2011-04-21T18:24:37-04:00 2010-06-30 CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2009-07-01 470443636 St Mary's Community Hospital STMA 4028733321 1314 3rd Avenue NEBRASKA CITY NE 68410 Shawn Closner 2011-04-20 7208741500 2009 2016-02-24 21:20:13Z Daniel Kelly CEO 1314 3rd Avenue Nebraska City NE 68410 15893806 false 0928 X WWW.STMARYSHOSPITALNECITY.COM X 1927 NE 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 11 7 157 15 20 68902 190696 14881530 15178699 -92258 345425 52220 128402 14910394 15843222 7490 9243 0 0 6813206 7083475 0 0 0 7044485 7193437 13865181 14286155 1045213 1557067 15714129 16859586 2684641 2025265 13029488 14834321 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. false false 11366640 3243 15178699 SEE SCHEDULE H 11366640 true true false true false false false false false true false true false false false false false false false false true true false true false false false false false false false false false false false false false true true false false true 0 0 157 true false false false false false false false false false 11 7 false false true false true true true true true false false true true true true true true true true false NE X Sharon Crunk 4028738929 1314 3rd Avenue Nebraska City NE 68410 Stacy Blum 1.0 X 270376 40372 Lidia Borer 1.0 X Brett Gay 1.0 X Patrick Haverty 1.0 X Daniel Kelly 40.0 X X 198965 38859 Rose Marie Imig 1.0 X Robert Lanik 1.0 X 685176 76471 Michael McCabe 1.0 X Kathryn Nelson 1.0 X Jonathan Stelling 1.0 X X 257208 40488 Scott VanderVeen 1.0 X X Shawn Closner 40.0 X 90259 26677 Joan Beccard 40.0 X 105813 28752 196072 1411725 251619 1 false true false 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 2 179842 10854 190696 Patient Services 900099 15178699 15178699 15178699 185417 20 185397 0 0 12260 10718 1542 1542 1542 173337 10500 23829 173337 -13329 160008 160008 0 0 15559 16037 -478 -478 Cafeteria 722100 46459 46459 Laboratory Services 621500 40355 40355 Meals on Wheels 624100 15318 15318 25206 25206 127338 15843222 15178699 20 473807 8993 8993 250 250 0 0 114763 9181 105582 0 5062599 4173672 888927 261169 206324 54845 1264871 999248 265623 380073 300258 79815 0 4070 4070 0 0 0 0 2319319 1730118 589201 0 1797784 1797784 0 0 283099 201416 81683 37712 26609 11103 0 23060 3546 19514 62918 62918 476028 476028 815498 754070 61428 36030 36030 Repairs and maintenance 577288 399037 178251 Bad debts 654034 654034 Dues & subscriptions 34576 10829 23747 Education 16344 15196 1148 Strategic Planning 19836 19836 35841 13157 22684 0 14286155 11366640 2919515 0 3253 300 2948507 1788900 2354215 2330724 212089 204518 34000 31975 13189197 8700504 5101990 4488693 5045350 7943097 14725 71379 15714129 16859586 1205044 835527 0 0 1479597 1189738 2684641 2025265 X 13026044 14830870 3444 3451 13029488 14834321 15714129 16859586 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 510 false false false 510 false Sch C Supplemental- Lobbying Activities Explanation Sch C Pt II-B 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. 22750 22750 165036 3202951 3150970 217017 5075934 2027233 3048701 4646695 3522300 1124395 75831 0 75831 4488694 CHI OIP - Fixed Income 4138826 F CHI OIP - Equity Securities 3804271 F CHI OIP - Money Market 0 7943097 0 UNCLAIMED PROPERTY 3852 INTERCOMPANY PAYABLES 1185886 1189738 15843222 14286155 1557067 347265 -99501 247764 1804831 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 true true false false true true false true true 233 256927 256927 0.01880 233 256927 256927 0.01880 12 2496 129187 90 129097 0.00950 2 16 15853 15853 0.00120 15 2468 29662 29662 0.00220 29 4980 174702 90 174612 0.01290 29 5213 431629 90 431539 0.03170 1 6 795 795 0.00010 2 244 56243 56243 0.00410 1 300 4022 4022 0.00030 2 7 15942 15942 0.00120 2 70 1642 1642 0.00010 8 627 78644 78644 0.00580 true 359719 0 5502849 5502849 X true true St Mary's Community Hospital

1314 3rd Avenue Nebraska City NE 68410

X X X X 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. 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. 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. 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. 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". (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. 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. 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 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. 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. 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. 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. 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. true St Mary's Community Hospital Foundation 1314 3rd Avenue Nebraska City NE 68410 470707604 501(C)(3) 6000 General Support 1 ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS SCH. I, PART I, Q. 2 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. false true false false false false false true false Stacy Blum 201390 67690 1295 40372 310748 Daniel Kelly 128265 32734 37966 11250 27609 237824 10958 Robert Lanik 507375 121891 55909 31501 44970 761647 27476 Jonathan Stelling 178841 77804 564 40488 297696 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. 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. 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 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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 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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 PO Box 10073 APO GeorgeTown Grand Cayman CJ KY1-1001 980663022 Captive Managemen CJ CHI C Corp 1.00000 First Initiatives Insurance Ltd PO Box 10073 APO GeorgeTown Grand Cayman CJ KY1-1001 980203038 Insurance CJ CHI C Corp 1.00000 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 false false true false false false false false false false false true false false true false true false 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