ST MARYS COMMUNITY HOSPITAL: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization: ST MARYS COMMUNITY HOSPITAL (EIN 47-0443636)
Tax period: 2009-07-01 to 2010-06-30
Filed: 2011-04-21
IRS object ID: 201141119349300319
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-04-21T18:24:37-04:00	Timestamp
Tax Period End Date	2010-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

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

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2009-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	470443636	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	St Mary's Community Hospital	BusinessNameLine1

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

US Address USAddress

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

Officer Officer

Field	Value	IRS element (for citing)
Name	Shawn Closner	Name
Title	CFO	Title
Date Signed	2011-04-20	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	7208741500	Phone

Field	Value	IRS element (for citing)
Tax Year	2009	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Daniel Kelly CEO	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

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

Field	Value	IRS element (for citing)
Gross Receipts	15893806	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Group Exemption Number	0928	GroupExemptionNumber
Organization501c	X	Organization501c
Web Site	WWW.STMARYSHOSPITALNECITY.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1927	YearFormation
State Legal Domicile	NE	StateLegalDomicile
Activity Or Mission Description	St. Mary's is a not for profit critical access hospital that provides acute care for the benefit of all regardless of ability to pay and promotes health through community outreach initatives and partnerships	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	157	TotalNbrEmployees
Total Nbr Volunteers	15	TotalNbrVolunteers
Total Gross UBI	20	TotalGrossUBI
Contributions Grants Prior Year	68902	ContributionsGrantsPriorYear
Contributions Grants Current Year	190696	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	14881530	ProgramServiceRevenuePriorYear
Program Service Revenue CY	15178699	ProgramServiceRevenueCY
Investment Income Prior Year	-92258	InvestmentIncomePriorYear
Investment Income Current Year	345425	InvestmentIncomeCurrentYear
Other Revenue Prior Year	52220	OtherRevenuePriorYear
Other Revenue Current Year	128402	OtherRevenueCurrentYear
Total Revenue Prior Year	14910394	TotalRevenuePriorYear
Total Revenue Current Year	15843222	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	7490	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	9243	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	6813206	SalariesEtcPriorYear
Salaries Etc Current Year	7083475	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	7044485	OtherExpensePriorYear
Other Expenses Current Year	7193437	OtherExpensesCurrentYear
Total Expenses Prior Year	13865181	TotalExpensesPriorYear
Total Expenses Current Year	14286155	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	1045213	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	1557067	RevenuesLessExpensesCY
Total Assets BOY	15714129	TotalAssetsBOY
Total Assets EOY	16859586	TotalAssetsEOY
Total Liabilities BOY	2684641	TotalLiabilitiesBOY
Total Liabilities EOY	2025265	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	13029488	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	14834321	NetAssetsOrFundBalancesEOY
Mission Description	The organization's mission is to nurture the healing ministry of the Church by bringing it new life, energy and viability in the 21st century. Fidelity to the Gospel urges us to emphasize human dignity and social justice as we move toward the creation of healthier communities.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	11366640	Expense
Grants	3243	Grants
Revenue	15178699	Revenue
Description	SEE SCHEDULE H	Description
Total Program Service Expense	11366640	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Balance Sheet Amounts Reported	true	BalanceSheetAmountsReported
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	157	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Nbr Voting Governing Body Members	11	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	true	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	NE	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	Sharon Crunk	NamePerson
Telephone Number	4028738929	TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Highest Compensated EmployeeHighestCompensatedEmployee
Stacy Blum
Board member	1.0	X	270376	40372
Lidia Borer
Board member	1.0	X
Brett Gay
Board Member	1.0	X
Patrick Haverty
Board Member	1.0	X
Daniel Kelly
PRESIDENT CEO-NE City	40.0	X	198965	38859	X
Rose Marie Imig
Board Member	1.0	X
Robert Lanik
PRESIDENT CEO-CHI Nebraska	1.0	X	685176	76471
Michael McCabe
Board Member	1.0	X
Kathryn Nelson
Board Member	1.0	X
Jonathan Stelling
Board Vice Chair	1.0	X	257208	40488	X
Scott VanderVeen
Board Chairperson	1.0	X			X
Shawn Closner
CHIEF FINANCIAL OFFICER	40.0			26677	X	90259
Joan Beccard
PHARMACY DIRECTOR	40.0			28752		105813	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	196072	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	1411725	TotalReportableCompFrmRltdOrgs
Total Other Compensation	251619	TotalOtherCompensation
Number Individuals GT100 K	1	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
Ketter and Associates
1819 F Street	Auburn	NE	68305	PT OT Therapy	406501
Sleep Tight Anesthesia
2640 Whitaker Road	Nebraska City	NE	68410	anesthesia	299550

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	2	NumberOfContractorsGT100K
Related Organizations	179842	RelatedOrganizations
All Other Contributions	10854	AllOtherContributions
Total Contributions	190696	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	Patient Services	Description
Business Code	900099	BusinessCode
Total Revenue Column	15178699	TotalRevenueColumn
Related Or Exempt Function Income	15178699	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	15178699	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	185417	TotalRevenueColumn
Unrelated Business Revenue	20	UnrelatedBusinessRevenue
Exclusion	$185,397	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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

Royalties Revenue RoyaltiesRevenue

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

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	12260	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	10718	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	1542	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	1542	TotalRevenueColumn
Exclusion	$1,542	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	173337	Securities
Other	10500	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	23829	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	173337	Securities
Other	-13329	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	160008	TotalRevenueColumn
Exclusion	$160,008	ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

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

Net Income From Gaming NetIncomeFromGaming

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

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	15559	GrossSalesOfInventory
Cost Of Goods Sold	16037	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-478	TotalRevenueColumn
Exclusion	-$478	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
Cafeteria	722100	46459	$46,459
Laboratory Services	621500	40355	$40,355
Meals on Wheels	624100	15318	$15,318

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	25206	TotalRevenueColumn
Exclusion	$25,206	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	127338	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	15843222	TotalRevenueColumn
Related Or Exempt Function Income	15178699	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	20	UnrelatedBusinessRevenue
Exclusion	$473,807	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	8993	Total
Program Services	8993	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	250	Total
Program Services	250	ProgramServices

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	114763	Total
Program Services	9181	ProgramServices
Management And General	105582	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	5062599	Total
Program Services	4173672	ProgramServices
Management And General	888927	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	261169	Total
Program Services	206324	ProgramServices
Management And General	54845	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1264871	Total
Program Services	999248	ProgramServices
Management And General	265623	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	380073	Total
Program Services	300258	ProgramServices
Management And General	79815	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	4070	Total
Management And General	4070	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	2319319	Total
Program Services	1730118	ProgramServices
Management And General	589201	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	0	Total

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	1797784	Total
Program Services	1797784	ProgramServices

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	283099	Total
Program Services	201416	ProgramServices
Management And General	81683	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	37712	Total
Program Services	26609	ProgramServices
Management And General	11103	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	23060	Total
Program Services	3546	ProgramServices
Management And General	19514	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	62918	Total
Program Services	62918	ProgramServices

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	476028	Total
Management And General	476028	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	815498	Total
Program Services	754070	ProgramServices
Management And General	61428	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	36030	Total
Management And General	36030	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
Repairs and maintenance	577288	399037	178251
Bad debts	654034	654034
Dues & subscriptions	34576	10829	23747
Education	16344	15196	1148
Strategic Planning	19836		19836

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	35841	Total
Program Services	13157	ProgramServices
Management And General	22684	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	14286155	Total
Program Services	11366640	ProgramServices
Management And General	2919515	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	3253	BOY
EOY	300	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	2948507	BOY
EOY	1788900	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	2354215	BOY
EOY	2330724	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	212089	BOY
EOY	204518	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	34000	BOY
EOY	31975	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	13189197	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	8700504	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	5101990	BOY
EOY	4488693	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	5045350	BOY
EOY	7943097	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	14725	BOY
EOY	71379	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	15714129	BOY
EOY	16859586	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	1205044	BOY
EOY	835527	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	1479597	BOY
EOY	1189738	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	2684641	BOY
EOY	2025265	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	13026044	BOY
EOY	14830870	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	3444	BOY
EOY	3451	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	13029488	BOY
EOY	14834321	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	15714129	BOY
EOY	16859586	EOY

Field	Value	IRS element (for citing)
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

