleep Lab Wound Clinic
Penrose Community Hospital
3205 N Cascade AveColorado SpringsCO80917OP Clinic Urgent Care No IP Services
Penrose Mountain Urgent Care Clinic
41 State Highway 67Woodland ParkCO80863Urgent Care OP Rehab
St Francis Medica Center
6001 E Woodman RdColorado SpringsCO80923XXXBirth Center NICU - IIIA ICU
St Thomas More Hospital
1338 Phay AvenueCanon CityCO81212XXX
ST MARY-CORWIN MEDICAL CENTER
1008 MINNEQUA AVEPUEBLOCO81004XXXXFamily Practice Clin Residency Program 6 employed physician

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaIf applicable, describe the income-based criteria for determining eligibility for free or discounted care under the organization's charity care policy. Also describe whether the organization uses the asset test or other threshold regardless of income to determine eligibility for free or discounted care. CHI Colorado has an established charity care policy based on the Federal Poverty Level. Charity is provided to patients based on a sliding scale that considers the patient's family size and income level. The charity provided ranges from 100% of the patient's bill for individuals whose household income is at 100% or less of the Federal poverty level, to a 60% deduction for individuals whose income is at 400% of the Federal poverty level. In addition, CHI Colorado takes into account specific facts and circumstances in granting charity in situations such as a catastrophic illness where the patient does not have liquid assets.IncomeBasedCriteria
Annual Community Benefit ExplnIf the organization's community benefit report is contained in a report prepared by a related organization, rather than a separate report prepared by the organization, identify the related organization. CHI Colorado is operated by Centura Health Corporation (CHC). CHC prepares its own written community benefit report which includes the activities of CHI Colorado and other entities managed by CHC. The annual report is published on Centura's website and available to anyone interested.AnnualCommunityBenefitExpln
Costing Method UsedProvide 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. CHI Colorado does not use a cost accounting system to determine the cost of charity care provided. The estimated cost of care is calculated by applying the ratio of each facility's total expenses to total gross revenue. Worksheet 2 was not used to develop the cost to charge ratio.CostingMethodUsed
Subsidized Health Services ExplnTo the extent that the organization included any costs associated with physician clinics as subsidized health services in Part I, line 7g it must describe that it has done so and report in Part VI such costs included in part I, line 7g, line 1 There are no physician clinics included in subsidized health services.SubsidizedHealthServicesExpln
Percent Of Total Expense ExplnIf applicable, state the bad debt expense included on Form 990 Part IX, line 25, column (A) but subtracted for purposes of calculating the percentage in this column. CHI Colorado recorded $148 million in bad debt expense for the fiscal year. The bad debt expense recorded, while included in functional expenses, was excluded from the calculation of community benefit expense.PercentOfTotalExpenseExpln
Bad Debt FootnoteProvide 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. 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 charity care policy, if sufficient information has been available to make a determination as to their eligibility. 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. CHI Colorado uses the overall cost to gross charge ratio applicable to each facility to determine the costs in Part III lines 2 and 3. CHI Colorado automatically discounts all self pay patient accounts by 30% and also offers a prompt pay discount. This allowance is not included in the calculation of the cost of bad debts in instances where a patient does not pay his or her bill. CHI Colorado provides information to patients at the time of registration with respect to its financial assistance policies. However, in some instances patients do not complete the necessary forms to apply for financial assistance. As a result, CHI Colorado uses an outside vendor to assist in determining a patient's eligibility for financial assistance. This includes a review of the patient's financial situation based on the vendor's database of external information. In instances where the review indicates that the patient qualifies for financial assistance, CHI Colorado adjusts the patient's bill to match its charity policy and does not pursue collection from the patient for the portion of the patient's obligation that qualifies for charity. CHI Colorado is consolidated with it's parent company, Catholic Health Initiatives and the Bad debt 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 periodically 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."BadDebtFootnote
Shortfall As Community BenefitDescribe 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. Describe, if applicable, the extent to which any shortfall reported in Part III, line 7 should be treated as a community benefit, and the rationale for the organization's position. CHI Colorado does not treat Medicare shortfalls as community benefit. CHI Colorado's position is consistent with that of CHI, its Sponsor. Medicare is not a differentiating feature of how tax-exempt health care organizations and for-profit hospitals treat and attempt to attract Medicare beneficiaries. CHI Colorado believes that excluding Medicare losses from community benefit makes the overall community benefit report more credible for these reasons: Unlike subsidized areas such as burn units or behavioral-health services, Medicare is not a differentiating feature of tax-exempt health care organizations. In fact, for-profit hospitals focus on attracting patients with Medicare coverage, especially in the case of well-paid services that include cardiac and orthopedics. Significant effort and resources are devoted to ensuring that hospitals are reimbursed appropriately by the Medicare program. The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency, carefully studies Medicare payment and the access to care that Medicare beneficiaries receive. The commission recommends payment adjustments to Congress accordingly. Though Medicare losses are not included by Catholic hospitals as community benefit, the Catholic Health Association guidelines allow hospitals to count as community benefit some programs that specifically serve the Medicare population. For instance, if hospitals operate programs for patients with Medicare benefits that respond to identified community needs, generate losses for the hospital, and meet other criteria, these programs can be included in the CHA framework in Category C as "subsidized health services." Medicare losses are different from Medicaid losses, which are counted in the CHA community benefit framework, because Medicaid reimbursements generally do not receive the level of attention paid to Medicare reimbursement. Medicaid payment is largely driven by what states can afford to pay, and is typically substantially less than what Medicare pays.ShortfallAsCommunityBenefit
Debt Collection PolicyIf 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 charity care or financial assistance, whether or not such practices apply specifically to such patients or more broadly to also cover other types of patients. CHI Colorado's debt collection policy provides the performance of a reasonable review of each patient's account prior to turning an account over to a third-party collection agent and prior to instituting any legal action for non-payment. The review of patient accounts is done to assure that the patient or their guarantor is not eligible for assistance through CHI Colorado's charity care policy, uninsured discount policy or another financial assistance program (i.e. Medicaid). CHI Colorado requires the following of its third-party collection agencies: * Neither CHI Colorado hospitals or their collection agencies will request bench or arrest warrants as a result of non-payment; * Neither CHI Colorado hospitals or their collection agencies will seek liens that would require the sale or foreclosure of a primary residence; and * No CHI Colorado collection agency may seek court action without hospital approval.DebtCollectionPolicy
