TY 2012 Form 990

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	190,520	190,520
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
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 ....	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	0
9	Other employee benefits .......	0
10	Payroll taxes ...........	0
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	0
c	Accounting ...........	31,435		31,435
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) ........	0	0	0	0
12	Advertising and promotion ....	5,928		2,827	3,101
13	Office expenses .......	17,556		7,836	9,720
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	0
17	Travel ............	1,193		109	1,084
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	21			21
20	Interest ...........	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	0
23	Insurance ..............	0
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	DUES & SUBSCRIPTIONS	1,369		530	839
b
c
d
e	All other expenses	774	0	764	10
25	Total functional expenses. Add lines 1 through 24e	248,796	190,520	43,501	14,775
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 .............		1	82
2	Savings and temporary cash investments .........	83,677	2	197,297
3	Pledges and grants receivable, net ...........	977	3	981
4	Accounts receivable, net .............		4
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5	0
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 .............		7
8	Inventories for sale or use ..............		8
9	Prepaid expenses and deferred charges ..........		9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	0
b	Less: accumulated depreciation .....	10b	0	0	10c	0
11	Investments—publicly traded securities ..........	0	11	0
12	Investments—other securities. See Part IV, line 11 .....	571,783	12	582,237
13	Investments—program-related. See Part IV, line 11 .....	0	13	0
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........	17,987	15	18,019
16	Total assets. Add lines 1 through 15 (must equal line 34)......	674,424	16	798,616
	17	Accounts payable and accrued expenses .........	0	17
18	Grants payable .................	11,697	18	2,643
19	Deferred revenue ................		19	39,481
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 ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
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....................	145,471	25	106,596
26	Total liabilities. Add lines 17 through 25.........	157,168	26	148,720
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	372,839	27	450,778
28	Temporarily restricted net assets ...........	82,494	28	131,713
29	Permanently restricted net assets ...........	61,923	29	67,405
	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 ...........	517,256	33	649,896
34	Total liabilities and net assets/fund balances ........	674,424	34	798,616

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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

HEALTHCARE AND WELLNESS FOUNDATION

Employer identification number

76-0761782

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	(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))	(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
(A) ST FRANCIS MEDICAL CENTER	410695598	3	Yes		Yes		Yes		180,120

Total									180,120

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

HEALTHCARE AND WELLNESS FOUNDATION

Employer identification number

76-0761782

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 HEALTHCARE AND WELLNESS FOUNDATION

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 HEALTHCARE AND WELLNESS FOUNDATION

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
HEALTHCARE AND WELLNESS FOUNDATION

Employer identification number

76-0761782

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 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

HEALTHCARE AND WELLNESS FOUNDATION

Employer identification number

76-0761782

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 ....	356,604	349,374	305,346	304,028	303,878
b	Contributions ........	5,482	7,230	44,028	1,318	150
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 ......	362,086	356,604	349,374	305,346	304,028

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

Board designated or quasi-endowment SchDMd Bullet

70.970 %

Permanent endowment SchDMd Bullet

29.030 %

Temporarily restricted endowment SchDMd Bullet

0 %

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		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................				0
b	Buildings ................				0
c	Leasehold improvements ............				0
d	Equipment ................				0
e	Other .................				0
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......					0

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) RAYMOND JAMES INVESTMENT	582,237	F








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	582,237

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
INTERCOMPANY PAYABLES		106,596








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		106,596
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
Intended uses of endowment funds	Schedule D, Part V, Line 4	THE FOUNDATION'S ENDOWMENTS ARE HELD FOR FUTURE GROWTH OF ST. FRANCIS HEALTHCARE CAMPUS.
FIN 48 (ASC 740) footnote	Schedule D, Part X, Line 2	HEALTHCARE AND WELLNESS FOUNDATION'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
HEALTHCARE AND WELLNESS FOUNDATION

Employer identification number

76-0761782

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 GALA (event type)	(b) Event #2 (event type)	(c) Other events (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . .	59,409			59,409
2	Less: Contributions . .	28,870			28,870
3	Gross income (line 1 minus line 2) . . .	30,539	0	0	30,539
4	Cash prizes . . .	0			0
5	Noncash prizes . .	1,497			1,497
6	Rent/facility costs . .	4,000			4,000
7	Food and beverages .	1,522			1,522
8	Entertainment . . .	750			750
9	Other direct expenses .	3,272			3,272
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........				11,041
11	Net income summary. Combine line 3, column (d), and line 10. ..........				19,498