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

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	true	GrantsOtherOrganizations
Grants Other Organizations	$510	GrantsOtherOrganizationsAmount
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	false	OtherActivities
Total Lobbying Expenditures IIB	510	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	Sch C Supplemental- Lobbying Activities Explanation	Identifier
Return Reference	Sch C Pt II-B	ReturnReference
Explanation	THE 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. THE AMOUNTS ALLOCATED FROM EACH ORGANIZATION ARE AS FOLLOWS: AHA - $297; CHA - $213.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	22750	OtherCostOrOtherBasis
Book Value	22750	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	165036	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	3202951	OtherCostOrOtherBasis
Depreciation	3150970	Depreciation
Book Value	217017	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5075934	OtherCostOrOtherBasis
Depreciation	2027233	Depreciation
Book Value	3048701	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4646695	OtherCostOrOtherBasis
Depreciation	3522300	Depreciation
Book Value	1124395	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	75831	OtherCostOrOtherBasis
Depreciation	0	Depreciation
Book Value	75831	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	4488694	TotalOfBookValueLandBuildings
Financial Derivatives		FinancialDerivatives
Closely Held Equity Interests		CloselyHeldEquityInterests

Other Securities OtherSecurities (3 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
CHI OIP - Fixed Income	4138826	F
CHI OIP - Equity Securities	3804271	F
CHI OIP - Money Market	0

Field	Value	IRS element (for citing)
Total Of Book Value Securities	7943097	TotalOfBookValueSecurities
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
UNCLAIMED PROPERTY	$3,852
INTERCOMPANY PAYABLES	$1,185,886

Field	Value	IRS element (for citing)
Total Of Amounts	1189738	TotalOfAmounts
Total Revenue	15843222	TotalRevenue
Total Expenses	14286155	TotalExpenses
Excess Or Deficit For Year	1557067	ExcessOrDeficitForYear
Net Unrealized GL On Investments	347265	NetUnrealizedGLOnInvestments
Other	-$99,501	OtherAmount
Total Adjustments	247764	TotalAdjustments
Excess Or Deficit Per FS	1804831	ExcessOrDeficitPerFS

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
REPORTING OF LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740	SCH D, PART XIV	St. Mary's Community Hospital's financial information is included in the consolidated audited financial statements of Catholic Health Initiatives (CHI), a related organization. CHI's FIN 48 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 RECONCILING ITEMS	Schedule D Part XI Q8	Reclassification to Restricted Funds - CAPITAL RESOURCE POOL CONTRIBUTION -$144,252 - CHI Connect Depreciation $44,751 Total -99,501

Schedule H IRS990ScheduleH

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

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Persons Served	233	PersonsServed
Total Community Benefit Expense	256927	TotalCommunityBenefitExpense
Net Community Benefit Expense	256927	NetCommunityBenefitExpense
Percent Of Total Expense	0.01880	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Persons Served	233	PersonsServed
Total Community Benefit Expense	256927	TotalCommunityBenefitExpense
Net Community Benefit Expense	256927	NetCommunityBenefitExpense
Percent Of Total Expense	0.01880	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	12	NumberOfActivitiesOrPrograms
Persons Served	2496	PersonsServed
Total Community Benefit Expense	129187	TotalCommunityBenefitExpense
Direct Offsetting Revenue	90	DirectOffsettingRevenue
Net Community Benefit Expense	129097	NetCommunityBenefitExpense
Percent Of Total Expense	0.00950	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	16	PersonsServed
Total Community Benefit Expense	15853	TotalCommunityBenefitExpense
Net Community Benefit Expense	15853	NetCommunityBenefitExpense
Percent Of Total Expense	0.00120	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	15	NumberOfActivitiesOrPrograms
Persons Served	2468	PersonsServed
Total Community Benefit Expense	29662	TotalCommunityBenefitExpense
Net Community Benefit Expense	29662	NetCommunityBenefitExpense
Percent Of Total Expense	0.00220	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	29	NumberOfActivitiesOrPrograms
Persons Served	4980	PersonsServed
Total Community Benefit Expense	174702	TotalCommunityBenefitExpense
Direct Offsetting Revenue	90	DirectOffsettingRevenue
Net Community Benefit Expense	174612	NetCommunityBenefitExpense
Percent Of Total Expense	0.01290	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	29	NumberOfActivitiesOrPrograms
Persons Served	5213	PersonsServed
Total Community Benefit Expense	431629	TotalCommunityBenefitExpense
Direct Offsetting Revenue	90	DirectOffsettingRevenue
Net Community Benefit Expense	431539	NetCommunityBenefitExpense
Percent Of Total Expense	0.03170	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	6	PersonsServed
Total Community Building Expense	795	TotalCommunityBuildingExpense
Net Community Building Expense	795	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	244	PersonsServed
Total Community Building Expense	56243	TotalCommunityBuildingExpense
Net Community Building Expense	56243	NetCommunityBuildingExpense
Percent Of Total Expense	0.00410	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	300	PersonsServed
Total Community Building Expense	4022	TotalCommunityBuildingExpense
Net Community Building Expense	4022	NetCommunityBuildingExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	7	PersonsServed
Total Community Building Expense	15942	TotalCommunityBuildingExpense
Net Community Building Expense	15942	NetCommunityBuildingExpense
Percent Of Total Expense	0.00120	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	70	PersonsServed
Total Community Building Expense	1642	TotalCommunityBuildingExpense
Net Community Building Expense	1642	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	8	NumberOfActivitiesOrPrograms
Persons Served	627	PersonsServed
Total Community Building Expense	78644	TotalCommunityBuildingExpense
Net Community Building Expense	78644	NetCommunityBuildingExpense
Percent Of Total Expense	0.00580	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$359,719	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	5502849	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	5502849	CostOfCareReimbursedByMedicare

Costing Methodology Used CostingMethodologyUsed

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	St Mary's Community Hospital	BusinessNameLine1