Number Of Facility Type ExplnList the number of each type of facility, other than those required to be licensed, registered or similarly recognized as a health care facility under state law (for example, 2 rehabilitation clinics, 4 diagnostic centers, 3 skilled nursing facilities, etc) Approximately 35 physician practices 5 independent living facilities 2 facilities that offer adult day careNumberOfFacilityTypeExpln
Needs AssessmentDescribe how the organization assesses the health care needs of the communities it serves. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves. Describe how the organization's community building activities, as reported in Part II, promote the health of the communities the organization serves. Provide any other information important to describing how the organization's hospitals or other health care facilities further its exempt purpose by promoting health of the community (e.g. open medical staff, community board, use of surplus funds, etc). Community Benefit Annual Report FY 2010 Summary Introduction Catholic Health Initiatives Colorado ("CHIC")is a faith-based, nonprofit health care entity, operating 8 hospital campuses in Colorado. Since their earliest days, CHIC hospitals have placed an emphasis on whole person care and on illness prevention. In addition, CHIC hospitals have preserved an unwavering commitment to their values and an understanding of the vital role that ministering to spiritual needs can play in health care. Committed to the mission of continuing the healing ministry of Christ, CHIC builds upon its unique history, heritage and traditions by creating a faith-based entity designed to advance the mission of their individual hospital facilities. Today, CHIC is comprised of: St. Anthony Central, Denver St. Anthony North, Westminster St. Anthony Summit Medical Center, Frisco Penrose, St. Francis Medical Center, Colorado Springs St. Francis Health Center, Colorado Springs St. Mary Corwin, Pueblo St. Thomas More, Canon City In keeping with our mission, CHIC hospitals provide care for all individuals regardless of ability to pay. In fiscal year 2010, CHIC gave $104.5 million to underprivileged individuals and the broader community in charity care, community education and outreach, and unpaid costs of Medicaid. Community Outreach provided to the Low Income Population Medicaid Program Enrollment: Screening uninsured patients to determine eligibility and facilitate enrollment in Medicaid, Medicare or Charity program. NurseFamily Partnership Program: Home visits to pregnant and parenting patients to ensure a good pregnancy and appropriate early childhood development through baby's third year. Pastoral Nurse Program: Health education and preventive care to low-income, uninsured and underserved populations. RX Assist - Ben Checkup- Prescription & Benefits Assistance Pharmaceutical discount counseling for seniors. School Based Health Center: Clinic within Denver Public Schools, providing physical and mental health care to the students of Lake Middle School and five feeder elementary schools. Mission Outreach Committee Projects: Various cash and in kind donation projects conducted to assist community members. Pharmaceutical Supplies Donation: Donations of Pharmaceutical and Medical supplies for the underprivileged. Pharmacy Discounted Prescription Program: Discount pricing for uninsured/underinsured community members. Compensated Rooms for Boarder Mothers of Newborns: Overnight stays, without charge, for mothers who need to be near hospitalized infants. Diabetes Education: Provide Diabetes Education to patients of the Family Medicine Residency program. Doula Program: Provides birth coaches for Spanish speaking women to facilitate the birth process in a culturally and linguistically appropriate manner, minimizing complications. Community Outreach for the Broader Community Ask-a Nurse Calls: Free health information and physician referral service for our community. Nurses also assess health conditions from neck pain to a fever, and give free professional advice on what action to take next. This program provides information and registration for hospital classes and events. Car Seat Fit Stations: Inspect car seat installations and educate parents regarding Colorado Laws regarding car seats. Car seats are provided for a minimum donation. Career Expos: Introduce students to the opportunities in healthcare and explain requirements for those positions. CPR Education Program: Prepare students for potential life threatening situations in public, home or while baby sitting. Education - Women's Services: Classes related to childbirth preparation and caring for a new baby. Health Fairs for the Community: Hospital Staff provide screenings and other health educational opportunities. Project Cure: Collection of Medical Supplies and Equipment is palletized and shrink wrapped for donation. SANE Program: Clinical examinations and forensic evidence collection for victims of sexual assault. Blood Drives: Hospital employees donate their blood to the Bonfils Blood Center Advance Medical Directive Education: Provide literature and forms to educate the public regarding their options for end of life medical care. Student Precepting: Provide a clinical setting and supervision by licensed staff for students of various health care positions (i.e. Nursing, EMT, Therapists) to complete their required clinical experience. First Aid Services at Community Events: Provide first aid services throughout the community. Transportation Services: Provide transportation to patients and patient families. Yaffee House/John Zay House: Provide lodging, at no cost, for out of area patients receiving out-patient care and for the family members of hospitalized patients. Various Health Screening, Counseling and Education Activities: CHIC Hospitals conduct numerous events and health screenings throughout the communities they serve to promote health awareness and encourage individuals to assume a partnership role in responsibility for maintaining health. These events include Sports Physicals, Behavioral Health Education, Flu Shot Clinics, Cancer Risk Assessments, Nutrition Services, Blood Pressure Checks, Child Safety, Managing Diabetes, and Discounted Mammography Screenings.NeedsAssessment
Patient Education AssistanceDescribe 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 charity care policy. Information concerning financial assistance is included on Centura's website. The website not only lists phone numbers for patients to call and discuss financial assistance, but also includes Centura's policy for charity care and its policies related to uninsured patients. In addition, at the time of registration, uninsured patients are screened to determine if the patients qualify for any Federal, State or County programs. Uninsured patients are also sent a letter requesting that the patient call to determine eligibility for various assistance programs, including charity.PatientEducationAssistance
Community InformationDescribe the community the organization serves, taking into account the geographic area and demographic constituents it serves. Please refer to the Needs Assessment Narrative, Part VI, Item 2. above.CommunityInformation
Community Building ActivitiesDescribe how the organization's community building activities, as reported in Part II, promote the health of the communities the organization serves. Please refer to the Needs Assessment Narrative, Part VI, Item 2. above.CommunityBuildingActivities
