2024-05-13T13:50:19-05:00 2023-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2022-07-01 263734606 ST LUKE'S HOSPITAL AT THE VINTAGE STLU 8325345000 6624 FANNIN ST 2505 HOUSTON TX 77030 MARK TERESI CFO 8325345000 2024-05-13 1 MARK TERESI 999009999 0 MARK STOCKI P00642127 3032989100 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z CHI ST LUKE'S HEALTH - THE VINTAGE HOSPITAL T DOUGLAS LAWSON 6624 FANNIN ST 2505 HOUSTON TX 77030 107000167 0 X WWW.STLUKESHEALTH.ORG/LOCATIONS/VINTAGE-HOSPITAL X 2008 TX TO NURTURE THE HEALING MINISTRY OF THE ROMAN CATHOLIC CHURCH BY BRINGING IT NEW LIFE, ENERGY, AND VIABILITY IN THE TWENTY-FIRST CENTURY. FIDELITY TO THE GOSPEL URGES US TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT MOVES TOWARD THE CREATION OF HEALTHIER COMMUNITIES. 9 8 0 8 0 0 282478 1618416 104166091 103177760 1846295 1846098 690800 357893 106985664 107000167 1050 1000 0 0 50671478 52271431 0 0 0 64902126 62091388 115574654 114363819 -8588990 -7363652 63736871 56905692 174759429 175286310 -111022558 -118380618 AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. 0 0 100572686 1000 103177760 SEE SCHEDULE H 100572686 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 1 0 X LINDA KULHANEK 8323552885 6624 FANNIN ST STE 1100 HOUSTON TX 77030 T DOUGLAS LAWSON PHD CEO OF CHI ST. LUKE'S HEALTH 5.00 45.00 X 0 2252440 209833 ELIZABETH YOUNGBLOOD FORMER OFFICER 1.00 49.00 X 1209931 0 102825 JAMES BRADLEY WHITE MD BOARD MEMBER/ PHYSICIAN 1.00 49.00 X 0 1123306 55915 LINDA KULHANEK CFO OF CHI ST. LUKE'S HEALTH SYSTEM 5.00 45.00 X 0 540498 33078 MARIO GARNER PRESIDENT OF SLVH 50.00 0.00 X 0 431674 47752 DAVID STRICKLER FORMER SECRETARY 0.00 50.00 X 0 296961 52425 INDIRA VISHNAMPET BOARD MEMBER 1.00 10.00 X 0 0 0 GARY WHITLOCK VICE CHAIR 1.00 10.00 X X 0 0 0 FRANK ASHLEY III CHAIR 1.00 10.00 X X 0 0 0 JANE AINSWORTH BOARD MEMBER 1.00 10.00 X 0 0 0 BROOKS BASS BOARD MEMBER 1.00 10.00 X 0 0 0 BRAD BEERS SECRETARY 1.00 10.00 X X 0 0 0 DEMETRESS HARRELL BOARD MEMBER 1.00 10.00 X 0 0 0 ROBERT UPCHURCH BOARD MEMBER 1.00 10.00 X 0 0 0 1209931 4644879 501828 0 1 1 0 WELLTOWER INC 4500 DORR STREET TOLEDO OH 43615 REAL ESTATE INVESTMENT SERVICES 606229 AXONICS MODULATION TECH INC 26 TECHNOLOGY DRIVE IRVINE CA 92618 TECH SERVICES 496665 MILLENNIUM PHYSICIANS ASSOC 20207 CHASEWOOD PARK DR STE 201 HOUSTON TX 77070 PHYSICIAN 465767 ORTHOLONESTAR PLLC 7401 MAIN STREET HOUSTON TX 77030 ORTHOPEDIC SERVICES 148296 TEXAS ORTHOPAEDIC & SPORTS MED 9319 PINECROFT DR SUITE 200 THE WOODLANDS TX 77380 SPORTS MEDICINE SERVICES 133892 10 5592 1612824 5592 1618416 PATIENT SERVICES 900099 103163378 103163378 0 0 MEDICAL SERVICES 621300 14382 14382 0 0 103177760 1846098 1846098 QUALITY INCENTIVE FUND 900099 271436 0 0 271436 CAFETERIA 611630 69736 0 0 69736 PHARMACY SERVICES 456110 6905 0 0 6905 9816 9816 357893 107000167 103177760 0 2203991 X 1000 1000 42219945 35886953 6332992 1998427 1698663 299764 4985268 4237478 747790 3067791 2607622 460169 95187 80909 14278 3073940 2612849 461091 1381 1381 26495249 22520962 3974287 25667 24384 1283 2232005 2120405 111600 3317219 3151358 165861 3718521 3532595 185926 8080 7676 404 14229 13518 711 2603028 2472877 130151 2687974 2553575 134399 749202 711742 37460 MEDICAL SUPPLIES 11741783 11741783 0 0 REPAIRS AND MAINTENANCE 2492511 2118634 373877 0 STATE PROVIDER TAX 2269005 1928654 340351 0 MEDICAID REIMBURSEMENT 459807 459807 0 0 106600 89242 17358 114363819 100572686 13791133 0 1921750 568176 0 19429016 16890897 0 0 0 2382899 2495742 1341436 1341436 38790863 34423955 6279150 4366908 0 0 31455440 31216760 0 927180 25773 63736871 56905692 12751616 9280437 0 13083 13083 0 0 0 0 0 161994730 165992790 174759429 175286310 X -111022558 -118380618 0 -111022558 -118380618 63736871 56905692 X -7363652 5592 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 1381 0 0 0 1381 0 PART II-B, LINE 1: THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $1,381 2080230 1378731 701499 36413863 33045224 3368639 296770 296770 4366908 HC SL VINTAGE I, LLC 31216760 C 31216760 296225 INTERCOMPANY PAYABLES 165696380 UNCLAIMED PROPERTY 185 165992790 X PART X, LINE 2: CHI ST. LUKE'S HEALTH-THE VINTAGE HOSPITAL'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 1 1 X 1 X 1 X 1 1 1 0 1 0 5416000 0 5416000 0.04740 22453923 14946818 7507105 0.06560 0 0 27869923 14946818 12923105 0.11300 2 1374 148814 0 148814 0.00130 1 39926 0 39926 0.00030 0 0 0 0 0 0 3 1374 188740 188740 0.00160 3 1374 28058663 14946818 13111845 0.11460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 23414198 0 12822735 16340412 -3517677 X 1 1 1 1 CHI ST LUKE'S HEALTH - THE VINTAGE HOSPITAL 20171 CHASEWOOD PARK DR HOUSTON TX 77070 HTTPS://WWW.STLUKESHEALTH.ORG/LOCATION 100235 X X X CHI ST LUKE'S HEALTH - THE VINTAGE HOSP 1 0 0 1 X X X X X X X X X 21 1 1 0 1 X SEE STATEMENT X X 1 22 1 SEE STATEMENT 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X SEE STATEMENT X SEE STATEMENT X SEE STATEMENT X X X X X X 1 X 0 X X X X 1 X 0 0 CHI ST. LUKE'S HEALTH - THE VINTAGE HOSPITAL PART V, SECTION B, LINE 5: INPUT WAS RECEIVED VIA