Address Address

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

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

Form990 Schedule H Part VI Form990ScheduleHPartVI

Field	Value	IRS element (for citing)
Income Based Criteria	If 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. When Catholic Health Initiatives (the parent company of St. Mary's Community Hospital) established its charity care policy it was determined that establishing a household income scale based on HUD very low income guidelines more accurately reflects the socioeconomic dispersions among the 69 urban and rural communities in 19 states served by CHI hospitals and health care facilities. In comparing HUD guidelines to the Federal Poverty Guidelines ("FPG"), we find that on average HUD guidelines compute to approximately 200% to 250% (and sometimes 300%) of FPG. St. Mary's Community Hospital ("SMCH") bases is charity care eligibility under HUD's 130% of Very Low Income Guidelines based on geography, and affords the uninsured and underinsured the ability to obtain charity write-offs, based on a sliding scale, ranging from 25%-100% of charges. An individual's income under HUD guidelines is a significant factor in determining eligibility for charity care. However, in determining whether to extend discounted or free care to a patient, the patient's assets may also be taken into consideration. For example, a patient suffering a catastrophic illness may have a reasonable level of income, but a low level of liquid assets such that the payment of medical bills would be seriously detrimental to the patient's basic financial (and ultimately physical) well-being and survival. Such a patient may be extended discount or free care based upon the facts and circumstances.	IncomeBasedCriteria
Annual Community Benefit Expln	If 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. SMCH prepares its own annual written community benefit report. Its community benefit report is not contained in that of a related organization.	AnnualCommunityBenefitExpln
Costing Method Used	Provide an explanation of the costing methodology used to calculate the amounts reported in the table. If a cost accounting system was used, indicate whether the cost accounting system addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured or self pay). Also indicate whether a cost-to-charge ratio was used for any of the figures reported in the table. Describe whether this cost-to-charge ratio was derived from Worksheet 2, and, if not, what kind of cost-to-charge ratio was used and how it was derived. If some other costing methodology was used besides a cost accounting system, cost-to-charge ratio, or a combination of the two, describe the method used. Costs in the table were computed using the organization's cost to charge ratio that covers all patient segments, specifically for charity care. The cost to charge ratio for the year ended 6/30/2010 was computed using the following formula: Operating expenses (before restructuring, impairment, and other losses) divided by total operating revenue for charity care. Based on that formula, $256,927 divided by $365,958 results in a 70.2068% cost to charge ratio.	CostingMethodUsed
Percent Of Total Expense Expln	If 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. Note: Column F is supposed to be "net community benefit expense" in column (e) divided by the sum of "total functional expenses" on Form 990, Part IX, line 25, column A (less bad debt expense), and the organizations proportionate share of total expenses of all joint ventures for which it reports expenses on the table on part 1. Total bad debt expense reported on Form 990 Part IX, line 25, Column A was $654,034.	PercentOfTotalExpenseExpln
Bad Debt Footnote	Provide the rationale and the costing methodology used to determine the amount reported in Part III lines 2 and 3. Describe how the organization accounts for discounts and payments on patient accounts in determining bad debt expense. 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. Costing methodology for amounts reported on line 2 is determined using the organization's cost/charge ratio. When discounts are extended to self-pay patients, these patient account discounts are recorded as a reduction in revenue, not as bad debt expense. SMCH does not believe that any portion of bad debt expense could reasonably be attributed to patients who qualify for financial assistance since amounts due from those individuals' accounts will be reclassified from bad debt expense to charity care within 30 days following the date that the patient is determined to qualify for charity care. SMCH does not issue separate company audited financial statements, however, SMCH is included in the Consolidated Financial Statements of Catholic Health Initiatives (CHI). CHI's 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 payer 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 Benefit	(A) Describe the costing methodology used to determine the Medicare allowable costs reported in the organization's Medicare Cost Report, as reflected in the amount reported in Part III, line 6. (B) 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. (A)St. Mary's Community Hospital is designated as a Critical Access Hospital ("CAH"). CAHs are rural community hospitals that are certified to receive cost-based reimbursement from Medicare. The reimbursement that CAHs receive is intended to improve their financial performance and thereby reduce hospital closures. CAHs are certified under a different set of Medicare Conditions of Participation (CoP). Shortfalls are created when a facility receives payments that are less than the costs of caring for program beneficiaries. Because shortfalls are based on costs, not charges, and St. Mary's Community Hospital, due to their designation as a CAH, received cost-based reimbursement for Medicare purposes, St. Mary's Community Hospital will not experience Medicare related shortfalls. (B) However, St. Mary's Community Hospital and its affiliates believe 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 reimbursement generally doesn't 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 Policy	If the organization has a written debt collection policy and answered "yes" to Part III, line 9b, describe the collection practices set forth in the policy that apply to patients who it knows qualify for 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. SMCH's debt collection policy provides that SMCH will perform a reasonable review of each inpatient account, prior to turning an account to a third party collection agent and prior to instituting any legal action for non-payment, to assure that the patient and patient guarantor are not eligible for any assistance program (e.g. Medicaid) and do not qualify for coverage through SMCH community assistance policy. After having been turned over to a third-party collection agent, any patient account that is subsequently determined to meet the SMCH community assistance policy is required to be returned immediately by the third party collection agent to SMCH for appropriate follow-up. All of Catholic Health Initiatives' hospitals' contracts with third party collection agencies include the following standards: * Neither CHI Hospitals nor their collection agencies will request bench or arrest warrants as a result of non-payment. * Neither CHI hospitals nor their collection agencies will seek liens that would require the sale or foreclosure of a primary residence; and * No Catholic Health Initiatives' collection agency may seek court action without hospital approval. Finally, collection agencies are trained on the Catholic Health Initiatives Mission, Core Values, and Standard of Conduct to make sure all patients are treated with dignity and respect.	DebtCollectionPolicy
Needs Assessment	Line 2: Describe how the organization assesses the health care needs of the communities it serves. Line 4: Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves. Line 5: Describe how the organization's community building activities, as reported in Part II, promote the health of the communities the organization serves. Line 6: 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). Organization's Mission, Vision, and Tax-Exempt Purpose St. Mary's Community Hospital ("St. Mary's") in Nebraska City, Nebraska has faithfully served the residents of Otoe County and the surrounding area of southeast Nebraska and southwest Iowa for over 80 years. In 1925 a local physician suggested a hospital be built in Nebraska City. By early 1926 there was a collaborative agreement between the Sisters of St. Francis of Maryville, Missouri and the residents of Otoe County. Just one year later, in February of 1927, St. Mary's opened its doors and began serving patients. As a Catholic institution, St. Mary's embraced the mission of the founding religious congregation to care for the sick and all those in need. In 1983 a transfer of hospital sponsorship was made from the Sisters of St. Francis of Maryville, Missouri to the Sisters of St. Francis of Colorado Springs, which has since joined with other religious congregations to form Catholic Health Initiatives. St. Mary's continues to serve the community by living out its mission to nurture the healing ministry of the Church by bringing it new life, energy and viability in the 21st century. Being faithful to the Gospel St. Mary's strives to emphasize human dignity and social justice as we move toward the creation of a healthier community. St. Mary's Community Hospital is included in the Official Catholic Directory as a tax-exempt hospital. St. Mary's Community Hospital is governed by a local board comprised primarily of independent community representatives. The hospital serves all persons on a non-discriminatory basis. St. Mary's Emergency Department is open 24 hours a day, seven day a week, and provides care regardless of ability to pay. St. Mary's Community Hospital has an open medical staff, participates in Medicare and Medicaid and has an active charity care program. Community service continues to be an important part of the hospital's identity just as it was for the founding congregation. Reaching beyond the hospital walls to build collaborative sustainable partnerships helps the hospital identify and respond to community health needs and ensures limited resources will be utilized for the common good. These efforts contribute to an improved overall quality of life for community members and reduces the burden on government to meet health needs through government supported entities. The hospital's vision is to live up to our name as one Catholic Health Initiatives (CHI): Catholic: Living our Mission and our Core Values, Health: Improving the health of the people and communities we serve, Initiatives: Pioneering models and systems of care to enhance care delivery. Fidelity to the vision will ensure St. Mary's Community Hospital continues to make a positive difference in people's lives and in the life of the community. Community Benefit Approach St. Mary's Community Hospital's Community Benefit approach is based on understanding area needs as derived from the Healthy Communities Coalition. The healthy community process is a consensus-building format where community participants identify issues and concerns, prioritize needs and set goals, develop and implement a plan, and work to evaluate outcomes through community meetings and focus groups. St. Mary's Community Hospital is located in Nebraska City, Nebraska which is geographically positioned in the southeast corner of the state in Otoe County. The oldest and largest community in the county, Nebraska City, is located on the Missouri River approximately 50 miles south of Omaha and 50 miles east of Lincoln. Almost one half of Otoe County's 15,747 residents reside within the community of Nebraska City; the other half live in or near one of nine communities with populations of less than 2,000. Demographic data from 2006 indicates 15,558 (98.8%) of Otoe county citizens are Caucasian, 77(.4%) are Black, 59(.4%) are Native American, 53(.3) are Asian, and 525(3.3%) are Hispanic. Although 98% of Otoe County's youth are White, the Hispanic population is growing. In 2006-07 there were 161 (13.7%) Hispanic children enrolled in Nebraska City Public Schools and 4.7% of students were English language learners. The hospital's primary service area is Otoe County, but also includes communities in southeast Nebraska as well as southwest Iowa. This encompasses the hospital's home zip code area and the 11 neighboring zip codes. St. Mary's Community Hospital has been extending into these areas for several years to improve the health of the communities it serves through a strong commitment to outreach initiatives. In 2004, SMCH officially launched the Healthy Communities Coalition (HCC). This initiative continues to be a vibrant community force and forum that links people and encourages community partnerships. A wide variety of citizens from the public and private sectors participate in this process. The following interests are present at the community table: business, civic/volunteer groups, cultural diversity, healthcare, law enforcement, media, parents, churches, schools, local government, youth, and youth-serving organizations because all have a stake in their community's future. St. Mary's commitment to creating a healthier community is also evidenced by the dedication of staff hours and allocation of resources to the healthy community process as well as to assist in the community benefit effort of the organization. St. Mary's commitment to the principles of its founding religious congregation has helped shape its practice to care for all those in need. To this end, St. Mary's Community Hospital provides uncompensated or discounted medical services for individuals who have demonstrated a need in excess of insurance, personal resources, or funds available through federal, state, and local medical funding programs, or determined to be medically indigent. Medically indigent patients are those patients whose health insurance coverage, if any, does not provide full coverage for all of their medical expenses, in relationship to their income, and would make them indigent if they had to pay full charges for their medical expenses. Notices to the uninsured/underinsured are posted in key areas of the hospital and information on financial assistance and how to request assistance are readily provided to patients. Process In 2007, St. Mary's Community Hospital's Healthy Communities Coalition and Otoe County Coalition merged to form Partners for Otoe County (P4OC). The coalition strives to maximize resources (financial and human), reduce duplication of work and work effectively to meet the needs and priorities of Nebraska City and Otoe County. P4OC encourages individuals, organizations and institutions to take responsibility for improving the health and quality of life in their communities. In Fiscal Year 2009, P4OC initiated a restructure process to streamline operations, programming, and better facilitate collaborative relationships among community partners. Summary of Assessment Findings P4OC completed the healthy communities' assessment process in 2007. The process identified issues having a significant impact on the overall health of the population of Nebraska City and Otoe County. From these identified issues, P40C's developed the following goal in the area of Healthy Youth and Families. In Fiscal Year 2010, the goal areas were evaluated and reorganized to better respond to the needs of the community. The current coalition goal is building a community where every family thrives. Ownership of this goal is shared between community partners. St. Mary's Community Hospital continues to have a leadership role in championing some of these initiatives and has incorporated them into the hospital's existing community benefit plan. St. Mary's Community Hospital's focus for community benefit activities includes: * Healthy Lifestyles and Behaviors * Violence Prevention * Child and Maternal Health * Access to Basic Needs/Community Health Services * Educational Programs Uncompensated Care Each year, St. Mary's Community Hospital provides a significant amount of free care to those who are in need. In Fiscal Year 2010, the cost of charity care provided by the organization was $256,927. St. Mary's Community Hospital does not experience a Medicaid shortfall due to our Critical Access status. QUALITATIVE DESCRIPTION OF COMMUNITY BENE	NeedsAssessment
Patient Education Assistance	Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization's charity care policy. St. Mary's clearly displays information concerning its financial assistance policy in obvious locations throughout the hospital, including admissions and the emergency department. In addition, St. Mary's Patient Access Staff are trained to provide consultation to those who have no insurance or potentially inadequate insurance concerning their financial options including application for Medicaid and for financial assistance under St. Mary's charity care policy. Upon registration (and once all EMTALA requirements are met), patients who are identified as uninsured (and not covered by Medicaid or Medicare) are provided with a packet of information that addresses the financial assistance policy and procedures including an application for assistance. St. Mary's staff will also assist the patient/guarantor with applying for other available coverage (such as Medicaid), if necessary. Counselors assist Medicare eligible patients in enrollment by providing referrals to the appropriate government agency.	PatientEducationAssistance
Community Information	Describe 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 Activities	Describe 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
Other Information	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). Please refer to the Needs Assessment Narrative, Part VI, Item 2. above.	OtherInformation
Affiliated Health Care System	If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served. St. Mary's Community Hospital in Nebraska City, NE, is part of Catholic Health Initiatives. Catholic Health Initiatives (CHI) is a national faith-based nonprofit health care organization with headquarters in Denver, Colorado. CHI's exempt purpose is to serve as an integral part of its national system of hospitals and other charitable entities, which are described as market-based organizations, or MBO's. An MBO is a direct provider of care or services within a defined market area that may be an integrated health system and/or a stand-alone hospital or other facility or service provider. CHI serves as the parent corporation of its MBO's which are comprised of 75 acute care hospitals, 40 long-term care, assisted living and residential units, and two Community Health-Services Organizations. These entities are located throughout 67 rural/urban communities in 19 states. Together, these facilities provided $590 million in charity care and community benefit in the 2010 fiscal year. Community benefit includes the cost of supplies and labor related to free clinics, donations, and other services provided to the poor and to meet community need. CHI provides strategic planning and management services as well as centralized "shared services" for the MBO's. The provision of centralized management and shared services including areas such as accounting, human resources, payroll and supply chain provides economies of scale and purchasing power to the MBO's. Cost savings associated with centralized services for the fiscal year ended June 30, 2010 include more than $105 million in supply chain expense, approximately $30 million for insurance costs and more than $10 million as the result of a system-wide effort to coordinate and negotiate technology and equipment purchases. The cost savings achieved through CHI's centralization enable MBO's to dedicate additional resources to high-quality health care and community outreach services to the most vulnerable members of our society. St. Mary's Community Hospital operates to serve the health care needs of Nebraska City, Nebraska and surrounding communities.	AffiliatedHealthCareSystem