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 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
HEALTHCARE AND WELLNESS FOUNDATION

Employer identification number
76-0761782

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	(h) Purpose of grant or assistance
(1) ST FRANCIS MEDICAL CENTER 2400 ST FRANCIS DRIVE BRECKENRIDGE,MN56520	41-0695598	501(C)(3)	180,120	PROGRAM SUPPORT
(2) NDSCS FOUNDATION 800 6TH STREET N WAHPETON,ND58076	45-0407617	501(C)(3)	10,400	SCHOLARSHIPS

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

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	HEALTHCARE AND WELLNESS FOUNDATION RAISES FUNDS ON BEHALF OF ITS SUPPORTED ORGANIZATION, ST. FRANCIS MEDICAL CENTER (SFMC). CONTRIBUTED FUNDS ARE RESERVED BY THE FOUNDATION ACCORDING TO THE DONORS' USE RESTRICTIONS. WHEN SFMC INCURS EXPENSES THAT MEET THESE USE RESTRICTIONS, THEY APPLY FOR AND RECEIVE REIMBURSEMENT FROM THE FOUNDATION, ENSURING THAT THE DONORS' USE RESTRICTIONS AND THE FOUNDATION'S PURPOSE HAVE BEEN MET.

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

HEALTHCARE AND WELLNESS FOUNDATION

Employer identification number

76-0761782

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)CYNTHIA ROONEY-OLSONVP, NORTH REGION FOUNDATION	(i) (ii)	0 157,442	0 31,800	0 1,000	0 22,608	0 13,278	0 226,128	0 0
(2)DAVID NELSONPRESIDENT/CEO	(i) (ii)	0 200,092	0 81,057	0 32,023	0 51,290	0 20,670	0 385,132	0 8,709
(3)NANCY WHITNEYTREASURER & VP FINANCE/CFO	(i) (ii)	0 116,025	0 12,774	0 337	0 11,503	0 16,462	0 157,101	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.
SEVERANCE OR CHANGE-OF-CONTROL 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. THERE WERE NO REPORTABLE INDIVIDUALS WHO RECEIVED SEVERANCE PAYMENTS FROM THE ORGANIZATION OR A RELATED ORGANIZATION DURING THE 2012 CALENDAR YEAR.
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: DAVID NELSON DURING 2012, THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: DAVID NELSON - $18,194 DURING 2012, THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI FROM THE DEFERRED COMPENSATION PLAN: DAVID NELSON - $8,709