INTERVIEWS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH, FROM THE FOLLOWING ORGANIZATIONS: TEXAS FAMILIAS COUNCIL, ST. LUKE'S HEALTH THE WOODLANDS HOSPITAL, ST. ISIDORE EPISCOPAL, MONTGOMERY COUNTY HOSPITAL DISTRICT, ST. IGNATIUS CATHOLIC CHURCH, COLLEGE OF HEALTH SCIENCES SAM HOUSTON UNIVERSITY, INTERFAITH OF THE WOODLANDS, INTERFAITH COMMUNITY CLINIC, INTERFAITH CHILD DEVELOPMENT CENTER, COMMUNITY ASSISTANCE CENTER, ST. DUNSTAN'S EPISCOPAL CHURCH, ST. LUKE'S HEALTH - NORTH HOUSTON MARKET, THE HOPE CENTER, MONTGOMERY COUNTY PUBLIC HEALTH DISTRICT. CHI ST. LUKE'S HEALTH - THE VINTAGE HOSPITAL PART V, SECTION B, LINE 6A: THIS CHNA WAS CONDUCTED IN PARTNERSHIP WITH ST. LUKE'S HEALTH PATIENTS MEDICAL CENTER, ST. LUKE'S HEALTH THE VINTAGE HOSPITAL, ST. LUKE'S HEALTH THE WOODLANDS HOSPITAL, ST. LUKE'S HEALTH SPRINGWOODS VILLAGE HOSPITAL, ST. LUKE'S HEALTH LAKESIDE HOSPITAL, AND ST. LUKE'S HEALTH SUGAR LAND HOSPITAL. CHI ST. LUKE'S HEALTH - THE VINTAGE HOSPITAL PART V, SECTION B, LINE 7D: THE CHNA REPORT IS SHARED WITH HOSPITAL BOARD MEMBERS, LEADERSHIP GROUPS, AND AT THE REQUEST OF ORGANIZATIONS THAT PARTICIPATED IN STAKEHOLDER/COMMUNITY DISCUSSION GROUPS. CHI ST. LUKE'S HEALTH - THE VINTAGE HOSPITAL PART V, SECTION B, LINE 11: THE HOSPITAL INTENDS TO TAKE ACTIONS AND TO DEDICATE RESOURCES TO ADDRESS THESE NEEDS, INCLUDING ACCESS TO CARE, PREVENTIVE PRACTICES, AND MENTAL HEALTH:- ACCESS TO CARE: HEALTH EQUITY: CULTURAL BIAS EDUCATION FOR ALL STAFF, INCREASED DIVERSITY EDUCATION COMMUNICATION; ELIGIBILITY AND ENROLLMENT SCREENINGS; CARE COORDINATION; FINANCIAL ASSISTANCE POLICY; COMMUNITY BUILDING ACTIVITIES; CLINICAL PARTNERSHIPS.- PREVENTIVE PRACTICES: COMMUNITY BUILDING, OUTREACH, AND WELLNESS PROMOTION ACTIVITIES.- MENTAL HEALTH: COMMUNITY BUILDING ACTIVITIES, SCREENING AND REFERRAL EVALUATION.THE HOSPITAL DOES NOT INTEND TO FOCUS ON BIRTH INDICATORS, CHRONIC DISEASE, COVID-19, HOMELESSNESS, OVERWEIGHT AND OBESITY, SUBSTANCE ABUSE, AND VIOLENCE AND INJURY/UNINTENTIONAL INJURY. THESE NEEDS ARE BEING FOCUSED ON BY OTHER ORGANIZATIONS IN OUR SERVICE AREA, SIMILAR FOCUSED WORK FALLS UNDER AN ALTERNATIVE SIGNIFICANT HEALTH NEED LABEL, IT IS NOT WITHIN THE CAPACITY OF THE HOSPITAL SYSTEM, OR IT IS BEYONDTHE MISSION OF OUR HEALTH SYSTEM. CHI ST. LUKE'S HEALTH - THE VINTAGE HOSPITAL PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS. SCHEDULE H, PART V, SECTION B, LINE 7A - CHNA REPORT URL HTTPS://WWW.STLUKESHEALTH.ORG/ABOUT-ST-LUKES-HEALTH/HEALTHY-COMMUNITIES SCHEDULE H, PART V, SECTION B, LINE 10A - IMPLEMENTATION STRATEGY URL HTTPS://WWW.STLUKESHEALTH.ORG/ABOUT-ST-LUKES-HEALTH/HEALTHY-COMMUNITIES PART V, SECTION B, LINE 3E: THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 16A - FAP AVAILABLE WEBSITE HTTPS://WWW.STLUKESHEALTH.ORG/PATIENTS-VISITORS/PATIENTS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16B - FAP APPLICATION FORM WEBSITE HTTPS://WWW.STLUKESHEALTH.ORG/PATIENTS-VISITORS/PATIENTS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16C - PLAIN LANGUAGE FAP SUMMARY WEBSITE HTTPS://WWW.STLUKESHEALTH.ORG/PATIENTS-VISITORS/PATIENTS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE PART I, LINE 3C: UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE:- THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.- THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS.- THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION (FAA).FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:- RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS;- HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS OR FREE CARE CLINIC;- PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);- FOOD STAMP ELIGIBILITY;- ELIGIBILITY OR REFERRALS FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID);- LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR- PATIENT IS DECEASED WITH NO KNOWN SPOUSE OR KNOWN ESTATE. PART I, LINE 7: COMMONSPIRIT HEALTH HOSPITALS USE A COST ACCOUNTING SYSTEM OR AN ADJUSTED COST TO CHARGE RATIO CALCULATED IN A MANNER CONSISTENT WITH WORKSHEET 2 FOR EACH REPORTING FACILITY, TO DERIVE THE REPORTED COSTS OF FINANCIAL ASSISTANCE, MEDICAID AND OTHER MEANS-TESTED PROGRAMS. WORKSHEET 3 OR THE EQUIVALENT IN THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY ("CBISA") SOFTWARE ARE USED TO CALCULATE EXPENSE AND REVENUE, INCLUDING WHERE APPLICABLE MEDICAID PROVIDER FEES AND PAYMENTS FROM UNCOMPENSATED CARE PROGRAMS. ACTUAL OR ESTIMATED COST AND ANY DIRECT OFFSETTING REVENUE IS REPORTED, AND SCHEDULE H WORKSHEETS OR THEIR EQUIVALENTS ARE USED, FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND DONATIONS. PART III, LINE 2: THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE COST TO CHARGE RATIO TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED.THE FILING ORGANIZATION PROVIDES FREE CARE TO ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL, OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS WHOSE FAMILY INCOME IS ABOVE 201% BUT LOWER THAN 400% OF THE FEDERAL POVERTY LEVEL. THE FILING ORGANIZATION ALSO PROVIDES OPTIONS FOR INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS AT ALL FACILITIES RECEIVE AN AUTOMATIC UNINSURED DISCOUNT. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE. PART III, LINE 3: CHI ST. LUKE'S HEALTH - THE VINTAGE HOSPITAL MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. CHI ST. LUKE'S HEALTH - THE VINTAGE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. CHI ST. LUKE'S HEALTH - THE VINTAGE HOSPITAL ALSO UTILIZES A PAYMENT ASSISTANCE RANK ORDERING (PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF A PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE ARE NOT REPORTED AS BAD DEBT. AS SUCH, CHI ST. LUKE'S HEALTH - THE VINTAGE HOSPITAL DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE. PART III, LINE 4: CHI ST. LUKE'S HEALTH - THE VINTAGE HOSPITAL DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2023, RELATED TO PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE. THE ENTIRE FOOTNOTE CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT CONSOLIDATED FINANCIAL STATEMENTS ON PAGES 11-12."PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION COMMONSPIRIT EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS, AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. NET PATIENT REVENUE IS PRIMARILY COMPRISED OF HOSPITAL AND PHYSICIAN SERVICES." PART III, LINE 8: COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 13). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS.COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. CHI ST. LUKE'S HEALTH - THE VINTAGE HOSPITAL'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $3,517,677 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS. PART III, LINE 9B: COMMONSPIRIT HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. COMMONSPIRIT HEALTH'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE COMMONSPIRIT HEALTH FACILITY, OR BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH, IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED ASSISTANCE OR FOR ASSISTANCE UNDER COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, COMMONSPIRIT HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. LEGAL ACTION WILL NOT BE PURSUED TO COLLECT DEBTS FROM PATIENTS WHO HAVE QUALIFIED FOR CHARITY OR ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DEBT. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, COMMONSPIRIT HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT. SCHEDULE H, PART V, SECTION A, LINE 1 - PRIMARY WEBSITE URL HTTPS://WWW.STLUKESHEALTH.ORG/LOCATIONS/VINTAGE-HOSPITAL PART VI, LINE 2: ST. LUKE'S HEALTH WORKS WITH THE TEXAS HOSPITAL ASSOCIATION AND THE TEXAS HEALTH CARE INFORMATION COLLECTION (THCIC) TO PROVIDE AND ASSESS PATIENT DISCHARGE INFORMATION FOR OUR FACILITIES, AND THE SERVICE AREA AND COMMUNITIES WE SERVE. THIS REPRESENTS PUBLIC PATIENT DATA THAT IS USED FOR STRATEGIC PLANNING, SERVICE NEEDS AND TO BETTER UNDERSTAND PATIENT ACCESS AND SERVICE NEED PATTERNS BY DRG, BY AGE, BY GENDER, BY RACE, ETHNICITY, AND PAYER SOURCES. ALSO, ST. LUKE'S HEALTH DEVELOPS A COMMUNITY PROVIDER NEEDS ASSESSMENT EVERY THREE TO FIVE YEARS TO ASSESS THE NEED FOR PRIMARY CARE AND PROVIDER SPECIALISTS FOR OUR FACILITIES AND THE COMMUNITIES WE SERVE. PART VI, LINE 3: INFORMATION ABOUT COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS EACH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES COMMONSPIRIT HEALTH SERVES. THE SIGNAGE INCLUDES NOTIFICATION THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION AND HOW TO REACH STAFF THAT CAN ASSIST WITH ANSWERING QUESTIONS AND GUIDE PATIENTS THROUGH THE APPLICATION PROCESS. INFORMATION CAN ALSO BE FOUND ON THE FACILITY WEBSITES. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED AND A STATEMENT INFORMING PATIENTS HOW TO CONTACT US REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF COMMONSPIRIT HEALTH REQUIRE THEY FOLLOW COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. ALSO, REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE COMMONSPIRIT HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. PART VI, LINE 4: THE POPULATION OF THE SERVICE AREA IS 1,330,899. CHILDREN AND YOUTH, AGES 0-17, MAKE UP 28.1% OF THE POPULATION, 62.1% ARE ADULTS, AGES 18-64, AND 9.8% OF THE POPULATION ARE SENIORS, AGES 65 AND OLDER. 35.8% OF THE POPULATION IN THE SERVICE AREA IDENTIFIES AS HISPANIC/LATINO AND 35.7% OF THE POPULATION IDENTIFIES AS NON-HISPANIC WHITE. 18.4% OF THE POPULATION IDENTIFIES AS BLACK/AFRICAN-AMERICAN, AND 7.8% OF THE POPULATION ARE ASIAN. 1.7% OF INDIVIDUALS IDENTIFY AS MULTIRACIAL (TWO-OR-MORE RACES), 0.3% AS A RACE/ETHNICITY NOT LISTED, 0.2% AS AMERICAN INDIAN/ALASKAN NATIVES, AND NATIVE HAWAIIANS/PACIFIC ISLANDERS REPRESENT 0.1% OF THE SERVICE AREA POPULATION. IN THE SERVICE AREA, 62.7% OF THE POPULATION, 5 YEARS AND OLDER, SPEAK ONLY ENGLISH IN THE HOME. AMONG THE AREA POPULATION, 28.3% SPEAK SPANISH, 5.1% SPEAK AN ASIAN/PACIFIC ISLANDER AND 2.9% SPEAK AN INDO-EUROPEAN LANGUAGE IN THE HOME.AMONG THE RESIDENTS IN THE SERVICE AREA, 12.1% LIVE AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL) AND 31.2% ARE AT 200% OF FPL OR BELOW. THOSE WHO SPEND MORE THAN 30% OF THEIR INCOME ON HOUSING ARE SAID TO BE "COST BURDENED." IN THE SERVICE AREA, 32.6% OF OWNER AND RENTER OCCUPIED HOUSEHOLDS SPEND 30% OR MORE OF THEIR INCOME ON HOUSING. EDUCATIONAL ATTAINMENT IS A KEY DRIVER OF HEALTH. IN THE HOSPITAL SERVICE AREA, 14.7% OF ADULTS, AGES 25 AND OLDER, LACK A HIGH SCHOOL DIPLOMA. 