TY 2010 Form 990

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21	1,457,253	1,457,253
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	0
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	0
9	Other employee benefits .......	0
10	Payroll taxes ...........	0
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	0
c	Accounting ...........	0
d	Lobbying ...........	0
e	Professional fundraising. See Part IV, line 17..	0
f	Investment management fees ......	0
g	Other ..........	680,453	128,513	206,578	345,362
12	Advertising and promotion ....	0
13	Office expenses .......	38,953	2,177	22,319	14,457
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	0
17	Travel ............	6,310	1,218	4,672	420
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	3,110	478	1,409	1,223
20	Interest ...........	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	3,333		3,333
23	Insurance ..............	0
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	Miscellaneous Expenses	19,452	11	6,067	13,374
b
c
d
e
f	All other expenses
25	Total functional expenses. Add lines 1 through 24f	2,208,864	1,589,650	244,378	374,836
26	Joint costs. Check here if following SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	1,000	1	2,158
2	Savings and temporary cash investments .......	925,512	2	396,507
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	29,706	4	111,813
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	79,921	8	93,050
9	Prepaid expenses and deferred charges ............		9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	54,805
b	Less: accumulated depreciation. .....	10b	19,894	42,094	10c	34,911
11	Investments—publicly traded securities ..........		11
12	Investments—other securities. See Part IV, line 11 ......	6,021,950	12	7,323,226
13	Investments—program-related. See Part IV, line 11 ..		13
14	Intangible assets .........		14
15	Other assets. See Part IV, line 11 ...........	157,408	15	175,714
16	Total assets. Add lines 1 through 15 (must equal line 34)...	7,257,591	16	8,137,379
	17	Accounts payable and accrued expenses .	345,599	17	374,150
18	Grants payable ..........		18
19	Deferred revenue ..........		19
20	Tax-exempt bond liabilities ..........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities. Complete Part X of Schedule D.....	56,649	25	52,066
26	Total liabilities. Add lines 17 through 25.....	402,248	26	426,216
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	4,575,385	27	5,342,932
28	Temporarily restricted net assets .....	2,060,166	28	2,146,955
29	Permanently restricted net assets .....	219,792	29	221,276
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	6,855,343	33	7,711,163
34	Total liabilities and net assets/fund balances .....	7,257,591	34	8,137,379

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

Saint Elizabeth Foundation

Employer identification number

47-0625523

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....	1,267,220	1,193,843	1,303,107	1,426,010	1,663,683	6,853,863
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..	1,267,220	1,193,843	1,303,107	1,426,010	1,663,683	6,853,863
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..						2,337,138
6	Public Support. Subtract line 5 from line 4.						4,516,725

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..	1,267,220	1,193,843	1,303,107	1,426,010	1,663,683	6,853,863
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	192,957	197,583	160,664	164,097	141,711	857,012
9	Net income from unrelated business activities, whether or not the business is regularly carried on..		57	91	22	600	770
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..	32,183	75,525	23,215	29,511	48,898	209,332
11	Total support (Add lines 7 through 10).						7,920,977

Gross receipts from related activities, etc. (See instructions.) ..................

1,930,968

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

57.022 %

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

86.294 %

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2010

Name of organization

Saint Elizabeth Foundation

Employer identification number

47-0625523

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization Saint Elizabeth Foundation
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Part I	Contributors (see Instructions)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization Saint Elizabeth Foundation
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part II
Part II	Noncash Property (see Instructions)
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Page 1 of 1 of Part III

Name of organization
Saint Elizabeth Foundation

Employer identification number

47-0625523

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Saint Elizabeth Foundation

Employer identification number

47-0625523

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back
1a	Beginning of year balance ....	219,792	213,883	182,091
b	Contributions ........	1,485	5,909	31,792
c	Investment earnings or losses ...		12,914	11,504
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........		12,914	11,504
f	Administrative expenses ....
g	End of year balance ......	221,277	219,792	213,883

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

Permanent endowment: SchDMd Bullet

100.000 %

Term endowment: SchDMd Bullet

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	32,134		32,134
b	Buildings ................
c	Leasehold improvements ............
d	Equipment ................	22,671	19,894	2,777
e	Other .................
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........				34,911

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives	0
(2)Closely-held equity interests	0
(3)Other (A) CHI OPERATING INV PROGRAM	7,122,415	F
(B) OTHER SECURITIES	200,811	F







Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)	7,323,226

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes		0
ANNUITIES		52,013
UNCLAIMED PROPERTY		53







Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		52,066
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3
4	Net unrealized gains (losses) on investments ..........................	4
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV) .................................	8
9	Total adjustments (net). Add lines 4 - 8 .............................	9
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV): ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......		5

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV): ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......		5

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
REPORTING OF LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740	SCHEDULE D, PART X	CHI is a tax-exempt Colorado corporation and has been granted an exemption from federal income tax under Section 501(c)(3) of the Internal Revenue Code. CHI owns certain taxable subsidiaries and engages in certain activities that are unrelated to its exempt purpose and therefore subject to income tax. As of June 30, 2011, CHI has current deferred tax assets of $2.1 million and a deferred tax liability of $5.4 million related to these taxable activities. Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the consolidated financial statements.
THE INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS	Schedule D Part V Q4	The Endowment Funds were used for Scholarships, contruction of the Walking Path adjacent to Saint Elizabeth Regional Medical Center and other General purposes.

Schedule D (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization
Saint Elizabeth Foundation

Employer identification number

47-0625523

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and e-mail solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.

(i) Name and address of individual or entity (fundraiser)	(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
	(ii) Activity	Yes	No	(iv) Gross receipts from activity		(vi) Amount paid to (or retained by) organization
Total .................

List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2010

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.

		(a) Event #1 Auctions (event type)	(b) Event #2 Concert (event type)	(d) Total Events (Add col. (a) through col. (c))
1	Gross receipts . . .	52,280	14,887	67,167
2	Less: Charitable contributions . . .	24,484		24,484
3	Gross income (line 1 minus line 2) . . .	27,796	14,887	42,683
4	Cash prizes . . .		100	100
5	Non-cash prizes . .
6	Rent/facility costs . .		1,000	1,000
7	Food and beverages . .		4,192	4,192
8	Entertainment . . .		2,000	2,000
9	Other direct expenses .	24,484	2,364	26,848
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........			34,140
11	Net income summary. Combine lines 3 and 10 in column (d)............			8,543

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (Add col. (a) through col. (c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes
	No

	Yes
	No

	Yes
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow

Enter the state(s) in which the organization operates gaming activities:

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," Explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," Explain:

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ...........................

YesNo

Schedule G (Form 990 or 990-EZ) 2010

Page 3

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

Provide the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)

Identifier	ReturnReference	Explanation

Schedule G (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization
Saint Elizabeth Foundation

Employer identification number
47-0625523

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant
(1) Saint Elizabeth Regional Medical Center555 South 70th Street Lincoln,NE68510	47-0379836	IRC Sec.501(C)3	951,567
(2) Saint Elizabeth Regional Medical Center555 South 70th Street Lincoln,NE68510	47-0379836	IRC Sec.501(C)3	477,068
(3) CHI Nebraska Health at Home245 S 84th ST STE 300 Lincoln,NE68510	26-4061099	IRC Sec.501(C)3	20,526
(4) St Elizabeth Health Services555 South 70th Street Lincoln,NE68510	36-3233120	IRC Sec.501(C)3	6,893

Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image

Enter total number of other organizations ................................ . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2010

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Identifier	Return Reference	Explanation
Procedures for monitoring the use of grants	Schedule I Pt I Q2	On receipt of an award notice, the Saint Elizabeth Foundation's Chief Development Officer signs the award agreement. A copy of the contract is entered into a database that manages contract deadlines and a new fund number is created to keep the grant funds separate from any others. The Saint Elizabeth Foundation's Resource Development Coordinator (RDC) also serves as Project Director or Principal Investigator on some of the grants. Due to the financial accounting structure of Saint Elizabeth Foundation (SEF) and Saint Elizabeth Regional Medical Center (SERMC), funds are spent by departments within the hospital and then reimbursed appropriately from grant funds in the Foundation. Department heads within the hospital submit a Request for Reimbursement form with all the pertinent information and the RDC in the Foundation reviews them for accuracy. The Chief Development Officer then approves the reimbursement. The RDC submits grant applications, reconciles all grant funds, provides required grant reports to funding agencies, and closes out grants when completed. These processes are reviewed and authorized by the Chief Development Officer.

