2025-05-14T12:56:31-05:00 2024-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2023-07-01 410729978 ST FRANCIS HOME STFR 2186433000 2400 ST FRANCIS DRIVE BRECKENRIDGE MN 56520 TIM SCHNACK MARKET CFO 2186433000 2025-05-14 1 0 MARK STOCKI P00642127 3032989100 2023 2025-03-06 01:10:19Z CHI ST FRANCIS HOME TERRY ANDERSON 2400 ST FRANCIS DRIVE BRECKENRIDGE MN 56520 6441309 0 0928 X SEE SCHEDULE O X 1952 MN ST. FRANCIS HOME IS A 501(C)(3) LONG TERM CARE FACILITY WHICH PROVIDES SKILLED NURSING CARE FOR ITS RESIDENTS. ALL RESIDENTS ARE CHARGED BASED ON CARE LEVELS, REGARDLESS OF PAYER SOURCE. 10 8 0 8 0 0 485080 118082 4687322 5072099 537473 996508 219334 254620 5929209 6441309 0 0 0 0 0 0 0 0 0 6096827 5919277 6096827 5919277 -167618 522032 31104558 34990839 7419197 9219365 23685361 25771474 X 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 5538228 0 5072099 ST. FRANCIS HOME WAS ESTABLISHED IN SEPTEMBER 1952 AS A NON-PROFIT, LONG TERM CARE PROVIDER. THIS 120-BED SKILLED NURSING FACILITY SPECIALIZES IN PROVIDING AN INDIVIDUALIZED, HOME-LIKE ATMOSPHERE FOR THE RESIDENTS. UNITS ARE DIVIDED INTO 20-BED NEIGHBORHOODS, WITH SEPARATE KITCHENS, DINING AREAS, LIVING ROOMS, LAUNDRY FACILITIES, ETC. RESIDENTS CAN CHOOSE TO GET UP WHEN THEY WANT TO AND CAN ORDER WHAT THEY WANT FOR BREAKFAST. ST. FRANCIS ALSO OFFERS INTER-GENERATIONAL ACTIVITIES FOR THE RESIDENTS AND YOUTH IN THE COMMUNITY. THE MISSION OF ST. FRANCIS HOME IS TO CARE FOR THE FRAIL ELDERLY MEMBERS OF OUR COMMUNITY WITH DIGNITY AND TO ADVOCATE FOR THEIR HEALTH CARE NEEDS. IN FISCAL YEAR 2014, ST. FRANCIS HOME PUT 40 OF THE 120 LICENSED BEDS ON LAY-AWAY DUE TO DIFFICULTIES IN RECRUITING ADEQUATE STAFFING TO MAINTAIN SAFE QUALITY CARE. CURRENTLY 80 BEDS ARE IN USE.AS A TAX-EXEMPT 501(C)(3) LONG TERM CARE FACILITY, ST. FRANCIS HOME IS COMMITTED TO SERVING THE NEEDS OF COMMUNITY. ST. FRANCIS HOME REQUIRES RESIDENTS TO DEMONSTRATE THE ABILITY TO PAY THE FACILITY FEES AND CHARGES, WHICH ARE SET BY THE STATE OF MINNESOTA, BUT WILL ASSIST IN LOCATING PAYER SOURCES THE RESIDENT MAY BE ELIGIBLE FOR. ALL RESIDENTS ARE CHARGED THE SAME RATES, BASED ON THEIR CARE LEVELS, REGARDLESS OF THEIR PAYER SOURCE. THE 8-MEMBER, VOLUNTEER, BOARD OF DIRECTORS LEADS ST. FRANCIS HOME'S COMMITMENT TO PROMOTE THE DEVELOPMENT OF HEALTHIER COMMUNITIES, ESPECIALLY AS IT CONCERNS OUR SENIOR CITIZENS. ST. FRANCIS HOME IS PROUD OF ITS CATHOLIC HERITAGE AND ITS ABILITY TO PROVIDE DIRECT AND INDIRECT SUPPORT TO THE COMMUNITIES IT SERVES.SINCE THE 1980'S, ST. FRANCIS HOME HAS BEEN ACTIVELY INVOLVED WITH ITS SISTER CORPORATION, ST. FRANCIS MEDICAL CENTER, WITH COMMUNITY HEALTH COLLABORATION. SEVERAL TIMES, ST. FRANCIS HAS TAKEN THE LEAD IN ORGANIZING COMMUNITY TEAMS AND FOCUS GROUPS TO LOOK AT HEALTH ISSUES, SET PRIORITIES AND PLANS FOR IMPROVEMENT. THAT COMMITMENT CONTINUES TODAY WITH ST. FRANCIS' MEMBERSHIP ON THE RICHLAND-WILKIN HEALTHY COMMUNITIES, INC BOARD OF DIRECTORS, BRECKENRIDGE ACTIVE LIVING COMMITTEE, ACTIVE TASK FORCE, VIOLENCE PREVENTION TASK FORCE AND OTHER COMMUNITY GROUPS.ST. FRANCIS COMMUNITY BENEFIT PLAN HAS BEEN ESTABLISHED IN CONJUNCTION WITH ITS SISTER CORPORATIONS OF ST. FRANCIS MEDICAL CENTER, APPLETREE COURT, AND THE HEALTHCARE