TY 2012 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) CHAD COOPER........................................................................ PRESIDENT/CEO	45.00 .......................5.00	X	X		0	449,460	68,572
(2) JOSEPH MESSMER........................................................................ INTERIM CEO	45.00 .......................5.00	X	X		0	300,163	33,096
(3) KURT OWEN........................................................................ SECRETARY	1.00 .......................1.00	X	X		0	0	0
(4) PAUL CAMERON........................................................................ CHAIRPERSON	1.00 .......................1.00	X	X		0	0	0
(5) RYAN KRAY MD........................................................................ VICE CHAIR/PHYSICIAN	45.00 .......................1.00	X	X		221,191	0	2,021
(6) BRIAN MACKINAC........................................................................ BOARD MEMBER	1.00 .......................1.00	X			0	0	0
(7) DEB GRUBER........................................................................ BOARD MEMBER	1.00 .......................1.00	X			0	0	0
(8) GREGORY MCNAMARA........................................................................ BOARD MEMBER/PHYSICIAN	45.00 .......................1.00	X			280,950	0	38,095
(9) JEFFREY DROP........................................................................ BOARD MEMBER/SVP DIVISION OFFICER	1.00 .......................59.00	X			0	606,104	98,488
(10) JILL GRIFFITH-MCRAITH........................................................................ BOARD MEMBER	1.00 .......................1.00	X			0	0	0
(11) RICHARD WEAVER........................................................................ BOARD MEMBER	1.00 .......................1.00	X			0	0	0
(12) SR BERNICE EBNER........................................................................ BOARD MEMBER	1.00 .......................2.00	X			0	0	0
(13) STEVEN SMITH........................................................................ Treasurer/CFO	45.00 .......................1.00		X		132,581	0	32,352
(14) DAVID JORGENSEN........................................................................ PHYSICIAN	45.00 .......................0			X	675,807	0	46,584
(15) PAUL JOHNSON........................................................................ PHYSICIAN	45.00 .......................0			X	593,665	0	44,352
(16) PHILIP PROSAPIO........................................................................ PHYSICIAN	45.00 .......................0			X	614,702	0	47,724
(17) SAUNG PARK........................................................................ PHYSICIAN	45.00 .......................0			X	494,319	0	29,757

(A) Name and business address	(B) Description of services	(C) Compensation
EMERGENCY PRACTICE ASSOCPO BOX 1260WATERLOOIA50704	ER PHYSICIAN	1,483,675
CENTRAL MN DIAGNOSTIC150 10TH ST NW PO BOX 158MILACAMN56353	RADIOLOGY SERVICES	1,391,060
LITTLE FALLS ANESTHESIASUITE 130 808 3RD STREETLITTLE FALLSMN56345	ANESTHESIA SERVICES	1,159,147
HY-TEC CONSTRUCTIONPO BOX 621BRAINERDMN56401	CONSTRUCTION	375,199
QUEST DIAGNOSTICS12989 COLLECTIONS CTR DRCHICAGOIL60693	LAB SERVICES	364,276
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 13

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 United States. See Part IV, line 21	68,053	68,053
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	25,689	25,689
3	Grants and other assistance to governments, organizations, and individuals outside the United States. 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 ....	611,832	477,453	134,379
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	30,575,211	27,959,174	2,616,037
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,676,420	1,528,575	147,845
9	Other employee benefits .......	4,768,767	4,347,294	421,473
10	Payroll taxes ...........	2,077,693	1,874,268	203,425
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	152,388		152,388
c	Accounting ...........	21,670		21,670
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	10,516,930	7,862,937	2,653,993	0
12	Advertising and promotion ....	158,668	49,492	109,176
13	Office expenses .......	1,586,506	1,244,468	342,038
14	Information technology ......	4,334,183	4,251,098	83,085
15	Royalties ..	0
16	Occupancy ...........	1,341,905	1,203,312	138,593
17	Travel ............	331,172	291,413	39,759
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	1,842	914	928
20	Interest ...........	798,402	798,402
21	Payments to affiliates .......	1,636,470		1,636,470
22	Depreciation, depletion, and amortization .....	2,744,280	2,452,755	291,525
23	Insurance ..............	322,636	316,556	6,080
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	8,080,774	8,073,537	7,237
b	MN CARE TAX & DHS SURCHARGE	1,272,969	1,272,969	0
c	BAD DEBTS	1,230,796	1,230,796
d	REPAIRS & MAINTENANCE	473,579	388,796	84,783
e	All other expenses	946,371	285,893	660,478	0
25	Total functional expenses. Add lines 1 through 24e	75,755,206	66,003,844	9,751,362	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).	0

Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	0	1	0
2	Savings and temporary cash investments .........	2,646,680	2	5,060,949
3	Pledges and grants receivable, net ...........	28,470	3	33,088
4	Accounts receivable, net .............	12,044,770	4	11,819,062
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		88,641	5	66,699
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6	0
7	Notes and loans receivable, net .............	509,332	7	199,343
8	Inventories for sale or use ..............	1,416,122	8	1,420,801
9	Prepaid expenses and deferred charges ..........	138,322	9	54,527
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	59,113,882
b	Less: accumulated depreciation .....	10b	30,835,050	27,525,554	10c	28,278,832
11	Investments—publicly traded securities ..........		11	0
12	Investments—other securities. See Part IV, line 11 .....	2,338,936	12	4,620,263
13	Investments—program-related. See Part IV, line 11 .....	0	13	0
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........	2,459,890	15	2,222,211
16	Total assets. Add lines 1 through 15 (must equal line 34)......	49,196,717	16	53,775,775
	17	Accounts payable and accrued expenses .........	2,927,008	17	5,589,979
18	Grants payable .................		18
19	Deferred revenue ................		19	93,468
20	Tax-exempt bond liabilities .............		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22	0
23	Secured mortgages and notes payable to unrelated third parties ..	156,667	23	1,029,501
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	18,299,127	25	16,700,675
26	Total liabilities. Add lines 17 through 25.........	21,382,802	26	23,413,623
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	27,552,460	27	30,078,616
28	Temporarily restricted net assets ...........	261,455	28	283,536
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........	27,813,915	33	30,362,152
34	Total liabilities and net assets/fund balances ........	49,196,717	34	53,775,775

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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

2012

Open to Public
Inspection

Name of the organization

UNITY FAMILY HEALTHCARE

Employer identification number

41-0721642

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 described in 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. See section 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 - Non-functionally integrated

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 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 monetary support
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
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
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)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

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

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 2012 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2011 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2012. 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—2011. If the organization did not check a 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—2012. 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—2011. 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) 2012

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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.)..

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 2012 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2011 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2011 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2012. 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—2011. 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) 2012

Page 4

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

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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

2012

Name of the organization

UNITY FAMILY HEALTHCARE

Employer identification number

41-0721642

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, total 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 total 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 on line H of its
Form 990-EZ or on Part I, 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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 2

Name of organization UNITY FAMILY HEALTHCARE

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total 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) Total 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) Total 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) Total 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) Total 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) Total 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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 3

Name of organization UNITY FAMILY HEALTHCARE

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 4

Name of organization
UNITY FAMILY HEALTHCARE

Employer identification number

41-0721642

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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

$
Use duplicate copies of Part III if additional space is needed.

(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) (2012)

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

UNITY FAMILY HEALTHCARE

Employer identification number

41-0721642

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2012

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2012

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Yes

6,714

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Total. Add lines 1c through 1i ...............................

6,714

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered “No” OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
Description of the activities reported on Lines 1a through 1i	Schedule C, Part II-B, Line 1	THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN ASSOCIATION OF NURSE PRACTITIONERS: $7 AMERICAN ASSOCIATION FOR RESPIRATORY CARE: $17 AMERICAN ACADEMY OF FAMILY PHYSICIANS: $910 AMERICAN ACADEMY OF PHYSICIAN ASSISTANTS: $44 AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS: $100 AMERICAN COLLEGE OF FOOT AND ANKLE SURGEONS: $139 AMERICAN HOSPITAL ASSOCIATION: $1,023 AMERICAN MEDICAL ASSOCIATION: $252 AMERICAN OSTEOPATHIC ASSOCIATION: $68 ASSOCIATION OF NUTRITION & FOODSERVICE PROFESSIONALS: $6 ASSOCIATION FOR PROFESSIONALS IN INFECTION CONTROL AND EPIDEMIOLOGY: $15 AMERICAN SOCIETY OF HEALTH-SYSTEM PHARMACISTS: $88 CATHOLIC HEALTH ASSOCIATION: $397 MINNESOTA ACADEMY OF PHYSICIAN ASSISTANTS: $43 MINNESOTA MEDICAL GROUP MANAGEMENT ASSOCIATION: $55 MINNESOTA HOMECARE: $1,794 MINNESOTA HOSPITAL ASSOCIATION: $1,517 MINNESOTA MEDICAL ASSOCIATION: $157 MINNESOTA MEDICAL GROUP MANAGEMENT ASSOCIATION: $26 MINNESOTA ORTHOPEDIC SOCIETY: $56

Schedule C (Form 990 or 990EZ) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

UNITY FAMILY HEALTHCARE

Employer identification number

41-0721642

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 can 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 education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 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, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax 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 section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, 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 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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 (ASC 958) 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

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

Using the organization’s acquisition, 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 XIII.

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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........

Part V

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

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

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 XIII the intended uses of the organization's endowment funds.

Part VI

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

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	681,604		681,604
b	Buildings ................	25,162,239	11,857,157	13,305,082
c	Leasehold improvements ............			0
d	Equipment ................	31,866,937	18,240,675	13,626,262
e	Other .................	1,403,102	737,218	665,884
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				28,278,832

Schedule D (Form 990) 2012

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 OIP - FIXED INCOME	2,283,053	F
(B) CHI OIP - EQUITY SECURITIES	2,337,210	F







Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	4,620,263

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) must 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) must 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) Book value
Federal income taxes		0
CHI DEBT PROGRAM		15,768,332
ENVIRONMENTAL REMEDIATION LIABILITY		832,606
INTERCOMPANY PAYABLES		99,353
UNCLAIMED PROPERTY		384





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		16,700,675
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

Part XI 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 XIII.) ............	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 XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII 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 XIII.) ............	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 XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
FIN 48 (ASC 740) footnote	Schedule D, Part X, Line 2	UNITY FAMILY HEALTHCARE'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI'S FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2013 READS AS FOLLOWS: "CHI IS A TAX-EXEMPT COLORADO CORPORATION AND HAS BEEN GRANTED AN EXEMPTION FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CHI OWNS CERTAIN TAXABLE SUBSIDIARIES AND ENGAGES IN CERTAIN ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE AND THEREFORE SUBJECT TO INCOME TAX. MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS."

Schedule D (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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. Form 990-EZ filers are not required to complete this part. right arrow

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

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization
UNITY FAMILY HEALTHCARE

Employer identification number

41-0721642

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 email 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.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2012

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 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 MOTORCYCLE RUN (event type)	(b) Event #2 ROCK N RUN (event type)	(c) Other events 1 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . .	6,441	13,079	7,021	26,541
2	Less: Contributions . .	1,026	1,841	1,289	4,156
3	Gross income (line 1 minus line 2) . . .	5,415	11,238	5,732	22,385
4	Cash prizes . . .	1,000			1,000
5	Noncash prizes . .				0
6	Rent/facility costs . .		575	1,276	1,851
7	Food and beverages .		76	534	610
8	Entertainment . . .				0
9	Other direct expenses .	474	4,401	52	4,927
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........				8,388
11	Net income summary. Combine line 3, column (d), and line 10. ..........				13,997

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:

Schedule G (Form 990 or 990-EZ) 2012

Page 3

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

Indicate the percentage of gaming activity operated in:

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

13a

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

13b

Enter 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 of the third party:

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

Supplemental Information. Complete this part to provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).

Identifier	Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

UNITY FAMILY HEALTHCARE

Employer identification number

41-0721642

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..		10,655	669,442	0	669,442	0.900 %
b	Medicaid (from Worksheet 3, column a) ....		64,482	26,526,311	14,811,476	11,714,835	15.720 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .		0	0	0	0	0 %
d	Total Financial Assistance and Means-Tested Government Programs .	0	75,137	27,195,753	14,811,476	12,384,277	16.620 %
Other Benefits		16	7,078	370,919	53,651	317,268	0.430 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	16	7,078	370,919	53,651	317,268	0.430 %
f	Health professions education (from Worksheet 5) ..	1	85	6,645	0	6,645	0 %
g	Subsidized health services (from Worksheet 6) ..	1	12,351	286,601	0	286,601	0.380 %
h	Research (from Worksheet 7)	0	0	0	0	0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	5	8,030	129,835	34,046	95,789	0.130 %
j	Total. Other Benefits ..	23	27,544	794,000	87,697	706,303	0.940 %
k	Total. Add lines 7d and 7j .	23	102,681	27,989,753	14,899,173	13,090,580	17.560 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012

Schedule H (Form 990) 2012

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	0	0	0	0	0	0 %
2	Economic development	0	0	0	0	0	0 %
3	Community support	0	0	0	0	0	0 %
4	Environmental improvements	0	0	0	0	0	0 %
5	Leadership development and training for community members	0	0	0	0	0	0 %
6	Coalition building	0	0	0	0	0	0 %
7	Community health improvement advocacy	0	0	0	0	0	0 %
8	Workforce development	0	0	0	0	0	0 %
9	Other	2	2,095	225,321	15,813	209,508	0.280 %
10	Total	2	2,095	225,321	15,813	209,508	0.280 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

1,230,796

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

20,936,401

Enter Medicare allowable costs of care relating to payments on line 5.....

20,909,760

Subtract line 6 from line 5. This is the surplus (or shortfall)........

26,641

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2012

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?2 Name, address, and primary website address						Other (Describe)
1	ST GABRIEL'S HOSPITAL 815 SE SECOND STREET LITTLE FALLS,MN56345 WWW.UNITYFAMILY.COM OR WWW.STGABRIELS.COM	X	X	X	X
2	ALBANY AREA HOSPITAL AND MEDICAL CENTER 300 THIRD AVENUE ALBANY,MN56307 WWW.ALBANYAREAHOSPITAL.COM	X	X	X	X	OUTPATIENT CLINIC

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	ST GABRIEL'S HOSPITAL
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10		No
	If "Yes," indicate the FPG family income limit for eligibility for free care: % If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11		No
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: % If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individuals to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care? ............................

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	ALBANY AREA HOSPITAL AND MEDICAL CENTER
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10		No
	If "Yes," indicate the FPG family income limit for eligibility for free care: % If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11		No
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: % If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?6
Name and address		Type of Facility (describe)
1	FAMILY MEDICAL CENTER 811 SE SECOND STREET LITTLE FALLS,MN56345	OUTPATIENT CLINIC
2	LITTLE FALLS ORTHOPEDICS 1108 1ST STREET SE LITTLE FALLS,MN56345	OUTPATIENT CLINIC
3	COMMUNITY MEDICAL CENTER 200 SOUTH FIRST AVENUE PIERZ,MN56364	OUTPATIENT CLINIC
4	ST CAMILLUS PLACE 1100 SE FOURTH STREET LITTLE FALLS,MN56345	LONG TERM CARE FACILITY
5	RANDALL LAKES AREA CLINIC 250 WHITE OAK DRIVE RANDALL,MN56475	OUTPATIENT CLINIC
6	AVON MEDICAL CENTER 108 STRATFORD STREET WEST AVON,MN56310	OUTPATIENT CLINIC
7
8
9
10

Schedule H (Form 990) 2012

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
8	Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.