Schedule I (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Saint Elizabeth Foundation

Employer identification number

47-0625523

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) DONNA HAMMACK	(i) (ii)	0 140,643	0 7,620	0 5,376	0 17,511	0 13,633	0 184,783
(2) ROBERT LANIK	(i) (ii)	0 503,686	0 124,161	0 62,000	0 32,478	0 13,246	0 735,571
(3) JEANETTE WOJTALEWICZ	(i) (ii)	0 299,926	0 30,142	0 9,865	0 22,678	0 19,160	0 381,771

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
POST-TERMINATION PAYMENTS	Schedule J Part I Q4A	POST-TERMINATION PAYMENTS ARE ADDRESSED IN THE EXECUTIVE EMPLOYMENT AGREEMENTS FOR CATHOLIC HEALTH INITIATIVES' ("CHI") MBO CEOS. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM CHI DURING THE 2010 CALENDAR YEAR.
SUPPLEMENTAL NON-QUALIFIED DEFERRED RETIREMENT PLAN	Schedule J Part I Q4B	PRIOR TO THE 2009 CALENDAR YEAR, SAINT ELIZABETH REGIONAL MEDICAL CENTER MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN. ELIGIBILITY WAS LIMITED TO CERTAIN VICE PRESIDENTS. THE PLAN CONTRIBUTED 5% OF SALARY INTO A DEFERRED INCOME ACCOUNT MANAGED BY ALLICANCE BENEFIT GROUP. THE PLAN WAS FROZEN AT THE BEGINNING OF 2009. During the 2010 calendar year Catholic Health Initiatives ("CHI"), a related organization, maintained a supplemental non-qualified deferred compensation plan for MBO CEOs and other CHI employees at the level of Senior Vice President and above. The following reportable individuals were eligible to participate in that plan: Robert Lanik Due to the "super" vesting provision under the CHI deferred compensation plan, Robert Lanik was eligible to receive his 2010 contributions in cash. During 2010, his contributions in the amount of $35,026 were paid to him and are included in Mr. Lanik's reportable compensation in column (iii) Other Reportable Compensation on Schedule J Part II.