AND WELLNESS FOUNDATION. THE PLAN IS BASED ON OUR UNDERSTANDING OF UNIQUE COMMUNITIES' NEEDS DERIVED FROM COLLABORATIVE NEEDS ASSESSMENTS, FOCUS GROUPS, AND SURVEYS CONDUCTED WITH OUR COMMUNITY PARTNERS. ST. FRANCIS CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2022 IN CONJUNCTION WITH THE PUBLIC HEALTH DEPARTMENTS FROM BOTH WILKIN COUNTY, MN AND RICHLAND COUNTY, ND, AS WELL AS THE TWO CLINICS IN OUR COMMUNITY. THE THREE MAIN AREAS OF NEED IDENTIFIED FROM THE DATA COLLECTED WERE MENTAL HEALTH, SUBSTANCE USE, AND HEALTH-RELATED SOCIAL NEEDS. 5538228 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X VICKI MALESKI 3206315674 815 SE 2ND STREET LITTLE FALLS MN 56345 DAVID JONES BOARD MEMBER/MARKET PRESIDENT REG HOSPITALS 1.00 59.00 X 0 460692 53617 DAVID NELSON PRESIDENT/CEO 18.00 42.00 X X 0 419784 41449 NICK OTOOL MARKET CFO (PARTIAL YEAR) 4.00 59.00 X 0 349020 50949 BRENT SCHMIDT FORMER OFFICER 0.00 0.00 X 0 395493 0 TIM SCHNACK MARKET CFO 1.00 62.00 X 0 369715 48053 AMBER STOWMAN FORMER OFFICER 0.00 40.00 X 0 221301 44587 JAY ROSS VP OPERATIONAL FINANCE/TREASURER 10.00 40.00 X 0 177852 43517 CARISSA JOST SECRETARY/ADMINISTRATIVE ASSISTANT 1.00 40.00 X 0 31150 12406 GLORIA DOHMAN BOARD CHAIR 1.00 2.00 X X 0 0 0 DOREEN REINKE VICE CHAIR 1.00 2.00 X X 0 0 0 JANEL FEDERICKSEN BOARD MEMBER 1.00 2.00 X 0 0 0 JANELLE KRUMP BOARD MEMBER 1.00 2.00 X 0 0 0 SHELLY GOMPF BOARD MEMBER 1.00 2.00 X 0 0 0 TREVOR STAV BOARD MEMBER 1.00 2.00 X 0 0 0 SISTER DORETTA MEIER BOARD MEMBER 1.00 2.00 X 0 0 0 DAVID WOODS BOARD MEMBER 1.00 2.00 X 0 0 0 0 2425007 294578 0 1 1 0 0 2735 115347 118082 PATIENT SERVICES 900099 5072099 5072099 0 0 5072099 307739 307739 688769 0 688769 688769 688769 CAFETERIA 722100 245672 0 0 245672 INTERCOMPANY TRANSACTI 900099 8948 0 0 8948 254620 6441309 5072099 0 1251128 X 4382594 4288317 94277 341694 334864 6830 82986 41493 41493 184359 184359 4231 1269 2962 233153 233153 233641 231305 2336 13520 13520 STATE PROVIDER TAX 206433 206433 0 0 MEDICAL SUPPLIES 139844 139844 0 0 REPAIRS AND MAINTENANCE 41733 41733 0 0 DUES & SUBSCRIPTIONS 21384 21384 0 0 33705 33707 -2 5919277 5538228 381049 0 499 501 2092186 3179771 0 215495 512715 0 0 0 0 0 14611040 10381871 4288284 4229169 0 24508094 27068683 0 0 0 31104558 34990839 285171 281436 0 8206 316060 0 0 0 0 0 7125820 8621869 7419197 9219365 X 23685361 25771474 0 23685361 25771474 31104558 34990839 522032 1564081 0 X 0 1 X 1 0 X 3136 14627 261645 484503 118082 881993 6644184 5381360 4993880 4687322 5072099 26778845 6647320 5395987 5255525 5171825 5190181 27660838 0 358421 396497 500669 595389 694786 2545762 358421 396497 500669 595389 694786 2545762 25115076 317888 251655 207015 256001 307739 1340298 3880 3776 7656 321768 255431 207015 256001 307739 1347954 152545 119692 131307 219334 254620 877498 7121633 5771110 5593847 5647160 5752540 29886290 0.84040 0.85700 0.04510 0.04310 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: CAFETERIA INCOME - 2019 AMOUNT: $ 143,377. 2020 AMOUNT: $ 110,901. 2021 AMOUNT: $ 101,631. 2022 AMOUNT: $ 211,360. 2023 AMOUNT: $ 245,672. INTERCOMPANY TRANSACTIONS - 2019 AMOUNT: $ 9,168. 2020 AMOUNT: $ 8,791. 2021 AMOUNT: $ 7,426. 2022 AMOUNT: $ 7,974. 