Identifier	ReturnReference	Explanation
Eligibility criteria for free or discounted care	Schedule H, Part I, Line 3c	WHEN CATHOLIC HEALTH INITIATIVES (THE ULTIMATE PARENT ORGANIZATION TO UNITY FAMILY HEALTHCARE) ESTABLISHED ITS FINANCIAL ASSISTANCE POLICY IT WAS DETERMINED THAT ESTABLISHING A HOUSEHOLD INCOME SCALE BASED ON THE HUD VERY LOW INCOME GUIDELINES MORE ACCURATELY REFLECTS THE SOCIOECONOMIC DISPERSIONS AMONG URBAN AND RURAL COMMUNITIES IN 17 STATES SERVED BY CHI HOSPITALS AND HEALTH CARE FACILITIES. IN COMPARING HUD GUIDELINES TO THE FEDERAL POVERTY GUIDELINES ("FPG"), WE FIND THAT ON AVERAGE HUD GUIDELINES COMPUTE TO APPROXIMATELY 200% TO 250% (AND SOMETIMES 300%) OF FPG. UNITY FAMILY HEALTHCARE BASES ITS FINANCIAL ASSISTANCE ELIGIBILITY ON HUD'S 130% OF VERY LOW INCOME GUIDELINES BASED ON GEOGRAPHY, AND AFFORDS THE UNINSURED AND UNDERINSURED THE ABILITY TO OBTAIN FINANCIAL ASSISTANCE WRITE-OFFS, BASED ON A SLIDING SCALE, RANGING FROM 25%-100% OF CHARGES. AN INDIVIDUAL'S INCOME UNDER THE HUD GUIDELINES IS A SIGNIFICANT FACTOR IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. HOWEVER, IN DETERMINING WHETHER TO EXTEND DISCOUNTED OR FREE CARE TO A PATIENT, THE PATIENT'S ASSETS MAY ALSO BE TAKEN INTO CONSIDERATION. FOR EXAMPLE, A PATIENT SUFFERING A CATASTROPHIC ILLNESS MAY HAVE A REASONABLE LEVEL OF INCOME, BUT A LOW LEVEL OF LIQUID ASSETS SUCH THAT THE PAYMENT OF MEDICAL BILLS WOULD BE SERIOUSLY DETRIMENTAL TO THE PATIENT'S BASIC FINANCIAL (AND ULTIMATELY PHYSICAL) WELL-BEING AND SURVIVAL. SUCH A PATIENT MAY BE EXTENDED DISCOUNTED OR FREE CARE BASED UPON THE FACTS AND CIRCUMSTANCES.
Costing Methodology used to calculate financial assistance	Schedule H, Part I, Line 7	A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING THE ORGANIZATION'S COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. WORKSHEET 2 WAS NOT USED TO DERIVE THE COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO FOR THE YEAR ENDED 6/30/13 WAS COMPUTED USING THE FOLLOWING FORMULA: OPERATING EXPENSE (BEFORE RESTRUCTURING, IMPAIRMENT AND OTHER LOSSES) DIVIDED BY GROSS PATIENT REVENUE. BASED ON THAT FORMULA, ST. GABRIEL'S HOSPITAL AND ALBANY AREA HOSPITAL HAD COST-TO-CHARGE RATIOS OF 53.01% AND 68.3% RESPECTIVELY.
Bad Debt Expense excluded from financial assistance calculation	Schedule H, Part I, Line 7, column(f)	1,230,796
Subsidized Health Services	Schedule H, Part I, Line 7g	UNITY FAMILY HEALTHCARE DOES NOT INCLUDE ANY COSTS ATTRIBUTABLE TO PHYSICIAN'S CLINICS AS SUBSIDIZED HEALTH CARE SERVICES.
Bad debt expense - methodology used to estimate amount	Schedule H, Part III, Line 2	COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 53.01% FOR ST. GABRIEL'S HOSPITAL AND 68.3% FOR ALBANY AREA HOSPITAL. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE.
Bad debt expense - methodology used to estimate amount as community benefit	Schedule H, Part III, Line 3	UNITY FAMILY HEALTHCARE DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE.
Bad debt expense - financial statement footnote	Schedule H, Part III, Line 4	UNITY FAMILY HEALTHCARE DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS: "THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, CHI FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. IN ACCORDANCE WITH ACCOUNTING STANDARDS UPDATE (ASU) NO. 2011-07, PRESENTATION AND DISCLOSURE OF PATIENT SERVICES REVENUE, PROVISION FOR BAD DEBTS, AND ALLOWANCES FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH ENTITIES, THE PROVISION FOR BAD DEBTS IS PRESENTED ON THE CONSOLIDATED STATEMENT OF OPERATIONS AS A DEDUCTION FROM PATIENT SERVICES REVENUES (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) SINCE CHI ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY."
Community benefit & methodology for determining medicare costs	Schedule H, Part III, Line 8	UNITY FAMILY HEALTHCARE IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL ("CAH"). CAHS ARE RURAL COMMUNITY HOSPITALS THAT ARE CERTIFIED TO RECEIVE COST-BASED REIMBURSEMENT FROM MEDICARE. THE REIMBURSEMENT THAT CAHS RECEIVE IS INTENDED TO IMPROVE THEIR FINANCIAL PERFORMANCE AND THEREBY REDUCE HOSPITAL CLOSURES. CAHS ARE CERTIFIED UNDER A DIFFERENT SET OF MEDICARE CONDITIONS OF PARTICIPATION (COP). SHORTFALLS ARE CREATED WHEN A FACILITY RECEIVES PAYMENTS THAT ARE LESS THAN THE COSTS OF CARING FOR PROGRAM BENEFICIARIES. BECAUSE SHORTFALLS ARE BASED ON COSTS, NOT CHARGES, UNITY FAMILY HEALTHCARE, DUE TO THEIR DESIGNATION AS A CAH, RECEIVED COST-BASED REIMBURSEMENT FOR MEDICARE PURPOSES, UNITY FAMILY HEALTHCARE WILL NOT EXPERIENCE MEDICARE RELATED SHORTFALLS. ALTHOUGH NOT PRESENTED ON THE MEDICARE COST REPORT, IN ORDER TO FACILITATE A MORE ACCURATE UNDERSTANDING OF THE "TRUE" COST OF SERVICES (FOR "SHORTFALL" PURPOSES) THE CHI WORKBOOK ALLOWS A HEALTH CARE FACILITY NOT TO OFFSET COSTS THAT MEDICARE CONSIDERS TO BE NON-ALLOWABLE, BUT FOR WHICH THE FACILITY CAN LEGITIMATELY ARGUE ARE RELATED TO THE CARE OF THE FACILITY'S PATIENTS. IN ADDITION, ALTHOUGH NOT REPORTABLE ON THE MEDICARE COST REPORT, THE CHI WORKBOOK INCLUDES THE COST OF SERVICES THAT ARE PAID VIA A SET FEE-SCHEDULE RATHER THAN BEING REIMBURSED BASED ON COSTS (E.G. OUTPATIENT CLINICAL LABORATORY). FINALLY, THE CHI WORKBOOK ALLOWS A FACILITY TO INCLUDE OTHER HEALTH CARE SERVICES PERFORMED BY A SEPARATE FACILITY (SUCH AS A PHYSICIAN PRACTICE) THAT ARE MAINTAINED ON SEPARATE BOOKS AND RECORDS (AS OPPOSED TO THE MAIN FACILITY'S BOOKS AND RECORDS WHICH HAS ITS COSTS OF SERVICE INCLUDED WITHIN A COST REPORT). TRUE COSTS OF MEDICARE COMPUTED USING THIS METHODOLOGY: TOTAL MEDICARE REVENUE: $20,936,401 TOTAL MEDICARE COSTS: $20,909,760 SURPLUS OR SHORTFALL $26,641 UNITY FAMILY HEALTHCARE BELIEVES THAT EXCLUDING MEDICARE LOSSES FROM COMMUNITY BENEFIT MAKES THE OVERALL COMMUNITY BENEFIT REPORT MORE CREDIBLE FOR THESE REASONS: UNLIKE SUBSIDIZED AREAS SUCH AS BURN UNITS OR BEHAVIORAL-HEALTH SERVICES, MEDICARE IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS. IN FACT, FOR-PROFIT HOSPITALS FOCUS ON ATTRACTING PATIENTS WITH MEDICARE COVERAGE, ESPECIALLY IN THE CASE OF WELL-PAID SERVICES THAT INCLUDE CARDIAC AND ORTHOPEDICS. SIGNIFICANT EFFORT AND RESOURCES ARE DEVOTED TO ENSURING THAT HOSPITALS ARE REIMBURSED APPROPRIATELY BY THE MEDICARE PROGRAM. THE MEDICARE PAYMENT ADVISORY COMMISSION (MEDPAC), AN INDEPENDENT CONGRESSIONAL AGENCY, CAREFULLY STUDIES MEDICARE PAYMENT AND THE ACCESS TO CARE THAT MEDICARE BENEFICIARIES RECEIVE. THE COMMISSION RECOMMENDS PAYMENT ADJUSTMENTS TO CONGRESS ACCORDINGLY. THOUGH MEDICARE LOSSES ARE NOT INCLUDED BY CATHOLIC HOSPITALS AS COMMUNITY BENEFIT, THE CATHOLIC HEALTH ASSOCIATION GUIDELINES ALLOW HOSPITALS TO COUNT AS COMMUNITY BENEFIT SOME PROGRAMS THAT SPECIFICALLY SERVE THE MEDICARE POPULATION. FOR INSTANCE, IF HOSPITALS OPERATE PROGRAMS FOR PATIENTS WITH MEDICARE BENEFITS THAT RESPOND TO IDENTIFIED COMMUNITY NEEDS, GENERATE LOSSES FOR THE HOSPITAL, AND MEET OTHER CRITERIA, THESE PROGRAMS CAN BE INCLUDED IN THE CHA FRAMEWORK IN CATEGORY C AS "SUBSIDIZED HEALTH SERVICES." AT UNITY FAMILY HEALTHCARE, OUR HOSPICE AND HOME CARE DEPARTMENT-UNITY FAMILY HOME CARE & HOSPICE-IS AN EXAMPLE OF SUBSIDIZED HEALTH SERVICES. MEDICARE LOSSES ARE DIFFERENT FROM MEDICAID LOSSES, WHICH ARE COUNTED IN THE CHA COMMUNITY BENEFIT FRAMEWORK, BECAUSE MEDICAID REIMBURSEMENTS GENERALLY DO NOT RECEIVE THE LEVEL OF ATTENTION PAID TO MEDICARE REIMBURSEMENT. MEDICAID PAYMENT IS LARGELY DRIVEN BY WHAT STATES CAN AFFORD TO PAY, AND IS TYPICALLY SUBSTANTIALLY LESS THAN WHAT MEDICARE PAYS.
Collection practices for patients eligible for financial assistance	Schedule H, Part III, Line 9b	UNITY FAMILY HEALTHCARE'S DEBT COLLECTION POLICY PROVIDES THAT UNITY FAMILY HEALTHCARE WILL PERFORM A REASONABLE REVIEW OF EACH INPATIENT ACCOUNT PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH UNITY FAMILY HEALTHCARE'S COMMUNITY ASSISTANCE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO MEET THE UNITY FAMILY HEALTHCARE COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO UNITY FAMILY HEALTHCARE FOR APPROPRIATE FOLLOW-UP. UNITY FAMILY HEALTHCARE REQUIRES ITS THIRD-PARTY COLLECTION AGENTS TO INCLUDE A MESSAGE ON ALL STATEMENTS INDICATING THAT IF A PATIENT OR PATIENT GUARANTOR MEETS CERTAIN STIPULATED INCOME REQUIREMENTS, THE PATIENT OR PATIENT GUARANTOR MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. ALL OF CATHOLIC HEALTH INITIATIVES' HOSPITALS' CONTRACTS WITH THIRD PARTY COLLECTION AGENCIES INCLUDE THE FOLLOWING STANDARDS: * NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL REQUEST BENCH OR ARREST WARRANTS AS A RESULT OF NON-PAYMENT; * NEITHER CHI HOSPITALS NOR THEIR COLLECTION AGENCIES WILL SEEK LIENS THAT WOULD REQUIRE THE SALE OR FORECLOSURE OF A PRIMARY RESIDENCE; AND * NO CATHOLIC HEALTH INITIATIVES' COLLECTION AGENCY MAY SEEK COURT ACTION WITHOUT HOSPITAL APPROVAL. FINALLY, COLLECTION AGENCIES ARE TRAINED ON THE CATHOLIC HEALTH INITIATIVES MISSION, CORE VALUES AND STANDARD OF CONDUCT TO MAKE SURE ALL PATIENTS ARE TREATED WITH DIGNITY AND RESPECT.
Community Served by Needs Assessment	Schedule H, Part V Section B, Line 3	(1) ST. GABRIEL'S HOSPITAL - SEVERAL INDIVIDUALS FROM THROUGHOUT THE COMMUNITY PROVIDED INPUT INTO OUR 2013 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THESE PEOPLE INCLUDED BOTH STAKEHOLDERS AS WELL AS THE GENERAL PUBLIC. A WIDE RANGE OF PEOPLE FROM MORRISON COUNTY PUBLIC HEALTH AND MORRISON COUNTY SOCIAL SERVICES, INCLUDING PUBLIC HEALTH DIRECTOR BONNIE PAULSEN AND SOCIAL SERVICES DIRECTOR BRAD VOLD, PROVIDED INPUT INTO THE CHNA. OTHER PUBLIC HEALTH WORKERS PARTICIPATED IN THE CHNA AS WELL, INCLUDING ANN MARCH AND SHEILA FUNK (PUBLIC HEALTH EDUCATORS), LYNETTE GESSELL (MORRISON COUNTY MENTAL HEALTH WORKER), KEN SZCZODROSKI (COUNTY LEAD ELIGIBILITY WORKER). OTHER COMMUNITY PARTICIPANTS WHO WERE INTERVIEWED AS PART OF THE STAKEHOLDER INTERVIEWS WERE: TOM WEST, MORRISON COUNTY RECORD GENERAL MANAGER AND HEALTHY COMMUNITIES COLLABORATIVE BOARD MEMBER; JILL GRIFFITH-MCRAITH, LINDBERGH ELEMENTARY SCHOOL PRINCIPAL; CHAD COOPER, UFH PRESIDENT; STEVE JONES LITTLE FALLS COMMUNITY SCHOOLS SUPERINTENDENT; SUE WASLAND, SCHOOL NURSE; KEVIN MAURER, INDEPENDENT CHEMICAL DEPENDENCY COUNSELOR AND VIOLENCE PREVENTION COUNCIL MEMBER; BRENDA VANHEEL, HOME CARE NURSE; MARY KLINKER, MD, FAMILY PRACTICE PHYSICIAN; STEPHENIE OCH, HANDS OF HOPE RESOURCE CENTER DIRECTOR; ANDREA FOOTE, CAMP RIPLEY NURSE; SANDY VOIGT, INITIATIVE FOUNDATION DEVELOPMENT OFFICER; JIM BIRCHEM, LONG-TERM CARE FACILITIES OWNER; SR. LATONA KALIS, OSF, FRANCISCAN SISTERS OF LITTLE FALLS; LORI KUSH, INSURANCE AGENT; BRIDGET BRITZ, HORIZON HEALTH DIRECTOR; AND KRISTIN JACKSON, DPM, PODIATRIST.;
Community Served by Needs Assessment	Schedule H, Part V Section B, Line 3	(2) ALBANY AREA HOSPITAL AND MEDICAL CENTER - SEVERAL INDIVIDUALS FROM THROUGHOUT THE COMMUNITY PROVIDED INPUT INTO OUR 2013 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THESE PEOPLE INCLUDED BOTH STAKEHOLDERS AS WELL AS THE GENERAL PUBLIC. THE FOLLOWING INDIVIDUALS WERE PART OF THIS INTERVIEW PROCESS: RENEE FRAUENDIENST, STEARNS COUNTY HUMAN SERVICES, PUBLIC HEALTH DIVISION DIRECTOR; KAY HANSON, ALBANY AREA SCHOOLS, SCHOOL NURSE; THE STUDENT COUNCIL MEMBERS OF ALBANY AREA HIGH SCHOOL VIA KAY HANSON, SCHOOL NURSE WHO CONDUCTED A QUESTIONNAIRE AT A STUDENT COUNCIL MEETING; JOE HENNEN, OWNER OF HENNEN FLOORS INC., FREEPORTAND BOARD MEMBER FOR ALBANY MUTUAL TELEPHONE FOUNDATION BOARD AND STEARNS ELECTRIC COOPERATIVE; JOHN HOEFS, ADMINISTRATOR, MOTHER OF MERCY CAMPUS OF CARE, AND ATTORNEY; ANN NEU, REGISTERED DIETICIAN FOR MOTHER OF MERCY CAMPUS OF CARE; CINDY NIENABER, RN, ALBANY HOME CARE & HOSPICE DIRECTOR; SHELLY VANKEUREN PIERSON - PAST AVON CHAMBER PRESIDENT, WORKS AT AVON BODY SHOP AND BUSINESS OWNER OF A CRAFTY GIRLS, A BOUTIQUE IN AVON; LYNN JENC, COMMUNITY EDUCATION DIRECTOR FOR ALBANY AREA SCHOOLS; DARON GERSCH, MD, FAMILY MEDICINE PHYSICIAN AT ALBANY AREA HOSPITAL & MEDICAL AND MAYOR OF ALBANY; ALEXIS LUTGEN, UNITED WAY REPRESENTATIVE AND YOUNG MOTHER, ALBANY RESIDENT; AND EDNA GOEBEL, ALBANY RESIDENT AND FOOD SHELF VOLUNTEER AND COORDINATOR. IN ADDITION, KIM MCCOY, PROGRAM MANAGER FOR STRATIS HEALTH, ASSISTED THE CHNA TEAM IN DEVELOPING ITS IMPLEMENTATION STRATEGY. ;
Availability of Needs Assessment	Schedule H, Part V Section B, Line 5c	(1) ST. GABRIEL'S HOSPITAL - THE CHNA IS ALSO EMAILED TO SPECIFIC INDIVIDUALS THROUGHOUT MORRISON COUNTY.;
Availability of Needs Assessment	Schedule H, Part V Section B, Line 5c	(2) ALBANY AREA HOSPITAL AND MEDICAL CENTER - THE CHNA IS ALSO EMAILED TO SPECIFIC INDIVIDUALS THROUGHOUT THE PRIMARY SERVICE AREA AND TO OTHER INTERESTED INDIVIDUALS.;
Needs not addressed in Needs Assessment	Schedule H, Part V Section B, Line 7	(1) ST. GABRIEL'S HOSPITAL - THE TWO PRIMARY NEEDS THAT THE MOST RECENT CHNA DISCOVERED, WHICH ST. GABRIEL'S HOSPITAL WILL NOT BE ADDRESSING ARE: 1) THE LIMITED ACCESS TO DENTAL SERVICES, SINCE ST. GABRIEL'S HOSPITAL DOES NOT HAVE APPROPRIATE RESOURCES FOR THE PROVISION OF DENTAL CARE; AND 2) ACCESS TO CHEMICAL DEPENDENCY SERVICES, SINCE THERE ARE SEVERAL CHEMICAL DEPENDENCY PROVIDERS IN THE COUNTY WHO ARE ABLE TO ADDRESS THIS NEED AND THE HOSPITAL CLOSED ITS BEHAVIORAL HEALTH UNIT IN 2002. ST. GABRIEL'S HOSPITAL IS FOCUSING ITS IMPLEMENTATION STRATEGY AROUND THREE GOAL AREAS: 1) CHRONIC ILLNESS THROUGH A PATIENT-CENTERED MEDICAL HOME; 2) OBESITY IN COLLABORATION WITH MCPH AND OTHER GRANT AND HEALTHY COMMUNITY INITIATIVES; AND 3) ACCESS TO MENTAL HEALTH SERVICES THROUGH THE EMPLOYMENT OF AN ADVANCED PRACTICE PSYCHIATRIC NURSE PRACTITIONER AND TELEPSYCHIATRY SERVICES.;
Needs not addressed in Needs Assessment	Schedule H, Part V Section B, Line 7	(2) ALBANY AREA HOSPITAL AND MEDICAL CENTER - THE CHNA IDENTIFIED SEVERAL COMMUNITY HEALTH PRIORITIES. THE MAJOR HEALTH PRIORITIES ARE OBESITY, MENTAL HEALTH, POVERTY, ALCOHOL USE, AND TOBACCO USE. THE IMPLEMENTATION STRATEGY WILL ADDRESS TWO OF THE FIVE MAJOR HEALTH ISSUES. EXCEPT ON A LIMITED SCALE, THE IMPLEMENTATION STRATEGY WILL NOT ADDRESS POVERTY, ALCOHOL AND TOBACCO USE. POVERTY IS A BROAD SOCIETAL ISSUE BEYOND THE CAPABILITIES OF A SMALL, RURAL COMMUNITY HOSPITAL WITH LIMITED RESOURCES. SPECIFIC ACTIONS RELATED TO IMPROVING COMMUNITY MENTAL HEALTH, MAY ADDRESS THE ISSUE OF ALCOHOL USE. TOBACCO USE WILL BE REVIEWED AGAIN AT THE NEXT THREE-YEAR CYCLE. ALBANY AREA HOSPITAL HAS DEVELOPED A THREE-YEAR ACTION PLAN TO ADDRESS AWARENESS OF TWO COMMUNITY HEALTH PRIORITIES: 1) HEALTHY LIFESTYLES INCLUDING THE IMPORTANCE OF PHYSICAL ACTIVITY AND PROPER NUTRITION; AND 2) COMMUNITY AWARENESS OF MENTAL WELLNESS BY REDUCING THE STIGMA ASSOCIATED WITH MENTAL ILLNESS AND INCREASING IDENTIFICATION OF MENTAL HEALTH ISSUES AMONG RESIDENTS OF THE SERVICE AREA. ;