Schedule J (Form 990) 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

HEALTHCARE AND WELLNESS FOUNDATION

Employer identification number

76-0761782

Identifier	Return Reference	Explanation
PROGRAM SERVICE ACCOMPLISHMENTS	FORM 990, PART III, LINE 4A	THE HEALTHCARE AND WELLNESS FOUNDATION WAS INCORPORATED AS A 501(C)(3), TAX-EXEMPT CHARITABLE FOUNDATION IN 2004, TO SERVE AS THE OFFICIAL GIFT-RECEIVING AND GIFT-ADMINISTRATION AGENCY FOR ST. FRANCIS MEDICAL CENTER AND ITS SUBSIDIARIES, ALSO KNOWN AS ST. FRANCIS HEALTHCARE CAMPUS, IN BRECKENRIDGE, MINNESOTA. THE HEALTHCARE AND WELLNESS FOUNDATION WAS ESTABLISHED TO PROMOTE THE DEVELOPMENT OF NEW HEALTH CARE RELATED SERVICES AND PUBLIC INFORMATION TO INCREASE QUALITY OF LIFE THROUGH WELLNESS INITIATIVES THAT EMPHASIZE THE HEALTH OF BODY, MIND, AND SPIRIT AND NURTURE HEALTHIER COMMUNITIES. THE HEALTHCARE AND WELLNESS FOUNDATION'S CURRENT BOARD OF DIRECTORS AND EXECUTIVE DIRECTOR RAISE FUNDS THROUGH SPECIAL EVENTS, ANNUAL GIVING, MAJOR GIFTS, PLANNED GIVING, CORPORATE AND FOUNDATION GRANTS, AND CAPITAL CAMPAIGNS TO HELP FUND THE HEALTH CARE SERVICES AND COMMUNITY OUTREACH OFFERED BY ST. FRANCIS HEALTHCARE CAMPUS. IN FY 13, THE HEALTHCARE AND WELLNESS FOUNDATION RECEIVED OVER $85,000 IN REVENUE THROUGH GIFTS AND PLEDGES FROM APPROXIMATELY 741 DONORS, INCLUDING $5,934 IN IN-KIND DONATIONS, AS WELL AS OVER $206,000 IN GRANT FUNDING. AT THE SAME TIME, IT DISBURSED OVER $65,630 BACK TO THE COMMUNITY THROUGH ITS SUPPORT OF ST. FRANCIS HEALTHCARE CAMPUS' AND COMMUNITY SERVICES. OVER $50,980 IN-KIND AND OTHER DONATIONS WERE GIVEN TO SUPPORT COMMUNITY EVENTS AND ACTIVITIES, SUCH AS SPONSORSHIP OF THE CARING BRIDGE WEBSITE AT ST. FRANCIS. THIS WEBSITE ALLOWS PATIENTS, RESIDENTS, AND FAMILY MEMBERS TO COMMUNICATE WITH FRIENDS AND LOVED ONES WHO ARE FAR AWAY. OVER $10,000 WAS GIVEN IN SCHOLARSHIPS TO AREA YOUTH WHO ARE PURSUING A CAREER IN HEALTH CARE. IN ADDITION, THE HEALTHCARE AND WELLNESS FOUNDATION ALSO COORDINATES FUNDRAISING EFFORTS FOR RIVEREDGE HOSPICE. FUNDS ARE USED TO HELP DEFRAY THE NON-COVERED COSTS OF CARE FOR HOSPICE PATIENTS, AS WELL AS TO COVER BEREAVEMENT AND VOLUNTEER EXPENSES. THIS YEAR, OVER $48,000 WAS GIVEN TO RIVEREDGE HOSPICE. THE HEALTHCARE AND WELLNESS FOUNDATION IS A RELATIVELY NEW ENTITY AND CONTINUES TO WORK TOWARDS ESTABLISHING ADEQUATE RESERVE ASSETS TO ENABLE FUNDING OF ITS OPERATIONS INTO THE FUTURE.
Classes of members or stockholders	Form 990, Part VI, Section A, Line 6	ACCORDING TO THE BYLAWS OF HEALTHCARE AND WELLNESS FOUNDATION, ARTICLE V, THE SOLE MEMBER OF THE CORPORATION IS ST. FRANCIS MEDICAL CENTER, A MINNESOTA NONPROFIT CORPORATION.
Members or stockholders electing members of governing body	Form 990, Part VI, Section A, Line 7a	ACCORDING TO THE BYLAWS OF HEALTHCARE AND WELLNESS FOUNDATION, ARTICLE VI, ST. FRANCIS MEDICAL CENTER HAS THE POWER TO APPOINT, REMOVE, OR REPLACE 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 CORPORATE MEMBER IS ST. FRANCIS MEDICAL CENTER (SFMC). PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, BOTH ST. FRANCIS MEDICAL CENTER AND CATHOLIC HEALTH INITIATIVES (CHI) (SFMC'S SOLE CORPORATE MEMBER) HAVE RESERVED POWERS AS OUTLINED IN THE CHI GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE HELD BY THE ST. FRANCIS MEDICAL CENTER BOARD OF DIRECTORS: APPROVE MEMBERS OF THE HEALTHCARE AND WELLNESS FOUNDATION BOARD; AMENDMENT OF THE CORPORATE DOCUMENTS OF THE HEALTHCARE AND WELLNESS FOUNDATION; APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE HEALTHCARE AND WELLNESS FOUNDATION; ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR THE HEALTHCARE AND WELLNESS FOUNDATION. THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD OF DIRECTORS, DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: * SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF THE HEALTHCARE AND WELLNESS FOUNDATION; * REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE HEALTHCARE AND WELLNESS FOUNDATION; * APPROVAL OF ISSUANCE OF DEBT BY HEALTHCARE AND WELLNESS FOUNDATION; * APPROVAL OF PARTICIPATION OF HEALTHCARE AND WELLNESS FOUNDATION IN A JOINT VENTURE; * APPROVAL OF FORMATION OF A NEW CORPORATION BY HEALTHCARE AND WELLNESS FOUNDATION; * APPROVAL OF A MERGER INVOLVING THE HEALTHCARE AND WELLNESS FOUNDATION; * APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE HEALTHCARE AND WELLNESS FOUNDATION; * TO REQUIRE THE TRANSFER OF ASSETS BY THE HEALTHCARE AND WELLNESS FOUNDATION TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. PURSUANT TO SECTION 5.5 OF THE ORGANIZATION'S BYLAWS, ST. FRANCIS MEDICAL CENTER OR CHI MAY, IN EXERCISE OF THEIR APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND ITS PRESIDENT AND THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE.
Review of form 990 by governing body	Form 990, Part VI, Section B, Line 11b	HEALTHCARE AND WELLNESS FOUNDATION'S BOARD OF DIRECTORS HAS CREATED A FORM 990 REVIEW SUBCOMMITTEE THAT CONSISTS OF TWO COMMUNITY MEMBERS WITH TAX RETURN EXPERIENCE, THE ORGANIZATION'S CEO AND CFO, AND AN ACCOUNTANT. AFTER THE RETURN IS PREPARED, IT IS REVIEWED BY THE CHIEF FINANCIAL OFFICER, WHO PRESENTS IT TO THE FORM 990 SUBCOMMITTEE FOR ADDITIONAL REVIEW. AFTER ANY NECESSARY REVISIONS ARE MADE, THE RETURN IS PROVIDED TO THE BOARD MEMBERS ELECTRONICALLY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. SUBSEQUENT TO PROVISION 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	HEALTHCARE AND WELLNESS FOUNDATION HAS A BOARD POLICY THAT REFERENCES THE DUALITY OF INTEREST AND CONFLICT OF INTEREST POLICIES PROVIDED BY CHI NATIONAL. AT THE ANNUAL BOARD AND BOARD COMMITTEE MEETINGS ALL MEMBERS ARE REQUESTED TO SIGN CONFLICT OF INTEREST STATEMENTS. THE SIGNED STATEMENTS ARE RETAINED IN THE ADMINISTRATIVE FILES. ALL MEMBERS ARE REQUESTED TO DECLARE POTENTIAL CONFLICTS OF INTEREST AT EACH BOARD AND/OR COMMITTEE MEETING OF THE BOARD (FINANCE/AUDIT AND COMPLIANCE COMMITTEE AND THE PERFORMANCE IMPROVEMENT COMMITTEE). IF THE BOARD FINDS THAT A CONFLICT DOES EXIST REGARDING THE AGENDA ITEMS TO BE PRESENTED FOR ACTION, MEMBERS ARE REQUESTED TO ABSTAIN FROM VOTING. IN ADDITION, A QUESTIONNAIRE IS SENT ANNUALLY TO ALL BOARD MEMBERS AND TOP PAID EMPLOYEES ASKING THEM TO DISCLOSE ANY BUSINESS OR FAMILY RELATIONSHIPS.
PROCESS FOR DETERMINING COMPENSATION OF TOP MANAGEMENT OFFICIAL	FORM 990, PART VI, LINE 15A	THE ORGANIZATION'S CEO'S COMPENSATION IS PAID BY CATHLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. 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 FOR DETERMINING COMPENSATION OF OTHER OFFICERS	FORM 990, PART VI, LINE 15B	DURING THE TAX YEAR ENDED 6/30/13, NO OFFICERS, DIRECTORS, OR TRUSTEES RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS, OR TRUSTEES BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THEREFORE, THIS QUESTION IS MORE APPROPRIATELY ANSWERED AS N/A.
Governing documents, conflict of interest policy and financial statements available to the public	Form 990, Part VI, Section C, Line 19	HEALTHCARE AND WELLNESS FOUNDATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.COM. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.