31.2% OF AREA ADULTS HAVE A BACHELOR'S DEGREE OR HIGHER DEGREE.HARRIS COUNTY AND HOUSTON ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS (MUA) AND HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA) FOR PRIMARY CARE, DENTAL HEALTH AND MENTAL HEALTH. MONTGOMERY COUNTY IS DESIGNATED AS A HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS) FOR MENTAL HEALTH CARE AND AS A MEDICALLY UNDERSERVED AREA (MUA) FOR PRIMARY CARE.THE FOLLOWING GROUPS WERE IDENTIFIED IN STAKEHOLDER INTERVIEWS AS POPULATIONS AND/OR GEOGRAPHIES THAT WERE LACKING ACCESS TO REGULAR HEALTH CARE AND SOCIAL SERVICES IN HARRIS COUNTY. DEMOGRAPHIC GROUPS: SENIORS LIVING ALONE WITH A LACK OF TRANSPORTATION, VIETNAMESE COMMUNITY IN SE CONROE AND SPRING (THERE IS A LANGUAGE BARRIER AND TRANSLATORS ARE NOT AVAILABLE), FOREIGN BORN, UNDOCUMENTED INDIVIDUALS, VETERANS, PERSONS LIVING IN POVERTY OR WHO ARE LOW-INCOME, PERSONS EXPERIENCING HOMELESSNESS, HISPANIC AND AFRICAN AMERICAN COMMUNITIES, PATIENTS WITH UNTREATED MENTAL HEALTH ISSUES, YOUNG MALES BETWEEN THE AGES OF 18-30, AFGHAN REFUGEES, AND SINGLE PARENTS. UNDER RESOURCED NEIGHBORHOOD AND GEOGRAPHIC LOCATIONS: EAST COUNTY- HISPANIC COMMUNITIES, RURAL AREAS WILLIS OR NORTH COUNTY, NEW CANEY, CLEVELAND, CENTRAL AND EAST CONROE, CONROE, NW HOUSTON, AND SOUTHSIDE HOUSTON. PART VI, LINE 5: FINANCIAL ASSISTANCE: IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY. THIS HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY THAT DESCRIBES THE ASSISTANCE PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A FINANCIAL HARDSHIP TO FULLY PAY THE EXPECTED OUT-OF-POCKET EXPENSES FOR SUCH CARE, AND WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE.USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, THE HOSPITAL REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR THE HOSPITAL TO DELIVER ON ITS MISSION, INCLUDING HELPING TO ENSURE THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTH CARE.OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS INCLUDES GATHERING AND VERIFYING CREDENTIALS, ALLOWING THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND ULTIMATELY MAKING A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS.ROLE OF THE BOARD: THE COMMONSPIRIT HEALTH BOARD AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL, POLICY-BASED ROLES TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REPORTS ON ACTIVITIES AND PERFORMANCE. HOSPITAL COMMUNITY BOARDS (OR THEIR DESIGNATED COMMITTEES) ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS CONDUCT AND ADOPT COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES, TAKE ACTIONS TO HELP ADDRESS IDENTIFIED SIGNIFICANT HEALTH NEEDS WITH AN EMPHASIS ON POOR AND VULNERABLE POPULATIONS AND HEALTH EQUITY, AND MONITORING ACTIONS AND PROGRESS TOWARD IDENTIFIED GOALS. PART VI, LINE 6: THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 24 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS. COMMONSPIRIT HEALTH AND SUBSTANTIALLY ALL OF ITS DIRECT AFFILIATES AND SUBSIDIARIES HAVE BEEN GRANTED EXEMPTIONS FROM FEDERAL INCOME TAX AS CHARITABLE ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF JUNE 30, 2023, COMMONSPIRIT HEALTH IS COMPRISED OF APPROXIMATELY 2,200 CARE SITES, CONSISTING OF 142 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. IN FISCAL YEAR 2023, COMMONSPIRIT HEALTH PROVIDED MORE THAN $2.937 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $5.02 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $34.5 BILLION IN FISCAL YEAR 2023, HAS TOTAL ASSETS OF APPROXIMATELY $51.87 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. 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 DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. PART VI, LINE 7, REPORTS FILED WITH STATES TX 0 1 0 0 0 0 0 0 0 T DOUGLAS LAWSON PHD CEO OF CHI ST. LUKE'S HEALTH 0 1063853 0 998886 0 189701 0 187354 0 22479 0 2462273 0 165402 ELIZABETH YOUNGBLOOD FORMER OFFICER 699471 0 423470 0 86990 0 80989 0 21836 0 1312756 0 55620 0 JAMES BRADLEY WHITE MD BOARD MEMBER/ PHYSICIAN 0 1121374 0 0 0 1932 0 18075 0 37840 0 1179221 0 0 LINDA KULHANEK CFO OF CHI ST. LUKE'S HEALTH SYSTEM 0 464144 0 72292 0 4062 0 18502 0 14576 0 573576 0 0 MARIO GARNER PRESIDENT OF SLVH 0 351770 0 62687 0 17217 0 35245 0 12507 0 479426 0 16398 DAVID STRICKLER FORMER SECRETARY 0 263892 0 30477 0 2592 0 17590 0 34835 0 349386 0 0 PART I, LINE 3 DURING THE CALENDAR YEAR 2022, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH, USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION SURVEY OR STUDY. PART I, LINE 4A: CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. PART I, LINE 4B: DURING THE 2022 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2022 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: T. DOUGLAS LAWSON, $174,690; MARIO GARNER, $16,425 AND ELIZABETH YOUNGBLOOD, $83,078. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2022 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. SCH J PART II CHI ST. LUKE'S HEALTH - THE VINTAGE HOSPITAL FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE COMMONSPIRIT TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES COMMONSPIRIT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND COMMONSPIRIT'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL, AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2022. FORM 990, PART V, LINE 1A - FORM 1096 REPORTING PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH (CSH) ARE MADE BY CSH. THEREFORE NO FORM 1099S ARE ISSUED BY THE ORGANIZATION. CSH FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099S ISSUED BY CSH ON BEHALF OF THE ORGANIZATION ARE REPORTED TO THE IRS. FORM 990, PART V, LINE 2A - FORM W-3 AND W-2 REPORTING THE EMPLOYEES OF ST. LUKE'S HOSPITAL AT THE VINTAGE ARE PAID BY A COMMON PAYMASTER, ST. LUKE'S HEALTH SYSTEM CORPORATION, (76-0536232). THEREFORE, NO FORM W-3 OR 941'S WERE FILED BY ST. LUKE'S HOSPITAL AT THE VINTAGE AS ALL PAYROLL INFORMATION RELATED TO THESE EMPLOYEES WAS INCLUDED IN THE FORM W-3 AND 941S FILED BY ST. LUKE'S HEALTH SYSTEM CORPORATION. FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO THE BYLAWS OF ST. LUKE'S HEALTH - THE VINTAGE HOSPITAL, THE ENTITY'S SOLE MEMBER IS ST. LUKE'S HEALTH CLINICAL OPERATIONS, A TEXAS NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A ALL DIRECTORS SHALL BE ELECTED BY THE SOLE MEMBER, ST. LUKE'S HEALTH CLINICAL OPERATIONS. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS MADE AVAILABLE TO THE OFFICERS AND DIRECTORS BEFORE FILING. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG. FORM 990, PART VI, LINE 14 WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY: ST LUKE'S HEALTH SYSTEM CORPORATION AND RELATED ENTITIES HAVE A WRITTEN GENERAL POLICY RELATED TO DOCUMENT RETENTION AND DESTRUCTION. DOCUMENTS AND RECORDS ARE RETAINED FOR VARIOUS FEDERAL, STATE OR OTHER JURISDICTION STATUTES FOR MEDICAL OR FINANCIAL REVIEW ON A DEPARTMENT BY-DEPARTMENT BASIS. FORM 990, PART VI, LINE 16B - JOINT VENTURE POLICY ST. LUKE'S HOSPITAL AT THE VINTAGE HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER COMMONSPIRIT HEALTH'S SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; AND (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 9,465,509. MANAGEMENT AND GENERAL EXPENSES 1,670,384. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,135,893. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,391,922. MANAGEMENT AND GENERAL EXPENSES 245,633. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,637,555. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 7,929,615. MANAGEMENT AND GENERAL EXPENSES 1,399,344. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,328,959. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,733,916. MANAGEMENT AND GENERAL EXPENSES 658,926. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,392,842. FORM 990, PART XI, LINE 9: OTHER CHANGES IN NA 5,592. ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HOSPITAL NE 501(C)(3) LINE 3 ACH 0 ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - COMM MEM HOSPITAL OF MO VALLEY IA 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(C)(3) LINE 10 CSH 0 APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(C)(3) LINE 10 SFH 0 ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION 345 S HALCYON RD ARROYO GRANDE CA 93420 203256066 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 BAKERSFIELD MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD CA 93301 951802779 HOSPITAL CA 501(C)(3) LINE 3 DCC 0 BARROW NEUROLOGICAL FOUNDATION 350 WEST THOMAS ROAD PHOENIX AZ 85013 860174371 FUNDRAISING FOUNDATION AZ 501(C)(3) LINE 7 DH 0 BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS TX 77384 274499340 PHYSICIANS TX 501(C)(3) LINE 12A, I SLHS 0 BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760458535 PHYSICIANS TX 501(C)(3) LINE 3 BSLHV 0 BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232187242 INACTIVE PA 501(C)(3) LINE 12A, I CSH 0 BRAZOSPORT HEALTH FOUNDATION INC 100 MEDICAL DRIVE LAKE JACKSON TX 77566 760080110 FUNDRAISING FOUNDATION TX 501(C)(3) LINE 12A, I TCHB 0 BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DRIVE LAKE JACKSON TX 77566 800240261 PHYSICIANS TX 501(C)(3) LINE 3 TCHB 0 BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HOSPITAL TX 501(C)(3) LINE 3 SLH-CO 0 BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 REHABILITATION TX 501(C)(3) LINE 10 SJSC 0 CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION 1401 SOUTH GRAND AVENUE LOS ANGELES CA 90015 954000909 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DCC 0 CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HOSPITAL ND 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES - COLORADO 9100 EAST MINERAL CIRCLE CENTENNIAL CO 80112 840405257 HOSPITAL CO 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVE DES MOINES IA 50314 420680448 HOSPITAL IA 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 9100 EAST MINERAL AVE CENTENNIAL CO 80112 840902211 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 7 CHIC 0 CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 1150 KELLY JOHNSON BLVD 204 COLORADO SPRINGS CO 80920 270930004 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 12A, I CSH 0 CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 460992796 TELEHEALTH CO 501(C)(3) LINE 12A, I CSH 0 CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG OR 97471 263946191 SURGERY CENTER OR 501(C)(3) LINE 10 MMC - ROSEBURG 0 CENTRAL CALIFORNIA HEALTH CENTERS 300 OLD RIVER ROAD STE 200 BAKERSFIELD CA 93311 844171789 CLINIC CA 501(C)(3) LINE 3 DCC 0 CENTRAL KANSAS MEDICAL CENTER 9100 E MINERAL CIRCLE CENTENNIAL CO 80112 480543724 INACTIVE KS 501(C)(3) LINE 3 CSH 0 CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO ND 58104 271966847 SENIOR LIVING MN 501(C)(3) LINE 10 CSH 0 CHI HEALTH FOUNDATION 12809 W DODGE RD OMAHA NE 68154 470648586 FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 ACH 0 CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER KY 41018 202741651 INVESTMENTS KY 501(C)(3) LINE 12A, I CSH 0 CHI LIVING COMMUNITIES 930 S WYNN ROAD OREGON OH 43616 341892096 SENIOR LIVING OH 501(C)(3) LINE 12A, I SFH-OH 0 CHI MEMORIAL HOSPITAL - GEORGIA 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 822748395 HOSPITAL GA 501(C)(3) LINE 3 MHCS 0 CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 451261716 HOME HEALTH CO 501(C)(3) LINE 10 CSH NS 0 CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 452532084 HOLDING CO CO 501(C)(3) LINE 12A, I CSH 0 CHI NEBRASKA 12809 WEST DODGE ROAD OMAHA NE 68510 363233121 HOLDING CO NE 501(C)(3) LINE 12A, I CSH 0 CHI ST JOSEPH CHILDREN'S HEALTH 1929 LINCOLN HWY E STE 150 LANCASTER PA 17602 232342997 HEALTHCARE PA 501(C)(3) LINE 12A, I CSH 0 CHI ST JOSEPH'S CHILDREN 1516 5TH ST NW ALBUQUERQUE NM 87102 710897107 COMMUNITY NM 501(C)(3) LINE 12A, I CSH 0 CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 710236913 HOSPITAL AR 501(C)(3) LINE 3 CHI-SVHS 0 CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125064 HOLDING CO AR 501(C)(3) LINE 12A, I SVIMC 0 CHI ST VINCENT MEDICAL GROUP HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125131 PHYSICIANS AR 501(C)(3) LINE 3 CHI-SVHS 0 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 470617373 HEALTHCARE CO 501(C)(3) LINE 12A, I N/A 0 COMMONSPIRIT HEALTH FOUNDATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 853374038 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 7 CSH 0 COMMONSPIRIT HEALTH OPERATING INVESTMENT POOL LLC 185 BERRY STREET STE 200 SAN FRANCISCO CA 94107 850919176 OPERATING INVESTMENTS DE 501(C)(3) LINE 12A, I CSH 0 COMMONSPIRIT HEALTH RESEARCH INSTITUTE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 271050565 RESEARCH CO 501(C)(3) LINE 12A, I CSH 0 COMMUNITY HOSPITAL OF SAN BERNARDINO 1805 MEDICAL CENTER DRIVE SAN BERNARDINO CA 92411 951643373 HOSPITAL CA 501(C)(3) LINE 3 DCC 0 COMMUNITY LIMITED CARE DIALYSIS CENTER 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 237419853 HOLDING CO OH 501(C)(2) GSH 0 COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION 631 N 8TH ST MISSOURI VALLEY IA 51555 421294399 FUNDRAISING FOUNDATION IA 501(C)(3) LINE 12A, I AH-CMHMV 0 CONTINUING CARE HOSPITAL ONE SAINT JOSEPH DRIVE LEXINGTON KY 40504 611400619 HOSPITAL KY 501(C)(3) LINE 3 SJHS 0 DIGNITY COMMUNITY CARE 185 BERRY STREET STE 200 SAN FRANCISCO CA 94107 815009488 HOSPITAL CO 501(C)(3) LINE 3 CSH 0 DIGNITY HEALTH 185 BERRY STREET STE 200 SAN FRANCISCO CA 94107 941196203 HOSPITAL CA 501(C)(3) LINE 3 CSH 0 DIGNITY HEALTH CONNECTED LIVING 200 MERCY OAKS DRIVE REDDING CA 96003 237115371 SENIOR CENTER SERVICES CA 501(C)(3) LINE 7 DH 0 DIGNITY HEALTH FOUNDATION 185 BERRY STREET STE 200 SAN FRANCISCO CA 94107 462037641 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 DIGNITY HEALTH FOUNDATION - INLAND EMPIRE 2101 N WATERMAN AVENUE SAN BERNARDINO CA 92404 237440086 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 DIGNITY HEALTH FOUNDATION EAST VALLEY 475 SOUTH DOBSON ROAD CHANDLER AZ 85224 742418514 FUNDRAISING FOUNDATION AZ 501(C)(3) LINE 12A, I DH 0 DIGNITY HEALTH MEDICAL FOUNDATION 3400 DATA DRIVE RANCHO CORDOVA CA 95670 680220314 MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC CA 501(C)(3) LINE 12A, I DCC 0 DOMINICAN HEALTH SERVICES 1555 SOQUEL DRIVE SANTA CRUZ CA 95065 770056778 COMMUNITY HEALTH SYSTEM CA 501(C)(3) LINE 12A, I DH 0 DOMINICAN HOSPITAL FOUNDATION 1555 SOQUEL DRIVE SANTA CRUZ CA 95065 942450442 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 DOMINICAN OAKS CORPORATION 1555 SOQUEL DRIVE SANTA CRUZ CA 95065 770127719 OPERATION AND MANAGEMENT OF HOUSING COMPLEX TO ELDERLY PERSONS CA 501(C)(3) LINE 10 DHS 0 ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1455 BATTERSBY AVE ENUMCLAW WA 98022 910715805 HOSPITAL WA 501(C)(3) LINE 3 FHS 0 FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 611345363 HOSPITAL KY 