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	St Mary's Community Hospital Foundation	BusinessNameLine1

Address US AddressUS

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

Field	Value	IRS element (for citing)
EIN Of Recipient	470707604	EINOfRecipient
IRC Section	501(C)(3)	IRCSection
Amount Of Cash Grant	6000	AmountOfCashGrant
Purpose Of Grant	General Support	PurposeOfGrant

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	1	TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS	Identifier
Return Reference	SCH. I, PART I, Q. 2	ReturnReference
Explanation	THE ORGANIZATION MADE A GRANT TO ST. MARY'S HOSPITAL FOUNDATION, A RELATED ORGANIZATION. UPON PROVIDING SATISFACTORY WRITTEN EVIDENCE THAT THE FUNDS WERE USED FOR THE PURPOSE THE GRANT WAS MADE, THE HOSPITAL RELEASES THE RESTRICTION AND THE FUNDS ARE TRANSFERRED.	Explanation

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Stacy Blum
201390	67690	1295	40372	310748
Daniel Kelly
128265	32734	37966	27609	237824	11250	10958
Robert Lanik
507375	121891	55909	44970	761647	31501	27476
Jonathan Stelling
178841	77804	564	40488	297696

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
METHODS USED TO ESTABLISH CEO/EXECUTIVE DIRECTOR COMPENSATION	Sch J Pt I Q3	COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR OF ST. MARY'S COMMUNITY HOSPITAL WAS ESTABLISHED AND PAID BY CATHOLIC HEALTH INTITIATIVES ("CHI"), A RELATED ORGANIZATION. CHI USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) WRITTEN EMPLOYMENT CONTRACTS; (4) COMPENSATION SURVEY OR STUDY; AND (5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
POST-TERMINATION PAYMENTS	Sch J Pt I Q4A	POST-TERMINATION PAYMENTS ARE ADDRESSED IN THE EXECUTIVE EMPLOYMENT AGREEMENTS FOR CHI'S VPS and above including MBO CEOS. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE CURRENT YEAR.
SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN	Sch J Pt I Q4B	DURING THE 2009 CALENDAR YEAR CHI MAINTAINED A SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLAN FOR VICE PRESIDENTS AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE: Robert Lanik and Daniel Kelly. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED CONTRIBUTIONS TO THE NON-QUALIFIED PLAN FOR THE 2009 CALENDAR YEAR: ROBERT LANIK $31,501; Daniel Kelly $11,250. 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: ROBERT Lanik $27,476; Daniel Kelly $10,958.
NON-FIXED PAYMENTS	Schedule J, PART I, Q. 7	DURING FY2010, ST. MARY'S COMMUNITY HOSPITAL MAINTAINED A DISCRETIONARY BONUS PROGRAM PAYABLE AT THE CLOSE OF THE FISCAL YEAR. AWARDS OF COMPENSATION FROM THIS PLAN WERE BASED ON THE ACHIEVEMENT OF CERTAIN ORGANIZATIONAL TARGETS (GENERALLY ASSOCIATED WITH PATIENT SATISFACTION, FINANCIAL PERFORMANCE AND QUALITY INITIATIVES) AND WERE PAYABLE AS A FIXED PERCENTAGE OF EACH PARTICIPANT'S BASE COMPENSATION IF SUCH TARGETS WERE ACHIEVED.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
EXECUTIVE COMMITTEE	FORM 990, PART VI, Q. 1A	THE EXECUTIVE COMMITTEE CONSISTS ONLY OF DIRECTORS OF THE CORPORATION AND IS COMPOSED OF THE CHAIR OF THE BOARD, THE VICE CHAIR OF THE BOARD, AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, EACH OF WHOM SERVE AS EX OFFICIO VOTING MEMBERS OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT THE ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIODS BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT THEIR ACTIONS ARE CONSISTENT WITH ANY ACTIONS OR POLICIES OF THE BOARD OR THE CORPORATE MEMBER. ALL ACTIONS TAKEN ARE CONTEMPORANEOUSLY DOCUMENTED AND REPORTED TO THE BOARD AT THE NEXT REGULARLY SCHEDULED MEETING.
MEMBERS OR STOCKHOLDERS	FORM 990, PART VI, Q. 6	THE SOLE MEMBER OF THE ORGANIZATION IS CHI Nebraska, A Nebraska NON-PROFIT CORPORATION.
MEMBERS ELECT ONE OR MORE MEMBERS OF GOVERNING BODY	FORM 990, PART VI, Q. 7A	THE SOLE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE GOVERNING BODY.
Governing Powers	FORM 990, PART VI, Q. 7B	The organization's corporate member is CHI Nebraska. Pursuant to Section 5.4.1 of the organization's bylaws, both CHI Nebraska and Catholic Health Initiatives ("CHI") (CHI Nebraska's sole corporate member) have reserved powers as outlined in the CHI governance matrix. Pursuant to the governance matrix the following rights are held by the CHI Nebraska's Board: * Approve members of the St. Mary's Community Hospital board * Amendment of the corporate documents of the St. Mary's Community Hospital * Approve removal of a member of the governing body of the St. Mary's Community Hospital * Adoption of long range and strategic plans for the St. Mary's Community Hospital The following rights are reserved to the CHI Board directly or through powers delegated to the CHI Chief Executive Officer: * Substantial change in the mission or philosophy of the St. Mary's Community Hospital * Removal of a member of the governing body of the St. Mary's Community Hospital * Approval of issuance of debt by St. Mary's Community Hospital * Approval of participation of St. Mary's Community Hospital in a joint venture * Approval of formation of a new corporation by St. Mary's Community Hospital * Approval of a merger involving the St. Mary's Community Hospital * Approval of the sale of all or substantially all of the assets of the St. Mary's Community Hospital * To require the transfer of assets by the St. Mary's Community Hospital to CHI to accomplish CHI's goals and objectives, and to satisfy CHI debts. Pursuant to Section 5.4.2 of the organization's bylaws, CHI Nebraska or CHI may, in exercise of their approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and its President and the Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate.
PROCESS THE ORGANIZATION USES TO REVIEW FORM 990	FORM 990, PART VI, Q. 11	Once the return is prepared, the return is reviewed by the Chief Financial Officer. The CFO then presents the return at the finance/audit committee board meeting for review. Finally, the CFO e-mails the return to the full board prior to filing. Subsequently, the tax department files the return with the appropriate federal agency, 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 POLICY	FORM 990, PART VI, Q. 12C	ST. MARY'S COMMUNITY HOSPITAL HAS A BOARD POLICY THAT REFERENCES THE DUALITY OF INTEREST AND CONFLICT OF INTEREST POLICIES PROVIDED BY CHI NATIONAL. AT THE ANNUAL BOARD AND BOARD COMMITTEE MEETINGS ALL MEMBERS ARE REQUESTED TO SIGN CONFLICT OF INTEREST STATEMENTS. THE SIGNED STATEMENTS ARE RETAINED IN THE ADMINISTRATIVE FILES. ALL MEMBERS ARE REQUESTED TO DECLARE POTENTIAL CONFLICTS OF INTEREST AT EACH BOARD AND/OR COMMITTEE MEETING OF THE BOARD (FINANCE/AUDIT AND COMPLIANCE COMMITTEE AND THE PERFORMANCE IMPROVEMENT COMMITTEE). IF THE BOARD FINDS THAT A CONFLICT DOES EXIST REGARDING THE AGENDA ITEMS TO BE PRESENTED FOR ACTION, MEMBERS ARE REQUESTED TO ABSTAIN FROM VOTING. IN ADDITION A QUESTIONNAIRE IS SENT ANNUALLY TO ALL BOARD MEMBERS, TOP PAID VENDORS, AND TOP PAID EMPLOYEES ASKING THEM TO DISCLOSE ANY BUSINESS OR FAMILY RELATIONSHIPS. although we have the annual disclosure completed, any time a potential conflict is identified, we seek guidance from our compliance officer. Additionally, our conflict of interest policy requires each director must promptly and fully report to the board chair situations that may create a conflict of interest when he/she becomes aware of such situations.
PROCESS FOR DETERMINING COMPENSATION - CEO	FORM 990, PART VI, Q. 15A	The organization's CEO's compensation is paid by CHI. CHI uses the Hay Group as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of CHI's senior most executives (including each MBO CEO) are reviewed on an individual basis annually. The Hay Group reviews both cash and total compensation for overall reasonableness, for adherence to CHI's compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review is delivered by Hay Group to the HR Committee of the CHI Board of Stewardship Trustees annually at their September meeting and minutes are shared with the full board at the December meeting. The last review was September, 2010. In addition, in December 2009, Hay Group completed a comprehensive review of all CHI's positions at the level of Vice President and above to determine and validate appropriate compensation levels.