Used federal poverty guidelines (FPG) to determine eligibility	Schedule H, Part V Section B, Line 10	(1) ST. GABRIEL'S HOSPITAL - ST. GABRIEL'S HOSPITAL BASES ITS FINANCIAL ASSISTANCE ELIGIBILITY ON HUD'S 130% OF VERY LOW INCOME GUIDELINES BASED ON GEOGRAPHY, AND AFFORD THE UNINSURED AND UNDERINSURED THE ABILITY TO OBTAIN FINANCIAL ASSISTANCE WRITE-OFFS, BASED ON A SLIDING SCALE, RANGING FROM 25% - 100% OF CHARGES.;
Used federal poverty guidelines (FPG) to determine eligibility	Schedule H, Part V Section B, Line 10	(2) ALBANY AREA HOSPITAL AND MEDICAL CENTER - ALBANY AREA HOSPITAL AND MEDICAL CENTER BASES ITS FINANCIAL ASSISTANCE ELIGIBILITY ON HUD'S 130% OF VERY LOW INCOME GUIDELINES BASED ON GEOGRAPHY, AND AFFORD THE UNINSURED AND UNDERINSURED THE ABILITY TO OBTAIN FINANCIAL ASSISTANCE WRITE-OFFS, BASED ON A SLIDING SCALE, RANGING FROM 25% - 100% OF CHARGES.;
Used FPG to determine eligibility for providing discounted care criteria	Schedule H, Part V Section B, Line 11	(1) ST. GABRIEL'S HOSPITAL - ST. GABRIEL'S HOSPITAL BASES ITS FINANCIAL ASSISTANCE ELIGIBILITY ON HUD'S 130% OF VERY LOW INCOME GUIDELINES BASED ON GEOGRAPHY, AND AFFORD THE UNINSURED AND UNDERINSURED THE ABILITY TO OBTAIN FINANCIAL ASSISTANCE WRITE-OFFS, BASED ON A SLIDING SCALE, RANGING FROM 25% - 100% OF CHARGES.;
Used FPG to determine eligibility for providing discounted care criteria	Schedule H, Part V Section B, Line 11	(2) ALBANY AREA HOSPITAL AND MEDICAL CENTER - ALBANY AREA HOSPITAL AND MEDICAL CENTER BASES ITS FINANCIAL ASSISTANCE ELIGIBILITY ON HUD'S 130% OF VERY LOW INCOME GUIDELINES BASED ON GEOGRAPHY, AND AFFORD THE UNINSURED AND UNDERINSURED THE ABILITY TO OBTAIN FINANCIAL ASSISTANCE WRITE-OFFS, BASED ON A SLIDING SCALE, RANGING FROM 25% - 100% OF CHARGES.;
COMMUNITY BENEFITS, NEEDS ASSESSMENTS, AND OTHER INFORMATION	SCHEDULE H, PART VI, LINE 2	ORGANIZATION'S MISSION, VISION, AND TAX-EXEMPT PURPOSE: UNITY FAMILY HEALTHCARE'S MISSION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH BY BRINGING IT NEW LIFE, ENERGY AND VIABILITY IN THE 21ST CENTURY. FIDELITY TO THE GOSPEL URGES US TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS WE MOVE TOWARD THE CREATION OF HEALTHIER COMMUNITIES. OUR VISION IS TO CREATE THE BEST POSSIBLE HEALTH CARE EXPERIENCE BY IGNITING THE SPIRIT FOR SUPERIOR CARE AND SERVICE. UNITY FAMILY HEALTHCARE WAS FOUNDED BY THE FRANCISCAN SISTERS OF LITTLE FALLS TO CARRY THE ORGANIZATION'S HEALING MINISTRY. THE CORNERSTONE OF UNITY FAMILY HEALTHCARE IS ST. GABRIEL'S HOSPITAL, A 25-BED CRITICAL ACCESS HOSPITAL (CAH), WHICH ORIGINALLY WAS ORGANIZED IN MAY OF 1891 AND RECEIVED ITS FIRST PATIENTS IN JANUARY OF 1892. ST. GABRIEL'S HOSPITAL AND THE OTHER ORGANIZATIONS THAT COMPRISE UNITY FAMILY HEALTHCARE, INCLUDING FAMILY MEDICAL CENTER, LITTLE FALLS ORTHOPEDICS, ST. CAMILLUS PLACE, AND ALBANY AREA HOSPITAL & MEDICAL CENTER, SERVE ALL PERSONS IN THE COMMUNITY ON A NON-DISCRIMINATORY BASIS. THE TWO HOSPITALS OPERATE EMERGENCY SERVICES DEPARTMENTS THAT ARE OPEN TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY AND HAVE OPEN MEDICAL STAFFS WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS AND MID-LEVEL PRACTITIONERS (PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS, ETC.). THE UNITY FAMILY HEALTHCARE BOARD OF DIRECTORS IS AN ELEVEN-MEMBER GOVERNING BOARD OF MOSTLY INDEPENDENT INDIVIDUALS WHO SERVE AS REPRESENTATIVES OF THE COMMUNITY AND OVERSEE OPERATIONS OF THE UFH FACILITIES. ONLY THREE MEMBERS OF THE GOVERNING BOARD ARE NOT DIRECTLY SERVING AS REPRESENTATIVES OF THE COMMUNITY-THE MARKET PRESIDENT, INTERIM PRESIDENT, AND THE SENIOR VICE PRESIDENT OF OPERATIONS FROM THE CATHOLIC HEALTH INITIATIVES (CHI) DIVISION OFFICE IN FARGO, ND. ST. GABRIEL'S HOSPITAL ENGAGES IN THE TRAINING OF HEALTH PROFESSIONALS, ESPECIALLY NURSES, PHARMACISTS, RADIOLOGIC TECHNOLOGISTS, PHYSICAL THERAPISTS, NURSE ANESTHETISTS AND PHYSICIAN ASSISTANTS. ST. GABRIEL'S HOSPITAL ALSO HAS BEEN AN ACTIVE PARTICIPANT IN THE UNIVERSITY OF MINNESOTA'S RURAL PHYSICIAN ASSOCIATE PROGRAM (RPAP) SINCE ITS INCEPTION IN 1973. THE PROGRAM PROVIDES A "HANDS-ON" EXPERIENCE OF SERVING THE PRIMARY CARE NEEDS OF PEOPLE IN RURAL AREAS. UNITY FAMILY HEALTHCARE FACILITIES PARTICIPATE IN ALL GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS SUCH AS MEDICAID, MEDICARE, CHAMPUS, MINNESOTACARE, TRI-CARE, AND OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS (I.E., THE SAGE PROGRAM, FORMERLY CALLED THE MINNESOTA BREAST & CERVICAL CANCER CONTROL PROGRAM, WHICH PROVIDES FREE OR LOW-COST SCREENING SERVICES TO WOMEN AT OR BELOW 200% OF FEDERAL POVERTY GUIDELINES). UNITY FAMILY HEALTHCARE'S TWO CRITICAL ACCESS HOSPITALS (CAHS) OPERATE 24-HOUR EMERGENCY ROOMS 365 DAYS PER YEAR. THAT EMERGENCY ROOM IS OPEN TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. FURTHERMORE, THE HOSPITALS HAVE OPEN MEDICAL STAFFS, PARTICIPATE IN MEDICARE AND MEDICAID, AND HAVE AN ACTIVE CHARITY CARE PROGRAM. COMMUNITY SERVICE HAS ALWAYS BEEN AT THE CORE OF UNITY FAMILY HEALTHCARE ACTIVITIES. FOR EXAMPLE, UNITY FAMILY HEALTHCARE WAS THE FIRST ORGANIZATION IN THE REGION TO OFFER PRENATAL EDUCATION TO EXPECTANT MOTHERS THROUGH ST. GABRIEL'S HOSPITAL IN THE 1950S. OTHER NOTABLE EXAMPLES FROM RECENT YEARS INCLUDE: THE YOUTH RECREATION INITIATIVE, YOUTH AS RESOURCES (YAR), AND THE BRIDGES: YOUTH, FAMILY, COMMUNITY PROGRAM WHICH PROVIDED BEHAVIORAL HEALTH COUNSELING AND OTHER SERVICES TO YOUTH IN THE PUBLIC SCHOOLS AND OTHER SERVICES TO FAMILIES UTILIZING COMMUNITY RESOURCES. THE PROGRAMS AND SERVICES DESCRIBED THROUGHOUT THIS REPORT NOT ONLY SERVE ALL PERSONS IN THE COMMUNITY, BUT ALSO HELP TO REDUCE THE BURDENS ON LOCAL GOVERNMENT THROUGH A SPIRIT OF COLLABORATION. BOTH ST. GABRIEL'S HOSPITAL AND ALBANY AREA HOSPITAL & MEDICAL CENTER PROVIDE CHARITY CARE, IN ADDITION TO A WIDE RANGE OF COMMUNITY BENEFIT ACTIVITIES ASSOCIATED WITH SERVING THE NEEDS OF THE POOR. PERFORMING THESE SERVICES AND PICKING UP THE RELATED COSTS HELPS LOCAL GOVERNMENT AGENCIES WHICH MIGHT OTHERWISE HAVE TO FUND THE SERVICES. FINALLY, BOTH HOSPITALS ARE INCLUDED IN THE OFFICIAL CATHOLIC DIRECTORY AS TAX-EXEMPT HOSPITALS. COMMUNITY BENEFIT APPROACH: UNITY FAMILY HEALTHCARE'S TWO CAHS ARE LOCATED APPROXIMATELY 38 MILES APART IN CENTRAL MINNESOTA AND WHILE THE PRIMARY SERVICE AREAS FOR BOTH FACILITIES HAVE SOME MINOR OVERLAP, THEY WILL BE ADDRESSED SEPARATELY. ST. GABRIEL'S HOSPITAL: LOCATED IN LITTLE FALLS, MN, ST. GABRIEL'S HOSPITAL SERVES THE PEOPLE OF MORRISON COUNTY, MINNESOTA AND SMALL PORTIONS OF THE SURROUNDING AREA OF CENTRAL MINNESOTA. MORRISON COUNTY HAS A POPULATION OF 32, 872 ACCORDING THE MOST RECENT (2013) ESTIMATE FROM THE U.S. CENSUS BUREAU. ON AVERAGE, MORRISON COUNTY IS OLDER AND POORER ON AVERAGE THAN THE OVERALL POPULATION OF THE STATE OF MINNESOTA. IN THE COUNTY, 16.7% OF THE POPULATION IS AGE 65 OR OLDER COMPARED TO 13.6% OF MINNESOTANS AS A WHOLE. THE MEDIAN AGE FOR MORRISON COUNTY IS 40.8 AND FOR MINNESOTA THE MEDIAN AGE IS 37.5. THE MEDIAN HOUSEHOLD INCOME FOR THE COUNTY IS $47,110 AND THE PER CAPITA INCOME FOR THE COUNTY IS $23,269, IN COMPARISON TO $59,126 AND $30,656 RESPECTIVELY FOR MINNESOTA. THE PERCENTAGE OF PERSONS BELOW THE POVERTY LEVEL (2008-2012) IN THE COUNTY IS 13.2%, WHILE IN THE STATE, IT IS 11.2%. MORRISON COUNTY HAS A LARGELY CAUCASIAN POPULATION, MAKING UP 96.5% OF THE COUNTY POPULATION. THIS IS IN COMPARISON TO THE STATE OF MINNESOTA AS A WHOLE, WHICH IS 82.4% CAUCASIAN. SIMILARLY, ONLY 1.1% OF THE POPULATION IN MORRISON COUNTY IS FOREIGN BORN, WHILE THE FOREIGN BORN MINNESOTA POPULATION IS 7.2%. FINALLY, THERE ARE 29.5 PERSONS PER SQUARE MILE IN MORRISON COUNTY, BUT THERE ARE 66.6 PERSONS PER SQUARE MILE IN MINNESOTA AS A WHOLE. A FEW AREAS OF THE COUNTY HAVE BEEN DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS), PRIMARILY DUE TO ECONOMIC FACTORS. ACCORDING TO THE BUREAU OF ECONOMIC ANALYSIS (BEA), THE AVERAGE EARNINGS PER JOB IS $36,717. THE COUNTY UNEMPLOYMENT RATE IS CURRENTLY (JANUARY 2014) 9.5%. THE TOTAL NUMBER OF JOBS IN THE COUNTY (2013 BEA ESTIMATE) IS 17,702, WITH APPROXIMATELY TWO-THIRDS OF THESE JOBS WAGE AND SALARY POSITIONS. SINCE ITS INCEPTION IN 1891, ST. GABRIEL'S HOSPITAL HAS BEEN INTIMATELY INVOLVED IN COMMUNITY HEALTH COLLABORATION, WORKING WITH LOCAL LUMBERING COMPANIES TO DEVELOP PLANS TO CARE FOR THEIR WORKERS IN THE LATE 1800S AND EARLY 1900S. MORE RECENTLY, ST. GABRIEL'S HAS BEEN COLLABORATING WITH MORRISON COUNTY PUBLIC HEALTH AND MORRISON COUNTY SOCIAL SERVICES SINCE THE 1980S TO EXAMINE AREA HEALTH ISSUES, ENABLING THE THREE PARTNERS TO SET PRIORITIES AND PLANS FOR HEALTH IMPROVEMENT. ST. GABRIEL'S HOSPITAL CONTINUES OUR DEEP COMMITMENT AND INVOLVEMENT IN THE COMMUNITY HEALTH ASSESSMENT AND ACTION PLANNING TODAY. (SEE CONTINUATION #1)
COMMUNITY BENEFITS, NEEDS ASSESSMENTS, AND OTHER INFORMATION	SCHEDULE H, PART VI, LINE 2	(CONTINUATION #1) COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS: UNITY FAMILY HEALTHCARE REGULARLY PERFORMS A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). TYPICALLY, THE CHNAS ARE PERFORMED EVERY THREE TO FIVE YEARS IN PARTNERSHIP WITH MORRISON COUNTY SOCIAL SERVICES (MCSS) AND MORRISON COUNTY PUBLIC HEALTH (MCPH). THE CHNAS HAVE TYPICALLY INCLUDED A WRITTEN SURVEY AS WELL AS STAKEHOLDER INTERVIEWS (OF VOLUNTEER AND SOCIAL SERVICES AGENCIES, ETC.), AND SOMETIMES FOCUS GROUPS AROUND PARTICULAR COMMUNITY HEALTH ISSUES OR ACCESS CONCERNS. THE THREE PARTNERS HAVE SHARED THE EXPENSES FOR THE CHNAS THAT WERE PERFORMED IN 1989, 1994, 1999, 2004 AND 2009. THE MOST RECENT CHNA WAS CONDUCTED IN FISCAL YEAR 2013 AND POSTED ON THE UNITY FAMILY HEALTHCARE WEBSITE ON JULY 1, 2013. ST. GABRIEL'S HOSPITAL HAS ALWAYS TAKEN THE LEADERSHIP ROLE IN COORDINATING THE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS PAST YEAR, IN ADDITION TO THE THREE LONG-TERM PARTNERS (MCPH, MCSS AND THE HOSPITAL), THE HOSPITAL ASKED OTHERS TO PARTICIPATE IN THE PLANNING AND IMPLEMENTATION STRATEGY DEVELOPMENT FOR THE CHNA. AMONG THE PEOPLE INVOLVED WERE THE ST. GABRIEL'S HEALTHCARE FOUNDATION DIRECTOR, THE DIRECTOR OF THE HEALTHY COMMUNITIES COLLABORATIVE OF MORRISON COUNTY (HCC), THE LARGEST SCHOOL DISTRICT IN THE COUNTY, AND THE VIOLENCE PREVENTION COUNCIL OF MORRISON COUNTY. THANKS TO A CATHOLIC HEALTH INITIATIVES (CHI) MISSION AND MINISTRY FUND PLANNING GRANT, ST. GABRIEL'S HOSPITAL LED THE FORMATION OF THE HEALTH COMMUNITIES COLLABORATIVE (HCC) IN 2005. THE HOSPITAL IS THE CORPORATE SPONSOR OF THE HCC, A MULTI-ORGANIZATION ENTITY WORKING TO ADDRESS VARIOUS COMMUNITY HEALTH ISSUES WITH REPRESENTATIVES FROM AREA SCHOOLS, CLERGY AS WELL AS THE COUNTY PUBLIC HEALTH AND SOCIAL SERVICES AGENCIES. EACH YEAR, THE HCC IDENTIFIES PROGRAMS AND SERVICES THAT ARE NEEDED IN THE COMMUNITY AND HELPS TO WRITE A PROJECT GRANT TO DEVELOP INITIATIVES THAT ADDRESS COMMUNITY NEEDS. FINALLY, UNITY FAMILY HEALTHCARE ALSO SPONSORS THE VIOLENCE PREVENTION INITIATIVE (VPI) OF MORRISON COUNTY, A COMMUNITY-BASED PROJECT AND LOCAL VIOLENCE PREVENTION COUNCIL WITH REPRESENTATION FROM LOCAL ENFORCEMENT, COURTS, SOCIAL SERVICES, OTHER NOT-FOR-PROFIT ORGANIZATIONS AND INDIVIDUALS (INCLUDING FORMER VICTIMS) THAT ADDRESSES PARTNER VIOLENCE, A SIGNIFICANT COMMUNITY HEALTH CONCERN IN THE COUNTY. VIOLENCE PREVENTION COUNCIL HAS THREE CORE GOALS: 1) REDUCE THE NUMBER OF DOMESTIC ASSAULTS CHARGED IN MORRISON COUNTY; 2) REDUCE THE NUMBER OF ORDERS FOR PROTECTION ISSUED IN THE COUNTY EACH YEAR; AND 3) REDUCE THE NUMBER OF VIOLATIONS OF ORDERS FOR PROTECTION THAT OCCUR EACH YEAR. AS PREVIOUSLY STATED, THE MOST-RECENT CHNA HAS BEEN POSTED ON THE UNITY FAMILY HEALTHCARE WEBSITE (WWW.UNITYFAMILY.COM OR WWW.STGABRIELS.COM). THE REPORT REFLECTS THE COMPILATION AND ANALYSIS OF EXTENSIVE DATA SOURCES TO IDENTIFY ISSUES HAVING A SIGNIFICANT IMPACT ON THE HEALTH AND GENERAL WELL BEING OF AREA RESIDENTS. THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS FOR BOTH HOSPITALS COMBINED-ST. GABRIEL'S HOSPITAL AND ALBANY AREA HOSPITAL-PRODUCED $28,066 IN COMMUNITY BENEFIT. SUMMARY OF ASSESSMENT FINDINGS: THE "HEALTH OF MORRISON COUNTY" COMMUNITY HEALTH NEEDS ASSESSMENT IS A MULTI-PRONGED PROCESS. THE ASSESSMENT CONTAINED SIX SECTIONS: 1) WHAT THE PEOPLE TOLD US (A WRITTEN SURVEY CONDUCTION BY INVITATION HEALTH THAT WAS DISTRIBUTED BOTH TRADITIONALLY THROUGH THE U.S. MAIL AS WELL AS THROUGH MAJOR EMPLOYERS WHO SENT SURVEYMONKEY LINKS TO THEIR EMPLOYEES); 2) WHAT STAKEHOLDERS TOLD US (INDIVIDUAL INTERVIEWS WITH 20-PLUS PEOPLE FROM THROUGHOUT THE COUNTY); 3) WHAT THE SECONDARY DATA TOLD US (A COMPREHENSIVE REVIEW OF MULTIPLE STATE, FEDERAL AND PRIVATE DATA SOURCES ON A WIDE-RANGING LIST OF HEALTH CARE TOPICS); 4) WHAT IS AVAILABLE (A COMPREHENSIVE LIST OF COMMUNITY HEALTH RESOURCES IN MORRISON COUNTY); 5) SUMMARY AND CONCLUSIONS; AND 6) IMPLEMENTATION STRATEGY (A THREE-YEAR ACTION PLAN TO IMPROVE THE HEALTH OF MORRISON COUNTY). THE MAIL/EMAIL SURVEY LISTED 52 POSSIBLE COMMUNITY HEALTH ISSUES AND ASKED RESPONDENTS TO IDENTIFY THEM AS "VERY SERIOUS," "SERIOUS," "A LITTLE SERIOUS," "NOT SERIOUS," OR "DON'T KNOW." IN A ORCHESTRATED EFFORT TO ESTABLISH SOME CLARIFICATION AMONG THE OVERALL SUBSET OF ALCOHOL AND DRUG USE/ABUSE, ETC., SOME ISSUES WERE IDENTIFIED MORE SPECIFICALLY (I.E., METHAMPHETAMINE, MARIJUANA, SMOKING, ETC.). OUT OF THE TOP 10 ISSUES FROM AMONG THE 52 POSSIBLE CHOICES, HALF OF THE ISSUES ARE RELATED TO ALCOHOL/CHEMICAL DEPENDENCY. THE TOP ISSUES WERE THOSE THAT HAD THE HIGHEST PERCENTAGE OF RESPONSES THAT WERE IDENTIFIED AS "VERY SERIOUS" OR "SERIOUS." INTERESTINGLY, OBESITY/OVERWEIGHT WAS IDENTIFIED AS THE MOST SIGNIFICANT HEALTH ISSUE, IDENTIFIED BY 67.4% AS EITHER VERY SERIOUS OR SERIOUS. IT WAS THE TOP CONCERN FOR THE CURRENT YEAR CHNA AND RANKED IN THE PRIOR YEAR CHNA. HERE'S THE COMPLETE LIST OF THE TOP TEN: 1. OBESITY/OVERWEIGHT 2. CHEMICAL DEPENDENCY (ALCOHOL/DRUG ABUSE) 3. FAMILIES NOT ABLE TO EARN A LIVABLE WAGE 4. METHAMPHETAMINE 5. UNDERAGE DRINKING 6. SMOKING 7. OTHER ILLICIT DRUGS (E.G. COCAINE, HEROIN, ECSTASY) 8. STRESS 9. MARIJUANA 10. DOMESTIC VIOLENCE THE RANGE OF HEALTH ISSUES IMPACTING MORRISON COUNTY, AS EVIDENCED BY POOR COUNTY HEALTH RANKINGS, LED ST. GABRIEL'S HOSPITAL AND ITS CHNA PARTNERS TO ADOPT AN IMPLEMENTATION STRATEGY THAT FOCUSES ON THREE GOALS: 1) REDUCE THE IMPACT OF CHRONIC ILLNESSES ON THE PEOPLE OF MORRISON COUNTY; 2) REDUCE THE PERCENTAGE OF INDIVIDUALS, BOTH ADULTS AND YOUTH (GRADES 9-12), IN MORRISON COUNTY WHO ARE OVERWEIGHT AND OBESE; AND 3) REDUCE THE IMPACT OF MENTAL ILLNESS ON THE PEOPLE. THE IMPLEMENTATION STRATEGY IDENTIFIES SPECIFIC STRATEGIES/ACTIONS OVER A THREE-YEAR PERIOD WHEN THE NEXT CHNA WILL BE CONDUCTED (FISCAL YEAR 2016). ALBANY AREA HOSPITAL: LOCATED IN