501(C)(3) LINE 3 KOH 0 FLAGET MEMORIAL HOSPITAL FOUNDATION INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 562351341 FUNDRAISING FOUNDATION KY 501(C)(3) LINE 12A, I FH 0 FRANCISCAN CARE CENTER 4111 N HOLLAND-SYLVANIA RD TOLEDO OH 43623 341931806 HEALTHCARE OH 501(C)(3) LINE 10 CHILC 0 FRANCISCAN FOUNDATION 1717 SOUTH J ST TACOMA WA 98405 911145592 FUNDRAISING FOUNDATION WA 501(C)(3) LINE 10 FHS 0 FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA WA 98405 910564491 HOSPITAL WA 501(C)(3) LINE 3 CSH 0 FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 200 TACOMA WA 98402 911939739 PHYSICIANS WA 501(C)(3) LINE 10 FHS 0 FRENCH HOSPITAL MEDICAL CENTER FOUNDATION 1911 JOHNSON AVENUE SAN LUIS OBISPO CA 93401 203256125 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DCC 0 GARRISON MEMORIAL HOSPITAL 407 THIRD AVENUE SOUTHEAST GARRISON ND 58540 450227752 HOSPITAL ND 501(C)(3) LINE 3 SAMC 0 GLENDALE MEMORIAL HEALTH FOUNDATION 1420 SOUTH CENTRAL AVENUE GLENDALE CA 91204 953625651 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DCC 0 GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 201536108 INACTIVE CO 501(C)(3) LINE 12A, I CSH 0 GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311778403 EDUCATION OH 501(C)(3) LINE 2 GSH 0 GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY NE 68848 470379755 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST ST KEARNEY NE 68847 470659443 FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 GSH-KN 0 GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311206047 FUNDRAISING FOUNDATION OH 501(C)(3) LINE 12A, I GSH 0 HARRISON MEDICAL CENTER 1800 NW MYHRE RD SILVERDALE WA 98383 910565546 HOSPITAL WA 501(C)(3) LINE 3 FHS 0 HEALTHCARE AND WELLNESS FOUNDATION 2400 ST FRANCIS DR BRECKENRIDGE MN 56520 760761782 FUNDRAISING FOUNDATION MN 501(C)(3) LINE 12A, I SFMC-MN 0 HOUSE OF MERCY 1111 6TH AVE DES MOINES IA 50314 421323808 ASSISTED LIVING IA 501(C)(3) LINE 7 CHI-IA CORP 0 JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC ONE SAINT JOSEPH DRIVE LEXINGTON KY 40504 611029768 HOSPITAL KY 501(C)(3) LINE 3 KOH 0 KENTUCKYONE HEALTH MEDICAL GROUP INC 100 E LIBERTY ST STE 800 LOUISVILLE KY 40202 611352729 PHYSICIANS KY 501(C)(3) LINE 10 JHSMH 0 KENTUCKYONE HEALTH INC ONE SAINT JOSEPH DRIVE LEXINGTON KY 40504 611029769 HEALTHCARE KY 501(C)(3) LINE 12A, I CSH 0 LAKEWOOD HEALTH CENTER 600 MAIN AVE S BAUDETTE MN 56623 410758434 HOSPITAL MN 501(C)(3) LINE 3 CSH 0 LAKEWOOD REGIONAL HEALTHCARE FOUNDATION 600 MAIN AVE S BAUDETTE MN 56623 411893795 FUNDRAISING FOUNDATION ND 501(C)(3) LINE 7 LHC 0 LEGACY FOUNDATION OF KENTUCKIANA INC 1451 HARRODSBURG RD STE D-308 LEXINGTON KY 40504 832170324 FUNDRAISING FOUNDATION KY 501(C)(3) LINE 12A, I KOH 0 LISBON AREA HEALTH SERVICES 905 MAIN ST LISBON ND 58054 820558836 HOSPITAL ND 501(C)(3) LINE 3 CSH 0 LONGMONT UNITED HOSPITAL 1950 MOUNTAIN VIEW AVE LONGMONT CO 80501 840460697 HOSPITAL CO 501(C)(3) LINE 3 CHIC 0 LUFKIN VISION ACQUISITIONS PO BOX 1447 LUFKIN TX 75901 820563768 PROPERTY MGMT TX 501(C)(3) LINE 12A, I MHSET 0 MADISON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742761145 HOSPITAL TX 501(C)(3) LINE 3 SLH-CO 0 MADONNA MANOR INC 2344 AMSTERDAM ROAD VILLA HILLS KY 51017 610654635 ASSISTED LIVING KY 501(C)(3) LINE 10 CHILC 0 MARIAN REGIONAL MEDICAL CENTER FOUNDATION 1400 E CHURCH STREET SANTA MARIA CA 93454 953818027 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 MARK TWAIN MEDICAL CENTER 768 MOUNTAIN RANCH ROAD SAN ANDREAS CA 95249 680127677 HOSPITAL CA 501(C)(3) LINE 3 DCC 0 MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC 2525 DE SALES AVE CHATTANOOGA TN 37404 621839548 FUNDRAISING FOUNDATION TN 501(C)(3) LINE 7 MHCS 0 MEMORIAL HEALTH CARE SYSTEM INC 2525 DE SALES AVE CHATTANOOGA TN 37404 620532345 HOSPITAL TN 501(C)(3) LINE 3 CSH 0 MEMORIAL HEALTH PARTNERS FOUNDATION INC 5600 BRAINERD RD STE 500 CHATTANOOGA TN 37411 030417049 HEALTHCARE TN 501(C)(3) LINE 10 MHCS 0 MEMORIAL HEALTH SYSTEM OF EAST TEXAS PO BOX 1447 LUFKIN TX 75902 750755367 HOSPITAL TX 501(C)(3) LINE 3 SLH-CO 0 MEMORIAL MEDICAL CENTER - LIVINGSTON PO BOX 1447 LUFKIN TX 75902 760436439 HOSPITAL TX 501(C)(3) LINE 3 SLH-CO 0 MEMORIAL MEDICAL CENTER - SAN AUGUSTINE PO BOX 1447 LUFKIN TX 75902 752663904 HOSPITAL TX 501(C)(3) LINE 3 SLH-CO 0 MEMORIAL MULTISPECIALTY ASSOCIATES 1201 FRANK AVE LUFKIN TX 75904 752721155 PHYSICIANS TX 501(C)(3) LINE 12A, I MHSET 0 MEMORIAL SPECIALTY HOSPITAL PO BOX 1447 LUFKIN TX 75902 752492741 INACTIVE TX 501(C)(3) LINE 3 MHSET 0 MERCY AUXILIARY OF CENTRAL IOWA 1111 6TH AVE DES MOINES IA 50314 426076069 AUXILIARY IA 501(C)(3) LINE 12A, I MF-DM IA 0 MERCY CLINICS INC 1111 6TH AVE DES MOINES IA 50314 421193699 PHYSICIANS IA 501(C)(3) LINE 10 CHI-IA CORP 0 MERCY COLLEGE OF HEALTH SCIENCES 1111 6TH AVE DES MOINES IA 50314 421511682 EDUCATION IA 501(C)(3) LINE 2 CHI-IA CORP 0 MERCY FOUNDATION BAKERSFIELD PO BOX 119 BAKERSFIELD CA 93302 770201321 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 MERCY FOUNDATION OF DES MOINES IA 1111 6TH AVE DES MOINES IA 50314 237358794 FUNDRAISING FOUNDATION IA 