2023 AMOUNT: $ 8,948. EMPLOYEE RETENTION CREDIT - 2021 AMOUNT: $ 22,250. 2023 AMOUNT: $ 0. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9178492 5543374 3635118 4853329 4290411 562918 579219 548086 31133 4229169 CSH OPERATING INVESTMENT POOL 27068683 F 27068683 INTERCOMPANY PAYABLES 8601106 RESTRICTED RESIDENTS FUNDS 20763 8621869 X PART X, LINE 2: ST. FRANCIS HOME'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 0 0 0 0 0 0 0 DAVID JONES BOARD MEMBER/MARKET PRESIDENT REG HO 0 303052 0 156175 0 1465 0 19175 0 34442 0 514309 0 0 DAVID NELSON PRESIDENT/CEO 0 260996 0 142215 0 16573 0 19350 0 22099 0 461233 0 0 NICK OTOOL MARKET CFO (PARTIAL YEAR) 0 252554 0 96047 0 419 0 16660 0 34289 0 399969 0 0 BRENT SCHMIDT FORMER OFFICER 0 0 0 0 0 395493 0 0 0 0 0 395493 0 0 TIM SCHNACK MARKET CFO 0 290959 0 74901 0 3855 0 19529 0 28524 0 417768 0 0 AMBER STOWMAN FORMER OFFICER 0 195050 0 25800 0 451 0 14252 0 30335 0 265888 0 0 JAY ROSS VP OPERATIONAL FINANCE/TREASURER 0 149006 0 28418 0 428 0 10656 0 32861 0 221369 0 0 PART I, LINE 3 DURING THE CALENDAR YEAR 2023, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SCHEDULE J, 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. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2023 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): BRENT SCHMIDT, $395,493. SCHEDULE J, PART I, LINE 4B DURING THE 2023 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. 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 2023 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2023, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: DAVID A. NELSON, $9,440. SCHEDULE J, PART II ST. FRANCIS HOME 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 2023. FORM 990, LETTER J HTTPS://WWW.CHISTFRANCISHEALTH.ORG/SENIOR-LIVING/NURSING-HOME 990, PART V, LINE 1C PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH ARE MADE BY COMMONSPIRIT HEALTH. THEREFORE, NO FORMS 1099 ARE ISSUED BY ST. FRANCIS HOME. COMMONSPIRIT HEALTH FILES THE FORMS 1099 AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAME WINNINGS. THE FORMS 1099 ISSUED ON BEHALF OF ST. FRANCIS HOME ARE REPORTED TO THE IRS. FORM 990, PART VI, SECTION A, LINE 1A PURSUANT TO SECTION 8.6 OF THE BYLAWS OF ST. FRANCIS HOME, THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, THE BOARD VICE CHAIR, THE PRESIDENT AND CEO, EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE, AND TWO VOTING MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. EACH INDIVIDUAL APPOINTED TO THE EXECUTIVE COMMITTEE SHALL SERVE FOR A TERM OF ONE YEAR OR UNTIL HIS OR HER SUCCESSOR IS DULY APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. PURSUANT TO SECTION 8.1 OF THE CORPORATION'S BYLAWS, COMMITTEES, SUCH AS THE EXECUTIVE COMMITTEE, THAT ARE GRANTED THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MAY INCLUDE ONLY DIRECTORS OF THE CORPORATION. FURTHER, PURSUANT TO SECTION 8.6 OF THE CORPORATION'S BYLAWS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO THE BYLAWS OF ST. FRANCIS HOME THE ENTITY'S SOLE MEMBER IS COMMONSPIRIT HEALTH, A COLORADO NONPROFIT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S CORPORATE MEMBER IS COMMONSPIRIT HEALTH. PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE COMMONSPIRIT HEALTH BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE COMMONSPIRIT HEALTH CHIEF EXECUTIVE OFFICER: - SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF ST. FRANCIS HOME; - AMENDMENT OF THE CORPORATE DOCUMENTS OF ST. FRANCIS HOME; - APPROVE MEMBERS OF THE ST. FRANCIS HOME BOARD; - REMOVAL OF A MEMBER OF THE GOVERNING BODY OF ST. FRANCIS HOME; - APPROVAL OF ISSUANCE OF DEBT BY ST. FRANCIS HOME; - APPROVAL OF PARTICIPATION OF ST. FRANCIS HOME IN A JOINT VENTURE; - APPROVAL OF FORMATION OF A NEW CORPORATION BY ST. FRANCIS HOME; - APPROVAL OF A MERGER INVOLVING ST. FRANCIS HOME; - APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF ST. FRANCIS HOME; - TO REQUIRE THE TRANSFER OF ASSETS BY THE ST. FRANCIS HOME TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH DEBTS; - ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR ST. FRANCIS HOME. PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, COMMONSPIRIT HEALTH MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION B, LINE 11B ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE CEO. THE CEO PROVIDES THE RETURN TO THE ST FRANCIS HOME BOARD MEMBERS. 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 - EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS - 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 IX, LINE 11G CONTRACT SERVICES - NURSING: PROGRAM SERVICE EXPENSES 474,494. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 474,494. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 115,551. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 115,551. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,695,040. MANAGEMENT AND GENERAL EXPENSES 94,107. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,789,147. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 3,232. MANAGEMENT AND GENERAL EXPENSES 170. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,402. 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 1 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 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 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 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 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 COMMONSPIRIT MOUNTAIN REGION 9100 EAST MINERAL CIRCLE CENTENNIAL CO 80112 841335382 MANAGEMENT COMPANY CO 501(C)(3) LINE 12A, I CHIC 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 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 KOH 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 FOUNDATION BAKERSFIELD PO BOX 119 BAKERSFIELD CA 93302 770201321 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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 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 1414 E MAIN STREET SUITE 201 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 HOSPITAL FOUNDATION 2500 FAIRWAY STREET DICKINSON ND 58601 363418207 FUNDRAISING FOUNDATION ND 501(C)(3) LINE 12A, I SJHHC 0 SAN GABRIEL VALLEY MEDICAL CENTER FOUNDATION 438 WEST LAS TUNAS DRIVE SAN GABRIEL CA 91776 953430341 INACTIVE CA 501(C)(3) LINE 12A, I DH 0 SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC 104 W 17TH ST 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