Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 01-01-2013 , 2013, and ending 12-31-2013
BCheck if applicable:
CName of organization
FRANCISCAN ALLIANCE INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1515 DRAGOON TRAIL
Suite
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MISHAWAKA, IN465444710
D Employer identification number

35-1330472
E Telephone number

G Gross receipts $ 2,596,912,525
F Name and address of principal officer:
KEVIN D LEAHY
1515 DRAGOON TRAIL
MISHAWAKA,IN46544
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.FRANCISCANALLIANCE.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:
 
L Year of formation: 1974
M State of legal domicile: IN
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 16
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 13
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 20,263
6 Total number of volunteers (estimate if necessary) ............. 6 1,988
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 5,277,312
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -604,488
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 5,479,482 4,960,347
9 Program service revenue (Part VIII, line 2g) ......... 2,532,599,050 2,506,575,052
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 80,546,006 69,417,001
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 6,667,468 7,629,975
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 2,625,292,006 2,588,582,375
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,643,789 160,000
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) 1,229,925,169 1,280,893,808
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,256,899,742 1,214,856,384
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,488,468,700 2,495,910,192
19 Revenue less expenses. Subtract line 18 from line 12....... 136,823,306 92,672,183
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 4,008,931,900 4,159,841,951
21 Total liabilities (Part X, line 26)............. 2,092,819,331 1,659,238,916
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,916,112,569 2,500,603,035
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: THE PURPOSES FOR WHICH FRANCISCAN ALLIANCE, INC. IS FORMED ARE: TO CONTINUE THE HEALING MINISTRY OF CHRIST IN ACCORDANCE WITH THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH AND, IN PARTNERSHIP WITH OTHERS, TO PROVIDE A FULL CONTINUUM OF HEALTH CARE SERVICES; TO CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE PROMOTION OF HEALTH; TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO HEALTH CARE; AND TO PARTICIPATE IN ANY ACTIVITY DESIGNED AND CONDUCTED TO PROMOTE THE GENERAL HEALTH OF THOSE SERVED BY FRANCISCAN ALLIANCE, INC. THE REVENUES OF FRANCISCAN ALLIANCE, INC. ALLOW FOR THE OPERATION OF HEALTH CARE FACILITIES WHERE THE PURPOSE IS TO RESPECT LIFE AND TO PRESERVE HEALTH AS WELL AS TREAT ILLNESS AND INJURY. THIS ALLOWS FOR THE ACCOMPLISHMENT OF THE CORPORATE MINISTRY WHICH HAS THE FOLLOWING CENTRAL CONCERNS: COMPASSION FOR THOSE IN NEED, RESPECT FOR LIFE AND THE DIGNITY OF PERSONS, WELLNESS AND THE PREVENTION OF ILLNESS, RESTORATION TO HEALTH, AND THE ACCEPTANCE OF DEATH AS THE FINAL ST
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 2,152,118,125 including grants of $ 160,000 ) (Revenue $ 2,497,798,681 )
For over 135 years, Franciscan Alliance, Inc. ("Franciscan") has endeavored to stay true to our founding mission of caring for patients who come through our doors and we continue to look for opportunities to serve our communities through the very best in medical care and service to the less fortunate among us. Franciscan's purpose is to continue the healing ministry of Christ in accordance with the teachings of the Roman Catholic Church and in partnership with others to provide a full continuum of health care services; to carry on educational activities related to the promotion of health; to promote and carry on scientific research related to health care; and to participate in activities designed and conducted to promote the general health of those served by Franciscan. Franciscan operates thirteen hospital campuses (two in Illinois and eleven in Indiana) along with numerous physician clinics and ancillary services centers and offers numerous community health improvement programs that is further described below. In 2013, Franciscan admitted approximately 82,000 inpatients and recorded over 372,000 inpatient days, 397,000 emergency room visits, and provided over $579 million in charity care and other community benefits which includes Medicaid and Medicare shortfalls at cost. Franciscan provides significant benefits that reflect the organization's commitment to healthcare and the communities it is privileged to serve. We break community benefits down into two primary categories: a) benefits for the poor and underserved which includes the cost of providing programs and services to persons who are economically poor or are medically indigent and cannot afford to pay for health care services because they have inadequate resources and/or are uninsured or underinsured and b) benefits for the broader community which includes the cost of providing programs and services aimed at persons and groups for reasons other than poverty (however it may include needy populations that may not qualify as poor but need special services and support) or broader populations who benefit from healthy community initiatives with the provision of these programs and services not intended to be financially self-supporting. In 2013, Franciscan provided over $579 million in quantifiable community benefits which included: Benefits for the Poor: Charity Care $93,613,679 Unpaid Costs of Medicaid $109,237,168 Community Services $4,327,132 Other Public Programs $757,884 _______________ Subtotal $207,935,863 Benefits for the Community: Unpaid Costs of Medicare $272,730,170 Other Community Benefits $61,646,559 Bad Debt $36,752,348 _____________ Subtotal $371,129,077 Total $579,064,940 "Our Giving Journal" at www.FranciscanAlliance.org/CommunityBenefit reflects Franciscan's mission of "Continuing Christ's Ministry in Our Franciscan Tradition" along with a report of our community benefit activities. Although it is not all inclusive of the many benefits provided by Franciscan it does portray the significant benefits that reflect our commitment to healthcare and the communities we are privileged to serve. The following is a subset of the many clinical services as well as population health improvement and community outreach activities offered by one or more of Franciscan's healthcare facilities: - Inpatient Hospital Services including: Medical Services, Surgical Services, Intensive Care Services, Telemetry Services, Obstetrics Services, Pediatrics Services, Neonatal Intensive Care Services, Acute Rehabilitation Services, Oncology Services, Bone Marrow Transplant Services, General Surgery Services, Cardiac Surgery Services, Vascular Services, Pulmonary Services, Interventional Radiology, Orthopedics, Joint and Spine Care, Gastrointestinal Care, Neurosciences Services, Colon and Rectal Services, Anesthesia Services, Hospice Services, Inpatient Psychiatric Care, Residential Treatment Program for Adolescents, etc. - Emergency Services including: 24 hour Emergency Room Services, Ambulance Services, Immediate Care Services, Advanced Life Support Services, Basic Life Support Services, Behavioral Health Emergency Consultation Services, 24-Hour Crisis and Referral Hotline, etc. - Outpatient Services including: Laboratory Services, Physical Therapy Services, Occupational Therapy Services, Speech Therapy Services, General Radiology Services, Computed Tomography Services, Magnetic Resonance Imaging (MRI), Nuclear Medicine Services, Mammography Services, Angiography Services, Neurodiagnostics Services, Gastro/Intestinal Services, Sleep Laboratory, Pulmonary Services, Outpatient Surgery, Cardiac Testing, Electrocardiogram (EKG) Services, Medical Oncology Services, Radiation Oncology Services, Pharmacy, Occupational Medicine Services, Cardiac/Pulmonary Rehabilitation Services, Congestive Health Failure Clinic, Wound Healing and Prevention, Nutritional Counseling, Diabetes Management, Bariatric Services, Pain Management, Social Services, Palliative Care, Sports Medicine, Behavioral Health, Stroke Services, Home Health Services, Skilled Nursing Services, Social Services, Durable Medical Equipment. - Primary Care and Specialty Care Physician Clinics. - Subsidized Healthcare Services offered by Franciscan: - Franciscan has neighborhood health clinics that offer family practice services designed for families without access to affordable health care. The focus is on providing primary and preventive care as well as health education. These clinics offer free immunizations. - Franciscan's Sexual Assault Clinics that provide medical and forensic assistance that is sensitive to the special needs of the victim as well as a victim advocate program and crisis intervention counselors. - Franciscan's Blood and Marrow Transplant program is only one of two programs in Indiana offering full service transplant care and specializes in the treatment of patients with leukemia, Hodgkin's or non-Hodgkin's lymphoma, multiple myeloma, and many other malignancies and blood disorders. - Franciscan's Diabetes Education Centers offer a number of diabetes classes and individualized sessions to help patients take control of their health with a focus on nutritional, exercise, medications, chronic conditions, preconception and pregnancy, blood glucose monitoring, goal setting, problem solving, psychosocial adjustment, detection/treatment of high and low blood sugar, and insulin administration. - Franciscan's Women's and Children's Services include preventive medical care and health screenings to gynecological care, maternity, lactation consultation services, and beyond, Franciscan's facilities focus on keeping women healthy. - Franciscan's Hospice Care Services provide a sense of dignity and compassion to both the patient and their family in caring for patients with a life expectancy of six months or less. Our programs affirm and celebrate life and regard dying as a natural process, recognizing that every person has the right to die with dignity, peace, and comfort regardless of their ethnic, faith background, or ability to pay. - Level III NICU - Ambulance Service - Physician Services - Residential Treatment Program for Adolescents - St. Monica Home for pregnant teens - Emergency Services - Inpatient Psychiatric Units - Palliative Care Services - Indigent Health Care Clinics. - Health and Wellness Centers and Healthy Living Education Centers. - Clinical care coordinators to support Franciscan's various Accountable Care Organizations which are designed to improve quality and reduce cost. - Community Outreach and Education Programs including: Health Fairs, Free Health Screenings, Free Immunizations, Free Breast Health Screening Services, Free Prostrate Screenings, Free Skin Cancer Screenings, Free Cervical Cancer Screenings, Free Glucose Screenings, Free Cholesterol Screenings, Free Bone Density Screenings, Free Lung Screenings, Free Spa Services for Cancer Patients, Online Health Condition Assessment Tools, Cancer Prevention Activities, Cancer Survivor Programs and Retreats, Cancer and Heart Care Clinical Symposiums, Health Care Decision-Making Sessions, Senior Health Education, Diabetes Management Education and Activities, Pain Management Seminars and Activities, Cardiac Risk Factors Educational Sessions and Online Tools, Hospice and Palliative Care Counseling and Education Services, Alzheimer Support Services, Behavioral Health Community Education, Smoking Cessation Programs, Mobile Dental Clinics, Basic Life-Saving Skills Programs, Children's Health Needs Activities, Childhood Obesity Activities, Weight Loss Education, Organ and Tissue Donation Fairs, Volunteer Advocates for Seniors, Parenting Programs, Residential Support Program for Pregnant Girls, Prenatal 'Baby Showers', Athletic Training (Schools and Various Marathons), Orthopedic Road Shows, Flu Vaccinations, Child Seat Safety Programs, Bereavement Support Groups, Community Education Lectures, Indigent Prescription Programs, Sex Can Wait Programs, Caregivers Educati
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 expensesMediumBullet2,152,118,125
Form 990 (2013)
Form 990 (2013)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III............................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
Yes
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II.................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
2,334
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
20,263
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletBR , CI , CH , CO , EZ , HU , ID , IS , KS , MY
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
16
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
13
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IL , IN
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletMARGUERITE EICHELBERGER1515 DRAGOON TRAILMISHAWAKAIN465444710 (574) 254-6268
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) SISTER M ALINE SHULTZ........................................................................
TRUSTEE & VP OF MARKETING
 40.0
.......................5.0 		X           0 0 0
(2) SISTER M CLARE REUILLE........................................................................
TRUSTEE
 5.0
.......................0.0 		X           0 0 0
(3) SISTER ROSE AGNES PFAUTSCH........................................................................
TRUSTEE
 5.0
.......................5.0 		X           0 0 0
(4) SISTER M ANGELA MELLADY........................................................................
TRUSTEE
 5.0
.......................0.0 		X           0 0 0
(5) SISTER M MARLENE SHAPLEY........................................................................
TRUSTEE
 40.0
.......................0.0 		X           0 0 0
(6) SISTER MARILYN OLIVER........................................................................
TRUSTEE
 5.0
.......................0.0 		X           0 0 0
(7) KATHLEEN GOEPPINGER PHD........................................................................
TRUSTEE
 5.0
.......................0.0 		X           0 0 0
(8) SISTER M MADONNA ROUGEAU........................................................................
TRUSTEE & VP OF MISSION - FSJH
 40.0
.......................11.0 		X   X       0 0 0
(9) JOHN LADOWICZ........................................................................
TRUSTEE (TERM. 8/13)
 5.0
.......................0.0 		X           0 0 0
(10) SISTER JANE MARIE KLEIN........................................................................
CHAIRPERSON AND TRUSTEE
 40.0
.......................11.0 		X   X       0 0 0
(11) SISTER M ANN KATHLEEN MAGIERA........................................................................
TREASURER AND TRUSTEE
 40.0
.......................6.0 		X   X       0 0 0
(12) KEVIN D LEAHY........................................................................
PRESIDENT AND TRUSTEE
 40.0
.......................11.0 		X   X       1,645,804 0 482,013
(13) DONALD J KERNER MD........................................................................
TRUSTEE
 5.0
.......................0.0 		X           0 0 0
(14) JAIRO CRUZ MD........................................................................
PHYSICIAN (UNPAID TRUSTEE)
 40.0
.......................0.0 		X           222,611 0 18,868
(15) ERNEST IANNOTTA........................................................................
TRUSTEE
 5.0
.......................0.0 		X           0 0 0
(16) JAMES MONKS MD........................................................................
TRUSTEE
 5.0
.......................0.0 		X           0 0 0
(17) KENNETH HERLIN........................................................................
TRUSTEE (APPOINTED 10/13)
 5.0
.......................0.0 		X           0 0 0
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) ROBERT E MCBRIDE MD........................................................................
EMERITUS TRUSTEE
 0.0
.......................0.0 		X           0 0 0
(19) SISTER LETHIA MARIE LEVEILLE........................................................................
SECRETARY
 40.0
.......................6.0 		    X       0 0 0
(20) EUGENE C DIAMOND........................................................................
REGIONAL CEO NIR
 40.0
.......................0.0 		      X     889,951 0 190,066
(21) ROBERT J BRODY........................................................................
REGIONAL CEO CIR
 40.0
.......................0.0 		      X     891,719 0 252,575
(22) JENNIFER P MARION........................................................................
SENIOR VP FINANCE, CFO
 40.0
.......................0.0 		      X     749,788 0 51,641
(23) TERRANCE E WILSON........................................................................
REGIONAL CEO WIR
 40.0
.......................0.0 		      X     672,816 0 83,304
(24) SETH CR WARREN........................................................................
REGIONAL CEO SSCR
 40.0
.......................6.0 		      X     670,847 0 22,987
(25) LOUIS METZMAN MD........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   983,466 0 32,450
(26) DAVID RUSKOWSKI........................................................................
HOSPITAL PRESIDENT
 40.0
.......................0.0 		        X   1,352,884 0 -25,002
(27) DANIEL G SPOMAR MD........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   1,054,105 0 14,595
(28) NADEEM IKHLAQUE MD........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   1,030,435 0 29,957
(29) ROWLAND O MBAOMA MD........................................................................
PHYSICIAN
 40.0
.......................0.0 		        X   1,051,774 0 19,504