501(C)(3) LINE 7 CHI-IA CORP 0 MERCY FOUNDATION INC 2700 STEWART PKWY ROSEBURG OR 97471 936088946 FUNDRAISING FOUNDATION OR 501(C)(3) LINE 7 MMC - ROSEBURG 0 MERCY HEALTH CARE FOUNDATION PO BOX 368 CORNING IA 50841 421461064 FUNDRAISING FOUNDATION IA 501(C)(3) LINE 12A, I AHMH-CORNING 0 MERCY HEALTHCARE FOUNDATION 570 CHAUTAUQUA BLVD VALLEY CITY ND 58072 450435338 FUNDRAISING FOUNDATION ND 501(C)(3) LINE 12A, I MHVC 0 MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS 800 MERCY DR COUNCIL BLUFFS IA 51503 421178204 FUNDRAISING FOUNDATION IA 501(C)(3) LINE 12A, I AHBMHS 0 MERCY HOSPITAL OF DEVILS LAKE 1031 7TH ST NE DEVILS LAKE ND 58301 450227012 HOSPITAL ND 501(C)(3) LINE 3 CSH 0 MERCY HOSPITAL OF DEVILS LAKE FOUNDATION 1031 7TH ST NE DEVILS LAKE ND 58301 352367360 FUNDRAISING FOUNDATION ND 501(C)(3) LINE 7 MHDL 0 MERCY HOSPITAL OF VALLEY CITY 570 CHAUTAUQUA BLVD VALLEY CITY ND 58072 450226553 HOSPITAL ND 501(C)(3) LINE 3 CSH 0 MERCY MCMAHON TERRACE 3865 J STREET SACRAMENTO CA 95816 680117340 SENIOR CITIZEN'S HOUSING/RETIREMENT COMMUNITIES CA 501(C)(3) LINE 10 DH 0 MERCY MEDICAL CENTER 1301 15TH AVE WEST WILLISTON ND 58801 450231183 HOSPITAL ND 501(C)(3) LINE 3 CSH 0 MERCY MEDICAL CENTER - CENTERVILLE ONE ST JOSEPHS DRIVE CENTERVILLE IA 52544 420680308 HOSPITAL IA 501(C)(3) LINE 3 CHI-IA CORP 0 MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER 204 N 4TH AVE E NEWTON IA 50314 421470935 HOSPITAL IA 501(C)(3) LINE 3 CHI-IA CORP 0 MERCY MEDICAL CENTER MERCED FOUNDATION 301 E 13TH STREET MERCED CA 95340 770035928 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 MERCY MEDICAL CENTER INC 2700 STEWART PKWY ROSEBURG OR 97471 930386868 HOSPITAL OR 501(C)(3) LINE 3 CSH 0 MERCY MEDICAL FOUNDATION 1301 15TH AVE WEST WILLISTON ND 58801 450381803 FUNDRAISING FOUNDATION ND 501(C)(3) LINE 12A, I MMC WILLISTON 0 NEBRASKA HEART HOSPITAL 7500 S 91ST ST LINCOLN NE 68526 392031968 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 NORTHLAND HEALTHCARE ALLIANCE 2223 EAST ROSSER AVENUE BISMARCK ND 58501 911845296 MANAGEMENT ND 501(C)(3) LINE 7 SAMC 0 NORTHLAND PACE PROGRAM 2223 EAST ROSSER AVENUE BISMARCK ND 58501 261689193 HEALTHCARE ND 501(C)(3) LINE 10 NHA 0 NORTHRIDGE HOSPITAL FOUNDATION 18300 ROSCOE BLVD NORTHRIDGE CA 91328 237444901 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DCC 0 OAKES COMMUNITY HOSPITAL 1200 N 7TH ST OAKES ND 58474 450231675 HOSPITAL ND 501(C)(3) LINE 3 CSH 0 OAKES COMMUNITY HOSPITAL FOUNDATION 1200 N 7TH ST OAKES ND 58474 710966606 FUNDRAISING FOUNDATION ND 501(C)(3) LINE 12A, I OCH 0 PACIFIC CENTRAL COAST HEALTH CENTERS 1400 E CHURCH STREET SANTA MARIA CA 93454 770447575 CLINIC CA 501(C)(3) LINE 3 DCC 0 PINEYWOODS MEDICAL DEVELOPMENT CORP PO BOX 1447 LUFKIN TX 75902 752493116 PROPERTY MGMT TX 501(C)(3) LINE 12A, I MHSET 0 PORT CITY OPERATING COMPANY LLC 3400 DATA DRIVE RANCHO CORDOVA CA 95670 465322209 HOSPITAL CA 501(C)(3) LINE 3 DH 0 PROVIDENCE CARE CENTER 2025 HAYES AVENUE SANDUSKY OH 44870 341658625 LTERM CARE OH 501(C)(3) LINE 10 CHILC 0 PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION 5055 PROVIDENCE DRIVE SANDUSKY OH 44870 341896807 LIVING COMM OH 501(C)(3) LINE 10 CHILC 0 SAINT CLARE'S COMMUNITY CARE INC 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 222876836 INACTIVE NJ 501(C)(3) LINE 12B, II SCHS 0 SAINT CLARE'S HEALTH SERVICES INC 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 223639733 INACTIVE NJ 501(C)(3) LINE 10 CSH 0 SAINT CLARE'S HOSPITAL INC 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 223319886 INACTIVE NJ 501(C)(3) LINE 3 SCHS 0 SAINT ELIZABETH FOUNDATION 555 S 70TH ST LINCOLN NE 68510 470625523 FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 SERMC 0 SAINT ELIZABETH HEALTH SERVICES 555 S 70TH ST LINCOLN NE 68510 363233120 INACTIVE NE 501(C)(3) LINE 3 SERMC 0 SAINT ELIZABETH REGIONAL MEDICAL CENTER 555 S 70TH ST LINCOLN NE 68510 470379836 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 SAINT FRANCIS MEDICAL CENTER 2620 W FAIDLEY GRAND ISLAND NE 68803 470376601 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 SAINT FRANCIS MEDICAL CENTER FOUNDATION PO BOX 9804 GRAND ISLAND NE 68802 470630267 FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 SFMC-NE 0 SAINT FRANCIS MEMORIAL HOSPITAL 900 HYDE STREET SAN FRANCISCO CA 94109 941156295 HOSPITAL CA 501(C)(3) LINE 3 DCC 0 SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC 305 ESTILL ST BEREA KY 40403 260152877 FUNDRAISING FOUNDATION KY 501(C)(3) LINE 7 SJHS 0 SAINT JOSEPH HEALTH SYSTEM INC ONE ST JOSEPHS DRIVE LEXINGTON KY 40504 611334601 HOSPITAL KY 501(C)(3) LINE 3 KOH 0 SAINT JOSEPH HOSPITAL FOUNDATION INC 701 BOB OLINK DR 200 LEXINGTON KY 40504 611159649 FUNDRAISING FOUNDATION KY 501(C)(3) LINE 12A, I SJHS 0 SAINT JOSEPH LONDON FOUNDATION INC 1001 SAINT JOSEPH LANE LONDON KY 40741 260438748 FUNDRAISING FOUNDATION KY 501(C)(3) LINE 7 SJHS 0 SAINT JOSEPH MOUNT STERLING FOUNDATION INC 225 FALCON DR MOUNT STERLING KY 40353 272884584 FUNDRAISING FOUNDATION KY 501(C)(3) LINE 7 SJHS 0 SAINT JOSEPH'S 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