Schedule J (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

Saint Elizabeth Foundation

Employer identification number

47-0625523

Identifier	Return Reference	Explanation
Program Services Accomplishments- Part I	Form 990, Part III, Q. 4A	PART III - STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS PRIMARY EXEMPT PURPOSE The Saint Elizabeth Foundation was incorporated as a 501(c)(3), tax exempt charitable foundation. Its purpose is to raise funds to promote care giving at Saint Elizabeth Regional Medical Center, providing excellent, compassionate and spiritual care through programs within the health system and the community it serves. The Foundation's staff and Board of Trustees raise funds through special events, annual giving, major gifts, capital campaigns, planned gifts and grants. In 2007, the Foundation's public charity status was changed to 509(a)(1) and 170(b)(1)(A)(vi); this was modified after the passage of the Pension Protection Act of 2006(HR4). Saint Elizabeth meets the public support test required of a public charity. This allows the Foundation to receive rollover contributions and also to receive gifts from private foundations. EXEMPT PURPOSE ACHIEVEMENTS Introduction The mission of the Corporation and of Catholic Health Initiatives is 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. Catholic Health Initiatives, sponsored by a lay-religious partnership, calls other Catholic sponsors and systems to unite to ensure the future of Catholic health care. To fulfill this mission, Saint Elizabeth Foundation and Catholic Health Initiatives, as values-based organizations and in partnership with laity and others, will research and develop new ministries that integrate health, education, pastoral, and social services; promote leadership development throughout the entire organization; advocate for systemic changes with specific concern for persons who are poor, alienated, and underserved; and steward resources by general oversight of the entire organization. The purpose of Saint Elizabeth Foundation is to raise funds to promote care giving at Saint Elizabeth Regional Medical Center, providing excellent, compassionate and spiritual care through programs within the Medical Center and the community it serves. To ensure gifts are administered in accordance with donors' intentions, the Saint Elizabeth Foundation establishes restricted accounts that assure funds are dedicated to the purpose for which they are given. During the last fiscal year the Foundation has raised $1,490,350 in contributions. At the same time it has disbursed $1,545,029 back into the community and the Saint Elizabeth Regional Medical Center. Capital for Saint Elizabeth Regional Medical Center Saint Elizabeth Foundation, with money from various donors, provided $594,627 for the purchase of capital/equipment for Saint Elizabeth Regional Medical Center, which was directly related to patient care. In addition to other equipment, birthing beds and regular hospital beds were purchased. Emergency & Hardship Charity Care Saint Elizabeth Foundation currently maintains a fund that provides assistance to patients after discharge. There were 247 patients and families served this fiscal year for a total of $54,004. Assistance is provided in areas of non-covered prescriptions, lodging, meals and travel needs. Patients must have no other means of support. Employee Emergency Fund The Foundation also maintains a fund designated strictly to emergency assistance for Saint Elizabeth Regional Medical Center associates. Assistance consists of helping with utilities, rent, food, transportation and medical needs for a qualifying associate. This year the fund was able to help 52 associates for a total of $37,193. Community Asthma Education Initiative The Community Asthma Education Initiative (CAEI), comprised of 50+ local agencies and institutions, was formed in 1998, in response to alarming statistics from the Center for Disease Control, showing high rates of asthma morbidity and mortality in the Midwest and Nebraska, in particular. The Foundation has assisted the CAEI in acquiring funding from Environmental Protection Agency, Lincoln/Lancaster County Health Department, Asthma and Allergy Foundation of America, Community Pharmacy Foundation and the Porter Foundation. The Foundation assists the Director of Pulmonary Services and CAEI coordinator to see to it that objectives and funding guidelines are being met as required from each grantor. Funding of $44,966 helped educate and inform the community about asthma triggers and managing the disease. Susan G. Komen for the Cure-Nebraska - Time to Heal The goals and objectives for A Time to Heal at Saint Elizabeth Regional Medical Center are: . Improve the quality of life for post-treatment breast cancer survivors as measured by surveys taken before and after the program. . Heighten the patients' knowledge about health-enhancing activities such as smart nutrition and supplementation, exercise, stress management, relaxation, journaling, and communication. . Encourage self-advocacy by introducing patients to survivorship issues; encouraging patients to listen to their bodies, and to communicate effectively with medical professionals. . Provide information through presentations, printed materials, web sites, and services that provide benefit and support to survivors. An additional Susan G. Komen for the Cure-Nebraska grant of $16,983.60 was secured in March 2011 to provide no-cost mammograms for lower-income and/or disadvantaged women in Lincoln/Lancaster County. Through June 30, 2011, 40 women have received no cost-mammograms.
Program Services Accomplishments- Part II	Form 990, Part III, Q. 4A	Neonatal Family Assistance Program Infants cared for in the Neonatal Intensive Care Unit usually need a minimum of 23-weeks for the lungs to be mature enough for survival. Full-term gestation is 40-weeks. Most babies stay in the NICU until their original due date. Saint Elizabeth Regional Medical Center assists these parents who live outside of Lancaster County by allowing them to stay close to their newborn. This allows them to develop that important bond and nurturing relationship with their child rather than traveling back and forth between home and hospital. The Chase Suites located within walking distance from the hospital has offered a special rate to families of patients. In FY 2011 the Foundation helped 15 families maintain a close bonding relationship with their newest family member by providing assistance and lodging totaling $12,085. CHI Mission & Ministry Fund - Caring Communities This project is designed to expand and enhance Palliative Care services in six Catholic Health Initiatives hospitals, including Saint Elizabeth Regional Medical Center. Palliative Care programs are developed to improve the quality of life of patients with chronic, serious and/or life-threatening illnesses. Total grant funds awarded were $306,735 over three years (2009-2012). Saint Elizabeth Foundation administered and distributed these funds to ensure the program guidelines are achieved. Saint Elizabeth Regional Medical Center Car Seat Fitting Station Saint Elizabeth Regional Medical Center is a recognized leader in Perinatal Services. The National Highway Traffic Safety Administration (NHTSA) reported that motor vehicle crashes are the leading cause of death among children in the United States. Educating parents/caregivers about proper installation and use are key components to improving correct usage rates, thereby greatly reducing injuries as a result of improper or lack of use of child passenger seats. Saint Elizabeth Car Seat Fitting Station is located at 6900 L Street, on the north side of the building - just north of Saint Elizabeth Regional Medical Center. Individualized educational sessions are by appointment only, though emergency appointments can be made, which are scheduled by Telephone Line to Care at Saint Elizabeth Regional Medical Center. The Foundation has assisted the Car Seat Fitting Station Coordinator in acquiring funding from: Nebraska Office of Highway Safety, Nebraska State Troopers Association and the Lincoln Public School's Regional Training Project and various donors. A total of $19,222 was secured for the program and the purchase of car seats for those who cannot afford them. Emergency Medical Services The Nebraska Department of Health and Human Services Emergency Medical Services Program have grants available to develop and implement continuing education courses for volunteer Emergency Medical Service providers. The Saint Elizabeth Foundation has provided one program per month, using telehealth - an interactive video system - connecting across the State of Nebraska through hospitals and public health departments via the Nebraska Statewide Telehealth Network (NSTN). These two to three hour topics have included Stroke, Treatment vs. Transport, Time is Muscle, Winter Emergencies, Burn and Wound Care, Asthma, Water Rescue, Sports Injuries, Pediatric Emergencies, OB/GYN Emergencies, Diabetic Emergencies, and Documentation. The Nebraska Health and Human Services department Of Emergency Medical Services paid $1,011 to promote 11 programs presented fiscal year 2011. Lincoln ED Connections ED Connections is a collaborative emergency department case management program, involving both Saint Elizabeth Regional Medical Center & BryanLGH. The program was created through a grant from the Community Health Endowment to assist people who utilize emergency departments as their primary source of health care. Patients are enrolled in ED Connections to help them with food, shelter, medication assistance, or other barriers they might have that prevent them from obtaining positive health outcomes. They are connected to other services in the community to help them overcome these barriers and helped along a pathway to a permanent medical home. Saint Elizabeth Foundation has secured additional funding of $77,027 for the program from Region V Mental Health Services, individual donors, and the Community Health Endowment. Career Mentoring Program Saint Elizabeth Regional Medical Center has developed a career mentoring program providing a Health Sciences Summer Internship Program and a Health Occupations Summer Camp for qualifying Lincoln public and parochial high school students interested in healthcare occupations. Students that successfully complete these programs are awarded scholarships through a gift from Wells Fargo and other donors, designated to Saint Elizabeth Foundation's Career Mentoring Fund. Six $800 scholarships were awarded students in Fiscal Year 2011.