ALBANY, MN, ALBANY AREA HOSPITAL & MEDICAL CENTER (AAHMC), THE PRIMARY SERVICE AREA (PSA) FOR THE HOSPITAL AND AFFILIATED CLINICS IS NORTH-CENTRAL STEARNS COUNTY AND THE SOUTHERN EDGE OF MORRISON COUNTY. IT INCLUDES 15 TOWNSHIPS AND "CITIES," RANGING IN SIZE FROM UPSALA (78) TO 2,590 (ALBANY CITY) AND HAS A TOTAL POPULATION OF 14,580. (ALL DATA REFLECTS U.S. CENSUS BUREAU NUMBERS.) IN THIS MORE NARROWLY DEFINED PRIMARY SERVICE AREA, 13.5% OF THE POPULATION IS AGE 65 OR OLDER AND THE MEDIAN AGE IS 37.6. SIMILAR TO ST. GABRIEL'S SERVICE AREA, THE POPULATION IS OLDER THAN THE STATE OF MINNESOTA WHICH, AS PREVIOUSLY STATED, HAS A SENIOR POPULATION (AGE 65 AND OVER) OF 13.6% AND A MEDIAN AGE OF 37.5 THE POVERTY DATA FOR THE SERVICE AREA IS NOT READILY AVAILABLE. FOR ALL OF STEARNS COUNTY, NOT JUST THE PSA, THE MEDIAN HOUSEHOLD INCOME IS $53,861 AND THE PER CAPITA INCOME IS $25,702, IN COMPARISON TO $59,126 AND $30,656, RESPECTIVELY FOR MINNESOTA. THE PERCENTAGE OF PERSONS BELOW THE POVERTY LEVEL (2008-2012) IN THE COUNTY IS 12.7%, WHILE IN THE STATE, IT IS 11.2%. SIMILAR TO MORRISON COUNTY STEARNS COUNTY IS LARGELY WHITE (92.6%), COMPARED TO THE STATE OF MINNESOTA AS A WHOLE, WHICH IS 82.4% WHITE. ONLY 4.3% OF THE POPULATION IS FOREIGN BORN, WHILE MINNESOTA FOREIGN-BORN POPULATION IS 7.2%. FINALLY, THE MOST SIGNIFICANT POPULATION STATISTIC THAT VARIES MOST DRAMATICALLY FROM BOTH STEARNS COUNTY AND MINNESOTA IS POPULATION DENSITY. THERE ARE 112.2 PERSONS PER SQUARE MILE IN THE COUNTY AND FOR MINNESOTA AS A WHOLE, THERE ARE 66.6 PERSONS PER SQUARE MILE. THIS IS DUE LARGELY TO THE ST. CLOUD METROPOLITAN STATISTICAL AREA AND NOT INDICATIVE OF AAHMC'S PSA. IN FACT, AAHMC IS LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS), PRIMARILY DUE TO A LIMITED NUMBER OF PHYSICIANS IN THE PSA OF JUST OVER 12,139 POPULATION. AAHMC OPENED IN 1969 IN ORDER TO SERVE THE HEALTH CARE NEEDS OF THE PEOPLE OF NORTH-CENTRAL STEARNS COUNTY. AAHMC RECENTLY JOINED A COLLABORATION TO PERFORM THE FIRST COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT FOR STEARNS COUNTY. THE CHNA WILL CLOSELY FOLLOW THE METHODOLOGY BEING EMPLOYED BY ST. GABRIEL'S HOSPITAL AND BOTH FACILITIES SHARE THE SAME FEDERAL EMPLOYEE IDENTIFICATION NUMBER AND TAX RETURN. THE FOLLOWING QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT REFLECTS THE ACTIVITIES OF BOTH FACILITIES. (SEE CONTINUATION #2)
COMMUNITY BENEFITS, NEEDS ASSESSMENTS, AND OTHER INFORMATION	SCHEDULE H, PART VI, LINE 2	(CONTINUATION #2) QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT: COMMUNITY OUTREACH FOR THE POOR: TRANSLATION SERVICES - ONE AREA THAT IS GROWING SIGNIFICANTLY AS THE COMMUNITY HAS BECOME MORE DIVERSE HAS BEEN THE INCREASE IN TRANSLATION SERVICES. IN 2013, THE AMOUNT OF TRANSLATION SERVICES INCREASED TO APPROXIMATELY $28,387, UP FROM A MERE $8,500 IN FISCAL YEAR 2010. COMMUNITY OUTREACH FOR THE BROADER COMMUNITY: YOUTH DEVELOPMENT AND PARTNER VIOLENCE PREVENTION: UNITY FAMILY HEALTHCARE HAS APPLIED FOR, RECEIVED, AND MANAGED THREE GRANTS IN 2013 SPECIFICALLY TARGETED TOWARD IMPROVING THE HEALTH OF THE PEOPLE OF MORRISON COUNTY. THE FIRST GRANT IS LIVE BETTER! LIVE LONGER!, A YOUTH DEVELOPMENT AND BREASTFEEDING ENHANCEMENT INITIATIVE. THIS INITIATIVE HAS TWO PRIMARY FOCUSES: 1) MAKING MINI-GRANTS TO YOUTH-LED, YOUTH-INITIATED PROJECTS AND 2) INCREASING THE NUMBER OF WOMEN IN MORRISON COUNTY WHO BREASTFEED THEIR BABIES. THE SECOND GRANT IS FOCUSED ON REDUCING PARTNER VIOLENCE (DOMESTIC VIOLENCE) IN MORRISON COUNTY AS MEASURED BY THE NUMBER OF DOMESTIC ASSAULTS CHARGED, THE NUMBER OF ORDERS FOR PROTECTION ISSUED AND THE NUMBER OF CHARGED VIOLATIONS OF ORDERS FOR PROTECTION. BY ALL THREE MEASURES, THINGS ARE IMPROVING. FINALLY, THE THIRD GRANT FOCUSES ON THE DEVELOPMENT OF A PATIENT-CENTERED MEDICAL HOME TO IMPROVE THE HEALTH OF RESIDENTS OF MORRISON COUNTY, ESPECIALLY THOSE WITH CHRONIC DISEASE. TOGETHER, THESE AND OTHER GRANT INITIATIVES RESULTED IN $85,655 IN COMMUNITY BENEFITS IN 2013. ALL THREE OF THESE INITIATIVES HAVE ALSO RECEIVED FUNDING FOR FISCAL YEAR 2014, SO THESE COMMUNITY BENEFIT EFFORTS WILL CONTINUE. YOUTH RECREATION INITIATIVE: IN 1997, ST. GABRIEL'S HOSPITAL RECEIVED A CHI MISSION & MINISTRY FUND GRANT TO ENHANCE RECREATION OPPORTUNITIES IN PARTNERSHIP WITH THE LITTLE FALLS AREA SCHOOLS. PRIOR TO 1997, THERE HAD BEEN SUBSTANTIAL CUTS IN A COLLABORATION BETWEEN THE CITY OF LITTLE FALLS AND THE LOCAL SCHOOL DISTRICT TO ADDRESS YOUTH RECREATION. THE YOUTH RECREATION INITIATIVE, AS IT IS CALLED, HAS CONTINUED DESPITE THE FACT THAT GRANT FUNDING THROUGH THE MISSION & MINISTRY HAS LONG BEEN DISCONTINUED. THE PROGRAM HAS BEEN SO FAVORABLY RECEIVED IN THE COMMUNITY THAT THE LEADERSHIP OF ST. GABRIEL'S HOSPITAL HAS CHOSEN TO CONTINUE SUPPORTING THE PROGRAM. THAT LEVEL OF SUPPORT TOTALED MORE THAN $56,121 IN FISCAL YEAR 2013 AND IMPACTED 7,285 PEOPLE. EARLY ON IN THE PROGRAM'S HISTORY, THERE WAS A NOTICEABLE DECLINE IN YOUTH DELINQUENCY AS MEASURED BY INTERACTIONS WITH THE JUDICIAL SYSTEM. UNITY FAMILY HEALTHCARE BELIEVE THE DECLINE WAS DUE TO THE INCREASED OPPORTUNITIES CREATED FOR AREA YOUTH. SUPPORT GROUPS: UNITY FAMILY HEALTHCARE FACILITIES OFFER A VARIETY OF SUPPORT GROUPS AND SIMILAR ACTIVITIES, INCLUDING SUCH ACTIVITIES AS THE PROSTATE CANCER SUPPORT GROUP, EATING DISORDERS SUPPORT GROUP, ADOPTION SUPPORT GROUP, THE ALANON GROUP, THE HOSPICE FAMILY SUPPORT ACTIVITIES AND THE SPECIAL SPIRITUAL SERVICES (EMPTY ARM FOR MISCARRIAGES, HOSPICE MEMORIAL SERVICES, ETC.). IN FISCAL YEAR 2013, THE VALUE OF THE SUPPORT FOR THIS ACTIVITY TOTALED NEARLY $5,125. MOST OF THESE GROUPS WERE DEVELOPED IN RESPONSE TO SPECIFIC REQUESTS FROM INDIVIDUALS WITHIN THE COMMUNITY. IN SOME CASES, UNITY FAMILY HEALTHCARE PROVIDES THE GROUP FACILITATORS. IN OTHER CASES, REPRESENTATIVES FROM THE COMMUNITY PROVIDE THAT LEADERSHIP. THE SUPPORT GROUPS SERVED 544 PEOPLE IN FISCAL YEAR 2013. HEALTH SCREENINGS: UNITY FAMILY HEALTHCARE FACILITIES, ESPECIALLY ST. GABRIEL'S HOSPITAL AND ALBANY AREA HOSPITAL, OFFER A VARIETY OF FREE HEALTH SCREENINGS. THE TOTAL VALUE OF THIS ACTIVITY WAS NEARLY $2,760 IN FISCAL YEAR 2013, WHICH PROVIDED 252 PEOPLE WITH VARIOUS HEALTH SCREENINGS. THE SCREENINGS INCLUDED SUCH THINGS AS BLOOD PRESSURE CHECKS AT A LOCAL EXTENDED CARE FACILITY (THAT IS NOT A PART OF UNITY FAMILY HEALTHCARE), FIREMAN PHYSICALS, PULMONARY SCREENING AND FLU SHOTS. DONATED SPACE: UNITY FAMILY HEALTHCARE FACILITIES DONATE THE USE OF OUR FACILITIES TO NON-PROFIT ORGANIZATIONS. SOME OF THESE INCLUDE TOPS (TAKE OFF POUNDS SENSIBLY), THE MENTAL HEALTH SUPPORT GROUP, AND OASIS SHARE-A-MEAL, TO NAME JUST A FEW. APPROXIMATELY 860 PEOPLE USED THE FACILITIES AND THE TOTAL VALUE OF THE DONATED SPACE IN FISCAL YEAR 2013 WAS $15,231. UNITY FAMILY HEALTHCARE PARTICIPATION WITH COMMUNITY HEALTH INITIATIVES: ONE OF THE LARGER COMMUNITY BENEFIT ACTIVITIES THAT UNITY FAMILY HEALTHCARE SUPPORTS IS THE PARTICIPATION IN COMMUNITY HEALTH INITIATIVES. THIS SUPPORT AFFECTED THE HEALTHY COMMUNITIES COLLABORATIVE, THE VIOLENCE PREVENTION COUNCIL, THE MORRISON COUNTY EMS BOARD, THE MORRISON COUNTY MINISTERIAL ASSOCIATION, AND THE ELDER NETWORK. THIS ACTIVITY DIRECTLY IMPACTED OVER 1,560 PEOPLE IN 2013 AND WAS VALUED AT MORE THAN $99,539. SENIOR COMPANION PROGRAM: LOCAL HEALTH CARE PROVIDERS AND COMMUNITY SERVICE ORGANIZATIONS RECOGNIZE THE BENEFITS PROVIDED THROUGH THE ST. GABRIEL'S HOSPITAL SENIOR COMPANIONS PROGRAM. PATIENTS CONNECT WITH THEIR INDIVIDUAL "COMPANIONS" BEFORE THEY LEAVE THE HOSPITAL AND ONCE HOME, THE COMPANIONS CONTINUE TO REGULARLY VISIT WITH THE PATIENTS WHILE THEY CONTINUE THEIR RECOVERY. IN FISCAL YEAR 2013, THE PROGRAM SERVED 58 DIFFERENT PEOPLE IN THE COMMUNITY WITH A TOTAL COMMUNITY BENEFIT OF $3,361. DONATIONS: IN THE FISCAL YEAR ENDING JUNE 30, 2013, UNITY FAMILY HEALTHCARE DONATED OVER $18,436 IN CASH TO LOCAL AND REGIONAL ENTITIES, SUCH AS THE MORRISON COUNTY RELAY FOR LIFE SPONSORED BY THE AMERICAN CANCER SOCIETY, THE ALBANY SENIOR CENTER, OASIS SHARE-A-MEAL, AND OTHER NOT-FOR-PROFIT ORGANIZATIONS. IN-KIND DONATIONS TOTALED AN ADDITIONAL $17,727 WITH AN ESTIMATED 2,000 PEOPLE SERVED. SUBSIDIZED HEALTH SERVICES: UNITY FAMILY HEALTHCARE HAS ONE MUCH-NEEDED AND APPRECIATED COMMUNITY SERVICE THAT OPERATES AS A LOSS TO THE ORGANIZATION. THIS SERVICE IS ST. GABRIEL'S HOSPITAL'S HOME CARE PROGRAM, UNITY FAMILY HOME CARE. IN FISCAL YEAR 2013, UNITY FAMILY HOME CARE PROVIDED 12,351 HOME CARE VISITS AND GENERATED OVER $286,601 IN COMMUNITY BENEFIT. THE COMMUNITY BENEFIT FROM THESE SERVICES IS SIGNIFICANT. (SEE CONTINUATION #3)
COMMUNITY BENEFITS, NEEDS ASSESSMENTS, AND OTHER INFORMATION	SCHEDULE H, PART VI, LINE 2	(CONTINUATION #3) PHYSICIAN RECRUITMENT: UNITY FAMILY HEALTHCARE'S PRIMARY SERVICE AREA (MORRISON COUNTY, MN) HAS A POPULATION OF APPROXIMATELY 33,198, OF WHICH OVER 16% ARE AGE 65 OR OLDER. THIS ELDERLY POPULATION, IN PARTICULAR, REQUIRES THE SKILLS OF TWO MEDICAL SPECIALTIES, INTERNAL MEDICINE AND GENERAL SURGERY. BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT AND PHYSICIAN SPECIALTY BY POPULATION STUDIES, IT WAS DETERMINED THAT AT LEAST ONE AND UP TO FOUR (DEPENDING UPON THE MIX OF FAMILY PRACTICE AND INTERNAL MEDICINE) INTERNISTS AND TWO GENERAL SURGEONS ARE NEEDED IN THE COMMUNITY TO ADEQUATELY SERVE PATIENTS' HEALTH NEEDS. IN ADDITION, DUE TO THE RETIREMENT OF ONE PEDIATRICIAN, A SECOND IS NEEDED. SIMILARLY, UNITY FAMILY HEALTHCARE INCURRED EXPENSES RELATED TO THE RECRUITMENT OF PRACTITIONERS IN ALBANY. PHYSICIAN AND HEALTHCARE RECRUITMENT HAS BEEN COMPLICATED WITH ADDITIONAL CHALLENGES DUE TO THE FACT THAT THERE ARE HEALTH PROFESSIONAL SHORTAGE AREAS IN BOTH THE MORRISON COUNTY AND ALBANY PRIMARY SERVICE AREAS. THE TOTAL COST OF EXPENSES ASSOCIATED WITH PHYSICIAN RECRUITMENT AND RETENTION IN THESE MUCH-NEEDED SPECIALTIES WAS OVER $203,528 IN FISCAL YEAR 2013. HEALTH PROFESSIONS EDUCATION: UNITY FAMILY HEALTHCARE'S TWO ACUTE CARE FACILITIES, ST. GABRIEL'S HOSPITAL AND, TO A MUCH LESSER DEGREE, ALBANY AREA HOSPITAL, ALSO SERVE AS CLINICAL EDUCATION SITES FOR MEDICAL PROFESSIONALS. IN FISCAL YEAR 2013, ST. GABRIEL'S HOSPITAL ASSISTED IN THE EDUCATION OF THE FOLLOWING HEALTH PROFESSIONALS: MEDICAL STUDENTS (THROUGH THE RURAL PHYSICIAN ASSOCIATE PROGRAM); NURSING STUDENTS; PHARMACISTS, RADIOLOGIC TECHNOLOGISTS, PHARMACISTS; AND NURSE ANESTHETISTS. THE COMMUNITY BENEFIT CLAIMED FOR THESE TRAININGS TOTALED $6,645 AND 85 PEOPLE RECEIVED THESE TRAININGS. COMMUNITY BUILDING ACTIVITIES: THE HEALTHY COMMUNITIES COLLABORATIVE (HCC) OF MORRISON COUNTY IS A COLLABORATIVE EFFORT OF OVER 20 ORGANIZATIONS AND IS A COUNTYWIDE COMMUNITY HEALTH STATUS IMPROVEMENT INITIATIVE. THE HCC'S MISSION IS: "THROUGH COLLABORATION, WE BUILD AND NURTURE THE TOTAL HEALTH AND WELL-BEING OF PEOPLE IN MORRISON COUNTY." ITS VISION READS: "MORRISON COUNTY STANDS OUT AS A VIBRANT, INTERCONNECTED COMMUNITY FOR ALL TO LIVE, WORK, LEARN, WORSHIP AND PLAY." UNITY FAMILY HEALTHCARE IS THE SPONSORING AGENCY FOR THE HCC AND UNITY FAMILY HEALTHCARE STAFF MEMBERS ALSO SERVE ON ITS BOARD. THE HCC IS CURRENTLY INVOLVED IN A GRANT-FUNDED INITIATIVE CALLED LIVE BETTER! LIVE LONGER! (LBLL). LBLL HAS ON THREE TENETS: EAT, MOVE, BELONG. THESE THREE TENETS ENCOURAGE PEOPLE IN THE COUNTY TO EAT HEALTHIER AND MORE NUTRIENT RICH MEALS (INCLUDING BREAST MILK FOR YOUNG CHILDREN); TO EXERCISE REGULARLY; AND TO BECOME INVOLVED IN THE MORRISON COUNTY COMMUNITY, WHETHER IT'S THROUGH RECREATION, BOOK CLUBS, CHURCHES OR OTHER INVOLVEMENT OPPORTUNITIES. UNITY FAMILY HEALTHCARE STAFF MEMBERS ARE NOT ONLY INVOLVED IN THE HCC BOARD AND ITS COMMITTEES, IT ALSO PARTNERS WITH OTHER PUBLIC AND PRIVATE ENTITIES ON MANY OTHER HEALTH INITIATIVES IN ORDER TO IMPROVE THE HEALTH OF THE PEOPLE OF MORRISON COUNTY AND NORTH-CENTRAL STEARNS COUNTY.
Patient education of eligibility for assistance.	Schedule H, Part VI, Line 3	UNITY FAMILY HEALTHCARE INCLUDES INFORMATION CONCERNING ITS FINANCIAL ASSISTANCE POLICY ON ITS WEBSITE. IN ADDITION, UNITY FAMILY HEALTHCARE PROMINENTLY DISPLAYS ITS FINANCIAL ASSISTANCE POLICY IN BOTH ENGLISH AND SPANISH IN OBVIOUS LOCATIONS THROUGHOUT THE HOSPITALS, INCLUDING THE EMERGENCY ROOMS AND OTHER PATIENT INTAKE AREAS, AS WELL AS IN UNITY FAMILY HEALTHCARE OUTPATIENT FACILITIES. IN ADDITION, UNITY FAMILY HEALTHCARE REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR FINANCIAL ASSISTANCE UNDER UNITY FAMILY HEALTHCARE'S FINANCIAL ASSISTANCE POLICY. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY AND PROCEDURES INCLUDING AN APPLICATION FOR ASSISTANCE. UNITY FAMILY HEALTHCARE REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON ENGLISH-SPEAKING INDIVIDUALS. UNITY FAMILY HEALTHCARE'S STAFF WILL ALSO ASSIST THE PATIENT/GUARANTOR WITH APPLYING FOR OTHER AVAILABLE COVERAGE (SUCH AS MEDICAID), IF NECESSARY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES.
Affiliated health care system	Schedule H, Part VI, Line 6	UNITY FAMILY HEALTHCARE, ALONG WITH ITS AFFILIATED OUTPATIENT FACILITIES ARE PART OF CATHOLIC HEALTH INITIATIVES. CATHOLIC HEALTH INITIATIVES (CHI) IS A NATIONAL FAITH-BASED NONPROFIT HEALTH CARE ORGANIZATION WITH HEADQUARTERS IN ENGLEWOOD, COLORADO. CHI'S EXEMPT PURPOSE IS TO SERVE AS AN INTEGRAL PART OF ITS NATIONAL SYSTEM OF HOSPITALS AND OTHER CHARITABLE ENTITIES, WHICH ARE DESCRIBED AS MARKET-BASED ORGANIZATIONS, OR MBOS. AN MBO IS A DIRECT PROVIDER OF CARE OR SERVICES WITHIN A DEFINED MARKET AREA THAT MAY BE AN INTEGRATED HEALTH SYSTEM AND/OR A STAND-ALONE HOSPITAL OR OTHER FACILITY OR SERVICE PROVIDER. CHI SERVES AS THE PARENT CORPORATION OF ITS MBOS WHICH ARE COMPRISED OF 73 HOSPITALS; 40 LONG-TERM CARE, ASSISTED- AND RESIDENTIAL-LIVING FACILITIES; TWO COMMUNITY HEALTH-SERVICES ORGANIZATIONS; TWO ACCREDITED NURSING COLLEGES; AND HOME HEALTH AGENCIES. TOGETHER, THESE FACILITIES PROVIDED $762 MILLION IN CHARITY CARE AND COMMUNITY BENEFIT IN THE 2013 FISCAL YEAR, INCLUDING SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. CHI PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED "SHARED SERVICES" FOR THE MBOS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES - INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN -- PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE MBOS. THE COST SAVINGS ACHIEVED THROUGH CHI'S CENTRALIZATION ENABLE MBOS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. UNITY FAMILY HEALTHCARE OPERATES WITH ITS WHOLLY OWNED AFFILIATES AND COMMUNITY PARTNERS, ALONG WITH ITS TWO FUNDRAISING ARMS, THE ST. GABRIEL'S HEALTHCARE FOUNDATION AND ALBANY AREA HEALTHCARE FOUNDATION, TO SERVE THE HEALTH CARE NEEDS OF THE MORRISON COUNTY AND NORTH-CENTRAL STEARNS COUNTY COMMUNITIES.
State filing of community benefit report	Schedule H, Part VI, Line 7	MN