PROCESS FOR DETERMINING COMPENSATION - OFFICERS/KEY EMPLOYEES	FORM 990, PART VI, Q. 15B	ANY EXECUTIVE COMPENSATION PAID BY ST. MARY'S COMMUNITY HOSPITAL WAS SET BY THE EXECUTIVE COMMITTEE UTILIZING COMPARABILITY STUDIES TO DETERMINE OFFICER COMPENSATION AS REQUIRED BY THE ORGANIZATION'S EXECUTIVE COMPENSATION REVIEW POLICY. THE BOARD OF DIRECTORS OVERSEES THE COMPENSATION SETTING PROCESS AND ENSURES REASONABLENESS AND COMPLIANCE WITH THE ORGANIZATION'S COMPENSATION PHILOSOPHY.
GOVERNING DOCUMENTS - FINANCIAL STATEMENTS AVAILABLE	FORM 990, PART VI, Q. 19	THE Organization's FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.COM. The organization's organizing documents are available from the Nebraska Secretary of State's website. The organization's conflict of interest policy is not publicly available.
ESTIMATE OF HOURS DEVOTED TO RELATED ORGANIZATIONS	FORM 990, PART VII	COMPENSATION REPORTED ON FORM 990, PART VII WAS PAID TO THESE INDIVIDUALS BY RELATED ORGANIZATIONS IN EXCHANGE FOR THE FULFILLMENT OF THEIR DUTIES AS FULL-TIME, 60 HOUR-PER-WEEK EMPLOYEES.
Significant Changes to Organizational Documents	990 Pt VI Q4	THE ORGANIZATIONAL DOCUMENTS WERE AMENDED TO REFLECT CHI NEBRASKA, A NEBRASKA NONPROFIT CORPORATION, AS THE SOLE CORPORATE MEMBER.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (132 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1
St Joseph Community Health Services
300 Central SW Suite 300	Albuquerque	NM	87102	710897107	Community	NM	501(c)(3)	11a	CHI
St Joseph Community Health Foundation
300 Central SW Suite 300	Albuquerque	NM	87102	850253087	Foundation	NM	501(c)(3)	7	SJCHS
St Francis of Baker City
3325 Pocahontas Road	Baker City	OR	97814	930412495	Hospital	OR	501(c)(3)	3	CHI
St Elizabeth Health Care Foundation
3325 Pocahontas Road	Baker City	OR	97814	943164869	Foundation	OR	501(c)(3)	7	SEHS
Flaget Memorial Hospital Foundation Inc
4305 New Shepherdsville Road	Bardstown	KY	40004	562351341	Fundraising	KY	501(c)(3)	11a	FH
Flaget Healthcare DBA Flaget Memorial
4305 New Shepherdsville Road	Bardstown	KY	40004	611345363	Hospital	KY	501(c)(3)	3	CHI
Lakewood Health Center
600 Main Avenue South	Baudette	MN	56623	410758434	LTerm Care	MN	501(c)(3)	3	CHI
Appletree Court
601 Oak Street	Breckenridge	MN	56520	411850500	Senior Homes	MN	501(c)(3)	9	SFH
Healthcare and Wellness Foundation
2400 St Francis Drive	Breckenridge	MN	56520	760761782	Foundation	MN	501(c)(3)	11a	SFMC
St Francis Home
2400 St Francis Drive	Breckenridge	MN	56520	410729978	LTerm Care	MN	501(c)(3)	9	CHI
St Francis Medical Center
2400 St Francis Drive	Breckenridge	MN	56520	410695598	Healthcare	MN	501(c)(3)	3	CHI
Carrington Health Center
800 North 4th Street	Carrington	ND	58421	450227311	Healthcare	ND	501(c)(3)	3	CHI
Saint Clare's Community Care
66 Ford Road	Denville	NJ	07834	222876836	Healthcare	NJ	501(c)(3)	11b	SCHS
Saint Clare's Foundation Inc
66 Ford Road	Denville	NJ	07834	222502997	Fundraising	NJ	501(c)(3)	7	SCHS
Good Samaritan College of Nursing & Heal
375 Dixmyth Ave	Cincinnati	OH	45220	311778403	Education	KY	501(c)(3)	2	GHS
Total Healthcare
PO Box 7021	Colorado Springs	CO	80933	840927232	Healthcare	CO	501(c)(3)	3	CHI Colorado
Memorial Health Care System Inc
2525 De Sales Avenue	Chattanooga	TN	37404	620532345	Hospital	TN	501(c)(3)	3	CHI
Memorial Health Care System Foundation
2525 De Sales Avenue	Chattanooga	TN	37404	621839548	Foundation	TN	501(c)(3)	7	MHCS
Memorial Health Partners Foundation Inc
6028 Shallowford Road	Chattanooga	TN	37421	030417049	Healthcare	TN	501(c)(3)	9	MHCS
The Community Limited Care Dialysis Cent
619 Oak Street Accounting-3 West	Cincinnati	OH	45206	237419853	Dialysis	OH	501(c)(2)	none	GSH
Good Samaritan Foundation of Cincinnati
619 Oak Street Accounting-3 West	Cincinnati	OH	45206	311206047	Foundation	OH	501(c)(3)	11a	GSH
The Good Samaritan Hospital of Cincinnat
619 Oak Street Accounting-3 West	Cincinnati	OH	45206	310537486	Hospital	OH	501(c)(3)	3	TRI-HEALTH
Saint Clare's Hospital
66 Ford Road	Denville	NJ	07834	223319886	Hospital	NJ	501(c)(3)	3	CHI
St Francis Life Care Corporation
19 Pocono Road	Denville	NJ	07834	222536017	Elderly Care	NJ	501(c)(3)	9	SCHS
TriHealth Physician Institute
619 Oak Street Accounting-3 West	Cincinnati	OH	45206	311074519	Physicians	OH	501(c)(3)	11a	GSH
Catholic Health Initiatives Colorado Fou
961 East Colorado Avenue	Colorado Springs	CO	80903	840902211	Foundation	CO	501(c)(3)	7	CHI Colorado
SET of Colorado Springs Inc
825 E Pikes Peak Avenue Bldg 29	Colorado Springs	CO	80903	841183335	LTerm Care	CO	501(c)(3)	7	CHI Colorado
Catholic Health Initiatives
1999 Broadway Suite 4000	Denver	CO	80202	470617373	Healthcare	CO	501(c)(3)	9	CHI
Catholic Health Care Federation
1999 Broadway Suite 4000	Denver	CO	80202	208473567	Jurdic Person	CO	501(c)(3)	11a	CHI
Global Health Initiatives
1999 Broadway Suite 4000	Denver	CO	80202	201536108	Ministries	CO	501(c)(3)	11a	CHI
Health SET
4200 West Conejos Place 436	Denver	CO	80204	841102943	Low Inc.Care	CO	501(c)(3)	7	CHI Colorado
Bishop Drumm Retirement Center
1111 6th Avenue	Des Moines	IA	50314	420725196	LTerm Care	IA	501(c)(3)	9	CHI-IA Corp
Mercy Medical Center - Des Moines AKA
1111 6th Avenue	Des Moines	IA	50314	420680448	Hospital	IA	501(c)(3)	3	CHI-IA Corp
House of Mercy
1111 6th Avenue	Des Moines	IA	50314	421323808	Shelter	IA	501(c)(3)	7	CHI-IA Corp
Mercy Auxiliary of Central Iowa
1111 6th Avenue	Des Moines	IA	50314	426076069	Auxiliary	IA	501(c)(3)	11a	CHI-IA Corp
Mercy Clinics Inc
1111 6th Avenue	Des Moines	IA	50314	421193699	Physician	IA	501(c)(3)	9	CHI-IA Corp
Mercy College of Health Sciences
1111 6th Avenue	Des Moines	IA	50314	421511682	Education	IA	501(c)(3)	2	CHI-IA Corp
Mercy Foundation of Des Moines IA
1111 6th Avenue	Des Moines	IA	50314	237358794	Foundation	IA	501(c)(3)	7	CHI-IA Corp
Mercy Medical Center - Centerville FKA
1 St Josephs Drive	Centerville	IA	52544	420680308	Hospital	IA	501(c)(3)	3	CHI-IA Corp
Mercy Professional Practice Associates
1111 6th Avenue	Des Moines	IA	50314	421470935	Physician	IA	501(c)(3)	9	CHI-IA Corp
Mercy Hospital of Devils Lake
1031 East Seventh Street	Devils Lake	ND	58301	450227012	Healthcare	ND	501(c)(3)	3	CHI
Saint Joseph's Hospital Foundation
30 West 7th Street	Dickinson	ND	58601	363418207	Foundation	ND	501(c)(3)	11a	SJHHC
St Joseph's Hospital and Health Center
30 West 7th Street	Dickinson	ND	58601	450226429	Healthcare	ND	501(c)(3)	3	CHI
Mercy Regional Medical Center of Durango
1010 Three Springs Blvd	Durango	CO	81301	840405515	Hospital	CO	501(c)(3)	3	CHI
CHI Kentucky Inc
3900 Olympic Blvd Suite 400	Erlanger	KY	41018	202741651	Healthcare	KY	501(c)(3)	11a	CHI
Villa Nazareth Inc
801 Page Drive	Fargo	ND	58103	450226714	LT Care	ND	501(c)(3)	9	CHI
St Catherine Hospital
401 East Spruce Street	Garden City	KS	67846	480543721	Hospital	KS	501(c)(3)	3	CHI
St Catherine Hospital Development Found
401 East Spruce Street	Garden City	KS	67846	200598702	Foundation	KS	501(c)(3)	11a	SCH
Saint Francis Medical Center Foundation
PO Box 9804	Grand Island	NE	68802	470630267	Foundation	NE	501(c)(3)	7	SFMC
Saint Francis Medical Center
PO Box 9804	Grand Island	NE	68802	470376601	HealthCare	NE	501(c)(3)	3	CHI Nebraska
Central Kansas Medical Center
3515 Broadway	Great Bend	KS	67530	480543724	Hospital	KS	501(c)(3)	3	CHI
St Joseph Memorial Hospital
923 Carroll Ave	Larned	KS	67550	481253246	Hospital	KS	501(c)(3)	3	CKMC
MNMCH Inc
220 North Pennsylvania	Columbus	KS	66725	481216238	Hospital	KS	501(c)(3)	3	SJRMC
Mercy Lifecare Systems
2727 McClelland Blvd	Joplin	MO	64804	431305163	Property Mgmt	MO	501(c)(3)	11a	SJRMC
St John's Medical Group
2727 McClelland Blvd	Joplin	MO	64804	431882377	Phys Practice	MO	501(c)(3)	9	SJRMC
St John's Mercy Regional Foundation
2727 McClelland Blvd	Joplin	MO	64804	431308084	Foundation	MO	501(c)(3)	7	SJRMC
St John's Regional Medical Center
2727 McClelland Blvd	Joplin	MO	64804	440545809	Hospital	MO	501(c)(3)	3	CHI
Good Samaritan Hospital
PO Box 1990	Kearney	NE	68848	470379755	HealthCare	NE	501(c)(3)	3	CHI Nebraska