Program Services Accomplishments- Part III	Form 990, Part III, Q. 4A	Kids Wish Network Saint Elizabeth Foundation assists the Saint Elizabeth Regional Medical Center with securing items for children who are here for an extended period of time or go through difficult exams. We have established a relationship with a special network for children. Kids Wish Network is different from other giving organizations in its efforts to actively seek out children who have "slipped through the cracks." Children who are patients at Saint Elizabeth Regional Medical Center benefit from the partnership that has been formed between the Foundation and the Kids Wish Network. Here are some of the ways that children benefit: Hero of the Month Each month, a nurse, social worker, or anyone actively working with children ages three to 18 may nominate them to be a Kids Wish Network - Hero of the Month. This fund is for children being treated at Saint Elizabeth Regional Medical Center but do not have life threatening illnesses, but instead are facing some very sad or extraordinary experiences and need some extra help. Recipients receive a $100 Wal-mart Gift Card, a t-shirt, a medallion much like the Olympic medal, certificate with their name and a card are awarded to the Hero each month. Ten children were nominated to become a Hero of the Month at Saint Elizabeth each receiving a Gift Card. Special Foundation Funds Twelve Saint Elizabeth Foundation Scholarships for $500 were awarded to associates who had been employed by Saint Elizabeth Regional Medical Center or their Lincoln-based affiliates for at least six months. Two teen scholarships were also awarded to deserving volunteers. A competitive process took place with a committee making the decisions. Auxiliary Under the umbrella of Saint Elizabeth Foundation, the Saint Elizabeth Auxiliary conducts supportive activities, which enhance the quality of care given to patients, their families, associates, and volunteers through fundraising efforts and positive community relations. They also provided funding for five scholarships. Fundraising events included Valentine and May Day sales, Books are Fun, Art sales and the annual Lights of Love event, which cumulatively totaled $26,189 for Fiscal Year 2011. Nursing Alumni Graduates of the Saint Elizabeth School of Nursing, which closed in 1970, promoted professionalism in nursing with five scholarships for nurses. The Foundation staff supports various activities of the Nursing Alumni, such as assisting with annual events and inclusion of their scholarships in the award process. Nurses' scholarships of $500 each have been established from an endowed fund, given from interest only and involving the principle that will continue into perpetuity. Gift Shop The Gift Shop at Saint Elizabeth Regional Medical Center provides goods and services which benefit patients, their families, visitors and staff. Operating under the umbrella of the Foundation, the Gift Shop proceeds of $53,860 for 2011 provide funding of projects at Saint Elizabeth Regional Medical Center. Camp for Children Who Have Experienced Burns Saint Elizabeth Foundation supported Kamp Kaleo - a children's camp for burn survivors and their siblings. Nurses from the Saint Elizabeth Burn Unit provide supervision and treatment at camp in Burwell, Nebraska. The camp provides children with similar experiences and opportunity to interact, while building self-esteem through physical activities and personal accomplishments.
Executive Committee	FORM 990, PART VI, Q. 1A	THE EXECUTIVE COMMITTEE CONSISTS ONLY OF DIRECTORS OF THE CORPORATION AND IS COMPOSED OF THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON OF THE BOARD, THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, THE VICE PRESIDENT, THE SECRETARY AND THE TREASURER, AND THE CHIEF DEVELOPMENT OFFICER EACH OF WHOM SERVES AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. ALL ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE ARE PROMPTLY REPORTED TO THE BOARD OF DIRECTORS AT THE NEXT REGULAR OR ANNUAL MEETING OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE KEEPS REGULAR MINUTES OF ITS PROCEEDINGS AND REPORTS THE SAME TO THE BOARD OF DIRECTORS AT EACH REGULAR MEETING OF THE BOARD.
Members or Stockholders	FORM 990, PART VI, Q. 6	THE SOLE MEMBER OF THE ORGANIZATION IS SAINT ELIZABETH Regional Medical Center, A NEBRASKA NONPROFIT CORPORATION.
Member elect one or more members of governing board	FORM 990, PART VI, Q. 7A	THE SOLE MEMBER OF THE ORGANIZATION HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS.
Governing Powers	FORM 990, PART VI, Q. 7B	The organization's corporate member is SAINT ELIZABETH Regional Medical Center. Pursuant to Section 5 of the organization's bylaws, both SAINT ELIZABETH Medical Center and Catholic Health Initiatives ("CHI") (SAINT ELIZABETH Regional Medical Center's sole corporate member) have reserved powers as outlined in the CHI governance matrix. Pursuant to the governance matrix the following rights are held by the SAINT ELIZABETH Regional Medical Center's Board: Approve members of the SAINT ELIZABETH FOUNDATION board Amendment of the corporate documents of SAINT ELIZABETH FOUNDATION Approve removal of a member of the governing body of SAINT ELIZABETH FOUNDATION Adoption of long range and strategic plans for SAINT ELIZABETH FOUNDATION The following rights are reserved to the CHI Board directly or through powers delegated to the CHI Chief Executive Officer: Substantial change in the mission or philosophy of SAINT ELIZABETH FOUNDATION Removal of a member of the governing body of SAINT ELIZABETH FOUNDATION Approval of issuance of debt by SAINT ELIZABETH FOUNDATION Approval of participation of SAINT ELIZABETH FOUNDATION in a joint venture Approval of formation of a new corporation by SAINT ELIZABETH FOUNDATION Approval of a merger involving SAINT ELIZABETH FOUNDATION Approval of the sale of all or substantially all of the assets of SAINT ELIZABETH FOUNDATION To require the transfer of assets by SAINT ELIZABETH FOUNDATION to CHI to accomplish CHI's goals and objectives, and to satisfy CHI debts. Pursuant to Section 5 of the organization's bylaws, SAINT ELIZABETH Regional Medical Center or CHI may, in exercise of their approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and its President and the Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate.
Process used to review form 990	Form 990, Part VI, Q. 11b	the organization's accounting personnel work with CHI Tax Department to prepare the form 990. When available, the returns are reviewed by the Director of Finance, CFO, Foundation Chief Development Officer and any necessary revisions are included in the final version. The final version is then provided to the board prior to the Board meeting date 2/15. Subsequently, the tax department files the return with the appropriate federal agencies, making any non-substantive changes necessary to effect e-filing
PROCEDURES FOR MONITORING AND ENFORCING THE COI POLICY	Form 990, Part VI, Q. 12c	All board members are required to complete an annual conflict of interest disclosure statement. In addition, any board member with a conflict is required to declare the conflict before the beginning of each board or committee meeting. The entire board or committee determines whether the affected board member should be excluded from the meeting due to the disclosed conflict.
Process for Determining CEO's Compensation	Form 990, Part VI, Q. 15A	CHI has a defined compensation philosophy. Both the executive and non-executive compensation structures and ranges are reviewed annually in comparison to market data. CHI uses the Hay Group as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of the senior most executives is reviewed annually. The Hay Group reviews both cash and total compensation for overall reasonableness, for adherence to CHI's compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review is delivered by Hay Group to the HR committee of the CHI board of stewardship trustees annually at their September meeting and minutes are shared with the full board at the December meeting. The last review was September 20, 2011
PROCESS FOR DETERMINING COMPENSATION	FORM 990, PART VI, Q. 15B	During the tax year ended 6/30/11, no officers, directors or trustees received compensation from the organization. Any executive compensation paid to officers, directors or trustees by related organizations was set by a compensation committee utilizing both an independent consultant and comparability studies to determine compensation. in addition, compensation is subject to board approval. Compensation for the Chief Development Officer is set by the CEO.
Public Inspection for Documents	FORM 990 PT VI Q19	The organization's governing documents are available on the Nebraska Secretary of State website. The Conflict of Interest Policy is available upon request. Saint Elizabeth Foundation'S FINANCIAL STATEMENTS ARE INCLUDED IN THE CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.COM
Estimate of Hours Devoted to Related Organizations	FORM 990, Part VII	COMPENSATION REPORTED ON FORM 990, PART VII WAS PAID TO THESE INDIVIDUALS BY RELATED ORGANIZATIONS IN EXCHANGE FOR THE FULFILLMENT OF THEIR DUTIES AS FULL-TIME, 60 HOUR-PER-WEEK EMPLOYEES.
Other changes in net assets or fund balances	990 Part XI Question 5	Saint Elizabeth Foundation's other changes in net assets are as follows: donated services - $15,679 net unrealized gain/loss - $749,179 return CHI Mission & Ministry Grants - $(87,776) Total $677,081