1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 11,216,200 0 1,172,958
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet1,293
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
LEIDOS HEALTH LLC, PO BOX 223866PITTSBURGHPA152512866 IT CONSULTING 11,774,437
METT THERAPY, 801 SOUTH BRIGGS STREET SECOND FLOJOLIETIL60433 THERAPY SERVICES 7,019,798
NORTHSTAR ANESTHESIA OF INDIANA LLC, PO BOX 612364DALLASTX752612364 ANESTHESIA SERVICES 6,793,535
BEACON PARTNERS INC, 97 LIBBEY PARKWAY SUITE 310WEYMOUTHMA02189 IT CONSULTING 4,030,771
PRICEWATERHOUSECOOPERS LLP, PO BOX 75647CHICAGOIL606755647 ACCOUNTING/AUDITING 3,299,377
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet160
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 4,930,350
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		29,997
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 4,960,347
Program Service RevenueAmt Business Code
2a PATIENT AND OTHER REVENUES 900099 2,395,717,582 2,394,585,619 1,131,963  
b PREMIUM REVENUE 900099 88,584,884 88,584,884    
c MEANINGFUL USE 812300 14,628,178 14,628,178    
d CAFETERIA 722514 5,491,949     5,491,949
e LAUNDRY 900099 2,152,459   2,152,459  
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 2,506,575,052
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 66,916,239   -1,453,683 68,369,922
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 8,172,496  
b Less: rental expenses 4,050,151  
c Rental income or (loss) 4,122,345 0
d Net rental income or (loss).......MediumBullet 4,122,345     4,122,345
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 23,000 6,513,015
b Less: cost or other basis and sales expenses 0 4,035,253
c Gain or (loss) 23,000 2,477,762
d Net gain or (loss)..........MediumBullet 2,500,762     2,500,762
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
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...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a 305,803
b Less: cost of goods sold ..b 244,746
c Net income or (loss) from sales of inventory..MediumBullet 61,057     61,057
Miscellaneous Revenue Business Code
11a OTHER OPERATING REVENUE 900099 3,446,573   3,446,573  
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 3,446,573
12 Total revenue. See Instructions......MediumBullet 2,588,582,375 2,497,798,681 5,277,312 80,546,035
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
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 21 160,000 160,000
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0 0
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0 0
4 Benefits paid to or for members 0 0
5 Compensation of current officers, directors, trustees, and key employees .... 16,140,674 8,598,975 7,541,699 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 0 0 0
7 Other salaries and wages 963,882,519 854,436,748 109,445,771 0
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 49,433,393 44,580,935 4,852,458 0
9 Other employee benefits ....... 189,406,774 158,148,311 31,258,463 0
10 Payroll taxes ........... 62,030,448 54,838,782 7,191,666 0
11 Fees for services (non-employees):        
a Management ...... 14,376,021 10,257,663 4,118,358 0
b Legal ......... 3,722,863 739,137 2,983,726 0
c Accounting ........... 2,604,388 981,893 1,622,495 0
d Lobbying ........... 524,333 3,227 521,106 0
e Professional fundraising services. See Part IV, line 17 0 0
f Investment management fees ...... 0 0 0 0
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 47,704,269 39,387,230 8,317,039 0
12 Advertising and promotion .... 15,047,671 4,368,148 10,679,523 0
13 Office expenses ....... 14,595,481 11,351,324 3,244,157 0
14 Information technology ...... 111,531,309 111,531,309 0 0
15 Royalties .. 0 0 0 0
16 Occupancy ........... 35,117,347 33,338,825 1,778,522 0
17 Travel ............ 2,815,895 1,766,061 1,049,834 0
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0 0 0 0
19 Conferences, conventions, and meetings .... 749,877 342,191 407,686 0
20 Interest ........... 37,097,100 37,097,100 0 0
21 Payments to affiliates ....... 0 0 0 0
22 Depreciation, depletion, and amortization ..... 117,506,141 101,844,283 15,661,858 0
23 Insurance .............. 25,656,410 21,518,268 4,138,142 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 MEDICAL SUPPLIES/ DRUGS 319,302,855 319,302,855 0 0
b PURCHASED SERVICES 255,075,057 208,109,720 46,965,337 0
c REPAIRS AND MAINTENANCE 32,440,385 27,012,138 5,428,247 0
d FEDERAL AND STATE UBI TAXES 455,186 0 455,186 0
e All other expenses 178,533,796 102,403,002 76,130,794  
25 Total functional expenses. Add lines 1 through 24e 2,495,910,192 2,152,118,125 343,792,067 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 0 1 0
2 Savings and temporary cash investments ......... 176,023,495 2 212,399,952
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 336,243,013 4 312,109,141
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 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
0 6 0
7 Notes and loans receivable, net ............. 265,852 7 126,119
8 Inventories for sale or use .............. 39,770,923 8 37,852,863
9 Prepaid expenses and deferred charges .......... 0 9 0
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 2,874,983,500
b Less: accumulated depreciation ..... 10b 1,294,538,550 1,536,768,498 10c 1,580,444,950
11 Investments—publicly traded securities .......... 1,556,826,786 11 1,684,514,497
12 Investments—other securities. See Part IV, line 11 ..... 134,488,493 12 132,238,117
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ............... 39,900,666 14 35,663,781
15 Other assets. See Part IV, line 11 ........... 188,644,174 15 164,492,531
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 4,008,931,900 16 4,159,841,951
Liabilities 17 Accounts payable and accrued expenses ......... 152,558,456 17 140,434,069
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 0
20 Tax-exempt bond liabilities ............. 1,091,522,183 20 1,075,956,068
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
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.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 4,616,535 24 3,397,159
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.................... 844,122,157 25 439,451,620
26 Total liabilities. Add lines 17 through 25......... 2,092,819,331 26 1,659,238,916
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 1,909,434,724 27 2,483,050,816
28 Temporarily restricted net assets ........... 612,232 28 4,251,943
29 Permanently restricted net assets ........... 6,065,613 29 13,300,276
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet 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 ........... 1,916,112,569 33 2,500,603,035
34 Total liabilities and net assets/fund balances ........ 4,008,931,900 34 4,159,841,951
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
2,588,582,375
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
2,495,910,192
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
92,672,183
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
1,916,112,569
5
Net unrealized gains (losses) on investments ...............
5
154,445,102
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
337,373,181
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
2,500,603,035
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
FRANCISCAN ALLIANCE INC
 
Employer identification number

35-1330472
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.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
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)
 
 
h
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
Yes No Yes No Yes No
Total  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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).  
12
12
 
13
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
14
14
0 %
15
15
0 %
16a
b
17a
b
18
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. 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) 2013

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Name of the organization
FRANCISCAN ALLIANCE INC
 
Employer identification number

35-1330472
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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
Special Rules
......................... 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 its Form 990PF, Part I, line 2, 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 2
Name of organization
FRANCISCAN ALLIANCE INC
  		Employer identification number

35-1330472
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, RESTRICTEDRESTRICTED

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 3
Name of organization
FRANCISCAN ALLIANCE INC
  		Employer identification number

35-1330472
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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 4
Name of organization
FRANCISCAN ALLIANCE INC
  		Employer identification number

35-1330472
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 (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2013)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
FRANCISCAN ALLIANCE INC
 
Employer identification number

35-1330472
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2013

Schedule C (Form 990 or 990-EZ) 2013
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2013


Schedule C (Form 990 or 990-EZ) 2013
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
39,720
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
279,093
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
205,520
j
Total. Add lines 1c through 1i ...............................
524,333
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
No
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
SCHEDULE C, PART IV Franciscan Alliance, Inc. ("FRANCISCAN") engages in insubstantial amounts of lobbying activities. FRANCISCAN makes grants to other organizations that lobby on its behalf including various health and hospital associations. FRANCISCAN also engages in direct contact with legislators and their staffs on topics related to FRANCISCAN's healthcare mission.
Schedule C (Form 990 or 990EZ) 2013

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
FRANCISCAN ALLIANCE INC
 
Employer identification number

35-1330472
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .......................................
9
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.
1a
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.
b
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 $  
2
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:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?........
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
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 .... 6,065,614 9,226,856 8,975,779 15,030,221 14,207,054
b Contributions ........   15,000     568,167
c Net investment earnings, gains, and losses 317,000 -34,000 274,000 267,000 255,000
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		-6,917,661 3,142,242 22,923 6,321,442  
f Administrative expenses ....          
g End of year balance ...... 13,300,275 6,065,614 9,226,856 8,975,779 15,030,221
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. 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 .................   109,424,030 109,424,030
b Buildings ................   1,121,889,784 607,806,541 514,083,243
c Leasehold improvements ............   47,963,466 20,501,640 27,461,825
d Equipment ................   1,507,153,891 648,346,376 858,807,515
e Other .................   88,552,329 17,883,992 70,668,337
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 1,580,444,950
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (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.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. 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.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
DUE TO THIRD PARTY PAYORS 29,043,479
ACCRUED PAYROLL 115,044,836
OTHER SHORT & LONG TERM LIABIL 111,468,773
ACCRUED PROF & GEN'L LIABILITY 13,097,785
ACCRUED PENSION LIABILITY 106,274,436
SWAP VALUATION 58,490,928
ACCRUED INTEREST PAYABLE 6,031,383


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 439,451,620
2. Liability for uncertain tax positions 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) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 3,071,470,575
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a 154,445,102
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 324,392,947
e Add lines 2a through 2d ..................... 2e 478,838,049
3 Subtract line 2e from line 1..................... 3 2,592,632,526
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 -4,050,151
c Add lines 4a and 4b....................... 4c -4,050,151
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 2,588,582,375
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 2,499,960,343
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 4,050,151
e Add lines 2a through 2d...................... 2e 4,050,151
3 Subtract line 2e from line 1..................... 3 2,495,910,192
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 2,495,910,192
Part XIII
Supplemental Information
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.
Return Reference Explanation
PART V, LINE 4 FRANCISCAN ALLIANCE, INC. USES ITS ENDOWMENT FUNDS FOR CAPITAL EXPENDITURES FOR EQUIPMENT, CAPITAL PROJECTS, OR OTHER CAPITAL NEEDS; MEDICAL EDUCATION PROGRAMS; AND HEALTH CARE PROGRAMS FOR MEDICAL AND PATIENT SERVICES IN ACCORDANCE WITH ANY STIPULATED DONOR RESTRICTIONS.
PART XI, LINE 2D EQUITY IN EARNINGS OF AFFILIATES $ 9,843,021 MINORITY INTEREST IN AFFILIATES (20,108,963) OTHER COMPREHENSIVE INCOME 307,308,328 DIVIDENDS RECEIVED FROM AFFILIATES 127,125 NET ASSETS RELEASED FOR OPERATIONS 1,614,362 NET ASSETS RELEASED FROM RESTRICTION (1,619,133) EQUITY TRANSFERS TO/FROM AFFILIATES 9,019,295 OTHER CHANGES IN NET ASSETS 18,208,912 ------------- TOTAL REVENUE/EXPENSE ON BOOKS NOT ON RETURN 324,392,947
PART XI, LINE 4B RENT EXPENSE $ (4,050,151) ----------- TOTAL EXPENSE ON RETURN NOT ON BOOKS (4,050,151)
PART XII, LINE 2D RENT EXPENSE $ 4,050,151 ----------- TOTAL EXPENSE ON RETURN NOT ON BOOKS 4,050,151
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
FRANCISCAN ALLIANCE INC
 
Employer identification number

35-1330472
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers.Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? ...............................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
Central America and the Caribbean     Investments   13,841,289
Europe (Including Iceland and Greenland)     Investments   5,302,593
North America     Investments   5,186,805
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     24,330,687
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     24,330,687
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2013
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
FRANCISCAN ALLIANCE INC
 
Employer identification number

35-1330472
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    93,613,679 0 93,613,679 3.750 %
b Medicaid (from Worksheet 3,
column a) .... 		    281,333,491 172,096,323 109,237,168 4.380 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		    757,884 0 757,884 0.030 %
d Total Financial Assistance
and Means-Tested
Government Programs . 		    375,705,054 172,096,323 203,608,731 8.160 %
Other Benefits
     4,988,389 319,808 4,668,581 0.190 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    18,782,916 5,932,678 12,850,238 0.510 %
g Subsidized health services
(from Worksheet 6) .. 		    159,381,659 115,519,085 43,862,574 1.760 %
h Research (from Worksheet 7)     1,349,131 0 1,349,131 0.050 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    2,169,890 3,685 2,166,205 0.090 %
j Total. Other Benefits ..     186,671,985 121,775,256 64,896,729 2.600 %
k Total. Add lines 7d and 7j .     562,377,039 293,871,579 268,505,460 10.760 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     323   323  
2 Economic development     2,500   2,500  
3 Community support     8,597   8,597  
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building     54,751   54,751  
7 Community health improvement advocacy     44,114   44,114  
8 Workforce development     4,416,882 3,485,780 931,102 0.040 %
9 Other     1,157   1,157  
10 Total     4,528,324 3,485,780 1,042,544 0.040 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
103,921,308
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
656,895,552
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
929,625,722
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-272,730,170
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1SEE PART VI
  		       