Schedule H (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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

2012

Open to Public
Inspection

Name of the organization
UNITY FAMILY HEALTHCARE

Employer identification number
41-0721642

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. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance
(1) HANDS OF HOPE RESOURCE CENTER PO BOX 67 LITTLE FALLS,MN56345	41-1740880	501(C)(3)	31,131	12,474	COST	AD PAYMENTS TO NEWSPAPER & RADIO	PROGRAM SUPPORT/VIOLENCE PREVENTION PROGRAMMING

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2012

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.
Part III can be duplicated 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
(1) SCHOLARSHIPS	6	3,000	0	N/A	N/A
(2) PATIENT INTERPRETERS	191	22,689	0	N/A	N/A

Part IV

Supplemental Information.

Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Identifier	Return Reference	Explanation
Procedures for monitoring use of grant funds	Schedule I, Part I, Line 2	REQUESTS FOR GRANTS TO BE PAID TO INDIVIDUALS OR ORGANIZATIONS ARE SENT TO THE MANAGER OF COMMUNICATIONS AND/OR THE FOUNDATION DIRECTOR FOR APPROVAL. THESE REQUESTS ARE REVIEWED TO ENSURE THEIR PURPOSE BENEFITS THE COMMUNITY AND ARE IN LINE WITH UNITY FAMILY HEALTHCARE'S MISSION AND VALUES. LARGE GRANT FUND REQUESTS ARE REVIEWED AND SIGNED OFF ON BY THE PRESIDENT/CEO. THE FOUNDATION DIRECTOR IS RESPONSIBLE FOR WORKING WITH EACH GRANTEE TO MEET THEIR REPORTING GUIDELINES AS STIPULATED TO ENSURE GRANT AWARDS ARE USED ACCORDING TO THE CONTRACT SIGNED BY BOTH PARTIES. GRANT CONTRACTS ARE MAINTAINED IN MEDITRACT WITH REMINDERS OF EXPIRATION DATES TO ENSURE TIMELY REPORTING AND COMPLETION.

Schedule I (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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

2012

Open to Public Inspection

Name of the organization

UNITY FAMILY HEALTHCARE

Employer identification number

41-0721642

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 or provision of all of 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 filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

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

Cat. No. 50053T

Schedule J (Form 990) 2012

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(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)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(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)	(F) Compensation reported as deferred in prior Form 990
(1)CHAD COOPERPRESIDENT/CEO	(i) (ii)	0 261,331	0 133,082	0 55,047	0 47,044	0 21,528	0 518,032	0 33,063
(2)DAVID JORGENSENPHYSICIAN	(i) (ii)	332,787 0	340,193 0	2,827 0	23,096 0	23,488 0	722,391 0	0 0
(3)GREGORY MCNAMARABOARD MEMBER/PHYSICIAN	(i) (ii)	199,328 0	80,720 0	902 0	20,596 0	17,499 0	319,045 0	0 0
(4)JEFFREY DROPBOARD MEMBER/SVP DIVISION OFFICER	(i) (ii)	0 400,148	0 146,277	0 59,679	0 76,703	0 21,785	0 704,592	0 36,347
(5)JOSEPH MESSMERINTERIM CEO	(i) (ii)	0 300,000	0 0	0 163	0 33,096	0 0	0 333,259	0 0
(6)PAUL JOHNSONPHYSICIAN	(i) (ii)	515,885 0	56,370 0	21,410 0	20,596 0	23,756 0	638,017 0	0 0
(7)PHILIP PROSAPIOPHYSICIAN	(i) (ii)	339,867 0	273,238 0	1,597 0	23,096 0	24,628 0	662,426 0	0 0
(8)RYAN KRAY MDVICE CHAIR/PHYSICIAN	(i) (ii)	166,703 0	50,874 0	3,614 0	0 0	2,021 0	223,212 0	0 0
(9)SAUNG PARKPHYSICIAN	(i) (ii)	446,564 0	26,500 0	21,255 0	20,596 0	9,161 0	524,076 0	0 0
(10)STEVEN SMITHTREASURER/CFO	(i) (ii)	116,133 0	16,207 0	241 0	9,576 0	22,776 0	164,933 0	0 0
(11)VIRGIL MEYERPHYSICIAN	(i) (ii)	228,729 0	169,653 0	3,238 0	23,096 0	12,002 0	436,718 0	0 0

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Identifier	Return Reference	Explanation
Arrangement used to establish the top management official's compensation	Schedule J, Part I, Line 3	COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) WRITTEN EMPLOYMENT CONTRACTS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
POST-TERMINATION PAYMENTS	SCHEDULE J, PART I, LINE 4A	POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR CATHOLIC HEALTH INITIATIVES ("CHI") AND RELATED ORGANIZATIONS' EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE, INCLUDING THE 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.
Supplemental nonqualified retirement plan	Schedule J, Part I, Line 4b	DURING THE 2012 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: CHAD COOPER AND JEFFREY DROP. DURING 2012 THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: CHAD COOPER - $23,948 JEFFREY DROP - $48,607 DURING 2012 THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI FROM THE DEFERRED COMPENSATION PLAN: CHAD COOPER - $33,063 JEFFREY DROP - $36,347

Schedule J (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

UNITY FAMILY HEALTHCARE

Employer identification number

41-0721642

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No
(1) PAUL JOHNSON	EMPLOYEE	PHYSICIAN RECRUITMENT		X	106,813	45,476		No		No	Yes
(2) SAUNG PARK	EMPLOYEE	PHYSICIAN RECRUITMENT		X	50,000	21,223		No		No	Yes




Total ...... $						66,699

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2012

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	Yes	No

Part V

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

Identifier	Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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

2012

Open to Public
Inspection

Name of the organization

UNITY FAMILY HEALTHCARE

Employer identification number

41-0721642

Identifier	Return Reference	Explanation
Delegate broad authority to a committee	Form 990, Part VI, Section A, Line 1a	PURSUANT TO SECTION 8.6 OF THE BYLAWS OF UNITY FAMILY HEALTHCARE, THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION AND SHALL BE COMPOSED OF THE CHAIRPERSON, VICE CHAIRPERSON, AND THE PRESIDENT AND CEO, EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE. EACH INDIVIDUAL APPOINTED SHALL SERVE A TERM OF ONE YEAR. EXCEPT AS PROVIDED BY LAW, THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. ADDITIONALLY, THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE SUCH POWERS TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT SUCH ACTIONS TAKEN SHALL BE CONSISTENT WITH AND NOT CONFLICT WITH ANY ACTIONS OR POLICIES OF THE BOARD OF DIRECTORS OR OF THE CORPORATE MEMBER, WITH THE BYLAWS, OR WITH APPLICABLE LAWS.
Classes of members or stockholders	Form 990, Part VI, Section A, Line 6	THE ORGANIZATION'S SOLE CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES, A COLORADO NON-PROFIT CORPORATION.
Members or stockholders electing members of governing body	Form 990, Part VI, Section A, Line 7a	THE SOLE CORPORATE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS.
Decisions requiring approval by members or stockholders	Form 990, Part VI, Section A, Line 7b	THE ORGANIZATION'S SOLE CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES ("CHI"). PURSUANT TO SECTION 5.5.1 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: - SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF UNITY FAMILY HEALTHCARE ("UFH"); - AMENDMENT OF THE CORPORATE DOCUMENTS OF UFH; - APPROVE MEMBERS OF THE UFH BOARD; - REMOVAL OF A MEMBER OF THE GOVERNING BODY OF UFH; - APPROVAL OF ISSUANCE OF DEBT BY UFH; - APPROVAL OF PARTICIPATION OF UFH IN A JOINT VENTURE; - APPROVAL OF FORMATION OF A NEW CORPORATION BY UFH; - APPROVAL OF A MERGER INVOLVING UFH; - APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF UFH; - TO REQUIRE THE TRANSFER OF ASSETS BY UFH TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS; AND - ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR UFH. PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, CHI MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE.
Review of form 990 by governing body	Form 990, Part VI, Section B, Line 11b	UNITY FAMILY HEALTHCARE'S VP OF FINANCE IS RESPONSIBLE FOR REVIEWING THE FORM 990 AS PREPARED BY THE CHI TAX DEPARTMENT. THE FORM 990 IS POSTED TO A COMMUNITY BOARD PORTAL WHERE ALL BOARD MEMBERS ARE ABLE TO ACCESS AND REVIEW PRIOR TO FILING. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
Conflict of interest policy	Form 990, Part VI, Section B, Line 12c	IT IS THE POLICY OF UNITY FAMILY HEALTHCARE ("THE CORPORATION") THAT: - EACH OF THE CORPORATION'S DIRECTORS AND OFFICERS ACTS AT ALL TIMES IN A MANNER THAT FURTHERS THE CORPORATION'S CHARITABLE PURPOSE OF SERVICE TO THE COMMUNITY AND EXERCISES CARE THAT HE OR SHE DOES NOT ACT IN A MANNER THAT FURTHERS HIS OR HER PRIVATE INTERESTS TO THE DETRIMENT OF THE CORPORATION'S COMMUNITY BENEFIT PURPOSES; AND - EACH OF THE CORPORATION'S DIRECTORS AND OFFICERS AVOIDS CONFLICTS OF INTEREST AND OTHERWISE FULLY DISCLOSES TO THE CORPORATION ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST IF SUCH CONFLICTS CANNOT BE AVOIDED SO THAT SUCH CONFLICTS ARE DEALT WITH IN THE BEST INTERESTS OF THE CORPORATION. THIS POLICY: (1) COVERS ALL OFFICERS WHO HOLD THE TITLE VICE PRESIDENT AND ABOVE; (2) APPLIES TO ALL AFFILIATES OF THE CORPORATION; AND (3) IS INTENDED TO SUPPLEMENT, BUT NOT REPLACE, ANY APPLICABLE STATE LAWS GOVERNING CONFLICTS OF INTEREST APPLICABLE TO NONPROFIT CORPORATIONS. "AFFILIATE" INCLUDES ANY ENTITY DIRECTLY OR INDIRECTLY CONTROLLING, CONTROLLED BY, OR UNDER COMMON CONTROL WITH THE CORPORATION WHETHER THROUGH MEMBERSHIP OR STOCK OWNERSHIP. IF A DIRECTOR OR OFFICER HAS A POTENTIAL OR ACTUAL CONFLICT WITH THE CORPORATION AND/OR ANY OF ITS AFFILIATES, SUCH DIRECTOR OR OFFICER IS DEEMED TO ALSO HAVE A POTENTIAL OR ACTUAL CONFLICT WITH RESPECT TO THE CORPORATION AND ALL OF ITS AFFILIATES. GENERAL OBLIGATION: EACH DIRECTOR MUST PROMPTLY AND FULLY REPORT TO THE BOARD CHAIR SITUATIONS THAT MAY CREATE A CONFLICT OF INTEREST WHEN HE OR SHE BECOMES AWARE OF SUCH SITUATIONS. IN THE CASE OF AN OFFICER, DISCLOSURE MUST BE MADE TO THE CORPORATION'S PRESIDENT AND CHIEF EXECUTIVE OFFICER WHO WILL REPORT SUCH DISCLOSURE TO THE BOARD CHAIR. IN ANY SITUATION WHERE A DIRECTOR OR OFFICER IS IN DOUBT, FULL DISCLOSURE SHOULD BE MADE SO AS TO PERMIT AN IMPARTIAL AND OBJECTIVE DETERMINATION. A WRITTEN RECORD OF THE DISCLOSURE WILL BE MADE. ANNUAL DISCLOSURE STATEMENT: IN ADDITION TO THE ONGOING DISCLOSURE OBLIGATION, THE CORPORATION'S PRESIDENT AND CHIEF EXECUTIVE OFFICER SHALL ANNUALLY SEND TO ALL DIRECTORS AND OFFICERS A COPY OF THE CONFLICT OF INTEREST POLICY STATEMENT AND THE CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DIRECTORS AND OFFICERS MUST PROMPTLY COMPLETE, SIGN, AND RETURN THE STATEMENT TO THE CORPORATION'S PRESIDENT AND CHIEF EXECUTIVE OFFICER. THE COMPLETED STATEMENTS ARE REVIEWED BY THE PRESIDENT AND CHIEF EXECUTIVE OFFICER AND THE BOARD CHAIR. REVIEW, EVALUATION AND INITIAL DETERMINATION: THE BOARD CHAIR OR DESIGNEE SHALL MAKE SUCH FURTHER INVESTIGATION OF CONFLICT OF INTEREST DISCLOSURES AS HE OR SHE MAY DEEM APPROPRIATE. IF THE CONFLICT INVOLVES THE BOARD CHAIR, THE VICE CHAIR WILL ASSUME THE CHAIR'S ROLE OUTLINED IN THE CONFLICT OF INTEREST POLICY. BASED ON REVIEW AND EVALUATION OF THE RELEVANT FACTS AND CIRCUMSTANCES, THE BOARD CHAIR WILL MAKE AN INITIAL DETERMINATION AS TO WHETHER A CONFLICT OF INTEREST EXISTS AND WHETHER, PURSUANT TO THE CONFLICT OF INTEREST POLICY STATEMENT, REVIEW AND APPROVAL OR OTHER ACTION BY THE BOARD OF DIRECTORS IS REQUIRED. A WRITTEN RECORD OF THE BOARD CHAIR'S DETERMINATION, INCLUDING RELEVANT FACTS AND CIRCUMSTANCES, WILL BE MADE. THE BOARD CHAIR SHALL THEN MAKE AN APPROPRIATE REPORT TO THE EXECUTIVE COMMITTEE OF THE BOARD CONCERNING SUCH REVIEW, EVALUATION AND DETERMINATION. IF THERE IS A DIFFERENCE OF OPINION BETWEEN THE BOARD CHAIR AND ANOTHER DIRECTOR OR OFFICER AS TO WHETHER THE FACTS AND CIRCUMSTANCES OF A GIVEN SITUATION CONSTITUTE A CONFLICT OF INTEREST OR WHETHER BOARD OF DIRECTORS' REVIEW AND APPROVAL OR OTHER ACTION IS REQUIRED WITHIN THE CONFLICT OF INTEREST POLICY STATEMENT, THE MATTER SHALL BE SUBMITTED TO THE BOARD'S EXECUTIVE COMMITTEE, WHICH SHALL MAKE A FINAL DETERMINATION AS TO THE MATTER PRESENTED. SUCH DETERMINATION, INCLUDING RELEVANT FACTS AND CIRCUMSTANCES, WILL BE REFLECTED IN THE COMMITTEE MINUTES AND WILL BE REPORTED TO THE BOARD OF DIRECTORS. BOARD REVIEW: TRANSACTIONAL CONFLICTS OF INTEREST: THE BOARD OF DIRECTORS SHALL CAREFULLY SCRUTINIZE AND MUST IN GOOD FAITH APPROVE OR DISAPPROVE ANY TRANSACTION IN WHICH THE CORPORATION AND/OR ANY OF ITS AFFILIATES IS A PARTY AND IN WHICH ONE OR MORE OF THE CORPORATION'S DIRECTORS OR OFFICERS EITHER: * HAS A MATERIAL FINANCIAL INTEREST; OR * IS A DIRECTOR OR OFFICER OF THE OTHER PARTY (OTHER THAN THE CORPORATION'S OWN AFFILIATES). THE BOARD OF DIRECTORS MUST APPROVE THE TRANSACTION BY A MAJORITY VOTE OF THE DIRECTORS ON THE BOARD, WITHOUT COUNTING THE VOTE OF ANY DIRECTOR WHO HAS AN INTEREST IN THE TRANSACTION. IN REVIEWING SUCH TRANSACTIONS BETWEEN THE CORPORATION AND VENDORS OR OTHER CONTRACTORS WHO ARE, OR ARE AFFILIATED WITH, DIRECTORS OR OFFICERS, THE BOARD SHALL ACT NO MORE OR LESS FAVORABLY THAN IT WOULD IN REVIEWING TRANSACTIONS WITH UNRELATED THIRD PARTIES. THE TRANSACTION WILL NOT BE APPROVED UNLESS THE BOARD DETERMINES THAT THE TRANSACTION IS FAIR TO THE CORPORATION. OTHER CONFLICTS OF INTEREST: THE BOARD SHALL CAREFULLY REVIEW AND SCRUTINIZE NON-TRANSACTIONAL CONFLICTS OF INTEREST (E.G. DISCLOSURE OF NONPUBLIC INFORMATION, COMPETITION WITH THE CORPORATION, FAILURE TO DISCLOSE A CORPORATE OPPORTUNITY, EXCESSIVE GIFTS OR ENTERTAINMENT, ETC.). BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS, THE BOARD SHALL TAKE WHATEVER ACTION IS DEEMED APPROPRIATE UNDER THE CIRCUMSTANCES WITH RESPECT TO THE DIRECTOR OR OFFICER IN ORDER TO BEST PROTECT THE INTERESTS OF THE CORPORATION, INCLUDING POSSIBLE DISCIPLINARY OR CORRECTIVE ACTION. THE BOARD SHOULD CONSULT WITH THE GENERAL COUNSEL OF THE CORPORATION WHEN CONSIDERING DISCIPLINARY ACTION. DISCLOSURE BY INTERESTED DIRECTOR: WHEN CONFLICTS OF INTEREST ARE CONSIDERED BY THE BOARD, THE DIRECTOR OR OFFICER MUST DISCLOSE ALL OF THE MATERIAL FACTS TO THE BOARD. THE DIRECTOR OR OFFICER SHALL NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. HOWEVER, IF REQUESTED, SUCH DIRECTOR OR OFFICER IS NOT PREVENTED FROM BRIEFLY STATING HIS OR HER POSITION IN THE MATTER, NOT FROM ANSWERING PERTINENT QUESTIONS FROM BOARD MEMBERS, AS HIS OR HER KNOWLEDGE MAY BE OF SIGNIFICANT IMPORTANCE. THE DIRECTOR OR OFFICER SHALL BE EXCUSED FROM THE MEETING DURING DISCUSSION AND VOTE ON THE CONFLICT OF INTEREST. BOARD OF PROCEEDINGS: MINUTES OF THE BOARD OF DIRECTORS SHALL REFLECT THE FOLLOWING: THE INDIVIDUAL MAKING THE DISCLOSURE, THE NATURE OF THE DISCLOSURE, DISCUSSION REGARDING ANY PROPOSED TRANSACTION, THE DECISION MADE BY THE BOARD, AND THAT THE INTERESTED DIRECTOR ABSTAINED FROM VOTING. IMPLEMENTATION AND INTERPRETATION: QUESTIONS REGARDING THE IMPLEMENTATION AND INTERPRETATION OF THE CONFLICT OF INTEREST POLICY SHALL BE REFERRED TO THE GENERAL COUNSEL OF THE CORPORATION. POLICY VIOLATIONS: IF THE BOARD REASONABLY BELIEVES THAT A DIRECTOR OR OFFICER HAS FAILED TO DISCLOSE EITHER AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, OR ALL MATERIAL FACTS SURROUNDING AN ACTUAL OR POSSIBLE CONFLICT AS REQUIRED BY THE CONFLICT OF INTEREST POLICY, THE DIRECTOR OR OFFICER WILL BE GIVEN AN OPPORTUNITY TO EXPLAIN SUCH ALLEGED FAILURE TO DISCLOSE. AFTER HEARING THE RESPONSE OF THE DIRECTOR OR OFFICER, THE BOARD WILL CONDUCT SUCH ADDITIONAL INVESTIGATION AS MAY BE APPROPRIATE. IF THE BOARD DETERMINES THAT THE DIRECTOR OR OFFICER HAS IN FACT FAILED TO DISCLOSE AS REQUIRED BY THE CONFLICT OF INTEREST POLICY, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION.
PROCESS FOR DETERMINING COMPENSATION OF TOP MANAGEMENT OFFICIAL	FORM 990, PART VI, LINE 15A	THE ORGANIZATION'S CEO'S COMPENSATION IS PAID BY CHI. 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 17, 2013. IN ADDITION, IN DECEMBER 2009, HAY GROUP COMPLETED A COMPREHENSIVE REVIEW OF ALL POSITIONS AT THE LEVEL OF VICE PRESIDENT AND ABOVE TO DETERMINE AND VALIDATE APPROPRIATE COMPENSATION LEVELS. THESE LEVELS HAVE BEEN REVIEWED ANNUALLY SINCE AND REVISED BASED ON MARKET DATA, WHERE APPLICABLE.
Process used to establish compensation of other officers/key employees	Form 990, Part VI, Section B, Line 15b	IT IS THE POLICY OF UNITY FAMILY HEALTHCARE THAT EACH EXECUTIVE COMPENSATION ARRANGEMENT BETWEEN UNITY FAMILY HEALTHCARE AND ANY PERSON OF SUBSTANTIAL INFLUENCE SHALL BE TARGETED AT THE 65TH PERCENTILE OF TOTAL EXECUTIVE REMUNERATION FOR COMPARABLY SIZED TAX-EXEMPT ORGANIZATIONS IN THE HEALTH CARE INDUSTRY. A COMMITTEE OF THE BOARD OF DIRECTORS MEETS ANNUALLY TO REVIEW AND APPROVE THE COMPENSATION OF ALL SENIOR LEADERSHIP TEAM MEMBERS, INCLUDING OTHER OFFICERS AND KEY EMPLOYEES. IN ADDITION, THE CEO PRESENTS A RECOMMENDATION AND SUPPORTING DOCUMENTATION TO THE COMMITTEE FOR ALL OTHER SENIOR LEADERSHIP TEAM POSITIONS BASED ON SURVEY DATA FROM THE HOSPITAL ASSOCIATION AND OTHER DATA SOURCES FOR COMPARABLE POSITIONS. THE MOST RECENT REVIEWS TOOK PLACE IN OCTOBER 2011 AND AGAIN IN OCTOBER 2012. EXECUTIVE COMPENSATION ARRANGEMENTS WITH ANY PHYSICIAN WHO IS A PERSON OF SUBSTANTIAL INFLUENCE (I.E. ALSO A VOTING BOARD MEMBER) ARE NOT SUBJECT TO THIS POLICY, BUT SHALL BE REVIEWED AND APPROVED IN ACCORDANCE WITH UNITY FAMILY HEALTHCARE'S PHYSICIAN TRANSACTION REVIEW POLICY. ACCORDING TO THE POLICY, ALL TERMS OF THE PHYSICIAN EMPLOYMENT CONTRACTS, INCLUDING ANY AND ALL COMPENSATION MATTERS, ARE REVIEWED AND APPROVED BY THE EMPLOYED PHYSICIAN INTEGRATION COUNCIL (EPIC) AND PHYSICIAN TRANSACTION REVIEW COMMITTEE (PTRC). ONLY AFTER EPIC RECOMMENDATION AND PTRC APPROVAL IS A PHYSICIAN EMPLOYMENT CONTRACT CREATED. IN ADDITION, DURING THE TAX YEAR ENDED 6/30/13, VARIOUS OFFICERS AND DIRECTORS RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS AND DIRECTORS BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION.
JOINT VENTURE POLICY	FORM 990, PART VI, LINE 16B	UNITY FAMILY HEALTHCARE HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER CHI'S SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS; AND (5) ALL CONTRACTS ENTERED INTO BY THE PARTNERSHIP WITH THE EXEMPT ORGANIZATION MUST BE AT ARM'S-LENGTH, WITH PRICES SET AT FAIR MARKET VALUE. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL.
Governing documents, conflict of interest policy and financial statements available to the public	Form 990, Part VI, Section C, Line 19	THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE NOT PUBLICLY AVAILABLE. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.ORG.
Other Expenses	Form 990, Part IX, Line 11g	CONTRACT SERVICES - TOTAL EXPENSE: 7911203, PROGRAM SERVICE EXPENSE: 5914776, MANAGEMENT AND GENERAL EXPENSES: 1996427, FUNDRAISING EXPENSES: ; CONTRACT LABOR - TOTAL EXPENSE: 492780, PROGRAM SERVICE EXPENSE: 368425, MANAGEMENT AND GENERAL EXPENSES: 124355, FUNDRAISING EXPENSES: ; CONSULTING - TOTAL EXPENSE: 386359, PROGRAM SERVICE EXPENSE: 288860, MANAGEMENT AND GENERAL EXPENSES: 97499, FUNDRAISING EXPENSES: ; OTHER FEES FOR SERVICES - TOTAL EXPENSE: 1726588, PROGRAM SERVICE EXPENSE: 1290876, MANAGEMENT AND GENERAL EXPENSES: 435712, FUNDRAISING EXPENSES: ;
Other changes in net assets or fund balances	Form 990 , Part XI, Line 9	CHI CONNECT DEPRECIATION - 16920; CAPITAL RESOURCE POOL CONTRIBUTION - -152724;