Good Samaritan Hospital Foundation
PO Box 1810	Kearney	NE	68848	470659443	Foundation	NE	501(c)(3)	7	GSH
St Joseph Health Ministries
2135 Noll Drive Suite C	Lancaster	PA	17603	232342997	Health	PA	501(c)(3)	11a	SJHM
St Joseph Health Ministries Foundation
2135 Noll Drive Suite C	Lancaster	PA	17603	232605579	Fundraising	PA	501(c)(3)	11a	SJHM
St Joseph Health Services Inc
2135 Noll Drive Suite C	Lancaster	PA	17603	201425375	Dental care	PA	501(c)(3)	11a	SJHM
Continuing Care Hospital
150 North Eagle Creek Drive	Lexington	KY	40509	611400619	LTACH	KY	501(c)(3)	3	SJHS
Saint Joseph Berea Hospital Foundation
305 Estill Street	Berea	KY	40403	260152877	Foundation	KY	501(c)(3)	7	SJHS
Saint Joseph Health System Inc
150 N Eagle Creek Dr	Lexington	KY	40509	611334601	Hospital	KY	501(c)(3)	3	CHI
St Joseph Hospital Foundation Inc
One St Joseph Drive	Lexington	KY	40504	611159649	Foundation	KY	501(c)(3)	11a	SJHS
Saint Joseph Medical Foundation Inc
One St Joseph Drive	Lexington	KY	40504	311539059	Phy Practices	KY	501(c)(3)	3	SJHS
Visiting Nurse Association of Saint Clar
191 Woodport Road	Sparta	NJ	07871	221768334	Home Health	NJ	501(c)(3)	9	SCHS
Saint Elizabeth Foundation
555 South 70th Street	Lincoln	NE	68510	470625523	Foundation	NE	501(c)(3)	7	SERMC
Saint Elizabeth Health Services
555 South 70th Street	Lincoln	NE	68510	363233120	Healthcare	NE	501(c)(3)	3	SERMC
CHI Nebraska
555 South 70th Street	Lincoln	NE	68510	363233121	Healthcare	NE	501(c)(3)	11a	CHI
Saint Elizabeth Regional Medical Center
555 South 70th Street	Lincoln	NE	68510	470379836	Healthcare	NE	501(c)(3)	3	CHI Nebraska
The Physician Network
8055 O Street Suite 300	Lincoln	NE	68510	470780857	Healthcare	NE	501(c)(3)	11a	CHI Nebraska
Lisbon Area Health Services
905 Main Street	Lisbon	ND	58054	820558836	Healthcare	ND	501(c)(3)	3	CHI
Alverna Apartments
300 SE 8th Avenue	Little Falls	MN	56345	411351177	Lterm Care	MN	501(c)(3)	9	CHI
Unity Family Healthcare
815 2nd Street SE	Little Falls	MN	56345	410721642	Healthcare	MN	501(c)(3)	3	CHI
St Anthony's Hospital Association
4 Hospital Drive	Morrilton	AR	72110	710245507	Healthcare	AR	501(c)(3)	3	SVIMC
St Vincent Infirmary Medical Center
2 St Vincent Circle	Little Rock	AR	72205	710236917	Healthcare	AR	501(c)(3)	3	CHI
St Vincent Medical Group
2 St Vincent Circle	Little Rock	AR	72205	710830696	Healthcare	AR	501(c)(3)	9	SVIMC
Maria-Joseph Center
4830 Salem Avenue	Dayton	OH	45416	310935118	Healthcare	OH	501(c)(3)	9	SHP
Saint Joseph London Foundation Inc
310 East Ninth Street	London	KY	40741	260438748	Foundation	KY	501(c)(3)	11a	SJHS
Samaritan Behavioral Health
601 S Edwin C Moses Blvd	Dayton	OH	45408	020633634	Hospital	OH	501(c)(3)	3	SHP
Mercy Medical Center
1512 12th Avenue Road	Nampa	ID	83686	820200896	Hospital	ID	501(c)(3)	3	CHI
Mercy Medical Center Foundation
1512 12th Avenue Road	Nampa	ID	83686	261737256	Foundation	ID	501(c)(3)	11a	Mercy Med Ct
Mercy Physician Group Inc
1512 12th Avenue Road	Nampa	ID	83686	208192593	Phys Group	ID	501(c)(3)	9	Mercy Med Ct
St Mary's Hospital
1314 3rd Avenue	Nebraska City	NE	68410	470443636	Hospital	NE	501(c)(3)	3	CHI Nebraska
St Mary's Hospital Foundation
1314 3rd Avenue	Nebraska City	NE	68410	470707604	Foundation	NE	501(c)(3)	7	SMH
Oakes Community Hospital
314 South 8th Street	Oakes	ND	58474	450231675	Hospital	ND	501(c)(3)	3	CHI
Oakes Community Hospital Foundation
314 South 8th Street	Oakes	ND	58474	710966606	Foundation	ND	501(c)(3)	11a	OCH
St Dominic at Ontario
351 SW 9th Street	Ontario	OR	97914	930433692	Hospital	OR	501(c)(3)	3	CHI
Holy Rosary Medical Center Foundation
351 SW 9th Street	Ontario	OR	97914	202683560	Foundation	OR	501(c)(3)	11a	HRMC
St Joseph's Area Health Services
600 Pleasant Avenue	Park Rapids	MN	56470	410695603	Hospital	MN	501(c)(3)	3	CHI
St Anthony Hospital
1601 SE Court Avenue	Pendleton	OR	97801	930391614	Hospital	OR	501(c)(3)	3	CHI
St Anthony Hospital Foundation
1601 SE Court Avenue	Pendleton	OR	97801	930992727	Foundation	OR	501(c)(3)	11a	SA Hospital
Gettysburg Medical Center
606 East Garfield Avenue	Gettysburg	SD	57442	460234354	Hospital	SD	501(c)(3)	3	SMHC
St Mary's Healthcare Center
801 East Sioux Avenue	Pierre	SD	57501	460230199	Healthcare	SD	501(c)(3)	3	CHI
Mt St Joseph Inc
3060 SE Stark Street	Portland	OR	97214	930386870	Nursing Care	OR	501(c)(3)	9	CHI
Pueblo Stepup
1925 East Orman Avenue Suite G52	Pueblo	CO	81004	841234295	Community	CO	501(c)(3)	7	CHI
Bornemann Healthcare Corporation
2500 Bernville Road PO Box 316	Reading	PA	19603	232187242	Healthcare	PA	501(c)(3)	11a	CHI
St Joseph Medical Center Foundation
2500 Bernville Road PO Box 316	Reading	PA	19603	232649362	Foundation	PA	501(c)(3)	11a	SJRHN
St Joseph Medical Group
2500 Bernville Road PO Box 316	Reading	PA	19603	208544021	Healthcare	PA	501(c)(3)	9	BHC
St Joseph Regional Health Network
2500 Bernville Road PO Box 316	Reading	PA	19603	231352211	Healthcare	PA	501(c)(3)	3	CHI
Linus Oakes Inc
2700 Stewart Parkway	Roseburg	OR	97470	930821381	Senior Living	OR	501(c)(3)	9	MMC
Mercy Foundation Inc
2700 Stewart Parkway	Roseburg	OR	97470	936088946	Foundation	OR	501(c)(3)	7	MMC
Mercy Medical Center
2700 Stewart Parkway	Roseburg	OR	97470	930386868	Hospital	OR	501(c)(3)	3	CHI
Franciscan Villa of South Milwaukee Inc
3601 South Chicago Avenue	South Milwaukee	WI	53172	391093829	Healthcare	WI	501(c)(3)	9	CHI
Enumclaw Community Hospital
1450 Battersby Avenue	Enumclaw	WA	98022	910715805	Hospital	WA	501(c)(3)	3	FHS
Franciscan Foundation
1717 South J Street	Tacoma	WA	98405	911145592	Fundraising	WA	501(c)(3)	9	FHS
Franciscan Health System FKA Franciscan
1717 South J Street	Tacoma	WA	98405	910564491	Healthcare	WA	501(c)(3)	3	CHI
Franciscan Medical Group
1708 South Yakima Avenue	Tacoma	WA	98405	911939739	Healthcare	WA	501(c)(3)	9	FHS
St Joseph Medical Center Foundation In
7601 Osler Drive	Towson	MD	21204	521681044	Fundraising	MD	501(c)(3)	7	SJMC
St Joseph Medical Center Inc
7601 Osler Drive	Towson	MD	21204	520591461	Hospital	MD	501(c)(3)	3	CHI
St Joseph Physician Enterprises
7601 Osler Drive	Towson	MD	21204	521311775	Physicians	MD	501(c)(3)	11a	CHI
Samaritan Health Foundation
2222 Philadelphia Drive	Dayton	OH	45406	237296923	Foundation	OH	501(c)(3)	7	SHP
Mercy Hospital of Valley City
570 Chautauqua Boulevard	Valley City	ND	58072	450226553	Hospital	ND	501(c)(3)	3	CHI
Mercy Medical Center
1301 15th Avenue West	Williston	ND	58801	450231183	Healthcare	ND	501(c)(3)	3	CHI
Mercy Medical Foundation
1301 15th Avenue West	Williston	ND	58801	450381803	Foundation	ND	501(c)(3)	11a	MMC
Samaritan Health Partners
2222 Philadelphia Drive	Dayton	OH	45406	311107411	Healthcare	OH	501(c)(3)	11a	CHI
St Vincent Foundation
Two St Vincent Circle	Little Rock	AR	72205	510169537	Fundraising	AR	501(c)(3)	11a	SVIMC
Auxiliary of Holy Rosary Hospital Inc
351 SW 9th Street	Ontario	OR	97914	943059469	Hospital	OR	501(c)(3)	9	HRMC
The Mercy Hospital of Devils Lake Fdn
1031 East Seventh Street	Devils Lake	ND	58301	352367360	Foundation	ND	501(c)(3)	11a	MHDL
Alegent Health - Bergan Mercy Health Sys
7500 Mercy Road	Omaha	NE	68124	470484764	Hospital	NE	501(c)(3)	3	CHI
Alegent Health - Mercy Hospital Corning
PO Box 368	Corning	IA	50841	420782518	Hospital	IA	501(c)(3)	3	AHBMHS
Mercy Health Care Foundation
PO Box 368	Corning	IA	50841	421461064	Foundation	NE	501(c)(3)	11a	AHMH
Mercy Hospital Foundation Council Bluff
800 Mercy Drive	Council Bluffs	IA	51503	421178204	Foundation	IA	501(c)(3)	11a	AHBMHS
CHI Institute For Research and Innovatio
198 Inverness Drive West	Englewood	CO	80112	271050565	Healthcare	CO	501(c)(3)	11a	CHI
CHI Colorado
188 Inverness Drive West	Englewood	CO	80112	840405257	Healthcare	CO	501(c)(3)	3	CHI
Saint Joseph Mount Sterling Foundation
50 Sterling Avenue	Mount Sterling	KY	40353	272884584	Foundation	KY	501(c)(3)	7	SJHS
Centennial Medical Group Inc
2700 Stewart Parkway	Roseburg	OR	97470	900433062	Physicians	OR	501(c)(3)	9	MMC
CHI National Foundation
198 Inverness Drive West	Englewood	CO	80112	270930004	Foundation	CO	501(c)(3)	11a	CHI
Saint Clare's Health Services Inc
25 Pocono Road	Denville	NJ	07834	223639733	Management	NJ	501(c)(3)	7	CHI
Good Samaritan Hospital
2222 Philadelphia Drive	Dayton	OH	45406	310536981	Hospital	OH	501(c)(3)	3	SHP