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?13
Name, address, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 FRANCISCAN ST FRANCIS HEALTH -
INDIANAPOLIS 8111 SOUTH EMERSON AV
INDIANAPOLIS,IN46217
WWW.FRANCISCANALLIANCE.ORG/HOSPITALS
11-004972-1 		X X   X     X X    
2 FRANCISCAN ST ANTHONY HEALTH -
CROWN POINT 1201 SOUTH MAIN STREET
CROWN POINT,IN46307
WWW.FRANCISCANALLIANCE.ORG/HOSPITALS
14-005107-1 		X X         X      
3 FRANCISCAN ST MARGARET HEALTH -
HAMMOND 5454 HOHMAN AVENUE
HAMMOND,IN46320
WWW.FRANCISCANALLIANCE.ORG/HOSPITALS
14-005004-1 		X X   X     X      
4 FRANCISCAN ST MARGARET HEALTH -
DYER 24 JOLIET STREET
DYER,IN46311
WWW.FRANCISCANALLIANCE.ORG/HOSPITALS
14-005080-1 		X X   X     X      
5 FRANCISCAN ST JAMES HEALTH -
CHICAGO HEIGHTS 1423 CHICAGO ROAD
CHICAGO HEIGHTS,IL60411
WWW.FRANCISCANALLIANCE.ORG/HOSPITALS
0002436 		X X   X     X      
6 FRANCISCAN ST ELIZABETH HEALTH -
LAFAYETTE 1701 S CREASY LANE
LAFAYETTE,IN47905
WWW.FRANCISCANALLIANCE.ORG/HOSPITALS
14-005096-1 		X X         X      
7 FRANCISCAN ST ANTHONY HEALTH -
MICHIGAN CITY 301 W HOMER STREET
MICHIGAN CITY,IN46360
WWW.FRANCISCANALLIANCE.ORG/HOSPITALS
14-005015-1 		X X   X     X X    
8 FRANCISCAN ST JAMES HEALTH -
OLYMPIA FIELDS 20201 SOUTH CRAWFOR
OLYMPIA FIELDS,IL60461
WWW.FRANCISCANALLIANCE.ORG/HOSPITALS
0005074 		X X   X     X      
9 FRANCISCAN ST FRANCIS HEALTH -
MOORESVILLE 1201 HADLEY ROAD
MOORESVILLE,IN46158
WWW.FRANCISCANALLIANCE.ORG/HOSPITALS
14-005052-1 		X X   X     X      
10 FRANCISCAN ST ELIZABETH HEALTH -
LAFAYETTE CENTRAL 1501 HARTFORD ST
LAFAYETTE,IN47904
WWW.FRANCISCANALLIANCE.ORG/HOSPITALS
14-005003-1 		X X         X      
11 FRANCISCAN ST ELIZABETH HEALTH -
CRAWFORDSVILLE 1710 LAFAYETTE ROAD
CRAWFORDSVILLE,IN47933
WWW.FRANCISCANALLIANCE.ORG/HOSPITALS
14-005021-1 		X X         X      
12 FRANCISCAN HEALTHCARE - MUNSTER
701 SUPERIOR STREET
MUNSTER,IN46321
WWW.FRANCISCANALLIANCE.ORG/HOSPITALS
14-005615-1 		X X   X            
13 FRANCISCAN ST FRANCIS HEALTH -
CARMEL 12188-B N MERIDIAN STREET
CARMEL,IN46032
WWW.FRANCISCANALLIANCE.ORG/HOSPITALS
13-012826-1 		X X                
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FSMH - DYER
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		4
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FSMH - HAMMOND
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		3
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FRANCISCAN HEALTHCARE - MUNSTER
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		12
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FSAH - CROWN POINT
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		2
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FSAH - MICHIGAN CITY
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		7
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4   No
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FSJH - CHICAGO HEIGHTS
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		5
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FSJH - OLYMPIA FIELDS
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		8
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FSEH - LAFAYETTE CENTRAL
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		10
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FSEH - LAFAYETTE EAST
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		6
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FSEH - CRAWFORDSVILLE
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		11
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4   No
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FSFH - INDIANAPOLIS
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FSFH - MOORESVILLE
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		9
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
FSFH - CARMEL
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		13
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
IN THIS SECTION, THE FOLLOWING ABBREVIATIONS ARE USED TO REFERENCE THE hospital facilities operated by Franciscan Alliance, Inc.: Franciscan St. Francis Health - Indianapolis: FSFH-Indianapolis Franciscan St. Anthony Health - Crown Point: FSAH-Crown Point Franciscan St. Margaret Health - Hammond: FSMH-Hammond Franciscan St. Margaret Health - Dyer: FSMH-Dyer Franciscan St. James Health - Chicago Heights: FSJH-Chicago Heights Franciscan St. Elizabeth Health - Lafayette: FSEH-Lafayette East Franciscan St. Anthony Health - Michigan City: FSAH-Michigan City Franciscan St. James Health - Olympia Fields: FSJH-Olympia Fields Franciscan St. Francis Health - Mooresville: FSFH-Mooresville Franciscan St. Elizabeth Health - Lafayette Central: FSEH-Lafayette Central Franciscan St. Elizabeth Health - Crawfordsville: FSEH-Crawfordsville Franciscan Healthcare - Munster: FH-Munster Franciscan St. Francis Health - Carmel: FSFH-Carmel LINE 3: FSMH-DYER, FSMH-HAMMOND, FSAH-CROWN POINT, FH-MUNSTER INPUT FROM INDIVIDUALS IN THE COMMUNITY: An independent, third party was retained to conduct the community assessment and a part of that work was the facilitation of several Focus Groups designed to have in-person exchange and information gathering about community health needs, including needs of low income, minorities and the uninsured. The following individuals attended and contributed to that information gathering opportunity: Dr. Janet Seabrook - Executive Director, Gary Community Health Center Dr. Janice Zunich, Indiana University School of Medicine Dr. Mark Feldner, Community Care Network Dr. Lisa Green - CEO, Family Christian Health Centers Janice Wilson - CEO, North Shore Health Centers Olga Gonzales - Manager, Women's Care Center of NWI Tracy Tucker - School Nurse, Eggers Middle School Duane Dedalow - Executive Director, Catholic Charities Diocese of Gary Gordon Johnson - CEO, American Red Cross of NWI Gary Olund - President, Northwest Indiana Community Action Grace Talbot - Director, Hammond Rescue Mission Jane Bisbee - Regional Manager, Child Protective Services Lou Martinez - President, Lake Area United Way Gilda Orange - Trustee, North Township Tom DeGuilio - Town Manager, Munster LINE 3: FSAH-MICHIGAN CITY INPUT FROM INDIVIDUALS IN THE COMMUNITY: A survey of community opinion leaders was conducted soliciting input regarding community health needs. Individuals contributing to this information resource included: Ed Merrion - Housing Program Manager, Catholic Charities Kathy Dennis - Commission on Women George Kucka - President, Fair Meadows Home Health Center Terese Fabbri - Friend of the Open Door Health Center Fred McNulty - EVP, HR Dimensions Deborah Chugg - Executive Director, Imagination Station (behavioral medicine) Patricia Pease - Administrator, LaPorte County Emergency Medical Services Cathy Ellis - Life Care Center of Valparaiso W. Faye Moore - VP, Michigan City Women's Commission/NAACP Deborah Briggs - Program Director, Open Door Adolescent Health Center Tyra Walker - Samaritan Center and LaPorte County Jail Cee Cee Taylor - Executive Director, Samaritan Counseling Center Terri Phillips - Executive Director, Life Care of MICHIGAN CITY (SKILLED NURSING FACILITY) Gerry Jones - Executive Director, Stepping Stone Shelter for Women Steve Birnth - Executive Director, Youth Service Bureau LINE 3: FSJH-CHICAGO HEIGHTS, FSJH-OLYMPIA FIELDS INPUT FROM INDIVIDUALS IN THE COMMUNITY: A community wide survey was conducted by a third party in collaboration with many hospitals coordinated by the Chicago Metropolitan Hospital Council. Subsequent to that community survey the same third party conducted a series of Focus Groups, specific to each participating hospital, comprised of individuals representing various sectors of the service area population including: public health; low income; minorities; medically underserved; chronic disease services; and more. Individuals providing input via the focus groups included: Apostle Carl White, Jr. - Victory International Christian Ministries Deborah Harper - Community and Economic Development Association, Chicago Heights Marianne Bithos - National Alliance on Mental Illness, South Suburbs of Chicago Mary Pat Ambrosino - Southwest Community Services, Tinley Park (services for the disabled) Yvonne Orr - South/Southwest Suburban United Way LINE 3: FSEH-LAFAYETTE EAST, FSEH-LAFAYETTE CENTRAL INPUT FROM INDIVIDUALS IN THE COMMUNITY: A community survey was conducted, followed by a review of results by a cross section of community representatives. That review resulted in conducting an Opinion Leader survey of approximately 200 individuals to add more information regarding priorities. Finally, individual interviews were conducted with the following individuals to further solicit direct input from their respective experiences and knowledge: John Dennis - Mayor, West Lafayette Tom Murtaugh - President of the County Council Sheila Klinker - Indiana State Representative Ronnie Alting - Indiana State Senator Randy Truitt - Indiana State Representative Brandt Hershman - Indiana State Senator Gary Henriott - Chairman and CEO, Henriott Group Trish Hauber - HR Manager, Caterpillar, Inc. Julia Cole - HR MANAGER, Subaru Veronique LeBlanc - President, Riggs Community Health Center Pam Biggs-Reed - CEO, Bauer Center (Head Start and Counseling Center) Marilyn Redmon - CEO, Right Steps Child Development Centers Ron Cripe - Tippecanoe County Health Department Barry Richards - Boys and Girls Club James Taylor - EXECUTIVE DIRECTOR, United Way of Greater Lafayette and Tippecanoe County Joe Seaman - President, Greater Lafayette Chamber of Commerce Cheryl Ubelhor - Program Manager, Community Foundation of Greater Lafayette Scott Hanback - Superintendent, Tippecanoe Schools Eric Davis - President, Lafayette Catholic School Corp. Rocky Killian - Superintendent, West Lafayette Schools Jane Kirkpatrick - Dean, Purdue School of Nursing Anita Reed - St. Elizabeth School of Nursing LINE 3: FSEH-CRAWFORDSVILLE INPUT FROM INDIVIDUALS IN THE COMMUNITY: A community wide survey was conducted, followed by an opinion leader survey. The opinion leaders were then interviewed for focused input. The individuals from whom input was gained are: Robert Cook - Abilities services Todd Barton - Mayor, City of Crawfordsville Fawn Johnson - Crawfordsville Community Center Joanie Crum - Division of Family and Children Phil Wray - FISH Clothes Closet/Food Pantry Brenda Deckard - Friendship Kitchen/HUB Ministries Denise Maxwell - Montgomery County American Red Cross Kelly Taylor - Montgomery County Community Foundation Cheryl Kiem - Montgomery County Community Foundation Jan Sears - St. Bernard Catholic Church Dave Peach - WCVL/WIMC/WCDQ (broadcasting) Joy Dugan - Purdue University Extension Service Deanna Durett - Montgomery County Commissioner Tina McGrady - Editor, Crawfordsville Journal Review Rich Holtz - The Paper of Montgomery County Amber Reed - Montgomery County Health Department Bill Doemel - Mary Ludwig Free Clinic LINE 3: FSFH-INDIANAPOLIS, FSFH-MOORESVILLE, FSFH-CARMEL INPUT FROM INDIVIDUALS IN THE COMMUNITY: A community survey was conducted followed by a survey of opinion leaders. Additionally, interviews were conducted with a variety of community leaders and people knowledgeable in the areas of public health and the needs of target populations. The individuals interviewed include the following: Robert Lyons - Church Odyssey Thomas Zoss - Executive Director, Community Foundation of Morgan County Betty Pedigo - Site Manager, Eskenazi Medical Group (a provider to low income and minorities) Marjorie Porter - Executive Director, Good Shepherd Clinic Mary Kay Mitchell - Horizon House Norman Connell - Board Member, Kendrick Foundation Michael Crosley - Executive Director, Life Bridge Community Julia Brillhart - VP, Magellan Health Joni Collins - Executive Director, Martin Luther King Community Center Dennis Payton - Pastor, Mooresville First United Methodist Church Debra Page - Mooresville Schools M. Cloud - Supervisor, Noble of Indiana Joseph Donahue - Sycamore Services Lydia Rychtarczyk - Director, Tomorrow's Promise Pre-school Pamela Taylor - EMS, Westfield Fire Department Additional Individuals providing information through means other than an interview: Mark Lindenlaub - Executive Director, Aging and Community Services of So. Central Indiana Carla Marchbanks - Director, Beech Grove Senior Citizens Center Rick Whitten - Executive Director, Boys and Girls Clubs of Indianapolis Elaisa Vahnie - Executive Director, Burmese American Community Julie Heger - Case Manager, Children's Bureau Frank Mascari - City-County Council Member Stephen Rink - Trustee, Decatur Township Nancy Beals - Drug Free Marion County Bud Swisher - Executive Director, Healthier Morgan County Initiative Beth Ann Leach - Executive Director, Hendricks County Senior Services Doug Bush - Executive Director, Indiana Dental Association Ann Alley - Director, Primary Care, Indiana State Department of Health Jane Zobel - Social Worker, Indianapolis Public Schools Glen
LINE 4: FSMH-DYER, FSMH-HAMMOND, FSAH-CROWN POINT, FH-MUNSTER CHNA CONDUCTED WITH ONE OR MORE OTHER FACILITIES: Franciscan St. Margaret Health-Dyer, Franciscan St. Margaret Health-Hammond, Franciscan St. Anthony Health-Crown Point, and Franciscan Healthcare-Munster are part of Franciscan Alliance, Inc. who collaborated in using the same third party resource (Professional Research Consultants). These five facilities in turn collaborated with two other hospitals in the region - Community Healthcare System and Methodist Hospitals, using the same third party resource. LINE 4: FSJH-CHICAGO HEIGHTS, FSJH-OLYMPIA FIELDS CHNA CONDUCTED WITH ONE OR MORE OTHER FACILITIES: FRANCISCAN ST. JAMES HEALTH-CHICAGO HEIGHTS AND FRANCISCAN ST. JAMES HEALTH-OLYMPIA FIELDS ARE PART OF Franciscan Alliance, Inc. who collaborated in using the same third party resource (Professional Research Consultants). Franciscan St. James Health-Chicago Heights and Franciscan St. James Health-Olympia Fields COORDINATED with a number of other hospitals as part of a coordinated program sponsored by the Metropolitan Chicago Hospital Council using the services of a third party, Professional Research Consultants. LINE 4: FSEH-LAFAYETTE EAST, FSEH-LAFAYETTE CENTRAL CHNA CONDUCTED WITH ONE OR MORE OTHER FACILITIES: FSEH-Lafayette East and FSEH-Lafayette Central are part of Franciscan Alliance, Inc. who collaborated in using the same third party resource (Professional Research Consultants). A community survey was conducted jointly with Franciscan St. Elizabeth Health-Lafayette East, Franciscan St. Elizabeth Health-Lafayette Central, the county health department, and Indiana University Arnett Hospital. LINE 4: FSFH-INDIANAPOLIS, FSFH-MOORESVILLE, FSFH-CARMEL CHNA CONDUCTED WITH ONE OR MORE OTHER FACILITIES: FSFH-INDIANAPOLIS, FSFH-MOORESVILLE, and FSFH-CARMEL are part of Franciscan Alliance, Inc. who collaborated in using the same third party resource (Professional Research Consultants). ALL CHNA RELATED ACTIVITIES WERE A JOINT EFFORT BETWEEN FRANCISCAN ST. FRANCIS HEALTH-INDIANAPOLIS, FRANCISCAN ST. FRANCIS HEALTH-MOORESVILLE, AND FRANCISCAN ST. FRANCIS HEALTH-CARMEL. LINE 5: ALL FACILITIES ALL 13 hospital's CHNAS ARE AVAILABLE ON FRANCISCAN ALLIANCE'S WEBSITE AT: HTTP://WWW.FRANCISCANALLIANCE.ORG/COMMUNITY/COMMUNITY-NEEDS-ASSESSMENT/ANN UAL-REPORT/PAGES/DEFAULT.ASPX