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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

2012

Open to Public Inspection

Name of the organization

UNITY FAMILY HEALTHCARE

Employer identification number

41-0721642

Part I

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

(a) Name, address, and EIN (if applicable) 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" to 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 entity?
(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) ALEGENT CREIGHTON CLINIC 12809 WEST DODGE ROAD OMAHA,NE68154	HEALTHCARE	NE	501(C)(3)	3	ACH	Yes
(2) ALEGENT CREIGHTON HEALTH 12809 WEST DODGE ROAD OMAHA,NE68154	HEALTHCARE	NE	501(C)(3)	3	NA	Yes
(3) ALEGENT HEALTH - BERGAN MERCY HEALTH SYS 7500 MERCY ROAD OMAHA,NE68124	HEALTHCARE	NE	501(C)(3)	3	ACH	Yes
(4) ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA 631 N 8TH STREET MISSOURI VALLEY,IA51555	HEALTHCARE	IA	501(C)(3)	3	AHIMC	Yes
(5) ALEGENT HEALTH FOUNDATION 12809 WEST DODGE ROAD OMAHA,NE68154	FUNDRAISING	NE	501(C)(3)	7	ACH	Yes
(6) ALEGENT HEALTH IMMANUEL MEDICAL CENTER 6901 NORTH 72ND STREET OMAHA,NE68122	HEALTHCARE	NE	501(C)(3)	3	ACH	Yes
(7) ALEGENT HEALTH MEMORIAL HOSPITAL SCHUYLER NE 104 W 17TH STREET SCHUYLER,NE68661	HEALTHCARE	NE	501(C)(3)	3	AHIMC	Yes
(8) ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING,IA50841	HEALTHCARE	IA	501(C)(3)	3	AHBMHS	Yes
(9) ALVERNA APARTMENTS 300 SE 8TH AVENUE LITTLE FALLS,MN56345	LTERM CARE	MN	501(C)(3)	9	CHI	Yes
(10) APPLETREE COURT 601 OAK STREET BRECKENRIDGE,MN56520	SENIOR HOMES	MN	501(C)(3)	9	SFH	Yes
(11) BISHOP DRUMM RETIREMENT CENTER 1111 6TH AVENUE DES MOINES,IA50314	LTERM CARE	IA	501(C)(3)	9	CHI-IA CORP	Yes
(12) BORNEMANN HEALTH CORPORATION 2500 BERNVILLE RD PO BOX 316 READING,PA19603	HEALTHCARE	PA	501(C)(3)	11 - Type I	CHI	Yes
(13) CARRINGTON HEALTH CENTER 800 NORTH 4TH STREET CARRINGTON,ND58421	HEALTHCARE	ND	501(C)(3)	3	CHI	Yes
(14) CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112	HEALTHCARE	CO	501(C)(3)	9	NA	Yes
(15) CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 6385 CORPORATE DRIVE COLORADO SPRINGS,CO80919	FUNDRAISING	CO	501(C)(3)	7	CHIC	Yes
(16) CATHOLIC HEALTH INITIATIVES INSTITUTE FOR RESEARCH AND INNOVATION 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112	HEALTHCARE	CO	501(C)(3)	11 - Type I	CHI	Yes
(17) CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 6385 CORPORATE DRIVE COLORADO SPRINGS,CO80919	FUNDRAISING	CO	501(C)(3)	9	CHI	Yes
(18) CATHOLIC HEALTH INITIATIVES-COLORADO 188 INVERNESS DRIVE WEST SUITE 500 ENGLEWOOD,CO80112	HEALTHCARE	CO	501(C)(3)	3	CHI	Yes
(19) CATHOLIC HEALTH INITIATIVES-IOWA CORP DBA MERCY MEDICAL CENTER-DES MOINES 1111 6TH AVENUE DES MOINES,IA50314	HEALTHCARE	IA	501(C)(3)	3	CHI	Yes
(20) CENTENNIAL MEDICAL GROUP INC 2700 STEWART PARKWAY ROSEBURG,OR97470	PHYSICIANS	OR	501(C)(3)	9	MMC	Yes
(21) CENTRAL KANSAS MEDICAL CENTER 3515 BROADWAY GREAT BEND,KS67530	SURGERY CNTR	KS	501(C)(3)	3	CHI	Yes
(22) CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PARKWAY SOUTH FARGO,ND58104	HEALTHCARE	ND	501(C)(3)	9	CHI	Yes
(23) CHI KENTUCKY INC 3900 OLYMPIC BLVD SUITE 400 ERLANGER,KY41018	HEALTHCARE	KY	501(C)(3)	11 - Type I	CHI	Yes
(24) CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112	HEALTHCARE	CO	501(C)(3)	9	CHI NHC	Yes
(25) CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112	HEALTHCARE	CO	501(C)(3)	11 - Type I	CHI	Yes
(26) CHI NEBRASKA 6940 O STREET LINCOLN,NE68510	HEALTHCARE	NE	501(C)(3)	11 - Type I	CHI	Yes
(27) COMMUNITY LIMITED CARE DIALYSIS CENTER 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI,OH45206	DIALYSIS	OH	501(C)(2)	N/A	GSH	Yes
(28) COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION MISSOURI VALLEY IA 631 N 8TH STREET MISSOURI VALLEY,IA51555	FUNDRAISING	IA	501(C)(3)	11 - Type I	AHCMH	Yes
(29) CONTINUING CARE HOSPITAL 150 NORTH EAGLE CREEK DRIVE LEXINGTON,KY40509	LTACH	KY	501(C)(3)	3	SJHS	Yes
(30) COVENANT HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112	HOME HEALTH	PA	501(C)(3)	11 - Type II	NA	Yes
(31) ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1450 BATTERSBY AVENUE ENUMCLAW,WA98022	HEALTHCARE	WA	501(C)(3)	3	FHS	Yes
(32) FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE ROAD BARDSTOWN,KY40004	HEALTHCARE	KY	501(C)(3)	3	KOH	Yes
(33) FLAGET MEMORIAL HOSPITAL FOUNDATION 4305 NEW SHEPHERDSVILLE ROAD BARDSTOWN,KY40004	FUNDRAISING	KY	501(C)(3)	11 - Type I	FH	Yes
(34) FRANCISCAN FOUNDATION 1717 SOUTH J STREET TACOMA,WA98405	FUNDRAISING	WA	501(C)(3)	9	FHS	Yes
(35) FRANCISCAN HEALTH SYSTEM 1717 SOUTH J STREET TACOMA,WA98405	HEALTHCARE	WA	501(C)(3)	3	CHI	Yes
(36) FRANCISCAN MEDICAL GROUP 1708 SOUTH YAKIMA AVENUE TACOMA,WA98405	HEALTHCARE	WA	501(C)(3)	9	FHS	Yes
(37) FRANCISCAN VILLA OF SOUTH MILWAUKEE 3601 SOUTH CHICAGO AVENUE SOUTH MILWAUKEE,WI53172	HEALTHCARE	WI	501(C)(3)	9	CHI	Yes
(38) GETTYSBURG MEDICAL CENTER 606 EAST GARFIELD AVENUE GETTYSBURG,SD57442	HEALTHCARE	SD	501(C)(3)	3	SMHC	Yes
(39) GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112	MINISTRIES	CO	501(C)(3)	11 - Type I	CHI	Yes
(40) GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI,OH45206	EDUCATION	OH	501(C)(3)	2	GSH	Yes
(41) GOOD SAMARITAN FOUNDATION OF CINCINNATI INC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI,OH45206	FUNDRAISING	OH	501(C)(3)	11 - Type I	GSH	Yes
(42) GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY,NE68848	HEALTHCARE	NE	501(C)(3)	3	CHI NEBRASKA	Yes
(43) GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST STREET KEARNEY,NE68847	FUNDRAISING	NE	501(C)(3)	7	GSH	Yes
(44) ST LUKE'S MEDICAL GROUP FKA GREATER HOUSTON HEALTH NETWORK 6624 FANNIN HOUSTON,TX77030	PHY PRACTICES	TX	501(C)(3)	3	SLHS	Yes
(45) HEALTH SET 4200 WEST CONEJOS PLACE 436 DENVER,CO80204	LOW INC.CARE	CO	501(C)(3)	7	CHIC	Yes
(46) HEALTHCARE AND WELLNESS FOUNDATION 2400 ST FRANCIS DRIVE BRECKENRIDGE,MN56520	FUNDRAISING	MN	501(C)(3)	11 - Type I	SFMC	Yes
(47) HIGHLINE MEDICAL CENTER 16251 SYLVESTER RD SW BURIEN,WA98166	HEALTHCARE	WA	501(C)(3)	3	FHS	Yes
(48) HOSPITAL ASSOCIATION FOR ST JOSEPH HOSPITAL 7601 OSLER DRIVE TOWSON,MD21204	HEALTHCARE	MD	501(C)(3)	9	SJMC	Yes
(49) HOUSE OF MERCY 1111 6TH AVENUE DES MOINES,IA50314	SHELTER	IA	501(C)(3)	7	CHI-IA CORP	Yes
(50) JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC 539 S 4TH STREET LOUISVILLE,KY40202	HEALTHCARE	KY	501(C)(3)	3	KOH	Yes
(51) JEWISH PHYSICIAN GROUP INC 539 S 4TH STREET LOUISVILLE,KY40202	HEALTHCARE	KY	501(C)(3)	9	JHSMH	Yes
(52) KENTUCKYONE HEALTH INC FKA JH PROPERTIES INC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202	HEALTHCARE	KY	501(C)(3)	9	CHI	Yes
(53) LAKEWOOD HEALTH CENTER 600 MAIN AVENUE SOUTH BAUDETTE,MN56623	HEALTHCARE	MN	501(C)(3)	3	CHI	Yes
(54) LINUS OAKES INC 2700 STEWART PARKWAY ROSEBURG,OR97470	SENIOR LIVING	OR	501(C)(3)	9	MMC	Yes
(55) LISBON AREA HEALTH SERVICES 905 MAIN STREET LISBON,ND58054	HEALTHCARE	ND	501(C)(3)	3	CHI	Yes
(56) MEMORIAL HEALTH CARE SYSTEM FOUNDATION 2525 DE SALES AVENUE CHATTANOOGA,TN37404	FUNDRAISING	TN	501(C)(3)	7	MHCS	Yes
(57) MEMORIAL HEALTH CARE SYSTEM INC 2525 DE SALES AVENUE CHATTANOOGA,TN37404	HEALTHCARE	TN	501(C)(3)	3	CHI	Yes
(58) MEMORIAL HEALTH PARTNERS FOUNDATION INC 5600 BRAINERD ROAD SUITE 500 CHATTANOOGA,TN37411	HEALTHCARE	TN	501(C)(3)	9	MHCS	Yes
(59) MERCY AUXILIARY OF CENTRAL IOWA 1111 6TH AVENUE DES MOINES,IA50314	AUXILIARY	IA	501(C)(3)	11 - Type I	CHI-IA CORP	Yes
(60) MERCY CLINICS INC 1111 6TH AVENUE DES MOINES,IA50314	PHYSICIAN	IA	501(C)(3)	9	CHI-IA CORP	Yes
(61) MERCY COLLEGE OF HEALTH SCIENCES 1111 6TH AVENUE DES MOINES,IA50314	EDUCATION	IA	501(C)(3)	2	CHI-IA CORP	Yes
(62) MERCY FOUNDATION OF DES MOINES IA 1111 6TH AVENUE DES MOINES,IA50314	FUNDRAISING	IA	501(C)(3)	7	CHI-IA CORP	Yes
(63) MERCY FOUNDATION INC 2700 STEWART PARKWAY ROSEBURG,OR97470	FUNDRAISING	OR	501(C)(3)	7	MMC	Yes
(64) MERCY HEALTH CARE FOUNDATION PO BOX 368 CORNING,IA50841	FUNDRAISING	NE	501(C)(3)	11 - Type I	AHMH	Yes
(65) MERCY HEALTHCARE FOUNDATION 570 CHAUTAUQUA BOULEVARD VALLEY CITY,ND58072	FUNDRAISING	ND	501(C)(3)	11 - Type III - FI	MHVC	Yes
(66) MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS 800 MERCY DRIVE COUNCIL BLUFFS,IA51503	FUNDRAISING	IA	501(C)(3)	11 - Type I	AHBMHS	Yes
(67) MERCY HOSPITAL OF DEVILS LAKE 1031 SEVENTH STREET NE DEVILS LAKE,ND58301	HEALTHCARE	ND	501(C)(3)	3	CHI	Yes
(68) MERCY HOSPITAL OF DEVILS LAKE FOUNDATION 1031 SEVENTH STREET NE DEVILS LAKE,ND58301	FUNDRAISING	ND	501(C)(3)	7	CHI	Yes
(69) MERCY HOSPITAL OF VALLEY CITY 570 CHAUTAUQUA BOULEVARD VALLEY CITY,ND58072	HEALTHCARE	ND	501(C)(3)	3	CHI	Yes
(70) MERCY MEDICAL CENTER 1301 15TH AVENUE WEST WILLISTON,ND58801	HEALTHCARE	ND	501(C)(3)	3	CHI	Yes
(71) MERCY MEDICAL CENTER - CENTERVILLE ONE ST JOSEPHS DRIVE CENTERVILLE,IA52544	HEALTHCARE	IA	501(C)(3)	3	CHI-IA CORP	Yes
(72) MERCY MEDICAL CENTER INC 2700 STEWART PARKWAY ROSEBURG,OR97470	HEALTHCARE	OR	501(C)(3)	3	CHI	Yes
(73) MERCY MEDICAL FOUNDATION 1301 15TH AVENUE WEST WILLISTON,ND58801	FUNDRAISING	ND	501(C)(3)	11 - Type I	MMC	Yes
(74) MERCY PROFESSIONAL PRACTICE ASSOCIATES INC 1111 6TH AVENUE DES MOINES,IA50314	PHYSICIAN	IA	501(C)(3)	9	CHI-IA CORP	Yes
(75) MLIFECARES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112	PROPERTY MGMT	MO	501(C)(3)	11 - Type I	SJRMC	Yes
(76) MNMCH INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112	HEALTHCARE	KS	501(C)(3)	3	SJRMC	Yes
(77) MT ST JOSEPH INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112	NURSING CARE	OR	501(C)(3)	11 - Type I	CHI	Yes
(78) NEBRASKA HEART HOSPITAL 7500 SOUTH 91ST STREET LINCOLN,NE68526	HEALTHCARE	NE	501(C)(3)	3	CHI NEBRASKA	Yes
(79) OAKES COMMUNITY HOSPITAL 314 SOUTH 8TH STREET OAKES,ND58474	HEALTHCARE	ND	501(C)(3)	3	CHI	Yes
(80) OAKES COMMUNITY HOSPITAL FOUNDATION 1200 N 7TH STREET OAKES,ND58474	FUNDRAISING	ND	501(C)(3)	11 - Type I	OCH	Yes
(81) PUEBLO STEPUP 1925 EAST ORMAN AVE SUITE G52 PUEBLO,CO81004	COMMUNITY	CO	501(C)(3)	7	CHIC	Yes
(82) SET OF COLORADO SPRINGS INC 2864 S CIRCLE DRIVE SUITE 450 COLORADO SPRINGS,CO80906	LTERM CARE	CO	501(C)(3)	7	CHIC	Yes
(83) SAINT CLARE'S COMMUNITY CARE 25 POCONO ROAD DENVILLE,NJ07834	HEALTHCARE	NJ	501(C)(3)	11 - Type II	SCHS	Yes
(84) SAINT CLARE'S FOUNDATION 25 POCONO ROAD DENVILLE,NJ07834	FUNDRAISING	NJ	501(C)(3)	7	SCHS	Yes
(85) SAINT CLARE'S HEALTH SERVICES INC 25 POCONO ROAD DENVILLE,NJ07834	MANAGEMENT	NJ	501(C)(3)	7	CHI	Yes
(86) SAINT CLARE'S HOSPITAL 25 POCONO ROAD DENVILLE,NJ07834	HEALTHCARE	NJ	501(C)(3)	3	SCHS	Yes
(87) SAINT ELIZABETH FOUNDATION 555 SOUTH 70TH STREET LINCOLN,NE68510	FUNDRAISING	NE	501(C)(3)	7	SERMC	Yes
(88) SAINT ELIZABETH HEALTH SERVICES 555 SOUTH 70TH STREET LINCOLN,NE68510	HEALTHCARE	NE	501(C)(3)	3	SERMC	Yes
(89) SAINT ELIZABETH REGIONAL MEDICAL CENTER 555 SOUTH 70TH STREET LINCOLN,NE68510	HEALTHCARE	NE	501(C)(3)	3	CHI NEBRASKA	Yes
(90) SAINT FRANCIS MEDICAL CENTER 2620 WEST FAIDLEY GRAND ISLAND,NE68803	HEALTHCARE	NE	501(C)(3)	3	CHI NEBRASKA	Yes
(91) SAINT FRANCIS MEDICAL CENTER FOUNDATION PO BOX 9804 GRAND ISLAND,NE68802	FUNDRAISING	NE	501(C)(3)	7	SFMC	Yes
(92) SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC 305 ESTILL STREET BEREA,KY40403	FUNDRAISING	KY	501(C)(3)	7	SJHS	Yes
(93) SAINT JOSEPH HEALTH SYSTEM INC 424 LEWIS HARGETT CIRCLE 160 LEXINGTON,KY40503	HEALTHCARE	KY	501(C)(3)	3	CHI	Yes
(94) SAINT JOSEPH LONDON FOUNDATION INC 1001 SAINT JOSEPH LANE LONDON,KY40741	FUNDRAISING	KY	501(C)(3)	7	SJHS	Yes
(95) SAINT JOSEPH MEDICAL FOUNDATION INC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202	PHY PRACTICES	KY	501(C)(3)	3	SJHS	Yes
(96) SAINT JOSEPH MOUNT STERLING FOUNDATION INC 225 FALCON DRIVE MOUNT STERLING,KY40353	FUNDRAISING	KY	501(C)(3)	7	SJHS	Yes
(97) SAINT JOSEPH'S HOSPITAL FOUNDATION 30 WEST 7TH STREET DICKINSON,ND58601	FUNDRAISING	ND	501(C)(3)	11 - Type I	SJHHC	Yes
(98) SAMARITAN BEHAVIORAL HEALTH 2222 PHILADELPHIA DRIVE DAYTON,OH45406	HEALTHCARE	OH	501(C)(3)	3	SHP	Yes
(99) SAMARITAN HEALTH FOUNDATION 2222 PHILADELPHIA DRIVE DAYTON,OH45406	FUNDRAISING	OH	501(C)(3)	7	SHP	Yes
(100) SAMARITAN HEALTH PARTNERS 110 NORTH MAIN STREET DAYTON,OH45402	HEALTHCARE	OH	501(C)(3)	11 - Type I	CHI	Yes
(101) SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC 104 W 17TH STREET SCHUYLER,NE68661	FUNDRAISING	NE	501(C)(3)	11 - Type I	AHMHS	Yes
(102) SJMGROUP 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112	PHYS PRACTICE	MO	501(C)(3)	9	SJRMC	Yes
(103) SJRMC JOPLIN MISSOURI 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112	HEALTHCARE	MO	501(C)(3)	3	CHI	Yes
(104) SL AUGUSTA CORP PO BOX 20269 HOUSTON,TX77225	TITLE HOLDING	TX	501(C)(2)	N/A	SL PROPERTIES	Yes
(105) ST JOSEPH HEALTH MINISTRIES 1929 LINCOLN HWY E STE 150 LANCASTER,PA17602	HEALTHCARE	PA	501(C)(3)	11 - Type I	CHI	Yes
(106) ST LUKE'S MEDICAL TOWER CORPORATION 6624 FANNIN SUITE 1100 HOUSTON,TX77030	PROPERTY MGMT	TX	501(C)(3)	11 - Type I	SL PROPERTIES	Yes
(107) ST ANTHONY HOSPITAL 1601 SE COURT AVENUE PENDLETON,OR97801	HEALTHCARE	OR	501(C)(3)	3	CHI	Yes
(108) ST ANTHONY HOSPITAL FOUNDATION 1601 SE COURT AVENUE PENDLETON,OR97801	FUNDRAISING	OR	501(C)(3)	11 - Type I	SA HOSPITAL	Yes
(109) ST ANTHONY'S HOSPITAL ASSOCIATION FOUR HOSPITAL DRIVE MORRILTON,AR72110	HEALTHCARE	AR	501(C)(3)	3	SVIMC	Yes
(110) ST CATHERINE HOSPITAL 401 EAST SPRUCE STREET GARDEN CITY,KS67846	HEALTHCARE	KS	501(C)(3)	3	CHI	Yes
(111) ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION 401 EAST SPRUCE STREET GARDEN CITY,KS67846	FUNDRAISING	KS	501(C)(3)	11 - Type I	SCH	Yes
(112) ST DOMINIC OF ONTARIO OREGON 351 SW 9TH STREET ONTARIO,OR97914	HEALTHCARE	OR	501(C)(4)	N/A	CHI	Yes
(113) ST FRANCIS HOME 2400 ST FRANCIS DRIVE BRECKENRIDGE,MN56520	LTERM CARE	MN	501(C)(3)	9	CHI	Yes
(114) ST FRANCIS LIFE CARE CORPORATION 19 POCONO ROAD DENVILLE,NJ07834	ELDERLY CARE	NJ	501(C)(3)	9	SCHS	Yes
(115) ST FRANCIS MEDICAL CENTER 2400 ST FRANCIS DRIVE BRECKENRIDGE,MN56520	HEALTHCARE	MN	501(C)(3)	3	CHI	Yes
(116) ST FRANCIS OF BAKER CITY 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112	HEALTHCARE	OR	501(C)(3)	3	CHI	Yes
(117) ST JOHN'S MERCY REGIONAL FOUNDATION 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112	FUNDRAISING	MO	501(C)(3)	7	SJRMC	Yes
(118) ST JOSEPH COMMUNITY HEALTH 300 CENTRAL AVENUE SW ALBUQUERQUE,NM87102	COMMUNITY	NM	501(C)(3)	11 - Type I	CHI	Yes
(119) ST JOSEPH HOSPITAL FOUNDATION INC ONE SAITN JOSEPH DRIVE LEXINGTON,KY40504	FUNDRAISING	KY	501(C)(3)	11 - Type I	SJHS	Yes
(120) ST JOSEPH MEDICAL CENTER FOUNDATION 2500 BERNVILLE ROAD PO BOX 316 READING,PA19603	FUNDRAISING	PA	501(C)(3)	11 - Type I	SJRHN	Yes
(121) ST JOSEPH MEDICAL CENTER FOUNDATION 7601 OSLER DRIVE TOWSON,MD21204	FUNDRAISING	MD	501(C)(3)	7	SJMC	Yes
(122) ST JOSEPH MEDICAL CENTER INC 7601 OSLER DRIVE TOWSON,MD21204	HEALTHCARE	MD	501(C)(3)	3	CHI	Yes
(123) ST JOSEPH MEDICAL GROUP 2500 BERNVILLE ROAD PO BOX 316 READING,PA19603	HEALTHCARE	PA	501(C)(3)	9	BHC	Yes
(124) ST JOSEPH PHYSICIAN ENTERPRISE INC 7601 OSLER DRIVE TOWSON,MD21204	PHYSICIANS	MD	501(C)(3)	11 - Type I	SJMC	Yes
(125) ST JOSEPH REGIONAL HEALTH NETWORK 2500 BERNVILLE ROAD PO BOX 316 READING,PA19603	HEALTHCARE	PA	501(C)(3)	3	CHI	Yes
(126) ST JOSEPH'S AREA HEALTH SERVICES 600 PLEASANT AVENUE PARK RAPIDS,MN56470	HEALTHCARE	MN	501(C)(3)	3	CHI	Yes
(127) ST JOSEPH'S HOSPITAL AND HEALTH CENTER 30 WEST 7TH STREET DICKINSON,ND58601	HEALTHCARE	ND	501(C)(3)	3	CHI	Yes
(128) ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS 6624 FANNIN SUITE 2505 HOUSTON,TX77030	HEALTHCARE	TX	501(C)(3)	3	SL CDC	Yes
(129) ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND DBA ST LUKE'S SUGA R LAND HOSPITAL 6624 FANNIN SUITE 2505 HOUSTON,TX77030	HEALTHCARE	TX	501(C)(3)	3	SLHS	Yes
(130) ST LUKE'S HEALTH SYSTEM CORPORATION DBA CHI ST LUKE'S HEALTH 6624 FANNIN SUITE 1100 HOUSTON,TX77030	MANAGEMENT	TX	501(C)(3)	11 - Type I	CHI	Yes
(131) ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION 6624 FANNIN SUITE 2505 HOUSTON,TX77030	MANAGEMENT	TX	501(C)(3)	11 - Type I	SLHS	Yes