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Saint Elizabeth Foundation

Employer identification number

47-0625523

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) Catholic Health Initiatives 198 Inverness Drive West Englewood,CO80112 47-0617373	Healthcare	CO	501(c)(3)	9	CHI
(2) Bornemann Healthcare Corporation 2500 Bernville Road PO Box 316 Reading,PA19603 23-2187242	Healthcare	PA	501(c)(3)	11a	CHI
(3) CHI Institute For Research and Innovatio 198 Inverness Drive West Englewood,CO80112 27-1050565	Healthcare	CO	501(c)(3)	11a	CHI
(4) CHI National Foundation 198 Inverness Drive West Englewood,CO80112 27-0930004	Fundraising	CO	501(c)(3)	11a	CHI
(5) CHI National Services 198 Inverness Drive West Englewood,CO80112 45-2532084	Healthcare	CO	501(c)(3)	9	CHI
(6) CHI National Home Care 198 Inverness Drive West Englewood,CO80112 45-1261716	Healthcare	CO	501(c)(3)	11a	CHI
(7) Global Health Initiatives 198 Inverness Drive West Englewood,CO80112 20-1536108	Ministries	CO	501(c)(3)	11a	CHI
(8) St Joseph Physician Enterprises 7601 Osler Drive Towson,MD21204 52-1311775	Physicians	MD	501(c)(3)	11a	CHI
(9) St Vincent Infirmary Medical Center 2 St Vincent Circle Little Rock,AR72205 71-0236917	Healthcare	AR	501(c)(3)	3	CHI
(10) St Anthony's Hospital Association 4 Hospital Drive Morrilton,AR72110 71-0245507	Healthcare	AR	501(c)(3)	3	SVIMC
(11) St Vincent Foundation Two St Vincent Circle Little Rock,AR72205 51-0169537	Fundraising	AR	501(c)(3)	11a	SVIMC
(12) St Vincent Medical Group 2 St Vincent Circle Little Rock,AR72205 71-0830696	Healthcare	AR	501(c)(3)	9	SVIMC
(13) CHI Colorado 188 Inverness Drive West Englewood,CO80112 84-0405257	Healthcare	CO	501(c)(3)	3	CHI
(14) Mercy Regional Medical Center of Durango 1010 Three Springs Blvd Durango,CO81301 84-0405515	Healthcare	CO	501(c)(3)	3	CHI
(15) Catholic Health Initiatives Colorado Fou 961 East Colorado Avenue Colorado Springs,CO80903 84-0902211	Fundraising	CO	501(c)(3)	7	CHI Colorado
(16) Health SET 4200 West Conejos Place 436 Denver,CO80204 84-1102943	Low Inc.Care	CO	501(c)(3)	7	CHI Colorado
(17) Pueblo Stepup 1925 East Orman Avenue Suite G52 Pueblo,CO81004 84-1234295	Community	CO	501(c)(3)	7	CHI
(18) SET of Colorado Springs Inc 825 E Pikes Peak Avenue Bldg 29 Colorado Springs,CO80903 84-1183335	LTerm Care	CO	501(c)(3)	7	CHI Colorado
(19) Total Healthcare PO Box 7021 Colorado Springs,CO80933 84-0927232	Healthcare	CO	501(c)(3)	3	CHI Colorado
(20) Mercy Medical Center - Des Moines AKA 1111 6th Avenue Des Moines,IA50314 42-0680448	Healthcare	IA	501(c)(3)	3	CHI-IA Corp
(21) Bishop Drumm Retirement Center 1111 6th Avenue Des Moines,IA50314 42-0725196	LTerm Care	IA	501(c)(3)	9	CHI-IA Corp
(22) House of Mercy 1111 6th Avenue Des Moines,IA50314 42-1323808	Shelter	IA	501(c)(3)	7	CHI-IA Corp
(23) Mercy Clinics Inc 1111 6th Avenue Des Moines,IA50314 42-1193699	Physician	IA	501(c)(3)	9	CHI-IA Corp
(24) Mercy College of Health Sciences 1111 6th Avenue Des Moines,IA50314 42-1511682	Education	IA	501(c)(3)	2	CHI-IA Corp
(25) Mercy Foundation of Des Moines IA 1111 6th Avenue Des Moines,IA50314 23-7358794	Fundraising	IA	501(c)(3)	7	CHI-IA Corp
(26) Mercy Auxiliary of Central Iowa 1111 6th Avenue Des Moines,IA50314 42-6076069	Auxiliary	IA	501(c)(3)	11a	CHI-IA Corp
(27) Mercy Professional Practice Associates 1111 6th Avenue Des Moines,IA50314 42-1470935	Physician	IA	501(c)(3)	9	CHI-IA Corp
(28) Mercy Medical Center - Centerville FKA 1 St Josephs Drive Centerville,IA52544 42-0680308	Healthcare	IA	501(c)(3)	3	CHI-IA Corp
(29) St Rose Ambulatory and Surgery Center F 3515 Broadway Great Bend,KS67530 48-0543724	Surgery Cntr	KS	501(c)(3)	3	CHI
(30) St Catherine Hospital 401 East Spruce Street Garden City,KS67846 48-0543721	Healthcare	KS	501(c)(3)	3	CHI
(31) St Catherine Hospital Development Found 401 East Spruce Street Garden City,KS67846 20-0598702	Fundraising	KS	501(c)(3)	11a	SCH
(32) CHI Kentucky Inc 3900 Olympic Blvd Suite 400 Erlanger,KY41018 20-2741651	Healthcare	KY	501(c)(3)	11a	CHI
(33) Saint Joseph Health System Inc 150 N Eagle Creek Dr Lexington,KY40509 61-1334601	Healthcare	KY	501(c)(3)	3	CHI
(34) Continuing Care Hospital 150 North Eagle Creek Drive Lexington,KY40509 61-1400619	LTACH	KY	501(c)(3)	3	SJHS
(35) Flaget Healthcare DBA Flaget Memorial 4305 New Shepherdsville Road Bardstown,KY40004 61-1345363	Healthcare	KY	501(c)(3)	3	CHI
(36) Flaget Memorial Hospital Foundation Inc 4305 New Shepherdsville Road Bardstown,KY40004 56-2351341	Fundraising	KY	501(c)(3)	11a	FH
(37) Saint Joseph London Foundation Inc 310 East Ninth Street London,KY40741 26-0438748	Fundraising	KY	501(c)(3)	11a	SJHS
(38) Saint Joseph Berea Hospital Foundation 305 Estill Street Berea,KY40403 26-0152877	Fundraising	KY	501(c)(3)	7	SJHS
(39) St Joseph Hospital Foundation Inc 305 Estill Street Lexington,KY40504 61-1159649	Fundraising	KY	501(c)(3)	11a	SJHS
(40) Saint Joseph Medical Foundation Inc One St Joseph Drive Lexington,KY40504 31-1539059	Phy Practices	KY	501(c)(3)	3	SJHS
(41) Saint Joseph Mount Sterling Foundation 50 Sterling Avenue Mount Sterling,KY40353 27-2884584	Fundraising	KY	501(c)(3)	7	SJHS
(42) St Joseph Medical Center Inc 7601 Osler Drive Towson,MD21204 52-0591461	Healthcare	MD	501(c)(3)	3	CHI
(43) St Joseph Medical Center Foundation In 7601 Osler Drive Towson,MD21204 52-1681044	Fundraising	MD	501(c)(3)	7	SJMC
(44) Alverna Apartments 300 SE 8th Avenue Little Falls,MN56345 41-1351177	Lterm Care	MN	501(c)(3)	9	CHI
(45) Lakewood Health Center 600 Main Avenue South Baudette,MN56623 41-0758434	LTerm Care	MN	501(c)(3)	3	CHI
(46) St Francis Home 2400 St Francis Drive Breckenridge,MN56520 41-0729978	LTerm Care	MN	501(c)(3)	9	CHI
(47) Appletree Court 601 Oak Street Breckenridge,MN56520 41-1850500	Senior Homes	MN	501(c)(3)	9	SFH
(48) St Francis Medical Center 2400 St Francis Drive Breckenridge,MN56520 41-0695598	Healthcare	MN	501(c)(3)	3	CHI
(49) Healthcare and Wellness Foundation 2400 St Francis Drive Breckenridge,MN56520 76-0761782	Fundraising	MN	501(c)(3)	11a	SFMC
(50) St Joseph's Area Health Services 600 Pleasant Avenue Park Rapids,MN56470 41-0695603	Healthcare	MN	501(c)(3)	3	CHI
(51) Unity Family Healthcare 815 2nd Street SE Little Falls,MN56345 41-0721642	Healthcare	MN	501(c)(3)	3	CHI
(52) St John's Regional Medical Center 2727 McClelland Blvd Joplin,MO64804 44-0545809	Healthcare	MO	501(c)(3)	3	CHI
(53) Mercy Lifecare Systems 2727 McClelland Blvd Joplin,MO64804 43-1305163	Property Mgmt	MO	501(c)(3)	11a	SJRMC
(54) MNMCH Inc 220 North Pennsylvania Columbus,KS66725 48-1216238	Healthcare	KS	501(c)(3)	3	SJRMC
(55) St John's Medical Group 2727 McClelland Blvd Joplin,MO64804 43-1882377	Phys Practice	MO	501(c)(3)	9	SJRMC
(56) St John's Mercy Regional Foundation 2727 McClelland Blvd Joplin,MO64804 43-1308084	Fundraising	MO	501(c)(3)	7	SJRMC
(57) Alegent Health - Bergan Mercy Health Sys 7500 Mercy Road Omaha,NE68124 47-0484764	Healthcare	NE	501(c)(3)	3	CHI
(58) Alegent Health - Mercy Hospital Corning PO Box 368 Corning,IA50841 42-0782518	Healthcare	IA	501(c)(3)	3	AHBMHS
(59) Mercy Health Care Foundation PO Box 368 Corning,IA50841 42-1461064	Fundraising	NE	501(c)(3)	11a	AHMH
(60) Mercy Hospital Foundation Council Bluff 800 Mercy Drive Council Bluffs,IA51503 42-1178204	Fundraising	IA	501(c)(3)	11a	AHBMHS
(61) CHI Nebraska 555 South 70th Street Lincoln,NE68510 36-3233121	Healthcare	NE	501(c)(3)	11a	CHI
(62) The Physician Network 8055 O Street Suite 300 Lincoln,NE68510 47-0780857	Phys Practice	NE	501(c)(3)	11a	CHI Nebraska