LINE 7: FSMH-DYER, FSMH-HAMMOND NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Access to health care services - The hospitals already operate a community clinic (Mother McAuley Clinic) to serve under and uninsured; operate physician practices that accept all patients; expect provisions of the Affordable care Act will improve access via Medicaid and employer insurance expansion. B. Cancer of the breast, cervix, colon and prostate - identified as being of higher incidence and being addressed through other, established programs and through gradually improving underlying social issues. C. Chlamydia Incidence Rate - As a Catholic organization we are limited by the Ethical and Religious Directives as to what we can do regarding the use of contraceptives. D. Chronic Kidney Disease - developing a program to improve diabetes management, which is an underlying cause of kidney disease. E. High Use of ER - Various new programs initiated as part of Franciscan's ACO, also we operate several Urgent Care centers and have expanded to include new sites. F. Injury and Violence Prevention - We regard this as primarily a task of the public sector as we do not have expertise or resources to develop and sustain programs. G. Maternal, Infant and Child Health - A robust program needs neo-natal resources we do not have. We do already offer some services through our community clinic and through our St. Monica Home for unwed mothers. H. Oral Health - we do not have dental services, staff, resources or expertise to meet this need. I. Social and Economic Factors - there are a variety of conditions including education, transportation, employment, crime, etc., which are obligations of government to address as we do not have needed expertise, funding, resources or experience to address. LINE 7: FSAH-MICHIGAN CITY NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Access to Health Services - The hospital already works closely with established Federally Qualified Health Centers in the community; operates physician practices that accept all patients; expect the provisions of the Affordable Care Act to improve access via Medicaid and employer expansion of insurance coverage. B. Maternal Infant and Child Health - some needs are served through Women's Care Center; limited capability in neo-natal care; shortage of physician staff with whom to partner. C. Homelessness - hospital does not have expertise in this area. D. Mental Health - limited resources (no psychiatric services) plus the existence of several other mental health resources in the community. E. Nutrition, Fitness/Life Style - existing programs address some of these needs plus the programs selected for development (diabetes and cardiovascular) will include emphasis on these factors for improved health. F. Tobacco Use - existing programs address this need plus, other community programs emphasize this problem; plus, the heart failure program that is a CHNA selection will include smoking cessation. LINE 7: FH-Munster NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Access to Care - Franciscan Alliance already operates a clinic for the under and uninsured population in the geographic area. The hospital does not operate an ER and expect that the provisions of the Affordable Care Act will improve access via Medicaid and employer expansion of insurance coverage. B. Preventable hospitalizations - Franciscan's ACO is working toward addressing this problem and there are other targeted programs addressing re-admissions. C. Maternal and Child Health - the hospital does not offer any obstetric or pediatric services and thus, does not have the resources or expertise typical for such programs. D. Adult Immunizations - other community resources and physician offices address this need. E. Asthma - due to our limited services we do not have the resources or expertise typical for such programs. F. Health Education - it was decided that broad-based health education is available from many sources. However, targeted health education in the areas of Diabetes and colon disease will be part of the selected CHNA programs provided. G. Substance Abuse - other programs are currently available in the community to address the need. H. Oral Health - the hospital does not have the expertise or resources required for this service. I. Nutrition, Physical Activity/Life-style - targeted effort will be a part of the diabetes program being developed; plus, other community programs are very active regarding this need. J. Mental Health - other community services are available and another Franciscan hospital that is part of this Form 990 already provides a variety of inpatient and outpatient mental health programs. K. Heart Disease and Stroke - existing services in our hospital address some of these needs and another Franciscan hospital that is part of this Form 990 already offers services specific to these needs and they are developing more targeted programs in their CHNA efforts. LINE 7: FSAH-CROWN POINT NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Access to Health Services - the hospital already operates a clinic (St. Clare Health Clinic) to serve the under and uninsured population. People can also access a Federally Qualified Health Clinic in the area; the hospital also operates physician practices that accept all patients; and expect that the provisions of the Affordable Care Act will improve access via Medicaid and employer insurance expansion. B. Cancer Care - several existing programs that focus on several types of cancer address many of the cancer needs of the community. C. Family Planning (teen births) - existing programs in the hospital and the community are addressing this need. D. Injury and Violence Prevention - we regard this as primarily a task of the public section as we do not have expertise, staff or funding. E. Mental Health - there are existing services in the area for both inpatient and outpatient mental health needs. F. Substance Abuse - existing programs in the community address these needs. LINE 7: FSJH-CHICAGO HEIGHTS NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Cancer - programs already in place address colonoscopy and mammography screening so it was decided that resources would be directed toward other needs. B. Chronic Kidney Disease - Franciscan St. James Health-Olympia Fields is developing a program that addresses diabetes, which is a major cause of kidney disease. Thus, rather than duplicate that effort, it was not selected for development at Franciscan St. James Health-Chicago Heights. C. Maternal, Infant and child health - This need is being addressed currently by a partner Federally Qualified Health Center and thus, was not selected for development. D. Mental Health - Other community and regional organizations are addressing this need plus, we do not have expertise or resources to adequately develop effective programs. E. Respiratory Disease - Existing inpatient and outpatient services address this need and thus, it was not selected for further development. F. Injury and Violence Prevention - This need is seen as being more appropriately met by other public resources plus, we do not have expertise, resources or funding to adequately address this need. G. Sexually Transmitted Diseases - We are a Catholic organization and are constrained from having a comprehensive program by the Ethical and Religious Directives plus, other organizations have established programs. LINE 7: FSJH-OLYMPIA FIELDS NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Cancer - programs already in place address colonoscopy and mammography screening so it was decided that resources would be directed toward other needs. B. Chronic Kidney Disease - We are implementing a diabetes program as one of our priorities and believe that this will somewhat address this need since diabetes is a major cause of kidney disease. C. Maternal, Infant and child health - This need is being addressed currently by a partner Federally Qualified Health Center and thus, was not selected for development. D. Mental Health - Other community and regional organizations are addressing this need plus, we do not have expertise or resources to adequately develop effective programs. E. Respiratory Disease - Existing inpatient and outpatient services address this need and thus, it was not selected for further development. F. Injury and Violence Prevention - This need is seen as being more appropriately met by other public resources plus, we do not have expertise, resources or funding to adequately address this need. G. Sexually Transmitted Diseases - We are a Catholic organization and are constrained from having a comprehensive program by the Ethical and Religious Directives plus, other organizations have established programs. LINE 7: FSEH-EAST NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Obesity - existing programs address aspects of this need plus, the CHNA programs in diabetes and congestive heart failure selected for development
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?167
Name and address Type of Facility (describe)
1 IIMC
701 E COUNTY LINE ROAD SUITE 101
GREENWOOD,IN46143 		PHYSICIAN PRACTICE
2 INDIANA ORTHOPEDIC SURGERY CENTER
5255 E STOP 11 ROAD SUITE 110
INDIANAPOLIS,IN46237 		AMBULATORY SURGERY CENTER
3 FRANCISCAN SURGERY CENTER
5255 E STOP 11 ROAD SUITE 100
INDIANAPOLIS,IN46237 		AMBULATORY SURGERY CENTER
4 THE ENDOSCOPY CENTER AT ST FRANCIS
8051 S EMERSON AVENUE SUITE 150
INDIANAPOLIS,IN46237 		ENDOSCOPY CENTER
5 ST FRANCIS RADIATION THERAPY CENTERS
8111 S EMERSON AVENUE
INDIANAPOLIS,IN46239 		RADIATION THERAPY
6 INDIANA HEART PHYSICIANS
5330 E STOP 11 ROAD
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
7 FRANCISCAN PHYSICIAN NETWORK - MC
1225 E COOLSPRING AVENUE
MICHIGAN CITY,IN46360 		PHYSICIAN PRACTICE
8 SOUTH EMERSON SURGERY CENTER
8141 S EMERSON AVENUE SUITE C
INDIANAPOLIS,IN46237 		AMBULATORY SURGERY CENTER
9 COOPERATIVE MANAGED CARE SERVICES
9045 RIVER ROAD SUITE 250
INDIANAPOLIS,IN46240 		MANAGED CARE
10 INDIANA BLODD AND MARROW TRANSPLANTATION
1500 ALBANY STREET SUITE 911
BEECH GROVE,IN46107 		BLOOD AND MARROW TRANSPLANT
11 FRANCISCAN ST JAMES HEALTH-HOME HEALTH
1400 OTTO BOULEVARD
CHICAGO HEIGHTS,IL60411 		HOME HEALTH
12 MOORESVILLE SURGERY CENTER
1215 HADLEY ROAD SUITE 100
MOORESVILLE,IN46260 		AMBULATORY SURGERY CENTER
13 FPN ORTHOPEDIC AND SPORTS MEDICINE
1702 LAFAYETTE ROAD
CRAWFORDSVILLE,IN47933 		PHYSICIAN PRACTICE
14 JOINT REPLACEMENT SURGEONS
1199 HADLEY ROAD
MOORESVILLE,IN46158 		PHYSICIAN PRACTICE
15 ONCOLOGY AND HEMATOLOGY SPECIALISTS
8111 S EMERSON AVENUE SUITE A
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
16 SOUTH INDY MRI AND REHAB
8141 S EMERSON AVENUE SUITE A
INDIANAPOLIS,IN46237 		RADIOLOGY AND PHYSICAL SERVICES
17 MOORESVILLE ENDOSCOPY CENTER
1215 HADLEY ROAD SUITE 101
MOORESVILLE,IN46158 		ENDOSCOPY CENTER
18 FRANCISCAN PHYSICIAN NETWORK
9470 BROADWAY
CROWN POINT,IN46307 		PHYSICIAN PRACTICE
19 FPN NEPHROLOGY FPN PULMONARY
2708 FERRY STREET
LAFAYETTE,IN47904 		PHYSICIAN PRACTICE
20 FRANCISCAN ST JAMES HEALTH -
HEALTH WELLNESS CENTER 100 W 197
CHICAGO HEIGHTS,IL60411 		WELLNESS CENTER
21 GREENWOOD PEDIATRIC ASSOCIATES
900 AVERITT ROAD
GREENWOOD,IN46143 		PHYSICIAN PRACTICE
22 FPN DERMATOLOGY FAMILY MEDICINE PEDS
915 SAGAMORE PARKWAY WEST
WEST LAFAYETTE,IN47906 		PHYSICIAN PRACTICE
23 ST FRANCIS IMAGING CENTER
3147 W SMITH VALLEY ROAD SUITE D
GREENWOOD,IN46143 		RADIOLOGY
24 FPN FAMILY & GERIATRIC MEDICINE
3920 ST FRANCIS WAY SUITE 209
LAFAYETTE,IN47905 		PHYSICIAN PRACTICE
25 FRANCISCAN PHYSICIAN NETWORK
1505 SOUTH COURT STREET
CROWN POINT,IN46307 		PHYSICIAN PRACTICE
26 FRANCISCAN PHYSICIAN NETWORK
12800 MISSISSIPPI PARKWAY
CROWN POINT,IN46307 		PHYSICIAN PRACTICE
27 FRANCISCAN PHYSICIAN NETWORK
2421 LAPORTE AVENUE
VALPARAISO,IN46385 		PHYSICIAN PRACTICE
28 AMER HEALTH NETWORK - MUNCIE
3631 N MORRISON ROAD
MUNCIE,IN47304 		PT, IMAGING, SURGERY
29 FPN INTERNAL MEDICINE & SURGICAL SPEC
1630 LAFAYETTE ROAD SUITE 300
CRAWFORDSVILLE,IN47933 		PHYSICIAN PRACTICE
30 FRANCISCAN PHYSICIAN NETWORK - MC
8865 W 400 NORTH
MICHIGAN CITY,IN46360 		PHYSICIAN PRACTICE
31 FPN CARDIOLOGY ELECTROPHYSIOLOGY
3900 SAINT FRANCIS WAY STE 200
LAFAYETTE,IN47905 		PHYSICIAN PRACTICE
32 AMER HEALTH NETWORK - GROUP ONE
4880 CENTURY PLAZA ROAD SUITE 100
INDIANAPOLIS,IN46254 		IMAGING
33 AMER HEALTH NETWORK - AVON
5250 E US 36 SUITE 610
AVON,IN46123 		IMAGING
34 FPN CRAWFORDSVILLE FAMILY MEDICINE
308 W MARKET STREET
CRAWFORDSVILLE,IN47933 		PHYSICIAN PRACTICE
35 FPN GREENACRES FAMILY MEDICINE
1500 DARLINGTON AVENUE SUITE 300
CRAWFORDSVILLE,IN47933 		PHYSICIAN PRACTICE
36 FRANCISCAN PHYSICIAN NETWORK - MC
1507 WABASH STREET
MICHIGAN CITY,IN46360 		PHYSICIAN PRACTICE
37 FRANCISCAN PHYSICIAN NETWORK
11161 RANDOLPH STREET
CROWN POINT,IN46307 		PHYSICIAN PRACTICE
38 SOUTHPORT FP AND SPORTS MEDICINE
7855 S EMERSON AVENUE SUITE P
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
39 FRANCISCAN PHYSICIAN NETWORK
1205 S MAIN STREET
CROWN POINT,IN46307 		PHYSICIAN PRACTICE
40 ST MARGARET MEDICAL ASSOCIATES
701 SUPERIOR AVE SUITE E
MUNSTER,IN46321 		PHYSICIAN PRACTICE
41 ALVERNO DURABLE MEDICAL EQUIPMENT
16149 SOUTH CLINTON STREET
HARVEY,IL60426 		DURABLE MEDICAL EQUIPMENT
42 IMPACT CENTER
1201 HADLEY ROAD
MOORESVILLE,IN46158 		PHYSICIAN PRACTICE
43 ST MARGARET MEDICAL ASSOCIATES
840 RICHARD ROAD
DYER,IN46311 		PHYSICIAN PRACTICE
44 BEECH GROVE FAMILY MEDICINE
2030 CHURCHMAN AVENUE
BEECH GROVE,IN46107 		PHYSICIAN PRACTICE
45 INDIANA SLEEP CENTER
701 E COUNTY LINE ROAD SUITE 207
GREENWOOD,IN46143 		SLEEP CENTER
46 FRANCISCAN PHYSICIAN NETWORK - MC
810 MICHAEL DRIVE
CHESTERTON,IN46304 		PHYSICIAN PRACTICE
47 FRANCISCAN PHYSICIAN NETWORK
CHERRY CREEK CENTER
CROWN POINT,IN46307 		PHYSICIAN PRACTICE
48 FPN NORTHRIDGE INTERNAL MEDICINE
1704 LAFAYETTE ROAD SUITE 8
CRAWFORDSVILLE,IN47933 		PHYSICIAN PRACTICE
49 DIABETES AND ENDOCRINOLOGY SPECIALISTS
5230A E STOP 11 ROAD SUITE 150
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
50 ST MARGARET MEDICAL ASSOCIATES
14785 WEST 101ST AVENUE
DYER,IN46311 		PHYSICIAN PRACTICE
51 KENDRICK FAMILY MEDICINE
1001 HADLEY ROAD SUITE 101
MOORESVILLE,IN46158 		PHYSICIAN PRACTICE
52 FPN CRAWFORDSVILLE GYNECOLOGY
407 E MARKET STREET SUITE 101
CRAWFORDSVILLE,IN47933 		PHYSICIAN PRACTICE
53 MOORESVILLE FAMILY CARE
1001 HADLEY ROAD SUITE 102
MOORESVILLE,IN46158 		PHYSICIAN PRACTICE
54 AMER HEALTH NETWORK - SLEEP (CARMEL)
12425 OLD MERIDIAN STREET SUITE A-
CARMEL,IN46032 		SLEEP CENTER
55 NEUROSURGICAL SPECIALISTS
8051 S EMERSON AVENUE SUITE 300
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
56 GRAY ROAD FAMILY MEDICINE
7825 MCFARLAND LANE SUITE A
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
57 AMER HEALTH NETWORK - FRANKLIN
1300 W JEFFERSON STREET SUITE C
FRANKLIN,IN46131 		PT, IMAGING
58 ORTHOPEDIC SPECIALISTS
5230A E STOP 11 ROAD SUITE 250
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
59 AMER HEALTH NETWORK - KOKOMO
2330 S DIXON ROAD
KOKOMO,IN46902 		IMAGING
60 CENTER GROVE FAMILY MEDICINE
362 MERIDIAN PARKE LANE
GREENWOOD,IN46142 		PHYSICIAN PRACTICE
61 SOUTH 31 FAMILY CARE
610 E SOUTHPORT ROAD SUITE 205
INDIANAPOLIS,IN46227 		PHYSICIAN PRACTICE
62 SOUTHEAST FAMILY MEDICINE
5136 E STOP 11 ROAD SUITE 30
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
63 FRANCISCAN PHYSICIAN NETWORK
2050 NORTH MAIN STREET
CROWN POINT,IN46307 		PHYSICIAN PRACTICE
64 FRANCISCAN ST JAMES HEALTH - AMBULANCE &
EMS 20201 SOUTH CRAWFORD AVENUE