(132) ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE VINTAGE 6624 FANNIN SUITE 2505 HOUSTON,TX77030	HEALTHCARE	TX	501(C)(3)	3	SL CDC	Yes
(133) ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION -PMC 6624 FANNIN SUITE 2505 HOUSTON,TX77030	HEALTHCARE	TX	501(C)(3)	3	SL CDC	Yes
(134) ST LUKE'S COMMUNITY HEALTH SERVICES DBA ST LUKE'S THE WOODLANDS HOSPITAL 6624 FANNIN SUITE 1100 HOUSTON,TX77030	HEALTHCARE	TX	501(C)(3)	3	SLHS	Yes
(135) ST LUKE'S HEALTH SYSTEM FOUNDATION 6624 FANNIN SUITE 1100 HOUSTON,TX77030	INVESTMENT MANAGEMENT	TX	501(C)(3)	11 - Type I	SLHS	Yes
(136) ST LUKE'S PROPERTIES CORPORATION 6624 FANNIN SUITE 1100 HOUSTON,TX77030	PROPERTY MGMT	TX	501(C)(3)	11 - Type I	SLHS	Yes
(137) ST LUKE'S FOUNDATION 1213 HERMANN DRIVE SUITE 855 HOUSTON,TX77004	FUNDRAISING	TX	501(C)(3)	7	SLHS	Yes
(138) ST LUKE'S MEDICAL CENTER 6624 FANNIN HOUSTON,TX77030	HEALTHCARE	TX	501(C)(3)	3	SLHS	Yes
(139) ST MARY'S COMMUNITY HOSPITAL 1314 3RD AVENUE NEBRASKA CITY,NE68410	HEALTHCARE	NE	501(C)(3)	3	CHI NEBRASKA	Yes
(140) ST MARY'S HEALTHCARE CENTER 801 EAST SIOUX AVENUE PIERRE,SD57501	HEALTHCARE	SD	501(C)(3)	3	CHI	Yes
(141) ST MARY'S HOSPITAL FOUNDATION 1314 3RD AVENUE NEBRASKA CITY,NE68410	FUNDRAISING	NE	501(C)(3)	7	SMH	Yes
(142) ST VINCENT FOUNDATION TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205	FUNDRAISING	AR	501(C)(3)	11 - Type I	SVIMC	Yes
(143) ST VINCENT INFIRMARY MEDICAL CENTER TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205	HEALTHCARE	AR	501(C)(3)	3	CHI	Yes
(144) ST VINCENT MEDICAL GROUP TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205	HEALTHCARE	AR	501(C)(3)	9	SVIMC	Yes
(145) ST LUKE'S SUGAR LAND PROPERTIES CORPORATION 6624 FANNIN SUITE 2505 HOUSTON,TX77030	PROPERTY MGMT	TX	501(C)(3)	11 - Type I	SL CDC - SL	Yes
(146) THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH 619 OAK STREET ACCOUNTING-3 W CINCINNATI,OH45206	HEALTHCARE	OH	501(C)(3)	3	CHI	Yes
(147) THE PHYSICIAN NETWORK 2000 Q STREET SUITE 500 LINCOLN,NE68503	PHYS PRACTICE	NE	501(C)(3)	11 - Type I	CHI NEBRASKA	Yes
(148) TOTAL HEALTHCARE 188 INVERNESS DRIVE WEST SUITE 500 ENGLEWOOD,CO80112	HEALTHCARE	CO	501(C)(3)	3	CHIC	Yes
(149) UNITY FAMILY HEALTHCARE 815 SE 2ND STREET LITTLE FALLS,MN56345	HEALTHCARE	MN	501(C)(3)	3	CHI	Yes
(150) VILLA NAZARETH INC 801 PAGE DRIVE FARGO,ND58103	LT CARE	ND	501(C)(3)	9	CHI	Yes
(151) VISITING NURSE ASSOCIATION OF ST CLARE'S 191 WOODPORT ROAD SPARTA,NJ07871	HOME HEALTH	NJ	501(C)(3)	9	SCHS	Yes
(152) WOMEN'S AUXILIARY OF HIGHLINE COMMUNITY HOSPITAL 16251 SYLVESTER RD SW BURIEN,WA98166	AUXILIARY	WA	501(C)(3)	11 - Type II	HMC	Yes
(153) WOODLANDS DOCTOR GROUP 17200 ST LUKES WAY SUITE 170 THE WOODLANDS,TX77384	PHY PRACTICES	TX	501(C)(3)	9	SL CHS	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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) AUDUBON LAND COMPANY LLC 5390 N ACADEMY BLVD SUITE 300 COLORADO SPRINGS,CO80918 84-1513085	REAL ESTATE	CO	CHIC	RELATED	34,991	8,665,388		No	0		No	50.1 %
(2) AVANTAS LLC 11128 JOHN GALT BLVD SUITE 400 OMAHA,NE68137 39-2045003	STAFFING OF NURSES	NE	AHBMHS	RELATED	-210,405	4,806,071		No	-439,536		No	95 %
(3) BERYWOOD OFFICE PROPERTIES LLC 400 BERYWOOD TRAIL CLEVELAND,TN37312 62-1875199	PHYS OFFICE	TN	MHCS	RELATED	57,545	1,013,237		No	0	Yes		63 %
(4) BLUEGRASS REGIONAL IMAGING CENTER 1218 SOUTH BROADWAY SUITE 310 LEXINGTON,KY40504 61-1386736	DIAGNOSTIC	KY	SJHS	RELATED	308,428	3,317,191		No	0		No	65 %
(5) CENTRAL NEBRASKA HOME CARE SERVICES PO BOX 1146-4510 SECOND AVENUE KEARNEY,NE68848 47-0692112	HEALTHCARE SRVC	NE	NA	RELATED	228,435	675,251		No	0	Yes		100 %
(6) CENTRAL NEBRASKA REHAB SERVICES 3004 W FAIDLEY AVE GRAND ISLAND,NE68802 81-0653461	PHYSICAL THERAPY	NE	SFMC	RELATED	1,710,199	2,712,656		No	0		No	51 %
(7) CHI OPERATING INVESTMENT PROGRAM LP 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 47-0727942	INVESTMENTS	CO	CHI	UNRELATED	344,962,532	4,617,413,792		No	0	Yes		79.92 %
(8) HEALTHCARE SUPPORT SERVICES PO BOX 9804 GRAND ISLAND,NE68802 72-1546196	LAUNDRY	NE	NA	RELATED	98,583	3,190,677		No	0		No	100 %
(9) MRI AT ST JOSEPH MEDICAL CENTER LLC 7253 AMBASSADOR ROAD BALTIMORE,MD21244 52-1958002	MEDICAL IMAGING	MD	SJMC	RELATED	423,167	2,174,155		No	0	Yes		51 %
(10) NORTH RIVER SURGERY CENTER LLC 2209 WILDWOOD AVENUE SHERWOOD,AR72120 71-0799771	AMBUL SURG CTR	AR	SVIMC	RELATED	81,071	1,077,536		No	0		No	57.45 %
(11) O'DEA MEDICAL ARTS LIMITED PARTNERSHIP 7601 OSLER DRIVE TOWSON,MD21204 52-1682964	REAL ESTATE	MD	TMI	RELATED	9,490	0		No	0	Yes		66.58 %
(12) ORTHOCOLORADO LLC 11650 WEST 2ND PLACE LAKEWOOD,CO80255 37-1577105	ORTHO HOSPITAL	CO	THC	RELATED	1,846,153	8,411,844		No	0		No	60 %
(13) PENINSULA RADIATION ONCOLOGY LLC 315 MARTIN LUTHER KING JR WAY 111 TACOMA,WA98405 87-0808610	HEALTHCARE SRVC	WA	FHS	RELATED	256,567	3,262,002		No	0		No	60 %
(14) PENRAD IMAGING 1390 KELLY JOHNSON BLVD COLORADO SPRINGS,CO80920 84-1072619	MEDICAL IMAGING	CO	CHIC	RELATED	715,094	3,489,436		No	0		No	70 %
(15) RUXTON SURGICENTER LLC 8322 BELLONA AVENUE SUITE 201 BALTIMORE,MD21204 52-2095835	SURGERY CENTER	MD	SJMC	RELATED	-69,345	0		No	0	Yes		51 %
(16) SAINT JOSEPH - SCA HOLDINGS LLC 1451 HARRDOSBURG ROAD LEXINGTON,KY40504 45-3801157	OP SURGERY	DE	SJHS	RELATED	0	0		No	0	Yes		51 %
(17) SCA PREMIER SURGERY CENTER OF LOUISVILLE LLC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 72-1386840	SURGERY CENTER	KY	JH	RELATED	3,388	666,017		No	0	Yes		51 %
(18) ST FRANCIS LAND COMPANY LLC 5390 N ACADEMY BLVD SUITE 300 COLORADO SPRINGS,CO80918 26-3134100	REAL ESTATE	CO	CHIC	RELATED	-130,967	13,823,763		No	0		No	51 %
(19) ST FRANCIS MEDICAL CENTER ASSOCIATES 1717 SOUTH J STREET TACOMA,WA98405 91-1352698	MED. OFFICE	WA	FHS	RELATED	238,717	1,907,063		No	0		No	58.46 %
(20) ST JOSEPH-PAML LLC 424 LEWIS HARGETT CIRCLE STE 160 LEXINGTON,KY40503 45-2116736	MGMT SVCS	KY	SJHS	RELATED	30,446	1,149,003		No	0	Yes		62.5 %
(21) SUPERIOR MEDICAL IMAGING LLC 5000 NORTH 26TH STREET LINCOLN,NE68521 26-2884555	OP DIAGNOSTICS	NE	SERMC	RELATED	-200,323	821,112		No	0	Yes		51 %
(22) SURGERY CENTER OF LEXINGTON LLC 424 LEWIS HARGETT CIRCLE STE 160 LEXINGTON,KY40503 62-1179539	SURGERY CENTER	DE	SJHS	RELATED	-200,318	4,079,584		No	0	Yes		51 %
(23) SURGERY CENTER OF LOUISVILLE LLC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 62-1179537	SURGERY CENTER	KY	JH	RELATED	-15,452	396,101		No	0	Yes		51 %
(24) ALEGENT HEALTH NORTHWEST IMAGING CENTER LLC 3606 N 156TH STREET OMAHA,NE68116 06-1786985	OP DIAGNOSTICS	NE	ACH	RELATED	116,752	776,649		No	0	Yes		51 %
(25) BERGAN MERCY SURGERY CENTER LLC 7710 MERCY ROAD STE 100 OMAHA,NE68124 20-8671994	AMBUL SURG CTR	NE	ACH	RELATED	142,085	3,294,472		No	0		No	63.94 %
(26) LAKESIDE AMBULATORY SURGICAL CENTER LLC 17031 LAKESIDE HILLS DR OMAHA,NE68130 20-4267902	AMBUL SURG CTR	NE	ACH	RELATED	3,465,880	1,951,221		No	0		No	51.6 %
(27) LAKESIDE ENDOSCOPY CENTER LLC 17001 LAKESIDE HILLS PLZ STE 201 OMAHA,NE68130 20-5544496	ENDOSCOPY SRVC	NE	ACH	RELATED	1,455,294	1,013,126		No	0		No	52.28 %
(28) NEBRASKA SPINE HOSPITAL LLC 6901 N 72ND STREET OMAHA,NE68122 27-0263191	SPINE HOSPITAL	NE	ACH	RELATED	10,501,730	17,301,869		No	0		No	51 %
(29) PRAIRIE HEALTH VENTURES LLC 421 S 9TH ST 102 LINCOLN,NE68508 20-4962103	TECH SERVICES	NE	AH-IMC	RELATED	1,011,804	5,564,586		No	68,565	Yes		62.7 %
(30) SAINT JOSEPH-ANC HOME CARE SERVICES 1700 EDISON DRIVE SUITE 300 MILFORD,OH45150 26-3330545	HOME HEALTH	KY	JH	RELATED	3,208,139	9,684,824		No	0		No	96.9 %
(31) LINCOLN CK LEASING LLC 8770 BRYN MAWR SUITE 1370 CHICAGO,IL60631 26-2496856	REAL ESTATE	NE	SERMC	RELATED	397,452	439,334		No	0		No	53.76 %
(32) HIGHLINE IMAGING LLC 275 SW 160TH ST BURIEN,WA98166 20-0460005	DIAGNOSTIC	WA	HMC	RELATED	840,222	1,784,058		No	0		No	80 %
(33) HC SL VINTAGE I LLC 18000 WEST SARAH LANE SUITE 250 BROOKFIELD,WI53045 27-0453767	PROPERTY HOLD	WI	SL CDC - VINTAGE	RELATED	1,027,057	105,658,490		No	0		No	51 %
(34) ST LUKE'S HOSPITAL AT THE VINTAGE LLC 6624 FANNIN SUITE 2505 HOUSTON,TX77030 26-3734516	HOSPITAL	TX	SL CDC - VINTAGE	RELATED	-19,253,743	69,158,748		No	0	Yes		51 %
(35) PMC HOSPITAL LLC 6624 FANNIN SUITE 2505 HOUSTON,TX77030 27-3280598	HOSPITAL	TX	SL CDC - PMC	RELATED	1,092,540	20,751,174		No	0	Yes		51 %
(36) ST LUKE'S DIAGNOSTIC CATH LAB LLP 6620 MAIN ST SUITE 1520 HOUSTON,TX77030 71-0959365	DIAGNOSTIC	TX	SLHS HOLDINGS	RELATED	273,448	868,814		No	0		No	57.3 %
(37) ST LUKE'S LAKESIDE HOSPITAL LLC 6624 FANNIN SUITE 2505 HOUSTON,TX77030 30-0427437	HOSPITAL	TX	SL CDC - WOODLANDS	RELATED	1,106,628	25,874,619		No	0	Yes		51 %
(38) ST LUKE'S THE WOODLANDS SLEEP CENTER LLC 6624 FANNIN SUITE 800 HOUSTON,TX77030 46-2795726	DIAGNOSTIC	TX	SLHS HOLDINGS	RELATED	0	0		No	0		No	51 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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	(i) Section 512(b)(13) controlled entity?
(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		Yes	No
(1) ALTERNATIVE INSURANCE MANAGEMENT SERVICE 3900 OLYMPIC BOULEVARD SUITE 400 ERLANGER,KY41018 84-1112049	MANAGEMENT SERVICES	CO	CHI	C CORPORATION	0	6,272,746	100 %	Yes
(2) AMERICAN NURSING CARE 1700 EDISON DRIVE MILFORD,OH45150 31-1085414	HOME HEALTH	OH	CHS	C CORPORATION	5,118,606	51,920,207	100 %	Yes
(3) AMERIMED INC 1700 EDISON DRIVE MILFORD,OH45150 31-1158699	HOME HEALTH	OH	ANC	C CORPORATION	2,134,392	14,669,219	100 %	Yes
(4) BC HOLDING COMPANY INC 1850 BLUEGRASS AVE LOUISVILLE,KY40215 31-1542851	FITNESS CLUB	KY	JH	C CORPORATION	0	0	100 %	Yes
(5) CADUCEUS MEDICAL ASSOCIATES INC 5600 BRAINERD ROAD SUITE 500 CHATTANOOGA,TN37411 62-1570736	HEALTHCARE	TN	MHCS	C CORPORATION	0	1,008	100 %	Yes
(6) CAPTIVE MANAGEMENT INITIATIVES PO BOX 10073 APO GEORGETOWN,GRAND CAYMANKY1-1001 CJ 98-0663022	CAPTIVE MANAGEMENT	CJ	CHI	C CORPORATION	0	0	100 %	Yes
(7) CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 27-2269511	RESEARCH	CO	CIRI	C CORPORATION	-2,286,538	1,241,259	100 %	Yes
(8) CGH REALTY COMPANY INC 2500 BERNVILLE RD READING,PA19603 23-2326801	REAL ESTATE	PA	SJHM	C CORPORATION	0	0	100 %	Yes
(9) COMCARE SERVICES 4231 W 16TH AVENUE DENVER,CO80204 84-0904813	INACTIVE	CO	CHIC	C CORPORATION	0	0	100 %	Yes
(10) CONSOLIDATED HEALTH SERVICES 1700 EDISON DRIVE MILFORD,OH45150 31-1378212	HOME HEALTH	OH	CHI	C CORPORATION	-879,467	52,379,487	100 %	Yes
(11) DES MOINES MEDICAL CENTER INC 1111 6TH AVENUE DES MOINES,IA50314 42-0837382	REAL ESTATE	IA	CHI-IA CORP	C CORPORATION	61,204	1,064,032	92.98 %	Yes
(12) FIRST INITIATIVES INSURANCE LTD PO BOX 10073 APO GEORGETOWN,GRAND CAYMANKY1-1001 CJ 98-0203038	INSURANCE	CJ	CHI	C CORPORATION	0	0	100 %	Yes
(13) FRANCISCAN SERVICES INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 23-2487967	HEALTHCARE	CO	CHI	C CORPORATION	-7,868	718,254	100 %	Yes
(14) GOOD SAMARITAN OUTREACH SERVICES PO BOX 1990 KEARNEY,NE68848 47-0659440	MEDICAL CLINIC	NE	CHI NEBRASKA	C CORPORATION	-257,418	180,468	100 %	Yes
(15) HEALTH SYSTEMS ENTERPRISES INC PO BOX 1990 KEARNEY,NE68848 47-0664558	MANAGEMENT	NE	GSH	C CORPORATION	87,278	1,377,820	100 %	Yes
(16) HEALTHCARE MGMT SERVICES ORG INC 1149 MARKET ST TACOMA,WA98402 91-1865474	HEALTH ORG.	WA	FHS	C CORPORATION	0	0	100 %	Yes
(17) MEDQUEST 1301 15TH AVENUE WEST WILLISTON,ND58801 45-0392137	SALE OF DME	ND	MMC WILLISTON	C CORPORATION	153,510	1,152,715	100 %	Yes
(18) MERCY PARK APARTMENTS LTD 1111 6TH AVENUE DES MOINES,IA50314 42-1202422	HOUSING	IA	CHI-IA CORP	C CORPORATION	369,231	1,937,218	100 %	Yes
(19) MERCY SERVICES CORP 2700 STEWART PARKWAY ROSEBURG,OR97470 93-0824308	RETAIL SALES	OR	MMC	C CORPORATION	-440,596	1,423,377	100 %	Yes
(20) MHSERVICES CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 43-1457881	DME	MO	SJRMC	C CORPORATION	0	0	100 %	Yes
(21) MOUNTAIN MANAGEMENT SERVICES INC 5600 BRAINERD ROAD SUITE 500 CHATTANOOGA,TN37411 62-1570739	MGMT SVC ORG	TN	MHCS	C CORPORATION	96,044	6,465,179	100 %	Yes
(22) NAZARETH ASSURANCE COMPANY PO BOX 10073 APO GEORGETOWN,GRAND CAYMANKY1-1001 CJ 03-0304831	INSURANCE	CJ	CHI	C CORPORATION	0	0	100 %	Yes
(23) PATIENT TRANSPORT SERVICES INC 1700 EDISON DRIVE MILFORD,OH45150 31-1100798	HOME HEALTH	OH	ANC	C CORPORATION	-164,340	5,488,275	100 %	Yes
(24) PHYSICIAN HEALTH SYSTEM NETWORK 1149 MARKET ST TACOMA,WA98402 91-1746721	HEALTH ORG.	WA	FHS	C CORPORATION	0	0	100 %	Yes
(25) SAINT CLARES PRIMARY CARE INC 66 FORD ROAD DENVILLE,NJ07834 22-2441202	BILLING SERVICES	NJ	SCCC	C CORPORATION	-357,263	1,361,242	100 %	Yes
(26) SAMARITAN FAMILY CARE INC 40 W FOURTH ST 1700 DAYTON,OH45402 31-1299450	HEALTHCARE	OH	SHP	C CORPORATION	0	0	100 %	Yes
(27) SJH SERVICES CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 23-2307408	HEALTHCARE	CO	FSI	C CORPORATION	-197,039	3,331,737	100 %	Yes
(28) SJL PHYSICIAN MANAGEMENT SERVICES INC 424 LEWIS HARGETT CR 160 LEXINGTON,KY40503 27-0164198	MANAGEMENT	KY	SJHS	C CORPORATION	0	0	100 %	Yes
(29) ST ANTHONY DEVELOPMENT COMPANY 1415 SOUTHGATE PENDLETON,OR97801 93-1216943	ATHLETIC CLUB	OR	SAH	C CORPORATION	114,663	2,936,102	100 %	Yes
(30) ST VINCENT COMMUNITY HEALTH SERVICES INC TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 71-0710785	HEALTHCARE	AR	SVIMC	C CORPORATION	2,408,638	15,225,732	100 %	Yes
(31) ST JOSEPH DEVELOPMENT COMPANY INC 1717 SOUTH J STREET TACOMA,WA98405 91-1480569	RENTAL	WA	FSI	C CORPORATION	655,478	12,357,418	100 %	Yes
(32) ST JOSEPH OFFICE PARK ASSOCIATION 1401 HARRODSBURG ROAD BLDG B70 LEXINGTON,KY40504 61-1079899	MANAGEMENT	KY	SJHS	C CORPORATION	0	882,139	85 %	Yes
(33) TOWSON MANAGEMENT INC 7601 OSLER DRIVE TOWSON,MD21204 52-1710750	MANAGEMENT SERVICES	MD	FSI	C CORPORATION	516,457	197,196	100 %	Yes
(34) COLLABHEALTH MANAGED SOLUTIONS INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-1222808	HOLDING CO	CO	CHI	C CORPORATION	0	23,806,707	100 %	Yes
(35) COLLABHEALTH PLAN SERVICES INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-1224037	ADMIN SERVICES	CO	CHMS	C CORPORATION	-1,082,933	38,272,608	100 %	Yes
(36) HIGHLINE MEDICAL GROUP 15811 AMBAUM BLVD SW 170 BURIEN,WA98166 91-1407026	MEDICAL SERVICES	WA	HMC	C CORPORATION	-6,049,147	5,689,139	100 %	Yes
(37) SOUNDPATH HEALTH INC 32129 WEYERHAEUSER WAY S SUITE 201 FEDERAL WAY,WA98001 42-1720801	INSURANCE	WA	CHPS	C CORPORATION	-154,741	10,976,973	55.6 %	Yes
(38) SLEHS HOLDINGS INC 6624 FANNIN SUITE 800 HOUSTON,TX77030 76-0637138	HOLDING CO	TX	SLHS	C CORPORATION	1,425,313	33,114,103	100 %	Yes
(39) ST LUKE'S ANESTHESIOLOGY ASSOCIATES 6624 FANNIN SUITE 1100 HOUSTON,TX77030 46-1517163	MEDICAL CLINIC	TX	SLMC	C CORPORATION	0	0	100 %	Yes
(40) SLMT PARKING INC 6624 FANNIN SUITE 800 HOUSTON,TX77030 76-0637140	PARKING	TX	SLHS	C CORPORATION	1,117,934	13,768,221	100 %	Yes
(41) ST LUKE'S 6620 MAIN CONDOMINIUM ASSOCIATION 6624 FANNIN SUITE 1100 HOUSTON,TX77030 30-0355517	CONDOMINIUM ASSOC	TX	SLPC	C CORPORATION	0	0	100 %	Yes
(42) ST LUKE'S EPISCOPAL HOSPITAL PHYSICIAN HOSPITAL ORGANIZATION INC 6720 BERTNER HOUSTON,TX77030 76-0377932	PHO	TX	SLMC	C CORPORATION	6	0	60 %	Yes
(43) ST LUKE'S MEDICAL ARTS CENTER I CONDOMINIUM ASSOCIATION 6624 FANNIN SUITE 1100 HOUSTON,TX77030 30-0355518	CONDOMINIUM ASSOC	TX	SLPC	C CORPORATION	0	0	100 %	Yes
(44) ST LUKE'S MEDICAL TOWER CONDOMINIUM ASSOCIATION 6624 FANNIN SUITE 1100 HOUSTON,TX77030 76-0298751	CONDOMINIUM ASSOC	TX	SLMTC	C CORPORATION	0	0	100 %	Yes
(45) SUGAR LAND DOCTOR GROUP 1317 LAKE POINTE PARKWAY SUGAR LAND,TX77478 45-4270163	MEDICAL CLINIC	TX	SL CHS	C CORPORATION	-1,159,411	566,590	100 %	Yes
(46) THE TEXAS HEART INSTITUTE AT ST LUKE'S EPISCOPAL HOSPITAL DENTON A COOLEY B UILDING CONDOMINIUM ASSOCIATION 6624 FANNIN SUITE 1100 HOUSTON,TX77030 90-0064009	CONDOMINIUM ASSOC	TX	SLMC	C CORPORATION	0	0	100 %	Yes
(47) ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SERVICES INC 12809 WEST DODGE ROAD OMAHA,NE68154 47-0802396	MANAGED CARE	NE	ACH	C CORPORATION	5,312,313	4,520,865	100 %	Yes
(48) ALL SAINTS INSURANCE COMPANY SPC LTD PO BOX 69 GT 720 WEST BAY ROAD GEORGETOWN,GRAND CAYMANKY-1102 CJ	INSURANCE	CJ	SLHS	C CORPORATION	0	43,866,961	100 %	Yes
(49) VINTAGE DOCTOR GROUP 6624 FANNIN SUITE 1100 HOUSTON,TX77030	MEDICAL CLINIC	TX	SLMC	C CORPORATION	0	0	100 %	Yes