Affiliated Health Care SystemIf 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. Catholic Health Initiatives Colorado is operated as part of Centura Health Corporation ("Centura"). Centura and its affiliated organizations are dedicated to extending the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities. Specifically, Centura has launched a system-wide strategic plan to improve the quality, consistency, availability, and affordability of health care to communities throughout Colorado. The three main components of this strategy are (1) to continue investing in technology advancements that improve the quality, costs, and coordination of care including the establishment of electronic health records linking our physicians, clinics, hospitals, long-term facilities and home care services; (2) providing wellness care, thereby potentially reducing health care costs by helping patients to maintain good health, growing the level of support and outreach provided to rural communities, and increasing access, affordability and quality of health care; and (3) coordinate and develop systems of care, looking to each facility and entity in Centura to share best practices and improve overall efficiency and communication system-wide from birth to home care.AffiliatedHealthCareSystem

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (17 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
CATHOLIC DIOCESE OF PUEBLO FOUNDATION
1001 N GRAND AVEPUEBLOCO81003840797660501(c)323000SPONSORSHIP
CROSSROADS MANAGED CARE
509 E 13th StreetPUEBLOCO81001840810723501(c)315400PROGRAM EXPENSES
COLORADO STATE UNIVERSITY OF PUEBLO
2200 BONFORTE BLVDPUEBLOCO81001840517947501(c)315000SPONSORSHIP
YMCA of the Pikes Peak Region
4025 Family PlaceColorado SpringsCO80920840404266501(c)3101290SPONSORSHIP
American Heart Association
1280 S Parker RdDenverCO80231135613797501(c)312500SPONSORSHIP
University of Colorado
12605 East 16th Ave PO Box 6510Colorado SpringsCO80922846000555501(c)316667SPONSORSHIP
Colorado Springs World Arena
3185 Venetucci BlvdColorado SpringsCO80906841264465501(c)312500SPONSORSHIP
Arrupe Jesuit High School
4343 Utica StDenverCO80204020628872501(c)315000SPONSORSHIP
Project CURE
10377 E Geddes Ave Suite 200CentennialCO80112841568566501(c)3EXPIRED SUPPLIES280227BOOKEXPIRED SUPPLIES
Craig Hospital Foundation
3425 S Clarkson StEnglewoodCO80113840404233501(c)37000SPONSORSHIP
CHI Colorado Foundation
961 E Colorado AvenueColorado SpringsCO80903840902211501(c)3279745PROGRAM EXPENSES
CHEYENNE MOUNTAIN ZOO
4250 Cheyenne Mountain Zoo RdColorado SpringsCO80906840407039501(C)36750sponsorship
HARBOR HOUSE COLLABORATIVE
225 North Weber StCOLORADO SPRINGSCO80903208006412501(c)320833SPONSORSHIP
Pikes Peak Hospice and Foundation
825 E Pikes Peak Ave Ste 600COLORADO SPRINGSCO80903840816047501(c)37500SPONSORSHIP
March Of Dimes
421 South Tejon Ste 311COLORADO SPRINGSCO80903131846366501(c)36500SPONSORSHIP
Pikes Peak Community College
840644739501(c)325000SPONSORSHIP
Colorado Springs Sky Sox
4385 Tutt BlvdCOLORADO SPRINGSCO8092299999999912750SPONSORSHIP
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants16TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrant
PATIENT FINANCIAL ASSISTANCE59114265
EMPLOYEE FINANCIAL ASSISTANCE21155

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSchedule I Part I Q2Identifier
Return ReferenceProcedures for monitoring the use of grantsReturnReference
Explanationgrants are at the discretion of the CHIC CEO. The CEO makes requests for fundings which are paid out in the form of a donation to the entity or used to reimburse an invoice submitted for an expense for a specific purpose. the majority of the donees are 501(c)(3) organizations that assume responsibility for ensuring that the funds are used in furtherance of the purpose of the grant.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrg
Colleen Blye
7434442072328366310646647771118857557993
John DiCola
543231159849275318456450627865801
Michael Drewek
72049910194327279748822
Todd Folkenberg
1841164436333130157258967
A Stewart Levy
865898152142125766893237
Peter Makowski
412720125327313756285665180619528
John Mehall
70714586538671746681
John Nichols
659392152345343365706362
James O'Connell
1227414607732047062102617042
Dirk Pikaart
68791189523368712174
Daniel Reeves
1825513375154325500242345
Michael Rowan
906783262756146204138021466151500379
Margaret Sabin
426353815283421822137564236
David Thompson
26040563112527392813686425317
Jameson Smith
2228963972940830628293661

Form990 Schedule J Part III Form990ScheduleJPartIII (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
BENEFITS PROVIDED TO EXECUTIVESSCH J, PART I, Q 1ASENIOR VPs AND HOSPITAL CEOs ARE PAID THROUGH CENTURA HEALTH CORP AND ARE ELIGIBLE FOR THE FOLLOWING BENEFITS: TRAVEL FOR COMPANIONS, HEALTH OR SOCIAL CLUB DUES, AND REIMBURSEMENT UP TO $10,000 FOR PERSONAL SERVICES SUCH AS TAX, FINANCIAL, AND ESTATE PLANNING SERVICES, ALONG WITH TAX GROSS-UP PAYMENTS FOR ANY REIMBURSEMENTS INCLUDED IN TAXABLE COMPENSATION. ALL BENEFITS ARE PROVIDED PURSUANT TO A WRITTEN POLICY GOVERNING PAYMENT AND REIMBURSEMENT, SUBSTANTIATION IS REQUIRED FOR ALL EXPENSES SUBMITTED FOR REIMBURSEMENT, AND REIMBURSEMENTS ARE INCLUDED IN TAXABLE COMPENSATION WHERE APPROPRIATE.
METHODS USED TO ESTABLISH CEO COMPENSATIONSCH J, PART I, Q 3chic's ceo is paid by centura health corporation (centura). OUTSIDE CONSULTANTS ARE ENGAGED TO PROVIDE RECOMMENDATIONS TO CENTURA'S COMPENSATION COMMITTEE REGARDING THE COMPENSATION OF FACILITY CEOS. THE CONSULTANT'S RECOMMENDATIONS ARE THEN PRESENTED TO AND APPROVED BY THE COMPENSATION COMMITTEE.
POST-TERMINATION PAYMENTSSCH J, PART I, Q4APOST-TERMINATION PAYMENTS ARE ADDRESSED IN THE EXECUTIVE EMPLOYMENT AGREEMENTS FOR CHI'S EXECUTIVES. 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. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM CHI DURING THE 2009 CALENDAR YEAR. in addition, CENTURA HAS A DEFINED SEVERANCE POLICY. SEVERANCE PAYMENTS ARE DETERIMINED BASED ON A COMBINATION OF THE INDIVIDUAL'S POSITION WITHIN THE ORGANIZATION AND YEARS OF SERVICE. SEVERANCE AGREEMENTS INCLUDE LIMITATIONS WITH RESPECT TO WORKING AT COMPETING FACILITIES AND OTHER REQUIREMENTS THAT CAN CAUSE FORFEITURE OF THE SEVERANCE BENEFIT. IN ADDITION, THE AGREEMENTS RELEASE CENTURA FROM LITIGATION AND FUTURE CLAIMS AGAINST THE ORGANIZATION. DURING THE 2009 CALENDAR YEAR ENDED THE FOLLOWING INDIVIDUALS RECEVIED SEVERANCE PAYMENTS: JAMES O'CONNELL $185,410.
SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANSCH J, PART I, Q 4BDURING THE 2009 CALENDAR YEAR, CHI MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR SENIOR VICE PRESIDENTS AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE: COLLEEN BLYE, MICHAEL ROWAN, JOHN DICOLA. TTHE FOLLOWING INDIVIDUALS RECEIVED CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN DURING THE 2009 CALENDAR YEAR: COLLEEN BLYE $106,466; JOHN DICOLA $84,564; MICHAEL ROWAN $138,021. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN DURING THE 2009 CALENDAR YEAR, AND THE FOLLOWING AMOUNTS WERE INCLUDED IN THE INDIVIDUALS' REPORTABLE COMPENSATION FOR SCHEDULE J: COLLEEN BLyE $57,993. IN ADDITION, CENTURA OFFERS A NON-QUALIFIED RETIREMENT PLAN IN WHICH SENIOR EXECUTIVES (SENIOR VPS AND ABOVE) ARE PROVIDED A 10% OF SALARY ALLOWANCE TO PURCHASE INSURANCE PRODUCTS OR CONTRIBUTED INTO THE DEFERRED COMPENSATION PLAN. IN ADDITION, A PENSION RESTORATION BENEFIT IS PROVIDED WHICH CREDITS PARTICIPANTS WITH A BENEFIT WHICH IS CALCULATED BASED ON THE EXCESS OF THE PARTICIPANT'S COMPENSATION OVER THE MAXIMUM ALLOWED FOR PENSION CONTRIBUTIONS. AMOUNTS DEFERRED ARE NOT REPORTED AS TAXABLE INCOME UNTIL/UNLESS A TRIGGERING EVENT OCCURS. THIS DEFERRED COMPENSATION PLAN HAS A SUBSTANTIAL RISK OF FORFEITURE PROVISION AND AN ELECTED VESTING SCHEDULE. THE FOLLOWING INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN AND RECEIVED PAYMENT FROM THE SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN: PETER MACKOWSKI $19,365; JAMES O'CONNELL $233; DAVID THOMPSON $5,317.
NON-FIXED PAYMENTSSCH J, PART I, Q 7PARTICIPANTS IN CENTURA'S INCENTIVE COMPENSATION PLANS INCLUDE DIRECTORS AND ABOVE. PAYOUTS ARE BASED ON METRICS ESTABLISHED AND APPROVED BY CENTURA'S COMPENSATION COMMITTEE. THE METRICS INCLUDE QUANTIFIABLE MEASURES PERTAINING TO FINANCIAL PERFORMANCE, SAFETY AND QUALITY AND ASSOCIATE SATISFACTION WITH EACH METRIC WEIGHTED IN DETERMINING THE OVERALL SCORE. THE INCENTIVE COMPENSATION PAYOUT IS CALCULATED BASED ON THE CUMULATIVE SCORE FOR ALL METRICS AND THE PAYOUT IS BASED ON A COMBINATION OF THE SCORE, THE INDIVIDUAL'S BASE COMPENSATION AMOUNT AND POSITION (E.G. DIRECTOR, VICE PRESIDENT).