(63) Good Samaritan Hospital PO Box 1990 Kearney,NE68848 47-0379755	HealthCare	NE	501(c)(3)	3	CHI Nebraska
(64) Good Samaritan Hospital Foundation PO Box 1810 Kearney,NE68848 47-0659443	Fundraising	NE	501(c)(3)	7	GSH
(65) Catholic Health Care Federation 198 Inverness Drive West Englewood,CO80112 20-8473567	Jurdic Person	CO	501(c)(3)	11a	CHI
(66) Saint Elizabeth Regional Medical Center 555 South 70th Street Lincoln,NE68510 47-0379836	Healthcare	NE	501(c)(3)	3	CHI Nebraska
(67) Saint Elizabeth Foundation 555 South 70th Street Lincoln,NE68510 47-0625523	Fundraising	NE	501(c)(3)	7	SERMC
(68) Saint Elizabeth Health Services 555 South 70th Street Lincoln,NE68510 36-3233120	Healthcare	NE	501(c)(3)	3	SERMC
(69) Saint Francis Medical Center PO Box 9804 Grand Island,NE68802 47-0376601	HealthCare	NE	501(c)(3)	3	CHI Nebraska
(70) Saint Francis Medical Center Foundation PO Box 9804 Grand Island,NE68802 47-0630267	Fundraising	NE	501(c)(3)	7	SFMC
(71) St Mary's Hospital 1314 3rd Avenue Nebraska City,NE68410 47-0443636	Healthcare	NE	501(c)(3)	3	CHI Nebraska
(72) St Mary's Hospital Foundation 1314 3rd Avenue Nebraska City,NE68410 47-0707604	Fundraising	NE	501(c)(3)	7	SMH
(73) Saint Clare's Health Services Inc 25 Pocono Road Denville,NJ07834 22-3639733	Management	NJ	501(c)(3)	7	CHI
(74) Saint Clare's Community Care 66 Ford Road Denville,NJ07834 22-2876836	Healthcare	NJ	501(c)(3)	11b	SCHS
(75) Saint Clare's Foundation Inc 66 Ford Road Denville,NJ07834 22-2502997	Fundraising	NJ	501(c)(3)	7	SCHS
(76) Saint Clare's Hospital 66 Ford Road Denville,NJ07834 22-3319886	Healthcare	NJ	501(c)(3)	3	CHI
(77) St Francis Life Care Corporation 19 Pocono Road Denville,NJ07834 22-2536017	Elderly Care	NJ	501(c)(3)	9	SCHS
(78) Visiting Nurse Association of Saint Clar 191 Woodport Road Sparta,NJ07871 22-1768334	Home Health	NJ	501(c)(3)	9	SCHS
(79) St Joseph Community Health Services 300 Central Ave SW Suite 3000W Albuquerque,NM87102 71-0897107	Community	NM	501(c)(3)	11a	CHI
(80) CHI Health Connect at Home - Fargo 4816 Amber Valley Parkway Fargo,ND58104 27-1966847	Healthcare	ND	501(c)(3)	3	CHI
(81) Carrington Health Center 800 North 4th Street Carrington,ND58421 45-0227311	Healthcare	ND	501(c)(3)	3	CHI
(82) Lisbon Area Health Services 905 Main Street Lisbon,ND58054 82-0558836	Healthcare	ND	501(c)(3)	3	CHI
(83) Mercy Hospital of Devils Lake 1031 East Seventh Street Devils Lake,ND58301 45-0227012	Healthcare	ND	501(c)(3)	3	CHI
(84) The Mercy Hospital of Devils Lake Fdn 1031 East Seventh Street Devils Lake,ND58301 35-2367360	Fundraising	ND	501(c)(3)	11a	MHDL
(85) Mercy Hospital of Valley City 570 Chautauqua Boulevard Valley City,ND58072 45-0226553	Healthcare	ND	501(c)(3)	3	CHI
(86) Mercy Medical Center 1301 15th Avenue West Williston,ND58801 45-0231183	Healthcare	ND	501(c)(3)	3	CHI
(87) Mercy Medical Foundation 1301 15th Avenue West Williston,ND58801 45-0381803	Fundraising	ND	501(c)(3)	11a	MMC
(88) Oakes Community Hospital 314 South 8th Street Oakes,ND58474 45-0231675	Healthcare	ND	501(c)(3)	3	CHI
(89) Oakes Community Hospital Foundation 314 South 8th Street Oakes,ND58474 71-0966606	Fundraising	ND	501(c)(3)	11a	OCH
(90) St Joseph's Hospital and Health Center 30 West 7th Street Dickinson,ND58601 45-0226429	Healthcare	ND	501(c)(3)	3	CHI
(91) Saint Joseph's Hospital Foundation 30 West 7th Street Dickinson,ND58601 36-3418207	Fundraising	ND	501(c)(3)	11a	SJHHC
(92) Villa Nazareth Inc 801 Page Drive Fargo,ND58103 45-0226714	LT Care	ND	501(c)(3)	9	CHI
(93) Samaritan Health Partners 2222 Philadelphia Drive Dayton,OH45406 31-1107411	Healthcare	OH	501(c)(3)	11a	CHI
(94) Samaritan Behavioral Health 601 S Edwin C Moses Blvd Dayton,OH45408 02-0633634	Healthcare	OH	501(c)(3)	3	SHP
(95) Samaritan Health Foundation 2222 Philadelphia Drive Dayton,OH45406 23-7296923	Fundraising	OH	501(c)(3)	7	SHP
(96) The Good Samaritan Hospital of Cincinnat 619 Oak Street Accounting-3 West Cincinnati,OH45206 31-0537486	Healthcare	OH	501(c)(3)	3	TRI-HEALTH
(97) The Community Limited Care Dialysis Cent 619 Oak Street Accounting-3 West Cincinnati,OH45206 23-7419853	Dialysis	OH	501(c)(2)	none	GSH
(98) Good Samaritan College of Nursing & Heal 375 Dixmyth Ave Cincinnati,OH45220 31-1778403	Education	KY	501(c)(3)	2	GHS
(99) Good Samaritan Foundation of Cincinnati 619 Oak Street Accounting-3 West Cincinnati,OH45206 31-1206047	Fundraising	OH	501(c)(3)	11a	GSH
(100) Hospital Association for St Joseph Hosp 7601 Osler Drive Towson,MD21204 52-6050777	Healthcare	MD	501(c)(3)	9	SJMC
(101) Mercy Medical Center 2700 Stewart Parkway Roseburg,OR97470 93-0386868	Healthcare	OR	501(c)(3)	3	CHI
(102) Centennial Medical Group Inc 2700 Stewart Parkway Roseburg,OR97470 90-0433062	Physicians	OR	501(c)(3)	9	MMC
(103) Linus Oakes Inc 2700 Stewart Parkway Roseburg,OR97470 93-0821381	Senior Living	OR	501(c)(3)	9	MMC
(104) Mercy Foundation Inc 2700 Stewart Parkway Roseburg,OR97470 93-6088946	Fundraising	OR	501(c)(3)	7	MMC
(105) Mt St Joseph Inc 3060 SE Stark Street Portland,OR97214 93-0386870	Nursing Care	OR	501(c)(3)	9	CHI
(106) St Anthony Hospital 1601 SE Court Avenue Pendleton,OR97801 93-0391614	Healthcare	OR	501(c)(3)	3	CHI
(107) St Anthony Hospital Foundation 1601 SE Court Avenue Pendleton,OR97801 93-0992727	Fundraising	OR	501(c)(3)	11a	SA Hospital
(108) St Dominic at Ontario 351 SW 9th Street Ontario,OR97914 93-0433692	Healthcare	OR	501(c)(3)	3	CHI
(109) St Francis of Baker City 3325 Pocahontas Road Baker City,OR97814 93-0412495	Healthcare	OR	501(c)(3)	3	CHI
(110) St Joseph Health Ministries 1929 Lincoln Hwy E Ste 150 Lancaster,PA17602 23-2342997	Health	PA	501(c)(3)	11a	CHI
(111) St Joseph Health Ministries Foundation 1929 Lincoln Hwy E Ste 150 Lancaster,PA17602 23-2605579	Fundraising	PA	501(c)(3)	11a	SJHM
(112) St Joseph Health Services Inc 1929 Lincoln Hwy E Ste 150 Lancaster,PA17602 20-1425375	Dental care	PA	501(c)(3)	11a	SJHM
(113) St Joseph Regional Health Network 2500 Bernville Road PO Box 316 Reading,PA19603 23-1352211	Healthcare	PA	501(c)(3)	3	CHI
(114) St Joseph Medical Group 2500 Bernville Road PO Box 316 Reading,PA19603 20-8544021	Healthcare	PA	501(c)(3)	9	BHC
(115) St Joseph Medical Center Foundation 2500 Bernville Road PO Box 316 Reading,PA19603 23-2649362	Fundraising	PA	501(c)(3)	11a	SJRHN
(116) St Mary's Healthcare Center 801 East Sioux Avenue Pierre,SD57501 46-0230199	Healthcare	SD	501(c)(3)	3	CHI
(117) Gettysburg Medical Center 606 East Garfield Avenue Gettysburg,SD57442 46-0234354	Healthcare	SD	501(c)(3)	3	SMHC
(118) Memorial Health Care System Inc 2525 De Sales Avenue Chattanooga,TN37404 62-0532345	Healthcare	TN	501(c)(3)	3	CHI
(119) Memorial Health Care System Foundation 2525 De Sales Avenue Chattanooga,TN37404 62-1839548	Fundraising	TN	501(c)(3)	7	MHCS
(120) Memorial Health Partners Foundation Inc 6028 Shallowford Road Chattanooga,TN37421 03-0417049	Healthcare	TN	501(c)(3)	9	MHCS
(121) Franciscan Health System FKA Franciscan 1717 South J Street Tacoma,WA98405 91-0564491	Healthcare	WA	501(c)(3)	3	CHI
(122) Enumclaw Regional Hospital Association 1450 Battersby Avenue Enumclaw,WA98022 91-0715805	Healthcare	WA	501(c)(3)	3	FHS
(123) Franciscan Foundation 1717 South J Street Tacoma,WA98405 91-1145592	Fundraising	WA	501(c)(3)	9	FHS
(124) Franciscan Medical Group 1708 South Yakima Avenue Tacoma,WA98405 91-1939739	Healthcare	WA	501(c)(3)	9	FHS
(125) Franciscan Villa of South Milwaukee Inc 3601 South Chicago Avenue South Milwaukee,WI53172 39-1093829	Healthcare	WI	501(c)(3)	9	CHI