Schedule R (Form 990) 2012

Page 3

Part V

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

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

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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

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

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

Yes

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

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

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related 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-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2012

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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)	(e) Are all partners section 501(c)(3) organizations?		(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(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

Schedule R (Form 990) 2012

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:	12000266
Software Version:	v2012.1.0

1	Briefly describe the organization’s mission or most significant activities: THE VISION IS TO CREATE THE BEST HEALTHCARE EXPERIENCE BY IGNITING THE SPIRIT FOR SUPERIOR CARE AND SERVICE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	7
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	635
6	Total number of volunteers (estimate if necessary) .............	6	337
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	200,526
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	222,673	737,212
9	Program service revenue (Part VIII, line 2g) .........	73,809,198	75,306,419
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	214,712	1,096,327
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,361,213	1,204,952
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	75,607,796	78,344,910
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	95,794	93,742
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)	39,521,389	39,709,923
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	33,963,421	35,951,541
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	73,580,604	75,755,206
19	Revenue less expenses. Subtract line 18 from line 12.......	2,027,192	2,589,704
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	49,196,717	53,775,775
21	Total liabilities (Part X, line 26).............	21,382,802	23,413,623
22	Net assets or fund balances. Subtract line 21 from line 20.....	27,813,915	30,362,152

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 66,003,844 including grants of $ 93,742 ) (Revenue $ 75,105,874 )
	SEE SCHEDULE H

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 expenses66,003,844

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,414,835	1,355,727	476,139

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)		(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
(18) VIRGIL MEYER........................................................................ PHYSICIAN	45.00 .......................0	X	401,620	0	35,098

				(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		4,156
d	Related organizations...1d		106,288
e	Government grants (contributions)1e		120,545

f	All other contributions, gifts, grants, and similar amounts not included above1f		506,223

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			737,212
			Business Code
2a	PATIENT SERVICES		900099	72,285,470	72,285,470
b	PHARMACY SERVICES		446110	2,288,404	2,087,859	200,545
c	INTERCOMPANY TRANSACTIONS		900099	432,956	432,956
d	RENTAL INCOME		900099	96,724	96,724
e	EQUITY CHANGES OF UNCONSOLIDATED ORGS		900099	18,376	18,376
f	All other program service revenue .			184,489	184,489	0	0
g	Total. Add lines 2a–2f........			75,306,419
3	Investment income (including dividends, interest, and other similar amounts).......			153,644		-19	153,663
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	13,209
b	Less: rental expenses	1,995
c	Rental income or (loss)	11,214	0
d	Net rental income or (loss).......			11,214			11,214
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	108,640	849,721
b	Less: cost or other basis and sales expenses		15,678
c	Gain or (loss)	108,640	834,043
d	Net gain or (loss)..........			942,683			942,683
8a	Gross income from fundraising events (not including $ 4,156 of contributions reported on line 1c). See Part IV, line 18 ..
	a		22,385
b	Less: direct expenses ...b		8,388
c	Net income or (loss) from fundraising events..			13,997			13,997
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
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	SERVICES SOLD		900099	239,500			239,500
b	REIMBURSEMENT OF EXPENSES		900099	494,957			494,957
c	CAFETERIA		722100	222,432			222,432
d	All other revenue ....			222,852	0	0	222,852
e	Total. Add lines 11a–11d ......			1,179,741
12	Total revenue. See Instructions......			78,344,910	75,105,874	200,526	2,301,298


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			0	1	0
2	Savings and temporary cash investments .........			2,646,680	2	5,060,949
3	Pledges and grants receivable, net ...........			28,470	3	33,088
4	Accounts receivable, net .............			12,044,770	4	11,819,062
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				88,641	5	66,699
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6	0
7	Notes and loans receivable, net .............			509,332	7	199,343
8	Inventories for sale or use ..............			1,416,122	8	1,420,801
9	Prepaid expenses and deferred charges ..........			138,322	9	54,527
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	59,113,882
b	Less: accumulated depreciation .....	10b	30,835,050	27,525,554	10c	28,278,832
11	Investments—publicly traded securities ..........				11	0
12	Investments—other securities. See Part IV, line 11 .....			2,338,936	12	4,620,263
13	Investments—program-related. See Part IV, line 11 .....			0	13	0
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			2,459,890	15	2,222,211
16	Total assets. Add lines 1 through 15 (must equal line 34)......			49,196,717	16	53,775,775
17	Accounts payable and accrued expenses .........			2,927,008	17	5,589,979
18	Grants payable .................				18
19	Deferred revenue ................				19	93,468
20	Tax-exempt bond liabilities .............				20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22	0
23	Secured mortgages and notes payable to unrelated third parties ..			156,667	23	1,029,501
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			18,299,127	25	16,700,675
26	Total liabilities. Add lines 17 through 25.........			21,382,802	26	23,413,623
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			27,552,460	27	30,078,616
28	Temporarily restricted net assets ...........			261,455	28	283,536
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........			27,813,915	33	30,362,152
34	Total liabilities and net assets/fund balances ........			49,196,717	34	53,775,775