Form990 Schedule R Part III Form990ScheduleRPartIII (17 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	Code VCodeVAmount	General Or Managing PartnerGeneralOrManagingPartner
Superior Medical Imaging LLC
5000 North 26th Street	Lincoln	NE	68521	262884555	OP Diagnostics	NE	SERMC	Related	-155495	993429	false	$272	false
Central Nebraska Rehab Services
3004 W Faidley Ave	Grand Island	NE	68802	810653461	Physical Therapy	NE	CHI	Related	1816979	2933623	false	$5,050	false
Mercy West Endoscopy LLC
1601 NW 114th St Suite 244	Clive	IA	50325	900129077	Ambulatory Surg	IA	CHI-IA Corp	Related	1917716	1695121	false		false
Audubon Land Company LLC
5390 N Academy Blvd Suite 300	Colorado Springs	CO	80918	841513085	Real Estate	CO	THC	Related	67577	9001605	false		false
Breckenridge Medical Clinic LLC
555 South Park Avenue Plaza 11	Breckenridge	CO	80424	651295958	Medical Clinic	CO	THC	Related			false		false
Penrad Imaging
1390 Kelly Johnson Blvd	Colorado Springs	CO	80920	841072619	Medical Imaging	CO	THC	Related	1922441	8248492	false		false
St Anthony Regional Mtn Cancer Center
4231 W 16th Avenue	Denver	CO	80112	371568013	Cancer Center	CO	THC	Related	60513	318803	false		false
St Francis Land Company
5390 N Academy Blvd Suite 300	Colorado Springs	CO	80918	263134100	Real Estate	CO	THC	Related	-180979	14886022	false		false
OrthoColorado LLC
11650 West 2nd Place	Lakewood	CO	80255	371577105	Ortho Hospital	CO	THC	Related	-5375165	15265510	false		false
Mercy Outpatient Surgery Center LLC
1512 12th Avenue Road	Nampa	ID	83686	841380439	Surgery Center	ID	MMC	Related	-812036	949357	false	$4,620	true
Peninsula Radiation Oncology
314 Martin Luther King Jr Way 11	Tacoma	WA	98405	870808610	Healthcare Srvc	WA	FHS	Related	-516076	3860362	false		false
Healthcare Support Services LLC
PO Box 9804	Grand Island	NE	68802	721546196	Laundry	NE	CHI	Related	199968	3913481	false	$58,436	false
Bluegrass Regional Imaging Center
1218 South Broadway Suite 310	Lexington	KY	40504	611386736	Diagnostic	KY	SJ HospitalLex	Related	242456	3773725	false		false
North River Surgery Center LLC
2209 Wildwood Avenue	Sherwood	AR	72120	710799771	Ambul Surg Ctr	AR	SVIMC	Related	213989	1696001	false		false
CHI Operating Investment Program LP
198 Inverness Drive West	Englewood	CO	80112	470727942	Investments	CO	CHI	Investment	58022	4069968	false	$14,031	true
Ruxton Surgicenter LLC
8322 Bellona Avenue Suite 201	Baltimore	MD	21204	522095835	Surgery Center	MD	SJMC	Related	-75716	3421084	false		true
Central Nebraska Home Care Services
PO Box 1146-4510 Second Avenue	Kearney	NE	68848	470692112	Healthcare Srvc	NE	HSEINC	Related	-102982	1021500	false		true