REPORTABLE INDIVIDUALS COMPENSATED BY UNRELATED ORGANIZATIONSFORM 990, PART VII, Q 5All key employees and hospital CEO's are compensated by Centura Health Corporation, who manages the daily activities of THE chi-COLORADO Hospitals under a Joint Operating Agreement dated December 8, 1995 between the Adventist Healthcare System and Catholic Health Initiatives. As such, their salaries are paid to them by Centura, an unrelated org, for services rendered in their capacity as key employees or officers of CHIC. All of their reportable compensation is disclosed on Form 990, Schedule J, Part II, Row (i) and 990, Part VII, Column (D) as reporting org compensation. In addition, the CEO AND CFO of chic were appointed as such by the CHIC board of directors. while they are officers of these entities, a very small portion of their time is directly related to the operations of CHIC. They are compensated by Centura, which is charged with managing the facilities. Their respective compensation is not reported on the filing org's 990 but in fact is reported in full on Part VII and Schedule J of Centura Health Corporation's Form 990.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
ANNE SMITH
SPOUSE OF KEY EMPLOYEE59770EMPLOYEE COMPENSTAIONfalse
TODD FOLKENBURG
KEY OF CHIC/BOARD OF HSS2297764HSS IS A VENDOR OF CHICfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
MEMBERS OR SHAREHOLDERSFORM 990, PART VI, Q. 6THE SOLE MEMBER OF THE ORGANIZATION IS CATHOLIC HEALTH INITIATIVES, A COLORADO NONPROFIT CORPORATION.
ELECTION OF BOARD MEMBERSFORM 990, PART VI, Q. 7ATHE SOLE CORPORATE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS. According to the organization's bylaws, the Sole Member shall fill all vacancies on the Board of Trustees created by removal, resignation, or death.
GOVERNING POWERSFORM 990, PART VI, Q. 7BCATHOLIC HEALTH INITIATIVES-COLORADO's ("CHIC") corporate member is Catholic Health Initiatives ("CHI"). Pursuant to the organization's bylaws, the Corporate Member shall have the specific rights set forth in the governance matrix except to the extent otherwise provided in organization's articles and bylaws. Pursuant to the governance matrix 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 CHIC * Amendment of the corporate documents of CHIC * Approve members of the CHIC board * Removal of a member of the governing body of CHIC * Approval of issuance of debt by CHIC * Approval of participation of CHIC in a joint venture * Approval of formation of a new corporation by CHIC * Approval of a merger involving CHIC * Approval of the sale of all or substantially all of the assets of CHIC * To require the transfer of assets by CHIC to CHI to accomplish CHI's goals and objectives, and to satisfy CHI debts * Adoption of long range and strategic plans for CHIC. Pursuant to THE organization's bylaws, CHI may, in exercise of its approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and the President and Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate. In addition, however, pursuant to the affiliation agreement between Catholic Health Initiatives, CHI Colorado, Centura Health Corporation, and Portercare Adventist health system, certain matters affecting CHI Colorado must be approved by both Portercare and CHI. Those items include: * the transfer of assets valued at over $1,000,000 * the issuance of a debt instrument in excess of $250,000 * the amendment of the organizing documents * the admission of a new sponsor * a merger or dissolution or reorganization.
Process Used to review Form 990Form 990, Part VI, Q 11AA draft of the Form 990 is provided to management, including the CFO, for review. The return is e-mailed to the entire board for review prior to filing. After presentation to the board, the tax department files the return with the appropriate federal agencies, making any non-substantive changes necessary to effect e-filing. Any such changes are not re-submitted to the board.
Procedures for monitoring and enforcing the COI policyFORM 990, PART VI, Q. 12CPROCEDURE: 1. PROCEDURE FOR CONFLICT OF INTEREST REPORTING 1.1. THE CATHOLIC HEALTH INITIATIVES - COLORADO ("CHIC") COMPLIANCE DEPARTMENT ADMINISTERS AN ANNUAL CONFLICT OF INTEREST PROCESS (MOST USUALLY STARTING IN NOVEMBER) COLLECTING AND ASSESSING ANY POTENTIAL CONFLICTS BOARD MEMBERS AND RELATED BOARD COMMITTEE MEMBERS, MATERIALS MANAGEMENT/SUPPLY CHAIN AS WELL AS CHIC MANAGEMENT MAY HAVE. THE FOLLOWING PROCESS IS FOLLOWED: 1.1.1. A COVER LETTER ALONG WITH THE CONFLICTS OF INTEREST POLICY AND THE CONFLICTS OF INTEREST DISCLOSURE STATEMENT ARE AUTOMATICALLY GENERATED AND DISTRIBUTED VIA EMAIL UTILIZING THE COMPLY TRACK SURVEY MANAGER TOOL. FOR THOSE WITHOUT EMAIL ADDRESSES, THE DOCUMENTS ARE SENT VIA US MAIL. 1.1.2. A REQUEST IS MADE TO COMPLETE THE DISCLOSURE STATEMENT FROM ONLINE AND SUBMIT AN ELECTRONIC SIGNATURE USING THE SURVEY TOOL. FOR THOSE WITHOUT AN EMAIL ADDRESS, A REQUEST IS MADE TO FAX OR MAIL ORIGINALS TO THE COMPLIANCE DEPARTMENT. 1.1.3. A REPORT IS COMPILED IDENTIFYING ALL REPORTED POTENTIAL CONFLICTS, NO RESPONSES AND NO NOTED CONFLICTS. 1.1.4. THE REPORT IS REVIEWED FOR POTENTIAL CONFLICTS AND CATEGORIZED BY TYPE OF CONFLICT. 1.1.5. A MEMO IS DISTRIBUTED TO EACH FACILITY CEO AND CFO ALONG WITH REPORTED CONFLICTS FOR PROCESSING AND RELEVANT ACTION OR FOLLOW UP. THE CEO OR CFO, ON BEHALF OF THE CEO, WILL DISTRIBUTE INFORMATION ABOUT SPECIFIC CONFLICTS TO RELEVANT DEPARTMENT MANAGEMENT FOR CONSIDERATION IN FUTURE BUSINESS DEALINGS/NEGOTIATIONS. 1.1.6. THE REPORT IS SHARED WITH THE CHIC BOARD FOR INFORMATION, DISCUSSION, AND POSSIBLE ACTION RELATIVE TO SPECIFIC CONFLICTIVE SITUATIONS. 2. PROCEDURE FOR DISCLOSURE 2.1. WHENEVER ANY MATTER COMES BEFORE A MEETING OF THE BOARD, A BOARD COMMITTEE MANAGEMENT OR MATERIALS MANAGEMENT/SUPPLY CHAIN THAT GIVES RISE TO A POTENTIAL CONFLICT OF INTEREST, THE FOLLOWING PROCEDURES SHALL APPLY: 2.1.1. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD, COMMITTEE MEETING OR MANAGEMENT MEETING BUT AFTER SUCH PRESENTATION, HE/SHE SHALL, IF REQUESTED BY THE BOARD OR COMMITTEE, LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. 2.1.2. THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINTS A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. 