OLYMPIA FIELDS,IL60461 		AMBULANCE SERVICES
65 ST MARGARET MEDICAL ASSOCIATES
8242 CALUMET AVENUE
MUNSTER,IN46321 		PHYSICIAN PRACTICE
66 VASCULAR SPECIALISTS
5255 E STOP 11 ROAD SUITE 200
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
67 ST JAMES HEALTH OUTPATIENT PHARMACY
3700 203RD STREET SUITE 108
OLYMPIA FIELDS,IL60461 		PHARMACY
68 FRANKLIN TOWNSHIP FAMILY MEDICINE
8325 E SOUTHPORT ROAD SUITE 100
INDIANAPOLIS,IN46259 		PHYSICIAN PRACTICE
69 ST MARGARET MEDICAL ASSOCIATES
1573 N CLINE AVENUE
GRIFFITH,IN46319 		PHYSICIAN PRACTICE
70 HEARTLAND CROSSING PEDIATRICS
10701 ALLIANCE DRIVE
CAMBY,IN46113 		PHYSICIAN PRACTICE
71 IRVINGTON FAMILY MEDICINE
5839 E WASHINGTON STREET
INDIANAPOLIS,IN46219 		PHYSICIAN PRACTICE
72 MAJOR HOSPITAL CARDIAC DIAGNOSTICS
150 WEST WASHINGTON STREET
SHELBYVILLE,IN46176 		CARDIOVASCULAR TESTING
73 FPN EASTSIDE FAMILY MEDICINE
2056 LEBANON ROAD
CRAWFORDSVILLE,IN47933 		PHYSICIAN PRACTICE
74 SPINE SPECIALISTS
8051 S EMERSON AVENUE SUITE 360
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
75 MADISON AVE FAMILY MEDICINE
8778 S MADISON AVENUE SUITE 200
INDIANAPOLIS,IN46227 		PHYSICIAN PRACTICE
76 AMER HEALTH NETWORK - PERU
315 W OLD KEY DRIVE IMAGING SUITE
PERU,IN46970 		IMAGING
77 HEARTLAND INTERNAL MEDICINE
10701 ALLIANCE DRIVE
CAMBY,IN46113 		PHYSICIAN PRACTICE
78 FRANCISCAN PHYSICIAN NETWORK
200 3RD COURT SE
DEMOTTE,IN46310 		PHYSICIAN PRACTICE
79 COUNTY LINE PEDIATRICS
8325 S EMERSON SUITE B1
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
80 ST MARGARET MEDICAL ASSOCIATES
5530 HOHMAN AVENUE
HAMMOND,IN46320 		PHYSICIAN PRACTICE
81 ST MARGARET MEDICAL ASSOCIATES
221 US HWY 41 SUITE I
SCHERERVILLE,IN46375 		PHYSICIAN PRACTICE
82 HONEY GROVE FAMILY MEDICINE
1711 S STATE ROAD 135 SUITE C
GREENWOOD,IN46143 		PHYSICIAN PRACTICE
83 FRANCISCAN PHYSICIAN NETWORK
297 WEST FRANCISCAN LANE SUITE 104
CROWN POINT,IN46307 		PHYSICIAN PRACTICE
84 FPN PHYSICAL MEDICINE & REHABILITATION
1012 N 14TH STREET
LAFAYETTE,IN47904 		PHYSICIAN PRACTICE
85 FPN WOMEN'S HEALTH SERVICES
1630 LAFAYETTE ROAD SUITE 200
CRAWFORDSVILLE,IN47933 		PHYSICIAN PRACTICE
86 FPN FAMILY MEDICINE - KENSINGTON
3875 KENSINGTON DRIVE
LAFAYETTE,IN47905 		PHYSICIAN PRACTICE
87 GYNECOLOGIC ONCOLOGY SPECIALISTS
5255 E STOP 11 ROAD SUITE 310
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
88 FPN NORTHSIDE FAMILY MEDICINE
1660 LAFAYETTE ROAD SUITE 170
CRAWFORDSVILLE,IN47933 		PHYSICIAN PRACTICE
89 PLAINFIELD FAMILY MEDICINE
315 DAN HONES ROAD SUITE 100
PLAINFIELD,IN46168 		PHYSICIAN PRACTICE
90 PSYCHIATRIC SPECIALISTS
610 E SOUTHPORT ROAD SUITE 200
INDIANAPOLIS,IN46227 		PHYSICIAN PRACTICE
91 FRANCISCAN PHYSICIAN NETWORK
10860 MAPLE LANE
SAINT JOHN,IN46373 		PHYSICIAN PRACTICE
92 ST MARGARET MEDICAL ASSOCIATES
3831 HOHMAN AVENUE
HAMMOND,IN46327 		PHYSICIAN PRACTICE
93 FRANCISCAN ST JAMES HEALTH CENTERS FOR
DIABETES 20201 SOUTH CRAWFORD AVEN
OLYMPIA FIELDS,IL60461 		DIABETES CLINIC
94 PLEASANT VIEW FAMILY MEDICINE
12524 SOUTHEASTERN AVENUE
INDIANAPOLIS,IN46259 		PHYSICIAN PRACTICE
95 AMER HEALTH NETWORK - EAGLE HIGHLANDS
6820 PARKDALE PLACE 105
INDIANAPOLIS,IN46254 		IMAGING
96 ST MARGARET MEDICAL ASSOCIATES
24 JOLIET STREET SUITE 101
DYER,IN46311 		PHYSICIAN PRACTICE
97 RHEUMATOLOGY & OSTEOPOROSIS SPECIALISTS
5255 E STOP 11 ROAD SUITE 320
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
98 WEIGHT LOSS SPECIALISTS
5230A E STOP 11 ROAD SUITE 190
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
99 ST MARGARET MEDICAL ASSOCIATES
10860 MAPLE LANE
ST JOHN,IN46373 		PHYSICIAN PRACTICE
100 FRANCISCAN ST JAMES HEALTH - FAMILY
HEALTH TINLEY PARK 17859 S 80TH A
TINLEY PARK,IL60477 		PHYSICIAN PRACTICE
101 FRANCISCAN PHYSICIAN NETWORK - MC
500 W BUFFALO STREET
NEW BUFFALO,MI49117 		PHYSICIAN PRACTICE
102 FRANCISCAN PHYSICIAN NETWORK
5985 EAST 1015 NORTH
ROSELAWN,IN46372 		PHYSICIAN PRACTICE
103 ST MARGARET MEDICAL ASSOCIATES
5500 HOHMAN AVENUE SUITE 2A
HAMMOND,IN46320 		PHYSICIAN PRACTICE
104 MOORESVILLE AFTER HOURS CLINIC
1001 HADLEY ROAD SUITE 101
MOORESVILLE,IN46158 		PHYSICIAN PRACTICE
105 FRANCISCAN PHYSICIAN NETWORK - MC
3340 MONROE STREET
LAPORTE,IN46350 		PHYSICIAN PRACTICE
106 FPN GATROENTEROLOGY
3218 DAUGHERTY DRIVE SUITE 140
LAFAYETTE,IN47909 		PHYSICIAN PRACTICE
107 BREAST SPECIALISTS
5255 E STOP 11 ROAD SUITE 250
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
108 INDY SOUTH AFTER HOURS CLINIC
7855 S EMERSON AVENUE SUITE P
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
109 SFMG REHABILITATION SPECIALISTS
8051 S EMERSON AVENUE SUITE 360
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
110 BEECH GROVE INTERNAL MEDICINE
2030 CHURCHMAN AVENUE
BEECH GROVE,IN46107 		PHYSICIAN PRACTICE
111 SFMG PAIN SPECIALISTS
8051 S EMERSON AVENUE SUITE 360
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
112 BEECH GROVE AFTER HOURS CLINIC
2030 CHURCHMAN AVENUE
BEECH GROVE,IN46107 		PHYSICIAN PRACTICE
113 MATERNAL FETAL SPECIALISTS
8051 S EMERSON AVENUE SUITE 450B
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
114 PLASTIC SURGERY SPECIALISTS
8051 S EMERSON AVENUE SUITE 450
INDIANAPOLIS,IN46237 		PHYSICIAN PRACTICE
115 ST JAMES COMMUNITY HEALTH CENTER -
BEECHER 989 DIXIE HIGHWAY
BEECHER,IL60401 		PHYSICAL THERAPY SERVICES
116 FPN NEIGHBORHOOD CLINIC
407 E MARKET STREET SUITE 101
CRAWFORDSVILLE,IN47933 		PHYSICIAN PRACTICE
117 ST MARGARET MEDICAL ASSOCIATES
5454 HOHMAN AVENUE
HAMMOND,IN46320 		PHYSICIAN PRACTICE
118 FPN FAMILY MEDICINE - MULBERRY
510 WEST JACKSON STREET
MULBERRY,IN46058 		PHYSICIAN PRACTICE
119 FRANCISCAN ST JAMES HEALTH - FAMILY
HEALTH HOMEWOOD 18636 DIXIE HIGHWA
HOMEWOOD,IL60430 		PHYSICIAN PRACTICE
120 PLAINFIELD SPORTS AND FAMILY MEDICINE
315 DAN JONES ROAD SUITE 150
PLAINFIELD,IN46168 		PHYSICIAN PRACTICE
121 AMER HEALTH NETWORK - SLEEP (MUNCIE)
3631 N MORRISON ROAD
MUNCIE,IN47304 		SLEEP CENTER
122 AMER HEALTH NETWORK - NOBLESVILLE
18051 RIVER AVENUE SUITE 103
NOBLESVILLE,IN46062 		IMAGING
123 MONTICELLO MEDICAL CENTER
826 N 6TH ST
MONTICELLO,IN47960 		MEDICAL PRACTICE
124 FPN FAMILY MEDICINE - MONTICELLO
902 FOXWOOD COURT
MONTICELLO,IN47960 		MEDICAL PRACTICE
125 FRANCISCAN PHYSICIANS HOSPITAL SLEEP CTR
7905 CALUMET AVENUE
MUNSTER,IN463214209 		SLEEP CENTER
126 FRANCISCAN HAMMOND CLINIC
7905 CALUMET AVENUE
MUNSTER,IN46321 		SPECIALTY CENTER/URGENT CARE
127 FRANCISCAN HAMMOND CLINIC
9800 VALPARAISO DRIVE
MUNSTER,IN46321 		FAMILY WELLNESS CENTER
128 FRANCISCAN HAMMOND CLINIC
11355 WEST 97TH LANE
ST JOHN,IN46373 		PRIMARY CARE
129 FRANCISCAN PHYSICIAN NETWORK
6831 133RD AVENUED
CEDAR LAKE,IN46303 		FAMILY PRACTICE
130 FRANCISCAN PHYSICIAN NETWORK
297 WEST FRANCISCAN LANE SUITE 203
CROWN POINT,IN46307 		FAMILY PRACTICE
131 ST JAMES HEALTH SURGERY CENTER
333 DIXIE HIGHWAY
CHICAGO HEIGHTS,IL60411 		OP SURGERY CENTER
132 FRANCISCAN ST JAMES HEALTH-FAMILY HEALTH
3700 WEST 203RD STREET SUITE 112
OLYMPIA FIELDS,IL60461 		PHYSICIAN PRACTICE
133 FRANKFORT REHABILITATION SERVICES
10043 LINCOLN HIGHWAY 2ND FLOOR
FRANKFORT,IL60423 		PHYSICAL THERAPY
134 DIXIE HIGHWAY REHABILITATION SERVICES
211 DIXIE HIGHWAY
CHICAGO HEIGHTS,IL60411 		PHYSICAL THERAPY
135 GREENWOOD IMMEDIATE CARE
1001 N MADISON AVENUE
GREENWOOD,IN46142 		IMMEDIATE CARE CENTER
136 CHAPEL HILL IMMEDIATE CARE
650 N GIRLS SCHOOL ROAD
INDIANAPOLIS,IN46214 		IMMEDIATE CARE CENTER
137 NORA IMMEDIATE CARE
860 E 86TH STREET
INDIANAPOLIS,IN46240 		IMMEDIATE CARE CENTER
138 WASHINGTON SQUARE IMMEDIATE CARE
992 N MITTHOEFFER
INDIANAPOLIS,IN46229 		IMMEDIATE CARE CENTER
139 FPN HILLSBORO FAMILY MEDICINE
203 EAST MAIN STREET
HILLSBORO,IN47949 		PHYSICIAN PRACTICE
140 FRANCISCAN PHYSICIAN NETWORK - MC
770 INDIAN BOUNDARY ROAD
CHESTERTON,IN46304 		PHYSICIAN PRACTICE
141 FRANCISCAN PHYSICIAN NETWORK - MC
900 I STREET
LAPORTE,IN46350 		PHYSICIAN PRACTICE
142 FRANCISCAN PHYSICIAN NETWORK
1020 EAST COMMERCIAL AVENUE
LOWELL,IN46356 		PHYSICIAN PRACTICE
143 HAMMOND CLINIC SPECIALTY CENTER
7905 CALUMET AVENUE
MUNSTER,IN46321 		MULTISPECIALTY/OUTPATIENT FACILITY
144 HAMMOND CLINIC FAMILY WELLNESS CENTER
9800 VALPARAISO DRIVE
MUNSTER,IN46321 		MULTI SPEC/OUTPATIENT FACILITY
145 HAMMOND CLINIC ST JOHN
11355 W 97TH LANE
ST JOHN,IN46373 		MULTISPEC/OUTPATIENT FACILITY
146 FRANCISCAN MEDICAL SPECIALISTS
919 MAIN STREET
DYER,IN46311 		PHYSICIAN PRACTICE
147 FRANCISCAN MEDICAL SPECIALISTS
5529 HOHMAN AVENUE
HAMMOND,IN46320 		PHYSICIAN PRACTICE
148 FRANCISCAN MEDICAL SPECIALISTS
1400 S LAKE PARK AVENUE SUITE 305
HOBART,IN46432 		PHYSICIAN PRACTICE
149 FRANCISCAN MEDICAL SPECIALISTS
901 LINCOLN WAY
LAPORTE,IN46350 		PHYSICIAN PRACTICE
150 FRANCISCAN MEDICAL SPECIALISTS
300 W 80TH PLACE
MERRILLVILLE,IN46410 		PHYSICIAN PRACTICE
151 FRANCISCAN MEDICAL SPECIALISTS
301 W HOMER STREET
MICHIGAN CITY,IN46360 		PHYSICIAN PRACTICE
152 FRANCISCAN MEDICAL SPECIALISTS
1950 45TH STREET
MUNSTER,IN46321 		PHYSICIAN PRACTICE
153 FRANCISCAN MEDICAL SPECIALISTS
9034 COLUMBIA
MUNSTER,IN46321 		PHYSICIAN PRACTICE
154 FRANCISCAN MEDICAL SPECIALISTS
761 45TH STREET
MUNSTER,IN46321 		PHYSICIAN PRACTICE
155 FRANCISCAN MEDICAL SPECIALISTS
757 45TH STREET
MUNSTER,IN46321 		PHYSICIAN PRACTICE
156 FRANCISCAN MEDICAL SPECIALISTS
2001 US 41
SCHERERVILLE,IN46375 		PHYSICIAN PRACTICE
157 FRANCISCAN MEDICAL SPECIALISTS
1101 GLENDALE ROAD SUITE 110
VALPARAISO,IN46383 		PHYSICIAN PRACTICE
158 FPN - MICHIGAN CITY
610 JEFFERSON AVE
LAPORTE,IN46360 		PHYSICIAN PRACTICE
159 FPN - MICHIGAN CITY
414 LINCOLN WAY
LAPORTE,IN46360 		PHYSICIAN PRACTICE
160 FPN- MICHIGAN CITY EXPRESS CARE
3325 WILLOWCREEK ROAD
PORTAGE,IN46368 		PHYSICIAN PRACTICE
161 FPN - MICHIGAN CITY EXPRESS CARE
2307 LAPORTE AVE STE B
VALPARAISO,IN46383 		PHYSICIAN PRACTICE
162 FPN - MICHIGAN CITY EXPRESS CARE
2590 MONTLAND DRIVE STE I
VALPARAISO,IN46383 		PHYSICIAN PRACTICE
163 FPN - MICHIGAN CITY EXPRESS CARE
6615 S BOUNDARY RD
PORTAGE,IN46368 		PHYSICIAN PRACTICE
164 PREMIER HEALTHCARE FOR WOMEN
3774 BAYLEY DRIVE SUITE B
LAFAYETTE,IN47905 		PHYSICIAN PRACTICE
165 St Margaret Medical Associates
8437 Kennedy Avenue
Highland,IN46322 		Physician Practice
166 St Margaret Medical Associates
19400 North Creek Drive
Lynwood,IL60411 		Physician Practice
167 St Margaret Medical Associates
2068 Lucas Parkway
Lowell,MA46350 		Physician Practice
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
IN THIS SECTION, THE FOLLOWING ABBREVIATIONS ARE USED TO REFERENCE THE hospital facilities operated by Franciscan Alliance, Inc.: Franciscan St. Francis Health - Indianapolis: FSFH-Indianapolis Franciscan St. Anthony Health - Crown Point: FSAH-Crown Point Franciscan St. Margaret Health - Hammond: FSMH-Hammond Franciscan St. Margaret Health - Dyer: FSMH-Dyer Franciscan St. James Health - Chicago Heights: FSJH-Chicago Heights Franciscan St. Elizabeth Health - Lafayette: FSEH-Lafayette East Franciscan St. Anthony Health - Michigan City: FSAH-Michigan City Franciscan St. James Health - Olympia Fields: FSJH-Olympia Fields Franciscan St. Francis Health - Mooresville: FSFH-Mooresville Franciscan St. Elizabeth Health - Lafayette Central: FSEH-Lafayette Central Franciscan St. Elizabeth Health - Crawfordsville: FSEH-Crawfordsville Franciscan Healthcare - Munster: FH-Munster Franciscan St. Francis Health - Carmel: FSFH-Carmel LINE 3: FSMH-DYER, FSMH-HAMMOND, FSAH-CROWN POINT, FH-MUNSTER INPUT FROM INDIVIDUALS IN THE COMMUNITY: An independent, third party was retained to conduct the community assessment and a part of that work was the facilitation of several Focus Groups designed to have in-person exchange and information gathering about community health needs, including needs of low income, minorities and the uninsured. The following individuals attended and contributed to that information gathering opportunity: Dr. Janet Seabrook - Executive Director, Gary Community Health Center Dr. Janice Zunich, Indiana University School of Medicine Dr. Mark Feldner, Community Care Network Dr. Lisa Green - CEO, Family Christian Health Centers Janice Wilson - CEO, North Shore Health Centers Olga Gonzales - Manager, Women's Care Center of NWI Tracy Tucker - School Nurse, Eggers Middle School Duane Dedalow - Executive Director, Catholic Charities Diocese of Gary Gordon Johnson - CEO, American Red Cross of NWI Gary Olund - President, Northwest Indiana Community Action Grace Talbot - Director, Hammond Rescue Mission Jane Bisbee - Regional Manager, Child Protective Services Lou Martinez - President, Lake Area United Way Gilda Orange - Trustee, North Township Tom DeGuilio - Town Manager, Munster LINE 3: FSAH-MICHIGAN CITY INPUT FROM INDIVIDUALS IN THE COMMUNITY: A survey of community opinion leaders was conducted soliciting input regarding community health needs. Individuals contributing to this information resource included: Ed Merrion - Housing Program Manager, Catholic Charities Kathy Dennis - Commission on Women George Kucka - President, Fair Meadows Home Health Center Terese Fabbri - Friend of the Open Door Health Center Fred McNulty - EVP, HR Dimensions Deborah Chugg - Executive Director, Imagination Station (behavioral medicine) Patricia Pease - Administrator, LaPorte County Emergency Medical Services Cathy Ellis - Life Care Center of Valparaiso W. Faye Moore - VP, Michigan City Women's Commission/NAACP Deborah Briggs - Program Director, Open Door Adolescent Health Center Tyra Walker - Samaritan Center and LaPorte County Jail Cee Cee Taylor - Executive Director, Samaritan Counseling Center Terri Phillips - Executive Director, Life Care of MICHIGAN CITY (SKILLED NURSING FACILITY) Gerry Jones - Executive Director, Stepping Stone Shelter for Women Steve Birnth - Executive Director, Youth Service Bureau LINE 3: FSJH-CHICAGO HEIGHTS, FSJH-OLYMPIA FIELDS INPUT FROM INDIVIDUALS IN THE COMMUNITY: A community wide survey was conducted by a third party in collaboration with many hospitals coordinated by the Chicago Metropolitan Hospital Council. Subsequent to that community survey the same third party conducted a series of Focus Groups, specific to each participating hospital, comprised of individuals representing various sectors of the service area population including: public health; low income; minorities; medically underserved; chronic disease services; and more. Individuals providing input via the focus groups included: Apostle Carl White, Jr. - Victory International Christian Ministries Deborah Harper - Community and Economic Development Association, Chicago Heights Marianne Bithos - National Alliance on Mental Illness, South Suburbs of Chicago Mary Pat Ambrosino - Southwest Community Services, Tinley Park (services for the disabled) Yvonne Orr - South/Southwest Suburban United Way LINE 3: FSEH-LAFAYETTE EAST, FSEH-LAFAYETTE CENTRAL INPUT FROM INDIVIDUALS IN THE COMMUNITY: A community survey was conducted, followed by a review of results by a cross section of community representatives. That review resulted in conducting an Opinion Leader survey of approximately 200 individuals to add more information regarding priorities. Finally, individual interviews were conducted with the following individuals to further solicit direct input from their respective experiences and knowledge: John Dennis - Mayor, West Lafayette Tom Murtaugh - President of the County Council Sheila Klinker - Indiana State Representative Ronnie Alting - Indiana State Senator Randy Truitt - Indiana State Representative Brandt Hershman - Indiana State Senator Gary Henriott - Chairman and CEO, Henriott Group Trish Hauber - HR Manager, Caterpillar, Inc. Julia