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2010

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) CHI Operating Investment Program LP 198 Inverness Drive West Englewood,CO80112 47-0727942	Investments	CO	CHI	Investment	256,854,242	5,189,978,011		No	14,031	Yes		100.000 %
(2) North River Surgery Center LLC 2209 Wildwood Avenue Sherwood,AR72120 71-0799771	Ambul Surg Ctr	AR	SVIMC	Related	198,313	1,758,688		No			No	57.450 %
(3) Audubon Land Company LLC 5390 N Academy Blvd Suite 300 Colorado Springs,CO80918 84-1513085	Real Estate	CO	THC	Related	67,577	9,001,605		No			No	50.100 %
(4) OrthoColorado LLC 11650 West 2nd Place Lakewood,CO80255 37-1577105	Ortho Hospital	CO	THC	Related	-5,375,165	15,265,510		No			No	60.000 %
(5) Penrad Imaging 1390 Kelly Johnson Blvd Colorado Springs,CO80920 84-1072619	Medical Imaging	CO	THC	Related	1,922,441	8,248,492		No			No	70.000 %
(6) St Anthony Regional Mtn Cancer Center 4231 W 16th Avenue Denver,CO80112 37-1568013	Cancer Center	CO	THC	Related	60,513	318,803		No			No	51.000 %
(7) St Francis Land Company 5390 N Academy Blvd Suite 300 Colorado Springs,CO80918 26-3134100	Real Estate	CO	THC	Related	-180,979	14,886,022		No			No	51.000 %
(8) Bluegrass Regional Imaging Center 1218 South Broadway Suite 310 Lexington,KY40504 61-1386736	Diagnostic	KY	SJ HospitalLex	Related				No			No	65.000 %
(9) St Joseph-PAML LLC 424 Lewis Hargett Circle Ste 160 Lexington,KY40503 45-2116736	Mgmt Svcs	KY	SJHS	Related				No		Yes		62.500 %
(10) Saint Joseph SCA Holdings LLC 424 Lewis Hargett Circle Ste 160 Lexington,KY40503 45-3801157	OP Surgery	DE	SJHS	Related				No		Yes		51.000 %
(11) Surgery Center of Lexington LLC 1451 Harrodsburg Road Lexington,KY40504 62-1179539	Surgery Center	DE	SJHS	Related	808,840	4,236,901		No		Yes		51.000 %
(12) Ruxton Surgicenter LLC 8322 Bellona Avenue Suite 201 Baltimore,MD21204 52-2095835	Surgery Center	MD	SJMC	Related				No		Yes		51.000 %
(13) Healthcare Support Services LLC PO Box 9804 Grand Island,NE68802 72-1546196	Laundry	NE	CHI	Related	196,124	3,913,481		No	-58,436		No	100.000 %
(14) Central Nebraska Home Care Services PO Box 1146-4510 Second Avenue Kearney,NE68848 47-0692112	Healthcare Srvc	NE	HSEINC	Related	-99,941	1,021,498		No	-48,712	Yes		100.000 %
(15) Superior Medical Imaging LLC 5000 North 26th Street Lincoln,NE68521 26-2884555	OP Diagnostics	NE	SERMC	Related				No			No	51.000 %
(16) Central Nebraska Rehab Services 3004 W Faidley Ave Grand Island,NE68802 81-0653461	Physical Therapy	NE	CHI	Related	1,857,991	2,262,775		No			No	51.000 %
(17) Legacay Medical LLC 1700 Edison Drive Suite 300 Milford,OH45150 26-1613348			N/A		147,616	1,400,198		No			No	51.000 %
(18) St Francis Medical Center Associates 1717 South J Street Tacoma,WA98405 91-1352698	Med. Office	WA	FHS	Related	116,948	1,652,280		No			No	54.000 %
(19) Peninsula Radiation Oncology 314 Martin Luther King Jr Way 11 Tacoma,WA98405 87-0808610	Healthcare Srvc	WA	FHS	Related	131,195	3,052,504		No			No	60.000 %
(20) Berywood Office Properties LLC 400 Berywood Trail Cleveland,TN37312 62-1875199	Phys Office	TN	MHCS	Related				No		Yes		63.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership
(1) Alternative Insurance Management Service 3900 Olympic Boulevard Suite 400 Erlanger,KY41018 84-1112049	Management Servic	CO	CHI	C Corp		3,267,441	100.000 %
(2) Captive Management Initiatives PO Box 10073 APO GeorgeTown,Grand CaymanKY1-1001 CJ 98-0663022	Captive Managemen	CJ	CHI	C Corp			100.000 %
(3) Center for Translational Research 198 Inverness Drive West Englewood,CO80112 27-2269511	Healthcare	CO	CHI	C Corp	-2,247,962	1,668,589	100.000 %
(4) First Initiatives Insurance Ltd PO Box 10073 APO GeorgeTown,Grand CaymanKY1-1001 CJ 98-0203038	Insurance	CJ	CHI	C Corp			100.000 %
(5) Franciscan Services Inc 198 Inverness Drive West Englewood,CO80112 23-2487967	Healthcare	CO	CHI	C Corp	-507,578	11,914,284	100.000 %
(6) SJH Services Corporation 198 Inverness Drive West Englewood,CO80112 23-2307408	Healthcare	CO	FSI	C Corp	-518,360	3,180,100	100.000 %
(7) St Joseph Development Company Inc 1717 South J Street Tacoma,WA98405 91-1480569	Rental	WA	FSI	C Corp	-36,395	12,168,022	100.000 %
(8) Towson Management Inc 7601 Osler Drive Towson,MD21204 52-1710750	Management Servic	MD	FSI	C Corp	-469,016	498,393	100.000 %
(9) Nazareth Assurance Company 76 St Paul Street Suite 500 Burlington,VT05401 03-0304831	Insurance	VT	CHI	C Corp	-379	123,535	100.000 %
(10) St Vincent Community Health Services In Two St Vincent Circle Little Rock,AR72205 71-0710785	Healthcare	AR	SVIMC	C Corp	2,309,129	14,049,375	100.000 %
(11) Comcare Services 4231 W 16th Avenue Denver,CO80204 84-0904813	Inactive	CO	CHIC	C Corp			100.000 %
(12) Des Moines Medical Center Inc 1111 6th Avenue Des Moines,IA50314 42-0837382	Real Estate	IA	CHI-IA Corp	C Corp		1,253,452	92.980 %
(13) Mercy Park Apartments Ltd 1111 6th Avenue Des Moines,IA50314 42-1202422	Housing	IA	CHI-IA Corp	C Corp	264,489	1,796,053	100.000 %
(14) Central Kansas Health Services Associati 3515 Broadway Great Bend,KS67530 48-1042853	MEDICAL EQUIPMENT	KS	CKMC	C Corp			100.000 %
(15) SJL Physician Management Services Inc 424 Lewis Hargett Cr 160 Lexington,KY40503 27-0164198	Management	KY	SJHS	C Corp			100.000 %
(16) St Joseph Office Park Association 1401 HarrodsBurg Road Bldg B70 Lexington,KY40504 61-1079899	Management	KY	SJHS	C Corp	16,644	882,139	85.000 %
(17) Mercy Health Services Corporation 2727 McClelland Blvd Joplin,MO64804 43-1457881	DME	MO	St John's RMC	C Corp	-1,533,371	1,369,083	100.000 %
(18) Good Samaritan Outreach Services PO BOX 1990 Kearney,NE68848 47-0659440	MEDICAL CLINIC	NE	CHI Nebraska	C Corp	-2,921,063	355,110	100.000 %
(19) Health Systems Enterprises Inc PO BOX 1990 Kearney,NE68848 47-0664558	MANAGEMENT	NE	GSH	C Corp	25,289	1,443,049	100.000 %
(20) Saint Clare's Primary Care Inc 66 Ford Road Denville,NJ07834 22-2441202	Billing Services	NJ	SCCC	C Corp	-342,970	2,177,166	100.000 %
(21) MedQuest 1301 15th Avenue West Williston,ND58801 45-0392137	Sale of DME	ND	MHof Williston	C Corp	9,852	962,554	100.000 %
(22) Consolidated Health Services 1700 Edison Drive Milford,OH45150 31-1378212	Home Health	OH	CHI	C Corp		11,595,125	100.000 %
(23) American Nursing Care 1700 Edison Drive Milford,OH45150 31-1085414	Home Health	OH	CHS	C Corp	1,765,139	44,470,358	100.000 %
(24) Amerimed Inc 1700 EDISON DRIVE Milford,OH45150 31-1158699	Home Health	OH	ANC	C Corp	2,337,294	11,869,657	100.000 %
(25) Patient Transport Services Inc 1700 EDISON DRIVE Milford,OH45150 31-1100798	Home Health	OH	ANC	C Corp	546,029	5,325,941	100.000 %
(26) Samaritan Family Care Inc 40 W Fourth St 1700 Dayton,OH45402 31-1299450	Healthcare	OH	SHP	C CORP			100.000 %
(27) Mercy Services Corp 2700 Stewart Parkway Roseburg,OR97470 93-0824308	Retail Sales	OR	MMC	C Corp	-690,267	954,798	100.000 %
(28) St Anthony Development Company 1415 Southgate Pendleton,OR97801 93-1216943	Athletic Club	OR	St Anthony H	C Corp	53,891	3,007,554	100.000 %
(29) CGH Realty Company Inc 215 N 12th St Reading,PA19603 23-2326801	Real Estate	PA	SJHM	C Corp	1,007	42,415	100.000 %
(30) Caduceus Medical Associates Inc 6028 Shallowford Road Suite D Chattanooga,TN37422 62-1570736	Healthcare	TN	MHCS	C Corp		1,008	100.000 %
(31) Mountain Management Services Inc 6028D Shallowford Road Chattanooga,TN37422 62-1570739	mgmt svc org	TN	MHCS	C Corp	-386,020	4,667,998	100.000 %
(32) Physician Health System Network 1149 Market St Tacoma,WA98402 91-1746721	Health Org.	WA	FHS	C Corp			100.000 %
(33) Healthcare Mgmt Services Org Inc 1149 Market St Tacoma,WA98402 91-1865474	Health Org.	WA	FHS	C Corp			100.000 %
(34) HAROLD W RASE 1995 CHARITABLE UNITRUST 30 WEST 7TH STREET DICKINSON,ND58601 45-6090420	INVESTMENTS	ND	SJHHC	TRUST	1,240	21,533	100.000 %
(35) HAROLD W RASE 1996 CHARITABLE UNITRUST 30 WEST 7TH STREET DICKINSON,ND58601 20-6037112	INVESTMENTS	ND	SJHHC	TRUST	900	15,495	100.000 %
(36) HAROLD W RASE 1997 CHARITABLE UNITRUST 30 WEST 7TH STREET DICKINSON,ND58601 20-6037104	INVESTMENTS	ND	SJHHC	TRUST	1,025	20,261	100.000 %
(37) HAROLD W RASE 1999 CHARITABLE UNITRUST 30 WEST 7TH STREET DICKINSON,ND58601 20-6037099	INVESTMENTS	ND	SJHHC	TRUST	1,313	25,027	100.000 %
(38) JAMES & HENRIETTA NISTLER CHARITABLE 30 WEST 7TH STREET DICKINSON,ND58601 20-6021899	INVESTMENTS	ND	SJHHC	TRUST	-16,708	41,455	100.000 %
(39) JOSEPH A SCHUSTER ANNUITY TRUST 400 UNIVERSITY AVENUE DES MOINES,IA50314 42-1195122	INVESTMENTS	IA	MFDM	TRUST	18,924	441,488	100.000 %
(40) RAY & SHIRLEY DAVID 1999 UNITRUST 30 WEST 7TH STREET DICKINSON,ND58601 20-6037077	INVESTMENTS	ND	SJHHC	TRUST	1,250	24,194	100.000 %
(41) TOM DEYLE CHARITABLE REMAINDER UNITRUST PO BOX 1810 KEARNEY,NE68848 47-6192393	INVESTMENTS	NE	GSHF	TRUST	4,884	166,321	100.000 %
(42) DAVID DEYLE CHARITABLE REMAINDER UNITRUS PO BOX 1810 KEARNEY,NE68848 47-6192395	INVESTMENTS	NE	GSHF	TRUST	4,880	166,425	100.000 %
(43) JEANNE DEYLE CHARITABLE REMAINDER PO BOX 1810 KEARNEY,NE68848 47-6192398	INVESTMENTS	NE	GSHF	TRUST	4,880	166,320	100.000 %
(44) LODESCA MILLER CHARITABLE REMAINDER PO BOX 1810 KEARNEY,NE68848 47-6186933	INVESTMENTS	NE	GSHF	TRUST	3,387	86,367	100.000 %
(45) ROBERT & WANDA HABER CHARITABLE REMAIND PO BOX 1810 KEARNEY,NE68848 26-6191916	INVESTMENTS	NE	GSHF	TRUST	13,030	537,775	100.000 %