2.1.3. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER CHIC CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. 2.1.4. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED MEMBERS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN CHIC'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO CHIC AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. 2.1.5. FOR TRANSACTIONS THAT ARE NEGOTIATED BY CHIC MANAGEMENT AND MATERIALS MANAGEMENT/SUPPLY CHAIN AND WHICH ARE NOT REQUIRED TO BE REPORTED TO THE BOARD, EACH MANAGER WILL TAKE PRECAUTIONS TO ENSURE THERE IS NO CONFLICT OR THE APPEARANCE OF CONFLICT RELATIVE TO THE BUSINESS NEGOTIATIONS AND TRANSACTION. IF A CONFLICT, OR THE APPEARANCE OF A CONFLICT EXISTS, THE INTERESTED PERSON WILL REMOVE HIMSELF/HERSELF OR OTHER INTERESTED PARTY FROM THE NEGOTIATIONS/TRANSACTION. 3. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY 3.1. IF THE BOARD, COMMITTEE OR CHIC MANAGEMENT HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE INTERESTED PERSON TO DISCLOSE. 3.2. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD, COMMITTEE OR CHIC MANAGEMENT DETERMINES THAT THE INTERESTED PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. 4. RECORDS OF PROCEEDINGS 4.1. THE MINUTES OF THE BOARD AND ANY COMMITTEES WITH BOARD DELEGATED POWERS SHALL CONTAIN: 4.1.1. THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE CONFLICT, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED, AND 4.1.2. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH AND A RECORD THAT THE PERSON(S) WITH A CONFLICT OF INTEREST DID NOT PARTICIPATE IN THE VOTE. 4.1.3. FOR BUSINESS TRANSACTIONS BEING NEGOTIATED OUTSIDE OF THOSE REQUIRED TO BE REPORTED TO THE BOARD AND ANY COMMITTEES, THE COMPLIANCE DEPARTMENT SHALL MAINTAIN DOCUMENTATION AS TO THE RESOLUTION AND APPROPRIATENESS OF ANY POTENTIAL CONFLICT RELATIVE TO MANAGEMENT AND MATERIALS MANAGEMENT/SUPPLY CHAIN ASSOCIATES CONDUCTING BUSINESS ON BEHALF OF CHIC. 5. COMPENSATION 5.1. A VOTING MEMBER OF A BOARD OR A BOARD COMMITTEE WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM CHIC FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. 5.2. A PHYSICIAN WHO IS A VOTING MEMBER OF A BOARD OR BOARD COMMITTEE AND RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM CHIC FOR SERVICES IS PRECLUDED FROM DISCUSSING AND VOTING ON MATTERS PERTAINING TO THAT MEMBER AND OTHER PHYSICIANS' COMPENSATION. NO PHYSICIAN OR PHYSICIAN BOARD MEMBER OR COMMITTEE MEMBER, EITHER INDIVIDUALLY OR COLLECTIVELY, IS PROHIBITED FROM PROVIDING INFORMATION TO THE BOARD OR BOARD COMMITTEE REGARDING PHYSICIAN COMPENSATION. 6. ANNUAL STATEMENTS 6.1. ALL INTERESTED PERSONS MUST COMPLETE A DISCLOSURE STATEMENT ANNUALLY. THIS DISCLOSURE STATEMENT MAY BE MODIFIED FROM TIME TO TIME AS DEEMED APPROPRIATE. THE VICE PRESIDENT OF CHIC COMPLIANCE IS RESPONSIBLE FOR CIRCULATING, ENSURING COMPLETION OF THE DISCLOSURE STATEMENT BY ALL INTERESTED PERSONS OF CHIC, AND REPORTING THE RESULTS TO THE CHIC HEALTH BOARD. 7. PERIODIC REVIEWS 7.1. ANNUALLY INTERNAL AUDIT WILL REVIEW COMPENSATION AND FINANCIAL ARRANGEMENTS FOR POTENTIAL CONFLICTS OF INTEREST.
PROCESS FOR DETERMINING EXECUTIVE COMPENSATIONFORM 990, PART VI, Q. 15A & 15BTHE ORGANIZATION'S CEO AND OFFICERS ARE EMPLOYED BY CENTURA HEALTH CORPORATION ("CENTURA"). OUTSIDE CONSULTANTS ARE ENGAGED TO PROVIDE RECOMMENDATIONS TO CENTURA'S COMPENSATION COMMITTEE REGARDING THE COMPENSATION OF FACILITY CEOS AND CENTURA SENIOR EXECUTIVES. THE CONSULTANT'S RECOMMENDATIONS ARE THEN PRESENTED TO AND APPROVED BY THE COMPENSATION COMMITTEE. CENTURA'S HUMAN RESOURCES DEPARTMENT PERFORMS ANALYSES OF THE MARKET TO DETERMINE COMPENSATION RANGES FOR THE REMAINDER OF CENTURA executives WHICH ARE REVIEWED AND APPROVED BY CENTURA'S SENIOR LEADERSHIP. FOR THOSE REPORTABLE INDIVIDUALS (I.E. BOARD MEMBERS) WHOSE COMPENSATION IS PAID BY CATHOLIC HEALTH INITIATIVES (CHI), THEIR compensation was set by a compensation committee utilizing an independent consultant and comparability studies to determine compensation AMOUNTS THAT WERE BOARD APPROVED AND PAID TO THEM ACCORDANCE WITH A WRITTEN CONTRACT.
PUBLIC INSPECTION OF DOCUMENTSFORM 990, PART VI, Q. 19The organization's governing documents are available on the COLORADO Secretary of State's website. THE organization's financial statements are included in the Catholic Health Initiatives' consolidated audited financial statements that are available at www.catholichealthinit.org or at http://www.DacBond.com. The organization's conflict of interest policy IS not publicly available.
ESTIMATE OF HOURS DEVOTED TO RELATED ORGANIZATIONSFORM 990, PART VIIThe organization's three voting board members are employed by Catholic Health Initiatives (CHI), a related organization. Compensation reported on Form 990, Part VII was paid to the board members by CHI in exchange for the fulfillment of their duties as full-time, 60 hour-per-week employees. ADDITIONALLY, COMPENSATION PAID TO EMPLOYEES OF CENTURA HEALTH CORPORATION WAS PAID TO THEM IN EXCHANGE FOR THE FULFILLMENT OF THEIR DUTIES AS FULL TIME, 40+ HOUR-PER-WEEK EMPLOYEES.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (132 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
St Joseph Community Health Services
300 Central SW Suite 300AlbuquerqueNM87102710897107CommunityNM501(c)(3)11aCHI
St Joseph Community Health Foundation
300 Central SW Suite 300AlbuquerqueNM87102850253087FoundationNM501(c)(3)7SJCHS
St Francis of Baker City
3325 Pocahontas RoadBaker CityOR97814930412495HospitalOR501(c)(3)3CHI
St Elizabeth Health Care Foundation
3325 Pocahontas RoadBaker CityOR97814943164869FoundationOR501(c)(3)7SEHS
Flaget Memorial Hospital Foundation Inc
4305 New Shepherdsville RoadBardstownKY40004562351341FundraisingKY501(c)(3)11aFH
Flaget Healthcare DBA Flaget Memorial
4305 New Shepherdsville RoadBardstownKY40004611345363HospitalKY501(c)(3)3CHI
Lakewood Health Center
600 Main Avenue SouthBaudetteMN56623410758434LTerm CareMN501(c)(3)3CHI
Appletree Court
601 Oak StreetBreckenridgeMN56520411850500Senior HomesMN501(c)(3)9SFH
Healthcare and Wellness Foundation
2400 St Francis DriveBreckenridgeMN56520760761782FoundationMN501(c)(3)11aSFMC
St Francis Home
2400 St Francis DriveBreckenridgeMN56520410729978LTerm CareMN501(c)(3)9CHI