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

HEALTHCARE AND WELLNESS FOUNDATION

Employer identification number

76-0761782

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 JOESPH 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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) . . . . . . . . . . . . . . . . . . . .

Yes

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

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

Yes

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

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

Yes

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

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

Yes

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 HEALTHCARE AND WELLNESS FOUNDATION IS A 501(C)(3) TAX EXEMPT CHARITABLE FOUNDATION ESTABLISHED TO PROMOTE THE FAITH BASED MINISTRY OF ST. FRANCIS HEALTHCARE CAMPUS AND THE COMMUNITY IT SERVES.
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	8
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	25
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
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) .........	160,283	291,218
9	Program service revenue (Part VIII, line 2g) .........	0	0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	21,252	30,881
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	19,935	19,498
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	201,470	341,597
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	96,999	190,520
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 14,775
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	123,496	58,276
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	220,495	248,796
19	Revenue less expenses. Subtract line 18 from line 12.......	-19,025	92,801
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	674,424	798,616
21	Total liabilities (Part X, line 26).............	157,168	148,720
22	Net assets or fund balances. Subtract line 21 from line 20.....	517,256	649,896

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 190,520 including grants of $ 190,520 ) (Revenue $ 0 )
	SEE SCHEDULE O

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses190,520

(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)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) BERNIE STEEVES........................................................................ CHAIR	1.00 .......................0	X	X	0	0	0
(2) DAVID NELSON........................................................................ PRESIDENT/CEO	5.00 .......................55.00	X	X	0	313,172	71,960
(3) JERI YAGGIE........................................................................ VICE CHAIR	1.00 .......................0	X	X	0	0	0
(4) NANCY WHITNEY........................................................................ TREASURER & VP FINANCE/CFO	2.00 .......................46.00	X	X	0	129,136	27,965
(5) CYNTHIA ROONEY-OLSON........................................................................ VP, NORTH REGION FOUNDATION	2.00 .......................52.00	X		0	190,242	35,886
(6) JANA BERNDT........................................................................ BOARD MEMBER	1.00 .......................4.00	X		0	0	0
(7) MAGGIE VERTIN........................................................................ BOARD MEMBER	1.00 .......................0	X		0	0	0
(8) MARY MAUCH........................................................................ BOARD MEMBER	1.00 .......................3.00	X		0	0	0
(9) STACIA HENNINGSEN........................................................................ BOARD MEMBER	1.00 .......................0	X		0	0	0
(10) STEVE LIES........................................................................ BOARD MEMBER	1.00 .......................0	X		0	0	0
(11) TRUDI SMITH........................................................................ BOARD MEMBER	1.00 .......................0	X		0	7,154	0
(12) JULIANNA MAUCH........................................................................ FOUNDATION DIRECTOR	40.00 .......................0		X	0	64,707	20,263
(13) MARY JACKLITCH........................................................................ SECRETARY/DIR OF PUBLIC RELATIONS SFMC	5.00 .......................40.00		X	0	64,067	17,939

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	0	768,478	174,013

(A) Name and business address	(B) Description of services	(C) Compensation





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 0

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c		28,870
d	Related organizations...1d
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		262,348

g	Noncash contributions included in lines 1a-1f:$		5,934
h	Total. Add lines 1a-1f.......			291,218
			Business Code
2a				0
b				0
c				0
d				0
e				0
f	All other program service revenue .			0	0	0	0
g	Total. Add lines 2a–2f........			0
3	Investment income (including dividends, interest, and other similar amounts).......			2,361			2,361
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss).......			0
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	28,520
b	Less: cost or other basis and sales expenses
c	Gain or (loss)	28,520	0
d	Net gain or (loss)..........			28,520			28,520
8a	Gross income from fundraising events (not including $ 28,870 of contributions reported on line 1c). See Part IV, line 18 ..
	a		30,539
b	Less: direct expenses ...b		11,041
c	Net income or (loss) from fundraising events..			19,498			19,498
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				0
b				0
c				0
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See Instructions......			341,597	0	0	50,379


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............				1	82
2	Savings and temporary cash investments .........			83,677	2	197,297
3	Pledges and grants receivable, net ...........			977	3	981
4	Accounts receivable, net .............				4
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5	0
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 .............				7
8	Inventories for sale or use ..............				8
9	Prepaid expenses and deferred charges ..........				9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	0
b	Less: accumulated depreciation .....	10b	0	0	10c	0
11	Investments—publicly traded securities ..........			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			571,783	12	582,237
13	Investments—program-related. See Part IV, line 11 .....			0	13	0
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			17,987	15	18,019
16	Total assets. Add lines 1 through 15 (must equal line 34)......			674,424	16	798,616
17	Accounts payable and accrued expenses .........			0	17
18	Grants payable .................			11,697	18	2,643
19	Deferred revenue ................				19	39,481
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 ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
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....................			145,471	25	106,596
26	Total liabilities. Add lines 17 through 25.........			157,168	26	148,720
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			372,839	27	450,778
28	Temporarily restricted net assets ...........			82,494	28	131,713
29	Permanently restricted net assets ...........			61,923	29	67,405
	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 ...........			517,256	33	649,896
34	Total liabilities and net assets/fund balances ........			674,424	34	798,616