Cole - HR MANAGER, Subaru Veronique LeBlanc - President, Riggs Community Health Center Pam Biggs-Reed - CEO, Bauer Center (Head Start and Counseling Center) Marilyn Redmon - CEO, Right Steps Child Development Centers Ron Cripe - Tippecanoe County Health Department Barry Richards - Boys and Girls Club James Taylor - EXECUTIVE DIRECTOR, United Way of Greater Lafayette and Tippecanoe County Joe Seaman - President, Greater Lafayette Chamber of Commerce Cheryl Ubelhor - Program Manager, Community Foundation of Greater Lafayette Scott Hanback - Superintendent, Tippecanoe Schools Eric Davis - President, Lafayette Catholic School Corp. Rocky Killian - Superintendent, West Lafayette Schools Jane Kirkpatrick - Dean, Purdue School of Nursing Anita Reed - St. Elizabeth School of Nursing LINE 3: FSEH-CRAWFORDSVILLE INPUT FROM INDIVIDUALS IN THE COMMUNITY: A community wide survey was conducted, followed by an opinion leader survey. The opinion leaders were then interviewed for focused input. The individuals from whom input was gained are: Robert Cook - Abilities services Todd Barton - Mayor, City of Crawfordsville Fawn Johnson - Crawfordsville Community Center Joanie Crum - Division of Family and Children Phil Wray - FISH Clothes Closet/Food Pantry Brenda Deckard - Friendship Kitchen/HUB Ministries Denise Maxwell - Montgomery County American Red Cross Kelly Taylor - Montgomery County Community Foundation Cheryl Kiem - Montgomery County Community Foundation Jan Sears - St. Bernard Catholic Church Dave Peach - WCVL/WIMC/WCDQ (broadcasting) Joy Dugan - Purdue University Extension Service Deanna Durett - Montgomery County Commissioner Tina McGrady - Editor, Crawfordsville Journal Review Rich Holtz - The Paper of Montgomery County Amber Reed - Montgomery County Health Department Bill Doemel - Mary Ludwig Free Clinic LINE 3: FSFH-INDIANAPOLIS, FSFH-MOORESVILLE, FSFH-CARMEL INPUT FROM INDIVIDUALS IN THE COMMUNITY: A community survey was conducted followed by a survey of opinion leaders. Additionally, interviews were conducted with a variety of community leaders and people knowledgeable in the areas of public health and the needs of target populations. The individuals interviewed include the following: Robert Lyons - Church Odyssey Thomas Zoss - Executive Director, Community Foundation of Morgan County Betty Pedigo - Site Manager, Eskenazi Medical Group (a provider to low income and minorities) Marjorie Porter - Executive Director, Good Shepherd Clinic Mary Kay Mitchell - Horizon House Norman Connell - Board Member, Kendrick Foundation Michael Crosley - Executive Director, Life Bridge Community Julia Brillhart - VP, Magellan Health Joni Collins - Executive Director, Martin Luther King Community Center Dennis Payton - Pastor, Mooresville First United Methodist Church Debra Page - Mooresville Schools M. Cloud - Supervisor, Noble of Indiana Joseph Donahue - Sycamore Services Lydia Rychtarczyk - Director, Tomorrow's Promise Pre-school Pamela Taylor - EMS, Westfield Fire Department Additional Individuals providing information through means other than an interview: Mark Lindenlaub - Executive Director, Aging and Community Services of So. Central Indiana Carla Marchbanks - Director, Beech Grove Senior Citizens Center Rick Whitten - Executive Director, Boys and Girls Clubs of Indianapolis Elaisa Vahnie - Executive Director, Burmese American Community Julie Heger - Case Manager, Children's Bureau Frank Mascari - City-County Council Member Stephen Rink - Trustee, Decatur Township Nancy Beals - Drug Free Marion County Bud Swisher - Executive Director, Healthier Morgan County Initiative Beth Ann Leach - Executive Director, Hendricks County Senior Services Doug Bush - Executive Director, Indiana Dental Association Ann Alley - Director, Primary Care, Indiana State Department of Health Jane Zobel - Social Worker, Indianapolis Public Schools Glen
LINE 4: FSMH-DYER, FSMH-HAMMOND, FSAH-CROWN POINT, FH-MUNSTER CHNA CONDUCTED WITH ONE OR MORE OTHER FACILITIES: Franciscan St. Margaret Health-Dyer, Franciscan St. Margaret Health-Hammond, Franciscan St. Anthony Health-Crown Point, and Franciscan Healthcare-Munster are part of Franciscan Alliance, Inc. who collaborated in using the same third party resource (Professional Research Consultants). These five facilities in turn collaborated with two other hospitals in the region - Community Healthcare System and Methodist Hospitals, using the same third party resource. LINE 4: FSJH-CHICAGO HEIGHTS, FSJH-OLYMPIA FIELDS CHNA CONDUCTED WITH ONE OR MORE OTHER FACILITIES: FRANCISCAN ST. JAMES HEALTH-CHICAGO HEIGHTS AND FRANCISCAN ST. JAMES HEALTH-OLYMPIA FIELDS ARE PART OF Franciscan Alliance, Inc. who collaborated in using the same third party resource (Professional Research Consultants). Franciscan St. James Health-Chicago Heights and Franciscan St. James Health-Olympia Fields COORDINATED with a number of other hospitals as part of a coordinated program sponsored by the Metropolitan Chicago Hospital Council using the services of a third party, Professional Research Consultants. LINE 4: FSEH-LAFAYETTE EAST, FSEH-LAFAYETTE CENTRAL CHNA CONDUCTED WITH ONE OR MORE OTHER FACILITIES: FSEH-Lafayette East and FSEH-Lafayette Central are part of Franciscan Alliance, Inc. who collaborated in using the same third party resource (Professional Research Consultants). A community survey was conducted jointly with Franciscan St. Elizabeth Health-Lafayette East, Franciscan St. Elizabeth Health-Lafayette Central, the county health department, and Indiana University Arnett Hospital. LINE 4: FSFH-INDIANAPOLIS, FSFH-MOORESVILLE, FSFH-CARMEL CHNA CONDUCTED WITH ONE OR MORE OTHER FACILITIES: FSFH-INDIANAPOLIS, FSFH-MOORESVILLE, and FSFH-CARMEL are part of Franciscan Alliance, Inc. who collaborated in using the same third party resource (Professional Research Consultants). ALL CHNA RELATED ACTIVITIES WERE A JOINT EFFORT BETWEEN FRANCISCAN ST. FRANCIS HEALTH-INDIANAPOLIS, FRANCISCAN ST. FRANCIS HEALTH-MOORESVILLE, AND FRANCISCAN ST. FRANCIS HEALTH-CARMEL. LINE 5: ALL FACILITIES ALL 13 hospital's CHNAS ARE AVAILABLE ON FRANCISCAN ALLIANCE'S WEBSITE AT: HTTP://WWW.FRANCISCANALLIANCE.ORG/COMMUNITY/COMMUNITY-NEEDS-ASSESSMENT/ANN UAL-REPORT/PAGES/DEFAULT.ASPX
LINE 7: FSMH-DYER, FSMH-HAMMOND NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Access to health care services - The hospitals already operate a community clinic (Mother McAuley Clinic) to serve under and uninsured; operate physician practices that accept all patients; expect provisions of the Affordable care Act will improve access via Medicaid and employer insurance expansion. B. Cancer of the breast, cervix, colon and prostate - identified as being of higher incidence and being addressed through other, established programs and through gradually improving underlying social issues. C. Chlamydia Incidence Rate - As a Catholic organization we are limited by the Ethical and Religious Directives as to what we can do regarding the use of contraceptives. D. Chronic Kidney Disease - developing a program to improve diabetes management, which is an underlying cause of kidney disease. E. High Use of ER - Various new programs initiated as part of Franciscan's ACO, also we operate several Urgent Care centers and have expanded to include new sites. F. Injury and Violence Prevention - We regard this as primarily a task of the public sector as we do not have expertise or resources to develop and sustain programs. G. Maternal, Infant and Child Health - A robust program needs neo-natal resources we do not have. We do already offer some services through our community clinic and through our St. Monica Home for unwed mothers. H. Oral Health - we do not have dental services, staff, resources or expertise to meet this need. I. Social and Economic Factors - there are a variety of conditions including education, transportation, employment, crime, etc., which are obligations of government to address as we do not have needed expertise, funding, resources or experience to address. LINE 7: FSAH-MICHIGAN CITY NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Access to Health Services - The hospital already works closely with established Federally Qualified Health Centers in the community; operates physician practices that accept all patients; expect the provisions of the Affordable Care Act to improve access via Medicaid and employer expansion of insurance coverage. B. Maternal Infant and Child Health - some needs are served through Women's Care Center; limited capability in neo-natal care; shortage of physician staff with whom to partner. C. Homelessness - hospital does not have expertise in this area. D. Mental Health - limited resources (no psychiatric services) plus the existence of several other mental health resources in the community. E. Nutrition, Fitness/Life Style - existing programs address some of these needs plus the programs selected for development (diabetes and cardiovascular) will include emphasis on these factors for improved health. F. Tobacco Use - existing programs address this need plus, other community programs emphasize this problem; plus, the heart failure program that is a CHNA selection will include smoking cessation. LINE 7: FH-Munster NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Access to Care - Franciscan Alliance already operates a clinic for the under and uninsured population in the geographic area. The hospital does not operate an ER and expect that the provisions of the Affordable Care Act will improve access via Medicaid and employer expansion of insurance coverage. B. Preventable hospitalizations - Franciscan's ACO is working toward addressing this problem and there are other targeted programs addressing re-admissions. C. Maternal and Child Health - the hospital does not offer any obstetric or pediatric services and thus, does not have the resources or expertise typical for such programs. D. Adult Immunizations - other community resources and physician offices address this need. E. Asthma - due to our limited services we do not have the resources or expertise typical for such programs. F. Health Education - it was decided that broad-based health education is available from many sources. However, targeted health education in the areas of Diabetes and colon disease will be part of the selected CHNA programs provided. G. Substance Abuse - other programs are currently available in the community to address the need. H. Oral Health - the hospital does not have the expertise or resources required for this service. I. Nutrition, Physical Activity/Life-style - targeted effort will be a part of the diabetes program being developed; plus, other community programs are very active regarding this need. J. Mental Health - other community services are available and another Franciscan hospital that is part of this Form 990 already provides a variety of inpatient and outpatient mental health programs. K. Heart Disease and Stroke - existing services in our hospital address some of these needs and another Franciscan hospital that is part of this Form 990 already offers services specific to these needs and they are developing more targeted programs in their CHNA efforts. LINE 7: FSAH-CROWN POINT NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Access to Health Services - the hospital already operates a clinic (St. Clare Health Clinic) to serve the under and uninsured population. People can also access a Federally Qualified Health Clinic in the area; the hospital also operates physician practices that accept all patients; and expect that the provisions of the Affordable Care Act will improve access via Medicaid and employer insurance expansion. B. Cancer Care - several existing programs that focus on several types of cancer address many of the cancer needs of the community. C. Family Planning (teen births) - existing programs in the hospital and the community are addressing this need. D. Injury and Violence Prevention - we regard this as primarily a task of the public section as we do not have expertise, staff or funding. E. Mental Health - there are existing services in the area for both inpatient and outpatient mental health needs. F. Substance Abuse - existing programs in the community address these needs. LINE 7: FSJH-CHICAGO HEIGHTS NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Cancer - programs already in place address colonoscopy and mammography screening so it was decided that resources would be directed toward other needs. B. Chronic Kidney Disease - Franciscan St. James Health-Olympia Fields is developing a program that addresses diabetes, which is a major cause of kidney disease. Thus, rather than duplicate that effort, it was not selected for development at Franciscan St. James Health-Chicago Heights. C. Maternal, Infant and child health - This need is being addressed currently by a partner Federally Qualified Health Center and thus, was not selected for development. D. Mental Health - Other community and regional organizations are addressing this need plus, we do not have expertise or resources to adequately develop effective programs. E. Respiratory Disease - Existing inpatient and outpatient services address this need and thus, it was not selected for further development. F. Injury and Violence Prevention - This need is seen as being more appropriately met by other public resources plus, we do not have expertise, resources or funding to adequately address this need. G. Sexually Transmitted Diseases - We are a Catholic organization and are constrained from having a comprehensive program by the Ethical and Religious Directives plus, other organizations have established programs. LINE 7: FSJH-OLYMPIA FIELDS NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Cancer - programs already in place address colonoscopy and mammography screening so it was decided that resources would be directed toward other needs. B. Chronic Kidney Disease - We are implementing a diabetes program as one of our priorities and believe that this will somewhat address this need since diabetes is a major cause of kidney disease. C. Maternal, Infant and child health - This need is being addressed currently by a partner Federally Qualified Health Center and thus, was not selected for development. D. Mental Health - Other community and regional organizations are addressing this need plus, we do not have expertise or resources to adequately develop effective programs. E. Respiratory Disease - Existing inpatient and outpatient services address this need and thus, it was not selected for further development. F. Injury and Violence Prevention - This need is seen as being more appropriately met by other public resources plus, we do not have expertise, resources or funding to adequately address this need. G. Sexually Transmitted Diseases - We are a Catholic organization and are constrained from having a comprehensive program by the Ethical and Religious Directives plus, other organizations have established programs. LINE 7: FSEH-EAST NEEDS IDENTIFIED BUT NOT SELECTED FOR CHNA INITIATIVES: A. Obesity - existing programs address aspects of this need plus, the CHNA programs in diabetes and congestive heart failure selected for development
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
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
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
FRANCISCAN ALLIANCE INC
 