St Francis Medical Center
2400 St Francis DriveBreckenridgeMN56520410695598HealthcareMN501(c)(3)3CHI
Carrington Health Center
800 North 4th StreetCarringtonND58421450227311HealthcareND501(c)(3)3CHI
Saint Clare's Community Care
66 Ford RoadDenvilleNJ07834222876836HealthcareNJ501(c)(3)11bSCHS
Saint Clare's Foundation Inc
66 Ford RoadDenvilleNJ07834222502997FundraisingNJ501(c)(3)7SCHS
Good Samaritan College of Nursing & Heal
375 Dixmyth AveCincinnatiOH45220311778403EducationKY501(c)(3)2GHS
Total Healthcare
PO Box 7021Colorado SpringsCO80933840927232HealthcareCO501(c)(3)3CHI Colorado
Memorial Health Care System Inc
2525 De Sales AvenueChattanoogaTN37404620532345HospitalTN501(c)(3)3CHI
Memorial Health Care System Foundation
2525 De Sales AvenueChattanoogaTN37404621839548FoundationTN501(c)(3)7MHCS
Memorial Health Partners Foundation Inc
6028 Shallowford RoadChattanoogaTN37421030417049HealthcareTN501(c)(3)9MHCS
The Community Limited Care Dialysis Cent
619 Oak Street Accounting-3 WestCincinnatiOH45206237419853DialysisOH501(c)(2)noneGSH
Good Samaritan Foundation of Cincinnati
619 Oak Street Accounting-3 WestCincinnatiOH45206311206047FoundationOH501(c)(3)11aGSH
The Good Samaritan Hospital of Cincinnat
619 Oak Street Accounting-3 WestCincinnatiOH45206310537486HospitalOH501(c)(3)3TRI-HEALTH
Saint Clare's Hospital
66 Ford RoadDenvilleNJ07834223319886HospitalNJ501(c)(3)3CHI
St Francis Life Care Corporation
19 Pocono RoadDenvilleNJ07834222536017Elderly CareNJ501(c)(3)9SCHS
TriHealth Physician Institute
619 Oak Street Accounting-3 WestCincinnatiOH45206311074519PhysiciansOH501(c)(3)11aGSH
Catholic Health Initiatives Colorado Fou
961 East Colorado AvenueColorado SpringsCO80903840902211FoundationCO501(c)(3)7CHI Colorado
SET of Colorado Springs Inc
825 E Pikes Peak Avenue Bldg 29Colorado SpringsCO80903841183335LTerm CareCO501(c)(3)7CHI Colorado
Catholic Health Initiatives
1999 Broadway Suite 4000DenverCO80202470617373HealthcareCO501(c)(3)9CHI
Catholic Health Care Federation
1999 Broadway Suite 4000DenverCO80202208473567Jurdic PersonCO501(c)(3)11aCHI
Global Health Initiatives
1999 Broadway Suite 4000DenverCO80202201536108MinistriesCO501(c)(3)11aCHI
Health SET
4200 West Conejos Place 436DenverCO80204841102943Low Inc.CareCO501(c)(3)7CHI Colorado
Bishop Drumm Retirement Center
1111 6th AvenueDes MoinesIA50314420725196LTerm CareIA501(c)(3)9CHI-IA Corp
Mercy Medical Center - Des Moines AKA
1111 6th AvenueDes MoinesIA50314420680448HospitalIA501(c)(3)3CHI-IA Corp
House of Mercy
1111 6th AvenueDes MoinesIA50314421323808ShelterIA501(c)(3)7CHI-IA Corp
Mercy Auxiliary of Central Iowa
1111 6th AvenueDes MoinesIA50314426076069AuxiliaryIA501(c)(3)11aCHI-IA Corp
Mercy Clinics Inc
1111 6th AvenueDes MoinesIA50314421193699PhysicianIA501(c)(3)9CHI-IA Corp
Mercy College of Health Sciences
1111 6th AvenueDes MoinesIA50314421511682EducationIA501(c)(3)2CHI-IA Corp
Mercy Foundation of Des Moines IA
1111 6th AvenueDes MoinesIA50314237358794FoundationIA501(c)(3)7CHI-IA Corp
Mercy Medical Center - Centerville FKA
1 St Josephs DriveCentervilleIA52544420680308HospitalIA501(c)(3)3CHI-IA Corp
Mercy Professional Practice Associates
1111 6th AvenueDes MoinesIA50314421470935PhysicianIA501(c)(3)9CHI-IA Corp
Mercy Hospital of Devils Lake
1031 East Seventh StreetDevils LakeND58301450227012HealthcareND501(c)(3)3CHI
Saint Joseph's Hospital Foundation
30 West 7th StreetDickinsonND58601363418207FoundationND501(c)(3)11aSJHHC
St Joseph's Hospital and Health Center
30 West 7th StreetDickinsonND58601450226429HealthcareND501(c)(3)3CHI
Mercy Regional Medical Center of Durango
1010 Three Springs BlvdDurangoCO81301840405515HospitalCO501(c)(3)3CHI
CHI Kentucky Inc
3900 Olympic Blvd Suite 400ErlangerKY41018202741651HealthcareKY501(c)(3)11aCHI
Villa Nazareth Inc
801 Page DriveFargoND58103450226714LT CareND501(c)(3)9CHI
St Catherine Hospital
401 East Spruce StreetGarden CityKS67846480543721HospitalKS501(c)(3)3CHI
St Catherine Hospital Development Found
401 East Spruce StreetGarden CityKS67846200598702FoundationKS501(c)(3)11aSCH
Saint Francis Medical Center Foundation
PO Box 9804Grand IslandNE68802470630267FoundationNE501(c)(3)7SFMC
Saint Francis Medical Center
PO Box 9804Grand IslandNE68802470376601HealthCareNE501(c)(3)3CHI Nebraska
Central Kansas Medical Center
3515 BroadwayGreat BendKS67530480543724HospitalKS501(c)(3)3CHI
St Joseph Memorial Hospital
923 Carroll AveLarnedKS67550481253246HospitalKS501(c)(3)3CKMC
MNMCH Inc
220 North PennsylvaniaColumbusKS66725481216238HospitalKS501(c)(3)3SJRMC
Mercy Lifecare Systems
2727 McClelland BlvdJoplinMO64804431305163Property MgmtMO501(c)(3)11aSJRMC
St John's Medical Group
2727 McClelland BlvdJoplinMO64804431882377Phys PracticeMO501(c)(3)9SJRMC
St John's Mercy Regional Foundation
2727 McClelland BlvdJoplinMO64804431308084FoundationMO501(c)(3)7SJRMC
St John's Regional Medical Center
2727 McClelland BlvdJoplinMO64804440545809HospitalMO501(c)(3)3CHI
Good Samaritan Hospital
PO Box 1990KearneyNE68848470379755HealthCareNE501(c)(3)3CHI Nebraska
Good Samaritan Hospital Foundation
PO Box 1810KearneyNE68848470659443FoundationNE501(c)(3)7GSH
St Joseph Health Ministries
1929 Lincoln Hwy E Ste 150LancasterPA17602232342997HealthPA501(c)(3)11aCHI
St Joseph Health Ministries Foundation
1929 Lincoln Hwy E Ste 150LancasterPA17602232605579FundraisingPA501(c)(3)11aSJHM
St Joseph Health Services Inc
1929 Lincoln Hwy E Ste 150LancasterPA17602201425375Dental carePA501(c)(3)11aSJHM
Continuing Care Hospital
150 North Eagle Creek DriveLexingtonKY40509611400619LTACHKY501(c)(3)3SJHS
Saint Joseph Berea Hospital Foundation
305 Estill StreetBereaKY40403260152877FoundationKY501(c)(3)7SJHS
Saint Joseph Health System Inc
150 N Eagle Creek DrLexingtonKY40509611334601HospitalKY501(c)(3)3CHI
St Joseph Hospital Foundation Inc
One St Joseph DriveLexingtonKY40504611159649FoundationKY501(c)(3)11aSJHS
Saint Joseph Medical Foundation Inc
One St Joseph DriveLexingtonKY40504311539059Phy PracticesKY501(c)(3)3SJHS
Visiting Nurse Association of Saint Clar
191 Woodport RoadSpartaNJ07871221768334Home HealthNJ501(c)(3)9SCHS
Saint Elizabeth Foundation
555 South 70th StreetLincolnNE68510470625523FoundationNE501(c)(3)7SERMC
Saint Elizabeth Health Services
555 South 70th StreetLincolnNE68510363233120HealthcareNE501(c)(3)3SERMC