Form990 Schedule R Part IV Form990ScheduleRPartIV (30 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership	Address Line1AddressForeign/AddressLine1	CityAddressForeign/City	Province Or StateAddressForeign/ProvinceOrState	CountryAddressForeign/Country	Postal CodeAddressForeign/PostalCode	Legal Domicile Foreign CountryLegalDomicileForeignCountry
Mercy Health Services Corporation
2727 McClelland Blvd	Joplin	MO	64804	431457881	DME	MO	St John's RMC	C Corp	-1033832	2093683	1.00000
Mountain Management Services Inc
6028D Shallowford Road	Chattanooga	TN	37422	621570739	mgmt svc org	TN	MHCS	C Corp	348642	4530845	1.00000
MedQuest
1301 15th Avenue West	Williston	ND	58801	450392137	Sale of DME	ND	MHof Williston	C Corp	-16794	911494	1.00000
St Anthony Development Company
1415 Southgate	Pendleton	OR	97801	931216943	Athletic Club	OR	St Anthony H	C Corp	41861	3047938	1.00000
GOOD SAMARITAN OUTREACH SERVICES
PO BOX 1990	KEARNEY	NE	68848	470659440	MEDICAL CLINIC	NE	CHI Nebraska	C Corp	-2491623	840232	1.00000
HEALTH SYSTEMS ENTERPRISES INC
PO BOX 1990	KEARNEY	NE	68848	470664558	MANAGEMENT	NE	GSH	C Corp	10957	1559747	1.00000
Mercy Park Apartments Ltd
1111 6th Avenue	Des Moines	IA	50314	421202422	Housing	IA	CHI-IA Corp	C Corp	227244	1806199	1.00000
Des Moines Medical Center Inc
1111 6th Avenue	Des Moines	IA	50314	420837382	Real Estate	IA	CHI-IA Corp	C Corp		1123173	0.92980
Comcare Services
4231 W 16th Avenue	Denver	CO	80204	840904813	Inactive	CO	CHIC	C Corp			1.00000
Mednow Inc
1512 12th Avenue Road	Nampa	ID	83686	820389927	Outpat Pharmacy	ID	Mercy Med Ctr	C Corp	-672954	5348476	1.00000
Saint Clare's Primary Care Inc
66 Ford Road	Denville	NJ	07834	222441202	Billing Services	NJ	SCCC	C Corp	-350630	2590487	1.00000
Healthcare Mgmt Services Org Inc
1149 Market St	Tacoma	WA	98402	911865474	Health Org.	WA	FHS	C Corp			1.00000
Physician Health System Network
1149 Market St	Tacoma	WA	98402	911746721	Health Org.	WA	FHS	C Corp			1.00000
Mercy Services Corp
2700 Stewart Parkway	Roseburg	OR	97470	930824308	Retail Sales	OR	Mercy Medical	C Corp	-499409	1403001	1.00000
Caduceus Medical Associates Inc
6028 Shallowford Road Suite D	Chattanooga	TN	37422	621570736	Healthcare	TN	MHCS	C Corp		1008	1.00000
CENTRAL KANSAS HEALTH SERVICES ASSOCIATI
3515 Broadway	Great Bend	KS	67530	481042853	MEDICAL EQUIPMENT	KS	CKMC	C Corp		110125	1.00000
St Vincent Community Health Services In
Two St Vincent Circle	Little Rock	AR	72205	710710785	Healthcare	AR	SVIMC	C Corp	2404944	10195000	1.00000
Alternative Insurance Management Service
3900 Olympic Boulevard Suite 400	Erlanger	KY	41018	841112049	Management Servic	CO	CHI	C Corp		3272176	1.00000
Nazareth Assurance Company
76 St Paul Street Suite 500	Burlington	VT	05401	030304831	Insurance	VT	CHI	C Corp			1.00000
Franciscan Services Inc
198 Inverness Drive West	Englewood	CO	80112	232487967	Healthcare	CO	CHI	C Corp	194756	12598258	1.00000
SJH Services Corporation
198 Inverness Drive West	Englewood	CO	80112	232307408	Healthcare	CO	FSI	C Corp	314346	3423012	1.00000
St Joseph Development Company Inc
1717 South J Street	Tacoma	WA	98405	911480569	Rental	WA	FSI	C Corp	1677122	11984725	1.00000
Towson Management Inc
7601 Osler Drive	Towson	MD	21204	521710750	Management Servic	MD	FSI	C Corp	99315	498383	1.00000
Captive Management Initiatives
				980663022	Captive Managemen		CHI	C Corp			1.00000	PO Box 10073 APO	GeorgeTown	Grand Cayman	CJ	KY1-1001	CJ
First Initiatives Insurance Ltd
				980203038	Insurance		CHI	C Corp			1.00000	PO Box 10073 APO	GeorgeTown	Grand Cayman	CJ	KY1-1001	CJ
Center for Translational Research
198 Inverness Drive West	Englewood	CO	80112	272269511	Healthcare	CO	CHI	C Corp	-840949	1746201	1.00000
Samaritan Family Care Inc
40 W Fourth St 1700	Dayton	OH	45402	311299450	Healthcare	OH	SHP	LLC	-1199836	4894397	1.00000
SJL Physician Management Services Inc
424 Lewis Hargett Cr 160	Lexington	KY	40503	999999999	Management	KY	SJHS	C Corp			1.00000
CGH Realty Company Inc
215 N 12th St	Reading	PA	19603	232326801	Real Estate	PA	SJHM	C Corp	1007	42415	1.00000
St Joseph Office Park Association
1401 HarrodsBurg Road Bldg B70	Lexington	KY	40504	611079899	Management	KY	SJHS	C Corp	10217	572843	0.85000

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

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved
St Mary's Community Hospital Foundation
C	69013
Saint Elizabeth REGIONAL MEDICAL CENTER
O	141350
Catholic Health Initiatives
c	101033
Catholic Health Initiatives
l	2371929
Catholic Health Initiatives
	152897
Catholic Health Initiatives
q	153129