Employer identification number
35-1330472
Part I
General Information on Grants and Assistance
1
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? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) LAFAYETTE MEDICAL EDUCATION FOUNDATION
1501 HARTFORD STREET RM 1128A
LAFAYETTE,IN47093 		35-1314750 501(C)(3) 10,000   FMV NONE MED. EDUC.
(2) SSFPA
PO BOX 766 1515 W DRAGOON TRAIL
MISHAWAKA,IN465460766 		35-1328145 501(C)(3) 150,000 0 FMV NONE FINANCIAL ASSISTANCE




















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
2
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2013

Schedule I (Form 990) 2013
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. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
PART I, LINE 2 CONTRIBUTIONS ARE GIVEN TO TAX-EXEMPT ORGANIZATIONS WHICH USE THE FUNDS FOR CHARITABLE PURPOSES IN FURTHERANCE OF MEDICAL RESEARCH, MEDICAL INITIATIVES, EDUCATION, AND/ OR COMMUNITY ACTIVITIES.
Schedule I (Form 990) 2013


Additional Data


Software ID:  
Software Version:  


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, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
FRANCISCAN ALLIANCE INC
 
Employer identification number

35-1330472
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
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....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
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:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
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 ............
7
 
No
8
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 .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)KEVIN D LEAHYPRESIDENT AND TRUSTEE (i)
(ii)		 1,577,662
0 		0
0 		68,142
0 		452,648
0 		29,365
0 		2,127,817
0 		0
0
(2)EUGENE C DIAMONDREGIONAL CEO NIR (i)
(ii)		 833,550
0 		0
0 		56,401
0 		163,744
0 		26,322
0 		1,080,017
0 		0
0
(3)ROBERT J BRODYREGIONAL CEO CIR (i)
(ii)		 832,050
0 		0
0 		59,669
0 		224,483
0 		28,092
0 		1,144,294
0 		0
0
(4)JENNIFER P MARIONSENIOR VP FINANCE, CFO (i)
(ii)		 720,938
0 		0
0 		28,850
0 		25,083
0 		26,558
0 		801,429
0 		0
0
(5)TERRANCE E WILSONREGIONAL CEO WIR (i)
(ii)		 634,826
0 		0
0 		37,990
0 		57,249
0 		26,055
0 		756,120
0 		0
0
(6)SETH CR WARRENREGIONAL CEO SSCR (i)
(ii)		 625,611
0 		0
0 		45,236
0 		0
0 		22,987
0 		693,834
0 		0
0
(7)LOUIS METZMAN MDPHYSICIAN (i)
(ii)		 904,273
0 		44,570
0 		34,623
0 		11,048
0 		21,402
0 		1,015,916
0 		0
0
(8)DAVID RUSKOWSKIHOSPITAL PRESIDENT (i)
(ii)		 483,303
0 		24,892
0 		844,689
0 		-43,312
0 		18,310
0 		1,327,882
0 		0
0
(9)JAIRO CRUZ MDPHYSICIAN (UNPAID TRUSTEE) (i)
(ii)		 197,459
0 		0
0 		25,152
0 		0
0 		18,868
0 		241,479
0 		0
0
(10)DANIEL G SPOMAR MDPHYSICIAN (i)
(ii)		 1,020,743
0 		0
0 		33,362
0 		278
0 		14,317
0 		1,068,700
0 		0
0
(11)NADEEM IKHLAQUE MDPHYSICIAN (i)
(ii)		 997,982
0 		0
0 		32,453
0 		13,099
0 		16,858
0 		1,060,392
0 		0
0
(12)ROWLAND O MBAOMA MDPHYSICIAN (i)
(ii)		 611,802
0 		426,682
0 		13,290
0 		0
0 		19,504
0 		1,071,278
0 		0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
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.
Return Reference Explanation
SCHEDULE J, PART II, COLUMN (C) Deferred compensation reported in this column includes split-dollar life insurance, employer deferral to section 403(B) Plan, and change in present value of the qualified and, if applicable, nonqualified defined benefit plan. The value of the nonqualified defined benefit plan is subject to a significant risk of forfeiture and as such possibly may never be paid to the executives participating in the plan. Under the nonqualified defined benefit plan, David Ruskowski received a vested benefit of $834,051 during 2013, and this amount is included in Schedule J, Part II, Column (B)(iii). Changes in the amount reflected between years is primarily a function of the fluctuation in the actuarial discount rate used to measure this future liability which may never be paid to the executives.
SCHEDULE J, PART I, LINE 4B Franciscan Alliance, Inc. ("FRANCISCAN") maintains a supplemental executive retirement plan. These benefits are subject to a significant risk of forfeiture and as such possibly may never be paid out to the executives participating in the plan.
Schedule J (Form 990) 2013

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
FRANCISCAN ALLIANCE INC
 
Employer identification number
35-1330472
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A INDIANA FINANCE AUTHORITY (06E)
  		35-1602316 454795DW2 04-25-2006 85,150,922 REFUND PRIOR ISSUE DATED 5/16/06   X   X   X
B INDIANA FINANCE AUTHORITY (08AB)
  		35-1602316 45480YAB7 05-12-2008 162,960,000 REFINANCING AND REFUND PRIOR ISSUE   X   X   X
C INDIANA FINANCE AUTHORITY (08C)
  		35-1602316 45470YAX9 09-15-2008 291,837,375 REFUND PRIOR ISSUE DATED 5/2/06   X   X   X
D INDIANA FINANCE AUTHORITY (08EFGH)
  		35-1602316 45470YBE0 10-10-2008 279,345,000 REFUND PRIOR ISSUE DATED 11/20/03   X   X   X
INDIANA FINANCE AUTHORITY (08IJ)
  		35-1602316 45470YBL4 11-20-2008 81,850,000 REFUND PRIOR ISSUE DATED 5/16/06   X   X   X
INDIANA FINANCE AUTHORITY (09A)
  		35-1602316 45470YCF6 11-05-2009 221,309,385 REFUNDING AND NEW PROJECTS   X   X   X
INDIANA FINANCE AUTHORITY (12AB)
  		35-1602316   04-25-2012 82,620,000 REFUND PRIOR ISSUES DATED '01&'08   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 475,922 1,275,000 22,787,375 75,000,000
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 86,903,209 162,624,820 290,462,634 278,919,324
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 144,210 1,924,820 1,505,785 503,876
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0 0 0
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 42,830,183 0 0 124,873,123
11 Other spent proceeds . . . . . . . . . . . . . . 43,928,816 160,700,000 288,956,849 153,542,325
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . . 2007 2012 2011
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X   X   X   X  
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.130 % 0.130 % 0 % 1.470 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0.050 %
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.130 % 0.130 % 0 % 1.520 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X        
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . .   X   X   X X  
c No rebate due? . . . . . . . . X   X   X     X
If you checked "No rebate due" in line 2c, provide in
Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .   X X     X X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . . 0
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . . 0
  		0
  		0
  		0
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . . X   X   X     X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K, PART II, LINE 13 FOR THE INDIANA FINANCE AUTHORITY 2008C AND INDIANA FINANCE AUTHORITY 2012 A/B BONDS, THESE BONDS SOLELY REFUNDED PRIOR ISSUES, SO THE YEAR OF SUBSTANTIAL COMPLETION HAS NOT BEEN ENTERED.
SCHEDULE K, PART III FOR THE INDIANA FINANCE AUTHORITY 2008C BONDS, PART III IS NOT COMPLETED SINCE ALL BOND PROCEEDS WERE USED TO REFUND BONDS ISSUED BEFORE JANUARY 1, 2003.
SCHEDULE K, PART III, LINE 8B FOR THE INDIANA FINANCE AUTHORITY 2006E, 2008A/B, 2008E-H, 2008I/J, AND 2012A/B BONDS, DURING 2012, THE DISPOSITION PROCEEDS FOR THE DISPOSED OF BOND-FINANCED PROPERTY WAS $1.00, WHICH WAS WELL BELOW A TENTH OF A PERCENT OF EACH ISSUE. SCHEDULE K, PART III, LINE 8C FRANCISCAN ALLIANCE, THE INDIANA FINANCE AUTHORITY, AND THE IRS ENTERED INTO A CLOSING AGREEMENT TO ADDRESS THE REQUIRED REMEDIAL ACTION UNDER REGULATIONS SECTION 1.142-12 AND 1.145-2. SCHEDULE K, PART IV, LINE 2C FOR EACH OF THE FOLLOWING BONDS, THE REBATE COMPUTATION WAS PERFORMED: SERIES 2006E - JANUARY 2011 SERIES 2008A/B - JANUARY 2011 SERIES 2008C - JANUARY 2011 SERIES 2008I/J - JANUARY 2011
SCHEDULE K, PART IV, LINE 5 FOR THE INDIANA FINANCE AUTHORITY 2006E, INDIANA FINANCE AUTHORITY 2008A/B, INDIANA FINANCE AUTHORITY 2008C, AND INDIANA FINANCE AUTHORITY 2008I/J ISSUES, ONLY SMALL AMOUNTS OF PROCEEDS RELATED TO THE COST OF ISSUANCE WERE NOT EXPENDED AT THE END OF THE TEMPORARY PERIODS.
Schedule K (Form 990) 2013

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
FRANCISCAN ALLIANCE INC
 
Employer identification number
35-1330472
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A INDIANA FINANCE AUTHORITY (06E)
  		35-1602316 454795DW2 04-25-2006 85,150,922 REFUND PRIOR ISSUE DATED 5/16/06   X   X   X
B INDIANA FINANCE AUTHORITY (08AB)
  		35-1602316 45480YAB7 05-12-2008 162,960,000 REFINANCING AND REFUND PRIOR ISSUE   X   X   X
C INDIANA FINANCE AUTHORITY (08C)
  		35-1602316 45470YAX9 09-15-2008 291,837,375 REFUND PRIOR ISSUE DATED 5/2/06   X   X   X
D INDIANA FINANCE AUTHORITY (08EFGH)
  		35-1602316 45470YBE0 10-10-2008 279,345,000 REFUND PRIOR ISSUE DATED 11/20/03   X   X   X
INDIANA FINANCE AUTHORITY (08IJ)
  		35-1602316 45470YBL4 11-20-2008 81,850,000 REFUND PRIOR ISSUE DATED 5/16/06   X   X   X
INDIANA FINANCE AUTHORITY (09A)
  		35-1602316 45470YCF6 11-05-2009 221,309,385 REFUNDING AND NEW PROJECTS   X   X   X
INDIANA FINANCE AUTHORITY (12AB)
  		35-1602316   04-25-2012 82,620,000 REFUND PRIOR ISSUES DATED '01&'08   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 475,922 1,275,000 22,787,375 75,000,000
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 86,903,209 162,624,820 290,462,634 278,919,324
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 144,210 1,924,820 1,505,785 503,876
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0 0 0
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 42,830,183 0 0 124,873,123
11 Other spent proceeds . . . . . . . . . . . . . . 43,928,816 160,700,000 288,956,849 153,542,325
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . . 2007 2012 2011
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X   X   X   X  
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.130 % 0.130 % 0 % 1.470 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0.050 %
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.130 % 0.130 % 0 % 1.520 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X        
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . .   X   X   X X  
c No rebate due? . . . . . . . . X   X   X     X
If you checked "No rebate due" in line 2c, provide in
Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .   X X     X X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . . 0
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . . 0
  		0
  		0
  		0
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . . X   X   X     X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K, PART II, LINE 13 FOR THE INDIANA FINANCE AUTHORITY 2008C AND INDIANA FINANCE AUTHORITY 2012 A/B BONDS, THESE BONDS SOLELY REFUNDED PRIOR ISSUES, SO THE YEAR OF SUBSTANTIAL COMPLETION HAS NOT BEEN ENTERED.
SCHEDULE K, PART III FOR THE INDIANA FINANCE AUTHORITY 2008C BONDS, PART III IS NOT COMPLETED SINCE ALL BOND PROCEEDS WERE USED TO REFUND BONDS ISSUED BEFORE JANUARY 1, 2003.
SCHEDULE K, PART III, LINE 8B FOR THE INDIANA FINANCE AUTHORITY 2006E, 2008A/B, 2008E-H, 2008I/J, AND 2012A/B BONDS, DURING 2012, THE DISPOSITION PROCEEDS FOR THE DISPOSED OF BOND-FINANCED PROPERTY WAS $1.00, WHICH WAS WELL BELOW A TENTH OF A PERCENT OF EACH ISSUE. SCHEDULE K, PART III, LINE 8C FRANCISCAN ALLIANCE, THE INDIANA FINANCE AUTHORITY, AND THE IRS ENTERED INTO A CLOSING AGREEMENT TO ADDRESS THE REQUIRED REMEDIAL ACTION UNDER REGULATIONS SECTION 1.142-12 AND 1.145-2. SCHEDULE K, PART IV, LINE 2C FOR EACH OF THE FOLLOWING BONDS, THE REBATE COMPUTATION WAS PERFORMED: SERIES 2006E - JANUARY 2011 SERIES 2008A/B - JANUARY 2011 SERIES 2008C - JANUARY 2011 SERIES 2008I/J - JANUARY 2011
SCHEDULE K, PART IV, LINE 5 FOR THE INDIANA FINANCE AUTHORITY 2006E, INDIANA FINANCE AUTHORITY 2008A/B, INDIANA FINANCE AUTHORITY 2008C, AND INDIANA FINANCE AUTHORITY 2008I/J ISSUES, ONLY SMALL AMOUNTS OF PROCEEDS RELATED TO THE COST OF ISSUANCE WERE NOT EXPENDED AT THE END OF THE TEMPORARY PERIODS.
Schedule K (Form 990) 2013

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
FRANCISCAN ALLIANCE INC
 
Employer identification number

35-1330472
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2013
Schedule L (Form 990 or 990-EZ) 2013
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) TONN AND BLANK CONSTRUCTION LLC COMMON DIRECTORS&OFFICERS 44,624,963 PURCHASE OF CONSTRUCTION SERVS   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCHEDULE L, PART IV TONN AND BLANK CONSTRUCTION COMPANY, LLC IS A LIMITED LIABILITY COMPANY IN WHICH FRANCISCAN ALLIANCE, INC. HOLDS A MEMBERSHIP INTEREST. THE FOLLOWING CURRENT TRUSTEES AND OFFICERS OF FRANCISCAN ALLIANCE, INC. ARE ALSO BOARD MEMBERS OF TONN AND BLANK CONSTRUCTION COMPANY, LLC: SISTER JANE MARIE KLEIN AND KEVIN D. LEAHY. TONN AND BLANK CONSTRUCTION COMPANY, LLC PROVIDES CONSTRUCTION SERVICES TO FRANCISCAN ALLIANCE, INC. FOR THE CONSTRUCTION AND IMPROVEMENT OF ITS HEALTHCARE FACILITIES.
Schedule L (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  




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.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
FRANCISCAN ALLIANCE INC
 