CHI Nebraska
555 South 70th StreetLincolnNE68510363233121HealthcareNE501(c)(3)11aCHI
Saint Elizabeth Regional Medical Center
555 South 70th StreetLincolnNE68510470379836HealthcareNE501(c)(3)3CHI Nebraska
The Physician Network
8055 O Street Suite 300LincolnNE68510470780857HealthcareNE501(c)(3)11aCHI Nebraska
Lisbon Area Health Services
905 Main StreetLisbonND58054820558836HealthcareND501(c)(3)3CHI
Alverna Apartments
300 SE 8th AvenueLittle FallsMN56345411351177Lterm CareMN501(c)(3)9CHI
Unity Family Healthcare
815 2nd Street SELittle FallsMN56345410721642HealthcareMN501(c)(3)3CHI
St Anthony's Hospital Association
4 Hospital DriveMorriltonAR72110710245507HealthcareAR501(c)(3)3SVIMC
St Vincent Infirmary Medical Center
2 St Vincent CircleLittle RockAR72205710236917HealthcareAR501(c)(3)3CHI
St Vincent Medical Group
2 St Vincent CircleLittle RockAR72205710830696HealthcareAR501(c)(3)9SVIMC
Maria-Joseph Center
4830 Salem AvenueDaytonOH45416310935118HealthcareOH501(c)(3)9SHP
Saint Joseph London Foundation Inc
310 East Ninth StreetLondonKY40741260438748FoundationKY501(c)(3)11aSJHS
Samaritan Behavioral Health
601 S Edwin C Moses BlvdDaytonOH45408020633634HospitalOH501(c)(3)3SHP
Mercy Medical Center
1512 12th Avenue RoadNampaID83686820200896HospitalID501(c)(3)3CHI
Mercy Medical Center Foundation
1512 12th Avenue RoadNampaID83686261737256FoundationID501(c)(3)11aMercy Med Ct
Mercy Physician Group Inc
1512 12th Avenue RoadNampaID83686208192593Phys GroupID501(c)(3)9Mercy Med Ct
St Mary's Hospital
1314 3rd AvenueNebraska CityNE68410470443636HospitalNE501(c)(3)3CHI Nebraska
St Mary's Hospital Foundation
1314 3rd AvenueNebraska CityNE68410470707604FoundationNE501(c)(3)7SMH
Oakes Community Hospital
314 South 8th StreetOakesND58474450231675HospitalND501(c)(3)3CHI
Oakes Community Hospital Foundation
314 South 8th StreetOakesND58474710966606FoundationND501(c)(3)11aOCH
St Dominic at Ontario
351 SW 9th StreetOntarioOR97914930433692HospitalOR501(c)(3)3CHI
Holy Rosary Medical Center Foundation
351 SW 9th StreetOntarioOR97914202683560FoundationOR501(c)(3)11aHRMC
St Joseph's Area Health Services
600 Pleasant AvenuePark RapidsMN56470410695603HospitalMN501(c)(3)3CHI
St Anthony Hospital
1601 SE Court AvenuePendletonOR97801930391614HospitalOR501(c)(3)3CHI
St Anthony Hospital Foundation
1601 SE Court AvenuePendletonOR97801930992727FoundationOR501(c)(3)11aSA Hospital
Gettysburg Medical Center
606 East Garfield AvenueGettysburgSD57442460234354HospitalSD501(c)(3)3SMHC
St Mary's Healthcare Center
801 East Sioux AvenuePierreSD57501460230199HealthcareSD501(c)(3)3CHI
Mt St Joseph Inc
3060 SE Stark StreetPortlandOR97214930386870Nursing CareOR501(c)(3)9CHI
Pueblo Stepup
1925 East Orman Avenue Suite G52PuebloCO81004841234295CommunityCO501(c)(3)7CHI
Bornemann Healthcare Corporation
2500 Bernville Road PO Box 316ReadingPA19603232187242HealthcarePA501(c)(3)11aCHI
St Joseph Medical Center Foundation
2500 Bernville Road PO Box 316ReadingPA19603232649362FoundationPA501(c)(3)11aSJRHN
St Joseph Medical Group
2500 Bernville Road PO Box 316ReadingPA19603208544021HealthcarePA501(c)(3)9BHC
St Joseph Regional Health Network
2500 Bernville Road PO Box 316ReadingPA19603231352211HealthcarePA501(c)(3)3CHI
Linus Oakes Inc
2700 Stewart ParkwayRoseburgOR97470930821381Senior LivingOR501(c)(3)9MMC
Mercy Foundation Inc
2700 Stewart ParkwayRoseburgOR97470936088946FoundationOR501(c)(3)7MMC
Mercy Medical Center
2700 Stewart ParkwayRoseburgOR97470930386868HospitalOR501(c)(3)3CHI
Franciscan Villa of South Milwaukee Inc
3601 South Chicago AvenueSouth MilwaukeeWI53172391093829HealthcareWI501(c)(3)9CHI
Enumclaw Community Hospital
1450 Battersby AvenueEnumclawWA98022910715805HospitalWA501(c)(3)3FHS
Franciscan Foundation
1717 South J StreetTacomaWA98405911145592FundraisingWA501(c)(3)9FHS
Franciscan Health System FKA Franciscan
1717 South J StreetTacomaWA98405910564491HealthcareWA501(c)(3)3CHI
Franciscan Medical Group
1708 South Yakima AvenueTacomaWA98405911939739HealthcareWA501(c)(3)9FHS
St Joseph Medical Center Foundation In
7601 Osler DriveTowsonMD21204521681044FundraisingMD501(c)(3)7SJMC
St Joseph Medical Center Inc
7601 Osler DriveTowsonMD21204520591461HospitalMD501(c)(3)3CHI
St Joseph Physician Enterprises
7601 Osler DriveTowsonMD21204521311775PhysiciansMD501(c)(3)11aCHI
Samaritan Health Foundation
2222 Philadelphia DriveDaytonOH45406237296923FoundationOH501(c)(3)7SHP
Mercy Hospital of Valley City
570 Chautauqua BoulevardValley CityND58072450226553HospitalND501(c)(3)3CHI
Mercy Medical Center
1301 15th Avenue WestWillistonND58801450231183HealthcareND501(c)(3)3CHI
Mercy Medical Foundation
1301 15th Avenue WestWillistonND58801450381803FoundationND501(c)(3)11aMMC
Samaritan Health Partners
2222 Philadelphia DriveDaytonOH45406311107411HealthcareOH501(c)(3)11aCHI
St Vincent Foundation
Two St Vincent CircleLittle RockAR72205510169537FundraisingAR501(c)(3)11aSVIMC
Auxiliary of Holy Rosary Hospital Inc
351 SW 9th StreetOntarioOR97914943059469HospitalOR501(c)(3)9HRMC
The Mercy Hospital of Devils Lake Fdn
1031 East Seventh StreetDevils LakeND58301352367360FoundationND501(c)(3)11aMHDL
Alegent Health - Bergan Mercy Health Sys
7500 Mercy RoadOmahaNE68124470484764HospitalNE501(c)(3)3CHI
Alegent Health - Mercy Hospital Corning
PO Box 368CorningIA50841420782518HospitalIA501(c)(3)3AHBMHS
Mercy Health Care Foundation
PO Box 368CorningIA50841421461064FoundationNE501(c)(3)11aAHMH
Mercy Hospital Foundation Council Bluff
800 Mercy DriveCouncil BluffsIA51503421178204FoundationIA501(c)(3)11aAHBMHS
CHI Institute For Research and Innovatio
198 Inverness Drive WestEnglewoodCO80112271050565HealthcareCO501(c)(3)11aCHI
CHI Colorado
188 Inverness Drive WestEnglewoodCO80112840405257HealthcareCO501(c)(3)3CHI
Saint Joseph Mount Sterling Foundation
50 Sterling AvenueMount SterlingKY40353272884584FoundationKY501(c)(3)7SJHS
Centennial Medical Group Inc
2700 Stewart ParkwayRoseburgOR97470900433062PhysiciansOR501(c)(3)9MMC
CHI National Foundation
198 Inverness Drive WestEnglewoodCO80112270930004FoundationCO501(c)(3)11aCHI
Saint Clare's Health Services Inc
25 Pocono RoadDenvilleNJ07834223639733ManagementNJ501(c)(3)7CHI
Good Samaritan Hospital
2222 Philadelphia DriveDaytonOH45406310536981HospitalOH501(c)(3)3SHP