Schedule R (Form 990) 2010

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .

m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved
(1) Saint Elizabeth Regional Medical Center	b	1,428,635
(2) Catholic Health Initiatives	c	203,248
(3)
(4)
(5)
(6)

Schedule R (Form 990) 2010

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Are all partners section 501(c)(3) organizations?		(e) Share of end-of-year assets	(f) Disproprtionate allocations?		(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(h) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(e) Share of end-of-year assets	Yes	No	(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2010

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,481,719	1,663,683
9	Program service revenue (Part VIII, line 2g) .........	0	0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	356,069	561,477
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	147,022	162,442
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	1,984,810	2,387,602
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,268,413	1,457,253
14	Benefits paid to or for members (Part IX, column (A), line 4) ....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 374,836
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	775,268	751,611
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,043,681	2,208,864
19	Revenue less expenses. Subtract line 18 from line 12......	-58,871	178,738
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	7,257,591	8,137,379
21	Total liabilities (Part X, line 26)............	402,248	426,216
22	Net assets or fund balances. Subtract line 21 from line 20 .....	6,855,343	7,711,163

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 1,589,650 including grants of $ 1,457,253 ) (Revenue $ )
	SEE SCHEDULE "O"

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services. (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 1,589,650

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) STEPHEN BURT BOARD MEMBER	1.0	X
(2) DEONNE BRUNING BOARD MEMBER	1.0	X
(3) CHARLIE CALHOUN BOARD CHAIR	1.0	X	X
(4) GREGORY HEIDRICK BOARD SECRETARY	1.0	X	X
(5) SR ELAINE HEROLD BOARD MEMBER	5.0	X
(6) AMY HARRIS BOARD MEMBER	1.0	X
(7) CONNIE JENSEN BOARD MEMBER	1.0	X
(8) ED PERRY BOARD MEMBER	1.0	X
(9) CHARLES PALLESEN BOARD MEMBER	1.0	X
(10) LOUISE SCHLEICH BOARD MEMBER	1.0	X
(11) ALAN SLATTERY BOARD VICE CHAIR	1.0	X	X
(12) SAMUEL BRYANT BOARD MEMBER	1.0	X
(13) GRACE LARSON BOARD MEMBER	1.0	X
(14) DONNA HAMMACK CHIEF DEVELOPMENT OFFICER	50.0	X	X	0	153,639	31,144
(15) ROBERT LANIK PRESIDENT CEO	1.0	X	X	0	689,847	45,724
(16) JEANETTE WOJTALEWICZ VICE PRESIDENT FINANCE/CFO	2.0		X	0	339,933	41,838

1	Briefly describe the organization’s mission or most significant activities: Saint Elizabeth Foundation raises funds to promote excellent, compassionate and spiritual care within CHI Nebraska and the communities the health system serves.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	13
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	0
6	Total number of volunteers (estimate if necessary) ....	6	54
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	600
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	0	1,183,419	118,706

(A) Name and business address	(B) Description of services	(C) Compensation
None




2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 0

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c		24,484
d	Related organizations...1d		203,248
e	Government grants (contributions)1e		70,047

f	All other contributions, gifts, grants, and similar amounts not included above1f		1,365,904
g	Noncash contributions included in lines 1a-1f:$ 12,000
h	Total. Add lines 1a-1f.......			1,663,683
			Business Code
2a
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			0
3	Investment income (including dividends, interest
	and other similar amounts).....			141,711		600	141,111
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross Rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss).......
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	419,766
b	Less: cost or other basis and sales expenses
c	Gain or (loss)	419,766
d	Net gain or (loss)..........			419,766			419,766
8a	Gross income from fundraising events (not including $ 24,484 of contributions reported on line 1c). See Part IV, line 18 ...
	a		42,683
b	Less: direct expenses ...b		34,140
c	Net income or (loss) from fundraising events..			8,543			8,543
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a		359,165
b	Less: cost of goods sold ..b		211,481
c	Net income or (loss) from sales of inventory..			147,684			147,684
Miscellaneous Revenue			Business Code
11a	ALL OTHER REVENUE		900,099	6,215			6,215
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			6,215
12	Total revenue. See Instructions....			2,387,602		600	723,319


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			1,000	1	2,158
2	Savings and temporary cash investments .......			925,512	2	396,507
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			29,706	4	111,813
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........				5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			79,921	8	93,050
9	Prepaid expenses and deferred charges ............				9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	54,805
b	Less: accumulated depreciation. .....	10b	19,894	42,094	10c	34,911
11	Investments—publicly traded securities ..........				11
12	Investments—other securities. See Part IV, line 11 ......			6,021,950	12	7,323,226
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			157,408	15	175,714
16	Total assets. Add lines 1 through 15 (must equal line 34)...			7,257,591	16	8,137,379
17	Accounts payable and accrued expenses .			345,599	17	374,150
18	Grants payable ..........				18
19	Deferred revenue ..........				19
20	Tax-exempt bond liabilities ..........				20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities. Complete Part X of Schedule D.....			56,649	25	52,066
26	Total liabilities. Add lines 17 through 25.....			402,248	26	426,216
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			4,575,385	27	5,342,932
28	Temporarily restricted net assets .....			2,060,166	28	2,146,955
29	Permanently restricted net assets .....			219,792	29	221,276
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			6,855,343	33	7,711,163
34	Total liabilities and net assets/fund balances .....			7,257,591	34	8,137,379