Employer identification number

35-1330472
Return Reference Explanation
FORM 990, PART I, LINE 1 FRANCISCAN ALLIANCE, INC.'S ("FRANCISCAN") PURPOSE IS TO CONTINUE THE HEALING MINISTRY OF CHRIST IN ACCORDANCE WITH THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH AND IN PARTNERSHIP WITH OTHERS TO PROVIDE A FULL CONTINUUM OF HEALTH CARE SERVICES; TO CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE PROMOTION OF HEALTH; TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO HEALTH CARE; AND TO PARTICIPATE IN ACTIVITIES DESIGNED AND CONDUCTED TO PROMOTE THE GENERAL HEALTH OF THOSE SERVED BY FRANCISCAN. PLEASE VIEW "OUR GIVING JOURNAL" AT WWW.FRANCISCANALLIANCE.ORG/COMMUNITYBENEFIT WHICH REFLECTS OUR MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION." FORM 990, PART V, LINE 4B ADDITIONAL FOREIGN COUNTRIES - PHILLIPPINES, POLAND, THAILAND, TURKEY, DENMARK, AND GREECE. FORM 990, PART VI, SECTION A, LINE 7A The entire Board of Trustees shall consist of no more than seventeen (17), with no fewer than seven (7) who shall be Sisters of the Eastern Province ("Province") of the Sisters of St. Francis of Perpetual Adoration, a religious congregation of women of the Roman Catholic Church ("Congregation"). The Trustees of the Board shall include the following persons: (A) Three Trustees shall be members of the Provincial Leadership of the Province, one of whom shall be the provincial, or her designee, and the remaining two shall be elected by the provincial leadership; (B) the Treasurer of the Province who may also be one of the Provincial Leadership representatives as described in (A); (C) the Sponsor Liaison for the Healthcare of the Province who may also be one of the Provincial Leadership representatives as described in (A); (D) the President/Chief Executive Officer of the Corporation; and (E) the Trustees elected by the Members to fill the remaining positions.
FORM 990, PART VI, SECTION A, LINE 7B NO ACTION ON THE PART OF THE BOARD OF TRUSTEES IN RESPECT OF ANY OF THE FOLLOWING MATTERS SHALL BE EFFECTIVE UNLESS THE ACTION HAS BEEN APPROVED BY A MAJORITY OF THE MEMBERS; NAMELY: (A) CORPORATE MISSION AND PHILOSOPHY; (B) APPOINTMENT OR REMOVAL OF THE CHAIRPERSON, PRESIDENT, SECRETARY, OR TREASURER OF THE CORPORATION; (C) ALIENATION OF PROPERTY AS DEFINED IN CANON LAW; OR (D) ENCUMBRANCE OF DEBT AS DEFINED BY CANON LAW.
FORM 990, PART VI, SECTION B, LINE 11B THE INFORMATION TO PREPARE THE FORM 990 OF FRANCISCAN ALLIANCE, INC. ("FRANCISCAN") IS GATHERED BY FINANCE STAFF AND MISSION REPRESENTATIVES AND PROVIDED TO ITS ACCOUNTING FIRM WHO PREPARES THE RETURN. SENIOR MANAGEMENT THEN REVIEWS THE RETURN PRIOR TO FILING. THE FORM 990 IS ALSO MADE AVAILABLE TO FRANCISCAN'S BOARD OF TRUSTEES PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C The Corporation requires annual conflict of interest statements from each director, principal officer, members of committees with board designated powers, key employees, and executive leadership committee members which affirms that they have received, read, and understand the conflict of interest policy and have agreed to comply with the policy. In connection with any actual or possible conflict of interest a director, principal officer or member of a committee with board designated powers must disclose the existence and nature of the financial interest to the directors and members of committees with board delegated powers considering the proposed transaction or arrangements. If after disclosure of the financial interest, the director, principal or committee member shall leave the board or committee meeting while the financial interest is discussed and vote taken. In addition, ongoing reviews and assessments are made to make certain that the Corporation operates in a manner consistent with its charitable purposes. In conducting the ongoing reviews and assessments, the Corporation uses internal and external advisors. Reviews include compensation arrangements, acquisitions, partnerships, joint venture arrangements, and agreements to provide health care products/services, etc.
FORM 990, PART VI, SECTION B, LINE 15 Franciscan Alliance, Inc.'s ("Franciscan") process for determining compensation for the organization's President/CEO, officers and key employees consists of periodic external reviews completed by national independent compensation consultants. The Executive Committee of the Board of Trustees approves the proposed compensation and benefits at an annual compensation review meeting held each year. The organization's President/CEO recuses himself from the vote on executive compensation. FORM 990, PART VII, SECTION A, COLUMN (F) Deferred compensation reported in this column includes split-dollar life insurance, employer deferral to section 403(B) Plan, and change in present value of the qualified and, if applicable, nonqualified defined benefit plan. The value of the nonqualified defined benefit plan is subject to a significant risk of forfeiture and as such possibly may never be paid to the executives participating in the plan. Changes in the amount reflected between years is primarily a function of the fluctuation in the actuarial discount rate used to measure this future liability which may never be paid to the executives.
FORM 990, PART XI, LINE 9 EQUITY IN EARNINGS OF AFFILIATES 9,843,021 MINORITY INTEREST IN AFFILIATES (20,108,963) OTHER COMPREHENSIVE INCOME 307,308,328 DIVIDENDS RECEIVED FROM AFFILIATES 127,125 NET ASSETS RELEASED FOR OPERATIONS 1,614,362 NET ASSETS RELEASED FROM RESTRICTION (1,619,133) EQUITY TRANSFERS TO/FROM AFFILIATES 9,019,295 CHANGE IN TEMP RESTRICTED NET ASSETS 3,639,714 CHANGE IN PERM RESTRICTED NET ASSETS 7,234,661 OTHER CHANGES IN NET ASSETS 18,188,625 NET ASSET RECLASS 2,126,146 ------------- TOTAL OTHER CHANGES IN NET ASSETS 337,373,181
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
FRANCISCAN ALLIANCE INC
 
Employer identification number

35-1330472
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on 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
(1) ATHENS OUTPATIENT SERVICES LLC
1710 LAFAYETTE ROAD
CRAWFORDSVILLE,IN47933
20-3686603 		MEDICAL SRVCS IN 30,768,849 7,427,991 FRANCISCAN
 
(2) FRANCISCAN ALLIANCE ACCOUNTABLE CARE ORG
1515 DRAGOON TRAIL
MISHAWAKA,IN46544
45-2884517 		ACCOUNT. CARE IN 6,659,149 1,619,680 FRANCISCAN
 
(3) ST FRANCIS INSURANCE SERVICES LLC
1600 ALBANY STREET
BEECH GROVE,IN46107
20-0048077 		INSURANCE IN 626,142 0 FRANCISCAN
 
(4) SPECIALTY PHYSICIANS OF ILLINOIS LLC
333 DIXIE HIGHWAY
CHICAGO HEIGHTS,IL60411
05-0540914 		PHYSICIAN IL 20,261,591 5,380,962 FRANCISCAN
 
(5) FAITH HOPE AND LOVE CANCER CENTER LLC
1250 SOUTH CREASY LN STE A
LAFAYETTE,IN47905
68-0612977 		MEDICAL SRVCS IN 18,397,365 0 FRANCISCAN
 
(6) FRANCISCAN HAMMOND CLINIC LLC
7905 CALUMET AVENUE
MUNSTER,IN46321
27-4958737 		MEDICAL SRVCS IN 48,152,881 3,570,907 FRANCISCAN
 
(7) FRANCISCAN PRACTICE MANAGEMENT LLC
5224 S EAST STREET SUITE 3
INDIANAPOLIS,IN46227
27-2919869 		HEALTHCARE IN 0 0 FRANCISCAN
 
(8) ST FRANCIS MEDICAL GROUP LLC
5330 E STOP 11 RD
INDIANAPOLIS,IN46237
26-3877295 		MEDICAL SVCS IN 106,590,753 35,261,291 FRANCISCAN
 
(9) HEALTHPARTNERS MEDICAL GROUP LLC
1225 E COLLSPRING AVENUE
MICHIGAN CITY,IN46320
20-0474054 		HEALTHCARE IN 0 0 FRANCISCAN
 
(10) FRANCISCAN AHN ACO LLC
1515 DRAGOON TRAIL
MISHAWAKA,IN46544
45-4171713 		ACCOUNT. CARE IN 5,576,402 1,448,355 FRAN ACO LLC
 
(11) FRANCISCAN UNION HOSPITAL ACO LLC
1515 DRAGOON TRAIL
MISHAWAKA,IN46544
46-0889127 		ACCOUNT. CARE IN 1,082,747 171,325 FRAN ACO LLC
 
(12) FRANCISCAN PHYSICIANS REAL PROPERTY LLC
701 SUPERIOR STREET
MUNSTER,IN46321
26-0787231 		REAL PROPERTY IN 2,952 42,058,128 FRANCISCAN
 
(13) FRANCISCAN CENTRAL INDIANA ACO LLC
1515 DRAGOON TRAIL
MISHAWAKA,IN46544
32-0410552 		ACCOUNT. CARE IN 0 0 FRAN ACO LLC
 
(14) FRANCISCAN COLLABORATIVE ACO LLC
1515 DRAGOON TRAIL
MISHAWAKA,IN46544
30-0785171 		ACCOUNT. CARE IN 0 0 FRAN ACO LLC
 
(15) FRANCISCAN SELECT HEALTH NETWORK ACO LLC
1515 DRAGOON TRAIL
MISHAWAKA,IN46544
38-3907094 		ACCOUNT. CARE IN 0 0 FRANCISCAN
 
(16) FRANCISCAN HEALTHCARE MUNSTER
701 SUPERIOR STREET
MUNSTER,IN46321
20-8411919 		HEALTHCARE IN 86,112,405 0 FRANCISCAN
 
(17) SIGMA MEDICAL GROUP LLC
2400 SOUTH ST
LAFAYETTE,IN47904
20-1716029 		HEALTHCARE IN 0 0 FRANCISCAN
 
Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) ALVERNO CLINICAL LABS INC

2434 INTERSTATE PLAZA DRIVE

HAMMOND,IN46324
35-2060754 		LAB SERVICES IN 501(C)(3) 11 - Type 1 FRANCISCAN
 
Yes
 
(2) HILLS INSURANCE COMPANY INC

1515 DRAGOON TRAIL

MISHAWAKA,IN46544
03-0372512 		CAPTIVE INS VT 501(C)(3) 11 - Type 1 FRANCISCAN
 
Yes
 
(3) SISTERS OF ST FRANCIS OF PERPETUAL ADOR

PO BOX 766

MISHAWAKA,IN46546
35-1328145 		RELIGIOUS IN 501(C)(3) 1 NA
 
 
No
(4) ST ALEXIS HOSPITAL ASSOCIATION

PO BOX 1290

MISHAWAKA,IN46546
34-0714485 		SUPPORT ALEXA OH 501(C)(3) 3 FRANCISCAN
 
Yes
 
(5) FRANCISCAN ALLIANCE FOUNDATION INC

1600 ALBANY STREET - FINANCE 9010

BEECH GROVE,IN46107
35-1955283 		FUNDRAISING IN 501(C)(3) 7 FRANCISCAN
 
Yes
 
(6) ST JAMES COMMUNITY FOUNDATION

1423 CHICAGO ROAD

CHICAGO HEIGHTS,IL60411
20-4249251 		FUNDRAISING IL 501(C)(3) 7 FRANCISCAN
 
Yes
 
(7) VNS AT ST FRANCIS INC

4701 N KEYSTONE AVE S418

INDIANAPOLIS,IN46205
35-0868199 		HOME HEALTH IN 501(C)(3) 9 FRANCISCAN
 
Yes
 
(8) AT YOUR SERVICE HOME CARE INC

4701 N KEYSTONE AVE S418

INDIANAPOLIS,IN46205
35-2107306 		HEALTHCARE IN 501(C)(3) 9 FRANCISCAN
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) FRANCISCAN PHYSICIANS REAL PROPERTY LLC

701 SUPERIOR STREET
MUNSTER,IN46321
26-0787231 		REAL PROPERTY IN FRANCISCAN
  		RELATED 1,279,406 42,058,128   No 0   No 100.000 %
(2) FRANCISCAN SURGERY CENTER LLC

1600 ALBANY ROAD
BEECH GROVE,IN46107
35-2128334 		MEDICAL SERVICES IN FRANCISCAN
  		RELATED 6,635,509 3,501,764   No 0   No 50.540 %
(3) LAFAYETTE HEART PROGRAM HOLDINGS LLC

1501 HARTFORD STREET
LAFAYETTE,IN47904
38-3750811 		MEDICAL SERVS IN FRANCISCAN
  		RELATED -407,961 14,397,410   No 0   No 51.000 %
(4) ST ANTHONY HEALTH NETWORK LLC

PO BOX 310
MISHAWAKA,IN46546
35-1985170 		CLAIMS PROCESSING IN FRANCISCAN
  		RELATED -334,964 253,180   No 0 Yes   88.070 %
(5) ST FRANCIS MOORESVILLE SURGERY CENTER

1215 HADLEY ROAD SUITE 100
MOORESVILLE,IN46158
20-2256900 		MEDICAL SERVS IN FRANCISCAN
  		RELATED 933,165 337,662   No 0   No 65.790 %
(6) ST FRANCIS RADIATION THERAPY CENTERS LLC

1600 ALBANY STREET
BEECH GROVE,IN46107
77-0663631 		MEDICAL SERVS IN FRANCISCAN
  		RELATED 5,791,386 6,373,401   No 0   No 88.950 %
(7) MAJOR HOSPITAL CARDIAC DIAGNOSTICS LLC

150 West Washington Street
Shelbyville,IN46176
20-8715441 		MEDICAL SERVICES IN FRANCISCAN
  		RELATED 351,006 290,738   No 0   No 53.600 %
(8) ST FRANCIS IMAGING CTR GREENWOOD LLC

3147 W SMITH VALLEY RD
GREENWOOD,IN46143
20-4607426 		IMAGING SERVICES IN FRANCISCAN
  		RELATED 680,404 656,071   No 0   No 60.000 %
(9) TONN AND BLANK CONST LLC

1623 GREENWOOD AVE
MICHIGAN CITY,IN46360
26-3919039 		CONSTRUCTION IN FRANCISCAN
  		RELATED 1,094,051 6,140,028   No 45,470   No 56.500 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) FRANCISCAN HOLDING CORPORATION

1515 DRAGOON TRAIL
MISHAWAKA,IN46544
36-3593505 		HOLDING COMP IN FRANCISCAN
  		C CORP 966,706 45,212,149 100.000 % Yes  
(2) ST FRANCIS HEALTH NETWORK

112 N 17TH AVENUE SUITE 210
BEECH GROVE,IN46107
35-1904455 		INSURANCE IN FRANCISCAN
  		C CORP 80,928,681 8,323,323 100.000 % Yes  
(3) ST JAMES PHO INC

1423 CHICAGO ROAD
CHICAGO HEIGHTS,IL60411
36-3945083 		MANAGED CARE IL FRANCISCAN
  		C CORP 17,155,699 1,276,212 50.000 %   No








Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on 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
No
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 . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) ALVERNO CLINICAL LABORATORIES INC

 B 139,188 FMV
(2) FRANCISCAN ALLIANCE FOUNDATION INC

 C 4,930,350 FMV
(3) TONN AND BLANK CONSTRUCTION LLC

 C 148,158 FMV
(4) FRANCISCAN PHYSICIANS REAL PROPERTY LLC

 K 1,295,235 FMV
(5) FRANCISCAN PHYSICIANS REAL PROPERTY LLC

 B 4,389,620 FMV
(6) FRANCISCAN SURGERY CENTER

 C 6,565,906 FMV
(7) MAJOR HOSPITAL CARDIAC DIAGNOSTICS LLC

 C 525,000 FMV
(8) ST FRANCIS MOORESVILLE SURGERY CENTER LLC

 C 945,000 FMV
(9) ST FRANCIS RADIATION THERAPY CENTERS LLC

 C 5,248,050 FMV
(10) ST FRANCIS IMAGING CENTER (GREENWOOD) LLC

 C 719,160 FMV
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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 V?UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013
Additional Data


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