Form990 Schedule R Part III Form990ScheduleRPartIII (17 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartner
Superior Medical Imaging LLC
5000 North 26th StreetLincolnNE68521262884555OP DiagnosticsNESERMCRelated-155495993429false$272false
Central Nebraska Rehab Services
3004 W Faidley AveGrand IslandNE68802810653461Physical TherapyNECHIRelated18169792933623false$5,050false
Mercy West Endoscopy LLC
1601 NW 114th St Suite 244CliveIA50325900129077Ambulatory SurgIACHI-IA CorpRelated19177161695121falsefalse
Audubon Land Company LLC
5390 N Academy Blvd Suite 300Colorado SpringsCO80918841513085Real EstateCOTHCRelated675779001605falsefalse
Breckenridge Medical Clinic LLC
555 South Park Avenue Plaza 11BreckenridgeCO80424651295958Medical ClinicCOTHCRelatedfalsefalse
Penrad Imaging
1390 Kelly Johnson BlvdColorado SpringsCO80920841072619Medical ImagingCOTHCRelated19224418248492falsefalse
St Anthony Regional Mtn Cancer Center
4231 W 16th AvenueDenverCO80112371568013Cancer CenterCOTHCRelated60513318803falsefalse
St Francis Land Company
5390 N Academy Blvd Suite 300Colorado SpringsCO80918263134100Real EstateCOTHCRelated-18097914886022falsefalse
OrthoColorado LLC
11650 West 2nd PlaceLakewoodCO80255371577105Ortho HospitalCOTHCRelated-537516515265510falsefalse
Mercy Outpatient Surgery Center LLC
1512 12th Avenue RoadNampaID83686841380439Surgery CenterIDMMCRelated-812036949357false$4,620true
Peninsula Radiation Oncology
314 Martin Luther King Jr Way 11TacomaWA98405870808610Healthcare SrvcWAFHSRelated-5160763860362falsefalse
Healthcare Support Services LLC
PO Box 9804Grand IslandNE68802721546196LaundryNECHIRelated1999683913481false$58,436false
Bluegrass Regional Imaging Center
1218 South Broadway Suite 310LexingtonKY40504611386736DiagnosticKYSJ HospitalLexRelated2424563773725falsefalse
North River Surgery Center LLC
2209 Wildwood AvenueSherwoodAR72120710799771Ambul Surg CtrARSVIMCRelated2139891696001falsefalse
CHI Operating Investment Program LP
198 Inverness Drive WestEnglewoodCO80112470727942InvestmentsCOCHIInvestment580224069968false$14,031true
Ruxton Surgicenter LLC
8322 Bellona Avenue Suite 201BaltimoreMD21204522095835Surgery CenterMDSJMCRelated-757163421084falsetrue
Central Nebraska Home Care Services
PO Box 1146-4510 Second AvenueKearneyNE68848470692112Healthcare SrvcNEHSEINCRelated-1029821021500falsetrue

Form990 Schedule R Part IV Form990ScheduleRPartIV (30 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipLegal Domicile Foreign CountryLegalDomicileForeignCountry
Mercy Health Services Corporation
2727 McClelland BlvdJoplinMO64804431457881DMEMOSt John's RMCC Corp-103383220936831.00000
Mountain Management Services Inc
6028D Shallowford RoadChattanoogaTN37422621570739mgmt svc orgTNMHCSC Corp34864245308451.00000
MedQuest
1301 15th Avenue WestWillistonND58801450392137Sale of DMENDMHof WillistonC Corp-167949114941.00000
St Anthony Development Company
1415 SouthgatePendletonOR97801931216943Athletic ClubORSt Anthony HC Corp4186130479381.00000
GOOD SAMARITAN OUTREACH SERVICES
PO BOX 1990KEARNEYNE68848470659440MEDICAL CLINICNECHI NebraskaC Corp-24916238402321.00000
HEALTH SYSTEMS ENTERPRISES INC
PO BOX 1990KEARNEYNE68848470664558MANAGEMENTNEGSHC Corp1095715597471.00000
Mercy Park Apartments Ltd
1111 6th AvenueDes MoinesIA50314421202422HousingIACHI-IA CorpC Corp22724418061991.00000
Des Moines Medical Center Inc
1111 6th AvenueDes MoinesIA50314420837382Real EstateIACHI-IA CorpC Corp11231730.92980
Comcare Services
4231 W 16th AvenueDenverCO80204840904813InactiveCOCHICC Corp1.00000
Mednow Inc
1512 12th Avenue RoadNampaID83686820389927Outpat PharmacyIDMercy Med CtrC Corp-67295453484761.00000
Saint Clare's Primary Care Inc
66 Ford RoadDenvilleNJ07834222441202Billing ServicesNJSCCCC Corp-35063025904871.00000
Healthcare Mgmt Services Org Inc
1149 Market StTacomaWA98402911865474Health Org.WAFHSC Corp1.00000
Physician Health System Network
1149 Market StTacomaWA98402911746721Health Org.WAFHSC Corp1.00000
Mercy Services Corp
2700 Stewart ParkwayRoseburgOR97470930824308Retail SalesORMercy MedicalC Corp-49940914030011.00000
Caduceus Medical Associates Inc
6028 Shallowford Road Suite DChattanoogaTN37422621570736HealthcareTNMHCSC Corp10081.00000
CENTRAL KANSAS HEALTH SERVICES ASSOCIATI
3515 BroadwayGreat BendKS67530481042853MEDICAL EQUIPMENTKSCKMCC Corp1101251.00000
St Vincent Community Health Services In
Two St Vincent CircleLittle RockAR72205710710785HealthcareARSVIMCC Corp2404944101950001.00000
Alternative Insurance Management Service
3900 Olympic Boulevard Suite 400ErlangerKY41018841112049Management ServicCOCHIC Corp32721761.00000
Nazareth Assurance Company
76 St Paul Street Suite 500BurlingtonVT05401030304831InsuranceVTCHIC Corp1.00000
Franciscan Services Inc
198 Inverness Drive WestEnglewoodCO80112232487967HealthcareCOCHIC Corp194756125982581.00000
SJH Services Corporation
198 Inverness Drive WestEnglewoodCO80112232307408HealthcareCOFSIC Corp31434634230121.00000
St Joseph Development Company Inc
1717 South J StreetTacomaWA98405911480569RentalWAFSIC Corp1677122119847251.00000
Towson Management Inc
7601 Osler DriveTowsonMD21204521710750Management ServicMDFSIC Corp993154983831.00000
Captive Management Initiatives
980663022Captive ManagemenCHIC Corp1.00000CJ
First Initiatives Insurance Ltd
980203038InsuranceCHIC Corp1.00000CJ
Center for Translational Research
198 Inverness Drive WestEnglewoodCO80112272269511HealthcareCOCHIC Corp-84094917462011.00000
Samaritan Family Care Inc
40 W Fourth St 1700DaytonOH45402311299450HealthcareOHSHPLLC-119983648943971.00000
SJL Physician Management Services Inc
424 Lewis Hargett Cr 160LexingtonKY40503999999999ManagementKYSJHSC Corp1.00000
CGH Realty Company Inc
215 N 12th StReadingPA19603232326801Real EstatePASJHMC Corp1007424151.00000
St Joseph Office Park Association
1401 HarrodsBurg Road Bldg B70LexingtonKY40504611079899ManagementKYSJHSC Corp102175728430.85000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Catholic Health Initiatives
c150020
Catholic Health Initiatives
e45000000
Catholic Health Initiatives
l11608791
Catholic Health Initiatives
q21645865
CHI Colorado Foundation
c4789114
CHI Colorado Foundation
b88233
SET of Colorado Springs
b88233
St Francis Land Company
a349778
St Francis Land Company
r2105761

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